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Sample records for baby-friendly hospital initiative

  1. Effects of baby-friendly hospital initiative on breast-feeding practices in Sindh

    International Nuclear Information System (INIS)

    To determine changes in the breastfeeding practices of mothers after receiving counseling on Ten Steps to Successful Breastfeeding as defined by the Baby Friendly Hospital Initiative comparing baby friendly hospitals (BFHs) and non-baby-friendly hospitals in Sindh, Pakistan. Methods: The observational study was conducted from June 2007 to June 2009 in randomly selected baby-friendly and non-baby-friendly hospitals of Sindh, Pakistan. Non-probability purposive sampling was employed. The maternity staff was trained on Ten Steps to Successful Breastfeeding. The changes in breastfeeding practices were analysed by SPSS version 15. Results: A total of 236 women were included in the study. Of them, 196 (83.05%) were from baby-friendly hospitals and 40 (16.94%) from non-baby-friendly hospitals. Besides, 174 (88.7%) mothers in baby-friendly hospitals and 5 (12.5%) in non-baby-friendly hospitals during antenatal care received counseling by healthcare providers. There was an increase in breastfeeding practice up to 194 (98.97%) in the first category compared to 12 (30%) in the other category. Conclusion: Counseling under the Baby Friendly Hospital Initiative improved breastfeeding practices up to 98.97% in baby-friendly compared to non-baby-friendly hospitals. (author)

  2. Implementing and revitalizing the Baby-Friendly Hospital Initiative.

    Science.gov (United States)

    Saadeh, Randa; Casanovas, Carmen

    2009-06-01

    The Baby-Friendly Hospital Initiative (BFHI) was launched in the 1990s by the World Health Organization (WHO) and UNICEF as a global effort with hospitals, health services, and parents to ensure babies are breastfed for the best start in life. It is one of the Operational Targets of the Global Strategy for Infant and Young Child Feeding endorsed in 2002 by the Fifty-Fifth World Health Assembly and the UNICEF Executive Board. After about 18 years, great progress has been made, and most countries have breastfeeding authorities or BFHI coordinating groups. The BFHI has led to increased rates of exclusive breastfeeding, which are reflected in improved health and survival. Based on this progress, the Initiative was streamlined according to the experience of the countries and materials were revised. The new package consolidated all WHO and UNICEF materials into one package, reflected new research and experience, revisited the criteria used for the BFHI in light of HIV/ AIDS, reinforced the International Code of Marketing of Breast-Milk Substitutes, provided modules for mother-friendly care, and gave more guidance for monitoring and reassessment. WHO and partners will continue to give support to BFHI implementation as one essential effort contributing to achievement of the Millennium Development Goals. PMID:20496615

  3. Exploring the impact of the Baby-Friendly Hospital Initiative on trends in exclusive breastfeeding

    Directory of Open Access Journals (Sweden)

    Labbok Miriam H

    2009-10-01

    Full Text Available Abstract Background The Baby-Friendly Hospital Initiative (BFHI seeks to support breastfeeding initiation in maternity services. This study uses country-level data to examine the relationship between BFHI programming and trends in exclusive breastfeeding (EBF in 14 developing countries. Methods Demographic and Health Surveys and UNICEF BFHI Reports provided EBF and BFHI data. Because country programs were initiated in different years, data points were realigned to the year that the first Baby-Friendly hospital was certified in that country. Pre-and post-implementation time periods were analyzed using fixed effects models to account for grouping of data by country, and compared to assess differences in trends. Results Statistically significant upward trends in EBF under two months and under six months, as assessed by whether fitted trends had slopes significantly different from 0, were observed only during the period following BFHI implementation, and not before. BFHI implementation was associated with average annual increases of 1.54 percentage points in the rate of EBF of infants under two months (p Conclusion BFHI implementation was associated with a statistically significant annual increase in rates of EBF in the countries under study; however, small sample sizes may have contributed to the fact that results do not demonstrate a significant difference from pre-BFHI trends. Further research is needed to consider trends according to the percentages of Baby-Friendly facilities, percent of all births occurring in these facilities, and continued compliance with the program.

  4. A Multifaceted Approach to Revitalizing the Baby-Friendly Hospital Initiative in Croatia.

    Science.gov (United States)

    Grgurić, Josip; Zakarija-Grković, Irena; Pavičić Bošnjak, Anita; Stanojević, Milan

    2016-08-01

    The Baby-Friendly Hospital Initiative (BFHI) was launched in Croatia in 1993. By 1998, 15 of 34 maternity facilities were designated "Baby-Friendly." Introduction of hospital bags, violating the International Code of the Marketing of Breastmilk Substitutes, led to a standstill in the BFHI. The aim of this article is to describe the successful reintroduction of the BFHI in Croatia between 2007 and 2015. After hospital bags were abolished in 2007, UNICEF Croatia undertook an assessment of BFHI implementation. All maternity facilities were invited by UNICEF and the Ministry of Health to join the renewed BFHI. UNICEF materials were translated and training for trainers, assessors, coordinators, and hospital staff held. By June 2015, 30 of 32 (94%) maternity facilities, providing care to 89% of newborns, were Baby-Friendly. Nine maternity hospitals have been renovated and 2 new hospitals have been built. Exclusive breastfeeding rates have risen 16% at 0 to 2 months (from 51% in 2007 to 67% in 2014) and 14% at 3 to 5 months (from 32% in 2007 to 46% in 2014). Fourteen "Breastfeeding-Friendly" primary care practices have been designated, 166 breastfeeding support groups are in operation, criteria for Mother-Friendly care are being piloted in 2 maternity facilities, and "Ten Steps in the Neonatal Intensive Care Unit" are being introduced. The BFHI provides an excellent opportunity for revitalizing breastfeeding protection, promotion, and support in all settings. Recognition and support of the BFHI by the Croatian government was crucial for implementing the BFHI, whereas the marketing practices of the breast milk substitutes industry are an ongoing challenge. PMID:27121238

  5. A quality improvement initiative project to evaluate a newborn hearing screening program in a Baby-Friendly Hospital Initiative setting

    Directory of Open Access Journals (Sweden)

    Stacey R. Lim

    2015-02-01

    Full Text Available Hearing loss present from birth can have a detrimental impact on later language and educational outcomes. Newborn hearing screening has allowed early identification and intervention of hearing loss, giving children the opportunity to develop age-appropriate language skills. The aim of this quality initiative study was to evaluate the quality of the newborn hearing screening program in the context of a newly implemented Baby-Friendly Hospital Initiative Program at Summa Health System Akron City Hospital. The goals were (1 to determine whether screening environment (mother’s room vs. nursery affected screening results, (2 to identify challenges and positive outcomes encountered by the audiologists, and (3 to ensure that Pass/Refer rates met state standards. A Quest Technologies sound level meter (Model 1800; St. Paul, MN, USA was used to measure noise levels in the nursery rooms where newborns were tested. The length of screening time was determined using a calibrated SP® Traceable® (ISO 17025 stopwatch (McGraw Park, IL, USA. Pass/Refer rates and observed challenges and benefits were noted. All well-baby infants born in the month of February 2013 (n = 101 were included, and Pass/Refer results were compared to those in years 2008-2012.Noise levels in the mother’s room did not appear to negatively affect the Pass/Refer rates. Some challenges were present, including interruptions and louder environmental noise. This protocol was considered appropriate for assessing a hearing screening program in a Baby-Friendly Hospital Initiative (BFHI setting.Benefits of performing hearing screening in the mother’s room included test transparency for parents and the ability to immediately discuss the results. Results obtained in the mother’s room were comparable to past results obtained in the nursery. Noise levels in the screening rooms and challenges should be noted, to ensure accuracy of screening results.

  6. Expansion of the baby-friendly hospital initiative ten steps to successful breastfeeding into neonatal intensive care

    DEFF Research Database (Denmark)

    Nyqvist, Kerstin H; Häggkvist, Anna-Pia; Hansen, Mette N;

    2013-01-01

    In the World Health Organization/United Nations Children's Fund document Baby-Friendly Hospital Initiative: Revised, Updated and Expanded for Integrated Care, neonatal care is mentioned as 1 area that would benefit from expansion of the original Ten Steps to Successful Breastfeeding. The different...... provision of antenatal information, that are specific to neonatal care. Facilitation of early, continuous, and prolonged skin-to-skin contact (kangaroo mother care), early initiation of breastfeeding, and mothers' access to breastfeeding support during the infants' whole hospital stay are important. Mother...... breast. Alternatives to bottles should be used until breastfeeding is well established. The discharge program should include adequate preparation of parents, information about access to lactation and breastfeeding support, both professional and peer support, and a plan for continued follow-up....

  7. Baby-friendly hospital: how to sustain?

    Science.gov (United States)

    Kasemsarn, P; Ngarmpiyasakul, C; Phongpanich, S; Pulkasisri, N

    1995-07-01

    The campaign for exclusive breast-feeding in a baby-friendly hospital at Prapokklao Hospital, Chanthaburi was increased. The contributory factors was likely due to enforcement of early bonding and attachment, by rooming-in of infants in the materity ward. After cessation of comprehensive intervention exclusive breast-feeding dropped significantly but increased in predominant breast-feeding. This might be due to family influence with the suggestion to give water in addition to breast milk. Data shows that rooming-in is essential in the promotion of breast-feeding. A decreased of abandoned children indicates early bonding. To sustain a baby-friendly hospital, 10 steps to successful breast-feeding must be followed strictly. Intervention activities must be done continuously with cooperation of health providers at all levels. It is felt that breast-feeding should not be considered a maternal instinct but a new behavior that needs to be changed to a point that mothers adopt breast-feeding practices for 4 months after delivery. PMID:7658181

  8. Factors Influencing the Intention of Perinatal Nurses to Adopt the Baby-Friendly Hospital Initiative in Southeastern Quebec, Canada: Implications for Practice

    Directory of Open Access Journals (Sweden)

    Guylaine Chabot

    2014-01-01

    Full Text Available Nurses play a major role in promoting the baby-friendly hospital initiative (BFHI, yet the adoption of this initiative by nurses remains a challenge in many countries, despite evidences of its positive impacts on breastfeeding outcomes. The aim of this study was to identify the factors influencing perinatal nurses to adopt the BFHI in their practice. Methods. A sample of 159 perinatal nurses from six hospital-based maternity centers completed a survey based on the theory of planned behavior. Hierarchical multiple linear regression analyses were performed to assess the relationship between key independent variables and nurses’ intention to adopt the BFHI in their practice. A discriminant analysis of nurses’ beliefs helped identify the targets of actions to foster the adoption the BFHI among nurses. Results. The participants are mainly influenced by factors pertaining to their perceived capacity to overcome the strict criteria of the BFHI, the mothers’ approval of a nursing practice based on the BFHI, and the antenatal preparation of the mothers. Conclusions. This study provides theory-based evidence for the development of effective interventions aimed at promoting the adoption of the BFHI in nurses’ practice.

  9. Is baby-friendly breastfeeding support in maternity hospitals associated with breastfeeding satisfaction among Japanese mothers?

    Science.gov (United States)

    Hongo, Hiroko; Nanishi, Keiko; Shibanuma, Akira; Jimba, Masamine

    2015-06-01

    While the World Health Organization's Baby-Friendly Hospital Initiative has increased breastfeeding duration and exclusivity, a survey found that only 8.5 % of maternity hospitals in 31 developed countries could be designated baby-friendly. Baby-friendly breastfeeding support is sometimes criticized as mother unfriendly. This study examined whether baby-friendly breastfeeding support was associated with breastfeeding satisfaction, duration, and exclusivity among Japanese mothers. In this cross-sectional study, 601 breastfeeding Japanese mothers completed questionnaires at their infants' 4-month health checkups at two wards in Yokohama, Japan; 363 were included in the analysis. Baby-friendly breastfeeding support was measured based on the WHO's "Ten Steps to Successful Breastfeeding." We measured satisfaction using two subscales of the Japanese version of the Maternal Breastfeeding Evaluation Scale. The association of baby-friendly support with maternal satisfaction was assessed using multiple linear regression, while the prevalence ratios (PRs) for breastfeeding were estimated using Poisson regression. Mothers were stratified by prepartum exclusive breastfeeding intention (yes, n = 256; no, n = 107). Mothers who experienced early skin-to-skin contact with their infants were more likely to report breastfeeding satisfaction than those who did not. Among mothers without exclusive breastfeeding intention, those who were encouraged to feed on demand were more likely to be breastfeeding without formula at 1 month (PR 2.66 [95 % CI 1.32, 5.36]) and to perceive breastfeeding as beneficial for their baby (regression coefficient = 3.14 [95 % CI 0.11, 6.17]) than those who were not so encouraged. Breastfeeding satisfaction was a useful measure of breastfeeding outcome. Early skin-to-skin contact and encouragement to feed on demand in the hospital facilitate breastfeeding satisfaction. PMID:25366103

  10. Barriers, facilitators, and recommendations related to implementing the Baby-Friendly Initiative (BFI): an integrative review.

    Science.gov (United States)

    Semenic, Sonia; Childerhose, Janet E; Lauzière, Julie; Groleau, Danielle

    2012-08-01

    Despite growing evidence for the positive impact of the Baby-Friendly Initiative (BFI) on breastfeeding outcomes, few studies have investigated the barriers and facilitators to the implementation of Baby-Friendly practices that can be used to improve uptake of the BFI at the local or country levels. This integrative review aimed to identify and synthesize information on the barriers, facilitators, and recommendations related to the BFI from the international, peer-reviewed literature. Thirteen databases were searched using the keywords Baby Friendly, Baby-Friendly Hospital Initiative, BFI, BFHI, Ten Steps, implementation, adoption, barriers, facilitators, and their combinations. A total of 45 English-language articles from 16 different countries met the inclusion criteria for the review. Data analysis was guided by Cooper's five stages of integrative research review. Using a multiple intervention program framework, findings were categorized into sociopolitical, organizational-level, and individual-level barriers and facilitators to implementing the BFI, as well as intra-, inter-, and extraorganizational recommendations for strengthening BFI implementation. A wide variety of obstacles and potential solutions to BFI implementation were identified. Findings suggest some priority issues to address when pursuing Baby-Friendly designation, including the endorsements of both local administrators and governmental policy makers, effective leadership of the practice change process, health care worker training, the marketing influence of formula companies, and integrating hospital and community health services. Framing the BFI as a complex, multilevel, evidence-based change process and using context-focused research implementation models to guide BFI implementation efforts may help identify effective strategies for promoting wider adoption of the BFI in health services. PMID:22628290

  11. Supporting 'Baby Friendly': a quality improvement initiative for the management of transitional neonatal hypoglycaemia.

    Science.gov (United States)

    Stewart, Claire Elizabeth; Sage, Emma Louise Maitland; Reynolds, Peter

    2016-07-01

    We describe a quality improvement initiative conducted in a medium-sized district general hospital with a neonatal intensive care unit, which involved working with the multidisciplinary team to create a 'Baby Friendly' neonatal hypoglycaemia pathway with implementation of dextrose gel as a first-line treatment. As a result of the project, formula supplementation rates and admissions for transitional hypoglycaemia were reduced and breastfeeding rates at 3 months improved. This initiative demonstrates that evidence-based guidelines with multidisciplinary team input can improve standards of care. PMID:26644391

  12. Implantation of the Baby Friendly Hospital initiative at a University Hospital Implantação da iniciativa Hospital Amigo da Criança em um hospital universitário

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    Marina Ferreira Réa

    2002-11-01

    Full Text Available The goals of this article are to describe the “Baby Friendly Hospital Initiative” implantation at the University Hospital of Northern Paraná, situated in Londrina, and point out the difficulties and advantages of this process. The methodology consisted of two inquiries based on the “Tem steps for the success of breast feeding” which were carried out before and after the “Baby Friendly Hospital Initiative” implantation at the hospital. The inquiry carried out after the implantation at the hospital showed the accomplishment of the ten steps and the significant increase of the levels of exclusive breast-feeding (6,7% to 95%. Considering that this work was developed at a school hospital, it was a great challenge for the health professional group, showing changes in behavior and breast-feeding practices, therefore, resulting in an important increase of breast-feeding levels.   Este artigo tem como objetivos descrever o processo de implantação da Iniciativa Hospital Amigo da Criança (IHAC no Hospital Universitário Regional do Norte do Paraná (HURNP e destacar as dificuldades e benefícios advindos dessa implantação. A metodologia empregada foi a utilização de inquéritos, com base nos “Dez Passos”, realizados antes e após a implantação do IHAC no HURNP. O inquérito realizado após a implantação, revelou o cumprimento dos “Dez Passos” e o aumento significativo dos índices de aleitamento exclusivo (de 6,7% para 95,0%. A implantação da IHAC no HURNP, por ser um hospital universitário, representou um grande desafio para a equipe, porém levou a mudança no comportamento e práticas relativas à amamentação, resultando no aumento dos índices de aleitamento materno e aleitamento materno exclusivo dos bebês que nasceram neste hospital.

  13. Factors influencing student midwives' competence and confidence when incorporating UNICEF UK Baby Friendly Initiative (BFI) Education Standards in clinical practice

    OpenAIRE

    McIntyre, Helen Rachel

    2013-01-01

    Background: Breastfeeding is crucial in providing optimum nutrition and health for babies' to develop into healthy adults and has important emotional, physical and psychological benefits on maternal health. The UK has stubbornly low breastfeeding initiation and continuation rates. To address this, the government has policies targeting maternity and public health services. Furthermore, UNICEF UK introduced Baby Friendly Initiative (BFI) Hospital Standards in 1998 and Midwifery Education St...

  14. Becoming Baby-Friendly and Transforming Maternity Care in a Safety-Net Hospital on the Texas-Mexico Border.

    Science.gov (United States)

    Eganhouse, Deborah J; Gutierrez, Leticia; Cuellar, Lorena; Velasquez, Cecilia

    2016-01-01

    Nurse leaders used the Centers for Disease Control and Prevention's survey on Maternity Practices in Infant Nutrition and Care, as well as Baby-Friendly Hospital Initiative guidelines, to transform maternity care in a safety-net hospital with more than 3,500 births annually. Implementing evidence-based guidelines to support breastfeeding was essential for a vulnerable population characterized by minimal prenatal care and high rates of diabetes, hypertension, obesity, and poverty. Research showing the importance of breastfeeding in protecting against these factors guided extensive changes in our maternity care model. The nursing and medical teams changed long-held practices that separated women from their newborns and observed substantial improvements in breastfeeding initiation and exclusive breastfeeding rates at discharge. PMID:27520602

  15. Bringing Baby-Friendly to the Indian Health Service: A Systemwide Approach to Implementation.

    Science.gov (United States)

    Karol, Susan; Tah, Tina; Kenon, Clifton; Meyer, Jenna; Yazzie, Jeannette; Stephens, Celissa; Merewood, Anne

    2016-05-01

    The Baby-Friendly Hospital Initiative (BFHI) increases exclusive breastfeeding. Breastfeeding protects against obesity and diabetes, conditions to which American Indians and Alaska Natives are particularly prone. As part of the First Lady'sLet's Move! in Indian Countryinitiative, the US Department of Health and Human Services' Indian Health Service (IHS) began implementing the BFHI in 2011. The IHS administers 13 US birthing hospitals. There are 5 tribally administered hospitals in the lower 48 states that receive IHS funding, and the IHS encouraged them to seek Baby-Friendly designation also. In the 13 federally administered hospitals, the IHS implemented a Baby-Friendly infant feeding policy, extensive clinician training, and Baby-Friendly compatible medical records. All hospitals also became compliant with the World Health Organization's International Code of Marketing of Breast-Milk Substitutes. Strategies and solutions were shared systemwide via webinars and conference calls. Quality improvement methods, technical assistance, and site visits assisted with the implementation process. Between 2011 and December 2014, 100% (13 of 13) of IHS federally administered hospitals gained Baby-Friendly designation. The first Baby-Friendly hospitals in Arizona, New Mexico, North Dakota, Oklahoma, and South Dakota were all IHS sites; 6% of all US Baby-Friendly hospitals are currently IHS hospitals. One tribal site has also been Baby-Friendly designated and 3 of the 5 remaining tribally administered hospitals in the lower 48 states are pursuing Baby-Friendly status. Baby-Friendly Hospital Initiative implementation systemwide is possible in a US government agency serving a high-risk, underprivileged population. Other systems looking to implement the BFHI can learn from the IHS model. PMID:26561492

  16. Impacto de treinamento baseado na Iniciativa Hospital Amigo da Criança sobre práticas relacionadas à amamentação no interior do Nordeste The impact of training based on the Baby-Friendly Hospital Initiative on breastfeeding practices in the Northeast of Brazil

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    Sonia B. Coutinho

    2005-12-01

    Full Text Available OBJETIVO: Avaliar o impacto de treinamento baseado na Iniciativa Hospital Amigo da Criança sobre práticas relacionadas à amamentação na maternidade e freqüências de aleitamento materno nos primeiros 6 meses de vida. MÉTODOS: Foram treinadas 90% das auxiliares de enfermagem e parteiras de duas maternidades (A e B de Palmares (PE. Foram entrevistadas 334 mães nas primeiras 48 horas e 10 dias após o parto, para avaliar práticas que estimulam a amamentação nas maternidades e o cumprimento do quarto ao 10º passo da Iniciativa Hospital Amigo da Criança. Uma subamostra de 166 mães recebeu sete visitas domiciliares, para avaliar as freqüências do aleitamento materno nos 6 primeiros meses de vida. Os resultados foram comparados com os de estudo de coorte realizado na área em 1998. RESULTADOS: O desempenho da maternidade B foi melhor que o da maternidade A quanto às práticas que promovem o aleitamento materno relacionadas aos passos avaliados e quanto às freqüências de amamentação exclusiva. Comparação com coorte histórica evidenciou melhora nas práticas relacionadas à amamentação nas maternidades e aumento nas freqüências do aleitamento materno exclusivo (de 21,2 para 70%, nas primeiras 48 horas após o parto e durante os 6 primeiros meses de vida. CONCLUSÕES: O treinamento promoveu mudanças parciais em algumas práticas relacionadas à amamentação, repercutindo de forma positiva sobre as freqüências de aleitamento materno e aleitamento materno exclusivo nas maternidades. Contudo, não houve mudanças expressivas nessas freqüências ao longo dos 6 meses de vida, sugerindo a necessidade de intervenções efetivas no apoio ao aleitamento exclusivo nos serviços de saúde e na comunidade.OBJECTIVE: To evaluate the impact of training based on the Baby Friendly Hospital Initiative on breastfeeding practices in maternity wards and during the first 6 months of life. METHODS: Ninety percent of nursing auxiliaries and

  17. Step 4 assessment of the promotion for breastfeeding in baby-friendly hospital

    OpenAIRE

    Giselle Carlos Santos Brandão Monte; Luciana Pedrosa Leal; Cleide Maria Pontes

    2012-01-01

    The objective of this study was to evaluate the implementation of the 4th step to promote maternal breast-feeding in a child-friendly hospital in Recife, PE, Brazil. It is a descriptive, observational, transversal and quantitative study. The sample covered 80 health professionals, of which 47 were doctors and 33 from the nursing team. The data collected through interviews and non-participative observation was analysed by the Epi-Info version 6.04 program, undergoing descriptive and bivariate ...

  18. Breastfeeding in the neonatal transitional period at a Baby-Friendly Hospital

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    Jéssica Machado Teles

    2015-03-01

    Full Text Available The objective of this study was to learn the breastfeeding rates in the neonatal transition period at a child-friendly hospital. A quantitative, exploratory, cross-sectional study was developed with 342 mother-baby pairs. Data were collected by means of interviews and analysis of medical records. Low breastfeeding rates were identified in the first hour of life of the newborns or neonatal reactivity period (53.2%. In the second transition period the rate was 20.7%, and 20.5% in the third period. Encouragement to breastfeeding is not appropriate for the phases of the neonatal transition period, as the rates for the first hour of life were expected to be higher than 90%, considering low risk newborns and births that occurred in a child-friendly hospital. Our findings indicate a need for adopting care strategies that favor the early contact and training of professionals at maternity hospitals toward the adequacy of breastfeeding to the neonatal transition period.

  19. The impact of the Baby Friendly Health Initiative in the Australian health care system: a critical narrative review of the evidence.

    Science.gov (United States)

    Atchan, Marjorie; Davis, Deborah; Foureur, Maralyn

    2013-07-01

    Studies have identified that the practices of maternity facilities and health professionals are crucial to women's experience of support and breastfeeding 'success'. The Baby Friendly Hospital Initiative (BFHI) was launched globally in 1991 to protect, promote and support breastfeeding. While a direct causal effect has not been established and critics suggest the rhetoric conflicts with women's lived experiences as new mothers, a positive association between the Initiative and breastfeeding prevalence is apparent. Internationally, impact studies have demonstrated that where the Initiative is well integrated, there is an increase in rates of breastfeeding initiation and, to a lesser extent, duration. In consideration of the known health risks associated with the use of artificial baby milks this would suggest that BFHI implementation and accreditation should be a desirable strategy for committed health facilities. However, a variation in both BFHI uptake and breastfeeding prevalence between nations has been reported. This narrative review critically discusses a variety of issues relevant to the uptake and support of breastfeeding and the BFHI, utilising Australia as a case study. Whilst it enjoys 'in principle' policy support, Australia also suffers from a lack of uniformity in uptake and perception of the benefits of BFHI at all levels of the health system. Australian and international studies have identified similar enablers and barriers to implementation. PMID:23957177

  20. Ten steps or climbing a mountain: A study of Australian health professionals' perceptions of implementing the baby friendly health initiative to protect, promote and support breastfeeding

    Directory of Open Access Journals (Sweden)

    Sheehan Athena

    2011-08-01

    Full Text Available Abstract Background The Baby Friendly Hospital (Health Initiative (BFHI is a global initiative aimed at protecting, promoting and supporting breastfeeding and is based on the ten steps to successful breastfeeding. Worldwide, over 20,000 health facilities have attained BFHI accreditation but only 77 Australian hospitals (approximately 23% have received accreditation. Few studies have investigated the factors that facilitate or hinder implementation of BFHI but it is acknowledged this is a major undertaking requiring strategic planning and change management throughout an institution. This paper examines the perceptions of BFHI held by midwives and nurses working in one Area Health Service in NSW, Australia. Methods The study used an interpretive, qualitative approach. A total of 132 health professionals, working across four maternity units, two neonatal intensive care units and related community services, participated in 10 focus groups. Data were analysed using thematic analysis. Results Three main themes were identified: 'Belief and Commitment'; 'Interpreting BFHI' and 'Climbing a Mountain'. Participants considered the BFHI implementation a high priority; an essential set of practices that would have positive benefits for babies and mothers both locally and globally as well as for health professionals. It was considered achievable but would take commitment and hard work to overcome the numerous challenges including a number of organisational constraints. There were, however, differing interpretations of what was required to attain BFHI accreditation with the potential that misinterpretation could hinder implementation. A model described by Greenhalgh and colleagues on adoption of innovation is drawn on to interpret the findings. Conclusion Despite strong support for BFHI, the principles of this global strategy are interpreted differently by health professionals and further education and accurate information is required. It may be that the

  1. Nurses' Perspectives on the Process of Attaining Baby-Friendly Designation.

    Science.gov (United States)

    Lundeen, Suzanne; Sorensen, Sherrill; Bland, Michelle; George, Sybil; Snyder, Brenton

    2016-01-01

    The Baby-Friendly Hospital Initiative is a global initiative that aims to protect, promote, and support breastfeeding. This study explores and describes the process of attaining Baby-Friendly designation from nurses' perspectives. A purposive sampling design was used to recruit registered nurse participants in a large, safety-net, tertiary care facility. Data were collected via semistructured interviews and were analyzed using descriptive interpretative analysis. The following themes were revealed: Resistance, Culture, Investment in the Journey, Teamwork, and Source of Pride. Results indicate that comfortable yet antiquated practices led to fear of change and resistance. Initial culture shock was mediated by a successful education model, powerful experiences, and positive outcomes. PMID:27287354

  2. Being baby friendly: evidence-based breastfeeding support.

    Science.gov (United States)

    Cleminson, J; Oddie, S; Renfrew, M J; McGuire, W

    2015-03-01

    Breast feeding improves important outcomes for mothers and infants. In the UK, breastfeeding rates have historically been low, particularly among socially disadvantaged young women. Although there have been gradual increases in breastfeeding initiation rates since 2000, rates of exclusive breast feeding and continuation until 6 months remain lower than those in similar countries. This review summarises the evidence for effective and cost-effective strategies to help women, particularly those in low income groups, make informed choices, overcome barriers and establish and maintain breast feeding. We describe the development and impact of the Unicef Baby Friendly Initiative, and the roles and responsibilities, and challenges and opportunities that clinicians have in promoting breast feeding and maintaining a baby-friendly culture and environment. PMID:25293712

  3. Nascer em Hospital Amigo da Criança no Rio de Janeiro, Brasil: um fator de proteção ao aleitamento materno? Birth in Baby-Friendly Hospitals in Rio de Janeiro, Brazil: a protective factor for breastfeeding?

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    Paula Florence Sampaio

    2011-07-01

    Full Text Available Este artigo pretende avaliar o papel da Iniciativa Hospital Amigo da Criança (IHAC na duração do aleitamento materno exclusivo (AME. Trata-se de estudo transversal, com população constituída de 811 mães de crianças menores de cinco meses de idade, selecionadas aleatoriamente em cinco unidades básicas de saúde (UBS no Município do Rio de Janeiro, Brasil. A exposição de interesse central foi o local de nascimento da criança: Hospital Amigo da Criança (HAC, em vias de receber a titulação (EVHAC e sem a titulação. Optou-se pelo modelo de análise de sobrevida log-log complementar, que recompõe a experiência longitudinal da coorte, caracterizando abordagem do tipo current status. Mesmo após o controle por variáveis sociodemográficas, relativas ao estilo de vida e aos aspectos psicossociais maternos, à utilização dos serviços de saúde, idade e saúde da criança, houve maior duração do AME em crianças nascidas em HAC e EVHAC. Os resultados sugerem a efetividade da IHAC na manutenção de AME nos primeiros meses de vida, reforçando a necessidade de ampliar sua cobertura para todo o território nacional.This article aims to investigate the impact of the Baby-Friendly Hospital Initiative (BFHI on exclusive breastfeeding (EBF. This was a cross-sectional study with 811 mothers of infants under five months of age, randomly selected at five health centers in Rio de Janeiro, Brazil. The exposure variable was hospital of birth, categorized in accredited hospitals (BFH, certified hospitals (CBFH, and hospitals without accreditation. The data were analyzed by complementary log-log transformation models, which capture cohort longitudinal experience (current status data. Even after adjusting the analysis for maternal socio-demographic, lifestyle, and psychological factors, health services use, and infants' age and health status, duration of EBF was longer in infants born in BFH and CBFH. The findings suggest the effectiveness of

  4. Comparing breast feeding practices in baby friendly and non-accredited hospitals in Salvador, Bahia Comparação das práticas de amamentação em hospitais IHAC e não credenciados em Salvador, Bahia

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    Priscilla Nunes Ortiz

    2011-12-01

    Full Text Available OBJECTIVES: to compare compliance with Steps 4 to 10 of "The Steps to Successful Breastfeeding" in two hospitals accredited by the Baby-Friendly Hospital Initiative (BFHI group with two not yet accredited hospitals in Salvador. METHODS: a cross-sectional study was conducted with 100 women in BFHI-accredited hospitals and 103 women in non-BFHI-accredited hospitals by collecting data on their obstetric history, any breast feeding counseling received during antenatal care, and data on delivery and hospitalization. Data were obtained by applying questionnaires and reviewing patients' medical charts. The chi-square test was used for bivariate variables and Student's t test for continuous variables. RESULTS: statistically significant differences (pOBJETIVOS: comparar o cumprimento dos Passos de 4 a 10 dos "Dez Passos para o Sucesso do Aleitamento Materno" nos hospitais credenciados pela Iniciativa Hospital Amigo da Criança (grupo IHAC em relação a hospitais não credenciados em Salvador. MÉTODOS: um estudo de corte transversal foi conduzido com 100 mulheres no grupo IHAC e 103 mulheres no grupo não-IHAC através de entrevista abordando história obstétrica, orientações sobre aleitamento materno durante o pré-natal, informações sobre o parto e internamento. A coleta de dados foi realizada através da aplicação de questionários e pesquisa de prontuários. O teste do quiquadrado foi realizado para variáveis dicotômicas e o t de Student para variáveis contínuas. RESULTADOS: diferença estatisticamente significante (p<0,05 foi encontrada entre os grupos IHAC e não-IHAC na avaliação dos passos 5 (77% vs 35,9%, 6 (81% vs 31%, 8 (77% vs 52,4%, e 9 (100% vs 94,2%. Não houve diferença entre os dois grupos na avaliação dos passos 4, 7 ou 10. O cumprimento satisfatório nos hospitais do grupo IHAC foi encontrado na avaliação dos Passos 6, 7 e 9. CONCLUSÕES: os resultados evidenciam os benefícios do credenciamento na IHAC, mas enfatiza

  5. Avaliação da promoção do aleitamento materno em Hospitais Amigos da Criança Evaluación de la promoción de la lactancia materna en hospitales amigos del niño Evaluation of breastfeeding promotion in Baby-Friendly Hospitals

    Directory of Open Access Journals (Sweden)

    Mateus Freire L Souza

    2011-12-01

    transversal. Fueron realizadas entrevistas con 100 puerperas en los dos hospitales acreditados en la IHAC en Salvador (Brasil. Se cuestionó sobre la historia obstétrica, lactancia materna anterior, atención prenatal y aspectos relacionados a los Pasos para el Éxito de la Lactancia Materna. Las cuestiones fueron elaboradas conforme a los Criterios Globales para la IHAC. Como mínimo, el 80% de las madres deberían contestar de modo satisfactorio a las preguntas correspondientes a cada paso para que se lo considerara cumplido. Se utilizó la descripción estadística de frecuencia en el SPSS 13.0 para evaluar las respuestas. No se incluyeron madres o recién nacidos que no podrían recibir lactancia materna exclusiva. RESULTADOS: El cumplimiento fue insatisfactorio para: Paso 4 (soporte a la lactancia materna después del parto - 58%, Paso 5 (lactancia materna exclusiva durante la internación - 77% y Paso 10 (encaminamiento al grupo de apoyo a la lactancia materna - 5%. Otros pasos demostraron buenos resultados: Paso 6 (oferta de sustitutos de la leche materna - 19%, Paso 7 (práctica del alojamiento conjunto - 91% y 9 (no utilización de chupos y biberones - 100%. CONCLUSIONES: Esos resultados demostraron buena adherencia a algunos aspectos de los Criterios Globales de IHAC. Se evidencia, sin embargo, la necesidad de ampliar las discusiones sobre los criterios para obtener y mantener el prestigioso título de «Hospital Amigo del Niño», una vez que los resultados fueron insatisfactorios respecto a los pasos 4, 5 y 10.OBJECTIVE: To evaluate the compliance to steps 4 to 10 of the Ten Steps Program to Successful Breastfeeding recommended by the Baby-Friendly Hospital Initiative (BFHI, created by World Health Organization (WHO. METHODS: Cross-sectional descriptive study of 100 mothers in the immediate post-partum period admitted to both BFHI accredited hospitals in Salvador (Northeast Brazil. Newborns that could not be exclusively breastfed were not included. The mothers

  6. Justificativas para uso de suplemento em recém-nascidos de baixo risco de um Hospital Amigo da Criança Justifications for formula supplementation in low-risk newborns at a Baby-Friendly Hospital

    OpenAIRE

    Cynthia de Almeida Brandão Meirelles; Maria Inês do Couto Oliveira; Rosane Reis de Mello; Maria Angélica Bonfim Varela; Vânia Matos Fonseca

    2008-01-01

    A Iniciativa Hospital Amigo da Criança preconiza que não se dê a recém-natos nenhum outro alimento ou líquido além do leite materno, a não ser que haja indicação clínica (passo 6). Este estudo teve como objetivo verificar a prevalência e identificar justificativas alegadas para suplementação ao aleitamento materno em recém-nascidos de alojamento conjunto. A amostra foi composta por 300 recém-nascidos de um Hospital Amigo da Criança do Rio de Janeiro, Brasil, que usaram suplemento dentre os qu...

  7. A good start in life: breast-feeding in hospital.

    Science.gov (United States)

    de Boer, A S; Darnton-Hill, I

    1994-01-01

    The World Health Organization (WHO) and UNICEF introduced the Baby- Friendly Hospital Initiative in 1992 to foster breast feeding in hospitals. The balanced composition of breast milk fulfills the 4-6 month old infant's nutrient requirements. Colostrum is rich in antibodies and immunoglobulins, which protect the newborn against infection. As economic development progresses, more mothers use infant formulas while fewer mothers breast feed. Between 1960 and 1985 in Japan, the proportion of mothers breast feeding 1-2 month old infants fell from 68% to 50%. Between 1975 and 1968 in Western Samoa, it fell from 69% to 48% in urban areas and 78% to 59% in rural areas. Hospital practices that discourage breast feeding include separation of mother and newborn, prelacteal feedings, and free samples of infant formula. These practices occur even in areas, such as the Western Pacific Region, where most mothers deliver at home. Hospital baby-friendly criteria include a written breast-feeding policy, training of all health care staff in skills needed to implement this policy, informing all pregnant women about the benefits and management of breast feeding, assisting mothers to begin breast feeding within 30 minutes of delivery, demonstrating to mothers how to breast feed and to maintain lactation, no prelacteal feeds, newborn rooming-in with mother, promoting breast feeding on demand, no artificial teats or pacifiers, and breast-feeding support groups. The Western Pacific Region supports the Baby-Friendly Hospital Initiative. Between March 1991 and March 1993, the number of baby-friendly hospitals in the Philippines rose from 4 to 103. Dr. Jose Fabella Memorial Hospital in Manila is a model baby-friendly hospital for other hospitals in the region. It does not release mothers until milk flow has been established. By late 1992, 21 Chinese hospitals were baby-friendly. The WHO Western Pacific Region distributes information about breast feeding and the Initiative and provides breast

  8. Implementing the ten steps to successful breastfeeding in multiple hospitals serving low-wealth patients in the US: innovative research design and baseline findings

    OpenAIRE

    Labbok, Miriam H; Taylor, Emily C; Nickel, Nathan C

    2013-01-01

    Background The Ten Steps to Successful Breastfeeding are maternity practices proven to support successful achievement of exclusive breastfeeding. They also are the basis for the WHO/UNICEF Baby-Friendly Hospital Initiative (BFHI). This study explores implementation of these steps in hospitals that serve predominantly low wealth populations. Methods A quasi-experimental design with mixed methods for data collection and analysis was included within an intervention project. We compared the impac...

  9. High initiation and long duration of breastfeeding despite absence of early skin-to-skin contact in Karen refugees on the Thai-Myanmar border: a mixed methods study

    OpenAIRE

    White Adrienne L; Carrara Verena I; Paw Moo Kho; Malika; Dahbu ColleyPaw; Gross Mechthild M; Stuetz Wolfgang; Nosten Francois H; McGready Rose

    2012-01-01

    Abstract Background Early skin-to-skin contact (SSC) after birth is recommended as part of the United Nations Children’s Fund (UNICEF) baby friendly health initiative to promote optimum breastfeeding. This paper reports rates of breastfeeding initiation and duration in a low resource environment, where early SSC is not practised, and explores views of pregnant women and midwives surrounding breastfeeding and swaddling. Methods Data from records from a single hospital on the Thai-Myanmar borde...

  10. Development of a baby friendly non-contact method for measuring vital signs: First results of clinical measurements in an open incubator at a neonatal intensive care unit

    Science.gov (United States)

    Klaessens, John H.; van den Born, Marlies; van der Veen, Albert; Sikkens-van de Kraats, Janine; van den Dungen, Frank A.; Verdaasdonk, Rudolf M.

    2014-02-01

    For infants and neonates in an incubator vital signs, such as heart rate, breathing, skin temperature and blood oxygen saturation are measured by sensors and electrodes sticking to the skin. This can damage the vulnerable skin of neonates and cause infections. In addition, the wires interfere with the care and hinder the parents in holding and touching the baby. These problems initiated the search for baby friendly 'non-contact' measurement of vital signs. Using a sensitive color video camera and specially developed software, the heart rate was derived from subtle repetitive color changes. Potentially also respiration and oxygen saturation could be obtained. A thermal camera was used to monitor the temperature distribution of the whole body and detect small temperature variations around the nose revealing the respiration rate. After testing in the laboratory, seven babies were monitored (with parental consent) in the neonatal intensive care unit (NICU) simultaneously with the regular monitoring equipment. From the color video recordings accurate heart rates could be derived and the thermal images provided accurate respiration rates. To correct for the movements of the baby, tracking software could be applied. At present, the image processing was performed off-line. Using narrow band light sources also non-contact blood oxygen saturation could be measured. Non-contact monitoring of vital signs has proven to be feasible and can be developed into a real time system. Besides the application on the NICU non-contact vital function monitoring has large potential for other patient groups.

  11. Hospital Quality Initiative - Outcome Measures

    Data.gov (United States)

    U.S. Department of Health & Human Services — In the interest of promoting high-quality, patient-centered care and accountability, the Centers for Medicare and Medicaid Services (CMS) and Hospital Quality...

  12. Implementing Patient Safety Initiatives in Rural Hospitals

    Science.gov (United States)

    Klingner, Jill; Moscovice, Ira; Tupper, Judith; Coburn, Andrew; Wakefield, Mary

    2009-01-01

    Implementation of patient safety initiatives can be costly in time and energy. Because of small volumes and limited resources, rural hospitals often are not included in nationally driven patient safety initiatives. This article describes the Tennessee Rural Hospital Patient Safety Demonstration project, whose goal was to strengthen capacity for…

  13. Becoming Baby-Friendly: Increasing breastfeeding exclusivity and duration rates through Vancouver's community health services

    OpenAIRE

    Graham, Katie Jacqueline

    2010-01-01

    Despite recent gains in breastfeeding initiation and ongoing public health recommendations for exclusive breastfeeding during the first six months of an infant’s life, breastfeeding exclusivity and duration rates remain suboptimal in Vancouver and across Canada. In an effort to establish breastfeeding as the cultural norm for women, children, and families, Vancouver Coastal Health (VCH) recently developed a VCH-wide policy and guidelines about the feeding of healthy term infants. This paper...

  14. CDC Vital Signs-Hospital Actions Affect Breastfeeding

    Centers for Disease Control (CDC) Podcasts

    2015-10-06

    This podcast is based on the October 2015 CDC Vital Signs report. Hospitals can implement the Ten Steps to Successful Breastfeeding to be designated as "Baby-Friendly" and support more moms in a decision to breastfeed.  Created: 10/6/2015 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 10/6/2015.

  15. Potential savings of harmonising hospital and community formularies for chronic disease medications initiated in hospital.

    Directory of Open Access Journals (Sweden)

    Lauren Lapointe-Shaw

    Full Text Available BACKGROUND: Hospitals in Canada manage their formularies independently, yet many inpatients are discharged on medications which will be purchased through publicly-funded programs. We sought to determine how much public money could be saved on chronic medications if hospitals promoted the initiation of agents with the lowest outpatient formulary prices. METHODS: We used administrative databases for the province of Ontario to identify patients initiated on a proton pump inhibitor (PPI, angiotensin-converting enzyme (ACE inhibitor or angiotensin receptor blocker (ARB following hospital admission from April 1(st 2008-March 31(st 2009. We assessed the cost to the Ontario Drug Benefit Program (ODB over the year following initiation and determined the cost savings if prescriptions were substituted with the least expensive agent in each class. RESULTS: The cost for filling all PPI, ACE inhibitor and ARB prescriptions was $ 2.48 million, $968 thousand and $325 thousand respectively. Substituting the least expensive agent could have saved $1.16 million (47% for PPIs, $162 thousand (17% for ACE inhibitors and $14 thousand (4% for ARBs over the year following discharge. INTERPRETATION: In a setting where outpatient prescriptions are publicly funded, harmonising outpatient formularies with inpatient therapeutic substitution resulted in modest cost savings and may be one way to control rising pharmaceutical costs.

  16. HOSPITAL VENTILATION STANDARDS AND ENERGY CONSERVATION: A REVIEW OF GOVERNMENTAL AND PRIVATE AGENCY ENERGY CONSERVATION INITIATIVES

    Energy Technology Data Exchange (ETDEWEB)

    Banks, Robert S.; Rainer, David

    1980-03-01

    This report presents the results of a recent research project originally concerned with review of governmental initiatives for changes to hospital design and operation standards at both the federal and state levels. However. it quickly became apparent that concern with energy conservation was not impacting hospital environmental standards, especially at the state level, irrespective of the energy implications. Consequently, the study was redirected to consider all energy conservation initiatives directed toward design and operating practices unique to the hospital environment. The scope was limited to agency programs (i.e., not undertaken at the initiative of individual hospitals), applicable to non-federal public and private hospitals.

  17. Assessment of Patient Safety Friendly Hospital Initiative in Three Hospitals Affiliated to Tehran University of Medical Sciences

    Directory of Open Access Journals (Sweden)

    Firoozeh Bairami

    2016-01-01

    Full Text Available Introduction: The aim of this study was to assess the status of patient safety in three hospitals, affiliated to Tehran University of Medical Sciences, based on the critical standards of Patient Safety Friendly Hospital Initiative (PSFHI. Materials and Methods:In this cross-sectional study, conducted in 2014, we used PSFHI assessment tool to evaluate the status of patient safety in three hospitals, affiliated to Tehran University of Medical Sciences; these general referral hospitals were selected purposefully. PSFHI assessment tool is comprised of 140 patient safety standards in five domains, categorized in 24 sub-domains. The five major domains include leadership and management, patient and public involvement, safe evidence-based clinical practices, safe environment, and lifelong learning. Results: All three hospitals met more than 70% of the critical standards. The highest score in critical standards (> 80% was related to the domain of leadership and management in all hospitals. The average score in the domain of safe evidence-based clinical practices was 70% in the studied hospitals. Finally, all the hospitals met 50% of the critical standards in the domains of patient and public involvement and safe environment. Conclusion: Based on the findings, PSFHI is a suitable program for meeting patient safety goals. The selected hospitals in this survey all had a high managerial commitment to patient safety; therefore, they could obtain high scores on critical standards.

  18. Initial breastfeeding attitudes and practices of women born in Turkey, Vietnam and Australia after giving birth in Australia

    Directory of Open Access Journals (Sweden)

    Forster Della A

    2006-04-01

    Full Text Available Abstract Background Cultural variations exist in the proportion of women who breastfeed. For some cultural groups, migration to a new country is associated with a reduction in the initiation and duration of breastfeeding. This paper describes the initial breastfeeding attitudes and practices of women born in Vietnam, Turkey and Australia who gave birth in Australia. Methods The study included 300 women: 100 hundred Turkish-born, 100 Vietnamese-born and 100 Australian-born women who had given birth in a large public, tertiary referral maternity hospital between January 1998 and May 1999 in Melbourne, Australia. Women were interviewed in hospital, between 24 hours after the birth and discharge from hospital. Data were collected using a structured questionnaire with some open-ended questions. Only women who had a normal vaginal birth and who gave birth to a healthy baby were included in the study. Results Almost all Turkish women initiated breastfeeding (98% compared with 84% of Australian women. Vietnamese women had the lowest rate of breastfeeding initiation (75%, perceived their partners to be more negative about breastfeeding and did not value the health benefits of colostrum to the same extent as the other two groups. Forty percent of Vietnamese women gave their baby formula in hospital. The results of this study add to the previously reported finding that immigrant Vietnamese women have low breastfeeding rates compared with other groups. Conclusion Despite the Baby Friendly status of the hospital where the study was conducted, major differences were found in breastfeeding initiation. Future research should develop and test interventions aimed at increasing breastfeeding initiation in Vietnamese women where initiation is low.

  19. Current legal initiative to integrated care - effects of outpatient care in hospitals

    International Nuclear Information System (INIS)

    The strict separation of the out-patient and hospital-based health care delivery sectors in Germany leads to deficits in effectiveness and efficiency. Newly introduced legal initiatives to overcome this separation, namely 'Ambulantes Operieren' (Paragraph 115b SGB V), 'Ambulante Behandlung durch Krankenhaeuser' and Disease Management Programs (Paragraphen 116a-b SGB V) are described in detail in this article. Their impact on hospital-based health provision for out-patients is discussed. The aim of a better integration of different sectors with a better quality and a more efficient use of resources seems to be the target of these initiatives. (orig.)

  20. An Intervention to Increase Availability of Healthy Foods and Beverages in New York City Hospitals: The Healthy Hospital Food Initiative, 2010–2014

    Science.gov (United States)

    Krepp, Erica M.; Johnson Curtis, Christine; Lederer, Ashley

    2016-01-01

    Background Hospitals serve millions of meals and snacks each year; however, hospital food is often unhealthy. Hospitals are ideal settings for modeling healthy eating, but few programs have sought to improve nutrition in all venues where food is served. Community Context The New York City Department of Health and Mental Hygiene created the Healthy Hospital Food Initiative (HHFI) to improve the healthfulness of food served in hospitals. The HHFI built on prior work implementing mandatory nutrition standards for patient meals and vending in public hospitals. Public hospitals joined the HHFI by voluntarily adopting standards for cafeterias and cafés. Private hospitals joined by implementing nutrition standards for patient meals, food and beverage vending machines, and cafeterias and cafés. Methods Hospitals were recruited from 2010 through 2014 and provided technical assistance from health department staff. Implementation in each of the 4 areas was monitored through on-site assessments and menu review. Twenty-eight hospital cafeterias and cafés were evaluated at baseline and at the end of the HHFI to assess changes. Outcome Sixteen public hospitals and 24 private hospitals joined the HHFI. Most (n = 18) private hospitals implemented standards in at least 2 areas. In cafeterias, most hospitals introduced a healthy value meal (n = 19), removed unhealthy items from the entrance and checkout (n = 18), increased whole grains to at least half of all grains served (n = 17), and reduced calories in pastries and desserts (n = 15). Interpretation Most New York City hospitals joined the HHFI and voluntarily adopted rigorous nutrition standards. Partnerships between hospitals and local government are feasible and can lead to significant improvements in hospital food environments. PMID:27281392

  1. Healthy hospital food initiatives in the United States: time to ban sugar sweetened beverages to reduce childhood obesity

    OpenAIRE

    Wojcicki, Janet M.

    2013-01-01

    While childhood obesity is a global problem, the extent and severity of the problem in United States, has resulted in a number of new initiatives, including recent hospital initiatives to limit the sale of sweetened beverages and other high calorie drinks in hospital vending machines and cafeterias. These proposed policy changes are not unique to United States, but are more comprehensive in the number of proposed hospitals that they will impact. Meanwhile, however, it is advised, that these i...

  2. Telephone follow-up initiated by a hospital-based health professional for postdischarge problems in patients discharged from hospital to home.

    NARCIS (Netherlands)

    Mistiaen, P.; Poot, E.

    2003-01-01

    OBJECTIVES: To determine the effects of follow-up telephone calls (TFU) in the first month post discharge, initiated by hospital-based health professionals, to patients discharged from hospital to home, with regard to physical and psycho-social outcomes in the first three months post discharge. The

  3. Telephone follow-up initiated by a hospital-based health professional for postdischarge problems in patients discharged from hospital to home. (Review)

    NARCIS (Netherlands)

    Mistiaen, P.; Poot, E.

    2006-01-01

    Objectives: To determine the effects of follow-up telephone calls (TFU) in the first month post discharge, initiated by hospital-based health professionals, to patients discharged from hospital to home, with regard to physical and psycho-social outcomes in the first three months post discharge. The

  4. The impact of charismatic leadership on followers' initiative-oriented behavior : a study in German hospitals

    OpenAIRE

    Boerner, Sabine; Dütschke, Elisabeth

    2008-01-01

    Background: Organizations in the health care sector are undergoing extensive structural reforms. To face these challenges, management initiatives that foster employees' commitment to and support for organizational change are needed in hospitals.Purposes: In literature, a charismatic leadership style has proved to be especially helpful in times of crisis and change as well as an essential antecedent of followers' discretionary behavior in organizations. Thus, the aim of the study was to invest...

  5. Determinants of successful breastfeeding initiation in healthy term singletons: a Swiss university hospital observational study

    OpenAIRE

    Gubler, Tabea; Krähenmann, Franziska; Roos, Malgorzata; Zimmermann, Roland; Ochsenbein-Kölble, Nicole

    2013-01-01

    Abstract Aims: Breastfeeding significantly benefits mothers and infants. We aimed to identify the determinants of its successful initiation. Methods: A retrospective study of 1893 mothers delivering healthy term singletons at a Swiss university hospital from 1/2008 to 3/2009 determined the associations between multiple breastfeeding and early postpartum parameters by univariate and multiple regression analysis. Results: Multiparity was associated with nursing exclusively at the breast at disc...

  6. Social shaping of food intervention initiatives at worksites: Canteen takeaway schemes at two Danish hospitals

    DEFF Research Database (Denmark)

    Poulsen, Signe; Jørgensen, Michael Søgaard

    2011-01-01

    take home or to eat at the worksite during irregular working hours. Data collection was carried out through semi-structured interviews with stakeholders within the two change processes. Two focus group interviews were also carried out at one hospital and results from a user survey carried out by other...... researchers at the other hospital were included. Theoretically, the study was based on the social constitution approach to change processes at worksites and a co-evolution approach to problem–solution complexes as part of change processes. RESULTS: Both interventions were initiated because of the need to....... It is recommended that future planning and analyses of worksite health promotion interventions apply a combination of the social constitution approach to worksites and an integrated food supply and demand perspective based on analyses of the co-evolution of problem–solution complexes....

  7. Development of a comprehensive hospital-based elder abuse intervention: an initial systematic scoping review.

    Directory of Open Access Journals (Sweden)

    Janice Du Mont

    Full Text Available Elder abuse, a universal human rights problem, is associated with many negative consequences. In most jurisdictions, however, there are no comprehensive hospital-based interventions for elder abuse that address the totality of needs of abused older adults: psychological, physical, legal, and social. As the first step towards the development of such an intervention, we undertook a systematic scoping review.Our primary objective was to systematically extract and synthesize actionable and applicable recommendations for components of a multidisciplinary intersectoral hospital-based elder abuse intervention. A secondary objective was to summarize the characteristics of the responses reviewed, including methods of development and validation.The grey and scholarly literatures were systematically searched, with two independent reviewers conducting the title, abstract and full text screening. Documents were considered eligible for inclusion if they: 1 addressed a response (e.g., an intervention to elder abuse, 2 contained recommendations for responding to abused older adults with potential relevance to a multidisciplinary and intersectoral hospital-based elder abuse intervention; and 3 were available in English.The extracted recommendations for care were collated, coded, categorized into themes, and further reviewed for relevancy to a comprehensive hospital-based response. Characteristics of the responses were summarized using descriptive statistics.649 recommendations were extracted from 68 distinct elder abuse responses, 149 of which were deemed relevant and were categorized into 5 themes: Initial contact; Capacity and consent; Interview with older adult, caregiver, collateral contacts, and/or suspected abuser;physical/forensic, mental, psychosocial, and environmental/functional; and care plan. Only 6 responses had been evaluated, suggesting a significant gap between development and implementation of recommendations.To address the lack of evidence to

  8. Sex reassignment surgery for male to female transsexuals: initial experience in Okayama university hospital.

    Directory of Open Access Journals (Sweden)

    Nagai,Atsushi

    2005-10-01

    Full Text Available

    The first case of sex reassignment surgery (SRS in our hospital was performed in January 2001; as of February, 2005, 4 cases of MTF-SRS had been performed. In the 2 most recent cases, we used penile and scrotal skin flaps to avoid complications. The depth and width of the new vagina was made to be adequate for sexual intercourse. Future attention should be focused on devising a surgical technique that will help prevent the complications of partial necrosis of the epidermal skin and wound dehiscence. Although ours is only an initial experience, we describe our surgical technique herein.

  9. Understanding the Determinants of Australian Hospital Nurses' Hand Hygiene Decisions Following the Implementation of a National Hand Hygiene Initiative

    Science.gov (United States)

    White, Katherine M.; Starfelt, Louise C.; Jimmieson, Nerina L.; Campbell, Megan; Graves, Nicholas; Barnett, Adrian G.; Cockshaw, Wendell; Gee, Phillip; Page, Katie; Martin, Elizabeth; Brain, David; Paterson, David

    2015-01-01

    Hand hygiene is the primary measure in hospitals to reduce the spread of infections, with nurses experiencing the greatest frequency of patient contact. The "5 critical moments" of hand hygiene initiative has been implemented in hospitals across Australia, accompanied by awareness-raising, staff training and auditing. The aim of this…

  10. Brigham Fracture Intervention Team Initiatives for Hospital Patients with Hip Fractures: A Paradigm Shift

    Directory of Open Access Journals (Sweden)

    Julie Glowacki

    2010-01-01

    Full Text Available We designed, implemented, and revised the Brigham Fracture Intervention Team (B-FIT initiatives to improve in-hospital care of fracture (Fx patients. Effectiveness was evaluated for 181 medical records of 4 cohorts in four successive years of consecutive patients who were admitted with a fragility hip Fx. The Discharge Initiative (DI (computer-based includes 1200 mg calcium and 1000 IU vitamin D3 daily. The Admission Initiative (AI was introduced one year later with reminders for serum 25OHD measurement, initiation of daily calcium (1200 mg and vitamin D (800 IU, and an order for Endocrinology consultation, with an amendment for a computer-assisted reminder and a dose of D2 (50 000 IU. Initially, the computer-based DI was more effective (67% than the surgeon-driven AI (33%, P<.001. After introduction of a computer-assisted reminder, AI effectiveness increased to 68%. The marked prevalence of vitamin D insufficiency reaffirms the importance of incorporating vitamin D recommendations in Fx care pathways.

  11. 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...

  12. Decline in hospitalization risk and health care cost after initiation of depot antipsychotics in the treatment of schizophrenia

    Directory of Open Access Journals (Sweden)

    Xiaomei Peng

    2011-01-01

    Full Text Available Xiaomei Peng, Haya Ascher-Svanum, Douglas Faries, Robert R Conley, Kory J SchuhEli Lilly and Company, Indianapolis, IN, USAPurpose: To assess change in hospitalization and cost of care from 6 months pre- to 6 months post-initiation on any depot antipsychotic among schizophrenia patients.Patients and methods: Using a large United States commercial claims and encounters database, patients younger than 65 years diagnosed with schizophrenia were identified. Patients initiated on a depot antipsychotic were studied in a mirror-image design to assess change in hospitalization rates, mean duration hospitalized, and hospitalization cost. McNemar’s test and paired t-tests compared the proportions of patients hospitalized and the mean duration. Paired t-test and bootstrapping methods compared costs.Results: In these patients (n = 147, psychiatric hospitalizations declined from 49.7% pre-initiation to 22.4% post-initiation (P < 0.001, and the mean hospitalized duration for psychiatric purposes numerically declined from 7.3 to 4.7 days (P = 0.05. Total health care costs declined from $11,111 to $7884 (P < 0.05 driven by reduction in costs for psychiatric hospitalizations from $5384 to $2538 (P < 0.05.Conclusion: Initiation of depot antipsychotic therapy appeared to be associated with a decline in hospitalization rates and costs. Current findings suggest that treatment with depot antipsychotics may be a cost-effective option for a subgroup of patients with schizophrenia who are at high risk of nonadherence with their oral antipsychotic medication regimen.Keywords: mirror-image, claims database, treatment outcomes, depot antipsychotics

  13. Degree of Acute Kidney Injury before Dialysis Initiation and Hospital Mortality in Critically Ill Patients

    Directory of Open Access Journals (Sweden)

    Charuhas V. Thakar

    2013-01-01

    Full Text Available In a multicenter observational cohort of patients-admitted to intensive care units (ICU, we assessed whether creatinine elevation prior to dialysis initiation in acute kidney injury (AKI-D further discriminates risk-adjusted mortality. AKI-D was categorized into four groups (Grp based on creatinine elevation after ICU admission but before dialysis initiation: Grp I  > 0.3 mg/dL to <2-fold increase, Grp II ≥2 times but <3 times increase, Grp III ≥3-fold increase in creatinine, and Grp IV none or <0.3 mg/dl increase. Standardized mortality rates (SMR were calculated by using a validated risk-adjusted mortality model and expressed with 95% confidence intervals (CI. 2,744 patients developed AKI-D during ICU stay; 36.7%, 20.9%, 31.2%, and 11.2% belonged to groups I, II, III, and IV, respectively. SMR showed a graded increase in Grp I, II, and III (1.40 (95% CI, 1.29–1.42, 1.84 (1.66–2.04, and 2.25 (2.07–2.45 and was 0.98 (0.78–1.20 in Grp IV. In ICU patients with AKI-D, degree of creatinine elevation prior to dialysis initiation is independently associated with hospital mortality. It is the lowest in those experiencing minor or no elevations in creatinine and may represent reversible fluid-electrolyte disturbances.

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

    Directory of Open Access Journals (Sweden)

    Omer Khalid

    2011-12-01

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

  15. Hospitals

    DEFF Research Database (Denmark)

    Mullins, Michael

    2013-01-01

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

  16. Global initiatives for improving hospital care for children: state of the art and future prospects

    OpenAIRE

    Campbell, Harry; Duke, Trevor; Weber, Martin; English, Mike; Carai, Susanne; Tamburlini, Giorgio

    2008-01-01

    Deficiencies in the quality of health care are major limiting factors to the achievement of the Millennium Development Goals for child and maternal health. Quality of patient care in hospitals is firmly on the agendas of Western countries, but has been slower to gain traction in developing countries, despite evidence that there is substantial scope for improvement, that hospitals have a major role in child survival and that inequities in quality may be as important as inequities in access. Th...

  17. Global initiatives for improving hospital care for children: State of the art and future prospects

    OpenAIRE

    Campbell, Harry; Duke, Trevor; Weber, Martin; English, Mike; Carai, Susanne; Tamburlini, Giorgio; Pediat Hosp Improvement Grp

    2008-01-01

    Deficiencies in the quality of health care are major limiting factors to the achievement of the Millennium Development Goals for child and maternal health. Quality of patient care in hospitals is firmly on the agendas of Western countries but has been slower to gain traction in developing countries, despite evidence that there is substantial scope for improvement, that hospitals have a major role in child survival, and that inequities in quality may be as important as inequities in access. Th...

  18. Expectations, Worries and Wishes: The Challenges of Returning to Home after Initial Hospital Rehabilitation for Traumatic Spinal Cord Injury

    DEFF Research Database (Denmark)

    Noe, Bodil Bjørnshave; Bjerrum, Merete; Angel, Sanne

    2014-01-01

    Literature highlights the barriers and problems that individuals who sustain traumatic spinal cord injury (TSCI) meet when they attempt to resume everyday life after hospital rehabilitation. However, what do patients think about before returning home, and what should professionals encourage...... patients to address while the patient is hospitalized in order to balance the patient’s expectations and to reveal what is of importance to the patient. This qualitative study explores the expectations, wishes and worries patients have before they return home after hospital rehabilitation due to TSCI....... Eight Danish residents aged 25-75 years, admitted for initial rehabilitation at the Spinal Cord Injury Center of Western Denmark, participated in an individual interview before returning home. The transcribed interviews were analyzed according to inductive content analysis. Transversal analyses revealed...

  19. Extracorporeal Shock-wave Lithotripsy Success Rate and Complications: Initial Experience at Sultan Qaboos University Hospital

    Directory of Open Access Journals (Sweden)

    Mohammed S. Al-Marhoon

    2013-07-01

    Full Text Available Objective: To assess the efficacy and safety of extracorporeal shock wave lithotripsy with Modularis Vario Siemens in the management of patients with renal and ureteral stones.Methods: Between 2007 and 2009, 225 outpatients were treated with Siemens Modularis Vario lithotripter at Sultan Qaboos University Hospital. Stone size, location, total number of shockwaves, stone-free rate, complications and adjunctive interventions were investigated. Chi-Square and Logistic Regression analyses were used, with p<0.05 set as the level of significance.Results: Of the 225 initial consecutive patients who underwent extracorporeal shock wave lithotripsy, 192 (85% had renal stones and 33 (15% had ureteric stones. The mean±SD stone size was 11.3 ± 4.5 mm, while the mean age of the patients was 39.9 ± 12.8 years with 68.5% males. The mean renal stone size was 11.6 ± 4.7 mm; a mean of 1.3 sessions was required. The mean ureteric stone size was 9.9 ± 3 mm; and a mean of 1.3 sessions was required. Treatment success (defined as complete clearance of ureteric stones, stone-free or clinically insignificant residual fragments of <4 mm for renal stones was 74% for renal stones and 88% for ureteric stones. Additional extracorporeal shock wave lithotripsy and ureteroscopy were the most adjunctive procedures used for stone clearance. Complications occurred in 74 patients (38.5% with renal stones and 13 patients (39.4% with uretetric stones. The most common complication was loin pain (experienced by 16.7% with renal stones and 21% with ureteric stones. Severe renal colic mandating admission occurred in 2% of patients with renal stones and 6% of patients with ureteric stones. In patients with renal stone, steinstrasse occurred in 3.6% and infection post extracorporeal shock wave lithotripsy in 0.5%. Using Multivariate Logistic Regression analysis, factors found to have significant effect on complete stone clearance were serum creatinine (p=0.004 and the number of

  20. Initiation of breastfeeding and prevalence of exclusive breastfeeding at hospital discharge in urban, suburban and rural areas of Zhejiang China

    OpenAIRE

    Binns Colin W; Zhao Yun; Qiu Liqian; Lee Andy H; Xie Xing

    2009-01-01

    Abstract Background Rates of exclusive breastfeeding in China are relatively low and below national targets. The aim of this study was to document the factors that influence exclusive breastfeeding initiation in Zhejiang, PR China. Methods A cohort study of infant feeding practices was undertaken in Zhejiang Province, an eastern coastal region of China. A total of 1520 mothers who delivered in four hospitals located in city, suburb and rural areas during late 2004 to 2005 were enrolled in the...

  1. Initial experience with transperitoneal laparoscopic nephrectomy in an Irish hospital setting.

    LENUS (Irish Health Repository)

    Forde, J C

    2009-08-01

    Laparoscopic nephrectomy has gained widespread acceptance as a treatment for both benign and malignant conditions and is becoming increasingly popular in Irish hospitals. We report a single surgeon, single centre experience with 20 consecutive laparoscopic nephrectomies comparing them to 20 open cases performed prior to the establishment of a laparoscopic service.

  2. Determining the Effect of One-On-One Education in Addition to Written Material on Breastfeeding Initiation Rates in the Hospital Setting

    OpenAIRE

    Grace, Carly Elizabeth

    2012-01-01

    The objective of this research was to determine the breastfeeding initiation rate among healthy, term infants at a select hospital, the effect of one-on-one breastfeeding education, in addition to written material on breastfeeding initiation rates in the hospital setting, and if other factors from available data are associated with differences in breastfeeding initiation. This was a quasi-experimental convenience sample study with subjects assigned to a control group (written education) or in...

  3. Pre-hospital and initial management of head injury patients: An update

    Directory of Open Access Journals (Sweden)

    Tumul Chowdhury

    2014-01-01

    Full Text Available Background: Most of the bad outcomes in patients with severe traumatic brain injury (TBI are related to the presence of a high incidence of pre-hospital secondary brain insults. Therefore, knowledge of these variables and timely management of the disease at the pre-hospital period can significantly improve the outcome and decrease the mortality. The Brain Trauma Foundation guideline on "Prehospital Management" published in 2008 could provide the standardized protocols for the management of patients with TBI; however, this guideline has included the relevant papers up to 2006. Methods: A PubMed search for relevant clinical trials and reviews (from 1 January 2007 to 31 March 2013, which specifically discussed about the topic, was conducted. Results: Based on the evidence, majority of the management strategies comprise of rapid correction of hypoxemia and hypotension, the two most important predictors for mortality. However, there is still a need to define the goals for the management of hypotension and inclusion of newer difficult airway carts as well as proper monitoring devices for ensuring better intubation and ventilatory management. Isotonic saline should be used as the first choice for fluid resuscitation. The pre-hospital hypothermia has more adverse effects; therefore, this should be avoided. Conclusion: Most of the management trials published after 2007 have focused mainly on the treatment as well as the prevention strategies for secondary brain injury. The results of these trials would be certainly adopted by new standardized guidelines and therefore may have a substantial impact on the pre-hospital management in patients with TBI.

  4. Continuous quality improvement programs provide new opportunities to drive value innovation initiatives in hospital-based radiology practices.

    Science.gov (United States)

    Steele, Joseph R; Schomer, Don F

    2009-07-01

    Imaging services constitute a huge portion of the of the total dollar investment within the health care enterprise. Accordingly, this generates competition among medical specialties organized along service lines for their pieces of the pie and increased scrutiny from third-party payers and government regulators. These market and political forces create challenge and opportunity for a hospital-based radiology practice. Clearly, change that creates or builds greater value for patients also creates sustainable competitive advantage for a radiology practice. The somewhat amorphous concept of quality constitutes a significant value driver for innovation in this scenario. Quality initiatives and programs seek to define and manage this amorphous concept and provide tools for a radiology practice to create or build more value. Leadership and the early adoption of these inevitable programs by a radiology practice strengthens relationships with hospital partners and slows the attrition of imaging service lines to competitors. PMID:19560065

  5. Initiation of breastfeeding and prevalence of exclusive breastfeeding at hospital discharge in urban, suburban and rural areas of Zhejiang China

    Directory of Open Access Journals (Sweden)

    Binns Colin W

    2009-01-01

    Full Text Available Abstract Background Rates of exclusive breastfeeding in China are relatively low and below national targets. The aim of this study was to document the factors that influence exclusive breastfeeding initiation in Zhejiang, PR China. Methods A cohort study of infant feeding practices was undertaken in Zhejiang Province, an eastern coastal region of China. A total of 1520 mothers who delivered in four hospitals located in city, suburb and rural areas during late 2004 to 2005 were enrolled in the study. Multivariate logistic regression analysis was used to explore factors related to exclusive breastfeeding initiation. Results On discharge from hospital, 50.3% of the mothers were exclusively breastfeeding their infants out of 96.9% of the mothers who had earlier initiated breastfeeding. Exclusive breastfeeding was positively related to vaginal birth, baby's first feed being breast milk, mother living in the suburbs or rural areas, younger age of mother, lower maternal education level and family income. Conclusion The exclusive breastfeeding rate in Zhejiang is only 50.3% on discharge and does not reach Chinese or international targets. A number of behaviours have been identified in the study that could be potentially incorporated into health promotion activities.

  6. Magnetic resonance imaging - guided vacuum-assisted breast biopsy: an initial experience in a community hospital

    International Nuclear Information System (INIS)

    To evaluate the effectiveness in diagnosing mammographically and sonographically occult breast lesions by using magnetic resonance imaging (MRI) guided vacuum-assisted breast biopsy in patients who presented to a community-based hospital with a newly established breast MRI program. The records of 142 consecutive patients, median age of 55 years, who had undergone MRI-guided biopsy at our institution between July 2006 and July 2007 were reviewed. From these patients, 197 mammographically and sonographically occult lesions were biopsied at the time of discovery. The pathology was then reviewed and correlated with the MRI findings. Cancer was present and subsequently discovered in 8% of the previously occult lesions (16/197) or 11% of the women studied (16/142). Of the cancerous lesions, 56% were invasive carcinomas (9/16) and 44% were ductal carcinomas in situ (7/16). Fourteen percent of the discovered lesions (28/197) were defined as high risk and included atypical ductal hyperplasia, atypical lobular hyperplasia, lobular carcinoma in situ, and radial scar. In total, occult cancerous and high-risk lesions were discovered in 22% of the found lesions (44/197) or 31% of the women who underwent MRI-guided biopsy (44/142). This study demonstrated that detection of cancerous and high-risk lesions can be significantly increased when an MRI-guided biopsy program is introduced at a community-based hospital. We believe that as radiologists gain confidence in imaging and histologic correlation, community-based hospitals can achieve similar rates of occult lesion diagnosis as those found in data emerging from academic institutions. (author)

  7. Sex reassignment surgery for male to female transsexuals: initial experience in Okayama university hospital.

    OpenAIRE

    Nagai, Atsushi; Tokuyama,Eijirou; Nanba,Yuzaburo; Tsutsui,Tetsuya; Kimata,Yoshihiro; Nakatsuka, Mikiya; Koshima, Isao; Saika,Takashi; NASU, YASUTOMO; KUMON, HIROMI

    2005-01-01

    The first case of sex reassignment surgery (SRS) in our hospital was performed in January 2001; as of February, 2005, 4 cases of MTF-SRS had been performed. In the 2 most recent cases, we used penile and scrotal skin flaps to avoid complications. The depth and width of the new vagina was made to be adequate for sexual intercourse. Future attention should be focused on devising a surgical technique that will help prevent the complications of partial necrosis of the epidermal skin and ...

  8. Evaluation of costs accrued through inadvertent continuation of hospital-initiated proton pump inhibitor therapy for stress ulcer prophylaxis beyond hospital discharge: a retrospective chart review

    Directory of Open Access Journals (Sweden)

    Shin S

    2015-04-01

    Full Text Available Sooyoung Shin Ajou University College of Pharmacy, Yeongtong-gu, Suwon-si, Gyeonggi-do, South Korea Background: Stress ulcers and related upper gastrointestinal bleeding are well-known complications in intensive care unit (ICU patients. Proton pump inhibitor (PPI-based stress ulcer prophylaxis (SUP has been widely prescribed in noncritically ill patients who are at low risk for clinically significant bleeding, which is then injudiciously continued after hospital discharge. This study aimed to evaluate the incidence of inappropriate prescribing of PPI-based preventative therapy in ICU versus non-ICU patients that subsequently continued postdischarge, and to estimate the costs incurred by the unwarranted outpatient continuation of PPI therapy.Methods: A retrospective review of patient data at a major teaching hospital in Korea was performed. During the 4-year study period, adult patients who were newly initiated on PPI-based SUP during hospital admission and subsequently discharged on a PPI without a medical indication for such therapy were captured for data analysis. The incidence rates of inappropriate prescribing of PPIs were compared between ICU and non-ICU patients, and the costs associated with such therapy were also examined.Results: A total of 4,410 patients, more than half of the inpatient-initiated PPI users, were deemed to have been inadvertently prescribed a PPI at discharge in the absence of a medical need for acid suppression. The incidence of inappropriate outpatient continuation of the prophylaxis was higher among ICU patients compared with non-ICU patients (57.7% versus 52.2%, respectively; P=0.001. The total expenditure accrued through the continuation of nonindicated PPI therapy was approximately US$40,175.Conclusion: This study confirmed that excess usage of PPIs for SUP has spread to low-risk, non-ICU patients. The overuse of unwarranted PPI therapy can incur large health care expenditure, as well as clinical complications

  9. Histerectomia Laparoscópica em um Hospital Geral Comunitário Experiência Inicial e Comparação de Custos Hospitalares Laparoscopic Hysterectomy in a Community General Hospital Initial Experience and Comparison of Hospital Costs

    Directory of Open Access Journals (Sweden)

    Randal Henrique de Oliveira

    2000-03-01

    Full Text Available Objetivo: comparar os custos hospitalares entre a histerectomia vaginal assistida por laparoscopia (HVAL e a histerectomia total abdominal (HTA, relatando a experiência inicial com a nova abordagem em um hospital geral comunitário. Pacientes e Métodos: foram comparados 11 casos de HVAL e 23 de HTA, realizados de setembro de 1998 a julho de 1999. Prontuários e demonstrativos das despesas hospitalares de cada paciente foram revistos para coletar as variáveis analisadas. Resultados: não houve diferença estat��stica entre os grupos quanto à idade, paridade e cirurgia abdominal prévia. A principal indicação cirúrgica para ambos os grupos foi leiomiomatose uterina. O grupo das HVAL apresentou tempo de internação menor, com mediana de 1 dia e o das HTA, de 2 dias (pPurpose: to compare hospital costs between laparoscopically assisted vaginal hysterectomy (LAVH and total abdominal hysterectomy (TAH, reporting the initial experience with the new approach in a communitary general hospital. Patients and Methods: eleven cases of LAVH and 23 of TAH, carried out from September 1998 to July 1999, were compared. Each patient's records and hospital charges were reviewed to collect the analyzed variables. Results: there was no statistical difference between the groups in relation to age, parity, and previous abdominal surgery. The main surgical indication for both groups was uterine leiomyomatosis. The LAVH group presented a shorter hospital stay with a median of one day, and the TAH group, of two days (p<0.01. LAVH showed to be 40.2% more expensive than TAH (p<0.01. Operating room charges contributed to the major part of hospital costs for both groups, corresponding to 79.8 and 57.9% of the total, for LAVH and TAH, respectively. LAVH infirmary charges were smaller than for TAH, with a statistically significant difference (p = 0.002. Conclusion: with shorter hospital stay and smaller infirmary costs, we demonstrated that LAVH provides better

  10. Racial and Ethnic Differences in Incident Hospitalized Heart Failure in Post Menopausal Women: The Women’s Health Initiative

    OpenAIRE

    Eaton, CB; Abdulbaki, AM; Margolis, KL; Manson, JE.; Limacher, M; L. Klein; Allison, MA; Robinson, JG; Curb, JD; Martin, LA; Liu, S; Howard, BV

    2012-01-01

    Background-The differences in the incidence of heart failure by race/ethnicity and the potential mechanisms for these differences are largely unexplored in women. Methods and Results-A total of 156 143 postmenopausal women free of self-reported heart failure enrolled from 1993 to 1998 at 40 clinical centers throughout the United States as part of the Women's Health Initiative and were followed up until 2005, for an average of 7.8 years, for incident hospitalized heart failure. Incident rates,...

  11. Rational use of antibiotics: a quality improvement initiative in hospital setting

    International Nuclear Information System (INIS)

    Objectives: To minimise irrational use of antibiotics by implementing guidelines for antibiotic usage in obstetrics and Gynaecology. Methods: The observational study was conducted from January to December 2010 at the maternity unit of Aga Khan Hospital for Women and children, Kharadar, a secondary care facility in Karachi, Pakistan. Data was collected from medical records related to the study period. Prophylactic antibiotics were given according to the American College of Obstetricians and Gynaecologists recommendation 2009. Surveillance was done by surgical site infection rates and infectious morbidity. Data was analysed on SPSS 13. Results: Therapeutic antibiotic use was rationalized, reducing the use of therapeutic antibiotics from 97% (n= 160/165) in January 2010 to 8% (n=10/125) in December 2010. Surgical site infection rates were less than 5%. Cost of antibiotics per patient decreased by 90%. Decrease in the length of stay and workload on nursing staff was also observed. Conclusion: Implementing guidelines for antibiotic use in obstetrics and gynaecology and translating it into our protocols was effective in decreasing the irrational antibiotic consumption and increasing the rational use of antibiotics in the hospital. (author)

  12. Improving growth in preterm infants during initial hospital stay: principles into practice.

    Science.gov (United States)

    Cooke, Richard J

    2016-07-01

    Despite recent innovations in nutritional care, postnatal growth failure between birth and hospital discharge remains a significant problem in preterm infants. Whether or not it is entirely preventable is unclear. What is clear is that feeding practices and growth outcomes vary widely between neonatal intensive care units (NICUs). This partly reflects lack of data in key areas but it also reflects inconsistent translation of principles into practice and limitations in the way infants are fed and growth monitored in the NICU. These issues will be reviewed, in the process underline the key roles that audit, standardised feeding protocol, individualised nutritional care and a nutritional support team play in improving outcome in these high-risk infants. PMID:26867763

  13. Ultrasound guided hydrostatic reduction of intussusception in children at Korle Bu teaching hospital: an initial experience

    International Nuclear Information System (INIS)

    Intussusceptions is the telescoping or invagination of a portion of intestine (intussusceptum) into an adjacent segment (intussuscipiens). It is one of the common causes of bowel obstruction in infants and toddlers. Sonography has now been accepted as a method for guiding hydrostatic reduction of intussusception with tap water, normal saline or Ringer’s lactate solution. This method is currently being used at Korle Bu Teaching Hospital. It is a very simple, efficient, economical and quick method of managing intussusception. The duration of the procedure ranges between two minutes and thirty minutes, with the majority being under ten minutes. A total of twenty intussusceptions were managed in eighteen patients over a nine month period. In fifteen patients (75%) the intussusception was reduced successfully. In five patients (25%), the procedure failed to reduce the intussusceptions. (author)

  14. Use of the Joint British Society cardiovascular risk calculator before initiating statins for primary prevention in hospital medicine: experience from a large university teaching hospital

    Directory of Open Access Journals (Sweden)

    Pankaj Garg

    2010-11-01

    Full Text Available Pankaj Garg, Prashanth Raju, Ewa Sondej, Erwin Rodrigues, Gershan DavisAintree Cardiac Centre, University Hospital Aintree, Liverpool, UKIntroduction: Statin therapy is a well established treatment for hyperlipidemia. However, little is known about prescribing of statins for primary prevention in the real world, and even less about what happens to patients requiring primary prevention who are seen in a secondary care setting. The purpose of this research was to investigate the appropriateness of statin prescriptions by using the Joint British Society cardiovascular disease (JBS CVD risk score for primary prevention in a large secondary care center.Methods: We retrospectively analyzed 500 consecutive patients in whom a statin prescription was initiated over a four-month period. We excluded patients who met secondary prevention criteria. We used the JBS CVD risk prediction chart to calculate 10-year composite risk. We also studied which statins were prescribed and their starting doses.Results: Of 500 patients consecutively started on statins in secondary care, 51 patients (10.2% were treated for primary prevention. Of these, seven (14% patients had a 10-year composite cardiovascular event risk of more than 20% (high-risk category, and were hence receiving appropriate therapy. Three main statins were prescribed for primary prevention, ie, atorvastatin (22 patients, 43%, simvastatin (25 patients, 49%, and pravastatin (four patients, 8%. The statins prescribed were initiated mainly at the 40 mg dose.Conclusions: Statin prescribing in secondary care for primary prevention is limited to about 10% of initiations. There is some overprescribing, because 86% of these patients did not require statins when risk-stratified appropriately. The majority of the prescriptions were for simvastatin 40 mg and atorvastatin 40 mg.Keywords: statins, primary prevention, hypercholesterolemia, cardiovascular disease, retrospective

  15. Survey of the initial management and imaging protocols for occult scaphoid fractures in UK hospitals

    International Nuclear Information System (INIS)

    The aim of this research was to survey how occult fractures of the scaphoid bone are both imaged and managed initially. A total of 832 questionnaires were sent via e-mail to active associate members of the British Orthopaedic Association. Included was a series of questions regarding the timing of initial and subsequent orthopaedic review of this group of patients and the use of serial radiographs and second-line imaging techniques. Nearly half of the UK's acute NHS trusts were represented (45%). The response rate was 16% (130 out of 832). Only 16% of respondents were aware of a local imaging protocol for the investigation of suspected fractures of the scaphoid. Ninety-four percent of respondents performed a second radiograph at first fracture clinic review. Fifty-eight percent used magnetic resonance imaging (MRI) as a second-line investigation; with computed tomography scan and radionuclide isotope bone scan being performed by 26% and 16% respondents, respectively. The survey revealed a wide variation in the management of occult fractures of the scaphoid. MRI has been shown to be both sensitive and specific in diagnosing occult carpal bone fractures. There is a need to standardise the management of these injuries to ensure early diagnosis and limit unnecessary wrist immobilisation. (orig.)

  16. Survey of the initial management and imaging protocols for occult scaphoid fractures in UK hospitals

    Energy Technology Data Exchange (ETDEWEB)

    Brookes-Fazakerley, S.D.; Kumar, A.J.S. [Countess of Chester Hospital NHS Foundation Trust, Department of Trauma and Orthopaedics, Chester (United Kingdom); Oakley, J. [Robert Jones and Agnes Hunt Orthopaedic and District Hospital NHS Trust, Oswestry, Shropshire (United Kingdom)

    2009-11-15

    The aim of this research was to survey how occult fractures of the scaphoid bone are both imaged and managed initially. A total of 832 questionnaires were sent via e-mail to active associate members of the British Orthopaedic Association. Included was a series of questions regarding the timing of initial and subsequent orthopaedic review of this group of patients and the use of serial radiographs and second-line imaging techniques. Nearly half of the UK's acute NHS trusts were represented (45%). The response rate was 16% (130 out of 832). Only 16% of respondents were aware of a local imaging protocol for the investigation of suspected fractures of the scaphoid. Ninety-four percent of respondents performed a second radiograph at first fracture clinic review. Fifty-eight percent used magnetic resonance imaging (MRI) as a second-line investigation; with computed tomography scan and radionuclide isotope bone scan being performed by 26% and 16% respondents, respectively. The survey revealed a wide variation in the management of occult fractures of the scaphoid. MRI has been shown to be both sensitive and specific in diagnosing occult carpal bone fractures. There is a need to standardise the management of these injuries to ensure early diagnosis and limit unnecessary wrist immobilisation. (orig.)

  17. A "migrant friendly hospital" initiative in Geneva, Switzerland: evaluation of the effects on staff knowledge and practices.

    Directory of Open Access Journals (Sweden)

    Patricia Hudelson

    Full Text Available BACKGROUND: International migration poses important challenges to European health care systems. The development of "migrant friendly hospitals" has been identified as a priority in both Europe and Switzerland. METHODS: A multi-pronged initiative was developed at Geneva University Hospitals (HUG to improve staff knowledge and use of existing "migrant friendly" resources. A self-administered questionnaire was sent pre and post-intervention to random samples of 4 major professional groups with direct patient contact at the HUG. The questionnaire assessed staff knowledge, attitudes and reported practices regarding the care of migrant patients. RESULTS: Overall response rate was 51% (N = 1460 in 2010 but only 19% (N = 761 in 2013 owing to an institutionally imposed change in survey method. Despite these difficulties, and after adjusting for sample differences, we found that respondents in 2013 were significantly more likely to have received training in how to organize an appointment with an interpreter, how to work with an interpreter and about health and social services available for migrant patients. Respondents were also significantly more likely to have used several Migrant Friendly structures at the HUG. Use of, preference for and perceived skill at working with professional interpreters all improved, and respondents were both more likely to be encouraged by their supervisors to use professional interpreters, and less likely to be encouraged to look for alternative solutions for communicating with non francophone patients. Finally, 2013 respondents encountered fewer difficulties caring for migrant patients, although lack of time and language barriers continued to be the most important sources of difficulty. CONCLUSION: Our results suggest that an institution-wide information campaign may contribute to increased awareness and use of migrant friendly resources by clinical staff. Hospital commitment and financing, along with inter

  18. Initial experience with intravenous pentobarbital sedation for children undergoing MRI at a tertiary care pediatric hospital: the learning curve

    International Nuclear Information System (INIS)

    Objective. Our purpose is to describe the initial experience with intravenous pentobarbital sedation in children undergoing MRI at a tertiary pediatric hospital to identify errors associated with inexperience. Subjects and methods. The study included the first 100 children sedated with intravenous pentobarbital prior to magnetic resonance examination at a tertiary pediatric hospital. The protocol included a maximum dose of 6 mg/kg administered in three divided doses with the total dose not to exceed 200 mg. Flow sheets documenting vital signs, administered drug doses, and adverse reactions were maintained contemporaneous to sedation. Results. Sedation was successful in 92 children. Of the eight children who failed sedation, three were at least 12 years old and three weighed more than 50 kg. χ2 tests identified significantly greater failure rates in children older than 11 years or weight greater than 50 kg. Two children had prolonged sedation after the maximum suggested dose was exceeded. Conclusions. The success rate was good, but could have been improved by restricting the use of pentobarbital to children less than 12 years of age and weighing less than 50 kg. Radiologists inexperienced with intravenous sedation should strictly observe the maximum suggested dose of pentobarbital to prevent prolonged sedation. (orig.)

  19. Predictors of mortality among HIV-infected patients initiating anti retroviral therapy at a tertiary care hospital in Eastern India

    Institute of Scientific and Technical Information of China (English)

    Ananya Bhowmik; Subhasis Bhandari; Rajyasree De; Subhasish Kamal Guha

    2012-01-01

    Objective: To assess early mortality and identify its predictors among the ART naive HIV-infected patients initiating anti retroviral therapy (ART) available free of cost at the ART Centres.Methods: A retrospective cohort analysis of routinely collected programme data was done for assessing mortality of all ART naive adult patients who received first-line ART at a government tertiary care hospital in eastern India during 1st March 2009 and 28th February 2010. Bivariate and multiple regression analyses of the baseline demographic, clinical and laboratory records using SPSS 15.0 were done to identify independent predictors of mortality. Results: The mortality rate at one year was estimated to be 7.66 (95% CI 5.84-9.83) deaths/100 patient-years and more than 50% of the deaths occurred during first three months of ART initiation with a median time interval of 73 days. Tuberculosis was the major cause of death. ART naive patients with baseline serum albumin <3.5 mg/dL were eight (OR 7.9; 95% CI: 3.8-16.5) at risk of death than those with higher serum albumin levels and patients with CD4 count <100 cells/μL were two times (OR 2.2;95% CI: 1.1-4.4) at risk of death compared to higher CD4 counts. Conclusions: Risk of mortality is increased when ART is initiated at advanced stages of immunosuppression denoted by low serum albumin levels and CD4 cell counts. This highlights the importance of early detection of HIV infection, early management of opportunistic infections including tuberculosis and timely initiation of the antiretroviral drugs in the resource-limited countries, now available free in the Indian national ART programme.

  20. Bystander-initiated chest compression-only CPR is better than standard CPR in out-of-hospital cardiac arrest

    OpenAIRE

    Cabrini, L; Biondi-Zoccai, G; Landoni, G; Greco, M.; Vinciguerra, F; Greco, T; Ruggeri, L; Sayeg, J; Zangrillo, A

    2010-01-01

    Introduction Out-of-hospital cardiac arrest has a low survival rate to hospital discharge. Recent studies compared a simplified form of CPR, based on chest compression alone versus standard CPR including ventilation. We performed systematic review and meta-analysis of randomized controlled trials, focusing on survival at hospital discharge. Methods We extensively searched the published literature on out-of hospital CPR for non traumatic cardiac arrest in different databases. Results We identi...

  1. The Evolution of the Council of Academic Hospitals of Ontario Statement of Principles--A Successful Harmonization Initiative

    Science.gov (United States)

    Porter, Katie; Lampson, Sarah

    2011-01-01

    To improve efficiency, consistency and transparency in clinical trial contract negotiations with industry sponsors, a Council of Academic Hospitals of Ontario (CAHO) committee facilitated the development of standard principles for member hospitals to follow during contract negotiation. Hospitals were encouraged to provide a link to the CAHO…

  2. Factors associated with initiation and exclusive breastfeeding at hospital discharge: late preterm compared to 37 week gestation mother and infant cohort

    Directory of Open Access Journals (Sweden)

    Ayton Jennifer

    2012-11-01

    Full Text Available Abstract Background To investigate and examine the factors associated with initiation of, and exclusive breastfeeding at hospital discharge of, late preterm (34 0/7 - 36 6/7 weeks compared to 37 week gestation (37 0/7 - 37 6/7 week mother and baby pairs. Methods A retrospective population-based cohort study using a Perinatal National Minimum Data Set and clinical medical records review, at the Royal Hobart Hospital, Tasmania, Australia in 2006. Results Late preterm and 37 week gestation infants had low rates of initiation of breastfeeding within one hour of birth, 31 (21.1% and 61 (41.5% respectively. After multiple regression analysis, late preterm infants were less likely to initiate breastfeeding within one hour of birth (OR 0.3 95% CI 0.1, 0.7 p = 0.009 and were less likely to be discharged exclusively breastfeeding from hospital (OR 0.4 95% CI 0.1, 1.0 p = 0.04 compared to 37 week gestation infants. Conclusion A late preterm birth is predictive of breastfeeding failure, with late preterm infants at greater risk of not initiating breastfeeding and/or exclusively breastfeeding at hospital discharge, compared with those infants born at 37 weeks gestation. Stratifying breastfeeding outcomes by gestational age groups may help to identify those sub-populations at greatest risk of premature cessation of breastfeeding.

  3. Association of National Initiatives to Improve Cardiac Arrest Management With Rates of Bystander Intervention and Patient Survival After Out-of-Hospital Cardiac Arrest

    DEFF Research Database (Denmark)

    Wissenberg, Mads; Lippert, Freddy K; Folke, Fredrik;

    2013-01-01

    IMPORTANCE Out-of-hospital cardiac arrest is a major health problem associated with poor outcomes. Early recognition and intervention are critical for patient survival. Bystander cardiopulmonary resuscitation (CPR) is one factor among many associated with improved survival. OBJECTIVE To examine...... temporal changes in bystander resuscitation attempts and survival during a 10-year period in which several national initiatives were taken to increase rates of bystander resuscitation and improve advanced care. DESIGN, SETTING, AND PARTICIPANTS Patients with out-of-hospital cardiac arrest for which...

  4. High initiation and long duration of breastfeeding despite absence of early skin-to-skin contact in Karen refugees on the Thai-Myanmar border: a mixed methods study

    Directory of Open Access Journals (Sweden)

    White Adrienne L

    2012-12-01

    Full Text Available Abstract Background Early skin-to-skin contact (SSC after birth is recommended as part of the United Nations Children’s Fund (UNICEF baby friendly health initiative to promote optimum breastfeeding. This paper reports rates of breastfeeding initiation and duration in a low resource environment, where early SSC is not practised, and explores views of pregnant women and midwives surrounding breastfeeding and swaddling. Methods Data from records from a single hospital on the Thai-Myanmar border where refugee women gave birth during a one-year period (2010 were used to determine breastfeeding initiation rates and the time of the first breastfeed, and duration of breastfeeding of the previous alive child in multigravidae. Focus group discussions (FGD were conducted to obtain information from pregnant women attending antenatal care about their intended or previous duration of breastfeeding and views on breastfeeding. Interviews with local midwives explored reasons for high rates of breastfeeding in this setting and the practice of newborn swaddling. Results Of 1404 live births in 2010 in Maela refugee camp there were 982 evaluable mother-newborn pairs, including 80 infants born before 37 weeks gestation. Initiation of breastfeeding within the first hour after birth and exclusive breastfeeding at discharge in term mother-newborn pairs was 91.2% (823/902 and 99.3% (896/902; and before 37 weeks gestation, 48.8% (39/80 and 98.8% (79/80. Reported duration of previous breastfeeding was 19 (range 2 to 72 months. During FGD all primigravidae (n = 17 intended to breastfeed and all multigravidae (n = 33 had previously breastfed; expected or previous duration of feeding was for more than one year or longer. The major theme identified during FGD was breastfeeding is “good”. Women stated their intention to breastfeed with certainty. This certainty was echoed during the interviews with midwifery staff. SSC requires a delay in early swaddling that in

  5. Implementation and evaluation of a multisite drug usage evaluation program across Australian hospitals - a quality improvement initiative

    Directory of Open Access Journals (Sweden)

    Robertson Marion B

    2011-08-01

    Full Text Available Abstract Background With the use of medicines being a broad and extensive part of health management, mechanisms to ensure quality use of medicines are essential. Drug usage evaluation (DUE is an evidence-based quality improvement methodology, designed to improve the quality, safety and cost-effectiveness of drug use. The purpose of this paper is to describe a national DUE methodology used to improve health care delivery across the continuum through multi-faceted intervention involving audit and feedback, academic detailing and system change, and a qualitative assessment of the methodology, as illustrated by the Acute Postoperative Pain Management (APOP project. Methods An established methodology, consisting of a baseline audit of inpatient medical records, structured patient interviews and general practitioner surveys, followed by an educational intervention and follow-up audit, is used. Australian hospitals, including private, public, metropolitan and regional, are invited to participate on a voluntary basis. De-identified data collected by hospitals are collated and evaluated nationally to provide descriptive comparative analyses. Hospitals benchmark their practices against state and national results to facilitate change. The educational intervention consists of academic detailing, group education, audit and feedback, point-of-prescribing prompts and system changes. A repeat data collection is undertaken to assess changes in practice. An online qualitative survey was undertaken to evaluate the APOP program. Qualitative assessment of hospitals' perceptions of the effectiveness of the overall DUE methodology and changes in procedure/prescribing/policy/clinical practice which resulted from participation were elicited. Results 62 hospitals participated in the APOP project. Among 23 respondents to the evaluation survey, 18 (78% reported improvements in the documentation of pain scores at their hospital. 15 (65% strongly agreed or agreed that

  6. Guideline-adherent initial intravenous antibiotic therapy for hospital-acquired/ventilator-associated pneumonia is clinically superior, saves lives and is cheaper than non guideline adherent therapy

    Directory of Open Access Journals (Sweden)

    Wilke MH

    2011-07-01

    Full Text Available Abstract Introduction Hospital-acquired pneumonia (HAP often occurring as ventilator-associated pneumonia (VAP is the most frequent hospital infection in intensive care units (ICU. Early adequate antimicrobial therapy is an essential determinant of clinical outcome. Organisations like the German PEG or ATS/IDSA provide guidelines for the initial calculated treatment in the absence of pathogen identification. We conducted a retrospective chart review for patients with HAP/VAP and assessed whether the initial intravenous antibiotic therapy (IIAT was adequate according to the PEG guidelines Materials and methods We collected data from 5 tertiary care hospitals. Electronic data filtering identified 895 patients with potential HAP/VAP. After chart review we finally identified 221 patients meeting the definition of HAP/VAP. Primary study endpoints were clinical improvement, survival and length of stay. Secondary endpoints included duration of mechanical ventilation, total costs, costs incurred on the intensive care unit (ICU, costs incurred on general wards and drug costs. Results We found that 107 patients received adequate initial intravenous antibiotic therapy (IIAT vs. 114 with inadequate IIAT according to the PEG guidelines. Baseline characteristics of both groups revealed no significant differences and good comparability. Clinical improvement was 64% over all patients and 82% (85/104 in the subpopulation with adequate IIAT while only 47% (48/103 inadequately treated patients improved (p Drug costs for the hospital stay were also lower (EUR 4,069 vs. EUR 4,833 yet not significant. The most frequent types of inadequate therapy were monotherapy instead of combination therapy, wrong type of penicillin and wrong type of cephalosporin. Discussion These findings are consistent with those from other studies analyzing the impact of guideline adherence on survival rates, clinical success, LOS and costs. However, inadequately treated patients had a higher

  7. The ESTHER hospital partnership initiative: a powerful levy for building capacities to combat the HIV pandemic in low-resource countries.

    Science.gov (United States)

    Raguin, Gilles

    2016-01-01

    Partnerships between hospitals in high income countries and low resource countries are uniquely capable of fulfilling the tripartite needs of care, training, and research required to address health care crises in low resource countries. Of particular interest, at a time when the EBOLA crisis highlights the weaknesses of health systems in resource-poor settings, the institutional resources and expertise of hospitals can also contribute to strengthening health systems with long-term sustainability.We describe a partnership network between French Hospitals and hospitals/health structures in 19 countries that demonstrates the power and efficacy of health partnership in the response to the HIV/AIDS pandemic in sub-Saharan Africa and south East Asia. Through the ESTHER initiative, the partnership network currently provides capacity development, care and treatment to over 165,000 HIV-positive patients at 87 urban and 92 peripheral sites in 17 countries and enrolls 19,000 new HIV positive patients, delivers psychosocial services to 120 000 people and tests more than 35,000 pregnant women for HIV annually. It also, engages communities and assists with the development of a robust electronic information system.Launched in 2002, the ESTHER (Ensemble pour une Solidarite Thérapeutique Hospitalière En Reseau) initiative has grown from small projects with a focus on access to antiretroviral treatment in a limited number of West African countries at its outset into a large and comprehensive HIV/AIDS-control system in Western and Central Africa. The partnership's rapid achievements in the fight against HIV/AIDS, combined with the comprehensive and long-term approach to countries' health care needs, suggest that this "twinning" and medical mentoring model can and should be duplicated and developed to address the ever more pressing demand for response to global health needs in low resource countries. PMID:27036882

  8. Taking Risk: Early Results From Teaching Hospitals' Participation in the Center for Medicare and Medicaid Innovation Bundled Payments for Care Improvement Initiative.

    Science.gov (United States)

    Kivlahan, Coleen; Orlowski, Janis M; Pearce, Jonathan; Walradt, Jessica; Baker, Matthew; Kirch, Darrell G

    2016-07-01

    The authors describe observations from the 27 teaching hospitals constituting the Association of American Medical Colleges (AAMC) cohort in the Center for Medicare and Medicaid Innovation (CMMI) Bundled Payments for Care Improvement (BPCI) initiative. CMMI introduced BPCI in August 2011 and selected the first set of participants in January 2013. BPCI participants enter into Medicare payment arrangements for episodes of care for which they take financial risk. The first round of participants entered risk agreements on October 1, 2013 and January 1, 2014. In April 2014, CMMI selected additional participants who started taking financial risk in 2015. Selected episodes include congestive heart failure (CHF), major joint replacement (MJR), and cardiac valve surgery. The AAMC cohort of participating hospitals selected clinical conditions on the basis of patient volume, opportunity to impact savings and quality, organizational and clinical team readiness, and prior process improvement experience. Early financial results suggest that focused attention to postacute care utilization and outcomes, rapid changes in care processes, program pricing rules, and team composition drove savings and losses. The first cohort of participants generated savings in MJR, CHF, and cardiac valve episodes; losses were experienced in stroke, percutaneous coronary intervention, and spine surgery. Although about one-quarter of U.S. teaching hospitals are participating in BPCI, the proliferation of existing and new payment models, as well as the 2015 announcement to increasingly pay providers according to value, mandates close scrutiny of program outcomes. The authors conclude by proposing additional opportunities for research related to alternative payment models. PMID:26886810

  9. Initial Management of Poisoned Patients in Emergency Medical Services and Non-poisoning Hospitals in Tehran: The Comparison between Expected and Performed Managements

    Directory of Open Access Journals (Sweden)

    Hossein Hassanian-Moghadam

    2014-06-01

    Full Text Available Background: There is no clear data on the adherence of emergency medical services (EMS paramedics and hospital staff rather than those working in poisoning centers to the guidelines for managing acutely poisoned patients in developing countries. Methods: During a 6-month period, all EMS-managed poisoned patients along with those initially managed in a non-poisoning center before being referred to a poisoning hospital in Tehran, Iran, were instructed. Then the indications for administrating the activated charcoal (AC as well as performing gastric lavage (GL and tracheal intubation were studied and compared to the recommended guidelines. Results: A total of 3347 cases, including 1859 males (55.6%, were evaluated. There were significant differences between expected and performed endotracheal intubations in both EMS and other medical centers (P-value = 0.002 and 0.001, respectively as well as the administration of GL and AC in other medical centers (P-values= 0.003 and 0.03, respectively. Conclusion: More extensive educational programs should be established to improve the preliminary management of poisoned patients performed by EMS paramedics and staff of hospitals other than poisoning centers.

  10. Bundled payment initiatives for Medicare and non-Medicare total joint arthroplasty patients at a community hospital: bundles in the real world.

    Science.gov (United States)

    Doran, James P; Zabinski, Stephen J

    2015-03-01

    In the setting of current United States healthcare reform, bundled payment initiatives and episode of care payment models for total joint arthroplasty (TJA) have become increasingly common. The following is a review of our results and experience in a community hospital with bundled payment initiatives for both non-Medicare and Medicare TJA patients since 2011. We have successfully decreased the cost of the TJA episode of care in comparison to our historical averages prior to 2011. This cost-reduction has primarily been achieved through decreased length of inpatient stay, increased discharge to home rather than to skilled nursing or inpatient rehabilitation facilities, reduction in implant cost, improvement in readmission rate and migration of cases to lower cost sites of service. PMID:25680450

  11. Target temperature management of 33°C and 36°C in patients with out-of-hospital cardiac arrest with initial non-shockable rhythm

    DEFF Research Database (Denmark)

    Frydland, Martin; Kjaergaard, Jesper; Erlinge, David;

    2015-01-01

    PURPOSE: Despite a lack of randomized trials in comatose survivors of out-of-hospital cardiac arrest (OHCA) with an initial non-shockable rhythm (NSR), guidelines recommend induced hypothermia to be considered in these patients. We assessed the effect on outcome of two levels of induced hypothermia...... in comatose patient resuscitated from NSR. METHODS: Hundred and seventy-eight patients out of 950 in the TTM trial with an initial NSR were randomly assigned to targeted temperature management at either 33°C (TTM33, n=96) or 36°C (TTM36, n=82). We assessed mortality, neurologic function (Cerebral...... prognosis. We found no effect of targeted temperature management at 33°C compared to 36°C in these patients....

  12. Cost-effectiveness of smoking cessation treatment initiated during psychiatric hospitalization: analysis from a randomized, controlled trial

    Science.gov (United States)

    Barnett, Paul G.; Wong, Wynnie; Jeffers, Abra; Hall, Sharon M.; Prochaska, Judith J.

    2016-01-01

    Objective We examined the cost-effectiveness of smoking cessation treatment for psychiatric inpatients. Method Smokers, regardless of intention to quit, were recruited during psychiatric hospitalization and randomized to receive stage-based smoking cessation services or usual aftercare. Smoking cessation services, quality of life, and biochemically-verified abstinence from cigarettes were assessed during 18-months of follow-up. Trial findings were combined with literature on changes in smoking status and the age and gender adjusted effect of smoking on health care cost, mortality, and quality of life in a Markov model of cost-effectiveness during a lifetime horizon. Results Among 223 smokers randomized between 2006 and 2008, the mean cost of smoking cessation services was $189 in the experimental treatment group and $37 in the usual care condition (p < 0.001). At the end of follow-up, 18.75% of the experimental group was abstinent from cigarettes, compared to 6.80% abstinence in the usual care group (p <0.05). The model projected that the intervention added $43 in lifetime cost and generated 0.101 additional Quality Adjusted Life Years (QALYs), an incremental cost-effectiveness ratio of $428 per QALY. Probabilistic sensitivity analysis found the experimental intervention was cost-effective against the acceptance criteria of $50,000/QALY in 99.0% of the replicates. Conclusions A cessation intervention for smokers identified in psychiatric hospitalization did not result in higher mental health care costs in the short-run and was highly cost-effective over the long-term. The stage-based intervention was a feasible and cost-effective way of addressing the high smoking prevalence in persons with serious mental illness. PMID:26528651

  13. Histerectomia Laparoscópica em um Hospital Geral Comunitário Experiência Inicial e Comparação de Custos Hospitalares Laparoscopic Hysterectomy in a Community General Hospital Initial Experience and Comparison of Hospital Costs

    OpenAIRE

    Randal Henrique de Oliveira; Antônio Alberto Nogueira; Álvaro Augusto Trigo; Francisco Spanó Neto; João Davanço Neto; Elias Dias Martins Jr.; Luciano Costa Marques

    2000-01-01

    Objetivo: comparar os custos hospitalares entre a histerectomia vaginal assistida por laparoscopia (HVAL) e a histerectomia total abdominal (HTA), relatando a experiência inicial com a nova abordagem em um hospital geral comunitário. Pacientes e Métodos: foram comparados 11 casos de HVAL e 23 de HTA, realizados de setembro de 1998 a julho de 1999. Prontuários e demonstrativos das despesas hospitalares de cada paciente foram revistos para coletar as variáveis analisadas. Resultados: não houve ...

  14. Perspectives of staff nurses of the reasons for and the nature of patient-initiated call lights: an exploratory survey study in four USA hospitals

    Directory of Open Access Journals (Sweden)

    Tzeng Huey-Ming

    2010-02-01

    Full Text Available Abstract Background Little research has been done on patient call light use and staff response time, which were found to be associated with inpatient falls and satisfaction. Nurses' perspectives may moderate or mediate the aforementioned relationships. This exploratory study intended to understand staff's perspectives about call lights, staff responsiveness, and the reasons for and the nature of call light use. It also explored differences among hospitals and identified significant predictors of the nature of call light use. Methods This cross-sectional, multihospital survey study was conducted from September 2008 to January 2009 in four hospitals located in the Midwestern region of the United States. A brief survey was used. All 2309 licensed and unlicensed nursing staff members who provide direct patient care in 27 adult care units were invited to participate. A total of 808 completed surveys were retrieved for an overall response rate of 35%. The SPSS 16.0 Window version was used. Descriptive and binary logistic regression analyses were conducted. Results The primary reasons for patient-initiated calls were for toileting assistance, pain medication, and intravenous problems. Toileting assistance was the leading reason. Each staff responded to 6 to 7 calls per hour and a call was answered within 4 minutes (estimated. 49% of staff perceived that patient-initiated calls mattered to patient safety. 77% agreed that that these calls were meaningful. 52% thought that these calls required the attention of nursing staff. 53% thought that answering calls prevented them from doing the critical aspects of their role. Staff's perceptions about the nature of calls varied across hospitals. Junior staff tended to overlook the importance of answering calls. A nurse participant tended to perceive calls as more likely requiring nursing staff's attention than a nurse aide participant. Conclusions If answering calls was a high priority among nursing tasks, staff

  15. HCAHPS Hospital Survey

    Data.gov (United States)

    U.S. Department of Health & Human Services — Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) Hospital Survey The intent of the HCAHPS initiative is to provide a standardized survey...

  16. Report from the Country of Georgia: Protecting and Promoting Breastfeeding through Regulation of Artificial-Feeding Marketing Practices

    OpenAIRE

    Nemsadze, Ketevan

    2004-01-01

    This paper highlights the southwest Asian country of Georgia's experience in creating efforts to protect and promote breastfeeding and to implement the International Code of Marketing of Breast-milk Substitutes. Since 1994, the country of Georgia (of the former Soviet Union) has successfully implemented the Baby-Friendly Hospital Initiative. In 1997–1998, Georgia conducted a study throughout the country's various regions to evaluate compliance with the International Code of Marketing of Breas...

  17. A Realistic Evaluation of Two Training Programs on Implementing Skin-to-Skin as a Standard of Care

    OpenAIRE

    Brimdyr, Kajsa; Widström, Ann-Marie; Cadwell, Karin; Svensson, Kristin; Turner-Maffei, Cynthia

    2012-01-01

    The authors used realistic evaluation to examine the real-world effectiveness of two 5-day training techniques on sustained optimal skin-to-skin practices that support Step 4 of the revised Baby-Friendly Hospital Initiative (BFHI). The authors found that education alone was insufficient to effect sustainable practice change. Exposure to the 5-day immersion model (Practice, Reflection, Education and training, Combined with Ethnography for Sustainable Success, or PRECESS) alone or combined with...

  18. Expansion of the ten steps to successful breastfeeding into neonatal intensive care

    DEFF Research Database (Denmark)

    Nyqvist, Kerstin Hedberg; Häggkvist, Anna-Pia; Hansen, Mette Ness;

    2012-01-01

    The World Health Organization/United Nations Children's Fund Baby-Friendly Hospital Initiative: Revised, Updated, and Expanded for Integrated Care (2009) identifies the need for expanding the guidelines originally developed for maternity units to include neonatal intensive care. For this purpose...... goal is to offer these documents to international health care, professional, and other nongovernmental organizations involved in lactation and breastfeeding support for mothers of infants who require special neonatal care....

  19. The Belgian trial with azithromycin for acute COPD exacerbations requiring hospitalization: an investigator-initiated study protocol for a multicenter, randomized, double-blind, placebo-controlled trial

    Science.gov (United States)

    Vermeersch, Kristina; Gabrovska, Maria; Deslypere, Griet; Demedts, Ingel K; Slabbynck, Hans; Aumann, Joseph; Ninane, Vincent; Verleden, Geert M; Troosters, Thierry; Bogaerts, Kris; Brusselle, Guy G; Janssens, Wim

    2016-01-01

    Background Long-term use of macrolide antibiotics is effective to prevent exacerbations in chronic obstructive pulmonary disease (COPD). As risks and side effects of long-term intervention outweigh the benefits in the general COPD population, the optimal dose, duration of treatment, and target population are yet to be defined. Hospitalization for an acute exacerbation (AE) of COPD may offer a targeted risk group and an obvious risk period for studying macrolide interventions. Methods/design Patients with COPD, hospitalized for an AE, who have a smoking history of ≥10 pack-years and had ≥1 exacerbation in the previous year will be enrolled in a multicenter, randomized, double-blind, placebo-controlled trial (NCT02135354). On top of a standardized treatment of systemic corticosteroids and antibiotics, subjects will be randomized to receive either azithromycin or placebo during 3 months, at an uploading dose of 500 mg once a day for 3 days, followed by a maintenance dose of 250 mg once every 2 days. The primary endpoint is the time-to-treatment failure during the treatment phase (ie, from the moment of randomization until the end of intervention). Treatment failure is a novel composite endpoint defined as either death, the admission to intensive care or the requirement of additional systemic steroids or new antibiotics for respiratory reasons, or the diagnosis of a new AE after discharge. Discussion We investigate whether azithromycin initiated at the onset of a severe exacerbation, with a limited duration and at a low dose, might be effective and safe in the highest risk period during and immediately after the acute event. If proven effective and safe, this targeted approach may improve the treatment of severe AEs and redirect the preventive use of azithromycin in COPD to a temporary intervention in the subgroup with the highest unmet needs. PMID:27099485

  20. Long-term outcome of infective endocarditis: A study on patients surviving over one year after the initial episode treated in a Finnish teaching hospital during 25 years

    Directory of Open Access Journals (Sweden)

    Engblom Erik

    2008-04-01

    Full Text Available Abstract Background Only a few previous studies have focused on the long-term prognosis of the patients with infective endocarditis (IE. Our purpose was to delineate factors potentially associated with the long-term outcome of IE, recurrences of IE and requirement for late valve surgery. Methods A total of 326 episodes of IE in 303 patients were treated during 1980–2004 in the Turku University Hospital. We evaluated the long-term outcome and requirement for late valve surgery for 243 of these episodes in 226 patients who survived longer than 1 year after the initial admission. Factors associated with recurrences were analysed both for the 1-year survivors and for all 303 patients. Results The mean (SD follow-up time for the 1-year survivors was 11.5 (7.3 years (range 25 days to 25.5 years. The overall survival was 95%, 82%, 66%, 51% and 45% at 2, 5, 10, 15 and 20 years. In age and sex adjusted multivariate analyses, significant predictors for long-term overall mortality were heart failure within 3 months of admission (HR 1.97, 95% CI 1.27 to 3.06; p = 0.003 and collagen disease (HR 2.54, 95% CI 1.25 to 5.19; p = 0.010 or alcohol abuse (HR 2.39, 95% CI 1.30 to 4.40; p = 0.005 as underlying conditions, while early surgery was significantly associated with lower overall mortality rates (HR 0.31, 95% CI 0.17 to 0.58; p Conclusion Heart failure during the index episode of IE was the complication, which significantly predicted a poor long-term outcome. Patients who underwent surgery during the initial hospitalisation for IE faired significantly better than those who did not.

  1. The Comparison Of The Efficacy Of Cefriaxon Monotherapy With Ceftazidim Plus Amikacin As Initial Empiric Antibiotic Therapy In Febrile Neutropenic Patients Emam Hospital (2000-2001

    Directory of Open Access Journals (Sweden)

    Mohammadi S M

    2003-07-01

    Full Text Available Neutropenic state with fever is exactly regarded as a medical emergency, with high mortality and morbidity rate, unless treated urgently and correctly. Every attempt should be made to find and establish the offending organism, but postponing treatment until obtaining culture results is not advised. Controversy exist on which antibiotic regimen to be used while waiting for culture results. Many antibiotic regiments both monotherapy or combination treatments have been used with varying result. The objective of this study is to compare the efficacy of cefriaxon monothenapy with ceftazidim. Plus Amikacin as initial empiric antibiotic therapy in febrile neutropenic patients."nMaterials and Methods: We performed a randomized, single blind clinical trial in 57 adult (age>12 years, neutropenic (PMN<1000 patients with fever (Temperature, oral >38.5c in Hematology ward, Imam khomeini hospital. After careful physical exam and obtaining blood & urine samples for culture, the patients were randomized to each of the two arms: Cefriaxon 2 grams daily, intravenously (arm A and; Ceftazidim 2g thrice daily plus amikacin 500 mg twice daily (arm B. Patients with shock, organ failure or previous antibiotic intake (during 48 hour before fever were excluded. If needed, dose adjustment of drugs were allowed. Effervescence in 3 days following initiation of treatment, lasting 48 hours or more, were regarded as effective (positive result."nResults: During a twelve months period of study, a total of 57 patients (17female, 40male were included. They were randomly selected to each arm of empirical treatment. Of 28 pts in arm A, 19 (67 percent, the treatment was effective, compared to 15 of 29 (51.7 percent in groups B. The duration of fever after initiation of treatment was 37.9 ± 17 hours in arm A and 40. 1 ± 20 h in arm B. Blood and / or urine culture was equally positive in two arms (25 percent in arm A and 27.6 percent in arm B."nConclusion: Cefriaxon monotherapy is at

  2. Improving documentation of clinical care within a clinical information network – an essential initial step in efforts to understand and improve care in kenyan hospitals

    OpenAIRE

    English, MC; Tuti, T; Paton, C.; Malla, L; Clinical Information Network

    2016-01-01

    In many low income countries health information systems are poorly equipped to provide detailed information on hospital care and outcomes. Information is thus rarely used to support practice improvement. We describe efforts to tackle this challenge and to foster learning concerning collection and use of information. This could improve hospital services in Kenya. We are developing a Clinical Information Network, a collaboration spanning 14 hospitals, policy makers and researchers with the g...

  3. Effectiveness of a government-organized and hospital-initiated treatment for multidrug-resistant tuberculosis patients--a retrospective cohort study.

    Directory of Open Access Journals (Sweden)

    Pei-Chun Chan

    Full Text Available BACKGROUND: In contrast to the conventional model of hospital-treated and government directly observed treatment (DOT for multidrug-resistant tuberculosis (MDR-TB patient care, the Taiwan MDR-TB Consortium (TMTC was launched in May 2007 with the collaboration of five medical care groups that have provided both care and DOT. This study aimed to determine whether the TMTC provided a better care model for MDR-TB patients than the conventional model. METHODS AND FINDINGS: A total of 651 pulmonary MDR-TB patients that were diagnosed nation-wide from January 2000-August 2008 were enrolled. Of those, 290 (45% MDR-TB patients whose initial sputum sample was taken in January 2007 or later were classified as patients in the TMTC era. All others were classified as patients in the pre-TMTC era. The treatment success rate at 36 months was better in the TMTC era group (82% than in the pre-TMTC era group (61% (p<0.001. With multiple logistic regressions, diagnosis in the TMTC era (adjusted odds ratio (aOR 2.8, 95% confidence interval (CI 1.9-4.2 was an independent predictor of a higher treatment success rate at 36 months. With the time-dependent proportional hazards method, a higher treatment success rate was still observed in the TMTC era group compared to the pre-TMTC era group (adjusted hazard ratio 6.3, 95% CI 4.2-9.5. CONCLUSION: The improved treatment success observed in the TMTC era compared to the pre-TMTC era is encouraging. The detailed TMTC components that contribute the most to the improved outcome will need confirmation in follow-up studies with large numbers of MDR-TB patients.

  4. FacilitiesHospitals_HOSPITAL

    Data.gov (United States)

    Vermont Center for Geographic Information — This datalayer contains point locations of all major community, regional, comprehensive health, and healthcare provider hospitals in the state of Vermont. The...

  5. Fatores associados ao início da amamentação em uma cidade do sul do Brasil Factors associated with the initiation of breastfeeding in a city in the south of Brazil

    Directory of Open Access Journals (Sweden)

    Regina Bosenbecker da Silveira

    2008-03-01

    . Univariate, bivariate and logistic regression analyses were performed. RESULTS: 2,741 mothers were interviewed and 35.5% breastfed in the first hour after delivery. Mothers who began breastfeeding earliest were the younger ones, those who had a lower level of education and lower family income. Mothers whose deliveries were cesarean had a risk two times higher of not breastfeeding in the first hour of the newborn's life. CONCLUSIONS: it is important that delivery be performed in an appropriate manner, since c-sections increase the time of separation between mother and baby. It would be worthwhile encouraging expansion of the "Baby-Friendly Hospital Initiative" in order to promote and protect breastfeeding.

  6. The ESTHER hospital partnership initiative: a powerful levy for building capacities to combat the HIV pandemic in low-resource countries

    OpenAIRE

    Raguin, Gilles; ,

    2016-01-01

    Partnerships between hospitals in high income countries and low resource countries are uniquely capable of fulfilling the tripartite needs of care, training, and research required to address health care crises in low resource countries. Of particular interest, at a time when the EBOLA crisis highlights the weaknesses of health systems in resource-poor settings, the institutional resources and expertise of hospitals can also contribute to strengthening health systems with long-term sustainabil...

  7. Promotion of hand hygiene strengthening initiative in a Nigerian teaching hospital: implication for improved patient safety in low-income health facilities

    OpenAIRE

    Chigozie Jesse Uneke; Chinwendu Daniel Ndukwe; Patrick Gold Oyibo; Kingsley Onuoha Nwakpu; Richard Chukwuka Nnabu; Nittita Prasopa-Plaizier

    2014-01-01

    Background: Health care-associated infection remains a significant hazard for hospitalized patients. Hand hygiene is a fundamental action for ensuring patient safety. Objective: To promote adoption of World Health Organization Hand Hygiene Guidelines to enhance compliance among doctors and nurses and improve patient safety. Methods: The study design was a cross sectional intervention in a Federal Teaching Hospital South-eastern Nigeria. Interventions involved training/education; introduct...

  8. FacilitiesHospitals_HOSPITAL

    Data.gov (United States)

    Vermont Center for Geographic Information — This data layer contains point locations of all major community, regional, comprehensive health, and healthcare provider hospitals in the state of Vermont. The...

  9. Hospitals; hospitals13

    Data.gov (United States)

    University of Rhode Island Geospatial Extension Program — Hospital Facilities information was compiled from several various sources. Main source was the RI Department of Health Facilities Regulation database, License 2000....

  10. Breastfeeding in Oman-The way forward

    OpenAIRE

    Sinani, Mohammed AL

    2008-01-01

    Child health programs in Oman are considered to be successful. Before 1970, the infant mortality rate was predictable to be 214 out of 1,000 live births declined to 25 by 1992. The significance of breastfeeding in the survival and health of the children was known by the health authorities and the Baby Friendly Hospitals Initiative (BFHI) was launched in the 1990’s. The WHO and UNICEF embarked on a national certification of all hospitals in Oman and by 1999 all marked hospitals were thus certi...

  11. Hospital Compare

    Data.gov (United States)

    U.S. Department of Health & Human Services — Hospital 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...

  12. 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...

  13. Norovirus - hospital

    Science.gov (United States)

    Gastroenteritis - norovirus; Colitis - norovirus; Hospital acquired infection - norovirus ... fluids ( dehydration ). Anyone can become infected with norovirus. Hospital patients who are very old, very young, or ...

  14. Radiation dose in coronary angiography and intervention: initial results from the establishment of a multi-centre diagnostic reference level in Queensland public hospitals

    Energy Technology Data Exchange (ETDEWEB)

    Crowhurst, James A, E-mail: jimcrowhurst@hotmail.com [The Prince Charles Hospital, Chermside, Queensland (Australia); School of Medicine, University of Queensland, St. Lucia, Brisbane, Queensland (Australia); Whitby, Mark [The Prince Charles Hospital, Chermside, Queensland (Australia); Biomedical Technology Services, Health Services Support Agency, Queensland Health, Herston, Queensland (Australia); Thiele, David [Biomedical Technology Services, Health Services Support Agency, Queensland Health, Herston, Queensland (Australia); Halligan, Toni [Allied Health Professions' Office of Queensland, Brisbane, Queensland (Australia); Westerink, Adam [Royal Brisbane and Women' s Hospital, Herston, Queensland (Australia); Crown, Suzanne [Princess Alexandra Hospital, Woolloongabba, Queensland (Australia); Milne, Jillian [Cardiac Clinical Informatics Unit - Queensland Health, Herston, Queensland (Australia); The Prince Charles Hospital, Chermside, Queensland (Australia)

    2014-09-15

    Radiation dose to patients undergoing invasive coronary angiography (ICA) is relatively high. Guidelines suggest that a local benchmark or diagnostic reference level (DRL) be established for these procedures. This study sought to create a DRL for ICA procedures in Queensland public hospitals. Data were collected for all Cardiac Catheter Laboratories in Queensland public hospitals. Data were collected for diagnostic coronary angiography (CA) and single-vessel percutaneous intervention (PCI) procedures. Dose area product (P{sub KA}), skin surface entrance dose (K{sub AR}), fluoroscopy time (FT), and patient height and weight were collected for 3 months. The DRL was set from the 75th percentile of the P{sub KA.} 2590 patients were included in the CA group where the median FT was 3.5 min (inter-quartile range = 2.3–6.1). Median K{sub AR} = 581 mGy (374–876). Median P{sub KA} = 3908 uGym{sup 2} (2489–5865) DRL = 5865 uGym{sup 2}. 947 patients were included in the PCI group where median FT was 11.2 min (7.7–17.4). Median K{sub AR} = 1501 mGy (928–2224). Median P{sub KA} = 8736 uGym{sup 2} (5449–12,900) DRL = 12,900 uGym{sup 2}. This study established a benchmark for radiation dose for diagnostic and interventional coronary angiography in Queensland public facilities.

  15. Radiation dose in coronary angiography and intervention: initial results from the establishment of a multi-centre diagnostic reference level in Queensland public hospitals

    International Nuclear Information System (INIS)

    Radiation dose to patients undergoing invasive coronary angiography (ICA) is relatively high. Guidelines suggest that a local benchmark or diagnostic reference level (DRL) be established for these procedures. This study sought to create a DRL for ICA procedures in Queensland public hospitals. Data were collected for all Cardiac Catheter Laboratories in Queensland public hospitals. Data were collected for diagnostic coronary angiography (CA) and single-vessel percutaneous intervention (PCI) procedures. Dose area product (PKA), skin surface entrance dose (KAR), fluoroscopy time (FT), and patient height and weight were collected for 3 months. The DRL was set from the 75th percentile of the PKA. 2590 patients were included in the CA group where the median FT was 3.5 min (inter-quartile range = 2.3–6.1). Median KAR = 581 mGy (374–876). Median PKA = 3908 uGym2 (2489–5865) DRL = 5865 uGym2. 947 patients were included in the PCI group where median FT was 11.2 min (7.7–17.4). Median KAR = 1501 mGy (928–2224). Median PKA = 8736 uGym2 (5449–12,900) DRL = 12,900 uGym2. This study established a benchmark for radiation dose for diagnostic and interventional coronary angiography in Queensland public facilities

  16. Hospital Variation in Survival After In‐hospital Cardiac Arrest

    OpenAIRE

    Merchant, Raina M.; Berg, Robert A.; Yang, Lin; Becker, Lance B.; Groeneveld, Peter W.; Chan, Paul S.; ,

    2014-01-01

    Background In‐hospital cardiac arrest (IHCA) is common and often fatal. However, the extent to which hospitals vary in survival outcomes and the degree to which this variation is explained by patient and hospital factors is unknown. Methods and Results Within Get with the Guidelines‐Resuscitation, we identified 135 896 index IHCA events at 468 hospitals. Using hierarchical models, we adjusted for demographics comorbidities and arrest characteristics (eg, initial rhythm, etiology, arrest locat...

  17. Cues-to-Action in Initiating Lesbian, Gay, Bisexual, and Transgender-Related Policies Among Magnet Hospital Chief Nursing Officers: A Demographic Assessment.

    Science.gov (United States)

    Klotzbaugh, Ralph; Spencer, Gale

    2015-01-01

    This study explored Magnet Chief Nursing Officers' cues-to-action initiating lesbian, gay, bisexual, or transgender (LGBT)-specific policies. Homonegativity has a negative effect on employee recruitment and retention and patient satisfaction. Little has been known about what cues-to-action might initiate LGBT inclusive training. Surveys were mailed to 343 Chief Nursing Officers. Cues-to-action survey was used to assess what inspires initiation of LGBT training. Demographic surveys were used to assess what impact variables might have on cues-to-action. Age, sex, religiosity, location, and region had significant effect on cues-to-action. Developing demographically informed training and policies for LGBT equality in health care is suggestive of greater employee and patient satisfaction. PMID:25932818

  18. [The founding of Zemun Hospital].

    Science.gov (United States)

    Milanović, Jasmina; Milenković, Sanja; Pavlović, Momcilo; Stojanović, Dragos

    2014-01-01

    This year Zemun Hospital--Clinical Hospital Center Zemun celebrates 230th anniversary of continuous work, thus becoming the oldest medical facility in Serbia.The exact date of the hospital founding has been often questioned in history. Various dates appeared in the literature, but the most frequent one was 25th of February 1784. Until now, the document which confirms this has never been published. This article represents the first official publication of the document which confirms that Zemun Hospital was indeed founded on this date. The first hospitals started emerging in Zemun when the town became a part of the Habsburg Monarchy. The first sanitary facility ever formed was the"Kontumac"--a quarantine established in 1730. Soon after, two more confessional hospitals were opened.The Serbian (Orthodox) Hospital was founded before 1769, whereas the German (Catholic) Hospital started working in 1758. Both hospitals were financed, amongst others, by the Town Hall--the Magistrate. In order to improve efficiency of these hospitals, a decision was made to merge them into a single City Hospital. It was founded on 25th February 1784, when the General Command ordered the Magistrate of Zemun to merge the financess of all existing hospitals and initiate the construction of a new building. Although financially united, the hospitals continued working in separate buildings over a certain period of time.The final, physical merging of these hospitals was completed in 1795. PMID:25233701

  19. The founding of Zemun Hospital

    Directory of Open Access Journals (Sweden)

    Milanović Jasmina

    2014-01-01

    Full Text Available This year Zemun Hospital - Clinical Hospital Center Zemun celebrates 230th anniversary of continuous work, thus becoming the oldest medical facility in Serbia. The exact date of the hospital founding has been often questioned in history. Various dates appeared in the literature, but the most frequent one was 25th of February 1784. Until now, the document which confirms this has never been published. This article represents the first official publication of the document which confirms that Zemun Hospital was indeed founded on this date. The first hospitals started emerging in Zemun when the town became a part of the Habsburg Monarchy. The first sanitary facility ever formed was the “Kontumac” - a quarantine established in 1730. Soon after, two more confessional hospitals were opened. The Serbian (Orthodox Hospital was founded before 1769, whereas the German (Catholic Hospital started working in 1758. Both hospitals were financed, amongst others, by the Town Hall - the Magistrate. In order to improve efficiency of these hospitals, a decision was made to merge them into a single City Hospital. It was founded on 25th February 1784, when the General Command ordered the Magistrate of Zemun to merge the financess of all existing hospitals and initiate the construction of a new building. Although financially united, the hospitals continued working in separate buildings over a certain period of time. The final, physical merging of these hospitals was completed in 1795. [Projekat Ministarstva nauke Republike Srbije, br. 47030

  20. Mental hospitals in India.

    Science.gov (United States)

    Krishnamurthy, K; Venugopal, D; Alimchandani, A K

    2000-04-01

    This review traces the history of the mental hospital movement, initially on the world stage, and later in India, in relation to advances in psychiatric care. Mental hospitals have played a significant role in the evolution of psychiatry to its present statusThe earliest hospital in India were established during the British colonial rule. They served as a means to isolate mentally ill persons from the societal mainstream and provide treatments that were in vogue at the time. Following India's independence, there has been a trend towards establishing general hospital psychiatry units and deinstitutionalization, while at the same time improving conditions in the existing mental hospitals.Since 1947, a series of workshops of superintendents was conducted to review the prevailing situations in mental hospitals and to propose recommendations to improve the same. Implementation of the Mental Health Act, 1987, and grovernmental focus upon mental hospital reform have paved way for a more specific and futuristic role for mental hospitals in planning psychiatric services for the new millenium, especially for severe mental illnesses. PMID:21407925

  1. Nursing Facility Initiative Annual Report

    Data.gov (United States)

    U.S. Department of Health & Human Services — This annual report summarizes impacts from the Initiative to Reduce Avoidable Hospitalizations among Nursing Facility Residents in 2014. This initiative is designed...

  2. Drawing Hospital Foodscapes

    DEFF Research Database (Denmark)

    Tvedebrink, Tenna Doktor Olsen; Fisker, Anna Marie; Kirkegaard, Poul Henning

    This poster presents a series of drawings depicting the initial considerations made with the Ph.D. project for an improved ‘Interior Design for Food’ in a Danish hospital ward. The project concerns a study on the ontological and symbolic interrelationship possibly existing between food and...

  3. Hospital Hints

    Science.gov (United States)

    ... and your family. They can help find homecare, rehabilitation, social services, long-term care, and support groups. Inside the Hospital Hospitals have many patient-care areas. For example, the intensive care unit (also called the ICU) has special equipment and staff to care for ...

  4. Early Mortality during Initial Treatment of Tuberculosis in Patients Co-Infected with HIV at the Yaounde Central Hospital, Cameroon: An 8-Year Retrospective Cohort Study (2006-2013.

    Directory of Open Access Journals (Sweden)

    Jean Joel R Bigna

    Full Text Available Understanding contributors to mortality during the initial phase of tuberculosis (TB treatment in patients co-infected with HIV would guide targeted interventions to improve survival. The aim of this study was to ascertain the incidence of death during the initial 2 months (new cases and 3 months (retreatment cases of TB treatment and to assess correlates of mortality in HIV co-infected patients.We conducted a hospital-based retrospective cohort study from January 2006 to December 2013 at Yaoundé Central Hospital, Cameroon. We reviewed medical records to identify co-infected TB/HIV inpatients aged 15 years and older who died during TB treatment. Death was defined as any death occurring during TB treatment, as per World Health Organization recommendations. We collected socio-demographic, clinical and laboratory data. We conducted multivariable logistic binary regression analysis to identify factors associated with death during the intensive phase of TB treatment. Magnitudes of associations were expressed by adjusted odds ratio (aOR with 95% confidence interval. A p value < 0.05 was considered statistically significant.The 99 patients enrolled had a mean age of 39.5 (standard deviation 10.9 years and 53% were male. Patients were followed for 276.3 person-months of observation (PMO. Forty nine patients were died during intensive phase of TB treatment. Death incidence during the intensive phase of TB treatment was 32.2 per 100 PMO. Having a non-AIDS comorbidity (aOR 2.47, 95%CI 1.22-5.02, p = 0.012, having extra-pulmonary TB (aOR 1.89, 95%CI 1.05-3.43, p = 0.035, and one year increase in duration of known HIV infection (aOR 1.23, 95%CI 1.004-1.49 were independently associated with death during the intensive phase of TB treatment.Mortality incidence during intensive phase of TB treatment was high among TB/HIV co-infected patients during TB treatment; and strongly associated with extra pulmonary TB suggesting advanced stage of immunosuppression and

  5. 新生儿院内纯母乳喂养情况及其影响因素分析%Status of in-hospital exclusive breastfeeding and its influence factors

    Institute of Scientific and Technical Information of China (English)

    张悦; 王惠珊; 罗倩; 张丽晋; 王硕; 姚礼明

    2012-01-01

    [Objective] To find out the status of in-hospital exclusive breastfeeding in urban areas of China,and explore the influence factors to in-hospital exclusive breastfeeding. {Methods] 1 288 data were collected in 32 maternity and children health care hospitals of provincial and municipal levels. The breastfeeding status within 24 hours were recalled. The associations between in-hospital exclusive breastfeeding with socio-demographic variables, pregnant and puerperal factors and hospital related factors were explored by Chi-square analyses and binary Logistic regression analyses. [Results] The rate of in-hospital exclusive breastfeeding was 46. 6%. Logistic regression showed that high education level,high family income were negative effects to in-hospital exclusive breastfeeding;sucking breast within 30 minutes after-born,breastfeeding during the first day and without feeding sugar water were positive effects to in-hospital exclusive breastfeeding. [Conclusion] Actively carrying out baby-friendly hospital implementation, promoting breastfeeding of focus person, will promote breastfeeding success.%[目的]了解我国城市地区新生儿院内纯母乳喂养情况及孕产情况、产后医院护理行为对院内纯母乳喂养的影响. [方法]以全国32所省、市级妇幼保健院的1 288例产妇为研究对象,采用单因素和Logistic回归法分析产妇出院前24 h内母乳喂养情况及影响院内纯母乳喂养的可能因素. [结果] 出院前产妇的纯母乳喂养率为46.6%.文化程度高、家庭收入高对纯母乳喂养有负性作用;生后半小时早开奶、生后第1天母乳喂养、不添加糖水对纯母乳喂养是正性作用. [结论]积极贯彻爱婴医院的措施,开展有针对性的母乳喂养干预,将有利于促进住院期间母乳喂养成功.

  6. Hospital fundamentals.

    Science.gov (United States)

    Althausen, Peter L; Hill, Austin D; Mead, Lisa

    2014-07-01

    Under the current system, orthopaedic trauma surgeons must work in some form of hospital setting as our primary service involves treatment of the trauma patient. We must not forget that just as a trauma center cannot exist without our services, we cannot function without their support. As a result, a clear understanding of the balance between physicians and hospitals is paramount. Historical perspective enables physicians and hospital personnel alike to understand the evolution of hospital-physician relationship. This process should be understood upon completion of this chapter. The relationship between physicians and hospitals is becoming increasingly complex and multiple forms of integration exist such as joint ventures, gain sharing, and co-management agreements. For the surgeon to negotiate well, an understanding of hospital governance and the role of the orthopaedic traumatologist is vital to success. An understanding of the value provided by the traumatologist includes all aspects of care including efficiency, availability, cost effectiveness, and research activities. To create effective and sustainable healthcare institutions, physicians and hospitals must be aligned over a sustained period of time. Unfortunately, external forces have eroded the historical basis for the working relationship between physicians and hospitals. Increased competition and reimbursement cuts, coupled with the increasing demands for quality, efficiency, and coordination and the payment changes outlined in healthcare reform, have left many organizations wondering how to best rebuild the relationship. The principal goal for the physician when partnering with a hospital or healthcare entity is to establish a sustainable model of service line management that protects or advances the physician's ability to make impactful improvements in quality of patient care, decreases in healthcare costs, and improvements in process efficiency through evidence-based practices and protocols. PMID

  7. Hospital Inspections

    Data.gov (United States)

    U.S. Department of Health & Human Services — Welcome to hospitalinspections.org, a website run by the Association of Health Care Journalists (AHCJ) that aims to make federal hospital inspection reports easier...

  8. Hospital Variation in Survival After In‐hospital Cardiac Arrest

    Science.gov (United States)

    Merchant, Raina M.; Berg, Robert A.; Yang, Lin; Becker, Lance B.; Groeneveld, Peter W.; Chan, Paul S.

    2014-01-01

    Background In‐hospital cardiac arrest (IHCA) is common and often fatal. However, the extent to which hospitals vary in survival outcomes and the degree to which this variation is explained by patient and hospital factors is unknown. Methods and Results Within Get with the Guidelines‐Resuscitation, we identified 135 896 index IHCA events at 468 hospitals. Using hierarchical models, we adjusted for demographics comorbidities and arrest characteristics (eg, initial rhythm, etiology, arrest location) to generate risk‐adjusted rates of in‐hospital survival. To quantify the extent of hospital‐level variation in risk‐adjusted rates, we calculated the median odds ratio (OR). Among study hospitals, there was significant variation in unadjusted survival rates. The median unadjusted rate for the bottom decile was 8.3% (range: 0% to 10.7%) and for the top decile was 31.4% (28.6% to 51.7%). After adjusting for 36 predictors of in‐hospital survival, there remained substantial variation in rates of in‐hospital survival across sites: bottom decile (median rate, 12.4% [0% to 15.6%]) versus top decile (median rate, 22.7% [21.0% to 36.2%]). The median OR for risk‐adjusted survival was 1.42 (95% CI: 1.37 to 1.46), which suggests a substantial 42% difference in the odds of survival for patients with similar case‐mix at similar hospitals. Further, significant variation persisted within hospital subgroups (eg, bed size, academic). Conclusion Significant variability in IHCA survival exists across hospitals, and this variation persists despite adjustment for measured patient factors and within hospital subgroups. These findings suggest that other hospital factors may account for the observed site‐level variations in IHCA survival. PMID:24487717

  9. Initial approach of patients admitted to third level hospitals with systemic inflamatory response syndrome Enfoque inicial de los pacientes admitidos a hospitales de tercer nivel con síndrome de respuesta inflamatoria sistémica (SRIS

    Directory of Open Access Journals (Sweden)

    Fabián Alberto Jaimes Barragán

    2000-04-01

    Full Text Available Objective: To know the initial approach of patients with diagnosis of SIRS from infectious origin in emergency rooms. Design: Analytic observational study of a concurrent cohort. Setting: Emergency rooms of Hospital Universitario San Vicente de Paúl (HUSVP and Hospital General de Medellín (HGM. Patients: Admitted through emergency rooms with non-traumatic SIRS between August, 1998, and March, 1999, older than 14 and with suspicion of infection as one of the main diagnosis at admission. Measurements: Description of the associated diseases frequency, the risk factors and findings on basic physical examination; also the usefulness of diagnostic tools, previous antibiotic use and empirical antibiotic therapy at the time of admission. We used chi2 or Fisher´s exact test to compare proportions. Results: 502 patients were admitted. The main antecedents were chronic obstructive pulmonary disease (COPD (21.5% and trauma or previous surgery (18.7%; vital signs were determined as follows: heart rate in 100%, breath rate in 94.8%, blood pressure in 99.2%, temperature in 80.3%, Glasgow scale in 75.6% of the patients. Laboratory requests were done in the following proportions : white blood cell count in 98.4%, chest X rays in 71.1%, platelet count in 94.4% and creatinine determination in 89% of patients. In 26.5% of the patients cultures were not requested; blood cultures were done in 48.8% of the patients and results were positive in 19.2% of the specimens. In 22.3% of the patients antibiotics had previously been used but this fact did not show association with the growth of microorganisms or the prescription of empiric antibiotic therapy in the emergency room (p=0.65. Conclusions: All of the signs that define SIRS are not determined in patients with suspected infection; neurological state, as determined by the Glasgow scale, and temperature, although being mandatory parameters in emergency room patients, are not determined in 25% of the patients

  10. Survival after in-hospital Cardiopulmonary Resuscitation

    OpenAIRE

    M Adib Hajbaghery; H. Akbari; GA. Mousavi

    2005-01-01

    Background: During recent years, cardiopulmonary resuscitation (CPR) in hospital has received much attention. However, the survival rate of CPR in Iran’s hospitals is unknown. This study was designed to evaluate outcome of in-hospital CPR in Kashan. Methods: A longitudinal case registry study was conducted on all cases of in-hospital CPR during 6 months at 2002. Necessary data including; age, sex, underlying disease, working shift, time from cardiac arrest until initiating of CPR and unt...

  11. Academic Hospitality

    Science.gov (United States)

    Phipps, Alison; Barnett, Ronald

    2007-01-01

    Academic hospitality is a feature of academic life. It takes many forms. It takes material form in the hosting of academics giving papers. It takes epistemological form in the welcome of new ideas. It takes linguistic form in the translation of academic work into other languages, and it takes touristic form through the welcome and generosity with…

  12. Hospital Malnutrition

    OpenAIRE

    Asumadu-Sarkodie, Samuel

    2012-01-01

    Malnutrition seen in hospitals usually occurs as some form of protein-energy malnutrition (PEM). Primary PEM results from an acute or chronic deficiency of both protein and calories. Secondary PEM, or cachexia, results from a disease or medical condition such as cancer or gastrointestinal disease that alters requirements or impairs utilization of nutrients.

  13. Hospitality and hostility in hospitals

    DEFF Research Database (Denmark)

    Jensen, Tina Blegind; Aanestad, Margunn

    2007-01-01

    The purpose of this paper is to discuss the adoption of healthcare information systems (HIS) from a user perspective. Our case study concerns how a group of orthopaedic surgeons experienced and reacted to the adoption and mandatory use of an Electronic Patient Record system in a Danish hospital. We...... propose to use the concepts of hospitality and hostility to turn our attention to the interaction between the host (the surgeons) and the guest (the information system) and consider how the boundaries between them evolved in the everyday work practices. As an alternative to previous studies on technology...

  14. [In-hospital emergency management].

    Science.gov (United States)

    Jantzen, Tanja; Fischer, Matthias; Müller, Michael P; Seewald, Stephan; Wnent, Jan; Gräsner, Jan-Thorsten

    2013-06-01

    5-10% of in-hospital patients are affected by adverse events, 10% of these requiring CPR. Standardized in-hospital emergency management may improve results, including reduction of mortality, hospital stay and cost. Early warning scores and clinical care outreach teams may help to identify patients at risk and should be combined with standard operation procedure and consented alarm criteria. These teams of doctors and nurses should be called for all in hospital emergencies, providing high-end care and initiate ICU measures at bedside. In combination with standard means of documentation assessment and evaluation--including entry in specific registers--the quality of in-hospital emergency management and patient safety could be improved. PMID:23828085

  15. Improving Hospital Breastfeeding Policies in New York State: Development of the Model Hospital Breastfeeding Policy

    OpenAIRE

    Hawke, Bethany A.; Dennison, Barbara A.; Hisgen, Stephanie

    2013-01-01

    The public health importance of breastfeeding, especially exclusive breastfeeding, is gaining increased recognition. Despite a strong evidence base that key hospital maternity practices (Ten Steps to Successful Breastfeeding) impact breastfeeding initiation and exclusivity in the hospital and breastfeeding duration post-discharge, they are not widely implemented. In 2009, written hospital breastfeeding policies were collected from all New York State (NYS) hospitals providing maternity care se...

  16. Fostering the practice of rooming-in in newborn care

    Directory of Open Access Journals (Sweden)

    Saurabh R. Shrivastava

    2013-09-01

    Full Text Available Practice of rooming-in meant that baby and mother stayed together in the same room day and night in the hospital, right from the time of delivery till the time of discharge. Adoption of rooming-in offers multiple benefits to the newborn, mother, and mother-child as a unit. It is a cost-effective approach wherefewer instruments are required and spares additional manpower. Rooming-in endeavors the opportunity to contribute signifi cantly in the child’s growth, development and survival by assisting in timely initiation of breastfeeding. To ensure universal application of rooming-in in hospitals, a comprehensive and technically sound strategy should be formulated and implemented with active participation of healthcare professionals. Measures such as advocating institutional delivery through outreach awareness activities; adoption of baby-friendly hospital initiative; inculcating a sense of ownership among health professionals, can be strategically enforced for better maternal and child health related outcomes.

  17. Evaluation of supportive breastfeeding hospital practices: a community perspective Evaluación de prácticas hospitalarias de lactancia: una perspectiva comunitaria Avaliação de práticas hospitaleres de lactancia de apoio: uma perspectiva comunitária

    Directory of Open Access Journals (Sweden)

    MYUNGHAN CHOI

    2010-12-01

    Full Text Available Study objectives: (1 describe the existing supportive hospital breastfeeding practices in a major urban region and (2 determine if supportive hospital breastfeeding practices are influenced by hospital characteristics. Methods: A cross-sectional telephone survey of all hospitals with maternity services (N = 21 in Maricopa County, Arizona (USA, was conducted between July 2009 and March 2010. This major urban county, which includes Phoenix, is the fourth largest city in the USA. Supportive breastfeeding practices were 12 maternity care practices consistent with WHO Baby Friendly Hospital Initiative Ten Steps. Hospital characteristics measured were professional breastfeeding services available, institutional ownership, number of births per year, births paid for by public funds, and the level of care provided. Descriptive and inferential statistics were conducted. Results: The total number of supportive practices ranged from 5 to 10 (M = 7.52; SD = 1.53. Two practices were uniformly implemented; the remainder varied from low (> 25% to moderate (50-75% levels of implementation. 86% of hospitals had widespread use of supplements and provided gift bags containing formula. The number of Board Certified Lactation Consultants (IBCLCs employed by a hospital was the only variable predicting higher levels of supportive practices. Facility ownership status was significantly correlated with the number of IBCLCs. Discussion: The differences in supportive hospital practices among hospitals suggest the effectiveness of IBCLCs in changing practice; however, additional research is needed to further explore this thesis. Findings of this study, while unique to the community studied, were consistent with a number of findings reported by researchers around the globe.Objetivos del estudio: (1 describir las prácticas de lactancia hospitalaria de apoyo en una gran región urbana y (2 determinar si las prácticas de lactancia hospitalaria de apoyo están bajo la

  18. ANALISA PENERAPAN SISTEM PADA HOSPITALITY INDUSTRY

    OpenAIRE

    Steeve Haryanto

    2014-01-01

    Analysis on the application of the system hospitality industry aims to determine whether the system from outside has a considerable influence on the number of luxury hotels in Jakarta as well as the factors that influence in picking the hospitality industry service system. The results of this survey are expected to be a consideration in implementing an information system in the field of hospitality industry. The method used in this paper is a literature review and analysis. The initi...

  19. Hospitals for sale.

    Science.gov (United States)

    Costello, Michael M; West, Daniel J; Ramirez, Bernardo

    2011-01-01

    The pace of hospital merger and acquisition activity reflects the economic theory of supply and demand: Publicly traded hospital companies, private equity funds, and large nonprofit hospital systems are investing capital to purchase and operate freestanding community hospitals at a time when many of those hospitals find themselves short of capital reserves and certain forms of management expertise. But the sale of those community hospitals also raises questions about the impact of absentee ownership on the communities which those hospitals serve. PMID:21864058

  20. How Major Public Hospital Initiative to Meet the Medical Insurance Reform under New Health-care Reform%大型公立医院如何适应新医改下的医保改革

    Institute of Scientific and Technical Information of China (English)

    李晓平; 余艳红; 许崇伟

    2011-01-01

    Through the study of medical insurance reform measure and trend under the situation, of new medical health-care reform, according to the practice of major public hospital, the paper discusses the influence of medical insurance reform, and provides feasible suggestions for public hospital.%通过研究新医改形势下的医保改革措施及趋势,根据大型公立医院的实践,探讨医保改革对大型公立医院的影响,并对大型公立医院如何主动适应医保改革提出可行性建议.

  1. A role for pharmacists in community-based post-discharge warfarin management: protocol for the 'the role of community pharmacy in post hospital management of patients initiated on warfarin' study

    Directory of Open Access Journals (Sweden)

    Bereznicki Luke RE

    2011-01-01

    Full Text Available Abstract Background Shorter periods of hospitalisation and increasing warfarin use have placed stress on community-based healthcare services to care for patients taking warfarin after hospital discharge, a high-risk period for these patients. A previous randomised controlled trial demonstrated that a post-discharge service of 4 home visits and point-of-care (POC International Normalised Ratio (INR testing by a trained pharmacist improved patients' outcomes. The current study aims to modify this previously trialled service model to implement and then evaluate a sustainable program to enable the smooth transition of patients taking warfarin from the hospital to community setting. Methods/Design The service will be trialled in 8 sites across 3 Australian states using a prospective, controlled cohort study design. Patients discharged from hospital taking warfarin will receive 2 or 3 home visits by a trained 'home medicines review (HMR-accredited' pharmacist in their 8 to 10 days after hospital discharge. Visits will involve a HMR, comprehensive warfarin education, and POC INR monitoring in collaboration with patients' general practitioners (GPs and community pharmacists. Patient outcomes will be compared to those in a control, or 'usual care', group. The primary outcome measure will be the proportion of patients experiencing a major bleeding event in the 90 days after discharge. Secondary outcome measures will include combined major bleeding and thromboembolic events, death, cessation of warfarin therapy, INR control at 8 days post-discharge and unplanned hospital readmissions from any cause. Stakeholder satisfaction will be assessed using structured postal questionnaire mailed to patients, GPs, community pharmacists and accredited pharmacists at the completion of their study involvement. Discussion This study design incorporates several aspects of prior interventions that have been demonstrated to improve warfarin management, including POC INR

  2. Eradicating reliance on free artificial milk.

    Science.gov (United States)

    Srinivas, Ganga L; Swiler, Kristin B; Marsi, Vicki A; Taylor, Sarah N

    2015-02-01

    Hospitals that set forth to obtain Baby-Friendly Hospital designation often face considerable challenges in implementing the purchase of formula and supplies at a fair market rate as outlined in the International Code of Marketing of Breast-milk Substitutes. Some of the challenges include difficulty tracking products in use and volumes used and obtaining pricing information from manufacturers of artificial milk. We report on our experience with assessing these factors, with an example of calculations used to arrive at fair market pricing, which might benefit other institutions seeking Baby-Friendly Hospital designation. PMID:25288607

  3. Hospital Outpatient PPS Partial Hospitalization Program LDS

    Data.gov (United States)

    U.S. Department of Health & Human Services — Hospital Outpatient Prospective Payment System (OPPS) Partial Hospitalization Program LDS This file contains select claim level data and is derived from 2010 claims...

  4. Can hospitals compete on quality? Hospital competition.

    Science.gov (United States)

    Sadat, Somayeh; Abouee-Mehrizi, Hossein; Carter, Michael W

    2015-09-01

    In this paper, we consider two hospitals with different perceived quality of care competing to capture a fraction of the total market demand. Patients select the hospital that provides the highest utility, which is a function of price and the patient's perceived quality of life during their life expectancy. We consider a market with a single class of patients and show that depending on the market demand and perceived quality of care of the hospitals, patients may enjoy a positive utility. Moreover, hospitals share the market demand based on their perceived quality of care and capacity. We also show that in a monopoly market (a market with a single hospital) the optimal demand captured by the hospital is independent of the perceived quality of care. We investigate the effects of different parameters including the market demand, hospitals' capacities, and perceived quality of care on the fraction of the demand that each hospital captures using some numerical examples. PMID:25711185

  5. Random output and hospital performance.

    Science.gov (United States)

    Barros, Pedro Pita

    2003-11-01

    Many countries are under pressure to reform health care financing and delivery. Hospital care is one part of the health system that is under scrutiny. Private management initiatives are a possible way to increase efficiency in health care delivery. This motivates the interest in developing methodologies to assess hospital performance, recognizing hospitals as a different sort of firm. We present a simple way to describe hospital production: hospital output as a change in the distribution of survival probabilities. This output definition allows us to separate hospital production from patients' characteristics. The notion of "better performance" has a precise meaning: (first-order) stochastic dominance of a distribution of survival probabilities over another distribution. As an illustration, we compare, for an important DRG, private and public management and find that private management performs better, mainly in the range of high-survival probabilities. The measured performance difference cannot be attributed to input prices or to economies of scale and/or scope. It reflects pure technological and organisational differences. PMID:14686628

  6. Hospitals as health educators

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000862.htm Hospitals as health educators To use the sharing features ... health education, look no further than your local hospital. From health videos to yoga classes, many hospitals ...

  7. Patient survey (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. Structural Measures - Hospital

    Data.gov (United States)

    U.S. Department of Health & Human Services — A list of hospitals and the availability of structural measures at that hospital. A structural measure reflects the environment in which hospitals care for...

  9. Critical Access Hospitals (CAH)

    Science.gov (United States)

    ... will not. Each hospital must perform its own financial analysis to determine if being a Prospective Payment System (PPS) hospital or a CAH would result in a better financial return. For financially distressed hospitals, even if CAH ...

  10. Surgery, Hospitals, and Medications

    Science.gov (United States)

    ... OTC products that are not commonly stocked in hospital pharmacies. Examples include: Salagen ® , Evoxac ® , and Restasis ® Eye drops, ... of your medication will be sent to the hospital pharmacy for verification. Depending on hospital policy, you may ...

  11. Exclusive breast-feeding practice and associated factors in Enugu, Nigeria.

    Science.gov (United States)

    Aghaji, Margaret N

    2002-01-01

    A cross-sectional questionnaire survey was conducted among 235 infant-mother pairs in five Baby Friendly pairs in five Baby Friendly Hospitals in Enugu-Nigeria in 1998. The aims were to study their breast-feeding practices and associated factors. The exclusive breast-feeding rate was 33.3% while the predominant breast-feeding rate was 50.2%. Factors associated with exclusive breast-feeding included infants' birth order (P = 0.015), fathers' education (P =0.0244), mothers' education (P = 0.000001), occupation (P = 0.0069) and parity (P = 0.004). However, the infants' age (P = 0.054) and sex (P = 0.403), mothers' age (P = 0.2005), number of breast-feeding counseling attendances (P = 0.0883) and the breast-feeding initiator (P = 0.473) were comparable irrespective of breast-feeding practice. In the mothers' perspectives, the commonest reasons for not breastfeeding exclusively included; insufficient breast milk (58,37.0%) and the sociocultural practice of giving water to babies because of the hot climate (52,33.1%). For an improvement in the exclusive breast-feeding rate of this population, health workers should highlight to mothers the dangers of water supplementation and the dynamics of breastmilk supply through health education, home visits and the formation of community based lactation support groups. PMID:12081350

  12. The architecture of enterprise hospital information system.

    Science.gov (United States)

    Lu, Xudong; Duan, Huilong; Li, Haomin; Zhao, Chenhui; An, Jiye

    2005-01-01

    Because of the complexity of the hospital environment, there exist a lot of medical information systems from different vendors with incompatible structures. In order to establish an enterprise hospital information system, the integration among these heterogeneous systems must be considered. Complete integration should cover three aspects: data integration, function integration and workflow integration. However most of the previous design of architecture did not accomplish such a complete integration. This article offers an architecture design of the enterprise hospital information system based on the concept of digital neural network system in hospital. It covers all three aspects of integration, and eventually achieves the target of one virtual data center with Enterprise Viewer for users of different roles. The initial implementation of the architecture in the 5-year Digital Hospital Project in Huzhou Central hospital of Zhejiang Province is also described. PMID:17281875

  13. Evaluation methods for hospital facilities

    DEFF Research Database (Denmark)

    Fronczek-Munter, Aneta

    2013-01-01

    according to focus areas and proposes which evaluation methods to use in different building phases of healthcare facilities. Hospital evaluations with experts and users are also considered; their subjective view on space, function, technology, usability and aesthetics. Results & solutions: This paper...... presents the different methods for evaluating buildings in use in a new model, the Evaluation Focus Flower, and proposes which evaluation methods are suitable for various aims and building phases, i.e. which is giving best input for the initial briefing process of new hospital facilities with ambition of...... creating buildings with enhanced usability. Additionally various evaluation methods used in hospital cases in Denmark and Norway are presented. Involvement of users is proposed, not just in defining requirements but also in co-creation/design and evaluation of solutions. The theories and preliminary...

  14. Hospital marketing revisited.

    Science.gov (United States)

    Costello, M M

    1987-05-01

    With more hospitals embracing the marketing function in their organizational management over the past decade, hospital marketing can no longer be considered a fad. However, a review of hospital marketing efforts as reported in the professional literature indicates that hospitals must pay greater attention to the marketing mix elements of service, price and distribution channels as their programs mature. PMID:10283019

  15. Valoración nutricional al ingreso hospitalario: iniciación al estudio entre distintas metodologías Nutritional assessment at the time of hospital-admission: study initiation smong different methodologies

    Directory of Open Access Journals (Sweden)

    L. Villamayor Blanco

    2006-04-01

    Full Text Available Antecedentes y Objetivos: Las altas cifras iniciales de prevalencia de desnutrición en los enfermos hospitalizados-cercanos al 40%- es un dato preocupante. Esto permite deducir que la identificación precoz de enfermos desnutridos o en riesgo de estarlo, mediante métodos de valoración nutricional eficaces puede constituir una herramienta fundamental de cara a la planificación nutricional. El objetivo del presente trabajo ha sido aplicar a un mismo grupo de pacientes distintos métodos de valoración nutricional (objetivos y subjetivos a su ingreso hospitalario, a fin de valorar el grado de efectividad para su aplicación en la clínica. Ámbito, Pacientes e Intervenciones: Se diseña un estudio prospectivo y aleatorio, en el cual se incluyen 50 pacientes ingresados en nuestro hospital entre el 1 de octubre y el 31 de diciembre del 2004, siendo desestimados 9 casos por fallos en las analíticas. En los tres primeros días de estancia hospitalaria se les realiza antropometría(peso, talla, circunferencia del brazo y medida del pliegue tricipital, bioquímica (hemograma, alb��mina, prealbúmina,proteína ligada al retinol, transferrina y colesterol dos encuestas de valoración nutricional (Valoración Subjetiva Global (VSG y Mini Nutricional Assessment (MNA. Resultados: Se ha aplicado el test de χ² para comparar los resultados obtenidos de los diferentes métodos objetivos, por separado y en conjunto, con métodos MNA y VSG, estableciéndose las siguientes comparaciones:Antropometría/MNA, Bioquímica/MNA, Inmunología/ MNA, Chang/MNA, Antropometría/VSG, Bioquímica/VSG, Inmunología/VSG, Chang/VSG y MNA/VSG.La significación estadística se ha considerado para un valor de p Background and objectives: The elevated prevalence figures of hyponutrition in hospitalized patients -near 40%- is an issue of concern. This allows deducing that early identification of malnourished, or at risk for hyponutrition, patients by means of effective

  16. Hypoglycemia in the hospital

    OpenAIRE

    Shomali, Mansur

    2011-01-01

    Hypoglycemia is a common adverse event affecting hospitalized patients with diabetes. This paper reviews the data regarding optimization of glucose in hospitalized patients, discusses the scope and significance of hypoglycemia in the hospital, and makes recommendations on how to reduce the risk of this serious adverse event. Keywords: hypoglycemia; hospital; diabetes; insulin(Published: 18 July 2011)Citation: Journal of Community Hospital Internal Medicine Perspectives 2011, 1: 7217 - DOI: 10...

  17. Initial Research on Standard Electronic Management Mode of Large-Scale Storage in Hospital Drug Storehouse%医院药库大库存电子化规范化管理模式初探

    Institute of Scientific and Technical Information of China (English)

    曾斌; 冯浩; 刘凯南

    2011-01-01

    目的 为医院药品仓储供需链衔接管理建立电子化、规范化管理提供参考.方法 论证引进医院药品仓储模糊聚类分析的多准则ABC供需链衔接库存管理;采用Excel和PASS等软件技术建立药品信息系统,以药品标准编码为基础与医院信息系统(HIS系统)联网,以实现医院药库大库存电子化、规范化管理.结果 实现了医院药品库存数量和金额的双重管理,省时省力,药品库存金额控制在l 500万元左右的合理范围,药品月转次数达每周1~3次,节省了医院资金成本,降低了过期药品损失及立体仓库运行成本,防止了药品管理不善造成的医疗风险.结论 运用这种模糊聚类分析的多准则ABC供需链衔接库存管理模式,效果良好,可以推广.%Objective To provide some reference for setting up the electronic and standard management on the hospital supply chain transfer in drug storehouse. Methods To discuss, prove and adopt the multicriteria optimization for ABC inventory classification in fuzzy clustering analysis to manage the supply chain transfer in our drug storehouse. A drug information system was built by Excel and PASS software, which was connected with the hospital information system (HIS) based on the standard drug coding so as to realize the electronization and standardization of the management of large - scale drug store. Results Time and energy were saved by simultaneous double management of the drug storage amount and financing. The drug storage amount of money was controlled under a reasonable range around 15 million yuan. The monthly turnover reached 1-3 times every week. The new management method saved the capital cost, reduced the expiry drug loss extensively, decreased the solid storehouse operating cost and prevent the medical risk caused by the drug poor management. Conclusion The multicriteria optimization for ABC inventory classification in fuzzy clustering analysis is practical with better effects

  18. Breastfeeding support in neonatal intensive care

    DEFF Research Database (Denmark)

    Maastrup, Ragnhild; Bojesen, Susanne Norby; Kronborg, Hanne; Hallström, Inger

    2012-01-01

    Background: The incidence of breastfeeding of preterm infants is affected by the support provided at the hospital and in the neonatal intensive care unit (NICU). However, policies and guidelines promoting breastfeeding vary both nationally and internationally. Objectives: The aim of this survey was...... to describe breastfeeding support in Danish NICUs, where approximately 98% of mothers initiate lactation. Methods: A national survey of all 19 Danish NICUs was conducted in 2009. Four NICUs were at designated Baby-Friendly hospitals, and 5 had a lactation consultant. In all NICUs, it was possible for...... some parents to stay overnight; 2 units had short restrictions on parents' presence. Five NICUs had integrated postpartum care for mothers. Breastfeeding policies, written guidelines, and systematic breastfeeding training for the staff were common in most NICUs. Seventeen NICUs recommended starting...

  19. Pay for Performance: Are Hospitals Ready and Willing?

    OpenAIRE

    Suzanne Felt-Lisk; Mary Laschober

    2006-01-01

    Public and private payers are developing hospital care pay for performance (P4P) initiatives as part of a broader national movement to improve the quality and cost-effectiveness of health care services. These initiatives augment or reduce payments to a hospital on the basis of its performance on a predefined set of quality measures. This issue brief is based on Mathematica’s study that examined hospital public reporting of quality information. The study included a nationally representative su...

  20. Pay for Performance Are Hospitals Ready and Willing

    OpenAIRE

    Suzanne Felt-Lisk Mary A Laschober

    2006-01-01

    Public and private payers are developing hospital care pay for performance (P4P) initiatives as part of a broader national movement to improve the quality and cost-effectiveness of health care services. These initiatives augment or reduce payments to a hospital on the basis of its performance on a predefined set of quality measures. This issue brief is based on Mathematica’s study that examined hospital public reporting of quality information. The study included a nationally representative ...

  1. Campaign supports new name for TX hospital. Effort expands children's hospital's image and increases awareness.

    Science.gov (United States)

    2007-01-01

    For years, the North Texas Hospital for Children at Medical City in Dallas struggled with its brand awareness. It's long-winded name was largely unknown among the city's 1.2 million residents. The hospital needed a new name and it needed one fast. The year 2005 proved to be both a burden and an opportunity for the 311-bed pediatric hospital. It survived a legal battle with a local competitor for the right to use the word "children's" in its name, created a new identity, and launched a three-year branding initiative to introduce its new name: Medical City Children's Hospital. PMID:17601087

  2. Hospital demand for physicians.

    Science.gov (United States)

    Morrisey, M A; Jensen, G A

    1990-01-01

    This article develops a derived demand for physicians that is general enough to encompass physician control, simple profit maximization and hospital utility maximization models of the hospital. The analysis focuses on three special aspects of physician affiliations: the price of adding a physician to the staff is unobserved; the physician holds appointments at multiple hospitals, and physicians are not homogeneous. Using 1983 American Hospital Association data, a system of specialty-specific demand equations is estimated. The results are consistent with the model and suggest that physicians should be concerned about reduced access to hospitals, particularly as the stock of hospitals declines. PMID:10104050

  3. Hospitable Classrooms: Biblical Hospitality and Inclusive Education

    Science.gov (United States)

    Anderson, David W.

    2011-01-01

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

  4. The application of hospitality elements in hospitals.

    Science.gov (United States)

    Wu, Ziqi; Robson, Stephani; Hollis, Brooke

    2013-01-01

    In the last decade, many hospital designs have taken inspiration from hotels, spurred by factors such as increased patient and family expectations and regulatory or financial incentives. Increasingly, research evidence suggests the value of enhancing the physical environment to foster healing and drive consumer decisions and perceptions of service quality. Although interest is increasing in the broader applicability of numerous hospitality concepts to the healthcare field, the focus of this article is design innovations, and the services that such innovations support, from the hospitality industry. To identify physical hotel design elements and associated operational features that have been used in the healthcare arena, a series of interviews with hospital and hotel design experts were conducted. Current examples and suggestions for future hospitality elements were also sought from the experts, academic journals, and news articles. Hospitality elements applied in existing hospitals that are addressed in this article include hotel-like rooms and decor; actual hotels incorporated into medical centers; hotel-quality food, room service, and dining facilities for families; welcoming lobbies and common spaces; hospitality-oriented customer service training; enhanced service offerings, including concierges; spas or therapy centers; hotel-style signage and way-finding tools; and entertainment features. Selected elements that have potential for future incorporation include executive lounges and/or communal lobbies with complimentary wireless Internet and refreshments, centralized controls for patients, and flexible furniture. Although the findings from this study underscore the need for more hospitality-like environments in hospitals, the investment decisions made by healthcare executives must be balanced with cost-effectiveness and the assurance that clinical excellence remains the top priority. PMID:23424818

  5. Hospital-acquired pneumonia

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/000146.htm Hospital-acquired pneumonia To use the sharing features on this page, please enable JavaScript. Hospital-acquired pneumonia is an infection of the lungs ...

  6. Staph infections - hospital

    Science.gov (United States)

    ... or skin cysts. Anyone can get a staph infection. Hospital patients can get staph infections of the skin: ... for and promptly reporting any sign of wound infections Many hospitals encourage patients to ask their providers if they ...

  7. Hospital Compare - Archived Data

    Data.gov (United States)

    U.S. Department of Health & Human Services — Hospital Compare is a consumer-oriented website that provides information on how well hospitals provide recommended care to their patients. This information can...

  8. Pre-hospital thrombolysis.

    Science.gov (United States)

    Vaishnav, Aditi; Vaishnav, Avani; Khandekar, Santosh; Vaishnav, Sudhir

    2011-12-01

    Coronary heart disease (CHD) is a major cause of mortality in India. Patients in India, who have acute coronary syndromes, have a higher rate of STEMI than do patients in developed countries. Since most of these patients are poor, they are less likely to get evidence-based treatments, and have a greater 30-day mortality. Reduction of delays in access to hospital and provision of affordable treatments could reduce this. Treatment regimes for AMI should aim to open the artery as soon as possible and as wide as possible. In patients suitable for thrombolytic treatment, time is critical and reperfusion should be initiated as soon as possible. Some adjunctive therapies are also beneficial, in particular, the antiplatelet agent aspirin, which should be given in the prehospital setting when a diagnosis of AMI is suspected. Despite availability of good treatment, mortality from AMI is showing no further reduction due to the prehospital phase and in-hospital delays. Thrombolysis is almost always delivered to patients after arriving in hospital, losing valuable time (and hence heart muscle). Newer drugs combined with recognition of improved outcomes have prompted attempts to decrease the time from symptom onset to treatment delivery via Pre Hospital Thrombolysis (PHT). However, PHT is significantly superior to in-hospital thrombolysis (IHT). This is especially important in regions where PCI is not available. In the RIKS-HIA and NRMI, PHT had better outcomes than IHT, but patients who received PPCI had lower mortality and re-infarction rates. They concluded that within 2 h of symptom onset, patients should receive PHT only if PPCI is not available within 4 h. In CAPTIM, which compared PPCI and PHT followed by PCI if thrombolysis failed and in GRACIA-1 trial, which tested the role of systematic PCI within 24 h of thrombolysis, the policy of systematic PCI following thrombolysis yielded better results than conservative management. The American Heart Association (AHA) and the

  9. Interruptions: Derrida and Hospitality

    OpenAIRE

    Mark W. Westmoreland

    2008-01-01

    Come in. Welcome. Be my guest and I will be yours. Shall we ask, in accordance with the Derridean question, "Is not hospitality an interruption of the self?" What is the relationship between the interruption and the moment one enters the host's home? Derrida calls us toward a new understanding of hospitality - as an interruption. This paper will illuminate the history of hospitality in the West as well as trace Derrida's discussions of hospitality throughout many of works. The overall goal of...

  10. Clinical course of untreated tonic-clonic seizures in childhood: prospective, hospital based study.

    NARCIS (Netherlands)

    C.A. van Donselaar (Cees); O.F. Brouwer (Oebele); A.T. Geerts (Ada); W.F.M. Arts (Willem Frans); H. Stroink (Hans); A.C.B. Peters (Boudewijn)

    1997-01-01

    textabstractTo assess declaration and acceleration in the disease process in the initial phase of epilepsy in children with new onset tonic-clonic seizures. STUDY DESIGN: Hospital based follow up study. SETTING: Two university hospitals, a general hospital, and a children's hospital in the Netherlan

  11. Initial Study

    DEFF Research Database (Denmark)

    Torp, Kristian

    2009-01-01

    increased. In the initial study presented here, the time it takes to pass an intersection is studied in details. Two major signal-controlled four-way intersections in the center of the city Aalborg are studied in details to estimate the congestion levels in these intersections, based on the time it takes to...

  12. Sex differences in clinical characteristics, hospital management practices, and in-hospital outcomes in patients hospitalized in a Vietnamese hospital with a first acute myocardial infarction.

    Directory of Open Access Journals (Sweden)

    Hoa L Nguyen

    Full Text Available BACKGROUND: Cardiovascular disease is one of the leading causes of morbidity and mortality in Vietnam. We conducted a pilot study of Hanoi residents hospitalized with acute myocardial infarction (AMI at the Vietnam National Heart Institute in Hanoi. The objectives of this observational study were to examine sex differences in clinical characteristics, hospital management, in-hospital clinical complications, and mortality in patients hospitalized with an initial AMI. METHODS: The study population consisted of 302 Hanoi residents hospitalized with a first AMI at the largest tertiary care medical center in Hanoi in 2010. RESULTS: The average age of study patients was 66 years and one third were women. Women were older (70 vs. 64 years and were more likely than men to have had hyperlipidemia previously diagnosed (10% vs. 2%. During hospitalization, women were less likely to have undergone percutaneous coronary intervention (PCI compared with men (57% vs. 74%, and women were more likely to have developed heart failure compared with men (19% vs. 10%. Women experienced higher in-hospital case-fatality rates (CFRs than men (13% vs. 4% and these differences were attenuated after adjustment for age and history of hyperlipidemia (OR: 2.64; 95% CI: 1.01, 6.89, and receipt of PCI during hospitalization (OR: 2.09; 95% CI: 0.77, 5.09. CONCLUSIONS: Our pilot data suggest that among patients hospitalized with a first AMI in Hanoi, women experienced higher in-hospital CFRs than men. Full-scale surveillance of all Hanoi residents hospitalized with AMI at all Hanoi medical centers is needed to confirm these findings. More targeted and timely educational and treatment approaches for women appear warranted.

  13. Interruptions: Derrida and Hospitality

    Directory of Open Access Journals (Sweden)

    Mark W. Westmoreland

    2008-06-01

    Full Text Available Come in. Welcome. Be my guest and I will be yours. Shall we ask, in accordance with the Derridean question, "Is not hospitality an interruption of the self?" What is the relationship between the interruption and the moment one enters the host's home? Derrida calls us toward a new understanding of hospitality - as an interruption. This paper will illuminate the history of hospitality in the West as well as trace Derrida's discussions of hospitality throughout many of works. The overall goal of this project is to provide readers of Derrida with a sort of reference guide for his discussions on and deconstructive approach to hospitality.

  14. Medicare Hospital Spending Per Patient - Hospital

    Data.gov (United States)

    U.S. Department of Health & Human Services — The "Medicare hospital spending per patient (Medicare Spending per Beneficiary)" measure shows whether Medicare spends more, less or about the same per Medicare...

  15. Hospital diversification strategy.

    Science.gov (United States)

    Eastaugh, Steven R

    2014-01-01

    To determine the impact of health system restructuring on the levels of hospital diversification and operating ratio this article analyzed 94 teaching hospitals and 94 community hospitals during the period 2008-2013. The 47 teaching hospitals are matched with 47 other teaching hospitals experiencing the same financial market position in 2008, but with different levels of preference for risk and diversification in their strategic plan. Covariates in the analysis included levels of hospital competition and the degree of local government planning (for example, highly regulated in New York, in contrast to Texas). Moreover, 47 nonteaching community hospitals are matched with 47 other community hospitals in 2008, having varying manager preferences for service-line diversification and risk. Diversification and operating ratio are modeled in a two-stage least squares (TSLS) framework as jointly dependent. Institutional diversification is found to yield better financial position, and the better operating profits provide the firm the wherewithal to diversify. Some services are in a growth phase, like bariatric weight-loss surgery and sleep disorder clinics. Hospital managers' preferences for risk/return potential were considered. An institution life cycle hypothesis is advanced to explain hospital behavior: boom and bust, diversification, and divestiture, occasionally leading to closure or merger. PMID:25223156

  16. Breastfeeding among Mothers on Opioid Maintenance Treatment: A Literature Review.

    Science.gov (United States)

    Tsai, Lillian C; Doan, Therese Jung

    2016-08-01

    Although there is an abundance of interventional studies to increase breastfeeding rates, little is known about how to support and promote breastfeeding among mothers on opioid maintenance treatment (OMT). The studies on maternal OMT mainly focus on medication excreted in breast milk and breastfeeding benefits for infants with neonatal abstinence syndrome (NAS). We aim to review interventions to improve breastfeeding outcomes among mothers on OMT to make recommendations for practice and future research. We searched CINAHL, PubMed, PsycINFO, and the Cochrane Database of Systematic Reviews for articles, preferably experimental/quasi-experimental studies published within the past 10 years, that examined interventions to increase rates of breastfeeding initiation and duration among mothers on OMT. Nine studies met our inclusion criteria, comprising 5 categories: 4 combined obstetric and addiction care, 1 rooming-in, 1 Baby-Friendly hospital, 2 inpatient/outpatient NAS treatment, and 1 divided methadone dose. Breastfeeding rates were relatively higher for divided methadone dose (81% initiated any breastfeeding) and rooming-in (62% initiated any breastfeeding); lower in Baby-Friendly hospital (24%) and inpatient/outpatient NAS treatment (45% and 24%, respectively); and mixed in combined obstetric and addiction care programs (2 studies reported 70% and 76%; 2 studies reported 17% and 28%). Studies that included both methadone and buprenorphine did not specify breastfeeding results by medication. We recommend future research to differentiate breastfeeding types and duration by OMT medication. Qualitative studies are needed to explore maternal view on breastfeeding regarding need, barrier, and motivating factors in order to develop effective interventions to promote breastfeeding among mothers on OMT. PMID:27053175

  17. Rill Initiation

    OpenAIRE

    Ottosen, Thor-Bjørn

    2008-01-01

    This project is about rill erosion. The aim is to test whether rill initiation can be predicted from the shear strength of the soil as measured with a torvane on saturated soil. This approach was set forward by Rauws and Govers 1988. Rainfall simulation experiments are conducted at a plot size 2x1m, performed in May on the Marbjerg experimental field. The results are evaluated using a chain set to measure alterations of the surface roughness as a result of the erosion, visual evaluation of ph...

  18. Towards the collaborative hospital

    DEFF Research Database (Denmark)

    Prætorius, Thim; Hasle, Peter; Edwards, Kasper;

    2015-01-01

    Hospitals are increasingly faced with conflicting demands as they have to respond to increasing patient demands as well as financial, clinical and quality challenges. To handle these demands the hospital need to reconfigure its organization, and we propose to build on a concept for the...... collaborative hospital as new organizational form which is better equipped to respond to the challenges facing modern hospitals. The collaborative hospital is an ambidextrous organization that opens for pursuing both exploration and exploitation within the same organizational structure. The basic principles of...... the collaborative hospital concern the creation of an appropriate balance between standardization and local autonomy, shared purpose centred around providing the best possible care, and use of enabling structures that sustain the new ways of collaborative work. The chapter builds on the theoretical...

  19. Hospital design for better infection control

    Directory of Open Access Journals (Sweden)

    Lateef Fatimah

    2009-01-01

    Full Text Available The physical design and infrastructure of a hospital or institution is an essential component of its infection control measure. Thus is must be a prerequisite to take these into consideration from the initial conception and planning stages of the building. The balance between designing a hospital to be an open, accessible and public place and the control to reduce the spread of infections diseases is a necessity. At Singapore General Hospital, many lessons were learnt during the SARS outbreak pertaining to this. During and subsequent to the SARS outbreak, many changes evolved in the hospital to enable us to handle and face any emerging infectious situation with calm, confidence and the knowledge that staff and patients will be in good stead. This paper will share some of our experiences as well as challenges

  20. Sustained Hospital-based Wellness Program

    OpenAIRE

    Danielson, Karen; Jeffers, Katharine; Kaiser, Leslie; McKinley, Lee; Kuhn, Thomas; Voorhies, Gigi

    2014-01-01

    Introduction: Beginning as a grassroots initiative, a community hospital employing 2800 celebrates the stress-transforming benefits of HeartMath for its employees and community. Initially introduced to address the deleterious effects of personal stress experienced by the high healthcare claimants of the organization, HeartMath was eventually introduced to every stratification of the organization's population health management. The ensuing depth and breadth of HeartMath's presence in the organ...

  1. After 9/11: priority focus areas for bioterrorism preparedness in hospitals.

    Science.gov (United States)

    Murphy, Jenifer K

    2004-01-01

    Following the terrorist attacks of September 11, 2001, bioterrorism preparedness was a priority in hospitals, but it did not remain a priority. As a result, hospitals are still unprepared to deal with the effects of a bioterrorist attack. The government has provided initial funding to state and local governments for bioterrorism preparedness; however, much of this money has yet to reach hospitals. With the inadequate funding available to hospitals, four initial measures must be focused on. These focus areas are community involvement, hospital staff education, information technology and disease surveillance improvement, and additional equipment and staff acquisition. Hospitals should also make bioterrorism-preparedness planning a regional effort. PMID:15328657

  2. What accounting leaves out of hospital financial management.

    Science.gov (United States)

    Boles, K E; Glenn, J K

    1986-01-01

    As PPS and other fixed-price initiatives replace cost-based reimbursement in the hospital industry, the burden of assuming the risk for business success or failure shifts from the payor to the hospital. As a consequence, theories of risk to the business firm which have found application in other industries now deserve attention by hospital management. Incorporating such risk concepts into hospital strategies and actions requires a view of financial management that goes beyond the generally accepted accounting principles of managing and assigning costs for maximum revenue and profitability. This article examines the financial theory of risk in business firms, illustrates the various components of risk as they apply to a hospital business, and discusses how the hospital management strategies of cost-reduction, marketing, diversification, and multiorganizational affiliation can alter the risk characteristics of a hospital business. PMID:10275567

  3. The Calvary Hospital Refugee Mentoring Program

    Science.gov (United States)

    Bradford, Dianne; King, Nicole

    2011-01-01

    In 2007 the Calvary Refugee Mentoring Program (CRMP) was initiated at Calvary Hospital, Canberra, to provide an affirmative and individualised learning placement in workplaces for individuals with a refugee background. This work placement was designed to enhance the participants' knowledge of workplaces and to prepare them for future career and…

  4. PRE-HOSPITAL MANAGEMENT OF FEBRILE SEIZURES IN CHILDREN SEEN AT THE UNIVERSITY COLLEGE HOSPITAL, IBADAN, NIGERIA

    OpenAIRE

    Jarrett, O.O.; Fatunde, O.J.; OSINUSI, K; Lagunju, I.A.

    2012-01-01

    Background: Febrile seizures are commonly encountered in emergency paediatric practice. Initial pre-hospital intervention given by caregivers has been shown to impact outcome. Objectives:: To describe the spectrum of pre-hospital interventions given for the treatment of childhood febrile seizures in Ibadan, Nigeria. Methods: All consecutive cases of febrile seizures seen at the emergency room of University College Hospital, Ibadan over a period of 13 months were the subjects of the study. Det...

  5. ROLE OF HOSPITAL ADMINISTRATION

    OpenAIRE

    UDAYSINH R. MANEPATIL

    2013-01-01

    Hospital administration is the management of the hospital as a business. The administration is made up of medical and health services managers (sometimes called health care executives and health care administrators) and assistant administrators. Administrations range in size and the duties of the administrator depends on the size of the administration.

  6. Hospitality, Tourism, and Recreation.

    Science.gov (United States)

    Novachek, James

    The Northern Arizona Hospitality Education Program is an exemplary three-year project designed to help students, mainly Indian, obtain job skills and attitudes necessary for successful employment in the hospitality industry. Nine high schools from Apache, Coconino, and Navajo Counties participated in the project. Objectives included providing an…

  7. 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…

  8. Openness initiative

    Energy Technology Data Exchange (ETDEWEB)

    Duncan, S.S. [Los Alamos National Lab., NM (United States)

    1995-12-31

    Although antinuclear campaigns seem to be effective, public communication and education efforts on low-level radioactive waste have mixed results. Attempts at public information programs on low-level radioactive waste still focus on influencing public opinion. A question then is: {open_quotes}Is it preferable to have a program focus on public education that will empower individuals to make informed decisions rather than trying to influence them in their decisions?{close_quotes} To address this question, a case study with both quantitative and qualitative data will be used. The Ohio Low-Level Radioactive Waste Education Program has a goal to provide people with information they want/need to make their own decisions. The program initiated its efforts by conducting a statewide survey to determine information needed by people and where they turned for that information. This presentation reports data from the survey and then explores the program development process in which programs were designed and presented using the information. Pre and post data from the programs reveal attitude and knowledge shifts.

  9. Health and Taxes: Hospitals, Community Health and the IRS.

    Science.gov (United States)

    Crossley, Mary

    2016-01-01

    The Affordable Care Act created new conditions of federal tax exemption for nonprofit hospitals, including a requirement that hospitals conduct a community health needs assessment (CHNA) every three years to identify significant health needs in their communities and then develop and implement a strategy responding to those needs. As a result, hospitals must now do more than provide charity care to their patients in exchange for the benefits of tax exemption. The CHNA requirement has the potential both to prompt a radical change in hospitals' relationship to their communities and to enlist hospitals as meaningful contributors to community health improvement initiatives. Final regulations issued in December 2014 clarify hospitals' obligations under the CHNA requirement, but could do more to facilitate hospitals' engagement in collaborative community health projects. The Internal Revenue Service (IRS) has a rich opportunity, while hospitals are still learning to conduct CHNAs, to develop guidance establishing clear but flexible expectations for how providers should assess and address community needs. This Article urges the IRS to seize that opportunity by refining its regulatory framework for the CHNA requirement. Specifically, the IRS should more robustly promote transparency, accountability, community engagement, and collaboration while simultaneously leaving hospitals a good degree of flexibility. By promoting alignment between hospitals' regulatory compliance activities and broader community health improvement initiatives, the IRS could play a meaningful role in efforts to reorient our system towards promoting health and not simply treating illness. PMID:27363258

  10. Patient life in hospital

    DEFF Research Database (Denmark)

    Ludvigsen, Mette Spliid

    Patient life in hospital.A qualitative study of informal relationships between hospitalised patients Introduction Within a patientology framework, this PhD dissertation is about an empirical study on patient life that provides insight into the nature of informal relationships between patients in...... hospitals today. Purpose The purpose was to explore how informal relationships between patients affect their hospital experiences in the hospital. The assumption is that, on the one hand, the impacts on patients' suffering affect the way they act and experience encounters with fellow patients for good or....... Methods The study is designed within a phenomenological-hermeneutical philosophic frame of reference and is based on ethnographic fieldwork among hospitalised patients in a Danish university hospital. Data for the study were collected through participant observations over a period of 18 months. Nine males...

  11. 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......, adaptable and scalable. Robots have to be semi-autonomous, and should reliably navigate in large and dynamic environments in the hospital. The complexity of the problem has to be manageable, and the solutions have to be flexible, so that the system can be applicable in real world settings. This thesis...

  12. 38 CFR 3.551 - Reduction because of hospitalization.

    Science.gov (United States)

    2010-07-01

    ... veteran is hospitalized for Hansen's disease. The provisions of this section apply to initial periods of... 38 CFR 3.552. (6) The provisions of paragraphs (e) (1) and (2) of this section are not applicable...

  13. Outpatient Imaging Efficiency - Hospital

    Data.gov (United States)

    U.S. Department of Health & Human Services — Use of medical imaging - provider data. These measures give you information about hospitals' use of medical imaging tests for outpatients. Examples of medical...

  14. Hospital Outpatient PPS

    Data.gov (United States)

    U.S. Department of Health & Human Services — Section 4523 of the Balanced Budget Act of 1997 (BBA) provides authority for CMS to implement a prospective payment system (PPS) under Medicare for hospital...

  15. Physician-Owned Hospitals

    Data.gov (United States)

    U.S. Department of Health & Human Services — Section 6001 of the Affordable Care Act of 2010 amended section 1877 of the Social Security Act to impose additional requirements for physician-owned hospitals to...

  16. Premier Hospital Historical Data

    Data.gov (United States)

    U.S. Department of Health & Human Services — To provide a historical overview of the participating hospitals, before the first project report, Premier Healthcare Informatics has used data already available for...

  17. On spaces of hospitality

    DEFF Research Database (Denmark)

    Greve, Anni

    the guest and the host. This has provided a much-needed rethinking of how to understand hospitality as a way of relating, as an ethics and as a politics. Within this work, there have often appeared discussions of ‘spaces of hospitality’, but these spaces have remained largely abstract. This is where...... this paper comes in: It will re open discussions of spaces of hospitality with an introduction into an on-going research project that studies the performative, structural and social dynamics of cultural encounters focusing on forms of hospitality that are related to particular sites in the city, namely...... the market place, the religious sanctuary and places for the performing arts and cultural heritage. For the modern city they are the tightly woven fabric of social reality, and their configuration can make certain cities more hospitable than others, is the leading idea....

  18. American Hospital Association

    Science.gov (United States)

    ... 2017 (Members Only) Special Bulletin: CMS Releases Hospital Star Ratings (Members Only) Special Bulletin: CMS Proposes New ... Term Care & Rehabilitation Psychiatric & Substance Abuse Services Maternal & Child Health Key Relationships AHA-Related Organizations Partnerships & Strategic ...

  19. Hospital Readmission Reduction

    Data.gov (United States)

    U.S. Department of Health & Human Services — In October 2012, CMS began reducing Medicare payments for Inpatient Prospective Payment System hospitals with excess readmissions. Excess readmissions are measured...

  20. Hospital Readmissions Reduction Program

    Data.gov (United States)

    U.S. Department of Health & Human Services — In October 2012, CMS began reducing Medicare payments for Inpatient Prospective Payment System hospitals with excess readmissions. Excess readmissions are measured...

  1. Hospital Compare Data

    Data.gov (United States)

    U.S. Department of Health & Human Services — These are the official datasets used on the Medicare.gov Hospital Compare Website provided by the Centers for Medicare and Medicaid Services. These data allow you...

  2. Nutrition support in hospitals

    DEFF Research Database (Denmark)

    Kondrup, Jens

    2005-01-01

    Nutrition support in hospitals is becoming an area of focus because of the evidence showing improved clinical outcome with nutrition support, its status as a human rights issue and its integration into quality assurance.......Nutrition support in hospitals is becoming an area of focus because of the evidence showing improved clinical outcome with nutrition support, its status as a human rights issue and its integration into quality assurance....

  3. Trick questions: cosmopolitan hospitality

    OpenAIRE

    Eleanor Byrne

    2013-01-01

    Byrne’s paper consists of two parallel texts. The first explores the limits of cosmopolitanism in practice, taking as its subject the Life in the UK Citizenship Test, inaugurated under the Labour Government in 2005. It argues that the test exemplifies the predicament of all attempts at cosmopolitan hospitality as unconditional welcoming, through a discussion of the relation between questioning and welcoming the stranger. Establishing the relationship between cosmopolitanism and hospitality a...

  4. Toward a network hospitality

    OpenAIRE

    Germann Molz, Jennie

    2014-01-01

    The growing popularity of online hospitality exchange networks like Couchsurfing and Airbnb point toward a new paradigm of sociality for a mobile and networked society as hospitable encounters among friends and strangers become entangled with social media and networking technologies. Inspired by Andreas Wittel’s notion of ‘network sociality’, this paper introduces the concept of ‘network hospitality’ to describe the kind of sociality that emerges around these new mobile, peer–to–peer, and onl...

  5. Grove - Stobhill Hospital

    OpenAIRE

    Urquhart, Donald

    2009-01-01

    Grove - Stobhill Hospital; A series of permanent artworks installed within the new build Stobhill Hospital in Glasgow, with the artists Ken Dingwall, Olwen Shone and Andreas Karl Shulze made in response to text works by Thomas A Clark. Project managed by Reiach and Hall Architects & Chris Fremantle. Commissioned by NHS Greater Glasgow & Clyde. Applying a conceptual approach to landscape representation the works examine the therapeutic aspect of contemporary art within an architectural...

  6. The Hospital Medicine Reengineering Network (HOMERuN): A learning organization focused on improving hospital care

    Science.gov (United States)

    Auerbach, Andrew D.; Patel, Mitesh S.; Metlay, Josh; Schnipper, Jeffrey; Williams, Mark V.; Robinson, Edmondo; Kripalani, Sunil; Lindenauer, Peter K.

    2016-01-01

    Converting the health care delivery system into a learning organization is a key strategy for improving health outcomes. While the learning organization approach has been successful in neonatal intensive care units and disease specific collaboratives there are few examples in general medicine and fewer still have leveraged the role of hospitalists to implement improvements. This paper describes the rationale for and early work of the Hospital Medicine Reengineering Network (HOMERuN), a collaborative of hospitals, hospitalists, and care teams whose overarching purpose is to use data to guide collaborative efforts aimed at improving the care of hospitalized patients. We review HOMERuN’s collaborative model, which focuses on a community-based participatory approach modified to include hospital-based as well as the larger community, and HOMERuN’s initial project focusing on care transition improvement using perspectives from the patient and caregiver. PMID:24448050

  7. Through the lens of young people: use of photography in hospital design.

    Science.gov (United States)

    Coad, Jane

    2016-05-01

    Whilst arts in hospitals have been perceived as therapeutic to patients, this paper will share evidence and research to support that photography and photo-elicitation has an important role in preference and choice about hospital design. The paper will initially draw on studies that used participatory photography in children's hospital design in international settings. PMID:27214415

  8. Corporate social responsibility and hospitals: US theory, Japanese experiences, and lessons for other countries.

    Science.gov (United States)

    Takahashi, Toshiro; Ellen, Moriah; Brown, Adalsteinn

    2013-01-01

    This paper examines the role that corporate social responsibility can play in advancing hospital management. Corporate social responsibility is the integration of social and environmental concerns within business operations. The authors discuss how corporate social responsibility can help hospitals and provide suggestions to hospitals in deciding which corporate social responsibility initiatives to pursue. PMID:24696941

  9. Medical education and the quality improvement spiral: A case study from Mpumalanga, South Africa

    Directory of Open Access Journals (Sweden)

    Martin Bac

    2015-02-01

    Full Text Available Background: The short timeframe of medical students’ rotations is not always conducive to successful, in-depth quality-improvement projects requiring a more longitudinal approach.Aim: To describe the process of inducting students into a longitudinal quality-improvement project,using the topic of the Mother- and Baby-Friendly Initiative as a case study; and to explore the possible contribution of a quality-improvement project to the development of student competencies.Setting: Mpumalanga clinical learning centres, where University of Pretoria medical students did their district health rotations.Method: Consecutive student groups had to engage with a hospital’s compliance with specific steps of the Ten Steps to Successful Breastfeeding that form the standards for the Mother- and Baby-Friendly Initiative. Primary data sources included an on-site PowerPoint group presentation (n = 42, a written group report (n = 42 and notes of individual interviews in an end-of-rotation objectively structured clinical examination station (n = 139.Results: Activities in each rotation varied according to the needs identified through the application of the quality-improvement cycle in consultation with the local health team. The development of student competencies is described according to the roles of a medical expert in the CanMEDS framework: collaborator, health advocate, scholar, communicator, manager and professional. The exposure to the real-life situation in South African public hospitals had a great influence on many students, who also acted as catalysts for transforming practice.Conclusion: Service learning and quality-improvement projects can be successfully integrated in one rotation and can contribute to the development of the different roles of a medical expert. More studies could provide insight into the potential of this approach in transforming institutions and student learning.

  10. Geriatrics and the triple aim: defining preventable hospitalizations in the long-term care population.

    Science.gov (United States)

    Ouslander, Joseph G; Maslow, Katie

    2012-12-01

    Reducing preventable hospitalizations is fundamental to the "triple aim" of improving care, improving health, and reducing costs. New federal government initiatives that create strong pressure to reduce such hospitalizations are being or will soon be implemented. These initiatives use quality measures to define which hospitalizations are preventable. Reducing hospitalizations could greatly benefit frail and chronically ill adults and older people who receive long-term care (LTC) because they often experience negative effects of hospitalization, including hospital-acquired conditions, morbidity, and loss of functional abilities. Conversely, reducing hospitalizations could mean that some people will not receive hospital care they need, especially if the selected measures do not adequately define hospitalizations that can be prevented without jeopardizing the person's health and safety. An extensive literature search identified 250 measures of preventable hospitalizations, but the measures have not been validated in the LTC population and generally do not account for comorbidity or the capacity of various LTC settings to provide the required care without hospitalization. Additional efforts are needed to develop measures that accurately differentiate preventable from necessary hospitalizations for the LTC population, are transparent and fair to providers, and minimize the potential for gaming and unintended consequences. As the new initiatives take effect, it is critical to monitor their effect and to develop and disseminate training and resources to support the many community- and institution-based healthcare professionals and emergency department staff involved in decisions about hospitalization for this population. PMID:23194066

  11. Trick questions: cosmopolitan hospitality

    Directory of Open Access Journals (Sweden)

    Eleanor Byrne

    2013-08-01

    Full Text Available Byrne’s paper consists of two parallel texts. The first explores the limits of cosmopolitanism in practice, taking as its subject the Life in the UK Citizenship Test, inaugurated under the Labour Government in 2005. It argues that the test exemplifies the predicament of all attempts at cosmopolitan hospitality as unconditional welcoming, through a discussion of the relation between questioning and welcoming the stranger. Establishing the relationship between cosmopolitanism and hospitality as envisaged in Derrida’s reading of Kant it asks what kind of cosmopolitan hospitality is either possible or desirable by exploring what Derrida calls the ‘perversions’ inherent in the structures of hospitality. It focuses on the concept of the ‘trick questions’ that the state asks the foreigner observed by Derrida in his reading of The Apology of Socrates; questions that seem to invite answers but foreclose the possibilities of a free response. The second text asks how this logic that Derrida identifies can be pushed or coaxed into new ways of addressing the perceived threats of ‘unconditional’ hospitality through a reading of ‘unconditional hospitality’ as queer in the work of Tove Jansson.

  12. Religiousness in hospitals

    Directory of Open Access Journals (Sweden)

    John Koutelekos

    2011-10-01

    Full Text Available The aim of the present study was to review the literature about religiousness within hospitals. The method οf this study included bibliography research from both the review and the research literature, in the "pubmed data base" which referred to the religiousness within hospitals. Results : According to the literature research an administrative institution, such as hospital does not include only one culture but on the contrary many different cultures that interact since health professionals have their own background. Hospital as a place of special care, that has its' own culture, is expected to fulfill patients' needs (family, social, occupational, health and disease. Faith is encouraged in hospitals where the icons and Christian churches are prevalent, while faith individuals express their deeper need for pray. The tendency of religious individuals to ask for an upper support mainly in difficult circumstances such as for recovery in the clinical environment is deeply rooted in its' soul and consists an element of its' nature. Conclusions: In contemporary Greek reality, medical science has always had at the practice a great charity: religion.

  13. Characteristics of Hospitals Associated with Complete and Partial Implementation of Electronic Health Records

    Science.gov (United States)

    Bhounsule, Prajakta; Peterson, Andrew M.

    2016-01-01

    Objectives (1) To determine the proportion of hospitals with and without implementation of electronic health records (EHRs). (2) To examine characteristics of hospitals that report implementation of EHRs partially or completely versus those that report no implementation. (3) To identify hospital characteristics associated with nonimplementation to help devise future policy initiatives. Methods This was a retrospective cross-sectional study using the 2012 American Hospital Association Annual Survey Database. The outcome variable was the implementation of EHRs completely or partially. Independent variables were hospital characteristics, such as staffing, organization structure, accreditations, ownership, and services and facilities provided at the hospitals. Descriptive frequencies were determined, and multinomial logistic regression was used to determine variables independently associated with complete or partial implementation of EHRs. Results In this study, 12.6 percent of hospitals reported no implementation of EHRs, while 43.9 percent of hospitals implemented EHRs partially and 43.5 percent implemented EHRs completely. Overall characteristics of hospitals with complete and partial implementation were similar. The multinomial regression model revealed a positive association between the number of licensed beds and complete implementation of EHRs. A positive association was found between children's general medical, surgical, and heart hospitals and complete implementation of EHRs. Conversely, psychiatric and rehabilitation hospitals, limited service hospitals, hospitals participating in a network, service hospitals, government nonfederal hospitals, and nongovernment not-for-profit hospitals showed less likelihood of complete implementation of EHRs. Conclusion Study findings suggest a disparity of EHR implementation between larger, for-profit hospitals and smaller, not-for-profit hospitals. Low rates of implementation were observed with psychiatric and

  14. Suboptimal use of statins at treatment initiation

    OpenAIRE

    Kiviniemi, Vesa; Peura, Piia; Helin-Salmivaara, Arja; Jaana E. Martikainen; Hartikainen, Juha; Huupponen, Risto; Korhonen, Maarit Jaana

    2011-01-01

    Suboptimal use of statins at treatment initiation phone: +358-40-3572081 (Korhonen, Maarit Jaana) (Korhonen, Maarit Jaana) Finnish Medicines Agency - Microkatu 1 - Kuopio - FINLAND (Kiviniemi, Vesa) Finnish Medicines Agency - Microkatu 1 - Kuopio - FINLAND (Peura, Piia) Department of Pharmacology, Drug Development and Therapeutics, University of Turku - 20014 - Turun yliopisto - FINLAND (Helin-Salmivaara, Arja) Unit of General Practice, Hospital D...

  15. Validation of a Framework for Measuring Hospital Disaster Resilience Using Factor Analysis

    OpenAIRE

    Shuang Zhong; Michele Clark; Xiang-Yu Hou; Yuli Zang; Gerard FitzGerald

    2014-01-01

    Hospital disaster resilience can be defined as “the ability of hospitals to resist, absorb, and respond to the shock of disasters while maintaining and surging essential health services, and then to recover to its original state or adapt to a new one.” This article aims to provide a framework which can be used to comprehensively measure hospital disaster resilience. An evaluation framework for assessing hospital resilience was initially proposed through a systematic literature review and Modi...

  16. Hospital Safety Culture in Taiwan: A Nationwide Survey Using Chinese Version Safety Attitude Questionnaire

    OpenAIRE

    Lee Wui-Chiang; Wung Hwei-Ying; Liao Hsun-Hsiang; Lo Chien-Ming; Chang Fei-Ling; Wang Pa-Chun; Fan Angela; Chen Hsin-Hsin; Yang Han-Chuan; Hou Sheng-Mou

    2010-01-01

    Abstract Background Safety activities have been initiated at many hospitals in Taiwan, but little is known about the safety culture at these hospitals. The aims of this study were to verify a safety culture survey instrument in Chinese and to assess hospital safety culture in Taiwan. Methods The Taiwan Patient Safety Culture Survey was conducted in 2008, using the adapted Safety Attitude Questionnaire in Chinese (SAQ-C). Hospitals and their healthcare workers participated in the survey on a v...

  17. Toward healthier hospitals.

    Science.gov (United States)

    Mintzberg, H

    1997-01-01

    This article builds around a framework of cure, care, control, and community, with collaboration at the center, to consider 12 issues common to many hospitals. These include, among others, the fragmentation of efforts, confusion in mission (and in mission statements), the problems of bundling research with clinical work, selectivity in informing board members, the dangers of professional management, and the difficulties of combining external advocacy with internal reconciliation in the senior manager's job. The article concludes that hospitals could better learn how to solve systemic problems systemically, and that to do so will require not the wish lists of strategic planning and structural reorganizing, but tangible changes in their collective behavior. PMID:9358257

  18. London Hospital Food Project

    OpenAIRE

    Westley Consulting Ltd.,

    2004-01-01

    The aim of the London is to incresae the amount of local and organic food served in four London hospitals. It is hoped that the project will not only result in healthier and better quality meals for hospital patients, staff and visitors, but will also benefit local communities, through supporting farming and food businesses in London and the South East. It is funded by the King's Fund, Defra and the European Agricultural Guidance and Guarantee Fund, and focuses on the food served in the ...

  19. Hospitality and aesthetics

    OpenAIRE

    Bergflødt, Sigurd

    2013-01-01

    Tobias Nygren is Professor and Head of Department at the School of Hospitality, Culinary Arts, and Meal Science in Grythyttan, Sweden. He has been working for several years on meals, restaurants and hospitality. We meet at Grythyttan, and we need a few more lines to describe the place, which is quite unique in the Nordic food landscape. The School of Culinary Arts is a branch of the Örebro University and since 1993 it has offered multidisciplinary studies, combining science with practical sk...

  20. Marketing the hospital library.

    Science.gov (United States)

    Bridges, Jane

    2005-01-01

    Many librarians do not see themselves as marketers, but marketing is an essential role for hospital librarians. Library work involves education, and there are parallels between marketing and education as described in this article. It is incumbent upon hospital librarians actively to pursue ways of reminding their customers about library services. This article reinforces the idea that marketing is an element in many of the things that librarians already do, and includes a list of suggested marketing strategies intended to remind administrators, physicians, and other customers that they have libraries in their organizations. PMID:15982957

  1. Hospitals as food arenas

    DEFF Research Database (Denmark)

    Poulsen, Signe; Jørgensen, Michael Søgaard

    2010-01-01

    Purpose: To analyse the interaction between hospital employees’ working conditions, and their health and dietary habits, including the role of canteen take-away schemes. Design/Methodology/approach: An international literature review combined with case studies based on stakeholder research...... also identified. Research limitations: The assessment of the dietary changes based on the canteen take-away food was only based on indirect assessments based on interviews with users and non-users and furthermore based on a questionnaire at one of the hospitals. Value/originality: Canteen take...

  2. A model of continuous professional development for registered pre-hospital practitioners in Ireland

    OpenAIRE

    Knox, Shane

    2015-01-01

    The introduction of a Regulatory body in Ireland with responsibility for ensuring high standards of education and professionalism for ambulance, and other pre-hospital, practitioners was a welcomed initiative in 2001 due to a need for improvement in care delivered to patients before arrival at hospital. This Regulatory body, the Pre-Hospital Emergency Care Council (PHECC), was established under Statutory Instrument with an initial priority being to develop three levels of pr...

  3. Optimal Hospital Layout Design

    DEFF Research Database (Denmark)

    Holst, Malene Kirstine

    This PhD project presents a design model that generates and evaluates hospital designs with respect to long-term performances and functionalities. By visualizing and quantifying costs and performances in the early design phases, it is possible to make design choices based on a qualified, profound...

  4. Cost characteristics of hospitals.

    Science.gov (United States)

    Smet, Mike

    2002-09-01

    Modern hospitals are complex multi-product organisations. The analysis of a hospital's production and/or cost structure should therefore use the appropriate techniques. Flexible functional forms based on the neo-classical theory of the firm seem to be most suitable. Using neo-classical cost functions implicitly assumes minimisation of (variable) costs given that input prices and outputs are exogenous. Local and global properties of flexible functional forms and short-run versus long-run equilibrium are further issues that require thorough investigation. In order to put the results based on econometric estimations of cost functions in the right perspective, it is important to keep these considerations in mind when using flexible functional forms. The more recent studies seem to agree that hospitals generally do not operate in their long-run equilibrium (they tend to over-invest in capital (capacity and equipment)) and that it is therefore appropriate to estimate a short-run variable cost function. However, few studies explicitly take into account the implicit assumptions and restrictions embedded in the models they use. An alternative method to explain differences in costs uses management accounting techniques to identify the cost drivers of overhead costs. Related issues such as cost-shifting and cost-adjusting behaviour of hospitals and the influence of market structure on competition, prices and costs are also discussed shortly. PMID:12220092

  5. Radiation accidents in hospitals

    International Nuclear Information System (INIS)

    Some of the radiation accidents that have occurred in Indian hospitals and causes that led to them are reviewed. Proper organization of radiation safety minimizes such accidents. It has been pointed out that there must be technical competence and mental preparedness to tackle emergencies when they do infrequently occur. (M.G.B.)

  6. Hospitals Embrace SMS Technology

    Institute of Scientific and Technical Information of China (English)

    Julie Clothier; 张琳

    2004-01-01

    @@ It is great for organizing meetings, to tell someone a piece of information and even voting for your favorite "Big Brother"① housemate. Now, text messaging is increasingly being used by UK hospitals to remind patients about outpatient② appointments-and could potentially save the National Health Service③ millions of pounds every year.

  7. Hospital restructuring and burnout.

    Science.gov (United States)

    Greenglass, Esther R; Burke, Ronald J

    2002-01-01

    Increasingly, organizations are experiencing changes as a result of extensive downsizing, restructuring, and merging. In Canada, government-sponsored medicine has been affected as hospitals have merged or closed, reducing essential medical services and resulting in extensive job loss for hospital workers, particularly nurses. Hospital restructuring has also resulted in greater stress and job insecurity in nurses. The escalation of stressors has created burnout in nurses. This study examines predictors of burnout in nurses experiencing hospital restructuring using the MBI-General Survey which yields scores on three scales: Emotional exhaustion, Cynicism, and Professional efficacy. Multiple regressions were conducted where each burnout scale was the criterion and stressors (e.g., amount of work, use of generic workers to do nurses' work), restructuring effects, social support, and individual resources (e.g., control coping, self-efficacy, prior organizational commitment) were predictors. There were differences in the amount of variance accounted for in the burnout components by stressors and resources. Stressors contributed most to emotional exhaustion and least to professional efficacy. Individual resources were more likely to contribute to professional efficacy and least to emotional exhaustion. Stressors and resources accounted for approximately equal amounts of variance in cynicism. Three conclusions were drawn. First, present findings parallel others by showing that individual coping patterns contribute to professional efficacy. Second, emotional exhaustion was found to be the prototype of stress. Third, prior organizational commitment, self-efficacy, and control coping resulted in lower burnout. PMID:15137570

  8. Responsible Hospitality. Prevention Updates

    Science.gov (United States)

    Colthurst, Tom

    2004-01-01

    Responsible Hospitality (RH)--also called Responsible Beverage Service (RBS)--encompasses a variety of strategies for reducing risks associated with the sale and service of alcoholic beverages. RH programs have three goals: (1) to prevent illegal alcohol service to minors; (2) to reduce the likelihood of drinkers becoming intoxicated; and (3) to…

  9. [Leadership in the hospital].

    Science.gov (United States)

    Schrappe, Matthias

    2009-01-01

    Current concepts in leadership and governance on the level of supervisory board, management and departments are often considered as insufficient to cope with the profound structural change which actually takes place in the German health care system. While vertical and horizontal disconnecting is typical of the professional bureaucracy of hospitals, transition from functional to divisional structure further increases this risk. Accordingly, medical experts are oriented towards their professional peers and patient care on the one side; on the other side the management gets isolated and looses operative and strategic control. Several studies provide evidence for the relevance of role models to serve as agents of change, which are now developed into the concept of "Clinical Governance": evidence-based medicine, guidelines, continuous quality improvement, safety culture, resource accountability and organisational learning. The present situation makes it necessary to extend this conception, which focuses on the departmental level in an organisation with divisional features, to one of "Clinical Corporate Governance". This term, which also includes supervisory structures and the management board and is relevant for the total hospital and company, respectively, is based on the corporate governance concept. Inside the hospital, the management and the heads of the departments have to agree that (1) experts really need to be integrated into the decision process, and that (2) the outcomes of the entire hospital have to be regarded as equal or superior to the aims of a single department. The public image of the hospital should be one of a strong and reliable partner in health care and health care business on a local, regional and national level. Members of the supervisory board should clearly put corporate aspects above political and other implications and pay attention to personal independence from the leaders of the medical departments. PMID:19545081

  10. 基层医院非瓣膜病性心房颤动患者抗凝治疗现状及华法林最佳初始剂量研究%Study on the current status of anti-coagulation treatment and the best initial warfarin dose in patients with nonvalvular atrial fibrillation in primary hospital

    Institute of Scientific and Technical Information of China (English)

    张澍; 孙彤; 程仁立; 谢厚田; 徐飞

    2011-01-01

    Objective: To study the current status of anti-coagulation treatment by guideline and the best initial warfa rin dose in patients with nonvalvular atrial fibrillation (NVAF) in primary hospital. Methods: Two hundred and fifty-six patients without contraindication to anti-coagulation therapy were enrolled into this study. The status of using warfarin were registered and analyzed.Patients with NVAF who used warfain to anti-coagulation treatment were randomly assigned to two groups according to different initial dose ,3. 125 mg and 5 mg. The dose of warfarin was adjusted according to international normalized ratio( INR), until INR was stabilized between 2.0 and 3.0 for at least 2 months at the same dose of warfarin. Results: Among two hundred and fifty-six cases with NVAF,only 47 cases ( 18.4 % ) were given anti-coagulation treatment by guideline. Of the total 164 cases (64.1% ) of high risk group, 29 cases (17.7%) were given warfarin. Among 164 patients of high risk group, the ratio of warfarin used in paroxysmal atrial fibrillation was significant lower than persistent atrial fibrillation and long standing atrial fibtillation ( P < 0. 05 ). Treatment decision-making of physicians and patients factors were associated with low rates of warfarin used. The mean time achieving a stabilized target INR in two groups was significant(P > 0.05 ). The incidence of exorbitant INR was shorter than that in the 5 mg group ( P < 0.05 ). There was no significant difference in thromboembolisms and important hemorrhage complications in two groups( P > 0.05 ). Conclusions:Most of the patients with NVAF did not receive appropriate antithrombotic therapy in primary hospital. An initial warfarin dose of 3. 125 mg treatment may reach the stabilized INR range quickly, safely and efficiently without increasing the bleeding complications.%目的:了解基层医院非瓣膜病性心房颤动(NVAF)患者接受指南推荐的抗凝剂应用情况,探讨基层医院NVAF患者应用

  11. Hospitals, Hospital locations, Published in unknown, Trempealeau County.

    Data.gov (United States)

    NSGIC GIS Inventory (aka Ramona) — This Hospitals dataset, was produced all or in part from Orthoimagery information as of unknown. It is described as 'Hospital locations'. Data by this publisher are...

  12. Forskelle mellem hospitaler i prognose efter hjertestop uden for hospital

    DEFF Research Database (Denmark)

    Kjaergaard, Jesper; Bro-Jeppesen, John; Rasmussen, Lars Simon;

    2009-01-01

    the patients admitted to hospital. Survival was determined using the Central Population Registry through Statistics Denmark. RESULTS: Patients admitted to a tertiary facility were younger, more frequently male, they had more commonly ventricular fibrillation/pulseless ventricular tachycardia (VF....../pVT) as their initial rhythm, and they had more frequently received bystander cardiopulmonary resuscitation. Survival at 4.6 years was 41% in patients admitted to the tertiary hospital and 10% in patients admitted to other hospitals, p < 0.0001. After adjustment for other known risk factors, patients...... admitted to other hospitals had a hazard ratio of 1.8 for death (95% confidence interval: 1,4-2,5) compared with patients admitted to a tertiary facility. CONCLUSION: The survival rate after out-of-hospital cardiac arrest was significantly higher in patients admitted to a tertiary facility than among...

  13. Preventing Infections in the Hospital

    Science.gov (United States)

    ... Share | With attention increasing on the incidence of infection in hospitals, patients everywhere need sensible principles to manage their ... will reduce the chance of developing a lung infection while in the hospital and may also improve your healing abilities following ...

  14. The general NFP hospital model.

    Science.gov (United States)

    Al-Amin, Mona

    2012-01-01

    Throughout the past 30 years, there has been a lot of controversy surrounding the proliferation of new forms of health care delivery organizations that challenge and compete with general NFP community hospitals. Traditionally, the health care system in the United States has been dominated by general NFP (NFP) voluntary hospitals. With the number of for-profit general hospitals, physician-owned specialty hospitals, and ambulatory surgical centers increasing, a question arises: “Why is the general NFP community hospital the dominant model?” In order to address this question, this paper reexamines the history of the hospital industry. By understanding how the “general NFP hospital” model emerged and dominated, we attempt to explain the current dominance of general NFP hospitals in the ever changing hospital industry in the United States. PMID:22324062

  15. Guide to Choosing a Hospital

    Science.gov (United States)

    ... Hospital It really helps when I take time to write down my questions before my doctor’s appointment. Before ... Look At Hospital Quality Notes Use this page to write down important notes. 19 SECTION Medicare and Your ...

  16. HSIP Hospitals in New Mexico

    Data.gov (United States)

    Earth Data Analysis Center, University of New Mexico — Hospitals in New Mexico The term "hospital" ... means an institution which- (1) is primarily engaged in providing, by or under the supervision of physicians, to...

  17. Parametric Optimization of Hospital Design

    DEFF Research Database (Denmark)

    Holst, Malene Kirstine; Kirkegaard, Poul Henning; Christoffersen, L.D.

    2013-01-01

    Present paper presents a parametric performancebased design model for optimizing hospital design. The design model operates with geometric input parameters defining the functional requirements of the hospital and input parameters in terms of performance objectives defining the design requirements...... and preferences of the hospital with respect to performances. The design model takes point of departure in the hospital functionalities as a set of defined parameters and rules describing the design requirements and preferences....

  18. Pseudomonas aeruginosa from hospital environment

    OpenAIRE

    Milind Davane; Namdev Suryawanshi; Asha Pichare; Basavraj Nagoba

    2014-01-01

    Hospital acquired infection is an additional affliction to the patient admitted to the hospital for some serious illness and is caused by pathogens which are prevalent in hospital environment. In the hospital, microbes are ubiquitous; and can reach the sick patient through various sources, such as air, water, food, contaminated equipments, linen, catheters, scopes, ventilators, contaminated disinfectants and other preparations used for treatment, visitors, infected patients, etc.

  19. Hacking the hospital environment

    DEFF Research Database (Denmark)

    Boisen, Kirsten A; Boisen, Anne Bank; Thomsen, Stine Legarth;

    2016-01-01

    ). Students in architecture, design, engineering, communication and anthropology participated (27 young adults) - forming eight groups. Adolescents and young adults (AYA) with current or former cancer experience participated as sparring partners. We provided workspace and food during the weekend. The groups...... in two-bed wardrooms and social contact with other hospitalized AYA. The winning project included an integrated concept for both wardrooms and the AYA day room, including logos and names for the rooms and an 'energy wall' in the day room. CONCLUSION: A hackathon event was an effective mode of youth...... participation. The design concepts and ideas were in line with current evidence regarding pleasing hospital environment and youth-friendly inpatient facilities and may be applicable to other young patients....

  20. Vocabulary of hospitality

    OpenAIRE

    Bedir, M.

    2014-01-01

    Attitudes about refugees begin with the words we ascribe them. In Turkey – which has historically absorbed newcomers from a variety of outside conflicts – the term ‘guest’ is commonly used. Taking this as a starting point, Merve Bedir questions the laws of hospitality in Turkey, and the inherent hostility embedded in the word. She argues for a heightened understanding of the vocabulary around refugees, as a necessary first step to an improved refugee policy.

  1. Exploring hospitality within hospital meals by means of visual methodologies

    DEFF Research Database (Denmark)

    Justesen, Lise

    2016-01-01

    ABSTRACT This paper reflects the application of visual methodologies adapted in an explorative study on hospitality and hospital meals. It takes point of departure in a multi-sited ethnographic fieldwork placed at a general hospital in 2012. Visual methodologies were applied in multiple ways. This...... includes visual methodologies as part of observation and interview strategies. The paper presents and discusses how the application of different visual methodologies can contribute to the construction of ethnographical knowledge on hospitality and hospital meals. Finally ethical considerations as well as...

  2. On Hospital Design – Identifying Building Attributes of Hospital Design

    DEFF Research Database (Denmark)

    Holst, Malene Kirstine; Kirkegaard, Poul Henning; Christoffersen, Lars D.

    The present paper surveys the input parameters in hospital design and describes them formally as building attributes in preparation for facilitating planning and designing of hospitals with the aim of a more optimal design process. The overview of the hospital functionalities, bonds, logistics and...... needs is based on an approach of understanding the complexity of the hospital functionalities based on capacities, qualities and times beforehand specific department or units are described. This approach attempts to create an overview of the hospital functionalities respecting capacities, qualities and...

  3. Hospital successes and failures indicate change in hospital marketing.

    Science.gov (United States)

    Krampf, R F; Miller, D W

    1993-01-01

    Marketing has become an essential management function for hospitals during the past decade. A number of changes have occurred in hospital marketing as they have progressed through the marketing adoption process. A survey of Hospital CEOs reporting hospital successes and failures in the area of marketing have recently placed emphasis on sales and advertising based upon marketing research programs thus indicating entrance into the "Integrated Tactical Marketing" phase. This study also indicates that a few hospitals have entered the "Strategic Marketing Orientation" phase while future plans reported by the CEOs provide evidence that this trend is likely to continue. PMID:10129242

  4. Hospitality in College Composition Courses

    Science.gov (United States)

    Haswell, Janis; Haswell, Richard; Blalock, Glenn

    2009-01-01

    There has been little discussion of hospitality as a practice in college writing courses. Possible misuses of hospitality as an educational and ethical practice are explored, and three traditional and still tenable modes of hospitality are described and historicized: Homeric, Judeo-Christian, and nomadic. Application of these modes to…

  5. Library Hospitality: Some Preliminary Considerations

    Science.gov (United States)

    Johnson, Eric D. M.; Kazmer, Michelle M.

    2011-01-01

    Library scholars and practitioners have frequently reflected on the various factors that in combination make up a hospitable library, but there has been little theoretical synthesis of the notion of the library as a place of hospitality. The hospitality industry provides a rich vein of theoretical material from which to draw definitions of…

  6. Hospitality Studies: Escaping the Tyranny?

    Science.gov (United States)

    Lashley, Conrad

    2015-01-01

    Purpose: The purpose of this paper is to explore current strands in hospitality management education and research, and suggest that future programs should reflect a more social science informed content. Design/methodology/approach: The paper reviews current research in hospitality management education and in the study of hospitality and…

  7. Latex allergies - for hospital patients

    Science.gov (United States)

    ... latex to be removed from your room The pharmacy and dietary staff to be told about your latex allergy so they do not use latex when they prepare your medicines and food Alternative Names Latex products - hospital; Latex allergy - hospital; Latex sensitivity - hospital; Contact dermatitis - ...

  8. 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…

  9. Correspondence Education and the Hospital.

    Science.gov (United States)

    Hospital Research and Educational Trust, Chicago, IL.

    Based primarily on questionnaire responses from 423 hospitals in the United States, this study dealt with noncredit correspondence courses designed to upgrade hospital personnel job skills and raise job performance and/or job level. It inquired into uses of correspondence as noted in the literature; awareness and use of the method in hospitals;…

  10. [The hospital ship Jutlandia].

    Science.gov (United States)

    Winge, M

    1996-01-01

    The Danish contribution to the United Nations action during the Korean War (1950-52) was the hospital ship "Jutlandia". The motorvessel Jutlandia - 8.500 tons - was built by the Nakskov Shipyard in 1934, and was rebuilt in three months at the same shipyard to a modern hospital ship with 300 beds, 3 operating theatres, a dental clinic, an x-ray department etc. The crew and the hospital staff consisted approximately each of 100 persons. Jutlandia sailed for Korea on Jan. 23. 1951 and the expedition ended in Copenhagen on Oct. 16. 1953. On the first two cruises the ship was stationed at Pusan. During the first period mostly as an "evacuation sick-bay" and during the second period the ship was opened for Korean military and civil patients, and extensive help was given to the local population on shore. While in Denmark between the second and third cruise a helicopter deck was installed and the operating theatre for neuro-surgery was changed to an opthalmic clinic. This time the ship was stationed at the Bay of Ichon so close to the front, that the wounded could be admitted directly from the advanced dressing stations. On the return journeys to Europe patients were sailed to their home countries. Commodore Kai Hammerich was in charge of the expedition and captain Christen Kondrup was in charge of the ship, throughout the whole expedition. PMID:11625136

  11. O Brincar como uma Acao Mediadora no Trabalho Desenvolvido com Criancas Hospitalizadas (Play as a Mediating Activity in Work Developed with Hospitalized Children).

    Science.gov (United States)

    Goulart, Aurea Maria Paes Leme; de Moraes, Silvia Pereira Gonzaga

    2000-01-01

    Describes experiences with hospitalized children through the extension project "Writing and Reading at the University Hospital", State University of Maringa Hospital (Brazil). States the initial project proposal provided educational assistance to the children separated from school due to being in the hospital. Used play and games as an effective…

  12. Consumer Nutrition Environments of Hospitals: An Exploratory Analysis Using the Hospital Nutrition Environment Scan for Cafeterias, Vending Machines, and Gift Shops, 2012

    OpenAIRE

    Courtney P. Winston, DrPH, RD, LD, CDE; James F. Sallis, PhD; Michael D. Swartz, PhD; Deanna M. Hoelscher, PhD, RD, LD, CNS; Melissa F. Peskin, PhD

    2013-01-01

    Introduction Hospitals are the primary worksite of over 5 million adults in the United States, and millions of meals are procured and consumed in this setting. Because many worksite nutrition initiatives use an ecological framework to improve the dietary habits of employees, the nutrition values of foods served in hospitals is receiving attention. Methods This study used the Hospital Nutrition Environment Scan for Cafeterias, Vending Machines, and Gift Shops to quantitatively describe the con...

  13. Organizing for the Collaborative Hospital

    DEFF Research Database (Denmark)

    Prætorius, Thim; Hasle, Peter; Nielsen, Anders Paarup

    highlights a management paradox that calls for balancing a both/and approach to bureaucratization and collaboration in hospitals. Through a qualitative multiple, embedded case study of four hospitals, the paper investigates how standardized processes and structural arrangements—instances of organizational...... design—facilitate collaboration in hospitals. This is important as the literature on formal organization is disconnected from the informal aspects of the organization, thereby limiting the understanding of how hospitals function. Findings suggest that hospitals use many different types of organizational...... design to foster and maintain collaboration, thereby pointing towards mechanisms for developing the collaborative hospital. The findings also provide insights to managers which can be utilized for the further development of hospitals....

  14. From corporate governance to hospital governance. Authority, transparency and accountability of Belgian non-profit hospitals' board and management.

    Science.gov (United States)

    Eeckloo, Kristof; Van Herck, Gustaaf; Van Hulle, Cynthia; Vleugels, Arthur

    2004-04-01

    As a result of multiple developments in health care and health care policy, hospital administrators, policy makers and researchers are increasingly challenged to reflect on the meaning of good hospital governance and how they can implement it in the hospital organisations. The question arises whether and to what extent governance models that have been developed within the corporate world can be valuable for these reflections. Due to the unique societal position of hospitals--which involves a large diversity of stakeholders--the claim for autonomy of various highly professional groups and the lack of clear business objectives, principles of corporate governance cannot be translated into the hospital sector without specific adjustments. However, irrespective of these contextual differences, corporate governance can provide for a comprehensive 'frame of reference', to which the hospital sector will have to give its own interpretation. A multidisciplinary research unit of the university of Leuven has taken the initiative to develop a governance model for Belgian hospitals. As part of the preliminary research work a survey has been performed among 82 hospitals of the Flemish Community on their governance structure, the composition of the governance entities, the partition of competencies and the relationship between management and medical staff. PMID:15033548

  15. IMPROVING HOSPITAL LOGISTICS BY RETHINKING TECHNOLOGY ASSESSMENT

    DEFF Research Database (Denmark)

    Jacobsen, Peter; Jørgensen, Pelle Morten Thomas

    2011-01-01

    In order to cope with the future challenges of the health care sector, there is an urging need for improving efficiency at hospitals. The study presents a framework enabling health care managers of improving the in-house logistics. The distinctiveness of the framework is the way in which it relates...... technology, logistics, structure and procedures to efficiency. Changing one factor e.g. technology, initiates an iterative loop focusing on change in the related factors in order to obtain the optimal efficiency. The search for an optimal efficient solution is the driving force of the framework, and will...... Danish hospital. The framework is tested on the blood sample logistics between the emergency department and laboratory with the goal of enhancing the efficiency of the emergency department....

  16. 12 hour shifts the Nambour Hospital experience.

    Science.gov (United States)

    2007-08-01

    Union members have a lengthy history of campaigning for fair working hours and conditions. The success of such campaigns has led to the implementation of the eight hour working day and the 40 hour and then 38 hour week as industrial standards. More recently though, calls for greater flexibility in their shift arrangements by nurses at Nambour Hospital have led to a voluntary 12 hour shift being implemented in their Intensive Care Unit. While union members are protective of their hard won gains in achieving reduced working hours through the 8 hour day--ICU nurses at Nambour Hospital say the voluntary 12 hour shift initiative goes a way in addressing their work/life balance issues. PMID:17879604

  17. Hospital mission and cost differences.

    Science.gov (United States)

    Sorrentino, E A

    1989-01-01

    The results show no significant differences on average length of stay, cost per patient day, or cost per admission among non-profit, government, and for-profit hospitals when controlling for bed capacities, occupancy rates, number of Medicare/Medicaid days, and hospitals without nurseries. For-profit hospital manhours per patient day were significantly lower than non-profit and government hospitals. This is an important finding because patient-care delivery is labor-intensive. A majority of for-profit hospitals do not have nurseries, which means that they should have more manhours per patient day. As indicated earlier, the manhours for hospitals with nurseries are higher than those for hospitals without nurseries. This indicates cost-cutting behavior on the part of a majority of for-profit hospitals. This method of limiting expenditures by decreasing labor costs associated with certain services is consistent with profit-maximization. The findings of this study with regard to cost differences among non-profit and for-profit hospitals contradict previous research. However, a recent study by Kralewski, Gifford and Porter (1988) noted that whereas ownership, when considered alone, differentiates hospitals, when evaluated within each community, most of the investor-owned and non-for-profit hospital differences disappear. Similar questions have been raised as to whether non-profit hospitals truly differ from for-profit hospitals (Pauly 1987). Caution needs to be exercised in attempting to extrapolate the findings of this study, because of the dynamic health care environment. Hospital ownership changes over time, reimbursement rules affect behavior, and internal factors in organizational operation affect outcomes. These should be considered in future studies exploring organizational mission and cost differences. PMID:10293600

  18. Controlling hospital library theft

    OpenAIRE

    Cuddy, Theresa M.; Marchok, Catherine

    2003-01-01

    At Capital Health System/Fuld Campus (formerly Helene Fuld Medical Center), the Health Sciences Library lost many books and videocassettes. These materials were listed in the catalog but were missing when staff went to the shelves. The hospital had experienced a downsizing of staff, a reorganization, and a merger. When the library staff did an inventory, $10,000 worth of materials were found to be missing. We corrected the situation through a series of steps that we believe will help other li...

  19. Electronic Cigarettes on Hospital Campuses

    Directory of Open Access Journals (Sweden)

    Clare Meernik

    2015-12-01

    Full Text Available Smoke and tobacco-free policies on hospital campuses have become more prevalent across the U.S. and Europe, de-normalizing smoking and reducing secondhand smoke exposure on hospital grounds. Concerns about the increasing use of electronic cigarettes (e-cigarettes and the impact of such use on smoke and tobacco-free policies have arisen, but to date, no systematic data describes e-cigarette policies on hospital campuses. The study surveyed all hospitals in North Carolina (n = 121 to assess what proportion of hospitals have developed e-cigarette policies, how policies have been implemented and communicated, and what motivators and barriers have influenced the development of e-cigarette regulations. Seventy-five hospitals (62% completed the survey. Over 80% of hospitals reported the existence of a policy regulating the use of e-cigarettes on campus and roughly half of the hospitals without a current e-cigarette policy are likely to develop one within the next year. Most e-cigarette policies have been incorporated into existing tobacco-free policies with few reported barriers, though effective communication of e-cigarette policies is lacking. The majority of hospitals strongly agree that e-cigarette use on campus should be prohibited for staff, patients, and visitors. Widespread incorporation of e-cigarette policies into existing hospital smoke and tobacco-free campus policies is feasible but needs communication to staff, patients, and visitors.

  20. Does Hospital Reputation Influence the Choice of Hospital?

    OpenAIRE

    Pilny, Adam; Mennicken, Roman

    2014-01-01

    A number of recent empirical studies document significant effects of in-patient care quality indicators on the choice of hospital. These studies use either objective quality indicators based on quantitative figures, or if subjective reputation scores are used, scores based on the opinion of hospital market insiders. We contribute to the current debate by using a subjective reputation score resorting to patient perceptions and examine its impact on the choice of hospital of patients undergoing...

  1. Design of paediatric hospitals.

    Science.gov (United States)

    Lambert, Veronica

    2016-05-01

    The impact of healthcare environments on children and young people's (CYP) health and psychosocial wellbeing has attracted much attention in recent years. This sits within the realm of the political drive for enhanced awareness of the need to take account of the rights and voice of the child. Perhaps as a direct result of the United Nations Convention on the Rights of the Child, and recognition from evidence in adult population studies of the impact of healthcare environments on psychosocial healing, contemporary times have witnessed a discernible movement towards enhancing quality care by promoting child and adolescent-friendly hospital environments. The Council of Europe guidelines on child-friendly health care moved to place the rights and needs of children at the heart of health care. The Council acknowledges that the delivery of child-oriented services, which includes the notion of family-centred care, should be delivered in child and family friendly environments. However, knowledge about what constitutes a child-friendly healthcare environment from CYP's perspective is often lacking with hospital architectural blueprints predominantly designed around adult proxy-reported assumptions about the needs and desires of children. PMID:27214414

  2. Characterization of Hospital Residuals

    International Nuclear Information System (INIS)

    The main objective of this investigation is the characterization of the solid residuals. A description of the handling of the liquid and gassy waste generated in hospitals is also given, identifying the source where they originate. To achieve the proposed objective the work was divided in three stages: The first one was the planning and the coordination with each hospital center, in this way, to determine the schedule of gathering of the waste can be possible. In the second stage a fieldwork was made; it consisted in gathering the quantitative and qualitative information of the general state of the handling of residuals. In the third and last stage, the information previously obtained was organized to express the results as the production rate per day by bed, generation of solid residuals for sampled services, type of solid residuals and density of the same ones. With the obtained results, approaches are settled down to either determine design parameters for final disposition whether for incineration, trituration, sanitary filler or recycling of some materials, and storage politics of the solid residuals that allow to determine the gathering frequency. The study concludes that it is necessary to improve the conditions of the residuals handling in some aspects, to provide the cleaning personnel of the equipment for gathering disposition and of security, minimum to carry out this work efficiently, and to maintain a control of all the dangerous waste, like sharp or polluted materials. In this way, an appreciable reduction is guaranteed in the impact on the atmosphere. (Author)

  3. Glutaraldehyde degradation in hospital wastewater by photoozonation.

    Science.gov (United States)

    Kist, Lourdes Teresinha; Rosa, Ellen Caroline; Machado, Enio Leandro; Camargo, Maria Emilia; Moro, Celso Camilo

    2013-01-01

    In this paper, we assessed aqueous solutions of glutaraldehyde (GA), a chemical used for the disinfection of hospital materials, using advanced oxidative processes, O3, and UV, and the combination of the latter two. Assays with different ozone concentrations at distinct pH levels were conducted to determine the best treatment process. GA concentrations before and after each treatment were measured by spectrophotometry. The best treatment was that which combined O3 and UV, yielding a degradation of 72.0-75.0% in relation to the initial concentration with pH between 4 and 9. Kinetics demonstrated that GA degradation is not dependent on pH, as there was a first-order reaction with a rate constant of k = 0.0180 min(-1) for initial pH 9 and of k = 0.0179 min(-1) for initial pH 7, that is, the values are virtually the same. Secondary wastewater samples were also analysed using the septic tank/filter system of a regional hospital in Vale do Rio Pardo, state of Rio Grande do Sul, southern Brazil. In this case, the characteristics of the wastewater were described and, after treatment, a GA degradation rate of 23.3% was noted, with reductions of 75% for chemical oxygen demand, 81% for biochemical oxygen demand, 68% for turbidity, 70% for surfactants and total disinfection in terms of thermotolerant coliforms. PMID:24527619

  4. Initialized Fractional Calculus

    Science.gov (United States)

    Lorenzo, Carl F.; Hartley, Tom T.

    2000-01-01

    This paper demonstrates the need for a nonconstant initialization for the fractional calculus and establishes a basic definition set for the initialized fractional differintegral. This definition set allows the formalization of an initialized fractional calculus. Two basis calculi are considered; the Riemann-Liouville and the Grunwald fractional calculi. Two forms of initialization, terminal and side are developed.

  5. Care initiation area yields dramatic results.

    Science.gov (United States)

    2009-03-01

    The ED at Gaston Memorial Hospital in Gastonia, NC, has achieved dramatic results in key department metrics with a Care Initiation Area (CIA) and a physician in triage. Here's how the ED arrived at this winning solution: Leadership was trained in and implemented the Kaizen method, which eliminates redundant or inefficient process steps. Simulation software helped determine additional space needed by analyzing arrival patterns and other key data. After only two days of meetings, new ideas were implemented and tested. PMID:19275059

  6. Current Initiatives in Cost and Management

    OpenAIRE

    Kirby, William H.

    1984-01-01

    This presentation addresses cost containment initiatives for employers and proposes a management system approach for cost reductions and improved control over the execution of their health care benefit programs. Standard cost management is emphasized as a management tool for more intensive application in hospitals and other large provider organizations. It is a powerful tool for cost reduction and control, prospective costing with reasonable precision, and improving organizational performance...

  7. Hospitals focus on physician relations.

    Science.gov (United States)

    Rubright, R

    1987-09-01

    Many hospital administrators are shifting their marketing focus from consumers and referral agents to the hospital's attending physicians. These new comprehensive physician relations or retention programs are much broader than those implemented in the past and are used to build mutual exchanges between hospitals and physicians, sharpen the physicians' awareness of the hospital's most appealing attributes, compete with nearby hospitals that develop their own aggressive physician relations programs, and ensure a more promising financial picture for both parties. "Cutting-edge" physician relations plans in Catholic hospitals include the following: Marketing plans for the medical staff alone or with key medical staff sections; A strong physician data base; A physician referral system; A director of medical affairs; Practice enhancement and business assistance services; A young physicians section; Continuing marketing auditing and research into physicians' opinions, attitudes, and behavior patterns; Physician inclusion in all major programs, services, policies, and events; Programs for physician office staff; Marketing committees consisting of physicians. PMID:10283486

  8. ANALISA PENERAPAN SISTEM PADA HOSPITALITY INDUSTRY

    Directory of Open Access Journals (Sweden)

    Steeve Haryanto

    2014-12-01

    consideration in implementing an information system in the field of hospitality industry. The method used in this paper is a literature review and analysis. The initial step in the analysis is to conduct a survey on the current system in hotels in Jakarta, and analysis of the survey results and the identification of the need for local companies to compete with foreign companies. Implementation of the system is no longer measured by how many facilities are available but the system is measured by how stable revenue generated calculations per day running at a hotel with no lost posts.

  9. Standards for hospital libraries 2002

    OpenAIRE

    Gluck, Jeannine Cyr; Hassig, Robin Ackley; Balogh, Leeni; Bandy, Margaret; Doyle, Jacqueline Donaldson; Kronenfeld, Michael R.; Lindner, Katherine Lois; Murray, Kathleen; Petersen, JoAn; Rand, Debra C.

    2002-01-01

    The Medical Library Association's “Standards for Hospital Libraries 2002” have been developed as a guide for hospital administrators, librarians, and accrediting bodies to ensure that hospitals have the resources and services to effectively meet their needs for knowledge-based information. Specific requirements for knowledge-based information include that the library be a separate department with its own budget. Knowledge-based information in the library should be directed by a qualified libr...

  10. Estimating Influenza Hospitalizations among Children

    OpenAIRE

    Grijalva, Carlos G.; Craig, Allen S.; DUPONT, William D.; Bridges, Carolyn B.; Schrag, Stephanie J.; Iwane, Marika K.; Schaffner, William; Edwards, Kathryn M.; Griffin, Marie R.

    2006-01-01

    Although influenza causes more hospitalizations and deaths among American children than any other vaccine-preventable disease, deriving accurate population-based estimates of disease impact is challenging. Using 2 independent surveillance systems, we performed a capture-recapture analysis to estimate influenza-associated hospitalizations in children in Davidson County, Tennessee, during the 2003–2004 influenza season. The New Vaccine Surveillance Network (NVSN) enrolled children hospitalized ...

  11. RFID solution benefits Cambridge hospital.

    Science.gov (United States)

    James, Andrew

    2013-10-01

    Keeping track of thousands of pieces of equipment in a busy hospital environment is a considerable challenge, but, according to RFID tagging and asset tracking specialist, Harland Simon, RFID technology can make the task considerably simpler. Here Andrew James, the company's RFID sales manager, describes the positive benefits the technology has brought the Medical Equipment Library (MEL) at Addenbrooke's Hospital, one of the world's most famous teaching hospitals. PMID:24341115

  12. NMR imaging of the brain: initial impressions

    International Nuclear Information System (INIS)

    An NMR imaging system designed and built by Thorn-EMI Ltd was installed at Hammersmith Hospital in March 1981. In the first year of operation 180 patients and 40 volunteers have had cranial examinations and initial impressions bases on this experience are presented. Patients with a wide variety of neurological diseases have been studied to provide a basis for diagnostic interpretation, to define distinctive features, and to evaluate different types of scanning sequences. NMR imaging appears to be of considerable value in neurological diagnosis and has a number of advantages over CT. The detailed evaluation of NMR imaging will require much more work but the initial results are very promising

  13. Deliberation Makes a Difference: Preparation Strategies for TeamSTEPPS Implementation in Small and Rural Hospitals.

    Science.gov (United States)

    Zhu, Xi; Baloh, Jure; Ward, Marcia M; Stewart, Greg L

    2016-06-01

    Small and rural hospitals face special challenges to implement and sustain organization-wide quality improvement (QI) initiatives due to limited resources and infrastructures. We studied the implementation of TeamSTEPPS, a national QI initiative, in 14 critical access hospitals. Drawing on QI and organization development theories, we propose five strategic preparation steps for TeamSTEPPS: assess needs, reflect on the context, set goals, develop a shared understanding, and select change agents. We explore how hospitals' practices correspond to suggested best practices by analyzing qualitative data collected through quarterly interviews with key informants. We find that the level of deliberation was a key factor that differentiated hospitals' practices. Hospitals that were more deliberate in preparing for the five strategic steps were more likely to experience engagement, perceive efficacy, foresee and manage barriers, and achieve progress during implementation. We discuss potential steps that hospitals may take to better prepare for TeamSTEPPS implementation. PMID:26429835

  14. Modeling Evacuation of a Hospital without Electric Power.

    Science.gov (United States)

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

    2015-06-01

    Hospital evacuations that occur during, or as a result of, infrastructure outages are complicated and demanding. Loss of infrastructure services can initiate a chain of events with corresponding management challenges. This report describes a modeling case study of the 2001 evacuation of the Memorial Hermann Hospital in Houston, Texas (USA). The study uses a model designed to track such cascading events following loss of infrastructure services and to identify the staff, resources, and operational adaptations required to sustain patient care and/or conduct an evacuation. The model is based on the assumption that a hospital's primary mission is to provide necessary medical care to all of its patients, even when critical infrastructure services to the hospital and surrounding areas are disrupted. Model logic evaluates the hospital's ability to provide an adequate level of care for all of its patients throughout a period of disruption. If hospital resources are insufficient to provide such care, the model recommends an evacuation. Model features also provide information to support evacuation and resource allocation decisions for optimizing care over the entire population of patients. This report documents the application of the model to a scenario designed to resemble the 2001 evacuation of the Memorial Hermann Hospital, demonstrating the model's ability to recreate the timeline of an actual evacuation. The model is also applied to scenarios demonstrating how its output can inform evacuation planning activities and timing. PMID:25868416

  15. Data mining based hospital management

    Institute of Scientific and Technical Information of China (English)

    TSUMOTO Yuko; TSUMOTO Shusaku

    2008-01-01

    Rapid progress in information technology has come to enable us to store all the information in a hospital in- formation system, including management data, patient records, discharge summary and laboratory data. Although the reuse of those data has not started, it has been expected that the stored data will contribute to analysis of hospi-tal management. In this paper, the diseharge summary of Chiba University Hospital, which has been stored since 980's were analyzed to characterize the university hospital. The results show several interesting results, which uggests that the reuse of stored data will give a powerful tool to support a long-period management of a university ospital.

  16. Hospital waste management in Lebanon

    International Nuclear Information System (INIS)

    Hospital wastes comprises approximately 80% domestic waste components, also known as non-risk waste and 20% hazardous or risk waste. The 20% of the hospital waste stream or the risk waste (also known as infectious, medical, clinical wastes) comprises components which could be potentially contaminated with infections, chemical or radioactive agents. Therefore, it should be handled and disposed of in such a manner as to minimize potential human exposure and cross-contamination. Hospital risk waste and be subdivided into seven general categories as follows: infections, anatomical/pathological, chemical, pharmaceutical, radioactive waste, sharps and pressurised containers. These waste categories are generated by many types of health care establishments, including hospitals, clinics, infirmaries.... The document presents also tables of number of hospitals and estimated bed number in different regions in Lebanon; estimated hospital risk and non-risk waste generation per tonnes per day for the years 1998 until 2010 and finally sensitivity analysis of estimated generation of hospital risk waste in Lebanon per tonnes per day for the years 1998 until 2010. The management, treatment and disposal of hospital risk waste constitute important environmental and public safety issues. It is recognised that there is alack of infrastructure for the safe and environmentally acceptable disposal of hospital waste in Lebanon

  17. Medicina e hospital

    Directory of Open Access Journals (Sweden)

    Alcindo Antônio Ferla

    2011-12-01

    Full Text Available Este texto é resultado de uma revisão das análises históricas de Michel Foucault a respeito da constituição da Medicina Moderna e de suas relações com outros saberes. Descreve-se de que modo a organização da atenção à saúde se efetuou a partir da tecnologia hospital e das relações de poder que investiram os corpos individuais e coletivos na concretização de um projeto de sociedade. Pergunta-se como a vida entrou em cena pela via de uma biopolítica e como se constituiu a anátomo-política em seus efeitos no campo da organização dos serviços médicos e dos modos de gerir a saúde.

  18. Practice and hospital economics.

    Science.gov (United States)

    Senagore, Anthony J

    2006-08-01

    There has been a significant effort over the past 10 years to attempt to control the rate of increase in the cost of medical care. However, as is true of any economic system, there are multiple stakeholders involved and often competing motivations. The single largest source of medical inflation is the cost of pharmaceuticals; however, this topic is not directly discussed in this article Similarly, the cost of medical insurance products is not included as these issues cannot be directly addressed by physician behavior. The body of this discussion focuses on costs directly experienced by or potentially controlled by physicians. These areas include practice expense and margin and hospital direct costs and margin. It is essential for physicians to understand fully factors they can potentially control and areas they may be able to influence in this troubling era of cost containment. PMID:20011377

  19. Caring for migrant and minority patients in European hospitals: a review of effective interventions

    OpenAIRE

    Bischoff, Alexander

    2007-01-01

    Social changes in European societies place migration and cultural diversity on the European political agenda. The European initiative Migrant Friendly Hospitals (MFH) aims to identify, develop and evaluate models of effective interventions. It has the following objectives: To strengthen the role of hospitals in promoting the health of migrants and ethnic minorities in the European Union and to improve hospital services for these groups. This report reviews models of effective intervention in ...

  20. Can soda fountains be recommended in hospitals?

    Science.gov (United States)

    Chaberny, Iris F; Kaiser, Peter; Sonntag, Hans-Günther

    2006-09-01

    Mineral water (soda water) is very popular in Germany. Therefore, soda fountains were developed as alternatives to the traditional deposit bottle system. Nowadays, different systems of these devices are commercially available. For several years, soda fountains produced by different companies have been examined at the University Hospital of Heidelberg. In 1998, it was possible for the first time to observe and evaluate one of these systems over a period of 320 days in a series of microbiological examinations. The evaluation was implemented on the basis of the German drinking water regulation (Anonymous, 1990. Gesetz über Trinkwasser und Wasser für Lebensmittelbetriebe (Trinkwasserverordnung - TrinkwV) vom 12. Dezember 1990. Bundesgesetzblatt 66, 2613ff). Initially, the bacteria counts exceeded the reference values imposed by the German drinking water regulation in almost 50% of the analyses. Pseudomonas aeruginosa was also detected in almost 38% of the samples. After a re-arrangement of the disinfection procedure and the removal of the charcoal filter, Pseudomonas aeruginosa was not detectable any more. However, the bacteria counts still frequently exceeded the reference values of the German drinking water regulation. Following our long-term analysis, we would not recommend soda fountains in high-risk areas of hospitals. If these devices are to be used in hospitals, the disinfection procedures should be executed in weekly or fortnightly intervals and the water quality should be examined periodically. PMID:16740412

  1. Training for Hospitality.

    Science.gov (United States)

    Herman, Francine A.; Eller, Martha E.

    1991-01-01

    The labor problems of hotels and restaurants are being addressed with partnership training initiatives. Examples are the Stratford Chef's School in Ontario, the University of Hawaii's Tourism Industry Management Program, and an English-as-a-Second-Language program sponsored by labor and management in New York City hotels. (SK)

  2. Pre-hospital emergency medicine.

    Science.gov (United States)

    Wilson, Mark H; Habig, Karel; Wright, Christopher; Hughes, Amy; Davies, Gareth; Imray, Chirstopher H E

    2015-12-19

    Pre-hospital care is emergency medical care given to patients before arrival in hospital after activation of emergency medical services. It traditionally incorporated a breadth of care from bystander resuscitation to statutory emergency medical services treatment and transfer. New concepts of care including community paramedicine, novel roles such as emergency care practitioners, and physician delivered pre-hospital emergency medicine are re-defining the scope of pre-hospital care. For severely ill or injured patients, acting quickly in the pre-hospital period is crucial with decisions and interventions greatly affecting outcomes. The transfer of skills and procedures from hospital care to pre-hospital medicine enables early advanced care across a range of disciplines. The variety of possible pathologies, challenges of environmental factors, and hazardous situations requires management that is tailored to the patient's clinical need and setting. Pre-hospital clinicians should be generalists with a broad understanding of medical, surgical, and trauma pathologies, who will often work from locally developed standard operating procedures, but who are able to revert to core principles. Pre-hospital emergency medicine consists of not only clinical care, but also logistics, rescue competencies, and scene management skills (especially in major incidents, which have their own set of management principles). Traditionally, research into the hyper-acute phase (the first hour) of disease has been difficult, largely because physicians are rarely present and issues of consent, transport expediency, and resourcing of research. However, the pre-hospital phase is acknowledged as a crucial period, when irreversible pathology and secondary injury to neuronal and cardiac tissue can be prevented. The development of pre-hospital emergency medicine into a sub-specialty in its own right should bring focus to this period of care. PMID:26738719

  3. Good management. Corporate governance: 'the hospital is listening'.

    Science.gov (United States)

    Brown, Pauline; Craig, Andrew

    2004-11-25

    Homerton University Hospital trust, a first-wave foundation, commissioned a specialist consultancy to devise an induction programme for the governors. It was vital to tailor activities to individual needs while retaining overall consistency. A concluding exercise demonstrated that the majority agreed they had overcome initial hesitancy. PMID:15597925

  4. Management of abortion complications at a rural hospital in Uganda

    DEFF Research Database (Denmark)

    Mellerup, Natja; Sørensen, Bjarke Lund; Kuriigamba, Gideon K.;

    2015-01-01

    hospital in Uganda. METHODS: A partially completed criterion-based audit was conducted comparing actual to optimal care. The audit criteria cover initial clinical assessment of vital signs and management of common severe complications such as sepsis and haemorrhage. Sepsis shall be managed by immediate...

  5. The Hospital Medicine Reengineering Network (HOMERuN): a learning organization focused on improving hospital care.

    Science.gov (United States)

    Auerbach, Andrew D; Patel, Mitesh S; Metlay, Joshua P; Schnipper, Jeffrey L; Williams, Mark V; Robinson, Edmondo J; Kripalani, Sunil; Lindenauer, Peter K

    2014-03-01

    Converting the health care delivery system into a learning organization is a key strategy for improving health outcomes. Although the collaborative learning organization approach has been successful in neonatal intensive care units and disease-specific collaboratives, there are few examples in general medicine and none in adult medicine that have leveraged the role of hospitalists nationally across multiple institutions to implement improvements. The authors describe the rationale for and early work of the Hospital Medicine Reengineering Network (HOMERuN), a collaborative of hospitals, hospitalists, and multidisciplinary care teams founded in 2011 that seeks to measure, benchmark, and improve the efficiency, quality, and outcomes of care in the hospital and afterwards. Robust and timely evaluation, with learning and refinement of approaches across institutions, should accelerate improvement efforts. The authors review HOMERuN's collaborative model, which focuses on a community-based participatory approach modified to include hospital-based staff as well as the larger community. HOMERuN's initial project is described, focusing on care transition measurement using perspectives from the patient, caregiver, and providers. Next steps and sustainability of the organization are discussed, including benchmarking, collaboration, and effective dissemination of best practices to stakeholders. PMID:24448050

  6. Emergencies in the hospital environment

    International Nuclear Information System (INIS)

    Every hospital center must have an emergency plan, which in case of an accident would immediately set off. The present article describes the particularities of radioactive installations already in existence in hospitals in case of an emergency and the radiologic risks which must be taken into account. (Author)

  7. Faculty Internships for Hospitality Instructors

    Science.gov (United States)

    Lynn, Christine; Hales, Jonathan A; Wiener, Paul

    2007-01-01

    Internships can help hospitality faculty build industry relationships while also ensuring the best and most current training for their students. Many hospitality organizations have structured faculty internships available or are willing to work with faculty to provide individualized internship opportunities. Career and technical educators in…

  8. Segmentation in local hospital markets.

    Science.gov (United States)

    Dranove, D; White, W D; Wu, L

    1993-01-01

    This study examines evidence of market segmentation on the basis of patients' insurance status, demographic characteristics, and medical condition in selected local markets in California in the years 1983 and 1989. Substantial differences exist in the probability patients may be admitted to particular hospitals based on insurance coverage, particularly Medicaid, and race. Segmentation based on insurance and race is related to hospital characteristics, but not the characteristics of the hospital's community. Medicaid patients are more likely to go to hospitals with lower costs and fewer service offerings. Privately insured patients go to hospitals offering more services, although cost concerns are increasing. Hispanic patients also go to low-cost hospitals, ceteris paribus. Results indicate little evidence of segmentation based on medical condition in either 1983 or 1989, suggesting that "centers of excellence" have yet to play an important role in patient choice of hospital. The authors found that distance matters, and that patients prefer nearby hospitals, moreso for some medical conditions than others, in ways consistent with economic theories of consumer choice. PMID:8417270

  9. Practicing Hospitality in the Classroom

    Science.gov (United States)

    Burwell, Rebecca; Huyser, Mackenzi

    2013-01-01

    This article explores pedagogical approaches to teaching students how to practice hospitality toward the other. Using case examples from the college classroom, the authors discuss the roots of Christian hospitality and educational theory on transformative learning to explore how students experience engaging with others after they have…

  10. Partners: group practices and hospitals.

    Science.gov (United States)

    Schryver, D L

    1990-02-01

    Many hospital executives see the emergence of medical group practices as a threat to their autonomy. However, the degree of future success of hospitals and group practices may depend on their willingness and ability to develop common goals and strategies. PMID:10106349

  11. Latex in the Hospital Environment

    Science.gov (United States)

    LATEX in the Hospital Environment Updated Fall 2015 This list provides a guide to some of the most common objects containing latex and offers some ... remover–Sepha Pharm) 1 LATEX in the Hospital Environment (continued) Frequently contains LATEX OR/Infection Control masks, ...

  12. Video interpretations in Danish hospitals

    DEFF Research Database (Denmark)

    Søbjerg, Lene Mosegaard; Noesgaard, Susanne; Henriksen, Jan Erik;

    2013-01-01

    This article presents a study of an RCT comparing video interpretation with in-person interpretation at the Endocrinology Ward at Odense University Hospital.......This article presents a study of an RCT comparing video interpretation with in-person interpretation at the Endocrinology Ward at Odense University Hospital....

  13. The effect of hospital-physician integration on health information technology adoption.

    Science.gov (United States)

    Lammers, Eric

    2013-10-01

    The US federal government has recently made a substantial investment to enhance the US health information technology (IT) infrastructure. Previous literature on the impact of IT on firm performance across multiple industries has emphasized the importance of a process of co-invention whereby organizations develop complementary practices to achieve greater benefit from their IT investments. In health care, employment of physicians by hospitals can confer greater administrative control to hospitals over physicians' actions and resources and thus enable the implementation of new technology and initiatives aimed at maximizing benefit from use of the technology. In this study, I tested for the relationship between hospital employment of physicians and hospitals' propensity to use health IT. I used state laws that prohibit hospital employment of physicians as an instrument to account for the endogenous relationship with hospital IT use. Hospital employment of physicians is associated with significant increases in the probability of hospital health IT use. Therefore, subsidization of health IT among hospitals not employing physicians may be less efficient. Furthermore, state laws prohibiting hospitals from employing physicians may inhibit adoption of health IT, thus working against policy initiatives aimed at promoting use of the technology. PMID:23055450

  14. New directions in hospital governance.

    Science.gov (United States)

    Shortell, S M

    1989-01-01

    This article suggests new directions for hospital governance to meet the demands of a rapidly changing health care environment. Board members must increasingly play roles as risk takers, strategic directors, experts, mentors, and evaluators. Lessons from other industries regarding risk taking, use of expertise, and streamlining decision making must be adapted to meet hospital needs. Recent data suggest that these needs may still differ by hospital ownership despite a convergence in investor-owned and not-for-profit corporate structures. The effectiveness of hospital boards in the future will depend on their ability to: (1) manage a diverse group of stakeholders; (2) involve physicians in the management and governance process; (3) meet the governance needs of multi-institutional systems and hospital restructuring; (4) meet the challenges of diversification and vertical integration; and (5) understand strategy formulation and implementation as interdependent and interrelated processes. PMID:10303235

  15. Brief hospitalizations of elderly patients

    DEFF Research Database (Denmark)

    Strømgaard, Sofie; Rasmussen, Søren Wistisen; Schmidt, Thomas Andersen

    2014-01-01

    BACKGROUND: Crowded departments are a common problem in Danish hospitals, especially in departments of internal medicine, where a large proportion of the patients are elderly. We therefore chose to investigate the number and character of hospitalizations of elderly patients with a duration of less...... than 24 hours, as such short admissions could indicate that the patients had not been severely ill and that it might have been possible in these cases to avoid hospitalization. METHODS: Medical records were examined to determine the number of patients aged 75 or more who passed through the emergency...... department over a period of two months, and the proportion of those patients who were discharged after less than 24 hours. The reasons for the hospitalization, the diagnoses and the treatment given were noted. RESULTS: There was a total of 595 hospitalizations of patients aged 75 or above in the emergency...

  16. Mobile Robots for Hospital Logistics

    DEFF Research Database (Denmark)

    Özkil, Ali Gürcan

    services to maintain the quality of healthcare provided. Logistics 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 talk consequently addresses the key technical issues of implementing service robots in hospitals. In simple terms, a robotic system for automating hospital logistics has to be reliable, adaptable and scalable. Robots have to be semi-autonomous, and...... a redundant layer for localization. The system features automatic annotation, which significantly reduces manual work and offer many advantages beyond robotics. A case study on logistics solutions is finally presented. A robotic solution is tested in a hospital to handle the transportation of blood...

  17. Light Atmosphere in Hospital Wards

    DEFF Research Database (Denmark)

    Stidsen, Lone Mandrup

    At the moment, the future of hospital design is a subject of interest and thereby also a subject of discussion. It is a fact that new hospitals have an increased focus on user perspectives and an interest for improving the physical environment in such a way it supports the user needs...... and preferences and thereby the experience of an admission to the hospital. Recent literature such as ‘Hospitals of the senses’ and ‘Healing Architecture’ presents research and design solutions focused on senses and experience of the design. The Danish Regions ask for ‘Evidence Based Design’ to future prove...... the hospitals by research base the design of the buildings. The present PhD project expands the existing knowledge of lighting research by focusing on the experienced light atmosphere. The project uses multi strategies of methodology based on a flexible design to elaborate on the sociocultural aspect of light...

  18. Hospital-diagnosed dementia and suicide

    DEFF Research Database (Denmark)

    Erlangsen, Annette; Zarit, Steven H; Conwell, Yeates

    2008-01-01

    OBJECTIVE: The current study aims to examine the risk of suicide in persons diagnosed with dementia during a hospitalization and its relationship to mood disorders. DESIGN: Event-history analysis using time-varying covariates. SETTING: Population-based record linkage. PARTICIPANTS: All individual...... for older adults. Preventive measures should focus on suicidal ideation after initial diagnosis but also acknowledge that suicides can occur well after a dementia diagnosis has been established....... who are aged 70 or older with dementia have a threefold higher risk than persons with no dementia. The time shortly after diagnosis is associated with an elevated suicide risk. The risk among persons with dementia remains significant when controlling for mood disorders. As many as 26% of the men...... and 14% of the women who died by suicide died within the first 3 months after being diagnosed whereas 38% of the men and 41% of the women died more than 3 years after initial dementia diagnosis. CONCLUSIONS: Dementia, determined during hospitalization, was associated with an elevated risk of suicide...

  19. Prevention of meticillin-resistant Staphylococcus aureus bloodstream infections in European hospitals: moving beyond policies

    NARCIS (Netherlands)

    Borg, M.A.; Hulscher, M.; Scicluna, E.A.; Richards, J.; Azanowsky, J.M.; Xuereb, D.; Huis, A. van; Moro, M.L.; Maltezou, H.C.; Frank, U.

    2014-01-01

    BACKGROUND: There is evidence that meticillin-resistant Staphylococcus aureus (MRSA) bacteraemia can be reduced with improved infection control and antibiotic stewardship. AIM: To survey infection control and antibiotic stewardship practices within European hospitals and to identify initiatives that

  20. Physicians and foundation hospitals.

    Science.gov (United States)

    Cooper, John; Black, Carol

    2003-01-01

    Foundation NHS Trusts will be constituted in the same way as Mutual Societies, and local people and patients will be invited to become subscribers. Subscribers will elect a board of governors who will appoint the non-executive directors of the Trusts. Foundation Trusts will be outside the performance management system, but will be subject to a regulator and to inspection. Contracts with commissioners will be legally enforceable. Issues discussed in the article include: financial borrowing; whether competition is being reintroduced; poaching staff; fears of a two-tier health service; fragmentation of the NHS; the impact on research and teaching; and the impact on the current 'target culture'. Local communities and patient groups may welcome involvement with their local hospitals, but special interest groups could be a danger. Foundation Trusts may bring back some of the better features of NHS Trusts as originally conceived, and offer better opportunities for clinicians to influence local policies and priorities. Fears of yet another organisational change are an important issue. Only time will tell whether the outcome will justify the effort the changes will involve. PMID:14703035

  1. Contrasting continuous quality improvement, Six Sigma, and lean management for enhanced outcomes in US hospitals

    OpenAIRE

    Charles R. Gowen III; Kathleen L. McFadden; Sriranjita Settaluri

    2012-01-01

    Rapidly rising healthcare costs, partially due to preventable medical errors, have led hospitals to redouble their process improvement (PI) efforts. The purpose of this paper is to examine how PI initiatives mediate the effect of medical error sources to enhance three hospital outcomes (patient safety, operational effectiveness, and competitiveness). Drawing from Dynamic Capabilities Theory, the authors develop a framework to explore three PI initiatives: Continuous Quality Improvement (CQI),...

  2. Educating leaders in hospital management: a new model in Sub-Saharan Africa

    OpenAIRE

    Kebede, Sosena; Abebe, Yigeremu; Wolde, Mirkuzie; Bekele, Biftu; Mantopoulos, Jeannie; Bradley, Elizabeth H

    2009-01-01

    Quality issue The vast majority of health system capacity-building efforts have focused on enhancing medical and public health skills; less attention has been directed at developing hospital managers despite their central role in improving the functioning and quality of health-care systems. Initial assessment and choice of intervention Initial assessment of hospital management systems demonstrated weak functioning in several management areas. In response, we developed with the Ethiopian Minis...

  3. Breastfeeding in Iran: prevalence, duration and current recommendations

    OpenAIRE

    Strandvik Birgitta; Heidarzadeh Abtin; Farivar Khalil; Olang Beheshteh; Yngve Agneta

    2009-01-01

    Abstract Background The need to promote breastfeeding is unquestionable for the health and development of infants. The aim of this study was to investigate prevalence, duration and promotion of breastfeeding status in Iran with respect to the Baby Friendly Hospital, government actions and activities by the Breastfeeding Promotion Society including comparison with European countries. Methods This retrospective study is based on data from 63,071 infants less than 24 months of age in all the 30 ...

  4. Governing boards and profound organizational change in hospitals.

    Science.gov (United States)

    Fennell, M L; Alexander, J A

    1989-01-01

    Over the past decade the importance of governing boards as policy-making setting and oversight units within organizations has increased dramatically. Although this is true for both corporate- and private-sector organizations (Bacon and Brown 1977; Gelman 1988), it is particularly relevant to the health sector. Hospital governing boards, long considered inconsequential in hospital management, have recently become subject to closer scrutiny. The role of governing boards in decisions affecting hospital strategy and hospital performance is once again a topic of some interest in boardrooms and hospital trade journals. Impressive evidence of the renewed interest in governance is provided by the funding of an instructional consortium by the S.K. Kellogg Foundation to help strengthen trusteeship and governing board decision making, and to improve education for health services managers in the area of governance. Members of the consortium include the Hospital Research and Educational Trust, the American Hospital Association, the American College of Healthcare Executives, and the Association for University Programs in Health Administration. Among the activities being undertaken by this consortium is the development of a self-assessment tool/methodology for boards, a bibliography and reference guide on effective governance for practicing trustees, research workshops for faculty in health administration programs, and a teaching guide on governance and trustee leadership. Despite this interest, the question with which we began this article persists. Do governing boards make a difference? In the course of our review of previous work on governance we found that, more often than not, that question has been transformed into: how do boards influence hospital performance? And very often that question has been further narrowed into: which board structure leads to better hospital performance? We have argued for a respecification of the initial question. Rather than pursuing a definition

  5. CDC Vital Signs: Hospital Actions Affect Breastfeeding

    Science.gov (United States)

    ... Read the MMWR Science Clips Hospital Actions Affect Breastfeeding Language: English Español (Spanish) Recommend on Facebook Tweet ... in many US hospitals do not fully support breastfeeding. Some of the Ten Steps on which hospitals ...

  6. Prognosis after Hospitalization for Erythroderma

    DEFF Research Database (Denmark)

    Egeberg, Alexander; Thyssen, Jacob P; Gislason, Gunnar H;

    2016-01-01

    Erythrodermic psoriasis (EP) and erythroderma exfoliativa (EE) are acute and potentially life-threatening inflammatory reactions. We estimated hazard ratios (HRs) of 3-year mortality following hospitalization for EP or EE compared with general population controls, patients hospitalized for...... psoriasis vulgaris, and toxic epidermal necrolysis (TEN), respectively. We identified 26 and 48 patients with a first-time hospitalization (1997-2010) for EP and EE, respectively (10 matched population-controls for each patient), 1,998 patients with psoriasis vulgaris, and 60 patients with TEN. During...

  7. Hospital-based neuropsychological services.

    Science.gov (United States)

    Sciara, A D

    1986-01-01

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

  8. Præhospital ultralyd

    DEFF Research Database (Denmark)

    Rognås, Leif Kåre; Christensen, Erika Frischknecht; Sloth, Erik;

    2009-01-01

    Danish anaesthesiologists use ultrasound (US) to examine and treat acutely ill or traumatized patients in the emergency room, operating theatre and intensive care unit. They are also involved in pre-hospital care where US may theoretically be beneficial for both diagnostic and therapeutic purposes....... The literature concerning the potential use of emergency US in the pre-hospital setting is evaluated. Evidence from both Europe and the USA indicates that pre-hospital US improves diagnosis and visitation of acutely ill or traumatized patients. Udgivelsesdato: 2009-Aug-31...

  9. Pennsylvania Critical Access Hospital Consortium: a strategy-focused performance improvement network.

    Science.gov (United States)

    Baronner, Larry; Wolf, Gregory

    2006-01-01

    The Pennsylvania Critical Access Hospital Consortium (PACAHC) has had success with an ambitious plan to bring together 12 small rural hospitals to support performance improvement initiatives. PACAHC differs from most other rural health networks or state Rural Hospital Flexibility (Flex) Programs because of its multiyear process to implement Balanced Scorecards at every member hospital and its innovative coordination of data collection and reporting systems to enable performance comparison. PACAHC also convenes statewide performance improvement meetings that allow partner organizations, such as the state quality improvement organization, to contribute to improvement activities. PMID:17518019

  10. Factors associated with breastfeeding cessation in nursing mothers in a peer support programme in Eastern Lancashire

    Directory of Open Access Journals (Sweden)

    Verma Arpana

    2010-01-01

    Full Text Available Abstract Background The UK has one of the lowest breastfeeding rates worldwide and in recent years the Government has made breastfeeding promotion one of its priorities. The UNICEF UK Baby Friendly Initiative is likely to increase breastfeeding initiation but not duration. Other strategies which involve provision of support for breastfeeding mothers in the early weeks after birth are therefore required to encourage UK mothers to breastfeed for the recommended duration. This paper examines the effects of maternal socio-demographic factors, maternal obstetric factors, and in-hospital infant feeding practices on breastfeeding cessation in a peer support setting. Methods Data on mothers from Blackburn with Darwen (BwD and Hyndburn in Eastern Lancashire who gave birth at the Royal Blackburn Hospital and initiated breastfeeding while in hospital were linked to the Index of Multiple Deprivation (IMD. The data were analysed to describe infant feeding methods up to 6 months and the association between breastfeeding cessation, and maternal factors and in-hospital infant feeding practices. Results The mean breastfeeding duration was 21.6 weeks (95% CI 20.86 to 22.37 weeks and the median duration was 27 weeks (95% CI 25.6 to 28.30 weeks. White mothers were 69% more likely to stop breastfeeding compared with non-White mothers (HR: 0.59; 95% CI, 0.52 to 0.67 [White mothers were the reference group]. Breastfeeding cessation was also independently associated with parity and infant feeding practices in hospital. There were no significant associations between breastfeeding cessation and marital status, mode of delivery, timing of breastfeeding initiation and socio-economic deprivation. Conclusion In this study ethnicity, parity and in-hospital infant feeding practices remained independent predictors of breastfeeding cessation in this peer support setting. However other recognised predictors such as marital status, mode of delivery, timing of breastfeeding

  11. TB as a cause of hospitalization and in-hospital mortality among people living with HIV worldwide: a systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Nathan Ford

    2016-01-01

    Full Text Available Introduction: Despite significant progress in improving access to antiretroviral therapy over the past decade, substantial numbers of people living with HIV (PLHIV in all regions continue to experience severe illness and require hospitalization. We undertook a global review assessing the proportion of hospitalizations and in-hospital deaths because of tuberculosis (TB in PLHIV. Methods: Seven databases were searched to identify studies reporting causes of hospitalizations among PLHIV from 1 January 2007 to 31 January 2015 irrespective of age, geographical region or language. The proportion of hospitalizations and in-hospital mortality attributable to TB was estimated using random effects meta-analysis. Results: From an initial screen of 9049 records, 66 studies were identified, providing data on 35,845 adults and 2792 children across 42 countries. Overall, 17.7% (95% CI 16.0 to 20.2% of all adult hospitalizations were because of TB, making it the leading cause of hospitalization overall; the proportion of adult hospitalizations because of TB exceeded 10% in all regions except the European region. Of all paediatric hospitalizations, 10.8% (95% CI 7.6 to 13.9% were because of TB. There was insufficient data among children for analysis by region. In-hospital mortality attributable to TB was 24.9% (95% CI 19.0 to 30.8% among adults and 30.1% (95% CI 11.2 to 48.9% among children. Discussion: TB remains a leading cause of hospitalization and in-hospital death among adults and children living with HIV worldwide.

  12. Modeling organizational determinants of hospital mortality.

    OpenAIRE

    al-Haider, A S; Wan, T T

    1991-01-01

    This study examines hospital characteristics that affect the differential in hospital mortality. Death rates for 1984 Medicare inpatients in acute care hospitals, released by the Health Care Financing Administration in 1986, were analyzed. A confirmatory statistical approach to organizational determinants of hospital mortality was formulated and validated through an empirical examination of 239 hospitals. The findings suggest that the effect of hospital size and specialization on mortality wa...

  13. Old Testament foundations for Christian hospitality

    OpenAIRE

    Lee Roy Martin

    2014-01-01

    In an effort to revive the ancient Christian practice of hospitality, scholars often appeal to the Old Testament as a model to be emulated. This article examined and described the practice of hospitality in the Old Testament and evaluated its relevancy for the recent discussions surrounding hospitality. Throughout the history of discussions on hospitality, Abraham has served as the exemplar of biblical hospitality. Therefore, the Old Testament practice of hospitality was evaluated through Abr...

  14. Myths and truths about Brazilian hospitality

    OpenAIRE

    Ferraz, Valéria de Souza

    2012-01-01

    The Brazilians image is often associated with sympathy and joy. However these characteristics do not necessarily make them hospitable. To be hospitable it´s not just have a smile or be helpful, you must have hospitability, that is, the ability to offer hospitality. Hospitality is a social phenomenon that manifests in the domestic, commercial or public context. It is believed that the Brazilian has a natural talent for the domestic hospitality, which extends somehow into the ...

  15. Hospital Mergers: A Spatial Competition Approach

    OpenAIRE

    Brekke, Kurt Richard; Siciliani, Luigi; Straume, Odd Rune

    2013-01-01

    Using a spatial competition framework with three ex ante identical hospitals, we study the effects of a hospital merger on quality, price and welfare. The merging hospitals always reduce quality, but the non-merging hospital responds by reducing quality if prices are fixed and increasing quality if not. The merging hospitals increase prices if demand responsiveness to quality is sufficiently low, whereas the non-merging hospital always increases its price. If prices are endogenous, a merger l...

  16. The Hospital System and the Urban Resilience

    Directory of Open Access Journals (Sweden)

    Francesca Pirlone

    2012-07-01

    Full Text Available The concept of resilience is critical when addressing the issue of natural hazards. The role of an urban planner is to analyze the territorial system, consisting of several functional sub-systems (housing, education, health, etc.. and its vulnerability. In order to have a specific knowledge of the territory in question, before the occurrence of a disaster it would be necessary, for each functional system, analyze various aspects and define risk simulations. In a city, in fact, there are strategic elements that should not lose functionality during or following a natural event; the definition of specific scenarios could put structures exposed to risk on safety in order not to compromise the system. In this paper I report a specific experience of research carried out within the hospital system that, in case of occurrence of a natural event, is often simultaneously exposed, and therefore need of rescue, and it is a dispenser of rescue. It’s considered strategic because it has to ensure the functionality of its service regardless of the occurrence of external events, such as natural ones; its functionality must be ensured in the continuum. In today is not very thorough the scientific literature about the analysis of the hospital system in respect of such events. Given the importance of the theme there are several initiatives, also promoted by The Italian Civil Protection, in particular the drafting of hospital emergency plans, which cover issues such as fire, road accidents, floods, ... Interesting was the collaboration between the Italian Civil Protection Department with Applied Technology Council for the planning of a background paper intended for the preparation of earthquake emergency plans, within which there are also aspects of prevention such as the evaluation of seismic vulnerability of hospitals themselves. The described methodology has allowed the definition of risk simulations for the hospital system, starting from the determination of

  17. Turning around an ailing district hospital: a realist evaluation of strategic changes at Ho Municipal Hospital (Ghana

    Directory of Open Access Journals (Sweden)

    Kegels Guy

    2010-12-01

    Full Text Available Abstract Background There is a growing consensus that linear approaches to improving the performance of health workers and health care organisations may only obtain short-term results. An alternative approach premised on the principle of human resource management described as a form of 'High commitment management', builds upon a bundles of balanced practices. This has been shown to contribute to better organisational performance. This paper illustrates an intervention and outcome of high commitment management (HiCom at an urban hospital in Ghana. Few studies have shown how HiCom management might contribute to better performance of health services and in particular of hospitals in low and middle-income settings. Methods A realist case study design was used to analyse how specific management practices might contribute to improving the performance of an urban district hospital in Ho, Volta Region, in Ghana. Mixed methods were used to collect data, including document review, in-depth interviews, group discussions, observations and a review of routine health information. Results At Ho Municipal Hospital, the management team dealt with the crisis engulfing the ailing urban district hospital by building an alliance between hospital staff to generate a sense of ownership with a focus around participative problem analysis. The creation of an alliance led to improving staff morale and attitude, and contributed also to improvements in the infrastructure and equipment. This in turn had a positive impact on the revenue generating capacity of the hospital. The quick turn around in the state of this hospital showed that change was indeed possible, a factor that greatly motivated the staff. In a second step, the management team initiated the development of a strategic plan for the hospital to maintain the dynamics of change. This was undertaken through participative methods and sustained earlier staff involvement, empowerment and feelings of reciprocity. We

  18. Sustainable Agricultural Marketing Initiatives

    OpenAIRE

    Hakan Adanacıoğlu

    2015-01-01

    Sustainable marketing is a holistic approach that puts equal emphasis on environmental, social equity, and economic concerns in the development of marketing strategies. The purpose of the study is to examine and discuss the sustainable agricultural marketing initiatives practiced throughout the World and Turkey, and to put forth suggestions to further improve the performance of agricultural marketing initiatives in Turkey. Some of the sustainable agricultural marketing initiatives practiced a...

  19. Emerging Pathogens Initiative (EPI)

    Data.gov (United States)

    Department of Veterans Affairs — The Emerging Pathogens Initiative (EPI) database contains emerging pathogens information from the local Veterans Affairs Medical Centers (VAMCs). The EPI software...

  20. Medicaid Disproportionate Share Hospital Payments

    Data.gov (United States)

    U.S. Department of Health & Human Services — Medicaid Disproportionate Share Hospital (DSH) Payments This link provides you with information about Medicaid DSH Payments. You can find information on DSH Audit...

  1. Radiation hazard control in hospitals

    International Nuclear Information System (INIS)

    This manual is designed to aid in the training of hospital personnel engaged in work with the more common sources of ionizing radiation. It emphasizes the essentials of safety procedures for users of radioisotopes and x-rays

  2. Hospitality: The conquest of Paradise

    Directory of Open Access Journals (Sweden)

    Maximiliano Korstanje

    2008-12-01

    Full Text Available The term hospitality is associated with the industry of tourism. In fact, it is very well considered as a form of relationship between hosts and guest in that modern activity. Nevertheless, its historical root remains occulted in the bottom of darkness. Under that circumstance, ancient history contributes with hard evidence that proves hospitality was present and used as a mechanism to create legitimacy in the conquest of America. That way, Hominem viatores assured that Crown’s boundaries were expanded by means of explorers and travelers. The figure of trips as well as hospitality reminded Europeans the superiority of their technique of production over the rest of the world. The present article is aimed at discussing not only ethimologically the origin of this term but also in shedding light into a scientific definition of hospitality.

  3. Functional textiles in hospital interiors

    DEFF Research Database (Denmark)

    Mogensen, Jeppe

    This PhD thesis explores the possibilities and design qualities of using functional textiles in the interior of hospital environments, and is the result of a three years collaboration between Aalborg University, Department of Civil Engineering, and VIA University College, VIA Design. The project is...... overall related to the construction of new Danish hospitals, where the design concept healing architecture is introduced in a national context, representing the vision of a promoted healing process of hospitalised patients, supported by design related influence. Past research studies provides evidence...... that the physical environments affect the patients’ level of stress and influence their process of recovery and healing. However, although research in this field of hospital design has increased substantially in recent years, knowledge on the use of new materials and textiles in hospital interiors is...

  4. Antifungal therapy in European hospitals

    DEFF Research Database (Denmark)

    Zarb, P; Amadeo, B; Muller, A;

    2012-01-01

    The study aimed to identify targets for quality improvement in antifungal use in European hospitals and determine the variability of such prescribing. Hospitals that participated in the European Surveillance of Antimicrobial Consumption Point Prevalence Surveys (ESAC-PPS) were included. The WHO...... 40,878 (3.7%) antimicrobials. Antifungals were mainly (54.2%) administered orally. Hospital-acquired infections represented 44.5% of indications for antifungals followed by medical prophylaxis at 31.2%. The site of infection was not defined in 36.0% of cases but the most commonly targeted sites were...... respiratory (19.2%) and gastrointestinal (18.8%). The most used antifungal was fluconazole (60.5%) followed by caspofungin (10.5%). Antifungal-antibacterial combinations were frequently used (77.5%). The predominance of fluconazole use in participating hospitals could result in an increase in prevalence of...

  5. Generalist palliative care in hospital

    DEFF Research Database (Denmark)

    Bergenholtz, Heidi; Jarlbæk, Lene; Hølge-Hazelton, Bibi

    2016-01-01

    Background: It can be challenging to provide generalist palliative care in hospitals, owing to difficulties in integrating disease-orientedtreatment with palliative care and the influences of cultural and organisational conditions. However, knowledge on the interactionsthat occur is sparse. Aim: To...... investigate the interactions between organisation and culture as conditions for integrated palliative care in hospital and, ifpossible, to suggest workable solutions for the provision of generalist palliative care. Design: A convergent parallel mixed-methods design was chosen using two independent studies: a...... hospital with 29 department managements and one hospital management. Results: Two overall themes emerged: (1) ‘generalist palliative care as a priority at the hospital’, suggesting contrasting issues regardingprioritisation of palliative care at different organisational levels, and (2) ‘knowledge and use...

  6. Hospital Value-Based Purchasing

    Data.gov (United States)

    U.S. Department of Health & Human Services — Hospital Value-Based Purchasing (VBP) is part of the Centers for Medicare and Medicaid Services (CMS) long-standing effort to link Medicares payment system to a...

  7. [Using SWOT to analyze breastfeeding education results in a medical center].

    Science.gov (United States)

    Lee, Pei-Shan; Huang, Chiu-Mieh

    2005-08-01

    The breastfeeding rate within the first month after postpartum dropped from 95% in 1962 to 25% in 1989. As a result, the Department of Health, Executive Yuan, has made a lot of effort to promote a baby-friendly hospital policy since 2001, with the aim of increasing the breastfeeding rate. However, many studies have pointed out that the Department of Health is encountering difficulties when implementing this policy. This study is designed to use the Strengths, Weakness, Opportunities, and Threats (SWOT) Analysis to evaluate the development of breastfeeding education in a certain medical center. We divide those factors that influence the effect of this policy into extrinsic environmental factors and intrinsic environmental factors. The intrinsic environmental factors are the strengths and weaknesses of the baby-friendly hospital policy. The extrinsic environmental factors are the opportunities and threats. The SWOT Matrix is also applied to develop appropriate strategies to take the greatest possible advantage of opportunities available. With the SWOT approach, managers can not only readily extinguish intrinsic advantages from intrinsic disadvantages, but also recognize external opportunities and threats. Furthermore, it assists managers in resolving problems and turning adversity into opportunity. In providing the SWOT analysis, we hope clinical nursing staff will gain a better understanding of the baby-friendly hospital policy and deliver higher quality of health care for postpartum mothers, thus increasing the breastfeeding rate. PMID:16088785

  8. Modelling Hospital Materials Management Processes

    OpenAIRE

    Raffaele Iannone; Alfredo Lambiase; Salvatore Miranda; Stefano Riemma; Debora Sarno

    2013-01-01

    Materials management is an important issue for healthcare systems because it influences clinical and financial outcomes. Before selecting, adapting and implementing leading or optimized practices, a good understanding of processes and activities has to be developed. In real applications, the information flows and business strategies involved are different from hospital to hospital, depending on context, culture and available resources; it is therefore difficult to find a comprehensive and exh...

  9. Pricing objectives in nonprofit hospitals.

    OpenAIRE

    Bauerschmidt, A D; P. Jacobs

    1985-01-01

    This article reports on a survey of 60 financial managers of nonprofit hospitals in the eastern United States relating to the importance of a number of factors which influence their pricing decisions and the pricing objectives which they pursue. Among the results uncovered by the responses: that trustees are the single most important body in the price-setting process (doctors play a relatively unimportant role); that hospital pricing goals are more related to target net revenue than profit ma...

  10. Introduction: Special issue in hospitality

    OpenAIRE

    Ríos-Morales, Ruth; Jenkins, Ian

    2012-01-01

    In the era of globalization, the economic contribution of the tourism, hospitality and leisure industry to the world’s GDP is significant. Tourism represents one of the main sources of income for many countries; tourism creates jobs, enhances exports and contributes to the economic welfare of a host country. Although the contribution of tourism, hospitality and the leisure industry in the era of globalization has been broadly recognized, there are also numerous challenges that this industry f...

  11. Hospitality: The conquest of Paradise

    OpenAIRE

    Maximiliano Korstanje

    2008-01-01

    The term hospitality is associated with the industry of tourism. In fact, it is very well considered as a form of relationship between hosts and guest in that modern activity. Nevertheless, its historical root remains occulted in the bottom of darkness. Under that circumstance, ancient history contributes with hard evidence that proves hospitality was present and used as a mechanism to create legitimacy in the conquest of America. That way, Hominem viatores assured that Crown’s boundaries wer...

  12. Surgery in a mission hospital.

    OpenAIRE

    Hankins, G. W.

    1980-01-01

    The western-trained surgeon working in a mission hospital in a developing country finds that in spite of the heavy demands placed upon him the work can be most absorbing, challenging, and satisfying. Some impressions gained during 31/2 years working in the department of surgery of a mission hospital in Kathmandu, Nepal, are recorded. Particular reference is made to the striking differences in disease incidence, as brought out in a review of operative surgery for 1977.

  13. Parenteral nutrition in hospital pharmacies.

    Science.gov (United States)

    Katoue, Maram Gamal; Al-Taweel, Dalal; Matar, Kamal Mohamed; Kombian, Samuel B

    2016-07-11

    Purpose - The purpose of this paper is to explore parenteral nutrition (PN) practices in hospital pharmacies of Kuwait and identify potential avenues for quality improvement in this service. Design/methodology/approach - A descriptive, qualitative study about PN practices was conducted from June 2012 to February 2013 in Kuwait. Data were collected via in-depth semi-structured interviews with the head total parenteral nutrition (TPN) pharmacists at seven hospitals using a developed questionnaire. The questionnaire obtained information about the PN service at each hospital including the existence of nutritional support teams (NSTs), PN preparation practices, quality controls and guidelines/protocols. The interviews were audio-recorded, transcribed verbatim and analyzed for content. Findings - Seven hospitals in Kuwait provided PN preparation service through TPN units within hospital pharmacies. Functional NSTs did not exist in any of these hospitals. All TPN units used paper-based standard PN order forms for requesting PN. The content of PN order forms and PN formulas labeling information were inconsistent across hospitals. Most of the prepared PN formulas were tailor-made and packed in single compartment bags. Quality controls used included gravimetric analysis and visual inspection of PN formulations, and less consistently reported periodic evaluation of the aseptic techniques. Six TPN units independently developed PN guidelines/protocols. Originality/value - This study revealed variations in many aspects of PN practices among the hospitals in Kuwait and provided recommendations to improve this service. Standardization of PN practices would enhance the quality of care provided to patients receiving PN and facilitate national monitoring. This can be accomplished through the involvement of healthcare professionals with expertise in nutrition support working within proactive NSTs. PMID:27298063

  14. IMPROVING GRAPHIC SKILLS DURING HOSPITALIZATION

    OpenAIRE

    Ana Cláudia Afonso Valladares; Ana Maria Pimenta Carvalho

    2006-01-01

    ABSTRACT: Hospitalization may have negative effects on child development. It takes the child off her routine and prevents her from contacts with stimulating environments. The aim of this work was to evaluate the development and quality on drew productions, before and after art therapy intervention, during the hospitalization of 7 to 10 years old children, with infectious diseases. It was proposed a quasi experimental design with a control group (n=9) and a group that was submitted to art ther...

  15. Downsizing of acute inpatient beds associated with private finance initiative: Scotland's case study

    OpenAIRE

    Dunnigan, M.G.; Pollock, A

    2003-01-01

    OBJECTIVES: To evaluate whether the projected 24% reduction in acute bed numbers in Lothian hospitals, which formed part of the private finance initiative (PFI) plans for the replacement Royal Infirmary of Edinburgh, is being compensated for by improvements in efficiency and greater use of community facilities, and to ascertain whether there is an independent PFI effect by comparing clinical activity and performance in acute specialties in Lothian hospitals with other NHS hospitals in Scotlan...

  16. Consumer Nutrition Environments of Hospitals: An Exploratory Analysis Using the Hospital Nutrition Environment Scan for Cafeterias, Vending Machines, and Gift Shops, 2012

    Directory of Open Access Journals (Sweden)

    Courtney P. Winston, DrPH, RD, LD, CDE

    2013-07-01

    Full Text Available Introduction Hospitals are the primary worksite of over 5 million adults in the United States, and millions of meals are procured and consumed in this setting. Because many worksite nutrition initiatives use an ecological framework to improve the dietary habits of employees, the nutrition values of foods served in hospitals is receiving attention. Methods This study used the Hospital Nutrition Environment Scan for Cafeterias, Vending Machines, and Gift Shops to quantitatively describe the consumer nutrition environments of 39 hospitals in Southern California. Data were collected by visiting each facility once from February 2012 through May 2012. Results On average, hospitals achieved only 29%, 33%, and less than 1% of the total possible points for their cafeteria, vending machines, and gift shops sections, respectively; overall, hospitals scored 25% of the total possible points. Large facility size and contracted food service operations were associated with some healthy practices in hospital cafeterias, but we found no association between these variables and the sectional or overall nutrition composite scores. Conclusion The average consumer nutrition environment of hospitals in this sample was minimally conducive to healthful eating. Nutrition-related interventions are warranted in hospital settings.

  17. Physician-initiated daily verbal reminders decrease the duration of indwelling urinary catheter use compared with nurse-initiated reminders.

    Science.gov (United States)

    Felix, Logan; Smith, Barbara A; Santos, Eloisa; Gabasan, Angela; Dzenkevych, Olena; Kourouni, Ismini; Klein, Robert S

    2016-03-01

    We compared the effectiveness of physician-initiated daily verbal reminders to primary care providers with nurse-initiated daily verbal reminders in decreasing the duration of inappropriate indwelling urinary catheter use in hospitalized patients. Catheter use duration was significantly decreased in the physician-initiated intervention group compared with the nurse-initiated intervention group (0.5 ± 0.8 vs 1.7 ± 2.7 days, respectively; P = .03). PMID:26717873

  18. Sustainable Agricultural Marketing Initiatives

    Directory of Open Access Journals (Sweden)

    Hakan Adanacıoğlu

    2015-07-01

    Full Text Available Sustainable marketing is a holistic approach that puts equal emphasis on environmental, social equity, and economic concerns in the development of marketing strategies. The purpose of the study is to examine and discuss the sustainable agricultural marketing initiatives practiced throughout the World and Turkey, and to put forth suggestions to further improve the performance of agricultural marketing initiatives in Turkey. Some of the sustainable agricultural marketing initiatives practiced around the world are carried out through civil organizations. Furthermore; some of these initiatives have also launched by farmers, consumers, food processors and retailers. The long-term strategies to increase these initiatives should be determined due to the fact that examples of successful sustainable agricultural marketing initiatives are inadequate and cannot be spread in Turkey. In this context, first of all, the supports provided by the government to improve agricultural marketing systems, such as EU funds for rural development should be compatible with the goals of sustainable marketing. For this purpose, it should be examined whether all proposed projects related to agricultural marketing meet the social, economic, and environmental principles of sustainable marketing. It is important that supporting organizations, especially civil society organisations, should take an active role for faster dissemination and adoption of sustainable agricultural marketing practices in Turkey. These organizations may provide technical assistance in preparing successful project proposals and training to farm groups. In addition, the other organizations, such as local administrations, producers' associations, cooperatives, can contribute to the success of sustainable agricultural marketing initiatives. The use of direct marketing strategies and vertical integration attempts in sustainable agricultural marketing initiatives that will likely be implemented in Turkey is

  19. Some account of the origin and plan of an association formed for the establishment of a house of recovery or fever hospital in the city of Dublin

    LENUS (Irish Health Repository)

    1801-01-01

    This particular year\\'s reports cover the initial meeting in October 1801, an appendix which considers the experience of fever hospital\\'s in Manchester and Waterford and finally medical testimony supporting the building of a fever hospital.\\r\

  20. Hospital medicine (Part 2): what would improve acute hospital care?

    LENUS (Irish Health Repository)

    Kellett, John

    2009-09-01

    There are so many obvious delays and inefficiencies in our traditional system of acute hospital care; it is clear that if outcomes are to be improved prompt accurate assessment immediately followed by competent and efficient treatment is essential. Early warning scores (EWS) help detect acutely ill patients who are seriously ill and likely to deteriorate. However, it is not known if any EWS has universal applicability to all patient populations. The benefit of Rapid Response Systems (RRS) such as Medical Emergency Teams has yet to be proven, possibly because doctors and nurses are reluctant to call the RRS for help. Reconfiguration of care delivery in an Acute Medical Assessment Unit has been suggested as a "proactive" alternative to the "reactive" approach of RRS. This method ensures every patient is in an appropriate and safe environment from the moment of first contact with the hospital. Further research is needed into what interventions are most effective in preventing the deterioration and\\/or resuscitating seriously ill patients. Although physicians expert in hospital care decrease the cost and length of hospitalization without compromising outcomes hospital care will continue to be both expensive and potentially dangerous.

  1. Occupational therapy in extra-hospital care offered by hospitals

    Directory of Open Access Journals (Sweden)

    Marilia Bense Othero

    2012-09-01

    Full Text Available The Extra-hospital Care offered by hospitals is one of the performance areas of the “OccupationalTherapy in Hospital Care Contexts” specialty and refers to the assistance provided by the hospitals at the patients’homes. The aim of this article is to introduce the area main concepts and describe the practice of OccupationalTherapy. There are four kinds of home health care assistance in Brazil, as recommended by the Ministry ofHealth, and all of them are in the area of occupational performance. The main focus of the occupational therapist’sintervention depends on the assistance level, and it may include preparation and information for hospitaldischarge, assessment and adaptation of the home environment, recovery of meaningful activities, promotion ofindependence and autonomy, cognitive rehabilitation, sensorial stimuli, information about positioning, prescriptionand manufacturing of adaptive devices, and guidance for family and care givers. There are many challenges to befaced in this professional area, such as: domiciliary context complexity, payment and organization, team work,support networks, etc. Occupational Therapy plays a very important role in extra-hospital care.

  2. Can nonprofit hospitals do both well and good?

    Science.gov (United States)

    Longest, Beaufort B; Lin, Chvonachiou Jeng

    2005-01-01

    This study demonstrates a significantly positive association between corporate citizenship and financial performance in a sample of nonprofit hospitals in Massachusetts. Without demonstrating causation in either direction, the analysis shows that the nonprofit hospitals in this study can simultaneously do well for themselves financially, and good in terms of the benefits provided to communities. That is, they perform better financially as they spend relatively more on their community benefits initiatives. This may reflect the same relationship found in numerous studies of corporate citizenship and financial performance in business firms. Namely, that business advantages accrue to firms through their practice of good corporate citizenship. Implications of the findings for public policymakers and for decision makers in nonprofit hospitals are considered. PMID:15773255

  3. Factors associated with breastfeeding cessation in nursing mothers in a peer support programme in Eastern Lancashire

    OpenAIRE

    Verma Arpana; Jackson Elaine; Michel Elaine; Agboado Gabriel

    2010-01-01

    Abstract Background The UK has one of the lowest breastfeeding rates worldwide and in recent years the Government has made breastfeeding promotion one of its priorities. The UNICEF UK Baby Friendly Initiative is likely to increase breastfeeding initiation but not duration. Other strategies which involve provision of support for breastfeeding mothers in the early weeks after birth are therefore required to encourage UK mothers to breastfeed for the recommended duration. This paper examines the...

  4. Validation of a Framework for Measuring Hospital Disaster Resilience Using Factor Analysis

    Directory of Open Access Journals (Sweden)

    Shuang Zhong

    2014-06-01

    Full Text Available Hospital disaster resilience can be defined as “the ability of hospitals to resist, absorb, and respond to the shock of disasters while maintaining and surging essential health services, and then to recover to its original state or adapt to a new one.” This article aims to provide a framework which can be used to comprehensively measure hospital disaster resilience. An evaluation framework for assessing hospital resilience was initially proposed through a systematic literature review and Modified-Delphi consultation. Eight key domains were identified: hospital safety, command, communication and cooperation system, disaster plan, resource stockpile, staff capability, disaster training and drills, emergency services and surge capability, and recovery and adaptation. The data for this study were collected from 41 tertiary hospitals in Shandong Province in China, using a specially designed questionnaire. Factor analysis was conducted to determine the underpinning structure of the framework. It identified a four-factor structure of hospital resilience, namely, emergency medical response capability (F1, disaster management mechanisms (F2, hospital infrastructural safety (F3, and disaster resources (F4. These factors displayed good internal consistency. The overall level of hospital disaster resilience (F was calculated using the scoring model: F = 0.615F1 + 0.202F2 + 0.103F3 + 0.080F4. This validated framework provides a new way to operationalise the concept of hospital resilience, and it is also a foundation for the further development of the measurement instrument in future studies.

  5. Validation of a framework for measuring hospital disaster resilience using factor analysis.

    Science.gov (United States)

    Zhong, Shuang; Clark, Michele; Hou, Xiang-Yu; Zang, Yuli; FitzGerald, Gerard

    2014-06-01

    Hospital disaster resilience can be defined as "the ability of hospitals to resist, absorb, and respond to the shock of disasters while maintaining and surging essential health services, and then to recover to its original state or adapt to a new one." This article aims to provide a framework which can be used to comprehensively measure hospital disaster resilience. An evaluation framework for assessing hospital resilience was initially proposed through a systematic literature review and Modified-Delphi consultation. Eight key domains were identified: hospital safety, command, communication and cooperation system, disaster plan, resource stockpile, staff capability, disaster training and drills, emergency services and surge capability, and recovery and adaptation. The data for this study were collected from 41 tertiary hospitals in Shandong Province in China, using a specially designed questionnaire. Factor analysis was conducted to determine the underpinning structure of the framework. It identified a four-factor structure of hospital resilience, namely, emergency medical response capability (F1), disaster management mechanisms (F2), hospital infrastructural safety (F3), and disaster resources (F4). These factors displayed good internal consistency. The overall level of hospital disaster resilience (F) was calculated using the scoring model: F = 0.615F1 + 0.202F2 + 0.103F3 + 0.080F4. This validated framework provides a new way to operationalise the concept of hospital resilience, and it is also a foundation for the further development of the measurement instrument in future studies. PMID:24945190

  6. Analysis of Niche Hospitals in Texas and the Financial Impact on General Hospitals

    OpenAIRE

    Deborah Chollet; Su Liu; Gilbert Gimm; Cheryl Fahlman; Laurie Felland; Anneliese Gerland; Michelle Banker; Allison Liebhaber

    2006-01-01

    In Texas, as in other states, the proliferation of niche hospitals has raised concern about the potential financial impact of these hospitals on full-service general hospitals. This report compares the financial status of physician-owned niche hospitals and general hospitals in Texas, analyzes the impact of niche hospitals on general hospital financial margins and levels of uncompensated care, analyzes potential bias in physician-owners' referral patterns, investigates stakeholders' perceptio...

  7. In-hospital stroke: characteristics and outcomes.

    LENUS (Irish Health Repository)

    Briggs, R

    2015-01-01

    In-hospital stroke (IS) made up 6.5% of strokes recorded in the Irish National Stroke Register in 2012. International research has demonstrated poorer outcomes post IS compared to out of hospital stroke (OS). We aimed to profile all IS and OS over a 22 month period and compare the two groups by gathering data from the HIPE portal stroke register. The study site is a primary stroke centre. IS represented 11% (50\\/458) of total strokes with over half (27\\/50, 54%) admitted initially with medical complaints. IS patients had a significantly longer length of stay (79.2 +\\/- 87.4 days vs. 21.9 +\\/- 45.9 days, p < 0.01) and higher mortality (13\\/50 vs. 39\\/408, p < 0.01). Patients in the IS group were also less likely to receive stroke unit care (1\\/50 vs. 136\\/408, p < 0.01). This study demonstrates the significant morbidity and mortality associated with IS and highlights the need for efforts to be made to optimize identification and management of acute stroke in this cohort.

  8. Hospitality Language as a Professional Skill.

    Science.gov (United States)

    Blue, George M.; Harun, Minah

    2003-01-01

    Argues that particular patterns of language are associated with host-guest interaction, and that this language, corresponding to the different stages of he arrival-departure hospitality cycle, may be termed "hospitality language." Investigates hospitality practices and defines hospitality language in the context of Great Britain and discusses…

  9. Hospitality and its Ambivalences : On Zygmunt Bauman

    NARCIS (Netherlands)

    Welten, R.B.J.M.

    2015-01-01

    Hospitality is often understood as an ethical openness towards the other. Hospitality, in this way, is a gift. But is this really the situation of hospitality in the world today? Europeans have created another, bespoke hospitality and they insist on being given a generous welcome all over the world

  10. Continuing education: vocational training in the context of hospital pharmacy as a strategy for integration in a multidisciplinary team of specialized hospital Sergipe

    OpenAIRE

    Carlos Adriano Santos Souza; Elisdete Maria Santos de Jesus; Ramissom Brandão; Anderson Leite Freitas; Wellington Barros da Silva; Aurélia Santos Faraoni

    2013-01-01

    The current reality of hospitals increasingly require professionals qualified to assume roles that require high levels of technical and scientific knowledge. The supervised internship in hospital pharmacy aims to train future professionals with critical awareness and ability to understand the reality and act on it. This study consists of an report of the experience of students supervised III internship of the graduate course in Pharmacy, Federal University of Sergipe. Initially the students m...

  11. The role of education for rural development : the case of selected Haydom Lutheran Hospital`s educational activities in Mbulu district, Tanzania

    OpenAIRE

    Kilasi, Perpetua Kalimasi

    2011-01-01

    This study explores the role that education and training programs initiated and/supported by Haydom Lutheran Hospital play to the development of the rural community. The study have identified some education and training programs by Haydom Lutheran Hospital and explored the motives behind the establishment of those programs as well as the perceptions of the local community towards education in general and established programs in specific. The challenges associated with the estab...

  12. HMO penetration: has it hurt public hospitals?

    Science.gov (United States)

    Clement, J P; Grazier, K L

    2001-01-01

    The purpose of this study is to determine the extent to which health maintenance organization (HMO) penetration within the public hospitals' market area affects the financial performance and viability of these institutions, relative to private hospitals. Hospital- and market-specific measures are examined in a fully interacted model of over 2,300 hospitals in 321 metropolitan statistical areas (MSAs) in 1995. Although hospitals located in markets with higher HMO penetration have lower financial performance as reflected in revenues, expenses and operating margin, public hospitals are not more disadvantaged than other hospitals by managed care. PMID:11669291

  13. OCCUPATIONAL ROLE AFTER PSYCHIATRIC HOSPITALIZATION

    Directory of Open Access Journals (Sweden)

    GH.R GHASSEMI

    2003-03-01

    Full Text Available Introduction: Severe Psychiatricillness is accompanied by gross disturbances in patient's occupational role. This study presents a comparative picture of work performance before and after psychiatric hospitalization. Method: Subjects comprised 440 psychiatric admitters from Noor Medical center - Isfahan - Iran, who were followed from November 1999 to November 2000. Their work adjustment was measured by means of Weiss man's index. Data were computer analyzed using SPSS by running paired t- student and ANOVA. Results: Majority of the patients (53 % were without permanent sources of income before psychiatric hospitalization, about 12 percent of those who were working prior to hospitalization lost their job after being discharged from hospital. Better work adjustment before hospitalization was positively correlated with better work adjustment after discharge for working patients (r =0/66. Working ability of the patients after discharge was lesser than before the attack f9r patients with regular and irregular job (P < 001. Discussion: Job loss or poor working ability after psychiatric admission reported by several researchers and has bean confirmed in this study as well. These observatoins have been discussed in view of the current socio economic problems in the society and nature of psychiatric disturbances.

  14. Is the maturity of hospitals' quality improvement systems associated with measures of quality and patient safety?

    Directory of Open Access Journals (Sweden)

    Groene Oliver

    2011-12-01

    Full Text Available Abstract Background Previous research addressed the development of a classification scheme for quality improvement systems in European hospitals. In this study we explore associations between the 'maturity' of the hospitals' quality improvement system and clinical outcomes. Methods The maturity classification scheme was developed based on survey results from 389 hospitals in eight European countries. We matched the hospitals from the Spanish sample (113 hospitals with those hospitals participating in a nation-wide, voluntary hospital performance initiative. We then compared sample distributions and explored associations between the 'maturity' of the hospitals' quality improvement system and a range of composite outcomes measures, such as adjusted hospital-wide mortality, -readmission, -complication and -length of stay indices. Statistical analysis includes bivariate correlations for parametrically and non-parametrically distributed data, multiple robust regression models and bootstrapping techniques to obtain confidence-intervals for the correlation and regression estimates. Results Overall, 43 hospitals were included. Compared to the original sample of 113, this sample was characterized by a higher representation of university hospitals. Maturity of the quality improvement system was similar, although the matched sample showed less variability. Analysis of associations between the quality improvement system and hospital-wide outcomes suggests significant correlations for the indicator adjusted hospital complications, borderline significance for adjusted hospital readmissions and non-significance for the adjusted hospital mortality and length of stay indicators. These results are confirmed by the bootstrap estimates of the robust regression model after adjusting for hospital characteristics. Conclusions We assessed associations between hospitals' quality improvement systems and clinical outcomes. From this data it seems that having a more

  15. Prairie Reconstruction Initiative

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — The purpose of the Prairie Reconstruction Initiative Advisory Team (PRIAT) is to identify and take steps to resolve uncertainties in the process of prairie...

  16. Nursing Home Quality Initiative

    Data.gov (United States)

    U.S. Department of Health & Human Services — This Nursing Home Quality Initiative (NHQI) website provides consumer and provider information regarding the quality of care in nursing homes. NHQI discusses...

  17. Surgical Critical Care Initiative

    Data.gov (United States)

    Federal Laboratory Consortium — The Surgical Critical Care Initiative (SC2i) is a USU research program established in October 2013 to develop, translate, and validate biology-driven critical care....

  18. Initial external events: floods

    International Nuclear Information System (INIS)

    The initial external event, specifically flood in a Nuclear power plant, and the calculation necessary to determine the contribution of this type of event in a Probabilistic Safety Analysis, are presented. (M.I.)

  19. Quality Initiatives - General Information

    Data.gov (United States)

    U.S. Department of Health & Human Services — CMS has developed a standardized approach for the development of quality measures that it uses in its quality initiatives. Known as the Measures Management System...

  20. The RAS Initiative

    Science.gov (United States)

    NCI established the RAS Initiative to explore innovative approaches for attacking the proteins encoded by mutant forms of RAS genes and to ultimately create effective, new therapies for RAS-related cancers.

  1. Initial Symptoms of ALS

    Science.gov (United States)

    ... Chapters Certified Centers and Clinics Support Groups About ALS About Us Our Research In Your Community Advocate ... Diagnosis En español Symptoms The initial symptoms of ALS can be quite varied in different people. One ...

  2. Piezoelectrically Initiated Pyrotechnic Igniter

    Science.gov (United States)

    Quince, Asia; Dutton, Maureen; Hicks, Robert; Burnham, Karen

    2013-01-01

    This innovation consists of a pyrotechnic initiator and piezoelectric initiation system. The device will be capable of being initiated mechanically; resisting initiation by EMF, RF, and EMI (electromagnetic field, radio frequency, and electromagnetic interference, respectively); and initiating in water environments and space environments. Current devices of this nature are initiated by the mechanical action of a firing pin against a primer. Primers historically are prone to failure. These failures are commonly known as misfires or hang-fires. In many cases, the primer shows the dent where the firing pin struck the primer, but the primer failed to fire. In devices such as "T" handles, which are commonly used to initiate the blowout of canopies, loss of function of the device may result in loss of crew. In devices such as flares or smoke generators, failure can result in failure to spot a downed pilot. The piezoelectrically initiated ignition system consists of a pyrotechnic device that plugs into a mechanical system (activator), which on activation, generates a high-voltage spark. The activator, when released, will strike a stack of electrically linked piezo crystals, generating a high-voltage, low-amperage current that is then conducted to the pyro-initiator. Within the initiator, an electrode releases a spark that passes through a pyrotechnic first-fire mixture, causing it to combust. The combustion of the first-fire initiates a primary pyrotechnic or explosive powder. If used in a "T" handle, the primary would ramp the speed of burn up to the speed of sound, generating a shock wave that would cause a high explosive to go "high order." In a flare or smoke generator, the secondary would produce the heat necessary to ignite the pyrotechnic mixture. The piezo activator subsystem is redundant in that a second stack of crystals would be struck at the same time with the same activation force, doubling the probability of a first strike spark generation. If the first

  3. Examining sustainability in a hospital setting: Case of smoking cessation

    Directory of Open Access Journals (Sweden)

    Reece Robin

    2011-09-01

    Full Text Available Abstract Background The Ottawa Model of Smoking Cessation (OMSC is a hospital-based smoking cessation program that is expanding across Canada. While the short-term effectiveness of hospital cessation programs has been documented, less is known about long-term sustainability. The purpose of this exploratory study was to understand how hospitals using the OMSC were addressing sustainability and determine if there were critical factors or issues that should be addressed as the program expanded. Methods Six hospitals that differed on OMSC program activities (identify and document smokers, advise quitting, provide medication, and offer follow-up were intentionally selected, and two key informants per hospital were interviewed using a semi-structured interview guide. Key informants were asked to reflect on the initial decision to implement the OMSC, the current implementation process, and perceived sustainability of the program. Qualitative analysis of the interview transcripts was conducted and themes related to problem definition, stakeholder influence, and program features emerged. Results Sustainability was operationalized as higher performance of OMSC activities than at baseline. Factors identified in the literature as important for sustainability, such as program design, differences in implementation, organizational characteristics, and the community environment did not explain differences in program sustainability. Instead, key informants identified factors that reflected the interaction between how the health problem was defined by stakeholders, how priorities and concerns were addressed, features of the program itself, and fit within the hospital context and resources as being influential to the sustainability of the program. Conclusions Applying a sustainability model to a hospital smoking cessation program allowed for an examination of how decisions made during implementation may impact sustainability. Examining these factors during

  4. Predictors and impacts of hospital readmissions following liver transplantation.

    Science.gov (United States)

    Yataco, Maria; Cowell, Alissa; David, Waseem; Keaveny, Andrew P; Taner, C Burcin; Patel, Tushar

    2016-01-01

    While liver transplantation is the definitive therapy for end stage liver disease, it remains a major procedure, with many potential complications. Hospital readmissions after the initial hospitalization for liver transplantation can be associated with adverse outcomes, increased cost, and resource utilization. Our aim was to define the incidence and reasons for hospital readmission after liver transplant and the impact of readmissions on patient outcomes. We retrospectively analyzed 30- and 90-day readmission rates and indications in patients who underwent liver transplant at a large-volume transplant center over a 3-year period. Four hundred seventy-nine adult patients underwent their first liver transplant during the study period. The 30-day readmission rate was 29.6%. Recipient and donor age, etiology of liver disease, biological Model for End-Stage Liver Disease score, and cold ischemia time were similar between patients who were readmitted within 30 days and those who were not readmitted. Readmissions occurred in 25% of patients who were hospitalized prior to liver transplant compared to 30% who were admitted for liver transplant. The most common indications for readmission were infection, severe abdominal pain, and biliary complications. Early discharge from hospital (fewer than 7 days after liver transplant), was not associated with readmission; however, a prolonged hospital stay after liver transplant was associated with an increased risk of readmission (p = 0.04). In conclusion, patients who undergo liver transplant have a high rate of readmission. In our cohort, readmissions were unrelated to pre-existing recipient or donor factors, but were associated with a longer hospital stay after liver transplant. PMID:27049489

  5. Length of Hospital Stay After Stroke: A Korean Nationwide Study

    Science.gov (United States)

    2016-01-01

    Objective To investigate the length of hospital stay (LOS) after stroke using the database of the Korean Health Insurance Review & Assessment Service. Methods We matched the data of patients admitted for ischemic stroke onset within 7 days in the Departments of Neurology of 12 hospitals to the data from the database of the Korean Health Insurance Review & Assessment Service. We recruited 3,839 patients who were hospitalized between January 2011 and December 2011, had a previous modified Rankin Scale of 0, and no acute hospital readmission after discharge. The patients were divided according to the initial National Institute of Health Stroke Scale score (mild, ≤5; moderate, >5 and ≤13; severe, >13); we compared the number of hospitals that admitted patients and LOS after stroke according to severity, age, and sex. Results The mean LOS was 115.6±219.0 days (median, 19.4 days) and the mean number of hospitals was 3.3±2.1 (median, 2.0). LOS was longer in patients with severe stroke (mild, 65.1±146.7 days; moderate, 223.1±286.0 days; and severe, 313.2±336.8 days). The number of admitting hospitals was greater for severe stroke (mild, 2.9±1.7; moderate, 4.3±2.6; and severe, 4.5±2.4). LOS was longer in women and shorter in patients less than 65 years of age. Conclusion LOS after stroke differed according to the stroke severity, sex, and age. These results will be useful in determining the appropriate LOS after stroke in the Korean medical system.

  6. Supply Chain Initiatives Database

    Energy Technology Data Exchange (ETDEWEB)

    None

    2012-11-01

    The Supply Chain Initiatives Database (SCID) presents innovative approaches to engaging industrial suppliers in efforts to save energy, increase productivity and improve environmental performance. This comprehensive and freely-accessible database was developed by the Institute for Industrial Productivity (IIP). IIP acknowledges Ecofys for their valuable contributions. The database contains case studies searchable according to the types of activities buyers are undertaking to motivate suppliers, target sector, organization leading the initiative, and program or partnership linkages.

  7. Implementing Development Initiatives

    OpenAIRE

    Jamal Khan

    1999-01-01

    Implementation is at the core of all development initiatives and strategies and experience has shown that there exists a gap between formulation and implementation. This paper focuses on the attempts for implementing initiatives for promoting decentralised management and increased participation in developing countries arid identifies the obstacles in the process. It is generally seen that problems of implementation cannot be entirely anticipated and planned for in advance. Also decentralisati...

  8. Solid waste management in the hospitality industry: a review.

    Science.gov (United States)

    Pirani, Sanaa I; Arafat, Hassan A

    2014-12-15

    Solid waste management is a key aspect of the environmental management of establishments belonging to the hospitality sector. In this study, we reviewed literature in this area, examining the current status of waste management for the hospitality sector, in general, with a focus on food waste management in particular. We specifically examined the for-profit subdivision of the hospitality sector, comprising primarily of hotels and restaurants. An account is given of the causes of the different types of waste encountered in this sector and what strategies may be used to reduce them. These strategies are further highlighted in terms of initiatives and practices which are already being implemented around the world to facilitate sustainable waste management. We also recommended a general waste management procedure to be followed by properties of the hospitality sector and described how waste mapping, an innovative yet simple strategy, can significantly reduce the waste generation of a hotel. Generally, we found that not many scholarly publications are available in this area of research. More studies need to be carried out on the implementation of sustainable waste management for the hospitality industry in different parts of the world and the challenges and opportunities involved. PMID:25194519

  9. Choice of initial therapy

    Directory of Open Access Journals (Sweden)

    Manuel Battegay

    2014-11-01

    Full Text Available Current international and national treatment guidelines such as EACS, BHIVA, DHHS or IAS update regularly recommendations on the choice of initial combination antiretroviral treatment (cART regimens. Preferred cART regimens include a backbone with two nucleoside (nucleotide reverse transcriptase inhibitors combined either with one non-nucleoside reverse transcriptase inhibitor or one ritonavir boosted protease inhibitor or more recently one integrase inhibitor. Response rates according to viral load measurements increased in recent years, in particular due to better tolerability. The choice of initial therapy is flexible and influenced by several factors such as height of viral load, genotypic resistance testing, CD4 cell count, co-morbidities, interactions, potential adverse events, (potential for pregnancy, convenience, adherence, costs as well as physician's and patient's preferences. Diverse highly potent initial cART regimens exist. Following the many possibilities, the choice of a regimen is based on a mixture of evidence-informed data and individualized concepts, some of the latter only partly supported by strong evidence. For example, different perceptions and personal experiences exist about boosted protease inhibitors compared to non-nucleoside reverse transcriptase inhibitors or integrase inhibitors and vice versa which may influence the initial choice. This lecture will discuss choices of initial cART in view of international guidelines and the evidence for individualization of initial HIV therapy.

  10. Disposable products in the hospital waste stream.

    OpenAIRE

    Gilden, D. J.; Scissors, K. N.; Reuler, J B

    1992-01-01

    Use of disposable products in hospitals continues to increase despite limited landfill space and dwindling natural resources. We analyzed the use and disposal patterns of disposable hospital products to identify means of reducing noninfectious, nonhazardous hospital waste. In a 385-bed private teaching hospital, the 20 disposable products of which the greatest amounts (by weight) were purchased, were identified, and total hospital waste was tabulated. Samples of trash from three areas were so...

  11. Are hospitals also for relatives?

    DEFF Research Database (Denmark)

    Nissen, Nina Konstantin; Madsen, Mette; Kjøller, Mette;

    2008-01-01

    relatives of patients with cardiac diseases is sparse. This study aimed to survey the prevalence of health services for relatives of cardiac patients in Denmark. METHODS: We surveyed activities offered by Danish hospitals to the relatives of cardiac patients. Data were obtained from an Internet-based survey...... and 50 of 55 invited hospital departments participated. RESULTS: Almost all departments offer activities to relatives of cardiac patients, but only one-quarter have activities specifically aimed at supporting relatives. Large departments offer activities for relatives more often than smaller...... departments. Participation rates for relatives are generally low, and the departments experience numerous barriers in providing activities for relatives of heart patients. CONCLUSIONS: Danish hospitals focus very little on relatives of cardiac patients, and this seems to be due to several factors, including...

  12. Fluid fragmentation from hospital toilets

    CERN Document Server

    Traverso, G; Lu, C -C; Maa, R; Langer, R; Bourouiba, L

    2013-01-01

    Hospital-acquired infections represent significant health and financial burdens to society. Clostridium difficile (C. difficile) is a particularly challenging bacteria with the potential to cause severe diarrhea and death. One mode of transmission for C. difficile, as well as other pathogens, which has received little attention is the potential air contamination by pathogen-bearing droplets emanating from toilets. In the fluid dynamics video submitted to the APS DFD Gallery of Fluid Motion 2013, we present flow visualizations via high-speed recordings showing the capture of the product of the fluid fragmentation generated by hospital toilet high-pressure flushes. Important quantities of both large and small droplets are observed. We illustrate how high-pressure flushes and cleaning products currently used in hospital toilets result in aggravating, rather than alleviating, the suspension and recirculation of tenacious airborne pathogen-bearing droplets.

  13. Monitoring deliberate self-harm presentations to general hospitals.

    Science.gov (United States)

    Hawton, Keith; Bale, Liz; Casey, Deborah; Shepherd, Anna; Simkin, Sue; Harriss, Louise

    2006-01-01

    Monitoring of deliberate self-harm (DSH) presentations to hospitals (and in other settings) is receiving increased attention in many countries. This is due to greater recognition of the size of the problem and awareness of its relevance to suicide prevention policy initiatives, because of the strong association between DSH and suicide. A system for monitoring all DSH presentations has been in place in the general hospital in Oxford for 30 years. Based on our experience, in this paper we describe procedures for monitoring, including case definition and identification, linkage of persons and episodes in order to investigate repetition of DSH and other outcomes (including deaths), and data protection and ethical issues. We also provide details of how to carry out monitoring, including different models of data collection, and what data to collect. Finally we consider the potential uses of the data for both clinical and research purposes, including evaluation of national suicide prevention initiatives. PMID:17219747

  14. Implementation of patient safety rounds in a children's hospital.

    Science.gov (United States)

    Yee, Patricia L; Edwards, Melanie L; Dixon, Jennifer; Gleason, Nancy S

    2009-01-01

    Many healthcare organizations have implemented patient safety initiatives aimed at creating a safer healthcare environment. At North Carolina Children's Hospital at University of North Carolina Hospitals, patient safety rounds were established in the fall of 2005. Rounds are held weekly and involve all members of the healthcare team. Senior leadership actively participates and helps staff seek out solutions for the identified issues. Within the first year of operation, 191 issues were identified, of which 58% were resolved. Rounds continue to occur and have expanded over to the Women's services. Other initiatives such as Just Culture and Six Sigma have been established and help further cultivate a climate that strives toward optimizing patient safety. PMID:19092523

  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 hospitals). 447.280 Section 447.280 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF... Inpatient Hospital and Long-Term Care Facility Services Swing-Bed Hospitals § 447.280 Hospital providers...

  16. 77 FR 69848 - Medicare Program; Inpatient Hospital Deductible and Hospital and Extended Care Services...

    Science.gov (United States)

    2012-11-21

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

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

    Science.gov (United States)

    2010-11-09

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

  18. Is the impact of hospital performance data greater in patients who have compared hospitals?

    NARCIS (Netherlands)

    Groot, I.B. de; Otten, W.; Smeets, H.J.; Marang-van de Mheen, P.J.

    2011-01-01

    Background. Public information on average has limited impact on patients' hospital choice. However, the impact may be greater in consumers who have compared hospitals prior to their hospital choice. We therefore assessed whether patients who have compared hospitals based their hospital choice mainly

  19. Unsafe driving behaviors and hospitalization.

    Science.gov (United States)

    Van Tuinen, M

    1994-04-01

    The medical costs associated with motor vehicle crashes are difficult to measure. Most attempts have used crash data and cost data that are only indirectly related to each other or have followed patients in a few hospitals or trauma centers. These studies produce localized estimates or rough national estimates of limited use to policy makers. The result has been a dependence on more readily available mortality data, such as the Fatal Accident Reporting System, to guide automotive safety efforts. The limitations of mortality data and the increasing sophistication of medical care data bases have resulted in a strong interest in obtaining crash-linked morbidity data. Hence, in 1993, the National Highway Traffic Safety Administration (NHTSA) awarded the Missouri Department of Health and six other applicants grants to link automotive crash records to statewide ambulance trip, outpatient care, hospitalization and mortality records. By identifying an individual across multiple data sets, states would be able to determine directly the relationship of driver behaviors and crash characteristics to hospitalization rates and other medical outcomes. Examination of hospital pay source information would expose the toll of automotive crashes on public tax dollars. Having recently completed the record linkage phase of this project, Missouri Department of Health staff are beginning to analyze the impact of automotive crashes on health care costs in Missouri. In this report, three unsafe driving behaviors, failure to use a safety device (seatbelts and motorcycle helmets), driving under the influence of alcohol, and speeding, are related to the risk of hospitalization or death, hospital costs, and expected pay source. PMID:8202067

  20. [The future of hospitals and the hospitals in the future].

    Science.gov (United States)

    Illés, S Tamás

    2016-07-01

    By the end of the 20th century the vertically organized hospitals formed into a closed hierarchical system, in which the healthcare supply significantly fragmented. The existing hospitals in the current organization are not prepared for the increase in longevity, nor for the high growth in the number of chronic and long-term illnesses and the multi-morbidity since they were not designed for extended carry treatments. The fast incorporation of high-tech and very expensive technologies into healthcare generates an economic crisis. Solving the supply and economic crisis at the same time cannot be achieved without changing the structure of hospitals. Future hospitals will be organized in a network, conducting special treatments according to disease profiles. According to present knowledge, this is the only structure that allows for economies in scale, the proper spending of the ever-shrinking resources, and to ensure the effective patient care required after the changing of disorder structures and patient corporate identities. Orv. Hetil., 2016, 157(28), 1099-1104. PMID:27397421

  1. Hospital en Neuwitteisbach, Alemania Federal

    Directory of Open Access Journals (Sweden)

    Haindl, Friedrich F.

    1975-04-01

    Full Text Available It consists of: the actual hospital, one house for the staff, one service yard and underground garage. The hospital comprises four storeys and two basements, whilst the other building only has three floors. On the ground floor of the hospital are we located: the entrance; the nucleus of vertical communication; work rooms for the doctors and nurses; the administration section; X-ray and cobalt installations; and a small chapel. The three remaining upper floors contain 160 beds distributed over 6 wards and in single, double or triple rooms. Each floor is equipped with a service section. The first basement includes the ambulance entrance, the medical wards of the hospital, the staff dining-room, a kitchen and the heating installation. The second basement is reserved for kitchen storage rooms and the remaining installations of the building. Structure of reinforced concrete and outer walls of brick covered with panels of washed concrete.Está formado por: el hospital propiamente dicho, un edificio destinado a viviendas para el personal, patio de servicio y garaje subterráneo. El hospital consta de cuatro plantas y dos sótanos, mientras que el otro edificio sólo tiene tres plantas. En la planta baja del hospital se encuentran: la entrada; el núcleo de comunicación vertical; las salas de trabajo de médicos y enfermeras; la zona de administración; las instalaciones de rayos X y bomba de cobalto; y una pequeña capilla. En las tres plantas superiores se distribuyen 160 camas repartidas en seis unidades de hospitalización, con habitaciones de 1, 2 ó 3 camas. Cada planta cuenta, además, con una zona de servicio. En el primer sótano se hallan, además de la entrada de ambulancias, los servicios médicos del hospital, los comedores del personal, una cocina, y la instalación de calefacción. El segundo sótano se dedica, en su totalidad, a almacenes de la cocina y del resto de las instalaciones del edificio. Estructura de

  2. Impact of hospital accreditation on patients' safety and quality indicators

    OpenAIRE

    Al-Awa, Bahjat

    2011-01-01

    Ecole de Santé Publique Université Libre de Bruxelles Academic Year 2010-2011 Al-Awa, Bahjat Impact of Hospital Accreditation on Patients' Safety and Quality Indicators Dissertation Summary I. Introduction: There is increased interest around the world in the evaluation of healthcare, coming not only from governments, but also from providers and consumers [1]. Therefore initiatives to address quality of health care have become worldwide phenomena [2]. As quality is crucial fa...

  3. Electrocardiogram characteristics prior to in-hospital cardiac arrest

    OpenAIRE

    Attin, Mina; Feld, Gregory; Lemus, Hector; Najarian, Kayvan; Shandilya, Sharad; Wang, Lu; Sabouriazad, Pouya; Lin, Chii-Dean

    2014-01-01

    Survival after in-hospital cardiac arrest (I-HCA) remains < 30 %. There is very limited literature exploring the electrocardiogram changes prior to I-HCA. The purpose of the study was to determine demographics and electrocardiographic predictors prior to I-HCA. A retrospective study was conducted among 39 cardiovascular subjects who had cardiopulmonary resuscitation from I-HCA with initial rhythms of pulseless electrical activity (PEA) and asystole. Demographics including medical history, eje...

  4. A decade of diabetes: keeping children out of hospital.

    OpenAIRE

    Swift, P G; Hearnshaw, J R; Botha, J L; Wright, G; Raymond, N. T.; Jamieson, K F

    1993-01-01

    OBJECTIVES--To document the number of children aged less than 15 years who developed diabetes and were managed within one large health district, and to evaluate the outcome of those children managed without hospital admission at diagnosis. DESIGN--A retrospective study over 1979-88, when a paediatrician and a physician with special interests in childhood diabetes initiated joint clinics. Data collected from the district diabetes register and files of consultants and health visitors specialisi...

  5. Hospital and patient characteristics of uncompensated hospital care: policy implications.

    Science.gov (United States)

    Saywell, R M; Zollinger, T W; Chu, D K; MacBeth, C A; Sechrist, M E

    1989-01-01

    For this study, a sample of 1,689 patients classified as "charity" and "bad debt" cases in 1986 were identified from 27 general acute care hospitals and one tertiary hospital in Indiana. Half of the hospitals were in rural areas and 57 percent were small (less than 150 beds). Most of the patients (87.2 percent) incurred uncompensated amounts under $2,500, and 40 percent of the cases were below $500. About 72 percent of the patients with uncompensated care were from the same county as the location of the hospital (range from 30.9% to 100.0%). The majority of the cases (79.4 percent) with over $5,000 in uncompensated care were treated in urban hospitals. The average age of these patients was 27.2 years. Fifty-four percent of the patients were single, 60.7 percent were female, and nearly all (83.0 percent) were discharged to home care. Only 44.6 percent of the patients with uncompensated care had no insurance; 46.8 percent had some form of commercial insurance which covered part of the charges for care. The most common diagnosis for these patients was pregnancy and childbirth (22.8 percent), with injury and poisoning second (10.7 percent). The cases with $5,000 or more in bad debt (about 4 percent of the cases) account for 28.3 percent of the total uncollected amount. Bad debt represents a cost of doing business. Any national effort to contain health care costs must address this problem. PMID:2738351

  6. Surveillance of Antibiotic Consumption Using the “Focus of Infection” Approach in 2 Hospitals in Ujjain, India

    OpenAIRE

    Pathak, Ashish; Mahadik, Kalpana; Dhaneria, Surya Prakesh; Sharma, Ashish; Eriksson, Bo; Lundborg, Cecilia Stålsby

    2012-01-01

    Antibiotic surveillance initiatives are limited in resource-constrained settings. In the present study, a quantitative comparison of antibiotic use rates for suspected infections in 2 hospitals in India was performed using the “focus of infection” approach to identify targets for quality improvement in antibiotic prescription patterns in hospitalized patients. Methods This observational study was carried out in one teaching and one nonteaching hospital. All the patients with suspected bacteri...

  7. Psychological sequelae of miscarriage: a controlled study using the general health questionnaire and the hospital anxiety and depression scale.

    OpenAIRE

    Thapar, A K; Thapar, A

    1992-01-01

    This study was carried out to assess whether psychiatric morbidity after a miscarriage is higher than that associated with early pregnancy. A total of 60 consecutive women admitted to a Swansea hospital with a miscarriage were compared with 62 consecutive women who attended an antenatal clinic at the same hospital, using the 28-item general health questionnaire and the hospital anxiety and depression scale. These were completed both at initial contact and six weeks later. Women who had had a ...

  8. 30-Day Survival Probabilities as a Quality Indicator for Norwegian Hospitals: Data Management and Analysis.

    Directory of Open Access Journals (Sweden)

    Sahar Hassani

    for AMI in 2011 varied from 80.6% (in the hospital with lowest estimated survival to 91.7% (in the hospital with highest estimated survival, whereas it ranged from 83.8% to 91.2% in 2013.Since 2011, several hospitals and hospital trusts have initiated quality improvement projects, and some of the hospitals have improved the survival over these years. Public reporting of survival/mortality indicators are increasingly being used as quality measures of health care systems. Openness regarding the methods used to calculate the indicators are important, as it provides the opportunity of critically reviewing and discussing the methods in the literature. In this way, the methods employed for establishing the indicators may be improved.

  9. Initial state propagators

    CERN Document Server

    Collins, Hael

    2013-01-01

    It is possible to define a general initial state for a quantum field by introducing a contribution to the action defined at an initial-time boundary. The propagator for this theory is composed of two parts, one associated with the free propagation of fields and another produced by the operators of this initial action. The derivation of this propagator is shown for the case of a translationally and rotationally invariant initial state. In addition to being able to treat more general states, these techniques can also be applied to effective field theories that start from an initial time. The eigenstates of a theory with interacting heavy and light fields are different from the eigenstates of the theory in the limit where the interactions vanish. Therefore, a product of states of the noninteracting heavy and light theories will usually contain excitations of the heavier state once the interactions are included. Such excitations appear as nonlocal effects in the effective theory, which are suppressed by powers of...

  10. Is the impact of hospital performance data greater in patients who have compared hospitals?

    Directory of Open Access Journals (Sweden)

    Smeets Harm J

    2011-09-01

    Full Text Available Abstract Background Public information on average has limited impact on patients' hospital choice. However, the impact may be greater in consumers who have compared hospitals prior to their hospital choice. We therefore assessed whether patients who have compared hospitals based their hospital choice mainly on public information, rather than e.g. advice of their general practitioner and consider other information important than patients who have not compared hospitals. Methods 337 new surgical patients completed an internet-based questionnaire. They were asked whether they had compared hospitals prior to their hospital choice and which factors influenced their choice. They were also asked to select between four and ten items of hospital information (total: 41 items relevant for their future hospital choice. These were subsequently used in a hospital choice experiment in which participants were asked to compare hospitals in an Adaptive Choice-Based Conjoint analysis to estimate which of the hospital characteristics had the highest Relative Importance (RI. Results Patients who have compared hospitals more often used public information for their hospital choice than patients who have not compared hospitals (12.7% vs. 1.5%, p Conclusion Public information has limited impact on patient's hospital choice, even in patients who have actually compared hospitals prior to hospital choice.

  11. Smart Hospital based on Internet of Things

    Directory of Open Access Journals (Sweden)

    Lei Yu

    2012-10-01

    Full Text Available In this paper, we propose an architecture and a scheme of smart hospital based on Internet of Things (IOT in order to overcome the disadvantages of the present hospital information system, such as the fixed information point, inflexible networking mode and so on. The key technologies and construction of smart hospital is presented based on understanding of the connotation and architecture of smart hospital. Furthermore, taking a third grade-A hospital as an example, a scheme of smart hospital is given, and its logic structure, application framework, the construction of basic network environment etc. are described in detail. Experiment proves that deployment of smart hospital can effectively solve the prominent problems existing the diagnosis and treatment of hospital and it brings a positive and profound effect for the present diagnosis and treatment mode in hospital.

  12. Application of Lean Six Sigma techniques to optimize hospital laboratory Emergency Department Turnaround time across a multi-hospital system

    OpenAIRE

    Hagg, Heather (Woodward); Scachitti, Susan; Mapa, Lash; Brandford, Lillie; Vanni, Chris; Cox, Catherine

    2007-01-01

    In January 2005, Indiana University, Purdue University at Indianapolis (IUPUI) and Purdue- Calumet were invited to partner with the Alverno Clinical Labs in adapting Lean Six Sigma methodologies for use within healthcare. Our initial project focused on optimization of lab services for the emergency department at the Saint Margaret Mercy Hospitals in Hammond, IN. This project resulted in reduction of lab test report time to the emergency department from 75 minutes to less than 35 minutes. Thes...

  13. Initiating events frequency determination

    International Nuclear Information System (INIS)

    The paper describes work performed for the Nuclear Power Station (NPS). Work is related to the periodic initiating events frequency update for the Probabilistic Safety Assessment (PSA). Data for all relevant NPS initiating events (IE) were reviewed. The main focus was on events occurring during most recent operating history (i.e., last four years). The final IE frequencies were estimated by incorporating both NPS experience and nuclear industry experience. Each event was categorized according to NPS individual plant examination (IPE) initiating events grouping approach. For the majority of the IE groups, few, or no events have occurred at the NPS. For those IE groups with few or no NPS events, the final estimate was made by means of a Bayesian update with general nuclear industry values. Exceptions are rare loss-of-coolant-accidents (LOCA) events, where evaluation of engineering aspects is used in order to determine frequency.(author)

  14. International EUREKA: Initialization Segment

    International Nuclear Information System (INIS)

    The Initialization Segment creates the starting description of the uranium market. The starting description includes the international boundaries of trade, the geologic provinces, resources, reserves, production, uranium demand forecasts, and existing market transactions. The Initialization Segment is designed to accept information of various degrees of detail, depending on what is known about each region. It must transform this information into a specific data structure required by the Market Segment of the model, filling in gaps in the information through a predetermined sequence of defaults and built in assumptions. A principal function of the Initialization Segment is to create diagnostic messages indicating any inconsistencies in data and explaining which assumptions were used to organize the data base. This permits the user to manipulate the data base until such time the user is satisfied that all the assumptions used are reasonable and that any inconsistencies are resolved in a satisfactory manner

  15. 76 FR 25550 - Medicare and Medicaid Programs: Changes Affecting Hospital and Critical Access Hospital...

    Science.gov (United States)

    2011-05-05

    ... May 26, 2010 (75 FR 29479). In that rule, we proposed to revise both the hospital and CAH..., neurology, and pathology services to hospital and CAH patients under the auspices of a non-hospital...

  16. Displacement Ventilation in Hospital Environments

    DEFF Research Database (Denmark)

    Li, Yuguo; Nielsen, Peter V.; Sandberg, Mats

    2011-01-01

    Hospital differ from conventional buildings in terms of ventilation needs. Exhaled infectious droplets or droplet nuclei of an infected patient need to be removed in general wards, waiting areas and isolation rooms to minimize transmission to health-care workers, other patients and visitors. In...

  17. What is your hospitality quotient?

    Science.gov (United States)

    DeSilets, Lyn

    2015-03-01

    In addition to the behind-the-scenes work involved with planning and implementing continuing nursing education activities, there are additional ways we can enhance the learner's experience. This article presents ideas on how to improve your hospitality quotient. PMID:25723328

  18. Carioca hospitality programme: Rio 2016

    OpenAIRE

    2016-01-01

    The "Hospitality programme" at the Rio 2016 Games venues was designed to attend the specific needs of partners and their clients in a transparent and flexible manner. In this guide, you will find information and standards that will help in your choice, and in the planning of this incredible experience.

  19. Hospital Patients Are Adult Learners.

    Science.gov (United States)

    Caffarella, Rosemary S.

    Patient education is recognized by health care providers and patients themselves as an important component of adequate health care for hospital patients. Through this informational process, patients receive information about specific health problems, learn the necessary competencies to deal with them, and develop accepting attitudes toward the…

  20. Challenges in Hospital-Associated Infection Management: A Unit Perspective.

    Science.gov (United States)

    Stacy, Kathleen M

    2015-01-01

    Maintaining a successful unit-based continuous quality improvement program for managing hospital-associated infections is a huge challenge and an overwhelming task. It requires strong organizational support and unit leadership, human and fiscal resources, time, and a dedicated and motivated nursing staff. A great deal of effort goes into implementing, monitoring, reporting, and evaluating quality improvement initiatives and can lead to significant frustration on the part of the leadership team and nursing staff when quality improvement efforts fail to produce the desired results. Each initiative presents its own unique set of challenges; however, common issues influence all initiatives. These common issues include organization and unit culture, current clinical practice guidelines being used to drive the initiatives, performance discrepancies on the part of nursing staff, availability of resources including equipment and supplies, monitoring of the data, and conflicting quality improvement priorities. PMID:26200734

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

    OpenAIRE

    Eskoz, Robin; Peddecord, K. Michael

    1985-01-01

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

  2. Nursing: the hospital's competitive edge.

    Science.gov (United States)

    Shaffer, F A; Preziosi, P

    1988-09-01

    The health care marketplace is becoming increasingly competitive. The hospital has a built-in marketing force with the nursing department, because nurses are in constant, direct contact with the customer. Nursing must identify the case mix profile of the community and focus the hospital product lines to meet community needs. The nursing department should decentralize, change, measure, and innovate the staff mix needed to operationalize these product lines. The development of nursing practice standards for the case mix will help to identify the staff mix needed and create systems to efficiently manage the product lines. Nursing management must become aware of cross-subsidization and downward skill substitution of nursing personnel. Nursing information systems must generate quality reports that invoke cost consciousness on the part of nursing staff. Quality assurance programs must become unit based and complete with frequent audits to correlate length of stay with nursing quality. Correlations must be determined between nursing productivity and case mix to determine the hospital's niche in the marketplace. The transformation of health care into a competitive business industry has created many opportunities for nursing. The health care industry's incentives for efficiency along with the decreasing demand for inpatient hospital services will be the forces driving health care toward a competitive marketplace. The hospital's nursing department should be strategically positioned to become accountable for increasing market share and enhancing quality patient outcomes. The focus has shifted from the theoretical to the tactical, which is a step in the right direction, particularly for nursing. Nursing, if strategically positioned, will not only thrive but will also excel in this chaotic environment by capturing the opportunities and being innovative. PMID:3047695

  3. Survey of the Information-Seeking Behaviour of Hospital Professionals at a Public Cancer Hospital in Greece Proves the Value of Hospital Libraries. A Review of: Kostagiolas, P. A., Ziavrou, K., Alexias, G., & Niakas, D. (2012. Studying the information-seeking behavior of hospital professionals: The case of METAXA Cancer Hospital in Greece. Journal of Hospital Librarianship, 12(1, 33-45.

    Directory of Open Access Journals (Sweden)

    Antonio DeRosa

    2013-06-01

    time (3.7 score on Likert scale. A lack of information services was second to the time issue with a Likert scale score of 3.6.Conclusion – Based on the research results, the authors affirmed the invaluable role of hospital libraries. The hospital library can help to eliminate the obstacles faced by healthcare professionals by providing support in the areas of weakness based on the survey results. This can be made possible through the hospital library’s involvement in educational activities, investigation of information technologies, and development of information services to accommodate the difficulties regularly experienced by hospital staff. Researchers revealed that funding for hospital libraries in Greece is an issue preventing many new initiatives, that there is no association to represent hospital libraries in Greece, that the few libraries operating in hospitals in Greece are understaffed with no administrative control, and the majority of Greek hospitals do not have adequate library facilities. These drawbacks contribute to the information-seeking challenges experienced by Greek healthcare professionals.

  4. Nutritional status of children hospitalized for parapneumonic effusion.

    Directory of Open Access Journals (Sweden)

    Koen Huysentruyt

    Full Text Available BACKGROUND & AIMS: Among children hospitalized for pneumonia, those with parapneumonic effusion (PPE are at particular risk for nutritional deterioration. This study aimed to 1 investigate the evolution of the nutritional status during hospitalization and at outpatient follow-up; 2 determine clinical risk factors for weight loss during hospitalization; 3 describe the nutritional interventions for these children. METHODS: Retrospective chart review (January '07 - September '12 of 56 children with pneumonia, complicated by PPE in two Belgian hospitals for data on body weight and height at admission (t0 and discharge (t1, and two weeks (t2 and one month (t3 after discharge. Length of hospitalization (LoS, length of stay in paediatric intensive care (LoSPICU and maximal in-hospital weight loss (tmax were calculated and nutritional interventions were recorded. RESULTS: The median (range age was 3.5 (1.0-14.8 years. Weight or height was lacking in five (8.9% children at t0 and in 28 (50% at t1; 21.4% was weighed only once during hospitalization. At tmax, respectively 17/44 and 5/44 children lost ≥ 5% and ≥ 10% of their weight. Median (range LoS and LoSPICU were 18.0 (10-41 and 4.0 (0-23 days. One-fourth received a nutritional intervention. Weight for height at admission (WFH(t0 significantly predicted maximal weight loss (β (95% CI = -0.34 (-2.0--0.1; p = 0.03. At t2 and t3, 13/32 and 5/22 of the children with available follow-up data did not reach WFH(t0, whilst in 4/35 and 5/26 body weight remained ≥ 5% under the weight(t0. CONCLUSIONS: One-third of children with pneumonia complicated by PPE and monitored for weight and height, lost ≥ 5% of their body weight during hospitalization. One-fourth did not reach initial WFH one month after discharge. Those with a higher WFH at admission were at higher risk of weight loss. More attention for monitoring of weight loss and the nutritional policy during and after hospitalization is warranted.

  5. Mixed-Initiative Clustering

    Science.gov (United States)

    Huang, Yifen

    2010-01-01

    Mixed-initiative clustering is a task where a user and a machine work collaboratively to analyze a large set of documents. We hypothesize that a user and a machine can both learn better clustering models through enriched communication and interactive learning from each other. The first contribution or this thesis is providing a framework of…

  6. The SEED Initiative

    Science.gov (United States)

    Teich, Carolyn R.

    2011-01-01

    Committed to fulfilling the promise of the green economy, the American Association of Community Colleges (AACC) launched the Sustainability Education and Economic Development (SEED) initiative (www.theseedcenter.org) in October 2010. The project advances sustainability and clean energy workforce development practices at community colleges by…

  7. Clean Energy Manufacturing Initiative

    Energy Technology Data Exchange (ETDEWEB)

    None

    2013-04-01

    The initiative will strategically focus and rally EERE’s clean energy technology offices and Advanced Manufacturing Office around the urgent competitive opportunity for the United States to be the leader in the clean energy manufacturing industries and jobs of today and tomorrow.

  8. Sustaining Participatory Design Initiatives

    DEFF Research Database (Denmark)

    Iversen, Ole Sejer; Dindler, Christian

    2014-01-01

    While many participatory design (PD) projects succeed in establishing new organisational initiatives or creating technology that is attuned to the people affected, the issue of how such results are sustained after the project ends remains an important challenge. We explore the challenge...

  9. Initial Market Assessment

    OpenAIRE

    World Bank, (WB)

    2013-01-01

    Responding appropriately to the country’s high exposure and vulnerability to natural disasters, and capitalizing on a well-functioning insurance industry, Vietnam has embraced insurance mechanisms in disaster risk management and agriculture more vigorously than most developing countries. But some initiatives like the disaster risk reduction (DRR) strategy’s mandate to implement disaster ri...

  10. Initial operation of PDX

    International Nuclear Information System (INIS)

    Initial operation of PDX with a circular cross-section plasma is described. The machine parameters are given and the glow discharge cleaning is discussed. Plasma parameters for a circular deuterium plasma discharge are given for both moderate and low q experiments

  11. Open Archives Initiative

    OpenAIRE

    McMillan, Gail

    2004-01-01

    This presentation, which was given at the annual meeting of the Society of Scholarly Publishing on June 1, 2000, describes the Open Archives Initiative (OAI), a protocol for exchanging content between digital repositories. The presentation outlines OAI's history, core components, key stakeholders, and ongoing developments. Presented at the Society for Scholarly Publishing: June 1, 2000

  12. Risk factors for recurrent hospital-acquired Clostridium difficile infection in a Japanese university hospital

    Directory of Open Access Journals (Sweden)

    Hikone M

    2015-07-01

    Full Text Available Mayu Hikone,1 Yusuke Ainoda,1,2 Sayaka Tago,2 Takahiro Fujita,2 Yuji Hirai,2 Kaori Takeuchi,2 Kyoichi Totsuka31Department of Infectious Diseases, Tokyo Metropolitan Bokutoh General Hospital, 2Department of Infectious Diseases, Tokyo Women's Medical University, 3Department of Internal Medicine, Kitatama Hospital, Tokyo, JapanBackground: Clostridium difficile infection (CDI is a highly prevalent hospital-associated infection. Although most patients respond well to discontinuation of antibiotics, 20%–30% of patients relapse. To initiate early therapeutic measures, the risk factors for recurrent CDI must be identified, although very few Japanese studies have used standard surveillance definitions to identify these risk factors.Methods: We retrospectively reviewed the medical records of patients with health care facility-onset CDI between August 2011 and September 2013. Patients with diarrhea who were positive for Clostridium difficile (via an enzyme immunoassay were defined as having CDI. Clinical data (eg, demographics, comorbidities, medication, laboratory results, and clinical outcomes were evaluated, and multivariate analysis was used to identify risk factors that were associated with recurrent CDI.Results: Seventy-six health care facility-onset CDI cases were identified, with an incidence rate of 0.8 cases per 10,000 patient-days. Fourteen cases (18.4% were recurrent, with 13 patients having experienced a single recurrent episode and one patient having experienced three recurrent episodes. The 30-day and 90-day mortality rates were 7.9% and 14.5%, respectively. Multivariate analysis revealed that recurrent patients were more likely to have underlying malignant disease (odds ratio: 7.98; 95% confidence interval: 1.22–52.2; P=0.03 and a history of intensive care unit hospitalization (odds ratio: 49.9; 95% confidence interval: 1.01–2,470; P=0.049.Conclusion: Intensive care unit hospitalization and malignancy are risk factors for recurrent

  13. Towards integrated care in breastfeeding support: a cross-sectional survey of practitioners’ perspectives

    OpenAIRE

    Rosin, Stefanie Inge; Zakarija-Grković, Irena

    2016-01-01

    Background Integrated care is defined as concerted action of healthcare providers ensuring continuity of care within a patient-centered approach, thus contributing to healthcare efficiency and quality. Apart from the WHO/UNICEF Baby-Friendly Initiatives, integrated care has been poorly explored within the context of breastfeeding support. The aim of this study was to investigate the experience of breastfeeding support practitioners, identifying barriers and facilitators towards integrated car...

  14. Medical education and the quality improvement spiral: A case study from Mpumalanga, South Africa

    OpenAIRE

    Martin Bac; Anne-Marie Bergh; Etsane, Mama E.; Jannie Hugo

    2015-01-01

    Background: The short timeframe of medical students’ rotations is not always conducive to successful, in-depth quality-improvement projects requiring a more longitudinal approach.Aim: To describe the process of inducting students into a longitudinal quality-improvement project,using the topic of the Mother- and Baby-Friendly Initiative as a case study; and to explore the possible contribution of a quality-improvement project to the development of student competencies.Setting: Mpumalanga clini...

  15. 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

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

  16. Profile of hospital care for external causes in public hospitals

    Directory of Open Access Journals (Sweden)

    Marlos Victor Fonsêca de Lima

    2012-04-01

    Full Text Available This study aimed to identify the profile of external causes in the emergency room of a public reference hospital in the state. Descriptive research document with a quantitative approach. The data analysis revealed that from January to December 2009 were made 4464 external causes. The higher frequency of injuries occurred in individuals aged 21 to 40 years (37.70%, males (68.6%. Regarding the causes, falls (29% was the biggest variable, followed by motorcycle accidents (17.98%, domestic accidents (16.53%, physical abuse (10.43% and bicycle accident (8, 84%. It was observed that 23.3% of the visits made to the emergency room were the people coming from surrounding municipalities. The study revealed the need to improve the quality of information about the grievances motivated by external causes, which are major causes of hospitalization and health care expenses.

  17. Conversations with the community: the Methodist Hospital System's experience with social media.

    Science.gov (United States)

    Angelle, Denny; Rose, Clare L

    2011-01-01

    The Methodist Hospital System has maintained a social media presence on Facebook, Twitter, and YouTube since 2009. After initial unofficial excursions into the world of social media, we discovered that social media can be a useful tool to extend a conversation with our patients and the community at large and share our hospital's culture with a larger base of like-minded people. But with this new power comes a heightened responsibility--platforms that can potentially reach millions of viewers and readers also provide a potential for misuse that can jeopardize patient privacy and place hospitals at risk. Because of their unique restrictions, even hospitals that use the tools regularly have much left to learn about social media. With constant monitoring and stewardship and a commitment to educating staff, hospitals can effectively use social media tools for marketing and education. PMID:22256507

  18. Profile of hospital care for external causes in public hospitals

    OpenAIRE

    Marlos Victor Fonsêca de Lima; Romântiezer Lourenço Pereira Silva; Nicelha Maria Guedes de Albuquerque; Jonas Sâmi Albuquerque de Oliveira; Cleonice Andréa Alves Cavalcante; Maria Lúcia Azevedo Ferreira de Macêdo

    2012-01-01

    This study aimed to identify the profile of external causes in the emergency room of a public reference hospital in the state. Descriptive research document with a quantitative approach. The data analysis revealed that from January to December 2009 were made 4464 external causes. The higher frequency of injuries occurred in individuals aged 21 to 40 years (37.70%), males (68.6%). Regarding the causes, falls (29%) was the biggest variable, followed by motorcycle accidents (17.98%), domestic ac...

  19. Bioaerosol sampling for airborne bacteria in a small animal veterinary teaching hospital

    OpenAIRE

    Adesiyun, Abiodun A.; Tisha A. M. Harper; Bridgewater, Shelley; Brown, Latoya; Pow-Brown, Patricia; Stewart-Johnson, Alva

    2013-01-01

    Background: Airborne microorganisms within the hospital environment can potentially cause infection in susceptible patients. The objectives of this study were to identify, quantify, and determine the nosocomial potential of common airborne microorganisms present within a small animal teaching hospital. Methods: Bioaerosol sampling was done initially in all 11 rooms and, subsequently, weekly samples were taken from selected rooms over a 9-week period. Samples were collected twice (morning and ...

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

    OpenAIRE

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

    2011-01-01

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

  1. Design Innovations and Implementation Challenges - A Case of Smart Textiles in Future Hospital Interiors

    DEFF Research Database (Denmark)

    Mogensen, Jeppe; Jørgensen, Poul-Erik; Poulsen, Søren Bolvig

    Concerned with the overall challenges of implementing design innovations, this paper relates to the specific case of applying smart textiles in future hospital interiors. The methodological approach is inspired by design thinking and implementation processes, and through the scope of a developed...... strategic framework, the implementation challenges will be discussed from a holistic integrative design perspective. With this explorative initiative, our aim is to present specific approaches to progress the design innovation of smart textiles, and the implementation climate of future hospitals....

  2. Guidance and Orientation Manual : Internal Diseases Ward 11 - Central Finland Central Hospital

    OpenAIRE

    Hirjaba, Marina

    2009-01-01

    The purpose of this Bachelor’s Thesis is to create an initiation manual for the foreign students, foreign visitors or anyone else interested about Internal Diseases ward 11, Central Finland Central Hospital. The aim of the guidance material is to help the foreign students, who are practicing on ward 11, to become acquainted with the Finnish Healthcare System, Central Finland Central Hospital and to offer orientation upon the nursing and organisation of Internal Diseases ward 11. It is taken i...

  3. Differential prognosis and utilization patterns among clinical subgroups of hospitalized geriatric patients.

    OpenAIRE

    Rubenstein, L. Z.; Josephson, K R; Wieland, G D; Kane, R L

    1986-01-01

    While screening elderly inpatients on acute Veterans Administration (VA) hospital wards for a special geriatric program, we prospectively classified all patients age 65 and over, who had been hospitalized at least a week, into five clinical subgroups using specific diagnostic, prognostic, and functional criteria. These five subgroups were "geriatric evaluation unit (GEU) candidate", "severely demented", "medical", "terminal", and "independent". Medical record data from the initial admission a...

  4. Rapid draft sequencing and real-time nanopore sequencing in a hospital outbreak of Salmonella

    OpenAIRE

    Quick, Joshua; Ashton, Philip; Calus, Szymon; Chatt, Carole; Gossain, Savita; Hawker, Jeremy; Nair, Satheesh; Neal, Keith; Nye, Kathy; Peters, Tansy; De Pinna, Elizabeth; Robinson, Esther; Struthers, Keith; Webber, Mark; Catto, Andrew

    2015-01-01

    Background Foodborne outbreaks of Salmonella remain a pressing public health concern. We recently detected a large outbreak of Salmonella enterica serovar Enteritidis phage type 14b affecting more than 30 patients in our hospital. This outbreak was linked to community, national and European-wide cases. Hospital patients with Salmonella are at high risk, and require a rapid response. We initially investigated this outbreak by whole-genome sequencing using a novel rapid protocol on the Illumina...

  5. A medical admission unit reduces duration of hospital stay and number of readmissions

    DEFF Research Database (Denmark)

    Vork, Jan C; Brabrand, Mikkel; Folkestad, Lars;

    2011-01-01

    Political initiatives promoting a more efficient emergency admission process have triggered a reorganisation of the Danish health system with a view to creating fewer and larger admission units counting more experienced physicians. At our hospital, a medical admission unit (MAU) was established. ...... present the effect of this on the length of hospital stay, mortality rates and the number of readmissions for the last year with the previous structure and the first year of the new MAU structure....

  6. Early management of traumatic brain injury in a Tertiary hospital in Central Kenya: A clinical audit

    OpenAIRE

    Clifford Chacha Mwita; Johnstone Muthoka; Stephen Maina; Phillip Mulingwa; Samson Gwer

    2016-01-01

    Background: Traumatic brain injury (TBI) is a major cause of death and disability worldwide and is mostly attributed to road traffic accidents in resource-poor areas. However, access to neurosurgical care is poor in these settings and patients in need of neurosurgical procedures are often managed by general practitioners or surgeons. Materials and Methods: A retrospective clinical audit of the initial management of patients with TBI in Thika Level 5 Hospital (TL5H), a Tertiary Hospital in Cen...

  7. The Conquest Hospital picture archiving and communications system development, 1992 to 1999

    OpenAIRE

    Foord, Keith; Tomlinson, Nigel

    1999-01-01

    Conquest Hospital was a UK regional development site for a pre-Digital Imaging and Communications in Medicine (DICOM) picture archiving and communication system (PACS). The initial system was installed in mid 1992. Identification has been made of data transfer, ergonomic and single point of failure issues in the original PACS, which was called “iLAN.” This has informed respecification of a DICOM/HTML PACS, the first stages of which have been hospital renetworking and installation of new DICOM...

  8. Microorganisms causing pyogenic spondylitis: Comparison of community and hospital-acquired types

    OpenAIRE

    Sasaji, Tatsuro; Yamada, Noboru; Iwai, Kazuo

    2012-01-01

    Staphylococcus aureus Pyogenic spondylitis is a common infectious disease caused by various microorganisms. It is difficult to predict the infecting microorganism at the time of initiation of treatment. Pneumonia is generally clarified into community or hospital-acquired types based on where the infection was acquired, and the infecting microorganisms are different for each type. We retrospectively analyzed 20 cases of pyogenic spondylitis treated in our hospital and categorized the cases int...

  9. Goldratt’s Theory Applied to the Problems Associated with an Emergency Department at a Hospital

    OpenAIRE

    Soumya Nayak; Lloyd J. Taylor

    2012-01-01

    Healthcare costs continue to increase dramatically, while quality remains a significant problem. Reform measures initiated by the government will drive expansion of these costs, further stressing taxpayers and employers, and forcing hospitals to adopt fundamental changes as they try to adjust to increased demands for services and to lessening reimbursements from all payers. This struggle is best seen at the point of entry for many at a hospital: the emergency department (ED). It is at the eme...

  10. Hospital Outpatient Prospective Payment System (OPPS) Lim...

    Data.gov (United States)

    U.S. Department of Health & Human Services — Hospital Outpatient Prospective Payment System (OPPS) Limited Data Set This file contains select claim level data and is derived from 2010 hospital outpatient PPS...

  11. Non-VA Hospital System (NVH)

    Data.gov (United States)

    Department of Veterans Affairs — The Veterans Health Administration (VHA) pays for care provided to VA beneficiaries in non-VA hospitals through its contract hospitalization program as mandated by...

  12. Medication safety during your hospital stay

    Science.gov (United States)

    ... your medicine. This prescription goes to the hospital pharmacy. The hospital pharmacist reads and fills the prescription. The medicine ... medicine. Alternative Names ... Date 2/6/2016 Updated by: Laura J. ...

  13. Acute IPPS - Disproportionate Share Hospital - DSH

    Data.gov (United States)

    U.S. Department of Health & Human Services — There are two methods for a hospital to qualify for the Medicare DSH adjustment. The primary method is for a hospital to qualify based on a statutory formula that...

  14. Enhancing Medicares Hospital Acquired Conditions Policy

    Data.gov (United States)

    U.S. Department of Health & Human Services — The current Medicare policy of non-payment to hospitals for Hospital Acquired Conditions (HAC) seeks to avoid payment for preventable complications identified...

  15. Fast Facts on U.S. Hospitals

    Science.gov (United States)

    ... for-Profit Community Hospitals 2,870 Number of Investor-Owned (For-Profit) Community Hospitals 1,053 Number ... on www.aha.org is granted to AHA Institutional Members, their employees and State, Regional and Metro ...

  16. Hospital-Acquired Condition Reduction Program

    Data.gov (United States)

    U.S. Department of Health & Human Services — In October 2014, CMS began reducing Medicare payments for subsection (d) hospitals that rank in the worst performing quartile with respect to hospital-acquired...

  17. National Hospital Ambulatory Medical Care Survey

    Data.gov (United States)

    U.S. Department of Health & Human Services — The National Hospital Ambulatory Medical Care Survey (NHAMCS) is designed to collect data on the utilization and provision of ambulatory care services in hospital...

  18. Improve Hospital-to-Home Transitions

    Science.gov (United States)

    ... Current Issue Past Issues Improve Hospital-to-Home Transitions Past Issues / Spring 2008 Table of Contents For ... groups. This indicates a serious breakdown during the transition from the hospital to home care. Nurse scientist ...

  19. Preliminary Investigations of Hospital Geography and Patient Choice in Iowa

    OpenAIRE

    Imerman, Mark D.; Eathington, Liesl; Jintanakul, Kanlaya; Otto, Daniel

    2006-01-01

    This report provides a spatial representation of hospital geography in Iowa and of the decisions of patients to patronize hospitals. It begins with a brief analysis of hospital proximity and hospital proximity’s relationship to population distributions and existing hospital capacity. This is followed with a discussion of hospital capacity as a proxy for the supply of hospital services and the construction of hospital service area gravity models based upon capacity. Patient patronage of hospit...

  20. Gravity wave initiated convection

    Science.gov (United States)

    Hung, R. J.

    1990-01-01

    The vertical velocity of convection initiated by gravity waves was investigated. In one particular case, the convective motion-initiated and supported by the gravity wave-induced activity (excluding contributions made by other mechanisms) reached its maximum value about one hour before the production of the funnel clouds. In another case, both rawinsonde and geosynchronous satellite imagery were used to study the life cycles of severe convective storms. Cloud modelling with input sounding data and rapid-scan imagery from GOES were used to investigate storm cloud formation, development and dissipation in terms of growth and collapse of cloud tops, as well as, the life cycles of the penetration of overshooting turrets above the tropopause. The results based on these two approaches are presented and discussed.

  1. INITIAL TRAINING OF RESEARCHERS

    Directory of Open Access Journals (Sweden)

    Karina Alejandra Cruz-Pallares

    2015-07-01

    Full Text Available The document presents results of a research that used as strategy a complementary training project with thirty-three students of a Bachelors Degree in Primary School 1997(DPS,1997 of an Education Faculty for the initial training of investigators, applied by four teachers members of the academic research group in Mexico; that develops through process of action research methodology. Highlighted in results is the strengthening of the competition of reading, understanding and writing scientific texts, which is analogous to the first feature of the graduate profile called intellectual skills. Among the conclusions it is emphasized that the initial training of teachers in a task that is quite interesting, challenging and complex, as is the educational complex phenomenon.

  2. Self-initiated expatriates

    DEFF Research Database (Denmark)

    Selmer, Jan; Lauring, Jakob

    2014-01-01

    Purpose – As it has been suggested that adult third-culture kids may be more culturally adaptable than others, they have been labelled “the ideal” expatriates. In this article, we explore the adjustment of self-initiated expatriate academics in Hong Kong, comparing adult third-culture kids with...... adult mono-culture kids. Design/methodology/approach – We use survey results from 267 self-initiated expatriate academics in Hong Kong. Findings – Exploratory results show that adult third-culture kids had a higher extent of general adjustment. No significant results were found in relation to...... interaction adjustment and job adjustment. We also found that recent expatriate experiences generally had a positive association with the adjustment of adult mono-culture kids, but this association only existed in terms of general adjustment for adult third-culture kids. Originality/value – Once corroborated...

  3. The Yekaterinburg headache initiative

    DEFF Research Database (Denmark)

    Lebedeva, Elena R; Olesen, Jes; Osipova, Vera V;

    2013-01-01

    disability are well in excess of the global and European averages, is no exception, while arcane diagnoses and treatment preferences are an aggravating factor. Urgent remedial action, with political support, is called for. METHODS: Yekaterinburg, in Sverdlovsk Oblast, is the chosen centre for a...... demonstrational interventional project in Russia, undertaken within the Global Campaign against Headache. The initiative proposes three actions: 1) raise awareness of need for improvement; 2) design and implement a three-tier model (from primary care to a single highly specialized centre with academic affiliation...... context of a health-care needs assessment, and as a model for all Russia. We present and discuss early progress of the initiative, justify the investment of resources required for implementation and call for the political support that full implementation requires. The more that the Yekaterinburg headache...

  4. Novel ventilation strategy for reducing the risk of airborne cross infection in hospital rooms

    DEFF Research Database (Denmark)

    Melikov, Arsen Krikor; Bolashikov, Zhecho Dimitrov; Georgiev, Emanuil

    2011-01-01

    Novel ventilation method comprising a mobile unit attachable to a hospital bed was used to improve the protection of occupants from exposure to airborne cross-infection initiated by a sick patient in hospital environment. Full-scale measurements were performed in a climate chamber set up as a two......-bed hospital room, ventilated at 3 h-1 by mixing air distribution. The air temperature was kept 22 0C. Two breathing thermal manikins were used: sick patient (lying on one side in one bed) and doctor. The doctor stood 0.55 m facing the sick patient. Tracer gas was mixed with the air exhaled by the sick patient...

  5. Breastfeeding practice in Bosnia and Herzegovina

    Directory of Open Access Journals (Sweden)

    Darinka Šumanović-Glamuzina

    2013-04-01

    Full Text Available Bosnia and Herzegovina is one of the new countries established after the break up of the former Yugoslavia. One of the unfortunate legacies of this country due to the 1992-1994 war is the destruction of human and material resources. Despite many negative events, steady progress can be seen in social, technological and cultural aspects of life. According to the global public health recommendation, infants should be breastfed for the first six months of life to achieve optimal growth, health and development. Therefore, to meet their evolving nutritional requirements, infants should receive nutritionally adequate and safe food, with Breastfeeding (BF extended up to and beyond two years of age. In Bosnia and Herzegovina (B&H majority of mothers (estimated at 95% have initiated breastfeeding. However, Exclusive Breastfeeding (EBF is not commonly practiced, and BF ceases by the age of five months. After 1995, a number of programs were introduced by WHO and UNICEF in B&H with a primary goal to ensure that babies were given a healthy start in life. Through implementation of Baby-Friendly Hospital Initiative (BFHI, enabling exact public health survey – the Multiple Indicator Cluster Survey (MICS, it would be possible to create comparable health indicators and make a step forward to promote and support breastfeeding practice as the best option for infants.

  6. Laser Initiated Actuator study

    Energy Technology Data Exchange (ETDEWEB)

    Watson, B.

    1991-06-27

    The program task was to design and study a laser initiated actuator. The design of the actuator is described, it being comprised of the fiber and body subassemblies. The energy source for all experiments was a Spectra Diode 2200-H2 laser diode. The diode is directly coupled to a 100 micron core, 0.3 numerical aperture fiber optic terminated with an SMA connector. The successful testing results are described and recommendations are made.

  7. Innovative Rural Development Initiatives

    OpenAIRE

    Wickenhagen, A.; Pontieri, A.; Heilig, G.K.

    2002-01-01

    This Interim Report provides first results from case studies of innovative rural development initiatives in Europe. They were conducted by IIASA's European Rural Development (ERD) project during 2001 -- primarily to test the feasibility of the research concept and to get a first realistic impression of rural development problems and possibilities at the IDeal level. These reports are only the first round of a much larger sample of some 40 to 50 case studies, which are planned for the nex...

  8. Current trends in hospital mergers and acquisitions.

    Science.gov (United States)

    Brown, Thomas C; Werling, Krist A; Walker, Barton C; Burgdorfer, Rex J; Shields, J Jordan

    2012-03-01

    Healthcare reform will impact hospital consolidation in three key areas: Payment rates will decrease, indirectly encouraging consolidation by forcing hospitals to find new ways to reduce costs and increase negotiating clout with suppliers and payers. The cost of doing business will increase as hospitals spend more on compliance, technology, and physician employment. The ACO model will encourage hospital network formation by rewarding integrated healthcare systems that can reduce costs and improve quality. PMID:22420144

  9. Estimating hospital service areas using mortality statistics.

    OpenAIRE

    Carpenter, E S; Plessas, D. J.

    1985-01-01

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

  10. Management strategies in hospitals: scenario planning

    OpenAIRE

    Ghanem, Mohamed; Schnoor, Jörg; Heyde, Christoph-Eckhard; Kuwatsch, Sandra; Bohn, Marco; Josten, Christoph

    2015-01-01

    Background: Instead of waiting for challenges to confront hospital management, doctors and managers should act in advance to optimize and sustain value-based health. This work highlights the importance of scenario planning in hospitals, proposes an elaborated definition of the stakeholders of a hospital and defines the influence factors to which hospitals are exposed to. Methodology: Based on literature analysis as well as on personal interviews with stakeholders we propose an elaborated defi...

  11. Hospital management contracts: institutional and community perspectives.

    OpenAIRE

    Wheeler, J. R.; Zuckerman, H S

    1984-01-01

    Previous studies have shown that external management by contract can improve the performance of managed hospitals. This article presents a conceptual framework which develops specific hypotheses concerning improved hospital operating efficiency, increased ability to meet hospital objectives, and increased ability to meet community objectives. Next, changes in the process and structure of management under contractual arrangements, based on observations from two not-for-profit hospital systems,...

  12. Caritas Norwood Hospital: back from the brink.

    Science.gov (United States)

    Guyon, Robert E

    2003-07-01

    Caritas Norwood Hospital and its affiliates went from $17 million in the red to a $4 million profit after implementing comprehensive financial and operational strategies, which included reengineering the revenue cycle, outsourcing some services, and focusing on the hospital's core business. External pressures were out of the hospital's control, but a comprehensive analysis identified many internal problems that the hospital had to resolve. The new management team also uncovered many undisclosed problems when it took the reins. PMID:12866153

  13. Positioning hospitals for improved access to capital.

    Science.gov (United States)

    Ponton, Kevin T; Sandrick, Karen M

    2002-11-01

    Hospitals need to actively position themselves in the next 18 to 24 months to ensure continued access to financing. Hospitals need to shift their focus from investment income to operations. Hospitals should recognize the importance of balance-sheet liquidity to institutional investors. Not-for-profit hospitals should focus on both sides of the balance sheet. Healthcare executives need to develop effective leadership and investor-relations skills. PMID:12656030

  14. Baltinglass District Hospital, Baltinglass, Wicklow.

    LENUS (Irish Health Repository)

    Shortall, C

    2015-02-01

    This study assessed the provision of education and support to parents of children on home enteral nutrition (HEN), current dietetic support available and perceived challenges facing parents and carers. From the 39 responses (13%), 29 (83%, n = 35) parents suggested services for HEN need improvement. 29 (74%, n = 39) parents wanted more structured follow up and 22 (56%) would like one person to co-ordinate HEN, education and discharge. 7 parents (18%) reported a need for further education of health care professionals (HCP). Hospital dietitians were the most common HCPs reported to provide support to patients following discharge. Specialist paediatric HEN dietetic services working in a dedicated HEN team, who would provide accurate training and education and liaise with both parents and community care services post discharge should be in place. This would facilitate transfer to community care, reduce hospital re-admissions, outpatient department attendances and costs.

  15. Occupational exposure in UK hospitals

    International Nuclear Information System (INIS)

    The Regional Radiation Physics and Protection Service (RRPPS) of the Medical Physics Department of Birmingham monitors the radiation dose of almost 10,000 hospital staff working in the West Midlands and some other NHS regions. The RRPPS is an Approved Dosimetry Service and holds dose records for over 30,000 staff. The earliest records date from 1949 when less than 200 people were monitored. The dosimetry service has been computerised since 1974. Analysis of the annual records for each category of staff shows the impact particularly of remote after-loading brachytherapy equipment on the reduction of staff doses. The evidence from dose records suggests that with proper working practices, no hospital staff should need to be designated as classified radiation workers under the Ionising Radiation regulations 1985. A significant reduction of the current dose limits may alter this situation. (author)

  16. Light atmosphere in hospital wards

    DEFF Research Database (Denmark)

    Stidsen, Lone Mandrup

    Sociocultural aspects of light are important for the user experience of the atmosphere in a ward. According to the Danish Regulation for light in hospitals (DS703, 1983), a home-like feeling is required to support the patients, as they needa pleasant environment for their recovery. The term ‘Light...... Atmosphere’ is explored using methods in the practice of lighting design where qualitative and quantitative methods are used to qualify important aspects of a lighting design. Measurable parameters such as the amount of Lux, composition of CRI and degree of Kelvin is well described so the designer can handle...... Atmosphere' is the focal point developed through the study. Primarily, the model frames the study and serves as a design tool for creating the light atmosphere in hospital wards. First, brain storming is used to open up the field supported by theoretical aspects based on Gernot Böhmes' concept of atmosphere...

  17. Initiation Train Experiments

    Science.gov (United States)

    Francois, Elizabeth; Johnson, Carl; Liechty, Gary; Whitley, Von

    2015-06-01

    In an effort to evaluate and qualify a new detonator diagnostic, booster selection and main charge configuration, a variety of small-scale tests have been conducted. This paper will describe the needs, testing approach and model validation. Because of the limited size available some novel approaches were made to understand the observed phenomenon. Function time and time of arrival at various locations in the initiation train are desirable data points. Knowing when each segment initiates the next segment and the time to run up to detonation is critical. Results of our experiments were modeled for timing accuracy, wave shape and pressure. Agreement between the experiments and models will be discussed. The testing that will be discussed is time of arrival wires, PDV, and fiber optic arrays. The time of arrival wire measures the detonator cup breakout time. When correlated to bridge burst, an absolute time is collected. This data point also gives time zero for the booster initiation. Many models actually start at the booster, rather than the detonator, so the inclusion of this data point will improve modeling efforts.

  18. Bed bathing patients in hospital

    OpenAIRE

    L Downey; Lloyd, Hilary

    2008-01-01

    There are a number of circumstances that may affect an individual's ability to maintain personal hygiene. Hospitalised patients, and in particular those who are bedridden, may become dependent on nursing staff to carry out their hygiene needs. Assisting patients to maintain personal hygiene is a fundamental aspect of nursing care. However, it is a task often delegated to junior or newly qualified staff. This article focuses on the principles of bed bathing patients in hospital, correct proced...

  19. Hyperkalaemia in patients in hospital.

    OpenAIRE

    Paice, B.; Gray, J M; McBride, D; Donnelly, T; Lawson, D H

    1983-01-01

    Significant hyperkalaemia occurred in 406 out of 29 063 patients admitted to a major Scottish teaching hospital in one year (1.4%). Mortality was higher in these patients than in control patients and was strongly correlated with the severity of the hyperkalaemia. Overall seven deaths were directly due to hyperkalaemia (out of 58 deaths among patients with hyperkalaemia). Factors contributing to a poor prognosis were severity and speed of onset of hyperkalaemia and the presence of appreciable ...

  20. Vip service in hospitality industry

    OpenAIRE

    Sirkiä, Noora

    2013-01-01

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

  1. Nutrition in the hospital setting.

    OpenAIRE

    Emily Felicia Jan Ee SHEN

    2012-01-01

    Nutrition is essential for human health. Malnutrition in the hospital setting is common, and often underrecognised. Malnutrition increases morbidity, length of stay and mortality in patients, and increases postoperative complications. Patients’ nutritional status should be screened upon admission and if there is evidence of a poor nutritional state, the patient should be referred for further evaluation and management. Nutritional requirements may vary in disease states and the route of feedin...

  2. Management of hospital radioactive wastes

    International Nuclear Information System (INIS)

    The general structure of a regulatory scheme for the management of hospital radioactive wastes is presented. The responsabilities of an institution in the radioactive waste management, and storage conditions are defined. The radioactive wastes are classified in physical terms, and the criteria for evaluating the activity of solid wastes are described. The container characteristics and, the types of treatments given to the wastes are specified. (M.C.K.)

  3. Pre-hospital trauma Interventions

    OpenAIRE

    Lockey, D. J.

    2013-01-01

    Considerable variation exists in the type and quality of interventions carried out on victims of major trauma in the pre-hospital phase of care. One model of care consists of high level interventions delivered by a doctor-led team. Examining two controversial areas of treatment (traumatic cardiac arrest and advanced airway management), this thesis set out to determine the quality and potential shortfalls of current practice and how they might be improved. A systematic review of traumatic card...

  4. Developing Marketing Strategies for University Teaching Hospitals.

    Science.gov (United States)

    Fink, Daniel J.

    1980-01-01

    University teaching hospitals face increasing competition from community hospitals, expanding regulation of health care, consumerism, and a declining urban population base. New marketing strategies are seen as ways in which teaching hospitals can achieve better relationships with institutions, practitioners, and surrounding communities and…

  5. 27 CFR 31.54 - Hospitals.

    Science.gov (United States)

    2010-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2010-04-01 2010-04-01 false Hospitals. 31.54 Section 31.54 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND TRADE BUREAU, DEPARTMENT OF... Registration And/or Recordkeeping § 31.54 Hospitals. Hospitals and similar institutions furnishing liquors...

  6. Hospital Prepardness for a Radiological Terrorist Event

    International Nuclear Information System (INIS)

    Radiological incidents present uniquely challenging scenarios for hospital emergency planning and response. Radiological terrorism has been recognized as a probable scenario with high impact and hospitals are being educated to deal with this threat. The purpose of this paper is to present the hospital's experience preparing staff and infrastructure for response to a Radiological Dispersal Device(RDD) explosion

  7. Epsom General Hospital orthopaedic theatre.

    Science.gov (United States)

    1992-11-01

    The Surrey Section of the London Branch held a very successful meeting on Wednesday 9th September 1992 at which Mr Stephen Kirby BSc, CEng, Director of Estates, gave a talk and tour of the new Private Ward Unit and Ultra Clean Ventilation Theatre at Epsom General Hospital. The new Northey Ward, is a result of the refurbishment of what was a 31 bed section of the Hospital Surgical Block on the 5th floor. The new Ward provides a total of 18 single bed Wards, each complete with bathroom/WC, the Unit also accommodates a 5 bed Day Ward. All the facilities provided are of extremely high standard, which given the very tight building programme, detailed elsewhere, is indicative of the dedication of both the Designers and Contractors who are congratulated on their achievement. With regard to the UCV Theatre the following information was prepared by Aidan Hardy who is a Project Engineer with Epsom General Hospital. We are delighted to be able to print this report for our readers. PMID:10122458

  8. Noise Level of Hospital Environment

    Directory of Open Access Journals (Sweden)

    Suphi Vehid

    2011-08-01

    Full Text Available Aim: Noise pollution is one of the important problems among the environmental pollution. In this present study we tried to show that the problem of noise at hospital is still exceeding and investigate the sources of noise that annoyed the patients mostly. We measured the sound levels randomly selected in wards and asked the patients the causes of the noise annoying the patients mostly. Material and Methods:Noise level were measured during August 2009 by Testo 816 Sound Lever Meter in Cerrahpasa Medical Faculty. Total of the readings were taken in the day time between 09.00 am and 15.00 pm with three minutes intervals Results: Daily sound level is differing between 45 dBA and 61 dBA. Measured sound level at the beginning time was significantly lower in Neurology and Otorhinolaryngology wards compare to others. During the day time maximum Leq was observed in Physical Therapy and Rehabilitation ward (61 dBA. Telephone bells and conversations, Talking in corridors and water running from faucet declared as a most frequent of noise source by the patients. Conclusion: Activities of medical and non-medical staff are the common source of noise which suggests the noise pollution is mostly “manmade”. In order to solve the noise problem at hospitals there is great need to staff education, administrative rules and may be first of all national guidelines for hospital noise. [TAF Prev Med Bull 2011; 10(4.000: 409-414

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

    Science.gov (United States)

    Pawloski, S J; Kersh, P L

    1992-08-01

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

  10. Measuring Hospital-Wide Mortality-Pitfalls and Potential.

    Science.gov (United States)

    Mackenzie, Simon J; Goldmann, Don A; Perla, Rocco J; Parry, Gareth J

    2016-01-01

    Risk-adjusted hospital-wide mortality has been proposed as a key indicator of system-level quality. Several risk-adjusted measures are available, and one-the hospital standardized mortality ratio (HSMR) - is publicly reported in a number of countries, but not in the United States. This paper reviews potential uses of such measures. We conclude that available methods are not suitable for interhospital comparisons or rankings and should not be used for pay-for-performance or value-based purchasing/payment. Hospital-wide mortality is a relatively imprecise, crude measure of quality, but disaggregation into condition- and service-line-specific mortality can facilitate targeted improvement efforts. If tracked over time, both observed and expected mortality rates should be monitored to ensure that apparent improvement is not due to increasing expected mortality, which could reflect changes in case mix or coding. Risk-adjusted mortality can be used as an initial signal that a hospital's mortality rate is significantly higher than statistically expected, prompting further inquiry. PMID:25103495

  11. 42 CFR 419.20 - Hospitals subject to the hospital outpatient prospective payment system.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Hospitals subject to the hospital outpatient..., DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM PROSPECTIVE PAYMENT SYSTEM FOR HOSPITAL OUTPATIENT DEPARTMENT SERVICES Categories of Hospitals and Services Subject to and Excluded From the...

  12. 42 CFR 486.322 - Condition: Relationships with hospitals, critical access hospitals, and tissue banks.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false Condition: Relationships with hospitals, critical access hospitals, and tissue banks. 486.322 Section 486.322 Public Health CENTERS FOR MEDICARE & MEDICAID... Measures § 486.322 Condition: Relationships with hospitals, critical access hospitals, and tissue banks....

  13. 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...

  14. 78 FR 64953 - Medicare Program; Inpatient Hospital Deductible and Hospital and Extended Care Services...

    Science.gov (United States)

    2013-10-30

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

  15. 40 CFR 63.10400 - How do I demonstrate initial compliance?

    Science.gov (United States)

    2010-07-01

    ... CATEGORIES (CONTINUED) National Emission Standards for Hospital Ethylene Oxide Sterilizers Initial Compliance... submitting an Initial Notification of Compliance Status certifying that you are venting the ethylene oxide.... (b) If you operate your sterilization unit(s) with an air pollution control device pursuant to...

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

    Science.gov (United States)

    Rezac, P J

    1991-03-01

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

  17. [The establishment of the hospital-system in the Byzantine Empire].

    Science.gov (United States)

    Józsa, László

    2011-01-01

    Byzantine hospitals developed out of Christian institutions for the poor and homeless. Philanthropy provided the initial impulse to create hospices (xenons) and to expand these institutions into specialized medical centers (iatreons or nosokomeions). However the Byzantine nosocomeions resemble more closely modern hospitals than they do any of the institutions of Greek-Roman antiquity or any of the houses of charity in the Latin West during the Middle Ages. Since the 4th century the Byzantine hospitals have stressed the central position of the nosocomeion in Byzantine society at the intersection of state, ecclesiastical and professional interest. In the great cities and in the capital, more than hundred hospitals worked in the East-Roman Empire. The Byzantine hospital rules guaranted patients private beds, required physicians to wash their hands after each examination and arranged the physical plant to keep all the sick warm. The Byzantine hospitals had separate sections (in modern terms: surgery-trauma surgery, internal medicine, ophthalmology, etc.) and at the beginning of the sixth century a separate institution for women. From the sixth century at least, bathing facilities normally adjoined Byzantine nosocomeia. By the twelfth century Byzantine hospitals also set aside a room or perhaps a separate building to treat outpatients. In addition to the main dormitories the surgery, baths and outpatient clinic, the large parts of hospitals also had separate rooms (or adjoining buildings) for library, for lecture hall, for administrative functions and record keeping for storage and for other services. PMID:22533247

  18. Use of complementary and alternative medicine at Norwegian and Danish hospitals

    Directory of Open Access Journals (Sweden)

    Launsø Laila

    2011-01-01

    Full Text Available Abstract Background Several studies have found that a high proportion of the population in western countries use complementary and alternative medicine (CAM. However, little is known about whether CAM is offered in hospitals. The aim of this study was to describe to what extent CAM is offered in Norwegian and Danish hospitals and investigate possible changes in Norway since 2001. Methods A one-page questionnaire was sent to all included hospitals in both countries. The questionnaire was sent to the person responsible for the clinical activity, typically the medical director. 99 hospitals in the authority (85% in Norway and 126 in Denmark (97% responded. Given contact persons were interviewed. Results CAM is presently offered in about 50% of Norwegian hospitals and one-third of Danish hospitals. In Norway CAM was offered in 50 hospitals, 40 of which involved acupuncture. 19 hospitals gave other alternative therapies like biofeedback, hypnosis, cupping, ear-acupuncture, herbal medicine, art therapy, homeopathy, reflexology, thought field therapy, gestalt therapy, aromatherapy, tai chi, acupressure, yoga, pilates and other. 9 hospitals offered more than one therapy form. In Denmark 38 hospitals offered acupuncture and one Eye Movement Desensitization and Reprocessing Light Therapy. The most commonly reported reason for offering CAM was scientific evidence in Denmark. In Norway it was the interest of a hospital employee, except for acupuncture where the introduction is more often initiated by the leadership and is more based on scientific evidence of effect. All persons (except one responsible for the alternative treatment had a medical or allied health professional background and their education/training in CAM treatment varied substantially. Conclusions The extent of CAM being offered has increased substantially in Norway during the first decade of the 21st century. This might indicate a shift in attitude regarding CAM within the conventional

  19. Oncology patients hospitalized in the Clinicas Hospital Dr. Manuel Quintela

    International Nuclear Information System (INIS)

    This work was carried out by a nursery licensed group in the Clinicas Hospital - Dr. Manuel Quintela.The nature and functioning of Services and the allocation of resources, are essential for the analysis of the Survey of the hospitalized oncology patients in the Institution. To develop a model of care that constitutes a health care as well as teaching and research in the country regarding the quality of care was defined the following topics: lower risks for the patient, safer care, personal trained and specialized to promote relationship between the offering and the person receiving the service. The assessment and management performance of the services involved in the operation are the result of the degree of user satisfaction. Objective: To determine the human and material necessary for the care of cancer resources users, considering their number, treatment, complications and nursing care derived from each pathology and stage of disease. Methodology: A comparative descriptive study of the same population was conducted in two transverse sections in relation to two different times which are based on the design of a form that allowed hospitalized to collect information on users 6/12/03 and 6/16/04. Other instruments used were the clinical history and the daily census staff Patients and Nursing Division. Results and conclusions: A comparative descriptive analysis already mentioned are: increased internships and cancer patients; between 50 and 64 is the highest number of patients; diagnoses Face and Neck and maintain the Digestive System more cases; the number of patients doubles and Hematology Neurological from one to another period. Chemotherapy is the treatment choice and there is a decrease in the surgical and medical; more patients in the study; in the origin, Montevideo has the largest number of patients followed by Canelones. Line of nursing intervention will be carried out in short, medium and long term

  20. Through bulkhead initiator studies

    Energy Technology Data Exchange (ETDEWEB)

    Begeal, D.R. [Sandia National Labs., Albuquerque, NM (United States). Explosive Subsystems and Materials Dept.

    1997-03-01

    This report describes recent work done to demonstrate feasibility of a fail-safe Through Bulkhead Initiator with minimum dimensions and suitable for use in cyclical thermal environments. Much of the ground work for a fail-safe TBI was previously done by A.C. Schwartz. This study is an expansion of Schwartz`s work to evaluate devices with bulkheads of 304 stainless steel and Inconel 718; explosive donors of PETN, BNCP, and a 0.005 inch thick steel flying plate donor traveling at 2.6 mm/{micro}s; and explosive acceptors of PETN and BNCP. Bulkhead thickness were evaluated in the range of 0.040 to 0.180 inch. The explosive acceptors initiated a small HMX pellet to drive a 0.005 inch thick steel flying plate, and VISAR histories of the HMX-driven flying plates were the measure of acceptable performance. A companion set of samples used a PMMA acceptor to measure the particle velocities at the bulkhead/PMMA interface with VISAR. These data were used to compute the input pressure to the acceptor explosives in an attempt to measure initiation threshold. Unfortunately, the range of bulkhead thicknesses tested did not give any failures, thus the threshold was not determined. It was found that either explosive or the flying plate would perform as a TBI in the bulkhead thickness range tested. The optimum TBI is about 0.060 inches thick, and steel bulkheads seem to be more structurally sound than those made of Inconel. That is, cross section views of the Inconel bulkheads showed it to be more prone to stress cracking than was the 304 stainless steel. Both PETN and BNCP showed good performance when tested at {minus}65 F following thermal cycling of {minus}65 F to +165 F. Analysis of the TBI function times showed that BNCP acceptor explosives were undergoing the classical deflagration to detonation process. The PETN acceptors were undergoing prompt detonation.

  1. Practices regarding hospital waste management at public and private sector hospitals of Lahore

    International Nuclear Information System (INIS)

    Health care (Biomedical) waste is a term used for all waste arising from health care establishments. In most of health care centers of Pakistan, including Lahore, hospital wastes are simply mixed with the municipal waste in collecting bins at road-sides and disposed off similarly. Proper Management of biomedical waste, especially the hazardous one, being produced in hospital settings is important in terms of their ability to cause harm to the related per-sons and the environment as well. To Observe and compare the practices regarding Hospital Waste management of the public sector hospital with private sector hospital. Descriptive, Cross sectional. Methodology: Standardized checklist was used to assess the practices of nursing and sanitary staff. Practices regarding waste segregation were same at both hospitals. While practices regarding waste collection and transportation were better at The Children's Hospital. Public sector hospital has, paradoxically, better practices regarding hospital waste management in comparison to private sector hospital. (author)

  2. Initial Cooling Experiment (ICE)

    CERN Multimedia

    Photographic Service

    1978-01-01

    In 1977, in a record-time of 9 months, the magnets of the g-2 experiment were modified and used to build a proton/antiproton storage ring: the "Initial Cooling Experiment" (ICE). It served for the verification of the cooling methods to be used for the "Antiproton Project". Stochastic cooling was proven the same year, electron cooling followed later. Also, with ICE the experimental lower limit for the antiproton lifetime was raised by 9 orders of magnitude: from 2 microseconds to 32 hours. For its previous life as g-2 storage ring, see 7405430. More on ICE: 7711282, 7809081, 7908242.

  3. Hanford tanks initiative plan

    International Nuclear Information System (INIS)

    Abstract: The Hanford Tanks Initiative (HTI) is a five-year project resulting from the technical and financial partnership of the U.S. Department of Energy's Office of Waste Management (EM-30) and Office of Science and Technology Development (EM-50). The HTI project accelerates activities to gain key technical, cost performance, and regulatory information on two high-level waste tanks. The HTI will provide a basis for design and regulatory decisions affecting the remainder of the Tank Waste Remediation System's tank waste retrieval Program

  4. Hanford tanks initiative plan

    Energy Technology Data Exchange (ETDEWEB)

    McKinney, K.E.

    1997-07-01

    Abstract: The Hanford Tanks Initiative (HTI) is a five-year project resulting from the technical and financial partnership of the U.S. Department of Energy`s Office of Waste Management (EM-30) and Office of Science and Technology Development (EM-50). The HTI project accelerates activities to gain key technical, cost performance, and regulatory information on two high-level waste tanks. The HTI will provide a basis for design and regulatory decisions affecting the remainder of the Tank Waste Remediation System`s tank waste retrieval Program.

  5. EFFECTIVE DIVERSITY MANAGEMENT INITIATIVES

    Directory of Open Access Journals (Sweden)

    Suat Begec

    2013-01-01

    Full Text Available Diversity characteristics defines into four areas; personality, internal and external characteristics, and organizational characteristics. Today it is hard to find individuals, organizational and management styles all similar to each other. Twenty-first century leaders face diversity challenges in many arenas and it is a fact that leaders have to live with these diversities. Values affects on the management and organization systems. The global values gain importance and remove the sources of diversities. The leaders believe that the values should be mostly protected. This article focuses on effective diversity management initiatives.

  6. IAEA knowledge management initiatives

    International Nuclear Information System (INIS)

    Since its inception the IAEA has always been a knowledge based organization, requested to serve and promote the cause of peaceful use of nuclear science and technology. For nearly five decades the IAEA has been providing nuclear information and knowledge to Member States. A substantial part of the IAEA's activities under the regular budget and technical cooperation programme are aimed at developing and sustaining adequate nuclear competence in the Member States, including helping to build capacity in different aspects of the peaceful uses of nuclear energy. The paper describes some knowledge management initiatives that are being implemented within the framework of the IAEA programme on nuclear knowledge management. (author)

  7. Feedback stabilization initiative

    International Nuclear Information System (INIS)

    Much progress has been made in attaining high confinement regimes in magnetic confinement devices. These operating modes tend to be transient, however, due to the onset of MHD instabilities, and their stabilization is critical for improved performance at steady state. This report describes the Feedback Stabilization Initiative (FSI), a broad-based, multi-institutional effort to develop and implement methods for raising the achievable plasma betas through active MHD feedback stabilization. A key element in this proposed effort is the Feedback Stabilization Experiment (FSX), a medium-sized, national facility that would be specifically dedicated to demonstrating beta improvement in reactor relevant plasmas by using a variety of MHD feedback stabilization schemes

  8. Stirling to Flight Initiative

    Science.gov (United States)

    Hibbard, Kenneth E.; Mason, Lee S.; Ndu, Obi; Smith, Clayton; Withrow, James P.

    2016-01-01

    Flight (S2F) initiative with the objective of developing a 100-500 We Stirling generator system. Additionally, a different approach is being devised for this initiative to avoid pitfalls of the past, and apply lessons learned from the recent ASRG experience. Two key aspects of this initiative are a Stirling System Technology Maturation Effort, and a Surrogate Mission Team (SMT) intended to provide clear mission pull and requirements context. The S2F project seeks to lead directly into a DOE flight system development of a new SRG. This paper will detail the proposed S2F initiative, and provide specifics on the key efforts designed to pave a forward path for bringing Stirling technology to flight.

  9. Initiation of slug flow

    Energy Technology Data Exchange (ETDEWEB)

    Hanratty, T.J.; Woods, B.D. [Univ. of Illinois, Urbana, IL (United States)

    1995-12-31

    The initiation of slug flow in a horizontal pipe can be predicted either by considering the stability of a slug or by considering the stability of a stratified flow. Measurements of the shedding rate of slugs are used to define necessary conditions for the existence of a slug. Recent results show that slugs develop from an unstable stratified flow through the evolution of small wavelength waves into large wavelength waves that have the possibility of growing to form a slug. The mechanism appears to be quite different for fluids with viscosities close to water than for fluids with large viscosities (20 centipoise).

  10. The European View of Hospital Undernutrition

    DEFF Research Database (Denmark)

    Beck, Anne Marie; Balknäs, Ulla N.; Camilo, Maria E.; Fürst, Peter; Gentile, Maria G.; Hasunen, Kaija; Jones, Liz; Jonkers-Schuitema, Cora; Keller, Ulrich; Melchior, Jean-Claude; Mikkelsen, Bent Egberg; Pavcic, Marusa; Schauder, Peter; Sivonen, Lauri; Zinck, Orla; Øien, Henriette; Ovesen, L.

    2003-01-01

    Disease-related undernutrition is significant in European hospitals but is seldom treated or prevented. In 1999, the Council of Europe decided to collect information regarding nutrition programs in hospitals, and for this purpose, a network consisting of national experts from 12 of the Partial...... Agreement member states was established. The aim was to review the current practices in Europe regarding hospital food provision, to highlight deficiencies, and to issue recommendations to improve the nutritional care and support of hospitalized patients. Five major common problems were identified: 1) lack...... effort is required from national authorities and hospital staff, including managers, to ensure appropriate nutritional care and support....

  11. 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. PMID:27273960

  12. Tratamento endovascular do aneurisma da aorta abdominal infrarrenal em pacientes com anatomia favorável para o procedimento: experiência inicial em um serviço universitário Endovascular treatment of infrarenal abdominal aortic aneurysm in patients with favorable anatomy for the repair: initial experience in a university hospital

    Directory of Open Access Journals (Sweden)

    José Manoel da Silva Silvestre

    2011-03-01

    Full Text Available CONTEXTO: Desde sua introdução, em 1991, o reparo endovascular do aneurisma da aorta abdominal infrarrenal tem se tornado uma alternativa atraente para o tratamento dessa doença. Avaliar nossos resultados iniciais quanto à segurança e eficácia dessa técnica nos levou à realização deste estudo. OBJETIVOS: Analisar a mortalidade perioperatória, a sobrevida tardia, as reoperações, as taxas de perviedade e o comportamento do saco aneurismático em pacientes com anatomia favorável para a realização do procedimento. MÉTODOS: Trata-se de um estudo longitudinal, observacional e retrospectivo realizado entre outubro de 2004 e janeiro de 2009 com 41 pacientes que foram submetidos à correção endovascular do aneurisma de aorta abdominal infrarrenal por apresentarem anatomia favorável para o procedimento. Foram analisados os achados dos exames diagnósticos, o tratamento e o seguimento em todos os pacientes. RESULTADOS: Foram implantadas, com sucesso, 31 (75,6% próteses bifurcadas e 10 (24,5% monoilíacas, de 5 diferentes marcas. O diâmetro médio dos aneurismas fusiformes era de 62 mm. A mortalidade perioperatória foi de 4,8% e a sobrevida tardia, 90,2%. Durante o acompanhamento médio de 30 meses, 2 (4,8% pacientes necessitaram de reintervenção, um por migração da endoprótese e outro por vazamento tipo II. Dois (4,8% pacientes apresentaram oclusão de ramo da prótese. Oito (19,5% vazamentos foram diagnosticados e não houve nenhuma rotura dos aneurismas. CONCLUSÃO: Apesar do pequeno número de pacientes, os resultados observados parecem justificar a realização do procedimento endovascular nos pacientes com anatomia favorável.BACKGROUND: Since its introduction in 1991, endovascular repair of infrarenal aortic aneurysms has become an attractive option to treat this disease. The evaluation of our initial results about safety and efficacy of this technique has led us to carry out this study. OBJECTIVES: To analyze

  13. How a hospital must face a massive emergency: the case of Martini Hospital, Turin

    OpenAIRE

    Antonio Morra; Lorenzo Odetto; Pierangelo Bozzetto

    2008-01-01

    The terms “disaster” or “surge capability”, referred to hospitals, are often used to define a massive casualty admission. This may be a misleading concept, because emergency may as well arise from inside hospitals, and the last years high figures related to fires in the about 2,000 italian hospitals should suggest a different point of view. In this article the authors describe their experience in hospital preparedness at Ospedale Martini in Turin. Hospital operators re...

  14. Possible adverse drug events leading to hospital admission in a Brazilian teaching hospital

    OpenAIRE

    Fabiana Rossi Varallo; Helaine Carneiro Capucho; Cleópatra da Silva Planeta; Patrícia de Carvalho Mastroianni

    2014-01-01

    OBJECTIVES: Drug safety problems can lead to hospital admission. In Brazil, the prevalence of hospitalization due to adverse drug events is unknown. This study aims to estimate the prevalence of hospitalization due to adverse drug events and to identify the drugs, the adverse drug events, and the risk factors associated with hospital admissions. METHOD: A cross-sectional study was performed in the internal medicine ward of a teaching hospital in São Paulo State, Brazil, from August to Decemb...

  15. Psychiatric referrals in two general hospitals.

    Directory of Open Access Journals (Sweden)

    Doongaji D

    1989-07-01

    Full Text Available A prospective study was undertaken to compare the patterns of psychiatric referrals in two general hospitals in Bombay viz. the King Edward Memorial Hospital (64 cases and the Jaslok Hospital and Research Centre (62 cases. It was observed that depressive symptoms were the most common presenting symptoms in these patients attending either of the hospitals. Similarly, the commonest diagnoses were depression and organic mental disorder. Attempted suicide with organophosphorous compounds was the commonest reason for hospitalization at K.E.M. Hospital (p less than 0.001. A significant number of these patients were females (p less than 0.05. The psychiatric referrals at Jaslok had been hospitalized mainly for suspected medical or neurological illness (p less than 0.001. These patients belonged to higher economic strata and hence had a better paying capacity compared to patients at KEM hospital, a significant number of whom were unemployed (p less than 0.001. The duration of pre-referred illness of patients and their stay at Jaslok hospital were longer as compared to those at KEM Hospital (p less than 0.01. The number of non-relevant special investigations carried out on patients in Jaslok was more (p less than 0.01. Further analysis of diagnoses revealed that a significant number of patients at KEM Hospital were admitted as primary psychiatric illness (p less than 0.05.

  16. Dokumentation af hjertestop på hospital

    DEFF Research Database (Denmark)

    Stagelund, Søren; Lippert, Freddy Knudsen

    2008-01-01

    INTRODUCTION: Documentation of and staff compliance with guidelines during in-hospital cardiac arrest are very important. The purpose of the study is to clarify to what extent treatment of cardiac arrest was documented and whether the staff followed the hospital's protocol for cardiac arrest...... treatment in 2005. MATERIALS AND METHOD: Medical records for 50 consecutive in-hospital cardiac arrests in 2005 were analysed and compared to 50 consecutive cardiac arrests in 2001. The hospital is a tertiary referral hospital with 1100 beds and all medical specialities available. INCLUSION CRITERIA: All in-hospital...... cardiac arrest calls. Essential data for the in-hospital Utstein-style was used as the golden standard for documentation when reviewing medical records. RESULTS: Results are expressed for 2005 (2001), Test: chi2 (Fisher). Treatment documented: Fully: 32 (22). (P=0.0704). Treatment complying with...

  17. Hospital corporate restructuring and financial performance.

    Science.gov (United States)

    Clement, J P; D'Aunno, T A; Poyzer, B L

    1993-11-01

    In the last decade, an important innovation in the organizational structure of acute care hospitals occurred. Many hospitals restructured by creating subsidiaries that segment assets or services into separate corporations. We know relatively little about the effects of such restructuring. This paper examines the association of restructuring with financial performance of not-for-profit hospital firms. The study uses data from all not-for-profit acute care hospital firms in Virginia, the only state for which the unique study data are available. We find that the consolidated financial performance of hospital firms is influenced by factors that affect the hospital's financial performance (i.e., payer-mix, staffing and service mix) but not the number or size of non-hospital subsidiaries. Future research should examine the effect of restructuring on other types of performance. PMID:8231338

  18. Brazilian Nanotechnology Initiative

    Science.gov (United States)

    Fazzio, Adalberto

    2015-03-01

    In Brazil there is intense research activity in nanotechnology, most of these developed in universities and research institutes. The Brazilian Nanotechnology Initiative (BNI) aims to integrate government actions to promote the competitiveness of the Brazilian industry. This initiative is founded on support for research and development in the laboratories of the National Laboratories for Nanotechnology (SisNANO), starting from an improvement in infrastructure and opening of laboratories for users of academia and business, promoting interaction and transfer knowledge between academia and business. Country currently has 26 thematic networks of nanotechnology, 16 -Virtual-National Institutes of Technology, seven National- Laboratories and 18 Associate Laboratories, which comprise the SisNANO. Seeking to expand and share governance with other government actors, the Interministries Committee for Nanotechnology was set up, composed of 10 ministries, and has the task of coordinating the entire program of the Federal Government Nanotechnology.Cooperation activities are an important part of BNI. Currently Brazil has cooperation programs with U.S., China, Canada and European Union among others. Recently, Brazil decided to join the European NanoReg program where 60 research groups are joining efforts to provide protocols and standards that can help regulatory agencies and governments.

  19. Initiatives for proliferation prevention

    International Nuclear Information System (INIS)

    Preventing the proliferation of weapons of mass destruction is a central part of US national security policy. A principal instrument of the Department of Energy's (DOE's) program for securing weapons of mass destruction technology and expertise and removing incentives for scientists, engineers and technicians in the newly independent states (NIS) of the former Soviet Union to go to rogue countries or assist terrorist groups is the Initiatives for Proliferation Prevention (IPP). IPP was initiated pursuant to the 1994 Foreign Operations Appropriations Act. IPP is a nonproliferation program with a commercialization strategy. IPP seeks to enhance US national security and to achieve nonproliferation objectives by engaging scientists, engineers and technicians from former NIS weapons institutes; redirecting their activities in cooperatively-developed, commercially viable non-weapons related projects. These projects lead to commercial and economic benefits for both the NIS and the US IPP projects are funded in Russian, Ukraine, Kazakhstan and Belarus. This booklet offers an overview of the IPP program as well as a sampling of some of the projects which are currently underway

  20. Initiatives for proliferation prevention

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-04-01

    Preventing the proliferation of weapons of mass destruction is a central part of US national security policy. A principal instrument of the Department of Energy`s (DOE`s) program for securing weapons of mass destruction technology and expertise and removing incentives for scientists, engineers and technicians in the newly independent states (NIS) of the former Soviet Union to go to rogue countries or assist terrorist groups is the Initiatives for Proliferation Prevention (IPP). IPP was initiated pursuant to the 1994 Foreign Operations Appropriations Act. IPP is a nonproliferation program with a commercialization strategy. IPP seeks to enhance US national security and to achieve nonproliferation objectives by engaging scientists, engineers and technicians from former NIS weapons institutes; redirecting their activities in cooperatively-developed, commercially viable non-weapons related projects. These projects lead to commercial and economic benefits for both the NIS and the US IPP projects are funded in Russian, Ukraine, Kazakhstan and Belarus. This booklet offers an overview of the IPP program as well as a sampling of some of the projects which are currently underway.