WorldWideScience

Sample records for ancillary services hospital

  1. Ancillary Services from Wind Farms

    DEFF Research Database (Denmark)

    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 Services Provided from DER

    Energy Technology Data Exchange (ETDEWEB)

    Campbell, J.B.

    2005-12-21

    Distributed energy resources (DER) are quickly making their way to industry primarily as backup generation. They are effective at starting and then producing full-load power within a few seconds. The distribution system is aging and transmission system development has not kept up with the growth in load and generation. The nation's transmission system is stressed with heavy power flows over long distances, and many areas are experiencing problems in providing the power quality needed to satisfy customers. Thus, a new market for DER is beginning to emerge. DER can alleviate the burden on the distribution system by providing ancillary services while providing a cost adjustment for the DER owner. This report describes 10 types of ancillary services that distributed generation (DG) can provide to the distribution system. Of these 10 services the feasibility, control strategy, effectiveness, and cost benefits are all analyzed as in the context of a future utility-power market. In this market, services will be provided at a local level that will benefit the customer, the distribution utility, and the transmission company.

  3. Ancillary service provision from distributed generation

    Energy Technology Data Exchange (ETDEWEB)

    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. Ancillary service provision from distributed generation

    International Nuclear Information System (INIS)

    2004-01-01

    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

  5. Pressure ulcer risk in ancillary services patients.

    Science.gov (United States)

    Messer, Monica S

    2010-01-01

    Although pressure ulcer prevention has received considerable attention in the literature since the 1960s, little has been published about the risk of pressure injury to patients undergoing procedures in diagnostic and interventional ancillary units such as radiology, renal dialysis, cardiac, and vascular procedure laboratories. In the only research study found in this population, the incidence of pressure injury in patients undergoing lengthy radiology procedures was 53.8%. Therefore, I reviewed the research literature in order to identify which specific factors are most likely to place persons undergoing ancillary procedures at risk for pressure injury. Sufficient evidence was found to implicate high interface pressures on ancillary support surfaces, shear incurred from patient movement and positioning, advanced age, severe neurologic impairment, anesthesia and sedation, fever, sepsis, and hypotension as risk factors for pressure injury while receiving services from interventional ancillary units.

  6. Power system studies of new ancillary services

    DEFF Research Database (Denmark)

    Hansen, Anca Daniela; Altin, Müfit

    The objective of this report is to illustrate and analyse, by means of simulation test cases, the impact of wind power advanced ancillary services, like inertial response (IR), power oscillation damping (POD) and synchronising power (SP) on the power system. Generic models for wind turbine, wind...... power plant and power system are used in the investigation....

  7. 39 CFR 122.1 - Ancillary special services.

    Science.gov (United States)

    2010-07-01

    ... 39 Postal Service 1 2010-07-01 2010-07-01 false Ancillary special services. 122.1 Section 122.1 Postal Service UNITED STATES POSTAL SERVICE POST OFFICE SERVICES [DOMESTIC MAIL] SERVICE STANDARDS FOR MARKET-DOMINANT SPECIAL SERVICES PRODUCTS § 122.1 Ancillary special services. (a) For the market-dominant...

  8. Ancillary services provided by PV power plants

    Directory of Open Access Journals (Sweden)

    Antonio PIERNO

    2016-07-01

    Full Text Available Renewable energy sources are widely utilized in distributed generation systems, and, recently, they are also considered for providing ancillary services. The paper is focused on PV plants, a survey of the most interesting papers published in the literature in the last decade is reported and the main characteristics of the technical proposals, with their advantages and limits, are evidenced. The results are schematically shown in a table that immediately gives the opportunity to be aware of what was already done, representing a reference tool.

  9. Integration of Flexible Consumers in the Ancillary Service Markets

    DEFF Research Database (Denmark)

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

    2014-01-01

    services. In this work we present a simple method based on the existing ancillary service markets that resolves these issues via increased information and communication technology. The method allows an aggregator to continuously utilize the markets for slower ancillary service to ensure that its portfolio...

  10. Illustration of Modern Wind Turbine Ancillary Services

    Directory of Open Access Journals (Sweden)

    Ioannis D. Margaris

    2010-06-01

    Full Text Available 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.

  11. Industrial Demand Management Providing Ancillary Services to the Distribution Grid

    DEFF Research Database (Denmark)

    Rahnama, Samira; Green, Torben; Lyhne, Casper

    2017-01-01

    A prominent feature of the future smart grid is the active participation of the consumer side in ancillary service provision. Grid operators procure ancillary services, including regulating power, voltage control, frequency control, and so on, to ensure safe, reliable, and high-quality electricity...

  12. Redefining Requirements of Ancillary Services for Technology Agnostic Sources

    DEFF Research Database (Denmark)

    Bondy, Daniel Esteban Morales; MacDonald, Jason; Kara, Emre Can

    2018-01-01

    New sources for ancillary services are needed, yet the requirements for service provision in most countries are explicitly formulated for traditional generators. This leads to waste of the potential for new technologies to deliver ancillary services. In order to harness this potential, we propose...... to parameterize the requirements of ancillary services so that reserves can be built by combining the advantageous properties of different technologies. The proposal is exemplified through a laboratory test where it shown that the system needs can be covered through cheaper and smaller reserves....

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

    Science.gov (United States)

    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.

  14. Survey of U.S. Ancillary Services Markets

    Energy Technology Data Exchange (ETDEWEB)

    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.

  15. Loads Providing Ancillary Services: Review of International Experience

    Energy Technology Data Exchange (ETDEWEB)

    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. EV and HP Providing Ancillary Services in the Nordic Region

    DEFF Research Database (Denmark)

    Liu, Zhaoxi; Wu, Qiuwei

    This report covers the analysis of the electric vehicle (EV) and heat pump (HP) providing ancillary services to the power system of the Nordic region including Denmark, Finland, Norway and Sweden. The analysis is to investigate the feasibility of EVs and HPs to serve as demand as frequency reserve...

  17. Impact of advanced wind power ancillary services on power system

    DEFF Research Database (Denmark)

    Hansen, Anca Daniela; Altin, Müfit

    The objective of this report is to illustrate and analyse, by means of simulation test cases, the impact of wind power advanced ancillary services, like inertial response (IR), power oscillation damping (POD) and synchronising power (SP) on the power system. Generic models for wind turbine, wind...... power plant and power system are used in the investigation....

  18. Review of Standby and Ancillary Services in the Context of Behind-the-Meter Photovoltaics

    Energy Technology Data Exchange (ETDEWEB)

    Gagnon, Pieter J [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Holm, Alison [National Renewable Energy Laboratory (NREL), Golden, CO (United States)

    2018-04-25

    The New Mexico Public Regulatory Commission (NMPRC) requested information on the following topics: Overview of ancillary and standby services. Examples of how ancillary and standby services are defined, used, and analyzed in other jurisdictions. Considerations regarding how ancillary and standby services may be economically valued. Background information on how ancillary and standby services differ from fixed costs to serve owners of behind-the-meter solar photovoltaic (BTM PV) systems.

  19. Advanced Pumped Storage Hydropower and Ancillary Services Provision

    Energy Technology Data Exchange (ETDEWEB)

    Muljadi, Eduard; Gevorgian, Vahan; Mohanpurkar, Manish; Luo, Yusheng; Hovsapian, Rob; Koritarov, Vladimir

    2017-07-12

    This paper presents a high-level overview of the capability of advanced pumped storage hydropower to provide ancillary services including frequency regulation and oscillation damping. Type 3 and Type 4 generators are discussed. The examples given are for a small power system that uses a diesel generator as the main generator and a very large system that uses a gas turbine as the main generator.

  20. Electric vehicle utilization for ancillary grid services

    Science.gov (United States)

    Aziz, Muhammad

    2018-02-01

    Electric vehicle has been developed through several decades as transportation mean, without paying sufficient attention of its utilization for other purposes. Recently, the utilization of electric vehicle to support the grid electricity has been proposed and studied intensively. This utilization covers several possible services including electricity storage, spinning reserve, frequency and voltage regulation, and emergency energy supply. This study focuses on theoretical and experimental analysis of utilization of electric vehicles and their used batteries to support a small-scale energy management system. Charging rate of electric vehicle under different ambient temperature (seasonal condition) is initially analyzed to measure the correlation of charging rate, charging time, and state-of-charge. It is confirmed that charging under warmer condition (such as in summer or warmer region) shows higher charging rate than one in colder condition, therefore, shorter charging time can be achieved. In addition, in the demonstration test, each five electric vehicles and used batteries from the same electric vehicles are employed and controlled to support the electricity of the office building. The performance of the system is evaluated throughout a year to measure the load leveling effect during peak-load time. The results show that the targeted peak-load can be shaved well under certain calculated peak-shaving threshold. The finding confirms that the utilization of electric vehicle for supporting the electricity of grid or certain energy management system is feasible and deployable in the future.

  1. Optimal generator bidding strategies for power and ancillary services

    Science.gov (United States)

    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

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

    Energy Technology Data Exchange (ETDEWEB)

    Subbarao, Krishnappa [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Fuller, Jason C. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Kalsi, Karanjit [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Somani, Abhishek [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Pratt, Robert G. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Widergren, Steven E. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Chassin, David P. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    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. A majority of states and the District of Columbia, representing over half of the total load, have passed renewable portfolio standards. California’s plans call for 33% renewable energy by 2020. For grid balancing and for meeting reliability standards, ancillary services are needed. The needs for these services are poised to increase significantly. Demand resources are receiving increasing attention as one means of providing the ancillary services. Control and coordination of a large number (~millions) of distributed smart grid assets requires innovative approaches. One such approach is transactive control and coordination (TC2)—a distributed, hierarchical, agent-based incentive and control system. The TC2 paradigm is to create a market-like control system in which participation is voluntary and the participant sets the price for participation. For transactions that are frequent, automation of bids and responses is necessary. Such an approach has been developed and demonstrated at the Pacific Northwest National Laboratory. The devices, typically thermostatically controlled heating, ventilating, and air conditioning (HVAC) loads, send their bids—the quantity of energy they need and, based on the consumer preferences encoded in a simple user interface, the price they are willing to pay. The typical bid period is 5 minutes. By aggregating all the bids, a demand curve is generated by the aggregating entity, and matched with a supply curve or supply constraint. The aggregator transmits the clearing price to the devices. The winning devices proceed to consume the energy they bid for and won

  3. Staff working in ancillary departments at a tertiary care hospital in Bengaluru, Karnataka, India: How healthy are they?

    Science.gov (United States)

    Balasubramanya, Bhavya; Nisha, Catherin; Ramesh, Naveen; Joseph, Bobby

    2016-01-01

    Background: Ancillary health services are those supplemental services other than room, board, and medical/nursing services provided to hospital patients in the course of care. Ancillary department staff forms an integral part in the smooth functioning of a hospital. There is a need to focus on the health of these individuals to ensure their well-being and in turn, productivity at the workplace. Objective: To study the morbidity profile of the staff working at ancillary departments of a tertiary care hospital in Bengaluru, Karnataka, India. Materials and Methods: We conducted our study in a 1,200-bedded tertiary care hospital in Bengaluru, Karnataka, India. Annual medical checkup (AMC) for all the staff working at the ancillary departments has been started in recent years and is provided free of cost and during working hours. A total of 150 employees from ancillary departments underwent AMC in the year 2013. Data were analyzed using Statistical Package for the Social Sciences (SPSS) version 20.0. Spearman's correlation and Chi-square test were used. Results: Of the 150 employees, the majority was male (72%); the mean age was 38 ± 11 years. The most common morbidities were diabetes mellitus (11%), hypertension (10.6%), musculoskeletal disorders (9.3%), surgical problems (8.6%, hemorrhoids, varicose veins), and dental caries (6.6%). On stool microscopy, 12% of the dietary workers showed ova/cyst. There was a significant positive correlation between age and the number of chronic morbidities (P < 0.01). Conclusion: Lifestyle disorders such as diabetes mellitus and hypertension were the major morbidities among the staff in the ancillary departments of the hospital. We ensured regular follow-up, adherence to medication, and lifestyle modifications in terms of diet and exercise. PMID:27390479

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

    International Nuclear Information System (INIS)

    Clastres, C.; Ha Pham, T.T.; Wurtz, F.; Bacha, S.

    2010-01-01

    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.

  5. Commercial Building Loads Providing Ancillary Services in PJM

    Energy Technology Data Exchange (ETDEWEB)

    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.

  6. Urology Group Compensation and Ancillary Service Models in an Era of Value-based Care.

    Science.gov (United States)

    Shore, Neal D; Jacoby, Dana

    2016-01-01

    Changes involving the health care economic landscape have affected physicians' workflow, productivity, compensation structures, and culture. Ongoing Federal legislation regarding regulatory documentation and imminent payment-changing methodologies have encouraged physician consolidation into larger practices, creating affiliations with hospitals, multidisciplinary medical specialties, and integrated delivery networks. As subspecialization and evolution of care models have accelerated, independent medical groups have broadened ancillary service lines by investing in enterprises that compete with hospital-based (academic and nonacademic) entities, as well as non-physician- owned multispecialty enterprises, for both outpatient and inpatient services. The looming and dramatic shift from volume- to value-based health care compensation will assuredly affect urology group compensation arrangements and productivity formulae. For groups that can implement change rapidly, efficiently, and harmoniously, there will be opportunities to achieve the Triple Aim goals of the Patient Protection and Affordable Care Act, while maintaining a successful medical-financial practice. In summary, implementing new payment algorithms alongside comprehensive care coordination will assist urology groups in addressing the health economic cost and quality challenges that have been historically encountered with fee-for-service systems. Urology group leadership and stakeholders will need to adjust internal processes, methods of care coordination, cultural dependency, and organizational structures in order to create better systems of care and management. In response, ancillary services and patient throughput will need to evolve in order to adequately align quality measurement and reporting systems across provider footprints and patient populations.

  7. Survey of U.S. Ancillary Services Markets

    Energy Technology Data Exchange (ETDEWEB)

    Zhou, Zhi; Levin, Todd; Conzelmann, Guenter

    2016-06-01

    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 that 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. Regulation Reserves are maintained to respond to supply/demand imbalances over short time frames, typically on the order of several seconds to one minute. Resources that provide Regulation Reserves adjust their generation or load levels in response to automatic generation control (AGC) signals provided by the system operator. Contingency reserves are maintained to provide additional generation capacity in the event that load increases substantially or supply side resources reduce their output or are taken offline. The reserves are typically segmented into two categories, 1) Spinning or Synchronized Reserves that are provided by generation units that are actively generating and have the ability to increase or decrease their output, 2) Non-spinning or Non-synchronized Reserves that are provided by generation resources that are not actively generating, but are able to start up and provide generation within a specified timeframe. Contingency reserves typically have response times on the order of ten to 30 minutes and can also be provided by demand-side resources that are capable of reducing their load. There are seven distinct power markets in the United States, each operated by a Regional Transmission Operator (RTO) or Independent System Operator (ISO) that operates the transmission system in its territory, operates markets for energy and ancillary services, and maintains system reliability. Each power market offers its own set of ancillary services, and precise definitions, requirements, and market mechanisms differ between markets

  8. Performance Requirements Modeling andAssessment for Active Power Ancillary Services

    DEFF Research Database (Denmark)

    Bondy, Daniel Esteban Morales; Thavlov, Anders; Tougaard, Janus Bundsgaard Mosbæk

    2017-01-01

    system operation, a reliable service delivery is required, yet it may not be appropriate to apply conventional performance requirements to new technologies and methods. The service performance requirements and assessment methods therefore need to be generalized and standardized in order to include future...... ancillary service sources. This paper develops a modeling method for ancillary services performance requirements, including performance and verification indices. The use of the modeling method and the indices is exemplified in two case studies....

  9. 77 FR 40413 - Third-Party Provision of Ancillary Services; Accounting and Financial Reporting for New Electric...

    Science.gov (United States)

    2012-07-09

    ... Ancillary Services; Accounting and Financial Reporting for New Electric Storage Technologies AGENCY: Federal... Ancillary Services; Accounting and Financial Reporting for New Electric Storage Technologies, 135 FERC ] 61... Commission 18 CFR Parts 35, 37, and 101 Third-Party Provision of Ancillary Services; Accounting and Financial...

  10. Exploiting ancillary services from distributed generation - perspectives for the Danish power system

    DEFF Research Database (Denmark)

    Nyeng, Preben; Pedersen, Knud Ole Helgesen; Østergaard, Jacob

    2007-01-01

    The share of the electric power production originating from distributed energy resources has rapidly increased during the recent past. However when it comes to ancillary services necessary to ensure the stability and appropriate operation of the power system, the distributed energy resources take...... a very passive role. This paper outlines suggestions on how to activate the potential of ancillary services from distributed energy resources, thereby exploiting their ability to contribute to power system operation. Furthermore, methods for integrating the ancillary service delivery into a deregulated...... power system are proposed and evaluated....

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

    DEFF Research Database (Denmark)

    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...

  12. 29 CFR 2550.408b-6 - Statutory exemption for ancillary services by a bank or similar financial institution.

    Science.gov (United States)

    2010-07-01

    ....408b-6 Statutory exemption for ancillary services by a bank or similar financial institution. (a) In... service is consistent with sound banking and financial practice, as determined by Federal or State... 29 Labor 9 2010-07-01 2010-07-01 false Statutory exemption for ancillary services by a bank or...

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

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

    International Nuclear Information System (INIS)

    Canizes, Bruno; Soares, João; Faria, Pedro; Vale, Zita

    2013-01-01

    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

  15. 78 FR 46177 - Third-Party Provision of Ancillary Services; Accounting and Financial Reporting for New Electric...

    Science.gov (United States)

    2013-07-30

    ...-Party Provision of Ancillary Services; Accounting and Financial Reporting for New Electric Storage... Financial Reporting for New Electric Storage Technologies, Notice of Proposed Rulemaking, FERC Stats. & Regs... Commission 18 CFR Parts 35 and 101 Third-Party Provision of Ancillary Services; Accounting and Financial...

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

    DEFF Research Database (Denmark)

    Soares, Tiago; Morais, Hugo; Pinson, Pierre

    2014-01-01

    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...

  17. Technical Feasibility of Ancillary Services provided by ReGen Plants

    DEFF Research Database (Denmark)

    Altin, Müfit; Han, Xue; Hansen, Anca Daniela

    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 ...

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

    DEFF Research Database (Denmark)

    Kordheili, Reza Ahmadi; Pourmousavi, Ali; Pillai, Jayakrishnan Radhakrishna

    2014-01-01

    requirements, such as voltage and current limits. This paper proposes an optimization method for determining the number of photovoltaic (PV) panels together with their arrangement in the grid in order to maximize ancillary service, without violating grid operation limits. The proposed optimization method...

  19. Grid-Scale Energy Storage Demonstration of Ancillary Services Using the UltraBattery Technology

    Energy Technology Data Exchange (ETDEWEB)

    Seasholtz, Jeff [East Penn Mfg. Co., Inc., Lyons, PA (United States)

    2015-08-20

    The collaboration described in this document is being done as part of a cooperative research agreement under the Department of Energy’s Smart Grid Demonstration Program. This document represents the Final Technical Performance Report, from July 2012 through April 2015, for the East Penn Manufacturing Smart Grid Program demonstration project. This Smart Grid Demonstration project demonstrates Distributed Energy Storage for Grid Support, in particular the economic and technical viability of a grid-scale, advanced energy storage system using UltraBattery ® technology for frequency regulation ancillary services and demand management services. This project entailed the construction of a dedicated facility on the East Penn campus in Lyon Station, PA that is being used as a working demonstration to provide regulation ancillary services to PJM and demand management services to Metropolitan Edison (Met-Ed).

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

    Energy Technology Data Exchange (ETDEWEB)

    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

  1. Application of microgrids in providing ancillary services to the utility grid

    International Nuclear Information System (INIS)

    Majzoobi, Alireza; Khodaei, Amin

    2017-01-01

    A microgrid optimal scheduling model is developed in this paper to demonstrate microgrid's capability in offering ancillary services to the utility grid. The application of localized ancillary services is of significant importance to grid operators as the growing proliferation of distributed renewable energy resources, mainly solar generation, is causing major technical challenges in supply-load balance. The proposed microgrid optimal scheduling model coordinates the microgrid net load with the aggregated consumers/prosumers net load in its connected distribution feeder to capture both inter-hour and intra-hour net load variations. In particular, net load variations for three various time resolutions are considered, including hourly ramping, 10-min based load following, and 1-min based frequency regulation. Numerical simulations on a test distribution feeder with one microgrid and several consumers/prosumers indicate the effectiveness of the proposed model and the viability of the microgrid application in supporting grid operation. - Highlights: • Microgrid optimal scheduling for providing ancillary services to the utility grid. • Local management and mitigation of distribution net load variations. • Offering various support services: ramping, load following, frequency regulation. • Proven effectiveness and accuracy in capturing net load variations.

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

  3. Ancillary services analysis of an offshore wind farm cluster-technical integration steps of a simulation tool

    OpenAIRE

    Hennig, Tobias; Löwer, Lothar; Faiella, Luis Mariano; Stock, Sebastian; Jansen, Malte; Hofmann, Lutz; Rohrig, Kurt

    2014-01-01

    In this publication, the authors present methodology and example results for the analysis of ancillary services of an offshore wind farm cluster and its electrical power system. Thereby the operation tool Wind Cluster Management System (WCMS) is used as simulation tool to evaluate certain planning scenarios. Emphasis is made on two topics: 1) the integration of high voltage direct current (HVDC) technology to the WCMS, 2) the ancillary service analysis. As examples, voltage source converter b...

  4. Impact of prenatal care provider on the use of ancillary health services during pregnancy

    Science.gov (United States)

    2013-01-01

    Background Recent declines in the provision of prenatal care by family physicians and the integration of midwives into the Canadian health care system have led to a shift in the pattern of prenatal care provision; however it is unknown if this also impacts use of other health services during pregnancy. This study aimed to assess the impact of the type of prenatal care provider on the self-reported use of ancillary services during pregnancy. Methods Data for this study was obtained from the All Our Babies study, a community-based prospective cohort study of women’s experiences during pregnancy and the post-partum period. Chi-square tests and logistic regression were used to assess the association between type of prenatal care provider and use of ancillary health services in pregnancy. Results During pregnancy, 85.8% of women reported accessing ancillary health services. Compared to women who received prenatal care from a family physician, women who saw a midwife were less likely to call a nurse telephone advice line (OR = 0.30, 95% CI: 0.18-0.50) and visit the emergency department (OR = 0.47, 95% CI: 0.24-0.89), but were more likely receive chiropractic care (OR = 4.07, 95% CI: 2.49-6.67). Women who received their prenatal care from an obstetrician were more likely to visit a walk-in clinic (OR = 1.51, 95% CI: 1.11-2.05) than those who were cared for by a family physician. Conclusions Prenatal care is a complex entity and referral pathways between care providers and services are not always clear. This can lead to the provision of fragmented care and create opportunities for errors and loss of information. All types of care providers have a role in addressing the full range of health needs that pregnant women experience. PMID:23497179

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

    DEFF Research Database (Denmark)

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

    2012-01-01

    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 experience and wind integration studies, the paper analyses impacts that high amounts of wind/solar will have on different......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...

  6. Hospitality Services Reference Book.

    Science.gov (United States)

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

    This reference book provides information needed by employees in hospitality services occupations. It includes 29 chapters that cover the following topics: the hospitality services industry; professional ethics; organization and management structures; safety practices and emergency procedures; technology; property maintenance and repair; purchasing…

  7. Enhancing the Role of Electric Vehicles in the Power Grid: Field Validation of Multiple Ancillary Services

    DEFF Research Database (Denmark)

    Knezovic, Katarina; Martinenas, Sergejus; Andersen, Peter Bach

    2016-01-01

    With increased penetration of distributed energy resources and electric vehicles (EVs), different EV integration strategies can be used for mitigating various adverse effects, and supporting the grid. However, the research regarding EV smart charging has mostly remained on simulations, whereas...... essentially means it is applicable to any EV complying with IEC 61851 and SAE J1772 standards. The field test validation is conducted in a real Danish distribution grid with a Nissan Leaf providing three ancillary services through unidirectional AC charging, namely congestion management, local voltage support...

  8. Identification of Conflicts between Transmission and Distribution System Operators when Acquiring Ancillary Services from Electric Vehicles

    DEFF Research Database (Denmark)

    Zecchino, Antonio; Knezovic, Katarina; Marinelli, Mattia

    2017-01-01

    products according to requests coming from both distribution and transmission system operators. The goal of this paper is to provide an identification procedure that is able to detect, identify and catalogue possible conflicts among the involved stakeholders that take place when requesting and/or acquiring...... ancillary services from flexible units. The investigation is carried out considering a 3-area power system which allows to take into account local constraints as well as system-wide needs. As outcome, this paper identifies the conflicts from both a theoretical and a practical point of view, by means...

  9. Hospital service duplication: evidence on the medical arms race.

    Science.gov (United States)

    Trinh, Hanh Q; Begun, James W; Luke, Roice D

    2008-01-01

    Hospital administrators face challenging decisions about whether to maintain, cut, or add services in response to changes in consumer demand or managed-care pressures. The challenge is heightened for services that are also offered by other hospitals in the local community. This study provides evidence on the financial effects of providing services that are also provided by other hospitals in the same county. Its purpose is to help guide administrators and policy makers in assessing the wisdom of service duplication at the local level. The unit of analysis is the individual hospital. The study reports data from the 2,204 general acute care hospitals located in counties with more than one hospital. A longitudinal path model is constructed for the years 1998, 2000, and 2002, with environmental and organizational factors from 1998 affecting service duplication in 2000, which in turn affects financial performance in 2002. Maximum likelihood estimation in linear structural relations is used to evaluate the path model and its coefficients. Hospital competition is associated with higher levels of duplication of inpatient, ancillary, and high-tech services. Duplication of inpatient services is associated with higher costs but also with higher operating margin. Duplication of ancillary services is associated with higher return on assets. Duplicated high-tech services are financial losers for hospitals. Higher levels of duplicated high-tech services are associated with higher cost per day, higher cost per discharge, and lower operating margin. From the standpoint of financial impact on the hospital, administrators should reexamine the costs and benefits of offering high-tech services that are offered by other providers in the local area. The higher costs may not be offset by revenues. Duplicated ancillary and inpatient services, on the other hand, produce some positive financial returns.

  10. Market and Policy Barriers for Demand Response Providing Ancillary Services in U.S. Markets

    Energy Technology Data Exchange (ETDEWEB)

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

    2013-03-01

    In this study, we attempt to provide a comprehensive 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.ii 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. We highlight the experience in each area as it relates to the identified barriers.

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

  12. Service Robots for Hospitals

    DEFF Research Database (Denmark)

    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...... manual work and offer many advantages beyond robotics. Finally, this thesis outlines our contributions in representation of multi-floor buildings, which is a vital requirement to achieve robust and practical, real-world service robot applications....

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

    International Nuclear Information System (INIS)

    Cappers, Peter; MacDonald, Jason; Goldman, Charles; Ma, Ookie

    2013-01-01

    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

  14. Hospitality Services. Curriculum Guide.

    Science.gov (United States)

    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…

  15. Hospitality services generate revenue.

    Science.gov (United States)

    Bizouati, S

    1993-01-01

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

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

    International Nuclear Information System (INIS)

    Jamalzadeh, R.; Ardehali, M.M.; Rashidinejad, M.

    2008-01-01

    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)

  17. 76 FR 36400 - Third-Party Provision of Ancillary Services; Accounting and Financial Reporting for New Electric...

    Science.gov (United States)

    2011-06-22

    ...-000 and AD10-13-000] Third-Party Provision of Ancillary Services; Accounting and Financial Reporting... Commission's accounting and financial reporting requirements currently do not contain specific accounting \\12... financial reporting requirements \\41\\ for public utilities \\42\\ are designed to provide information about a...

  18. Approaches to Enable Demand Response by Industrial Loads for Ancillary Services Provision

    Science.gov (United States)

    Zhang, Xiao

    Demand response has gained significant attention in recent years as it demonstrates potentials to enhance the power system's operational flexibility in a cost-effective way. Industrial loads such as aluminum smelters, steel manufacturers, and cement plants demonstrate advantages in supporting power system operation through demand response programs, because of their intensive power consumption, already existing advanced monitoring and control infrastructure, and the strong economic incentive due to the high energy costs. In this thesis, we study approaches to efficiently integrate each of these types of manufacturing processes as demand response resources. The aluminum smelting process is able to change its power consumption both accurately and quickly by controlling the pots' DC voltage, without affecting the production quality. Hence, an aluminum smelter has both the motivation and the ability to participate in demand response. First, we focus on determining the optimal regulation capacity that such a manufacturing plant should provide. Next, we focus on determining its optimal bidding strategy in the day-ahead energy and ancillary services markets. Electric arc furnaces (EAFs) in steel manufacturing consume a large amount of electric energy. However, a steel plant can take advantage of time-based electricity prices by optimally arranging energy-consuming activities to avoid peak hours. We first propose scheduling methods that incorporate the EAFs' flexibilities to reduce the electricity cost. We then propose methods to make the computations more tractable. Finally, we extend the scheduling formulations to enable the provision of spinning reserve. Cement plants are able to quickly adjust their power consumption rate by switching on/off the crushers. However, switching on/off the loading units only achieves discrete power changes, which restricts the load from offering valuable ancillary services such as regulation and load following, as continuous power changes

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

  20. An Experimental Study of Energy Consumption in Buildings Providing Ancillary Services

    Energy Technology Data Exchange (ETDEWEB)

    Lin, Yashen [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Afshari, Sina [University of Michigan; Wolfe, John [University of Michigan; Nazir, Md Salman [University of Michigan; Hiskens, Ian A. [University of Michigan; Johnson, Jeremiah X. [University of Michigan; Mathieu, Johanna L. [University of Michigan; Barnes, Arthur K. [Los Alamos National Laboratory; Geller, Drew A. [Los Alamos National Laboratory; Backhaus, Scott N. [Los Alamos National Laboratory

    2017-10-03

    Heating, ventilation, and air conditioning (HVAC) systems in commercial buildings can provide ancillary services (AS) to the power grid, but by providing AS their energy consumption may increase. This inefficiency is evaluated using round-trip efficiency (RTE), which is defined as the ratio between the decrease and the increase in the HVAC system's energy consumption compared to the baseline consumption as a result of providing AS. This paper evaluates the RTE of a 30,000 m2 commercial building providing AS. We propose two methods to estimate the HVAC system's settling time after an AS event based on temperature and the air flow measurements from the building. Experimental data gathered over a 4-month period are used to calculate the RTE for AS signals of various waveforms, magnitudes, durations, and polarities. The results indicate that the settling time estimation algorithm based on the air flow measurements obtains more accurate results compared to the temperature-based algorithm. Further, we study the impact of the AS signal shape parameters on the RTE and discuss the practical implications of our findings.

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  3. Short-Term Output Variations in Wind Farms--Implications for Ancillary Services in the United States: Preprint

    Energy Technology Data Exchange (ETDEWEB)

    Cadogan, J. [U.S. Department of Energy (US); Milligan, M. [National Renewable Energy Laboratory (US); Wan, Y. [National Renewable Energy Laboratory (US); Kirby, B. [Oak Ridge National Laboratory (US)

    2001-09-21

    With the advent of competition in the electric power marketplace, this paper reviews changes that affect wind and other renewable energy technologies, and discusses the role of federal and state policies in the recent wind installations in the United States. In particular, it reviews the implications of ancillary service requirements on a wind farm and presents initial operating results of monitoring one Midwest wind farm. Under federal energy policy, each generator must purchase, or otherwise provide for, ancillary services, such as dispatch, regulation, operation reserve, voltage regulation, and scheduling required to move power to load. As a renewable technology that depends on the forces of nature, short-term output variations are inherently greater for a wind farm than for a gas-fired combined cycle or a supercritical coal-fired unit.

  4. Breaking through the hydrogen cost barrier by using electrolysis loads to access ancillary services and demand response programs

    International Nuclear Information System (INIS)

    Wilson, D.; McGillivray, R.

    2009-01-01

    This presentation described the use of hydrogen electrolysis as a load resource for handling grid instability resulting from the increased penetration of intermittent renewable power. In particular, it focused on Hydrogenics, the leading global supplier of industrial scale electrolysis equipment and fuel cells. The presentation included an overview of the current incentive and market value of ancillary services provided by the company and demand responses in a number of grids around the world. There is a link between the amount of ancillary services required by the grid and the penetration level of renewable energy power such as wind and solar. The ability of hydrogen generation from electrolysis to satisfy all the requirements of ancillary services markets was also demonstrated. The economic analysis of hydrogen generation was discussed with particular reference to the cost of hydrogen fully loading all capital, energy and operating costs. The resulting reduction in the cost of hydrogen was compared to the existing markets for hydrogen, including use of hydrogen as a fuel for municipal bus fleets relative to the existing cost of fossil fuel fleets. Current industrial hydrogen merchant and bulk market prices were also compared

  5. Investigating the Impact of Climate Change on Hydroelectric Generation and Ancillary Services in California

    Science.gov (United States)

    Forrest, K.; Tarroja, B.; AghaKouchak, A.; Chiang, F.; Samuelsen, S.

    2017-12-01

    Spatial and temporal shifts in hydrological regimes predicted under climate change conditions have implications for the management of reservoirs and hydropower contributions to generation and ancillary services. California relies on large hydropower plants to provide flexible electricity generation, which will be increasingly important for supporting renewable resources. This study examines the impact of climate change on large hydropower generation in California. Four climate models for Representative Concentration Pathways (RCP) 4.5 and RCP 8.5 are utilized to evaluate the impact of the climate change conditions on (1) the magnitude and profile of hydropower generation and (2) the ability of hydropower to provide spinning reserve. Under both RCP scenarios, impacts are regionally dependent, with precipitation projected to increase in northern California and decrease in southern California for the ten-year period investigated (2046-2055). The overall result is a net increase in inflow into large hydropower units as a majority of the hydropower plants studied are located in the northern part of the state. Increased inflow is primarily driven by increased runoff during the winter and does not necessarily result in increased generation, as extreme events yield greater overall spillage, up to 45% of total inflow. Increased winter hydropower generation paired with increased reservoir constraints in summer result in an 11 to 18% decrease in spinning reserve potential across the year. Under high inflow conditions there is a decreased flexibility for choosing generation versus spinning reserve as water needs to be released, regardless. During summer, hydropower units providing spinning reserve experienced decreased inflow and lower reservoir levels compared to the historical baseline, resulting in decreased spinning reserve bidding potential. Decreased bidding, especially during summer periods at peak electricity demand, can result in greater demand for other dispatchable

  6. Hospitality Services. Student Activity Book.

    Science.gov (United States)

    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…

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

    Energy Technology Data Exchange (ETDEWEB)

    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

    Science.gov (United States)

    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

    International Nuclear Information System (INIS)

    Raineri, Ricardo; Arce, Raul; Rios, Sebastian; Salamanca, Carlos

    2008-01-01

    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. VT - Vermont Hospital Service Areas

    Data.gov (United States)

    Vermont Center for Geographic Information — Hospital service areas (HSAs) are organized by towns and are based on inpatient discharges where the diagnosis indicated the need for immediate care. Plurality...

  11. Methodology and forecast products for the optimal offering of ancillary services from wind in a market environment

    DEFF Research Database (Denmark)

    Bacher, Peder; Madsen, Henrik; Pinson, Pierre

    of wind power for example in the planning of ancillary power services, where the level of available wind power with a high degree of certainty is important to know. The presented extreme value models are applied to negative forecast residuals from state-of-the-art wind power forecast software...... of extreme weather induced phenomena, for example extreme water levels in a river, wind levels or at sea for design of dykes (de Haan and de Ronde, 1998). In insurance and finance the extreme value modelling is widespread (Embrechts et al., 1997). Extreme value statistics for energy and power applications...... is also widely used, for example for planning in wind power operation (Horvat et al., 2013) and peak wind prediction (Cook, 1982) and (Friederichs and Thorarinsdottir, 2012). Several books provide comprehensive introductions to extreme value theory, for example Coles (2001) and Beirlant et al. (2006...

  12. Risk-constrained dynamic self-scheduling of a pumped-storage plant in the energy and ancillary service markets

    International Nuclear Information System (INIS)

    Kazempour, S. Jalal; Moghaddam, M. Parsa; Haghifam, M.R.; Yousefi, G.R.

    2009-01-01

    This work addresses a new framework for self-scheduling of an individual price-taker pumped-storage plant in a day-ahead (DA) market. The goal is achieving the best trade-off between the expected profit and the risks when the plant participates in DA energy, spinning reserve and regulation markets. In this paper, a set of uncertainties including price forecasting errors and also the uncertainty of power delivery requests in the ancillary service markets are contemplated. Considering these uncertainties, a new approach is proposed which is called dynamic self-scheduling (DSS). This risk-constrained dynamic self-scheduling problem is therefore formulated and solved as a mixed integer programming (MIP) problem. Numerical results for a case study are discussed. (author)

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

    Science.gov (United States)

    Hard, R

    1992-05-20

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

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

    CERN Document Server

    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-...

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

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

    Science.gov (United States)

    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.

  17. Transactive Control and Coordination of Distributed Assets for Ancillary Services: Controls, Markets and Simulations

    Energy Technology Data Exchange (ETDEWEB)

    Subbarao, Krishnappa; Fuller, Jason C.; Kalsi, Karanjit; Lian, Jianming; Mayhorn, Ebony T.

    2015-02-01

    The purpose of this project is to develop a plausible transactive framework for DER participation in a regulation market. This document focuses on the methodology for creating a transactive-based regulation market, using one class of end-use devices as an example. The system contains two parts, one for acquiring resources at a longer timescale and a second for controlling the devices in a distributed manner at much shorter timescales. The first is based on a formal double-auction market where every five minutes each device bids the amount of resource it is able to provide and the minimum price that it would accept to provide that resource. The bid price is determined by the current state of the device and the willingness of the consumer to participate. The market system collects and orders the bids by price, and then determines a cleared price to meet the level of regulation needed. It broadcasts the cleared price to the devices, which results in contracting the services of the least cost resources. By contract, the devices that cleared the market are now engaged for the next five-minute market period. They are part of a distributed control system that allows them to respond at four-second intervals to a broadcasted regulation signal. The approach also limits the number of times devices can cycle between states (say on to off) in a given amount of time to protect the equipment life.

  18. Stochastic scheduling of aggregators of plug-in electric vehicles for participation in energy and ancillary service markets

    International Nuclear Information System (INIS)

    Alipour, Manijeh; Mohammadi-Ivatloo, Behnam; Moradi-Dalvand, Mohammad; Zare, Kazem

    2017-01-01

    Plug-in electric vehicles are expected to play a major role in the transportation system as the environmental problems and energy crisis are being more and more urgent recently. Implementing a large number of vehicles with proper control could bring an opportunity of large storage and flexibility for power systems. The plug-in electric vehicle aggregator is responsible for providing power and controlling the charging pattern of the plug-in electric vehicles under its contracted area. This paper deals with the problem of optimal scheduling problem of plug-in electric vehicle aggregators in electricity market considering the uncertainties of market prices, availability of vehicles and status of being called by the ISO in the reserve market. The impact of the market price and reserve market uncertainties on the electric vehicle scheduling problem is characterized through a stochastic programming framework. The objective of the aggregator is to maximize its profit by charging the plug-in electric vehicles on the low price time intervals as well as participating in ancillary service markets. The operational constraints of plug-in electric vehicles and constraints of vehicle to grid are modeled in the proposed framework. An illustrative example is provided to confirm the performance of the proposed model. - Highlights: • Optimal scheduling of vehicle aggregators in electricity market has been addressed. • The operational constraints of plug-in vehicle to grid are considered. • The uncertainties of calling status in reserve market and market prices are modeled. • Vehicles' driving patterns and availability uncertainty are modeled. • The effect of risk measure weight in the vehicle to grid model has been studied.

  19. Controllable Grid Interface for Testing Ancillary Service Controls and Fault Performance of Utility-Scale Wind Power Generation: Preprint

    Energy Technology Data Exchange (ETDEWEB)

    Gevorgian, Vahan; Koralewicz, Przemyslaw; Wallen, Robb; Muljadi, Eduard

    2017-02-01

    The rapid expansion of wind power has led many transmission system operators to demand modern wind power plants to comply with strict interconnection requirements. Such requirements involve various aspects of wind power plant operation, including fault ride-through and power quality performance as well as the provision of ancillary services to enhance grid reliability. During recent years, the National Renewable Energy Laboratory (NREL) of the U.S. Department of Energy has developed a new, groundbreaking testing apparatus and methodology to test and demonstrate many existing and future advanced controls for wind generation (and other renewable generation technologies) on the multimegawatt scale and medium-voltage levels. This paper describes the capabilities and control features of NREL's 7-MVA power electronic grid simulator (also called a controllable grid interface, or CGI) that enables testing many active and reactive power control features of modern wind turbine generators -- including inertial response, primary and secondary frequency responses, and voltage regulation -- under a controlled, medium-voltage grid environment. In particular, this paper focuses on the specifics of testing the balanced and unbalanced fault ride-through characteristics of wind turbine generators under simulated strong and weak medium-voltage grid conditions. In addition, this paper provides insights on the power hardware-in-the-loop feature implemented in the CGI to emulate (in real time) the conditions that might exist in various types of electric power systems under normal operations and/or contingency scenarios. Using actual test examples and simulation results, this paper describes the value of CGI as an ultimate modeling validation tool for all types of 'grid-friendly' controls by wind generation.

  20. [Service encounters and customer satisfaction in hospitals].

    Science.gov (United States)

    de Moura, Gisela Maria Schebella Souto; Luce, Fernando Bins

    2004-01-01

    This research is about service encounters and customer satisfaction in hospitals. The study is exploratory and was aimed at identifying the service encounters maintained in hospitals and the satisfaction attributes related to them. The data were collected with hospital professionals and customer, in 2003, by means of interviews using the critical incident technique. The content analysis evidentiated the satisfaction attributes of the service encounters regarding admission, hospitalization and discharge procedures. The results provide important information to hospital service managers, allowing for the planning of customer-focused actions.

  1. Strategic management of Public Hospitals' medical services.

    Science.gov (United States)

    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.

  2. Abortion services at hospitals in Istanbul.

    Science.gov (United States)

    O'Neil, Mary Lou

    2017-04-01

    Despite the existence of a liberal law on abortion in Turkey, there is growing evidence that actually securing an abortion in Istanbul may prove difficult. This study aimed to determine whether or not state hospitals and private hospitals that accept state health insurance in Istanbul are providing abortion services and for what indications. Between October and December 2015, a mystery patient telephone survey of 154 hospitals, 43 public and 111 private, in Istanbul was conducted. 14% of the state hospitals in Istanbul perform abortions without restriction as to reason provided in the current law while 60% provide the service if there is a medical necessity. A quarter of state hospitals in Istanbul do not provide abortion services at all. 48.6% of private hospitals that accept the state health insurance also provide for abortion without restriction while 10% do not provide abortion services under any circumstances. State and private hospitals in Istanbul are not providing abortion services to the full extent allowed under the law. The low numbers of state hospitals offering abortions without restriction indicates a de facto privatization of the service. This same trend is also visible in many private hospitals partnering with the state that do not provide abortion care. While many women may choose a private provider, the lack of provision of abortion care at state hospitals and those private hospitals working with the state leaves women little option but to purchase these services from private providers at some times subtantial costs.

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

    International Nuclear Information System (INIS)

    Rezaei, Navid; Kalantar, Mohsen

    2015-01-01

    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

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

  5. Service quality for facilities management in hospitals

    CERN Document Server

    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...

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

    Science.gov (United States)

    Bergrath, Sebastian; Rossaint, Rolf; Lenssen, Niklas; Fitzner, Christina; Skorning, Max

    2013-01-16

    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. 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. 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 transmission (26 vs. 22 min, p = 0.011), but ambulance

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

    Directory of Open Access Journals (Sweden)

    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

  8. Evaluation of service quality of hospital outpatient department services.

    Science.gov (United States)

    Chakravarty, Abhijit

    2011-07-01

    It has become essential for hospital managers to understand and measure consumer perspectives and service quality gaps, so that any perceived gap in delivery of service is identified and suitably addressed. A study was conducted at a peripheral service hospital to ascertain any service gap between consumer expectations and perceptions in respect of the hospital outpatient department (OPD) services. A cross-sectional study was conducted using SERVQUAL as the survey instrument, the instrument being validated for use in the hospital environment. Consumer ratings across 22 items of the survey instrument were collected in paired expectation and perception scores and then service quality gaps were identified and statistically analysed. Service quality gaps were identified to exist across all the five dimensions of the survey instrument, with statistically significant gaps across the dimensions of 'tangibles' and 'responsiveness.' The quality gaps were further validated by a total unweighted SERVQUAL score of (-) 1.63. The study concludes that significant service quality gaps existed in the delivery of the hospital OPD services, which need to be addressed by focused improvement efforts by the hospital management.

  9. Hospital pharmacists' evaluation of drug wholesaler services.

    Science.gov (United States)

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

    1983-10-01

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

  10. 42 CFR 440.140 - Inpatient hospital services, nursing facility services, and intermediate care facility services...

    Science.gov (United States)

    2010-10-01

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

  11. [Preclinic in the hospital. In-hospital emergency and rescue service in a large hospital].

    Science.gov (United States)

    Byhahn, C; Meininger, D; Bueck, M; Kessler, P; Füllner, M; Lischke, V

    2001-06-08

    Many hospitals have a special resuscitation service that is responsible for life-threatening emergencies outside the hospitals intensive care unit, i.e. in the wards and in patient-treatment areas. In contrast, there is generally no emergency service caring for patients, visitors or personnel outside of these areas. In order to provide emergency medical help in the entire hospital area, in 1999 we instituted an additional in-hospital emergency service to cover the larger hospital area. This paper describes the structure of our in-hospital emergency service and our experience in the first 26 months after its establishment. We analysed the emergency protocols of all 147 episodes, that had occurred within the first 26 months. We classified them according to type of disease and/or injury by using the NACA score (range 1 to 7) to assess the severity of disease and/or injury. 45 episodes took place within one of the 17 hospital buildings. 92 requests for help came from the hospital service and treatment areas including walkways and passages, while 3 came from the immediate vicinity outside of the hospital. A total of 7 requests turned out to be pranks, and 31.3% responses proved to be unnecessary when the team arrived at the scene. Of the total of 125 treated cases, 30 had a NACA score between 4 and 6, denoting life-threatening injury and/or disease. 6 patients were found dead at the scene or died shortly after arrival of the team. 101 of the patients had to be admitted to the hospital's emergency room. Since its establishment, knowledge of the existence of our in-hospital emergency service has steadily increased within the hospital community. As a consequence, number of events have likewise steadily increased. We believe that a total of 20.4% life-threatening events underscores the importance of the service in our large and extended hospital area. We also feel that our adherence to the training and personnel requirements demanded of public emergency services is

  12. How to perform a feasibility study and market analysis to determine if an ancillary service makes sense.

    Science.gov (United States)

    Brockman, Ken

    2008-01-01

    A feasibility study, as the name implies, is a study of the viability of a business venture. The study is an analysis of the market potential of the new products or services to be offered and investigates the primary issues related to the new business. This article discusses the elements that are essential for a valid feasibility study.

  13. 75 FR 14342 - Market-Based Rates for Wholesale Sales of Electric Energy, Capacity and Ancillary Services by...

    Science.gov (United States)

    2010-03-25

    ... pricing of sales of non-power goods and services and the tariff provision governing sales at the metered... II. Background 2 III. Discussion 10 A. Vertical Market Power 10 Other Barriers to Entry 10 B... capacity development.\\2\\ The Commission denies the requests for rehearing of the tariff provision governing...

  14. 42 CFR 419.22 - Hospital outpatient services excluded from payment under the hospital outpatient prospective...

    Science.gov (United States)

    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 Services...

  15. Life-Cycle Cost Modeling to Determine Whether Vehicle-to-Grid (V2G) Integration and Ancillary Service Revenue Can Generate a Viable Case for Plug-In Electric Drive Vehicles

    Science.gov (United States)

    2013-09-01

    Bidirectional Charger My analysis compares the LCCs of two base case internal combustion engine (ICE) vehicles with those of a non–plug-in hybrid electric ...MODELING TO DETERMINE WHETHER VEHICLE -TO-GRID (V2G) INTEGRATION AND ANCILLARY SERVICE REVENUE CAN GENERATE A VIABLE CASE FOR PLUG-IN ELECTRIC DRIVE...VIABLE CASE FOR PLUG-IN ELECTRIC DRIVE VEHICLES 5. FUNDING NUMBERS 6. AUTHOR(S) Joseph Monahan 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES

  16. Hospitality and service: leading real change.

    Science.gov (United States)

    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.

  17. Ancillary service details: Voltage control

    Energy Technology Data Exchange (ETDEWEB)

    Kirby, B.; Hirst, E.

    1997-12-01

    Voltage control is accomplished by managing reactive power on an alternating-current power system. Reactive power can be produced and absorbed by both generation and transmission equipment. Reactive-power devices differ substantially in the magnitude and speed of response and in their capital costs. System operators, transmission owners, generators, customers, power marketers, and government regulators need to pay close attention to voltage control as they restructure the U.S. electricity industry. Voltage control can affect reliability and commerce in three ways: (1) Voltages must be maintained within an acceptable range for both customer and power-system equipment to function properly. (2) The movement of reactive power consumes transmission resources, which limits the ability to move real power and worsens congestion. (3) The movement of reactive power results in real-power losses. When generators are required to supply excessive amounts of reactive power, their real-power production must be curtailed. These opportunity costs are not currently compensated for in most regions. Current tariffs are based on embedded costs. These embedded-cost tariffs average about $0.51/MWh, equivalent to $1.5 billion annually for the United States as a whole. Although this cost is low when compared with the cost of energy, it still aggregates to a significant amount of money. This report takes a basic look at why the power system requires reactive power (an appendix explains the fundamentals of real and reactive power). The report then examines the various types of generation and transmission resources used to supply reactive power and to control voltage. Finally it discusses how these resources are deployed and paid for in several reliability regions around the country. As the U.S. electricity industry is restructured, the generation, transmission, and system-control equipment and functions that maintain voltages within the appropriate ranges are being deintegrated.

  18. Computerized system for hospital engineering service management

    International Nuclear Information System (INIS)

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

    2007-01-01

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

  19. Computerized system for hospital engineering service management

    Energy Technology Data Exchange (ETDEWEB)

    Centeno, C A; Gonzalez, E A; Cagnolo, F J; Olmos, C E [Clinical Engineering Group, National Technological University, Cordoba Regional Faculty, Maestro M Lopez St and Cruz Roja Argentina St, Cordoba (Argentina)

    2007-11-15

    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.

  20. Innovations in health service delivery: the corporatization of public hospitals

    National Research Council Canada - National Science Library

    Harding, April; Preker, Alexander S

    2003-01-01

    ... hospitals play a critical role in ensuring delivery of health services, less is known about how to improve the efficiency and quality of care provided. Much can be learned in this respect from the experiences of hospital reforms initiated during the 1990s. Innovations in Health Service Delivery: The Corporatization of Public Hospitals is an a...

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

    Science.gov (United States)

    Chen, Minya; Zheng, Konglin; Xia, Yong

    2012-01-01

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

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

    Science.gov (United States)

    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.

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

    Science.gov (United States)

    Chatterjee, Susmita; Levin, Carol; Laxminarayan, Ramanan

    2013-01-01

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

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

    Directory of Open Access Journals (Sweden)

    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

  5. Ancillary personnel faced with living liver donation in a Spanish hospital with a transplant program El personal no sanitario de un hospital español con programa de trasplantes ante la donación de vivo hepática

    Directory of Open Access Journals (Sweden)

    A. Ríos

    2006-12-01

    Full Text Available Introduction: ancillary hospital personnel represent an important body of opinion because as they work in a hospital their opinion has more credibility for the general public as a result of their activity in hospitals. However, in most cases they do not have any health care training which means that their attitude could be based on a lack of knowledge or unfounded fears. The objective of this study is to analyze the attitude toward living liver donation among ancillary personnel in a hospital with a cadaveric and living liver organ transplant program and to analyze the variables that might influence such attitude. Patients and method: a random sample was taken which was stratified by service (n = 401 among ancillary personnel in the hospital. Attitude was evaluated using a survey that was validated in our geographical area. A representative from each service was contacted. This person was given an explanation of the study and was made responsible for the distribution of the questionnaire in selected work shifts. The survey was completed anonymously and was self-administered. The c2 test, Student's t-test and logistical regression analysis were used in the statistical analysis. Results: the questionnaire completion rate was 94% (n = 377. Of all the respondents, 20% (n = 74 are in favor of donating a living hemi-liver, but an additional 62% (n = 233 are in favor if donation is for a relative. Of the rest, 8% (n = 30 do not accept this type of donation and the remaining 11% (n = 40 are unsure. The following variables are related to attitude toward living liver donation: attitude toward cadaveric donation (p = 0.002; a respondent's belief that he or she might need a transplant in the future (p Introducción: los profesionales no sanitarios de centros hospitalarios representan un grupo de opinión importante, pues por el hecho de trabajar en un centro hospitalario su opinión tiene credibilidad entre la población, y sin embargo no tienen la

  6. A survey of hospital outpatient services for chronic diseases in ...

    African Journals Online (AJOL)

    communicable diseases, in particular aspects of the organisation of services, and indirect indicators of patient care. Design. A postal survey of services for asthma, epilepsy, diabetes and hypertension at nine hospitals. Assessment over 1 week of ...

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

    DEFF Research Database (Denmark)

    Özkil, Ali Gürcan; Fan, Zhun; Dawids, Steen

    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 ver...... for implementing mobile service robots for transportation tasks in hospitals....

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

    DEFF Research Database (Denmark)

    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...

  9. HOSPITAL IMAGE AS A MODERATING VARIABLE ON THE EFFECT OF HOSPITAL SERVICE QUALITY ON THE CUSTOMER PERCEIVED VALUE, CUSTOMER TRUST AND CUSTOMER LOYALTY IN HOSPITAL SERVICES

    OpenAIRE

    Indrianawati Usman

    2017-01-01

    This is an explanatory research, analyzing the hospital image as a moderating variable on the effect of hospital service quality on customer perceived value and trust. Research was conducted at several hospitals in Surabaya Indonesia, especially to outpatients. Data was collected by survey to the outpatients of the hospitals. The purpose of this research was empirically examining the effects of hospital service quality on customer perceived value and customer trust, examine eff...

  10. Study of Marketing Components Affecting Health Care Services in Hospitals

    Directory of Open Access Journals (Sweden)

    Mohammad Javad Akbarian Bafghi

    2016-10-01

    Full Text Available Background: Hospitals, in extreme competition, have accepted principles of marketing designed for industrial goods and customers. One of the important factors in health services marketing is the type of services. Organizations, including health centers, require meeting the clients' needs in order to survive and try to promote the way of providing services effectively. The present study aims to identify effective components in providing clinical services in hospitals. Methods: This was a practical and cross-sectional study. Data were collected using a questionnaire completed through random sampling after confirming the validity and reliability. Data were analyzed by SPSS 21 and Lisrel 8.50 using descriptive statistics and factor analysis. Results: The results of this study indicated that nine components had the highest impact on providing health services. Confirmatory factor analysis showed that the quality of providing services in the hospital, offering distinctive services compared with other hospitals, and considering quality of service beyond the patient's expectation had the greatest impact on marketing services in the hospital. Conclusion: Providing quality and distinctive services beyond the patient's expectation enables hospitals to improve their marketing activities and, beside higher level of patient satisfaction, develop their clinical services market share.

  11. Obesity, hospital services use and costs

    DEFF Research Database (Denmark)

    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 info......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...

  12. Customer Contribution to improving Service Quality in the Hospitality Industry

    OpenAIRE

    Dragos Constantin Vasile

    2009-01-01

    The actors on the today business stage have no more well-defined roles with clear and rigid borders between them. Hospitality industry in particular is a good example how it has been blurred the roles that customers play in dealing with service providers. The study reveals that customers can influence the quality of hospitality service through performing a qualitycontrol function. This involves a series of activities to be achieved by them: (1) on-the-spot quality control, (2) service failure...

  13. Obesity, hospital services use and costs

    DEFF Research Database (Denmark)

    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...

  14. Hospitableness: the new service metaphor? Developing an ...

    African Journals Online (AJOL)

    Whilst it has been possible to describe the behaviour of hospitable individuals, there has not been until now an instrument to measure the strength of genuine hospitality in individuals. This paper describes the development of a suite of questions designed to measure these qualities in individuals. This paper describes the ...

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

    Science.gov (United States)

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

    2017-02-13

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

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

    Science.gov (United States)

    Thibodeau, Patricia L; Funk, Carla J

    2009-10-01

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

  17. 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.

    Science.gov (United States)

    Couturier, Berengere; Carrat, Fabrice; Hejblum, Gilles

    2015-06-24

    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. Our primary objective was to compare patients' opinions on the discharge process collected with 2 different methods: self-questionnaire completed on a dedicated website versus a telephone interview. The secondary goal was to estimate patient satisfaction. We created a questionnaire to examine hospital discharge according to 3 dimensions: discharge logistics organization, preplanned posthospital continuity-of-care organization, and patients' impressions at the time of discharge. A satisfaction score (between 0 and 1) for each of those dimensions and an associated total score were calculated. Taking advantage of the randomized SENTIPAT trial that questioned patients recruited at hospital discharge about the evolution of their health after returning home and randomly assigned them to complete a self-questionnaire directly online or during a telephone interview, we conducted an ancillary study comparing satisfaction with the organization of hospital discharge for these 2 patient groups. The questionnaire was proposed to 1141 patients included in the trial who were hospitalized for ≥2 days, among whom 867 eligible patients had access to the Internet at home and were randomized to the Internet or telephone group. Of the 1141 patients included, 755 (66.17%) completed the questionnaire. The response rates for the Internet (39.1%, 168/430) and telephone groups (87.2%, 381/437) differed significantly (PInternet requires patients' active participation and those planning surveys in the domain explored in this study should anticipate a lower

  18. Queueing and Service Patterns in a University Teaching Hospital FO

    African Journals Online (AJOL)

    acer

    ABSTRACT: Analysis of queueing and service times is essential for designing effective congestion control at a service point. The objective of this is to be able to offer satisfactory service to waiting customers with minimum delay. In this study, using University of Abuja Teaching Hospital as a case study, we compared the ...

  19. Satisfaction with outpatient health services at Jimma Hospital

    African Journals Online (AJOL)

    Satisfaction with outpatient health services at. Jimma Hospital, South West Ethiopia. Lemessa Oljira, Solomon Gebre-Selassie. Abstract. Background: The opinions of users about the health care services and the degree of their satisfaction may indicate the efficiency of the services. Objective: To assess consumer satisfaction ...

  20. Hospital Supply Expenses: An Important Ingredient in Health Services Research.

    Science.gov (United States)

    Abdulsalam, Yousef; Schneller, Eugene

    2017-07-01

    The purpose of this article is to shed light on hospital supply expenses, which form the second largest expense category after payroll and hold more promise for improving cost-efficiency compared to payroll. However, limited research has rigorously scrutinized this cost category, and it is rarely given specific consideration across cost-focused studies in health services publications. After reviewing previously cited estimates, we examine and independently validate supply expense data (collected by the American Hospital Association) for over 3,500 U.S. hospitals. We find supply expenses to make up 15% of total hospital expenses, on average, but as high as 30% or 40% in hospitals with a high case-mix index, such as surgery-intensive hospitals. Future research can use supply expense data to better understand hospital strategies that aim to manage costs, such as systemization, physician-hospital arrangements, and value-based purchasing.

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

    OpenAIRE

    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.

  2. Development of Service Quality Scale for Surgical Hospitalization

    Directory of Open Access Journals (Sweden)

    Ching-I Teng

    2007-01-01

    Conclusion: The SQSH has sufficient usefulness, reliability and validity. Future research on service quality can apply the SQSH scale to link with utilization intention and patient loyalty and attempt to develop a hospitalization quality scale for other departments.

  3. Optimal assignment of workers to supporting services in a hospital

    Science.gov (United States)

    Sawik, Bartosz; Mikulik, Jerzy

    2008-01-01

    Supporting services play an important role in health care institutions such as hospitals. This paper presents an application of operations research model for optimal allocation of workers among supporting services in a public hospital. The services include logistics, inventory management, financial management, operations management, medical analysis, etc. The optimality criterion of the problem is to minimize operations costs of supporting services subject to some specific constraints. The constraints represent specific conditions for resource allocation in a hospital. The overall problem is formulated as an integer program in the literature known as the assignment problem, where the decision variables represent the assignment of people to various jobs. The results of some computational experiments modeled on a real data from a selected Polish hospital are reported.

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

    Science.gov (United States)

    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.

  5. Utilisation of Antenatal Services at the Provincial Hospital, Mongomo ...

    African Journals Online (AJOL)

    Utilisation of Antenatal Services at the Provincial Hospital, Mongomo, Guinea Equatoria. AAG Jimoh. Abstract. This prospective study was carried out to evaluate the utilisation of antenatal care at the Provincial Specialist Hospital, Mongomo, Guinea Equatoria, paying close attention to the confounding factors affecting ...

  6. The quality of hospital services in eastern Ethiopia: Patient's

    African Journals Online (AJOL)

    rate and hence meeting patient satisfaction improves the utilization of health services. Methodology. In Harari region there are two secondary (Zonal) hospitals under the Regional Health Bureau, which act as major referral hospitals for the whole of the eastern part of Ethiopia. A cross-sectional survey was conducted in.

  7. 42 CFR 419.21 - Hospital outpatient services subject to the outpatient prospective payment system.

    Science.gov (United States)

    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 services...

  8. How to give the gift of hospitality. Great customer service.

    Science.gov (United States)

    Schechter, M

    1994-08-01

    Whether it takes the form of greeting customers with a smile, redressing a diner's grievance or conducting special kitchen tours, providing customer service has become the number-one priority in foodservices coast to coast. Operators share tips & training methods that are helping staffs provide the hospitable services today's customers are demanding.

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

    International Nuclear Information System (INIS)

    Quarneti, A.; Levaggi, G.

    2004-01-01

    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

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

    Directory of Open Access Journals (Sweden)

    Zarei Asghar

    2012-02-01

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

  11. Service quality of private hospitals: the Iranian patients' perspective.

    Science.gov (United States)

    Zarei, Asghar; Arab, Mohammad; Froushani, Abbas Rahimi; Rashidian, Arash; Ghazi Tabatabaei, S Mahmoud

    2012-02-02

    Highly competitive market in the private hospital industry has caused increasing pressure on them to provide services with higher quality. The aim of this study was to determine the different dimensions of the service quality in the private hospitals of Iran and evaluating the service quality from the patients' perspective. A cross-sectional study was conducted between October and November 2010 in Tehran, Iran. The study sample was composed of 983 patients randomly selected from 8 private general hospitals. The study questionnaire was the SERVQUAL questionnaire, consisting of 21 items in service quality dimensions. The result of factor analysis revealed 3 factors, explaining 69% of the total variance. The total mean score of patients' expectation and perception was 4.91(SD = 0.2) and 4.02(SD = 0.6), respectively. The highest expectation and perception related to the tangibles dimension and the lowest expectation and perception related to the empathy dimension. The differences between perception and expectation were significant (p SERVQUAL is a valid, reliable, and flexible instrument to monitor and measure the quality of the services in private hospitals of Iran. Our findings clarified the importance of creating a strong relationship between patients and the hospital practitioners/personnel and the need for hospital staff to be responsive, credible, and empathetic when dealing with patients.

  12. Predictors of language service availability in U.S. hospitals.

    Science.gov (United States)

    Schiaffino, Melody K; Al-Amin, Mona; Schumacher, Jessica R

    2014-10-01

    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. 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. 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, Phospitals with a strategic orientation toward diversity had nearly 2-fold greater odds of adopting LS (AOR: 1.90, Psystem level factors have a place in disparities research and warrant further analysis; additional spatial methods could enhance our understanding of population factors

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

    Science.gov (United States)

    Babakus, E; Mangold, W G

    1992-02-01

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

  14. Failing hospitals: mission statements to drive service improvement?

    Science.gov (United States)

    McDonald, Annabel; Sarfraz, Aamer

    2015-01-01

    This paper aims to consider whether the hospital mission statement can be used as a management tool to improve service provision in failing hospitals. A literature search into the potential value and harm of hospital mission statements was done, followed by a survey of initial attitudes within a failing hospital. Do they indicate likely success of the tool? Mission statement is a potentially valuable leadership tool in the hospital environment. The success of its implementation is broadly dependent on its being developed with the support of stakeholders and its real application to all management decisions and questions of asset allocation. The potential danger lies in the fact that it can be seen as an expensive expression of politically correct platitudes which leads to cynical alienation of stakeholders. This was a small study within a single UK failing hospital, and extending its range will help to clarify whether its findings are typical of attitudes within such institutions. The likely success of the hospital mission statement as a management tool within a failing hospital is significantly limited by initial attitudes and preconceptions. Our research suggests that implementation is likely to be detrimental without preparatory involvement of the local community and hospital staff at all levels. Hospital management cannot be divorced from the local community where patient confidence must be maintained. This paper complements previous research, which has looked at mission statement acceptance among the upper echelons of hospital management.

  15. Do hospital service areas and hospital referral regions define discrete health care populations?

    Science.gov (United States)

    Kilaru, Austin S; Wiebe, Douglas J; Karp, David N; Love, Jennifer; Kallan, Michael J; Carr, Brendan G

    2015-06-01

    Effective measurement of health care quality, access, and cost for populations requires an accountable geographic unit. Although Hospital Service Areas (HSAs) and Hospital Referral Regions (HRRs) have been extensively used in health services research, it is unknown whether these units accurately describe patterns of hospital use for patients living within them. To evaluate the ability of HSAs, HRRs, and counties to define discrete health care populations. Cross-sectional geographic analysis of hospital admissions. All hospital admissions during the year 2011 in Washington, Arizona, and Florida. The main outcomes of interest were 3 metrics that describe patient movement across HSA, HRR, and county boundaries: localization index, market share index, and net patient flow. Regression models tested the association of these metrics with different HSA characteristics. For 45% of HSAs, fewer than half of the patients were admitted to hospitals located in their HSA of residence. For 16% of HSAs, more than half of the treated patients lived elsewhere. There was an equivalent degree of movement across county boundaries but less movement across HRR boundaries. Patients living in populous, urban HSAs with multiple, large, and teaching hospitals tended to remain for inpatient care. Patients admitted through the emergency department tended to receive care at local hospitals relative to other patients. HSAs and HRRs are geographic units commonly used in health services research yet vary in their ability to describe where patients receive hospital care. Geographic models may need to account for differences between emergent and nonemergent care.

  16. Maternity Care Services Provided by Family Physicians in Rural Hospitals.

    Science.gov (United States)

    Young, Richard A

    The purpose of this study was to describe how many rural family physicians (FPs) and other types of providers currently provide maternity care services, and the requirements to obtain privileges. Chief executive officers of rural hospitals were purposively sampled in 15 geographically diverse states with significant rural areas in 2013 to 2014. Questions were asked about the provision of maternity care services, the physicians who perform them, and qualifications required to obtain maternity care privileges. Analysis used descriptive statistics, with comparisons between the states, community rurality, and hospital size. The overall response rate was 51.2% (437/854). Among all identified hospitals, 44.9% provided maternity care services, which varied considerably by state (range, 17-83%; P maternity care, a mean of 271 babies were delivered per year, 27% by cesarean delivery. A mean of 7.0 FPs had privileges in these hospitals, of which 2.8 provided maternity care and 1.8 performed cesarean deliveries. The percentage of FPs who provide maternity care (mean, 48%; range, 10-69%; P maternity care who are FPs (mean, 63%; range, 10-88%; P maternity care services in US rural hospitals, including cesarean deliveries. Some family medicine residencies should continue to train their residents to provide these services to keep replenishing this valuable workforce. © Copyright 2017 by the American Board of Family Medicine.

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

    Science.gov (United States)

    Pai, Yogesh P; Chary, Satyanarayana T

    2016-04-18

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

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

    Science.gov (United States)

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

    2015-01-01

    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. This study aimed to examine the effect of quality of services provided in private hospitals on the patient's trust. In this descriptive cross-sectional study, 969 patients were selected using the consecutive method from eight private general hospitals of Tehran, Iran, in 2010. Data were collected through a questionnaire containing 20 items (14 items for quality, 6 items for trust) and its validity and reliability were confirmed. Data were analyzed using descriptive statistics and multivariate regression. The mean score of patients' perception of trust was 3.80 and 4.01 for service quality. Approximately 38% of the variance in patient trust was explained by service quality dimensions. Quality of interaction and process (P quality of the environment had no significant effect on the patients' degree of trust. The interaction quality and process quality were the key determinants of patient's trust in the private hospitals of Tehran. To enhance the patients' trust, quality improvement efforts should focus on service delivery aspects such as scheduling, timely and accurate doing of the service, and strengthening the interpersonal aspects of care and communication skills of doctors, nurses and staff.

  19. Evaluation of a radioisotope service in a general hospital

    International Nuclear Information System (INIS)

    Mateil, P.-Y.

    1978-12-01

    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 [fr

  20. Identifying key hospital service quality factors in online health communities.

    Science.gov (United States)

    Jung, Yuchul; Hur, Cinyoung; Jung, Dain; Kim, Minki

    2015-04-07

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

  1. The Lesotho Hospital PPP experience: catalyst for integrated service delivery.

    Science.gov (United States)

    Coelho, Carla Faustino; O'Farrell, Catherine Commander

    2011-01-01

    For many years, Lesotho urgently needed to replace its main public hospital, Queen Elizabeth II. The project was initially conceived as a single replacement hospital, but eventually included the design and construction of a new 425 bed public hospital and adjacent primary care clinic, the renovation and expansion of three strategically located primary care clinics in the region and the management of all facilities, equipment and delivery of all clinical services in the health network by a private operator under contract for 18 years. The project's design was influenced by the recognition that a new facility alone would not address the underlying issues in service provision. The creation of this PPP health network and the contracting mechanism has increased accountability for service quality, shifted Government to a more strategic role and may also benefit other public facilities and providers in Lesotho. The county is considering the PPP approach for other health facilities.

  2. Language services in hospitals: discordance in availability and staff use.

    Science.gov (United States)

    Tschurtz, Brette A; Koss, Richard G; Kupka, Nancy J; Williams, Scott C

    2011-01-01

    Despite efforts to advance effective patient-provider communication, many patients' language needs continue to be unmet or inappropriately addressed by healthcare providers (Wielawski 2010; Patek et al. 2009; Wilson-Stronks and Galvez 2007). This study presents a picture of the language resources currently provided by hospitals and those resources practitioners actually use. Questionnaire data were collected from 14 hospitals in Florida's Palm Beach, St. Lucie, and Martin counties on availability, staff awareness, and staff use of linguistic resources and services. Inconsistencies were identified between the language tools, services, and resources hospitals provide and those staff use. In addition, a large majority of staff respondents still rely upon someone accompanying the patient for communication with patients who have limited English proficiency, despite evidence that this practice contributes to miscommunication and serious medical errors (Flores et al. 2003; Flores 2005; HHS OMH 2001; Patek et al. 2009). Hospitals that use bilingual staff as interpreters often do not test the competency of these staff, nor do they assess the utilization or effectiveness of the tools and resources they provide. Hospitals can improve the cultural and linguistic care they provide if they (1) address the practice of using ad hoc interpreters, (2) effectively disseminate information to hospital staff regarding how and when to access available resources, and (3) collect patient population data and use it to plan for and evaluate the language services they provide to their patients.

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

    Science.gov (United States)

    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.

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

    Science.gov (United States)

    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 CAH...

  5. Mobile information and communication in the hospital outpatient service.

    Science.gov (United States)

    Jen, Wen-Yuan; Chao, Chia-Chen; Hung, Ming-Chien; Li, Yu-Chuan; Chi, Y P

    2007-08-01

    Most healthcare providers provide mobile service for their medical staff; however, few healthcare providers provide mobile service as part of their outpatient service. The mobile outpatient service system (MOSS) focuses on illness treatment, illness prevention and patient relation management for outpatient service users. Initiated in a local hospital in Taiwan, the MOSS pilot project was developed to improve outpatient service quality and pursue higher patient safety. This study focuses on the development of the MOSS. The workflow, architecture and target users of the MOSS are delineated. In addition, there were two surveys conducted as part of this study. After a focus group of medical staff identified areas in which outpatient services might be improved by the MOSS, the first survey was administered to outpatients to confirm the focus group's intuitions. The second administration of the survey explored outpatient satisfaction after they used the MOSS service. With regard to outpatient attitudes, about 93% of participants agreed that the mobile outpatient service improved outpatient service quality. In the area of outpatient satisfaction, about 89% of participants indicated they were satisfied with the mobile outpatient service. Supported by our study finding, we propose that more diverse mobile outpatient services can be provided in the future.

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

    Directory of Open Access Journals (Sweden)

    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

  7. The labour ward analgesic service at King Edward VIII Hospital ...

    African Journals Online (AJOL)

    Abstract The provision of analgesic services to the labour ward at King Edward VIII Hospital was studied during a I-week period. Of249 patients, 113 (45%) received no analgesia whatsoever. Intramuscular pethidine was the commonest form of analgesia and was used in 97 patients (39%). Thirty-six patients (14%) received ...

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

    Science.gov (United States)

    Calhoun, Olivia H.

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

  9. Community-oriented services in a psychiatric hospital. Effort to ...

    African Journals Online (AJOL)

    “Yaba apa osi” (Yaba to the left side). Consequently, in the year 2000 the hospital stepped up its efforts on destigmatization through public enlightenment programmes and provision of commercial /social as well as general health care services in the institution that would bring or attract the citizenry to its facilities. We carried ...

  10. Service quality of hospital outpatient departments: patients' perspective.

    Science.gov (United States)

    Zarei, Ehsan

    2015-01-01

    Assessment of patient perceptions of health service quality as an important element in quality assessments has attracted much attention in recent years. The purpose of this paper is to assess the service quality of hospital outpatient departments affiliated to Shahid Beheshti University of Medical Sciences from the patients' perspective. This cross-sectional study was conducted in 2014 in Tehran, Iran. The study samples included 500 patients who were selected by multi-stage random sampling from four hospitals. The data collection instrument was a questionnaire consisting of 50 items, and the validity and reliability of the questionnaire were confirmed. For data analysis, exploratory and confirmatory factor analysis, Friedman test, and descriptive statistics were used through LISREL 8.54 and SPSS 18 applications. Eight significant factors were extracted for outpatient service quality, which explained about 67 per cent of the total variance. Physician consultation, information provided to the patient, and the physical environment of the clinic were the three determining factors of the quality of outpatient services. The highest and lowest perceptions were related to physician consultation and perceived waiting time dimension, respectively. The mean score of patients' perception of outpatient service quality was 3.89 (±0.60). About 59.5 per cent of patients assessed the quality of outpatient services as good, 38.2 per cent as moderate, and 2.3 per cent as poor. Practical implications - The instrument developed for this study is valid and reliable, and it can help hospital managers to identify the areas needing improvement and correction. According to the findings of this study, the majority of patients had a positive experience with outpatient departments of teaching hospitals, and the services provided in these centres were of adequate quality, based on patient assessments.

  11. HOSPITAL IMAGE AS A MODERATING VARIABLE ON THE EFFECT OF HOSPITAL SERVICE QUALITY ON THE CUSTOMER PERCEIVED VALUE, CUSTOMER TRUST AND CUSTOMER LOYALTY IN HOSPITAL SERVICES

    Directory of Open Access Journals (Sweden)

    Indrianawati Usman

    2017-12-01

    Full Text Available This is an explanatory research, analyzing the hospital image as a moderating variable on the effect of hospital service quality on customer perceived value and trust. Research was conducted at several hospitals in Surabaya Indonesia, especially to outpatients. Data was collected by survey to the outpatients of the hospitals. The purpose of this research was empirically examining the effects of hospital service quality on customer perceived value and customer trust, examine effects of customer perceived value and customer trust on customer loyalty. Moreover This research also examined the variable of hospital image as a moderating variable in the effects of hospital service quality on customer perceived value and customer trust. The result of this research gave a perspective to hospital management about the importance of building patient trust, since trust is very important, even more important than satisfaction level. Further studies with more emphasis on identifying the factors building patient trust to the hospital in order to raise customer loyalty should be conducted.

  12. Organization structure and the performance of hospital emergency services.

    Science.gov (United States)

    Georgopoulos, B S

    1985-07-01

    A comparative study of 30 hospital emergency departments (EDs) and nearly 1,500 individuals associated with them was conducted. Data were obtained from institutional records, physicians, patients, and other sources. The object was to investigate the relationship between the organization and performance of these health service systems. The study assessed the quality of medical care, the quality of nursing care, and the economic efficiency of hospital EDs. The results show substantial interinstitutional differences in these criteria. They also show a significant relationship between medical and nursing care, but not between the quality of care and economic efficiency. Differences in ED performance are related to medical staffing patterns, medical teaching affiliation, personnel training, scope of emergency services, number of patient visits processed, and hospital size and complexity. Not all of these variables, however, correlate positively with all three criteria of performance, nor are they equally important to each.

  13. The restoration of abortion services at Cook County Hospital.

    Science.gov (United States)

    Donovan, P

    1993-01-01

    Chicago's Cook County Hospital is the first public hospital in the US to ban, then reinstate, abortion services. After the 1973 legalization of abortion in the US, Cook County Hospital's Voluntary Interruption of Pregnancy Clinic performed 3000-3500 procedures annually for low-income women. The clinic was closed abruptly in October 1980 by George Dunne, president of the hospital's Board of Commissioners. Dunne maintained the ban was consistent with a 1977 Illinois law restricting state funding to abortions essential to save a woman's life. The ban was lifted in 1992, after a series of competing lawsuits and restraining orders, by the next Board president, Richard Phelan. Given the 12-year hiatus in abortion provision, the hospital had to acquire equipment, recruit staff, conduct training, and develop medical protocols. Doctors and nurses already employed in the hospital's obstetrics and gynecology department volunteered to staff the service and abortion procedures were scheduled for off-peak hours to minimize overwhelming of the outpatient facility. Planned Parenthood provided equipment as well as consultation. Abortions are limited to Cook County residents and a minimum fee of US$50 is required, even from Medical Assistance recipients. Although the restoration of abortion services is hailed by pro-choice advocates as a legal victory, there remain serious concerns about the adequacy of the Cook County program. A maximum of 30 abortions are performed a week, meaning that not all abortion seekers can be served, and 2nd-trimester abortions are limited to women whose health would be affected by carrying a pregnancy to term and rape or incest victims. Also problematic has been the 24-hour waiting period between medical examination and counseling and the abortion procedure Finally, pro-choice groups are concerned that the hospital is not training residents to perform abortions.

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

    Science.gov (United States)

    Nashrath, Mariyam; Akkadechanunt, Thitinut; Chontawan, Ratanawadee

    2011-12-01

    The present study explored nurses' and patients' expectations of nursing service quality, their perception of performance of nursing service quality performed by nurses, and compared nursing service quality, as perceived by nurses and patients. The sample consisted of 162 nurses and 383 patients from 11 inpatient wards/units in a tertiary care hospital in the Maldives. Data were collected using the Service Quality scale, and analyzed using descriptive statistics and the Mann-Whitney U-test. The results indicated that the highest expected dimension and perceived dimension for nursing service quality was Reliability. The Responsiveness dimension was the least expected dimension and the lowest performing dimension for nursing service quality as perceived by nurses and patients. There was a statistically significant difference between nursing service quality perceived by nurses and patients. The study results could be used by nurse administrators to develop strategies for improving nursing service quality so that nursing service delivery process can be formulated in such a way as to reduce differences of perception between nurses and patients regarding nursing service quality. © 2011 Blackwell Publishing Asia Pty Ltd.

  15. CURRENT TRENDS IN HOSPITALITY INDUSTRY

    OpenAIRE

    Ivica Batinić

    2013-01-01

    Hospitality industry is a complex product-service economic activity which besides accommodation, food and beverages offers a variety of complementary and ancillary services in order to meet modern needs, demands and desires of tourists consumers. Contemporary needs, demands and desires of tourists consumers (increased need for security and preservation of health; emphasis on ecology and healthy food; pure nature stay; growing demand for adventure activities and e...

  16. Identification of service demand and Occupational Therapy service implementation in a university hospital

    Directory of Open Access Journals (Sweden)

    Miryam Bonadiu Pelosi

    2016-10-01

    Full Text Available Introduction: The occupational therapist acts as a promoter of health and quality of occupational life in the hospital context. To implement the Occupational Therapy Service in a hospital, it may need to adopt and articulate different strategies. Objective: To characterize the main requests and therapeutic services developed by the Occupational Therapy residents during the demand analysis process to implement the service. Method: This is a quantitative and qualitative research approach. We analyzed 151 assessment requests received for the Occupational Therapy service of patients treated at a university hospital, from June 2012 to June 2013. Data were submitted to descriptive and content analysis. Results: During the study period, the Occupational Therapy developed actions involving hospitalized patients, their caregivers, and staff. Patients referred for care were aged between 14 and 88 years and had difficulties mainly related to emotional regulation and the hospitalization process. The service was provided through individual and group approaches, and among them, the most requested were welcoming and orientation to the patient, family, caregivers and professional. Conclusion: The results of this study add knowledge to the factors related to the demand analysis for of Occupational Therapy and reinforce the need for these professionals focus their attention on the requirements essential to implement the services.

  17. Literature Study: The Nature of Service, The Nature of Hospitality, The Nature of Experiences

    OpenAIRE

    Esselink, P. (Priscilla)

    2010-01-01

    In this report the concepts services, hospitality and experiences will be discussed. The goal of this report is to provide insight in what is written in literature about services, hospitality and experiences and to help defining the concept hospitality services for the Research Centre of the Saxion Hospitality Business School. Important concepts which are related to hospitality are services and experiences. These three domains are the centre of this report.

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

    LENUS (Irish Health Repository)

    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.

  19. 42 CFR 410.28 - Hospital or CAH diagnostic services furnished to outpatients: Conditions.

    Science.gov (United States)

    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 outpatients...

  20. Cost of Treatment of Hospitalized Patients with Diabetes in Prenda Hospital Medicine Service, Angola

    Directory of Open Access Journals (Sweden)

    António Zangulo

    2017-07-01

    Full Text Available Introduction: Diabetes has a major impact on morbidity and mortality today. It is estimated that by 2040, about 642 million people are affected worldwide, of which, 34.2 million are from sub-Saharan countries. The direct annual cost of diabetes health care worldwide is estimated at about 153 billion dollars. These patients represent 30% to 40% of all admissions to emergency services, leading to high values of hospital expenditure. We aim to evaluate the cost of treatment of patients with diabetes admitted to Prenda Hospital Medicine Service in 2012. Methods: Retrospective analytical observational study, with data collected from the clinical processes of medical service (age and gender, length of hospitalization, resources consumed, cost of treatment per patient and discharge. Results: Out of 121 patients, the majority was female (n = 70, 57.9%. The age group of 36 to 45 years old was the most frequent among these patients (n = 26, 21.5%. November was the month that recorded the largest number of admissions (n = 17, 14%. About 45.5% were hospitalized during five to eight days, on average for nine days. The majority (76.9% was discharged due to health condition improvement. The price of materials used for treatment of the disease had high variation, and 31 550.15 kwanzas was spent to acquire them. The direct cost per patient per day was 4170.11 kwanzas and the estimated annual cost of care of diabetic patients admitted to Prenda Hospital was 45 525 490.9 kwanzas in 2012. Discussion and Conclusion: These results are in accordance with other studies, indicating a relevant cost of treatment of diabetic patients admitted to Prenda Hospital Medicine Service in 2012.

  1. Deinstitutionalisation--from hospital closure to service development.

    Science.gov (United States)

    Thornicroft, G; Bebbington, P

    1989-12-01

    The necessary components of a comprehensive service of local non-institutional forms of care for the seriously mentally ill have been researched separately in pilot trials, but not within integrated programmes for defined populations. Reported outcomes are at least as favourable as for traditional long-term hospital care, but alternative provisions are no less costly. A case manager system may allow co-ordinated formal and informal services to meet the individual needs of chronically ill patients. Poorly integrated programmes will expose discharged patients to disadvantages.

  2. [Quality assurance of cooked food in conventional hospital food service].

    Science.gov (United States)

    De Giusti, Maria; Tufi, Daniela; Tassoni, Alessandra; Del Cimmuto, Angela; Villari, Paolo

    2004-01-01

    The aim of this study was to evaluate the effectiveness of the hospital food service of the Azienda in preserving microbiological quality and temperature of cooked foods during the distribution to the different wards of the hospital. During three years, microbiological parameters and temperatures were monitored in the central kitchen before distribution (T0), in the first (T1) and in the last ward (T2) of the distribution route during a three-year period for a total of 337 analytical determinations. Temperature values before distribution improved during the study period, whereas the capacity of keeping adequate temperature values during the distribution decreased over time, in spite of the introduction of a new technology after the first year of the study. No significant deteriorations of the microbiological quality of the cooked foods were detected. The results of the study clearly indicate that an integrated approach involving new technology, work organization and personnel training is needed in preserving food quality in hospitals.

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

    LENUS (Irish Health Repository)

    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.

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

    Science.gov (United States)

    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. PsycINFO Database Record (c) 2014 APA, all rights reserved.

  5. In a niche of time: do specialty hospitals outperform general services hospitals?

    Science.gov (United States)

    Poole, LeJon; Davis, Jullet A; Gunby, Norris W

    2013-01-01

    Niche hospitals represent a growing segment in the health care industry. Niche facilities are primarily engaged in the treatment of cardiac or orthopedic conditions. The effectiveness of this strategy is of interest because niche hospitals focus on only the most profitable services. The purpose of this research was to assess the financial effectiveness of the niche strategy. We theorize that firm and market-level factors concomitantly with the strategy of the hospital-niche versus traditional-are associated with financial performance. This research used 2 data sources, the 2003 Medicare Cost Report and the 2003 Area Resource File. The sample was limited to only for-profit, urban, nongovernmental hospitals (n = 995). The data were analyzed using hierarchical least squares regression. Financial performance was operationalized using the hospital's return on assets. The principal finding of this project is that niche hospitals had significantly higher performance than traditional facilities. From the organizational perspective, the niche strategy leads to better financial performance. From a societal perspective, the niche strategy provides increased focus and efficiencies through repetition. Despite the limited focus of this strategy, patients who can access these providers may experience better outcomes than patients in more traditional hospitals.

  6. Is mobile teleconsulting equivalent to hospital-based telestroke services?

    Science.gov (United States)

    Audebert, Heinrich J; Boy, Sandra; Jankovits, Ralf; Pilz, Philipp; Klucken, Jochen; Fehm, Nando P; Schenkel, Johannes

    2008-12-01

    Telemedicine is increasingly used to provide acute stroke expertise for hospitals without full-time neurological services. Teleconsulting through mobile laptop computers may offer more flexibility compared with hospital-based services, but concerns about quality and technical reliability remain. We conducted a controlled trial, allocating hospital-based or mobile teleconsulting in a shift-by-shift sequence and evaluating technical parameters, acceptability, and impact on immediate clinical decisions. Both types of telemedicine workstations were equipped with DICOM (Digital-Imaging-and-Communications-in-Medicine) viewer and videoconference software. The laptop connected by asymmetrical broadband UMTS (Universal-Mobile-Telecommunication-Systems) technology with a one-way spoke-to-hub video transmission, whereas the hospital-based device used landline symmetrical telecommunication, including a 2-way videoconference. One hundred twenty-seven hospital-based and 96 mobile teleconsultations were conducted within 2 months without any technical breakdown. The rates per allocated time were similar with 3.8 and 4.0 per day. No significant differences were found for durations of videoconference (mean: 11+/-3 versus 10+/-3 minutes, P=0.07), DICOM download (3+/-3 versus 4+/-3 minutes, P=0.19), and total duration of teleconsultations (44+/-19 versus 45+/-21 minutes, P=0.98). Technical quality of mobile teleconsultations was rated worse on both sides, but this did not affect the ability to make remote clinical decisions like initiating thrombolysis (17% versus 13% of all, P=0.32). Teleconsultation using a laptop workstation and broadband mobile telecommunication was technically stable and allowed remote clinical decision-making. There remain disadvantages regarding videoconference quality on the hub side and lack of video transmission to the spoke side.

  7. Patient Perception Influence on the Food Service Quality of the Image of Jayapura Regional General Hospital

    OpenAIRE

    Gustiani Pakendek; A. L. Rantetampang; Arry Pongtiku

    2017-01-01

    Competition strict hospital competitiveness requires high hospital. One way is to improve the quality of food service. The quality of hospital food service will affect the image of the hospital. This study was to analyze the effect of perceived quality food service consisting of quality food menu, quality of food appearance, taste quality of food, quality of food presenter, timeliness of presentation of the food on the image of the hospital. This study was descriptive quantitative approach cr...

  8. 26 CFR 31.3121(b)(13)-1 - Services of student nurse or hospital intern.

    Science.gov (United States)

    2010-04-01

    ... 26 Internal Revenue 15 2010-04-01 2010-04-01 false Services of student nurse or hospital intern... 1954) General Provisions § 31.3121(b)(13)-1 Services of student nurse or hospital intern. (a) Services... before 1966 as an intern (as distinguished from a resident doctor), in the employ of a hospital are...

  9. Literature Study : The Nature of Service, The Nature of Hospitality, The Nature of Experiences

    NARCIS (Netherlands)

    Esselink, P. (Priscilla)

    2010-01-01

    In this report the concepts services, hospitality and experiences will be discussed. The goal of this report is to provide insight in what is written in literature about services, hospitality and experiences and to help defining the concept hospitality services for the Research Centre of the Saxion

  10. [Factors related to patient satisfaction with hospital emergency services].

    Science.gov (United States)

    Parra Hidalgo, Pedro; Bermejo Alegría, Rosa María; Más Castillo, Adelia; Hidalgo Montesinos, María Dolores; Gomis Cebrián, Rafael; Calle Urra, José Eduardo

    2012-01-01

    To determine the perceived quality variables related to satisfaction and to identify the influence of sociodemographic factors on user satisfaction with hospital emergencies. A telephone survey was conducted with a specifically designed questionnaire for use in a sample of 3,600 users of hospital emergency services in nine public hospitals in 2008 and 2009. The adjusted model including all perceived quality and sociodemographic variables explained 47.1% of the variance (adjusted R(2)). Of all the independent variables included, only eight were significant in predicting the level of patient satisfaction. These variables were related to the patient's opinion of the relationship with medical staff (p = 0.041), nurses' and porters' professionalism (p = 0.010 and 0.022), infrastructure (cleanliness and comfort) (p = 0.033 and 0.008), information received at discharge (p = 0.000), waiting time in the emergency department (p = 0.000) and the perception of treatment-diagnosis without failure (p = 0.028). The variables influencing emergency patients' satisfaction were determined, allowing areas where corrective action could be introduced to be identified. In addition, possible confounding factors that should be controlled for when comparing results among distinct hospitals were identified. The emergency satisfaction questionnaire is a useful instrument to evaluate and improve quality of care. Copyright © 2011 SESPAS. Published by Elsevier Espana. All rights reserved.

  11. Illustration of Modern Wind Turbine Ancillary Services

    DEFF Research Database (Denmark)

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

    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...

  12. Supercapacitor to Provide Ancillary Services: Preprint

    Energy Technology Data Exchange (ETDEWEB)

    Muljadi, Eduard [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Gevorgian, Vahan [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Luo, Yusheng [Idaho National Laboratory; Mohanpurkar, M. [Idaho National Laboratory; Hovsapian, R. [Idaho National Laboratory; Koritarov, V. [Argonne National Laboratory

    2017-10-09

    Supercapacitor technology has reached a level of maturity as a viable energy storage option available to support a modern electric power system grid; however, its application is still limited because of its energy capacity and the cost of the commercial product. In this paper, we demonstrate transient models of supercapacitor energy storage plants operating in coordination with run-of-the-river (ROR), doubly-fed induction generator hydropower plants (HPP) using a system control concept and architecture developed. A detailed transient model of a supercapacitor energy storage device is coupled with the grid via a three-phase inverter/rectifier and bidirectional DC-DC converter. In addition, we use a version of a 14-bus IEEE test case that includes the models of the supercapacitor energy storage device, ROR HPPs, and synchronous condensers that use the rotating synchronous generators of retired coal-powered plants. The purpose of the synchronous condensers is to enhance the system stability by providing voltage and reactive power control, provide power system oscillations damping, and maintain system inertia at secure levels. The control layer provides coordinated, decentralized operation of distributed ROR HPPs and energy storage as aggregate support to power system operations.

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

    Science.gov (United States)

    2010-04-01

    ... 26 Internal Revenue 15 2010-04-01 2010-04-01 false Services of student nurse or hospital intern...) § 31.3306(c)(13)-1 Services of student nurse or hospital intern. (a) Services performed as a student...' training school is chartered or approved pursuant to State law. (b) Services performed as an intern (as...

  14. Occupational exposure in services of Oncological Hospital of Camaguey

    International Nuclear Information System (INIS)

    Barreras, C.A.; Brigido, F.O.; Naranjo, L.A.; Sanches, M.P.; Lasserra, S.O.; Hernandez, G.J.

    2001-01-01

    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

  15. Patient satisfaction with a hospital-based neuropsychology service.

    Science.gov (United States)

    Foran, Amie; Millar, Elisa; Dorstyn, Diana

    2016-09-01

    Objective The aim of the present study was to develop and pilot a measure of patient satisfaction that encompasses themes, activities, settings and interactions specific to the neuropsychological assessment process. Methods A focus group of out-patients (n=15) was surveyed to identify the factors commonly associated with a satisfactory neuropsychological experience. Responses informed a purposely designed 14-item patient satisfaction scale (α=0.88) that was completed by 66 hospital out-patients with mild to moderate cognitive impairment. Results Satisfaction with the neuropsychological assessment process was generally reported, with the testing phase (85%) rated significantly more favourably than the pre-assessment (79%) and feedback (70%) phases. Commentaries provided by 32 respondents identified interpersonal facilitators to a satisfactory neuropsychological assessment experience, but also dissatisfaction with physical aspects of the testing environment in addition to service availability. Conclusions The patient satisfaction scale can be used as a quality assurance tool to evaluate neuropsychological service delivery. Large-scale research is needed to confirm the scale's psychometric properties. Further research may also include a broader perspective on the consumers' experience of neuropsychological services.

  16. Rural hospital ownership: medical service provision, market mix, and spillover effects.

    Science.gov (United States)

    Horwitz, Jill R; Nichols, Austin

    2011-10-01

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

  17. 48 CFR 831.7001-4 - Medical services and hospital care.

    Science.gov (United States)

    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, but...

  18. Attitude of Supervisors of Yazd Educational Hospitals towards the Role of Personnel Element on the Market Share of Hospital Services

    Directory of Open Access Journals (Sweden)

    Mohammad Zare Zadeh

    2013-07-01

    Full Text Available Introduction: Quality of services extremely depends on how personnel have contact and interaction with the clients. Moreover, the personnel’s attitudes and their behaviors with the clients significantly affect clients’ perception of quality of services and consequently influence their satisfaction as well as their absorption to the services of an institution. This study intends to investigate the supervisor’s attitude towards the effect of persons or the personal element (as one of the elements of the service marketing mix on choosing the hospital by the patients and their companions. Materials and Methods: This cross-sectional descriptive study conducted in the winter of 2012. The study participant involved 35 supervisors in Yazd educational hospitals of Shahid Sadoughi University of Medical Sciences; Shahid Rahnemoun and Afshar. The research data were gleaned via a researcher-made questionnaire on factors of the marketing mix which its validity and reliability were confirmed. Data analysis was performed using SPSS software. Results: Results revealed that supervisor’s belief in the increasing of market share of a hospital services in public hospitals are consist of: 1-Physical evidence 2- Service or product 3- People or persons 4- Efficiency and quality 5- Process 6- Distribution 7-Promotion or propagation and 8- Price. Therefore, the significance of the personnel role in absorption of a definite patient involves the third element in choosing the hospital by the patients. Conclusion: Based on this study, since the third factor in clients’ (patients, etc. choices of hospital are the personnel and persons who provide services, it is confirmed that in service-based organizations like hospitals, the most important elements of quality of services in retaining and absorbing new clients and surviving the organization are the personnel activities who has been connected with organization clients. Moreover, it is regarded as a vital factor in

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

    Directory of Open Access Journals (Sweden)

    Inmaculada Gómez-Villegas

    2015-01-01

    Full Text Available 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. Results and Discussion. The application of the NANDA diagnoses to professional practice enabled the establishment of a nursing diagnosis with the implementation of measures designed to overcome a stressful situation with a risk of becoming unmotivated. Main Conclusion. The capacity to adapt the nursing profession to undertake new roles in the field of healthcare and the power of nursing own methodological resources permit the indirect care of “faceless” patients to be complemented with the inclusion of nurses from other services as clients, forming the focus of care, who can thus be helped with their daily care work.

  20. Why do we buy luxury experiences?: Measuring value perceptions of luxury hospitality services

    OpenAIRE

    Mattila, Anna S.; Yang, Wan

    2015-01-01

    Abstract The luxury segment of the hospitality industry has experienced substantial growth in the past decade. Unfortunately, the notion of perceived luxury values has received scant attention, and there is a lack of a valid framework to capture consumers' value perceptions in the context of luxury hospitality services. Using luxury restaurant as an example of luxury hospitality services, this paper aims to establish the structure of luxury hospitality values and their measures and to inve...

  1. PERSPECTIVES OF IMPLEMENTATION OF WELLNESS SERVICES IN HOSPITALITY PROPERTIES: THE CASE OF HOTELS OF VLADIVOSTOK

    Directory of Open Access Journals (Sweden)

    Natalya Petrovna Ovcharenko

    2018-01-01

    Full Text Available Wellness tourism is a growing segment in the world tourism market and tourism is not possible without hospitality properties. The popularity of the hotel, its attendance and profit can be significantly increased in case of implementation of wellness services in the hotel. In the article the authors examine perspectives of implementation of wellness services in hospitality properties. The study is held through the example of hotels of Vladivostok. The authors note the diversity of wellness services and their growing popularity among consumers of tourism services and, therefore, the expediency of implementation of wellness services in hospitality properties. Purpose: the study of perspectives of implementation of wellness services in hospitality properties, aimed to evaluate the relevance of such services at the market of hospitality properties of Vladivostok and to find out the different forms of delivering of wellness services. Methodology: comparison method, questionnaire approach, statistical method, literature analysis of the investigated problem. Results: the conclusions on wellness services market in hospitality properties of Vladivostok were made. The preferences of citizens of Primorsky Krai concerning different types of wellness services were discovered. Recommendations on promotion of wellness services in hospitality properties were proposed. Practical implications: the results of the study may be useful for workers of hospitality industry, travel agencies and tour operators, business representatives in the wellness sphere and everybody who are interested in wellness conception.

  2. The Statistical Analysis of the Consumer Attitudes toward the Hospitality Services from Romania

    OpenAIRE

    Vasilescu Ramona; Saierli Olivia

    2010-01-01

    In this paper, we have statistical analyze the consumer attitudes toward the hospitality services from Romania. We have developed a questionnaire which was answered by 83 people. Based on these responses we have made a top of the hospitality services in terms of respondent. Then, we applied the Helmert univariante test to show that these results can be generalized. Also, we asked respondents to give a note for each service of hospitality from our country (for the past two years). We calculate...

  3. Better to receive than to give? Interorganizational service arrangements and hospital performance.

    Science.gov (United States)

    Trinh, Hanh Q; Begun, James W; Luke, Roice D

    2010-01-01

    The literature points to possible efficiencies in local-hospital-system performance, but little is known about the internal dynamics that might contribute to this. Study of the service arrangements that nearby same-system hospitals have with one another should provide clues into how system efficiencies might be attained. The purpose of this research was to better understand the financial and operational effects of service sharing and receiving arrangements among nearby hospitals belonging to the same systems. Data are compiled for the 1,227 U.S. urban acute care hospitals that belong to multihospital systems. A longitudinal structural equation model is employed-environmental pressures and organizational characteristics in 1997 are associated with service sharing and receiving arrangements in 2000; service sharing and receiving arrangements are then associated with performance in 2003. Service sharing and receiving are measured by counts of services focal hospitals report that are not duplicated by other-system hospitals within the same county. Linear Structural Relations (LISREL) is used to estimate the model. In general, market competition from managed care and hospitals influences hospitals to exchange services. For individual hospitals, service sharing has no effects on operational efficiency and financial performance. Service receiving, however, is related to greater efficiencies and higher profits. The findings underscore the asymmetrical relationships that exist among local-system hospitals. Individual hospitals benefit from service receiving arrangements but not from sharing arrangements-it is better to receive than to give. To the extent that individual hospitals independently determine service capacities, systems may not be able to effectively rationalize service offerings.

  4. Exogam with its ancillary detectors

    International Nuclear Information System (INIS)

    Theisen, Ch.

    2004-01-01

    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 100 via the nuclear lifetime measurements in Pd 96 and Cd 98 p.57-68, 5) experiment E375: spectroscopy of trans-fermium nuclei p.69-91, 6) experiment E408S: He 8 on Pb 208 and Bi 209 p.92-102, 7) experiment E462: very neutron rich calcium isotopes at N=32, structure of magic Ca 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 92 and Ru 88 p.116-141, and 9) experiment E404aS: identification of gamma rays in nuclei around the drip-line nucleus Sm 130 , probing the maximally deformed light rare earth region

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

    DEFF Research Database (Denmark)

    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....

  6. Prospective Payment for CHAMPUS Exempt Services. An Analysis of Children’s Hospitals, Substance Abuse Services, and Psychiatric Services

    Science.gov (United States)

    1992-01-01

    fibrosis, bone-marrow trans- plants, and Acquired Immune Deficiency Syndrome . Neonatal services were subse- quently incorporated into the CHAMPUS DRG...detoxification syndrome except dependence or other symptomatic treat- and/or other symptomatic ment, with complications or treatment comorbidities 435 Alcohol...teaching costs and in the local area wage index. bAHA ID refers to missing hospital type. Medicare ID indicates missing direct medi- cal education and

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

    Science.gov (United States)

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

    2008-08-01

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

  8. SMEX03 Ancillary Soil Characteristics Data, Alabama

    Data.gov (United States)

    National Aeronautics and Space Administration — The SMEX03 Ancillary Soil Characteristics data set contains data for the regional study areas of Alabama, Georgia, and Oklahoma, USA as part of the 2003 Soil...

  9. Access to hospital interpreter services for limited English proficient patients in New Jersey: a statewide evaluation.

    Science.gov (United States)

    Flores, Glenn; Torres, Sylvia; Holmes, Linda Janet; Salas-Lopez, Debbie; Youdelman, Mara K; Tomany-Korman, Sandra C

    2008-05-01

    We surveyed New Jersey (NJ) hospitals to assess current language services and identify policy recommendations on meeting limited English proficiency (LEP) patients' needs. Survey with 37 questions regarding hospital/patient features, interpreter services, and resources/policies needed to provide quality interpreter services. Sixty-seven hospitals responded (55% response rate). Most NJ hospitals have no interpreter services department, 80% provide no staff training on working with interpreters, 31% lack multilingual signs, and 19% offer no written translation services. Only 3% of hospitals have full-time interpreters, a ratio of 1 interpreter:240,748 LEP NJ residents. Most hospitals stated third-party reimbursement for interpreters would be beneficial, by reducing costs, adding interpreters, meeting population growth, and improving communication. Most NJ hospitals have no full-time interpreters, interpreter services department, or staff training on working with interpreters, and deficiencies exist in hospital signage and translation services. Most NJ hospitals stated third-party reimbursement for interpreter services would be beneficial.

  10. Exogam with its ancillary detectors

    Energy Technology Data Exchange (ETDEWEB)

    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.

  11. Identifying maternity services in public hospitals in rural and remote Australia.

    Science.gov (United States)

    Longman, Jo; Pilcher, Jennifer M; Donoghue, Deborah A; Rolfe, Margaret; Kildea, Sue V; Kruske, Sue; Oats, Jeremy J N; Morgan, Geoffrey G; Barclay, Lesley M

    2014-06-01

    This paper articulates the importance of accurately identifying maternity services. It describes the process and challenges of identifying the number, level and networks of rural and remote maternity services in public hospitals serving communities of between 1000 and 25000 people across Australia, and presents the findings of this process. Health departments and the national government's websites, along with lists of public hospitals, were used to identify all rural and remote Australian public hospitals offering maternity services in small towns. State perinatal reports were reviewed to establish numbers of births by hospital. The level of maternity services and networks of hospitals within which services functioned were determined via discussion with senior jurisdictional representatives. In all, 198 rural and remote public hospitals offering maternity services were identified. There were challenges in sourcing information on maternity services to generate an accurate national picture. The nature of information about maternity services held centrally by jurisdictions varied, and different frameworks were used to describe minimum requirements for service levels. Service networks appeared to be based on a combination of individual links, geography and transport infrastructure. The lack of readily available centralised and comparable information on rural and remote maternity services has implications for policy review and development, equity, safety and quality, network development and planning. Accountability for services and capacity to identify problems is also compromised.

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

    Science.gov (United States)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  14. 77 FR 69848 - Medicare Program; Inpatient Hospital Deductible and Hospital and Extended Care Services...

    Science.gov (United States)

    2012-11-21

    ... prospective payment system is as follows: For FY 2013, the percentage increase for long term care hospitals is... Hospitals and FY 2013 Rates and to the Long Term Care Hospital PPS and FY 2013 Rates'' (77 FR 53257... CY 2013 will be: $296 for the 61st through 90th day of hospitalization in a benefit period; $592 for...

  15. 78 FR 64953 - Medicare Program; Inpatient Hospital Deductible and Hospital and Extended Care Services...

    Science.gov (United States)

    2013-10-30

    ... follows: For FY 2014, the percentage increase for long term care hospitals is the market basket percentage... for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Fiscal Year... CY 2014 will be: $304 for the 61st through 90th day of hospitalization in a benefit period; $608 for...

  16. 76 FR 67567 - Medicare Program; Inpatient Hospital Deductible and Hospital and Extended Care Services...

    Science.gov (United States)

    2011-11-01

    ... prospective payment system is as follows: For FY 2012, the percentage increase for long term care hospitals is... Prospective Payment Systems for Acute Care Hospitals and FY 2012 Rates and to the Long Term Care Hospital PPS...--(1) $289 for the 61st through 90th day of hospitalization in a benefit period; (2) $578 for lifetime...

  17. 75 FR 68799 - Medicare Program; Inpatient Hospital Deductible and Hospital and Extended Care Services...

    Science.gov (United States)

    2010-11-09

    ... percentage increase reduced by .5 percentage points for Long Term Care Hospitals and reduced by .25... Hospitals and Fiscal Year 2011 Rates; and Changes to the Long-Term Care Hospital Prospective Payment System... coinsurance amounts for CY 2011 will be--(a) $283 for the 61st through 90th day of hospitalization in a...

  18. [Mental Health in the General Hospital: Results of the Patient Health Questionnaire (PHQ) in Four Hospital Services].

    Science.gov (United States)

    Castro-Camacho, Leonidas; Escobar, Juan Manuel; Sáenz-Moncaleano, Camilo; Delgado-Barrera, Lucía; Aparicio-Turbay, Soraya; Molano, Juan Carlos; Noguera, Efraín

    2012-03-01

    Few individuals have access to mental health services due in part to underdetection. As it is more likely to consult for medical conditions, primary care may be a useful gateway for early detection of mental health problems. Detection of the frequency of mental health problems in four hospital services at the Fundación Santa Fe de Bogotá: Outpatient unit, hospitalization, emergency department, and primary care through a brief detection questionnaire, the Patient Health Questionnaire (PHQ). Cross-sectional study of patients seen at the four services who answered a Demographic Data Questionnaire and the PHQ together with information gathered about current medical diagnosis, history of visits, and hospitalizations during the last year. 1094 patients seen at the four hospital services between September 2010 and May 2011 were selected at random. A mental health problem was detected in 36.7% of the total sample. Major depressive disorder (7.3%), alcohol abuse (14.4%), and any anxiety disorder (7.7%) showed the highest prevalence with the emergency department showing the highest frequency of detection. The usefulness of a brief detection questionnaire such as the PHQ in hospital settings is demonstrated and implications in the design of mental health programs in the general hospital are discussed. The need to replicate this study in other settings and to undertake further research is outlined. Copyright © 2012 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

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

    Science.gov (United States)

    Howard, J

    1999-01-01

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

  20. The Effect of Service Compact (SERVICOM) on Service Delivery in Nnamdi Azikiwe University Teaching Hospital Nnewi, Nigeria

    OpenAIRE

    Jude Kennedy Emejulu; M. C. Muo; E. E.O. Chukwuemeka

    2014-01-01

    This study examined the effect of service compact (Servicom Service delivery) in Nnamdi Azikiwe University Teaching Hospital Nnewi. Questionnaire and face-to-face interviews were used in the collection of data. The hypotheses were tested using descriptive statistics. The study discovered among other things that with the inauguration of the SERVICOM Charter by the Federal Government of Nigeria, the Management of Nnamdi Azikiwe University Teaching Hospital Nnewi identified key areas that requir...

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

    Science.gov (United States)

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

    2015-01-01

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

  2. Longitudinal analysis of high-technology medical services and hospital financial performance.

    Science.gov (United States)

    Zengul, Ferhat D; Weech-Maldonado, Robert; Ozaydin, Bunyamin; Patrician, Patricia A; OʼConnor, Stephen J

    U.S. hospitals have been investing in high-technology medical services as a strategy to improve financial performance. Despite the interest in high-tech medical services, there is not much information available about the impact of high-tech services on financial performance. The aim of this study was to examine the impact of high-tech medical services on financial performance of U.S. hospitals by using the resource-based view of the firm as a conceptual framework. Fixed-effects regressions with 2 years lagged independent variables using a longitudinal panel sample of 3,268 hospitals (2005-2010). It was hypothesized that hospitals with rare or large numbers (breadth) of high-tech medical services will experience better financial performance. Fixed effects regression results supported the link between a larger breadth of high-tech services and total margin, but only among not-for-profit hospitals. Both breadth and rareness of high-tech services were associated with high total margin among not-for-profit hospitals. Neither breadth nor rareness of high-tech services was associated with operating margin. Although breadth and rareness of high-tech services resulted in lower expenses per inpatient day among not-for-profit hospitals, these lower costs were offset by lower revenues per inpatient day. Enhancing the breadth of high-tech services may be a legitimate organizational strategy to improve financial performance, especially among not-for-profit hospitals. Hospitals may experience increased productivity and efficiency, and therefore lower inpatient operating costs, as a result of newer technologies. However, the negative impact on operating revenue should caution hospital administrators about revenue reducing features of these technologies, which may be related to the payer mix that these technologies may attract. Therefore, managers should consider both the cost and revenue implications of these technologies.

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

    Directory of Open Access Journals (Sweden)

    Chen H

    2016-04-01

    Full Text Available 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 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

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

    Science.gov (United States)

    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.

  5. Poor Self-Rated Health Influences Hospital Service Use in Hospitalized Inpatients With Chronic Conditions in Taiwan.

    Science.gov (United States)

    Isaac, Vivian; McLachlan, Craig S; Baune, Bernhard T; Huang, Chun-Ta; Wu, Chia-Yi

    2015-09-01

    Our aim was to investigate the association between self-rated health (SRH) and use of hospital services (ie, medical outpatient department, emergency department, and general ward. admissions). Cross-sectional study data were collected from 230 consecutive patients admitted to medical departments of a 2000-bed academic medical center in Taiwan using standardized operating procedures for data collection of SRH (ie, a single-item question inquiring overall perceived health status), medical disorders, depressive symptoms, and combined service utilization over a 1-year period (ie, number of visits to outpatient department, number of visits to emergency department, and number of hospitalizations). Electronic medical records were retrieved, with self-reported external medical visits added to in-hospital frequencies of service use to provide better estimation of health service utilization. Fifty-two percent of study patients rated their health as poor or very poor. Poor SRH was associated with more visits to medical outpatient department, emergency department, and hospital admission. Multivariate logistic regression demonstrated an independent association between poor SRH and services utilization after adjustment for age, gender, hypertension, diabetes, metastatic cancer, number of chronic illness, life-threatening event, life-time suicidal ideation, and depression. SRH may be a useful research tool to model medical service use for inpatients with chronic conditions.

  6. Factors Affecting Outsourcing for Information Technology Services in Rural Hospitals: Theory and Evidence

    OpenAIRE

    Whitacre, Brian E.; Fannin, James Matthew; Barnes, James N.

    2008-01-01

    As health information technology becomes more prevalent for most healthcare facilities, hospitals across the nation are choosing between performing this service in-house and outsourcing to a technology firm in the health industry. This paper examines factors affecting the information technology (IT) outsource decision for various hospitals. Using 2004 data from the American Hospital Association, logistic regression models find that governmental ownership and a proxy variable for hospitals tha...

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

    Science.gov (United States)

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

    2012-01-01

    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. 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. 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. 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.

  8. COORDINATING HOSPITAL AND COMMUNITY WORK ADJUSTMENT SERVICES. FINAL REPORT.

    Science.gov (United States)

    GOERTZEL, VICTOR; AND OTHERS

    THE GOALS OF THIS STUDY WERE TO USE WORK TO HELP PATIENTS LEAVE THE CAMARILLO STATE HOSPITAL SOONER, BECOME A PART OF THE COMMUNITY, AND BECOME SELF-SUPPORTING. THE PROJECT SELECTED 146 SCHIZOPHRENIC MALES WHO HAD A HISTORY OF POOR WORK ADJUSTMENT. AS PART OF THE TREATMENT, THE MEN WERE PLACED IN THE HOSPITAL BAKERY. AFTER ADJUSTMENT TO THE WORK…

  9. Medical Facility Requirements - Naval Hospital Bremerton, Washington

    National Research Council Canada - National Science Library

    1997-01-01

    .... The Navy planned the project to expand administrative functions, ancillary services, occupational health services, and primary care to meet the demands of its current beneficiary population. Audit Objectives...

  10. Changes in knowledge and attitudes of hospital environmental services staff: The Researching Effective Approaches to Cleaning in Hospitals (REACH) study.

    Science.gov (United States)

    Mitchell, Brett G; White, Nicole; Farrington, Alison; Allen, Michelle; Page, Katie; Gardner, Anne; Halton, Kate; Riley, Thomas V; Gericke, Christian A; Paterson, David L; Graves, Nicholas; Hall, Lisa

    2018-03-14

    The Researching Effective Approaches to Cleaning in Hospitals (REACH) study tested a multimodal cleaning intervention in Australian hospitals. This article reports findings from a pre/post questionnaire, embedded into the REACH study, that was administered prior to the implementation of the intervention and at the conclusion of the study. A cross-sectional questionnaire, nested within a stepped-wedge trial, was administered. The REACH intervention was a cleaning bundle comprising 5 interdependent components. The questionnaire explored the knowledge, reported practice, attitudes, roles, and perceived organizational support of environmental services staff members in the hospitals participating in the REACH study. Environmental services staff members in 11 participating hospitals completed 616 pre- and 307 post-test questionnaires (n = 923). Increases in knowledge and practice were seen between the pre-and post-test questionnaires. Minimal changes were observed in attitudes regarding the role of cleaning and in perceived organizational support. To our knowledge, this is the first study to report changes in knowledge, attitudes, and perceived organizational support in environmental services staff members, in the context of a large multicenter clinical trial. In this underexplored group of hospital workers, findings suggest that environmental services staff members have a high level of knowledge related to cleaning practices and understand the importance of their role. Copyright © 2018 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  11. AX Tank Farm ancillary equipment study

    International Nuclear Information System (INIS)

    SKELLY, W.A.

    1999-01-01

    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. Improving Service Quality in Long-term Care Hospitals: National Evaluation on Long-term Care Hospitals and Employees Perception of Quality Dimensions

    OpenAIRE

    Kim, Jinkyung; Han, Woosok

    2012-01-01

    Objectives To investigate predictors for specific dimensions of service quality perceived by hospital employees in long-term care hospitals. Methods Data collected from a survey of 298 hospital employees in 18 long-term care hospitals were analysed. Multivariate ordinary least squares regression analysis with hospital fixed effects was used to determine the predictors of service quality using respondents? and organizational characteristics. Results The most significant predictors of employee-...

  13. 42 CFR 440.10 - Inpatient hospital services, other than services in an institution for mental diseases.

    Science.gov (United States)

    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 formally...

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

    International Nuclear Information System (INIS)

    Shaib, Ali Hani

    1995-08-01

    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)

  15. The impact of an enhanced interpreter service intervention on hospital costs and patient satisfaction.

    Science.gov (United States)

    Jacobs, Elizabeth A; Sadowski, Laura S; Rathouz, Paul J

    2007-11-01

    Many health care providers do not provide adequate language access services for their patients who are limited English-speaking because they view the costs of these services as prohibitive. However, little is known about the costs they might bear because of unaddressed language barriers or the costs of providing language access services. To investigate how language barriers and the provision of enhanced interpreter services impact the costs of a hospital stay. Prospective intervention study. Public hospital inpatient medicine service. Three hundred twenty-three adult inpatients: 124 Spanish-speakers whose physicians had access to the enhanced interpreter intervention, 99 Spanish-speakers whose physicians only had access to usual interpreter services, and 100 English-speakers matched to Spanish-speaking participants on age, gender, and admission firm. Patient satisfaction, hospital length of stay, number of inpatient consultations and radiology tests conducted in the hospital, adherence with follow-up appointments, use of emergency department (ED) services and hospitalizations in the 3 months after discharge, and the costs associated with provision of the intervention and any resulting change in health care utilization. The enhanced interpreter service intervention did not significantly impact any of the measured outcomes or their associated costs. The cost of the enhanced interpreter service was $234 per Spanish-speaking intervention patient and represented 1.5% of the average hospital cost. Having a Spanish-speaking attending physician significantly increased Spanish-speaking patient satisfaction with physician, overall hospital experience, and reduced ED visits, thereby reducing costs by $92 per Spanish-speaking patient over the study period. The enhanced interpreter service intervention did not significantly increase or decrease hospital costs. Physician-patient language concordance reduced return ED visit and costs. Health care providers need to examine all the

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

    Science.gov (United States)

    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.

  17. Logistics and Customer Service in the Hospitality Industry

    Directory of Open Access Journals (Sweden)

    Angelo Nicolaides

    2011-01-01

    Full Text Available This article evaluates the statement that companies may increase efficiencies and profitability by segmenting their customer base in terms of importance, for the purpose of providing specialised services. We specifically refer to how customer segmentation compares to basic service as proposed by Bowersox and Closs and discuss the advantages and disadvantages of the basic service approach as well as the factors which have contributed to its success. We also discuss the background and current state of the customer service environment and provide an opinion of which approach to customer service is preferable.

  18. Measuring service quality in a hospital colposcopy clinic.

    Science.gov (United States)

    Wisniewski, Mik; Wisniewski, Hazel

    2005-01-01

    The issues surrounding the measurement and provision of service quality in a health care setting are becoming increasingly important to nursing. This research study aims to apply the SERVQUAL measurement instrument in a Scottish colposcopy clinic. The study involved adapting the SERVQUAL instrument to the colposcopy setting and asking a sample of patients to complete the questionnaire. Patient expectations of service were obtained on first attendance at the clinic. Patient perceptions of service received were obtained on completion of treatment. Perceptions and expectations are then compared to identify where the largest service gaps exist. Although patient satisfaction with the overall service provided was generally high, the instrument provided evidence of where specific service improvements were needed. The largest service quality gap was for the reliability of service. The research also revealed the need for improved premises. Although the study has a limited sample size, it does appear that the SERVQUAL instrument has a useful diagnostic role to play in assessing and monitoring service quality in nursing, enabling nursing staff to identify where improvements are needed from the patients' perspective. The study has raised a number of issues which would form the basis for useful further research. Service quality from the patients' perspective should be routinely monitored and assessed. The findings should be useful to nursing staff seeking to assess, and improve, service quality.

  19. Addressing geographic access barriers to emergency care services: a national ecologic study of hospitals in Brazil.

    Science.gov (United States)

    Rocha, Thiago Augusto Hernandes; da Silva, Núbia Cristina; Amaral, Pedro Vasconcelos; Barbosa, Allan Claudius Queiroz; Rocha, João Victor Muniz; Alvares, Viviane; de Almeida, Dante Grapiuna; Thumé, Elaine; Thomaz, Erika Bárbara Abreu Fonseca; de Sousa Queiroz, Rejane Christine; de Souza, Marta Rovery; Lein, Adriana; Lopes, Daniel Paulino; Staton, Catherine A; Vissoci, João Ricardo Nickenig; Facchini, Luiz Augusto

    2017-08-22

    Unequal distribution of emergency care services is a critical barrier to be overcome to assure access to emergency and surgical care. Considering this context it was objective of the present work analyze geographic access barriers to emergency care services in Brazil. A secondary aim of the study is to define possible roles to be assumed by small hospitals in the Brazilian healthcare network to overcome geographic access challenges. The present work can be classified as a cross-sectional ecological study. To carry out the present study, data of all 5843 Brazilian hospitals were categorized among high complexity centers and small hospitals. The geographical access barriers were identified through the use of two-step floating catchment area method. Once concluded the previous step an evaluation using the Getis-Ord-Gi method was performed to identify spatial clusters of municipalities with limited access to high complexity centers but well covered by well-equipped small hospitals. The analysis of accessibility index of high complexity centers highlighted large portions of the country with nearly zero hospital beds by inhabitant. In contrast, it was possible observe a group of 1595 municipalities with high accessibility to small hospitals, simultaneously with a low coverage of high complexity centers. Among the 1595 municipalities with good accessibility to small hospitals, 74% (1183) were covered by small hospitals with at least 60% of minimum emergency service requirements. The spatial clusters analysis aggregated 589 municipalities with high values related to minimum emergency service requirements. Small hospitals in these 589 cities could promote the equity in access to emergency services benefiting more than eight million people. There is a spatial disequilibrium within the country with prominent gaps in the health care network for emergency services. Taking this challenge into consideration, small hospitals could be a possible solution and foster equity in access

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

    Science.gov (United States)

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

    2008-01-01

    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. 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 expectations and perceptions questions. This study identifies six factors regarding the service quality as perceived in both public and private Northern Cyprus hospitals. These are: empathy, giving priority to the inpatients needs, relationships between staff and patients, professionalism of staff, food and the physical environment. Research results revealed that the various expectations of inpatients have not been met in either the public or the private hospitals At the micro level, the lack of management commitment to service quality in both hospital settings leads doctors and nurses to expend less effort increasing or improving inpatient satisfaction. Hospital managers should also satisfy their employees, since job satisfaction leads to customer satisfaction and loyalty. Additionally, hospital administrations need to gather systematic feedback from their inpatients, establish visible and transparent complaint procedures so that inpatients' complaints can be addressed effectively and efficiently. The hospitals need to organize training sessions based on the critical importance of service quality and the crucial role of inpatient satisfaction in the health care industry. Future studies should include the remaining regions in Cyprus in order to increase research findings' generalizability. Additionally, including other dimensions such as hospital processes and discharge management and co-ordination may provide further insights into understanding inpatients' perceptions and intentions.

  1. The effect of concentrating obstetrics services in fewer hospitals on patient access: a simulation.

    Science.gov (United States)

    Koike, Soichi; Matsumoto, Masatoshi; Ide, Hiroo; Kashima, Saori; Atarashi, Hidenao; Yasunaga, Hideo

    2016-01-22

    In Japan, the number of obstetrics facilities has steadily decreased and the selection and concentration of obstetrics facilities is progressing rapidly. Obstetrics services should be concentrated in fewer hospitals to improve quality of care and reduce the workload of obstetricians. However, the impact of this intensification of services on access to obstetrics hospitals is not known. We undertook a simulation to examine how the intensification of obstetrics services would affect access to hospitals based on a variety of scenarios, and the implications for health policy. The female population aged between 15 and 49 living within a 30-min drive of an obstetrics hospital was calculated using a Geographic Information System for three possible intensification scenarios: Scenario 1 retained facilities with a higher volume of deliveries without considering the geographic boundaries of Medical Service Areas (MSAs, zones of healthcare administration and management); Scenario 2 prioritized retaining at least one hospital in each MSA and then retained higher delivery volume institutions, while Scenario 3 retained facilities to maximize population coverage using location-allocation modeling. We also assessed the impact of concentrating services in academic hospitals and specialist perinatal medical centers (PMCs) alone. In 2011, 95.0% of women aged 15-49 years lived within a 30-min drive of one of 1075 obstetrics hospitals. This would fall to 82.7% if obstetrics services were intensified into academic hospitals and general and regional PMCs. If 55.0% of institutions provided obstetrics services, the coverage would be 87.6% in Scenario 1, whereas intensification based on access would achieve over 90.5% coverage in Scenario 2 and 93.9% in Scenario 3. Intensification of obstetrics facilities impairs access, but a greater caseload and better staffing have the potential advantages of better clinical outcomes and reduced costs. It is essential to consult residents of hospital

  2. Management perception of service quality in the hospitality industry

    OpenAIRE

    Lacle, Randall

    2013-01-01

    The service industry has never been so competative then it is today. In order to survive companies must focus on delivering quality to their customers and meeting their expectations. Management must make decisions on how to effectively improve business performance in order to compete in a highly competative industry. Service quality is on of these focus areas. Theoretical knowledge on service quality management has presentated a great deal of models and theories for management to follow y...

  3. Perceived service quality in healthcare organizations and a research in Ankara by hospital type

    Directory of Open Access Journals (Sweden)

    İbrahim H. Kayral

    2014-06-01

    Full Text Available The purpose of healthcare services is to protect and improve individuals’ physical, mental and social health and ensure its continuity to increase the level of welfare and happiness in the society. As in all service organizations, service quality has an important place in healthcare organizations. Therefore, measuring the impacts of the efforts made by enterprises for service quality and the clients’ perceptions of the services provided, assessing how their perceptions differ in different dimensions of quality, and taking new measures according to the results are the key to continuous improvement. In this study, with respect to the abovementioned issues, perception of the quality of services provided in the field of health by those who receive them is compared according to different types of hospitals providing such service, and evaluations are made accordingly. Thus, whether patients’ perceptions of service quality differ according to hospital types, in what dimensions of quality these differences occur and perceived quality by different patient profiles like age, sex, incomes etc. are assessed. In the measurement of service quality, a set of 34 questions with six dimensions was used, which was used by Kara, Tarım and Zaim (2003 in several hospitals and then used in several research studies in Turkey on service quality in healthcare enterprises (Çaha, 2007; Kara, 2006. Based on the findings of the research, it can be said that public general branch hospitals are perceived as quality at the same level with private hospitals and even they reach higher levels of patient satisfaction. On the other hand, when the sub-dimensions of quality are examined, it is seen that public hospitals are still behind private hospitals in terms of physical quality.

  4. A new customer service partnership for hospitals and physicians.

    Science.gov (United States)

    Sanford, Kathleen D

    2011-12-01

    To promote better customer service, clinical and finance leaders should work as partners to: Make customer service as important a goal as clinical quality. Educate staff on better communication with patients and families. Perform a root-cause analysis to identify problem trends.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Science.gov (United States)

    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…

  7. Relationships Between Service Personal Values, Service Value, Satisfaction, and Loyalty: A Study Regarding Services of Private and State Hospitals in Turkey

    Directory of Open Access Journals (Sweden)

    Metin Argan

    2017-06-01

    Full Text Available Service and value are the two inseparable concepts in experiential service environment. Service personal value is a concept that is subjectively assessed from a consumer perspective, and is associated with service value, consumer satisfaction and loyalty. In this context, the purpose of this study was to examine the relationships between services personal values, service value, satisfaction, and loyalty. Data were collected from persons (996 receiving services from private hospitals and state hospitals using convenience sampling method. The scales of service personal values, service value, satisfaction and loyalty were adapted from literature. Confirmatory factor analysis (CFA was used to investigate validity and reliability of the scales. Then, a structural equation model (SEM was developed and tested using data with Lisrel 8.80 software. The results of the study indicate significant relationships between services personal values, service value, satisfaction, and loyalty. The results of the study have significant implications as to how well private hospital managers design strategies of health service, satisfaction, and loyalty.

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

    Science.gov (United States)

    Andrews, Hannah; Singh, Yogen

    2016-03-01

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

  9. Adoption of HIV-related services among urban US hospitals: 1988 and 1991.

    Science.gov (United States)

    LeBlanc, A J; Hurley, R E

    1995-09-01

    Recent reports document that US hospitals vary considerably, notably by ownership, in the number of acquired immunodeficiency syndrome (AIDS) patients they treat. Still, little is known about other types of hospital response to human immunodeficiency virus (HIV) and AIDS and the relative strength of ownership as a determining factor. With annual survey data from the American Hospital Association the authors examine the formal adoption of HIV-related services among urban US hospitals at the turn of the decade. Descriptive analyses of 2 years of data (1988 and 1991) are presented. A multivariate logistic regression analysis, conducted on the 1991 data, tests for unique ownership effects on the likelihood that hospitals are heavy investors in HIV-related care. Patterns of service adoption for 1991 strongly resemble those for 1988. Nearly three fourths of urban US hospitals offer general inpatient AIDS care, and over half provide HIV testing. Few urban hospitals offer outpatient services; even fewer operate AIDS units. A substantial minority report no formal adoption of HIV-related services. For-profit hospitals stand out as least likely to formally adopt these HIV-related services. Those adopting a comprehensive set of HIV-related services typically are public or secular, not-for-profit in ownership, large, affiliated with a medical school, and high volume users of Medicaid funding. The logistic regression analysis suggests that public ownership is a key determinant of greater service investment, even after controlling for other explanatory factors. This study appears to mirror a familiar pattern of hospital response to undercompensated care in the United States.

  10. PERSPECTIVES OF IMPLEMENTATION OF WELLNESS SERVICES IN HOSPITALITY PROPERTIES: THE CASE OF HOTELS OF VLADIVOSTOK

    OpenAIRE

    Natalya Petrovna Ovcharenko; Viktoriya Vladimirovna Chistyak

    2018-01-01

    Wellness tourism is a growing segment in the world tourism market and tourism is not possible without hospitality properties. The popularity of the hotel, its attendance and profit can be significantly increased in case of implementation of wellness services in the hotel. In the article the authors examine perspectives of implementation of wellness services in hospitality properties. The study is held through the example of hotels of Vladivostok. The authors note the diversity of wellness ser...

  11. THE IMPACT OF SERVICE QUALITY ON BEHAVIORAL INTENTION IN HOSPITALITY INDUSTRY

    OpenAIRE

    KURUUZUM, Ayse; KOKSAL, Can Deniz

    2010-01-01

    The purpose of this study is to determine the impact of service quality on behavioral intention in hospitality industry. In order to measure service quality, five-dimensional and twenty two-itemed scale which adapted for hospitality industry by Tsaur, Lin and Wu from Parasuraman, Zeithaml and Berry’s SERVQUAL scale, was used. Together with this scale, five-dimensional and thirteenitemed scale which developed by Parasuraman, Zeithaml and Berry was used in order to measure behavioral intention....

  12. Hungry in hospital, well-fed in prison? A comparative analysis of food service systems.

    Science.gov (United States)

    Johns, Nick; Edwards, John S A; Hartwell, Heather J

    2013-09-01

    Meals served in prisons and hospitals are produced in similar ways and have similar characteristics, yet hospital patients are often at risk of being undernourished, while prisoners typically are not. This article examines field notes collected during nutritional studies of prison and hospital food service, which confirmed the difference in nutrient intake claimed by other authors. A comparison of food service processes and systems showed that the production of meals and the quality leaving the kitchen was similar in both types of institution. However, the delivery and service system was found to be much less coherent in hospital than in prison. Transport and service of hospital food were subject to delays and disruptions from a number of sources, including poor communication and the demands of medical professionals. These meant that meals reached hospital patients in a poorer, less appetising condition than those received by prisoners. The findings are discussed in the light of previous work and in terms of hospital food service practice. Crown Copyright © 2013. Published by Elsevier Ltd. All rights reserved.

  13. The development of hospital-based palliative care services in public ...

    African Journals Online (AJOL)

    The development of hospital-based palliative care services in public hospitals in the Western Cape, South Africa. L Gwyther, R Krause, C Cupido, J Stanford, H Grey, T Credé, A de Vos, J Arendse, P Raubenheimer ...

  14. Saint Anthony Hospital: Infusing Developmental and Family Support Services in Community-Based Medical Practice

    Science.gov (United States)

    Casas, Paula; Isarowong, Nucha

    2015-01-01

    Physicians affiliated with small community hospitals face numerous barriers to using developmentally oriented best practices in primary care with young children. Saint Anthony Hospital's Developmental Support Project model promotes improved developmental outcomes for children through two complementary strands of services: (a) training and…

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

    Science.gov (United States)

    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.

  16. Hospitality and Facility Care Services. Ohio's Competency Analysis Profile.

    Science.gov (United States)

    Ohio State Univ., Columbus. Vocational Instructional Materials Lab.

    Developed through a modified DACUM (Developing a Curriculum) process involving business, industry, labor, and community agency representatives in Ohio, this document is a comprehensive and verified employer competency profile for hospitality and facility care occupations. The list contains units (with and without subunits), competencies, and…

  17. [Service productivity in hospital nursing--conceptual framework of a productivity analysis].

    Science.gov (United States)

    Thomas, D; Borchert, M; Brockhaus, N; Jäschke, L; Schmitz, G; Wasem, J

    2015-01-01

    Decreasing staff numbers compounded by an increasing number of cases is regarded as main challenge in German hospital nursing. These input reductions accompanied by output extensions imply that hospital nursing services have had to achieve a continuous productivity growth in the recent years. Appropriately targeted productivity enhancements require approved and effective methods for productivity acquisition and measurement. However, there is a lack of suitable productivity measurement instruments for hospital nursing services. This deficit is addressed in the present study by the development of an integrated productivity model for hospital nursing services. Conceptually, qualitative as well as quantitative aspects of nursing services productivity are equally taken into consideration. Based on systematic literature reviews different conceptual frameworks of service productivity and the current state of research in hospital nursing services productivity were analysed. On this basis nursing sensitive inputs, processes and outputs were identified and integrated into a productivity model. As an adequate framework for a hospital nursing services productivity model the conceptual approach by Grönroos/Ojasalo was identified. The basic structure of this model was adapted stepwise to our study purpose by integrating theoretical and empirical findings from the research fields of service productivity, nursing productivity as well as national and international nursing research. Special challenges existed concerning the identification of relevant influencing factors as well as the representation of nursing sensitive outputs. The final result is an integrated productivity model, which can be used as an adequate framework for further research in hospital nursing productivity. Research on hospital nursing services productivity is rare, especially in Germany. The conceptual framework developed in this study builds on established knowledge in service productivity research. The

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

    Science.gov (United States)

    Sahin, Alper A

    2014-01-01

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

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

    Directory of Open Access Journals (Sweden)

    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.

  20. [Nutritional assessment in hospitalized children in a Paediatric service].

    Science.gov (United States)

    Velandia, Silvia; Hodgson, Maria Isabel; Le Roy, Catalina

    Malnutrition in hospitalized children is associated with increased morbidity and mortality. To determine the nutritional status in children admitted to the Hospital Clínico de la Universidad Católica de Chile. A retrospective, cross-sectional study was conducted on hospital patients less than 17 years old within the period from November 2010 to April 2011. A record was made of the demographic data, admission diagnosis, biochemistry results (albumin, haemoglobin, haematocrit), hospital stay, and anthropometry data. Nutritional diagnosis was expressed as standard deviation (SD) for weight-for-height (WFH) by WHO in children younger than 5 y, and body mass index (BMI) by CDC-NCHS in older children. Height-for-age (HFA) ≤-2SD indicated stunted growth. A total of 365 children, including 201 boys (55.1%), were evaluated. The median age was 3.35 years (IQR: 1.2-8.2). The most frequent reason for admission was heart disease (30.4%). The median hospital stay was 2 days (IQR: 2.0-4.0). Undernutrition was observed in 3.3% of the children, 8% were nutritionally at risk, 15% were overweight, and 10.9% were obese. As regards HFA, short stature was reported in 12.9%. There was a significant relationship between lower age and heart disease, and higher age with gastrointestinal and neurological diseases. By ordinal logistic regression for each year of age, the weight/height ratio (ZP/T) increases by 6.9% (OR=1.07). The biochemistry results (albumin, haemoglobin and haematocrit levels) were not associated with nutritional status. A high percentage of children at risk of undernutrition was found. The percentage overweight was similar to the general Chilean paediatric population. Early detection will allow an opportune intervention, and nutritional monitoring at discharge. Copyright © 2016 Sociedad Chilena de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

  1. The marketing concept of customer value of hospitality service

    OpenAIRE

    O.V. Gerasimenko

    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...

  2. Action Research on Development and Application of Internet of Things Services in Hospital.

    Science.gov (United States)

    Park, Arum; Chang, Hyejung; Lee, Kyoung Jun

    2017-01-01

    Services based on the Internet of Things (IoT) technologies have emerged in various business environments. To enhance health service quality and maximize benefits, this study applied an IoT technology based on NFC and iBeacon as an omni-channel service for patient care in hospitals. Application of the IoT technology based on NFC and iBeacon was conducted in a general hospital during August 2015 through June 2016, and the development and evaluation results were aligned to an action research framework. The five phases in the action research included diagnosing, planning action, taking action, evaluating action, and specifying learning phases. During the first two phases, problems of functional operations in a hospital were diagnosed and eight service models were designed by using iBeacon and NFC to solve the problems. Service models were applied to the hospital by installing beacons, wearable beacons, beacon scanners, and NFC tags during the third phase. During the fourth and fifth phases, the roles and benefits of stakeholders participating in the service models were evaluated, and issues and knowledge of the whole application process were derived and summarized from technological, economic, social and legal perspectives, respectively. From an action research perspective, IoT-based healthcare services were developed and verified. IoT-based services enable the hospital to acquire lifelog data for precision medicine and ultimately be able to go one step closer to precision medical care. The derived service models could provide patients more enhanced healthcare services and improve the work efficiency and effectiveness of the hospital.

  3. HEALTH WORKERS' PERCEPTIONON THE QUALITY OF SERVICE AND CORPORATE CULTURE OF A TEACHING HOSPITAL IN NIGERIA.

    Science.gov (United States)

    Akpan, Etukumana Etiobong; Bassey, Orie Jacob

    2015-01-01

    Quality of service delivery remains the most important issue in hospitals since patients expect higher standard care and services. This quality service is rooted in the culture of the health care organization. Therefore,this study seeks to determine health workers' perception on the quality of service and corporate culture at University of Uyo Teaching hospital, Uyo, Nigeria. A cross-sectional descriptive study was carried out. Using structured questionnaire and convenient sampling technique, data were collected from 250 hospital workers.The responses on questions to elicit the hospital's quality of service and corporate culture were rated on a five-point Likert Scale as follows; Strongly Agree (SA), Agree (A), Neutral(N), Disagree (D) and Strongly Disagree (SD). Data entry and analysis were performed using Epi Info 3.2.2 (CDC, Atlanta, Georgia, USA). The minimum and maximum ages of the respondents were 21 years and 60 years respectively. The mean, median and mode ages in the respondents were 34.6 (± 7.88) years, 33 years, and 30 years respectively. Majority of the study respondents were in the age group of 31-40 years (30%), female (56.8%) and Doctors (36%). The respondents' positive perception on quality of service offered by the hospital was 69.2% (OR 5.05, 95% CI 3.39-7.52, P corporate culture to achieve a higher quality of service.

  4. Mothers' satisfaction with referral hospital delivery service in Amhara Region, Ethiopia.

    Science.gov (United States)

    Tayelgn, Azmeraw; Zegeye, Desalegn T; Kebede, Yigzaw

    2011-10-24

    A woman's satisfaction with the delivery service may have immediate and long-term effects on her health and subsequent utilization of the services. Providing satisfying delivery care increases service utilization. The objective of this study is to assess the satisfaction of mothers with referral hospitals' delivery service and identify some possible factors affecting satisfaction in Amhara region of Ethiopia. A hospital-based cross-sectional survey that involved an exit interview was conducted from September to November 2009 in three referral hospitals in Ethiopia. A total of 417 delivering mothers were enrolled in the study. Client satisfaction was measured using a survey instrument adopted from the Donabedian quality assessment framework. We collect data systematically from every other postnatal woman who delivered in the referral hospitals. Multivariate and binary logistic regression was applied to identify the relative effect of each explanatory variable on the outcome (satisfaction). The proportion of mothers who were satisfied with delivery care in this study was 61.9%. Women's satisfaction with delivery care was associated with wanted status of the pregnancy, immediate maternal condition after delivery, waiting time to see the health worker, availability of waiting area, care providers' measure taken to assure privacy during examinations, and amount of cost paid for service. The overall satisfaction of hospital delivery services in this study is found to be suboptimal. The study strongly suggests that more could be done to assure that services provided are more patient centered.

  5. The new old market: trends in hospital services for the aged.

    Science.gov (United States)

    Mullner, R; Cohen, D

    1990-01-01

    Hospital health care services for the rapidly aging population should continue to expand. Several recent trends include the following: The overall number and proportion of admissions for the aged have increased since 1967 and will probably continue to increase in the future; The overall percentage of older patients in smaller hospitals has dropped steadily since 1967, but smaller hospitals continue to have a higher percentage of older admissions than do larger hospitals; The aged have a different seasonal pattern of admission compared to younger persons, reaching a nadir in August and an apex between January and April. The average inpatient length of stay for the aged has been dropping steadily over the last twenty years, long before the recent cost containment emphasis; Community hospitals are expanding their operations into long-term care services, including skilled nursing home care, intermediate care, and psychiatric long-term care; Emphasis on early patient discharge has led many hospitals to concentrate on continuity of care between institutions and the community, including increased emphasis on discharge planning and the coordination of services; and Hospitals plan to continue to expand care for the aging and aged population. As the population of the nation ages, hospitals will increasingly address the needs of older persons and continue to plan actively and aggressively and market their services to the aged, not only for humanitarian reasons but also for survival in an increasingly competitive environment. In the future, hospitals seem likely to continue to acquire new and more costly technology to enhance their acute care delivery. At the same time, however, they will continue to provide an increasing array of health care services to older persons. They will convert acute care beds to long-term care use, construct and or purchase nursing homes, and expand into other areas of care for the aged. Thus, the authors predict that hospitals will indeed evolve

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

    LENUS (Irish Health Repository)

    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.

  7. Cluster analysis of medical service resources at district hospitals in Taiwan, 2007-2011.

    Science.gov (United States)

    Tseng, Shu-Fang; Lee, Tian-Shyug; Deng, Chung-Yeh

    2015-12-01

    A vast amount of the annual/national budget has been spent on the National Health Insurance program in Taiwan. However, the market for district hospitals has become increasingly competitive, and district hospitals are under pressure to optimize the use of health service resources. Therefore, we employed a clustering method to explore variations in input and output service volumes, and investigate resource allocation and health care service efficiency in district hospitals. Descriptive and cluster analyses were conducted to examine the district hospitals included in the Ministry of Health and Welfare database during 2007-2011. The results, according to the types of hospital ownership, suggested that the number of public hospitals has decreased and that of private hospitals increased; the largest increase in the number of district hospitals occurred when Taichung City was merged into Taichung County. The descriptive statistics from 2007 to 2011 indicated that 43% and 36.4% of the hospitals had 501-800 occupied beds and 101-200 physicians, respectively, and > 401 medical staff members. However, the number of outpatients and discharged patients exceeded 6001 and 90,001, respectively. In addition, the highest percentage of hospitals (43.9%) had 30,001-60,000 emergency department patients. In 2010, the number of patients varied widely, and the analysis of variance cluster results were nonsignificant (p > 0.05). District hospitals belonging to low-throughput and low-performance groups were encouraged to improve resource utilization for enhancing health care service efficiency. Copyright © 2015. Published by Elsevier Taiwan.

  8. 30 CFR 250.207 - What ancillary activities may I conduct?

    Science.gov (United States)

    2010-07-01

    ... surveys; or (c) Studies that model potential oil and hazardous substance spills, drilling muds and... 30 Mineral Resources 2 2010-07-01 2010-07-01 false What ancillary activities may I conduct? 250.207 Section 250.207 Mineral Resources MINERALS MANAGEMENT SERVICE, DEPARTMENT OF THE INTERIOR OFFSHORE...

  9. Hospital services quality assessment: hospitals of Kerman University of Medical Sciences, as a tangible example of a developing country.

    Science.gov (United States)

    Nekoei-Moghadam, Mahmood; Amiresmaili, Mohammadreza

    2011-01-01

    Although quality orientation is one of the main priorities of any progressive organization, quality evaluation in organizations providing services such as hospitals is one of the key challenges, because in this sector quality is determined by many intangible factors. Applying the service quality gap model is one of the common tools for quality evaluation in the service sector. This paper seeks to evaluate this issue. The present descriptive study was carried out through a cross-sectional method in 2008. The participants of this study were patients who had been referred to Kerman University of Medical Sciences hospitals. The sample comprised 385 patients, the data were collected by SERVQUAL as a standard questionnaire, and data analysis was carried out on 385 completed questionnaires. In all five dimensions of quality, a gap was observed between patients' perceptions and expectations as follows: Assurance: -1.28, Empathy: -1.36, Responsiveness: -1.80, Tangibles: -1.86 and Reliability: -1.69. A paired T-test showed that the differences between quality perceptions and expectations are significant (p value SERVQUAL approach to hospital services of a developing country.

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

    LENUS (Irish Health Repository)

    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\

  11. [Work ability in hospital housekeeping services and associated factors].

    Science.gov (United States)

    Beltrame, Marlize Tatsch; Magnago, Tânia Solange Bosi de Souza; Kirchhof, Ana Lúcia Cardoso; Marconato, Cintia da Silva; Moraise, Bruna Xavier

    2014-12-01

    This study aimed to measure the Work Ability Index of workers of a hospital housekeeping staff and identify the associated factors. Cross-sectional study conducted in 201 with 157 workers of the housekeeping staff of a university hospital in Rio Grande do Sul, Brazil. A questionnaire containing sociodemographic, labor and health variables and the Brazilian version of the Work Ability Index was used. As a result, 79.6% of the workers were classified as having good/great work capacity. Mild mental (31.8%) and musculoskeletal disorders (15.9%) were the most prevalent medical diagnoses. After some adjustments, the workers that did not have time for leisure showed a 2.67 times higher prevalence of having the work ability reduced (CI95%=1.23-5.82). The other variables lost their association with the outcome. Measures aimed at the maintenance of work ability and the practice of physical activity and training for postural care are indicated.

  12. Impact of a major hurricane on surgical services in a university hospital.

    Science.gov (United States)

    Norcross, E D; Elliott, B M; Adams, D B; Crawford, F A

    1993-01-01

    Hurricane Hugo struck Charleston, South Carolina, on September 21, 1989. This report analyzes the impact this storm had upon surgical care at a university medical center. Although disaster planning began on September 17, hurricane damage by high winds and an 8.7-foot tidal surge led to loss of emergency power and water. Consequently, system failures occurred in air conditioning, vacuum suction, steam and ethylene oxide sterilization, plumbing, central paging, lighting, and refrigeration. The following surgical support services were affected. In the blood bank, lack of refrigeration meant no platelet packs for 2 days. In radiology, loss of electrical power damaged CT/MRI scanners and flooding ruined patient files, resulting in lost information. In the intensive care unit, loss of electricity meant no monitors and hand ventilation was used for 4 hours. In the operating room, lack of temperature and humidity control (steam, water, and suction supply) halted elective surgery until October 2. Ground and air transportation were limited by unsafe landing sites, impassable roads, and personnel exhaustion. Surgical planning for a major hurricane should include: 1) a fail-safe source of electrical power, 2) evacuation of as many critically ill patients as possible before the storm, 3) cancellation of all elective surgery, and 4) augmented ancillary service staffing with some, although limited, physician support.

  13. Food Services and Hospitality for 10th, 11th, and 12th Grades. Course Outline.

    Science.gov (United States)

    Bucks County Technical School, Fairless Hills, PA.

    The outline describes the food services and hospitality course offered to senior high school students at the Bucks County Technical School. Specifically, the course seeks to provide students with a workable knowledge of food services and foster in them a sense of personal pride for quality workmanship. In addition to a statement of the philosophy…

  14. 42 CFR 415.162 - Determining payment for physician services furnished to beneficiaries in teaching hospitals.

    Science.gov (United States)

    2010-10-01

    ... furnished to beneficiaries in teaching hospitals. 415.162 Section 415.162 Public Health CENTERS FOR MEDICARE... BY PHYSICIANS IN PROVIDERS, SUPERVISING PHYSICIANS IN TEACHING SETTINGS, AND RESIDENTS IN CERTAIN SETTINGS Physician Services in Teaching Settings § 415.162 Determining payment for physician services...

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

    Science.gov (United States)

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

    2009-01-01

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

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

    Science.gov (United States)

    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.

  17. Service Quality Assessment of Hospitals in Asian Context: An Empirical Evidence From Pakistan

    Science.gov (United States)

    Shafiq, Muhammad; Naeem, Muhammad Azhar; Munawar, Zartasha; Fatima, Iram

    2017-01-01

    Hospitals vary from one another in terms of their specialty, services offered, and resource availability. Their services are widely measured with scales that gauge patients’ perspective. Therefore, there is a need for research to develop a scale that measures hospital service quality in Asian hospitals, regardless of their nature or ownership. To address this research need, this study adapted the SERVQUAL instrument to develop a service quality measurement scale. Data were collected from inpatients and outpatients at 9 different hospitals, and the scale was developed using structural equation modeling. The developed scale was then validated by identifying service quality gaps and ranking the areas that require managerial effort. The findings indicated that all 5 dimensions of SERVQUAL are valid in Asian countries such as Pakistan, with 13 items retained. Reliability, tangibility, responsiveness, empathy, and assurance were ranked first, second, third, fourth, and fifth, respectively, in terms of the size of the quality gap. The gaps were statistically significant, with values ≤.05; therefore, hospital administrators must focus on each of these areas. By focusing on the identified areas of improvement, health care authorities, managers, practitioners, and decision makers can bring substantial change within hospitals. PMID:28660771

  18. Service Quality Assessment of Hospitals in Asian Context: An Empirical Evidence From Pakistan.

    Science.gov (United States)

    Shafiq, Muhammad; Naeem, Muhammad Azhar; Munawar, Zartasha; Fatima, Iram

    2017-01-01

    Hospitals vary from one another in terms of their specialty, services offered, and resource availability. Their services are widely measured with scales that gauge patients' perspective. Therefore, there is a need for research to develop a scale that measures hospital service quality in Asian hospitals, regardless of their nature or ownership. To address this research need, this study adapted the SERVQUAL instrument to develop a service quality measurement scale. Data were collected from inpatients and outpatients at 9 different hospitals, and the scale was developed using structural equation modeling. The developed scale was then validated by identifying service quality gaps and ranking the areas that require managerial effort. The findings indicated that all 5 dimensions of SERVQUAL are valid in Asian countries such as Pakistan, with 13 items retained. Reliability, tangibility, responsiveness, empathy, and assurance were ranked first, second, third, fourth, and fifth, respectively, in terms of the size of the quality gap. The gaps were statistically significant, with values ≤.05; therefore, hospital administrators must focus on each of these areas. By focusing on the identified areas of improvement, health care authorities, managers, practitioners, and decision makers can bring substantial change within hospitals.

  19. The field hospital at Zagreb: tri-service medical care in a peacekeeping operation.

    Science.gov (United States)

    Reed, R J; Martino, J; Eyestone, S M; Pugh, W M

    1998-06-01

    The objective of this investigation was to provide military medical planners with insights into the specific materiel, skills, and information requirements demanded by humanitarian missions through review of approximately 16,000 records from a tri-service medical patient database used at the field hospital in Zagreb, Croatia, during Operation Provide Promise. This review describes (1) the origin, rationale, structure, and implementation of the database; (2) the patients who used medical services provided by the hospital; (3) the diagnoses encountered in outpatient visits, admissions, and surgical operations; and (4) the distribution of medical services used by various subgroups of interest.

  20. Barriers to the implementation of advanced clinical pharmacy services at Portuguese hospitals.

    Science.gov (United States)

    Brazinha, Isabel; Fernandez-Llimos, Fernando

    2014-10-01

    In some countries, such as Portugal, clinical pharmacy services in the hospital setting may be implemented to a lower extent than desirable. Several studies have analysed the perceived barriers to pharmacy service implementation in community pharmacy. To identify the barriers towards the implementation of advanced clinical pharmacy services at a hospital level in Portugal, using medication follow-up as an example. Hospital pharmacies in Portugal. A qualitative study based on 20 face-to-face semi-structured interviews of strategists and hospital pharmacists. The interview guide was based on two theoretical frameworks, the Borum's theory of organisational change and the Social Network Theory, and then adapted for the Portuguese reality and hospital environments. A constant comparison process with previously analysed interviews, using an inductive approach, was carried out to allow themes to emerge. Themes were organised following the Leavitt's Organizational Model: functions and objectives; hospital pharmacist; structure of pharmacy services; environment; technology; and medication follow-up based on the study topic. Barriers towards practice change. Medication follow-up appeared not to be a well-known service in Portuguese hospital pharmacies. The major barriers at the pharmacist level were their mind-set, resistance to change, and lack of readiness. Lack of time, excessive bureaucratic and administrative workload, reduced workforce, and lack of support from the head of the service and other colleagues were identified as structural barriers. Lack of access to patients' clinical records and cumbersome procedures to implement medication follow-up were recognised as technological barriers. Poor communication with other healthcare professionals, and lack of support from professional associations were the major environmental barriers. Few of the barriers identified by Portuguese hospital pharmacists were consistent with previous reports from community pharmacy. The mind

  1. Satisfaction with outpatient health services at Jimma Hospital, South ...

    African Journals Online (AJOL)

    % of the males visited for own health care. Overall, 57.1% of interviewee believed that the service they received was either good or very good. Satisfaction with health care was found to have a direct relationship with increase in age but has an ...

  2. Scope of neonatal care services in major Nigerian hospitals

    African Journals Online (AJOL)

    2015-10-12

    Oct 12, 2015 ... This definition is adapted from the AAP guidelines to meet with available resources in a developing commu- nity. This standard of tiered level of neonatal services as contained in the policy statement of the American Acad- emy of Pediatrics8 and utilized in developed communi- ties is yet to be applied in ...

  3. The labour ward analgesic service at King Edward VIII Hospital ...

    African Journals Online (AJOL)

    In addition to pain relief, there are a number of obstetric indications for epidural analgesia, including first deliveries, breech presentations, preterm labour, induced labour, hyper- tensive disorders of pregnancy and multiple gestation. The provision of an adequate epidural service is there- fore warranted for any labour ward.

  4. Customer Relationship Management and Hospital Service Quality in ...

    African Journals Online (AJOL)

    Health care delivery has become one of the fundamental issues being given attention by governments of most developing countries. The Objective of this study therefore is to examine how Customer Relationship Management can be employed to bring about improve health service quality in Nigeria. The data for the study ...

  5. Patients' satisfaction of service quality in Saudi hospitals: a SERVQUAL analysis.

    Science.gov (United States)

    Al-Borie, Hussein M; Damanhouri, Amal M Sheikh

    2013-01-01

    Saudi Arabian hospital performance, vis-á-vis patient satisfaction with service provision, has emerged as a key policy and planning concern. Keeping in view public and private hospital service quality, this article seeks to provide guidelines to the on-going Saudi Arabian health service reorganization, which emphasizes decentralization, bed-capacity expansion, research-based policymaking and initiatives in the health insurance sector. The article outlines an empirical study that compares patient satisfaction with service quality in Saudi Arabian public and private sector hospitals. The authors employ a stratified random sample (1,000 inpatients) from five Saudi Arabian public and five private hospitals. Data were collected through questionnaire using the SERVQUAL scale. For reducing the language bias the questionnaire was translated into Arabic. The response rate was 74.9 percent. Data were analyzed using SPSS and appropriate descriptive and inferential statistical techniques. Cronbach's alpha for five service-quality dimensions (tangibles, reliability, responsiveness, safety and empathy) were high and the SERVQUAL instrument proved to be reliable, valid and appropriate. The results showed that sex, education, income and occupation were statistically significant in influencing inpatients' satisfaction, and all the null hypotheses were rejected. Only inpatient age was not significant. The study highlights service quality influence in the design of broader healthcare strategies for Saudi Arabian public and private hospitals. It demands that management researchers and analysts must identify regional service quality consistencies and related inpatient demographic indicators. The study offers some insights into, and guidance for, hospital quality assurance in Saudi Arabia in general and the urban hospital setting in the Middle-East in particular.

  6. Rates and predictors of aftercare services among formerly hospitalized adolescents: a prospective naturalistic study.

    Science.gov (United States)

    Goldston, David B; Reboussin, Beth A; Kancler, Cynthia; Daniel, Stephanie Sergent; Frazier, Patricia H; Harris, Ashley E; Kelley, Arthur E; Reboussin, David M

    2003-01-01

    To examine rates and predictors of aftercare use, lengths of service use, and predictors of the duration of aftercare service use among 180 adolescents monitored for up to 8.1 years after discharge from an inpatient psychiatry unit. Drawing upon the Anderson-Newman model of service use, severity of illness, enabling, and predisposing factors assessed during the hospitalization were examined as potential predictors of service use. Information about outpatient mental health specialty services after hospitalization was assessed repeatedly and verified with treatment records. Seventy-three percent of adolescents received aftercare within the first month after discharge, and 92% eventually received outpatient services. Fifty-seven percent of adolescents remained in treatment 6 months after initiation of services. Psychiatric comorbidity, prior service use, and presence of a biological parent or grandparent in the home were related to initial service use. Psychiatric comorbidity and history of repeated suicide attempts were related to longer duration, and older age and minority group status were related to shorter duration of aftercare service use. Most adolescents receive aftercare services, but there are certain groups that are relatively less likely to access or remain in services. Interventions to decrease the barriers to care in such groups may be beneficial.

  7. [Emotional climate and internal communication in a clinical management unit compared with two traditional hospital services].

    Science.gov (United States)

    Alonso, E; Rubio, A; March, J C; Danet, A

    2011-01-01

    The aim of this study is to compare the emotional climate, quality of communication and performance indicators in a clinical management unit and two traditional hospital services. Quantitative study. questionnaire of 94 questions. 83 health professionals (63 responders) from the clinical management unit of breast pathology and the hospital services of medical oncology and radiation oncology. descriptive statistics, comparison of means, correlation and linear regression models. The clinical management unit reaches higher values compared with the hospital services about: performance indicators, emotional climate, internal communication and evaluation of the leadership. An important gap between existing and desired sources, channels, media and subjects of communication appear, in both clinical management unit and traditional services. The clinical management organization promotes better internal communication and interpersonal relations, leading to improved performance indicators. Copyright © 2011 SECA. Published by Elsevier Espana. All rights reserved.

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

    Science.gov (United States)

    2013-01-01

    Introduction Hypothermia is associated with increased morbidity and mortality in trauma patients and poses a challenge in pre-hospital treatment. The aim of this study was to identify equipment to prevent, diagnose, and treat hypothermia in Norwegian pre-hospital services. Method In the period of April-August 2011, we conducted a survey of 42 respondents representing a total of 543 pre-hospital units, which included all the national ground ambulance services, the fixed wing and helicopter air ambulance service, and the national search and rescue service. The survey explored available insulation materials, active warming devices, and the presence of protocols describing wrapping methods, temperature monitoring, and the use of warm i.v. fluids. Results Throughout the services, hospital duvets, cotton blankets and plastic “bubble-wrap” were the most common insulation materials. Active warming devices were to a small degree available in vehicle ambulances (14%) and the fixed wing ambulance service (44%) but were more common in the helicopter services (58-70%). Suitable thermometers for diagnosing hypothermia were lacking in the vehicle ambulance services (12%). Protocols describing how to insulate patients were present for 73% of vehicle ambulances and 70% of Search and Rescue helicopters. The minority of Helicopter Emergency Medical Services (42%) and Fixed Wing (22%) units was reported to have such protocols. Conclusion The most common equipment types to treat and prevent hypothermia in Norwegian pre-hospital services are duvets, plastic “bubble wrap”, and cotton blankets. Active external heating devices and suitable thermometers are not available in most vehicle ambulance units. PMID:23938145

  9. Current status, challenges and the way forward for clinical pharmacy service in Ethiopian public hospitals.

    Science.gov (United States)

    Bilal, Arebu Issa; Tilahun, Zelalem; Gebretekle, Gebremedhin Beedemariam; Ayalneh, Belete; Hailemeskel, Bisrat; Engidawork, Ephrem

    2017-05-19

    Clinical pharmacy service has evolved steadily over the past few decades and is now contributing to the 'patient care journey' at all stages. It is improving the safety and effectiveness of medicines and has made a significant contribution to the avoidance of medication errors. In Ethiopia, clinical pharmacy service is in its initial phase, being started in July 2013. This study therefore aimed at assessing the status, challenges and way forward of clinical pharmacy service in the country. A cross-sectional survey was conducted in six regional states and one city- administration in September 2014. A total of 51 hospitals were included in the study. Both qualitative and quantitative methods were employed for data collection. A total of 160 pharmacy graduates, and 51 pharmacy heads participated in the study. Internal Medicine and Pediatric wards were the major wards where the graduates provide clinical pharmacy service. Almost 94% of the new graduates were found to be involved in clinical pharmacy service, but 47% of them rated their service as poor. The overall satisfaction of the graduates was close to 36%. Thirteen hospitals discontinued and two hospitals not even initiated the service largely due to shortage of pharmacists and lack of management support. About 44% of the surveyed hospitals documented the clinical pharmacy service provided using either developed or adopted formats. Lack of awareness by the medical fraternity, high attrition rate, lack of support from the management as well as from the health care team, readiness of the graduates to deliver the service, and shortage of pharmacists were identified by the key informants as the major stumbling block to deliver clinical pharmacy service. Clinical pharmacy service is initiated in most of the surveyed hospitals and a large proportion of the graduates were involved in the service. Although there is a great enthusiasm to promote clinical pharmacy service in the surveyed hospitals, efforts made to

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

    Science.gov (United States)

    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…

  11. An empirical study of the impact of service quality on patient satisfaction in private hospitals, Iran.

    Science.gov (United States)

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

    2014-07-29

    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. 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 collection; contacting 21 items (17 items about service quality and 4 items about overall satisfaction) and its validity and reliability were confirmed. Data analysis was performed using t-test, ANOVA and multivariate regression. this study found a strong relationship between service quality and patient satisfaction. About 45% of the variance in overall satisfaction was explained by four dimensions of perceived service quality. The cost of services, the quality of the process and the quality of interaction had the greatest effects on the overall satisfaction of patients, but not found a significant effect on the quality of the physical environment on patient satisfaction. Constructs related to costs, delivery of service and interpersonal aspect of care had the most positive impact on overall satisfaction of patients. Managers and owners of private hospitals should set reasonable prices compared to the quality of service. In terms of process quality, waiting time for visits, admissions, and surgeries must be declined and services provided at the fastest possible time. It should be emphasized to strengthen of interpersonal aspects of care and communication skills of care providers.

  12. The decision-making matrix of propensity to outsourcing hospital services in Bandar Abbas, Iran.

    Science.gov (United States)

    Hayati, Ramin; Setoodehzadeh, Fateme; Heydarvand, Sanaz; Khammarnia, Mohammad; Ravangard, Ramin; Sadeghi, Ahmad; Sobhani, Ghasem

    2015-12-01

    To determine the level of managers' propensity for outsourcing the services in hospitals using decision-making matrix. The applied, cross-sectional study was conducted at three hospitals affiliated to Bandar Abbas University of Medical Sciences, Iran, in 2013, and comprised managers and employees of four service units: radiology, laboratory, nursing, and nutrition services. Data was collected using two questionnaires and face-to-face interviews. Data was analysed using SPSS 16 and by using decision-making matrix. Of the 122 subjects in the study, 12(9.8%) were managers and 110(90.2%) were other employees. The highest and lowest propensities for outsourcing were related to nutrition (66.6%) and nursing services one (8.33%). The decision-making matrix showed low outsourcing of the nursing, radiology, and laboratory services based on the services' features. However, there were difference between the results obtained from laboratory service decision-making matrix and the propensity for laboratory service outsourcing. The difference between the results obtained from the matrix and managers' viewpoint can be due to the lack of managers' sufficient attention to the features of hospital services when making decisions on outsourcing them.

  13. General surgical services at an urban teaching hospital in Mozambique.

    Science.gov (United States)

    Snyder, Elizabeth; Amado, Vanda; Jacobe, Mário; Sacks, Greg D; Bruzoni, Matias; Mapasse, Domingos; DeUgarte, Daniel A

    2015-10-01

    As surgery becomes incorporated into global health programs, it will be critical for clinicians to take into account already existing surgical care systems within low-income countries. To inform future efforts to expand the local system and systems in comparable regions of the developing world, we aimed to describe current patterns of surgical care at a major urban teaching hospital in Mozambique. We performed a retrospective review of all general surgery patients treated between August 2012 and August 2013 at the Hospital Central Maputo in Maputo, Mozambique. We reviewed emergency and elective surgical logbooks, inpatient discharge records, and death records to report case volume, disease etiology, and mortality. There were 1598 operations (910 emergency and 688 elective) and 2606 patient discharges during our study period. The most common emergent surgeries were for nontrauma laparotomy (22%) followed by all trauma procedures (18%), whereas the most common elective surgery was hernia repair (31%). The majority of lower extremity amputations were above knee (69%). The most common diagnostic categories for inpatients were infectious (31%), trauma (18%), hernia (12%), neoplasm (10%), and appendicitis (5%). The mortality rate was 5.6% (146 deaths), approximately half of which were related to sepsis. Our data demonstrate the general surgery caseload of a large, academic, urban training and referral center in Mozambique. We describe resource limitations that impact operative capacity, trauma care, and management of amputations and cancer. These findings highlight challenges that are applicable to a broad range of global surgery efforts. Copyright © 2015 Elsevier Inc. All rights reserved.

  14. Health on wheels: public service of a private hospital.

    Science.gov (United States)

    Soriano, M B

    1977-06-01

    This article describes the history and activities of the mobile clinic field by the Lorma Medical Center in Carlatan, San Fernando, in the province of La Union. The clinic is free and offers integrated medical services to 4-5 baranguays (villages) per day, averaging 861 cases including an average of 86 family planning cases. The clinic is part of Lorma's Outreach Program which includes a daily radio program answering questions on "Better Health for You and Your Family," a seminar program for local, voluntary health assistants and an "Adopt a Family" program in which nursing students visit and care for an indigent family throughout their training. In September 1977, a mobile vasectomy clinic will begin daily rounds. The mobile clinic program has little access to remote areas because the van cannot navigate the narrow, bumpy roads. However, funding is the program's only real limitation and its possibilities for improved health and family planning services are very great.

  15. Teleradiology service for mission hospitals: initial experiences in Ethiopia and Kenya

    Directory of Open Access Journals (Sweden)

    Matthew Larrison

    2016-01-01

    Full Text Available Throughout their history, mission hospitals have provided high quality and lifesaving medical care to regions of the world where medical care is sparse. These hospitals are generally built and equipped through a combination of governmental and non-governmental sources. As advances in diagnostic medical imaging have progressed and become mainstream in the developed world, mission hospitals have adopted advanced imaging modalities. These modalities provide early diagnosis and treatment options for their patients. In addition to the installation and operation of advanced imaging equipment, the need for professional expert interpretation of these studies remains a challenge for mission hospitals. Historically these hospitals have used either voluntary services on site or paid for interpretations from local radiologists; however, with the introduction of high speed internet, teleradiology has become a possibility. This article describes the teleradiology experience of two mission hospitals in rural Africa.

  16. Hospital food service: a comparative analysis of two foodservice systems at a Danish Hospital

    DEFF Research Database (Denmark)

    Justesen, Lise; René, Michael; Kristensen, Marianne Boll

    2016-01-01

    Background Insufficient dietary intake is common among hospitalised patients and may affect prognosis negatively. Hence hospital meals are central in the treatment, and their efficacy in ensuring adequate intake is crucial. This study aimed to compare patients’ dietary intake from a cook-serve bu......Background Insufficient dietary intake is common among hospitalised patients and may affect prognosis negatively. Hence hospital meals are central in the treatment, and their efficacy in ensuring adequate intake is crucial. This study aimed to compare patients’ dietary intake from a cook......-serve buffet-trolley serving system (BTS) to a new cook-chill pre-plated concept (CCP) allowing patients to choose from a static menu 24/7. Methods A quasi-experimental study was conducted at two orthopaedic surgical and a gynaecological surgical ward at a Danish Hospital. 57patients (≥3 days) were served......% of the protein requirements on CCP compared to 33 % on BTS (p=0,216). Conclusions A new foodservice system (CCP) which increases availability and choice of food 24/7 does not show a significant improvement of energy and protein intake in hospitalized patients and patients at nutritional risk. However, further...

  17. An investigation Into Traditional Chinese Medicine Hospitals in China: Development Trend and Medical Service Innovation

    Directory of Open Access Journals (Sweden)

    Liang Wang

    2017-01-01

    Full Text Available Background This paper aims to investigate the development trend of traditional Chinese medicine (TCM hospitals in China and explore their medical service innovations, with special reference to the changing co-existence with western medicine (WM at TCM hospitals. Methods Quantitative data at macro level was collected from official databases of China Health Statistical Yearbook and Extracts of Traditional Chinese Medicine Statistics. Qualitative data at micro level was gathered through interviews and second-hand material collection at two of the top-level TCM hospitals. Results In both outpatient and inpatient sectors of TCM hospitals, drug fees accounted for the biggest part of hospital revenue. Application of WM medical exanimation increased in both outpatient and inpatient services. Even though the demand for WM drugs was much higher in inpatient care, TCM drugs was the winner in the outpatient. Also qualitative evidence showed that TCM dominated the outpatient hospital service with WM incorporated in the assisting role. However, it was in the inpatient medical care that WM prevailed over TCM which was mostly applied to the rehabilitation of patients. Conclusion By drawing on WM while keeping it active in supporting and strengthening the TCM operation in the TCM hospital, the current system accommodates the overriding objective which is for TCM to evolve into a fully informed and more viable medical field.

  18. An investigation Into Traditional Chinese Medicine Hospitals in China: Development Trend and Medical Service Innovation

    Science.gov (United States)

    Wang, Liang; Suo, Sizhuo; Li, Jian; Hu, Yuanjia; Li, Peng; Wang, Yitao; Hu, Hao

    2017-01-01

    Background: This paper aims to investigate the development trend of traditional Chinese medicine (TCM) hospitals in China and explore their medical service innovations, with special reference to the changing co-existence with western medicine (WM) at TCM hospitals. Methods: Quantitative data at macro level was collected from official databases of China Health Statistical Yearbook and Extracts of Traditional Chinese Medicine Statistics. Qualitative data at micro level was gathered through interviews and second-hand material collection at two of the top-level TCM hospitals. Results: In both outpatient and inpatient sectors of TCM hospitals, drug fees accounted for the biggest part of hospital revenue. Application of WM medical exanimation increased in both outpatient and inpatient services. Even though the demand for WM drugs was much higher in inpatient care, TCM drugs was the winner in the outpatient. Also qualitative evidence showed that TCM dominated the outpatient hospital service with WM incorporated in the assisting role. However, it was in the inpatient medical care that WM prevailed over TCM which was mostly applied to the rehabilitation of patients. Conclusion: By drawing on WM while keeping it active in supporting and strengthening the TCM operation in the TCM hospital, the current system accommodates the overriding objective which is for TCM to evolve into a fully informed and more viable medical field. PMID:28005539

  19. Patient satisfaction with the dental services offered by a dental Hospital in India

    Directory of Open Access Journals (Sweden)

    N Nagappan

    2014-01-01

    Full Text Available Introduction: A major component of quality of health care is patient satisfaction. Patient satisfaction is multifaceted and a very challenging outcome to define. Patient expectations of care and attitudes greatly contribute to the satisfaction; other psychosocial factors, including facilities and treatments services are also known to contribute to patient satisfaction scores. Aim: To measure patient satisfaction about facilities, services and treatments offered by a dental hospital in India. Materials and Methods: Self administrated questionnaire was distributed to outpatients reporting to the dental hospital for treatment. The questionnaire consisted of 30 items that included information about personal data of the patients and their satisfaction with the facilities, services and treatment received in the hospital. Results: About 89.9% of patients felt that the cost of dental hygiene services were reasonable, 57.6% of patients felt that drinking water facilities were enough in the hospital, 31.9% of patients felt that they have problem with scheduling appointments, 86% of patients felt that they had problem in contacting student dentist. Conclusion: The majority of the patients were satisfied with the facilities, services and treatment received at hospital except for facilities such as water supply and scheduling appointments with patient convenience.

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

    Science.gov (United States)

    Rajabi, A; Dabiri, A

    2012-01-01

    Activity Based Costing (ABC) is one of the new methods began appearing as a costing methodology in the 1990's. 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. 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. 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. 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.

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

    Energy Technology Data Exchange (ETDEWEB)

    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.)

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

    Science.gov (United States)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  4. A comparison of congestive heart failure readmissions among teaching and nonteaching hospital services.

    Science.gov (United States)

    Palacio, Carlos; House, Jeffrey; Ibrahim, Saif; Touchan, Jean N; Mooradian, Ariana

    2014-08-01

    Heart failure (HF) is a leading cause of hospitalization in the United States. With the population trend shifting to a higher volume of elderly adults, the efficient management of HF will become increasingly essential. The development and implementation of The Patient Protection and Affordable Care Act and subsequent changes in reimbursement practices have made 30-day readmission rates a topic of much interest and relevance. The aim of the study was to compare rates of readmission among teaching and nonteaching hospitals. The authors gathered retrospective data on HF quality measures and readmission rates between August 2011 and July 2012, extracted from the institution's managerial accounting database. These data were compared among teaching and nonteaching hospitals. Patient demographics, readmission rates, readmission diagnoses, severity of illness, patient disposition, medications prescribed, cost of services, and mortality were reviewed. Analysis of variance was used for continuous variables; χ(2) analysis was used for evaluating categorical variables. A higher proportion of patients on the cardiology teaching service were men than on either the medicine teaching service or the medicine nonteaching service. Length of stay, case costs, and care costs were lowest for the cardiology teaching service; however, patient illness severity was lower on this service than on the other two services. Overall, readmissions and mortality were similar among all groups, but readmission for the same diagnosis was more likely on the cardiology service than on the medicine teaching and nonteaching services. Studies comparing teaching and nonteaching providers for an HF diagnosis are needed. Hospital readmission and mortality rates were similar across services and compared favorably with national data. Opportunities that target cost reduction and length of stay may be leveraged.

  5. Transfers to civil psychiatric inpatient services from a maximum security forensic hospital.

    Science.gov (United States)

    Way, Bruce B; Smith, Hal; Sawyer, Don

    2004-01-01

    To examine inpatients discharged from a forensic psychiatric hospital to a civil hospital at the completion of their correctional sentence. Extract information from a patient database. About 20% of the discharges from the New York State forensic hospital that serves mentally ill state prison inmates, Central New York Psychiatric Center (CNYPC), are transferred to a civil psychiatric hospital; the remainder are returned to a correctional setting. Although their diagnoses, Global Assessment of Functioning scores, and number of prior inpatient admissions are similar, CNYPC transfers stay 1(1/2) times as long in their civil hospital admission as other civil hospital admissions. If total inpatient hospitalization before release to the community at large is considered (CNYPC plus the subsequent civil hospital), the stay is about 2(1/2) times as long. Fifty-two percent of the CNYPC transfers had been incarcerated for violent offenses and 28% are re-hospitalized within 12 months after release from the civil hospital. Longer lengths of stay in the civil hospital for these CNYPC transfers do not seem to be related to psychiatric functioning. Instead, it may be related to being harder to place in a community setting. All these CNYPC transfers have prison histories, many have a violent offense history, and all have been geographically remote from their home communities for a long time periods. As a result, the social support networks of CNYPC transfers may be weaker than those of other civil inpatients. The families and neighborhood agencies of CNYPC transfers are probably less willing to accept them on their return than those of other civil patients.Enhanced discharge planning and support services targeted specially for correctional transfers to a civil psychiatric inpatient environment should be considered. These type of service may reduce inpatient length of stay and thereby allow the inpatient resources to be used by other patients. Copyright 2004 John Wiley & Sons, Ltd.

  6. The Effect of Service Compact (SERVICOM on Service Delivery in Nnamdi Azikiwe University Teaching Hospital Nnewi, Nigeria

    Directory of Open Access Journals (Sweden)

    Jude Kennedy Emejulu

    2014-12-01

    Full Text Available This study examined the effect of service compact (Servicom Service delivery in Nnamdi Azikiwe University Teaching Hospital Nnewi. Questionnaire and face-to-face interviews were used in the collection of data. The hypotheses were tested using descriptive statistics. The study discovered among other things that with the inauguration of the SERVICOM Charter by the Federal Government of Nigeria, the Management of Nnamdi Azikiwe University Teaching Hospital Nnewi identified key areas that required re-evaluation and attention based on the submissions of every service unit and department, after an analysis of the Strengths, Weaknesses, Opportunities and Threats (SWOT of each of the service areas. A pre-SERVICOM Charter workshop which was supervised by the Federal Government was held in the various institutions nationwide to enable care providers enumerate their current service capacity and identify their impediments. In the light of the foregoing, some of the recommendations proffered are that the SERVICOM Charter project should be sustained and supervision and control of the SERVICOM Charter project should be intensified in order to ensure that the Nigerian factor of service-fatigue would not supervene in care delivery in the near future.

  7. Using creative problem solving (TRIZ) in improving the quality of hospital services.

    Science.gov (United States)

    LariSemnani, Behrouz; Mohebbi Far, Rafat; Shalipoor, Elham; Mohseni, Mohammad

    2014-08-14

    TRIZ is an initiative and SERVQUAL is a structured methodology for quality improvement. Using these tools, inventive problem solving can be applied for quality improvement, and the highest quality can be reached using creative quality improvement methodology. The present study seeks to determine the priority of quality aspects of services provided for patients in the hospital as well as how TRIZ can help in improving the quality of those services. This Study is an applied research which used a dynamic qualitative descriptive survey method during year 2011. Statistical population includes every patient who visited in one of the University Hospitals from March 2011. There existed a big gap between patients' expectations from what seemingly is seen (the design of the hospital) and timely provision of services with their perceptions. Also, quality aspects of services were prioritized as follows: keeping the appearance of hospital (the design), accountability, assurance, credibility and having empathy. Thus, the only thing which mattered most for all staff and managers of studied hospital was the appearance of hospital as well as its staff look. This can grasp a high percentage of patients' satisfaction. By referring to contradiction matrix, the most important principles of TRIZ model were related to tangible factors including principles No. 13 (discarding and recovering), 25 (self-service), 35 (parameter changes), and 2 (taking out). Furthermore, in addition to these four principles, principle No. 24 (intermediary) was repeated most among the others. By utilizing TRIZ, hospital problems can be examined with a more open view, Go beyond The conceptual framework of the organization and responded more quickly to patients ' needs.

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

    OpenAIRE

    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...

  9. ADVERSE REACTIONS TO ANTIMICROBIAL AGENTS IN INTERNAL MEDICINE AND ORTHOPEDIC SERVICES. JOSINA MACHEL HOSPITAL, 2014

    OpenAIRE

    Mateus Sebastião João Fernandes; Héctor Lara Fernández; Vladimir Calzadilla Moreira

    2015-01-01

    A descriptive, prospective study was conducted to characterize the incidence and type of Adverse Drug Reactions (ADR) to antimicrobial agents in patients hospitalized in internal medicine and Orthopedic services at “Josina Machel” Central Hospital, in Luanda, in the period from January to February 2014 . The occurrence of adverse drug reactions was assessed by daily review of the clinical history of the patients with active search for potentially adverse effects associated with prescription a...

  10. Postdischarge community pharmacist-provided home services for patients after hospitalization for heart failure.

    Science.gov (United States)

    Kalista, Tom; Lemay, Virginia; Cohen, Lisa

    2015-01-01

    To establish a community pharmacist-provided home health service to improve medication adherence and reduce 30-day heart failure-related hospital readmissions. Visiting Nurse Services of Newport and Bristol Counties located in Portsmouth, RI, from December 2013 to April 2014. Each patient received one in-home visit provided by a Postgraduate Year 1 community pharmacy resident within 1 week of admission to visiting nurse services followed by two follow-up telephone calls, 1 week and 4 weeks after the visit. The in-home visit consisted of a baseline assessment of medication adherence using the Morisky 8-Item Medication Adherence Questionnaire as well as pharmacist-provided education regarding chronic heart failure management. The follow-up telephone calls were used to reassess patient adherence and to monitor for hospital readmission within 30 days of the initial in-home visit. Community pharmacist-provided in-home medication reconciliation and medication teaching has not been described in the literature previously. In addition, pharmacists are often not included on home health care teams placing patients undergoing transitions in care at risk for potential medication-related errors. Improvement in medication adherence and reduction in 30-day heart failure-related hospital readmission rates. Ten patients were enrolled from December 2013 through April 2014. Following intervention, all patients saw improvements in adherence questionnaire scores during follow-up. Hospital readmission rates for patients seen by the pharmacist were lower compared with agencywide figures over a similar time period. A community pharmacist-provided in-home medication teaching service for patients following recent hospital discharge helps facilitate successful transitions of care from an inpatient to outpatient setting, improves medication adherence and has produced lower observed 30-day heart failure-related hospital readmission rates. Expansion of this or a similar service within the

  11. [Impact of single disease payment system on hospital delivery service providers' behavior].

    Science.gov (United States)

    Chen, Ming; Guo, Yan

    2012-06-18

    To find out whether single disease payment system would have an impact on hospital delivery service providers' behavior. Zhouzhi County in Shaanxi Province where there was a payment change from fee for service (FFS) to single disease payment in 2007 was selected as the treatment group, and Guangling County in Shanxi Province with FFS was selected as the control group. Using a difference-in-difference (DD) design, this study empirically examined the impact of single disease payment on the cost of hospital delivery and length of stay. The data of 1 050 samples were taken from the hospitalization medical records and list of charges in the hospitals between 2005-11-01 and 2010-12-31. When taking the expense as dependent variable, the estimated value of DD variable was -262.73 with parity, length of stay, delivery mode, and payment controlled, which was significant at the 1‰ level. It indicated that the expense had decreased by 262.73 yuan after single disease payment was introduced. When taking the length of stay as dependent variable, the estimated value of DD variable was 0.53, which was not significant at the 5% level,meaning that the length of stay was not different between single disease payment and FFS. The payment change from FFS to single disease payment has an impact on hospital delivery service providers' behavior. It could make hospitals try their best to reduce the expenses under the price ceiling to avoid paying for the exceeding cost, and it also can restrict induced demand, but it could not motivate hospitals to reduce length of stay. This research provides evidence for policy makers that compared with FFS, single disease payment system is an effective payment method for controlling the expense of hospital delivery under the new cooperative medical scheme (NCMS) and the policy of subsidy for rural hospital delivery (SRHD) .

  12. A description of weekend physiotherapy services in three tertiary hospitals in the greater Toronto area.

    Science.gov (United States)

    Hill, Kylie; Brooks, Dina

    2010-01-01

    The aims of this study were (1) to describe the cardiorespiratory physiotherapy weekend service (PWS) at three tertiary hospitals in the Greater Toronto Area (GTA) and (2) to compare measures of staff burden among the clinical service areas in one of the hospitals that had a programme-based management structure. Two focus-group meetings were held with physiotherapists from hospitals within the GTA. Thereafter, variables characterizing the PWS were collected over 8 months, using a standardized data-collection form. A total of 632 data-collection forms were received. Response rates exceeded 75% at each hospital. Workload variables, including the number of patient visits, new referrals per hour, and the proportion of staff completing unpaid overtime, differed between the hospitals (pholidays (p>0.13). Workload measures varied between clinical service areas at the hospital that provided PWS using a programme-based approach. These findings highlight the important shortcomings of a programme-based management approach to providing PWS and may constitute a catalyst for change.

  13. The provision of weekend physiotherapy services in tertiary-care hospitals in Canada.

    Science.gov (United States)

    Campbell, Lauren; Bunston, Rebecca; Colangelo, Sarah; Kim, Dorothy; Nargi, Jessica; Hill, Kylie; Brooks, Dina

    2010-01-01

    To describe the provision of weekend physiotherapy (PT) services in tertiary-care hospitals in Canada. A prospective cross-sectional survey was conducted across tertiary-care hospitals, defined as those with university affiliation and at least one intensive care unit (ICU). Data were collected via telephone-administered questionnaires addressing hospital demographics, weekend staffing, workload, and weekend referral criteria. A response rate of 84% (n=36) was obtained. Of facilities providing weekend PT services (97%), 35 (100%) provided care on Saturdays, 32 (91%) on Sundays, and 33 (94%) on statutory holidays. Weekend services were staffed using permanent full-time (n=35; 100%) or part-time (n=28; 80%) in-patient staff or outsourced staff (n=1; 3%). The number of physiotherapists available on the weekend was smaller than the number available during the week (p<0.001). Common weekend referral criteria included cardiorespiratory problems (n=35; 100%), postoperative assessment of patients at risk for deterioration (n=32; 91%), and patients scheduled for discharge pending PT assessment (n=30; 86%). Both the scope and the number of staff available to provide PT services were less on the weekend than during the week. Despite the use of common criteria for weekend referral, variability in this service exists. Knowledge pertaining to current weekend PT services provides opportunities for harmonization of service delivery.

  14. Service quality assessment of a referral hospital in Southern Iran with SERVQUAL technique: patients’ perspective

    Science.gov (United States)

    2014-01-01

    Background Providing services to patients according to their expectations and needs is necessary for the success of an organization in order to remain in the competitive market. Recognizing these needs and expectations is an important step in offering high quality services. This study was designed to determine the service quality gap of the main hospital of Hormozgan province. Methods This cross sectional study was conducted in 2013 in Bandar Abbas ShahidMohammadi Hospital in the south of Iran. All 96 participants of this study were provided by SERVQUAL questionnaire. Data was analyzed by Wilcoxon and Kruskal-Wallis tests. Results Service quality gaps were seen in all five service quality dimensions and the overall quality of service. The mean of quality perception score and quality expectation score was 3.44 ± 0.693 and 4.736 ± 0.34, respectively. The highest perception was in assurance dimension and the highest expectation was in Responsiveness and assurance dimensions. Also, the lowest perception was in responsiveness dimension and the lowest expectation was about empathy. In this study, 56.1% of participants defined the quality of services as average. Conclusion According to the results, this hospital was not able to meet patients’ expectations completely. Therefore, action must be taken to decrease the gap between the perception and expectation of the patients. PMID:25064475

  15. Service quality assessment of a referral hospital in southern Iran with SERVQUAL technique: patients' perspective.

    Science.gov (United States)

    Aghamolaei, Teamur; Eftekhaari, Tasnim Eghbal; Rafati, Shideh; Kahnouji, Kobra; Ahangari, Shamsieh; Shahrzad, Mohammad Esmaeil; Kahnouji, Ataollah; Hoseini, Seyedeh Hamideh

    2014-07-27

    Providing services to patients according to their expectations and needs is necessary for the success of an organization in order to remain in the competitive market. Recognizing these needs and expectations is an important step in offering high quality services. This study was designed to determine the service quality gap of the main hospital of Hormozgan province. This cross sectional study was conducted in 2013 in Bandar Abbas ShahidMohammadi Hospital in the south of Iran. All 96 participants of this study were provided by SERVQUAL questionnaire. Data was analyzed by Wilcoxon and Kruskal-Wallis tests. Service quality gaps were seen in all five service quality dimensions and the overall quality of service. The mean of quality perception score and quality expectation score was 3.44 ± 0.693 and 4.736 ± 0.34, respectively. The highest perception was in assurance dimension and the highest expectation was in Responsiveness and assurance dimensions. Also, the lowest perception was in responsiveness dimension and the lowest expectation was about empathy. In this study, 56.1% of participants defined the quality of services as average. According to the results, this hospital was not able to meet patients' expectations completely. Therefore, action must be taken to decrease the gap between the perception and expectation of the patients.

  16. A Survey of Acute Pain Service Structure and Function in United States Hospitals

    Directory of Open Access Journals (Sweden)

    Dawood Nasir

    2011-01-01

    Full Text Available Although the number of U.S. hospitals offering an acute pain service (APS is increasing, the typical structure remains unknown. This survey was undertaken to describe the structure and function of the APS in U.S. hospitals only. We contacted 200 non-teaching and 101 teaching U.S. hospitals. The person in charge of postoperative pain management completed and returned the survey. Seventy-four percent of responding hospitals had an organized APS. An APS was significantly more formally organized in academic/teaching hospitals when compared to non-teaching hospitals. Pain assessments included “pain at rest” (97%, “pain on activity” (63%, and reassessment after pain therapy intervention (88.8%. Responding hospitals utilized postoperative pain protocols significantly more commonly in teaching hospitals when compared to non-teaching and VA hospitals. Intravenous patient controlled analgesia (IV-PCA was managed most commonly by surgeons (75%, while epidural analgesia and peripheral nerve block infusions were exclusively managed by anesthesiologists. For improved analgesia, 62% allowed RNs to adjust the IV-PCA settings within set parameters, 43% allowed RN adjustment of epidural infusion rates, and 21% allowed RN adjustment of peripheral nerve catheter local anesthetic infusion rates.

  17. Intermediate Services After Behavioral Health Hospitalization: Effect on Rehospitalization and Emergency Department Visits.

    Science.gov (United States)

    Fullerton, Catherine A; Lin, Hollis; O'Brien, Peggy L; Lenhart, Gregory M; Crable, Erika L; Mark, Tami L

    2016-11-01

    This study examined the effect of intermediate service use on behavioral health inpatient readmissions and subsequent emergency department (ED) visits among Medicaid enrollees. Data were from fee-for-service inpatient admissions from the 2008 Medicaid Analytic eXtract files for adults with a primary diagnosis of a mental or substance use disorder. A multivariate survival analysis estimated the association between posthospital services-particularly intermediate services (residential, partial hospital, intensive outpatient, and other rehabilitative services)-and time to readmission or ED visit. A propensity score-matched sample was used to examine the relationship between time to readmission and ED visit in the nondisabled and disabled populations more closely. The sample included 32,037 adults (nondisabled, 27.6%; disabled, 72.4%). Only 2.5% of nondisabled adults and 5.4% of disabled adults used intermediate services within seven days of hospital discharge. In the multivariate analysis, significant associations were found between intermediate service use and readmissions and ED visits in the nondisabled population (hazard ratio [HR]=.71, p=.04, and HR=.68, p<.01, respectively), but not in the disabled population. Significant associations were also found between use of other health care in the seven-day posthospitalization period and decreased time to readmission and ED visits in the nondisabled population and increased time to readmission and ED visits in the disabled population. In the propensity score--matched analysis, use of intermediate services was not significant in either population. The low use of intermediate services may reflect limited availability as well as Medicaid coverage limits. Research is needed to determine the optimal number and type of intermediate services for this population to minimize the need for additional hospital services.

  18. Developing a palliative care service for children in the Queen Elizabeth Central Hospital, Blantyre, Malawi.

    Science.gov (United States)

    Molyneux, Elizabeth M; Lavy, Vicky; Bunn, Mary; Palmer, Zoe; Chiputula, Fred

    2013-09-01

    There are too few palliative care services for children in resource poor countries. Health carers are overwhelmed with cases of acute illness that need their urgent attention, and chronically ill children with life-limiting diseases have been sidelined. The HIV epidemic in southern Africa revealed the huge needs in our own hospital, and in 2002, we started a hospital-based paediatric palliative care service. It was the first in Africa. We describe here how it developed and expanded in the ensuing years and how it has affected our staff, the children and their families in our care.

  19. Focus on: ORBIS International Flying Eye Hospital, Department of Technical Services.

    Science.gov (United States)

    Prausnitz, M R; Cordero, I; Levenson, A

    1995-01-01

    The ORBIS International Flying Eye Hospital is dedicated to restoring sight to the blind through medical education programs in developing countries. The modification of a DC-10 aircraft to house a teaching hospital for ophthalmic surgery involved a variety of engineering challenges to satisfy standards for both hospital and aircraft safety. The Technical Services Department maintains all medical equipment on the aircraft, encountering situations not found in traditional clinical engineering departments. Technical education is also an important part of the ORBIS biomedical engineering program. Future plans include expansion of existing technical training efforts, as well as using technology to improve the medical education program as a whole.

  20. Factors Affecting Staff Perceptions of Tele-ICU Service in Rural Hospitals.

    Science.gov (United States)

    Ward, Marcia M; Ullrich, Fred; Potter, Andrew J; MacKinney, A Clinton; Kappel, Sarah; Mueller, Keith J

    2015-06-01

    Telemedicine is designed to increase access to specialist care, especially in settings distant from tertiary-care centers. One of the more established telemedicine applications in hospitals is the tele-intensive care unit (tele-ICU). Perceptions of tele-ICU users are not well studied. Thus, we undertook a study focused on assessing staff acceptance at multiple hospitals that had implemented a tele-ICU system. We designed a survey instrument that gathered perceptions on multiple facets of tele-ICU use and administered it to clinical and administrative staff at 28 hospitals that had implemented a tele-ICU system. We also conducted interviews at half of these hospitals to gain a deeper understanding of factors affecting staff perceptions of tele-ICU services. The 145 survey respondents were generally positive about all facets of the service. Analyses found no significant differences in comparisons between critical access and larger hospitals or between clinical and administrative/managerial respondents, although a few differences between providers and nurses emerged. Respondents at hospitals averaging more tele-ICU use and that had implemented it longer were significantly (phospitals retained critical care patients during special circumstances and when the tele-ICU hub could monitor patients to provide relief for local providers and nurses. Tele-ICU can aid rural hospitals, but multiple delivery models are warranted to meet disparate needs.

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

    Science.gov (United States)

    Pouragha, Behrouz; Zarei, Ehsan

    2016-02-01

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

  2. A systematic review of the methodologies used to evaluate telemedicine service initiatives in hospital facilities.

    Science.gov (United States)

    AlDossary, Sharifah; Martin-Khan, Melinda G; Bradford, Natalie K; Smith, Anthony C

    2017-01-01

    The adoption of telemedicine into mainstream health services has been slower than expected. Many telemedicine projects tend not to progress beyond the trial phase; there are a large number of pilot or project publications and fewer 'service' publications. This issue has been noted since 1999 and continues to be acknowledged in the literature. While overall telemedicine uptake has been slow, some services have been successful. The reporting and evaluation of these successful services may help to improve future uptake and sustainability. The aim of this literature review was to identify peer-reviewed publications of deployed telemedicine services in hospital facilities; and to report, and appraise, the methodology used to evaluate these services. Computerised literature searches of bibliographic databases were performed using the MeSH terms for "Telemedicine" and "Hospital Services" or "Hospital", for papers published up to May 2016. A total of 164 papers were identified, representing 137 telemedicine services. The majority of reported telemedicine services were based in the United States of America (n=61, 44.5%). Almost two thirds of the services (n=86, 62.7%) were delivered by real time telemedicine. Of the reviewed studies, almost half (n=81, 49.3%) assessed their services from three different evaluation perspectives: clinical outcomes, economics and satisfaction. While the remaining half (n=83, 50.6%) described their service and its activities without reporting any evaluation measures. Only 30 (18.2%) studies indicated a two-step implementation and evaluation process. There was limited information in all reported studies regarding description of a structured planning strategy. Our systematic review identified only 137 telemedicine services. This suggests either telemedicine service implementation is still not a part of mainstream clinical services, or it is not being reported in the peer-reviewed literature. The depth and the quality of information were variable

  3. Adoption of robots and service automation by tourism and hospitality companies

    OpenAIRE

    Ivanov, Stanislav; Webster, Craig; Berezina, Katerina

    2018-01-01

    This paper explores the current state and the potential adoption of service automation and robots by tourist, travel and hospitality companies. Despite the huge advancements in social robotics, the research on robots in tourism has been extremely limited – a gap that is partially filled by this paper. Specifically the paper looks at service automation in hotels, restaurants, events, theme and amusement parks, airports, car rental companies, travel agencies and tourist information centres, mus...

  4. Analysis on the Implementation of Nutrition Services in Tugurejo General Hospital Semarang

    OpenAIRE

    Dewi, Emy Shinta; Kartasurya, Martha Irene; Sriatmi, Ayun

    2015-01-01

    Nutrition was an important factor for patient care and cure. Results of an evaluation by nutritionalresearch and development unit of Tugurejo district general hospital (RSUD) in 2011 indicated thatfood remains of patient were still below the minimal standard of service. Objective of this study wasto analyze the implementation of nutritional service in the RSUD Tugurejo Semarang.This was a qualitative study with 4 nutritionists, 8 cook assistants, and 8 waitresses as maininformants. Triangulat...

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

    Directory of Open Access Journals (Sweden)

    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

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

    Science.gov (United States)

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

    2015-05-20

    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. A descriptive cross-sectional study was conducted in 2009/2010. Data were collected from 554 DCSS units among 84 hospitals. 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. 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 strategies in practice, and the application of

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

    Science.gov (United States)

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

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

    Science.gov (United States)

    Alinia, Shahrokh; Khankeh, Hamidreza; Maddah, Sadat Seyed Bagher; Negarandeh, Reza

    2015-10-01

    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. 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. 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. 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.

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

    Science.gov (United States)

    Alinia, Shahrokh; Khankeh, Hamidreza; Maddah, Sadat Seyed Bagher; Negarandeh, Reza

    2015-01-01

    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. PMID:26448954

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

    Directory of Open Access Journals (Sweden)

    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.

  11. Post-abortion and induced abortion services in two public hospitals in Colombia.

    Science.gov (United States)

    Darney, Blair G; Simancas-Mendoza, Willis; Edelman, Alison B; Guerra-Palacio, Camilo; Tolosa, Jorge E; Rodriguez, Maria I

    2014-07-01

    Until 2006, legal induced abortion was completely banned in Colombia. Few facilities are equipped or willing to offer abortion services; often adolescents experience even greater barriers of access in this context. We examined post abortion care (PAC) and legal induced abortion in two large public hospitals. We tested the association of hospital site, procedure type (manual vacuum aspiration vs. sharp curettage), and age (adolescents vs. women 20 years and over) with service type (PAC or legal induced abortion). Retrospective cohort study using 2010 billing data routinely collected for reimbursement (N=1353 procedures). We utilized descriptive statistics, multivariable logistic regression and predicted probabilities. Adolescents made up 22% of the overall sample (300/1353). Manual vacuum aspiration was used in one-third of cases (vs. sharp curettage). Adolescents had lower odds of documented PAC (vs. induced abortion) compared with women over age 20 (OR=0.42; 95% CI=0.21-0.86). The absolute difference of service type by age, however, is very small, controlling for hospital site and procedure type (.97 probability of PAC for adolescents compared with .99 for women 20 and over). Regardless of age, PAC via sharp curettage is the current standard in these two public hospitals. Both adolescents and women over 20 are in need of access to legal abortion services utilizing modern technologies in the public sector in Colombia. Documentation of abortion care is an essential first step to determining barriers to access and opportunities for quality improvement and better health outcomes for women. Following partial decriminalization of abortion in Colombia, in public hospitals nearly all abortion services are post-abortion care, not induced abortion. Sharp curettage is the dominant treatment for both adolescents and women over 20. Women seek care in the public sector for abortion, and must have access to safe, quality services. Copyright © 2014. Published by Elsevier Inc.

  12. Service quality of diagnostic fine needle aspiration cytology in a tertiary care hospital of lahore

    International Nuclear Information System (INIS)

    Rizvi, Z.; Usmani, R.A.; Zahra, T.; Rasool, H.; Rizvi, A.

    2017-01-01

    Quality of any service is the most important aspect for the manufacturer as well as the consumer. The primary objective of any nation's health system is to provide supreme quality health care services to its patients. The objective of this study was to assess the quality of diagnostic fine needle aspiration cytology service in a tertiary care hospital. As Patient's perspectives provide valuable information on quality of process, therefore, patient's perception in terms of satisfaction with the service was measured. Methods: In this cross sectional analytical study, 291 patients undergoing fine needle aspiration cytology in Mayo Hospital were selected by systematic sampling technique. Information regarding satisfaction of patients with four dimensions of service quality process, namely procedure, sterilization, conduct and competency of doctor was collected through interview on questionnaire. The questionnaire was developed on SERVQUAL model, a measurement tool, for quality assessment of services provided to patients. All items were assessed on 2- point likert scale (0=dissatisfied, 1=satisfied). Frequencies and percentages of satisfied and dissatisfied patients were recorded for each item and all items in each dimension were scored. If the percentage of sum of all item scores of a dimension was =60, the dimension was 'good quality'. Whereas <60% was 'poor quality' dimension. Data was analysed using epi-info-3.5.1. Fisher test was applied to check statistical significance. (p-value <0.05) Results: Out of the 4 dimensions of service quality process, Procedure (48.8%), Sterilization (51.5%) and practitioner conduct (50.9%) were perceived as 'poor' by the patients. Only practitioner competency (67.4%) was perceived as 'good'. Comparison of dimensions of service quality scoring with overall level of patient satisfaction revealed that all 4 dimensions were significantly related to patient dissatisfaction (p<.05

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

    Directory of Open Access Journals (Sweden)

    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

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

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    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

  15. [A call for organizational and managerial changes in primary and hospital care services].

    Science.gov (United States)

    Meloni, Cesare

    2005-01-01

    The changing epidemiological situation and socio-economic conditions in Italy have led to a situation where the Italian health care system no longer adequately satisfies the actual needs of society. Organizational and managerial changes in both primary and hospital care are needed and are proposed in this article. As regards general practice and primary healthcare it is crucial that a stable and exclusive relationship between GPs and their patients be regained through continuous and qualified care by the GP. This can be achieved through the establishment of primary care structures where a team of general practitioners work in association with nursing personnel for the delivery of key services including continuous at-home assistance. As for the organization of hospital care it would be useful to set up, in addition to existing general hospitals, "zonal inpatient facilities", resembling the old "infirmaries", directed by a specialized nurse and with a small full-time medical staff. In these facilities, designed for brief hospitalizations of patients with chronic conditions, GPs could take part in the management of their patients. Two important results could be achieved by establishing such facilities: a substantial reduction of healthcare costs related to frequent hospitalizations of patients with chronic medical conditions, and a structural reorganization of existing hospitals. Presently hospitals are often too large especially considering the continuous progresses made in diagnostic and therapeutic techniques which allow consistently shorter lengths of hospital stay and consequently, a more rapid turnover of patients.

  16. 'Being a conduit' between hospital and home: stakeholders' views and perceptions of a nurse-led Palliative Care Discharge Facilitator Service in an acute hospital setting.

    Science.gov (United States)

    Venkatasalu, Munikumar Ramasamy; Clarke, Amanda; Atkinson, Joanne

    2015-06-01

    To explore and critically examine stakeholders' views and perceptions concerning the nurse-led Palliative Care Discharge Service in an acute hospital setting and to inform sustainability, service development and future service configuration. The drive in policy and practice is to enable individuals to achieve their preferred place of care during their last days of life. However, most people in UK die in acute hospital settings against their wishes. To facilitate individuals' preferred place of care, a large acute hospital in northeast England implemented a pilot project to establish a nurse-led Macmillan Palliative Care Discharge Facilitator Service. A pluralistic evaluation design using qualitative methods was used to seek stakeholders' views and perceptions of this service. In total, 12 participants (five bereaved carers and seven health professionals) participated in the evaluation. Semi-structured interviews were conducted with bereaved carers who used this service for their relatives. A focus group and an individual interview were undertaken with health professionals who had used the service since its inception. Individual interviews were also conducted with the Discharge Facilitator and service manager. Analysis of all data was guided by Framework Analysis. Four key themes emerged relating to the role of the Discharge Facilitator Service: achieving preferred place of care; the Discharge Facilitator as the 'conduit' between hospital and community settings; delays in hospital discharge and stakeholders' perceptions of the way forward for the service. The Discharge Facilitator Service acted as a reliable resource and support for facilitating the fast-tracking of end-of-life patients to their preferred place of care. Future planning for hospital-based palliative care discharge facilitating services need to consider incorporating strategies that include: increased profile of the service, expansion of service provision and the Discharge Facilitator's earlier

  17. [Analysis of the technical efficiency of hospitals in the Spanish National Health Service].

    Science.gov (United States)

    Pérez-Romero, Carmen; Ortega-Díaz, M Isabel; Ocaña-Riola, Ricardo; Martín-Martín, José Jesús

    To analyse the technical efficiency and productivity of general hospitals in the Spanish National Health Service (NHS) (2010-2012) and identify explanatory hospital and regional variables. 230 NHS hospitals were analysed by data envelopment analysis for overall, technical and scale efficiency, and Malmquist index. The robustness of the analysis is contrasted with alternative input-output models. A fixed effects multilevel cross-sectional linear model was used to analyse the explanatory efficiency variables. The average rate of overall technical efficiency (OTE) was 0.736 in 2012; there was considerable variability by region. Malmquist index (2010-2012) is 1.013. A 23% variability in OTE is attributable to the region in question. Statistically significant exogenous variables (residents per 100 physicians, aging index, average annual income per household, essential public service expenditure and public health expenditure per capita) explain 42% of the OTE variability between hospitals and 64% between regions. The number of residents showed a statistically significant relationship. As regards regions, there is a statistically significant direct linear association between OTE and annual income per capita and essential public service expenditure, and an indirect association with the aging index and annual public health expenditure per capita. The significant room for improvement in the efficiency of hospitals is conditioned by region-specific characteristics, specifically aging, wealth and the public expenditure policies of each one. Copyright © 2016 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

  18. Improved Clinical Efficacy with Wound Support Network Between Hospital and Home Care Service.

    Science.gov (United States)

    Bergersen, Tone Kristin; Storheim, Elisabeth; Gundersen, Stina; Kleven, Linn; Johnson, Maria; Sandvik, Leiv; Kvaerner, Kari Jorunn; Ørjasæter, Nils-Otto

    2016-11-01

    The aim of this study was to test the efficacy of a wound support network model between the primary home care service and the hospital. The impact on wound healing rate, cost benefit, and transfer of knowledge was investigated. The intervention group was exposed to a wound support network (n = 32), and the control group continued standard organization of treatment (n = 21). Nonrandomized controlled study; observations were made before (baseline) and after the implementation of the intervention (12 weeks). Patients with chronic wounds (lasting >6 weeks and with wound area >1 cm) in Oslo, Norway. Closure of the observation wound; wound size; total number of wounds; presence of eczema, edema, and pain; number of dressings per week; time spent per dressing; and number of control appointments at the hospital. The economic impact is calculated for the hospital and for the community of Oslo, Norway. The number of control appointments (t = 3.80, P observational wound (46.7% cases in the intervention group versus 25.0% in the control group). A wound support network between the primary home care service and the hospital is cost-effective, improves clinical efficacy of the home care services' work, and reduces the need for consultations at the hospital.

  19. CURRENT TRENDS IN HOSPITALITY INDUSTRY

    Directory of Open Access Journals (Sweden)

    Ivica Batinić

    2013-10-01

    Full Text Available Hospitality industry is a complex product-service economic activity which besides accommodation, food and beverages offers a variety of complementary and ancillary services in order to meet modern needs, demands and desires of tourists consumers. Contemporary needs, demands and desires of tourists consumers (increased need for security and preservation of health; emphasis on ecology and healthy food; pure nature stay; growing demand for adventure activities and excitement; convention facilities and incentive offerings; visits to towns, big sports, cultural, religious, business events; new travel motivation have led to the emergence of new trends in hospitality offering design. Wellness and spa hotels, boutique hotels, all inclusive hotels, slow-food restaurants, and wine and lounge bars are just some of the main trends, and successful hoteliers and caterers will examine each of the trends and devise development politics in accordance with the new requirements and global market needs.

  20. Development of a Process to Internationalize Occupational Programs in the Consumer and Hospitality Services Division.

    Science.gov (United States)

    Advincula-Carpenter, Marietta M.

    The purpose of a practicum project was to develop a process to internationalize occupational programs in the consumer and hospitality services division (CHSD). Five procedures were used to complete the project. First, a review of literature was conducted on how other colleges had internalized their courses. It included some research and practices…

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

    Science.gov (United States)

    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…

  2. Hospitality Services. Curriculum Guide [and] Student Activity Book [and] Reference Book.

    Science.gov (United States)

    Texas Tech Univ., Lubbock. Curriculum Center for Family and Consumer Sciences.

    These three publications comprise a course that provides occupationally specific training designed to develop knowledge and skills for employment in the multifaceted hospitality services industry. The curriculum guide is the teacher component of the series. Contents include the Texas Essential Knowledge and Skills (TEKS); sample course outlines;…

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

    NARCIS (Netherlands)

    Boerkamp, E.J.C.; Reuijl, J.C.; Haaijer-Ruskamp, F.M.

    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

  4. Measuring innovation in a 'low-tech' service industry: the case of the Dutch hospitality industry

    NARCIS (Netherlands)

    den Hertog, P.; Gallouj, F.; Segers, J.

    2011-01-01

    This article presents the findings of a survey among 613 firms in the Dutch hospitality industry adopting a demarcation perspective. The paper illustrates that innovation in this service industry is much higher and more varied than regularly reported. It further indicates that innovation activities

  5. Estimating the financial savings from maintaining the level of acute services with fewer hospital beds.

    Science.gov (United States)

    Beech, R; Larkinson, J

    1990-01-01

    All district health authorities are obliged to use resources most efficiently. One approach to increasing efficiency is to identify measures which allow service levels, in terms of patients treated and standards of care, to be maintained at a lower cost. This could be achieved by maintaining service levels with fewer hospital beds. Reducing lengths of stay by removing organizational delays and expansions of day-case care, are policies which can increase patient caseload per bed. This paper puts forward an approach for estimating the resources released by such policies and assesses the savings achieved by realizing efficiency gains identified in a previous study by Beech et al. (1987). That study identified significant potential for maintaining services with fewer beds, with the expansion of day-case care being a key mechanism. However this paper concludes that when services are maintained with fewer beds, the vast majority of hospital costs remain fixed. It also reaches the alarming conclusion that as a vehicle for reducing costs, day-case care is much less effective than previous studies have implied. However, increasing hospital throughput per bed does release capacity to treat more patients. The proposed reforms of the NHS (Secretaries of State, 1989) envisage an internal market for health care, allowing hospitals to enter into contracts with purchasers of health care. The approach to costing described in this paper is applicable to assessing the increased costs associated with such developments. These extra costs can then be compared with expected income.

  6. Evaluation of outsourcing in nursing services: a case study of kashani hospital, isfahan in 2011.

    Science.gov (United States)

    Ferdosi, Masoud; Farahabadi, Ehsan; Mofid, Maryam; Rejalian, Farzaneh; Haghighat, Maryam; Naghdi, Parnaz

    2013-03-01

    Hospitals need to focus on their core activities, thus outsourcing of services may be effective in some instances. However, monitoring and supervision is a vital mechanism to preserving and enhancing the quality of outsourced services, and to identify the benefits and losses occurred. The purpose of this study is evaluation of nursing services outsourced in a general hospital from different point of views. This is a descriptive and applied study done by case study (before and after) method. Outsourcing nursing services of clinical wards (ENT and Neurosurgery) of Kashani Hospital in 2011 has been studied. We extracted data from a handmade questionnaire about internal customer's satisfaction and semi-structured interviews with officials, and also survey of financial and administrative documents and records related to the topic. The findings indicate an increased number of graduated nurses per bed to fulfill the main objective of outsourcing in this case. But achieving this objective is accompanied with remarkable increased costs per bed after outsourcing. Besides, we noticed minor changes in internal customer satisfaction rate. While outsourcing should bring about staff and patients' satisfaction and increase the efficiency and effectiveness, outsourcing nursing workforce singly, leaded to a loss of efficiency. Therefore, the applied outsourcing has not met the productivity for the hospital.

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

    Science.gov (United States)

    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…

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

    Science.gov (United States)

    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,…

  9. 26 CFR 1.513-6 - Certain hospital services not unrelated trade or business.

    Science.gov (United States)

    2010-04-01

    ... 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 exceed... for each of the months included in the taxable year of the hospital duringwhich the captial goods are...

  10. Evaluation of Outsourcing in Nursing Services: A Case Study of Kashani Hospital, Isfahan in 2011

    Science.gov (United States)

    Ferdosi, Masoud; Farahabadi, Ehsan; Mofid, Maryam; Rejalian, Farzaneh; Haghighat, Maryam; Naghdi, Parnaz

    2013-01-01

    Background: Hospitals need to focus on their core activities, thus outsourcing of services may be effective in some instances. However, monitoring and supervision is a vital mechanism to preserving and enhancing the quality of outsourced services, and to identify the benefits and losses occurred. The purpose of this study is evaluation of nursing services outsourced in a general hospital from different point of views. Methods: This is a descriptive and applied study done by case study (before and after) method. Outsourcing nursing services of clinical wards (ENT and Neurosurgery) of Kashani Hospital in 2011 has been studied. We extracted data from a handmade questionnaire about internal customer’s satisfaction and semi-structured interviews with officials, and also survey of financial and administrative documents and records related to the topic. Results: The findings indicate an increased number of graduated nurses per bed to fulfill the main objective of outsourcing in this case. But achieving this objective is accompanied with remarkable increased costs per bed after outsourcing. Besides, we noticed minor changes in internal customer satisfaction rate. Conclusion: While outsourcing should bring about staff and patients’ satisfaction and increase the efficiency and effectiveness, outsourcing nursing workforce singly, leaded to a loss of efficiency. Therefore, the applied outsourcing has not met the productivity for the hospital. PMID:23678338

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

    Directory of Open Access Journals (Sweden)

    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.

  12. The health services wastes management of a sample of brazilian hospitals

    Directory of Open Access Journals (Sweden)

    Claude Machline

    2006-07-01

    Full Text Available This paper focuses the Health Services wastes management of 70 Brazilian hospitals. As the outcome of a distance course, in 2003, each hospital was required to describe its existing Health Services wastes system and its Plan for improvement.The project was administered by an association of two leading Brazilian educational entities, the Fundação Getulio Vargas and the Universidade Federal de Santa Catarina. Data concerning collection, disposal and final treatment of infectious, hazardous, chemical, radioactive and common wastes were tabulated and analysed. Water supply, liquid effluents and gaseous emissions were also investigated..Their technical and economical aspects were appraised. The research indicates that the sampled hospitals are still in an incipient stage of wastes management. An extensive gap exists between the present situation and the legal and acceptable requirements they should comply with, both on health care and on environmental standpoints.

  13. Changes in paediatric hospital ENT service utilisation following the implementation of a mobile, indigenous health screening service.

    Science.gov (United States)

    Smith, Anthony C; Armfield, Nigel R; Wu, Wei-I; Brown, Cecil A; Mickan, Brooke; Perry, Chris

    2013-10-01

    In 2009, we established a mobile ear-screening service for children in a remote community approximately 350 km north-west of Brisbane. We compared pre-implementation health service utilisation data (2006-2008) with data for the following three years. The study included only children in schools that had participated in screening since the start of the screening programme and for which data for the 6-year study period were available. In the baseline period there were 329 ear, nose and throat (ENT) outpatient appointments at the Royal Children's Hospital (RCH) in Brisbane for children from the selected catchment area. Of these, 166 (51%) were failure-to-attends (FTAs). In the following three years, there were 105 appointments, of which 40 (38%) were FTAs. In the baseline period, 100 children received surgical procedures at the RCH; in the following three years there were 43. In the three years following implementation, 136 children were booked to receive surgical procedures locally at the Cherbourg hospital, and 117 (86%) were completed. Since no other major health service changes occurred in the region during the study period, we conclude that the telemedicine-enabled screening service improved access to specialist care in the community and resulted in fewer outpatient and surgical appointments at the tertiary centre in Brisbane.

  14. An investigation Into Traditional Chinese Medicine Hospitals in China: Development Trend and Medical Service Innovation.

    Science.gov (United States)

    Wang, Liang; Suo, Sizhuo; Li, Jian; Hu, Yuanjia; Li, Peng; Wang, Yitao; Hu, Hao

    2016-06-07

    This paper aims to investigate the development trend of traditional Chinese medicine (TCM) hospitals in China and explore their medical service innovations, with special reference to the changing co-existence with western medicine (WM) at TCM hospitals. Quantitative data at macro level was collected from official databases of China Health Statistical Yearbook and Extracts of Traditional Chinese Medicine Statistics. Qualitative data at micro level was gathered through interviews and second-hand material collection at two of the top-level TCM hospitals. In both outpatient and inpatient sectors of TCM hospitals, drug fees accounted for the biggest part of hospital revenue. Application of WM medical exanimation increased in both outpatient and inpatient services. Even though the demand for WM drugs was much higher in inpatient care, TCM drugs was the winner in the outpatient. Also qualitative evidence showed that TCM dominated the outpatient hospital service with WM incorporated in the assisting role. However, it was in the inpatient medical care that WM prevailed over TCM which was mostly applied to the rehabilitation of patients. By drawing on WM while keeping it active in supporting and strengthening the TCM operation in the TCM hospital, the current system accommodates the overriding objective which is for TCM to evolve into a fully informed and more viable medical field. © 2017 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

  16. Room service improves patient food intake and satisfaction with hospital food.

    Science.gov (United States)

    Williams, R; Virtue, K; Adkins, A

    1998-07-01

    Cancer therapy causes side effects that interfere with oral intake. Frequently, patients undergoing such therapy suffer from anorexia, nausea, vomiting, food aversions, dysgeusia, and xerostomia, all which adversely affect oral intake. Adequate nutrition intake is an important part of therapy for the cancer patient, especially when that patient is a child. Children who are well nourished are better able to withstand infection and tolerate therapy. Parents and staff at our hospital have worked diligently to improve patient's oral intake with limited success. Hence, a multidisciplinary team was organized to develop a new approach to food services that would improve patients' oral intake. The team initiated patient "room service," and patients were allowed to call the kitchen when they were ready to eat. The system works much like room service in a hotel. After the introduction of room service, patients' caloric intake improved significantly (P = .008), and protein intake increased by 18%. Patient satisfaction with hospital food service also improved; excellent ratings increased by as much as 35%. We conclude that room service is a viable alternative to traditional food services in the pediatric oncology setting and may be useful in other patient populations, such as maternity and general pediatrics.

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

    LENUS (Irish Health Repository)

    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.

  18. Status of Medical Library Resources and Services in Teaching Hospitals in Enugu State, Nigeria: implications for quality health care services

    Directory of Open Access Journals (Sweden)

    Oluchi C. Okeke

    2017-06-01

    Full Text Available Considering the need for quality health information and resultant health care services in any society, this study was carried out to look into the status of library and information resources and services provided by medical libraries in Enugu State, Nigeria. The main objective of the study was to find out the information resources and services available for medical library users towards quality health care provision. Five (5 medical libraries of major teaching hospitals were used for the study with 980 registered users as the study population from where 245 users were sampled. Observation checklist was used to collect data on resources while questionnaire was used to collect data from the respondents on the services provided. The Medical Library Association Standard guided the analysis of data from observation while frequency counts and mean scores were used to analyze data from the questionnaire. Major findings showed that even though some of the required resources and services are available and provided the medical libraries, most of the required resources and services are not adequately provided by these libraries.

  19. Psychiatric social workers in legal aid services in hospitals: Exploring roles in Indian context

    Directory of Open Access Journals (Sweden)

    Priya Treesa Thomas

    2017-01-01

    Full Text Available Mental health and legal problems are interlinked in many ways. People facing legal issues may develop mental health problems, and people with mental illness and family also face legal issues. In India, Legal Services Authorities Act, 1987 gives provision for free legal aid services for the poor sections of society. Authors explain the roles of psychiatric social workers in legal aid services in hospitals. Social case work as a method of social work is suitable in legal aid services. Counseling, referrals, collateral contacts, advocacy and networking are major services from the social work perspective. Knowledge about laws and mental illness is essential for social workers to work in legal aid clinics (LACs.

  20. Using standard treatment protocols to manage costs and quality of hospital services.

    Science.gov (United States)

    Meyer, J W; Feingold, M G

    1993-06-01

    The current health care environment has made it critically important that hospital costs and quality be managed in an integrated fashion. Promised health care reforms are expected to make cost reduction and quality enhancement only more important. Traditional methods of hospital cost and quality control have largely been replaced by such approaches as practice parameters, outcomes measurement, clinical indicators, clinical paths, benchmarking, patient-centered care, and a focus on patient selection criteria. This Special Report describes an integrated process for strategically managing costs and quality simultaneously, incorporating key elements of many important new quality and cost control tools. By using a multidisciplinary group process to develop standard treatment protocols, hospitals and their medical staffs address the most important services provided within major product lines. Using both clinical and financial data, groups of physicians, nurses, department managers, financial analysts, and administrators redesign key patterns of care within their hospital, incorporating the best practices of their own and other institutions. The outcome of this process is a new, standardized set of clinical guidelines that reduce unnecessary variation in care, eliminate redundant interventions, establish clear lines of communication for all caregivers, and reduce the cost of each stay. The hospital, medical staff, and patients benefit from the improved opportunities for managed care contracting, more efficient hospital systems, consensus-based quality measures, and reductions in the cost of care. STPs offer a workable and worthwhile approach to positioning the hospital of the 1990s for operational efficiency and cost and quality competitiveness.

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

    Science.gov (United States)

    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.

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

    Science.gov (United States)

    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

  3. The Cost of Medical Services per Patient and the Efficiency of Hospital Care Activity – an Insight from the Romanian Hospitals

    Directory of Open Access Journals (Sweden)

    Violeta ISAI

    2016-09-01

    Full Text Available The cost of medical services is a concept which cannot be overlooked from the managerial strategy of hospitals, given the fact that it reflects the expenses incurred in order to make the medical act possible. It adds up the direct and indirect costs which are recorded under hospital departments, regarded as cost centres. The result of the calculation is materialized in Expenses Settlement drawn for every discharged patient. The cost thus determined underlies the calculation of efficiency, both at hospital level and at each department and helps at conducting comparative analyses between different health care institutions. In fact, hospital financing is based on average costs established per case, according to the diagnosis groups. The financing system allows monitoring the quality of services and increasing efficiency through cost control. The present study analyses the calculation of the cost of medical services and of the efficiency for average level hospitals from Romania.

  4. Chi-Square Test of Word of Mouth Marketing with Impact on the Evaluation of Patients' Hospital and Services: An Application in Teaching and Research Hospital

    Directory of Open Access Journals (Sweden)

    Yelda ŞENER

    2014-12-01

    Full Text Available The purpose of this study, using data provided from 223 inpatients in a teaching and research hospital, hospital’s preference is to explain the effect of word of mouth marketing. For this purpose, word of mouth marketing process is evaluated in terms of providing information about the hospital and the patient’s level of intimacy, both of patients and information provider’s level of expertise with related to hospital and services, the patient’s perceived level of risk for hospitals and services and providing information’s level of impact on patient being treated in hospital. The obtain data, after evaluation by frequency distributions these factors impact on word of mouth marketing is demonstrated by descriptive statistics, chi-square analysis and pearson’s correlation analysis. As a result of this study is concluded word of mouth marketing on the training and research hospital is preferred by the patints to have a significant impact.

  5. Patient satisfaction regarding eye care services at tertiary hospital of central India

    Directory of Open Access Journals (Sweden)

    Anand Sudhan

    2011-01-01

    Study Design : Descriptive study. Materials and Methods : This study was conducted between September 2005 and June 2006. Patients attending the eye clinic of Sadguru Netra Chikitsalaya, Chitrakoot, Madhya Pradesh, India, and admitted as in-patients in this hospital were our study population. Randomly selected patients were interviewed by trained staff. Close-ended questionnaire was used to conduct these structured interviews. Their responses were grouped into one of five categories and evaluated to determine satisfaction for different components of eye care services. Results : Three hundred and twenty persons were interviewed. The satisfaction was of excellent grade among 77 (48.1% patients attending clinic and 156 (97.5% patients who were admitted in the hospital. The participants expressed dissatisfaction for the long waiting period in clinics, poor cleanliness, and insufficient toilet facilities. Those admitted in the hospital felt that food facilities were less than the expected quality. Child-friendly facilities received high satisfaction scores. Conclusion : Although eye care services both in clinics and in the wards were satisfactory according to the end-users, there are scopes for improvement. Patient satisfaction surveys should be encouraged in hospitals for better accountability and also for strengthening the quality of eye care services.

  6. Organizational characteristics associated with cultural and linguistic service provision within Alabama hospitals.

    Science.gov (United States)

    Davis, Jullet A; Whitman, Marilyn V

    2008-01-01

    Like several states in the Southeast, Alabama is in the nascent stages of an increase in the population of foreign-born individuals for whom English is a second language. These individuals are also culturally different from the traditional southern population. Given the impact of culture and language on a person's service utilization, the introduction of new cultures may pose significant challenges for Alabama's health care providers if they are not prepared. The purpose of this project is to examine the organizational characteristics associated with the provision of culturally and linguistically appropriate services by Alabama hospitals. The data for the project come from a survey of all medical/surgical hospitals (N = 101). Fifty-nine surveys were returned, giving us a 58% response rate. The data were analyzed using correlations, analysis of variance, and logistic regression. Approximately 47% of the sample hospitals reported having a staff interpreter. Furthermore, hospitals that had staff interpreters did seem to be more aware of their community, which was reflected in their mission statements. In addition, directors who viewed their role as fulfilling the strategic plan accepted the task of providing staff interpreters. Thus, several hospitals in Alabama seemed to be ready to meet the cultural and language needs of their markets.

  7. 16 CFR 1.62 - Ancillary court orders pending review.

    Science.gov (United States)

    2010-01-01

    ... 16 Commercial Practices 1 2010-01-01 2010-01-01 false Ancillary court orders pending review. 1.62 Section 1.62 Commercial Practices FEDERAL TRADE COMMISSION ORGANIZATION, PROCEDURES AND RULES OF PRACTICE GENERAL PROCEDURES Injunctive and Condemnation Proceedings § 1.62 Ancillary court orders pending review...

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Science.gov (United States)

    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.

  10. Effect of the implementation of the mixed cafeteria system in a hospital nutrition and dietetic service.

    Science.gov (United States)

    Carvalho, Kamila Pires de; Martins, Flaviana Pereira de Oliveira; Custódio, Isis Danyelle Dias; Lima, Emanuelle Do Nascimento Santos; Souza, Daniela Nogueira Prado de; Maia, Yara Cristina de Paiva

    2017-10-24

    The type of service offered by the nutrition and dietetics service (NDS) of a hospital has a direct impact on food waste. To evaluate waste in the transition from a simple to a mixed cafeteria service. The study was carried out in a NDS of a University Hospital during 60 days (30 days for each type of service). The meals prepared and distributed and the leftovers of lunch and dinner were weighed. Per capita values of non-usable leftovers were below the acceptable range (7-25 g), not varying with the service transition (p = 0.3) at lunch. At dinner, on the contrary, values were above the acceptable range, with a median of 190 g and 202 g, also showing no difference with the service modification (p = 0.5). At lunch, with the transition, there was a reduction in the plate waste-ingestion (p foods (p = 0.007). At dinner, there was a reduction in the plate waste-ingestion (p food handlers and supervisors, implementation of standardized operating procedures and cost control in order to reduce waste, which has an economic, social and political impact.

  11. Measuring patients' satisfaction with pharmaceutical services at a public hospital in Qatar.

    Science.gov (United States)

    Khudair, Imran Fahmi; Raza, Syed Asif

    2013-01-01

    The aim of this paper is to study pharmacy service impact on patient satisfaction and to determine what factors saliently link with pharmaceutical service performance at Hamad General Hospital. A patient satisfaction questionnaire was designed using the literature and consultation with Hamad General Hospital medical experts. The questionnaire contained 22 items that focused on five influencing factors: promptness; attitude; supply; location; medication education; and respondent demographic aspects. A total of 220 respondents completed the questionnaire. An exploratory factor analysis was used to group items and a structural equation model was developed to test causality between five factors along with their influence on patient satisfaction. The study establishes statistical evidence that patient satisfaction is positively influenced by service promptness, pharmacist attitude, medication counseling, pharmacy location and waiting area. Several socio-demographic characteristics have statistically different effect on satisfaction, notably: gender; marital status; health status; age; educational level; and ethnicity. However, medication supply did not influence patient satisfaction. Pharmaceutical services are recognized as an essential healthcare-system component. Their impact on customer satisfaction has been investigated in many countries; however, there is no such study in Qatar. The findings identify pharmaceutical service performance indicators and provide guidelines to improve Qatari pharmaceutical services.

  12. Patient's perceptions about the service quality of public hospitals located at District Kohat.

    Science.gov (United States)

    Aman, Bakhtiar; Abbas, Faisal

    2016-01-01

    To determine patients' perception regarding service and quality of healthcare at public-sector institutions. The descriptive quantitative study was conducted in Kohat district, Pakistan, between July and December 2014, and focussed on 30 variables to assess the participants' perceptions of the actual healthcare service quality delivered. SERVQUAL instrument was used to measure the reliability and cronbach alpha was calculated to measure the reliability and validity of the instrument. A total of 200 questionnaires were distributed and 157(78.5%) were received back fully filled. Of them, 105(67%) were men and 52(33%) were women.The mean value of Assurance parameter was 3.05±0.88, indicating trust in public hospitals was high as they had experienced and capable doctors. On the other hand, the lowest mean value of 2.61±0.84 was for Empathy, highlighting the fact that public hospitals lacked the ability to handle patients' problem properly, services were not offered in time and they were short of staff. Public hospitals were largely seen as failing to deliver quality service.

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

    Science.gov (United States)

    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.

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

    Science.gov (United States)

    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. Development of a nurse case management service: a proposed business plan for rural hospitals.

    Science.gov (United States)

    Adams, Marsha Howell; Crow, Carolyn S

    2005-01-01

    The nurse case management service (NCMS) for rural hospitals is an entrepreneurial endeavor designed to provide rural patients with quality, cost-effective healthcare. This article describes the development of an NCMS. A detailed marketing and financial plan, a review of industry trends, and the legal structure and risks associated with the development of the venture are presented. The financial plan projects a minimum savings of 223,200 dollars for rural institutions annually. To improve quality and reduce cost for rural hospitals, the authors recommend implementation of an NCMS.

  16. Hospitalization Among HIV-Infected U.S. Marshals Service Prisoners.

    Science.gov (United States)

    Price, Valisha D; Swanson, Barbara A; Jegier, Briana J; Phillips, Janice; Swartout, Kathryn; Fogg, Louis

    2016-10-01

    The U.S. Marshals Service (USMS) prisoner population is diverse and includes immigration violators, fugitives that have evaded apprehension, perpetrators of Medicaid fraud, and parole and probation violators. Unlike state and local jails, the USMS has numerous housing options for its prisoners. Given the unique characteristics, federal prisoners' quality of care, and subsequent clinical outcomes, may differ from those of state and local inmates. However, little is known about hospitalization rates and length of stay for HIV-positive USMS prisoners. The purpose of this study is to examine hospitalizations among HIV-infected prisoners in the custody of the USMS. © The Author(s) 2016.

  17. [Decentralized psychiatry. Evaluation of the first 5 years of psychiatric service based on a general hospital].

    Science.gov (United States)

    Saameli, W; Kopp, W

    1990-11-01

    In 1977 the state parliament of Berne took the decision to reform the existing psychiatric health care. decentralized, community oriented institutions were to be established with the aim of preventing secondary disabilities due to psychiatric illness, and of enhancing or instigating rehabilitative measures. 4 different psychiatric services based in general hospitals were installed. The present report presents an analysis of statistical data collected during the first 5 years on one of these services. We found a linear increase of admission which appears to be due to several factors: demand, image, manpower, cooperation with other institutions, breadth of the offered service. Furthermore, the distance between the institution and the place of living proved to be an important factor influencing the incidence of psychiatric treatment and the degree of cooperation with other care services--this aspect being consistent with the arguments for a decentralization of care. The degree of consistency in the distribution of diagnoses and the changes of treatment was surprising: an average of 50% of our patients were referred on an out-patient basis, approx. 40% by general hospital wards, 16% remain under the care of the general hospital. Our statistical analysis shows that in an average of 61% of the cases in which a referral to a psychiatric hospital was discussed, this measure could be avoided (although there is a certain degree of subjectivity in this judgement). The psychiatric service does not appear to compete with private practice care: 44% of the patients are referred to general practitioners and practing psychiatrists for after care, while only half as many are referred from private practices.

  18. [Extended medical services to the inpatient sector--"medical services on individual demand" in the hospital. General legal conditions, 10 basic rules, and practical examples].

    Science.gov (United States)

    Kersting, Thomas; Pillokat, Alexander

    2006-01-01

    Today, extended medical services--previously known in the context of ambulant healthcare provision or plastic surgery only--are increasingly being offered by hospitals. Hospitals have started to offer these services with good reason: in times of budgetary restraints they want to exploit this emerging new market due to economic necessities and they try to meet rising demands from patients. It is not easy to draw the line between special (extended) medical services and general hospital services. These different categories need to be kept apart, though. Special contracts for these specific extended medical services have to be entered into by hospital and patient in any case where the hospital wants to charge him later on. Different preconditions are to be considered with patients insured by statutory health insurance companies and privately insured patients. The price of extended medical services must be carefully calculated and, in particular, has to be related to the price charged from patients insured via statutory health insurance. Attention should also be paid to other aspects such as taxes, liability law, and hospital subsidisation. The present article presents some basic rules for offering extra medical services in a hospital.

  19. Predicting the decisions of hospital based child protection teams to report to child protective services, police and community welfare services.

    Science.gov (United States)

    Benbenishty, Rami; Jedwab, Merav; Chen, Wendy; Glasser, Saralee; Slutzky, Hanna; Siegal, Gil; Lavi-Sahar, Zohar; Lerner-Geva, Liat

    2014-01-01

    This study examines judgments made by hospital-based child protection teams (CPTs) when determining if there is reasonable suspicion that a child has been maltreated, and whether to report the case to a community welfare agency, to child protective services (CPS) and/or to the police. A prospective multi-center study of all 968 consecutive cases referred to CPTs during 2010-2011 in six medical centers in Israel. Centers were purposefully selected to represent the heterogeneity of medical centers in Israel in terms of size, geographical location and population characteristics. A structured questionnaire was designed to capture relevant information and judgments on each child referred to the team. Bivariate associations and multivariate multinomial logistic regressions were conducted to predict whether the decisions would be (a) to close the case, (b) to refer the case to community welfare services, or (c) to report it to CPS and/or the police. Bivariate and multivariate analyses identified a large number of case characteristics associated with higher probability of reporting to CPS/police or of referral to community welfare services. Case characteristics associated with the decisions include socio-demographic (e.g., ethnicity and financial status), parental functioning (e.g., mental health), previous contacts with authorities and hospital, current referral characteristics (e.g., parental referral vs. child referral), physical findings, and suspicious behaviors of child and parent. Most of the findings suggest that decisions of CPTs are based on indices that have strong support in the professional literature. Existing heterogeneity between cases, practitioners and medical centers had an impact on the overall predictability of the decision to report. Attending to collaboration between hospitals and community agencies is suggested to support learning and quality improvement. Copyright © 2013 Elsevier Ltd. All rights reserved.

  20. Improving service quality of hospital front office using an integrated Kano model and quality function deployment

    Directory of Open Access Journals (Sweden)

    Anjar Priyono

    2017-11-01

    Full Text Available Purpose: The aims of this study are twofold: first, it attempts to investigate service attributes in a hospital front office; and second, to identify strategies to improve those service attributes. Design/methodology/approach: This study used integration of Quality Function Deployment and Kano Model. The research instrument, which takes the SERVQUAL model as its starting point, was developed using a comprehensive set of techniques, including a literature review of relevant topics, interviews and focus group discussions. Using a sample of 140 customers of an international hospital situated in Yogyakarta, Indonesia, 14 service attributes required by customers were identified. The attributes, which were further categorised into 5 attractive, 4 one-dimensional and 5 ‘must-be’ attributes, were analysed using the Kano Model. Findings: Using the integrated QFD and Kano Model, the service attributes needed for improvement were identified. The results are different from those when the company used either SERVQUAL or QFD alone. This study also reveals that benchmarking with competitor might produce misleading results. The results are different when the analysis combined a comprehensive method of QFD and Kano Model. Practical implications: Service providers will benefit from the findings of this study, as both the service attributes and technical requirements that require improvement as a priority are identified. Originality/value: It is the first time that front office quality of hospital is examined using integrated method of SERVQUAL, QFD and Kano Model. The recommendations proposed from this comprehensive method offer novel solution that has never been found in existing study.

  1. Client perception of service quality at the outpatient clinics of a General hospital in Lagos, Nigeria.

    Science.gov (United States)

    Ogunnowo, Babatunde Enitan; Olufunlayo, Tolulope Florence; Sule, Salami Suberu

    2015-01-01

    Service quality assessments have assumed increasing importance in the last two decades. They are useful in identifying gaps in services been provided with the ultimate aim of guaranteeing quality assurance. The objective of this study was to assess the client perception of service quality at the outpatient clinics of Randle General hospital, Lagos. A descriptive cross sectional study was conducted from March to May 2013. A multistage sampling technique was used to select respondents and data was collected with the aid of modified SERVQUAL questionnaires. The data was analysed with aid of EPI-INFO 2002 and statistical significance was set at a P value 0.05 for statistical significance. Total of 400 respondents were interviewed. The mean age was 40 years with a standard deviation of 15.2 yrs. The highest mean score of 4.35 out of a possible maximum of 5 was recorded in assurance domain while the lowest mean score of 4.00 was recorded in the responsiveness domain. The overall mean score of all the domains was 4.20 with standard deviation of 0.51. Overall majority (80.8%) of respondents rated the overall service quality as good/ very good. After linear regression, the assurance domain was the most important predictor of the overall perceived service quality (p< 0.001). The overall perceived service quality was good. The major deficiencies were in the responsiveness domain and especially the waiting time. The hospital management should implement measures to improve the responsiveness of services by ensuring prompt delivery of services.

  2. Therapeutic activities in mental health extra-hospital services: the inclusion of psychosocial actions

    Directory of Open Access Journals (Sweden)

    Regina Célia Fiorati

    2012-09-01

    Full Text Available Two studies were carried out in Ribeirao Preto, State of Sao Paulo, Brazil, in two extra-hospital mentalhealth services: one regional mental health outpatient clinic and one psychosocial care center. The purpose of thisresearch was to study the organization of the extra-hospital and therapeutic projects of these services, and theinclusion of psychosocial rehabilitation in such projects. The study was based on qualitative methodology and usedsemi-directive interviews and focal groups to collect data. Data analysis was based on the hermeneutic dialecticphilosophy of Jürgen Habermas according to the interpretative technique of reconstruction. Results indicated thatthese services are organized focusing on the clinical-psychiatric work, emphasizing the diagnosis, pathology andmedication treatment; while psychosocial actions have a secondary role in the therapeutic project. This articlediscusses part of this study in relation to the therapeutic activities and how they are implemented. Therapeuticactions are extremely technical, individually applied and imposed to an interdisciplinary field aiming to integratehealth actions. From a complementary perspective, as the therapeutic activities are mainly implemented in theinternal areas of the services and minimize territorial and community actions, they do not include individuals withpsychological distress in society; rather, they include these individuals in the service itself.

  3. A Case Study of the Technology Use and Information Flow at a Hospital-driven Telemedicine Service

    OpenAIRE

    Smaradottir, Berglind; Fensli, Rune Werner

    2017-01-01

    Health care services face the challenge of providing individualised treatment to a growing ageing population prone to chronic conditions and multi-morbidities. The research project Patients and Professionals in Productive Teams aims to study health care services that are run with a patient-centred teamwork approach. In this context, a case study was made of a hospital-driven telemedicine service for chronic obstructive pulmonary disease patients after hospital discharge, with a focus on infor...

  4. Mobility trends of Patients across Italian Regions: implications for planning and evaluation of hospital services.

    Science.gov (United States)

    Nante, N; Messina, G; Lispi, L; Serafini, A; Prisco, G; Moirano, F

    2016-01-01

    The study of patients' mobility is useful for health planning and identifying deficiencies in care supply. The Italian Health Service, with 21 different regional realities, can be considered as a macrocosmic test bench. Our study aims: (1) to describe the trend of patients' hospital mobility across the Italian Regions; (2) to offer an immediate visual approach for decision making; (3) to identify some factors involved in patient's mobility. Observational cross sectional study. We used ordinary and day hospital discharge data from 1998 to 2014. The study was carried out using: (1) the Gandy's Nomogram (GN), a graphical tool that assesses the power of attraction and the escape's containment of hospital regional networks; (2) the vector analysis; (3) the trend analysis with Cuzik's test; (4) the panel data analysis, with multiple logistic regression model. The mean number of annual admissions, in Italian hospitals, was 10,976,290, progressively decreasing from 2001 to 2014, and 7% of it occurred "in mobility". We have drawn the different paths of patients' mobility by Regions and observed critical situations almost in Regions of Southern Italy, compared with Regions of the Centre-North. Moreover we analyzed the factors implied in such mobility, highlighting that attraction is influenced by the hospitalization rate in private structures, by the percentage of graduates in the Regions, and by the number of hospital beds/10,000 inhabitants; while escapes are influenced by GDP per capita, by the number of hospital beds/10,000 inhabitants and by the sanitary expenses per capita of the Region. We have shown the potentialities of the GN, applicable at micro level but also on a large scale in the analysis of patients' hospital mobility; and this, together with panel data analysis, can lead to a more conscious and effective health planning.

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

    Science.gov (United States)

    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.

  6. Fraud Prevention A Study In Regional Public Service Agency BLUD For Hospital In Malang Regency Indonesia

    Directory of Open Access Journals (Sweden)

    Koenta Adji Koerniawan

    2017-04-01

    Full Text Available This study aims to understand the effect of management perceptions in Regional Public Service Agency BLUD for Hospital in Malang regency Indonesia on the role of the Independent Auditor and their understanding towards Good Governance the General Audit Engagement and its implications for the prevention of corruption. This research is quantitative which placed latent variables General Audit Engagements as intervening variables. Partial Least Square PLS is used to confirm the model created in order to explain the relationship between variables. The results show that the perception of BLUD hospital management on the role of independent auditors and their understanding of good governance to give effect to the implementation of the audit engagement and the implications for the prevention of fraud in BLUDs hospital. This is consistent with the theory of auditing and fraud prevention concepts. JEL Classification M420 K420

  7. Psychopathology of adolescents with an intellectual disability who present to general hospital services.

    Science.gov (United States)

    Theodoratos, Oreste; McPherson, Lyn; Franklin, Catherine; Tonge, Bruce; Einfeld, Stewart; Lennox, Nicholas; Ware, Robert S

    2017-10-01

    Adolescents with intellectual disability have increased rates of psychopathology compared with their typically developing peers and present to hospital more frequently for ambulant conditions. The aim of this study is to describe the psychopathology and related characteristics of a sample of adolescents with intellectual disability who presented to general hospital services. We investigated a cohort of adolescents with intellectual disability in South East Queensland, Australia between January 2006 and June 2010. Demographic and clinical data were obtained via mailed questionnaires and from general practice notes. Psychopathology was measured with the Short Form of the Developmental Behaviour Checklist. Of 98 individuals presenting to hospital, 71 (72.5%) had significant levels of psychopathology. Unknown aetiology for the intellectual disability was associated with presence of problem behaviours. Adolescents with more severe intellectual disability were more likely to have major problem behaviours. Co-morbid physical health issues were not associated with psychopathology. Only 12 (12.1%) adolescents had undergone specialized mental health intervention. The general hospital environment may offer opportunities for liaison psychiatry services to screen and provide management expertise for adolescent individuals with intellectual disability presenting for physical health issues.

  8. Growing Pains at Hospitals: Opportunities and Issues of Service Expansion in Maximum Care.

    Science.gov (United States)

    Hinkelmann, Juergen; Hasebrook, Joachim Paul; Volkert, Thomas; Hahnenkamp, Klaus

    2017-01-01

    Due to the demographic change morbidity raises the demand for medical hospital services as well as a need for medical specialization, while economic and human resources are diminishing. Unlike other industries hospitals do not have sufficient data and adequate models to relate growing demands and increasing performance to growth in staff capacity and to increase in staff competences. Based on huge medical data sample covering the years from 2010 to 2014 with more than 150,000 operations of the Department for Anesthesiology at the University Hospital Muenster, Germany, comparisons are drawn between the development of medical services and the development of personnel capacity and expertise. The numbers of surgical operations increased by 21% and "skin incision to closure" time by 17%. Simultaneously, personnel capacity grew by 16% largely resting upon recruiting first-time employees. Expertise measured as "years of professional experience" dwindled from 10 years to 5.4 years on average and staff turnover accelerated. Static benchmark data collected at fixed reference dates do not sufficiently reflect the nexus between capacity and competence and do not reflect the dynamic changes in a hospital's requirements for expertise and specialization, at all. Staff turnover leads to a loss of experience, which jeopardizes patient safety and hampers medical specialization. In consequence of the dramatic shortage of medical specialists, drop-off rates must be reduced and retention rates must be increased. To that end, working conditions need to be fundamentally converted for a multigeneration, multicultural, and increasingly female workforce.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  11. Emergency department boarding and adverse hospitalization outcomes among patients admitted to a general medical service.

    Science.gov (United States)

    Lord, Kito; Parwani, Vivek; Ulrich, Andrew; Finn, Emily B; Rothenberg, Craig; Emerson, Beth; Rosenberg, Alana; Venkatesh, Arjun K

    2018-03-20

    Overcrowding in the emergency department (ED) has been associated with patient harm, yet little is known about the association between ED boarding and adverse hospitalization outcomes. We sought to examine the association between ED boarding and three common adverse hospitalization outcomes: rapid response team activation (RRT), escalation in care, and mortality. We conducted an observational analysis of consecutive patient encounters admitted from the ED to the general medical service between February 2013 and June 2015. This study was conducted in an urban, academic hospital with an annual adult ED census over 90,000. We defined boarding as patients with greater than 4h from ED bed order to ED departure to hospital ward. The primary outcome was a composite of adverse outcomes in the first 24h of admission, including RRT activation, care escalation to intensive care, or in-hospital mortality. A total of 31,426 patient encounters were included of which 3978 (12.7%) boarded in the ED for 4h or more. Adverse outcomes occurred in 1.92% of all encounters. Comparing boarded vs. non-boarded patients, 41 (1.03%) vs. 244 (0.90%) patients experienced a RRT activation, 53 (1.33%) vs. 387 (1.42%) experienced a care escalation, and 1 (0.03%) vs.12 (0.04%) experienced unanticipated in-hospital death, within 24h of ED admission. In unadjusted analysis, there was no difference in the composite outcome between boarding and non-boarding patients (1.91% vs. 1.91%, p=0.994). Regression analysis adjusted for patient demographics, acuity, and comorbidities also showed no association between boarding and the primary outcome. A sensitivity analysis showed an association between ED boarding and the composite outcome inclusive of the entire inpatient hospital stay (5.8% vs. 4.7%, p=0.003). Within the first 24h of hospital admission to a general medicine service, adverse hospitalization outcomes are rare and not associated with ED boarding. Copyright © 2018 Elsevier Inc. All rights

  12. Service quality and patient experiences of ambulatory care in a specialized clinic vs. a general hospital.

    Science.gov (United States)

    De Regge, Melissa; De Groote, Hélène; Trybou, Jeroen; Gemmel, Paul; Brugada, Pedro

    2017-04-01

    Health care organizations are constantly looking for ways to establish a differential advantage to attract customers. To this end, service quality has become an important differentiator in the strategy of health care organizations. In this study, we compared the service quality and patient experience in an ambulatory care setting of a physician-owned specialized facility with that of a general hospital. A comparative case study with a mixed method design was employed. Data were gathered through a survey on health service quality and patient experience, completed with observations, walkthroughs, and photographic material. Service quality and patient experiences are high in both the investigated health care facilities. A significant distinction can be made between the two facilities in terms of interpersonal quality (p = 0.001) and environmental quality (P ≤ 0.001), in favor of the medical center. The difference in environmental quality is also indicated by the scores given by participants who had been in both facilities. Qualitative analysis showed higher administrative quality in the medical center. Environmental quality and patient experience can predict the interpersonal quality; for environmental quality, interpersonal quality and age are significant predictors. Service quality and patient experiences are high in both facilities. The medical center has higher service quality for interpersonal and environmental service quality and is more process-centered.

  13. Validation of Medical Tourism Service Quality Questionnaire (MTSQQ) for Iranian Hospitals.

    Science.gov (United States)

    Qolipour, Mohammad; Torabipour, Amin; Khiavi, Farzad Faraji; Malehi, Amal Saki

    2017-03-01

    Assessing service quality is one of the basic requirements to develop the medical tourism industry. There is no valid and reliable tool to measure service quality of medical tourism. This study aimed to determine the reliability and validity of a Persian version of medical tourism service quality questionnaire for Iranian hospitals. To validate the medical tourism service quality questionnaire (MTSQQ), a cross-sectional study was conducted on 250 Iraqi patients referred to hospitals in Ahvaz (Iran) from 2015. To design a questionnaire and determine its content validity, the Delphi Technique (3 rounds) with the participation of 20 medical tourism experts was used. Construct validity of the questionnaire was assessed through exploratory and confirmatory factor analysis. Reliability was assessed using Cronbach's alpha coefficient. Data were analyzed by Excel 2007, SPSS version18, and Lisrel l8.0 software. The content validity of the questionnaire with CVI=0.775 was confirmed. According to exploratory factor analysis, the MTSQQ included 31 items and 8 dimensions (tangibility, reliability, responsiveness, assurance, empathy, exchange and travel facilities, technical and infrastructure facilities and safety and security). Construct validity of the questionnaire was confirmed, based on the goodness of fit quantities of model (RMSEA=0.032, CFI= 0.98, GFI=0.88). Cronbach's alpha coefficient was 0.837 and 0.919 for expectation and perception questionnaire. The results of the study showed that the medical tourism SERVQUAL questionnaire with 31 items and 8 dimensions was a valid and reliable tool to measure service quality of medical tourism in Iranian hospitals.

  14. [Qualitative fungal composition of services at risk of nosocomial infections at Aristide Le Dantec Hospital (Dakar)].

    Science.gov (United States)

    Diongue, K; Badiane, A S; Seck, M C; Ndiaye, M; Diallo, M A; Diallo, S; Sy, O; Ndiaye, J L; Faye, B; Ndir, O; Ndiaye, D

    2015-03-01

    In hospitals, the quality control of the air is a key element. Indeed airborne fungi constitute a real danger for patients hospitalized in wards at risk of nosocomial infections especially when they are immunocompromised. The objective was to determine the qualitative fungal flora composition of wards at risk of nosocomial infections at Le Dantec teaching hospital. Between April and May 2013, 73 samples were collected from 45 compartments within seven services at risk of nosocomial infection at Aristide Le Dantec teaching Hospital (Dakar). Samples were made once by sedimentation method and the percentage of positive cultures was 100%. The most represented species were Cladosporium spp. (91.1%), Aspergillus spp. (86.6%), Penicillium spp. 71.1% and Candida spp. (57.7%). Candida albicans and Aspergillus fumigatus were isolated respectively at 15.5% and 11.1%. Wards have been classified according to the number of species isolated; 11 species in pediatric oncology, 10 species in pediatric surgery/neonatal and intensive care, nine species for oncology, eight species in general surgery and dermatology, and four species in internal medicine. This study shows that fungi causing nosocomial infections are present in hospital and their monitoring should be included in the program of Nosocomial Infections Prevention Committees (CLIN). Copyright © 2014 Elsevier Masson SAS. All rights reserved.

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

    DEFF Research Database (Denmark)

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

    2011-01-01

    -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...... have established a core data set for documenting and reporting in physician-staffed pre-hospital services. We believe that this template could facilitate future studies within the field and facilitate standardised reporting and future shared research efforts in advanced pre-hospital care....

  16. Patients' Expectations and Perceptions of Service Quality in the Selected Hospitals.

    Science.gov (United States)

    Nadi, Aliasghar; Shojaee, Jalil; Abedi, Ghassem; Siamian, Hasan; Abedini, Ehsan; Rostami, Farideh

    2016-04-01

    Hospital's success depends on patients' expectations, perceptions, and judgment on the quality of services provided by hospitals. This study was conducted to assess the patients' perceptions and expectations from the quality of inpatient health care in Vali-Asr hospital, Ghaemshahr, and Imam Khomeini and Shafa Hospitals, Sari. This study is applied regarding the objective of the study. Considering the research methodology, it is a descriptive - analytical study. The sample of this study consists of 600 patients with at least 24 hours of being hospitalized in internal, surgery, women, and children sectors of Vali-Asr, Ghaemshahr, Imam Khomeini, and Shafa Hospitals. Using random sampling method, the classifications relevant to the size of each class were selected. The data required was collected through the standard SERVQUAL questionnaire and then it was analyzed using the SPSS software. The overall mean value and standard deviation of expectations were equal to 10.4 and 28, respectively. The mean value for the field of perception was 69.2 and the relevant standard deviation was 26. In terms of patients and hospital visits in concrete cases, the highest priority is related to empathy. The second priority is related to physical appearance, the third priority is related to responsiveness, the fourth priority is related to assurance, and the lowest priority is related to the reliability of the SERVQUAL approach. Examining the gap between patients' perceptions and expectations, the widest gap was observed in the Vali-Asr Hospital with the mean and SD (-92.0±39.0) and the lowest gap was observed in Shafa Hospital with the mean value of (-39.9±44.0). According to The Kruskal-Wallis test, the difference observed in these three hospitals were significant. The results showed that patients' expectations had not been met in any of the examined dimensions and their consent has not been achieved. It seemed that necessary for managers and relevant authorities to plan and pay

  17. Hospitals

    Data.gov (United States)

    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...

  18. Developing a pediatric palliative care service in a large urban hospital: challenges, lessons, and successes.

    Science.gov (United States)

    Edlynn, Emily S; Derrington, Sabrina; Morgan, Helene; Murray, Jennifer; Ornelas, Beatriz; Cucchiaro, Giovanni

    2013-04-01

    We report the process of creating a new palliative care service at a large, urban children's hospital. Our aim was to provide a detailed guide to developing an inpatient consultation service, along with reporting on the challenges, lessons, and evaluation. We examined the hiring process of personnel and marketing strategies, a clinical database facilitated ongoing quality review and identified trends, and a survey project assessed provider satisfaction and how referring physicians used the palliative care service. The pilot phase of service delivery laid the groundwork for a more effective service by creating documentation templates and identifying relevant data to track growth and outcomes. It also allowed time to establish a clear delineation of team members and distinction of roles. The survey of referring physicians proved a useful evaluation starting point, but conclusions could not be generalized because of the low response rate. It may be necessary to reconsider the survey technique and to expand the sample to include patients and families. Future research is needed to measure the financial benefits of a well-staffed inpatient pediatric palliative care service.

  19. Protection against cold - a survey of available equipment in Swedish pre-hospital services.

    Science.gov (United States)

    Henriksson, O; Björnstig, U; Saveman, B-I; Lundgren, P J

    2017-11-01

    The aim of this study was to survey the current equipment used for prevention, treatment and monitoring of accidental hypothermia in Swedish pre-hospital services. A questionnaire was sent to all road ambulance services (AS), the helicopter emergency medical services (HEMS), the national helicopter search and rescue service (SAR) and the municipal rescue services (RS) in Sweden to determine the availability of insulation, active warming, fluid heating, and low-reading thermometers. The response rate was 77% (n = 255). All units carried woollen or polyester blankets for basic insulation. Specific windproof insulation materials were common in the HEMS, SAR and RS units but only present in about half of the AS units. Active warming equipment was present in all the SAR units, but only in about two-thirds of the HEMS units and about one-third of the AS units. About half of the RS units had the ability to provide a heated tent or container. Low-reading thermometers were present in less than half of the AS and HEMS units and were non-existent in the SAR units. Pre-warmed intravenous fluids were carried by almost all of the AS units and half of the HEMS units but infusion heaters were absent in most units. Basic insulation capabilities are well established in the Swedish pre-hospital services. Specific wind and waterproof insulation materials, active warming devices, low-reading thermometers and IV fluid heating systems are less common. We suggest the development and implementation of national guidelines on accidental hypothermia that include basic recommendations on equipment requirements. © 2017 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  20. Buildings' impact on effective hospital services--the means of the property management role in Norwegian hospitals.

    Science.gov (United States)

    Støre-Valen, Marit; Larssen, Anne Kathrine; Bjørberg, Svein

    2014-01-01

    The purpose of this paper is to assess the status of the physical assets of Norwegian hospital facilities in terms of technical condition, building performance, usability and adaptability, thereby comprehending the main challenges for property management as part of facilities management (FM) within hospitals of the Norwegian Specialist Health-Care Services and permitting a discussion on a more strategic property management role. The research is based on an action research approach using data collection from surveys, schemes and questionnaires, literature studies, documentation analysis and workshops with an active research team involvement with stakeholders. In-depth interviews were undertaken with owner representatives, property management representatives and health-care deliverers, and a GAP analysis allowed a study of the quality of property management (as part of the FM). A severe technical backlog was documented together with a strong demand for structural upgrading, which was roughly estimated to be approximately 30-35 billion NOK in 2012 (3.75-4.4 billion euros). Improvements are necessary in all areas of FM delivery within limited economic frameworks, even though several examples of good property management (as part of FM delivery) were found. A gap exists between the general strategy concerning hospital assets and the property management role, particularly with regard to the translation of change in user needs into changed facilities. A need for an increasing professionalization of the role is pressing, turning attention from operational costs and control to potential added value. This requires a shift of focus from the property manager in order to implement visions and goals for the health-care sector, which involves several actions such as an improved communication between stakeholders and technically improved skills, thus ensuring the recruitment and capability of property management staff and improved measurement processes. This paper give two major

  1. An inexpensive, interdisciplinary, methodology to conduct an impact study of homeless persons on hospital based services.

    Science.gov (United States)

    Parker, R David; Regier, Michael; Brown, Zachary; Davis, Stephen

    2015-02-01

    Homelessness is a primary concern for community health. Scientific literature on homelessness is wide ranging and diverse. One opportunity to add to existing literature is the development and testing of affordable, easily implemented methods for measuring the impact of homeless on the healthcare system. Such methodological approaches rely on the strengths in a multidisciplinary approach, including providers, both healthcare and homeless services and applied clinical researchers. This paper is a proof of concept for a methodology which is easily adaptable nationwide, given the mandated implementation of homeless management information systems in the United States and other countries; medical billing systems by hospitals; and research methods of researchers. Adaptation is independent of geographic region, budget restraints, specific agency skill sets, and many other factors that impact the application of a consistent methodological science based approach to assess and address homelessness. We conducted a secondary data analysis merging data from homeless utilization and hospital case based data. These data detailed care utilization among homeless persons in a small, Appalachian city in the United States. In our sample of 269 persons who received at least one hospital based service and one homeless service between July 1, 2012 and June 30, 2013, the total billed costs were $5,979,463 with 10 people costing more than one-third ($1,957,469) of the total. Those persons were primarily men, living in an emergency shelter, with pre-existing disabling conditions. We theorize that targeted services, including Housing First, would be an effective intervention. This is proposed in a future study.

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

    Science.gov (United States)

    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

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

    Science.gov (United States)

    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

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

    Science.gov (United States)

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

    2016-03-01

    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. 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. 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. 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.

  5. Validation of the process criteria for assessment of a hospital nursing service

    Directory of Open Access Journals (Sweden)

    Liliane Bauer Feldman

    2013-07-01

    Full Text Available OBJECTIVE: to validate an instrument containing process criteria for assessment of a hospital nursing service based on the National Accreditation Organization program. METHOD: a descriptive, quantitative methodological study performed in stages. An instrument constructed with 69 process criteria was assessed by 49 nurses from accredited hospitals in 2009, according to a Likert scale, and validated by 16 judges through Delphi rounds in 2010. RESULT: the original instrument assessed by nurses with 69 process criteria was judged by the degree of importance, and changed to 39 criteria. In the first Delphi round, the 39 criteria reached consensus among the 19 judges, with a medium reliability by Cronbach's alpha. In the second round, 40 converging criteria were validated by 16 judges, with high reliability. The criteria addressed management, costs, teaching, education, indicators, protocols, human resources, communication, among others. CONCLUSION: the 40 process criteria formed a validated instrument to assess the hospital nursing service which, when measured, can better direct interventions by nurses in reaching and strengthening outcomes.

  6. Ancillary Care: From Theory to Practice in International Clinical Research

    Science.gov (United States)

    Pratt, Bridget; Zion, Deborah; Lwin, Khin Maung; Cheah, Phaik Yeong; Nosten, Francois; Loff, Bebe

    2013-01-01

    How international research might contribute to justice in global health has not been substantively addressed by bioethics. This article describes how the provision of ancillary care can link international clinical research to the reduction of global health disparities. It identifies the ancillary care obligations supported by a theory of global justice, showing that Jennifer Ruger’s health capability paradigm requires the delivery of ancillary care to trial participants for a limited subset of conditions that cause severe morbidity and mortality. Empirical research on the Shoklo Malaria Research Unit’s (SMRU) vivax malaria treatment trial was then undertaken to demonstrate whether and how these obligations might be upheld in a resource-poor setting. Our findings show that fulfilment of the ancillary care obligations is feasible where there is commitment from chief investigators and funders and is strongly facilitated by SMRU’s dual role as a research unit and medical non-governmental organization. PMID:23864908

  7. System-level factors affecting clinicians' perceptions and use of interpreter services in California public hospitals.

    Science.gov (United States)

    Baurer, Danielle; Yonek, Julie C; Cohen, Alan B; Restuccia, Joseph D; Hasnain-Wynia, Romana

    2014-04-01

    Professional language interpreters are skilled in the nuances of interpretation and are less likely to make errors of clinical significance but clinicians infrequently use them. We examine system-level factors that may shape clinicians' perceptions and use of professional interpreters. Exploratory qualitative study in 12 California public hospitals. We conducted in-person key informant interviews with hospital leadership, clinical staff, and administrative staff. Five emergent themes highlight system-level factors that may influence clinicians' perceptions and use of professional interpreters in hospitals: (1) organization-wide commitment to improving language access for LEP patients; (2) organizational investment in remote interpreter technologies to increase language access; (3)training clinicians on how to access and work with interpreters; (4) hospital supports the training and certification of bilingual staff to serve as interpreters to expand in-person, on-site, interpreter capacity; and (5)organizational investment in readily accessible telephonic interpretation. Multiple system-level factors underlie clinicians' use of professional interpreters. Interventions that target these factors could improve language services for patients with limited English proficiency.

  8. Selected aspects of the logistics network of public hospitals in the competitive market of health services

    Directory of Open Access Journals (Sweden)

    Justyna Majchrzak-Lepczyk

    2016-12-01

    Full Text Available Background: The below considerations provide an overview of the issues of sustainable development, logistics, to financial engineering instruments and the role of intellectual capital in the process of transformation of public hospitals. The aim of this research was to assess the competitiveness of the network of public hospitals in the market of health services based on literature studies, as well as empirical research. Methods: Empirical study using a questionnaire survey was conducted in the period from January 2007 to December 2011, in the area of Warmia and Mazury, Pomerania and Wielkopolska. The goal of this questionnaire survey was to know the medical staff reviews issues related to adaptation to the nature of the network of public hospitals methods and logistics tools, sustainable development, corporate social responsibility - CSR. The study was carried out in 104 public hospitals, on a sample of 8975 respondents. Results and conclusions: Analysis of the completed study showed that the logistic processes and their improvement in the health sector play a significant role. The surveyed entities explicitly draw attention to the need for information systems,  pro-environment activities, access to information, or the use of GS1 global standards. These tools allow you to increase the efficiency of supply chains, ensuring not only tracking and tracing of products from the manufacturer to the patient, but also enabling better protection against making a mistake or counterfeit products.

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

    Science.gov (United States)

    Oja, Paula; Kouri, Timo; Pakarinen, Arto

    2010-01-01

    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

  10. From customer satisfaction survey to corrective actions in laboratory services in a university hospital.

    Science.gov (United States)

    Oja, Paula I; Kouri, Timo T; Pakarinen, Arto J

    2006-12-01

    To find out the satisfaction of clinical units with laboratory services in a university hospital, to point out the most important problems and defects in services, to carry out corrective actions, and thereafter to identify the possible changes in satisfaction. and Senior physicians and nurses-in-charge of the clinical units at Oulu University Hospital, Finland. Customer satisfaction survey using a questionnaire was carried out in 2001, indicating the essential aspects of laboratory services. Customer-specific problems were clarified, corrective actions were performed, and the survey was repeated in 2004. In 2001, the highest dissatisfaction rates were recorded for computerized test requesting and reporting, turnaround times of tests, and the schedule of phlebotomy rounds. The old laboratory information system was not amenable to major improvements, and it was renewed in 2004-05. Several clinical units perceived turnaround times to be long, because the tests were ordered as routine despite emergency needs. Instructions about stat requesting were given to these units. However, no changes were evident in the satisfaction level in the 2004 survey. Following negotiations with the clinics, phlebotomy rounds were re-scheduled. This resulted in a distinct increase in satisfaction in 2004. Satisfaction survey is a screening tool that identifies topics of dissatisfaction. Without further clarifications, it is not possible to find out the specific problems of customers and to undertake targeted corrective actions. Customer-specific corrections are rarely seen as improvements in overall satisfaction rates.

  11. Analysis of the medical imaging services at three hospitals of the Mexican National Health System.

    Science.gov (United States)

    Azpiroz-Leehan, Joaquín; Méndez, Miguel Cadena; Licona, Fabiola Martínez

    2007-08-01

    We present a study on the quality of operation and the characteristics of the medical imaging equipment in three specialty hospitals of the Mexican Health System. Six month residencies were carried out in order to better understand the problems and internal functioning of the three imaging departments. The kinds of equipment, the types of equipment failures and the internal operation of these services were analyzed. The results allow us to identify four factors that are linked to faults in the quality of the health care delivered to patients. The first factor is equipment obsolescence; the second is related to deficient preventive maintenance procedures and problems associated the supervising of external service providers. The third factor is derived from the equipment's (over) workload, which is indirectly tied to the age of the imaging modalities and the fourth factor is misuse of the equipment. The solutions to these problems include the modernization of the equipment and a better supervision by the clinical engineering department of all the processes involving the medical imaging services in each hospital. In addition to this, a special effort of the continuing education of personnel associated with medical imaging at all levels should be carried out.

  12. Measuring the quality of Hospital Food Services: Development and reliability of a Meal Quality Audit Tool.

    Science.gov (United States)

    Banks, Merrilyn; Hannan-Jones, Mary; Ross, Lynda; Buckley, Ann; Ellick, Jennifer; Young, Adrienne

    2017-04-01

    To develop and test the reliability of a Meal Quality Audit Tool (MQAT) to audit the quality of hospital meals to assist food service managers and dietitians in identifying areas for improvement. The MQAT was developed using expert opinion and was modified over time with extensive use and feedback. A phased approach was used to assess content validity and test reliability: (i) trial with 60 dietetic students, (ii) trial with 12 food service dietitians in practice and (iii) interrater reliability study. Phases 1 and 2 confirmed content validity and informed minor revision of scoring, language and formatting of the MQAT. To assess reliability of the final MQAT, eight separate meal quality audits of five identical meals were conducted over several weeks in the hospital setting. Each audit comprised an 'expert' team and four 'test' teams (dietitians, food services and ward staff). Interrater reliability was determined using intra-class correlation analysis. There was statistically significant interrater reliability for dimensions of Temperature and Accuracy (P < 0.001) but not for Appearance or Sensory. Composition of the 'test' team appeared to influence results for Appearance and Sensory, with food service-led teams scoring higher on these dimensions. 'Test' teams reported that MQAT was clear and easy to use. MQAT was found to be reliable for Temperature and Accuracy domains, with further work required to improve the reliability of the Appearance and Sensory dimensions. The systematic use of the tool, used in conjunction with patient satisfaction, could provide pertinent and useful information regarding the quality of food services and areas for improvement. © 2017 Dietitians Association of Australia.

  13. From a medical tourism hospital to a National Health Service hospitak in eight easy years! A case study of the Golden Jubilee Hospital in Glasgow, Scotland

    OpenAIRE

    Hay, Brian

    2010-01-01

    The aim of this paper is to outline how and why a private-sector, purpose-built hospital designed to attract overseas medical tourists to Glasgow in the early 1990s, did develop into a centre of medical excellence – but one wholly owned and managed by the National Health Service Scotland (NHS Scotland), as a Special Health Board Hospital and not as a centre for medical tourism.

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

    OpenAIRE

    Nasim Kazemi; Parisa Ehsani; Farshid Abdi; Mohammad Kazem Bighami

    2013-01-01

    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 mod...

  15. Distributed Smart Grid Asset Control Strategies for Providing Ancillary Services

    Energy Technology Data Exchange (ETDEWEB)

    Kalsi, Karanjit [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Zhang, Wei [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Lian, Jianming [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Marinovici, Laurentiu D. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Moya, Christian [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Dagle, Jeffery E. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    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.

  16. Portsmouth Naval Shipyard Microgrid and Ancillary Services - Kittery, ME

    Science.gov (United States)

    2017-08-30

    Gigabyte(s) GE General Electric GOOSE Generic Object Oriented Substation Events GPS Global Positioning System GTG Gas Turbine Generator HDD Hard Disk...switches, status of battery banks) at the central controller.  Global Positioning System (GPS) time synchronization of the MCS components. Phase I...Production Number of events per year, value of lost Shipyard production per event History of lost production costs for LoU events The simple

  17. Applying the variety reduction principle to management of ancillary services

    NARCIS (Netherlands)

    Elkhuizen, Sylvia G.; van Sambeek, Jasper R. C.; Hans, Erwin W.; Krabbendam, Koos (J. J. ); Bakker, Piet J. M.

    2007-01-01

    BACKGROUND: As central diagnostic facilities, computer tomography (CT) scans appear to be bottlenecks in many patient-care processes. This study describes a case study concerning redesign of a CT scan department in the Academic Medical Center in Amsterdam, the Netherlands. PURPOSES: The aim was to

  18. Evaluation of advanced medical imaging services at Governmental Hospitals-Gaza Governorates, Palestine

    Directory of Open Access Journals (Sweden)

    K.M. Abushab

    2018-01-01

    Full Text Available Medical imaging services are the key tool to diagnose many diseases and have an important role in monitoring treatment and predicting outcome. The current study conducted to evaluate advanced medical imaging services (CT and MRI at Governmental Hospitals-Gaza Governorates, Palestine. Triangulated study design was used (checklist, questionnaire and key informant interview. The researcher used arbitrated checklist to evaluate medical imaging facilities. Census study conducted on all Radiologic Technologists and medical imaging departments at three main governmental hospitals in the Gaza Strip, which offered advanced medical imaging. In addition, three key informant interviews with Radiologic Technologists manager were conducted. Researcher have directly interviewed 20 participants (75% Males; 80% older than 30; 90% bachelor and master degrees and 80% more than 10 years' experience. Researcher have directly interviewed 20 participants (75% Males; 80% older than 30; 90% bachelor and master degrees and 80% more than 10 years' experience. Each RT at European Gaza hospital is expected to perform 25 cases in the morning shift against 6 and 13 cases at Indonesia and Al-Shifa Hospital, respectively. Both of Computed Tomography and Magnetic Resonance Imaging departments showed that “60%, 78% and 91%” and “86%, 100% and 90%” followed standard regarding to their structures, occupational safety and essential supplies, respectively. An observable shortage in number of radiographic machines and Radiologic Technologists at all advanced medical imaging departments. All departments showed clear defect in structure, design and essential supplies. Critical readings were observed respecting to insufficient radiation protection tools and holding of Thermoluminescence Dosimeters.

  19. Helicopter emergency medical services (HEMS response to out-of-hospital cardiac arrest

    Directory of Open Access Journals (Sweden)

    Lyon Richard M

    2013-01-01

    Full Text Available Abstract Background Out-of-hospital cardiac arrest (OHCA is a common medical emergency with significant mortality and significant neurological morbidity. Helicopter emergency medical services (HEMS may be tasked to OHCA. We sought to assess the impact of tasking a HEMS service to OHCA and characterise the nature of these calls. Method Retrospective case review of all HEMS calls to Surrey and Sussex Air Ambulance, United Kingdom, over a 1-year period (1/9/2010-1/9/2011. All missions to cases of suspected OHCA, of presumed medical origin, were reviewed systematically. Results HEMS was activated 89 times to suspected OHCA. This represented 11% of the total HEMS missions. In 23 cases HEMS was stood-down en-route and in 2 cases the patient had not suffered an OHCA on arrival of HEMS. 25 patients achieved return-of-spontaneous circulation (ROSC, 13 (52% prior to HEMS arrival. The HEMS team were never first on-scene. The median time from first collapse to HEMS arrival was 31 minutes (IQR 22–40. The median time from HEMS activation to arrival on scene was 17 minutes (IQR 11.5-21. 19 patients underwent pre-hospital anaesthesia, 5 patients had electrical or chemical cardioversion and 19 patients had therapeutic hypothermia initiated by HEMS. Only 1 post-OHCA patient was transported to hospital by air. The survival to discharge rate was 6.3%. Conclusion OHCA represents a significant proportion of HEMS call outs. HEMS most commonly attend post-ROSC OHCA patients and interventions, including pre-hospital anaesthesia and therapeutic hypothermia should be targeted to this phase. HEMS are rarely first on-scene and should only be tasked as a first response to OHCA in remote locations. HEMS may be most appropriately utilised in OHCA by only attending the scene if a patient achieves ROSC.

  20. Community services' involvement in the discharge of older adults from hospital into the community

    Directory of Open Access Journals (Sweden)

    Michelle Guerin

    2013-09-01

    Full Text Available Background: Community services are playing an increasing role in supporting older adults who are discharged from hospital with ongoing non-acute care needs.  However, there is a paucity of information regarding how community services are involved in the discharge process of older individuals from hospital into the community.  Methods: 29 databases were searched from 1980 to 2012 (inclusive for relevant primary published research, of any study design, as well as relevant unpublished work (e.g. clinical guidelines which investigated community services’ involvement in the discharge of older individuals from hospital into the community. Data analysis and quality appraisal (using McMaster critical appraisal tools was undertaken predominately by the lead author.  Data was synthesised qualitatively. Results: 12 papers were eligible for inclusion (five randomised controlled trials, four before and after studies and three controlled trials, involving a total of 8440 older adults (> 65 years.  These papers reported on a range of interventions.  During data synthesis, descriptors were assigned to four emergent discharge methods: Virtual Interface Model, In-reach Interface Model, Out-reach Interface Model, and Independent Interface Model.   In each model, the findings were mixed in terms of healthcare and patient and carer outcomes.  Conclusions: It is plausible that each model identified in this systematic review has a role to play in successfully discharging different cohorts of older adults from hospital.  Further research is required to identify appropriate population groups for various discharge models, and to select suitable outcomes measures to determine the effectiveness of these models, considering all stakeholders' involved.

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

    Science.gov (United States)

    Bao, Yuhua; Fan, Guanrong; Zou, Dongdong; Wang, Tong; Xue, Di

    2017-01-01

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

  2. Coordinating Education & Industry in the 1990's: A Strategy for Managing a Food Service/Hospitality Program.

    Science.gov (United States)

    Rogalla, Edward V.

    Research was conducted to determine areas of strengths and weaknesses of the Food Service/Hospitality Management program of Ferris State University (Michigan). The study examined graduates' perceptions of the preparation they received and of the adequacy of their preparation for the hospitality industry. A literature review focused on strategies…

  3. ADVERSE REACTIONS TO ANTIMICROBIAL AGENTS IN INTERNAL MEDICINE AND ORTHOPEDIC SERVICES. JOSINA MACHEL HOSPITAL, 2014

    Directory of Open Access Journals (Sweden)

    Mateus Sebastião João Fernandes

    2015-10-01

    Full Text Available A descriptive, prospective study was conducted to characterize the incidence and type of Adverse Drug Reactions (ADR to antimicrobial agents in patients hospitalized in internal medicine and Orthopedic services at “Josina Machel” Central Hospital, in Luanda, in the period from January to February 2014 . The occurrence of adverse drug reactions was assessed by daily review of the clinical history of the patients with active search for potentially adverse effects associated with prescription antimicrobial agents. Of a total of 206 hospitalized patients, 21 were affected by ADR, corresponding to an incidence rate of 10.2%. The incidence was significantly higher in the internal medicine service, occurring in 11.7% of 137 patients admitted, while in the orthopedic service the incidence was 7.2% (5/69. The highest incidence of ADR was recorded in patients aged 30-39 years in 10 patients (4.9%, and in the female gender (7.8%. The most common clinical manifestations of ADR were rash (17.2%, followed by headache, pruritus and nausea and vomiting (13.8%. The antimicrobials most frequently associated with the occurrence of ADR were the antimalarial, related to more than half the cases. Among the antibacterial agents cephalosporins were associated to five cases of ADR (23.8%. Most ADR were classified according to severity as mild (52.4% and as probable (57.1% regarding the attribution of causality. Given the growing impact of the occurrence of ADR we recommend pursuing this research, in order to further deepen this problem.

  4. A quantitative summary of nutrition support services in a veterinary teaching hospital.

    Science.gov (United States)

    Donoghue, S

    1991-04-01

    A full-time nutrition support service provided 1,133 consultations in a small animal teaching hospital from July 1986 to June 1988, consisting of 840 dogs, 260 cats, 23 exotic species, and 10 consultations with incomplete information. The dog and cat consultations represented 2.1 and 3.7% of canine and feline admissions, respectively. Consultations involved the determination of nutritional goals which led to recommendations of specific dietary regimens. Most frequent requests were for diet evaluation and diet formulation to meet estimated calorie and protein needs during illness and stress (23%), for specific calorie or nutrient modification given a working diagnosis (23%), and for avoidance of tissue utilization or weight loss (23%). Frequently involved single organ systems were gastrointestinal (16%), liver (12%), kidney (9%), and pancreas (4%), but multiple system involvement was more common (19%). Most frequent diagnostic categories were metabolic disorders (17%), chronic organ failure (17%), and neoplasia (12%). Enteral nutrition was preferred for 98% of consultations. Voluntary consumption was deemed adequate in 81% of consultations, and highly palatable balanced homemade diets and specialty products were recommended in 74% of these. Human hospital liquid enteral products were used in 95% of consultations recommending involuntary feeding, either fed alone, blended with petfoods, or supplemented with modules of protein or fat. The service demonstrated that full-time nutrition support can be utilized effectively in a small animal teaching hospital. Further development of such services will depend on research focused especially on determination of case-specific nutritional goals, patient responses, and cost effectiveness.

  5. Assessment of client satisfaction on emergency department services in Hawassa University Referral Hospital, Hawassa, Southern Ethiopia.

    Science.gov (United States)

    Worku, Mesfin; Loha, Eskindir

    2017-06-27

    Satisfaction refers to a state of pleasure or contentment with an action, event or service, especially one that was previously desired. Regarding to client, satisfaction is the level of happiness that clients experience having used a service. It therefore reflects the gap between the expected service and the experience of the service, from the client's point of view. Information was unavailable regarding the level of satisfaction of patients towards emergency health care servicesat Hawassa University Referral Hospital thatserve a huge catchment area; and this study addressed this gap. Cross-sectional study was conducted from March 13 to May 15/2014. Systematic sampling method was used to enroll study participants. The data was collected by trained data collectors using pre-structured questionnaire. A total 407 clients were enrolled under this study with respondent rate of 96.9%. Nearly two third of study participants were male, 270 (66.3%). 86.7% of study participants were satisfied by services provided in Emergency Out Patient Department (OPD). The percentage of study satisfaction with physical examination by Doctor, nursing, laboratory and pharmacy services were 95.6%, 89.9%, 84.7% and 67.6%, respectively. Only 31.9% were satisfied with availability of drugs in the pharmacy. Regarding to staff courtesy, 91.7% of study participants were satisfied by the manner shown by the staffs working in Emergency OPD. The vast majority of the participants (97%) were satisfied with the courtesy of Medical laboratory personnel and the least satisfaction (79.4%) was recorded for security guards. This study showed low level of patient satisfaction in pharmacy services specifically due to unavailability of drugs due to lack of sustained supply of drugs.

  6. [Rescue service: initial measures on the spot and in hospital (author's transl)].

    Science.gov (United States)

    1975-11-01

    Improvement of any rescue service is inextricably bound up with the provision of optimal conditions with regard to first aid at the site of the accident, transport and immediate care in hospital. Only properly trained and experienced doctors are able to take appropriate life-saving action on the spot. Therefore ane should aim at getting the doctor to the site of the accident by helicopter or by ambulance as fast as possible. After immediate life-saving action has been taken, the various injuries should also be provisionally attended to as well as possible. The entire scope of these problems was discussed at the refresher course.

  7. KEYS TO SUCCESS™: A Baker's Dozen of Formulas to Thrive in the Service and Hospitality Industry!

    OpenAIRE

    Hogan, John

    2017-01-01

    Over the last ten years, I have researched and found more than 100 proven strategies that have varying degrees of particular value to hospitality businesses. While some of them are not new, they all have specific benefits to anyone in the service industry. In order for them to work though, everyone in the organization must make a personal commitment to allow these strategies to work. When the owner or senior management introduces them in a positive and re-enforcing manner, today's staff wil...

  8. Hospital-level correlation between clinical and service quality performance for heart failure treatment.

    Science.gov (United States)

    Gesell, Sabina B; Clark, Paul Alexander; Mylod, Deirdre E; Wolosin, Robert J; Drain, Maxwell; Lanser, Peter; Hall, Melvin F

    2005-01-01

    A national cross-sectional study correlates the satisfaction ratings of heart failure patients (diagnosis related group 127) and the Centers for Medicare & Medicaid Services' process-based quality measures for heart failure treatment for 32 hospitals during the first and second quarters of 2004. Two of the four measures of clinical quality showed statistically significant, moderately strong, positive correlations with a global measure of satisfaction and with, respectively, 5 and 7 subscales of the 10 subscales of satisfaction under examination (Pearson's r ranged between .40 and .67, 2-tailed; p < .05). Findings demonstrate that quality need not be a zero-sum issue, with clinical quality and service quality competing for resources and attention.

  9. Can sonographers offer an accurate upper abdominal ultrasound service in a district general hospital?

    International Nuclear Information System (INIS)

    Dongola, N.A.; Guy, R.L.; Giles, J.A.; Ward, S.

    2003-01-01

    Purpose: This study was performed to evaluate the accuracy of upper abdominal ultrasound (US) scanning performed by sonographers in a district general hospital, to identify potential areas of weakness and to make recommendations to improve the service. Materials and methods: Upper abdominal US examinations performed and reported by sonographers over a 4-week period were retrospectively reviewed. The accuracy of the imaging findings and reports were assessed against other imaging, surgical, histological or laboratory findings and against clinical outcome. Results: A heterogenous group of 104 patients were included in the study, 62 of whom had an US abnormality. Errors of scanning or interpretation were identified in 10 patients (9.6%) of whom five (4.8%) were felt to be potentially significant. Conclusions: The sonographers' accuracy in reporting upper abdominal US scans was 90%. However, on the basis of this study we have implemented specific recommendations to improve the quality of the service

  10. Hospitals

    DEFF Research Database (Denmark)

    Mullins, Michael

    2013-01-01

    The challenge could be briefly seen in these terms: hospitals as places for treatment where there’s a technology focus and hospitals for healing where there’s a human focus. In the 60s - 70s wave of new hospital building, an emphasis on technology can be seen. It’s time to move from the technology....... Documentation exists in; well-being of patients and staff, sleep disorders, pain distraction, confidentiality and privacy, levels of errors in hospitals. Art and the use of color: Art can be context related so one should be aware whether it is in a private ward or the foyer and related to the experience...... of the patient. Art can be used as a stress reducing factor, pain distracter, and also to orientate and to provide landmarks in the hospital landscape. Air, the use of natural ventilation as much as possible, complemented by mechanical ventilation in most cases, particularly in northern Europe; the emphasis...

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

    Directory of Open Access Journals (Sweden)

    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.

  12. 42 CFR 410.27 - Outpatient hospital or CAH services and supplies incident to a physician or nonphysician...

    Science.gov (United States)

    2010-10-01

    ... SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS Medical and Other Health Services § 410.27 Outpatient hospital or... intensive cardiac rehabilitation services, direct supervision must be furnished by a doctor of medicine or... of medicine or osteopathy, as specified in §§ 410.47 and 410.49, respectively. (b) Drugs and...

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

    OpenAIRE

    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.

  14. Role and function of a paediatric clinical ethics service: experiences at the Royal Children's Hospital, Melbourne.

    Science.gov (United States)

    Gold, Hugo; Hall, Georgina; Gillam, Lynn

    2011-09-01

    This article explores and analyses the role and functions of a clinical ethics service in paediatrics. It is based on the experiences of developing ethics capacity at the Royal Children's Hospital, Melbourne, which has evolved since 2002 from a multidisciplinary advisory panel into Australia's first dedicated paediatric Children's Bioethics Centre, which opened in 2008. The ultimate goal is building ethics capacity and literacy across the hospital and continuing to support clinical staff managing patients and their families in ethically problematic cases. This is achieved through current case consultation, education and training, research and institutional policy, and guideline development. The experience of building a clinical ethics service has led to many changes to its structure over the years, with issues like timeliness of meeting, constitution of the group and referral and reporting structures arising as key elements of evolution. Challenges include resourcing and structure, institutional support, and family involvement in ethics consultations. © 2011 The Authors. Journal of Paediatrics and Child Health © 2011 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

  15. Continuity of care in hospital rehabilitation services: a qualitative insight from inpatients' experience.

    Science.gov (United States)

    Medina-Mirapeix, Francesc; Oliveira-Sousa, Silvana L; Escolar-Reina, Pilar; Sobral-Ferreira, Marta; Lillo-Navarro, M Carmen; Collins, Sean M

    Few empirical studies have been conducted on the continuity of rehabilitation services, despite the fact that it may affect clinical outcomes, patient satisfaction, the perception of quality, and safety. The aim of this study was to explore experiences and perceptions of inpatients receiving physical rehabilitation in an acute care hospital and how these experiences may have led to perceived gaps in the continuity of rehabilitation care. Using qualitative research methods, fifteen semi-structured interviews were conducted with patients who received physical rehabilitation during hospital stay in an acute care hospital in Murcia, Spain. Interviews were transcribed verbatim, analyzed, and grouped into predetermined and emergent codes. Patients described three main themes in continuity of care: informational, management, and relational continuity. Several factors were described as influencing the perceived gaps in these three types of continuity. Informational continuity was influenced by the transfer of information among care providers. Relational continuity was influenced by patient-therapist relations and consistency on the part of the provider. Management continuity was influenced by consistency of care between providers and the involvement of patients in their own care. The participants in this study identified several gaps in three types of continuity of care (informational, management, and relational). Inpatients often perceive their experiences of rehabilitation as being disconnected or incoherent over time. Copyright © 2017 Associação Brasileira de Pesquisa e Pós-Graduação em Fisioterapia. Publicado por Elsevier Editora Ltda. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    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.

  17. A novel in-hospital meal service improves protein and energy intake.

    Science.gov (United States)

    Dijxhoorn, Dorian N; van den Berg, Manon G A; Kievit, Wietske; Korzilius, Julia; Drenth, Joost P H; Wanten, Geert J A

    2017-11-09

    Improvement of hospital meal services is a strategy to optimize protein and energy intake and prevent or treat malnutrition during hospitalization. FoodforCare (FfC) is a new concept comprising 6-protein-rich meals per day, provided directly at the bedside following proactive advice from a nutritional assistant. Our aim is to investigate whether this new concept, FfC, improves dietary intake and patient satisfaction, compared to the traditional 3-meals a day service (TMS). We performed a quasi experimental study at medical (Gastroenterology) and surgical (Gynecology, Urology, Orthopedics) wards. Patients were offered TMS (July 2015-May 2016; n = 326) or FfC meal service (after stepwise introduction per ward from January 2016-December 2016; n = 311). Primary outcome was the mean percentage of protein and energy intake relative to requirements, between patients receiving TMS and those receiving FfC, on the first and fourth day of full oral intake. Patient satisfaction comprised rating of the experienced quality of the meals and the meal service by means of a validated questionnaire. Patient characteristics were similar between groups, with the exception that the FfC group contained more oncology patients (p = 0.028). FfC improved mean daily protein intake (in g/day) relative to requirements (1.2 g/kg/day) at day 1 (mean % ±SD: 79 ± 33 vs. 59 ± 28; p improved at day 1 (88 ± 34 vs. 70 ± 30; p service (7.8 ± 1.3 vs. 7.7 ± 1.1; p = 0.29). The FfC group was more satisfied with the appearance and smell of the meals (both p service substantially improved protein and energy intake while maintaining, and to some extent, improving patient satisfaction. NCT03195283. Copyright © 2017 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

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

    Science.gov (United States)

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

    2015-11-01

    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. 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. 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 < 0.001). A significant difference was observed between three educational levels, including externships, internships, and assistantships regarding the dimensions of the quality gaps (p < 0.001). 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.

  19. Growing Pains at Hospitals: Opportunities and Issues of Service Expansion in Maximum Care

    Directory of Open Access Journals (Sweden)

    Juergen Hinkelmann

    2017-06-01

    Full Text Available PurposeDue to the demographic change morbidity raises the demand for medical hospital services as well as a need for medical specialization, while economic and human resources are diminishing. Unlike other industries hospitals do not have sufficient data and adequate models to relate growing demands and increasing performance to growth in staff capacity and to increase in staff competences.MethodBased on huge medical data sample covering the years from 2010 to 2014 with more than 150,000 operations of the Department for Anesthesiology at the University Hospital Muenster, Germany, comparisons are drawn between the development of medical services and the development of personnel capacity and expertise.ResultsThe numbers of surgical operations increased by 21% and “skin incision to closure” time by 17%. Simultaneously, personnel capacity grew by 16% largely resting upon recruiting first-time employees. Expertise measured as “years of professional experience” dwindled from 10 years to 5.4 years on average and staff turnover accelerated.ConclusionStatic benchmark data collected at fixed reference dates do not sufficiently reflect the nexus between capacity and competence and do not reflect the dynamic changes in a hospital’s requirements for expertise and specialization, at all. Staff turnover leads to a loss of experience, which jeopardizes patient safety and hampers medical specialization. In consequence of the dramatic shortage of medical specialists, drop-off rates must be reduced and retention rates must be increased. To that end, working conditions need to be fundamentally converted for a multigeneration, multicultural, and increasingly female workforce.

  20. [The Asahi Model-Regional Mental Health Services at Department of Psychiatry and Child Psychiatry, Asahi General Hospital].

    Science.gov (United States)

    Aoki, Tsutomu

    2015-01-01

    The Asahi model, Psychiatric Services of Department of Psychiatry and Child Psychiatry, Asahi General Hospital, is characterized by multiple dimensions of mental health services, such as multidisciplinary team approach, medical cooperation, specialized psychiatric treatment of acute care, clozapine and modified ECT, outreach services of home nursing and assertive community treatment, and the close and mutual coordination with housing services and social welfare services. The Asahi Model makes it possible to be deinstitutionalized, to improve patients satisfaction, to shorten hospitalization, to decrease psychiatric emergency visits and to be of service in a natural disaster. It also might prevent the relapse of schizophrenics within twelve months after discharge and improve the quality of mental health staffs trainings to support patients better. In the future, we will need to work on providing sectorized care, early psychosis intervention programs, to construct networking systems of clozapine and modified ECT, to strengthen growth of home nursing, and to take place mental health anti-stigma campaigns.

  1. Examining leadership as a strategy to enhance health care service delivery in regional hospitals in South Africa

    Science.gov (United States)

    Govender, Sagaren; Gerwel Proches, Cecile N; Kader, Abdulla

    2018-01-01

    Background Four public hospitals in South Africa, which render both specialized and nonspecialized services to thousands of patients, were examined to determine the impact of leadership on health care service delivery. These hospitals were inundated by various problems that were impacting negatively on health care service delivery. Purpose This research study aimed to gain a comprehensive understanding of the challenges, complexities and constraints facing public health care in KwaZulu-Natal (KZN) and to examine leadership as a strategy to enhance healthcare service delivery with a particular focus on four regional hospitals in the KZN Province. Methods The mixed-method research approach was utilized. Purposive sampling and stratified random sampling were employed in the research setting, and in-depth, semistructured interviews and questionnaires were used to collect data. Data were analyzed using the Nvivo computer software package for in-depth interviews and the Statistical Package for the Social Sciences (SPSS) software for the quantitative analysis. Results The research findings showed that the current leadership framework adopted by the health care leaders in regional hospitals in KZN is weak and is contributing to poor health care service delivery. Conclusion This study, therefore, aimed to address the current challenges and weaknesses that are impacting negatively on health care service delivery in regional hospitals in the KZN Province and made recommendations for improvement. PMID:29535529

  2. Examining leadership as a strategy to enhance health care service delivery in regional hospitals in South Africa.

    Science.gov (United States)

    Govender, Sagaren; Gerwel Proches, Cecile N; Kader, Abdulla

    2018-01-01

    Four public hospitals in South Africa, which render both specialized and nonspecialized services to thousands of patients, were examined to determine the impact of leadership on health care service delivery. These hospitals were inundated by various problems that were impacting negatively on health care service delivery. This research study aimed to gain a comprehensive understanding of the challenges, complexities and constraints facing public health care in KwaZulu-Natal (KZN) and to examine leadership as a strategy to enhance healthcare service delivery with a particular focus on four regional hospitals in the KZN Province. The mixed-method research approach was utilized. Purposive sampling and stratified random sampling were employed in the research setting, and in-depth, semistructured interviews and questionnaires were used to collect data. Data were analyzed using the Nvivo computer software package for in-depth interviews and the Statistical Package for the Social Sciences (SPSS) software for the quantitative analysis. The research findings showed that the current leadership framework adopted by the health care leaders in regional hospitals in KZN is weak and is contributing to poor health care service delivery. This study, therefore, aimed to address the current challenges and weaknesses that are impacting negatively on health care service delivery in regional hospitals in the KZN Province and made recommendations for improvement.

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

    International Nuclear Information System (INIS)

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

    2009-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Corinne M Hohl

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

  5. Assessment of Service Quality in Teaching Hospitals of Yazd University of Medical Sciences: Using Multi-criteria Decision Making Techniques.

    Science.gov (United States)

    Shafii, Milad; Rafiei, Sima; Abooee, Fatemeh; Bahrami, Mohammad Amin; Nouhi, Mojtaba; Lotfi, Farhad; Khanjankhani, Khatere

    2016-08-01

    Hospitals as integrated parts of the wide-ranging health care systems have dominant focus on health care provision to meet, maintain and promote people's health needs of a community. This study aimed to assess the service quality of teaching hospitals of Yazd University of Medical Sciences using Fuzzy Analytical Hierarchy Process (FAHP) and Technique for Order Preference by Similarity to Ideal Solution (TOPSIS). A literature review and a qualitative method were used to obtain experts' viewpoints about the quality dimensions of hospital services to design a questionnaire. Then, using a self-made questionnaire, perceptions of 300 patients about the quality of delivered services were gathered. Finally, FAHP was applied to weigh each quality dimension and TOPSIS method to rank hospital wards. Six dimensions including responsiveness, assurance, security, tangibles, health communication and Patient orientation were identified as affecting aspects of hospital services quality among which, security and tangibles got the highest and lowest importance respectively (0.25406, 0.06883). Findings also revealed that in hospital A, orthopedics and ophthalmology wards obtained the highest score in terms of quality while cardiology department got the lowest ranking (0.954, 0.323). In hospital B, the highest and the lowest ranking was belonged to cardiology and surgical wards (0.895, 0.00) while in hospital C, surgical units were rated higher than internal wards (0.959, 0.851). Findings emphasized that the security dimension got the lowest ranking among SERVQUAL facets in studied hospitals. This requires hospital executives to pay special attention to the issue of patients' security and plan effectively for its promotion.

  6. [Outsourcing: theory and practice at a clinical hospital in Szczecin exemplified by medical waste transport and treatment service].

    Science.gov (United States)

    Kotlega, Dariusz; Nowacki, Przemysław; Lewiński, Dariusz; Chmurowicz, Ryszard; Ciećwiez, Sylwester

    2011-01-01

    Outsourcing proves to be a useful tool in the difficult process of improving the financial result of hospitals. Outsourcing means separation of some functions and services in one entity and their transfer to another. The aim of this study was to analyze the use of outsourcing at the Second Independent Public University Hospital of the Pomeranian Medical University (SPSK 2 PUM) in Szczecin. We studied the transport and treatment of medical waste. Outsourcing of waste treatment services led to financial savings. The cost of treatment of one kilogram of waste by an external company was PLN 2.53. The same service provided by the hospital would cost approximately PLN 7 per kilogram. Appropriate attention should be paid to the quality of services. It seems useful to have appropriate tools for quality control and monitoring. SPSK 2 PUM can serve as a good example of effective use of outsourcing.

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

    OpenAIRE

    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 ...

  8. Psychosocial risk factors for hospital readmission in COPD patients on early discharge services: a cohort study

    Directory of Open Access Journals (Sweden)

    Todd Christopher J

    2011-11-01

    Full Text Available Abstract Background Hospital readmission for acute exacerbation of COPD (AECOPD occurs in up to 30% of patients, leading to excess morbidity and poor survival. Physiological risk factors predict readmission, but the impact of modifiable psychosocial risk factors remains uncertain. We aimed to evaluate whether psychosocial risk factors independently predict readmission for AECOPD in patients referred to early discharge services (EDS. Methods This prospective cohort study included 79 patients with AECOPD cared for by nurse led EDS in the UK, and followed up for 12 months. Data on lung function, medical comorbidities, previous hospital admissions, medications, and sociodemographics were collected at baseline; St George's Respiratory Questionnaire (SGRQ, Hospital Anxiety and Depression Scale (HADS, and social support were measured at baseline, 3 and 12-months. Exploratory multivariate models were fitted to identify psychosocial factors associated with readmission adjusted for known confounders. Results 26 patients were readmitted within 90 days and 60 patients were readmitted at least once during follow-up. Depression at baseline predicted readmission adjusted for sociodemographics and forced expiratory volume in 1 second (odds ratio 1.30, 95% CI 1.06 to 1.60, p = 0.013. Perceived social support was not significantly associated with risk of readmission. Home ownership was associated with the total number of readmissions (B = 0.46, 95% CI -0.86 to -0.06, p = 0.024. Compared with those not readmitted, readmitted patients had worse SGRQ and HADS scores at 12 months. Conclusion Depressive symptoms and socioeconomic status, but not perceived social support, predict risk of readmission and readmission frequency for AECOPD in patients cared for by nurse-led EDS. Future work on reducing demand for unscheduled hospital admissions could include the design and evaluation of interventions aimed at optimising the psychosocial care of AECOPD patients managed at

  9. Pre-hospital pelvic girdle injury: Improving diagnostic accuracy in a physician-led trauma service.

    Science.gov (United States)

    Yong, E; Vasireddy, A; Pavitt, A; Davies, G E; Lockey, D J

    2016-02-01

    Examination of missed injuries in our physician-led pre-hospital trauma service indicated that the significant injuries missed were often pelvic fractures. We therefore conducted a study whose aim was to evaluate the pre-hospital diagnostic accuracy of pelvic girdle injuries, and how this would be affected by implementing the pelvic injury treatment guidelines recently published by the Faculty of Pre-Hospital Care. All blunt trauma patients attended in a 5-month period were included in the study. The presence or absence of pelvic girdle injury on computed tomography (CT) or, if unavailable, pelvic X-ray was used as a primary outcome measure. A retrospective database and case note review was conducted to identify patients who had pelvic binder applied in the study period. For the purposes of the study, pelvic ring and acetabular fractures were grouped together as patients with suspected pelvic girdle injury that should be fitted with a pelvic binder in the pre-hospital setting. The sensitivity and specificity, relating to the presence of pelvic girdle injury in patients with pelvic binders, was calculated in order to determine pre-hospital diagnostic accuracy. 785 patients were attended during the study period. 170 met the study inclusion criteria. 26 (15.3%) sustained a pelvic girdle injury. 45 (26.5%) had a pelvic binder applied. There were eight missed fractures (31%), of which the majority (six) sustained less severe injuries that were managed non-operatively. Two patients required operative fixation. Radiological images and/or reports were available on 169 (99.4%) patients. As a test of the presence of pelvic fracture, pelvic binder application had a sensitivity of 0.69 (95% CI 0.50-0.85) and a specificity of 0.81 (95% CI 0.74-0.87). Even with a careful clinical assessment and a low threshold for binder application, this study highlights the problems of distracting injury when trying to diagnose and manage pelvic fractures. By implementing the pelvic treatment

  10. Developing Indicators of Service Quality Provided for Cardiovascular Patients Hospitalized in Cardiac Care Unit

    Directory of Open Access Journals (Sweden)

    Saber Azami-Aghdash

    2013-03-01

    Full Text Available Introduction: Cardiovascular diseases are among the most prevalent chronic diseases leading to high degrees of mortality and morbidity worldwide and in Iran. The aim of the current study was to determine and develop appropriate indicators for evaluating provided service quality for cardiovascular patients admitted to Cardiac Care Units (CCU in Iran. Methods: In order to determine the indicators for evaluating provided service quality, a four-stage process including reviewing systematic review articles in premier bibliographic databases, interview, performing two rounds of Delphi technique, and holding experts panel by attendance of experts in different fields was adopted. Finally, after recognizing relevant indicators in resources, these indicators were finalized during various stages using ideas of 27 experts in different fields. Results: Among 2800 found articles in the text reviewing phase, 21 articles, which had completely mentioned relevant indicators, were studied and 48 related indicators were extracted. After two interviews with a cardiologist and an epidemiologist, 32 items of the indicators were omitted and replaced by 27 indicators coping with the conditions of Iranian hospitals. Finally, 43 indicators were added into the Delphi phase and after 2 rounds of Delphi with 18 specialists, 7 cases were excluded due to their low scores of applicability. In the experts’ panel stage, 6 items were also omitted and 10 new indicators were developed to replace them. Eventually, 40 indicators were finalized. Conclusion: In this study, some proper indicators for evaluating provided service quality for CCU admissions in Iran were determined. Considering the informative richness of these indicators, they can be used by managers, policy makers, health service providers, and also insurance agencies in order to improve the quality of services, decisions, and policies.

  11. Ancillary effects of selected acid deposition control policies

    Energy Technology Data Exchange (ETDEWEB)

    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.

  12. Unplanned Hospital Visits - Hospital

    Data.gov (United States)

    U.S. Department of Health & Human Services — Unplanned Hospital Visits – provider data. This data set includes provider data for the hospital return days (or excess days in acute care) measures, the unplanned...

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

    Directory of Open Access Journals (Sweden)

    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.

  14. Hospital administration team development and support in a children's cancer service.

    Science.gov (United States)

    Slater, Penelope J

    2011-11-01

    The administration team in the Queensland Children's Cancer Centre at the Royal Children's Hospital, Brisbane, included a team of 16 administration staff supporting the service and the state-wide clinical network. Shortly after the creation of a new expanded service, issues became apparent in administration team morale, relationships, communication, processes, leadership, support and training. The analysis of these issues included team interviews and surveys, consultation with senior administration staff and monthly sick leave monitoring. Strategies implemented included providing information; the joint development of a team business plan and individual performance plans; a review of the team's structure, workload and business processes; engaging staff in quality improvements; and the development of relationships and leadership. As a result, the team reported being more comfortable and supported in their roles, had improved morale and worked better together with more consistent and improving business processes. They had clear purpose and expectations of their roles, displayed better customer service and had reduced sick leave. The study shows that in a high stress environment, such as a children's cancer centre, attention to the team's culture, vision and purpose, providing information and improving communication and relationships, when combined with a team's enthusiasm, will improve the team's growth, cooperation and work outcomes.

  15. Comparison of Patient Outcome Measures between a Traditional Teaching Hospitalist Service and a Non-Teaching Hospitalist Service at an Academic Children's Hospital.

    Science.gov (United States)

    Tarchichi, Tony R; Garrison, Jessica; Jeong, Kwonho; Fabio, Anthony

    2017-12-01

    Inpatient pediatric care is increasingly provided by pediatric hospitalists. This, in addition to changes in resident duty hour restrictions, has led to the creation of new models of care for inpatient pediatric patients. The objective of this study was to compare traditional outcome measures between a pediatric hospitalist-only service and a more traditional academic service in which care was provided by pediatric hospitalists, residents, and medical students. Attending physicians on the hospitalist-only service had an average of 1.7 years of post-residency experience compared to an average 16 years of experience for those working on the traditional academic service. This retrospective cohort study (hospitalist-only v. teaching service) used electronic medical records data of patients (n=1,059) admitted to a quaternary care, academic, children's hospital in Pittsburgh Pennsylvania with diagnoses of bronchiolitis, viral syndrome, and gastroenteritis from July 2011 to June 2014. Primary outcome measures included length of stay, hospital costs, and readmission rates. Patients with a diagnosis of bronchiolitis admitted to the hospitalist-only service had a significantly higher severity-of-illness-score than those admitted to the teaching service. A decreased length of stay and lower hospital costs were seen for patients admitted to the hospitalist-only service; however, these differences did not reach a level of statistical significance. There were no statistically significant differences in the outcome measures of patients with common pediatric illnesses admitted to a hospitalist-only versus a teaching hospitalist service. The model of a hospitalist-only service staffed by recent residency graduates may provide an efficient and effective model of care as patients admitted to this service had similar outcome measures to those patients cared for by more-experienced attending physicians.

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

    Directory of Open Access Journals (Sweden)

    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.

  17. Inequity in Hospitalization Care: A Study on Utilization of Healthcare Services in West Bengal, India

    Directory of Open Access Journals (Sweden)

    Montu Bose

    2015-01-01

    Full Text Available Background Out of eight commonly agreed Millennium Development Goals (MDG, six are related to the attainment of Universal Health Coverage (UHC throughout the globe. This universalization of health status suggests policies to narrow the gap in access and benefit sharing between different socially and economically underprivileged classes with that of the better placed ones and a consequent expansion of subsidized healthcare appears to be a common feature for most of the developing nations. The National Health Policy in India (2002 suggests expansion of market-based care for the affording class and subsidized care for the deserving class of the society. So, the benefit distribution of this limited public support in health sector is important to examine to study the welfare consequences of the policy. This paper examines the nature of utilizationto inpatient care by different socio-economic groups across regions and gender in West Bengal (WB, India. The benefit incidence of public subsidies across these socio-economic groups has also been verified for different types of services like medicines, diagnostics and professional care etc. Methods National Sample Survey Organization (NSSO has collected information on all hospitalized cases (60th round, 2004 with a recall period of 365 days from the sampled households through stratified random sampling technique. The data has been used to assess utilization of healthcare services during hospitalization and the distribution of public subsidies among the patients of different socio-economic background; a Benefit Incidence Analysis (BIA has also been carried out. Results Analysis shows that though the rate of utilization of public hospitals is quite high, other complementary services like medicine, doctor and diagnostic tests are mostly purchased from private market. This leads to high Out-of-Pocket (OOP expenditure. Moreover, BIA reveals that the public subsidies are mostly enjoyed by the relatively better

  18. Evaluating the impact of decentralising tuberculosis microscopy services to rural township hospitals in gansu province, china

    Directory of Open Access Journals (Sweden)

    Newell James N

    2011-02-01

    Full Text Available Abstract Background In 2004, the Ministry of Health issued the policy of decentralising microscopy services (MCs to one third of all township hospitals in China. The study was conducted in Gansu Province, a poor western one in China. Ganzhou was one county in Gansu Province. Ganzhou County was identified as a unique case of further decentralisation of tuberculosis (TB treatment services in township hospitals. The study evaluated the impact of the MC policy on providers and patients in Gansu Province. The second objective was to assess the unique case of Ganzhou County compared with other counties in the province. Methods Both quantitative and qualitative methods were used. All 523 MCs in the province completed an institutional survey regarding their performance. Four counties were selected for in-depth investigation, where 169 TB suspects were randomly selected from the MC and county TB dispensary registers for questionnaire surveys. Informant interviews were conducted with 38 health staff at the township and county levels in the four counties. Results Gansu established MCs in 39% of its township hospitals. From January 2006 to June 2007, 8% of MCs identified more than 10 TB sputum smear positive patients while 54% did not find any. MCs identified 1546 TB sputum smear positive patients, accounting for 9% of the total in the province. The throughputs of MCs in Ganzhou County were eight times of those in other counties. Interviews identified several barriers to implement the MC policy, such as inadequate health financing, low laboratory capacity, lack of human resources, poor treatment and management capacities, and lack of supervisions from county TB dispensaries. Conclusion Microscopy centre throughputs were generally low in Gansu Province, and the contribution of MCs to TB case detection was insignificant taking account the number of MCs established. As a unique case of full decentralisation of TB service, Ganzhou County presented better

  19. Evaluating the outcomes of a podiatry-led assessment service in a public hospital orthopaedic unit.

    Science.gov (United States)

    Bonanno, Daniel R; Medica, Virginia G; Tan, Daphne S; Spring, Anita A; Bird, Adam R; Gazarek, Jana

    2014-01-01

    In Australia, the demand for foot and ankle orthopaedic services in public health settings currently outweighs capacity. Introducing experienced allied health professionals into orthopaedic units to initiate the triage, assessment and management of patients has been proposed to help meet demand. The aim of this study was to evaluate the effect of introducing a podiatry-led assessment service in a public hospital orthopaedic unit. The outcomes of interest were determining: the proportion of patients discharged without requiring an orthopaedic appointment, agreement in diagnosis between the patient referral and the assessing podiatrist, the proportion of foot and ankle conditions presenting to the service, and the proportion of each condition to require an orthopaedic appointment. This study audited the first 100 patients to receive an appointment at a new podiatry-led assessment service. The podiatrist triaged 'Category 3' referrals consisting of musculoskeletal foot and ankle conditions and appointments were provided for those considered likely to benefit from non-surgical management. Following assessment, patients were referred to an appropriate healthcare professional or were discharged. At the initial appointment or following a period of care, patients were discharged if non-surgical management was successful, surgery was not indicated, patients did not want surgery, and if patient's failed to attend their appointments. All other patients were referred for an orthopaedic consultation as indicated. Ninety-five of the 100 patients (69 females and 31 males; mean age 51.9, SD 16.4 years) attended their appointment at the podiatry-led assessment service. The 95 referrals contained a total of 107 diagnoses, of which the podiatrist agreed with the diagnosis stated on the referral in 56 cases (Kappa =0.49, SE = 0.05). Overall, 34 of the 100 patients were referred to an orthopaedic surgeon and the remaining 66 patients were discharged from the orthopaedic waiting

  20. Impact of free delivery policy on utilization of maternal health services in county referral hospitals in Kenya.

    Science.gov (United States)

    Njuguna, John; Kamau, Njoroge; Muruka, Charles

    2017-06-21

    Kenya has a high maternal mortality rate. Provision of skilled delivery plays a major role in reducing maternal mortality. Cost is a hindrance to the utilization of skilled delivery. The Government of Kenya introduced a policy of free delivery services in government facilities beginning June 2013. We sought to determine the impact of this intervention on facility based deliveries in Kenya. We compared deliveries and antenatal attendance in 47 county referral hospitals and 30 low cost private hospitals not participating in the free delivery policy for 2013 and 2014 respectively. The data was extracted from the Kenya Health Information System. Multiple regression was done to assess factors influencing increase in number of deliveries among the county referral hospitals. The number of deliveries and antenatal attendance increased by 26.8% and 16.2% in county referral hospitals and decreased by 11.9% and 5.4% respectively in low cost private hospitals. Increase in deliveries among county referral hospitals was influenced by population size of county and type of county referral hospital. Counties with level 5 hospitals recorded more deliveries compared to those with level 4 hospitals. This intervention increased the number of facility based deliveries. Policy makers may consider incorporating low cost private hospitals so as to increase the coverage of this intervention.

  1. The University Hospital Zurich Offers a Medical Online Consultation Service for Men With Intimate Health Problems.

    Science.gov (United States)

    Schmidt-Weitmann, Sabine; Schulz, Urs; Schmid, Daniel Max; Brockes, Christiane

    2017-05-01

    The University Hospital of Zurich offers a text-based, Medical Online Consultation Service to the public since 1999. Users asked health questions anonymously to tele-doctors. This study focused on the characteristics of male enquirers with intimate health problems, the content of their questions, the medical advice given by tele-doctors and the rating of the service to prove the benefit of an online service for medical laymen. This retrospective study included 5.1% of 3,305 enquiries from 2008 to 2010 using the International Classification of Diseases-10 and International Classification of Primary Care codes relevant for intimate and sexual health problems in men. A professional text analysis program (MAXQDA) supported the content analysis, which is based on the procedure of inductive category development described by Mayring. The average age was 40 years, 63.1% enquirers had no comorbidity, in 62.5% it was the first time they consulted a doctor, and 70.2% asked for a specific, single, intimate health issue. In 64.3%, the most important organ of concern was the penis. Overall, 30.4% asked about sexually transmitted diseases. In 74.4% a doctor visit was recommended to clarify the health issue. The rating of the problem solving was very good. The service was mainly used by younger men without comorbidity and no previous contact with a doctor with regard to an intimate health problem. The anonymous setting of the teleconsultation provided men individual, professional medical advice and decision support. Teleconsultation is suggested to empower patients by developing more health literacy.

  2. [Supply medicinal products improvement in outpatient care in a hospital pharmacy service].

    Science.gov (United States)

    Santiago Pérez, A; Peña Pedrosa, J A; Alguacil Pau, A I; Pérez Morales, A; Molina Muñoz, P; Benítez Giménez, M T

    2018-02-17

    Pharmaceutical care to outpatients is currently one of the main occupations of hospital pharmacy services (PEX). There are several questionnaires to measure the satisfaction of the PEX of a pharmacy service, and the results of these questionnaires can generate improvement actions that result in satisfaction. To verify if a satisfaction questionnaire for outpatients is valid for the generation of improvements in the care provided, and if after its implementation, the same questionnaire is able to detect changes in satisfaction. Prospective study of a single center carried out in a tertiary hospital in 2015 and 2016. A questionnaire previously validated with 16 Likert-type items was used. Demographic and classification data were collected. A descriptive analysis was performed and the internal consistency was calculated using the Cronbach's α value. A total of 258 questionnaires were collected in 2015 and 493 in 2016. There were no differences in the baseline characteristics of the patients and users of the service. The items with the lowest satisfaction scores in 2015 (comfort of the waiting room, dispensing privacy, drug pick-up time and medication pick-up time) guided the improvement actions to be implemented. In 2016 there was an improvement in the waiting time until collection in 12.3% (p = 0.002); in the comfort of the waiting room 4.9% (p = 0.304); business hours for medication collection, 10.7% (p = 0.013); and in the confidentiality of the dispensation 4% (p = 0.292). The remaining scores fluctuated minimally, with no statistical significance at all. A 5.1% improvement in overall satisfaction was found (p < 0.001). Satisfaction values obtained as a whole were high. The satisfaction questionnaire is a valid instrument for generating actions to improve the care received in an outpatient unit of a pharmacy service. This same questionnaire is a tool to monitor the changes implemented to improve the care received. Copyright © 2018 SECA. Publicado por

  3. Physicians' and nurses' satisfaction with the clinical laboratory service of Gondar University Hospital, northwest Ethiopia.

    Science.gov (United States)

    Addis, Zelalem; Birhan, Wubet; Derseh, Dejene; Sahle, Biruktawit; Gizaw, Netsanet

    2013-09-01

    To assess physicians' and nurses' satisfaction with the service provided by the laboratory at Gondar University Hospital. We conducted a cross-sectional study involving 196 nurses and physicians. Overall level of satisfaction was 51.1% for nurses and 51.5% for physicians. Lack of consistency in the quality of laboratory work, absence of a timely report of critical values, test turnaround time, acceptability of results released, and reporting of reference ranges with test results were areas mentioned as sources of dissatisfaction. The study showed wide room for improvement. In addition to taking intervention, root causes of dissatisfaction need to be investigated and means of improving the satisfaction level should be designed and implemented.

  4. Services quality in emergency department of Nemazee Hospital: Using SERVQUAL model

    Directory of Open Access Journals (Sweden)

    Maryam Gholami

    2016-10-01

    Full Text Available Introduction: Patient satisfaction is crucial to the long-run success in health care center. With regard to the highest patients’ referral to the emergency department and the existing challenges due to the patient’s need to urgent care, we aimed to evaluate health care services quality in this unit to find out whether the patients have different expectations from health care providers and if they perceive some dimensions of care more important than others. Method: The SERVQUAL scale method was used in this cross-sectional study on 100 patients in June 2015. Patient satisfaction questionnaire based on SERVQUAL model was evaluated with high content validity and the reliability was 0.97 and 0.81. The data collected were analyzed using SPSS, version 20.0 (IBM, USA. Statistical analyses included descriptive statistics, paired and independence sample t-test and ANOVA at the significance level 0.05. Results:The results showed that the quality gap in all dimensions was significant (P<0.001. The largest quality gap was related to responsiveness (-1.08 and the lowest belonged to assurance (-0.8. Demographic characteristics were analyzed and the number of referrals was significant in tangibility and assurance dimensions (P = 0.04; also, in all cases the patients’ expectations (total Mean=4.35 were higher than their perception (total Mean = 3.295. Conclusion: In order to improve emergency services, it is recommended that the hospital management should provide appropriate facilities, reduce waiting time, increase in attention to ordering system based on the patients’ condition, and improve the behavior of health care personnel to patient is placed on the agenda of hospital management.

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

    Directory of Open Access Journals (Sweden)

    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

  6. Youth and young adults with spina bifida: their utilization of physician and hospital services.

    Science.gov (United States)

    Young, Nancy L; Anselmo, Lianne A; Burke, Tricia A; McCormick, Anna; Mukherjee, Shubhra

    2014-03-01

    To describe current patterns of health care utilization of youth and young adults who have spina bifida (SB) and provide evidence to guide the development of health care for this growing population. We conducted a secondary analysis of health services utilization data from the Canadian Institute for Health Information to determine the rates and patterns of health care utilization, because comprehensive health care has been recognized as critical to positive health outcomes. Participants were identified from 6 publicly funded children's treatment centers. Health records from youth (n=164; age range, 13.0-17.9y) and adults (n=120; age range, 23.0-32.9y) with SB contributed to this study. Not applicable. The rates of outpatient physician visits and hospital admissions for the youth and adult groups were calculated. The proportion with a "medical home" was also calculated. The annual rates of outpatient physician visits per 1000 persons were 8031 for youth and 8524 for adults with SB. These rates were approximately 2.9 and 2.2 times higher, respectively, than for their age-matched peers. On average, 12% of youth and 24% of adults with SB had a medical home. The annual rates of hospital admissions per 1000 persons were 329 for youth and 285 for adults with SB. Rates of admissions were 19.4 and 12.4 times higher, respectively, for these groups than for the general population. It appears that persons with SB are accessing health services more often than their age-matched peers, and few have a medical home. We recommend that seamless medical care be provided to all adults with SB, coordinated by a primary care provider, to facilitate comprehensive care. Copyright © 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  7. Implementation of a model of quality control program in the radiodiagnostic service at the general hospital Dos de Mayo

    International Nuclear Information System (INIS)

    Acosta Reginfo, N.; Ramirez Quijada, R.

    1998-01-01

    In order to implement a model of quality control program, the General Hospital Dos de Mayo was selected, since it manages a specialized radiology service - defined according to the OMS criteria - This radiology service attends nearly 60 % of total patients of the Hospital. This program intends to be a model for application to another hospitals havings similar characteritics, since any formal quality control program has been implemented in neither private nor public hospitals in the country. The model, while allowing to make measurements of main parameters, also allows to verify that radiation doses to patients, radiation workers and public trend to a level as low as reasonably achievable, and also to yield images with enough diagnostic quality, and to induce work environment with shared responsibility and commitment

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

    Directory of Open Access Journals (Sweden)

    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

  9. [Interventions to solve overcrowding in hospital emergency services: a systematic review].

    Science.gov (United States)

    Bittencourt, Roberto José; Hortale, Virginia Alonso

    2009-07-01

    This review discusses interventions aimed at solving the problem of overcrowding in hospital emergency services (HES), characteristic of low organizational effectiveness. In free-access and restricted-access databases, the target descriptors were 'overcrowding; emergency; medicine; first aid'. The survey identified 66 citations of interventions, grouped in 47 related interventions. The majority of the studies used observational designs that evaluated the results before and after interventions. Of the 47 related interventions, 34 had results for organizational performance. Four were the most frequently cited: implementation of an observation unit for patients already hospitalized and awaiting diagnosis or clinical stabilization; designation of a dedicated nursing station for the patient's admission, discharge, or transfer; establishment of protocols with indicators of operational saturation and implementation of an emergency care unit. Analyzing 21 interventions that were intended to solve overcrowding in HES and with positive results for length-of-stay, 15 were related to patient stream improvement, interfering actively and positively in patient stream. Interventions that increased access barriers or that merely improved the HES structure were ineffective.

  10. Hospital

    African Journals Online (AJOL)

    Burkitt's lymphoma of the head and neck region in a Nigerian tertiary. Hospital ... Some complications of treatment were noted. Discussion: ..... Cancer. Biother Radiopharm 1999 14: 251-62 (Medline). Reece DE. Evidence based management of Hodgkin's disease. The role of autologous stem cell transplantation. Cancer ...

  11. Cultural competency assessment tool for hospitals: Evaluating hospitals’ adherence to the culturally and linguistically appropriate services standards

    Science.gov (United States)

    Weech-Maldonado, Robert; Dreachslin, Janice L.; Brown, Julie; Pradhan, Rohit; Rubin, Kelly L.; Schiller, Cameron; Hays, Ron D.

    2016-01-01

    Background The U.S. national standards for culturally and linguistically appropriate services (CLAS) in health care provide guidelines on policies and practices aimed at developing culturally competent systems of care. The Cultural Competency Assessment Tool for Hospitals (CCATH) was developed as an organizational tool to assess adherence to the CLAS standards. Purposes First, we describe the development of the CCATH and estimate the reliability and validity of the CCATH measures. Second, we discuss the managerial implications of the CCATH as an organizational tool to assess cultural competency. Methodology/Approach We pilot tested an initial draft of the CCATH, revised it based on a focus group and cognitive interviews, and then administered it in a field test with a sample of California hospitals. The reliability and validity of the CCATH were evaluated using factor analysis, analysis of variance, and Cronbach’s alphas. Findings Exploratory and confirmatory factor analyses identified 12 CCATH composites: leadership and strategic planning, data collection on inpatient population, data collection on service area, performance management systems and quality improvement, human resources practices, diversity training, community representation, availability of interpreter services, interpreter services policies, quality of interpreter services, translation of written materials, and clinical cultural competency practices. All the CCATH scales had internal consistency reliability of .65 or above, and the reliability was .70 or above for 9 of the 12 scales. Analysis of variance results showed that not-for-profit hospitals have higher CCATH scores than for-profit hospitals in five CCATH scales and higher CCATH scores than government hospitals in two CCATH scales. Practice Implications The CCATH showed adequate psychometric properties. Managers and policy makers can use the CCATH as a tool to evaluate hospital performance in cultural competency and identify and target

  12. IDENTIFYING ELEVEN FACTORS OF SERVICE MARKETING MIX (4PS) EFFECTIVE ON TENDENCY OF PATIENTS TOWARD PRIVATE HOSPITAL

    OpenAIRE

    Hosseini, Seyed Mojtaba; Etesaminia, Samira; Jafari, Mehrnoosh

    2016-01-01

    Introduction: One of the important factors of correct management is to identify the reasons for patient tendency toward private hospitals. This study measures these factors based on service marketing mixes. Patients and methods: This study used a cross sectional descriptive methodology. The study was conducted during 6 months in 2015. The studied population included patients of private hospitals in Tehran. Random sampling was used (n = 200). Data was collected by an author-made questionnaire ...

  13. [Comprehensive study on the prevention of food poisoning through the investigation of an affected hospital food service facility].

    Science.gov (United States)

    Kubota, Satoshi; Kawai, Hiromi

    2015-01-01

    In Japan, more than 20,000 people suffer from various types of food poisoning annually. In this paper, we discuss the prevention of food poisoning in hospital food service facilities from the perspective of hygiene management and organizational behavior. We inspected the kitchen environment and the meal preparation process in a hospital food service facility in Japan that had been the site of a food poisoning incident. To clarify the present state of hygiene management, interviews were conducted with both the head of the nutrition and food service section and the administrative manager. In addition, questionnaires were distributed to the food service staff to assess their level of satisfaction with the working environment. The facility had been built about 10 years previously and was well maintained. Meal preparations were performed according to the operation manual, and education and training for the food service staff were carried out daily. No problems were evident regarding hygiene management. However, concerning organizational behavior, the satisfaction level of the staff was found to be relatively low, which may have led to a reduction in their organizational commitment and a decrease in their performance. To aid in the prevention of food poisoning incidents in hospital food service facilities, it is essential not only to conduct standard hygiene management and training, but also to consider the organizational behavior of the food service staff.

  14. Medicare Program; hospital inpatient prospective payment systems for acute care hospitals and the long-term care hospital prospective payment system changes and FY2011 rates; provider agreements and supplier approvals; and hospital conditions of participation for rehabilitation and respiratory care services; Medicaid program: accreditation for providers of inpatient psychiatric services. Final rules and interim final rule with comment period.

    Science.gov (United States)

    2010-08-16

    : We are revising the Medicare hospital inpatient prospective payment systems (IPPS) for operating and capital-related costs of acute care hospitals to implement changes arising from our continuing experience with these systems and to implement certain provisions of the Affordable Care Act and other legislation. In addition, we describe the changes to the amounts and factors used to determine the rates for Medicare acute care hospital inpatient services for operating costs and capital-related costs. We also are setting forth the update to the rate-of-increase limits for certain hospitals excluded from the IPPS that are paid on a reasonable cost basis subject to these limits. We are updating the payment policy and the annual payment rates for the Medicare prospective payment system (PPS) for inpatient hospital services provided by long-term care hospitals (LTCHs) and setting forth the changes to the payment rates, factors, and other payment rate policies under the LTCH PPS. In addition, we are finalizing the provisions of the August 27, 2009 interim final rule that implemented statutory provisions relating to payments to LTCHs and LTCH satellite facilities and increases in beds in existing LTCHs and LTCH satellite facilities under the LTCH PPS. We are making changes affecting the: Medicare conditions of participation for hospitals relating to the types of practitioners who may provide rehabilitation services and respiratory care services; and determination of the effective date of provider agreements and supplier approvals under Medicare. We are also setting forth provisions that offer psychiatric hospitals and hospitals with inpatient psychiatric programs increased flexibility in obtaining accreditation to participate in the Medicaid program. Psychiatric hospitals and hospitals with inpatient psychiatric programs will have the choice of undergoing a State survey or of obtaining accreditation from a national accrediting organization whose hospital accreditation

  15. Customer service as an act of(f balance: lessons for the tourism and hospitality industry

    Directory of Open Access Journals (Sweden)

    S Henning

    2014-01-01

    Full Text Available This article reports on corporate customers' perceptions of a telecommunications organisation in South Africa and the lessons learned for the tourism industry. The purpose of the research was to explore reasons for the decline in customers' perceptions of overall quality of service at Telematics SA from a systems theory perspective. The Three State Triangle model (Henning, 2009 was presented as the three dynamic states of all living systems, including businesses and industries. The states were identified as Stable equilibrium (Se, Explosive instability (Ei and Bounded instability (Bi. The model was applied to interpret the findings and offered a way to interpret customer experiences at Telematics SA. Qualitative research was the chosen method of inquiry. A card game was the conversational instrument used to conduct 10 in-depth interviews with Virtual Private Network customers. Purposeful sampling fitted the rationale of the study. Content analysis was done to identify coding categories, while touch-point validity confirmed that the findings were aligned with the systems theoretical concepts. The research methodology can be applied as a qualitative diagnostic tool in different business contexts, while the Three State Triangle model reveals the underlying dynamic processes in organisations. The research results are applied as lessons to be learned for the continuous improvement of products and services of businesses in the hospitality and tourism industry. Businesses should not get stuck in old strategies and policies but adopt a state of Bounded instability where innovation and renewal is possible.

  16. Assessment of surveys for the management of hospital clinical pharmacy services.

    Science.gov (United States)

    Čufar, Andreja; Mrhar, Aleš; Robnik-Šikonja, Marko

    2015-06-01

    Survey data sets are important sources of data, and their successful exploitation is of key importance for informed policy decision-making. We present how a survey analysis approach initially developed for customer satisfaction research in marketing can be adapted for an introduction of clinical pharmacy services into a hospital. We use a data mining analytical approach to extract relevant managerial consequences. We evaluate the importance of competences for users of a clinical pharmacy with the OrdEval algorithm and determine their nature according to the users' expectations. For this, we need substantially fewer questions than are required by the Kano approach. From 52 clinical pharmacy activities we were able to identify seven activities with a substantial negative impact (i.e., negative reinforcement) on the overall satisfaction of clinical pharmacy services, and two activities with a strong positive impact (upward reinforcement). Using analysis of individual feature values, we identified six performance, 10 excitement, and one basic clinical pharmacists' activity. We show how the OrdEval algorithm can exploit the information hidden in the ordering of class and attribute values, and their inherent correlation using a small sample of highly relevant respondents. The visualization of the outputs turns out highly useful in our clinical pharmacy research case study. Copyright © 2015 Elsevier B.V. All rights reserved.

  17. Clinical nutrition counselling service in the veterinary hospital: retrospective analysis of equine patients and nutritional considerations.

    Science.gov (United States)

    Vergnano, D; Bergero, D; Valle, E

    2017-06-01

    Nutrition plays a very important role in the healthy and in the ill horse. Although research in this field clearly shows that incorrect nutritional practices may lead to severe pathologies, inappropriate feeding plans often continue to be used. A clinical nutrition counselling (CNC) service could thus be of great use to both horse owners and veterinarians. The aim of this study was to provide information on equine patients referred to the CNC service of the University of Turin and to provide standard dietary protocols as used in our Veterinary Teaching Hospital for the most common nutrition-related pathologies. The data were obtained by retrospective analysis of the nutritional records of referred equine patients. The data collected included information about anamnesis, nutritional assessment, current diet, referring person and follow-up of each patient. Sixty-one horses were included in the study. The majority were adult males. The most common breeds were the Italian Saddle Horse and the Friesian Horse. Old horses (>19 years) had a statistically lower BCS than brood mares or other adult horses (p equine gastric ulcer syndrome. All horses received first-cut meadow hay; 85% also ate concentrates. Young horses (equine population. Journal of Animal Physiology and Animal Nutrition © 2017 Blackwell Verlag GmbH.

  18. Problematic of the implantation of quality control in the radiodiagnostic service of a hospital with more than 5000 beds with a urgency service

    International Nuclear Information System (INIS)

    Castell, A.; Lizuain, M.C.; Cinos, C.; Linero, D.

    1992-01-01

    The quality control of the x-ray equipment is not normal in the Hospitals. This technique has very difficulties. In this report we show the methodology in order to implant the quality control in radiodiagnostic service : data acquisition and format of communication

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

    Science.gov (United States)

    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.

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

    Directory of Open Access Journals (Sweden)

    Ebin J Arries

    2008-11-01

    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

  1. Factors associated with hospital service satisfaction in a sample of Arab subjects with schizophrenia

    Directory of Open Access Journals (Sweden)

    Al-Zayed Adel A

    2010-10-01

    Full Text Available Abstract Background Assessment of patients' satisfaction with health care services could help to identify the strengths and weaknesses of the system and provide guidance for further development. The study's objectives were to: (i assess the pattern of satisfaction with hospital care for a sample of people with schizophrenia in Kuwait, using the Verona Service Satisfaction Scale (VSSS-EU; ii compare the pattern of satisfaction with those of similar studies; and iii assess the association of VSSS seven domains with a number of variables representing met and unmet needs for care, family caregiver burden, severity of psychopathology, level of psychosocial functioning, socio-demographic characteristics, psychological well-being and objective quality of life. Methods Consecutive outpatients in stable condition and their family caregivers were interviewed with the VSSS-EU and measures of needs for care, caregiver burden, quality of life and psychopathology. Results There were 130 patients (66.1%m, mean age 36.8. While over two-thirds expressed satisfaction with the domains of "overall satisfaction", "professionals' skills", "access", "efficacy", and "relatives' involvement", only about one-third were satisfied with the domains of "information" and "types of intervention". The later two domains were the areas in which European patients had better satisfaction than our patients, while our patients expressed better satisfaction than the Europeans in the domain of "relatives' involvement". In multiple regression analyses, self-esteem, positive and negative affect were the most important correlates of the domains of service satisfaction, while clinical severity, caregiver burden and health unmet needs for care played relatively minor roles. Conclusion The noted differences and similarities with the international data, as well as the predictive power of self-esteem and affective state, support the impression that patients' attitudes towards psychiatric care

  2. Factors Influencing Customer Satisfaction in Health care services: The Case of Public and Private Hospitals in North Cyprus

    OpenAIRE

    Efuteba, Catherine

    2013-01-01

    This study is aimed to examine the important changing aspects that influence customers‟ satisfaction in Health Care institutions. The two models developed in this study investigate the factors influencing customers‟ satisfaction and also evaluate the services provided from both private and state hospital settings in the Turkish Republic of North Cyprus. Today, the service world is in pursuit of resources to invest on efficiency. Most governments focus on the public healthcare system since pri...

  3. Operation evaluation of Venezuelan radiological service; Evaluacion del funcionamiento de un servicio de radiologia de un hospital venezolano

    Energy Technology Data Exchange (ETDEWEB)

    Padron, A.; Sanchez, A.; Martinez, V.; D' Alessandro, A.

    2006-07-01

    This work's intention is to evaluate the Radiology Service operation of Venezuelan hospital based on the Venezuelan Norms for the ionizing radiations use in medical diagnostic. The investigation's results show a violation of these norms. Therefore we propose some recommendations (about the personal and area dosimetry, medical equipment maintenance and calibration and the elaboration of procedures manuals) to be considered by the Institution to optimizing the Service's activities. (Author)

  4. Drug information services: an experience from a high complexity hospital in bogotá, colombia, 2010-2011

    OpenAIRE

    Gutiérrez Clavijo, Juan Camilo; Córdoba Matta, Óscar Armando

    2013-01-01

    Although Colombia has several drug information services and centers, there aren't studies about the information requests to this institutions. This is a retrospective and descriptive study, conducted with data from the requests for passive information to the Drug Information Service of the San Ignacio University Hospital in Bogotá, since April 2010 until December 2011. There were 197 requests for information, equivalent to 9 per month; and 232 questions, equivalent to 11 per month. 79.2% of r...

  5. Assessing the service quality of Iran military hospitals: Joint Commission International standards and Analytic Hierarchy Process (AHP) technique.

    Science.gov (United States)

    Bahadori, Mohammadkarim; Ravangard, Ramin; Yaghoubi, Maryam; Alimohammadzadeh, Khalil

    2014-01-01

    Military hospitals are responsible for preserving, restoring and improving the health of not only armed forces, but also other people. According to the military organizations strategy, which is being a leader and pioneer in all areas, providing quality health services is one of the main goals of the military health care organizations. This study was aimed to evaluate the service quality of selected military hospitals in Iran based on the Joint Commission International (JCI) standards and comparing these hospitals with each other and ranking them using the analytic hierarchy process (AHP) technique in 2013. This was a cross-sectional and descriptive study conducted on five military hospitals, selected using the purposive sampling method, in 2013. Required data collected using checklists of accreditation standards and nominal group technique. AHP technique was used for prioritizing. Furthermore, Expert Choice 11.0 was used to analyze the collected data. Among JCI standards, the standards of access to care and continuity of care (weight = 0.122), quality improvement and patient safety (weight = 0.121) and leadership and management (weight = 0.117) had the greatest importance, respectively. Furthermore, in the overall ranking, BGT (weight = 0.369), IHM (0.238), SAU (0.202), IHK (weight = 0.125) and SAB (weight = 0.066) ranked first to fifth, respectively. AHP is an appropriate technique for measuring the overall performance of hospitals and their quality of services. It is a holistic approach that takes all hospital processes into consideration. The results of the present study can be used to improve hospitals performance through identifying areas, which are in need of focus for quality improvement and selecting strategies to improve service quality.

  6. Availability and use of emergency obstetric care services in public hospitals in Laos PDR: a systems analysis.

    Science.gov (United States)

    Douangphachanh, Xaysomphou; Ali, Moazzam; Outavong, Phathammavong; Alongkon, Phengsavanh; Sing, Menorath; Chushi, Kuroiwa

    2010-12-01

    The maternal mortality ratio in Laos in 2005 was 660 per 100,000 lives birth which was the third highest in Asia-Pacific Region. The objective was to determine the availability and use of emergency obstetric care (EmOC) in provincial and district hospitals in Borikhamxay, Khammouane, and Savannakhet provinces using UN guidelines. A hospital-based cross sectional survey was conducted from January to March 2008. All district (30) and provincial hospitals (3) from three provinces were included. Analysis was based on hospital records reflecting 12 months of facility data. Data indicates that only 14 hospitals (42.4%) were providing EmOC services, i.e., 9 basic, 5 comprehensive services. The proportion of births in EmOC facilities was only 11.2%, the met need was a very low 14.5%, and the cesarean section rate was only 0.9%. The case fatality rate in Borikhanxay province was 2.8%; in Khammouane and in Savannakhet provinces it was less than 1%. Record keeping at hospitals was poor. Signal functions provided in the last three months showed only 48.5% of the facilities performed assisted vaginal delivery. This is the first study in Lao PDR to assess EmOC services. Almost all the indicators were below the UN recommendations. Health planners must take evidence-based decisions to rectify and improve the situation in the hospitals regarding EmOC services. These data can therefore help government to assign and allocate budgets appropriately, and help policymakers and planners to identify systemic bottlenecks and prioritize solutions and will help in improving maternal health.

  7. Factors driving physician-hospital alignment in orthopaedic surgery.

    Science.gov (United States)

    Page, Alexandra E; Butler, Craig A; Bozic, Kevin J

    2013-06-01

    The relationships between physicians and hospitals are viewed as central to the proposition of delivering high-quality health care at a sustainable cost. Over the last two decades, major changes in the scope, breadth, and complexities of these relationships have emerged. Despite understanding the need for physician-hospital alignment, identification and understanding the incentives and drivers of alignment prove challenging. Our review identifies the primary drivers of physician alignment with hospitals from both the physician and hospital perspectives. Further, we assess the drivers more specific to motivating orthopaedic surgeons to align with hospitals. We performed a comprehensive literature review from 1992 to March 2012 to evaluate published studies and opinions on the issues surrounding physician-hospital alignment. Literature searches were performed in both MEDLINE(®) and Health Business™ Elite. Available literature identifies economic and regulatory shifts in health care and cultural factors as primary drivers of physician-hospital alignment. Specific to orthopaedics, factors driving alignment include the profitability of orthopaedic service lines, the expense of implants, and issues surrounding ambulatory surgery centers and other ancillary services. Evolving healthcare delivery and payment reforms promote increased collaboration between physicians and hospitals. While economic incentives and increasing regulatory demands provide the strongest drivers, cultural changes including physician leadership and changing expectations of work-life balance must be considered when pursuing successful alignment models. Physicians and hospitals view each other as critical to achieving lower-cost, higher-quality health care.

  8. FLECH PowerMax Service Requirement Specification

    OpenAIRE

    2014-01-01

    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 and the Distribution System Operator (DSO) services defined in [1]. The PowerMax service has been further discussed in [2], and this technical report seeks to clarify the implementation details first dis...

  9. HCAHPS - Hospital

    Data.gov (United States)

    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...

  10. Hospital Compare

    Data.gov (United States)

    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. Long-term pavement performance ancillary information management system (AIMS) reference guide.

    Science.gov (United States)

    2012-11-01

    This document provides information on the Long-Term Pavement Performance (LTPP) program ancillary information. : Ancillary information includes data, images, reference materials, resource documents, and other information that : support and extend the...

  12. Accounting for costs, QALYs, and capacity constraints: using discrete-event simulation to evaluate alternative service delivery and organizational scenarios for hospital-based glaucoma services.

    Science.gov (United States)

    Crane, Glenis J; Kymes, Steven M; Hiller, Janet E; Casson, Robert; Martin, Adam; Karnon, Jonathan D

    2013-11-01

    Decision-analytic models are routinely used as a framework for cost-effectiveness analyses of health care services and technologies; however, these models mostly ignore resource constraints. In this study, we use a discrete-event simulation model to inform a cost-effectiveness analysis of alternative options for the organization and delivery of clinical services in the ophthalmology department of a public hospital. The model is novel, given that it represents both disease outcomes and resource constraints in a routine clinical setting. A 5-year discrete-event simulation model representing glaucoma patient services at the Royal Adelaide Hospital (RAH) was implemented and calibrated to patient-level data. The data were sourced from routinely collected waiting and appointment lists, patient record data, and the published literature. Patient-level costs and quality-adjusted life years were estimated for a range of alternative scenarios, including combinations of alternate follow-up times, booking cycles, and treatment pathways. The model shows that a) extending booking cycle length from 4 to 6 months, b) extending follow-up visit times by 2 to 3 months, and c) using laser in preference to medication are more cost-effective than current practice at the RAH eye clinic. The current simulation model provides a useful tool for informing improvements in the organization and delivery of glaucoma services at a local level (e.g., within a hospital), on the basis of expected effects on costs and health outcomes while accounting for current capacity constraints. Our model may be adapted to represent glaucoma services at other hospitals, whereas the general modeling approach could be applied to many other clinical service areas.

  13. 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

    Directory of Open Access Journals (Sweden)

    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.

  14. Service Quality Of Diagnostic Fine Needle Aspiration Cytology In A Tertiary Care Hospital Of Lahore (Process Measure As Patient's Perspective).

    Science.gov (United States)

    Rizvi, Zainab; Usmani, Rabia Arshed; Rizvi, Amna; Wazir, Salim; Zahra, Taskeen; Rasool, Hafza

    2017-01-01

    Quality of any service is the most important aspect for the manufacturer as well as the consumer. The primary objective of any nation's health system is to provide supreme quality health care services to its patients. The objective of this study was to assess the quality of diagnostic fine needle aspiration cytology service in a tertiary care hospital. As Patient's perspectives provide valuable information on quality of process, therefore, patient's perception in terms of satisfaction with the service was measured. In this cross sectional analytical study, 291 patients undergoing fine needle aspiration cytology in Mayo Hospital were selected by systematic sampling technique. Information regarding satisfaction of patients with four dimensions of service quality process, namely "procedure, sterilization, conduct and competency of doctor" was collected through interview on questionnaire. The questionnaire was developed on SERVQUAL model, a measurement tool, for quality assessment of services provided to patients. All items were assessed on 2- point likert scale (0=dissatisfied, 1=satisfied). Frequencies and percentages of satisfied and dissatisfied patients were recorded for each item and all items in each dimension were scored. If the percentage of sum of all item scores of a dimension was ≥60, the dimension was 'good quality'. Whereas <60% was 'poor quality' dimension. Data was analysed using epi-info-3.5.1. Fisher test was applied to check statistical significance. (p-value <0.05). Out of the 4 dimensions of service quality process, Procedure (48.8%), Sterilization (51.5%) and practitioner conduct (50.9%) were perceived as 'poor' by the patients. Only practitioner competency (67.4%) was perceived as 'good'. Comparison of dimensions of service quality scoring with overall level of patient satisfaction revealed that all 4 dimensions were significantly related to patient dissatisfaction (p<.05). The study suggests that service quality of therapeutic and diagnostic

  15. Pre-Hospital Emergency Medical Services: An Epidemiological Survey in Mashhad, Iran

    Directory of Open Access Journals (Sweden)

    Mohsen Seyyednozadi

    2017-07-01

    Full Text Available Introduction: Providing appropriate care, in the right place and at the right time, is the main goal of emergency medical services (EMS to save lives. The present study aimed to assess the pre-hospital EMS in Mashhad, the second largest metropolis in Iran. Materials and Methods: In this research, data were extracted from the pre-hospital emergency mission forms, which were collected from the EMS stations in Mashhad and suburbs through systematic random sampling. In addition, supplementary information was obtained from the ambulance dispatch cards and emergency communication center forms. Results:Automobile accidents (33.7% and cardiovascular events (17.8% were the most common causes of contacts to the EMS. In the city and road stations, the mean response time was 2.6 and 1.6 minutes, while the mean time of arrival at the scene was 13.2 and 11.4 minutes, and the mean evacuation time was 13.2 and 11.4 minutes, respectively. Individuals aged 20-29 (25.2% and more than 60 years (23.9% constituted the majority of the cases receiving EMS. Conclusion: According to the results, the ‘golden time’ for emergency care was of great importance in the patients injured in car accidents or affected by cardiovascular events. Furthermore, a significant difference was observed in the time indices of EMS in Mashhad city with the EMS standards due to the lack of human resources or EMS facilities. Some contacts to the EMS were unnecessary, and no expert team aid was needed in some cases. It is recommended that citizens be trained on solving the problems associated with road traffic by implementing mobile emergency, while transfer units must be established for the better provision of emergency care by the EMS in Mashhad.

  16. The Economic Standpoint of Referral System at Using Tertiary Hospital Services in Iran

    Directory of Open Access Journals (Sweden)

    Samad Rouhani

    2017-03-01

    Full Text Available Background and purpose: Although, economically, referral systems make utilization of health facilities at different levels sound, in many countries caretakers often bypass primary care facilities that are regularly costlier for caretakers and health care systems. The main objective of the current study was to assess the utilization of hospital services with more emphasis on economic point of view.  Materials and methods: The present study was a facility-based cross-sectional study. A researcher developed questionnaire was used to collect the data. The samples were randomly selected and interviewed on their consent. SPSS Software was also used to analyze the collected data through Chi-2, correlation, and t-test. Results: Just 29.4 percent of the attendees to the hospital were carrying out a referral slip from their family medicine. Five variables including type of care, type of attending, appointment arrangement, satisfaction with family medicine, and vising family medicine were statistically analyzed and found significantly related to carrying referral slip. Conclusion: Because of dysfunction of referral system, Iran’s health care system was found to be far from achieving economic advantages of a referral based DHS. It is actually an inappropriate use of limited health resources in a country like Iran that seriously suffers from shortage of financial and health system resources. This is likely due to deficiencies in the components of its referral system, therefore, a full revision of current reforms and appropriate remedies for deficiencies in the components of referral system was found to be in top priority in Iran.

  17. 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

    Directory of Open Access Journals (Sweden)

    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

  18. Magnet status as a competitive strategy of hospital organizations: marketing a culture of excellence in nursing services.

    Science.gov (United States)

    Tropello, Paula Grace Dunn

    2003-01-01

    With issues of patient safety, the nursing shortage, and managed care fiscal constraints, hospital organizations can strategically capture market share, while insuring best care practices, if they adopt the "Magnet Status" accreditation model. This quality indicator signifies to the consumer a culture of excellence in nursing services and fulfills the priority of customer satisfaction as a marketing strategy objective.

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

    NARCIS (Netherlands)

    Glind, I.M. van de; Berben, S.A.A.; Zeegers, F.; Poppen, H.; Hoogeveen, M.; Bolt, I.; Grunsven, P. van; Vloet, L.C.M.

    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

  20. The effect of certification and accreditation on quality management in 4 clinical services in 73 European hospitals.

    NARCIS (Netherlands)

    Shaw, C.D.; Groene, O.; Botje, D.; Suñol, R.; Kutryba, B.; Klazinga, N.; Bruneau, C.; Hammer, A.; Wang, A.; Arah, O.A.; Wagner, C.

    2014-01-01

    Objective: To investigate the relationship between ISO 9001 certification, healthcare accreditation and quality management in European hospitals. Design: A mixed method multi-level cross-sectional design in seven countries. External teams assessed clinical services on the use of quality management

  1. Understanding Barriers to Optimal Cleaning and Disinfection in Hospitals: A Knowledge, Attitudes, and Practices Survey of Environmental Services Workers.

    Science.gov (United States)

    Bernstein, Daniel A; Salsgiver, Elizabeth; Simon, Matthew S; Greendyke, William; Eiras, Daniel P; Ito, Masahiro; Caruso, Dean A; Woodward, Timothy M; Perriel, Odette T; Saiman, Lisa; Furuya, E Yoko; Calfee, David P

    2016-12-01

    In this study, we used an online survey to assess knowledge, attitudes, and practices related to environmental cleaning and other infection prevention strategies among environmental services workers (ESWs) at 5 hospitals. Our findings suggest that ESWs could benefit from additional education and feedback as well as new strategies to address workflow challenges. Infect Control Hosp Epidemiol 2016;1492-1495.

  2. BLINK REFLEX IN MULTIPLE SCLEROSIS: AN ANCILLARY TEST FOR DETECTING BRAIN STEM LESIONS

    Directory of Open Access Journals (Sweden)

    M ETEMEDYFAR

    2001-09-01

    Full Text Available Introduction. Electrodiagnostic tests are one of the ancillary procedures that are used for diagnosis of multiple sclerosis (MS. This study investigates the frequency of abnormal blink reflex in patients with MS. Methods. In this cross sectional diagnostic study, 100 patients (26 male and 74 female with definite MS were selected based on clinical and MRI findings. they were referred to Al- zahra hospital (affiliated to iUMSHS during year 2000. Blink reflex (BR waves including R1, R2, R2 were recorded inpatients through the stimulation of supraorbital nerve. Results. The frequency of abnormal BR in MS patients with brain stem involvement was 77.9 percent and in those without brain stem involvement was 36.6 percent (P < 0.001. There was a significant relationship between the duration of MS and the abnormality in BR. Discussion. The frequency of abnormal blink reflex in MS is significantly associated with site of involvement in the brain. The majority of MS patients with brain stem involvement have abnormal BR. It is proposed that in patients with symptoms and signs of MS if there was no accessibility for MRI or if the results of MRI were equivocal, blink reflex test should be performed in addition to other ancillary tests.

  3. IDENTIFYING ELEVEN FACTORS OF SERVICE MARKETING MIX (4PS) EFFECTIVE ON TENDENCY OF PATIENTS TOWARD PRIVATE HOSPITAL.

    Science.gov (United States)

    Hosseini, Seyed Mojtaba; Etesaminia, Samira; Jafari, Mehrnoosh

    2016-10-01

    One of the important factors of correct management is to identify the reasons for patient tendency toward private hospitals. This study measures these factors based on service marketing mixes. This study used a cross sectional descriptive methodology. The study was conducted during 6 months in 2015. The studied population included patients of private hospitals in Tehran. Random sampling was used (n = 200). Data was collected by an author-made questionnaire for service marketing factors. Reliability and validity of the questionnaire were confirmed. Data analysis was done using factor analysis test in SPSS 20. The results showed that constant attendance of physicians and nurses has the highest effect (0.707%) on patient tendency toward private hospitals.

  4. Concerns and hopes about outsourcing decisions regarding health information management services at two teaching hospitals in Semnan, Iran.

    Science.gov (United States)

    Kahouei, Mehdi; Farrokhi, Maryam; Abadi, Zahra Nasr; Karimi, Arefe

    2016-04-01

    Changes in health programs in Iran have led to an increase in administrative costs. One cost-saving option available to hospital administrators is to outsource administrative services. This study aimed to explore the attitudes of hospital staff towards outsourcing health information management services in advance of a decision being taken, to assist healthcare organisations to assess the potential benefits and challenges of outsourcing such services. Six hundred and four clinical and allied health employees in two hospitals in Iran, who had had prior experience with outsourcing hospital services, responded to a survey designed to measure staff attitudes towards outsourcing health information management services, based on their perceptions of potential costs and benefits for the organisation and their own employment prospects. A 16-item attitude scale, developed by the researchers, was used in the study and demographic data were also collected. Summary statistics showed that approximately one third of the sample (34.53%) had a negative view of outsourcing, one third (35.16%) had a positive view, and 30.31% were neutral. An exploratory factor analysis of items on the attitude scale identified three underlying constructs, labelled: data security and management; workplace environment; and staff and customer satisfaction. One item (concern about the impact of outsourcing on staffing levels) did not load on any of the factors. A separate analysis of this single item showed a significant relationship between the sex of participants and their views on the impact of outsourcing on the number of hospital staff employed (poutsourcing, a large number of staff in these hospitals (a third of the total sample) had reservations about the skills of outside providers to securely manage hospital data, and did not consider that outsourcing health information management services would be positive for the organisation, their working environment or for staff and patient satisfaction

  5. Costs to hospitals of acquiring and processing blood in the US: a survey of hospital-based blood banks and transfusion services.

    Science.gov (United States)

    Toner, Richard W; Pizzi, Laura; Leas, Brian; Ballas, Samir K; Quigley, Alyson; Goldfarb, Neil I

    2011-01-01

    little is known about the economics of acquiring and processing the more than 14 million units of red blood cells used annually in the US. to determine the average price paid by hospitals to suppliers for a unit of red blood cells and to identify cost variations by region and facility type and size. A secondary objective was to examine costs for additional blood components as well as costs for blood-related processes performed by hospitals. Qualitative input was sought to identify potential cost drivers. a cross-sectional survey was performed of a randomized sample of hospital-based blood bank and transfusion service directors. The survey instrument assessed costs of specific blood components and services as incurred by hospitals. Analysis of variance was performed to test for significant variation in costs for red blood cells by geographic region and division, facility type and bed capacity. a total of 213 surveys were completed. The mean (SD) acquisition cost for one unit of red blood cells purchased from a supplier (n = 204) was $US210.74 ± 37.9 and the mean charge to the patient (n = 167) was $US343.63 ± 135. There was significant statistical variation in acquisition cost by US census region (p cost for mandated screening performed onsite (n = 56) was $US50.00 ± 120 and the median storage and retrieval cost (n = 46) was $US68.00 ± 81 per unit. A total of 28% of respondents reported that costs for acquisition, screening and transfusion had 'increased dramatically' over the past 5 years and 23% reported that blood shortages were a significant problem. the cost of blood continues to increase and price varies by geography. However, the rate of increase in acquisition costs for red blood cells appears to be slowing. This information should be used by organizations and policy makers to improve financing and utilization management for blood components and services.

  6. Patient Satisfaction with Pre-Hospital Emergency Services. A Qualitative Study Comparing Professionals' and Patients' Views.

    Science.gov (United States)

    García-Alfranca, Fernando; Puig, Anna; Galup, Carles; Aguado, Hortensia; Cerdá, Ismael; Guilabert, Mercedes; Pérez-Jover, Virtudes; Carrillo, Irene; Mira, José Joaquín

    2018-01-30

    Objective : To describe patient satisfaction with pre-hospital emergency knowledge and determine if patients and professionals share a common vision on the satisfaction predictors. Methods: A qualitative study was conducted in two phases. First, a systematic review following the PRISMA protocol was carried out searching publications between January 2000 and July 2016 in Medline, Scopus, and Cochrane. Second, three focus groups involving professionals (advisers and healthcare providers) and a total of 79 semi-structured interviews involving patients were conducted to obtain information about what dimensions of care were a priority for patients. Results: Thirty-three relevant studies were identified, with a majority conducted in Europe using questionnaires. They pointed out a very high level of satisfaction of callers and patients. Delay with the assistance and the ability for resolution of the case are the elements that overlap in fostering satisfaction. The published studies reviewed with satisfaction neither the overall care process nor related the measurement of the real time in responding to an emergency. The patients and professionals concurred in their assessments about the most relevant elements for patient satisfaction, although safety was not a predictive factor for patients. Response capacity and perceived capacity for resolving the situation were crucial factors for satisfaction. Conclusions: Published studies have assessed similar dimensions of satisfaction and have shown high patient satisfaction. Expanded services resolving a wide number of issues that can concern citizens are also positively assessed. Delays and resolution capacity are crucial for satisfaction. Furthermore, despite the fact that few explanations may be given due to a lack of face-to-face attention, finding the patient's location, taking into account the caller's emotional needs, and maintaining phone contact until the emergency services arrive are high predictors of satisfaction.

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

    Directory of Open Access Journals (Sweden)

    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.

  8. [Designing a software for drug management in special situations at a hospital's drug administration service].

    Science.gov (United States)

    Sánchez Cuervo, Marina; Muñoz García, María; Gómez de Salazar López de Silanes, María Esther; Bermejo Vicedo, Teresa

    2015-03-01

    to describe the features of a computer program for management of drugs in special situations (off-label and compassionate use) in a Department of Hospital Pharmacy (PD). To describe the methodology followed for its implementation in the Medical Services. To evaluate their use after 2 years of practice. the design was carried out by pharmacists of the PD. The stages of the process were: selection of a software development company, establishment of a working group, selection of a development platform, design of an interactive Viewer, definition of functionality and data processing, creation of databases, connection, installation and configuration, application testing and improvements development. A directed sequential strategy was used for implementation in the Medical Services. The program's utility and experience of use were evaluated after 2 years. a multidisciplinary working group was formed and developed Pk_Usos®. The program works in web environment with a common viewer for all users enabling real time checking of the request files' status and that adapts to the management of medications in special situations procedure. Pk_Usos® was introduced first in the Oncology Department, with 15 oncologists as users of the program. 343 patients had 384 treatment requests managed, of which 363 are authorized throughout two years. PK_Usos® is the first software designed for the management of drugs in special situations in the PD. It is a dynamic and efficient tool for all professionals involved in the process by optimization of times. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

  9. Patient Satisfaction with Pre-Hospital Emergency Services. A Qualitative Study Comparing Professionals’ and Patients’ Views

    Science.gov (United States)

    García-Alfranca, Fernando; Puig, Anna; Galup, Carles; Aguado, Hortensia; Cerdá, Ismael; Guilabert, Mercedes; Pérez-Jover, Virtudes; Carrillo, Irene

    2018-01-01

    Objective: To describe patient satisfaction with pre-hospital emergency knowledge and determine if patients and professionals share a common vision on the satisfaction predictors. Methods: A qualitative study was conducted in two phases. First, a systematic review following the PRISMA protocol was carried out searching publications between January 2000 and July 2016 in Medline, Scopus, and Cochrane. Second, three focus groups involving professionals (advisers and healthcare providers) and a total of 79 semi-structured interviews involving patients were conducted to obtain information about what dimensions of care were a priority for patients. Results: Thirty-three relevant studies were identified, with a majority conducted in Europe using questionnaires. They pointed out a very high level of satisfaction of callers and patients. Delay with the assistance and the ability for resolution of the case are the elements that overlap in fostering satisfaction. The published studies reviewed with satisfaction neither the overall care process nor related the measurement of the real time in responding to an emergency. The patients and professionals concurred in their assessments about the most relevant elements for patient satisfaction, although safety was not a predictive factor for patients. Response capacity and perceived capacity for resolving the situation were crucial factors for satisfaction. Conclusions: Published studies have assessed similar dimensions of satisfaction and have shown high patient satisfaction. Expanded services resolving a wide number of issues that can concern citizens are also positively assessed. Delays and resolution capacity are crucial for satisfaction. Furthermore, despite the fact that few explanations may be given due to a lack of face-to-face attention, finding the patient’s location, taking into account the caller’s emotional needs, and maintaining phone contact until the emergency services arrive are high predictors of satisfaction

  10. [Retrospective study of hospitalizations for heart failure in elderly patients in a cardiology service of a general hospital center].

    Science.gov (United States)

    Zumer-Meulenbelt, A; Joubert, A; Lefort, J F; Perchet, H

    2002-09-01

    The results of a retrospective study of patients over 70 years of age admitted to the cardiology department of Meaux Hospital for cardiac failure in 1997 are reported. The cases of 143 patients were analysed with respect to two age groups: 70-79 years, and over 80 years of age. The principal aetiology of cardiac failure in all ages was ischaemic heart disease. Hypertensive heart disease was observed in younger patients and valvular heart disease in the more elderly. No significant gender differences were observed in those affected by this pathology or by left ventricular systolic or diastolic dysfunction between the younger and older patients, men having more systolic dysfunction than women. The main causal factor of decompensation in all ages was supraventricular arrhythmias. From the therapeutic point of view, the prescription of ACE inhibitors was relatively common but at low doses. Re-hospitalisation for cardiac failure was common and observed mainly in patients with low ejection fractions. The average hospital stay was 12.58 days. The hospital mortality was high: 15%. Two year survival was 41% with no difference between patients with systolic or diastolic dysfunction. Pluridisciplinary management should reduce the number of re-hospitalisation, improve the quality of life and, perhaps, improve survival.

  11. A Service evaluation of a hospital child death review process to elucidate understanding of contributory factors to child mortality and inform practice in the English National Health Service.

    Science.gov (United States)

    Magnus, Daniel S; Schindler, Margrid B; Marlow, Robin D; Fraser, James I

    2018-03-16

    To describe a novel approach to hospital mortality meetings to elucidate understanding of contributory factors to child death and inform practice in the National Health Service. All child deaths were separately reviewed at a meeting attended by professionals across the healthcare pathway, and an assessment was made of contributory factors to death across domains intrinsic to the child, family and environment, parenting capacity and service delivery. Data were analysed from a centrally held database of records. All child deaths in a tertiary children's hospital between 1 April 2010 and 1 April 2013. Descriptive data summarising contributory factors to child deaths. 95 deaths were reviewed. In 85% cases, factors intrinsic to the child provided complete explanation for death. In 11% cases, factors in the family and environment and, in 5% cases, factors in parenting capacity, contributed to patient vulnerability. In 33% cases, factors in service provision contributed to patient vulnerability and in two patients provided complete explanation for death. 26% deaths were classified as potentially preventable and in those cases factors in service provision were more commonly identified than factors across other domains (OR: 4.89; 95% CI 1.26 to 18.9). Hospital child death review meetings attended by professionals involved in patient management across the healthcare pathway inform understanding of events leading to a child's death. Using a bioecological approach to scrutinise contributory factors the multidisciplinary team concluded most deaths occurred as a consequence of underlying illness. Although factors relating to service provision were commonly identified, they rarely provided a complete explanation for death. Efforts to reduce child mortality should be driven by an understanding of modifiable risk factors. Systematic data collection arising from a standardised approach to hospital reviews should be the basis for national mortality review processes and database

  12. Social deprivation and hospital admission rates, length of stay and readmissions in emergency medical admissions.

    Science.gov (United States)

    Cournane, Seán; Byrne, Declan; Conway, Richard; O'Riordan, Deirdre; Coveney, Seamus; Silke, Bernard

    2015-12-01

    Patients from deprived backgrounds have a higher in-patient mortality following an emergency medical admission. How deprivation relates to the admission or readmission incidence rates, episode length of stay (LOS) and ancillary resource utilization is less clear. All emergency medical admissions (66,861 episodes in 36,214 patients) between 2002 and 2013, categorized by quintile of Irish National Deprivation Index were assessed against admission or readmission incidence rates (/1000 local population by electoral division), LOS and utilization of five ancillary services. Univariate and multi-variable risk estimates (odds ratios (OR) or incidence rate ratios (IRR)) were calculated, using truncated Poisson regression. The deprivation index quintile was strongly correlated with the emergency medical admission rate with IRR (as compared with quintile 1) as follows: Q2 1.99 (95% CI: 1.96, 2.01), Q3 3.45 (95% CI: 3.41, 3.49), Q4 3.27 (95% CI: 3.23, 3.31) and Q5 4.29 (95% CI: 4.23, 4.35). LOS was not influenced by deprivation status; although increasing deprivation resulted in increased utilization of social services (OR 1.04: 95% CI: 1.03, 1.06), with a lower requirement for occupational therapy (OR 0.94: 95% CI: 0.93, 0.96) and speech/language services (OR 0.83: 95% CI: 0.80, 0.86). There was a rather decreased use of ancillary services with increasing deprivation; however, the readmission rate was strongly predicted by deprivation status. Deprivation status strongly influenced the admission and readmission rates for medical patients admitted as emergencies; however, ancillary resource utilization was not increased. Deprivation index will increase demand on hospital resources due to the aggregate effect on both admission and readmission incidence rates. Copyright © 2015 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

  13. Assessment of patient satisfaction of the quality of health care provided by outpatient services of an oncology hospital.

    Science.gov (United States)

    Pini, Anastasia; Sarafis, Pavlos; Malliarou, Maria; Tsounis, Andreas; Igoumenidis, Michael; Bamidis, Panagiotis; Niakas, Dimitris

    2014-06-12

    The purpose of this research is to investigate the patient's satisfaction (patient's satisfaction) with medical services provided in Outpatients' Departments of a Greek Anti-Cancer Hospital in morning and afternoon clinics. The assessment of patients and identification of factors that contribute to their satisfaction will highlight the organizational and operational problems of outpatient department and assist in finding solutions to upgrade the quality of services provided. For the collection of data, a questionnaire with closed answers in a five-point scale 'Likert' scale was used. The questions were related to demographics, social data users, and the overall service process in the outpatient Hospital. The sample consisted of 100 patients (RR: 76%) who visited the outpatient clinic in the morning or afternoon over a month long period of time. The results of our research showed that cancer patients reported a high satisfaction rate with the health services provided in outpatient department of Anti-Cancer Hospital. The highest reported levels of satisfaction were related to working with medical staff because of the special relationship of trust that patients develop with their physician. Some problems were noted during the morning shift by patients. Patients reported frustration over long waiting times to get an appointment, last minute appointments, lack of flexibility when making appointments and long waiting times before being examined by a doctor. No statistically significant relationship was found between overall satisfaction with demographics' and other factors, although the grading services seem to be affected by the health status of patients, education and sex.

  14. Supporting management of medical equipment for inpatient service in public hospitals: a case study.

    Science.gov (United States)

    Figueroa, Rosa L; Vallejos, Guido E

    2013-01-01

    This work presents a study of medical equipment availability in the short and long term. The work is divided