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Sample records for baby-friendly hospital initiative

  1. 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

  2. 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.

  3. 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

  4. 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.

  5. 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...... at the 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....

  6. 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.

  7. 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

  8. 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

  9. 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

    Directory of Open Access Journals (Sweden)

    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

  10. 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

  11. 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 ...

  12. Hypernatraemic dehydration in Jamaican breastfed neonates: a 12-year review in a baby-friendly hospital.

    Science.gov (United States)

    Trotman, H; Lord, C; Barton, M; Antoine, M

    2004-12-01

    A 12-year retrospective review of neonates admitted with hypernatraemic dehydration to the neonatal unit of the University Hospital of the West Indies was conducted between 1 January 1990 and 31 December 2001. Twenty-four infants fulfilled the criteria for hypernatraemic dehydration. Nineteen (79%) women were either nulliparous or primiparous with a mean (SD) age of 26.9 (4.4) yrs. Modal length of hospital stay for mothers was 24 hrs. Twenty (83.3%) infants were exclusively breastfed. Mean (SD) age at presentation was 7.4 (3.8) days. Mean (SD) percentage weight loss between birth and presentation was 18.9% (6.3). Mean (SD) serum sodium at presentation was 164.8 (13.9) mmol/L. Babies visited at home by nurses had a lower mean serum sodium, were less dehydrated and were significantly less acidiotic. Their mean (SD) length of hospital stay was also significantly less [4.2 (1.4) days] than those who were not visited [7.9 (3.8) days] (p Hypernatraemic dehydration is an uncommon complication of failure to establish breastfeeding but is associated with severe morbidity and mortality. Education programmes are needed to increase awareness amongst health-care workers and mothers in order to prevent the problem.

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

    Directory of Open Access Journals (Sweden)

    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.

  14. Implementing baby-friendly practices: strategies for success.

    Science.gov (United States)

    Smith, Pat Bohling; Moore, Karen; Peters, Liz

    2012-01-01

    Breastfeeding is widely viewed as the optimal feeding method for infants among professional nursing and medical organizations. Its health benefits have been comprehensively studied and documented for both infants and mothers. Hospitals and birthing centers can strongly influence the outcomes for mothers who choose to breastfeed by establishing effective breastfeeding behaviors immediately after birth and during the hospital stay. The Baby-Friendly USA initiative outlines 10 steps to successful breastfeeding. Although these steps have been successfully supported in practice, they can be difficult to implement due to a variety of factors, including resistance to change. Specific steps generate more barriers to overcome than others--namely exclusive breastfeeding without supplementation or pacifiers, rooming-in for 23 out of 24 hours, and skin-to-skin contact with a parent immediately after birth and during the hospital stay. Our hospital spent 5 years implementing Baby-Friendly practices to prepare for a successful site visit. In the process, barriers to key Baby-Friendly steps were overcome through creative approaches and strategic education for staff, physicians, and parents. The purpose of this article is to outline specific actions taken that assisted our hospital in its successful journey. Those actions and strategies will hopefully be of value to others in their journey toward designation. PMID:22596036

  15. 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

  16. 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

  17. 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

  18. 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

  19. 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

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    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

  20. 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...

  1. 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.

  2. 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...

  3. 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…

  4. 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.

  5. 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.

  6. 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.

  7. 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.

  8. The Dementia Friendly Hospital Initiative education program for acute care nurses and staff.

    Science.gov (United States)

    Palmer, Janice L; Lach, Helen W; McGillick, Janis; Murphy-White, Maggie; Carroll, Maria B; Armstrong, Johanna L

    2014-09-01

    Individuals with Alzheimer's disease and other dementias have 3.2 million hospital stays annually, which is significantly more than older individuals without dementia. Hospitalized patients with dementia are at greater risk of delirium, falls, overwhelming functional decline that may extend the hospital stay, and prolonged or complicated rehabilitation. These risks highlight the need for staff education on the special care needs of this vulnerable population. This article describes a one-day education program, the Dementia Friendly Hospital Initiative, designed to teach staff how to provide the specialized care required by patients with dementia. Participants (N = 355) from five different hospitals, including 221 nurses, completed a pretest-posttest evaluation for the program. Changes in participants attitudes and practices, confidence, and knowledge were evaluated. Scores indicated significant improvement on the posttest. The evaluation provides further evidence for recommending dissemination of the Dementia Friendly Hospital Initiative. PMID:25299008

  9. Early ambulance initiation versus in-hospital initiation of high dose clopidogrel in ST-segment elevation myocardial infarction

    NARCIS (Netherlands)

    Postma, S.; Dambrink, J.H.; Ottervanger, J.P.; Gosselink, A.T.M.; Koopmans, P.C.; Berg, J.M. van den; Suryapranata, H.; Hof, A.W. van 't

    2014-01-01

    Pre-hospital infarct diagnosis gives the opportunity to start anti-platelet and anti-thrombotic agents before arrival at the PCI centre. However, more evidence is necessary to demonstrate whether high dose (HD) clopidogrel (600 mg) administered in the ambulance is associated with improved initial pa

  10. 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.)

  11. 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

  12. The GDAHA hospital performance reports project: a successful community-based quality improvement initiative.

    Science.gov (United States)

    Snow, Richard J; Engler, David; Krella, Joseph M

    2003-01-01

    During the past decade there has been increasing distribution of hospital performance information but few examples of how this information is affecting the quality of health care delivery. This article describes the methods of implementation and factors influencing a successful community-based quality improvement initiative in Dayton, Ohio, involving a collaborative of five competing hospitals in partnership with the business community and local and state hospital associations. The initiative contributed to a 36% reduction in acute myocardial infarction mortality over a 3-year period by changing reperfusion patterns in patients with ST segment elevated myocardial infarction. Identification of an opportunity gap, root cause analysis, and development of process measures used to facilitate health care provider change are summarized. The driving and restraining forces that have shaped this initiative from a report card to a quality improvement program are outlined and a list of five contributors to success are presented. These factors can serve as a basis for how other communities can benefit from this collaborative model.

  13. 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

  14. 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

  15. 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

    , to 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....... 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....

  16. 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

  17. 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.

  18. Long-term care and hospital collaboration. To survive in a reformed healthcare system, long-term care facilities can initiate hospital-based SNFs.

    Science.gov (United States)

    Hume, S K

    1993-06-01

    Establishing relationships with hospitals may be critical for long-term care facilities facing financial pressures and uncertain futures. One option is to initiate collaborative efforts to develop hospital-based skilled nursing facilities (SNFs). Hospitals, under pressure to move patients to less intensive settings and to diversify, are naturally drawn to long-term care as a related business where they can make limited personnel and financial commitments and extend their continuum of care. Before approaching hospitals to initiate collaborative efforts, long-term care providers should understand how they think and what their strengths and weaknesses are. Long-term and acute care providers have many options for collaboration, including management contracts and joint ventures. In a traditional management contract, the long-term care provider furnishes the administrator and a few key staff in exchange for direct reimbursement for those staff plus a management fee. Another option is for the long-term care facility to provide all the staff for a fee or percentage of revenue. Joint venture options are to form a subsidiary corporation to renovate a floor of the hospital or to have the hospital buy a large percentage of the long-term care facility and share the profits. All these options have potential pitfalls, including differing financial expectations and the threat of unionization at the SNF. Nevertheless, for long-term care facilities struggling under reimbursement cutbacks and other pressures, the benefits may outweigh the risks.

  19. 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...

  20. 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.

  1. Pneumatic reduction of intussusception in children at Korle Bu Teaching Hospital: An initial experience

    Directory of Open Access Journals (Sweden)

    Yaw Boateng Mensah

    2011-01-01

    Full Text Available Background: Intussusception is a common abdominal emergency in children which necessitates prompt diagnosis and management. Nonsurgical methods of managing this condition are rapidly gaining popularity with fluoroscopic-guided pneumatic reduction being one of such methods that has been used with great success in many countries. We present our initial experience with fluoroscopic-guided pneumatic reduction of intussusception at Korle Bu Teaching Hospital which is also the first time the technique has been used in Ghana. Materials and Methods: A total of 18 children were enrolled in the study between August 2007 and February 2008 at Korle Bu Teaching Hospital, Accra, Ghana. Patients were given air enema under fluoroscopic-guidance using locally assembled equipment. The intraluminal pressure was monitored with a pressure gauge and was not permitted to go above 120 mmHg. A total of three attempts of 3 min each were allowed. Results: There were 12 males and 6 females. The average age of the patients was 8.3 months (SD= 3 months. Twelve (67% of the cases were reduced successfully while 6 (33% failed to reduce. A majority of those that did not reduced had symptoms for at least 2 days. Bowel perforation occurred in three (16.7% cases. Conclusion: Pneumatic reduction of intussusception is a cost-effective and rapid method of management of intussusception. It however has limitations like high reported rate of bowel perforation and limited ability to identify lead points. The benefits however seem to outweigh these challenges, such as fluoroscopic-guided pneumatic reduction has a very high success rate. Fluoroscopic guided pneumatic reduction should be considered as one of the primary modes of reduction in Ghana and other neighbouring countries that are yet to practice it.

  2. Female sterilization with Hulka clips--initial experience at the University Hospital, Kuala Lumpur.

    Science.gov (United States)

    Rahman, A A; Sivanesaratnam, V; Nuruddin, A A

    1982-09-01

    The initial experience with the use of Hulka clips for sterilization in 100 patients is reported. In July, 1979, University Hospital physicians in Kuala Lumpur introduced spring-loaded clips, and have found the procedure to be safe and the method acceptable. The 86 patients available for the followup were admitted 1 day prior to the operation for a detailed interview, physical and pelvic examinations, pap smear, and hemoglobin estimation. The laparoscopy was performed under general anesthesia, although others report using local anesthesia, and the patients were discharged the following day. Follow-up was conducted at 3, 6, and 12 months. The women were between 25-40 years old and the majority were para 3-5; 10.5% had only 2 live births. The average age of the patients' youngest child at the time of sterilization was 2.8. Indians comprised the largest ethnic group. The problems encountered at laparoscopy generally occurred in the initial stages of the study and included: difficulty at insertion of trochar, inability to visualize fimbria, tubal transection, and the need for additional clips to ensure occlusion. 2 pregnancies were reported, 1 patient had a luteal phase pregnancy and in the other patient, the left tube was only partially occluded. The actual failure rate in the series was 1.16%, which is acceptable and similar to other reports. A distinct advantage of the clip was the low incidence of tubal transection, .6%, which is a more common occurrence with silastic bands. In addition, the clips offer good prospects for reversibility, compared to other sterilization methods.

  3. Long-term survival after initial hospital admission for peripheral arterial disease in the lower extremities

    Directory of Open Access Journals (Sweden)

    Grobbee DE

    2009-08-01

    Full Text Available Abstract Background As the population ages, peripheral arterial disease (PAD in the lower extremities will become a larger public health problem. Awareness in patients as well clinicians of the high risk of morbidity and mortality is important but seems currently low. Insights in absolute mortality risks following admission for PAD in the lower extremities can be useful to improve awareness as they are easy to interpret. Methods A nationwide cohort of 4,158 patients with an initial admission for PAD in the lower extremities was identified through linkage of the national hospital and population register in 1997 and 2000. Results Over 60% of 4,158 patients were men. 28 days, 1 year and 5 year mortality risk were 2.4%, 10.3% and 31.0% for men and 3.5%, 10.4% and 27.4% for women. Coronary heart disease and stroke were frequent cause of death. Five years mortality risk was higher for men compared to women (HR 1.36, 95% CI 1.21–1.53. Conclusion In conclusion, our findings demonstrate that, 5 year mortality risk is high, especially in men and comparable to that of patients admitted for acute myocardial infarction or ischemic stroke. Though, in general population the awareness of the severity of PAD in the lower extremities is significantly lower than that for any other cardiovascular disease and it seems that cardiovascular risk factor management for prevention in PAD patients is very modest.

  4. Hospitals

    DEFF Research Database (Denmark)

    Mullins, Michael

    2013-01-01

    The challenge could be briefly seen in these terms: hospitals as places for treatment where there’s a technology focus and hospitals for healing where there’s a human focus. In the 60s - 70s wave of new hospital building, an emphasis on technology can be seen. It’s time to move from the technology...... 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......’t be doing in hospitals. Design factors which should be carefully considered include: Light, as in daylight, artificial light, its color, its temperature, the level and quality of lighting and the effects of light on circadian rhythms. There is documented evidence in: users’ satisfaction, orientation, 24...

  5. Improvements in Pain Outcomes in a Canadian Pediatric Teaching Hospital Following Implementation of a Multifaceted, Knowledge Translation Initiative

    Directory of Open Access Journals (Sweden)

    Lisa M Zhu

    2012-01-01

    Full Text Available BACKGROUND: A previous audit performed at a tertiary/quaternary pediatric hospital in Toronto, Ontario, demonstrated suboptimal assessment and treatment of children’s pain. Knowledge translation (KT initiatives (education, reminders, audit and feedback were implemented to address identified care gaps; however, the impact is unknown.

  6. 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

  7. Evaluation of early implementations of antibiotic stewardship program initiatives in nine Dutch hospitals

    NARCIS (Netherlands)

    van Limburg, Maarten; Sinha, Bhanu; Lo-Ten-Foe, Jerome R; van Gemert-Pijnen, Julia Ewc

    2014-01-01

    BACKGROUND: Antibiotic resistance is a global threat to patient safety and care. In response, hospitals start antibiotic stewardship programs to optimise antibiotic use. Expert-based guidelines recommend strategies to implement such programs, but local implementations may differ per hospital. Earlie

  8. Federating clinical data from six pediatric hospitals: process and initial results for microbiology from the PHIS+ consortium.

    Science.gov (United States)

    Gouripeddi, Ramkiran; Warner, Phillip B; Mo, Peter; Levin, James E; Srivastava, Rajendu; Shah, Samir S; de Regt, David; Kirkendall, Eric; Bickel, Jonathan; Korgenski, E Kent; Precourt, Michelle; Stepanek, Richard L; Mitchell, Joyce A; Narus, Scott P; Keren, Ron

    2012-01-01

    Microbiology study results are necessary for conducting many comparative effectiveness research studies. Unlike core laboratory test results, microbiology results have a complex structure. Federating and integrating microbiology data from six disparate electronic medical record systems is challenging and requires a team of varied skills. The PHIS+ consortium which is partnership between members of the Pediatric Research in Inpatient Settings (PRIS) network, the Children's Hospital Association and the University of Utah, have used "FURTHeR' for federating laboratory data. We present our process and initial results for federating microbiology data from six pediatric hospitals.

  9. 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

  10. Risk factors for developing clinical infection with methicillin-resistant Staphylococcus aureus (MRSA) amongst hospital patients initially only colonized with MRSA.

    NARCIS (Netherlands)

    R. Coello; J.R. Glynn (Judith); J. J. Picazo; J. Fereres; C. Gaspar

    1997-01-01

    textabstractIn hospital outbreaks of methicillin-resistant Staphylococcus aureus (MRSA) many patients are initially colonized without infection. The reasons why some progress to infection while others do not are not known. A cohort of 479 hospital patients, initially only colonized with MRSA, was fo

  11. A crisis management quality improvement initiative in a children's psychiatric hospital: design, implementation, and outcome.

    Science.gov (United States)

    Paccione-Dyszlewski, Margaret R; Conelea, Christine A; Heisler, Walter C; Vilardi, Jodie C; Sachs, Henry T

    2012-07-01

    Behavioral crisis management, including the use of seclusion and restraint, is the most high risk process in the psychiatric care of children and adolescents. The authors describe hospital-wide programmatic changes implemented at a children's psychiatric hospital that aimed to improve the quality of crisis management services. Pre/post quantitative and qualitative data suggest reduced restraint and seclusion use, reduced patient and staff injury related to crisis management, and increased patient satisfaction during the post-program period. Factors deemed beneficial in program implementation are discussed.

  12. 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.

  13. Downsizing-initiated job transfer of hospital nurses: how do the job transferees fare?

    Science.gov (United States)

    Armstrong-Stassen, M; Cameron, S J; Horsburgh, M E

    2001-01-01

    In this longitudinal panel study, the authors compared the reactions to hospital amalgamation of 66 nurses who had been transferred to a different unit for a downsizing-related reason (bumped/displaced, unit closed, redundancy) with the reactions of 181 nurses who remained on their same unit. Prior to any job transfers, the two groups perceived comparable levels of support and held similar attitudes towards their job and the hospital. Two years later, after job transfers had taken place, transferred nurses perceived significantly lower coworker support. They also reported a significantly greater decrease in organizational commitment than nurses who were not transferred. However, both groups reported a significant decrease between time a and time 2 in perceived organizational support, satisfaction with amount of work and career future, hospital identification, and organization trust. Overall, the results indicate that the downsizing associated with the amalgamation of the hospitals had a highly negative effects not only on those nurses who were transferred because of the downsizing but also on those nurses who remained on their original unit.

  14. 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...

  15. Radiology Image Management in a Teaching Hospital Network Scenario: Initial Experience

    OpenAIRE

    Indrajit, IK; Souza, JD; Singh, Rajvir; Shekar, Anjanish

    2003-01-01

    INHS Asvini has the distinction of emerging as the first Armed Forces Hospital with networked radiology images, sourced principally from a recently installed Digital Substraction Angiography (DSA) machine (Siemens Polystar Top 1000 MA). In recent times, newer imaging machines offer digital images that are in DICOM format. DICOM denotes ‘Digital Imaging and Communications in Medicine”. Image management at INHS Asvini, involves transfer of DSA images in DICOM format, their conversion into Joint...

  16. 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.

  17. 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.

  18. 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)

  19. Hospital care in severe trauma: Initial strategies and life-saving surgical procedures.

    Science.gov (United States)

    Monchal, T; Hornez, E; Prunet, B; Beaume, S; Marsaa, H; Bourgouin, S; Baudoin, Y; Bonnet, S; Morvan, J-B; Avaro, J-P; Dagain, A; Platel, J-P; Balandraud, P

    2016-08-01

    Severe trauma patients should be received at the hospital by a multidisciplinary team directed by a "trauma leader" and all institutions capable of receiving such patients should be well organized. As soon as the patient is accepted for care, the entire team should be prepared so that there is no interruption in the pre-hospital chain of care. All caregivers should thoroughly understand the pre-established protocols of diagnostic and therapeutic strategies to allow optimal management of unstable trauma victims in whom hemostasis must be obtained as soon as possible to decrease the morbid consequences of post-hemorrhagic shock. In patients with acute respiratory, circulatory or neurologic distress, several surgical procedures must be performed without delay by whichever surgeon is on call. Our goal is to describe these salvage procedures including invasive approaches to the upper respiratory tract, decompressive thoracostomy, hemostatic or resuscitative thoracotomy, hemostatic laparotomy, preperitoneal pelvic packing, external pelvic fixation by a pelvi-clamp, decompressive craniotomy. All of these procedures can be performed by all practitioners but they require polyvalent skills and training beforehand. PMID:27260640

  20. 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)

  1. Adult allogeneic bone marrow transplantation: initial experience in the University Hospital, Kuala Lumpur.

    Science.gov (United States)

    Teh, A; Bosco, J J; Leong, K W; Saw, M H; Menaka, N; Devashanti, P

    1997-03-01

    Prior to 1993, bone marrow transplantation for adult patients was not available in Malaysia. Adult allogeneic bone marrow transplantation commenced in Malaysia when the first transplant was conducted at the University Hospital, Kuala Lumpur on 2 November 1993. Up till July 1995, 10 adult bone marrow transplants had been conducted at the University Hospital. Five patients had acute myeloid leukaemia in first remission, 4 had chronic myeloid leukaemia and 1 had acute lymphoblastic leukaemia in first partial remission. The age range of patients at the time of transplant is 16-40 years (mean 25.5 years). All patients engrafted successfully and the survival for the first 100 days post-transplant is 90%. One patient demonstrated haematological relapse post-transplant but achieved remission with donor buffy-coat infusion. The mean drug cost incurred was RM28,269 for the first 100 days. Locally available adult allogeneic bone marrow transplantation is safe, affordable and has comparable results with reputable overseas transplant centres.

  2. 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,...

  3. Radiology Image Management in a Teaching Hospital Network Scenario: Initial Experience.

    Science.gov (United States)

    Indrajit, I K; Souza, J D; Singh, Rajvir; Shekar, Anjanish

    2003-07-01

    INHS Asvini has the distinction of emerging as the first Armed Forces Hospital with networked radiology images, sourced principally from a recently installed Digital Substraction Angiography (DSA) machine (Siemens Polystar Top 1000 MA). In recent times, newer imaging machines offer digital images that are in DICOM format. DICOM denotes 'Digital Imaging and Communications in Medicine". Image management at INHS Asvini, involves transfer of DSA images in DICOM format, their conversion into Joint Photographic Experts Group (JPG) format and subsequent transmission of JPG images through a robust networking system that connects all departments/OPD/Wards, facilitating direct access of images to a variety of specialists and specialities. Clearly, this encouraging outcome is a small but useful step heralding the concept of 'anytime anywhere' images, and has the scalable expansibility of including CT and MRI images in future. PMID:27407523

  4. 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

  5. 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)

  6. 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

  7. 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.)

  8. 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.)

  9. 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

  10. 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.

  11. 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...

  12. 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…

  13. 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 patie...

  14. 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

  15. 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

    resuscitation was attempted were identified between 2001 and 2010 in the nationwide Danish Cardiac Arrest Registry. Of 29 111 patients with cardiac arrest, we excluded those with presumed noncardiac cause of arrest (n = 7390) and those with cardiac arrests witnessed by emergency medical services personnel (n......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...

  16. 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

  17. Endovascular Aneurysm Repair (EVAR) for Infra-renal Abdominal Aortic Aneurysm (AAA) under Local Anaesthesia - Initial Experience in Hospital Kuala Lumpur.

    Science.gov (United States)

    Syed, A; Zainal, A A; Hanif, H; Naresh, G

    2012-12-01

    This is our initial report on the first 4 cases of infra-renal abdominal aortic aneurysm undergoing Endovascular Aneurysm Repair (EVAR) with local anaesthesia, controlled sedation and monitoring by an anaesthetist. All four patients were males with a mean age of 66.7 years. Only one required ICU stay of two days for cardiac monitoring due to bradycardia and transient hypotension post procedure. No mortality or major post operative morbidity was recorded and the mean hospital stay post procedure was 3.5 days (range 2-5 days).

  18. 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

  19. 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.

  20. 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....

  1. 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

  2. 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 ...

  3. 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

  4. 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...

  5. Intratympanic steroids as primary initial treatment of idiopathic sudden sensorineural hearing loss. The Hospital Universitario Ramón y Cajal experience and review of the literature.

    Science.gov (United States)

    Labatut, Tomás; Daza, María José; Alonso, Antonio

    2013-11-01

    The objective of this study was to determine the effectiveness, dosage, safety and comfort of intratympanic steroids as primary initial treatment of idiopathic sudden sensorineural hearing loss (ISSHL). Prospective nonrandomized clinical practice study was performed in Tertiary referral center university hospital. A total of 35 consecutive patients suffering from newly diagnosed sudden sensorineural hearing loss with mean pure-tone average thresholds of 81 ± 21 dB were treated. No previous therapy had been undertaken. Intratympanic steroid injection as primary initial treatment was administered during 2 weeks on a twice a week schedule, between 2010 and 2011. Treatment was started on average within 2 days of symptoms onset. Pre and post-treatment audiometric evaluations were analyzed on follow-up as well as tolerance of the procedure and possible adverse effects. 66-85 % of patients achieved successful treatment according to the different outcome criteria used to evaluate hearing improvement (Furuhashi criteria/improvement of ≥10 dB in pure-tone average). Mean post-treatment improvement regarding pure-tone average was 34 ± 21 dB. A 48 ± 43 % improvement in speech discrimination score was observed. Patients received an average of 18 mg of methylprednisolone per injection and a total dose of 72 mg per treatment cycle. No serious adverse effects were noted. Intratympanic steroid injection is an effective, safe and well-tolerated office based-procedure for the treatment of ISSHL as primary initial treatment that can avoid the potential adverse effects of systemic steroids. A higher dose, schedule of administration as well as standardization of hearing recovery criteria still need to be established.

  6. 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...

  7. Hospitality Management.

    Science.gov (United States)

    College of the Canyons, Valencia, CA.

    A project was conducted at College of the Canyons (Valencia, California) to initiate a new 2-year hospitality program with career options in hotel or restaurant management. A mail and telephone survey of area employers in the restaurant and hotel field demonstrated a need for, interest in, and willingness to provide internships for such a program.…

  8. 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

  9. 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.

  10. ¿Por qué los pacientes utilizan los servicios de urgencias hospitalarios por iniciativa propia? Why do patients use hospital emergency services on their own initiative?

    Directory of Open Access Journals (Sweden)

    Jesús M Aranaz Andrés

    2006-08-01

    Full Text Available Introducción: Se pretende describir el perfil de usuario y determinar su motivación para visitar el servicio de urgencias hospitalario (SUH por iniciativa propia. Método: Se elaboró un cuestionario ad hoc que se aplicó por selección consecutiva a los pacientes que podían esperar asistencia (nivel 1 del triage durante una semana de noviembre de 2002. Resultados: Respondieron el cuestionario 348 pacientes, acudiendo por iniciativa propia el 82,5%. De éstos, el 17,7% desconocía el funcionamiento de atención primaria respecto a urgencias; el 18,8% consultó con su centro de salud; el 55,0% refirió preferencia por el SUH y el 13,5% acudió por demora en otros niveles asistenciales. El 50,5% era menor de 40 años y el 9,2%, extranjero. Conclusiones: Los cambios en el patrón de consumo de servicios sanitarios pueden comprometer la organización del Sistema Nacional de Salud, si no se adapta la oferta a la necesidad expresada y/o se interviene modulando el uso racional de los recursos sanitarios.Introduction: The aim of this study was to determine the reasons why patients use hospital emergency services (HES on their own initiative and the characteristics of these users. Method: An ad hoc questionnaire was designed and applied by consecutive selection to patients who could have waited for medical care (level 1 triage over a 1-week period in November 2002. Results: A total of 348 patients completed the questionnaire; 82.5% attended on their own initiative; of these, 17.7% reported they did not know how Primary Care worked in relation to the Emergency Services; 18.8% consulted a Primary Care physician; 55.0% preferred the HES and 13.5% attended because of a delay in another health care setting. Half the patients (50.5% were younger than 40 years old and 9.2% were foreigners. Conclusions: Changes in health services' consumption patterns could jeopardize the public health system unless supply is adapted to the demand expressed and

  11. 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.

  12. Collaborative effects of bystander-initiated cardiopulmonary resuscitation and prehospital advanced cardiac life support by physicians on survival of out-of-hospital cardiac arrest: a nationwide population-based observational study

    OpenAIRE

    Yasunaga, Hideo; Horiguchi, Hiromasa; Tanabe, Seizan; Akahane, Manabu; OGAWA, Toshio; Koike, Soichi; Imamura, Tomoaki

    2010-01-01

    Introduction There are inconsistent data about the effectiveness of prehospital physician-staffed advanced cardiac life support (ACLS) on the outcomes of out-of-hospital cardiac arrest (OHCA). Furthermore, the relative importance of bystander-initiated cardiopulmonary resuscitation (BCPR) and ACLS and the effectiveness of their combination have not been clearly demonstrated. Methods Using a prospective, nationwide, population-based registry of all OHCA patients in Japan, we enrolled 95,072 pa...

  13. [Quality management according to the new SN EN ISO-Norm 9001:2000--experiences from initial certification of a hospital department].

    Science.gov (United States)

    Steffen, Th; Hochberger, G; Eisner, L

    2002-04-24

    Those who want to implement a quality-management system at a hospital these days cannot fall back on a broad-based system proven over the years. Though quality management as defined by ISO norm 9001 has been established as the central standard in many industrial areas, applicability of this ISO norm in the hospital sector has stirred up much controversy during recent years. Introduction of the new ISO norm 9001:2000 has changed the situation. The 2000 version of the new standard seeks to meet the demand for service operations--especially by establishing a clear procedural orientation. This report describes the new standard and its introduction in the Department of Surgery at the Cantonal Hospital in Olten, Canton Solothurn, Switzerland. It indicates the steps taken, for instance in the spheres of top management, quality management, procedural guidance, as well as customer and staff counselling. It also discusses the project's cost/benefit ratio for the organization.

  14. 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...

  15. 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...

  16. 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....

  17. 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.

  18. 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

  19. 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.

  20. 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...

  1. 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...

  2. Cost analysis of initial highly active antiretroviral therapy regimens for managing human immunodeficiency virus-infected patients according to clinical practice in a hospital setting

    Directory of Open Access Journals (Sweden)

    Colombo GL

    2013-12-01

    Full Text Available Giorgio L Colombo,1,2 Antonella Castagna,3 Sergio Di Matteo,2 Laura Galli,3 Giacomo Bruno,2 Andrea Poli,3 Stefania Salpietro,3 Alessia Carbone,3 Adriano Lazzarin3,41Department of Drug Sciences, School of Pharmacy, University of Pavia, Italy; 2Studi Analisi Valutazioni Economiche (S.A.V.E., Milan, 3Infectious Diseases Department, San Raffaele Hospital, Milan, 4Vita-Salute San Raffaele University, Milan, ItalyObjective: In the study reported here, single-tablet regimen (STR versus (vs multi-tablet regimen (MTR strategies were evaluated through a cost analysis in a large cohort of patients starting their first highly active antiretroviral therapy (HAART. Adult human immunodeficiency virus (HIV 1-naïve patients, followed at the San Raffaele Hospital, Milan, Italy, starting their first-line regimen from June 2008 to April 2012 were included in the analysis.Methods: The most frequently used first-line HAART regimens (>10% were grouped into two classes: 1 STR of tenofovir disoproxil fumarate (TDF + emtricitabine (FTC + efavirenz (EFV and 2 MTR including TDF + FTC + EFV, TDF + FTC + atazanavir/ritonavir (ATV/r, TDF + FTC + darunavir/ritonavir (DRV/r, and TDF + FTC + lopinavir/ritoavir (LPV/r. Data were analyzed from the point of view of the Lombardy Regional Health Service. HAART, hospitalizations, visits, medical examinations, and other concomitant non-HAART drug costs were evaluated and price variations included. Descriptive statistics were calculated for baseline demographic, clinical, and laboratory characteristics; associations between categorical variables and type of antiretroviral strategy (STR vs MTR were examined using chi-square or Fisher's exact tests. At multivariate analysis, the generalized linear model was used to identify the predictive factors of the overall costs of the first-line HAART regimens.Results: A total of 474 naïve patients (90% male, mean age 42.2 years, mean baseline HIV-RNA 4.50 log10 copies/mL, and cluster of

  3. Evaluation of the implementation of Healthcare Improvement Initiative at China's tertiary hospitals%我国三级医院医疗服务改善现状评估

    Institute of Scientific and Technical Information of China (English)

    刘晓宁; 罗力; 白鸽; 卫李梅; 丁亚奇; 黄河; 孙静; 蒋锋; 田格媛

    2016-01-01

    目的 评估全国三级医院2015年落实《进一步改善医疗服务行动计划》(以下简称“行动计划”)情况.方法 面向全国31个省、自治区、直辖市的136所三级医院发放《改善医疗服务行动计划医院调查表》,采用描述性统计分析和Spearman秩相关分析,分别对医院落实“行动计划”情况及落实情况与患者满意度之间的关联性进行分析.结果 全国样本医院平均得分(70.4±5.5)分(满分80分),“行动计划”各维度中得分率最高的是“妥善化解医疗纠纷,构建和谐医患关系”维度(98.3%);各医院得分总分与其门诊患者和住院患者满意度均呈正相关,相关系数分别为0.197(P=0.023)、0.229(P=0.008).结论 “行动计划”得到较好落实,但尚有提升空间,其中“推进预约诊疗服务”和“发挥信息技术优势”方面普遍需要加强,医疗资源配置需进一步优化,医患和谐关系的构建需要全社会参与;患者满意度可作为评价医院落实“行动计划”的重要依据.%Objective To evaluate the implementation of the Healthcare Improvement Initiative (the Initiative)at tertiary hospitals of the country in 2015.Methods The questionnaire for the Initiative was used to evaluate the implementation of the Initiative at 136 tertiary hospitals of 31 provinces.Descriptive statistical analysis and Spearman correlation analysis evaluate,the implementation and analyzed the correlation between the implementation status and patient satisfaction.Results The national average score is 70.4 ± 5.5 (full score is 80).The highest score of all the dimensions is "Harmonious doctor-patient relationship to resolve medical disputes"(98.3%).Scoring of the hospitals are positively correlated to the satisfaction of their outpatients and inpatients,with correlation coefficient of 0.197(P =0.023) and 0.229 (P =0.008) respectively.Conclusions The Initiative calls for better implementation despite initial success

  4. 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...

  5. 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

  6. 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

  7. Initial serum (1,3)-β-D-glucan as a predictor of mortality in proven candidaemia: findings from a retrospective study in two teaching hospitals in Italy and Brazil.

    Science.gov (United States)

    Giacobbe, D R; Esteves, P; Bruzzi, P; Mikulska, M; Furfaro, E; Mesini, A; Tatarelli, P; Grignolo, S; Viscoli, C; Colombo, A L; Del Bono, V

    2015-10-01

    A retrospective study was conducted to assess the role of initial serum (1,3)-β-d-glucan (BDG) values in predicting mortality in proven candidaemia. The study was conducted in two large teaching hospitals in Italy and Brazil. From January 2009 to June 2014, all patients with proven candidaemia who underwent a BDG test within 96 hours before or after the first positive blood culture were included in the study. The primary end point was 28-day mortality, with the role of initial BDG being assessed by univariate and multivariate analyses. A total of 104 patients met the inclusion criteria. Overall, the crude 28-day mortality was 30% (31/104). In the final multivariate model, an initial BDG of >287 pg/mL (odds ratio (OR) 4.40, 95% confidence interval (CI) 1.56-12.39, p 0.005), haemodialysis (OR 4.33, 95% CI 1.24-15.17, p 0.022) and a Pitt score of ≥ 2 (OR 4.10, 95% CI 1.24-13.54, p 0.021) were significant predictors of 28-day mortality. The >287 pg/mL cutoff predicted 28-day mortality with 65% sensitivity and 70% specificity. Centre of enrolment (p for interaction 0.012), haemodialysis (p for interaction 0.062) and timing of BDG test of more than 24 hours before or after the positive culture (p for interaction 0.143) appeared to interact with BDG's ability to predict mortality. Although not statistically significant, the last two of these interactions might partially explain why BDG's ability to predict mortality was present only in the Italian cohort.

  8. 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 archit......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...

  9. 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

  10. 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.

  11. 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

  12. 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

  13. 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...

  14. Hospital marketing.

    Science.gov (United States)

    Carter, Tony

    2003-01-01

    This article looks at a prescribed academic framework for various criteria that serve as a checklist for marketing performance that can be applied to hospital marketing organizations. These guidelines are drawn from some of Dr. Noel Capon of Columbia University's book Marketing Management in the 21st Century and applied to actual practices of hospital marketing organizations. In many ways this checklist can act as a "marketing" balanced scorecard to verify performance effectiveness and develop opportunities for innovation.

  15. 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...

  16. 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…

  17. 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.

  18. 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.

  19. 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.

  20. 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

  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. [Historical exploration of Acapulco hospitals, Guerrero, Mexico].

    Science.gov (United States)

    Fajardo-Ortiz, Guillermo; Salcedo-Alvarez, Rey Arturo

    2006-01-01

    This study attempts to recount the history of the main hospitals of the port of Acapulco from colonial times until the end of the 20th century. The Augustine friars began hospital care at the end of the first part of the 16th century. Later, Bernardino Alvarez (1514?-1584), with the support of the Spanish crown, founded the first formal hospital in Acapulco called Hospital de Nuestra Señora de la Consolación (Our Lady of Consolation Hospital). During the 16th and 17th centuries, the sick were attended by friars, and by the end of the 19th century there were physicians and surgeons. From the end of the Independence War until the end of the 19th century, the port did not have any true hospital. The first degreed physicians and surgeons arrived and resided in Acapulco in 1920. In 1938, the Hospital Civil Morelos (Morelos Civil Hospital) began providing services. It was replaced by the Hospital General de Acapulco (General Hospital of Acapulco). At the fourth decade of the past century the Cruz Roja (Red Cross) was created. In 1957 the hospital services of the Instituto Mexicano del Seguro Social (IMSS, Mexican Institute of Social Security), which was founded in 1963, was inaugurated with the Unidad Medico/Social (Medical and Social Unit) of the IMSS in Acapulco. This began the journey of modernity in Acapulco. In 1992, Hospital Regional Vicente Guerrero (Regional Hospital Vicente Guerrero) of the IMSS, initiated its services. In 1960, medical services for civil workers and their families were housed in the Hospital Civil Morelos (Morelos Civil Hospital). Shortly afterwards, the Instituto de Seguridad y Servicios Sociales para los Trabajadores del Estado (ISSSTE, Security and Social Services Institute for State Employees) had their own hospital. During the 20th century, Acapulco has added other hospital services to care for members of the navy and armed forces, as well as for those persons with financial resources for private care.

  3. 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

  4. 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...

  5. 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...

  6. 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

  7. 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

  8. Developing a strategic marketing plan for hospitals.

    Science.gov (United States)

    Dychtwald, K; Zitter, M

    1988-09-01

    The initial stages of developing a strategic marketing plan for hospitals are explored in this excerpt from the book, The Role of the Hospital in an Aging Society: A Blueprint for Action. The elderly have unique perceptual, cognitive, social, and psychological needs and preferences, and a marketing strategy for eldercare services must reflect these factors, as well as the financial role of third-party payers and the decision-making influence of families and physicians. Among the elements the hospital must address when developing a marketing strategy are market selection and segmentation, targeting markets with specific services, pricing, and positioning the hospital for a maximum share of the eldercare market.

  9. Hospital-acquired pneumonia

    Science.gov (United States)

    ... tends to be more serious than other lung infections because: People in the hospital are often very sick and cannot fight off ... prevent pneumonia. Most hospitals have programs to prevent hospital-acquired infections.

  10. 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...

  11. 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 ...

  12. 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 ...

  13. 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 ...

  14. 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...

  15. 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

  16. Successful breastfeeding: a global intervention for a physiological process.

    Science.gov (United States)

    Corona, M F; Cataldi, P; Zaccagnini, G; Maddaluno, S; Capone, V; Conti, A; Carlucci, D; Silvano, S; Bertone, A; Parmigiani, Stefano

    2016-01-01

    In our perinatal unit we applied the ten steps of WHO/UNICEF for Baby Friendly Hospital Initiative and evaluated the percentage of exclusive (EBF) or complementary breastfeeding (CBF), and of formula fed (FF) healthy full-term infants (HFI) at hospital discharge (HD). HFI performing EBF at HD were 85.3%, a quite high value. At the age of 3 mths EBF percentage ranged between 59-62.4%, and at 6 mths it decreased to 51.7-37.7%. Customer satisfaction questionnaire at HD ranked "good" to "very good" in 92.8%. Causes of breastfeeding reduction with time and comparison with previous and actual situation in Italy and civilized countries are discussed. PMID:27648997

  17. Federal government expands compliance initiatives.

    Science.gov (United States)

    Dugan, J K

    1997-09-01

    In 1995, the Federal government initiated Operation Restore Trust to increase enforcement of fraud and abuse regulations in Medicare and Medicaid programs. With the success of the original initiative, the government is expanding the project to additional states and program areas. The initial scrutiny of home health agencies, nursing homes, hospice care, and durable medical equipment is being expanded to managed care plans and acute care hospitals with an eye toward DRG creep. To manage this increased enforcement activity, healthcare organizations should institute comprehensive corporate compliance programs. Such programs should provide a framework that delineates responsibilities and provides a systematic means to resolve issues in a timely manner.

  18. 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...

  19. Characteristics, treatment and in-hospital outcomes of patients with STEMI in a metropolitan area of a developing country: an initial report of the extended Jakarta Acute Coronary Syndrome registry

    Science.gov (United States)

    Dharma, Surya; Andriantoro, Hananto; Purnawan, Ismi; Dakota, Iwan; Basalamah, Faris; Hartono, Beny; Rasmin, Ronaly; Isnanijah, Herawati; Yamin, Muhammad; Wijaya, Ika Prasetya; Pratama, Vireza; Gunawan, Tjatur Bagus; Juwana, Yahya Berkahanto; Suling, Frits R W; Witjaksono, A M Onny; Lasanudin, Hengkie F; Iskandarsyah, Kurniawan; Priatna, Hardja; Tedjasukmana, Pradana; Wahyumandradi, Uki; Kosasih, Adrianus; Budhiarti, Imelda A; Pribadi, Wisnoe; Wirianta, Jeffrey; Lubiantoro, Utojo; Pramesti, Rini; Widowati, Diah Retno; Aminda, Sissy Kartini; Basalamah, M Abas; Rao, Sunil V

    2016-01-01

    Objective We studied the characteristics of patients with ST segment elevation myocardial infarction (STEMI) after expansion of a STEMI registry as part of the STEMI network programme in a metropolitan city and the surrounding area covering ∼26 million inhabitants. Design Retrospective cohort study. Setting Emergency department of 56 health centres. Participants 3015 patients with acute coronary syndrome, of which 1024 patients had STEMI. Main outcome measure Characteristics of reperfusion therapy. Results The majority of patients with STEMI (81%; N=826) were admitted to six academic percutaneous coronary intervention (PCI) centres. PCI centres received patients predominantly (56%; N=514) from a transfer process. The proportion of patients receiving acute reperfusion therapy was higher than non-reperfused patients (54% vs 46%, p<0.001), and primary PCI was the most common method of reperfusion (86%). The mean door-to-device (DTD) time was 102±68 min. In-hospital mortality of non-reperfused patients was higher than patients receiving primary PCI or fibrinolytic therapy (9.1% vs 3.2% vs 3.8%, p<0.001). Compared with non-academic PCI centres, patients with STEMI admitted to academic PCI centres who underwent primary PCI had shorter mean DTD time (96±44 min vs 140±151 min, p<0.001), higher use of manual thrombectomy (60.2% vs13.8%, p<0.001) and drug-eluting stent implantation (87% vs 69%, p=0.001), but had similar use of radial approach and intra-aortic balloon pump (55.7% vs 67.2%, and 2.2% vs 3.4%, respectively). In patients transferred for primary PCI, TIMI risk score ≥4 on presentation was associated with a prolonged door-in to door-out (DI-DO) time (adjusted OR 2.08; 95% CI 1.09 to 3.95, p=0.02). Conclusions In the expanded JAC registry, a higher proportion of patients with STEMI received reperfusion therapy, but 46% still did not. In developing countries, focusing the prehospital care in the network should be a major focus of care to improve the DI

  20. 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

  1. Initial Study

    DEFF Research Database (Denmark)

    Torp, Kristian

    2009-01-01

    Congestion is a major problem in most cities and the problem is growing (Quiroga, 2000) (Faghri & Hamad, 2002). When the congestion level is increased the drivers notice this as delays in the traffic (Taylor, Woolley, & Zito, 2000), i.e., the travel time for the individual driver is simply...... 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...

  2. 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...

  3. 42 CFR 456.233 - Initial continued stay review date.

    Science.gov (United States)

    2010-10-01

    ... assigns the initial continued stay review date within 1 working day after the mental hospital is notified... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Mental Hospitals... must provide that— (a) When a recipient is admitted to the mental hospital under admission...

  4. 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...

  5. 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

  6. 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…

  7. 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

  8. 初次住院与重复住院冠状动脉硬化性心脏病患者健康教育认知缺陷的对比研究%The Comparative Study on Health Education Cognition Defects for the Coronary Artery Heart Disease Patients in the Aspect of being Hospitalized for Initial or Repetition

    Institute of Scientific and Technical Information of China (English)

    张旭; 王蕊; 隋雪芝; 王晓琳

    2014-01-01

    Objective To understand the health education cognition defects for coronary artery heart dis‐ease patients in the aspect of be hospitalized for initial or repetition ,and compare the differences of cogni‐tion and analyze its influencing factors ,to provide evidence for set a measure for health education efficient‐ly .Methods By convenience sampling ,197 cases of coronary heart disease patients were selected and divid‐ed into initial and repetition be hospitalized .T he participants w ere investigated by using health education cognition defects questionnaire .Results There was no significant statistical difference between two groups of patients in the aspects of age ,sex ,education background ,genetic history ,blood lipids ,blood pressure ,di‐abetes ,smoking and so on(all P>0 0.5) .The two groups of patients on the level of cognitive education were higher than norm ;the initial patients were poor than those who has repetition be hospitalized (P0 0.5) ,while there was statistic significance of patients in healthy lifestyle cognition(P<0 0.5) .Conclusion Nurse should be differently to patients based on the times be hospitalized ,fully assess cognitive deficits inpatients with coronary heart disease and lay a foundation to provide effective health education .%目的:了解初次住院与重复住院冠状动脉硬化性心脏病(简称冠心病)患者健康教育认知缺陷状况,比较其认知差异并分析其影响因素,以期为临床制定有效的健康教育措施提供依据。方法2012年3-12月,便利抽样法选择在哈尔滨医科大学附属第二医院心内科住院治疗的197例冠心病患者为研究对象,按其是否为初次住院患者将其分为初次住院组和重复住院组,采用冠心病患者健康教育认知缺陷问卷对其进行调查。结果两组患者在年龄、性别、文化程度、遗传史、血脂、血压、糖尿病、吸烟等方面的差异均无统计学意义(均 P>00.5)。

  9. 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.

  10. 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

  11. 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.

  12. 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

  13. 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...

  14. 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...

  15. 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

  16. 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.

  17. 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.

  18. 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...

  19. Santa Barbara Cottage Hospital.

    Science.gov (United States)

    1984-01-01

    The 465-bed Santa Barbara Cottage Hospital is the largest medical facility on the California coast between Los Angeles and the San Francisco bay area. The hospital dates back to 1888, when a group of local citizens began raising funds to build a "cottage-style" hospital for the growing community. Their original plans called for a complex in which each medical specialty would be housed in a separate bungalow. Even then, however, such a decentralized plan was too costly, so work began instead on a single cottage for all hospital departments. The first Cottage Hospital opened in 1891, with 25 beds housed in a two story Victorian building. Now a hugh medical complex employing some 1,500 people, the hospital continues to be called "Cottage" after the original home-like building. Rodney J. Lamb has been Hospital Administrator for the last 30 years.

  20. Two Belgian University Hospitals

    Directory of Open Access Journals (Sweden)

    M. Huylebrouck

    2012-01-01

    Full Text Available Background. Bevacizumab (BEV, a humanized immunoglobulin G1 monoclonal antibody that inhibits VEGF has demonstrated activity against recurrent high-grade gliomas (HGG in phase II clinical trials. Patients and Methods. Data were collected from patients with recurrent HGG who initiated treatment with BEV outside a clinical trial protocol at two Belgian university hospitals. Results. 19 patients (11 M/8 F were administered a total of 138 cycles of BEV (median 4, range 1–31. Tumor response assessment by MRI was available for 15 patients; 2 complete responses and 3 partial responses for an objective response rate of 26% for the intent to treat population were observed on gadolinium-enhanced T1-weighted images; significant regressions on T2/FLAIR were documented in 10 out of 15 patients (67%. A reduced uptake on PET was documented in 3 out of 4 evaluable patients. The six-month progression-free survival was 21% (95% CI 2.7–39.5. Two patients had an ongoing tumor response and remained free from progression after 12 months of BEV treatment. Conclusions. The activity and tolerability of BEV were comparable to results from previous prospective phase II trials. Reduced uptake on PET suggests a metabolic response in addition to an antiangiogenic effect in some cases with favorable clinical outcome.

  1. 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.

  2. 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...

  3. 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

  4. Financing the future of independent community hospitals.

    Science.gov (United States)

    Richman, Alan P

    2011-11-01

    Effingham Hospital, a critical access hospital, undertook a modernization initiative to expand the limited scope of its inpatient services to improve financial performance and ability to build liquidity reserves. FHA Section 242 mortgage insurance was the only means for Effingham to credit enhance its debt and obtain a low-interest rate loan. Effingham needed to convince residents and county commissioners to pledge 27 years of additional tax support to offset its annual uncompensated care. The hospital won support from the community and the commissioners, in part because of the educational outreach of the CEO, CFO, and board in articulating the imperative for maintaining local hospital care and the present and future economic benefits for Effingham County.

  5. MANPOWER FOR CALIFORNIA HOSPITALS, 1964-1975.

    Science.gov (United States)

    California State Commission on Manpower, Automation, and Technology, Sacramento.

    AN EXAMINATION OF THE HOSPITAL AND NURSING AND CONVALESCENT HOME INDUSTRY IN 1964 AND EMPLOYMENT PROJECTIONS ARE PRESENTED AS AN INITIAL CONTRIBUTION TO THE DEVELOPMENT OF AN ONGOING MANPOWER INFORMATION PROGRAM IN THE STATE. DATA WERE COMPILED FROM POPULATION PROJECTIONS BY THE CALIFORNIA DEPARTMENT OF FINANCE, WAGE SURVEY STUDIES BY THE…

  6. 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…

  7. 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

  8. 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...

  9. 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...

  10. The impact of critical total quality management practices on hospital performance in the ministry of health hospitals in saudi arabia.

    Science.gov (United States)

    Alaraki, Mohammad Shamsuddin

    2014-01-01

    Total Quality Management (TQM) offers a method for solving quality and patient safety problems and bringing significant improvement to hospital performance. However, only few studies have been conducted in this area in developing countries, particularly in Saudi Arabia. This research is carried out in an attempt to address this gap, exploring the impact of applying TQM practices on hospital performance in the Saudi Ministry of Health hospitals. The study has included 4 hospitals in Tabuk Region, namely, King Khaled Hospital, King Fahad Hospital, Maternity and Children Hospital, and Hagel General Hospital. The data collection was done by the researcher when 400 questionnaires were distributed using a convenient sampling technique to access the required data. The response rate was 67.25% of the total questionnaires distributed. The TQM practices used in the study were as follows: leadership, employee management, information analysis, training, customer focus, continuous improvement, process management, and supplier management. The findings of the research show a significant positive correlation between the 8 practices of TQM and hospital performance with a correlation coefficient r value of 0.9 (P = .0001). The study also reveals that Saudi hospitals are facing difficulties in engaging the clinical staff in their quality initiative. Moreover, our findings show that accredited hospitals have significantly applied TQM practices more than unaccredited hospitals.

  11. 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

  12. 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 collaborat......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 framework...

  13. 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.

  14. 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…

  15. 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…

  16. 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....... 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...

  17. Driving hospital transformation with SLMTA in a regional hospital in Cameroon

    Directory of Open Access Journals (Sweden)

    Laura T. Eno

    2014-09-01

    Full Text Available Background: Inspired by the transformation of the Regional Hospital Buea laboratory through implementation of the Strengthening Laboratory Management Toward Accreditation (SLMTA programme, hospital management adapted the SLMTA toolkit to drive hospital wide quality improvement.Objective: This paper describes changes in the hospital following the quality improvement activities in hygiene and sanitation, the outpatient waiting area and the surgical and maternity wards.Methods: In March 2011, hospital management established a quality improvement task force and created a hospital-wide quality improvement roadmap, following the SLMTA model. The roadmap comprised improvement projects, accountability plans, patient feedback forms and log books to track quality indicators including patient wait time, satisfaction level, infectionrates, birth outcomes and hospital revenue.Results: There was steady improvement in service delivery during the 11 months after the introduction of the quality improvement initiatives: patient wait time at the reception was reduced from three hours to less than 30 minutes and patient satisfaction increased from 15% to 60%. Treatment protocols were developed and documented for various units, infrastructure and workflow processes were improved and there was increased staff awareness of the importance of providing quality services. Maternal infection rates dropped from 3% to 0.5% and stillbirths from 5% to < 1%. The number of clients increased as a result of improvedservices, leading to a 25% increase in hospital revenue.Conclusion: The SLMTA approach was adapted successfully to meet the needs of the entire hospital. Such a programme has the potential to impact positively on hospital quality systems; consideration should be made for development of a formal SLMTA-like programmefor hospital quality improvement.

  18. 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.

  19. 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...

  20. Hospital diversification: evaluating alternatives.

    Science.gov (United States)

    Hammer, L

    1987-05-01

    The appropriateness of diversification as a growth strategy for hospitals is discussed, and planning for diversification is described. Because new forms of health-care delivery are now in direct competition with hospitals, many hospitals are confronting environmental pressures and preparing for future survival through diversification. To explore the potential risks and benefits of diversification, the hospital must identify opportunities for new business ventures. Diversification can be "related," through an expansion of the primary product line (health care), or "unrelated," into areas not directly associated with health care. The hospital must establish specific criteria for evaluating each diversification alternative, and the two or three most attractive options should be analyzed further through a financial feasibility study. The hospital should also seek legal advice to determine the implications of diversification for maintenance of tax status, antitrust limitations, and applicability of certificate of need. Although diversification may not be appropriate for every institution, hospitals should consider it as a strategy for increasing their revenue base, confronting environmental pressures, and securing future survival. PMID:3300300

  1. Hospital diversification: evaluating alternatives.

    Science.gov (United States)

    Hammer, L

    1987-05-01

    The appropriateness of diversification as a growth strategy for hospitals is discussed, and planning for diversification is described. Because new forms of health-care delivery are now in direct competition with hospitals, many hospitals are confronting environmental pressures and preparing for future survival through diversification. To explore the potential risks and benefits of diversification, the hospital must identify opportunities for new business ventures. Diversification can be "related," through an expansion of the primary product line (health care), or "unrelated," into areas not directly associated with health care. The hospital must establish specific criteria for evaluating each diversification alternative, and the two or three most attractive options should be analyzed further through a financial feasibility study. The hospital should also seek legal advice to determine the implications of diversification for maintenance of tax status, antitrust limitations, and applicability of certificate of need. Although diversification may not be appropriate for every institution, hospitals should consider it as a strategy for increasing their revenue base, confronting environmental pressures, and securing future survival.

  2. Survival after in-hospital Cardiopulmonary Resuscitation

    Directory of Open Access Journals (Sweden)

    M Adib Hajbaghery

    2005-05-01

    Full Text Available 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 until defibrillation, duration and result of CPR, frequency of tracheal intubations and time served for it were collected in a checklist. Results: In six months study, 206 cases of cardiopulmonary resuscitation attempted. The survival rate was similar for both sexes. Short-term survival observed in19.9% of cases and only 5.3% survived to discharge. Conclusions: Duration of CPR, time of the first defibrillation, response time and the location of cardiac arrest are the key predictors of survival to hospital discharge and in-hospital CPR strategies require improvement. This study promotes a national study on post CPR survival for accurate data on our performance in attention to chain of survival. KeyWords: Cardiopulmonary Resuscitation (CPR, Survival rate, Iran

  3. The impact of HCA's 2006 leveraged buyout on hospital performance.

    Science.gov (United States)

    McCue, Michael J; Thompson, Jon M

    2012-01-01

    Leveraged buyout (LBO) arrangements are a reorganization strategy whereby a firm assumes a substantial amount of debt to buy back its publicly held stock to become privately held. LBOs offer a firm several advantages and have the potential to increase efficiency. In the past 20 years, several healthcare firms have engaged in LBOs, but the literature on performance changes in healthcare organizations as a result of an LBO is limited. In this article, we report on a study that examined the performance of Hospital Corporation of America (HCA) hospitals before and after the LBO that was initiated in 2006. We used data from the Medicare Hospital Cost Report Information System and analyzed data from 130 HCA hospitals and 490 comparison hospitals. Findings show that HCA hospitals reduced expenses and their number of full-time equivalents (FTEs) relative to local competitor hospitals. HCA hospitals' cash-flow-margin ratio was substantially higher when adjusted for its local competing hospitals at the beginning of the LBO as well as at end of the LBO. When compared to local hospitals, HCA hospitals had a significant decrease in their capital investment in fixed assets from 2006 to 2009. These findings underscore the effectiveness of HCA's management strategies to repay debt and increase the value of the company, and they are informative for healthcare firms and their managers who are considering LBOs.

  4. Using Public Reports of Patient Satisfaction for Hospital Quality Improvement

    Science.gov (United States)

    Barr, Judith K; Giannotti, Tierney E; Sofaer, Shoshanna; Duquette, Cathy E; Waters, William J; Petrillo, Marcia K

    2006-01-01

    Objective To explore the impact of statewide public reporting of hospital patient satisfaction on hospital quality improvement (QI), using Rhode Island (RI) as a case example. Data Source Primary data collected through semi-structured interviews between September 2002 and January 2003. Study Design The design is a retrospective study of hospital executives at all 11 general and two specialty hospitals in RI. Respondents were asked about hospital QI activities at several points throughout the public reporting process, as well as about hospital structure and processes to accomplish QI. Qualitative analysis of the interview data proceeded through an iterative process to identify themes and categories in the data. Principal Findings Data from the standardized statewide patient satisfaction survey process were used by hospitals to identify and target new QI initiatives, evaluate performance, and monitor progress. While all hospitals fully participated in the public reporting process, they varied in the stage of development of their QI activities and adoption of the statewide standardized survey for ongoing monitoring of their QI programs. Most hospitals placed responsibility for QI within each department, with results reported to top management, who were perceived as giving strong support for QI. The external environment facilitated QI efforts. Conclusion Public reporting of comparative data on patient views can enhance and reinforce QI efforts in hospitals. The participation of key stakeholders facilitated successful implementation of statewide public reporting. This experience in RI offers lessons for other states or regions as they move to public reporting of hospital quality data. PMID:16704506

  5. Does hospital diversification improve financial outcomes?

    Science.gov (United States)

    Clement, J P

    1987-10-01

    Service or product diversification is a popular recommendation made to hospitals to increase profitability and reduce financial risk as they face a more hostile environment. This paper presents results from an empirical study of these claims. Using data from all California nonprofit hospitals, the study finds that diversification, regardless of whether it is related or unrelated to preexisting services, is not associated with either increased profitability or reduced financial risk. However, other variables that do have these effects are identified in the research. Future research should evaluate the effect of both the size of and the length of time since the initial diversifying investment on financial variables.

  6. On spaces of hospitality

    DEFF Research Database (Denmark)

    Greve, Anni

    Although specialists in hospitality have worked extensively on hospitality with respect to relations between different nations or between nations and individuals of a different nationality, for instance when they seek asylum, Jacques Derrida preferred to focus instead upon the relationship between...... 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....

  7. 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...... foundation. The basis of the present study lies in solving the architectural design problem in order to respond to functionalities and performances. The emphasis is the practical applicability for architects, engineers and hospital planners for assuring usability and a holistic approach of functionalities...... and performances. By formal descriptions, a design model can weigh and compare the impact of different perspectives and, even in the early design phase, it can visualize and quantify consequences for design choices. By qualitative study of hospital design and hospital functionality, formal descriptions develop...

  8. 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...

  9. 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...

  10. Service Robots for Hospitals

    DEFF Research Database (Denmark)

    Özkil, Ali Gürcan

    services to maintain the quality of healthcare provided. This thesis and the Industrial PhD project aim to address logistics, which is the most resource demanding service in a hospital. The scale of the transportation tasks is huge and the material flow in a hospital is comparable to that of a factory. We...... believe that these transportation tasks, to a great extent, can be and will be automated using mobile robots. This thesis consequently addresses the key technical issues of implementing service robots in hospitals. In simple terms, a robotic system for automating hospital logistics has to be reliable...... manual work and offer many advantages beyond robotics. Finally, this thesis outlines our contributions in representation of multi-floor buildings, which is a vital requirement to achieve robust and practical, real-world service robot applications....

  11. 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...

  12. Hospitals of The Future

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    An overseas biometric and RFID solutions provider eyes up China’s emerging healthcare IT solutions market New mothers in China can look forward to more peaceful hos-pital stays without worries that their precious newborns might be

  13. 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...

  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. 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...

  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. 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...

  18. 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...

  19. 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...

  20. [Hospital organizational structure].

    Science.gov (United States)

    Bittar, O J

    1994-01-01

    The basic point for an Institution to work is the existence of a definite organizational structure that puts together similar areas allowing decisions and the operationalization of different tasks. Knowledge and analysis of structures of private and public hospitals and a bibliography review about the issue is the purpose of this paper. Suggestions are given about the elaboration of small structures and the utilization of matrix management in order to accomplish the hospitals objectives.

  1. Hacking the hospital environment

    DEFF Research Database (Denmark)

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

    2016-01-01

    BACKGROUND: There is a need for youth-friendly hospital environments as the ward environment may affect both patient satisfaction and health outcomes. OBJECTIVE: To involve young people in designing youth-friendly ward environment. METHODS: We arranged a design competition lasting 42 h (Hackathon...... 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....

  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. Sisters in Dutch hospitals.

    Science.gov (United States)

    van den Bergh-Braam, A H

    1985-11-01

    This study focuses on hospital sisters in 30 Dutch hospitals. The so-called role-set approach has been adopted. In this approach the sisters are the focal persons. Direct superiors, specialists, registered nurses and student nurses acted as role-senders. The possible number of respondents is 600 (120 of each group). The response of hospital sisters is 100%, that of role-senders 88%. The study started out as an attempt to collect background information on the causes of wastage of sisters. High wastage rates are generally regarded as an indication of an unfavourable working environment. Since hospital sisters occupy a key position in hospitals, the ward problems will be studied from their angle. Although wastage rates have dropped recently, it does not necessarily follow that the working environment has improved. Wastage is known to act as a safety valve, thus allowing tensions to resolve. The threat of unemployment clogs this outlet, which increases the tensions on the hospital ward. Data from the study show that work overload is one of the major stress factors for sisters. Analyses demonstrated that there exists a relationship between work overload and tensions with the management and direct superiors, tensions in job execution, irritableness on the ward, low self-esteem, health complaints and psychological condition. Sisters with an excessive job involvement refer to work overload more often than their moderate colleagues. There is a relationship between an unfavourable working environment and irritableness of sisters.

  4. 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

  5. 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.

  6. 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

  7. Nutrition in the hospitalized patient.

    Science.gov (United States)

    Kirkland, Lisa L; Kashiwagi, Deanne T; Brantley, Susan; Scheurer, Danielle; Varkey, Prathibha

    2013-01-01

    Almost 50% of patients are malnourished on admission; many others develop malnutrition during admission. Malnutrition contributes to hospital morbidity, mortality, costs, and readmissions. The Joint Commission requires malnutrition risk screening on admission. If screening identifies malnutrition risk, a nutrition assessment is required to create a nutrition care plan. The plan should be initiated early in the hospital course, as even patients with normal nutrition become malnourished quickly when acutely ill. While the Harris-Benedict equation is the most commonly used method to estimate calories, its accuracy may not be optimal in all patients. Calculating the caloric needs of acutely ill obese patients is particularly problematic. In general, a patient's caloric intake should be slightly less than calculated needs to avoid the metabolic risks of overfeeding. However, most patients do not receive their goal calories or receive parenteral nutrition due to erroneous practices of awaiting return of bowel sounds or holding feeding for gastric residual volumes. Patients with inadequate intake over time may develop potentially fatal refeeding syndrome. The hospitalist must be able to recognize the risk factors for malnutrition, patients at risk of refeeding syndrome, and the optimal route for nutrition support. Finally, education of patients and their caregivers about nutrition support must begin before discharge, and include coordination of care with outpatient facilities. As with all other aspects of discharge, it is the hospitalist's role to assure smooth transition of the nutrition care plan to an outpatient setting.

  8. 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

  9. 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.

  10. 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.

  11. Hospital overcrowding: an opportunity for case managers.

    Science.gov (United States)

    Simmons, Florence M

    2005-01-01

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

  12. 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...

  13. Internal auditing in hospitals.

    Science.gov (United States)

    Edwards, Don; Kusel, Jim; Oxner, Tom

    2003-01-01

    The authors analyzed two national surveys to determine answers for two basic questions: How do the roles of internal auditors compare with those of their counterparts in other industries and to what extent over the past 6 years have the activities of internal auditors changed? Internal auditors in hospitals allocate their time primarily to financial/compliance and operational types of audits, as do their counterparts. The current trend is toward more operational types of audits. In the early years of employment, staff turnover in hospitals is significantly higher than in all combined industries, often leading to internal auditors' filling other positions in the organization. Hospital staff salaries are higher than are salaries in other industries combined. Staff composition continues to reflect the growing presence of women in the field. The majority of internal auditing directors believe that their salaries are fair, would recommend internal auditing as a career position, and are treated as valued consultants in the organization.

  14. Hospital Prices Increase in California, Especially Among Hospitals in the Largest Multi-hospital Systems

    Directory of Open Access Journals (Sweden)

    Glenn A. Melnick PhD

    2016-06-01

    Full Text Available A surge in hospital consolidation is fueling formation of ever larger multi-hospital systems throughout the United States. This article examines hospital prices in California over time with a focus on hospitals in the largest multi-hospital systems. Our data show that hospital prices in California grew substantially (+76% per hospital admission across all hospitals and all services between 2004 and 2013 and that prices at hospitals that are members of the largest, multi-hospital systems grew substantially more (113% than prices paid to all other California hospitals (70%. Prices were similar in both groups at the start of the period (approximately $9200 per admission. By the end of the period, prices at hospitals in the largest systems exceeded prices at other California hospitals by almost $4000 per patient admission. Our study findings are potentially useful to policy makers across the country for several reasons. Our data measure actual prices for a large sample of hospitals over a long period of time in California. California experienced its wave of consolidation much earlier than the rest of the country and as such our findings may provide some insights into what may happen across the United States from hospital consolidation including growth of large, multi-hospital systems now forming in the rest of the rest of the country.

  15. 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 ...

  16. 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...

  17. 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

  18. 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.

  19. 42 CFR 407.14 - Initial enrollment period.

    Science.gov (United States)

    2010-10-01

    ... PROGRAM SUPPLEMENTARY MEDICAL INSURANCE (SMI) ENROLLMENT AND ENTITLEMENT Individual Enrollment and Entitlement for SMI § 407.14 Initial enrollment period. (a) Duration. (1) The initial enrollment period is the... eligibility requirements for SMI n the first day he or she becomes entitled to hospital insurance or...

  20. 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.

  1. 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…

  2. 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.

  3. Hospitals as food arenas

    DEFF Research Database (Denmark)

    Poulsen, Signe; Jørgensen, Michael Søgaard

    2010-01-01

    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...

  4. Speech intelligibility in hospitals.

    Science.gov (United States)

    Ryherd, Erica E; Moeller, Michael; Hsu, Timothy

    2013-07-01

    Effective communication between staff members is key to patient safety in hospitals. A variety of patient care activities including admittance, evaluation, and treatment rely on oral communication. Surprisingly, published information on speech intelligibility in hospitals is extremely limited. In this study, speech intelligibility measurements and occupant evaluations were conducted in 20 units of five different U.S. hospitals. A variety of unit types and locations were studied. Results show that overall, no unit had "good" intelligibility based on the speech intelligibility index (SII > 0.75) and several locations found to have "poor" intelligibility (SII SII than unoccupied spaces on average. Additionally, staff perception of communication problems at nurse stations was significantly correlated with SII ratings. In a targeted second phase, a unit treated with sound absorption had higher SII ratings for a larger percentage of time as compared to an identical untreated unit. Taken as a whole, the study provides an extensive baseline evaluation of speech intelligibility across a variety of hospitals and unit types, offers some evidence of the positive impact of absorption on intelligibility, and identifies areas for future research.

  5. 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

  6. [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.

  7. [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

  8. Hospital-acquired infections - when are hospitals legally liable?

    Science.gov (United States)

    McQuoid-Mason, David

    2012-04-12

    Hospital-acquired infections (nosocomial infections) are acquired in healthcare settings by patients admitted for reasons unrelated to the infection or not previously infected when admitted to the facility. Liability for hospital-acquired infections depends on whether the hospital: (i) has introduced best practice infection control measures; (ii) has implemented best practice infection control measures; or (iii) will be vicariously liable for negligent or intentional failures by staff to comply with the infection control measures implemented. A hospital and hospital administrators may be held directly liable for not introducing or implementing best practice infection control measures, resulting in harm to patients. The hospital may also be held vicariously liable where patients have been harmed because hospital staff negligently or intentionally failed to comply with the infection control measures that have been implemented by the hospital, during the course and scope of their employment.

  9. 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

  10. 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.

  11. [Hospital clinical ethics committees].

    Science.gov (United States)

    Gómez Velásquez, Luis; Gómez Espinosa, Luis Néstor

    2007-01-01

    The scientific and technological advances have been surprising, more in the two last decades, but they don't go united with to the ethical values of the medical professional practice, it has been totally escaped, specially when the biological subsistence, the maintenance of the life through apparatuses and the mechanisms that prolong the existence are who undergoes an alteration that until recently time was mortal shortly lapse. It is common listening that exist a crisis in the medical profession, but what really is it of human values, which as soon and taken into nowadays, actually professional account, which gives rise to a dehumanization towards the life, the health, the disease, the suffering and the death. The ideal of the doctor to give to service to the man in its life and health, as well to be conscious that the last biological process that must fulfill is the death, and when it appears, does not have considered as a actually professional failure. It has protect to the patient as the extreme cruelty therapeutic, that it has right a worthy death. It's taking to the birth of the hospital ethics committees, they have like function to analyze, to advise and to think about the ethical dilemmas that appear actually clinical or in the biomedical investigation. In 1982 in the UEA only 1% of its hospitals had a ethics committees; by 1988, it was 67% and the 100% in 2000. In Mexico the process of the formation by these committees begins, only in the Military Central Hospital, to count the ethics committee on 1983, also the Hospital no. 14 of the IMSS in Guadalajara, it works with regularity from 1995, with internal teaching of bioethic. The Secretariat of Health has asked the formation of the bioethical committees in each hospital, and order the it was be coordinated by the National Committee of Bioética. The integration of these committees is indispensable that their members have the knowledge necessary of bioética. The Mexican Society of Ortopedia, conscious of

  12. 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

  13. 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...

  14. 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 ...

  15. A Multidisciplinary Hospital-based Antimicrobial Use Program: Impact on Hospital Pharmacy Expenditures and Drug Use

    Directory of Open Access Journals (Sweden)

    Suzette Salama

    1996-01-01

    Full Text Available The authors’ hospital embarked on a three-component, multidisciplinary, hospital-based antimicrobial use program to cut costs and reduce inappropriate antimicrobial use. Initially, antimicrobial use patterns and costs were monitored for 12 months. For the next two years, an antimicrobial use program was implemented consisting of three strategies: automatic therapeutic interchanges; antimicrobial restriction policies; and parenteral to oral conversion. The program resulted in a reduction in the antimicrobial portion of the total pharmacy drug budget from 41.6% to 28.2%. Simultaneously, the average cost per dose per patient day dropped from $11.88 in 1991 to $10.16 in 1994. Overall, mean monthly acquisition cost savings rose from $6,810 in 1992 to $27,590 in 1994. This study demonstrates that a multidisciplinary antimicrobial use program in a Canadian hospital can effect dramatic cost savings and serve as a quality assurance activity of physician antimicrobial prescribing behaviour.

  16. 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....

  17. Hospital Presbiteriano Valley

    Directory of Open Access Journals (Sweden)

    Luckman, Charles

    1964-12-01

    Full Text Available This hospital is built on the circular system. This arrangement has economic and functional advantages. The nurses walk 40 % less distance than in a hospital of similar size, of conventional layout. The rooms are situated along the external perimeter and the beds are orientated towards the corridor, rather than towards the window. However, the patients can see out of doors by turning on their side. The hospital is most carefully fitted out, and is very comfortable. There is air conditioning, and patients can control their own TV sets. There are also curtains separating each bed form the rest, thus providing maximum independence. Warm colours have been adopted in the decoration of rooms facing north, whilst those facing south are painted in cooler tones. The circular design arrangement makes the distribution far more flexible, and it will be easier to include further units later on; by adding small adjustments to the central building. To reduce external noise, and to improve the surrounding landscape, small sand hills have been provided in the garden, and the parking site also serves to partially absorb the noise.Presenta esta solución de unidades circulares numerosas ventajas de tipo económico, ahorra espacio y da eficiencia a la circulación— las enfermeras recorren un 40 por 100 menos de camino que en otro hospital de dimensiones similares—. Las habitaciones están distribuidas a lo largo del perímetro exterior y tienen las camas orientadas hacia los corredores, en lugar de hacia las ventanas, pero de tal modo que los pacientes puedan contemplar el exterior al volverse sobre uno de sus costados. Están cuidadosamente diseñadas y dotadas de las máximas comodidades: aire acondicionado y aparatos de televisión controlados por el paciente; así como cortinas divisorias que le proporcionan el grado de aislamiento deseado.

  18. 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.

  19. Hospital Princesa Margarita

    Directory of Open Access Journals (Sweden)

    Powell y Moya, Aquitectos

    1961-04-01

    Full Text Available El amplio programa desarrollado en este grande e importante Centro sanitario, abarcó tres fases de construcción, al final de las cuales se consiguió el Hospital General, capaz para 600 camas. En la primera parte se construyeron los siguientes departamentos: Enfermos del exterior, Accidentes, Medicina Física, Patología, Rayos X, y el primero de los cuatro núcleos quirúrgicos.

  20. Health care quality in NHS hospitals.

    Science.gov (United States)

    Youssef, F N; Nel, D; Bovaird, T

    1996-01-01

    Hospitals provide the same type of service, but they do not all provide the same quality of service. No one knows this better than patients. Reports the results of a market research exercise initiated to ascertain the different factors which patients of health care identify as being necessary to provide error-free service quality in the NHS hospitals. To measure patients' satisfaction with NHS hospitals, the internationally-used market research technique called SERVQUAL was used in order to measure patients' expectations before admission, record their perceptions after discharge from the hospital, and then to close the gap between them. This technique compares expectations with perceptions of service received across five broad dimensions of service quality, namely: tangibility; reliability; responsiveness; assurance; and empathy. This analysis covered 174 patients who had completed the SERVQUAL questionnaire, including patients who had had treatment in surgical, orthopaedic, spinal injury, medicinal, dental and other specialties in the West Midlands region. Recorded the average weighted NHS service quality score overall for the five dimensions as significantly negative.

  1. Health care quality in NHS hospitals.

    Science.gov (United States)

    Youssef, F N; Nel, D; Bovaird, T

    1996-01-01

    Hospitals provide the same type of service, but they do not all provide the same quality of service. No one knows this better than patients. Reports the results of a market research exercise initiated to ascertain the different factors which patients of health care identify as being necessary to provide error-free service quality in the NHS hospitals. To measure patients' satisfaction with NHS hospitals, the internationally-used market research technique called SERVQUAL was used in order to measure patients' expectations before admission, record their perceptions after discharge from the hospital, and then to close the gap between them. This technique compares expectations with perceptions of service received across five broad dimensions of service quality, namely: tangibility; reliability; responsiveness; assurance; and empathy. This analysis covered 174 patients who had completed the SERVQUAL questionnaire, including patients who had had treatment in surgical, orthopaedic, spinal injury, medicinal, dental and other specialties in the West Midlands region. Recorded the average weighted NHS service quality score overall for the five dimensions as significantly negative. PMID:10156537

  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...

  3. 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...

  4. Strategic market planning for hospitals.

    Science.gov (United States)

    Zallocco, R L; Joseph, W B; Doremus, H

    1984-01-01

    The application of strategic market planning to hospital management is discussed, along with features of the strategic marketing management process. A portfolio analysis tool, the McKinsey/G.E. Business Screen, is presented and, using a large urban hospital as an example, discussed in detail relative to hospital administration. Finally, strategic implications of the portfolio analysis are examined.

  5. 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 - ...

  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. 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…

  8. 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…

  9. 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…

  10. [Refuse disposal at the hospital].

    Science.gov (United States)

    Knoll, K H

    1990-02-01

    For the classification of hospital-wastes in the categories infectious-contaminate or special waste are only significant views of the prevention by nosocomial infection in the hospital. Solely infectious waste become removed hospital-intern and -extern on conditions of hygienic prevention, namely through secure packing during the transport, combustion or desinfection. Special wastes to be defeated by special-conditions. The hygienist of the hospital is only competent for the classification of the wastes in the hospital as well as for their refuse.

  11. 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.

  12. 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

  13. Mobile Robots for Hospital Logistics

    DEFF Research Database (Denmark)

    Özkil, Ali Gürcan

    Hospitals are complex and dynamic organisms that are vital to the well-being of societies. Providing good quality healthcare is the ultimate goal of a hospital, and it is what most of us are only concerned with. A hospital, on the other hand, has to orchestrate a great deal of supplementary...... 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 should reliably...

  14. 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...

  15. 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...

  16. 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.

  17. 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

  18. Medicare's Hospital Compare quality reports appear to have slowed price increases for two major procedures.

    Science.gov (United States)

    Dor, Avi; Encinosa, William E; Carey, Kathleen

    2015-01-01

    Previous research has found that Hospital Compare, Medicare's public reporting initiative, has had little impact on patient outcomes. However, little is known about the initiative's impact on hospital prices, which may be significant because private insurers are generally well positioned to respond to quality information when negotiating prices with hospitals. We estimated difference-in-differences models of the effects of Hospital Compare quality reporting on transaction prices for two major cardiac procedures, coronary artery bypass graft (CABG) and percutaneous coronary intervention (PCI). States that had mandated their own public reporting systems before the implementation of Hospital Compare formed the control group. We found that prices for these procedures continued to increase overall after the initiation of Hospital Compare quality scores, but the rate of increase was significantly lower in states with no quality reporting metrics of their own before Hospital Compare, when compared to the control states (annual rates of increase of 4.4 percent versus 8.7 percent for PCI, and 3.9 percent versus 10.6 percent for CABG, adjusted for overall inflation). This finding implies that Hospital Compare provided leverage to purchasers in moderating price increases, while adding competitive pressures on hospitals. Providing accurate quality information on both hospitals and health plans could benefit consumers.

  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. [Satisfaction of hospitalized patients in a hospital in Apurimac, Peru].

    Science.gov (United States)

    Sihuin-Tapia, Elsa Yudy; Gómez-Quispe, Oscar Elisban; Ibáñez-Quispe, Vladimiro

    2015-01-01

    In order to determine the satisfaction of hospitalized patients in the Sub-regional Hospital of Andahuaylas, 175 patients were surveyed using the Servqual multidimensional model. The estimate of variables associated with the satisfaction of the hospitalized patients was performed by using bivariate and multivariate logistic regression analysis. We found 25.0% satisfaction. Lower levels of satisfaction were associated with having a secondary level education (aOR: 0.05; 95% CI: 0.01 to 0.64) and with having been hospitalized in the surgery department (aOR 0.14, CI: 95%: 0.04 to 0.53). It was concluded that there was a low level of satisfaction with the quality of care received by hospitalized patients and this was associated with the level of education and type of hospital department. PMID:26338391

  1. [Satisfaction of hospitalized patients in a hospital in Apurimac, Peru].

    Science.gov (United States)

    Sihuin-Tapia, Elsa Yudy; Gómez-Quispe, Oscar Elisban; Ibáñez-Quispe, Vladimiro

    2015-01-01

    In order to determine the satisfaction of hospitalized patients in the Sub-regional Hospital of Andahuaylas, 175 patients were surveyed using the Servqual multidimensional model. The estimate of variables associated with the satisfaction of the hospitalized patients was performed by using bivariate and multivariate logistic regression analysis. We found 25.0% satisfaction. Lower levels of satisfaction were associated with having a secondary level education (aOR: 0.05; 95% CI: 0.01 to 0.64) and with having been hospitalized in the surgery department (aOR 0.14, CI: 95%: 0.04 to 0.53). It was concluded that there was a low level of satisfaction with the quality of care received by hospitalized patients and this was associated with the level of education and type of hospital department.

  2. 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.

  3. 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

  4. Hospital antibiogram: A necessity

    Directory of Open Access Journals (Sweden)

    Joshi S

    2010-01-01

    Full Text Available The hospital antibiogram is a periodic summary of antimicrobial susceptibilities of local bacterial isolates submitted to the hospital′s clinical microbiology laboratory. Antibiograms are often used by clinicians to assess local susceptibility rates, as an aid in selecting empiric antibiotic therapy, and in monitoring resistance trends over time within an institution. Antibiograms can also used to compare susceptibility rates across institutions and track resistance trends. Some hospitals have adequate support from the computer department to be able to extract data from their reporting module. The WHONET software can be freely downloaded and used for analysis. Consensus guidelines have been developed by the Clinical and Laboratory Standards Institute (CLSI to standardise methods used in constructing antibiograms. These guidelines can be incorporated into the WHONET software for analysis. Only the first isolate from the patient is to be included in the analysis. The analysis should be done on the basis of patient location and specimen type. The percentage susceptibility of the most frequently isolated bacteria should be presented in the antibiogram, preferably in a tabular form. The antibiogram must be printed or put up in the intranet for easy access to all clinicians. Antibiotic policy is one of the mandatory requirements for accreditation, and making an antibiogram is the first step before framing the antibiotic policy. The future of antibiograms would be the incorporation of patient related data to make information more reliable and for predicting outbreaks.

  5. Electronic Cigarettes on Hospital Campuses.

    Science.gov (United States)

    Meernik, Clare; Baker, Hannah M; Paci, Karina; Fischer-Brown, Isaiah; Dunlap, Daniel; Goldstein, Adam O

    2015-12-29

    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.

  6. 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.

  7. Structural determinants of hospital closure.

    Science.gov (United States)

    Longo, D R; Chase, G A

    1984-05-01

    In a retrospective case-control study, structural characteristics of hospitals that closed during the years 1976-1980 were contrasted with three comparison groups: hospitals that were acquired in a merger; hospitals that joined a multihospital system; and hospitals that remained autonomously opened, to investigate these characteristics as predictors of closure. Characteristics investigated included environmental, structural, and process variables. The independent variables were measured 5 years prior to outcome. Findings indicate that closed hospitals resemble hospitals acquired in a merger ("failure"), and likewise autonomous hospitals resemble hospitals that join a multihospital system ("success"). The most important predictors of hospital failure were the physician-to-population ratio, the East North Central and West North Central census regions, the level of diversification, low occupancy rate, location in a standard metropolitan statistical area, the chief executive officer's lack of affiliation in the American College of Hospital Administrators, profit status, bed size of less than 50, and presence in a state with a rate-setting agency. Surprisingly, this study shows the bed-to-population ratio to be unrelated to closure. In addition, the findings strongly support the open-system perspective, which, unlike the closed-system perspective, is concerned with the vulnerability of the organization to the uncontrollable and often unpredictable influences of the environment.

  8. 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...

  9. Total quality in acute care hospitals: guidelines for hospital managers.

    Science.gov (United States)

    Holthof, B

    1991-08-01

    Quality improvement can not focus exclusively on peer review and the scientific evaluation of medical care processes. These essential elements have to be complemented with a focus on individual patient needs and preferences. Only then will hospitals create the competitive advantage needed to survive in an increasingly market-driven hospital industry. Hospital managers can identify these patients' needs by 'living the patient experience' and should then set the hospital's quality objectives according to its target patients and their needs. Excellent quality program design, however, is not sufficient. Successful implementation of a quality improvement program further requires fundamental changes in pivotal jobholders' behavior and mindset and in the supporting organizational design elements.

  10. 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.

  11. 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

  12. Organizing for the Collaborative Hospital

    DEFF Research Database (Denmark)

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

    To meet demands for high quality and efficient care, hospitals increasingly organize horizontally around standardized processes (like lean and care pathways) and/or set-up formal structural arrangements such as using performance boards, having daily huddles or assigning specific roles. This trend...... 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...

  13. Union Density and Hospital Outcomes.

    Science.gov (United States)

    Koys, Daniel J; Martin, Wm Marty; LaVan, Helen; Katz, Marsha

    2015-01-01

    The authors address the hospital outcomes of patient satisfaction, healthcare quality, and net income per bed. They define union density as the percentage of a hospital's employees who are in unions, healthcare quality as its 30-day acute myocardial infraction (AMI; heart attack) mortality rate, and patient satisfaction as its overall Hospital Consumer Assessment of Healthcare Providers and Systems score. Using a random sample of 84 union and 84 nonunion hospitals from across the United States, multiple regression analyses show that union density is negatively related to patient satisfaction. Union density is not related to healthcare quality as measured by the AMI mortality rate or to net income per bed. This implies that unions per se are not good or bad for hospitals. The authors suggest that it is better for hospital administrators to take a Balanced Scorecard approach and be concerned about employee satisfaction, patient satisfaction, healthcare quality, and net income. PMID:26652043

  14. Does outsourcing affect hospital profitability?

    Science.gov (United States)

    Danvers, Kreag; Nikolov, Pavel

    2010-01-01

    Organizations outsource non-core service functions to achieve cost reductions and strategic benefits, both of which can impact profitability performance. This article examines relations between managerial outsourcing decisions and profitability for a multi-state sample of non-profit hospitals, across 16 states and four regions of the United States. Overall regression results indicate that outsourcing does not necessarily improve hospital profitability. In addition, we identify no profitability impact from outsourcing for urban hospitals, but somewhat positive effects for teaching hospitals. Our regional analysis suggests that hospitals located in the Midwest maintain positive profitability effects with outsourcing, but those located in the South realize negative effects. These findings have implications for cost reduction efforts and the financial viability of non-profit hospitals.

  15. 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.

  16. 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

  17. 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.

  18. Organizational design and hospital performance

    OpenAIRE

    Creteur, Muriel; POCHET, Yves

    2002-01-01

    This paper is only one part of a larger research that aims at modeling the relationship between organizational design and hospital performance. This research is related to the changing context of hospital payment systems. We observe the generalization of either prospective payment systems or more controlled retrospective payment systems. We want to analyze whether or not the traditional structure of hospitals is still appropriate by analyzing the existing literature in a single global model. ...

  19. 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...

  20. 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 ...

  1. 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.

  2. 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

  3. 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 ...

  4. 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

  5. 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.

  6. The Yekaterinburg headache initiative

    DEFF Research Database (Denmark)

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

    2013-01-01

    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...... 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 initiative...

  7. 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

  8. 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.

  9. Rediscovering university teaching hospitals for Australia.

    Science.gov (United States)

    Penington, David G

    2008-09-15

    Partnership between research and health services has a long history in other countries, but has been relatively recent in Australia, with several models arising in the 1960s and 1970s as research-based specialties developed. Since the implementation of Medibank, which became Medicare, Australian Health Care Agreements have been primarily crafted on the basis of transactional numbers, ignoring the need for links with teaching and research and the need to implement new developments. Education and research have been seen as the responsibility of the federal government, and hospitals are progressively less recognised or funded for these functions by the states. Australia's teaching hospitals are in danger of falling seriously behind those in other countries and losing their capacity to monitor quality, to innovate and to branch into new strategies in partnership with primary care services. We should look at initiatives in other countries such as the United Kingdom and Canada, which are making big strides in tackling similar issues. University hospitals hold the key, if appropriately linked with other services. The current Australian Health Care Agreements are on hold. A new agency is needed to support clinical and service-related research, with a new structure and track for federal government funding, and providing oversight of research and development, of clinical governance and quality of outcomes in health care, linked with new strategies for prevention and treatment. A component of the foreshadowed additional federal government funding for health should be sequestered to set up such an agency. PMID:18803539

  10. 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...

  11. 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...

  12. 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.

  13. RAS Initiative - Events

    Science.gov (United States)

    The NCI RAS Initiative has organized multiple events with outside experts to discuss how the latest scientific and technological breakthroughs can be applied to discover vulnerabilities in RAS-driven cancers.

  14. 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...

  15. 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....

  16. 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

  17. 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

  18. 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.

  19. Longitudinal analysis on the development of hospital quality management systems in the Netherlands.

    NARCIS (Netherlands)

    Dückers, M.; Makai, P.; Vos, L.; Groenewegen, P.; Wagner, C.

    2009-01-01

    OBJECTIVE: Many changes have been initiated in the Dutch hospital sector to optimize health-care delivery: national agenda-setting, increased competition and transparency, a new system of hospital reimbursement based on diagnosis-treatment combinations, intensified monitoring of quality and a multi-

  20. Changing hospital care: evaluation of a multi-layered organisational development and quality improvement programme

    NARCIS (Netherlands)

    Dückers, M.L.A

    2009-01-01

    In the last decades many different policy changes have been initiated in the Dutch hospital sector to optimise health care delivery: national agenda-setting, increased competition and transparency, a new system of hospital reimbursement based on diagnosis-treatment-combinations, intensified monitori

  1. 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

  2. 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.

  3. 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

  4. 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.

  5. 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

  6. 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...

  7. 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, ...

  8. 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…

  9. 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…

  10. 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....

  11. 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)

  12. 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.

  13. Hospitality Management Education and Training.

    Science.gov (United States)

    Brotherton, Bob, Ed.; And Others

    1995-01-01

    Seven articles on hospitality management training discuss the following: computerized management games for restaurant manager training, work placement, real-life exercises, management information systems in hospitality degree programs, modular programming, service quality concepts in the curriculum, and General National Vocational Qualifications…

  14. [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.

  15. [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

  16. 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

  17. 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.

  18. 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...

  19. National hospital development, 1948-2000: The WHO as an international propagator

    DEFF Research Database (Denmark)

    Malmmose, Margit

    2015-01-01

    This study investigates the role of hospitals in the interrelation between the World Health Organization (WHO) and Anglo-Saxon health initiatives prior to and during the New Public Management wave. The analysis is undertaken according to a discursive, governmentality framework. The results find......-war nationalisation, hospitals have come to play a dominant role in the set-up of governmental health infrastructure, and are formed by political and legal reform initiatives mobilised through calculative practices....

  20. 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...

  1. 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...

  2. Measuring nutritional risk in hospitals

    Directory of Open Access Journals (Sweden)

    Henrik H Rasmussen

    2010-09-01

    Full Text Available Henrik H Rasmussen1,2, Mette Holst3, Jens Kondrup41Centre for Nutrition and Bowel Disease, Department of Medical Gastroenterology, Aarhus University Hospital, Aalborg, Denmark; 2Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark; 3Centre for Nutrition and Bowel Disease, Aarhus University Hospital, Aalborg, Denmark; 4Department of Human Nutrition, Faculty of Life Sciences, University of Copenhagen, Clinical Nutrition Unit, Rigshospitalet University Hospital, Copenhagen, DenmarkAbstract: About 20%–50% of patients in hospitals are undernourished. The number varies depending on the screening tool amended and clinical setting. A large number of these patients are undernourished when admitted to the hospital, and in most of these patients, undernutrition develops further during hospital stay. The nutrition course of the patient starts by nutritional screening and is linked to the prescription of a nutrition plan and monitoring. The purpose of nutritional screening is to predict the probability of a better or worse outcome due to nutritional factors and whether nutritional treatment is likely to influence this. Most screening tools address four basic questions: recent weight loss, recent food intake, current body mass index, and disease severity. Some screening tools, moreover, include other measurements for predicting the risk of malnutrition. The usefulness of screening methods recommended is based on the aspects of predictive validity, content validity, reliability, and practicability. Various tools are recommended depending on the setting, ie, in the community, in the hospital, and among elderly in institutions. The Nutrition Risk Screening (NRS 2002 seems to be the best validated screening tool, in terms of predictive validity ie, the clinical outcome improves when patients identified to be at risk are treated. For adult patients in hospital, thus, the NRS 2002 is recommended.Keywords: nutritional risk screening

  3. 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

  4. Initial conditions for inflation

    CERN Document Server

    Dimopoulos, Konstantinos

    2016-01-01

    A novel proposal is presented, which manages to overcome the initial conditions problem of inflation with a plateau. An earlier period of proto-inflation, beginning at Planck scale, accounts for the Universe expansion and arranges the required initial conditions for inflation on the plateu to commence. We show that, if proto-inflation is power-law, it does not suffer from any eternal inflationary stage. A simple model realisation is constructed in the context of $\\alpha$-attractors, which can both generate the inflationary plateau and the exponential slopes around it, necessary for the two inflation stages. Our mechanism allows to assume chaotic initial conditions at the Planck scale for proto-inflation, it is generic and it is shown to work without fine-tunings.

  5. 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

  6. Win-win initiatives

    Energy Technology Data Exchange (ETDEWEB)

    Specter, Herschel

    1999-03-01

    This paper explores the use of win-win initiatives as a means of making safety improvements while simultaneously reducing plant operating costs. A two-phased process for implementing these initiatives is provided. Near-term progress is emphasized in the first phase by using presently available information. The second phase addresses complex issues such as closure in the regulatory process, modernizing the role of determinism in decisionmaking, closer coupling of performance-based regulation and risk-informed regulation, modernizing the testing of important plant equipment, and the treatment of uncertainties.

  7. Measuring LEED–NC applicability in design for hospitality

    Directory of Open Access Journals (Sweden)

    Teresa Marie Cracknell

    2015-12-01

    Full Text Available Mounting awareness of climate change in recent years has led the construction industry to initiate new approaches toward sustainable building design, yet stakeholders in hospitality development still hesitate to build green. This reluctance is due to perceived high guest expectations of comfort levels and amenity access among these properties. Research was conducted to determine precisely which green building innovations present the most significant barriers to incorporating sustainability into design for hospitality. Average LEED credit implementation rates among 28 existing LEED hotel projects were calculated and compared with average credits employed among common commercial building projects. 15 of those projects’ designers also offered survey opinions on which sustainable innovations were most commonly avoided in their approaches for hospitality. The results indicate that certain credits do experience decreased popularity among hospitality projects, yet guest comfort was not the only barrier identified. Cost of implementation and local applicability affected by climate and local bylaws were also found as major role players in the selection of credits specific to hospitality design. Conclusions are presented according to the data and recommendations made to support further growth and success in future applications of LEED sustainable design in hospitality.

  8. 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

  9. Best Practices & Outstanding Initiatives

    Science.gov (United States)

    Training, 2011

    2011-01-01

    In this article, "Training" editors recognize innovative and successful learning and development programs and practices. They share best practices from Automatic Data Processing, Inc., Farmers Insurance Group, FedEx Express, InterContinental Hotels Group, and Oakwood Temporary Housing. They also present the outstanding initiatives of EMD Serono,…

  10. 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 a...

  11. 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...

  12. 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.

  13. 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…

  14. 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...

  15. Martyrs of the psychiatric hospitals

    Directory of Open Access Journals (Sweden)

    Serra Paolo

    2013-01-01

    Full Text Available This article is based on the history of an Italian psychiatric hospital (Arezzo that closed in 1989 and was turned into a university. The illegal and inhumane treatment in asylum-type institutions is condemned. In particular the treatment of those patients who, according to the analysis, hospital directors referred to as “social cases.” These individuals did not stay in hospital because of health problems but only due to the lack of social care by the state. AS a consequence they are condemned to be “prisoners” without committing any crimes.

  16. Trends affecting hospitals' human resources.

    Science.gov (United States)

    Neudeck, M M

    1985-01-01

    Hospital workers at every level--from administrators to housekeepers--will be affected by the interaction of changes already underway in the healthcare industry. Societal forces that will affect the hospital workforce include demographic change, the rise of the participatory ethic and decentralization, a growing philosophy of job entitlement, and new pressures for unionization. At the same time, the industry is faced with changing manpower requirements, cost containment, and the oversupply of physicians. This article identifies some of the likely effects of these changes on hospital human resources and suggests ways that administrators can prepare for them.

  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...... 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. 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...

  19. A Decomposition of Hospital Profitability

    Directory of Open Access Journals (Sweden)

    Jason Turner

    2015-06-01

    Full Text Available Objectives: This paper evaluates the drivers of profitability for a large sample of U.S. hospitals. Following a methodology frequently used by financial analysts, we use a DuPont analysis as a framework to evaluate the quality of earnings. By decomposing returns on equity (ROE into profit margin, total asset turnover, and capital structure, the DuPont analysis reveals what drives overall profitability. Methods: Profit margin, the efficiency with which services are rendered (total asset turnover, and capital structure is calculated for 3,255 U.S. hospitals between 2007 and 2012 using data from the Centers for Medicare & Medicaid Services’ Healthcare Cost Report Information System (CMS Form 2552. The sample is then stratified by ownership, size, system affiliation, teaching status, critical access designation, and urban or non-urban location. Those hospital characteristics and interaction terms are then regressed (OLS against the ROE and the respective DuPont components. Sensitivity to regression methodology is also investigated using a seemingly unrelated regression. Results: When the sample is stratified by hospital characteristics, the results indicate investor-owned hospitals have higher profit margins, higher efficiency, and are substantially more leveraged. Hospitals in systems are found to have higher ROE, margins, and efficiency but are associated with less leverage. In addition, a number of important and significant interactions between teaching status, ownership, location, critical access designation, and inclusion in a system are documented. Many of the significant relationships, most notably not-for-profit ownership, lose significance or are predominately associated with one interaction effect when interaction terms are introduced as explanatory variables. Results are not sensitive to the alternative methodology. Conclusion: The results of the DuPont analysis suggest that although there appears to be convergence in the behavior of

  20. Energy audits at 48 hospitals

    Science.gov (United States)

    Hirst, E.

    1981-11-01

    Staff at the Oak Ridge Associated Universities (ORAU) conducted energy audits at 48 hospitals in four states (New York, Pennsylvania, Virginia, Tennessee) between 1978 and 1980. Staff at the Oak Ridge National Laboratory (ORNL) and ORAU developed and organized a computerized data base containing information from these audits. This paper describes the ORAU audit process; summarizes the data collected from these audits on hospital characteristics annual energy use, and the audit recommendations; and analyzes the audit data in terms of cost effectiveness, type of recommendations, and the relationship between potential energy saving and characteristics of the individual hospital.

  1. 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.

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

    Science.gov (United States)

    Ford, Nathan; Matteelli, Alberto; Shubber, Zara; Hermans, Sabine; Meintjes, Graeme; Grinsztejn, Beatriz; Waldrop, Greer; Kranzer, Katharina; Doherty, Meg; Getahun, Haileyesus

    2016-01-01

    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. PMID:26765347

  3. In-hospital Cardiac Arrest at Cork University Hospital.

    Science.gov (United States)

    O'Sullivan, E; Deasy, C

    2016-01-01

    We describe the incidence and outcomes of in-hospital cardiac arrest (IHCA) at Cork University Hospital over a one year time period (2011), prior to the implementation of national early warning scoring (NEWS) systems. There were 43 217 coded CUH admissions, in 2011, to 518 in-patient beds. The Hospital In-Patient Enquiry Database was used to identify adults (>/= 18 years) who sustained IHCA. Available Utstein variables were collected. Fifty-two patients were found to be incorrectly coded IHCA. 17 of 63 (27.0%) IHCA survived to discharge. IHCA with shockable rhythm had significantly higher survival. IHCA survival was significantly lower on wards versus any other hospital location. Median days of stay prior to arrest were significantly different between survivors and non-survivors. All survivors (n = 17) had intact neurological outcome post-event. Our outcomes from IHCA are poorest on hospital wards when compared to other areas of the hospital. Those that survive have excellent function and one-year survival.

  4. 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

  5. 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

  6. 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...

  7. 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 ...

  8. 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...

  9. 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...... 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...

  10. Usability Briefing for hospital design

    DEFF Research Database (Denmark)

    Fronczek-Munter, Aneta

    This PhD thesis is a contribution to an ongoing debate in Denmark about improving the building design processes of complex buildings, especially in relation to the current hospital developments. It provides knowledge about capturing user needs and defines the process model for usability briefing...... for hospital architecture from a user perspective. The thesis is based on comprehensive literature studies, three main case studies at hospitals,numerous expert interviews and workshops. The research results generate a better understanding of how knowledge about user needs, acquired from workshops...... participatory design, where users are seen as partners and co-creators, and where innovation and design are not done ‘for’ users, but‘with‘ or ‘by’ users. Research results from the presented hospital cases demonstrate that user-driven innovation is possible even in the hierarchic and technically advanced...

  11. 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 still rather...

  12. 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

  13. 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.

  14. 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.

  15. 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...

  16. 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...

  17. 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...

  18. 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...

  19. 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...

  20. 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...

  1. 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.

  2. 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...

  3. Facility management in German hospitals.

    Science.gov (United States)

    Gudat, H

    2000-04-01

    Facility management and optimum building management offer for hospitals a chance to reduce costs and to increase quality, process sequences, employee motivation and customer satisfaction. Some years ago simple services such as cleaning, catering or laundry were outsourced. Now, German hospitals progress to more complex fields such as building and medical technology, clinical support processes such as pharmacy, central laboratory and sterilization, goods and logistics services. PMID:11066999

  4. 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

  5. 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.

  6. Hospital diversification and financial management.

    Science.gov (United States)

    Eastaugh, S R

    1984-08-01

    Hospital diversification and its impact on the operating ratio are studied for 62 New York hospitals during the period 1974-1979. Diversification and operating ratio are modeled in a two-stage least squares (TSLS) framework as being jointly dependent. Institutional diversification is found to yield better financial position, and the better operating ratio allows the institution the wherewithal to diversify. The impact of external government planning and hospital competition are also measured. An institution life cycle hypothesis is advanced to explain hospital behavior: boom and bust, diversification and divestiture, occasionally leading to closure or merger. These results should not be generalized beyond the New York State context. Restructuring of the organization, unrelated business ventures, and transactions with related organizations were not a problem in this sample. However, in 1983, many a new corporation is set up whose revenues do not become part of the hospital's and whose complex transactions conceal unallowable costs and maximize reimbursement. A number of hypotheses are advanced concerning hospital administrator's attitude toward risk.

  7. 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.

  8. Candiduria in Hospitalized Patients in Teaching Hospitals of Ahvaz

    Directory of Open Access Journals (Sweden)

    Ali Zarei Mahmoudabadi

    2012-12-01

    Full Text Available Background and Objectives: Nosocomial infections are usually acquired during hospitalization. Fungal infection of the urinary tract is increasing due to predisposing factors such as; antibacterial agents, indwelling urinary catheters, diabetes mellitus, long hospitalization, immunosuppressive agents, use of IV catheters, radiation therapy, malignancy. The aim of our study was to determine the prevalence of candiduria and urinary tract infection in patients admitted in Golestan and Emam Khomeini hospitals of Ahvaz, Iran.Materials and Methods: During 14 months, a total of 744 urine samples were collected and transferred to medical mycology laboratory immediately. Ten μl of uncentrifuged sample was cultured on CHROM agar Candida plates and incubated at 37°C for 24-48h aerobically. Candida species were identified based on colony morphology on CHROM agar Candida, germ tube production and micro-morphology on corn meal agar including 1% Tween 80.Results: In the present study, 744 hospitalized patients were sampled (49.5%, female; 50.5%, male. The prevalence of candiduria in subjects was 16.5% that included 65.1% female and 34.9% male. The most common isolates were C. albicans (53.3%, followed by C. glabrata (24.4%, C. tropicalis (3.7%, C. krusei (2.2%, and Geotrichum spp. (0.7% Urine cultures yielded more than 10,000 yeast colonies in 34.1% of cases, and the major predisposing factor associated with candiduria was antibiotic therapy (69.1%.Conclusion: Candiduria is relatively common in hospitalized patients in educational hospitals of Ahvaz. In addition, there is a strong correlation between the incidence of candiduria in hospitalized patients and broad-spectrum antibiotics therapy.

  9. 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.

  10. 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\

  11. COPD stage and risk of hospitalization for infectious disease

    DEFF Research Database (Denmark)

    Benfield, Thomas; Lange, Peter; Vestbo, Jørgen

    2008-01-01

    , and were followed for up to 25 years. All hospitalizations due to any infection were identified through registry linkage. Impaired lung function was defined according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) staging system. MAIN RESULTS: A total of 3,333 infectious disease...... hospitalizations (IDHs) occurred during 230,653 person-years of follow-up (PY), corresponding to an overall incidence of 145 IDHs (95% confidence interval [CI], 139 to 149) per 10,000 PY. The incidence increased with GOLD stage, from 131 (95% CI, 126 to 136) for normal COPD, to 170 (95% CI, 146 to 193) for mild......, or other infectious diseases. CONCLUSIONS: The presence of obstructive lung disease is a significant predictor of IDH caused by respiratory tract infections, but not of hospitalizations due to infections outside the respiratory system....

  12. TQM implementation strategies in hospitals: an empirical perspective.

    Science.gov (United States)

    Bringelson, L S; Basappa, L S

    1998-01-01

    This article reports an analysis of the effectiveness of Total Quality Management (TQM) programs. The objective of the study was gain a better understanding of how hospitals implement TQM and quality improvement initiatives. Results show that some hospital staffs have not realized that they are implementing TQM, even though they report to be using the strategies for quality improvement. On the other hand, some hospitals said that they were involved in quality programs, though not practically implementing TQM strategies. These results suggest two major conclusions about the implementation of TQM programs. First, data indicate that TQM programs may not be as effective as promised, due to a lack of understanding about TQM by the people within the organization. Second, implementation strategies that are statistically correlated are identified. These conclusions may be helpful for successful TQM implementation in from healthcare organizations as well as other service industries.

  13. Quality Improvement in Hospitals: Identifying and Understanding Behaviors

    Directory of Open Access Journals (Sweden)

    Lukasz M. Mazur

    2012-01-01

    Full Text Available Improving operational performance in hospitals is complicated, particularly if process improvement requires complex behavioral changes. Using single-loop and double-loop learning theory as a foundation, the purpose of this research is to empirically uncover key improvement behaviors and the factors that may be associated with such behaviors in hospitals. A two-phased approach was taken to collect data regarding improvement behaviors and associated factors, and data analysis was conducted using methods proposed by grounded theorists. The contributions of this research are twofold. First, five key behaviors related to process improvement are identified, namely Quick Fixing, Initiating, Conforming, Expediting, and Enhancing. Second, based on these observed behaviors, a set of force field diagrams is developed to structure and organize possible factors that are important to consider when attempting to change improvement behaviors. This begins to fill the gap in the knowledge about what factors drive effective improvement efforts in hospital settings.

  14. 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.

  15. 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.

  16. 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.

  17. 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.

  18. 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...

  19. Hospital Acquired Pneumonia: Issues in Therapy

    Directory of Open Access Journals (Sweden)

    Lionel A Mandell

    1994-01-01

    Full Text Available In December 1992. a meeting was convened in Toronto to develop guidelines for the initial treatment of hospital acquired pneumonia. Issues considered related lo the patient. the possible drugs used for treatment, and the pathogen(s. From the perspective of the patient. the two major issues were the presence or absence of risk factors for specific microbial pathogens and the severity of illness upon clinical presentation, Criteria for defining severly ill patients were developed and are presented in this paper. Drug and pathogen related issues focused on selection of antimicrobial agents thal would provide coverage for the likely pathogens. Concern was also expressed regarding use of aminoglycosides as single-agent treatment of Gram-negative infections in the lung. and the issue of monotherapy versus combination therapy of Pseudomonas aeruginosa infections was discussed. The use of various diagnostic tests was briefly reviewed. including the protected specimen brush and bronchoalveolar lavage. Treatment regimens are presented in tabular format.

  20. Refeeding syndrome in hospitalized pediatric patients.

    Science.gov (United States)

    Dunn, Rebecca L; Stettler, Nicolas; Mascarenhas, Maria R

    2003-08-01

    Refeeding syndrome has been well documented over the years, primarily through case reports and literature reviews. Awareness of refeeding syndrome is crucial in preventing the occurrence of, and the metabolic and physiologic complications associated with, aggressive nutrition support in malnourished populations. Once compromised patients have been identified to be at risk of refeeding syndrome, nutrition rehabilitation should be cautiously initiated. We have found a lack of clinical validation for instituting nutrition support in high-risk pediatric patients who may develop refeeding syndrome. The purposes of our investigation were to determine the incidence of refeeding syndrome in pediatric hospitalized patients beginning on parenteral nutrition and to determine how consistently the Department of Clinical Nutrition standards of care for screening and prevention were followed at our institution.

  1. 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...

  2. 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...

  3. 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.

  4. 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.

  5. 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.

  6. 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.

  7. UNLV Nuclear Hydrogen Initiative

    Energy Technology Data Exchange (ETDEWEB)

    Hechanova, Anthony E.; Johnson, Allen; O' Toole, Brendan; Trabia, Mohamed; Peterson, Per

    2012-10-25

    Evaluation of the Crack growth rate (CGR) of Alloy 617 and Alloy 276 under constant K at ambient temperature has been completed. Creep deformation of Alloy 230 at different temperature range and load level has been completed and heat to heat variation has been noticed. Creep deformation study of Alloy 276 has been completed under an applied initial stress level of 10% of yield stress at 950ºC. The grain size evaluation of the tested creep specimens of Alloy 276 has been completed.

  8. 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

  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. 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.

  11. 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

  12. 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...

  13. Predictors of inhospital mortality and re-hospitalization in older adults with community-acquired pneumonia: a prospective cohort study

    Directory of Open Access Journals (Sweden)

    Marrie Tom

    2010-05-01

    Full Text Available Abstract Background A better understanding of potentially modifiable predictors of in-hospital mortality and re-admission to the hospital following discharge may help to improve management of community-acquired pneumonia in older adults. We aimed to assess the associations of potentially modifiable factors with mortality and re-hospitalization in older adults hospitalized with community-acquired pneumonia. Methods A prospective cohort study was conducted from July 2003 to April 2005 in two Canadian cities. Patients aged 65 years or older hospitalized for community-acquired pneumonia were followed up for up to 30 days from initial hospitalization for mortality and these patients who were discharged alive within 30 days of initial hospitalization were followed up to 90 days of initial hospitalization for re-hospitalization. Separate logistic regression analyses were performed identify the predictors of mortality and re-hospitalization. Results Of 717 enrolled patients hospitalized for community-acquired pneumonia, 49 (6.8% died within 30 days of hospital admission. Among these patients, 526 were discharged alive within 30 days of hospitalization of whom 58 (11.2% were re-hospitalized within 90 days of initial hospitalization. History of hip fracture (odds ratio (OR = 4.00, 95% confidence interval (CI = (1.46, 10.96, P = .007, chronic obstructive pulmonary disease (OR = 2.31, 95% CI = (1.18, 4.50, P = .014, cerebrovascular disease (OR = 2.11, 95% CI = (1.03, 4.31, P = .040 were associated with mortality. Male sex (OR = 2.35, 95% CI = (1.13, 4.85, P = .022 was associated with re-hospitalization while vitamin E supplementation was protective (OR = 0.37 (0.16, 0.90, P = .028. Lower socioeconomic status, prior influenza and pneumococcal vaccinations, appropriate antibiotic prescription upon admission, and lower nutrition risk were not significantly associated with mortality or re-hospitalization. Conclusion Chronic comorbidities appear to be the most

  14. 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

  15. 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…

  16. Hyperoxia Early After Hospital Admission in Comatose Patients with Non-Traumatic Out-of-Hospital Cardiac Arrest

    Science.gov (United States)

    Christ, Martin; von Auenmueller, Katharina Isabel; Brand, Michael; Amirie, Scharbanu; Sasko, Benjamin Michel; Trappe, Hans-Joachim

    2016-01-01

    Background The clinical effect of hyperoxia in patients with non-traumatic out-of-hospital cardiac arrest (OHCA) remains uncertain. We therefore initiated this study to find out whether there is an association between survival and hyperoxia early after return of spontaneous circulation (ROSC) in OHCA patients admitted to our hospital. Material/Methods All OHCA patients admitted to our hospital between 1 January 2008 and 30 June 2015 were identified by analysis of our central admission register. Data from individual patients were collected from patient health records and anonymously stored on a central database. Results Altogether, there were 280 OHCA patients admitted to our hospital between 1 January 2008 and 30 June 2015, including 35 patients (12.5%) with hyperoxia and 99 patients (35.4%) with normoxia. Comparison of these 2 groups showed lower pH values in OHCA patients admitted with normoxia compared to those with hyperoxia (7.10±0.18 vs. 7.21±0.17; p=0.001) but similar rates of initial lactate (7.92±3.87 mmol/l vs. 11.14±16.40 mmol/l; p=0.072). Survival rates differed between both groups (34.4% vs. 54.3%; p=0.038) with better survival rates in OHCA patients with hyperoxia at hospital admission. Conclusions Currently, different criteria are used to define hyperoxia following OHCA, but if the negative effects of hyperoxia in OHCA patients are a cumulative effect over time, hyperoxia < 60 min after hospital admission as investigated in this study would be equivalent to a short period of hyperoxia. It may be that the positive effect of buffering metabolic acidosis early after cardiac arrest maintains the negative effects of hyperoxia in general. PMID:27638399

  17. 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

  18. Global cancer research initiative

    Directory of Open Access Journals (Sweden)

    Richard R Love

    2010-05-01

    Full Text Available Richard R LoveThe Ohio State University Comprehensive Cancer Center, Columbus, OH, USAAbstract: Cancer is an increasing problem for low- and middle-income countries undergoing an epidemiologic transition from dominantly acute communicable disease to more frequent chronic disease with increased public health successes in the former domain. Progress against cancer in high-income countries has been modest and has come at enormous expense. There are several well-conceived global policy and planning initiatives which, with adequate political will, can favorably impact the growing global cancer challenges. Most financial resources for cancer, however, are spent on diagnosis and management of patients with disease in circumstances where specific knowledge about effective approaches is significantly limited, and the majority of interventions, other than surgery, are not cost-effective in resource-limited countries by global standards. In summary, how to intervene effectively on a global scale for the majority of citizens who develop cancer is poorly defined. In contrast to technology-transfer approaches, markedly increased clinical research activities are more likely to benefit cancer sufferers. In these contexts, a global cancer research initiative is proposed, and mechanisms for realizing such an effort are suggested.Keywords: breast cancer, research, global, international, low-income, middle-income

  19. 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.

  20. 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.

  1. 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

  2. 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

  3. 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.

  4. [Involuntary hospitalization and treatment: the interface between psychiatry and law].

    Science.gov (United States)

    Zemishlany, Zvi

    2007-08-01

    Involuntary or compulsory hospitalization and treatment of mentally ill patients is one of the most distressing societal needs. The decision to hospitalize or treat an individual involuntarily must balance between three ethical issues: the patient's right to receive medical care, the patient's personal rights to liberty and dignity, and the protection of the public. The psychiatrist is concerned with the need for medical treatment, while the courts follow the letter of the law in order to ensure protection of the individual's rights, as well as those of the public. The interaction between the psychiatric (or medical) discipline and the judicial discipline comprises inherent difficulties, due to these differences in focus of concern and due to the differences in the language they use. In the civil compulsory hospitalization, it is the definition and prediction of dangerousness that comprises a potential discourse and misunderstanding between the psychiatric and the judicial system. It seems that both systems, as well as the patients, may benefit if the initial decision to hospitalize involuntarily is taken by the medical representatives (the District Psychiatrist, Hospital Director, three physicians, etc.) as an emergency procedure. The decision to continue the involuntary hospitalization should be taken by a judicial representative (or a committee), based on the psychiatric evaluation, within 72 hours instead of the 14 days as is currently stated in the Mental Health Law. The less restrictive alternative to hospitalization, compulsory outpatient treatment, is still controversial. This is an order "with no bite" and its implementation is determined, in effect, by the patient's goodwill and cooperation. There are no legal or other consequences for patients who do not comply with the outpatient treatment order. This is true for both civil and criminal outpatient orders. Without legal sanctions this model of outpatient treatment is not really "compulsory" and does not

  5. 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

  6. 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.

  7. Management of Hyperglycemia and Enteral Nutrition in the Hospitalized Patient.

    Science.gov (United States)

    Davidson, Patricia; Kwiatkowski, Cynthia Ann; Wien, Michelle

    2015-10-01

    There has been increased attention on the importance of identifying and distinguishing the differences between stress-induced hyperglycemia (SH), newly diagnosed hyperglycemia (NDH), and hyperglycemia in persons with established diabetes mellitus (DM). Inpatient blood glucose control is now being recognized as not only a cost issue for hospitals but also a concern for patient safety and care. The reasons for the increased incidence of hyperglycemia in hospitalized patients include preexisting DM, undiagnosed DM or prediabetes, SH, and medication-induced hyperglycemia with resulting transient blood glucose variability. It is clear that identifying and documenting hyperglycemia in hospitalized patients with and without a previous diagnosis of DM and initiating prompt insulin treatment are important. Agreement on the optimum treatment goals for hyperglycemia remains quite controversial, and the benefits of intensive glucose management may be lost at the cost of hypoglycemia in intensive care unit patients. Nutrition support in the form of enteral nutrition (EN) increases the risk of hyperglycemia in both critical and non-critically ill hospitalized patients. Reasons for beginning a tube feeding are the same whether a person has NDH or DM. What differs is how to incorporate EN into the established insulin management protocols. The risk for hyperglycemia with the addition of EN is even higher in those without a previous diagnosis of DM. This review discusses the incidence of hyperglycemia, the pathogenesis of hyperglycemia, factors contributing to hyperglycemia in the hospitalized patient, glycemic management goals, current glycemic management recommendations, and considerations for EN formula selection, administration, and treatment.

  8. Stress and the effects of hospital restructuring in nurses.

    Science.gov (United States)

    Greenglass, E R; Burke, R J

    2001-09-01

    This study examines the extent of stress and burnout experienced by nurses during hospital restructuring. It includes both job-related outcomes such as job satisfaction and burnout, and psychosomatic outcomes such as depression. The study compares effects attributable to number of hospital restructuring initiatives with those attributable to specific work stressors such as workload, bumping (where one nurse replaces another due to greater seniority), and use of unlicensed personnel to do the work of nurses. It also examines the role of personal resources including self-efficacy and coping. Results show that, in hospitals undergoing restructuring, workload is the most significant and consistent predictor of distress in nurses, as manifested in lower job satisfaction, professional efficacy, and job security. Greater workload also contributed to depression, cynicism, and anxiety. The practice of bumping contributed to job insecurity, depression, and anxiety. The results point to specific deleterious effects of hospital restructuring. Implications of the findings are discussed. The extent to which workload issues are managed through appropriate practices can be expected to match the extent of nurses' experience of either job satisfaction or depression and anxiety. Such practices need to be part of an ongoing process of interaction between the hospital administration and nurses. PMID:11928340

  9. 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...

  10. 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.

  11. Light Therapy in Mental Hospitals.

    Science.gov (United States)

    Cormac, H D

    1929-02-01

    The position of actinotherapy in Mental Hospitals in this country is reviewed. An investigation of the results of ultra-violet irradiation in mental disorders at Parkside Mental Hospital is described and it is shown that certain types of the psychoses appear to benefit. The physiological action of actinic rays in relation to mental disorders is discussed and their mode of action on the nervous system suggested. Reference is made to substances which sensitize the body tissues to sunlight and ultra-violet radiation. An allusion is made to glass, penetrable by a portion of the actinic rays, and its uses. The need for ultra-violet ray apparatus in every mental hospital is urged both for treatment of mental and physical conditions and for the study of its action.

  12. Enterprise resource planning for hospitals.

    Science.gov (United States)

    van Merode, Godefridus G; Groothuis, Siebren; Hasman, Arie

    2004-06-30

    Integrated hospitals need a central planning and control system to plan patients' processes and the required capacity. Given the changes in healthcare one can ask the question what type of information systems can best support these healthcare delivery organizations. We focus in this review on the potential of enterprise resource planning (ERP) systems for healthcare delivery organizations. First ERP systems are explained. An overview is then presented of the characteristics of the planning process in hospital environments. Problems with ERP that are due to the special characteristics of healthcare are presented. The situations in which ERP can or cannot be used are discussed. It is suggested to divide hospitals in a part that is concerned only with deterministic processes and a part that is concerned with non-deterministic processes. ERP can be very useful for planning and controlling the deterministic processes. PMID:15171978

  13. 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...

  14. 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

  15. Instrumented Pipeline Initiative

    Energy Technology Data Exchange (ETDEWEB)

    Thomas Piro; Michael Ream

    2010-07-31

    This report summarizes technical progress achieved during the cooperative agreement between Concurrent Technologies Corporation (CTC) and U.S. Department of Energy to address the need for a for low-cost monitoring and inspection sensor system as identified in the Department of Energy (DOE) National Gas Infrastructure Research & Development (R&D) Delivery Reliability Program Roadmap.. The Instrumented Pipeline Initiative (IPI) achieved the objective by researching technologies for the monitoring of pipeline delivery integrity, through a ubiquitous network of sensors and controllers to detect and diagnose incipient defects, leaks, and failures. This report is organized by tasks as detailed in the Statement of Project Objectives (SOPO). The sections all state the objective and approach before detailing results of work.

  16. The Knowledge Stealing Initiative?

    Science.gov (United States)

    Goshorn, Larry

    2005-01-01

    I have the honor of being on the Academy of Program and Project Leadership (APPL) Knowledge Sharing Feedback and Assessment Team (FAA), and as such, I am privileged to receive the feedback written by many of you as attendees of the Project Management (PM) Master s Forums. It is the intent of the FAA Team and APPL leadership to use this feedback as a tool for continuous program improvement. As a retired (sort of) PM in the payload contracting industry, I'm a big supporter of NASA s Knowledge Sharing Initiative (KSI), especially the Master's Forums. I really enjoy participating in them. Unfortunately I had to miss the 8th forum in Pasadena this past Spring, but I did get the feedback package for the Assessment Team work. So here I was, reviewing twelve pages of comments, reflections, learning notes and critiques from attendees of the 8th forum.

  17. Breckinridge Project, initial effort

    Energy Technology Data Exchange (ETDEWEB)

    None, None

    1982-09-01

    Report III, Volume 1 contains those specifications numbered A through J, as follows: General Specifications (A); Specifications for Pressure Vessels (C); Specifications for Tanks (D); Specifications for Exchangers (E); Specifications for Fired Heaters (F); Specifications for Pumps and Drivers (G); and Specifications for Instrumentation (J). The standard specifications of Bechtel Petroleum Incorporated have been amended as necessary to reflect the specific requirements of the Breckinridge Project, and the more stringent specifications of Ashland Synthetic Fuels, Inc. These standard specifications are available to the Initial Effort (Phase Zero) work performed by all contractors and subcontractors. Report III, Volume 1 also contains the unique specifications prepared for Plants 8, 15, and 27. These specifications will be substantially reviewed during Phase I of the project, and modified as necessary for use during the engineering, procurement, and construction of this project.

  18. The Ombudperson Initiative Group

    CERN Document Server

    Laura Stewart

    Following many discussions that took place at some of the ATLAS Women's Network lunch gatherings, a few ATLAS women joined forces with similarly concerned CERN staff women to form a small group last Fall to discuss the need for a CERN-wide Ombudsperson. This has since evolved into the Ombudsperson Initiative Group (OIG) currently composed of the following members: Barbro Asman, Stockholm University; Pierre Charrue, CERN AB; Anna Cook, CERN IT; Catherine Delamare, CERN and IT Ombudsperson; Paula Eerola, Lund University; Pauline Gagnon, Indiana University; Eugenia Hatziangeli, CERN AB; Doreen Klem, CERN IT; Bertrand Nicquevert, CERN TS and Laura Stewart, CERN AT. On June 12, members of the OIG met with representatives of Human Resources (HR) and the Equal Opportunity Advisory Panel (EOAP) to discuss the proposal drafted by the OIG. The meeting was very positive. Everybody agreed that the current procedures at CERN applicable in the event of conflict required a thorough review, and that a professionnally trai...

  19. [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

  20. Nursing care plan standardized breastfeeding

    Directory of Open Access Journals (Sweden)

    Susana de la Flor Picado

    2013-01-01

    Full Text Available The superiority of human milk in feeding the human infant is incontestable. Breastmilk is a living food can´t be copied and is supported by numerous arguments in support of excellence, both biological and anthropometric or economic. Despite it, has been a significant decline in this practice. Scientific advances, sociological changes and the lack f health personnel have contributed to this expense. Currently, both the WHO and UNICEF cone try relaunching excusive breastfeeding as feeding the infant until 6 months of life. Initiatives whit the Baby Friendly Hospital or the Strategic Plan for the Protection, Promotion and Support of Breastfeeding trying to promote the recognition of breastfeeding as irrefutable cornerstone for optimal growth and development of our children.Goal: Unify care criteria and actions to promote breastfeeding initiation and maintenance of the same, improving communication between professionals and between them and patients.Methodology: Care Development Plan following the NANDA taxonomies, NOC, NIC.Conclusions: Standardized work promotes decision making and performance of nursing staff to develop a happy breastfeeding.

  1. 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.

  2. 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...

  3. 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

  4. 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 ...

  5. 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...

  6. Epidemiology of hospitalized pediatric glaucoma patients in Beijing Tongren Hospital

    Institute of Scientific and Technical Information of China (English)

    QIAO Chun-yan; WANG Liang-hai; TANG Xin; WANG Tao; YANG Di-ya; WANG Ning-li

    2009-01-01

    Background No population-based assessment of the prevalence and incidence of pediatric glaucoma in China are available. Here we describe the spectrum of hospitalized pediatric glaucoma patients in Beijing Tongren Hospital in China.Methods We reviewed the charts of pediatric patients, from birth to 18 years old, with a discharge diagnosis of glaucoma in Beijing Tongren Hospital, from 2002 to 2008. All children were admitted for anti-glaucoma surgery, treating the sequelae of the glaucoma, or managing postoperative complications. We evaluated the demographic characteristics and the proportion of different glaucoma subtypes.Results Pediatric patients (n=1452) accounted for 12.91% of the total glaucoma in-patients from 2002 to 2008, and at last data of pediatric glaucoma were presented for 1055 children who came from 28 provinces, municipalities and autonomous regions in China. Boys were more common in all subtypes and et all ages, with a total ratio of boys to girls of 2.32:1. Congenital glaucoma was the most common subtype, accounting for 46.07% in all patients and accounting for 69.95% in children under 3 years of age. The median presenting age of congenital glaucoma patients was 2 years.Patients with traumatic glaucoma were the second most common group (n=128, 12.13%), and presented at older age (the median presenting age was 11 years). The majority of traumatic glaucoma occurred in children between 10 and 15 years of age (n=72, 56.25%). Aphakic glaucoma was the third most common (9.19%) subtype.Conclusions Congenital glaucoma is the most prevalent glaucoma subtype in hospitalized pediatric patients in Beijing Tongren Hospital. The prevention and treatment of traumatic glaucoma can reduce the incidence of visual damage in developing countries. Close follow-up for glaucoma is important after pediatric cataract surgery.

  7. 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.

  8. Successful control of a hospital-wide outbreak of OXA-48 producing Enterobacteriaceae in the Netherlands, 2009 to 2011

    NARCIS (Netherlands)

    Dautzenberg, M. J.; Ossewaarde, J. M.; de Kraker, M. E.; van der Zee, A.; van Burgh, S.; de Greeff, S. C.; Bijlmer, H. A.; Grundmann, H.; Stuart, J. W. Cohen; Fluit, A. C.; Troelstra, A.; Bonten, M. J.

    2014-01-01

    On 31 May 2011, after notification of Klebsiella pneumoniae(KP)(OXA-48);(CTX-M-15) in two patients, nosocomial transmission was suspected in a Dutch hospital. Hospital-wide infection control measures and an outbreak investigation were initiated. A total of 72,147 patients were categorised into group

  9. MONTANA PALLADIUM RESEARCH INITIATIVE

    Energy Technology Data Exchange (ETDEWEB)

    Peters, John; McCloskey, Jay; Douglas, Trevor; Young, Mark; Snyder, Stuart; Gurney, Brian

    2012-05-09

    Project Objective: The overarching objective of the Montana Palladium Research Initiative is to perform scientific research on the properties and uses of palladium in the context of the U.S. Department of Energy's Hydrogen, Fuel Cells and Infrastructure Technologies Program. The purpose of the research will be to explore possible palladium as an alternative to platinum in hydrogen-economy applications. To achieve this objective, the Initiatives activities will focus on several cutting-edge research approaches across a range of disciplines, including metallurgy, biomimetics, instrumentation development, and systems analysis. Background: Platinum-group elements (PGEs) play significant roles in processing hydrogen, an element that shows high potential to address this need in the U.S. and the world for inexpensive, reliable, clean energy. Platinum, however, is a very expensive component of current and planned systems, so less-expensive alternatives that have similar physical properties are being sought. To this end, several tasks have been defined under the rubric of the Montana Palladium Research Iniative. This broad swath of activities will allow progress on several fronts. The membrane-related activities of Task 1 employs state-of-the-art and leading-edge technologies to develop new, ceramic-substrate metallic membranes for the production of high-purity hydrogen, and develop techniques for the production of thin, defect-free platinum group element catalytic membranes for energy production and pollution control. The biomimetic work in Task 2 explores the use of substrate-attached hydrogen-producing enzymes and the encapsulation of palladium in virion-based protein coats to determine their utility for distributed hydrogen production. Task 3 work involves developing laser-induced breakdown spectroscopy (LIBS) as a real-time, in situ diagnostic technique to characterize PGEs nanoparticles for process monitoring and control. The systems engineering work in task 4

  10. MONTANA PALLADIUM RESEARCH INITIATIVE

    Energy Technology Data Exchange (ETDEWEB)

    Peters, John

    2012-05-09

    Project Objective: The overarching objective of the Montana Palladium Research Initiative is to perform scientific research on the properties and uses of palladium in the context of the U.S. Department of Energy'™s Hydrogen, Fuel Cells and Infrastructure Technologies Program. The purpose of the research will be to explore possible palladium as an alternative to platinum in hydrogen-economy applications. To achieve this objective, the Initiatives activities will focus on several cutting-edge research approaches across a range of disciplines, including metallurgy, biomimetics, instrumentation development, and systems analysis. Background: Platinum-group elements (PGEs) play significant roles in processing hydrogen, an element that shows high potential to address this need in the U.S. and the world for inexpensive, reliable, clean energy. Platinum, however, is a very expensive component of current and planned systems, so less-expensive alternatives that have similar physical properties are being sought. To this end, several tasks have been defined under the rubric of the Montana Palladium Research Iniative. This broad swath of activities will allow progress on several fronts. The membrane-related activities of Task 1 employs state-of-the-art and leading-edge technologies to develop new, ceramic-substrate metallic membranes for the production of high-purity hydrogen, and develop techniques for the production of thin, defect-free platinum group element catalytic membranes for energy production and pollution control. The biomimetic work in Task 2 explores the use of substrate-attached hydrogen-producing enzymes and the encapsulation of palladium in virion-based protein coats to determine their utility for distributed hydrogen production. Task 3 work involves developing laser-induced breakdown spectroscopy (LIBS) as a real-time, in situ diagnostic technique to characterize PGEs nanoparticles for process

  11. 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.

  12. Global Threat Reduction Initiative Domestic Security Program

    International Nuclear Information System (INIS)

    The Global Threat Reduction Initiative (GTRI) is part of the Department of Energy’s National Nuclear Security Administration (DOE/NNSA). One of GTRI’s primary missions is to work throughout the United States to enhance security for radiological materials located at civilian sites such as hospitals and universities that could be potentially used in a radiological dispersal device (RDD). In partnership with other federal organizations such as the Nuclear Regulatory Commission (NRC), the Federal Bureau of Investigation (FBI), and the Department of Homeland Security (DHS), GTRI has assisted sites in enhancing security for thousands of radioactive sources located throughout the U.S. This paper provides an overview of GTRI’s partnership with the NRC, the FBI, DHS, and host sites to enhance the security of radioactive sources

  13. 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.

  14. 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...

  15. 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

  16. 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.

  17. Hospital de Morges – Suiza

    Directory of Open Access Journals (Sweden)

    Bosshabdt, E.

    1975-05-01

    Full Text Available This hospital basically serves the districts of Aubonne and Morges and partly those of Cossonay and Rolle. It comprises a block of six storeys, with the actual hospital, and another one of five storeys with a college for nurses and male nurses; both of them equipped with the latest inventions with regard to technique and comfort. Both centres mutually use the service installations and the rooms that the other building disposes of, for a more rational utilization of the investment made. The complex has a magnificent location in a natural environment. The construction is traditional, the structure being of reinforced concrete and the finishing of high quality.Este hospital atiende fundamentalmente a los distritos Aubonne y Morges y, parcialmente, a los de Cossonay y Rolle. Consta de un bloque de seis plantas, como hospital propiamente dicho, y otro de cinco plantas, para escuela de enfermeras y enfermeros asistentes; ambos dotados con los últimos adelantos de la técnica y el confort. Uno y otro centro utilizan, recíprocamente, los servicios y locales de que disponen, para un más racional aprovechamiento de la inversión realizada. El conjunto está magníficamente ambientado en el entorno natural que lo rodea. La construcción es tradicional, con estructura de hormigón armado y acabados de gran calidad.

  18. 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...

  19. Measuring efficiency among US federal hospitals.

    Science.gov (United States)

    Harrison, Jeffrey P; Meyer, Sean

    2014-01-01

    This study evaluates the efficiency of federal hospitals, specifically those hospitals administered by the US Department of Veterans Affairs and the US Department of Defense. Hospital executives, health care policymakers, taxpayers, and federal hospital beneficiaries benefit from studies that improve hospital efficiency. This study uses data envelopment analysis to evaluate a panel of 165 federal hospitals in 2007 and 157 of the same hospitals again in 2011. Results indicate that overall efficiency in federal hospitals improved from 81% in 2007 to 86% in 2011. The number of federal hospitals operating on the efficiency frontier decreased slightly from 25 in 2007 to 21 in 2011. The higher efficiency score clearly documents that federal hospitals are becoming more efficient in the management of resources. From a policy perspective, this study highlights the economic importance of encouraging increased efficiency throughout the health care industry. This research examines benchmarking strategies to improve the efficiency of hospital services to federal beneficiaries. Through the use of strategies such as integrated information systems, consolidation of services, transaction-cost economics, and focusing on preventative health care, these organizations have been able to provide quality service while maintaining fiscal responsibility. In addition, the research documented the characteristics of those federal hospitals that were found to be on the Efficiency Frontier. These hospitals serve as benchmarks for less efficient federal hospitals as they develop strategies for improvement.

  20. Scientific Component Technology Initiative

    Energy Technology Data Exchange (ETDEWEB)

    Kohn, S; Bosl, B; Dahlgren, T; Kumfert, G; Smith, S

    2003-02-07

    The laboratory has invested a significant amount of resources towards the development of high-performance scientific simulation software, including numerical libraries, visualization, steering, software frameworks, and physics packages. Unfortunately, because this software was not designed for interoperability and re-use, it is often difficult to share these sophisticated software packages among applications due to differences in implementation language, programming style, or calling interfaces. This LDRD Strategic Initiative investigated and developed software component technology for high-performance parallel scientific computing to address problems of complexity, re-use, and interoperability for laboratory software. Component technology is an extension of scripting and object-oriented software development techniques that specifically focuses on the needs of software interoperability. Component approaches based on CORBA, COM, and Java technologies are widely used in industry; however, they do not support massively parallel applications in science and engineering. Our research focused on the unique requirements of scientific computing on ASCI-class machines, such as fast in-process connections among components, language interoperability for scientific languages, and data distribution support for massively parallel SPMD components.

  1. ALOS-2 initial results

    Science.gov (United States)

    Kankaku, Yukihiro; Suzuki, Shinichi; Shimada, Masanobu

    2015-10-01

    The Advanced Land Observing Satellite-2 (ALOS-2) was launched from Tanegashima Space Center by H-IIA rocket successfully on 24th May 2014. ALOS-2 carries the Phased Array type L-band Synthetic Aperture Radar-2 (PALSAR-2) as the state-of-the-art L-band SAR system which succeeds to PALSAR onboard ALOS. PALSAR-2 uses almost whole bandwidth allocated for L-band active sensor of Earth Exploration Satellites Service specified by the Radio Regulation in order to realize the high resolution observation, and also, it transmits more than 6 kW power for lower Noise Equivalent Sigma Zero using 180 TRMs driven by Gallium Nitride (GaN) amplifier which is the first use in space. Furthermore, because ALOS-2 carries the SAR system only, PALSAR-2 antenna can be mounted under the satellite body. It enables to observe right-/left-looking observation by satellite maneuvering. And the high accuracy orbit control to maintain the satellite within 500 m radius tube against the reference orbit enables high coherence for the InSAR processing. Using these new technologies, ALOS-2 has been operating to fulfill the mission requirements such as disaster monitoring and so on. This document introduces the initial result of ALOS-2 from the first year operation.

  2. The new childcare initiative

    CERN Multimedia

    Cigdem Issever

    The ATLAS Women's Network recently sent out a general mailing to all ATLAS and CMS members to announce a new initiative aimed at improving childcare facilities for Users coming to CERN. Several people have expressed the need that CERN should provide or facilitate affordable day care for children of temporary visitors at CERN. The ATLAS Women's Network is now forming a child care task force from concerned people and invites all those interested to join this effort. You can do so by either adding your name to the mailing list cern-users-childcare@cern.ch in Simba or by contacting Cigdem.Issever@cern.NOSPAM.ch and Pauline.Gagnon@cern.NOSPAM.ch. More than 50 people have already joined this effort. Those who have joined the mailing list will soon receive all the details about the next conference call meeting which has been scheduled for Thursday October 25th from 16:30 to 18:00 CERN time. The preliminary agenda is the following: Summary of our first contact of ATLAS and CMS (5 min) Discussion about the co-conv...

  3. Peptic ulcers: mortality and hospitalization.

    Science.gov (United States)

    Riley, R

    1991-01-01

    This study analyzes data on peptic ulcer disease based on deaths for 1951-1988 and hospital separations for 1969-1988. The source of the data are mortality and morbidity statistics provided to Statistics Canada by the provinces. The age-standardized mortality rates (ASMR) for peptic ulcer disease decreased from 1951 to 1988 by 69.4% for men (8.5 to 2.6 per 100,000 population), and 31.8% for women (2.2 to 1.5). Separation rates from hospitals during 1969-1988 for peptic ulcer disease also decreased by 59.8% for men (242.7 to 97.6 per 100,000 population) and 35.6% for women (103.2 to 66.5). Age-specific rates for both mortality and hospital separations increased with age. Epidemiological studies indicate that the incidence of peptic ulcer disease is declining in the general population. The downward trends in mortality and hospitalization rates for peptic ulcer disease reflect this change in incidence, but additional factors probably contribute as well to this decline. Male rates for both mortality and hospital separations were much higher than female rates at the beginning of the study period; but toward the end, the gap between the sexes narrowed considerably, mainly because the male rates declined substantially while the female rates decline moderately. The slower decline in the rates for women may be related to such factors as the increasing labour force participation among women and the slower decline in the population of female smokers.

  4. 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

  5. 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.

  6. 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.

  7. 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

  8. The effects of hospital-physician integration strategies on hospital financial performance.

    OpenAIRE

    Goes, J B; Zhan, C.

    1995-01-01

    STUDY QUESTION. This study investigated the longitudinal relations between hospital financial performance outcomes and three hospital-physician integration strategies: physician involvement in hospital governance, hospital ownership by physicians, and the integration of hospital-physician financial relationships. DATA SOURCES AND STUDY SETTING. Using secondary data from the State of California, integration strategies in approximately 300 California short-term acute care hospitals were tracked...

  9. 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

  10. 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.

  11. Strategies for survival in the hospital industry.

    Science.gov (United States)

    Coddington, D C; Palmquist, L E; Trollinger, W V

    1985-01-01

    Hospitals, besieged by new competitors and pressured to cut costs, are entering a new and unfamiliar environment. As usage declines and the government's new prospective payment system makes itself felt, hospitals are feeling the pinch. Nonprofit hospitals face competition from newer, for-profit providers of health care. These authors discuss the factors that have led some hospitals to close and forced most others to consider how they can lower costs while maintaining high-quality care. Several strategies exist to help hospitals cope with their new problems. The authors point out the advantages and disadvantages of downsizing, diversification, and joint ventures, among other practical measures that hospitals can take.

  12. European nuclear education initiatives

    International Nuclear Information System (INIS)

    Whatever option regarding their future nuclear energy development is chosen by European Union Member States, the availability of a sufficient number of well trained and experienced staff is key for the responsible use of nuclear energy. This is true in all areas including design, construction, operation, decommissioning, fuel cycle and waste management as well as radiation protection. Given the high average age of existing experts leading to a significant retirement induce a real risk of the loss of nuclear competencies in the coming years. Therefore the demand of hiring skilled employees is rising. The challenge of ensuring a sufficient number of qualified staff in the nuclear sector has been acknowledged widely among the different stakeholders, in particular the nuclear industry, national regulatory authorities and Technical Support Organisations (TSOs). Already the EURATOM Treaty refers explicitly to the obligation for the Commission to carry out training actions. Recently initiatives have been launched at EU level to facilitate and strengthen the efforts of national stakeholders. The European Nuclear Education Network (ENEN) Association aims at preservation and further development of expertise in the nuclear field by higher education and training. The goal of the European Nuclear Energy Leadership Academy (ENELA) is to educate future leaders in the nuclear field to ensure the further development of sustainable European nuclear energy solutions The European Nuclear Energy Forum (ENEF) is a platform operated by the European Commission for a broad discussion on the opportunities and risks of nuclear energy. The nuclear programs under investigation in the Joint Research Center (JRC) are increasingly contributing to Education and Training (E and T) initiatives, promoting a better cooperation between key players and universities as well as operators and regulatory bodies in order to mutually optimise their training programmes. Another objective is to increase

  13. 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

  14. Gauging without initial symmetry

    Science.gov (United States)

    Kotov, Alexei; Strobl, Thomas

    2016-01-01

    The gauge principle is at the heart of a good part of fundamental physics: Starting with a group G of so-called rigid symmetries of a functional defined over space-time Σ, the original functional is extended appropriately by additional Lie(G) -valued 1-form gauge fields so as to lift the symmetry to Maps(Σ , G) . Physically relevant quantities are then to be obtained as the quotient of the solutions to the Euler-Lagrange equations by these gauge symmetries. In this article we show that one can construct a gauge theory for a standard sigma model in arbitrary space-time dimensions where the target metric is not invariant with respect to any rigid symmetry group, but satisfies a much weaker condition: It is sufficient to find a collection of vector fields va on the target M satisfying the extended Killing equationv a(i ; j) = 0 for some connection acting on the index a. For regular foliations this is equivalent to requiring the conormal bundle to the leaves with its induced metric to be invariant under leaf-preserving diffeomorphisms of M, which in turn generalizes Riemannian submersions to which the notion reduces for smooth leaf spaces M / ∼. The resulting gauge theory has the usual quotient effect with respect to the original ungauged theory: in this way, much more general orbits can be factored out than usually considered. In some cases these are orbits that do not correspond to an initial symmetry, but still can be generated by a finite-dimensional Lie group G. Then the presented gauging procedure leads to an ordinary gauge theory with Lie algebra valued 1-form gauge fields, but showing an unconventional transformation law. In general, however, one finds that the notion of an ordinary structural Lie group is too restrictive and should be replaced by the much more general notion of a structural Lie groupoid.

  15. Initial Cladding Condition

    International Nuclear Information System (INIS)

    The purpose of this analysis is to describe the condition of commercial Zircaloy clad fuel as it is received at the Yucca Mountain Project (YMP) site. Most commercial nuclear fuel is encased in Zircaloy cladding. This analysis is developed to describe cladding degradation from the expected failure modes. This includes reactor operation impacts including incipient failures, potential degradation after reactor operation during spent fuel storage in pool and dry storage and impacts due to transportation. Degradation modes include cladding creep, and delayed hydride cracking during dry storage and transportation. Mechanical stresses from fuel handling and transportation vibrations are also included. This Analysis and Model Report (AMR) does not address any potential damage to assemblies that might occur at the YMP surface facilities. Ranges and uncertainties have been defined. This analysis will be the initial boundary condition for the analysis of cladding degradation inside the repository. In accordance with AP-2.13Q, ''Technical Product Development Planning'', a work plan (CRWMS M andO 2000c) was developed, issued, and utilized in the preparation of this document. There are constraints, caveats and limitations to this analysis. This cladding degradation analysis is based on commercial Pressurized Water Reactor (PWR) fuel with Zircaloy cladding but is applicable to Boiling Water Reactor (BWR) fuel. Reactor operating experience for both PWRs and BWRs is used to establish fuel reliability from reactor operation. It is limited to fuel exposed to normal operation and anticipated operational occurrences (i.e. events which are anticipated to occur within a reactor lifetime), and not to fuel that has been exposed to severe accidents. Fuel burnup projections have been limited to the current commercial reactor licensing environment with restrictions on fuel enrichment, oxide coating thickness and rod plenum pressures. The information provided in this analysis will be used in

  16. Initial Radionuclide Inventories

    International Nuclear Information System (INIS)

    The purpose of this analysis is to provide an initial radionuclide inventory (in grams per waste package) and associated uncertainty distributions for use in the Total System Performance Assessment for the License Application (TSPA-LA) in support of the license application for the repository at Yucca Mountain, Nevada. This document is intended for use in postclosure analysis only. Bounding waste stream information and data were collected that capture probable limits. For commercially generated waste, this analysis considers alternative waste stream projections to bound the characteristics of wastes likely to be encountered using arrival scenarios that potentially impact the commercial spent nuclear fuel (CSNF) waste stream. For TSPA-LA, this radionuclide inventory analysis considers U.S. Department of Energy (DOE) high-level radioactive waste (DHLW) glass and two types of spent nuclear fuel (SNF): CSNF and DOE-owned (DSNF). These wastes are placed in two groups of waste packages: the CSNF waste package and the codisposal waste package (CDSP), which are designated to contain DHLW glass and DSNF, or DHLW glass only. The radionuclide inventory for naval SNF is provided separately in the classified ''Naval Nuclear Propulsion Program Technical Support Document'' for the License Application. As noted previously, the radionuclide inventory data presented here is intended only for TSPA-LA postclosure calculations. It is not applicable to preclosure safety calculations. Safe storage, transportation, and ultimate disposal of these wastes require safety analyses to support the design and licensing of repository equipment and facilities. These analyses will require radionuclide inventories to represent the radioactive source term that must be accommodated during handling, storage and disposition of these wastes. This analysis uses the best available information to identify the radionuclide inventory that is expected at the last year of last emplacement, currently identified as

  17. Initial Cladding Condition

    Energy Technology Data Exchange (ETDEWEB)

    E. Siegmann

    2000-08-22

    The purpose of this analysis is to describe the condition of commercial Zircaloy clad fuel as it is received at the Yucca Mountain Project (YMP) site. Most commercial nuclear fuel is encased in Zircaloy cladding. This analysis is developed to describe cladding degradation from the expected failure modes. This includes reactor operation impacts including incipient failures, potential degradation after reactor operation during spent fuel storage in pool and dry storage and impacts due to transportation. Degradation modes include cladding creep, and delayed hydride cracking during dry storage and transportation. Mechanical stresses from fuel handling and transportation vibrations are also included. This Analysis and Model Report (AMR) does not address any potential damage to assemblies that might occur at the YMP surface facilities. Ranges and uncertainties have been defined. This analysis will be the initial boundary condition for the analysis of cladding degradation inside the repository. In accordance with AP-2.13Q, ''Technical Product Development Planning'', a work plan (CRWMS M&O 2000c) was developed, issued, and utilized in the preparation of this document. There are constraints, caveats and limitations to this analysis. This cladding degradation analysis is based on commercial Pressurized Water Reactor (PWR) fuel with Zircaloy cladding but is applicable to Boiling Water Reactor (BWR) fuel. Reactor operating experience for both PWRs and BWRs is used to establish fuel reliability from reactor operation. It is limited to fuel exposed to normal operation and anticipated operational occurrences (i.e. events which are anticipated to occur within a reactor lifetime), and not to fuel that has been exposed to severe accidents. Fuel burnup projections have been limited to the current commercial reactor licensing environment with restrictions on fuel enrichment, oxide coating thickness and rod plenum pressures. The information provided in this analysis

  18. Initiatives of Ecological Responsibility

    Directory of Open Access Journals (Sweden)

    Roman Sergeevich Volodin

    2015-12-01

    Full Text Available Preservation of environment is one of the global problems for the mankind. The concept of sustainable development presented at the governmental level in 1987 urged to fix at the interstate level the basic principles of development of humanity in harmony with the nature. The Charter signed in 1991 “Business and sustainable development” proclaimed a new stage of development of world entrepreneurship – business had to become ecologicallyoriented and to form the ecologically-oriented demand. In recent years it is possible to state the huge growth of technologies of effective environmental management, energy saving and energy efficiency. The leading world corporations include reduction of the ecological aspects in priority strategic objectives, as much as possible promoting transition to the use of green technologies. “Green” experience of the Western companies showed that reduction of influence on environment is not only the task of the state, but also the effective instrument to increase competitiveness of the organization. Besides the growth of favorable perception of the company by consumers, it receives considerable decrease in prime cost of the made production or the rendered services due to effective and economical use of natural resources. Russia is among the first countries who accepted the concept of sustainable development at the legislative level, nevertheless, only recently we can note that technologies of rational environmental management, energy saving and energy efficiency became one of priority problems of its development. In the present article the advanced methods of the state and private initiatives in the field of ecological responsibility are considered, and the methods of overcoming the new challenges are offered.

  19. Sustainable Forest Bioenergy Initiative

    Energy Technology Data Exchange (ETDEWEB)

    Breger, Dwayne; Rizzo, Rob

    2011-09-20

    In the state’s Electricity Restructuring Act of 1998, the Commonwealth of Massachusetts recognized the opportunity and strategic benefits to diversifying its electric generation capacity with renewable energy. Through this legislation, the Commonwealth established one of the nation’s first Renewable Energy Portfolio Standard (RPS) programs, mandating the increasing use of renewable resources in its energy mix. Bioenergy, meeting low emissions and advanced technology standards, was recognized as an eligible renewable energy technology. Stimulated by the state’s RPS program, several project development groups have been looking seriously at building large woody biomass generation units in western Massachusetts to utilize the woody biomass resource. As a direct result of this development, numerous stakeholders have raised concerns and have prompted the state to take a leadership position in pursuing a science based analysis of biomass impacts on forest and carbon emissions, and proceed through a rulemaking process to establish prudent policy to support biomass development which can contribute to the state’s carbon reduction commitments and maintain safeguards for forest sustainability. The Massachusetts Sustainable Forest Bioenergy Initiative (SFBI) was funded by the Department of Energy and started by the Department of Energy Resources before these contentious biomass issues were fully raised in the state, and continued throughout the substantive periods of this policy development. Thereby, while SFBI maintained its focus on the initially proposed Scope of Work, some aspects of this scope were expanded or realigned to meet the needs for groundbreaking research and policy development being advanced by DOER. SFBI provided DOER and the Commonwealth with a foundation of state specific information on biomass technology and the biomass industry and markets, the most comprehensive biomass fuel supply assessment for the region, the economic development impact

  20. Is the pro-competition policy an effective solution for China's public hospital reform?

    Science.gov (United States)

    Pan, Jay; Qin, Xuezheng; Hsieh, Chee-Ruey

    2016-10-01

    The new round of health care reforms in China achieved significant initial results. New and emerging problems coinciding with the deepening of the reforms, however, require further institutional changes to strengthen the competition mechanism and promote public hospital efficiency. This paper provides a conceptual framework and preliminary assessment of public hospital competition in China. Specifically, we distinguish between two closely related concepts - competition and privatization, and identify several critical conditions under which hospital competition can be used as a policy instrument to improve health care delivery in China. We also investigate the current performance and identify several unintended consequences of public hospital competition - mainly, medical arms race, drug over-prescription and the erosion of a trusting relationship between patients and physicians. Finally, we discuss the policy options for enhancing the internal competition in China's hospital market, and conclude that public investment on information provision is key to reaping the positive outcomes of pro-competition policies.

  1. 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

  2. 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.

  3. 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

    2014-01-01

    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....

  4. 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....

  5. 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...

  6. 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...

  7. The Impact of China's Entry into WTO on Chinese Public Hospitals

    Institute of Scientific and Technical Information of China (English)

    王宇

    2006-01-01

    China's entry into WTO has had a tremendous effect on Chinese public hospitals as it introduced some challenges and, ushered in an opportunity to provide a new development space. This report aims at to analyze and evaluate the initial impact of China's entry into the WTO on Chinese public hospitals, particularly in the field of the human resources department, financial department and quality service control department. As well as make feasible recommendations to the Chinese government.

  8. 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...

  9. 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...

  10. 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...

  11. Initial assessment of jaundice in otherwise healthy infants--a comparison of methods in two postnatal units.

    LENUS (Irish Health Repository)

    Allen, N M

    2012-02-01

    Transcutaneous bilirubin (TcB) has the potential to reduce total serum bilirubin (TS) sampling. The principal aim of this study was to determine and compare the number of initial TSB samples (TSBs) in two postnatal units (hospitals A & B) whereby hospital A used TcB and hospital B did not. A secondary aim was to determine the clinical factors that led to initial TSBs exceeding exchange transfusion level in both hospitals. Results demonstrated both hospitals had similar populations and patient numbers following selection criteria. 1645 neonates (10.4%) had one or more TSBs performed in hospital A, versus 2373 neonates (15.1%) in hospital B (p < 0.01). Fourteen neonates in hospital A and 3 neonates in hospital B had initial TSBs above exchange transfusion level. For neonates with TSBs above exchange, preventable factors related to earlier testing and follow up. In routine clinical practice, TcB is associated with a significantly reduced number of TSB measurements. TSB levels above exchange transfusion are linked to preventable factors, in otherwise healthy neonates.

  12. National Take-Back Initiative

    Science.gov (United States)

    ... Physicians Drug Disposal Information Drug and Chemical Information E-commerce Initiatives Federal Agencies & Related Links Federal Register Notices ... Physicians Drug Disposal Information Drug and Chemical Information E-commerce Initiatives Federal Agencies & Related Links Federal Register Notices ...

  13. Graduates and initial employment.

    Science.gov (United States)

    Rydon, Sharon Elizabeth; Rolleston, Anna; Mackie, Joan

    2008-07-01

    This research project was undertaken to inform nurse educators in the Department of Nursing and Health Studies of Manukau Institute of Technology of the employment opportunities for new graduate nurses emerging from the three year degree and registration programme. The research study aimed to contribute evidence for informed discussion when issues around curriculum development arose, particularly those issues that affect employment success of graduates. A literature review was undertaken of local and international studies and this highlighted a number of studies that examined the experience of new graduates in employment. There was however little evidence that studies had focused on the experiences of graduates as they initially sought employment or their perceptions of how their ability to successfully gain employment was linked to the nursing programme they were exiting from. The data collection tool was a survey consisting of a number of closed questions which required respondents to indicate the option most closely fitting their experience. Analysis of these results was undertaken using SPSS. The last section of the survey invited respondents to comment on any aspect of the focus of the study and qualitative analysis was undertaken of these comments. Graduates from the programme for the previous three years were targeted and names and addresses were available from departmental and institute databases. The research was submitted to the MIT Research and Ethics Committee who stated that the project did not require ethical approval as a retrospective, anonymous survey. 89.8% of graduates across the three years were successful in gaining employment in the first three months post registration. The number of graduates employed within a District Health Board (DHB) declined across the three years but there were no significant differences between cohorts. Overall, 73% of graduates were employed into new graduate positions. The majority of graduates felt that their

  14. Hospital automation system RFID-based: technology embedded in smart devices (cards, tags and bracelets).

    Science.gov (United States)

    Florentino, Gustavo H P; Paz de Araujo, Carlos A; Bezerra, Heitor U; Junior, Helio B A; Xavier, Marcelo Araujo; de Souza, Vinicius S V; de M Valentim, Ricardo A A; Morais, Antonio H F; Guerreiro, Ana M G; Brandao, Glaucio B

    2008-01-01

    RFID is a technology being adopted in many business fields, especially in the medical field. This work has the objective to present a system for automation of a hospital clinical analysis laboratory. This system initially uses contactless smart cards to store patient's data and for authentication of hospital employees in the system. The proposed system also uses RFID tags stuck to containers containing patient's collected samples for the correct identification of the patient who gave away the samples. This work depicts a hospital laboratory workflow, presents the system modeling and deals with security matters related to information stored in the smart cards.

  15. How can emerging disinfection technologies gain a foothold in the current culture of hospitals?

    Science.gov (United States)

    St Clair, David

    2014-01-01

    In the United States, more than 90% of hospitals still use only the traditional "spray and wipe" disinfection methods initiated over a century ago to protect patients from their environment; international adoption of new methods is even lower. Innovative approaches like whole room disinfection find an inhospitable reception in spite of clearly superior reductions in health care-acquired infections. Much of the resistance is due to a lack of true accountability for patient safety in hospital organizations and to perverse incentive structures in historical reimbursement policies. But all of that may change in the coming years as hospitals and doctors become more responsible for the health outcomes of their patients. PMID:26502486

  16. 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...

  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. 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. ...

  19. 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...

  20. 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 ...

  1. 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...

  2. 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...

  3. 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...

  4. 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.

  5. Hospital Disaster Preparedness Tools: a Systematic Review

    OpenAIRE

    Heidaranlu, Esmail; Abbas EBADI; Khankeh, Hamid Reza; Ardalan, Ali

    2015-01-01

    Aim: Evaluating hospital disaster preparedness is one the best ways for hospital accreditation. The aim of this study was to evaluate the quality of outcome measure that offer the level of measurement, reliability and validity that are known as the ‘ psychometric properties’ of the current hospital disaster preparedness tools. Methods: In total, 140 studies were retrieved. Studies which had been published from 2000 to 2014 and had used hospital disaster preparedness tools were appraised by us...

  6. 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...

  7. 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

  8. 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

  9. AUDIT FEE DETERMINANTS IN THE HOSPITAL SECTOR

    OpenAIRE

    Vanderbeke, Dave; Christiaens, Johan; Verbruggen, Sandra

    2014-01-01

    Although the number of non-profit audit fee studies recently has risen, evidence in the hospital sector is rather scarce. Apart from NHS studies, hospitals are a fairly new topic and several specific fee determinants are yet to be tested. For instance, hospitals can have a private or a public status and they have a distinct number of clinical services. These and other dependent variables known from earlier research are added to a fee model and investigated. As hypothesized the hospital status...

  10. 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...

  11. 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 ...

  12. 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...

  13. 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...

  14. Business Intelligence in Hospital Management.

    Science.gov (United States)

    Escher, Achim; Hainc, Nicolin; Boll, Daniel

    2016-01-01

    Business intelligence (BI) is a worthwhile investment, and will play a significant role in hospital management in the near future. Implementation of BI is challenging and requires resources, skills, and a strategy, but enables management to have easy access to relevant analysis of data and visualization of important key performance indicators (KPI). Modern BI applications will help to overcome shortages of common "hand-made" analysis, save time and money, and will enable even managers to do "self-service" analysis and reporting.

  15. Florida Hydrogen Initiative

    Energy Technology Data Exchange (ETDEWEB)

    Block, David L

    2013-06-30

    The Florida Hydrogen Initiative (FHI) was a research, development and demonstration hydrogen and fuel cell program. The FHI program objectives were to develop Florida?s hydrogen and fuel cell infrastructure and to assist DOE in its hydrogen and fuel cell activities The FHI program funded 12 RD&D projects as follows: Hydrogen Refueling Infrastructure and Rental Car Strategies -- L. Lines, Rollins College This project analyzes strategies for Florida's early stage adaptation of hydrogen-powered public transportation. In particular, the report investigates urban and statewide network of refueling stations and the feasibility of establishing a hydrogen rental-car fleet based in Orlando. Methanol Fuel Cell Vehicle Charging Station at Florida Atlantic University ? M. Fuchs, EnerFuel, Inc. The project objectives were to design, and demonstrate a 10 kWnet proton exchange membrane fuel cell stationary power plant operating on methanol, to achieve an electrical energy efficiency of 32% and to demonstrate transient response time of less than 3 milliseconds. Assessment of Public Understanding of the Hydrogen Economy Through Science Center Exhibits, J. Newman, Orlando Science Center The project objective was to design and build an interactive Science Center exhibit called: ?H2Now: the Great Hydrogen Xchange?. On-site Reformation of Diesel Fuel for Hydrogen Fueling Station Applications ? A. Raissi, Florida Solar Energy Center This project developed an on-demand forecourt hydrogen production technology by catalytically converting high-sulfur hydrocarbon fuels to an essentially sulfur-free gas. The removal of sulfur from reformate is critical since most catalysts used for the steam reformation have limited sulfur tolerance. Chemochromic Hydrogen Leak Detectors for Safety Monitoring ? N. Mohajeri and N. Muradov, Florida Solar Energy Center This project developed and demonstrated a cost-effective and highly selective chemochromic (visual) hydrogen leak detector for safety

  16. [Saint-Jacques de Besançon Hospital].

    Science.gov (United States)

    Deridder, Annick

    2007-01-01

    The first plan (1670) was carried out by Archbishop Antoine Pierre 1st de Grammont under the Spanish administration, with the aid of the Community Saint Marthe whose Congregation was at the start of a new monastic order and whose last members left Besançon a few years ago. At the beginning King Louis XIVth supported the building of the new hospital (1865) which was intended to shelter numerous soldiers like some other hospitals of the time. The main walls were ended in 1701 and the garden in 1702. The first patients were received in 1691. The cross-shaped Italian building is centred on a chapel and looks like many other buildings such as "La Salpêtriere" in Paris. It superseded the ancient medieval building "Saint-Jacques des Arènes" vowed to the travellers and pilgrims, the site of which was on the main crossing roads but on too small a space. The main architect was Canon Jacques Magnin, the material was found in the country and the gorgeous railings were forged by a local craftsman Chappuis. A local practitioner Gabriel Gascon bequeathed his sumptuous apothecary's shop. Some extensions of the building occured during the following centuries: a wing towards the garden, the "Couvent du Refuge" and its brilliant baroque chapel allowed the whole building to have a praise worthy chapel. At last the "Hôtel de Mont martin" initially built for Cardinal Granvelle was joined to the main hospital and became the Maternity Hospital. PMID:18175607

  17. 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

  18. Legislation should support optimal breastfeeding practices and access to low-cost, high-quality complementary foods: Indonesia provides a case study.

    Science.gov (United States)

    Soekarjo, Damayanti; Zehner, Elizabeth

    2011-10-01

    It is important to support women to exclusively breastfeed for 6 months and continue breastfeeding for 24 months and beyond. It is also necessary to provide the poor with access to affordable ways to improve the quality of complementary foods. Currently, many countries do not have the legal and policy environment necessary to support exclusive and continued breastfeeding. Legislative and policy changes are also necessary for introducing complementary food supplements, allowing them to be marketed to those who need them, and ensuring that marketing remains appropriate and in full compliance with the International Code of Marketing of Breastmilk Substitutes. This paper aims to illustrate the above with examples from Indonesia and to identify legislative requirements for supporting breastfeeding and enabling appropriate access to high-quality complementary food supplements for children 6-24 months of age. Requirements include improved information, training, monitoring and enforcement systems for the International Code of Marketing of Breastmilk Substitutes; implementation and monitoring of the Baby-Friendly Hospital Initiative; establishment of a registration category for complementary food supplements to enhance availability of high-quality, low-cost fortified products to help improve young child feeding; clear identification and marketing of these products as complementary food supplements for 6-24-month-olds so as to promote proper use and not interfere with breastfeeding. PMID:21929639

  19. The importance of breastfeeding training.

    Science.gov (United States)

    Palmer, G

    1996-05-01

    The lack of knowledge about breast feeding on the part of health personnel represents a major barrier to improving child health in developing countries. For example, in many areas, health workers convince new mothers that they cannot breast feed because of the shape of the breast or nipple. To promote breast feeding, WHO and UNICEF are encouraging the development of specialized training programs. The WHO/UNICEF Baby Friendly Hospital Initiative was established to implement the goals of the Innocenti Declaration, which calls for global breast feeding and the removal of obstacles to breast feeding within the health care system, at the workplace, and in the community. Each year, 25 health professionals from all regions of the world attend a four-week course on "Breast feeding: Practice and Policy" at London's Institute of Child Health. The curriculum covers the physiology, biochemistry, and management of breast feeding; counseling skills; social and political issues; and special situations such as feeding sick babies. African physicians, midwives, nurses, and nutritionists who have participated in this course have returned to establish similar seminars in their region. In addition, WHO and UNICEF have developed a 40-hour training package intended for regional training. PMID:12320278

  20. Welfare standards in hospital mergers.

    Science.gov (United States)

    Katona, Katalin; Canoy, Marcel

    2013-08-01

    There is a broad literature on the consequences of applying different welfare standards in merger control. Total welfare is usually defined as the sum of consumer and provider surplus, i.e., potential external effects are not considered. The general result is then that consumer welfare is a more restrictive standard than total welfare, which is advantageous in certain situations. This relationship between the two standards is not necessarily true when the merger has significant external effects. We model mergers on hospital markets and allow for not-profit-maximizing behavior of providers and mandatory health insurance. Mandatory health insurance detaches the financial and consumption side of health care markets, and the concept consumer in merger control becomes non-evident. Patients not visiting the merging hospitals still are affected by price changes through their insurance premiums. External financial effects emerge on not directly affected consumers. We show that applying a restricted interpretation of consumer (neglecting externality) in health care merger control can reverse the relation between the two standards; consumer welfare standard can be weaker than total welfare. Consequently, applying the wrong standard can lead to both clearing socially undesirable and to blocking socially desirable mergers. The possible negative consequences of applying a simple consumer welfare standard in merger control can be even stronger when hospitals maximize quality and put less weight on financial considerations. We also investigate the implications of these results for the practice of merger control.