WorldWideScience

Sample records for ancillary services hospital

  1. 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.

  2. 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.......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 power...

  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. An overview of ancillary services in Spain

    Energy Technology Data Exchange (ETDEWEB)

    Lobato Miguelez, Enrique; Egido Cortes, Ignacio; Rouco Rodriguez, Luis; Lopez Camino, Gerardo [School of Engineering of Universidad Pontifica Comillas, C/Alberto Aguilera, 23, 28015 Madrid (Spain)

    2008-03-15

    Under a deregulated environment, ancillary services (AS) are defined as the set of products separated from the energy production, which are related to security and reliability of a power system. Ancillary services can be classified in: (a) active power ancillary services (load-frequency control (LFC) - including primary control, automatic generation control (AGC), tertiary control, balancing service and black start provision) and (b) reactive power ancillary services (voltage control). The system operator is the entity responsible for the secure operation of the power system and in this way, the management of all the AS is considered a specific function of the system operator. Under a deregulated framework, ancillary services are separated from the energy production, and can be mandatory or remunerated under market-driven mechanisms. This paper overviews the management of ancillary services in the Spanish power system, including a detailed technical description of the services and the organization of the ancillary services markets. In addition, a comprehensive review of different optimization algorithms and tools used by the agents and system operator within the Spanish electricity business is presented. (author)

  5. 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....

  6. 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.

  7. 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...... to power system security. An overview of ancillary services provided by wind turbine technology nowadays is provided, i.e., fault ride-through capability, reactive power supply and frequency-active power control....

  8. 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.

  9. Integration of Flexible Consumers in the Ancillary Service Markets

    DEFF Research Database (Denmark)

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

    2014-01-01

    Flexible consumption devices are often able to quickly adjust the power consumption making these devices very well suited as providers of fast ancillary services such as primary and secondary reserves. As these reserves are among the most well-paid ancillary services, it is an interesting idea to...

  10. 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.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2011-10-25

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

  12. 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.

  13. 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.

  14. Ancillary-service costs for 12 US electric utilities

    Energy Technology Data Exchange (ETDEWEB)

    Kirby, B.; Hirst, E.

    1996-03-01

    Ancillary services are those functions performed by electrical generating, transmission, system-control, and distribution-system equipment and people to support the basic services of generating capacity, energy supply, and power delivery. The Federal Energy Regulatory Commission defined ancillary services as ``those services necessary to support the transmission of electric power from seller to purchaser given the obligations of control areas and transmitting utilities within those control areas to maintain reliable operations of the interconnected transmission system.`` FERC divided these services into three categories: ``actions taken to effect the transaction (such as scheduling and dispatching services) , services that are necessary to maintain the integrity of the transmission system [and] services needed to correct for the effects associated with undertaking a transaction.`` In March 1995, FERC published a proposed rule to ensure open and comparable access to transmission networks throughout the country. The rule defined six ancillary services and developed pro forma tariffs for these services: scheduling and dispatch, load following, system protection, energy imbalance, loss compensation, and reactive power/voltage control.

  15. 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...... (DFR) providers in the distribution power system in the four mentioned Nordic countries....

  16. 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....

  17. 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.

  18. 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

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

    Energy Technology Data Exchange (ETDEWEB)

    Hummon, M.

    2014-04-01

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

  20. 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

  1. 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

  2. Survey of U.S. Ancillary Services Markets

    Energy Technology Data Exchange (ETDEWEB)

    Zhou, Zhi [Argonne National Lab. (ANL), Argonne, IL (United States). Center for Energy, Environmental, and Economic Systems Analysis, Energy Systems Division; Levin, Todd [Argonne National Lab. (ANL), Argonne, IL (United States). Center for Energy, Environmental, and Economic Systems Analysis, Energy Systems Division; Conzelmann, Guenter [Argonne National Lab. (ANL), Argonne, IL (United States). Center for Energy, Environmental, and Economic Systems Analysis, Energy Systems Division

    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

  3. 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.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2011-12-01

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

  5. Analysis of wind power ancillary services characteristics with German 250-MW wind data

    Energy Technology Data Exchange (ETDEWEB)

    Ernst, B.

    1999-12-09

    With the increasing availability of wind power worldwide, power fluctuations have become a concern for some utilities. Under electric industry restructuring in the US, the impact of these fluctuations will be evaluated by examining provisions and costs of ancillary services for wind power. This paper analyzes wind power in the context of ancillary services, using data from a German 250 Megawatt Wind project.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2013-09-18

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

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

    Energy Technology Data Exchange (ETDEWEB)

    Raineri, R. [Ingenieria Industrial y de Sistema e Ingenieria Electrica, Pontificia Universidad Catolica de Chile, Casilla 306, Correo 22, Santiago (Chile)]. E-mail: rraineri@ing.puc.cl; Rios, S. [Ingenieria Industrial y de Sistema e Ingenieria Electrica, Pontificia Universidad Catolica de Chile, Casilla 306, Correo 22, Santiago (Chile); Schiele, D. [Ingenieria Industrial y de Sistema e Ingenieria Electrica, Pontificia Universidad Catolica de Chile, Casilla 306, Correo 22, Santiago (Chile)

    2006-09-15

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

  8. 77 FR 40413 - Third-Party Provision of Ancillary Services; Accounting and Financial Reporting for New Electric...

    Science.gov (United States)

    2012-07-09

    ... 101 Third-Party Provision of Ancillary Services; Accounting and Financial Reporting for New Electric... 101 Third-Party Provision of Ancillary Services; Accounting and Financial Reporting for New Electric... of its current market-based rate regulations, ancillary services requirements under the pro forma...

  9. 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

    New sources of ancillary services are expected in the power system. For large and conventional generation units the dynamic response is well understood and detailed individual measurement is feasible, which factors in to the straightforward performance requirements applied today. For secure power...... 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.......New sources of ancillary services are expected in the power system. For large and conventional generation units the dynamic response is well understood and detailed individual measurement is feasible, which factors in to the straightforward performance requirements applied today. For secure power...... 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...

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

    DEFF Research Database (Denmark)

    Faiella, Mariano; Hennig, Tobias; Cutululis, Nicolaos Antonio;

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

  12. 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. The....... The table will be used as a starting point in the REServiceS project to see how much these services would cost when provided from wind/PV (WP3/4), and how often these services would be used in systems with higher penetrations of wind and solar (WP5/6).......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...

  13. 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

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

  14. 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.

  15. 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 ...

  16. Provision of enhanced ancillary services from wind power plants - Examples and challenges

    DEFF Research Database (Denmark)

    Hansen, Anca Daniela; Altin, Müfit; Iov, Florin

    2016-01-01

    Emphasis in this article is on the power system impact of wind power plants capability to provide enhanced ancillary services, i.e. temporary frequency response (TFR) and power oscillation damping (POD). The main objective of the article is to analyze and justify the challenges in the use of TFR ...

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

    DEFF Research Database (Denmark)

    Rahnama, Samira; Green, Torben; Lyhne, Casper

    2017-01-01

    delivery. Consumers' involvement requires new entities and infrastructure. A so-called aggregator has been introduced as a new player to manage the services that are offered by the consumption units. This paper describes an industrial scale experimental setup for evaluating a particular type of aggregator....... The aggregator aims to provide a distribution grid service from industrial thermal loads through a direct control policy. Our specific case studies are a supermarket refrigeration system and an HVac chiller in conjunction with an ice storage, which are virtually connected to the aggregator. Practical results...... obtained from testing on real industrial consumers demonstrate the theoretical studies of the aggregator design to a satisfactory level....

  18. 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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-03-01

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

  20. 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.

  1. Coordinated Control Scheme for Ancillary Services from Offshore Wind Power Plants to AC and DC Grids

    DEFF Research Database (Denmark)

    Sakamuri, Jayachandra N.; Altin, Müfit; Hansen, Anca Daniela;

    2016-01-01

    This paper proposes a new approach of providing ancillary services to AC and DC grids from offshore wind power plants (OWPPs), connected through multi-terminal HVDC network. A coordinated control scheme where OWPP’s AC grid frequency modulated according to DC grid voltage variations is used...... to detect and provide the ancillary service requirements of both AC and DC grids, is proposed in this paper. In particular, control strategies for onshore frequency control, fault ridethrough support in the onshore grid, and DC grid voltage control are considered. The proposed control scheme involves only...... local measurements and therefore avoids the need of communication infrastructure otherwise required for communication based control, and thus increases the reliability of the control system. The effectiveness of the proposed control scheme is demonstrated on a MTDC connected wind power system developed...

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

    Science.gov (United States)

    Nayor, David

    2012-01-01

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

  3. 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......The impact of a high penetration of wind power generation in power systems motivates need for an assessment of its inte raction with electricity markets. With the continuous evolution of wind turbines technology, wind farms have today the ability to provide certain ancillary services...... with appropriate levels of security and reliability . The participation of wind f arms i n ancillary service market s ought to rely on market designs and offering strategies that satisfy power system needs, as well as their operating characteristics . Here we evaluate the system impact of different offering...

  4. A hybrid PSO technique for procuring VAR ancillary service in the deregulated electricity markets

    Energy Technology Data Exchange (ETDEWEB)

    El-Araby, E.E. [Department of Electrical Engineering, Suez Canal University (Egypt); Yorino, Naoto [Department of Artificial Complex Systems Engineering, Hiroshima University (Japan)

    2010-07-15

    This paper develops a new market-based technique for acquiring VAR ancillary service in the electricity market. The main objective of the developed market is to enable transmission operator ''TO'' to procure VAR service in a long term contract from the critical VAR providers that satisfy minimum VAR service payment while maintaining system security. Reactive power control problem for voltage stability is introduced into the VAR market problem in an explicit manner for normal and emergency states. An integration of particle swarm optimization ''PSO'' is presented with successive linear programming ''SLP'' for dealing with the VAR ancillary service problem. The problem is formulated as a large-scale nonlinear constrained optimization problem with a non-differentiable objective function representing VAR payment and operational costs. This type of problem is hard to be treated straightforwardly by the classical optimization methods. Therefore, we propose here a two-layer hybrid PSO/SLP approach, which is suited for carrying out the difficulties associated with non-differentiable and discontinuous objective functions. The proposed method has been examined on the standard IEEE 57 bus-system and compared with GA/SLP method to demonstrate its capability. (author)

  5. 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....

  6. 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…

  7. 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.

  8. 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.

  9. DR Resources for Energy and Ancillary Services in the West (Presentation)

    Energy Technology Data Exchange (ETDEWEB)

    Hummon, M.; Kiliccote, S.

    2014-04-01

    Demand response (DR) resources present a potentially important source of grid flexibility however, DR in grid models is limited by data availability and modeling complexity. This presentation focuses on the co-optimization of DR resources to provide energy and ancillary services in a production cost model of the Colorado "test system". We assume each DR resource can provide energy services by either shedding load or shifting its use between different times, as well as operating reserves: frequency regulation, contingency reserve, and flexibility (or ramping) reserve. There are significant variations in the availabilities of different types of DR resources, which affect both the operational savings as well as the revenue for each DR resource. The results presented include the system-wide avoided fuel and generator start-up costs as well as the composite revenue for each DR resource by energy and operating reserves.

  10. Measuring Generator Performance in Providing Regulation and Load-Following Ancillary Services

    Energy Technology Data Exchange (ETDEWEB)

    Hirst, E.

    2001-04-05

    In an earlier project, we analyzed data on total system load as well as the loads of eight large industrial customers (Kirby and Hirst 2000). We analyzed these data in terms of system and customer-specific requirements for two real-power ancillary services, regulation and load following. We conducted these analyses using 12 days of data from February 1999 plus 12 days of data from August and September 1999. The project discussed here focused on the supply side (provision) of these two services. Specifically, we examined the output of this control area's generation resources, in aggregate and by unit. We analyzed the performance of these generating units in two ways. First, we analyzed the contribution of these generators to overall system performance [generally relative to the North American Electric Reliability Council (NERC) standards]. Second, we analyzed performance relative to what the control center requested of the generators.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1997-12-31

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

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

    Energy Technology Data Exchange (ETDEWEB)

    OEstergaard, Poul Alberg [Department of Development and Planning, Aalborg University, Fibigerstraede 13, 9220 Aalborg OE (Denmark)

    2006-05-15

    Denmark has the World's highest penetration of grid connected wind power in electricity generation with a share of 15.0% of total domestic demand in 2002 [Danish Energy Authority. Rapport fra arbejdsgruppen om kraftvarme- og VE-elektricitet. Bilagsrapport. Copenhagen: Danish Energy Authority; 2001]. This is unevenly distributed in the two separate electricity systems comprising Denmark, giving a 2003 share as high as 21% in Western Denmark [Eltra. http://www.Eltra.dk. Skaerbaek: Eltra; 2004] compared with a more modest 8% in the more densely populated Eastern Denmark [Elkraft System. Miljoberetning 2004. Ballerup: Elkraft System; 2004]. At the same time, Denmark has other forms of distributed generation, e.g., extensive cogeneration of heat and power (CHP) plants for district heating or for covering industrial heat demands. This results in a high fuel-efficiency but also in a technically complex energy system. This combination of wind power and CHP is a challenge for system operators but also gives opportunities. This article analyses the possibilities for integrating even more wind power using new power balancing strategies that exploit the possibilities given by the existence of CHP plants as well as the potential impact of heat pumps used for district heating and installed for integration purposes. The analyses are made with particular focus on grid stability and delivery of ancillary services (required to control voltage and frequency) and demonstrate that it is possible to accommodate 50% or more wind power without having to rely on import or export for power balancing. Relying on import and export sets demands on the neighbouring countries which may not be met. Compulsion to export or import furthermore gives a poor bargaining position on the electricity market. However, in order to reach such high levels of wind power, the generating equipment must be able to supply ancillary services in contrast to their present abilities. (author)

  13. 75 FR 63167 - San Diego Gas and Electric Company v. Sellers of Energy and Ancillary Services Into Markets...

    Science.gov (United States)

    2010-10-14

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF ENERGY Federal Energy Regulatory Commission San Diego Gas and Electric Company v. Sellers of Energy and Ancillary Services Into Markets Operated by the California Independent System Operator Corporation and the...

  14. 75 FR 22125 - Market-Based Rates for Wholesale Sales of Electric Energy, Capacity and Ancillary Services by...

    Science.gov (United States)

    2010-04-27

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF ENERGY Federal Energy Regulatory Commission Market-Based Rates for Wholesale Sales of Electric Energy, Capacity and... Electric Energy, Capacity and Ancillary Services by Public Utilities, Order No. 697- C, FERC Stats. &...

  15. 75 FR 14342 - Market-Based Rates for Wholesale Sales of Electric Energy, Capacity and Ancillary Services by...

    Science.gov (United States)

    2010-03-25

    ... Energy Regulatory Commission 18 CFR Part 35 Market-Based Rates for Wholesale Sales of Electric Energy... Electric Energy, Capacity and Ancillary Services by Public Utilities, Order No. 697- C, FERC Stats. & Regs. ] 31,291 (2009). \\2\\ 18 CFR 35.42. \\3\\ Market-Based Rates for Wholesale Sales of Electric...

  16. 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

  17. Unmet Needs for Ancillary Services Among Hispanics/Latinos Receiving HIV Medical Care - United States, 2013-2014.

    Science.gov (United States)

    Korhonen, Lauren C; DeGroote, Nicholas P; Shouse, R Luke; Valleroy, Linda A; Prejean, Joseph; Bradley, Heather

    2016-10-14

    The prevalence of diagnosed human immunodeficiency virus (HIV) infection in Hispanics/Latinos in the United States is more than twice as high as the prevalence among non-Hispanic whites (1). Services that support retention in HIV medical care and assist with day-to-day living, referred to here as ancillary services, help persons living with HIV access HIV medical care, adhere to HIV treatment, and attain HIV viral suppression. The needs for these ancillary services among Hispanics/Latinos are not well described (2). To obtain nationally representative estimates of and reasons for unmet needs for such services among Hispanic/Latino adults receiving outpatient HIV medical care during 2013-2014, CDC analyzed data from the Medical Monitoring Project (MMP). The analysis found that Hispanics/Latinos in all age and sexual orientation/behavior subgroups reported substantial unmet needs, including 24% needing dental care, 21% needing eye or vision care, 15% needing food and nutrition services, and 9% needing transportation assistance. Addressing unmet needs for ancillary services among Hispanics/Latinos living with HIV might help increase access to HIV care, improve health outcomes, and reduce health disparities.

  18. 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.

  19. Incorporating residential AC load control into ancillary service markets: Measurement and settlement

    Energy Technology Data Exchange (ETDEWEB)

    Bode, Josh L.; Sullivan, Michael J.; Berghman, Dries; Eto, Joseph H.

    2013-05-01

    Many pre-existing air conditioner load control programs can provide valuable operational flexibility but have not been incorporated into electricity ancillary service markets or grid operations. Multiple demonstrations have shown that residential air conditioner (AC) response can deliver resources quickly and can provide contingency reserves. A key policy hurdle to be overcome before AC load control can be fully incorporated into markets is how to balance the accuracy, cost, and complexity of methods available for the settlement of load curtailment. Overcoming this hurdle requires a means for assessing the accuracy of shorter-term AC load control demand reduction estimation approaches in an unbiased manner. This paper applies such a method to compare the accuracy of approaches varying in cost and complexity ? including regression analysis, load matching and control group approaches ? using feeder data, household data and AC end-use data. We recommend a practical approach for settlement, relying on an annually updated set of tables, with pre-calculated reduction estimates. These tables allow users to look up the demand reduction per device based on daily maximum temperature, geographic region and hour of day, simplifying settlement and providing a solution to the policy problem presented in this paper.

  20. 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.

  1. Assessing the economic potential of electric vehicles to provide ancillary services. The case of Germany

    Energy Technology Data Exchange (ETDEWEB)

    Schuller, Alexander; Rieger, Fabian [Karlsruhe Institute of Technology, Karlsruhe (Germany)

    2013-09-15

    The Vehicle-to-Grid (V2G) concept is a promising possibility for the integration of electric vehicles (EVs) into the power grid. This article presents an economic evaluation of EVs participating in the ancillary service market (primary, secondary and tertiary regulation) for the case of Germany, based on a price data set from 2011 and 2012. We examine the economic potential of nine general options to participate in the regulation market based on real-life EV specifications, connection powers and regulation energy prices. Results show that in the most profitable case a maximum average yearly profit of 730.31 Euro per vehicle is possible for negative regulation with payment direction TSO to provider in the secondary regulation market. Furthermore a sensitivity analysis is performed for all of the analyzed participation scenarios in order to identify crucial parameters for a possible V2G implementation. Major parameters for the successful implementation of V2G are the provided power per vehicle, the time an EV is available to the grid and the variable energy storage costs it incurs.

  2. 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…

  3. 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

  4. 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

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

    Energy Technology Data Exchange (ETDEWEB)

    Raineri, Ricardo; Arce, Raul; Salamanca, Carlos [Departamento de Ingenieria Industrial y de Sistemas, Pontificia Universidad Catolica de Chile, Casilla 306, Correo 22, Santiago (Chile); Rios, Sebastian [Departamento de Ingenieria Electrica, Pontificia Universidad Catolica de Chile, Casilla 306, Correo 22, Santiago (Chile)

    2008-08-15

    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. (author)

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2016-08-01

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

  7. 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...

  8. 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.

  9. 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....... This enables the estimation of return levels below which the extreme wind power forecast error events occur only at a specified rate, e.g. once a month or once every year. The techniques allows extrapolation beyond the available data period. In the study data from 1.5 years is used. It consists of hourly wind...... power production in the two regions of Denmark (DK1 and DK2) and corresponding wind power forecasts. The wind power forecasts are generated using the software WPPT and are based on the outcome of three numerical weather prediction models. They cover horizons from 1 to 42 hours ahead in time...

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

    Energy Technology Data Exchange (ETDEWEB)

    Kazempour, S. Jalal; Moghaddam, M. Parsa; Haghifam, M.R.; Yousefi, G.R. [Department of Electrical Engineering, Tarbiat Modares University (TMU), Tehran (Iran)

    2009-05-15

    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)

  11. 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

    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...

  12. 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

    Distributed energy resources are able to provide services to grid operators, possibly with competing objectives. With the development of active distribution grid management, various market designs arise. Here, a reference market framework is considered, which allocates the available flexibility p...

  13. 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-...

  14. SPDF Ancillary Services and Technologies Supporting Open Access, Use and Archiving of MMS Data

    Science.gov (United States)

    Candey, R. M.; Bilitza, D.; Chimiak, R.; Cooper, J. F.; Garcia, L. N.; Harris, B. T.; Hills, H. K.; Johnson, R. C.; Kovalick, T. J.; Lal, N.; Leckner, H. A.; Liu, M. H.; McGuire, R. E.; Papitashvili, N. E.; Roberts, D. A.; Yurow, R. E.

    2015-12-01

    The primary data and orbit services of NASA's Space Physics Data Facility (SPDF) now or soon to be supporting direct and correlative analysis of MMS survey and burst science data products are discussed in the McGuire et.al. paper "SPDF Data and Orbit Services Supporting Open Access, Use and Archiving of MMS Data." This present paper will review additional services and elements of the SPDF program relevant to SPDF's support of MMS and SPDF's broader long-term role as an active heliophysics final archive. Specific topics include - Additional detail on options and APIs for accessing data in SPDF; - Status and plans for the Common Data Format (CDF) and ISTP/SPDF metadata standard, including extension of the metadata standard to planned science data in netCDF from the upcoming GOLD and ICON missions; - Future missions to be supported by SPDF; - Overview and status of MMS and other data descriptions in the Heliophysics Data Portal (HDP)/Virtual Space Physics Observatory (VSPO) - Status and plans for the OMNI database and services, as baseline solar wind data for interpreting magnetospheric data such as that of MMS; - An overview of SPDF's ingest and archiving architecture, including our ongoing effort to bring online legacy heliophysics data originally archived at NSSDC. All SPDF data and services are available from the SPDF home page at http://spdf.gsfc.nasa.gov .

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

    DEFF Research Database (Denmark)

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

    2014-01-01

    networks must be matched to small dynamic loads, while spinning reserves of conventional generation that are required to maintain security of supply, must be reduced to more efficient margins. Domestic loads, likely to form significant proportions of the loads on islanded power systems such as those......With conventional generation capacity being constrained on environmental grounds and renewable alternatives carrying capacity uncertainties, increasingly accurate forecasts of demand are likely to be required in future power systems: highly distributed renewable generation penetrating low voltage...... of small loads is presented. This would allow them to be assessed for their availability to provide demand services to the grid. In the method presented, significant changes in behavior are detected using Bayesian changepoint analysis which tracks a multivariate Gaussian representation of a residential...

  18. Assessing the Energy Content of System Frequency and Electric Vehicle Charging Efficiency for Ancillary Service Provision

    DEFF Research Database (Denmark)

    Thingvad, Andreas; Ziras, Charalampos; Hu, Junjie

    2017-01-01

    . Additionally, a method for calculating the expected energy loss caused by continuous charging and discharging is presented together with efficiency measurements of a commercial bidirectional EV charger. It is found that during a year, the energy balance of the service provider, relative to the grid, is within......The purpose of this paper is to quantify the effect of biased system frequency deviations and charger losses in order for an aggregation of electric vehicles (EVs) to provide reliable primary frequency control (PFC). A data set consisting of one year of frequency measurements of the Nordic...... the calculated bounds. The efficiency losses are calculated and validated to have a linear relationship with the reserve capacity and the provision time....

  19. A Three-Part Electricity Price Mechanism for Photovoltaic-Battery Energy Storage Power Plants Considering the Power Quality and Ancillary Service

    Directory of Open Access Journals (Sweden)

    Yajing Gao

    2017-08-01

    Full Text Available To solve the problem of solar abandoning, which is accompanied by the rapid development of photovoltaic (PV power generation, a demonstration of a photovoltaic-battery energy storage system (PV-BESS power plant has been constructed in Qinghai province in China. However, it is difficult for the PV-BESS power plant to survive and develop with the current electricity price mechanism and subsidy policy. In this paper, a three-part electricity price mechanism is proposed based on a deep analysis of the construction and operation costs and economic income. The on-grid electricity price is divided into three parts: the capacity price, graded electricity price, and ancillary service price. First, to ensure that the investment of the PV-BESS power plant would achieve the industry benchmark income, the capacity price and benchmark electricity price are calculated using the discounted cash flow method. Then, the graded electricity price is calculated according to the grade of the quality of grid-connected power. Finally, the ancillary service price is calculated based on the graded electricity price and ancillary service compensation. The case studies verify the validity of the three-part electricity price mechanism. The verification shows that the three-part electricity price mechanism can help PV-BESS power plants to obtain good economic returns, which can promote the development of PV-BESS power plants.

  20. 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.

  1. 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.

  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. Evaluation system for regional ancillary service of power market%区域电力辅助服务市场评价体系

    Institute of Scientific and Technical Information of China (English)

    周旭; 顾洁; 程浩忠

    2011-01-01

    According to the achievement of evaluation research in the ancillary service of power market home and abroad, combined with the "two rules" issued by State Electricity Regulatory Commission of China (SERC), the evaluation index system for regional ancillary service of power market is built in this paper. It includes technical assessment, market conditions, market behavior, market performance, market risk, etc. The gray relative analysis evaluation model based on entropy weight is then established. Finally an example analysis results show that the model can objectively describe the importance degree of different indexes and then determine their weights, and comprehensively evaluate the market structure and operation of regional ancillary services, therefore to provide reference for healthy operation and scientific management.%结合中国电监会颁布的辅助服务的"两个细则"参考国内外对电力辅助服务市场的评价成果,从技术考核、市场条件、市场行为、市场表现以及市场风险等方面构建辅助服务市场评价指标体系,并建立基于熵权的灰色关联综合评价模型.算例分析表明:所建模型能够客观地描述不同指标的重要程度进而确定各指标的权重,从而对区域电力辅助服务市场的市场结构、运营情况等进行全面综合的比较和评价,为辅助服务市场的健康运营和科学管理提供参考.

  4. 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...

  5. 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.

  6. 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.

  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. 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

  9. Obesity, hospital services use and costs

    DEFF Research Database (Denmark)

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

    2007-01-01

    OBJECTIVE: To quantify the association between obesity and somatic hospital costs and number of overall somatic hospital contacts--number of inpatient admissions, number of outpatient visits, and number of emergency department visits--based on anthropometric measurements of waist circumference (WC.......5-24.9 kg/m2 were defined as normal weight. Individuals with BMI costs were obtained from The National Patient...... Registry and DRG. Analyses were performed using two-part models and Poisson regression. Outcome variables were costs and hospital contacts. RESULTS: This study has demonstrated that obese individuals have a greater use of hospital services and greater hospital costs compared with normal weight individuals...

  10. eServices for Hospital Equipment

    NARCIS (Netherlands)

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

    2007-01-01

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

  11. Coldwater River NWR Ancillary Bird Observations 2006

    Data.gov (United States)

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

  12. Coldwater River NWR Ancillary Bird Observations 2009

    Data.gov (United States)

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

  13. UHS development and hospital services rationing.

    Science.gov (United States)

    Ribeiro, José Mendes

    2009-01-01

    We analyze Brazilian health system in comparative perspective. Middle income beneficiaries migration to pre-paid private insurance makes Brazilian case similar to United States. Public hospital services delivery shows an important retrenchment enhanced by demographic growth and new expectations due to constitutional definitions. Retrenchment is selective and concentrates on obstetric and clinic services and private for-profit services. To ensure equal access it is necessary to improve public spending; diminish out-of-pocket spending; develop organizational reforms; improve government capacity.

  14. 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...

  15. 42 CFR 447.280 - Hospital providers of NF services (swing-bed hospitals).

    Science.gov (United States)

    2010-10-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-12-15

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

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

    Science.gov (United States)

    2010-11-09

    ... Hospital Deductible and Hospital and Extended Care Services Coinsurance Amounts for CY 2011 AGENCY: Centers... inpatient hospital deductible and the hospital and extended care services coinsurance amounts for services... (c) $141.50 for the 21st through 100th day of extended care services in a skilled nursing facility...

  18. 29 CFR 2550.408b-6 - Statutory exemption for ancillary services by a bank or similar financial institution.

    Science.gov (United States)

    2010-07-01

    ... service is consistent with sound banking and financial practice, as determined by Federal or State.... See, for example, section 401 of the Internal Revenue Code of 1954. The provisions of section 408(b)(6...

  19. Changes in service availability in california hospitals, 1995 to 2002.

    Science.gov (United States)

    Kirby, Paul B; Spetz, Joanne; Maiuro, Lisa; Scheffler, Richard M

    2006-01-01

    Hospitals face serious financial challenges in the current healthcare marketplace. In response to these challenges, they may alter their service offerings, eliminating services that are perceived as money-losing or adding new services in areas where profitability is expected to be greater. Although research has examined hospital closures, the more subtle phenomenon of hospital service changes has not been systematically studied. This issue is important because different types of hospital service changes could have different effects on hospital financial viability: extensive service closures could contribute to a downward spiral leading to hospital closure, whereas adding new services might help improve a hospital's finances. This article' examines changes in hospital service availability in California general acute care hospitals between 1995 and 2002. Our major findings indicate that many California hospitals made changes in their service offerings during the study period, although few made extensive changes. Altogether, about half of the hospitals in our study population either closed or opened at least one service. Nearly one-fourth of the hospitals in our study population closed one or more services, whereas just under one-third opened one or more new services. However, the vast majority of the hospitals that closed or added a service made only one or two such changes. In addition, few hospitals both closed and opened services. The service closed most frequently was normal newborn labor and delivery (obstetrics), whereas inpatient rehabilitation was the most frequently opened service. Hospitals that made the most service changes tended to be small, rural, and financially troubled at the start of the study period. Among this group of hospitals, service closures were associated with continued financial deterioration, whereas new service openings were associated with improvements in key financial ratios.

  20. Hospital-physician joint ventures: threat-or opportunity?

    Science.gov (United States)

    Strode, Roger D

    2004-07-01

    Physicians are increasingly drifting away from their hospitals to form ventures that compete with those very hospitals. Healthcare executives are being pressed to think of creative ways to maintain relationships with their physicians and "stay in the swim" of the revenue stream generated by ancillary services. Among these arrangements are integrated "centers ol excellence," ancillary services joint ventures, physician medical director-management relationships, and exclusive specialty services contracts.

  1. 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...

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

    African Journals Online (AJOL)

    A survey of hospital outpatient services for chronic diseases in Gauteng. ... in particular aspects of the organisation of services, and indirect indicators of patient care. Design ... Management guidelines were used for all conditions in 5 hospitals.

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

    OpenAIRE

    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 s...

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

    Science.gov (United States)

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

    2015-01-01

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

  5. Evaluation of hospital service level agreements.

    Science.gov (United States)

    Berbée, Rieneke G; Gemmel, Paul; Droesbeke, Brenda; Casteleyn, Hugo; Vandaele, Darline

    2009-01-01

    The purpose of the paper is to evaluate the development and use of service level agreements (SLAs) in a Belgian hospital from a client's point of view. The paper is based on a theoretical framework indicating the variables that influence the relationship between the use of a specific governance mechanisms and performance, a new instrument was developed and applied on a convenience sample of 107 SLA clients from a Belgian hospital. SLAs are useful for hospitals, as they improve people's insight into processes, stimulate people to think about performance measurement and, in some cases, also lead to improved services. The main advantages of SLAs do not really lie in improved relationships and better fits with clients' needs, but in improved process mapping and improved performance measurement. The questionnaire from this research study proves to be a useful and reliable instrument for evaluating internal SLAs from a client's point of view. The results of this study are limited, as they are only based on one Belgian institution. Other limitations include the posttest-only research design and the unequal distribution of the respondents over the different SLAs. Recommendations for future research include applying the questionnaire in other Belgian hospitals and in settings where both a pretest and posttest can be conducted. As far as known, no other studies have yet evaluated the effectiveness of SLAs in the healthcare sector. While a fairly-substantial amount of scientific literature deals with SLAs in the world of ICT, this literature is often very specific and cannot always be applied to other service sectors.

  6. 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.

  7. 42 CFR 440.20 - Outpatient hospital services and rural health clinic services.

    Science.gov (United States)

    2010-10-01

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

  8. Optimal policies for simultaneous energy consumption and ancillary service provision for flexible loads under stochastic prices and no capacity reservation constraint

    Science.gov (United States)

    Kefayati, Mahdi; Baldick, Ross

    2015-07-01

    Flexible loads, i.e. the loads whose power trajectory is not bound to a specific one, constitute a sizable portion of current and future electric demand. This flexibility can be used to improve the performance of the grid, should the right incentives be in place. In this paper, we consider the optimal decision making problem faced by a flexible load, demanding a certain amount of energy over its availability period, subject to rate constraints. The load is also capable of providing ancillary services (AS) by decreasing or increasing its consumption in response to signals from the independent system operator (ISO). Under arbitrarily distributed and correlated Markovian energy and AS prices, we obtain the optimal policy for minimising expected total cost, which includes cost of energy and benefits from AS provision, assuming no capacity reservation requirement for AS provision. We also prove that the optimal policy has a multi-threshold form and can be computed, stored and operated efficiently. We further study the effectiveness of our proposed optimal policy and its impact on the grid. We show that, while optimal simultaneous consumption and AS provision under real-time stochastic prices are achievable with acceptable computational burden, the impact of adopting such real-time pricing schemes on the network might not be as good as suggested by the majority of the existing literature. In fact, we show that such price responsive loads are likely to induce peak-to-average ratios much more than what is observed in the current distribution networks and adversely affect the grid.

  9. 42 CFR 409.26 - Transfer agreement hospital services.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Transfer agreement hospital services. 409.26... SERVICES MEDICARE PROGRAM HOSPITAL INSURANCE BENEFITS Posthospital SNF Care § 409.26 Transfer agreement...) of this chapter for the transfer of patients and exchange of medical records; or (2) A hospital that...

  10. 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.

  11. [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.

  12. 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.

  13. Medicaid program; clarification of outpatient hospital facility (including outpatient hospital clinic) services definition. Final rule.

    Science.gov (United States)

    2008-11-07

    Outpatient hospital services are a mandatory part of the standard Medicaid benefit package. This final rule aligns the Medicaid definition of outpatient hospital services more closely to the Medicare definition in order to: Improve the functionality of the applicable upper payment limits (which are based on a comparison to Medicare payments for the same services), provide more transparency in determining available hospital coverage in any State, and generally clarify the scope of services for which Federal financial participation (FFP) is available under the outpatient hospital services benefit category.

  14. 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

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

    African Journals Online (AJOL)

    Customer Relationship Management and Hospital Service Quality in Nigeria. ... Relationship Management can be employed to bring about improve health service quality in Nigeria. ... EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT

  16. Factor Analysis 01- Healthcare Service Quality In Medan Government Hospital

    OpenAIRE

    Lubis, Arlina Nurbaity; Lumbanraja, Prihatin; Lubis, Rahmawaty; Hasibuan, Beby Kendida

    2016-01-01

    Service sector increases rapidly especially in Indonesia. This can be seen from the distribution of the percentage of Product Domestic Bruto (PDB) based on job vacancy showing that the service sector contribution approaches 50%. One of the service/care industries with rapid growth is healthcare service. It can be seen from the government plan year 2015-2016 to do healthcare reinforcement. Generally, healthcare is identically related to hospital. A hospital is a professional healthcare institu...

  17. Comparing public and private hospital care service quality.

    Science.gov (United States)

    Camilleri, D; O'Callaghan, M

    1998-01-01

    The study applies the principles behind the SERVQUAL model and uses Donabedian's framework to compare and contrast Malta's public and private hospital care service quality. Through the identification of 16 service quality indicators and the use of a Likert-type scale, two questionnaires were developed. The first questionnaire measured patient pre-admission expectations for public and private hospital service quality (in respect of one another). It also determined the weighted importance given to the different service quality indicators. The second questionnaire measured patient perceptions of provided service quality. Results showed that private hospitals are expected to offer a higher quality service, particularly in the "hotel services", but it was the public sector that was exceeding its patients' expectations by the wider margin. A number of implications for public and private hospital management and policy makers were identified.

  18. Birthing Centers and Hospital Maternity Services

    Science.gov (United States)

    ... What are the hospital's statistics for cesarean sections, episiotomies, and mortality? (Keep in mind, though, that these ... What are the center's statistics for hospital transfers, episiotomies, and mortality? What procedures are followed after your ...

  19. 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...

  20. 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.

  1. Advanced services in hospital logistics in the German health service sector

    National Research Council Canada - National Science Library

    Kriegel, Johannes; Jehle, Franziska; Dieck, Marcel; Mallory, Patricia

    2013-01-01

    ...: What are the developmental options to expand the current capabilities of the hospital contract logistics service providers on the basis of the priorities of the decision-makers in the German hospital sector...

  2. 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.

  3. 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...

  4. Status of radiological services in Addis Ababa public hospitals.

    Science.gov (United States)

    Shimelis, Dagmawit; Tsige, Mesfin; Atnafu, Asfaw

    2011-07-01

    The availability and quality of radiological service in the developing countries are generally poor. Ethiopia is one of the countries where overall health service has been compromised by inadequate & poorly maintained infrastructure and scarcity of health professionals. Radiological service is a resource intensive unit in a hospital and most developing countries radiological service is expected to be poor or may not be available at all. However, there is no study conducted to assess the radiological service in Ethiopia. The aim of the study is to assess the status of radiological service in all public hospitals in Addis Ababa, capital of Ethiopia, and to render insight to the overall national service status. A cross sectional survey was conducted from Aug 2008 to Oct 2009 G C in all twelve public hospitals in Addis Ababa, including specialized and military hospitals. Self administered pre-tested questioners were used to collect data from key informants, chief radiographers and radiologist. In addition, departmental daily work record book was used to extract the type of radiological examination performed Data analysis was done manually. All hospitals in the study provide a basic level of radiological services. Plain x-ray and ultrasound is the type of service (100%) available, whereas services like mammography (9%), CT scan (18%) and MRI (0%) were found to be the least available. There are a total of 78 radiographers and 20 radiologists in Addis Ababa public hospitals with no radiologist in three. The average number of examinations performed in a year amounts to 113,204 and US and routine x-ray examinations account for nearly 98% of the service offered The study showed 25% of the radiological equipments are non-functional and no appropriately trained dark room technicians & no maintenance staffpresent in all hospitals This study verifies the poor radiological infrastructure, poor level of support and the basic nature of the radiological service in the capital. We

  5. 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 verify the need for automation and identify possible areas of improvement. The analysis shows that most of the existing transportation is carried out manually, and hospitals can greatly benefit from automated transportation. Based on the results of the analysis, three alternatives are derived...... for implementing mobile service robots for transportation tasks in hospitals....

  6. Language Services In Hospitals Vary By Ownership And Location.

    Science.gov (United States)

    Schiaffino, Melody K; Nara, Atsushi; Mao, Liang

    2016-08-01

    Twenty-four million people in the United States have limited English proficiency. They experience barriers to health care because of their inability to communicate effectively with providers. Hospitals are required to provide language services that reflect the needs of people in their communities, but these services are not available systematically.

  7. 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.

  8. Public expectations for nonemergency hospital resources and services during disasters.

    Science.gov (United States)

    Charney, Rachel L; Rebmann, Terri; Esguerra, Cybill R; Lai, Charlene W; Dalawari, Preeti

    2013-04-01

    The public's expectations of hospital services during disasters may not reflect current hospital disaster plans. The objective of this study was to determine the public's expected hospital service utilization during a pandemic, earthquake, and terrorist bombing. A survey was distributed to adult patients or family members at 3 emergency departments (EDs). Participants identified resources and services they expect to need during 3 disaster scenarios. Linear regression was used to describe factors associated with higher expected utilization scores for each scenario. Of the 961 people who participated in the study, 66.9% were women, 47.5% were white, and 44.6% were black. Determinants of higher pandemic resource utilization included persons who were younger (P expectations of hospitals during disasters are high, and some expectations are inappropriate. Better community disaster planning and public risk communication are needed.

  9. Embedded ubiquitous services on hospital information systems.

    Science.gov (United States)

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

    2012-11-01

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

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

    Directory of Open Access Journals (Sweden)

    Dharmesh, MOTWANI

    2014-07-01

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

  11. 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.

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

    Science.gov (United States)

    Jajko, P

    1992-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Sienny Thio

    2001-01-01

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

  14. 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.

  15. Costing hospital surgery services: the method matters.

    Directory of Open Access Journals (Sweden)

    Gregoire Mercier

    Full Text Available BACKGROUND: Accurate hospital costs are required for policy-makers, hospital managers and clinicians to improve efficiency and transparency. However, different methods are used to allocate direct costs, and their agreement is poorly understood. The aim of this study was to assess the agreement between bottom-up and top-down unit costs of a large sample of surgical operations in a French tertiary centre. METHODS: Two thousand one hundred and thirty consecutive procedures performed between January and October 2010 were analysed. Top-down costs were based on pre-determined weights, while bottom-up costs were calculated through an activity-based costing (ABC model. The agreement was assessed using correlation coefficients and the Bland and Altman method. Variables associated with the difference between methods were identified with bivariate and multivariate linear regressions. RESULTS: The correlation coefficient amounted to 0.73 (95%CI: 0.72; 0.76. The overall agreement between methods was poor. In a multivariate analysis, the cost difference was independently associated with age (Beta = -2.4; p = 0.02, ASA score (Beta = 76.3; p<0.001, RCI (Beta = 5.5; p<0.001, staffing level (Beta = 437.0; p<0.001 and intervention duration (Beta = -10.5; p<0.001. CONCLUSIONS: The ability of the current method to provide relevant information to managers, clinicians and payers is questionable. As in other European countries, a shift towards time-driven activity-based costing should be advocated.

  16. 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.

  17. 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

  18. Providing Support Services in Selected Decentral¬ized Hospital

    Directory of Open Access Journals (Sweden)

    R Hafezi

    2009-03-01

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

  19. 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...

  20. 42 CFR 440.10 - Inpatient hospital services, other than services in an institution for mental diseases.

    Science.gov (United States)

    2010-10-01

    ... furnished by a hospital with a swing-bed approval. ... 42 Public Health 4 2010-10-01 2010-10-01 false Inpatient hospital services, other than services in...: GENERAL PROVISIONS Definitions § 440.10 Inpatient hospital services, other than services in an institution...

  1. LIFENET hospitals (India): developing new services' case study.

    Science.gov (United States)

    Rahman, Zillur; Qureshi, M N

    2008-01-01

    Indian healthcare is in the process of offering a plethora of services to customers hailing largely from India and from neighboring countries. The Indian hospital sector consists of private "nursing homes" and government and charitable missionary hospitals. Government and missionary hospitals determine their charges according to patients' income levels and treat poor patients freely. Nursing homes charged higher, market-determined rates. They offer services in just a few medical specialties, owned and operated by physicians who worked with them. Nursing homes cannot afford the latest medical technology, but they provide more intimate settings than government hospitals. This case study aims to demonstrate the various strategic options available to a for-profit hospital, in an emerging economy with a burgeoning middle-class population and how it can choose which services that it can best offer to its target population. Diagnosing and treating complex ailments in nursing homes could be a time-consuming and expensive proposition as visits to several nursing homes with different specialties may be necessary. This paper demonstrates how an hospital can develop new customer-oriented services and eliminate the hassle for patients needing to run around different healthcare outlets even for minor ailments. The paper finds that large government hospitals generally have better facilities than nursing homes, but they were widely believed to provide poor-quality care. They failed to keep up with advanced equipment, train their technicians adequately and did not publicize their capabilities to doctors who might refer patients. Many missionary and charitable hospitals were undercapitalized and did not offer all services. These conditions left an unsatisfied demand for high-quality medical care. In 1983, LIFENET opened in Madras, becoming the first comprehensive, for-profit hospital in India. LIFENET, invested in a cardiology laboratory and clinics with capacity to diagnose heart

  2. Evolution of a youth work service in hospital.

    Science.gov (United States)

    Hilton, Donna; Jepson, Shelley

    2012-07-01

    Youth workers are based predominantly in the community and use a range of informal educational activities to help young people between the ages of 11 and 25 cultivate their personal and social development. The supraregional paediatric nephrology unit at Nottingham City Hospital successfully evaluated the role of a youth worker, funded by a national renal charity, and secured long-term funding for the post in 2000 (Hilton et al 2004, Watson 2004). This article describes the evolution of the youth service over a decade, following the amalgamation of two children's units into one site and the creation of a unified youth service for the Nottingham Children's Hospital in 2008.

  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. 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

  5. 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.

  6. 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.

  7. 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.

  8. Ancillary testing in brain death.

    Science.gov (United States)

    Kramer, Andreas H

    2015-04-01

    Despite worldwide acceptance of the concept of brain death, there is marked variability in the use of ancillary testing. In most countries, ancillary tests are used primarily when confounding factors interfere with reliable completion of a clinical assessment, or physiologic instability precludes performance of an apnea test. Alternatively, in some countries, confirmatory ancillary tests are routinely required before brain death can be diagnosed. Ancillary tests assess brain function (e.g., electroencephalography) or blood flow (e.g., cerebral angiography). Evaluation of blood flow is affected less by confounding clinical factors and is now preferred in most jurisdictions. With angiographic techniques, a significant proportion of patients meeting clinical criteria for brain death have some opacification of proximal intracranial arteries. Consequently, the sensitivity of angiography is strongly influenced by the particular criteria that are used to define intracranial circulatory arrest. Lack of enhancement of the great cerebral and internal cerebral veins has the highest sensitivity. Worldwide experience with newer tests, such as computed tomography and magnetic resonance angiography, is growing. Radionuclide imaging has the advantage of not requiring use of potentially nephrotoxic contrast material. Transcranial Doppler ultrasonography can be brought to the bedside to demonstrate lack of brain blood flow. The specificity of imaging techniques in the detection of intracranial circulatory arrest has not been as well studied as their sensitivity.

  9. 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...

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

    Science.gov (United States)

    Noble, Vanessa; Parle, Julie

    2014-04-01

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

  11. 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.

  12. The marketing concept of customer value of hospitality service

    Directory of Open Access Journals (Sweden)

    O.V. Gerasimenko

    2015-12-01

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

  13. 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.

  14. 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.

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

    Science.gov (United States)

    Smith, S M; Clark, M

    1990-09-01

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

  16. Insurance Theory Based Pricing Method for Black-start Ancillary Service%基于保险理论的黑启动辅助服务定价方法

    Institute of Scientific and Technical Information of China (English)

    赵达维; 刘天琪; 李兴源

    2014-01-01

    以黑启动辅助服务补偿费用采取“取于用户,补偿网源”的思路为出发点,提出了一种基于保险理论的服务定价方法。首先,定义黑启动辅助服务保险合同参与主体,设计符合系统恢复特征的保险标的,提出以协议时间作为投保人与保险人之间的保险约定:大停电发生后,保险人应在协议时间内向投保人提供恢复功率,否则被视为违约。然后,详细阐述各项合同要素的计算方法。最后,将服务最优定价问题转化为求解最优协议时间:第1步,根据协议时间与不同合同要素的函数关系,获得合同要素曲线间理想交点对应的协议时间,推导临界协议时间,共同作为服务定价优化模型的约束条件;第2步,以主体间概率收益差距最小为目标函数,计及上述约束,计算最优协议时间,从而求得相应的服务价格。针对某实际系统进行算例分析,说明了所提方法的应用步骤和基本特征。%An insurance theory based pricing method is proposed by proceeding from the idea of using the compensation fee from black-start ancillary service to power consumers to remunerate power grid corporation and power generation enterprises.First of all,the entities of black-start ancillary service insurance contract are defined and the insurance obj ect conforming to the characteristics of system restoration is designed.Furthermore,the protocol time (PT) is proposed to be the insurance stipulation between policy-holder and insurer:once blackout occurred,the insurer should provide restored power to the policy-holder within the PT,otherwise it will be considered a breach of contract.Then,the steps to calculate contract elements are elaborated.Finally,service pricing optimization is converted to solving the optimal PT:in the first step,according to the functional relation between PT and different contract elements,four kinds of ideal PT corresponding to the

  17. The contribution of hospital library information services to clinical care: a study in eight hospitals.

    Science.gov (United States)

    King, D N

    1987-10-01

    Hospital health sciences libraries represent, for the vast majority of health professionals, the most accessible source for library information and services. Most health professionals do not have available the specialized services of a clinical medical librarian, and rely instead upon general information services for their case-related information needs. The ability of the hospital library to meet these needs and the impact of the information on quality patient care have not been previously examined. A study was conducted in eight hospitals in the Chicago area as a quality assurance project. A total of 176 physicians, nurses, and other health professionals requested information from their hospital libraries related to a current case or clinical situation. They then assessed the quality of information received, its cognitive value, its contribution to patient care, and its impact on case management. Nearly two-thirds of the respondents asserted that they would definitely or probably handle their cases differently as a result of the information provided by the library. Almost all rated the libraries' performance and response highly. An overview of the context and purpose of the study, its methods, selected results, limitations, and conclusions are presented here, as is a review of selected earlier research.

  18. Comparison of pharmacy services at critical access hospitals and other rural and small hospitals in Illinois.

    Science.gov (United States)

    Crawford, Stephanie Y; Schumock, Glen T; Ursan, Iulia D; Ursan, Julia D; Walton, Surrey M; Donnelly, Andrew J

    2013-08-01

    The results of a survey evaluating pharmacy services and technology use at critical access hospitals (CAHs) and other small and rural hospitals in Illinois are reported. A mail survey was sent to pharmacy directors at 86 CAHs and other rural and small hospitals in Illinois not designated as CAHs. Independent sample t tests and chi-square statistics were used to compare CAHs and non-CAHs in areas such as pharmacy services, staffing, use of technology, and sterile compounding practices. The survey response rate was 46.5%, with usable data received from 40 hospitals. Analysis of the survey data indicated that hospitals designated as CAHs were significantly less likely than non-CAHs to have automatic therapeutic interchange policies (p = 0.012) and more likely to conduct pharmacist-provided educational programs on medication costs for physicians and other health care personnel (p = 0.037). Relative to non-CAHs, CAHs were significantly less likely to have automated dispensing cabinets (p = 0.016) and to out-source the preparation of sterile products to offsite vendors (p = 0.012); pharmacy directors at CAHs were less likely to report the use of technology for remote medication order entry or review (p = 0.038). At both types of facilities, pharmacists typically have both distributive and clinical responsibilities, and patient-specific clinical pharmacy services (e.g., patient education or counseling, other drug therapy monitoring, medication reconciliation, pharmacokinetic consultations) are offered at similar frequencies. A survey of pharmacy departments at small and rural hospitals in Illinois determined that there were more similarities than differences between CAHs and non-CAHs. The survey indicated significant differences in dispensing processes, the use of technology and drug policy tools, and outsourcing of sterile product preparation.

  19. 42 CFR 410.172 - Payment for partial hospitalization services in CMHCs: Conditions.

    Science.gov (United States)

    2010-10-01

    ..., DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS Payment of SMI Benefits § 410.172 Payment for partial hospitalization services in CMHCs:...

  20. 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...

  1. New hospital telemedicine services: potential market for a nighttime telehospitalist service.

    Science.gov (United States)

    Sanders, Richard B; Simpson, Kit N; Kazley, Abby S; Giarrizzi, Dana P

    2014-10-01

    A critical shortage in the supply of physicians in the United States has necessitated innovative approaches to physician service delivery. Telemedicine is a viable service delivery model for a variety of physician and health services. Telemedicine is most effective when applied where physician resources are scarce, patient care is time sensitive, and service volume may be distributed across a network. Shortages in critical care and neurology specialists have led to the use of tele-intensive care unit and telestroke services in hospital settings. These hospital-based telemedicine services have gained acceptance and recommendation. Hospitalist staffing shortages may provide an opportunity to apply similar telemedicine models to hospitalist medicine. This study assesses the potential market for a nighttime telehospitalist service. An analysis of the Florida state hospital discharge dataset investigated the potential market for a new nighttime telehospitalist service. Admissions were filtered and stratified for common hospitalist metrics, time of day, and age of patients. Admissions were further expressed by hour of day and location. Nineteen percent of common hospitalist admissions occurred between 7:00 p.m. and 7:00 a.m., with a range of 17%-27% or 0.23-10.09 admissions per night per facility. Eighty percent of admissions occurred prior to midnight. Nonrural facilities averaged 6.69 hospitalist admissions per night, whereas rural facilities averaged 1.35 admissions per night. The low volume of nighttime admissions indicates an opportunity to leverage a telehospitalist physician service to deliver inpatient medical admission services across a network. Lower volumes of nighttime admissions in rural facilities may indicate a market for telehospitalist solutions to address the dilemma of hospitalist staffing shortages.

  2. Manchester Protocol at a school hospital emergency service

    Directory of Open Access Journals (Sweden)

    Mayara Raphaela Morais Rezende

    2016-01-01

    Full Text Available Objective: to analyze the flow of directing patients triaged by the Manchester Protocol in the emergency service of a school hospital. Methods: a retrospective, descriptive and documentary study using triage records. The sample was composed of 364 records that were analyzed through descriptive statistics, using simple and relative frequencies and measures of central tendency. Results: the most frequent complaints were those related to the musculoskeletal system (26.1% and gastrointestinal system (15.1%. The highest demand was for general practice (47.5%. The most frequent risk classification was green (78.3%. Most of the individuals studied received hospital discharge (92.6%. Conclusion: the results suggest that urgency and emergency units are being sought to solve problems that could be solved by primary care units.

  3. 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...

  4. [Worker's health & outsourcing: worker's profile in a hospital cleaning service].

    Science.gov (United States)

    Chillida, Manuela de Santana Pi; Cocco, Maria Inês Monteiro

    2004-01-01

    In the last two decades, service outsourcing has reduced companies' costs by the rationalization of their actions and the exploration of precarious work relations. This research aimed to outline the profile of outsourced workers in the cleaning service of a university hospital, identify their points of view about the health-illness process and future plans. This is a descriptive study from a quantitative approach, involving a random sample with 50 cleaning workers. Most of them started to work early, 74% were women and education level was low. In 36% of the cases, physicians diagnosed some kind of illness. In the analyzed period, 84% of the interviewees had realized medical consultations, resulting in an average of 3.6 consultations per worker, 56% of which involved general clinicians. Data analysis allowed for the identification of these professionals' perspectives in relation to the health/illness process and their future.

  5. Economic Analysis of Ancillary Service Provision by Plug-in Electric Vehicles%电动汽车提供辅助服务的经济性分析

    Institute of Scientific and Technical Information of China (English)

    陆凌蓉; 文福拴; 薛禹胜; 康俊建

    2013-01-01

    Reasonably controlling or dispatching the charging and discharging behaviors of aggregated electric vehicles (PEVs) can provide ancillary services for a power system,and hence improve the security and economics of the system.Based on the driving pattern statistic data from the New Jersey region in USA,an economic analysis model is developed for an agent/ aggregator of PEVs in providing regulation and spinning reserve services for the power system concerned,considering the optimal control of the PEVs'charging and discharging.An optimization model is developed to maximize the agent's profit while respecting relevant constraints.The revenue of the agent consists of the incomes from the regulation and spinning reserve markets,as well as the allowances for mitigating emissions,while the cost includes the battery depreciation cost and charging cost.The developed model is demonstrated with actual data from the New York Independent System Operator (NYISO) with 5 000 PEVs specified,and the economic analysis result shows that the agent of PEVs can make profits by providing regulation and spinning reserve services in the electricity environment.%合理控制/调度电动汽车充放电,可以为电力系统提供辅助服务,改善系统运行的安全性和经济性.基于美国新泽西地区的汽车日常交通行为数据,建立了分析电动汽车提供调频和旋转备用的经济效益的数学模型,并就如何控制充放电以使电动汽车代理的总收益最大化作了分析.电动汽车的调频和旋转备用总收益包括备用容量收益、电能收益和环境保护补偿收益;其成本则包括电池充电成本和电池损耗.以纽约独立系统调度机构所管理的辅助服务市场模式为例进行了计算分析,仿真结果表明,在电力市场环境下电动汽车通过代理机构提供调频和旋转备用服务在经济上是可行的.

  6. Competitive ancillary service procurement in California

    Energy Technology Data Exchange (ETDEWEB)

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

    2000-01-01

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

  7. EVALUATION OF THE PARENTERAL NUTRITION SERVICES IN HOSPITAL PULAU PINANG

    Directory of Open Access Journals (Sweden)

    RIYADH AL BATANI

    2006-01-01

    Full Text Available Parenteral nutrition (PN has been practiced in Hospital Pulau Pinang, Malaysia since 1986. However, there is no published data on the cost, complications and outcome of patients receiving PN in this hospital. A retrospective study was carried out to evaluate the cost, complications and outcome of PN. Data were obtained from patient medical records and analysed using SPSS version 11. From 2003 to 2005, 429 PN cases were evaluated. Of the PN cases, 65% were neonates, 28.2% adults and 6.8% paediatric, where 60.8% of patients were male and 38.5% were female. Malay patients constituted 57.3%, Chinese 30.8% and Indian 11.9%. The reasons for PN were feeding intolerence (86.7%, oral intake restrictions (9.3%, poor oral intake (1.4% and others (2.6%. The average cost for PN in a neonate was found to be RM185 ± 69, RM 233 ± 126 for a paediatric patient and RM 235 ± 107 for an adult. PN-associated complications were bacterial sepsis (30.4%, metabolic acidosis (13.0%, catheter dislodgment (8.7%, long line swelling (8.7%, hepatic complication (21.8%, long line blockage (4.4% and catheter-related infection (13.0%. A total of 82.7% of cases tolerated oral nutrition after PN, 7.4% expired, 5.3% developed PN complications and others were discharged, transferred to other ward, transferred to another hospital, or discharged at own risk (0.3%. The study showed a significant difference in the cost of PN in each group of patients (p = 0.002. We concluded that PN services in Hospital Pulau Pinang were associated with low PN-related complications and good outcomes.

  8. 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

    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....

  9. 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.

  10. 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...

  11. 14 CFR 135.271 - Helicopter hospital emergency medical evacuation service (HEMES).

    Science.gov (United States)

    2010-01-01

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

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

    Science.gov (United States)

    Parkum, K H

    1985-09-01

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

  13. 38 CFR 17.52 - Hospital care and medical services in non-VA facilities.

    Science.gov (United States)

    2010-07-01

    ... or equipped to perform, and transfer to a public or private hospital which has the necessary staff or... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Hospital care and medical... VETERANS AFFAIRS MEDICAL Use of Public Or Private Hospitals § 17.52 Hospital care and medical services in...

  14. 42 CFR 424.122 - Conditions for payment for emergency inpatient hospital services.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Conditions for payment for emergency inpatient hospital services. 424.122 Section 424.122 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... hospital services, the beneficiary was— (1) In the United States; or (2) In Canada traveling between Alaska...

  15. 42 CFR 403.321 - State systems for hospital outpatient services.

    Science.gov (United States)

    2010-10-01

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

  16. 42 CFR 482.2 - Provision of emergency services by nonparticipating hospitals.

    Science.gov (United States)

    2010-10-01

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

  17. 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

  18. A notion on restructuring the Bali hospitality and service industry by

    African Journals Online (AJOL)

    An essay on Karma Karana: A notion on restructuring the Bali hospitality and service industry by ... Research in Hospitality Management ... Does the money that is generated from tourism really help the people and the island itself to grow?

  19. 26 CFR 1.513-6 - Certain hospital services not unrelated trade or business.

    Science.gov (United States)

    2010-04-01

    ...) The service is provided at a fee not in excess of actual cost, including straight line depreciation... effect on or before April 20, 1983. (b) Hospital defined. As used in this section the word hospital...

  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. Factors and models associated with the amount of hospital care services as demanded by hospitalized patients: a systematic review.

    Directory of Open Access Journals (Sweden)

    Catharina J van Oostveen

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

  2. 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.

  3. 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 market competition had a positive and significant relationship with patients' choice to receive obstetric care. That is, rural patients prefer to receive care from a hospital that participates in a network, that provides more number of services, and that has a greater market share (i.e., a lower level of market competition) in their locality. Rural hospitals could actively increase their competitiveness and market share by increasing the number of health care services provided and seeking to network with other hospitals.

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

    Institute of Scientific and Technical Information of China (English)

    张钦; 辛颂旭; 白建华; 林祺蔚

    2013-01-01

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

  5. 42 CFR 410.66 - Emergency outpatient services furnished by a nonparticipating hospital and services furnished in...

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Emergency outpatient services furnished by a... SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS Medical and Other Health Services § 410.66 Emergency outpatient... for payment of emergency inpatient services furnished by a nonparticipating U.S. hospital and...

  6. Elementary Rehabilitation Nursing Care; a Manual for Nurses and Ancillary Workers in Nursing Homes, Hospitals, Convalescent Facilities, and Public Health Agencies. Public Health Service Publication No. 1436.

    Science.gov (United States)

    Colorado State Dept. of Public Health, Denver. Public Health Nursing Section.

    This guide for teacher and student use presents a comprehensive program of physical rehabilitation for aged and physically disabled patients. Developed by the Public Health Nursing Section, the manual was tested by state health department personnel and persons doing inservice teaching in their respective nursing homes. The program is designed to…

  7. 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.

  8. Dimensions of managerial work in hospital dietetic services.

    Science.gov (United States)

    Palacio, J P; Spears, M C; Vaden, A G; Downey, R G

    1985-07-01

    The objective of this study was to identify underlying dimensions of the managerial work of hospital dietetic services professional staff. A survey instrument was developed on the basis of Mintzberg's role theory of management. Respondents were asked to rate 80 activity statements on the relative importance and time demand of each. Principal component analysis was used to determine whether items could be conceptualized meaningfully by a smaller number of components capable of accounting for interrelationships. Reliabilities and correlations were computed for the resulting managerial factor scores. Six factors were identified from the importance ratings: Upper Management, Interaction with Subordinates, Outside Activities, Quality Assurance, Communication Activities, and Personnel Activities. Similar dimensions were identified from the time-demand ratings. Findings from this analysis suggest that managers in different functional specialties and at various organizational levels tend to vary in their allocation of time and to stress different roles. As a person rises on the administrative ladder of responsibility, concentration on extramural affairs and involvement in planning are greater, and concern with specific operational problems decreases. The importance of conceptual skills was especially evident in upper administrative positions, as was the critical need for intergroup skills.

  9. Introducing a new stop smoking service in an acute UK hospital: a qualitative study to evaluate service user experience.

    Science.gov (United States)

    Jones, Susan E; Hamilton, Sharon

    2013-10-01

    Smoking is a risk factor for numerous cancers yet many smokers do not become motivated to quit until they are admitted to hospital with a smoking-related illness. The provision of smoking cessation services in hospitals could therefore be helpful to these patients. This study aimed to explore the user experience of one such service in a UK hospital and identify whether the service assisted patients to quit smoking. A qualitative approach was used which incorporated face-to-face structured interviews with 44 patients across 4 clinical specialties in an acute hospital in the UK. Data collection also involved follow-up telephone interviews with nineteen participants approximately 6 weeks later. Data were analysed using a thematic analysis. Patients with a variety of diagnoses, including cancer, participated in the study and all welcomed the opportunity to access the hospital service. Hospital was seen as an appropriate venue, where it was easier to make a quit attempt and there was ready access to nicotine replacement therapy (NRT) and a supportive environment. A number of 'pushes' towards, and 'pulls' away from quitting emerged from the data and were demonstrated outwardly by how ready the patient was to quit. The hospital environment provided a prime opportunity to offer stop smoking advice, assessment and treatment to patients. The provision of this service outside of traditional locations broadened opportunities for access particularly when patients were ready to quit. This service therefore made a positive contribution to the stop smoking agenda. Copyright © 2013 Elsevier Ltd. All rights reserved.

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

    Science.gov (United States)

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

    2009-01-01

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

  11. 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.

  12. 42 CFR 136.30 - Payment to Medicare-participating hospitals for authorized Contract Health Services.

    Science.gov (United States)

    2010-10-01

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

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

    Science.gov (United States)

    Peay, Moiselle

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

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

    Science.gov (United States)

    Leman, Hope

    2010-04-01

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

  15. 38 CFR 4.29 - Ratings for service-connected disabilities requiring hospital treatment or observation.

    Science.gov (United States)

    2010-07-01

    ...-connected disabilities requiring hospital treatment or observation. 4.29 Section 4.29 Pensions, Bonuses, and... § 4.29 Ratings for service-connected disabilities requiring hospital treatment or observation. A total... observation at Department of Veterans Affairs expense for a service-connected disability for a period in...

  16. 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.

  17. Report of the review of the governance arrangements as reflected in the safety, quality and standards of services at UL Hospitals

    LENUS (Irish Health Repository)

    Jayaprakash, Namita

    2009-11-01

    Emergency department (ED) crowding is a multifactorial problem, resulting in increased ED waiting times, decreased patient satisfaction and deleterious domino effects on the entire hospital. Although difficult to define and once limited to anecdotal evidence, crowding is receiving more attention as attempts are made to quantify the problem objectively. It is a worldwide phenomenon with regional influences, as exemplified when analyzing the problem in Europe compared to that of the United States. In both regions, an aging population, limited hospital resources, staff shortages and delayed ancillary services are key contributors; however, because the structure of healthcare differs from country to country, varying influences affect the issue of crowding. The approach to healthcare delivery as a right of all people, as opposed to a free market commodity, depends on governmental organization and appropriation of funds. Thus, public funding directly influences potential crowding factors, such as number of hospital beds, community care facilities, and staffing. Ultimately ED crowding is a universal problem with distinctly regional root causes; thus, any approach to address the problem must be tailored to regional influences.

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

    Science.gov (United States)

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

    2014-12-30

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

  1. 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

  2. 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.

  3. 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…

  4. Assessing the impact of community-based mobile crisis services on preventing hospitalization.

    Science.gov (United States)

    Guo, S; Biegel, D E; Johnsen, J A; Dyches, H

    2001-02-01

    This study evaluated the impact of a community-based mobile crisis intervention program on the rate and timing of hospitalization. It also explored major consumer characteristics related to the likelihood of hospitalization. A quasi-experimental design with an ex post matched control group was used. A community-based mobile crisis intervention cohort (N=1,696) was matched with a hospital-based intervention cohort (N=4,106) on seven variables: gender, race, age at the time of crisis service, primary diagnosis, recency of prior use of services, indication of substance abuse, and severe mental disability certification status. The matching process resulted in a treatment group and a comparison group, each consisting of 1,100 subjects. Differences in hospitalization rate and timing between the two groups were assessed with a Cox proportional hazards model. The community-based crisis intervention reduced the hospitalization rate by 8 percentage points. A consumer using a hospital-based intervention was 51 percent more likely than one using community-based mobile crisis services to be hospitalized within the 30 days after the crisis (phomeless, and experiencing acute problems; they were referred by psychiatric hospitals, the legal system, or other treatment facilities; they showed signs of substance abuse, had no income, and were severely mentally disabled. Results indicate that community-based mobile crisis services resulted in a lower rate of hospitalization than hospital-based interventions. Consumer characteristics were also associated with the risk of hospitalization.

  5. Evaluation of a pediatric hospitalist service: impact on length of stay and hospital charges.

    Science.gov (United States)

    Bellet, P S; Whitaker, R C

    2000-03-01

    Inpatient medical services supervised by pediatric hospitalist physicians are a new development in academic medical centers in the United States. In a large pediatric teaching hospital, we compared length of stay, readmission rates, and hospital charges for children admitted to medical services with and without a hospitalist system of care. This retrospective observational study compared a baseline year of a traditional ward service (TS) with a subsequent year of a new hospitalist system of care called the Generalist Inpatient Service (GIS). Data were obtained from the hospital's clinical, demographic, and financial databases and from selected record review. All hospitalizations were at least 24 hours long and did not involve a stay in an intensive care unit. The average length of stay was longer for the 627 TS hospitalizations than for the 813 GIS hospitalizations (2.7 +/- 2.0 vs 2.4 +/- 1.7 days). Total hospital charges were significantly lower on the GIS ($3002 +/- $2160 vs $2720 +/- $1933) because of lower room and respiratory therapy charges. Three readmissions to the TS and 8 to the GIS occurred within 24 hours of hospital discharge and were, therefore, considered potentially preventable by a longer initial hospital stay. In a large pediatric teaching hospital, a system of inpatient care provided by hospitalists can reduce length of stay. This model has the potential to control hospital charges in a period of increasing health care costs.

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

    Science.gov (United States)

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

    2016-04-01

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

  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. The Analysis of the Financing Method for Hospital Services providers. The Situation Of Municipal Hospitals in Romania

    OpenAIRE

    Iulian Bogdan DOBRA

    2011-01-01

    Given that the total value contracted by hospitals with Heath Insurance Houses is over 80% of the amounts associated with hospital care services, whose payment is done on the basis of the Diagnosis-related group (DRG), we hope the scientific approach that we bring forward will add more value to the performance audit of the Romanian social health insurance system. Following the correlation between the analyzed indicators, a series of conclusions emerged regarding the values recorded by them an...

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

    Science.gov (United States)

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

    2013-01-01

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

  10. Proposed standards for professional health sciences library services in hospitals of New York State.

    Science.gov (United States)

    Hutchinson, A P; O'Connell, M; Richards, B B; Thompson, J L; Wheeler, R A

    1981-07-01

    Hospital libraries are considered to be the basic unit of the medical information system. A major statewide effort was begun in 1978 to introduce and support legislation in the New York State Legislature which would encourage hospitals to establish and maintain libraries that meet minimum services standards. Included in this legislation is the concept that the Commissioner of Education in consultation with the Commissioner of Health shall have the power to establish standards for hospital libraries. The Ad Hoc Committee for the Promotion of Hospital Library Services, Western New York Library Resources Council, proposes The Standards for Professional Health Sciences Library Services in Hospitals of New York State to clarify and to strengthen existing hospital library standards. These standards differ specifically from the Joint Commission on Accreditation of Hospitals standards in that they place equal and specific emphasis on eleven points: administration, qualifications of library staff, continuing education of library staff, requirement for a library advisory committee, required library services, required library resources, library space requirements, library budget, library network and consortium membership, documentation of library policy, and continued evaluation of the needs of the hospital for library service. Detailed interpretations are provided. An appendix describes the qualifications of a hospital library consultant.

  11. 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.

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

    Science.gov (United States)

    Karlsen, Anders M; Thomassen, Oyvind; Vikenes, Bjarne H; Brattebø, Guttorm

    2013-08-12

    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. 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. 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. 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.

  13. Implementation of nutrition care service development plan at Banning Memorial Hospital: a case study.

    Science.gov (United States)

    Ben Oumlil, A; Rao, C P

    1992-01-01

    Health care service markets in general and hospital care service markets in particular are characterized by many competitive developments. Hence, hospital marketing managers are forced to respond to these emerging competitive pressures. However, in formulating appropriate marketing management strategies, hospital managers need to have detailed knowledge about consumers and their behaviors in the marketplace. This paper focuses on the Nutrition Care division of the Department of Nutrition Service at a hospital and its venture into new service development. This case study is intended to emphasize the significance of acquiring adequate knowledge of customers in the health care services industry. It particularly emphasizes the critical role that this type of information concerning customer behavior plays in the development and implementation of an appropriate business expansion strategy. Furthermore, the aim of this case study is to help the reader to relate the acquired marketing information to the problem at hand, and make the appropriate marketing management decision.

  14. Establishing a successful pre-hospital emergency service in a developing country: experience from Rescue 1122 service in Pakistan.

    Science.gov (United States)

    Waseem, Hunniya; Naseer, Rizwan; Razzak, Junaid Abdul

    2011-06-01

    As in many other developing countries, emergency medical services, especially pre-hospital emergency care, has long been neglected in Pakistan. Consequently, patients are brought to the emergency departments by relatives or bystanders in private cars, taxis or any other readily available mode of transportation. Ambulances, where they exist, have barely a stretcher and arrangements for oxygen supply. Modern emergency services are considered too costly for many countries. A model of pre-hospital emergency services, called Rescue 1122 and established in Punjab province of Pakistan, is presented. The system is supported by government funding and provides a quality service. The article describes the process of establishment of the service, the organisational structure, the scope of services and the role it is currently playing in the healthcare of the region it serves.

  15. Simulating Service System and Estimating the Hospital Beds for ICU Patients of Behbahan Shahidzade Hospital in 2015

    Directory of Open Access Journals (Sweden)

    Gholamreza Shahbazi Moghadam

    2016-04-01

    Full Text Available Introduction: Hospital bed is one of the most important resources of a hospital. The optimal estimation of the future number of beds needed is one of the important and interesting subjects for the policy makers. The aim of the present study was to simulate the service system and estimate the hospital beds for the ICU patients. Method: This is a simulation and modeling study. Stochastic simulation method was used to model the services system of ICU. The initial research population was consisted of 560 patients hospitalized in the ICU of Shahidzadeh general hospital in Behbahan, Khuzestan. The beds needed in the future was estimated based on key and significant parameters and variables including length of stay, admissions rate, and discharges rate for 10000 days and 5000 patients simulated (admission rate, =2 Data were analyzed using SPSS 18.0 and EXCEL 2010 software’s. Findings: the results showed that mean and median of the patients' length of stay were 5.4 9.3 and 3 days, respectively. Among the different variables, the patients' age, having diabetes, having dyslipidemia , the number of diagnostic tests, and the number of radiography services were the most important predictors of the patients' length of stay .The findings of simulation model showed that if the bed estimation is performed based on 10 and 20 initial beds , ICU will approximately encounter the shortage of bed up to the future 13 years (5000 days . If only the ICU works with 40 initial beds, it will need some additional hospital beds for 42.7 % of days (2135 days. Therefore, the ICU in the study can provide service for 57.3% of days (2865 days with the same existing 40 beds. Conclusion: we concluded that according to the existing beds and resources, the studied hospital will strongly face a shortage of ICU beds in most of the future days.

  16. 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

  17. 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.

  18. 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

  19. [Surgical service at the Central Military Hospital of People's Commissariat of Defence shortly before the Great Patriotic War].

    Science.gov (United States)

    Krainyukov, P E; Efimenko, N A; Abashin, V G

    2015-04-01

    Authors present the article historical data on the foundation and development of surgical service at the 1st Therapeutic Red Cross Hospital (Central Military Hospital of People's Commissariat. of Defense) since its organization. The structure of the hospital surgical service and organization of surgical activity during the pre-war years is presented. Provided information about outstanding surgeons who was working in the hospital.

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

    Directory of Open Access Journals (Sweden)

    Mariana Boaro Fernandez Canon

    2014-09-01

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

  1. [Evaluation of financial status of public hospitals considering the updated costs of their services].

    Science.gov (United States)

    Cid P, Camilo; Bastías S, Gabriel

    2014-02-01

    In 2011 the Chilean National Health Fund (FONASA) commissioned a study to assess the costs of the 120 most relevant hospital care services with an established fee, in a large sample of public hospitals. We herein report the cost evaluation results of such study, considering the financial condition of those hospitals in the year of the study. Based on the premise that the expenses derived from the provision of institutional and appraised hospital services should be identical to the billing of hospitals to FONASA, the prices are undervalued, since they cover only 56% of billing, generating a gap between expenses and invoicing. This gap shows an important limitation of tariffs, since their prices do not cover the real costs. However not all hospitals behave in the same way. While the provision of services of some hospitals is even higher than their billing, most hospitals do not completely justify their invoicing. These assumptions would imply that, generally speaking, hospital debts are justified by the costs incurred. However, hospitals have heterogeneous financial situations that need to be analyzed carefully. In particular, nothing can be said about their relative efficiency if cost estimations are not adjusted by the complexity of patients attended and comparison groups are not defined.

  2. Ancillary Testing in Lung Cancer Diagnosis

    Directory of Open Access Journals (Sweden)

    William Dubinski

    2012-01-01

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

  3. Nurses' Emotional Intelligence Impact on the Quality of Hospital Services

    OpenAIRE

    RANJBAR EZZATABADI, Mohammad; Bahrami, Mohammad Amin; Hadizadeh, Farzaneh; Arab, Masoomeh; Nasiri, Soheyla; AMIRESMAILI, Mohammadreza; Ahmadi Tehrani, Gholamreza

    2012-01-01

    Background Emotional intelligence is the potential to feel, use, communicate, recognize, remember, describe, identify, learn from, manage, understand and explain emotions. Service quality also can be defined as the post-consumption assessment of the services by consumers that are determined by many variables. Objectives This study was aimed to determine the nurses’ emotional intelligence impact on the delivered services quality. Materials and Methods This descriptive - applied study was carri...

  4. 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...

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

    Science.gov (United States)

    Fukunaga, Hisanori; Momonoi, Toshiyuki; Kumakawa, Hiromi

    2016-01-01

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

  6. 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.

  7. 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.

  8. 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.

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

    OpenAIRE

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

    2016-01-01

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

  10. 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.

  11. 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…

  12. 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…

  13. Internal and External Perspectives on Quality of Healthcare Services at Sanglah General Hospital Denpasar

    Directory of Open Access Journals (Sweden)

    Made Nopy Diah Sundari

    2015-04-01

    Full Text Available Background and purpose: Customer satisfaction is a primary indicator of the quality of public healthcare services. This study investigated internal (hospital staff and external (hospital clients perspectives in order to gain insight into the quality of care at Sanglah General Hospital.Methods: The study used both qualitative and quantitative methodologies with 11 informants and 106 respondents. Qualitative data obtained through in-depth interviews with hospital staff were analyzed thematically. Quantitative data obtained through self-administered questionnaire were analyzed using univariate analysis.Results: Informants from the qualitative data collection stated that Sanglah General Hospital has a relatively high level of service and that existing structures to mitigate issues are in place, which act as reinforcing factors. Data from the quantitative survey indicated that clients were satisfied with the quality of service (ServQual, with an overall percentage of 83.82%.Conclusion: Further efforts could be made in order to improve healthcare provision at Sanglah Hospital, particularly from the perspective of hospital facilities, staff support and increased implementation of clinical governance.Keywords: quality of service, internal perspectives, external perspectives, Sanglah Hospital

  14. 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.

  15. 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.

  16. 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.

  17. A clinical information consultation service at a teaching hospital.

    Science.gov (United States)

    Tobia, R C; Kronick, D A; Harris, G D

    1983-10-01

    The library and the department of medicine at the University of Texas Health Science Center at San Antonio cooperated in a three-month pilot project to test a clinical information consultation service that provides patient care information to house staff members in the clinical setting. Evaluation indicated that users were highly satisfied with the service. Results of our pilot project seem to show that a clinical information consultation service can be an efficient and cost-effective means to provide information in a patient-care setting.

  18. 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.

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

    Science.gov (United States)

    Park, Arum; Chang, Hyejung

    2017-01-01

    Objectives Services based on the Internet of Things (IoT) technologies have emerged in various business environments. To enhance health service quality and maximize benefits, this study applied an IoT technology based on NFC and iBeacon as an omni-channel service for patient care in hospitals. Methods Application of the IoT technology based on NFC and iBeacon was conducted in a general hospital during August 2015 through June 2016, and the development and evaluation results were aligned to an action research framework. The five phases in the action research included diagnosing, planning action, taking action, evaluating action, and specifying learning phases. Results During the first two phases, problems of functional operations in a hospital were diagnosed and eight service models were designed by using iBeacon and NFC to solve the problems. Service models were applied to the hospital by installing beacons, wearable beacons, beacon scanners, and NFC tags during the third phase. During the fourth and fifth phases, the roles and benefits of stakeholders participating in the service models were evaluated, and issues and knowledge of the whole application process were derived and summarized from technological, economic, social and legal perspectives, respectively. Conclusions From an action research perspective, IoT-based healthcare services were developed and verified. IoT-based services enable the hospital to acquire lifelog data for precision medicine and ultimately be able to go one step closer to precision medical care. The derived service models could provide patients more enhanced healthcare services and improve the work efficiency and effectiveness of the hospital. PMID:28261528

  20. Nursing management in hospital emergency service: integrative review of the literature

    Directory of Open Access Journals (Sweden)

    Renata Cristina Antonelli

    2014-12-01

    Full Text Available This is an integrative literature review, which aims to analyze scientific articles that discuss the work of nurses in the management of hospital emergency services. The databases used were Latin American and Caribbean Health Science Literature (LILACS, Medical Literature Analysis and Retrieval System Online (MEDLINE, Integrated Building Environmental Communications System (IBECS, Scientific Electronic Library Online (SciELO and Nursing Database (BDENF. To conduct the survey, 10 articles were selected and classified into two themes, namely: "analyzing the work of the nurse in hospital emergency services" and "organizing the nurse work in hospital emergency services". The first category discussed the functions of the nurse and the satisfaction of these professionals, and the second, the problems identified in the hospital emergency service and strategies to organize the service, respectively. The theme developed showed how the work of the nurse presents as manager of that service, in addition to various strategies to alleviate or eliminate the identified problems in the urgency and emergency units of the hospital services.

  1. Accounting for Inventories as Service Producing Cost in Hospitals In According To Turkish Accounting Standard-2

    Directory of Open Access Journals (Sweden)

    Seyhan Çil Koçyiğit

    2011-03-01

    Full Text Available As known, service is an intangible concept. This prevents services to be stored and makes them impossible to be used in another time in the future. Thus, it is a matter of discussion to suppose the services (which occur in the hospitals as an intangible concept as inventory. There are some differences between Turkish uniform accounting system and Turkish accounting standards in stockpiling the service producing costs in hospitals. In this study, especially Turkish Accounting Standard-2 Inventories is considered regarding service inventories in order to emphasise the differences and guiding to apply this standard towards hospitals is aimed. Furthermore, a sample is issued in booking the service inventories in hospitals by using financials of Acıbadem Health Services CO. as the unique hospital written in İstanbul Stock Exchange. At the end of the study, more truthful results has been inspected by applying Turkish Accounting Standard-2 instead of current application by compliying with the matching principle as well.

  2. 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.

  3. [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.

  4. 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\

  5. The impact on neonatal mortality of shifting childbirth services among levels of hospitals: Taiwan's experience

    Directory of Open Access Journals (Sweden)

    Hsu Sylvia H

    2009-06-01

    Full Text Available Abstract Background There is considerable discussion surrounding whether advanced hospitals provide better childbirth care than local community hospitals. This study examines the effect of shifting childbirth services from advanced hospitals (i.e., medical centers and regional hospitals to local community hospitals (i.e., clinics and district hospitals. The sample population was tracked over a seven-year period, which includes the four months of the 2003 severe acute respiratory syndrome (SARS epidemic in Taiwan. During the SARS epidemic, pregnant women avoided using maternity services in advanced hospitals. Concerns have been raised about maintaining the quality of maternity care with increased demands on childbirth services in local community hospitals. In this study, we analyzed the impact of shifting maternity services among hospitals of different levels on neonatal mortality and maternal deaths. Methods A population-based study was conducted using data from Taiwan's National Health Insurance annual statistics of monthly county neonatal morality rates. Based on a pre-SARS sample from January 1998 to December 2002, we estimated a linear regression model which included "trend," a continuous variable representing the effect of yearly changes, and two binary variables, "month" and "county," controlling for seasonal and county-specific effects. With the estimated coefficients, we obtained predicted neonatal mortality rates for each county-month. We compared the differences between observed mortality rates of the SARS period and predicted rates to examine whether the shifting in maternity services during the SARS epidemic significantly affected neonatal mortality rates. Results With an analysis of a total of 1,848 observations between 1998 and 2004, an insignificantly negative mean of standardized predicted errors during the SARS period was found. The result of a sub-sample containing areas with advanced hospitals showed a significant negative

  6. Unit cost of healthcare services at 200-bed public hospitals in Myanmar: what plays an important role of hospital budgeting?

    Science.gov (United States)

    Than, Thet Mon; Saw, Yu Mon; Khaing, Moe; Win, Ei Mon; Cho, Su Myat; Kariya, Tetsuyoshi; Yamamoto, Eiko; Hamajima, Nobuyuki

    2017-09-19

    Cost information is important for efficient allocation of healthcare expenditure, estimating future budget allocation, and setting user fees to start new financing systems. Myanmar is in political transition, and trying to achieve universal health coverage by 2030. This study assessed the unit cost of healthcare services at two public hospitals in the country from the provider perspective. The study also analyzed the cost structure of the hospitals to allocate and manage the budgets appropriately. A hospital-based cross-sectional study was conducted at 200-bed Magway Teaching Hospital (MTH) and Pyinmanar General Hospital (PMN GH), in Myanmar, for the financial year 2015-2016. The step-down costing method was applied to calculate unit cost per inpatient day and per outpatient visit. The costs were calculated by using Microsoft Excel 2010. The unit costs per inpatient day varied largely from unit to unit in both hospitals. At PMN GH, unit cost per inpatient day was 28,374 Kyats (27.60 USD) for pediatric unit and 1,961,806 Kyats (1908.37 USD) for ear, nose, and throat unit. At MTH, the unit costs per inpatient day were 19,704 Kyats (19.17 USD) for medicine unit and 168,835 Kyats (164.24 USD) for eye unit. The unit cost of outpatient visit was 14,882 Kyats (14.48 USD) at PMN GH, while 23,059 Kyats (22.43 USD) at MTH. Regarding cost structure, medicines and medical supplies was the largest component at MTH, and the equipment was the largest component at PMN GH. The surgery unit of MTH and the eye unit of PMN GH consumed most of the total cost of the hospitals. The unit costs were influenced by the utilization of hospital services by the patients, the efficiency of available resources, type of medical services provided, and medical practice of the physicians. The cost structures variation was also found between MTH and PMN GH. The findings provided the basic information regarding the healthcare cost of public hospitals which can apply the efficient utilization of the

  7. 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…

  8. 42 CFR 413.122 - Payment for hospital outpatient radiology services and other diagnostic procedures.

    Science.gov (United States)

    2010-10-01

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

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

    Science.gov (United States)

    Tan, Kar Way; Shankararaman, Venky

    2014-01-01

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

  10. Hospital takes customer service to new level, sees positive effect on bottom line.

    Science.gov (United States)

    1997-06-01

    Service with a smile boosts bottom line. Treating co-workers and patients like guests is the linchpin of a whole new philosophy at Bradley Memorial Hospital in Cleveland, TN. Administrators there insist a host of new customer service programs, from cap and gown graduation ceremonies to bunny bucks, has resulted in dramatic financial improvements and more satisfied patients and staff.

  11. 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.

  12. 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.

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

    Directory of Open Access Journals (Sweden)

    Nancy L. Weaver

    2014-10-01

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

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

    Science.gov (United States)

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

    2014-01-01

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

  15. 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

  16. Towards best practice in acute stroke care in Ghana: a survey of hospital services.

    Science.gov (United States)

    Baatiema, Leonard; Otim, Michael; Mnatzaganian, George; Aikins, Ama De-Graft; Coombes, Judith; Somerset, Shawn

    2017-02-02

    Stroke and other non-communicable diseases are important emerging public health concerns in sub-Saharan Africa where stroke-related mortality and morbidity are higher compared to other parts of the world. Despite the availability of evidence-based acute stroke interventions globally, uptake in low-middle income countries (LMIC) such as Ghana is uncertain. This study aimed to identify and evaluate available acute stroke services in Ghana and the extent to which these services align with global best practice. A multi-site, hospital-based survey was conducted in 11 major referral hospitals (regional and tertiary - teaching hospitals) in Ghana from November 2015 to April 2016. Respondents included neurologists, physician specialists and medical officers (general physicians). A pre-tested, structured questionnaire was used to gather data on available hospital-based acute stroke services in the study sites, using The World Stroke Organisation Global Stroke Services Guideline as a reference for global standards. Availability of evidence-based services for acute stroke care in the study hospitals were varied and limited. The results showed one tertiary-teaching hospital had a stroke unit. However, thrombolytic therapy (thrombolysis) using recombinant tissue plasminogen activator for acute ischemic stroke care was not available in any of the study hospitals. Aspirin therapy was administered in all the 11 study hospitals. Although eight study sites reported having a brain computed tomographic (CT) scan, only 7 (63.6%) were functional at the time of the study. Magnetic resonance imaging (MRI scan) services were also limited to only 4 (36.4%) hospitals (only functional in three). Acute stroke care by specialists, especially neurologists, was found in 36.4% (4) of the study hospitals whilst none of the study hospitals had an occupational or a speech pathologist to support in the provision of acute stroke care. This study confirms previous reports of limited and variable

  17. 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 quality services as obtained in other hospitals. Majority of the workers in all the professions except Medical Doctors accepted that the hospital values the individual workers. Majority of the Pharmacists and Non-clinical staff accepted that the hospital management was flexible and understands the importance of balancing their work and personal life. Majority of the Doctors, Pharmacists and laboratory/image scientists did not accept that top management communicates changes in decisions that affect employees. The perception of health workers on the quality of service rendered by the University of Uyo Teaching Hospital was satisfactory. However, the hospital needs to improve on its

  18. 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.

  19. 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.

  20. 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

  1. 77 FR 25105 - Reporting of Ancillary Airline Passenger Revenues

    Science.gov (United States)

    2012-04-27

    ... Office of the Secretary 14 CFR Parts 234 and 241 RIN 2139-AA13 Reporting of Ancillary Airline Passenger... (NPRM) issued on July 15, 2011. The NPRM proposed changes regarding reporting of airline ancillary... collect airline ancillary revenue information in a more detailed manner, change the way mishandled baggage...

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

    African Journals Online (AJOL)

    acer

    algorithms at a service points such as the ones obtainable in the ... determines the measure of performance of waiting lines such as ... the queue based on some order of priority. (Taha, 2007). ..... time get faster later in the day. The reason for.

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

    Science.gov (United States)

    Schirg, G

    1995-10-01

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

  4. 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.

  5. SERVICE QUALITY PERCEPTIONS AND PATIENTS' SATISFACTION: A COMPARATIVE CASE STUDY OF A PUBLIC AND A PRIVATE SECTOR HOSPITAL IN PAKISTAN

    OpenAIRE

    Kanwal Nasim; Saquib Yusaf Janjua

    2014-01-01

    Management of hospitals should take initiatives to improve the overall service quality of patient care. Regular feed-back from patients should be taken and rules should be made considering the expectations and requirements of patients. This study attempts to examine the satisfaction of patients from service quality they received from hospitals. Moreover, satisfaction is measured in both public and private hospital.

  6. 42 CFR 482.66 - Special requirements for hospital providers of long-term care services (“swing-beds”).

    Science.gov (United States)

    2010-10-01

    ... providers of long-term care services (“swing-beds”). A hospital that has a Medicare provider agreement must... extended care services, as specified in § 409.30 of this chapter, and be reimbursed as a swing-bed hospital... eligibility requirements: (1) The facility has fewer than 100 hospital beds, excluding beds for newborns and...

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

    Science.gov (United States)

    2010-07-01

    ... Defense, Public Health Service or other Federal hospitals with beds allocated to the Department of... of Department of Defense, Public Health Service or other Federal hospitals with beds allocated to the... hospital covered by the agreement, care may be authorized within the bed allocation for any veteran...

  8. Establishing in-hospital geriatrics services in Africa: Insights from the University of Benin Teaching Hospital geriatrics project.

    Science.gov (United States)

    Akoria, Obehi Aituaje

    2016-01-01

    Unawareness of the peculiar healthcare needs of the elderly and resource constraints may be some reasons why until recently, Nigerian hospitals have not been equipped with the human and infrastructural resources required to meet older adults' special healthcare needs. There is paucity of specialized health services for the elderly in Africa. Nigeria, with a population of over 170 million, did not have any healthcare facility with dedicated services for the elderly until 2012. The University of Benin Teaching Hospital (UBTH) in Nigeria was established in 1973 and created its geriatrics unit in October 2013. A prepared environment and trained interdisciplinary teams are pivotal in providing effective healthcare services for the elderly. The ongoing UBTH geriatrics project aims to provide specialized interdisciplinary health services to older adults and to provide training and continuing professional development in geriatrics for healthcare staff. In developing our inpatient services, we adopted the acute care for elders (ACE) model and worked in tandem with the "ABCs" of implementing ACE units. In the face of limited resources, it was possible to establish a functional geriatrics unit with a trained interdisciplinary team. Family participation is central in our practice. Since October 2013, residents and house officers in internal medicine have been undertaking 4- and 12-weekly rotations, respectively. There is also a robust academic program, which includes once-weekly geriatric pharmacotherapy seminars, once-weekly interdisciplinary seminars, and 2-weekly journal club meetings alternating with seminars on geriatric assessment tools. It is possible to establish geriatric services and achieve best practices in resource-limited settings by investing on improving available human resources and infrastructure. We also make recommendations for setting up similar services in other parts of Africa.

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

    Science.gov (United States)

    Kim, Jinkyung; Han, Woosok

    2012-06-01

    To investigate predictors for specific dimensions of service quality perceived by hospital employees in long-term care hospitals. 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. The most significant predictors of employee-perceived service quality were job satisfaction and degree of consent on national evaluation criteria. National evaluation results on long-term care hospitals and work environment also had positive effects on service quality. The findings of the study show that organizational characteristics are significant determinants of service quality in long-term care hospitals. Assessment of the extent to which hospitals address factors related to employeeperceived quality of services could be the first step in quality improvement activities. Results have implications for efforts to improve service quality in longterm care hospitals and designing more comprehensive national evaluation criteria.

  10. 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.

  11. 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

  12. 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.

  13. 78 FR 64953 - Medicare Program; Inpatient Hospital Deductible and Hospital and Extended Care Services...

    Science.gov (United States)

    2013-10-30

    ... entities include small businesses, nonprofit organizations, and small governmental jurisdictions. Most hospitals and most other providers and suppliers are small entities, either by nonprofit status or by having... and states are not included in the definition of a small entity. As discussed above, this...

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

    Science.gov (United States)

    2012-11-21

    ...) of the Act requires us to determine and publish each year the amount of the inpatient hospital... (see section 1886(b)(3)(B)(xii)(II) of the Act), and an adjustment based on changes in the economy-wide.... In addition, section 1102(b) of the Social Security Act requires us to prepare a regulatory impact...

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

    Directory of Open Access Journals (Sweden)

    A Dabiri

    2012-04-01

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

  16. 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.

  17. 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.

  18. 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.)

  19. Second order ancillary: A differential view from continuity

    CERN Document Server

    Fraser, Ailana M; Staicu, Ana-Maria; 10.3150/10-BEJ248

    2010-01-01

    Second order approximate ancillaries have evolved as the primary ingredient for recent likelihood development in statistical inference. This uses quantile functions rather than the equivalent distribution functions, and the intrinsic ancillary contour is given explicitly as the plug-in estimate of the vector quantile function. The derivation uses a Taylor expansion of the full quantile function, and the linear term gives a tangent to the observed ancillary contour. For the scalar parameter case, there is a vector field that integrates to give the ancillary contours, but for the vector case, there are multiple vector fields and the Frobenius conditions for mutual consistency may not hold. We demonstrate, however, that the conditions hold in a restricted way and that this verifies the second order ancillary contours in moderate deviations. The methodology can generate an appropriate exact ancillary when such exists or an approximate ancillary for the numerical or Monte Carlo calculation of $p$-values and confid...

  20. 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.

  1. Analysis of HIV / AIDS Patients Service Management in Paniai Hospital, Paniai, Papua

    Directory of Open Access Journals (Sweden)

    Agus Agus

    2017-02-01

    Full Text Available Clinical Voluntary Counseling Testing (VCT was established in 2009 in hospitals Paniai Papua. VCT Clinic Hospital Papua Paniai aims to prevent and break the chain of transmission of HIV, screening and early diagnosis, ongoing counseling, as well as preventing the transmission of HIV infection from mother to child. VCT is also becoming more access to management for people with HIV, either the antiretroviral drugs, prevention and treatment of opportunistic infections, and the treatment of HIV infection holistically. Objective: The identification of patient care management of HIV / AIDS in patient wards of hospitals Paniai Papua Province. Mixed Methods ie qualitative and quantitative research. The quantitative data obtained from medical records of 287 patients with HIV-AIDS hospitalizations in 2014-2016. The qualitative data obtained from interviews with key informants were 13 people selected by purposive sampling and analyzed descriptively. Characteristics of patients with HIV / AIDS are the patients most aged 25-49 years (54%, female gender (56%, high school (26%, not working (54%, risk factors for heterosexual (74%, tuberculosis coinfection (46%, duration of treatment ARV therapy for less than 1 year (57%, non-compliance with taking medication (61.1%, length of stay of 1-5 days (48%, stage III (65%, CD4 <200 mg (55%, the difference in the payment of fees at the rate parties BPJS RS Rp. 764 715 036. Inputs include human resources, facilities, infrastructure in the service of HIV / AIDS patients in hospitals Paniai accordance Hospital classification type D. Sources of funds from DAU (General Allocation Fund, DAK (Special Allocation Fund, Papua Health Card (KPS as well as the Public Service Board (BLUD. Optimal service process is already running with the service flow and SOP examination and treatment of HIV. Output inpatient care including HIV / AIDS patients were optimal given by SPM (Minimum Service Standards Hospital Health Ministerial Decree No

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

    Science.gov (United States)

    2009-09-01

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

  3. A management information system to plan and monitor the delivery of health-care services in government hospitals in India.

    Science.gov (United States)

    Ramani, K V

    2004-01-01

    Governments all over the world are getting increasingly concerned about their ability to meet their social obligations in the health sector. In this paper, we discuss the design and development of a management information system (MIS) to plan and monitor the delivery of healthcare services in government hospitals in India. Our MIS design is based on an understanding of the working of several municipal, district, and state government hospitals. In order to understand the magnitude and complexity of various issues faced by the government hospitals, we analyze the working of three large tertiary care hospitals administered by the Ahmedabad Municipal Corporation. The hospital managers are very concerned about the lack of hospital infrastructure and resources to provide a satisfactory level of service. Equally concerned are the government administrators who have limited financial resources to offer healthcare services at subsidized rates. A comprehensive hospital MIS is thus necessary to plan and monitor the delivery of hospital services efficiently and effectively.

  4. Elderly Patients’ Satisfaction with Provided Services in Yazd Shahid Sadoughi Hospital

    Directory of Open Access Journals (Sweden)

    Ali Dehghani Ahmadabad

    2016-06-01

    Full Text Available Introduction: Most of the older adults have to be hospitalized and patients’ satisfaction from the provided services is one of the key performance indicators in healthcare centers. Feeling satisfied with the treatment process and provided services can motivate the elderly patients to continue their treatment, which ultimately leads to a reduction in the disease load and disability in older adults. The aim of this study was to examine the satisfaction status of elderly patients admitted in different wards in Yazd Shahid Sadoughi Hospital of provided services in winter 2015. Methods: This was a cross-sectional study in which, the elderly patients who were hospitalized in different wards of Yazd Shahid Sadoughi Hospital were investigated. Totally, 100 patients entered in the study through convenience sampling during the winter 2015. A modified Persian version of Patient Satisfaction Questionnaire III was applied for data collection. To analyze the data, In addition to descriptive statistics, in inferential section student-t and Pearson and Spearman correlation coefficients were applied. Results: The mean score of total satisfaction from hospital services of Yazd Shahid Sadoughi Hospital was 65.4 (range 0-100. There was a significant positive relation between the different domains of satisfactions. It was only the financial aspects which was not in relation with other domains. The highest score of the patient satisfaction belonged to the technical quality (73.7 and nursing services (69.6 and the lowest score was in the communication domain (48.7. The score of satisfaction in financial aspects was lower in men than women (P< 0.05. Conclusion: Most of the elderly patients had little satisfaction with the communication. Medical students and staff should consider good communication while delivering services to the elderly, and provide adequate information to help them decide which treatment pathway is suitable.

  5. 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

  6. 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.

  7. Private medical services in the Italian public hospitals: the case for improving HRM.

    Science.gov (United States)

    De Pietro, Carlo

    2006-08-22

    This study explores how Italian public hospitals can use private medical activities run by their employed physicians as a human resources management (HRM) tool. It is based on field research in two acute-care hospitals and a review of Italian literature and laws. The Italian National Health Service (NHS) allows employed physicians to run private, patient-funded activities ("private beds", surgical operations, hospital outpatient clinics, etc.). Basic regulation is set at the national level, but it can be greatly improved at the hospital level. Private activities, if poorly managed, can damage efficiency, equity, quality of care, and public trust in the NHS. On the other hand, hospitals can also use them as leverage to improve HRM, with special attention to three issues: (1) professional evaluation, development, and training; (2) compensation policies; (3) competition for, and retention of, professionals in short supply. The two case studies presented here show great differences between the two hospitals in terms of regulation and organizational solutions that have been adopted to deal with such activities. However, in both hospitals, private activities do not seem to benefit HRM. Private activities are not systematically considered in compensation policies. Moreover, private revenues are strongly concentrated in a few physicians. Hospitals use very little of the information provided by the private activities to improve knowledge management, career development, or training planning. Finally, hospitals do not use private activities management as a tool for competing in the labor market for health professionals who are in short supply.

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

    Science.gov (United States)

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

    2006-01-01

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

  9. Execution of Computerized Management Systems in Facility Maintenance Services of Government Hospitals

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    Othuman Mydin Md Azree

    2014-01-01

    Full Text Available Maintenance management of a hospital is the most important element in determining the ability of a hospital to provide its services successfully. On 28th October 1996, the Ministry of Health (MOH privatized five Hospital Support Services (HSS, one of them being Facility and Engineering Maintenance Services (FEMS. Currently, the Ministry has granted concessions for the privatized services to three contractors where they have established and are maintaining their own basic Management Information System (MIS to manage the entire project and track the work performed for all of their services. These MISs consist of a variety of modules which help maintenance strategies adopted in a building run smoothly. The purpose of this paper is to study the utilization of computerized management system modules in the MISs of those three HSS providers and to investigate problems that have occurred during the utilization of these systems. This study was conducted in the form of case studies at three different hospitals that subscribed to three different concession companies. Targeting maintenance staff and users of computerized management systems, 60 sets of questionnaires were distributed and interview sessions were conducted. This study will also highlight the challenges of using computerized management systems and propose suitable recommendations to improve the utilization of such systems.

  10. 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.

  11. [Prevalence of psychiatric disorders in men and women hospitalized in a internal medicine service of a hospital of Santiago, Chile].

    Science.gov (United States)

    Hernández, G; Ibáñez, C; Kimelman, M; Orellana, G; Montino, O; Núñez, C

    2001-11-01

    Mental disorders may interfere, aggravate or mimic medical conditions. To study the prevalence of psychiatric disorders among patients hospitalized in a medical ward of a general hospital. A structured interview for DSM-III, devised for "non patients", was applied to 203 men and 203 women, aged 11 to 90 years old, hospitalized in an internal medicine service of a public hospital. Thirty four psychiatric conditions that can be discriminated with the instrument and others that complied with DSM-III criteria, were investigated. There was a 60% prevalence of mental disorders among men (alcohol dependency in 26%, delirium or dementia in 10.8%, anxiety disorders in 10.4%, major depression in 7.8% and adaptation disorders in 3%). Among women, the prevalence of mental disorders was 65% (major depression in 23.2%, anxiety disorders in 14.3%, adaptation disorders in 8.4%, dementia in 5.6%, delirium in 3% and alcohol dependency in 2.5%). Most conditions were of moderate or mild intensity. Two or more conditions coexisted in 40% of cases. Only in 8% of these subjects, a psychiatric consultation was requested. There is a high frequency of psychiatric disorders among medical patients. These must be adequately diagnosed and treated.

  12. Clinicians' satisfaction with a hospital blood transfusion service: a marketing analysis of a monopoly supplier.

    Science.gov (United States)

    Pennington, S J; McClelland, D B; Murphy, W G

    1993-01-01

    One of the objectives of the NHS reforms is to improve customer focus within the health service. In a study to assess the quality of customer service provided by the Edinburgh and South East Scotland Blood Transfusion Service a 19 item questionnaire survey of the main clinical users of the service was performed to ascertain their satisfaction, measured on a 5 point anchored scale, with important aspects of the service, including medical consultation, diagnostic services, blood and blood components or products and their delivery, and general satisfaction with the service. Of 122 clinicians in medical and surgical disciplines in five hospitals in Edinburgh, 72 (59%) replied. Fourteen (22%) indicated dissatisfaction with any aspect of the medical consultation service, owing to inadequate follow up of clinical contacts and unsatisfactory routing of incoming calls. Diagnostic services were criticised for the presentation, communication, and interpretation of results. The restricted availability of whole blood, the necessity to order platelets and plasma through the duty blood transfusion service doctor, and the use of a group and screen policy, attracted criticism from a small number of clinicians. Ten of 68 respondents expressed dissatisfaction with delivery of blood and components to the wards and theatres. The findings indicate that the clinicians served by this blood transfusion service are largely satisfied with the service. Changes are being implemented to improve reporting of laboratory results and measures taken to improve liaison with clinicians. PMID:10132458

  13. Clinicians' satisfaction with a hospital blood transfusion service: a marketing analysis of a monopoly supplier.

    Science.gov (United States)

    Pennington, S J; McClelland, D B; Murphy, W G

    1993-12-01

    One of the objectives of the NHS reforms is to improve customer focus within the health service. In a study to assess the quality of customer service provided by the Edinburgh and South East Scotland Blood Transfusion Service a 19 item questionnaire survey of the main clinical users of the service was performed to ascertain their satisfaction, measured on a 5 point anchored scale, with important aspects of the service, including medical consultation, diagnostic services, blood and blood components or products and their delivery, and general satisfaction with the service. Of 122 clinicians in medical and surgical disciplines in five hospitals in Edinburgh, 72 (59%) replied. Fourteen (22%) indicated dissatisfaction with any aspect of the medical consultation service, owing to inadequate follow up of clinical contacts and unsatisfactory routing of incoming calls. Diagnostic services were criticised for the presentation, communication, and interpretation of results. The restricted availability of whole blood, the necessity to order platelets and plasma through the duty blood transfusion service doctor, and the use of a group and screen policy, attracted criticism from a small number of clinicians. Ten of 68 respondents expressed dissatisfaction with delivery of blood and components to the wards and theatres. The findings indicate that the clinicians served by this blood transfusion service are largely satisfied with the service. Changes are being implemented to improve reporting of laboratory results and measures taken to improve liaison with clinicians.

  14. Staff training in hospitality sector as benefit for improved service quality

    OpenAIRE

    Ivanka Nestoroska; Irina Petrovska

    2014-01-01

    Contemporary hotel industry is facing many challenges which are closely connected to the changes that occur both in the field of tourist demand and tourist supply. The changes refer to quality of services at first place, since the needs of tourists change rapidly towards higher quality and different products. Having in mind the character of the activities in hospitality industry where a direct contact between employees and guests is necessary for providing and realizing the services, the succ...

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

    OpenAIRE

    Ana Stranjancevic; Iva Bulatovic

    2015-01-01

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

  16. 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

  17. 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

  18. Patient management: measuring patients' expectations and perceptions of service quality in a dental training hospital.

    Science.gov (United States)

    White, J G; Slabber, J; Schreuder, A

    2001-04-01

    The difference between service quality expectations and perceptions (experiences) of patients (customers) attending a dental training hospital was investigated by using a modified version of the Parasuraman SERVQUAL model. A questionnaire comprising 28 service quality-related statements and four open-ended questions was used at the interviews. The study showed that 11.6% of respondents experienced problems with the service. A principal component factor analysis indicated that two of the five dimensions of service quality, namely reliability and assurance, contributed to 59% of service level variance. Female patients showed larger mean differences than male patients. The greater the number of visits to the hospital, the smaller the difference between expectations and perceptions. Patients in the category 36-45 years of age, showed larger mean differences than younger or older patients. Respondents with no academic qualifications had lower expectations of the service, while professional people seemed to have more realistic expectations prior to a visit to the hospital than respondents in the technical/clerical category.

  19. 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.

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

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    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

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

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    Shahrokh Alinia

    2015-10-01

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

  2. 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

  3. [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.

  4. 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...

  5. 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

  6. Improvement of district hospital service system to increase treatment adherence among tuberculosis patients in Pakistan.

    Science.gov (United States)

    Khan, Muhammad Shafiq; Suwannapong, Nawarat; Howteerakul, Nopporn; Pacheun, Oranut; Rajatanun, Titipat

    2011-05-01

    Adherence to medication regimen is essential for tuberculosis (TB) treatment success. We carried out quasi-experimental, single group intervention study at Rawalpindi District Hospital to improve TB patient treatment adherence using a Chronic Care Model (CCM). Ninety-nine newly diagnosed TB patients at the TB Clinic, Rawalpindi District Hospital, during February-March 2009, were included in the study. A set of four quality indicators were determined based on current scientific evidence: quality of service system, patient satisfaction, treatment adherence and cure rate. Care quality changes over time were analyzed by paired t-test. Significant improvements in service quality were seen post-intervention. Overall, the hospital service system quality improved to "good" (from 1.0% to 28.3%), and patient satisfaction increased to "good" (10.2% to 54.1%). Treatment adherence increased (from 23.2% to 56.1%). The quarterly cure rate increased notably (5.3% to 17.2%). The overall mean scores for hospital service system quality, patient satisfaction, and TB patient treatment adherence, improved significantly 6 month post-intervention (p<0.001).

  7. 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…

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

    NARCIS (Netherlands)

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

    1997-01-01

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

  9. 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…

  10. A Case Study of Job Satisfaction in Surgical Services at Martin Army Community Hospital

    Science.gov (United States)

    2003-04-01

    anesthesiologists, and registered nurses. The research was qualitative in nature, primarily employing comprehensive nonprobability sampling . Primary data...Community Hospital (MACH), Fort Benning, Georgia. The case study employed the nominal group technique to garner job factors specific to the...group technique to garner job factors specific to the professionals involved in surgical services at MACH. Job satisfaction was structured under the

  11. 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

  12. Good hygiene practices in hospital nutrition services: the view of internal and external auditors

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    Lize STANGARLIN-FIORI

    2016-01-01

    Full Text Available Abstract The objective of this study was to evaluate the hygienic-sanitary conditions of hospital nutrition services according to internal and external auditors, before and after intervention, based on the requirements of Good Hygiene Practices. Fifteen hospital nutrition services were evaluated based on a checklist applied by internal auditors and by an external auditor. The intervention program was prepared and implemented in all the locations over one year, and was composed of four points: 1 training; 2 preparation of the action plan; 3 preparation of the documentation; 4 monthly visits to motivate the food handlers and responsible technicians, accompaniment and assistance in the implementation of Good Hygiene Practices. An improvment in the application of Good Hygiene Practices was observed in the hospital nutrition services after the systematic intervention, in the view of both the internal and external auditors, except the requirement related to operational aspects, which had a low percentage of adequacy, both before and after the intervention Before the intervention, there was a significant difference between the evaluation of the internal auditors and the external auditor, which was not found later. These results suggest that the systematic intervention assisted in the adoption of Good Hygiene Practices by hospital nutrition services, according to both the internal and external auditors, and contributed to increasing the knowledge of the internal auditors.

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

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

    2011-01-01

    Full Text Available Background: The HIV/AIDS pandemic is a major public health problem with an estimated 33.33 million people living with the virus globally. Free antiretroviral treatment was initiated in India 2004. Patients’ satisfaction is one of the commonly used outcome measures of patient care. Objective: To assess the satisfaction of people living with HIV/AIDS with services provided at anti retroviral therapy Centre Hamidia Hospital Bhopal. Material and Methods: A hospital based cross-sectional study was undertaken from August 2008 to July 2009 on all the registered people living with HIV/AIDS (PLWHA following antiretroviral treatment at Hamidia Hospital Bhopal. Data was collected and by using pre-designed & pre-tested questionnaire and analyzed using Epi-info version 3.5.3. Results: For most of the questions regarding satisfaction on the care services of the center, participants responded positively (excellent & good.The overall mean satisfaction score was “Excellent”. Conclusion: The services of the Center were rated positively (Excellent and above.The hospital management should work to strengthen the clinic services by helping the ART clinic staff to involve patients in the treatment process and recognize their opinions on follow up.

  14. 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…

  15. 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.

  16. [An evaluation of the services of state hospital pharmacies in Rio de Janeiro, Brazil].

    Science.gov (United States)

    da Silva, Mario Jorge Sobreira; Magarinos-Torres, Rachel; Oliveira, Maria Auxiliadora; Osorio-de-Castro, Claudia Garcia Serpa

    2013-12-01

    This article presents an evaluation of state-run hospital pharmacies in Rio de Janeiro. For the regulatory evaluation, 62 indicators of structure and procedures were used in order to establish the adequacy of the activities of the hospital pharmacy. The services were then stratified by level of complexity of the hospital. A scaled rating algorithm was applied to each stratum in accordance with the activities carried out. The hospitals were then hierarchically grouped for each stratum and the best and worst services at each level of complexity were chosen for the multiple case study, resulting in a total of six units. In these units 16 result indicators were applied and analysis of the resulting data was conducted by cross-case synthesis. The performance evaluation revealed that only one unit performed management and forecasting activities satisfactorily. Four units administered medication procurement inadequately. The worst results in terms of performance in the six hospitals studied were related to stock management and the best to distribution activities. The data are a cause for concern, since these are considered the core activities of the hospital pharmacy.

  17. Migration to an electronic journal collection in a hospital library: implications for reference service.

    Science.gov (United States)

    Bardyn, Tania P; Young, Caroline S

    2007-01-01

    This article provides a perspective on the migration to an electronic-only journal collection in a hospital library and its effect on reference services, information-seeking, and library use patterns. Bellevue Hospital Center in New York, NY is one of the first major teaching hospitals in the United States to begin a fundamental shift to a current, electronic-only journal collection. This article describes the process and develops a model for use by other hospital libraries, with commentary on the impact on reference services to library users. Key findings are that physicians, residents, and nurses have come to expect electronic journal collections and use the Internet in the hospital library to access electronic journals. Similar to many academic health sciences libraries, the reference desk in a hospital library has become more like a technical support desk. Users who contact the library have questions about access to the library's electronic resources or about searching techniques. In the future, medical reference librarians will continue to assist searchers who cannot find what they are looking for and will assist those who repeatedly get results that do not match their information needs.

  18. 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.

  19. Applying the theory of constraints to the logistics service of medical records of a hospital

    Directory of Open Access Journals (Sweden)

    Víctor-G. Aguilar-Escobar

    2016-09-01

    Full Text Available Management of patient records in a hospital is of major importance, for its impact both on the quality of care and on the associated costs. Since this process is circular, the prevention of the building up of bottlenecks is especially important. Thus, the objective of this paper was to analyze whether the Theory of Constraints (TOC can be useful to the logistics of medical records in hospitals. The paper is based on a case study conducted about the 2007-2011 period in the Medical Records Logistics Service at the Hospital Universitario Virgen Macarena in Seville (Spain. From April 2008, a set of actions in the clinical record logistics system were implemented based on the application of TOC principles. The results obtained show a significant increase in the level of service and employee productivity, as well as a reduction of cost and the number of patients’ complaints.

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

    Directory of Open Access Journals (Sweden)

    Edem Max Azila-Gbettor

    2013-09-01

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

  1. 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.

  2. 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.

  3. 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 (pservice 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.

  4. Consultation-liaison service in a regional hospital in Hong Kong.

    Science.gov (United States)

    Wong, M M C; Yiu, M G C

    2014-06-01

    To examine consultation-liaison psychiatric services in a general hospital in Hong Kong. All records of Tseung Kwan O Hospital psychiatric consultations from 1 July 2012 to 30 June 2013 were extracted from the database. Patients' demographic data, sources and reasons of referral, psychiatric and suicidal histories, current suicidal attempt, psychiatric diagnoses, psychiatric outcomes, as well as waiting times were analysed accordingly. A total of 1392 psychiatric consultations were received, of which 82% were attended to within the same working day when the referral was received, and 99% were attended to by the end of the next working day. The commonest reasons of consultation were unstable emotion followed by suicidal / deliberate self-harm and aggression. There were 246 consultations with actual suicidal attempt. Overall, 270 (19%) patients who received consultation-liaison psychiatric services were admitted to the psychiatric wards. Follow-up in the psychiatric outpatient department was arranged for 691 (50%) patients while 57 (4%) required referral to the community psychiatric nursing service in addition to outpatient department arrangement. Management of suicidal attempters and provision of risk assessment continue to be the major tasks of consultation-liaison psychiatrists and nurses. A readily available on-site consultation-liaison psychiatric service is an essential component of services provided in acute general hospitals.

  5. Hospital support services and the impacts of outsourcing on occupational health and safety.

    Science.gov (United States)

    Siganporia, Pearl; Astrakianakis, George; Alamgir, Hasanat; Ostry, Aleck; Nicol, Anne-Marie; Koehoorn, Mieke

    2016-10-01

    Outsourcing labor is linked to negative impacts on occupational health and safety (OHS). In British Columbia, Canada, provincial health care service providers outsource support services such as cleaners and food service workers (CFSWs) to external contractors. This study investigates the impact of outsourcing on the occupational health safety of hospital CFSWs through a mixed methods approach. Worker's compensation data for hospital CFSWs were analyzed by negative binomial and multiple linear regressions supplemented by iterative thematic analysis of telephone interviews of the same job groups. Non-significant decreases in injury rates and days lost per injury were observed in outsourced CFSWs post outsourcing. Significant decreases (P outsourcing. Outsourced workers interviewed implied instances of underreporting workplace injuries. This mixed methods study describes the impact of outsourcing on OHS of healthcare workers in British Columbia. Results will be helpful for policy-makers and workplace regulators to assess program effectiveness for outsourced workers.

  6. 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.

  7. Ancillary procedures in facial animation surgery.

    Science.gov (United States)

    Bianchi, Bernardo; Ferri, Andrea; Ferrari, Silvano; Leporati, Massimiliano; Ferri, Teore; Sesenna, Enrico

    2014-12-01

    Facial animation surgery with neuromuscular transplants has become a standard procedure for the treatment of facial palsies. However, the forehead, periocular complex, nasal base area, and inferior lip are secondary sites that also need to be considered in the complete rehabilitation of a flaccid facial palsy. A total of 136 ancillary procedures were performed in 49 patients between 2003 and 2013 and consisted of eyebrow suspensions (11), upper eyelid loading with a platinum chain (39), inferior palpebral suspension with fascia lata (22), nasal base suspension with fascia lata (26), and botulinum toxin injection (38). Cosmetic results were good and excellent in 30.7% and 63.2% of the procedures, respectively. Functionally, periocular complex rehabilitation and nasal base suspension led to excellent improvements in function in 87.2% and 73.1% of the patients, respectively. The use of ancillary procedures can improve the functional and esthetic results of facial animation surgery. Copyright © 2014 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  8. 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.

  9. 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

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

    Science.gov (United States)

    2010-07-01

    ... Health Service Or Other Federal Hospitals § 17.51 Emergency use of Department of Defense, Public Health... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Emergency use of Department of Defense, Public Health Service or other Federal hospitals. 17.51 Section 17.51...

  11. 42 CFR 409.68 - Guarantee of payment for inpatient hospital or inpatient CAH services furnished before...

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Guarantee of payment for inpatient hospital or inpatient CAH services furnished before notification of exhaustion of benefits. 409.68 Section 409.68 Public... HOSPITAL INSURANCE BENEFITS Scope of Hospital Insurance Benefits § 409.68 Guarantee of payment...

  12. 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.

  13. Success Rate of Pre-hospital Emergency Medical Service Personnel in Implementing Pre Hospital Trauma Life Support Guidelines on Traffic Accident Victims

    OpenAIRE

    Gholipour, Changiz; Vahdati, Samad Shams; NOTASH, Mehdi; MIRI, Seyed Hassan; Ghafouri, Rouzbeh Rajaei

    2016-01-01

    SUMMARY Objectives Road traffic injuries are responsible for a vast number of trauma-related deaths in middle- and low-income countries. Pre-hospital emergency medical service (PHEMS) provides care and transports the injured patients from the scene of accident to the destined hospital. The PHEMS providers and paramedics were recently trained in the Pre Hospital Trauma Life Support (PHTLS) guidelines to improve the outcome of trauma patients in developing countries. We decided to carry out a s...

  14. Success Rate of Pre-hospital Emergency Medical Service Personnel in Implementing Pre Hospital Trauma Life Support Guidelines on Traffic Accident Victims

    OpenAIRE

    Gholipour, Changiz; Vahdati, Samad Shams; NOTASH, Mehdi; MIRI, Seyed Hassan; Ghafouri, Rouzbeh Rajaei

    2016-01-01

    SUMMARY Objectives Road traffic injuries are responsible for a vast number of trauma-related deaths in middle- and low-income countries. Pre-hospital emergency medical service (PHEMS) provides care and transports the injured patients from the scene of accident to the destined hospital. The PHEMS providers and paramedics were recently trained in the Pre Hospital Trauma Life Support (PHTLS) guidelines to improve the outcome of trauma patients in developing countries. We decided to carry out a s...

  15. The inpatient costs and hospital service use associated with invasive meningococcal disease in South Australian children.

    Science.gov (United States)

    Wang, Bing; Haji Ali Afzali, Hossein; Marshall, Helen

    2014-08-20

    Invasive meningococcal disease (IMD) remains a serious public health concern due to a sustained high case fatality rate and morbidity in survivors. This study aimed to estimate the hospital service costs associated with IMD and variables associated with the highest costs in Australian children admitted to a tertiary paediatric hospital. Clinical details were obtained from medical records and associated inpatient costs were collected and inflated to 2011 Australian dollars using the medical and hospital services component of the Australian Consumer Price Index. Both unadjusted and adjusted analyses were undertaken. Multivariate regression models were used to adjust for potential covariates and determine independent predictors of high costs and increased length of hospital stay. Of 109 children hospitalised with IMD between May 2000 and April 2011, the majority were caused by serogroup B (70.6%). Presence of sequelae, serogroup B infection, male gender, infants less than one year of age, and previous medical diagnosis were associated with higher inpatient costs and length of stay (LOS) in hospital (pcosts and LOS during the IMD related readmissions for patients with sequelae (passociated long-term sequelae result in high health care costs, which should be considered in meningococcal B vaccine funding considerations. Copyright © 2014 Elsevier Ltd. All rights reserved.

  16. 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.

  17. 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.

  18. SERVICE QUALITY PERCEPTIONS AND PATIENTS' SATISFACTION: A COMPARATIVE CASE STUDY OF A PUBLIC AND A PRIVATE SECTOR HOSPITAL IN PAKISTAN

    Directory of Open Access Journals (Sweden)

    Kanwal Nasim

    2014-09-01

    Full Text Available Management of hospitals should take initiatives to improve the overall service quality of patient care. Regular feed-back from patients should be taken and rules should be made considering the expectations and requirements of patients. This study attempts to examine the satisfaction of patients from service quality they received from hospitals. Moreover, satisfaction is measured in both public and private hospital.

  19. Optimal administrative scale for planning public services: a social cost model applied to Flemish hospital care.

    Science.gov (United States)

    Blank, Jos L T; van Hulst, Bart

    2015-01-01

    In choosing the scale of public services, such as hospitals, both economic and public administrative considerations play important roles. The scale and the corresponding spatial distribution of public institutions have consequences for social costs, defined as the institutions' operating costs and the users' travel costs (which include the money and time costs). Insight into the relationship between scale and spatial distribution and social costs provides a practical guide for the best possible administrative planning level. This article presents a purely economic model that is suitable for deriving the optimal scale for public services. The model also reveals the corresponding optimal administrative planning level from an economic perspective. We applied this model to hospital care in Flanders for three different types of care. For its application, we examined the social costs of hospital services at different levels of administrative planning. The outcomes show that the social costs of rehabilitation in Flanders with planning at the urban level (38 areas) are 11% higher than those at the provincial level (five provinces). At the regional level (18 areas), the social costs of rehabilitation are virtually equal to those at the provincial level. For radiotherapy, there is a difference of 88% in the social costs between the urban and the provincial level. For general care, there are hardly any cost differences between the three administrative levels. Thus, purely from the perspective of social costs, rehabilitation should preferably be planned at the regional level, general services at the urban level and radiotherapy at the provincial level.

  20. 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.

  1. 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.

  2. Regional and supraregional biochemistry services in Scotland: a survey of hospital laboratory users.

    Science.gov (United States)

    Murphy, M J; Dryburgh, F J; Shepherd, J

    1994-05-01

    To ascertain the views of Scottish hospital laboratory users on aspects of regional and supraregional biochemical services offered by the Institute of Biochemistry at Glasgow Royal Infirmary. A questionnaire was circulated asking questions or inviting opinions under various headings, including current patterns of usage of the services provided, availability of information on specimen collection requirements and reference ranges, current arrangements for transport of specimens, turnaround times for delivery of reports, layout and content of request and report forms, quantity and quality of interpretive advice, potential changes in laboratory services, and overall impression of the services provided. Opportunities were provided for free text comment. The questionnaire was circulated in 1992 to heads of department in 23 Scottish hospital biochemistry laboratories. Twenty one replies were received. Services used widely included trace metals/vitamins (n = 20) and specialised endocrine tests (n = 19). Other services also used included specialised lipid tests (n = 13), toxicology (n = 12), thyroid function tests (n = nine), and tumour markers (n = eight). Fifteen laboratories used one or more of the services at least weekly. Most (n = 20) welcomed the idea of a handbook providing information on specimen collection and reference ranges. Nine identified loss of specimens as a problem. Other perceived problems included the absence of reference ranges from report forms, quantity and quality of interpretive advice, and turnaround times of some tests. Overall impressions of the service(s) offered were very good (n = 12); adequate (n = seven); poor (n = one). Useful information was obtained about patterns of use and transport arrangements. Areas identified as requiring follow up included provision of information, alternative ways of communicating reports, and improvement in quantity and quality of interpretive advice.

  3. The provision of dental implants in the National Health Service Hospital dental services--a national questionnaire.

    Science.gov (United States)

    Butterworth, C J; Baxter, A M; Shaw, M J; Bradnock, G

    2001-01-27

    To assess the activity of consultants in restorative dentistry in the United Kingdom in the provision of osseointegrated dental implants within the National Health Service Hospital service and to evaluate their attitudes concerning the relevant medical and oral factors considered in patient selection for implant treatment. Anonymous postal questionnaire in the United Kingdom. Consultants in restorative dentistry. Out of the sample of 145, 109 consultants (75%) completed the questionnaire in 1999. 54 of the 109 consultants (49.5%) are involved in the provision of osseointegrated implant treatment, treating an average of 29 cases/year (range 2-150). However, over one third of the respondents treated 10 or less cases/year. 89% worked with oral surgeons as an implant team. 68% used Branemark (Nobel Biocare) implants as their main system. The majority of consultants felt that smoking, psychoses and previous irradiation were the most important medical factors that contra-indicated implant retained restorations whilst untreated periodontitis, poor oral hygiene and uncontrolled caries were the most important oral contra-indications. Many centres were experiencing significant problems with the funding of implant treatment with one centre receiving no funding. The implications for patient care and specialist training are discussed. There is a marked variation in the number of patients treated with endosseous dental implants within the United Kingdom National Health Service hospitals. Many consultants treat 10 or fewer patients each year. In the main, there is agreement about the factors that contra-indicate implant treatment; these are in line with national guidelines.

  4. Evaluation of an aged care nurse practitioner service: quality of care within a residential aged care facility hospital avoidance service.

    Science.gov (United States)

    Dwyer, Trudy; Craswell, Alison; Rossi, Dolene; Holzberger, Darren

    2017-01-13

    Reducing avoidable hospitialisation of aged care facility (ACF) residents can improve the resident experience and their health outcomes. Consequently many variations of hospital avoidance (HA) programs continue to evolve. Nurse practitioners (NP) with expertise in aged care have the potential to make a unique contribution to hospital avoidance programs. However, little attention has been dedicated to service evaluation of this model and the quality of care provided. The purpose of this study was to evaluate the quality of an aged care NP model of care situated within a HA service in a regional area of Australia. Donabedian's structure, process and outcome framework was applied to evaluate the quality of the NP model of care. The Australian Nurse Practitioner Study standardised interview schedules for evaluating NP models of care guided the semi-structured interviews of nine health professionals (including ACF nurses, medical doctors and allied health professionals), four ACF residents and their families and two NPs. Theory driven coding consistent with the Donabedian framework guided analysis of interview data and presentation of findings. Structural dimensions identified included the 'in-reach' nature of the HA service, distance, limitations of professional regulation and the residential care model. These dimensions influenced the process of referring the resident to the NP, the NPs timely response and interactions with other professionals. The processes where the NPs take time connecting with residents, initiating collaborative care plans, up-skilling aged care staff and function as intra and interprofessional boundary spanners all contributed to quality outcomes. Quality outcomes in this study were about timely intervention, HA, timely return home, partnering with residents and family (knowing what they want) and resident and health professional satisfaction. This study provides valuable insights into the contribution of the NP model of care within an aged care

  5. Personnel and patient scheduling in the high demanded hospital services: a case study in the physiotherapy service.

    Science.gov (United States)

    Ogulata, S Noyan; Koyuncu, Melik; Karaskas, Esra

    2008-06-01

    High demand but limited staffs within some services of a hospital require a proper scheduling of staff and patients. In this study, a hierarchical mathematical model is proposed to generate weekly staff scheduling. Due to computational difficulty of this scheduling problem, the entire model is broken down into manageable three hierarchical stages: (1) selection of patients, (2) assignment of patients to the staff, (3) scheduling of patients throughout a day. The developed models were tested on the data collected in College of Medicine Research Hospital at Cukurova University using GAMS and MPL optimization packages. From the results of the case study, the presented hierarchical model provided a schedule that ensures to maximize the number of selected patients, to balance the workload of physiotherapist, and to minimize waiting time of patients in their treatment day.

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

    Directory of Open Access Journals (Sweden)

    Fereshteh Farzianpour

    2011-01-01

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

  7. 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.

  8. Gold award: mental health services for the deaf--St. Elizabeths Hospital, Washington, D.C.

    Science.gov (United States)

    1978-10-01

    The mental health program for the deaf at St. Elizabeths Hospital offers comprehensive services to adolescents and adults who were born deaf or who became deaf early in life. A staff of 49, six of whom have impaired hearing, provide services to about 33 inpatients and about 71 outpatients. Activity therapies that do not require oral communication, such as occupational therapy, art therapy, dance therapy, and psychodrama, play an important role in the program, as does group psychotherapy. The program provides training, field experience, and consultation for workers throughout the U.S. and from foreign countries. Some guidelines for communicating with the deaf are given.

  9. [Review of legislation regarding clinical research in the Spanish health care system and hospital pharmacy services].

    Science.gov (United States)

    Laguna-Goya, Noa; Serrano, M Antonia; Gómez-Chacón, Cristina

    2009-01-01

    The call for public funding for the Spanish Health Care System clinical research with drugs for human use projects Subprogramme highlights the need for hospital pharmacy services to include the manufacture of investigational drugs which are the subject of a clinical trial, developed by either a researcher or a group of researchers, within its activities. This article discusses the legislation concerning the manufacture of investigational drugs and the requirements that the pharmacy services must meet in order to develop, distribute, or conceal an investigational drug in a clinical trial sponsored by a professional from the SHS.

  10. The costs and service implications of substituting intermediate care for acute hospital care.

    Science.gov (United States)

    Mayhew, Leslie; Lawrence, David

    2006-05-01

    Intermediate care is part of a package of initiatives introduced by the UK Government mainly to relieve pressure on acute hospital beds and reduce delayed discharge (bed blocking). Intermediate care involves caring for patients in a range of settings, such as in the home or community or in nursing and residential homes. This paper considers the scope of intermediate care and its role in relation to acute hospital services. In particular, it develops a framework that can be used to inform decisions about the most cost-effective care pathways for given clinical situations, and also for wider planning purposes. It does this by providing a model for evaluating the costs of intermediate care services provided by different agencies and techniques for calibrating the model locally. It finds that consistent application of the techniques over a period of time, coupled with sound planning and accounting, should result in savings to the health economy.

  11. 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

    2015-08-01

    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

  12. Nursing management in hospital emergency service: integrative review of the literature

    OpenAIRE

    Renata Cristina Antonelli; José Aparecido Bellucci Junior

    2014-01-01

    This is an integrative literature review, which aims to analyze scientific articles that discuss the work of nurses in the management of hospital emergency services. The databases used were Latin American and Caribbean Health Science Literature (LILACS), Medical Literature Analysis and Retrieval System Online (MEDLINE), Integrated Building Environmental Communications System (IBECS), Scientific Electronic Library Online (SciELO) and Nursing Database (BDENF). To conduct the survey, 10 articles...

  13. Improving the efficiency of hospital porter services, part 2: schedule optimization and simulation model.

    Science.gov (United States)

    Odegaard, Fredrik; Chen, Li; Quee, Ryan; Puterman, Martin L

    2007-01-01

    This article is the second of a 2-part series on a study of porter operations at Vancouver General Hospital, Vancouver, British Columbia, Canada. Part 1 describes the importance of efficient porter services, the system's operation at the time of the study, the challenges faced in carrying out the study, the performance measures developed, the recommendations, and the outcomes. Part 2 describes the simulation model that measured the impact of system changes and the linear programming model developed to improve porter schedules.

  14. Joint Commission on Accreditation of Hospitals--twenty-five years of promoting improved health care services.

    Science.gov (United States)

    McCleary, D

    1977-09-01

    A brief history of the Joint Commission on Accreditation of Hospitals (JCAH), as well as its structure, purpose and activities, is presented. The procedure for developing JCAH standards for health care facilities is discussed. Also presented are the survey and accreditation processes. It is concluded that as long as the United States values its tradition of voluntarism and believes in positive motivation, the JCAH will be an effective influence on improved health care services.

  15. Depression in patients with schizophrenia admitted to the acute services of the Psychiatric Hospital of Havana

    OpenAIRE

    Llanes Basulto, Yasmani; Barrios Hernández, Yanquiel; Oliva Hernández, Ignacio; Pimentel Noda, Susel de la Caridad; Calvo Guerra, Esvieta

    2014-01-01

    The presence of depression in the acute phase of schizophrenia is evaluated, and the clinical and psychosocial characteristics that can be associated with depression are identified. Participants included 73 patients that were admitted to the acute services of the Psychiatric Hospital of Havana, given that depression is a symptom in a significant amount of the patients with schizophrenia, 35.6% of the patients presented clinically significant symp- toms, and these were related significantly wi...

  16. Evaluation of pharmacy information system in teaching, private and social services Hospitals in 2011

    Science.gov (United States)

    Saghaeiannejad-Isfahani, Sakineh; Mirzaeian, Razieh; Jannesari, Hasan; Ehteshami, Asghar; Feizi, Awat; Raeisi, Ahmadreza

    2014-01-01

    Objective: Supporting a therapeutic approach and medication therapy management, the pharmacy information system (PIS) acts as one of the pillars of hospital information system. This ensures that medication therapy is being supported with an optimal level of safety and quality similar to other treatments and services. Materials and Methods: The present study is an applied, cross-sectional study conducted on the PIS in use in selected hospitals. The research population included all users of PIS. The research sample is the same as the research population. The data collection instrument was the self-designed checklist developed from the guidelines of the American Society of Health System Pharmacists, Australia pharmaceutical Society and Therapeutic guidelines of the Drug Commission of the German Medical Association. The checklist validity was assessed by research supervisors and PIS users and pharmacists. Findings: The findings of this study were revealed that regarding the degree of meeting the standards given in the guidelines issued by the Society of Pharmacists, the highest rank in observing input standards belonged to Social Services hospitals with a mean score of 32.75. Although teaching hospitals gained the highest score both in process standards with a mean score of 29.15 and output standards with a mean score of 43.95, the private hospitals had the lowest mean score of 23.32, 17.78, 24.25 in input, process and output standards, respectively. Conclusion: Based on the findings, it can be claimed that the studied hospitals had a minimal compliance with the input, output and processing standards related to the PIS. PMID:25013832

  17. 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.

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

    Directory of Open Access Journals (Sweden)

    Durey Angela

    2011-03-01

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

  19. Socioeconomic status and utilization of amblyopia services at a tertiary pediatric hospital in Canada.

    Science.gov (United States)

    Sharma, Abhishek; Wong, Agnes M F; Colpa, Linda; Chow, Amy H Y; Jin, Ya-Ping

    2016-12-01

    To evaluate whether socioeconomic status is associated with equal utilization of amblyopia services at The Hospital for Sick Children (SickKids), a pediatric tertiary hospital in Canada. This is a retrospective, cross-sectional study. The medical records of children aged under 7 years diagnosed with amblyopia at SickKids from 2007 to 2009 were reviewed. Socioeconomic status was derived from patients' residential postal codes through linking with income data in the 2006 Canadian census report. Patients were divided into 5 income quintiles to compare with amblyopia service utilization. The main outcome measure was the observed distribution of amblyopia patients by socioeconomic status versus the expected distribution of 20% for each quintile. The analyses included 336 patients. Children with amblyopia at SickKids were more likely to come from the richest neighbourhood (32.5%), whereas children from each of the 3 lowest quintiles (14.6%-15.5%) were less likely to present at SickKids. These results differed significantly from the expected 20% for each quintile (p hospital, a significant inequality between the lower and higher income quintiles remained for nonmetropolitan Toronto patients, but not for metropolitan Toronto patients. Despite a publicly funded health-care system in Canada, children from lower socioeconomic neighbourhoods in distant areas utilize the amblyopia services in a tertiary pediatric centre less often than those from higher socioeconomic status. Copyright © 2016 Canadian Ophthalmological Society. All rights reserved.

  20. [Prevalence of delirium in hospitalized patients from an internal medicine service].

    Science.gov (United States)

    González Pezoa, Ana Carolina; Carrillo Venezian, Bernardita Claudia; Castillo Rojas, Sandra

    2015-11-11

    Delirium is a common neurocognitive syndrome that takes place during hospitalizations, associated with worse global outcomes in patients who present it. Despite this, it is usually under-recognized as a disease that needs specific treatment. To determine the rate of prevalence of delirium in Internal Medicine Service patients and evaluate missed diagnosis of the syndrome made by attending physicians, medical residents or interns in charge. This is a descriptive observational study carried out in the Internal Medicine Service of Dr. Eduardo Pereira Hospital (April 12 - May 12, 2014) evaluating 125 patients who were admitted to this service. Through the Confusion Assessment Method Instrument, the prevalence of delirium disease and the number of missed diagnosis was established. One hundred and two (102) patients met the inclusion criteria. Nineteen (19) (18.6%) of them were diagnosed with delirium. In the diagnosed patient group, 13 (68.4%) were women. Delirium diagnosis was missed in eight patients (42.1%). The prevalence of delirium in this specific Hospital is as expected, according to the literature. Considering the diagnostic tools available, it is crucial to train health workers to improve recognition and management of this syndrome.

  1. Quality of psychiatric care in the general hospital: referrer perceptions of an inpatient liaison psychiatry service.

    Science.gov (United States)

    Solomons, Luke C; Thachil, Ajoy; Burgess, Caroline; Hopper, Adrian; Glen-Day, Vicky; Ranjith, Gopinath; Hodgkiss, Andrew

    2011-01-01

    To explore the experience of senior staff on acute medical wards using an established inpatient liaison psychiatry service and obtain their views on clinically relevant performance measures. Semistructured face-to-face interviews with consultants and senior nurses were taped, transcribed and analyzed manually using the framework method of analysis. Twenty-five referrers were interviewed. Four key themes were identified - benefits of the liaison service, potential areas of improvement, indices of service performance such as speed and quality of response and expanded substance misuse service. Respondents felt the liaison service benefited patients, staff and service delivery in the general hospital. Medical consultants wanted stepped management plans devised by consultant liaison psychiatrists. Senior nurses, who perceived themselves as frontline crisis managers, valued on-the-spot input on patient management. Consultants and senior nurses differed in their expectations of liaison psychiatry. Referrers valued speed of response and regarded time from referral to definitive management plan as a key performance indicator for benchmarking services. Copyright © 2011 Elsevier Inc. All rights reserved.

  2. 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.

  3. 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.

  4. Analysis of the question-answer service of the Emma Children's Hospital information centre.

    Science.gov (United States)

    Kruisinga, Frea H; Heinen, Richard C; Heymans, Hugo S A

    2010-07-01

    The information centre of the Emma Children's Hospital AMC (EKZ AMC) is a specialised information centre where paediatric patients and persons involved with the patient can ask questions about all aspects of disease and its social implications. The aim of the study was to evaluate the question-answer service of this information centre in order to determine the role of a specialised information centre in an academic children's hospital, identify the appropriate resources for the service and potential positive effects. For this purpose, a case management system was developed in MS ACCESS. The characteristics of the requester and the question, the time it took to answer questions, the information sources used and the extent to which we were able to answer the questions were registered. The costs of the service were determined. We analysed all questions that were asked in the year 2007. Fourteen hundred thirty-four questions were asked. Most questions were asked by parents (23.3%), healthcare workers (other than nurses; 16.5%) and nurses (15.3%). The scope of the most frequently asked questions include disease (20.2%) and treatment (13.0%). Information on paper was the main information source used. Most questions could be solved within 15 min. Twelve percent to 28% of total working hours are used for the question-answer service. Total costs including staff salary are rather large. In conclusions, taking over the task of providing additional medical information and by providing readily available, good quality information that healthcare professionals can use to inform their patients will lead to less time investment of these more expensive staff members. A specialised information service can anticipate on the information need of parents and persons involved with the paediatric patient. It improves information by providing with relatively simple resources that has the potential to improve patient and parent satisfaction, coping and medical results. A specialised

  5. Effects of changes in micro- and macro-environmental factors on the supply of hospitals services.

    Science.gov (United States)

    Kassaye, W W; Tseng, K C

    1990-01-01

    The failures, marketing difficulties and financial hardships hospitals have experienced raises a question as to whether they have been responsive to the changes in the micro and macro-environmental factors. To determine how responsive hospitals have been to these changes, we investigate the impact of a number of selected factors on the supply of hospital services during 1972 through 1978. The findings indicate that despite the fact that the economy went through recessionary periods, and the demographic distribution exhibited both a shift and a change in the aging and birth rates of the nation, the changes in hospitals' responsiveness have been less than satisfactory. It appears that hospitals readily respond to the changes in the micro-environment than to the changes in macro-environment. Their response to the changes in the macro-environment. Their response to the changes in the macro-environment may be characterized as an effort to create a higher level of production whose goal is to create a still higher level of needs and wants.

  6. 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...

  7. A Utility-Scale Deployment Project of Behind-the-Meter Energy Storage for Use in Ancillary Services, Energy Resiliency, Grid Infrastructure Investment Deferment, and Demand-Response Integration

    Science.gov (United States)

    Wilson, Joseph Nathanael

    Electric utilities are increasingly incentivized to integrate new renewable energy generation resources to their systems; however, operations-related issues arise due to the non-dispatchable and stochastic nature of these renewable energy sources. These characteristics lead to a variety of issues for utilities, among which are voltage fluctuations, balancing dispatch against ramping events, short-duration power fluctuations, and the need to invest in peaking generation facilities just to accommodate the renewable energy. A traditional solution to these issues is to employ renewable generation-following techniques using either newly constructed gas peaking plants, or by shifting existing generation resources to this following responsibility. Unfortunately, use of these traditional methods introduces a new set of issues; namely, wear-and-tear due to more frequent cycling, reduced capacity factors, decreased plant efficiency, and additional investment in large-scale captital infrastructure. This thesis proposes an alternate solution: a utility-owned and utility-managed battery energy storage system sited on residential customer premises, deployed at scale to create a 200MW / 1320MWh distributed network of Residential Battery Energy Storage Systems (ResBESS). In partnership with Portland General Electric (PGE) stakeholders, a conceptual design was prepared for a ResBESS unit, a laboratory prototype of a single such storage system was constructed, and an alpha prototype is now being installed in a field demonstration project in Milwaukie, Oregon within PGE's service territory. The motivations, design constraints, and design methodology of the laboratory prototype are presented and discussed, and preliminary work from the field prototype build is examined to demonstrate the results of the thesis project.

  8. 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

  9. Satisfaction of oncologic patients hospitalized in centers with and without service of palliative cares: multicentric study

    Directory of Open Access Journals (Sweden)

    Fernando Campaña Castillo

    2013-09-01

    Full Text Available The aim of this study is to determine the satisfaction regarding care of patients suffering advanced stage cancer admitted in Hospital Sant Jaume de Calella, Sant Rafael de Barcelona and San Lorenzo de Viladecans, subject to the presence or absence of Palliative Care Unit during 2012. An observational, descriptive and transversal study will be conducted.The assessed population are patients admitted to these centers that meet the requirements for inclusion and exclusion.In the Hospital Sant Jaume de Calella, which provides Palliative Care service, patients will be check into the Internal Medicine unit and the Medium-Stay unit. In the other two hospitals, there isn’t any Palliative Care Service and patients will be admitted in the Internal Medicine units of both hospitals. Data will be collected during one year with a sample of 200 patients and non-probably sampling case row.The main variables to consider are the presence or absence of palliative service, satisfaction of care and quality of life of patients to be studied. The secondaries are sex, age, pap score, reason for admission, cancer diagnosis and origin. For the collection of the data we used the questionnaire EORTC IN-PASAT32 modified by the research team and the EORTC QLQ C-15 PAL.The analysis of the quantitative variables will be done through centralization and dispersal parameters. Categorical variables satisfaction of care and quality of life will be analysed using frequencies and joined together by the Chi square. The statistical program SPSS v 16.0 will be used.

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

    Directory of Open Access Journals (Sweden)

    Gonsaga Ricardo

    2012-08-01

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

  11. Safety of labour and delivery following closures of obstetric services in small community hospitals.

    Science.gov (United States)

    Hutcheon, Jennifer A; Riddell, Corinne A; Strumpf, Erin C; Lee, Lily; Harper, Sam

    2017-03-20

    In recent decades, many smaller hospitals in British Columbia, Canada, have stopped providing planned obstetric services. We examined the effect of these service closures on the labour and delivery outcomes of pregnant women living in affected communities. We used maternal postal codes to identify delivery records (1998-2014) of women residing in a community affected by service closure. The records were obtained from the British Columbia Perinatal Data Registry. We examined the effect of the closures using a within-communities fixed-effects framework and included similar-sized communities without service closures to control for underlying time trends. The primary outcome was a previously published composite measure of labour and delivery safety, the Adverse Outcome Index, which includes adverse events such as birth injury and unanticipated operative procedures, and includes weights for severity of adverse events. Secondary outcomes included maternal or newborn transfer, and use of obstetric interventions. We found little evidence that closure of planned obstetric services affected the risk of composite adverse maternal-newborn outcome (-0.4 excess adverse events per 100 deliveries, 95% confidence interval [CI] -2.0 to 1.1), or most other secondary outcomes. The severity of composite outcome events decreased following the closures (rate ratio 0.58, 95% CI 0.36 to 0.89). Closures were associated with increases in use of epidural analgesia (3.4 excess events per 100 deliveries, 95% CI 0.4 to 6.3) and length of antepartum stay (0.6 h, 95% CI 0.1 to 1.0 h). Closure of planned obstetric services in low-volume hospitals was not associated with an increase or decrease in frequency of adverse events during labour and delivery. © 2017 Canadian Medical Association or its licensors.

  12. 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

  13. Managing preconceived expectations: mental health service users experiences of going home from hospital: a grounded theory study.

    Science.gov (United States)

    Keogh, B; Callaghan, P; Higgins, A

    2015-11-01

    What is known on the subject? The time of discharge from a mental health hospital can be challenging for mental health service users, with high rates of readmission in the immediate months following discharge. Although some research exists that explores service users' perspectives of being discharged, little evidence exists that explores the processes influencing or used by service users' to adapt to the transition from in-patient acute mental health service. What this papers adds to existing knowledge? The findings of this grounded theory study demonstrates the strategies service users used to managed their own, as well as their social audiences, preconceived expectations arising from their new identity as 'psychiatric patients' following their discharge from hospital. While there is a move to develop recovery-orientated mental health services, key indicators of recovery-oriented practices were often absent from service users' experiences of service provision. What are the implications for practice? Nurses and other mental health professionals need to recognize their contribution to the architecture of stigma that transcends the physical structures of hospital or ward and are entrenched within attitudes, interactions and practices. The findings of this study can provide guidance to those working with service users and help them to understand the complexities of their experiences when using mental health services, which go far beyond the management of their symptoms. Following a period of hospitalization, the transition to home can result in increased vulnerability and a source of stress for mental health service users. Readmission rates have been suggested as one indicator of the success of the transition from hospital to community care. Despite knowledge of some of the factors that impact on service users following discharge, no coherent model or theoretical framework could be located in the literature, which explains or aides an in-depth understanding of the

  14. Utilization of a consultation liaison psychiatry service in a general hospital.

    Science.gov (United States)

    Gobar, A H; Collins, J L; Mathura, C B

    1987-05-01

    This retrospective study was conducted in response to a need to evaluate the overall utilization rates of the psychiatric consultation liaison service by nonpsychiatric units within Howard University Hospital, which deals almost exclusively with a black, inner-city population. The study covers a three-year period (July 1982 to July 1985). During this time only 815 patients (2 percent) were referred for psychiatric evaluation out of the total number of hospital admissions (40,000 patients).Patient characteristics and general attitudes appear to have had a major role in this low ratio of referrals, particularly a lack of awareness and bias against psychiatry. This latter finding is in disparity with other published reports. Diagnostically, depression, organic mental disorders (acute), and substance abuse (mainly PCP) constituted the greater bulk of the patients seen by the consultation liaison psychiatry service. The review of a random sample of psychiatric inpatients (n = 100) revealed that in 50 percent of the cases there was a coexisting physical illness or abnormality.The role of mental health education and the liaison function needs to be emphasized. It is suggested that efforts should be directed toward a wider acceptance and utilization of consultation liaison psychiatry by primary care physicians in general hospitals. The factors listed by physicians and patients that may account for the observed underutilization of consultation liaison services are discussed. The results of 20 interviews and the reasons given by referring physicians as to whether or not they will seek consultation from the consultation liaison services are also reviewed.

  15. An empirical analysis of the public's attitudes toward advertising hospital services: a comparative cross-sectional study.

    Science.gov (United States)

    Moser, H Ronald; Freeman, Gordon L

    2014-01-01

    This study investigates current opinions about hospital advertising and compares them to the attitudes expressed 25 years ago. It replicates a survey done in 1985, using the same questionnaire and population to compare responses longitudinally. The study indicates some changes in the public's opinions of hospital advertising. Although the image of hospitals remains positive, most of the 2010 respondents' opinions were rather mixed regarding whether it is proper for hospitals to advertise. The study also confirmed that the quality of service and reputation of hospitals remain more important to the public than price.

  16. [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

  17. 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

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

    Science.gov (United States)

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

    1985-07-01

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

  19. Performance indicators for quality in surgical and laboratory services at Muhimbili National Hospital (MNH) in Tanzania.

    Science.gov (United States)

    Mbembati, Naboth A; Mwangu, Mugwira; Muhondwa, Eustace P Y; Leshabari, Melkizedek M

    2008-04-01

    Muhimbili National Hospital (MNH), a teaching and national referral hospital, is undergoing major reforms to improve the quality of health care. We performed a retrospective descriptive study using a set of performance indicators for the surgical and laboratory services of MNH in years 2001 and 2002, to help monitor and evaluate the impact of reforms on the quality of health care during and after the reform process. Hospital records were reviewed and information recorded for planned and postponed operations, laboratory equipment, reagents, laboratory tests and quality assurance programmes. In the year 2001 a total of 4332 non-emergency operations were planned, 3313 operations were performed and 1019 (23.5%) operations were postponed. In the year 2002, 4301 non-emergency operations were planned, 3046 were performed and 1255 (29%) were postponed. The most common reasons for operation postponement were "time-barred", interference by emergency operations, no show of patients and inoperable anaesthetic machines. Equipment problems and supply and staff shortages together accounted for one quarter of postponements. In the laboratory, a lack of equipment prevented some tests, but quality assurance was performed for most tests. Current surgical services at MNH are inadequate; operating theatres require modern, functioning equipment and adequate supplies of consumables to provide satisfactory care.

  20. 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

    2016-01-01

    Background: 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. Materials and Methods: 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. Results: 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. Conclusion: 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

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

    Directory of Open Access Journals (Sweden)

    Cordell-Smith James

    2007-11-01

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

  2. 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.

  3. Total quality management (TQM) in a hospital library: identifying service benchmarks.

    Science.gov (United States)

    Fischer, W W; Reel, L B

    1992-10-01

    Hospitals are turning to total quality management (TQM) to lower costs of providing care. A hospital library in a TQM environment needs to embrace corporate goals while maintaining its accountability as a contributor to quality patient care. Alliant Health System (AHS) Library at Norton Hospital and Kosair Children's Hospital in Louisville, Kentucky, conducted a study to establish TQM benchmarks and to examine the significance of its role in clinical care. Using a methodology designed to allow both library user and nonuser to respond, 2,091 surveys were distributed to physicians and nursing and allied health personnel. Areas surveyed included frequency of library use, impact of information received on clinical judgments, cognitive value of the information, and satisfaction with library products and services. Results confirm that the library has a substantial clinical role. Eighty-eight percent of reporting physicians agreed that information from the library contributed to higher quality care. Nursing and allied health were less convinced of the importance of the library's clinical role. Sixty-nine percent of nursing personnel and 58% of allied health personnel agreed that the library contributed to higher quality care. Nursing and allied health personnel also used the library less frequently than physicians. With these results as benchmarks, improving the clinical role of the library will take commitment to the TQM process and a willingness to change.

  4. 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.

  5. [Barriers and challenges of the functional healthcare risk management units in hospitals of Madrid health service].

    Science.gov (United States)

    Pardo-Hernández, A; Navarro-Royo, C; Arguedas-Sanz, R; Albeniz-Lizarraga, C; Morón-Merchante, J

    2014-01-01

    To identify the barriers and challenges for the effective development of risk management units in hospitals of the Madrid Health Service. Descriptive cross-sectional study aimed at the management teams and members of the functional units of 31 hospitals in the Madrid Health Service. A self-administered questionnaire requesting answers in free text was used, identifying up to five barriers and challenges, and their prioritization by awarding from 1-5 points according to their importance. A discourse analysis was then conducted, grouping common themes and sorting them according to their score. The overall response rate was 94%. The most frequently identified barriers were lack of time (21%), inadequate safety culture (13%), lack of publication of their activities (10%), and lack of training (10%). The most important challenge was developing the training (18%), followed by improving the culture (17%), communication of safety activities (11%), and achieve leadership from the managers of the services (11%). According to the study conditions, the main identified barrier identified was the lack of available time, and the principal challenge found was promoting a proactive learning culture. Copyright © 2013 SECA. Published by Elsevier Espana. All rights reserved.

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

    Science.gov (United States)

    Rom, William N; Reibman, Joan

    2015-10-01

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

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

    OpenAIRE

    2015-01-01

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

  8. Clinical Characteristics and Pharmacological Treatment of Psychotic Patients Attending the Mental Health Services of the Pediatric Hospital of Cienfuegos

    OpenAIRE

    Beatriz Sabina Roméu; Daimí Sarmiento González; Mario Isaías Alzuri Falcato; Anais Leyva Madrigales

    2016-01-01

    Background: the mental health services of the Pediatric Hospital of Cienfuegos receive all patients in the province that need to be hospitalized. Among them, children and adolescents functioning at the psychotic level are of great clinical and social importance. Objective: to describe the clinical characteristics and pharmacological treatment of psychotic patients treated in the mental health services. Methods: a case series study of 35 psychotic patients admitted to the mental health unit of...

  9. 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.

  10. Design of price incentives for adjunct policy goals in formula funding for hospitals and health services

    Directory of Open Access Journals (Sweden)

    Duckett Stephen J

    2008-04-01

    Full Text Available Abstract Background Hospital policy involves multiple objectives: efficiency of service delivery, pursuit of high quality care, promoting access. Funding policy based on hospital casemix has traditionally been considered to be only about promoting efficiency. Discussion Formula-based funding policy can be (and has been used to pursue a range of policy objectives, not only efficiency. These are termed 'adjunct' goals. Strategies to incorporate adjunct goals into funding design must, implicitly or explicitly, address key decision choices outlined in this paper. Summary Policy must be clear and explicit about the behaviour to be rewarded; incentives must be designed so that all facilities with an opportunity to improve have an opportunity to benefit; the reward structure is stable and meaningful; and the funder monitors performance and gaming.

  11. Defense Health Care: Availability and Quality Measurement of Women’s Health Care Services in U.S. Military Hospitals

    Science.gov (United States)

    2016-06-01

    not selected randomly, they do not constitute a representative sample of all domestic military hospitals, and the information obtained from these...clinical judgement . The MHS, the Military Services and NCR, and Individual Military Hospitals Used Quality Measures to Identify and Implement

  12. 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…

  13. Do smoke-free environment policies reduce smoking on hospital grounds? Evaluation of a smoke-free health service policy at two Sydney hospitals.

    Science.gov (United States)

    Poder, Natasha; Carroll, Therese; Wallace, Cate; Hua, Myna

    2012-05-01

    To evaluate the compliance of hospital staff, inpatients and visitors with Sydney South West Area Health Service's Smoke-free Environment Policy. Six sites were observed at two Sydney hospitals 2 weeks before implementation of the policy and at 2 weeks, 6 months, 12 months, 18 months and 2 years after implementation. There was an overall significant 36% (P≤0.05) reduction in observed smoking incidents on hospital grounds 2 years after implementation. Two years after implementation, observed smoking incidents reduced by 44% (P≤0.05) in staff, 37% (P≤0.05) in visitors and remained unchanged among inpatients. The Smoke-free Environment Policy was effective in reducing visitors and staff observed smoking on hospital grounds, but had little effect on inpatients' smoking. Identifying strategies to effectively manage nicotine addiction and promote cessation amongst hospital inpatients remains a key priority.

  14. Minimally interrupted cardiac resuscitation by emergency medical services for out-of-hospital cardiac arrest.

    Science.gov (United States)

    Bobrow, Bentley J; Clark, Lani L; Ewy, Gordon A; Chikani, Vatsal; Sanders, Arthur B; Berg, Robert A; Richman, Peter B; Kern, Karl B

    2008-03-12

    Out-of-hospital cardiac arrest is a major public health problem. To investigate whether the survival of patients with out-of-hospital cardiac arrest would improve with minimally interrupted cardiac resuscitation (MICR), an alternate emergency medical services (EMS) protocol. A prospective study of survival-to-hospital discharge between January 1, 2005, and November 22, 2007. Patients with out-of-hospital cardiac arrests in 2 metropolitan cities in Arizona before and after MICR training of fire department emergency medical personnel were assessed. In a second analysis of protocol compliance, patients from the 2 metropolitan cities and 60 additional fire departments in Arizona who actually received MICR were compared with patients who did not receive MICR but received standard advanced life support. Instruction for EMS personnel in MICR, an approach that includes an initial series of 200 uninterrupted chest compressions, rhythm analysis with a single shock, 200 immediate postshock chest compressions before pulse check or rhythm reanalysis, early administration of epinephrine, and delayed endotracheal intubation. Survival-to-hospital discharge. Among the 886 patients in the 2 metropolitan cities, survival-to-hospital discharge increased from 1.8% (4/218) before MICR training to 5.4% (36/668) after MICR training (odds ratio [OR], 3.0; 95% confidence interval [CI], 1.1-8.9). In the subgroup of 174 patients with witnessed cardiac arrest and ventricular fibrillation, survival increased from 4.7% (2/43) before MICR training to 17.6% (23/131) after MICR training (OR, 8.6; 95% CI, 1.8-42.0). In the analysis of MICR protocol compliance involving 2460 patients with cardiac arrest, survival was significantly better among patients who received MICR than those who did not (9.1% [60/661] vs 3.8% [69/1799]; OR, 2.7; 95% CI, 1.9-4.1), as well as patients with witnessed ventricular fibrillation (28.4% [40/141] vs 11.9% [46/387]; OR, 3.4; 95% CI, 2.0-5.8). Survival-to-hospital

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

    Science.gov (United States)

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

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

  16. Improving the efficiency of hospital porter services, part 1: study objectives and results.

    Science.gov (United States)

    Odegaard, Fredrik; Chen, Li; Quee, Ryan; Puterman, Martin L

    2007-01-01

    This article is the first of a 2-part series reporting the results of a 7-month study of porter operations at Vancouver General Hospital, Vancouver, British Columbia, Canada. Part 1 describes the importance of efficient porter services, the system's operation at the time of the study, the challenges faced in carrying out the study, the performance measures developed, the recommendations, and the outcomes. Part 2 describes the simulation model that measured the impact of system changes and the linear programming model developed to improve porter schedules.

  17. [Assessment of mononucleosis syndromes in the emergency service of the Hospital 12 of October].

    Science.gov (United States)

    Rodríguez López, E M; González Rojas, C; Rojo Hernádez, A; Pérez-Hernansaiz, M; Kessler Saiz, P

    1994-03-01

    We studied all the cases with suspicion of Mononucleosis Syndrome admitted at the Emergency Service of the Hospital 12 de Octubre from october to december of 1992. The selection was conducted on the basis of clinical criteria, being the more frequent observations fever, faringitis and adenopathies. Signs and symptoms were compared with other series without observing any significant differences. The diagnosis was confirmed through the quick detection of Heterophil antibodies (50% +), conducting afterwards specific serologic test for the most frequent germs. We conclude that the Mononucleosis Syndrome is an infection whose diagnosis, treatment and out-patient follow-up can be made by a Primary Health Care Team.

  18. [The Day Service as a tool to reduce inappropriateness of care: the experience of a research hospital in Rome (Italy)].

    Science.gov (United States)

    Cadeddu, Chiara; Specchia, Maria Lucia; Principi, Francesca; Marchini, Raffaele; Cerimele, Marina; Ricciardi, Walter; Cavuto, Costanza

    2015-01-01

    The Day Service was established in Italy to promote appropriateness of care and consists in the delivery of packages of complex outpatient services. A Working Group for the continuous improvement of pre-hospitalization activities of the Regina Elena Scientific Institute in Rome, Italy, established that the outpatient management of surgical patients in the hospital would occur in a Day Service, through a package of services identified at the regional level or appropriate diagnostic and therapeutic pathways. This article describes the experience of the hospital's Day Service and compares results from the last four months of 2013 with those of the first four months of 2014. The introduction of a Day Service has led to a reduction in the number of inappropriate pre-admission tests (mainly computerized tomography, magnetic resonance and Positron emission scans and scintigraphy) and this has had a positive impact not only in terms of organization, reduction of hospital stay and overall hospitalization-related activities, but also from an economic standpoint. The implementation of a Day Service has also improved the overall patient experience, from an organizational point of view, and this is an important aspect, considering that patients at the Regina Elena Scientific Institute are oncological patients, they are often elderly and most reside in other Italian regions.

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

    CERN Document Server

    Santos, Carlos; Ferreira, Carla; Tribolet, José

    2011-01-01

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

  20. Ancillary-service details: regulation, load following, and generator response

    Energy Technology Data Exchange (ETDEWEB)

    Hirst, E.; Kirby, B.

    1996-09-01

    The purpose of this report is to examine empirically these intrahour and interhour load changes and the responses of a utility`s generating resources to those load changes. We analyze data, primarily from one control area, to see how it maintains ACE close to zero in an effort to meet the A1 and A2 criteria. Overall, we estimate that load following costs US electric utilities over one billion dollars a year. We first test alternative ways to identify trends over multihour periods using both regression analysis and rolling averages. Then, we consider several metrics for intrahour load following. Next we examine characteristics of load following for different time-averaging periods and compare the dynamics of loads and load following generation across these time periods. Finally, we consider the contribution of each load to the total load following requirements of the control area.

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

    Energy Technology Data Exchange (ETDEWEB)

    Kalsi, Karanjit; Zhang, Wei; Lian, Jianming; Marinovici, Laurentiu D.; Moya, Christian; Dagle, Jeffery E.

    2013-10-30

    With large-scale plans to integrate renewable generation driven mainly by state-level renewable portfolio requirements, more resources will be needed to compensate for the uncertainty and variability associated with intermittent generation resources. Distributed assets can be used to mitigate the concerns associated with renewable energy resources and to keep costs down. Under such conditions, performing primary frequency control using only supply-side resources becomes not only prohibitively expensive but also technically difficult. It is therefore important to explore how a sufficient proportion of the loads could assume a routine role in primary frequency control to maintain the stability of the system at an acceptable cost. The main objective of this project is to develop a novel hierarchical distributed framework for frequency based load control. The framework involves two decision layers. The top decision layer determines the optimal gain for aggregated loads for each load bus. The gains are computed using decentralized robust control methods, and will be broadcast to the corresponding participating loads every control period. The second layer consists of a large number of heterogeneous devices, which switch probabilistically during contingencies so that aggregated power change matches the desired amount according to the most recently received gains. The simulation results show great potential to enable systematic design of demand-side primary frequency control with stability guarantees on the overall power system. The proposed design systematically accounts for the interactions between the total load response and bulk power system frequency dynamics. It also guarantees frequency stability under a wide range of time varying operating conditions. The local device-level load response rules fully respect the device constraints (such as temperature setpoint, compressor time delays of HVACs, or arrival and departure of the deferrable loads), which are crucial for implementing real load control programs. The promise of autonomous, Grid Friendly™ response by smart appliances in the form of under-frequency load shedding was demonstrated in the GridWise Olympic Peninsula Demonstration in 2006. Each controller monitored the power grid voltage signal and requested that electrical load be shed by its appliance whenever electric power-grid frequency fell below 59.95 Hz. The controllers and their appliances responded reliably to each shallow under-frequency event, which was an average of one event per day and shed their loads for the durations of these events. Another objective of this project was to perform extensive simulation studies to investigate the impact of a population of Grid Friendly™ Appliances (GFAs) on the bulk power system frequency stability. The GFAs considered in this report are represented as demonstration units with water heaters individually modeled.

  2. Genetic Algorithm based PID controller for Frequency Regulation Ancillary services

    Directory of Open Access Journals (Sweden)

    Sandeep Bhongade

    2010-12-01

    Full Text Available In this paper, the parameters of Proportional, Integral and Derivative (PID controller for Automatic Generation Control (AGC suitable in restructured power system is tuned according to Generic Algorithms (GAs based performance indices. The key idea of the proposed method is to use the fitness function based on Area Control Error (ACE. The functioning of the proposed Genetic Algorithm based PID (GAPID controller has been demonstrated on a 75-bus Indian power system network and the results have been compared with those obtained by using Least Square Minimization method.

  3. Modelling optimal location for pre-hospital helicopter emergency medical services.

    Science.gov (United States)

    Schuurman, Nadine; Bell, Nathaniel J; L'Heureux, Randy; Hameed, Syed M

    2009-05-09

    Increasing the range and scope of early activation/auto launch helicopter emergency medical services (HEMS) may alleviate unnecessary injury mortality that disproportionately affects rural populations. To date, attempts to develop a quantitative framework for the optimal location of HEMS facilities have been absent. Our analysis used five years of critical care data from tertiary health care facilities, spatial data on origin of transport and accurate road travel time catchments for tertiary centres. A location optimization model was developed to identify where the expansion of HEMS would cover the greatest population among those currently underserved. The protocol was developed using geographic information systems (GIS) to measure populations, distances and accessibility to services. Our model determined Royal Inland Hospital (RIH) was the optimal site for an expanded HEMS - based on denominator population, distance to services and historical usage patterns. GIS based protocols for location of emergency medical resources can provide supportive evidence for allocation decisions - especially when resources are limited. In this study, we were able to demonstrate conclusively that a logical choice exists for location of additional HEMS. This protocol could be extended to location analysis for other emergency and health services.

  4. Modelling optimal location for pre-hospital helicopter emergency medical services

    Directory of Open Access Journals (Sweden)

    L'Heureux Randy

    2009-05-01

    Full Text Available Abstract Background Increasing the range and scope of early activation/auto launch helicopter emergency medical services (HEMS may alleviate unnecessary injury mortality that disproportionately affects rural populations. To date, attempts to develop a quantitative framework for the optimal location of HEMS facilities have been absent. Methods Our analysis used five years of critical care data from tertiary health care facilities, spatial data on origin of transport and accurate road travel time catchments for tertiary centres. A location optimization model was developed to identify where the expansion of HEMS would cover the greatest population among those currently underserved. The protocol was developed using geographic information systems (GIS to measure populations, distances and accessibility to services. Results Our model determined Royal Inland Hospital (RIH was the optimal site for an expanded HEMS – based on denominator population, distance to services and historical usage patterns. Conclusion GIS based protocols for location of emergency medical resources can provide supportive evidence for allocation decisions – especially when resources are limited. In this study, we were able to demonstrate conclusively that a logical choice exists for location of additional HEMS. This protocol could be extended to location analysis for other emergency and health services.

  5. 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.

  6. 42 CFR 413.118 - Payment for facility services related to covered ASC surgical procedures performed in hospitals...

    Science.gov (United States)

    2010-10-01

    ... ASC surgical procedures performed in hospitals on an outpatient basis. 413.118 Section 413.118 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM... PROSPECTIVELY DETERMINED PAYMENT RATES FOR SKILLED NURSING FACILITIES Specific Categories of Costs §...

  7. Characterization of trauma patients treated in a pre-hospital care service

    Directory of Open Access Journals (Sweden)

    Amanda de Ornelas Carvalho

    2004-09-01

    Full Text Available Objectives: To identify the characteristics of trauma patientstreated in a pre-hospital care service, to characterize the factorsrelated to the trauma event and quantify the severity of trauma,according to the Revised Trauma Score. Methods: This is adescriptive, exploratory, retrospective study carried out at thePre-Hospital Care Service of the Military Police - Rescue in thecity of São Paulo. Data comprised a randomized sample of 60nursing charts, distributed among the four advanced life supportunits in the city. Results: Of the occurrences dealt with, 65% arerelated to public streets, 20% are medical cases, 65% are maleindividuals, predominantly young adults. The predominantmechanisms of trauma are crash and run-over. Casa Verde wasthe care unit which obtained the highest Revised Trauma Scoreweighted mean. Conclusions: The results presented here are inconformity with the national statistics on trauma: young adults, ofworking age, involved in road accidents are most frequentlyaffected. Identifying this population is of utmost importance forthe development of preventive and educational measures.

  8. 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.

  9. Clinical pharmacy services, pharmacy staffing, and adverse drug reactions in United States hospitals.

    Science.gov (United States)

    Bond, C A; Raehl, Cynthia L

    2006-06-01

    Adverse drug reactions (ADRs) were examined in 1,960,059 hospitalized Medicare patients in 584 United States hospitals in 1998. A database was constructed from the MedPAR database and the National Clinical Pharmacy Services survey. The 584 hospitals were selected because they provided specific information on 14 clinical pharmacy services and on pharmacy staffing; they also had functional ADR reporting systems. The study population consisted of 35,193 Medicare patients who experienced an ADR (rate of 1.8%). Of the 14 clinical pharmacy services, 12 were associated with reduced ADR rates. The most significant reductions occurred in hospitals offering pharmacist-provided admission drug histories (odds ratio [OR] 1.864, 95% confidence interval [CI] 1.765-1.968), drug protocol management (OR 1.365, 95% CI 1.335-1.395), and ADR management (OR 1.360, 95% CI 1.328-1.392). Multivariate analysis, performed to further evaluate these findings, showed that nine variables were associated with ADR rate: pharmacist-provided in-service education (slope -0.469, p=0.018), drug information (slope -0.488, p=0.005), ADR management (slope -0.424, p=0.021), drug protocol management (slope -0.732, p=0.002), participation on the total parenteral nutrition team (slope 0.384, p=0.04), participation on the cardiopulmonary resuscitation team (slope -0.506, p=0.008), medical round participation (slope -0.422, p=0.037), admission drug histories (slope -0.712, p=0.008), and increased clinical pharmacist staffing (slope -4.345, p=0.009). As clinical pharmacist staffing increased from the 20th to the 100th percentile (from 0.93+/-0.77/100 to 5.16+/-4.11/100 occupied beds), ADRs decreased by 47.88%. In hospitals without pharmacist-provided ADR management, the following increases were noted: mean number of ADRs/100 admissions by 34.90% (OR 1.360, 95% CI 1.328-1.392), length of stay 13.64% (Mann-Whitney U test [U]=11047367, p=0.017), death rate 53.64% (OR 1.574, 95% CI 1.423-1.731), total Medicare

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

    Directory of Open Access Journals (Sweden)

    Pallavi Sarji Uthkarsh

    2016-04-01

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

  11. hospital

    African Journals Online (AJOL)

    Pattern of congenital orthopaedic malformations in an African teaching hospital ... malformation in this environment while congenital hip dislocation (CDH) is rare when .... malformations of radial dysplasia and other congenital malformations.

  12. Quality of Services and Health Financing efficiency of Community Health Insurance (Jamkesmas at 21 General and Specialty Hospitals in Indonesia

    Directory of Open Access Journals (Sweden)

    Ristrini Ristrini

    2014-08-01

    Full Text Available Background: Community Health Insurance (Jamkesmas has been implementing maintained since 2008 with 76.4million individual quota increased to 86.4 million in 2012. The major problem of involved is unfairness (inequity in the quality and financing of health services for participants. This study aims to analyse the quality and financing of health perspective of Jamkesmas participants in the hospital. Method: This study was conducted in 21 general and specialty hospitals in Indonesia, The sample were selected purposively They were 9 Central Government hospitals (RSUP, Regional hospital and 3 specialty hospital ie cancer hospital, cardiologie hospital and stroke hospital. Those hospital involved covers 8 RSU Class A General Hospital. 8 RSU Class B, 2 RSU Class Cand 3 Specialty Hospital. Primary data wascollected by interviewing 1700 outpatient and inpatients, and 280 hospital staffs. Secondary data were human resources, finance and coverage. Results: Quality of services review on the adequacy of the physician’s quality was very varied.There were 570–2372 outpatient visits per physician, and 37-674 inpatients per doctor visit. Adequacy of nursing staff(nurses and midwives was better, 123–671 outpatient visits per nursing staff and 3–127 inpatient visits per nursing staff.Quality of services according to health officers perceptions on equipment and facilities was good and complete. Quality ofservices according to patients’ expectations and reality was appropriate, never the less the direct heath services, were low. Hospital financing was very large, 33–460 billion, and one third for Jamkesmas and Regency Community Health Insurance (Jamkesda services. Proportion Jamkesda funding in RSUD was larger than Jamkesmas while in RSUP, Jamkesda was smaller than Jamkesmas. Jamkesmas financing perspective according to the staff, was most of them stated that funding for Jamkesmas was matched and appropriate the number of served patients served

  13. 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.

  14. 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

    2015-01-01

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

  15. 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.

  16. 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 quality' dimension. Data was analysed using epi-info-3.5.1. Fisher test was applied to check statistical significance. (p-value 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 (pservice quality of therapeutic and diagnostic procedures in public hospitals should be routinely monitored from the patients

  17. [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.

  18. Use of pharmacy informatics resources by clinical pharmacy services in acute care hospitals.

    Science.gov (United States)

    Matsuura, Gregory T; Weeks, Douglas L

    2009-11-01

    The use of pharmacy informatics resources by clinical pharmacy services and the presence of a pharmacy informatics specialist in acute care hospitals were evaluated. Two hundred randomly selected pharmacies in general medical and surgical hospitals in the United States with at least 100 acute care beds were surveyed via mail. Survey items gathered information regarding facility attributes, opinions about staff pharmacists' understanding of information technology, and departmental utilization of pharmacy informatics. Of the 200 surveys mailed, 114 (57%) were returned completed. When asked to rate their departments' use of pharmacy informatics, 82% indicated that pharmacy informatics use was good or fair, while 12% considered information use to be optimized. A majority of respondents (60%) indicated that a pharmacy informatics specialist was employed within the pharmacy, with 47% indicating that the specialist was a pharmacist. An overwhelming percentage of these pharmacists received informatics training on the job, and roughly half had specialty positions integrated into their pharmacist job description. No significant association existed between the use of pharmacy informatics and facility teaching status (teaching versus nonteaching), geographic location (urban versus rural), or use of computerized prescriber order entry. Employment of a pharmacy informatics specialist was significantly associated with the use of such informatics applications as database mining, renal-dosing-rules engines, antibiotic-pathogen matching-rules engines, and pharmacokinetic-monitoring rules engines. The use of clinical pharmacy informatics in patient care in acute care hospitals with at least 100 beds was significantly more likely when a pharmacy informatics specialist was present in the pharmacy. However, 4 in 10 hospital pharmacies did not employ a pharmacy informatics specialist.

  19. 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

  20. Prevalence and cognitive impact of medial temporal atrophy in a hospital stroke service: retrospective cohort study.

    Science.gov (United States)

    Kebets, Valeria; Gregoire, Simone M; Charidimou, Andreas; Barnes, Josephine; Rantell, Khadija; Brown, Martin M; Jäger, Hans R; Cipolotti, Lisa; Werring, David J

    2015-08-01

    Cerebrovascular disease and neurodegeneration cause cognitive impairment and frequently coexist. Our objectives were to investigate the prevalence and cognitive impact of medial temporal lobe atrophy - a radiological marker often associated with Alzheimer's disease - in a hospital stroke service. Retrospective cohort study of patients from a hospital stroke service. Patients assessed for suspected ischemic stroke or transient ischemic attack, irrespective of final diagnosis, underwent neuropsychological testing and magnetic resonance imaging. medial temporal lobe atrophy, white matter hyperintensities, lacunes, and cerebral microbleeds were rated using established criteria and validated scales. The associations between medial temporal lobe atrophy and cognition were tested using multivariable logistic regression analyses, adjusted for age and imaging markers of cerebrovascular disease. Three hundred and ninety-three patients were included, of whom 169 (43%; 95% confidence interval: 38·1-48·1%) had medial temporal lobe atrophy; in 38 patients (9·7%), medial temporal lobe atrophy was severe (mean score ≥2). In unadjusted logistic regression analyses in the whole cohort, mean medial temporal lobe atrophy score was associated with verbal memory, nominal and perceptual skills, executive function, and speed and attention. After adjustment for age, white matter hyperintensities, number of lacunes, presence of cerebral microbleeds, previous ischemic stroke or transient ischemic attack, and premorbid intelligence quotient, mean medial temporal lobe atrophy score remained associated with impairment in verbal memory (odds ratio: 1·64; 95% confidence interval 1·04-2·58) and nominal skills (odds ratio: 1·61; 95% confidence interval 1·04-2·48). Medial temporal lobe atrophy is common and has an independent impact on cognitive function in a stroke service population, independent of confounding factors including age and magnetic resonance imaging markers of

  1. 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.

  2. Implementation of a large-scale hospital information infrastructure for multi-unit health-care services.

    Science.gov (United States)

    Yoo, Sun K; Kim, Dong Keun; Kim, Jung C; Park, Youn Jung; Chang, Byung Chul

    2008-01-01

    With the increase in demand for high quality medical services, the need for an innovative hospital information system has become essential. An improved system has been implemented in all hospital units of the Yonsei University Health System. Interoperability between multi-units required appropriate hardware infrastructure and software architecture. This large-scale hospital information system encompassed PACS (Picture Archiving and Communications Systems), EMR (Electronic Medical Records) and ERP (Enterprise Resource Planning). It involved two tertiary hospitals and 50 community hospitals. The monthly data production rate by the integrated hospital information system is about 1.8 TByte and the total quantity of data produced so far is about 60 TByte. Large scale information exchange and sharing will be particularly useful for telemedicine applications.

  3. Academic-Hospital Partnership: Conducting a Community Health Needs Assessment as a Service Learning Project.

    Science.gov (United States)

    Krumwiede, Kelly A; Van Gelderen, Stacey A; Krumwiede, Norma K

    2015-01-01

    The purposes of this service learning project were to trial nursing student application of the Community-Based Collaborative Action Research (CBCAR) framework while conducting a community health needs assessment and to assess the effectiveness of the CBCAR framework in providing real-world learning opportunities for enhancing baccalaureate nursing students' public health knowledge. In this case study analysis, the CBCAR framework linked service learning and community health needs assessment with public health nursing core competencies. Fifteen nursing students partnered with collaborative members. Student observational field notes and narrative reflections were analyzed qualitatively for fidelity to the CBCAR framework and to evaluate student public health knowledge. Students successfully employed the CBCAR framework in collaboration with the critical access hospital and community stakeholders to design and conduct the community health needs assessment. Service learning themes were real-world solutions, professional development, community collaboration, and making a difference. Students developed skills in six of the eight domains of the Quad Council's core competencies for public health nurses. Community-Based Collaborative Action Research facilitates collaborative partnerships and relationships throughout the research process. Students benefited by applying what they have learned from their education to a real community who lacks resources. © 2014 Wiley Periodicals, Inc.

  4. [Effect of reproductive health services restructuring on antenatal care at Marcory General Hospital, Ivory Coast].

    Science.gov (United States)

    Benie Bi, Joseph Vroh; Tiembre, Issaka; Ahoussou, Éric Martial; Tchiny, Koutoua; Dagnan, N Cho Simplice; Tagliante-Saracino, Janine

    2015-01-01

    Improvement of the work environment and staff training are health promotion strategies that can contribute to improving the supply of health care. This study evaluated the effects of reorganization of health services on antenatal care (ANC) activities. A cross-sectional study was conducted over a period of 4 months in the ANC unit of Marcory General Hospital in Abidjan. The study population was health workers in charge of ANC and pregnant women attending the health facility. Self-administered questionnaires and observation sheets were used to collect data that were analysed with Epi Info 3.5.1 software. results: After reorganization, health workers said they were satisfied with the work environment and the care provided in 91% and 96.9% of cases, respectively. These results were confirmed by all pregnant respondents (100%) attending the centre, who said they were satisfied with the quality of care received. This could explain the ANC 4 coverage rate, which increased from 39.4% in 2010 to 56.7% in 2012 and tetanus vaccination coverage which increased from 59.4% to 87.5%, although the waiting time was still too long. This study showed an increase of ANC activity indicators, such as ANC 4 and tetanus vaccination coverage rate, after reorganization of health care services. This strategy could be an opportunity to strengthen ANC services.

  5. 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.

  6. 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.

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

    Directory of Open Access Journals (Sweden)

    Lize Stangarlin

    2013-09-01

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

  8. Hospital organization and importance of an interventional radiology inpatient admitting service: Italian single-center 3-year experience.

    Science.gov (United States)

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

    2009-03-01

    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 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 1,009,095.35 euros. 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.

  9. 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

  10. 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.

  11. Medical Researchers' Ancillary Care Obligations: The Relationship-Based Approach.

    Science.gov (United States)

    Olson, Nate W

    2016-06-01

    In this article, I provide a new account of the basis of medical researchers' ancillary care obligations. Ancillary care in medical research, or medical care that research participants need but that is not required for the validity or safety of a study or to redress research injuries, is a topic that has drawn increasing attention in research ethics over the last ten years. My view, the relationship-based approach, improves on the main existing theory, Richardson and Belsky's 'partial-entrustment model', by avoiding its problematic restriction on the scope of health needs for which researchers could be obligated to provide ancillary care. Instead, it grounds ancillary care obligations in a wide range of morally relevant features of the researcher-participant relationship, including the level of engagement between researchers and participants, and weighs these factors against each other. I argue that the level of engagement, that is, the duration and intensity of interactions, between researchers and participants matters for ancillary care because of its connection to the meaningfulness of a relationship, and I suggest that other morally relevant features can be grounded in researchers' role obligations.

  12. 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.

  13. A comparison between latent variable models for evaluating the quality perceived from the hospital service users

    Directory of Open Access Journals (Sweden)

    Silvia Cagnone

    2007-10-01

    Full Text Available During the last years, costumer satisfaction analysis is becoming more and more important in evaluating the service quality of the sanitary system. Typically the construct ‘satisfaction’ is assumed to be a not observable variable, that is a latent variable. In this paper we illustrate and compare two different methods for analyzing latent variable models. The first one is the structural equation models with Lisrel, the second one is the generalized linear latent variable models. The comparison is performed through an application of the satisfaction analysis to a real data set referred to the patients of a hospital in Bologna. The results highlights the methodological and the applicative similarity and dissimilarity between the two methods.

  14. 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.

  15. 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

  16. 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.

  17. Salang Hospital: Lack of Water and Power Severely Limits Hospital Services, and Major Construction Deficiencies Raise Safety Concerns

    Science.gov (United States)

    2014-01-01

    hospital needed to provide scrubable surfaces in high-risk sterile areas like the surgery room to facilitate disinfection . To correct these...of a well house, and establishment of a process to ensure that hospital water lines were disinfected . However, we found that the water well was not...floors is dangerous due to the lack of hand rails. Further, a steep flat surface constructed in the center stairway, presumably for moving wheelchair and

  18. Using a safe taxi service to transport newborn babies home from hospital.

    Science.gov (United States)

    Eventov-Friedman, S; Bar-Oz, B; Zisk-Rony, R Y

    2014-01-01

    To evaluate an intervention to enhance parents' use of car safety seats (CSSs) for their newborn baby's first journey home from the hospital in a population not usually exposed to television, internet and mainstream printed media. Parents of newborn babies who did not bring a CSS to the hospital before their baby was discharged were lent a CSS to use in a 'safe taxi' service. All taxi drivers were trained to install the CSS safely. The intervention was evaluated using preprogramme questionnaires and follow-up interviews 4-8 weeks after discharge. Twelve parents participated in the intervention during the study period (January to April 2011) and in the evaluation process. Eleven couples were Jewish and one was Muslim. Most (75%) reported that they had not previously used CSS routinely and the reason was not financial. Following the 'safe taxi' intervention, 83% reported the use of CSS when travelling in all vehicles (excluding buses). On follow-up, most participants reported that the intervention increased their awareness and the use of CSS. The intervention, targeted at this specific population, was well received by the parents, increased awareness, changed practices and assured that more newborns travelled home safely in a CSS. ©2013 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  19. Impact of hospital type II violent events: use of psychotropic drugs and mental health services.

    Science.gov (United States)

    Dement, John M; Lipscomb, Hester J; Schoenfisch, Ashley L; Pompeii, Lisa A

    2014-06-01

    While violence can adversely affect mental health of victims, repercussions of violence against workers is not as well characterized. We explored relationships between workplace violent events perpetrated by patients or visitors (Type II) against hospital employees and the employee use of psychotropic medications or mental health services using a data system that linked violent events with health claims. Significant associations were observed between reported Type II workplace violent events and employee prescription claims for anti-depressants and anxiolytics combined (RR = 1.45, 95% CI = 1.01-2.33) and anti-depressants alone (RR = 1.65, 95% CI = 1.10-2.48). No significant association between reported violent events and health claims for treatment of depression or anxiety was observed. Type II violence experienced by hospital workers may lead to increased use of psychotropic drugs, particularly anti-depressants but also anxiolytics. Our results suggest an important role of employee assistance programs in mitigating the psychological consequences of workplace violent events. © 2014 Wiley Periodicals, Inc.

  20. 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 educational levels, including externships, internships, and assistantships regarding the dimensions of the quality gaps (p 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.

  1. 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 ...

  2. 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

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

    Science.gov (United States)

    Holder, Reynaldo; Fabrega, Ricardo

    2015-01-01

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

  4. Ancillary Studies, Including Immunohistochemistry and Molecular Studies, in Pancreatic Cytology.

    Science.gov (United States)

    Reid, Michelle D; Centeno, Barbara A

    2014-03-01

    Fine-needle aspiration biopsy of the pancreas is indicated for sampling of solid and cystic masses. Preoperative cytologic diagnosis of pancreatic ductal adenocarcinoma and cystic lesions on cytology can be problematic, and ancillary studies may help confirm diagnosis. Ancillary studies in pancreatic cytology include special stains, immunohistochemistry, mutational analyses of specific genes, cyst fluid analysis of tumor markers and enzymes, and, in some instances, flow cytometry. Proteomics, microRNA sequencing, and whole-exome gene sequencing have been used to illustrate the progression of pancreatic neoplasms and identify key diagnostic markers. This article summarizes recent literature on ancillary studies in pancreatic fine-needle aspiration samples. Copyright © 2014 Elsevier Inc. All rights reserved.

  5. Frequent use of hospital inpatient services during a nine year period: a retrospective cohort study.

    Science.gov (United States)

    Springer, Adelle M; Condon, John R; Li, Shu Q; Guthridge, Steven L

    2017-05-12

    Frequent use (FU) of hospital services impacts on patients and health service expenditure. Studies examining FU in emergency departments and inpatient settings have found heterogeneity and the need to differentiate between potentially preventable FU and that associated with ongoing management of complex conditions. Psychosocial factors have often been reported as underpinning or exacerbating the phenomena. Most FU studies have been limited by time, to a single study site, or restricted to specific diagnoses or patient groups. This study provides a comprehensive description of adult patient characteristics, conditions and risk factors associated with FU, based on admissions to the five public hospitals in the Northern Territory (NT) of Australia over a nine year period. The study population is distinctive comprising both Aboriginal and non-Aboriginal patients. Data on all inpatient episodes in NT public hospitals between 2005 and 2013 was analysed to identify patients with any FU (four or more episodes within any 12-month period) and measure FU duration (number of FU years) and intensity (mean number of episodes per FU year). Pregnancy, alcohol-related and mental health condition flags were assigned to patients with any episode with relevant diagnoses during the study period. Multivariate analysis was used to assess factors associated with any FU, FU duration and FU intensity, separately for Aboriginal and non-Aboriginal patients. Of people with any inpatient episodes during the study period, 13.6% were frequent users (Aboriginal 22%, non-Aboriginal 10%) accounting for 46.6% of all episodes. 73% of frequent users had only one FU year. Any FU and increased FU duration were more common among individuals who were: Aboriginal; older; female; and those with a pregnancy, alcohol or mental health flag. Having two or more alcohol-related episodes in the nine-year period was strongly associated with any FU for both Aboriginal (odds ratio 8.9, 95% CI. 8.20-9.66) and non

  6. 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...

  7. 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...

  8. 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.

  9. Public and private hospital services reform using data envelopment analysis to measure technical, scale, allocative, and cost efficiencies.

    Science.gov (United States)

    Sheikhzadeh, Yaghoub; Roudsari, Abdul V; Vahidi, Reza Gholi; Emrouznejad, Ali; Dastgiri, Saeed

    2012-01-01

    The aim of this study was to suggest a suitable context to develop efficient hospital systems while maintaining the quality of care at minimum expenditures. This research aimed to present a model of efficiency for selected public and private hospitals of East Azerbaijani Province of Iran by making use of Data Envelopment Analysis approach in order to recognize and suggest the best practice standards. Among the six inefficient hospitals, 2 (33%) had a technical efficiency score of less than 50% (both private), 2 (33%) between 51 and 74% (one private and one public) and the rest (2, 33%) between 75 and 99% (one private and one public). In general, the public hospitals are relatively more efficient than private ones; it is recommended for inefficient hospitals to make use of the followings: transferring, selling, or renting idle/unused beds; transferring excess doctors and nurses to the efficient hospitals or other health centers; pensioning off, early retirement clinic officers, technicians/technologists, and other technical staff. The saving obtained from the above approaches could be used to improve remuneration for remaining staff and quality of health care services of hospitals, rural and urban health centers, support communities to start or sustain systematic risk and resource pooling and cost sharing mechanisms for protecting beneficiaries against unexpected health care costs, compensate the capital depreciation, increasing investments, and improve diseases prevention services and facilities in the provincial level.

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

    Science.gov (United States)

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

    2015-10-01

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

  11. 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.

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

    Directory of Open Access Journals (Sweden)

    Odette Newman

    2008-01-01

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

  13. 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

  14. 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.

  15. 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.

  16. Factors and models associated with the amount of hospital care services as demanded by hospitalized patients: a systematic review.

    NARCIS (Netherlands)

    Oostveen, C.J. van; Ubbink, D.T.; Huis in het Veld, J.G.; Bakker, P.J.; Vermeulen, H.

    2014-01-01

    Background: Hospitals are constantly being challenged to provide high-quality care despite ageing populations, diminishing resources, and budgetary restraints. While the costs of care depend on the patients' needs, it is not clear which patient characteristics are associated with the demand for care

  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. Acute Respiratory Infections In Underfives : Experience At Comprehensive Rural Health Services Project Hospital. Ballabgarh

    Directory of Open Access Journals (Sweden)

    Reddaiah V.P

    1995-01-01

    Full Text Available Research Question: What are the symptoms and signs with which under-fives with acute respiratory infections are admitted to a rural hospital? Objectives: i To analyse the symptoms, signs and diagnosis of Acute Respiratory Infections in under-fives. ii To compare the experience with WHO guidelines. Design: Retrospective analysis of under-five patients admitted with ARI. Setting: Comprehensive Rural Health Services Project Hospital, Ballabgarh. Participants; Under-fives admitted with ARI. Outcome: Signs, symptoms, diagnosis of ARI. Statistical Analysis: Descriptive analysis of findings. Results: 73.6% admitted were males, 63.2% were infants. The most commonly complained symptoms at the time of admission were fever (69.6%, Cough (63.2%, breathlessness (61.6% inability to feed (19.2 and diarrhoea (19.2%. 76.0% had crepitations, 26.4% had chest in drawing, 23.2% had ronchi, and 14.4%had respiratory distress. Only 33.3% had respiratory rate more than 60 per minute among children less than 2 months old, 56.9% had respiratory rate more than 50 per minute among children 2-12 month old. 54.3% had respiratory rate more than 40 per minute among 12 months to 5 years of age. 76% had pneumonias. The case fatality rate (CFR was 12.8% and most of the deaths occurred within 24 hours of arrival. The C.F.R was more in females and among young infants. Conclusion: Fever should be included in the lead symptoms of ARI along with cough and breathlessness. There is a need for looking at Respiratory rate for recognition of Pneumonias.

  19. 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.

  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 s

  1. 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.

  2. 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

    2016-01-01

    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 for service marketing factors. Reliability and validity of the questionnaire were confirmed. Data analysis was done using factor analysis test in SPSS 20. Results: The results showed that constant attendance of physicians and nurses has the highest effect (0.707%) on patient tendency toward private hospitals. PMID:27999486

  3. 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

  4. The Paediatric Ambulatory Consulting Service (PACS) program: a role for family pediatricians in the hospital emergency rooms.

    Science.gov (United States)

    Nigri, Luigi; Piazzolla, Ruggiero; Pettoello-Mantovani, Massimo; Giardino, Ida; Abbinante, Micaela; Gorgoni, Giovanni

    2016-02-25

    This paper describes the Paediatric Ambulatory Consulting Service (PACS) project, developed by ASL-BT (Azienda Sanitaria Locale, Barletta-Andria-Trani), an Italian regional Public Health Centers network, in response to the current global situation of economic distress.PACS consist in integrating existing public health care services that are independently provided by hospitals and the Primary Care Paediatrics network. It has been developed with the aim to establish innovative yet efficient managerial solutions able to rationalize the resources not weakening the quality of services provided to the population.

  5. 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.

  6. Emergency medical service provider decision-making in out of hospital cardiac arrest: an exploratory study.

    Science.gov (United States)

    Brandling, J; Kirby, K; Black, S; Voss, S; Benger, J

    2017-07-25

    There are approximately 60,000 out-of-hospital cardiac arrests (OHCA) in the United Kingdom (UK) each year. Within the UK there are well-established clinical practice guidelines that define when resuscitation should be commenced in OHCA, and when resuscitation should cease. Background literature indicates that decision-making in the commencement and cessation of resuscitation efforts in OHCA is complex, and not comprehensively understood. No relevant research from the UK has been published to date and this research study seeks to explore the influences on UK Emergency Medical Service (EMS) provider decision-making when commencing and ceasing resuscitation attempts in OHCA. The aim of this research to explore the influences on UK Emergency Medical Services provider decision-making when commencing and ceasing resuscitation attempts in OHCA. Four focus groups were convened with 16 clinically active EMS providers. Four case vignettes were discussed to explore decision-making within the focus groups. Thematic analysis was used to analyse transcripts. This research found that there are three stages in the decision-making process when EMS providers consider whether to commence or cease resuscitation attempts in OHCA. These stages are: the call; arrival on scene; the protocol. Influential factors present at each of the three stages can lead to different decisions and variability in practice. These influences are: factual information available to the EMS provider; structural factors such as protocol, guidance and research; cultural beliefs and values; interpersonal factors; risk factors; personal values and beliefs. An improved understanding of the circumstantial, individual and interpersonal factors that mediate the decision-making process in clinical practice could inform the development of more effective clinical guidelines, education and clinical decision support in OHCA. These changes have the potential to lead to greater consistency. and EMS provider confidence, with

  7. [Emergency care for traffic accidents in Bavaria: current process analysis depending on hospital and emergency service structures].

    Science.gov (United States)

    Lackner, C K; Bielmeier, S; Burghofer, K

    2010-03-01

    A change is emerging in the hospital landscape due to health political measures, which in consequence also influences the prehospital medical care in emergencies. The main focus of this study was to gather information about emergency medical care after traffic accidents on the basis of data from Bavarian emergency medical services. In 2006 there were 14,261 traffic accidents in Bavaria where an emergency doctor attended the scene. The patients were primarily cared for by land-based rescue services and air rescue services were only used in 19.1% of the cases. Of the patients involved in a traffic accident 47.6% were transported to a primary health care hospital. A prehospital interval of more than 60 min occurred in 20% of the missions. Of the patients 96.2% were transported to tertiary or maximum care hospital by air rescue services but emergency facilities were, however restricted to daylight hours. There was a further limitation due to the routine duty hours in hospitals as only 36.7% of accidents occurred during this time intervall. An increase of admission post trauma in maximum care clinics occurred from 2002 until 2006 while simultaneously the prehospital period was extended. In order to assure sufficient trauma care for seriously injured persons a continuous 24 h availability of emergency trauma facilities is necessary. For this purpose it is necessary to establish regional trauma networks between receiving hospitals as well as air rescue services at night time. Furthermore, a cost-efficient compensation of the structural, personnel and logistic expenses for the treatment of the severely injured has to be assured.

  8. 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

    by the experts. Subsequent rounds reduced the number of core variables to 45. These constituted the final core data set. Emphasis was placed on the standardisation of reporting time variables, chief complaints and diagnostic and therapeutic procedures. CONCLUSIONS: Using a modified nominal group technique, we...... a higher quality of care to pre-hospital patients. There is no current data set collected to document the activity of physician pre-hospital activity which makes shared research efforts difficult. The aim of this study was to develop a core data set for routine documentation and reporting in physician......-staffed pre-hospital services in Europe. METHODS: Using predefined criteria, we recruited sixteen European experts in the field of pre-hospital care. These experts were guided through a four-step modified nominal group technique. The process was carried out using both e-mail-based communication and a plenary...

  9. Reducing wait time in a hospital pharmacy to promote customer service.

    Science.gov (United States)

    Slowiak, Julie M; Huitema, Bradley E; Dickinson, Alyce M

    2008-01-01

    The purpose of this study was to compare the effects of 2 different interventions on wait times at a hospital outpatient pharmacy: (1) giving feedback to employees about customer satisfaction with wait times and (2) giving a combined intervention package that included giving more specific feedback about actual wait times and goal setting for wait time reduction in addition to the customer satisfaction feedback. The relationship between customer satisfaction ratings and wait times was examined to determine whether wait times affected customer service satisfaction. Participants were 10 employees (4 pharmacists and 6 technicians) of an outpatient pharmacy. Wait times and customer satisfaction ratings were collected for "waiting customers." An ABCBA' within-subjects design was used to assess the effects of the interventions on both wait time and customer satisfaction, where A was the baseline (no feedback and no goal setting); B was the customer satisfaction feedback; C was the customer satisfaction feedback, the wait time feedback, and the goal setting for wait time reduction; and A' was a follow-up condition that was similar to the original baseline condition. Wait times were reduced by approximately 20%, and there was concomitant increased shift in levels of customer satisfaction, as indicated by the correlation between these variables (r = -0.57 and P customer's wait time. Data from this study may provide useful preliminary benchmarking data for standard pharmacy wait times.

  10. [Abdominal unplanned reoperations in the Service of General Surgery, University Hospital of Puebla].

    Science.gov (United States)

    León-Asdrúbal, Samuel Báez; Juárez-de la Torre, Juan Carlos; Navarro-Tovar, Fernando; Heredia-Montaño, Mónica; Quintero-Cabrera, José Eduardo

    2016-01-01

    The reoperation is considered as the access to the abdominal cavity before complete healing of the surgical wound from a previous operation within the first 60 days after the first procedure. It occurs in 0.5 to 15% of patients undergoing abdominal surgery and generates significant increase in morbidity and mortality in patients undergoing abdominal surgery. Identify the number of unplanned abdominal surgical reoperations and identify the causes of these unplanned reoperations were performed in our department. This is a retrospective study conducted at the University Hospital of Puebla in the period between April 2009 to February 2012, a total of 1,709 abdominal surgeries performed by the Service of General Surgery were included. Ninety-seven cases of reoperation of which 50 cases were not planned surgery cases were identified; 72% (36 cases) from emergency operations, and 28% of elective surgery. The incidence found in our study is low compared to similar studies. Prospective studies and focus on risk factors and causes of unplanned reoperations are required, in order to know them in detail and, consequently, reduce its incidence and morbidity and mortality they add.

  11. Exploration of key stakeholders' preferences for pre-hospital physiologic monitoring by emergency rescue services.

    Science.gov (United States)

    Mort, Alasdair J; Rushworth, Gordon F

    2013-12-01

    To gather preferences for novel pre-hospital physiologic monitoring technologies from emergency rescue services. Qualitative semi-structured interviews and focus groups were conducted with three groups from UK Search and Rescue (SAR); (1) Extractors (e.g. SAR teams), (2) Transporters (personnel primarily responsible for casualty transport), and (3) Treaters (e.g. Emergency Department doctors). Three themes were defined; SAR casualty management, novel physiologic monitor potential, and physiologic monitor physical properties. Some SAR groups already employed physiologic monitoring but there was no consensus on which monitor(s) to carry or what to monitor and how frequently. Existing monitors also tended to be bulky and heavy and could be unreliable in an unstable environment or if the casualty was cold. Those performing monitoring tended to have only basic first-aid training, and their workload was often high particularly if there was more than one casualty. The potential benefits of employing a novel monitor were strategic and clinical; an opportunity for transmitting data off-scene in order to facilitate monitoring or generate advice (i.e. telemedicine) was also voiced. A range of more intuitive, physical properties was also raised (e.g. small/compact, lightweight). SAR-specific technology should be simple to operate by those with less medical training, which means that clinical data interpretation and presentation should be carefully considered. It would be beneficial if novel monitors carried out a majority of the interpretation, allowing rescuers to proceed with their priority task of removing the casualty to safety.

  12. Success Rate of Pre-hospital Emergency Medical Service Personnel in Implementing Pre Hospital Trauma Life Support Guidelines on Traffic Accident Victims.

    Science.gov (United States)

    Gholipour, Changiz; Vahdati, Samad Shams; Notash, Mehdi; Miri, Seyed Hassan; Ghafouri, Rouzbeh Rajaei

    2014-06-01

    Road traffic injuries are responsible for a vast number of trauma-related deaths in middle- and low-income countries. Pre-hospital emergency medical service (PHEMS) provides care and transports the injured patients from the scene of accident to the destined hospital. The PHEMS providers and paramedics were recently trained in the Pre Hospital Trauma Life Support (PHTLS) guidelines to improve the outcome of trauma patients in developing countries. We decided to carry out a study on the success rate of PHEMS personnel in implementing PHTLS guidelines at the scene of trauma. Severe trauma patients who had been transferred to the emergency department were included in the study. Evaluations included transfer time, airway management, spinal immobilization, external bleeding management, intravenous (IV) line access, and fluid therapy. All evaluations were performed by an expert emergency physician in the emergency department. The mean response time was 17.87±9.1 minutes. The PHEMS personnel immobilized cervical spine in 60.4% of patients, out of whom 16.7% were not properly immobilized. Out of 99 (98%) cases of established IV line access by the PHEMS providers, 57% were satisfactory. Fluid therapy, which was carried out in 99 (98%) patients by the PHEMS personnel, was appropriate in 92% of the cases. PHEMS personnel need more education and supervising to provide services according to PHTLS guidelines.

  13. The way the quality of health services is perceived and treated by the managerial personnel of public hospitals

    Directory of Open Access Journals (Sweden)

    Anna Rybarczyk-Szwajkowska

    2016-06-01

    Full Text Available Background: Managerial knowledge and skills as well as profound understanding of goals and objectives of management determine the effectiveness and efficiency in all areas of managerial activities. In particular, this applies to the quality of healthcare services, perceived as a compliance between the effects (of medical treatment and the assumed relevant objectives (defined/desired health condition. The aim of the research was to distinguish and define the way the health service quality is perceived by the hospital managerial personnel. Material and Methods: The questionnaire was mailed to 836 members of the managerial personnel of public hospitals in the Łódź province. Of this number 122 questionnaires were returned. Results: Only 22 (18.49% of respondents presented the definition of quality. Attempts to meet patients’ expectations and to satisfy them were found to be the prevailing perception of the healthcare quality and 96.64% of respondents considered competences of medical staff contributory. Almost 64% of respondents disagree with the opinion that the number of medical staff does not affect the service quality. According to the respondents, a 46% increase in financial resources on average could significantly improve the quality of healthcare services. More than half (66.76% of respondents claim that healthcare services that are available cover 82% of patients’ needs. Almost 57% (56.52% of respondents consider that the subordinate- superior relationship influences their work involvement. According to 42.61% of respondents, the offered incentives encourage actions for the quality improvement. Conclusions: The results of the research indicate the need to develop a clear cut definition of the health service quality by the managerial personnel of public hospitals and to change their understanding, perception and treatment of the discussed issue, which provides a basis for the effective and efficient hospital management. Med Pr 2016

  14. US military service members vaccinated against smallpox in 2003 and 2004 experience a slightly higher risk of hospitalization postvaccination.

    Science.gov (United States)

    Jacobson, Isabel G; Smith, Tyler C; Smith, Besa; Wells, Timothy S; Reed, Robert J; Ryan, Margaret A K

    2008-07-29

    This study explores adverse events severe enough to warrant hospitalization that may have been associated with receiving the smallpox vaccine in conjunction with military service. Cox proportional hazards modeling was used to identify the risk of hospitalization among US active-duty military personnel during a 1-year period following receipt of the smallpox vaccine. The reference group consisted of active-duty military personnel who also received the smallpox vaccine after the conclusion of their health care observation period, allowing for comparison to a temporally and demographically similar population. The risk of hospitalization was slightly elevated among the postvaccine group for any-cause hospitalization and for hospitalization in several broad diagnostic categories. Hospitalizations for asthma, autoimmune diseases, and myopericarditis, were more likely in the postvaccine group. The increased risk of hospitalization for varied outcomes does not necessarily imply a cause-effect relationship, but it does offer areas for more focused study, using longitudinal data to explore the long-term impact of smallpox vaccination on the health of young adults.

  15. Mothers’ access to supportive hospital services after the loss of a baby through stillbirth or neonatal death

    Directory of Open Access Journals (Sweden)

    J Conry

    2008-02-01

    Full Text Available Every year, 3-5% of pregnant mothers in South Africa lose their babies to a stillbirth or neonatal death. These mothers need adequate services to prevent complications in their grieving process. Most of these babies are lost in hospital settings, so the treatment medical staff provide is vital. This study examined mothers’ experiences of accessing hospital, religious, formal and social services after a stillbirth or neonatal death. An exploratory research design was used to conduct applied research. A semi-structured interview schedule was used with a sample of 15 mothers who had lost a baby in the last 5 years. The findings were analysed quantitatively and qualitatively. The primary focus of this article is the quantitative findings relating to hospital services. The sample was small and these results cannot be generalised, but some conclusions are reached and recommendations are made to service providers in hospitals working with mothers who have lost babies. Mothers generally experienced the support services from hospitals as inadequate, compared to what hospitals could offer. Mothers that receive support after the loss of a baby generally cope better. This support thus assists them in the grieving process. Hospital staff can be trained to provide these services. Opsomming In Suid-Afrika verloor 3-5% swanger moeders hulle babas deur stilgeboorte of neonatale dood. Hierdie moeders benodig voldoende dienste om komplikasies in die rouproses te verhoed. Die behandeling deur mediese personeel is uiters belangrik omdat die meeste van dié babas in ‘n hospitaalopset sterf. Hierdie studie het moeders se ervarings van die toeganklikheid van hospitaal-, godsdienstige, formele en sosiale dienste na die dood van hulle babas deur stilgeboorte of neonatale dood ondersoek. Toegepaste navorsing is met behulp van ‘n verkennende navorsingsontwerp gedoen. ‘n Semi-gestruktureerde onderhoudskedule is gebruik met ‘n steekproef van 15 moeders wat

  16. Evaluation of community mental health services: comparison of a primary care mental health team and an extended day hospital service.

    Science.gov (United States)

    Secker, J; Gulliver, P; Peck, E; Robinson, J; Bell, R; Hughes, J

    2001-11-01

    Alongside mental health policies emphasising the need to focus on people experiencing serious, long-term problems, recent general healthcare policy is leading to the development in the UK of a primary care-led National Health Service. While most primary care-led mental health initiatives have focused on supporting general practitioners (GPs) in managing milder depression and anxiety, this article describes an evaluation comparing primary care-based and secondary care-based services for people with serious long-term problems. A survey of service users was carried out at three points in time using three measures: the Camberwell Assessment of Need, the Verona Satisfaction with Services Scales and the Lancashire Quality of Life Profile. Staff views were sought at two time intervals and carers' views were obtained towards the end of the 2-year study period. The results indicate that both services reduced overall needs and the users' need for information. The primary care service also reduced the need for help with psychotic symptoms whereas the secondary care service reduced users' need for help with benefits and occupation. There were no major differences in terms of satisfaction or quality of life. Primary care-based services therefore appear to have the potential to be as effective as more traditional secondary care services. However, a more comprehensive range of services is required to address the whole spectrum of needs, a conclusion supported by the views of staff and carers.

  17. Hospital overcrowding: an opportunity for case managers.

    Science.gov (United States)

    Simmons, Florence M

    2005-01-01

    Hospital overcrowding is primarily a shortage of inpatient beds, not a lack of emergency department capacity, as initially assumed. According to Asplin et al., many factors contribute to overcrowding, including inadequate or inflexible nurse-to-patient staffing ratios, isolation precautions, or delays in cleaning rooms after patient discharge; an overreliance on intensive care or telemetry beds; inefficient diagnostic and ancillary services on inpatient units; and delays in discharging hospitalized patients to postacute-care facilities. Hospital overcrowding presents a challenge for hospital employees and clients, often leading to frustration and dissatisfaction. Overcrowding also has a direct effect on patient care, including compromised patient safety, increased costs, increased length of stay, and increased mortality and morbidity rates. The emergency department is changed from a temporary holding area to an extended patient care unit, decreasing its ability to handle new admissions and to manage a mass casualty. Beds in the critical care units become filled with inappropriate patients if floor beds are not available, making placement of seriously ill patients difficult. Trauma patients may have to be diverted to other hospitals to receive the appropriate level of care. Patients who require specialty services may have to wait for extended periods to obtain a bed in a referral center.

  18. Framing in policy processes: a case study from hospital planning in the National Health Service in England.

    Science.gov (United States)

    Jones, Lorelei; Exworthy, Mark

    2015-01-01

    This paper reports from an ethnographic study of hospital planning in England undertaken between 2006 and 2009. We explored how a policy to centralise hospital services was espoused in national policy documents, how this shifted over time and how it was translated in practice. We found that policy texts defined hospital planning as a clinical issue and framed decisions to close hospitals or hospital departments as based on the evidence and necessary to ensure safety. We interpreted this framing as a rhetorical strategy for implementing organisational change in the context of community resistance to service closure and a concomitant policy emphasising the importance of public and patient involvement in planning. Although the persuasive power of the framing was limited, a more insidious form of power was identified in the way the framing disguised the political nature of the issue by defining it as a clinical problem. We conclude by discussing how the clinical rationale constrains public participation in decisions about the delivery and organisation of healthcare and restricts the extent to which alternative courses of action can be considered. Copyright © 2014 Elsevier Ltd. All rights reserved.

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

    National Research Council Canada - National Science Library

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

    2016-01-01

    .... These include the following characteristics: market position, customer satisfaction, service orientation, environmental thinking, employee involvement, incentive mechanism, human resource development, environmental services, cultural...

  20. Hospitality Industry

    Directory of Open Access Journals (Sweden)

    Marian Ionel

    2017-03-01

    Full Text Available Development of accommodation, as basic services offered to tourists, led to the creation of a genuine hospitality industry. Currently, the hospitality industry is no longer just the accommodation service itself but also requires an atmosphere that ensures leisure tourists in the hotel. Thus, hospitable unit manager offers its service in addition to accommodation and catering services, leisure services, treatment services, business services required.. The existence of factors such as revenue growth, increasing leisure time, the development of transport services, the emergence of new tourist attractions have caused increasing international flows of tourists, with consequent development of units hospitable, and therefore a strong hospitality industry. In Romania, after 1990, the tourism sector experienced a true expansion, both through the development of the hotel sector, but also by developing rural hospitality units.

  1. Variation in access to community rehabilitation services and length of stay in hospital following a hip fracture: a cross-sectional study

    Science.gov (United States)

    Neuburger, Jenny; Harding, Karen A; Bradley, Rachel J D; Cromwell, David A; Gregson, Celia L

    2014-01-01

    Objectives To assess variation in access to and use of community rehabilitation services for patients with a hip fracture, and whether this affects length of stay in hospital. Design Cross-sectional study using administrative patient-level data from Hospital Episode Statistics (HES) and organisational survey data. Setting A regional health economy in South West England served by four acute National Health Service (NHS) hospital trusts and six former Primary Care Trusts (PCTs). Population 1230 hip fracture patients treated in an acute hospital between 1 April 2011 and 29 February 2012. Main outcomes Information about access to community rehabilitation services for each acute hospital and PCT, reported by organisational survey. Rates of patients transferred from acute hospital to community rehabilitation hospitals (CRH) across eight groups with varying access; determined by acute hospital and PCT. Median lengths of stay in the acute hospital, and in the acute hospital plus CRH combined. Associations between the rate of transfer to a CRH and median lengths of stay assessed using Spearman's rank correlation coefficient (rs). Results Access to community rehabilitation services varied, including the number of CRH inpatient beds, formal access criteria and waiting times. In one PCT, no home-based rehabilitation service was available. The percentage of patients transferred to a CRH ranged from 2.1% to 54.7%. A higher transfer rate was associated with a shorter median length of stay in the acute hospital (rs=−0.8; p=0.01), but a longer median combined length of stay in the acute hospital and CRH (rs=+0.7; p=0.04). Conclusions Within one geographical area, there was wide variation in availability and use of community rehabilitation services for patients discharged from an acute hospital following a hip fracture. Reliance on transfers to community rehabilitation hospitals was associated with a longer length of stay in the NHS. PMID:25208849

  2. Monitoring the impact of the DRG payment system on nursing service context factors in Swiss acute care hospitals: Study protocol.

    Science.gov (United States)

    Spirig, Rebecca; Spichiger, Elisabeth; Martin, Jacqueline S; Frei, Irena Anna; Müller, Marianne; Kleinknecht, Michael

    2014-01-01

    With this study protocol, a research program is introduced. Its overall aim is to prepare the instruments and to conduct the first monitoring of nursing service context factors at three university and two cantonal hospitals in Switzerland prior to the introduction of the reimbursement system based on Diagnosis Related Groups (DRG) and to further develop a theoretical model as well as a methodology for future monitoring following the introduction of DRGs. DRG was introduced to all acute care hospitals in Switzerland in 2012. In other countries, DRG introduction led to rationing and subsequently to a reduction in nursing care. As result, nursing-sensitive patient outcomes were seriously jeopardised. Switzerland has the opportunity to learn from the consequences experienced by other countries when they introduced DRGs. Their experiences highlight that DRGs influence nursing service context factors such as complexity of nursing care or leadership, which in turn influence nursing-sensitive patient outcomes. For this reason, the monitoring of nursing service context factors needs to be an integral part of the introduction of DRGs. However, most acute care hospitals in Switzerland do not monitor nursing service context data. Nursing managers and hospital executive boards will be in need of this data in the future, in order to distribute resources effectively. A mixed methods design in the form of a sequential explanatory strategy was chosen. During the preparation phase, starting in spring 2011, instruments were selected and prepared, and the access to patient and nursing data in the hospitals was organized. Following this, online collection of quantitative data was conducted in fall 2011. In summer 2012, qualitative data was gathered using focus group interviews, which helped to describe the processes in more detail. During 2013 and 2014, an integration process is being conducted involving complementing, comparing and contrasting quantitative and qualitative findings

  3. Escalation of oncologic services at the end of life among patients with gynecologic cancer at an urban, public hospital.

    Science.gov (United States)

    Wu, Eijean; Rogers, Anna; Ji, Lingyun; Sposto, Richard; Church, Terry; Roman, Lynda; Tripathy, Debu; Lin, Yvonne G

    2015-03-01

    Use of oncology-related services is increasingly scrutinized, yet precisely which services are actually rendered to patients, particularly at the end of life, is unknown. This study characterizes the end-of-life use of medical services by patients with gynecologic cancer at a safety-net hospital. Oncologic history and metrics of medical use (eg, hospitalizations, chemotherapy infusions, procedures) for patients with gynecologic oncology who died between December 2006 and February 2012 were evaluated. Mixed-effect regression models were used to test time effects and construct usage summaries. Among 116 subjects, cervical cancer accounted for the most deaths (42%). The median age at diagnosis was 55 years; 63% were Hispanic, and 65% had advanced disease. Only 34% died in hospice care. The median times from do not resuscitate/do not intubate documentation and from last therapeutic intervention to death were 9 days and 55 days, respectively. Significant time effects for all services (eg, hospitalizations, diagnostics, procedures, treatments, clinic appointments) were detected during the patient's final year (P care used significantly fewer resources toward the end of life. To our knowledge, this is the first report enumerating medical services obtained by patients with gynecologic cancer in a large, public hospital during the end of life. Marked changes in interventions in the patient's final 2 months highlight the need for cost-effective, evidence-based metrics for delivering cancer care. Our data emphasize continuity of care as a significant determinant of oncologic resource use during this critical period. Copyright © 2015 by American Society of Clinical Oncology.

  4. Evaluation of Police General Hospital's Fracture Liaison Service (PGH's FLS: The first study of a Fracture Liaison Service in Thailand

    Directory of Open Access Journals (Sweden)

    Tanawat Amphansap

    2016-12-01

    Conclusions: Patients with recent hip fractures participating in the Fracture Liaison service had a significantly higher post-injury BMD follow up and osteoporotic medication administration rates. This resulted in a lower risk of secondary fracture than those who did not participate in the Fracture Liaison service at a follow up time of one year.

  5. Strategic responses to fiscal constraints: a health policy analysis of hospital-based ambulatory physical therapy services in the Greater Toronto Area (GTA).

    Science.gov (United States)

    Landry, Michel D; Verrier, Molly C; Williams, A Paul; Zakus, David; Deber, Raisa B

    2009-01-01

    Ambulatory physical therapy (PT) services in Canada are required to be insured under the Canada Health Act, but only if delivered within hospitals. The present study analyzed strategic responses used by hospitals in the Greater Toronto Area (GTA) to deliver PT services in an environment of fiscal constraint. Key informant interviews (n = 47) were conducted with participants from all hospitals located within the GTA. Two primary strategic responses were identified: (1) "load shedding" through the elimination or reduction of services, and (2) "privatization" through contracting out or creating internal for-profit subsidiary clinics. All hospitals reported reductions in service delivery between 1996 and 2003, and 15.0% (7/47 hospitals) fully eliminated ambulatory services. Although only one of 47 hospitals contracted out services, another 15.0% (7/47) reported that for-profit subsidiary clinics were created within the hospital in order to access other more profitable forms of quasi-public and private funding. Strategic restructuring of services, aimed primarily at cost containment, may have yielded short-term financial savings but has also created a ripple effect across the continuum of care. Moreover, the rise of for-profit subsidiary clinics operating within not-for-profit hospitals has emerged without much public debate and with little research to evaluate its impact.

  6. New alternatives for reference evapotranspiration estimation in West Africa using limited weather data and ancillary data supply strategies.

    Science.gov (United States)

    Landeras, Gorka; Bekoe, Emmanuel; Ampofo, Joseph; Logah, Frederick; Diop, Mbaye; Cisse, Madiama; Shiri, Jalal

    2017-04-01

    Accurate estimation of reference evapotranspiration (ET 0 ) is essential for the computation of crop water requirements, irrigation scheduling, and water resources management. In this context, having a battery of alternative local calibrated ET 0 estimation methods is of great interest for any irrigation advisory service. The development of irrigation advisory services will be a major breakthrough for West African agriculture. In the case of many West African countries, the high number of meteorological inputs required by the Penman-Monteith equation has been indicated as constraining. The present paper investigates for the first time in Ghana, the estimation ability of artificial intelligence-based models (Artificial Neural Networks (ANNs) and Gene Expression Programing (GEPs)), and ancillary/external approaches for modeling reference evapotranspiration (ET 0 ) using limited weather data. According to the results of this study, GEPs have emerged as a very interesting alternative for ET 0 estimation at all the locations of Ghana which have been evaluated in this study under different scenarios of meteorological data availability. The adoption of ancillary/external approaches has been also successful, moreover in the southern locations. The interesting results obtained in this study using GEPs and some ancillary approaches could be a reference for future studies about ET 0 estimation in West Africa.

  7. [Smoking cessation among HIV smokers: Experience of a French hospital-based smoking cessation service].

    Science.gov (United States)

    Choulika, S; Le Faou, A-L

    2017-04-01

    There is a particular need among HIV-infected patients to stop smoking because of the risk of smoking-related complications and the high prevalence of cigarette smoking among them. Only a few studies have focused on this population in real-world settings. Investigate the effectiveness of a smoking cessation support for HIV-infected patients at the Georges Pompidou University hospital (HEGP) smoking cessation service during the 2011-2012 period. A retrospective study of smoking cessation medical records was performed for 39 smokers who had visited for the first time the HEGP smoking cessation service during the 2011-2012 period and declared to be infected by the HIV on their smoking cessation self-questionnaire. The study has described smokers' characteristics and follow-up to measure the abstinence rate, validated by the patient declaration, the registration of the number of days without cigarettes between each visit and a measure of expired carbon monoxide ≤ 5ppm at each visit. We examined smokers lost to follow-up and they have been considered as smokers. Maintained abstinence rates at 3 month-follow-up and at 9 months/one year were registered. The 39 HIV-infected smokers registered in the study were mainly male (30/39), were heavy smokers with a consumption mean of nearly 23 cigarettes per day. One third presented high nicotine dependence with a Fagerström test ≥ 7. A depression history was reported among one third of them. Symptoms of anxiety and depression were declared by 20% and 33% respectively among them. Thirteen percent of them received opioid replacement therapies, 41% were cannabis users (one out of four were daily users) and 10 % declared alcohol abuse. 85% of patients received nicotine replacement therapy (patch and/or oral forms) and 15% varenicline(®), along with behavioral support techniques. At 3 month-follow-up, smoking cessation was validated for 20.5% of patients and at 9 months/1 year, smoking cessation rate decreased at 13%. When

  8. Calidad en los Servicios Farmacéuticos Hospitalarios Quality of the pharmaceutical service at hospital

    Directory of Open Access Journals (Sweden)

    María de las Mercedes Cuba Venereo

    2008-12-01

    Full Text Available La calidad es un concepto clave hoy día para los servicios sanitarios. Ella es considerada una variable esencial por la mayoría de las organizaciones. No es posible hablar de buena gestión en un centro o servicio sanitario, si no se incorpora un sistema de mejora continua de la calidad, ya que hay suficiente evidencia para afirmar que dichos programas son un instrumento para elevar la eficiencia clínica y económica. Esto ha provocado una larga carrera hacia la acreditación y evaluación externa por entidades que puedan dar fe del nivel de calidad alcanzado por la organización. Es por ello que lograr un sistema de acreditación de farmacias hospitalarias, con fines no solo evaluativos sino de crecimiento y desarrollo, sería una respuesta a esta necesidad. Cabe señalar la importancia de que dicho programa se ajuste a la realidad existente en Cuba y se pueda adaptar dinámicamente a las diferentes situaciones que se presentarán.Quality is a key concept for health services today and considered as a fundamental variable for most of the organizations. It is impossible to speak about good management in a health care service or center if a permanent quality improvement system is not involved since enough evidence indicates that such programs are tools for higher clinical and economic efficiency. The aforementioned has brought about a long run for accreditation and external evaluation by agencies that are able to endorse the quality level attained by the organization in question. This is why implementing an accreditation system for hospital pharmacies, not only for evaluation but for growth and development, would be an appropriate response to this requirement. There should be pointed out the importance of adapting this program to the existing realities of Cuba and of adjusting it in a dynamic way to the many situations that may come up.

  9. 38 CFR 17.166 - Dental services for hospital or nursing home patients and domiciled members.

    Science.gov (United States)

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Dental services for... Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Dental Services § 17.166 Dental services for... domiciliary care pursuant to the provisions of §§ 17.46 and 17.47, will be furnished such dental services...

  10. A STUDY OF ENTHESITIS IN SPONDYLOARTHROPATHY IN PATIENTS FROM A TERTIARY CARE SERVICE HOSPITAL

    Directory of Open Access Journals (Sweden)

    Surajit

    2014-07-01

    Full Text Available INTRODUCTION: The enthesis is defined as the site of insertion of a tendon, ligament, joint capsule, or fascia to bone. A variety of anatomical sites can be symptomatically affected in Spondyloarthropathy. The spectrum of Spondyloarthropathy consists of Primary Ankylosing spondylitis, Reiter's syndrome/ reactive arthritis, Psoriatic arthropathy and arthropathy associated with Inflammatory Bowel Disease. One of the pathologic hallmarks of the disease is entheseal involvement with insertional tendonitis at different locations. AIM: To study the distribution of involved enthesis in patients with spondyloarthropathy. MATERIAL AND METHODS: The study group included 54 patients from diverse age groups and from different geographic areas in India and was carried out in a tertiary care service hospital. All these patients had historical evidence of sacroiliitis in the form of Inflammatory Back Pain and were diagnosed as Spondyloarthropathy according to ESSG criteria. RESULT: The male to female ratio in this study is 8.2:1. The distribution of enthesitis in our study showed a maximum incidence of heel and costosternal joint. The other enthesis involved were greater trochanter, anterior superior iliac spine and ischial tuberosity. MRI was compared against Plain radiography of Sacroiliac joints for detecting sacroiliitis changes. CONCLUSION: The disease expression has been considered different in males and females. The males with Ankylosing spondylitis have more often had radiological spinal changes and hip involvement than their female counterparts. MRI was compared against Plain radiography of Sacroiliac joints for detecting sacroiliitis changes. MRI was found to be better as compared to Plain radiography in detecting early sacroiliitis with a P value <0.05.

  11. The Toronto General Hospital Transitional Pain Service: development and implementation of a multidisciplinary program to prevent chronic postsurgical pain

    Directory of Open Access Journals (Sweden)

    Katz J

    2015-10-01

    Full Text Available Joel Katz,1–3 Aliza Weinrib,1,2 Samantha R Fashler,2 Rita Katznelzon,1,3 Bansi R Shah,1 Salima SJ Ladak,1 Jiao Jiang,1 Qing Li,1 Kayla McMillan,1 Daniel Santa Mina,5,6 Kirsten Wentlandt,7 Karen McRae,1,3 Diana Tamir,1,3 Sheldon Lyn,1,3 Marc de Perrot,8 Vivek Rao,9 David Grant,10 Graham Roche-Nagle,11 Sean P Cleary,12 Stefan OP Hofer,13 Ralph Gilbert,14 Duminda Wijeysundera,1,3 Paul Ritvo,15 Tahir Janmohamed,16 Gerald O’Leary,1,3 Hance Clarke1,3 1Department of Anesthesia and Pain Management, Toronto General Hospital, University Health Network, University of Toronto, 2Department of Psychology, York University, 3Department of Anesthesia, University of Toronto, 4Palliative Care, University Health Network, University of Toronto, 5Princess Margaret Cancer Centre, University Health Network, University of Toronto, 6Faculty of Kinesiology and Physical Education, University of Toronto, 7Department of Family and Community Medicine, University of Toronto, 8Division of Thoracic Surgery, Toronto General Hospital, 9Division of Cardiovascular Surgery, Toronto General Hospital, 10Multiorgan Transplant Program, Toronto General Hospital, 11Division of Vascular Surgery, Toronto General Hospital, 12Division of General Surgery, Toronto General Hospital, 13Division of Plastic Surgery, Toronto General Hospital, 14Division of Otolaryngology – Head and Neck Surgery, Toronto General Hospital, 15Department of Kinesiology and Health Science, York University, 16ManagingLife, Toronto, ON, CanadaAbstract: Chronic postsurgical pain (CPSP, an often unanticipated result of necessary and even life-saving procedures, develops in 5–10% of patients one-year after major surgery. Substantial advances have been made in identifying patients at elevated risk of developing CPSP based on perioperative pain, opioid use, and negative affect, including depression, anxiety, pain catastrophizing, and posttraumatic stress disorder-like symptoms. The Transitional Pain Service (TPS at

  12. ISO 9001 certification for hospitals in Bulgaria: does it help service?

    Science.gov (United States)

    Stoimenova, Assena; Stoilova, Ani; Petrova, Guenka

    2014-03-04

    The aim of our study is to review the published literature on establishment and implementation of ISO 9001 QMS in European hospitals, to study the availability of International Organization for Standardization (ISO) quality management systems (QMS) in Bulgarian hospitals and to outline the main advantages of ISO implementation in the hospitals in Bulgaria. The information on availability of ISO QMS in the hospitals in Bulgaria was gathered via Bulgarian certification register, the registries of various quality associations, websites of hospitals and certification companies presented in Bulgaria. A total number of 312 hospitals in Bulgaria were screened for the availability of QMS certified against the ISO 9001 requirements. The experience of European hospitals that implemented QMS is positive and the used approaches to improve the processes and the demonstrated effects from ISO implementation are analysed by the researchers. Unlike other European Union member states, the establishment of quality management systems in Bulgaria is not compulsory. However, our study revealed that 14.42% of the hospitals in Bulgaria have implemented and have certified quality systems against the requirements of ISO 9001. Our study confirmed that a quality management system using the ISO 9001 standard is useful for the hospitals as it can help to increase the operational efficiencies, to reduce errors, improve patient safety and produce a more preventive approach instead of a reactive environment.

  13. Clinical and microbiological study of catheter-associated urinary tract infections in internal medicine services of a Venezuelan university hospital

    OpenAIRE

    Quijada-Martínez, Pedro; Servicio de Medicina Interna. Instituto Autónomo Hospital Universitario de Los Andes. Mérida, Venezuela. Médico internista; Flores-Carrero, Ana; Instituto de Previsión y Asistencia Social del Ministerio de Educación. Mérida, Venezuela. Centro de Microscopia Electrónica, Universidad de Los Andes. Mérida, Venezuela. bioanalista, magíster en Ciencias Médicas Fundamentales; Labrador, Indira; Laboratorio de Microbiología Molecular, Universidad de Los Andes. Mérida, Venezuela. biólogo, magíster en Ciencias Biomédicas Experimentales; Araque, María; Laboratorio de Microbiología Molecular, Universidad de Los Andes. Mérida, Venezuela. médico cirujano, doctor en Ciencias Médicas Fundamentales.

    2017-01-01

    Objectives. To determine the clinical and microbiological characteristics of catheter-associated urinary tract infections (CA-UTI) in patients admitted to the Internal Medicine services of the Hospital Universitario de Los Andes (HULA), Mérida, Venezuela and to establish the clonal distribution of multi-resistant Enterobacteriaceae that produce this infection. Materials and Methods. Seventy-three adult patients with bladder catheterization were studied between January and July 2015. The micro...

  14. The Influence Of Policy Implementation From The Change Of Institutional Status Toward Quality Of Patient Service In Hospital

    Directory of Open Access Journals (Sweden)

    Dadang Kusnadi

    2015-08-01

    Full Text Available Abstract Fenomenon and comunity problem in goverment hospital management not aware to wont and need public. Silent safety and consumen satisfaction is fenomenon lack quallity care. Goal this research goal for analysis about influence of policy implementation of hospital change institution status to the quality of patien service in Hospital. Kind of reserch is the quantity desain on approach the eksplanatory survey research analysis regresi linier multipel with analysis method validitas product moment pearson exam and reliability exam is alpha cronbach technique to hypotesis exam is path analysis and statistic exam t. Datum transformation is Skala Likert with measurement the method succesive interval. The population one thausand seventh two person with sample technique stratified random sampling the instrument research is quesioner and interview patien on caunter imforman. The result of assuming research that it is anticipated that implementation of change policy of institution status of hospital X there is significant influence to quality of service of patient Y is 66.31 and the other factor e is 33.69. In the implementation factor is significant to positif influence to quality service is communication X1 is 049 human resources X2 is 025 disposition X3 is 032 and structure birocratic X4 is 033. The conculsion from four factor independen variable X is the implementation of policy to quality service patient Y to influence and can receive in knowledge. To concept the development in implementation of policy need culture job factor because every product policy to contac direct with the community as to basic public policy.

  15. The impact of PPS on hospital-sponsored post-acute services: a case study of Delaware Medicare providers.

    Science.gov (United States)

    Kulesher, Robert R; Wilder, Margaret G

    2008-01-01

    Hospitals were the first providers to experience the change in Medicare reimbursement from a cost basis to the prospective payment system (PPS). In the 1980s, this switch was accomplished through the development of diagnosis-related groups, a unique formula for Medicare reimbursement of inpatient hospital services. During that time, the concern was that, with the anticipated reduced payments to hospitals, adverse impacts on Medicare beneficiaries were likely, including premature release of patients from hospital care resulting in medical complications, increased readmissions, prolonged episodes of recuperation, and preventable mortality. The Balanced Budget Act of 1997 (BBA) mandated the implementation of the PPS for Medicare providers of skilled nursing home care and home health care. This change from cost-based reimbursement to PPS raised concerns that these providers would react as hospitals had done-that is, skilled nursing homes might limit their admission of Medicare patients and home health agencies might cut back on visits. As a result of that, hospitals might be faced with providing care for these post-acute patients without receiving additional reimbursement, and these changes in utilization patterns would be of critical importance to both providers and Medicare beneficiaries. This article examines the decisions that providers made in response to the perceived impact of the BBA. Qualitative data were derived from provider interviews. The article concludes with a discussion of how changes in Medicare reimbursement policy have influenced providers of post-acute care services to alter their level of participation in Medicare and the impact this may have on the general public as well as on Medicare beneficiaries.

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

    Directory of Open Access Journals (Sweden)

    Wilson Sue

    2008-08-01

    Full Text Available Abstract Background With high levels of obesity and related illness, improving the health of the nation is a major public health concern. This study aimed to identify factors that prevent healthy eating among doctors, and that are associated with satisfaction with catering services. Findings Methods: Cross-sectional survey of 328 NHS doctors working in two NHS Trusts with on-site hospital canteen. Questionnaire to establish perceived barriers to healthy eating, weekly use and satisfaction with the hospital canteen, lifestyle and dietary habits, gender, age, height, weight, job details, and affect. Results: 70% of doctors reported using their hospital canteen each week, with 2 visits per week on average. Canteen opening times, lack of selection and lack of breaks were the most commonly perceived barriers to healthy eating. Availability of healthy options caused the most dissatisfaction. Only 12% felt the NHS was supportive of healthy eating. 74% did not feel their canteen advocated healthy eating. Canteen use is associated with younger age (r = -0.254, p Conclusion Interventions to encourage regular meal breaks, eating breakfast and drinking more water each day need developing. Improved canteen accessibility and availability of healthy options at evenings and weekends may be beneficial.

  17. [An evaluation of the 4 years of the Oral Rehydration Service of the Hospital Infantil de Monterrey].

    Science.gov (United States)

    Muraira-Gutiérrez, A; Méndez-Jara, A; Ruiz-Villalpando, G

    1992-06-01

    At four years of being founded the Service of Oral Hydration from Hospital Infantil de Monterrey, we carried out this investigation to know its productivity, to determine costs of internments, death rates due to diarrhea and dehydration in the hospital and at a State level. The statistics from the hospital were revised in the previous and subsequent years to the institution of the Service in September of 1986, so as the statistics of death due to diarrhea from the State Health Department. The cases attended were 12,139, from which 9,024 belonged to plan A, 2,983 to plan B and 72 to plan C. Three hundred (300) doctors were trained and nine (9) research studies were accomplished. A decrease was achieved from the hospital rate admission by diarrhea and dehydration, throw the oral dehydration therapy in a 66%, the mortality rate was reduced 72% and an expenditure of $619,243,480.00 pesos in drugs and auxiliary examinations of diagnostic was avoided. At a State level the general death rate due to diarrhea got a cutdown of 13.1 to 5.8, and in infants under a year old decreased from 275 to 122.3. The oral hydration therapy applied in the State seems to be the main reason in that results.

  18. Effect of implementing dental services in Israeli psychiatric hospitals on the oral and dental health of inpatients.

    Science.gov (United States)

    Ponizovsky, Alexander M; Zusman, Shlomo P; Dekel, Dan; Masarwa, Abd-el-Samia; Ramon, Tirza; Natapov, Lena; Yoffe, Rinat; Weizman, Abraham; Grinshpoon, Alexander

    2009-06-01

    Psychiatric disorders (schizophrenia, mood disorders, and organic brain disorders) and their treatment may lead to oral diseases, but assessment of dental status and oral care needs among patients with these disorders is lacking. This study reports changes in dental health and oral care needs of psychiatric inpatients after 1998, when psychiatric hospitals in Israel were required to provide regular dental examinations and treatment for every inpatient hospitalized longer than a year. Two epidemiological cohorts from 1997 and 2006 representing long-term psychiatric inpatients before (N=431) and after (N=254) the reform of dental services were compared on the standardized criteria of the Decayed, Missing, and Filled Teeth (DMFT) index scores and DMFT component scores, as well as on the use of and need for dentures. Compared with the prereform cohort, the postreform cohort h