Débora de Araújo Milfont
Full Text Available Objective: Verify the prevalence of dental caries and its relationship with the type of feeding, oral hygiene habits, and gender of children at the Cândida Vargas Maternity hospital in João Pessoa, Paraíba, Brazil. Methods: The study population included 50 mentally and physically healthy children ranging from 12 the 48 months of age. This was descriptive study using direct documentation (forms and the clinical examinations performed by one calibrated examiner (Kappa = 1. Dental caries diagnosis was according to World Health Organization criteria. Interviews were conducted with the parents for information about the children’s oral hygiene and dietary habits. Data was analysed by means of descriptive statistics (frequencies and percentages and statistical analyses, using the Pearson Chi – Square and Fisher tests. Results: the prevalence of dental caries was 28%; the majority of the parents cared for the children’s daytime oral hygiene (60%, and the prevalent type of feeding was with powdered milk. The average dmf-t was 0.28 and 16% of children had early childhood caries. There was no statistically significant association with any of the variables studied.Conclusion: the prevalence of caries–free children was high. However, the poor oral hygiene after nocturnal breast-feeding and the early introduction of artificial milk, especially with bottle feeding suggests the need to reinforce educational strategies for the parents.
Reis, M M; Tessaro, M M; Cruz e Silva, J; Giordano, S A; d'Azevedo, P A
Rubella serum assays performed in the laboratory of the Materno-Infantil Presidente Vargas Hospital (HMIPV) from 1998 to 2002 were reviewed to determine if IgG avidity assays should be implemented. IgG was determined using the Enzyme Linked Fluorescent Assay, ELFA, VIDAS system, bioMerieux or the Microparticle Enzyme Immunoassay, MEIA, Axsym system, Abbott, and IgM was determined using the ELFA, VIDAS system, bioMerieux, a capture format assay. Specific IgG was assayed in 2,863 samples, with positive results for 84% of the patients, for the most part with high levels of antibodies. IgM was assayed in 2,851 samples, being positive in 14 (0.49%) and inconclusive in 25 (0.88%). Serology for toxoplasmosis was also positive or inconclusive in 5 patients. After a cost-effectiveness analysis, it was decided not to implement avidity assays, considering that the HMIPV is a public institution, with limited funding. Difficulties concerning the integration of the Clinical Pathology Service with the Clinical Staff of the institution were also considered.
Pesquisa de Micobactérias Ambientais em água de torneira, luvas e soluções utilizadas em procedimentos cirúrgicos no Hospital Universitário Getúlio Vargas - Manaus/AM Investigation of Environmental Mycobacteria in tap water, surgical gloves and antiseptic solutions used in surgical procedures at the Getúlio Vargas University Hospital, Manaus-AM/Brazil
Adriana Vallejo Restrepo
Full Text Available Investigou-se por métodos bacteriológicos (cultivo e moleculares (PCR - Restriction Enzyme Analysis, PRA, a presença de micobactérias ambientais em águas de torneira, soluções e luvas cirúrgicas, utilizadas nas etapas dos procedimentos cirúrgicos executados no centro cirúrgico do Hospital Universitário Getulio Vargas (HUGV, na cidade de Manaus-Amazonas/Brasil. Foram colhidas e analisadas 105 amostras sendo: 24 de águas (colhidas das 2 torneiras existentes no centro cirúrgico, 8 de solução de Povidine e 7 de solução de Clorhexidina, que servem para a higienização das mãos dos cirurgiões; 39 de luvas cirúrgicas (superfícies internas e externas; e 27 de soluções que foram efetivamente utilizadas durante o ato cirúrgico. Por método bacteriológico obteve-se 41 isolados micobacterianos apenas de águas das torneiras. Pelo PRA obteve-se a detecção de DNA micobacteriano somente na amostra de água que forneceu acima de 100 colônias de micobactérias por tubo semeado. Os isolados foram identificados como sendo Mycobacterium celatum perfil 2, M. gordonae perfil 3, M. gordonae perfil 6, M. intracellulare perfil 1, M. lentiflavum perfil 3 e M. mucogenicum perfil 1. O encontro de M. mucogenicum, espécie já incriminada em surtos pós-cirúrgicos, indica que devem ser efetuados procedimentos de limpeza e monitoramento em todos os pontos de distribuição de águas, visando à prevenção de surtos de micobacterioses nosocomiais induzidos pelo uso das águas nas diferentes atividades de manuseio ou higienização dos pacientes submetidos a procedimentos invasivos.Using bacteriological (culture and molecular (PCR - Restriction Enzyme Analysis, PRA methods, we investigated the presence of environmental mycobacteria in tap water, antiseptic solutions and surgical gloves, used in carrying out surgical procedures at the Getúlio Vargas University Hospital Surgical Center, in Manaus -Amazonas/Brazil. Samples (105 were collected and
Arenas Planelles, Antonio; D'Arrigo, A.; Arenas Miquélez, A.; Duart, J.
Se presentan 27 casos de fractura de húmero proximal tratados mediante osteosíntesis con clavo proximal bloqueado. Los resultados fueron buenos en la mayor parte de los pacientes, con un dolor medio de 11,67/15 en la cotación cifrada de Constant, una fuerza de 14/25 puntos y una movilidad de 20,52/40 puntos. Las complicaciones más importantes fueron el conflicto subacromial (29,6%), la consolidación viciosa de la fractura en varo (29,6%) y la protrusión de los tornillos de bloqueo...
Amador Pacheco, Julia
El objetivo de esta tesis es profundizar en los sistemas de colas con reintentos M/M/c y M/G/1 mediante el estudio de nuevos descriptores como son el número de eventos exitosos y bloqueados. El interés de estos descriptores radica en la idea de aumentar el conocimiento sobre el grupo de clientes de la órbita, es decir, aquellos clientes que tras haber abandonado el sistema sin obtener servicio vuelven a intentarlo transcurrido un tiempo. En la mayoría de las aplicaciones es imposible discerni...
José Luis Mata-Mata; Diana Mendoza Olivares; Diego Ismael Alvarado Castro; Fernando de Jesús Amézquita López
Se sintetizaron y se evaluaron como agentes curtientes de pieles vacunas dos tipos de agentes de reticulación base poliuretano bloqueado. Se presentan los resultados de la síntesis de dispersiones acuosas de poliuretano bloqueado (DPU’s), basadas en prepolímeros a partir de la reacción de los diisocianatos alifáticos H12MDI (4,4’ metilenbis-ciclohexilisocianato) y HDI (hexametilendiisocianato) con polioles base poliéter óxido de etileno de peso molecular 1 y 2 KDa, en una relación molar isoci...
Full Text Available El artículo revisa las vinculaciones estético-políticas que la obra de Mario Vargas Llosa mantiene con el cine y enfatiza la permanente conexión entre palabra e imagen que hay en sus novelas más conocidas. Una correspondencia entre cine y literatura, pues son el modo que tiene el autor peruano de imaginar la identidad y sus figuras.The article points out the relation between film and literature in the work of Mario Vargas Llosa, especially between word and image in some of his most well-known novels. This relation suggests that to configure his characters and their identity, Vargas Llosa requires both: text and images, literature and film.
Full Text Available En numerosos artículos y ensayos Vargas Llosa ha tomado posición a favor de los derechos de homosexuales (lo que ha provocado fuertes reacciones de ciertas personas u organizaciones homófobas. En su obra de ficción, la homosexualidad no tiene un papel muy importante, pero con la figura de Mayta, encontramos, ya en los años 1980, a un homosexual en el proceso de su emancipación. En contra de estas tendencias en su obra, el protagonista de El sueño del Celta sufre permanentemente de su 'disposición sexual' supuestamente problemática.Vargas Llosa has defended the rights of homosexuals in numerous articles and essays, a fact that has provoked strong reactions by homophobic individuals and organizations. In his fiction, homosexuality does not play an important role, but in the figure of Mayta we find, as early as in the 1980s, a homosexual in the process of emancipation. Against these trends in his work, the protagonist of El sueño del Celta suffers permanently from his supposedly problematic "sexual disposition".
Clemens A Franken Kurzen
Full Text Available Luego de exponer los antecedentes blo-blbllográficos más relevantes, la visión de la sociedad y el concepto de la literatura y del lector del escritor peruano Mario Vargas Llosa se analiza en forma detallada su novela con formato policial ¿Quién mató a Palomino Motero? (1986, señalando rasgos característicos de los detectives, su forma de pensar, su perfil psicológico y su modo de investigar, los motivos sociales y culturales del crimen y la crítica a la sociedad peruana. Especial énfasis se pone en destacar la hibridez Ínter e intragenérica presente en esta obra literaria, es decir, la mezcla de diferentes géneros literarios y subgéneros policiales.IAfter presenting his most relevant bio-bibliographic antecedents, his view of society and his concept of literature, Mario Vargas Llosa's novel Who killed PalominoMolero?(] 986, written with a detective fiction format, isanalysed in detail pointing at characteristic features that detectives have, at their way of thinking, at their psychological profile and at their method of investigation; the social and cultural motives for crime and a criticism towards Peruvian society are also analysed. Special attention is paid to highlighting the Ínter and ¡ntrageneríc hybridation -the mixture of different literary genres and detective subgenres- that appear in this novel.
Pedro Cezar Dutra Fonseca
Full Text Available The myth of Vargas' economic populism. The Second Vargas Administration in Brazil (1951-1954 is commonly associated with the phenomenon of populism. However, based on the models of economic populism, it is clear that the economic policy of the period is not the one shown by those models. Besides, based on this historic experience, it is advocated that there is no incompatibility between developmentalism and the adoption of macroeconomic stability-oriented measures.
Martha L. Canfield
Full Text Available In this article the polycentric and polymorphous writing of Mario Vargas Llosa is presented from his first novels until his most recent critic production. Just one literary genre seemed to miss in his long and prolific career: poetry. Nevertheless, this article demonstrates how poetry too is an unknown but fundamental part of Vargas Llosa’s lifework. As a tribute to this incredible trajectory, the University of Florence will be honoured to confer him the Honorary Doctorate in spring 2014.
Este articulo se trata de un comentario del escritor Mario Vargas Llosa, quien tue el ganador del Premio Nobel de literatura en el afio 2010, y las relaciones entre el ＂Realismo Estructural＂ y el escritor. E1 articulo contiene un anālisis de algunas obras representativas y las técnicas utilizadas en ellas. En este trabajo, trato de analizar las tbr- mas narrativas utilizadas en sus obras, tanto la estructura como otras técnicas narrativas, mús la combinacin de lo real y lo ficticio, con el fin de disfrutar de las artes del lengueje de Mario Vargas Llosa para describir una historia real, en forma fictional.
Fabiola Escárzaga Nicté
Full Text Available The article analyzes the principles and postulates of the neoliberal ideology as conceived and made public by world-renowned writer and journalist Mario Vargas Llosa, as well as the process followed in its formulation. It also discusses the inconsistencies of the neoliberal program he advanced as Peruvian right-wing presidential candidate in 1990, and his erratic campaign strategies, both of which factors contributed to his defeat before Alberto Fujimori.
Full Text Available El comerciante Roberto Barreto y su mujer María Elena Vargas de Barreto han dejado en Bogotá, su ciudad de residencia, a sus dos pequeños hijos. Roberto y Enrique, para viajar a Europa. Los niños. que al parecer están entre los siete y diez años, han quedado bajo el cuidado de la abuela Teresita de Vargas, mamá Teté, que goza de buena salud a pesar de su edad, en su casa de la calle 12 No 92. Los viajeros, en cada lugar al que llegan y encuentran un correo, escriben como para que toda la familia que han dejado en el frío altiplano andino sepa que la llevan en su corazón. Este texto describe y narra el viaje de la familia Barreto Vargas a través de las postales y mensajes enviados y recuperados en este siglo.
José Luis Mata-Mata
Full Text Available Se sintetizaron y se evaluaron como agentes curtientes de pieles vacunas dos tipos de agentes de reticulación base poliuretano bloqueado. Se presentan los resultados de la síntesis de dispersiones acuosas de poliuretano bloqueado (DPU’s, basadas en prepolímeros a partir de la reacción de los diisocianatos alifáticos H12MDI (4,4’ metilenbis-ciclohexilisocianato y HDI (hexametilendiisocianato con polioles base poliéter óxido de etileno de peso molecular 1 y 2 KDa, en una relación molar isocianato/oxhidrilo (NCO/OH de 4:1 y 6:1 a 100 °C por 2 y 4 horas. En una segunda reacción, los grupos isocianato (NCO libres del prepolímero se bloquearon con una solución acuosa de NaHSO3 ó Na2S2O5 al 40%p/p. Los prepolímeros se caracterizaron mediante espectroscopia IR y RMN de ¹H. El tanto por ciento de isocianato libre en el prepolímero, así como el bloqueo de dichos grupos, se determinaron por espectroscopía IR. La evaluación de la capacidad curtiente de las DPU’s se determinó de acuerdo a la estabilidad térmica de la piel (temperatura de desnaturalización, mediante Calorimetría Diferencial de Barrido (DSC y a la determinación del índice de reticulación de las DPU’s con la colágena de la piel mediante un ensayo con ninhidrina.Two types of crosslinking agents blocked polyurethanes were synthesized and evaluated as tanning agents of bovine skins. The results of the synthesis of aqueous dispersions of blocked polyurethane (DPU’s are presented. They were based on prepolymers from the reaction of the aliphatic diisocyanates H12MDI 4,4’-methylenebis(cyclohexyl isocyanate and HDI (hexamethylene diisocyanate with HO-polyols such as polyethylene oxide of molecular weight 1 and 2 kDa. The molar NCO/OH ratio was fixed in 4:1 or 6:1, at 100 °C and 2 or 4 hours for the reaction time. In a second reaction, the prepolymer containing terminal NCO groups were blocked by reaction with an aqueous NaHSO3 or Na2S2O5 solution to 40% w/w. The
Full Text Available Siddhamantra, the Nighantu of early 13th century AD, written by Vaidyacharya Kesava is now a forgotten work among the lexicons of Indian Materia Medica. Kesava has adopted a reverse method of describing the drugs in this Nighantu. In Siddhamantra the drugs have been arranged according to effect on Dosas. Rasa, Veerya, Vipaka have to be inferred on this basis. Literary research on Siddhamantra was carried out using all available literatures in Dravyagunashastra and clarified with Vopadeva’s Prakasha commentary. Objectives of the study were to establish known botanical source of the medicinal plants mentioned in Siddhamantra through profound literary research, analysing the mode of classification of the drugs in Siddhamantra and a literary review of Rasapanchaka of each drug in Pittaghna Varga of Siddhamantra.
Jorge Valenzuela Garcés
Full Text Available La historia del otorgamiento del Premio Nobel de Literatura es bien conocida yen ella podemos advertir, con los estupores del caso, injusticias notables, omisionesimperdonables, olvidos que podrían poner en duda la relevancia de este premio decarácter ecuménico. Felizmente tenemos, y son las más, premiaciones muy justas,reconocimientos que concitaron el acuerdo y el aplauso de todos en su momentoy que no solo confirmaron la notable trayectoria del autor laureado, sino su lanzamientoa nivel universal. Nombres como los de Steinbeck, Camus o García Márqueznos devolvieron la fe en este premio y en lo que no debería dejar de ser nunca: laverdadera consagración de una obra, de notable calidad e importancia, y la de unescritor, ejemplo de conducta moral. Afortunadamente esto es lo que ha sucedido el2010, al recaer el Premio Nobel en un escritor de nuestra casa, comprometido con sutiempo y con su obra como Mario Vargas Llosa, quien es, antes que nada, un hombreconsecuente con sus ideas y creencias.
Miguel Ángel Huamán
Full Text Available Uno de los efectos más recurrentes de la escritura literaria es el asombro que se produce en el lector frente a la revelación de la dimensión estética.A partir de esa experiencia, el usuario intenta descifrar o comprender la peculiar naturaleza de la creación verbal. Entonces, en el afán por entender el secreto de la palabra poética, la primera alternativa consiste en indagar en el autor o escritor al respecto, porque se supone que quién ha concretado una obra que genera tal reacción, debe de saber en qué consiste su arte, su destreza, su particular habilidad creativa. En este sentido, la intención de este artículo es realizar una rápida revisión del “arte poética”del autor de La casa verde, con el objeto de clarificar la continuidad de sus convicciones básicas y observar cómo la aparente adscripción de su postura a una opción esteticista, que algunos han considerado homóloga a su postura ideológica a favor del liberalismo, ha sido modificada, de conformidad con sus últimas reflexiones. Ello acerca su obra a la del otrogran narrador peruano del siglo XX: José María Arguedas.Palabras claves: Mario Vargas Llosa, arte poética, escritura utópica, narrativa peruana.
Adriane Vidal Costa
Full Text Available O propósito desse artigo é refletir sobre o compromisso político do escritor peruano Mario Vargas Llosa a partir de textos “circunstanciais” escritos pelo autor entre 1962 e 1982, e, posteriormente, compilados no livro Contra viento y marea (1983. Enfim, buscamos compreender como Vargas Llosa, à luz dos argumentos contrapostos por Sartre e Camus, procurou desvendar seu próprio engajamento em uma época de grande efervescência política. E, ao mesmo tempo, compreender os motivos que levaram Vargas Llosa a dar razão a Camus duas décadas após tê-la dado a Sartre.
Full Text Available La intención de estas páginas es analizar de qué modo se despliega el imaginario perruno en La ciudad y los perros de Mario Vargas Llosa. Se estudiará cómo se vinculan y relacionan los significantes: animal - humano.This work intends to study the ways in which the conceptual image of the dog is represented in Mario Vargas Llosa's novel La ciudady los perros, particularly the significant connections and relationships between animals and humans.
Maria Luiza Felippe-Bauer
Full Text Available Two new species of Culicoides Latreille of the Neotropical subgenus Mataemyia Vargas are described and illustrated based on female specimens from Juruti, Pará, Brazil and compared with their similar congeners. This paper also presents a diagnosis of the subgenus Mataemyia and a systematic key for the identification of the 19 species of the subgenus.
Cellini, Alva V.
As Latin American literature progressively enters into the English curriculum, two writers deserve special commentary for their representative contribution to the literary world. Through their works, the Columbian author, Gabriel Garcia Marquez, and the Peruvian author, Mario Vargas Llosa clearly convey the Latin American writer's desire to be…
Héctor A. Vargas
Full Text Available First host plant records for Iridopsis hausmanni Vargas (Lepidoptera, Geometridae in the coastal valleys of northern Chile. The trees Haplorhus peruviana Engl. and Schinus molle L. (Anacardiaceae are mentioned as the first host plant records for the little known native moth Iridopsis hausmanni Vargas, 2007 (Lepidoptera, Geometridae, Ennominae in the coastal valleys of the northern Chilean Atacama Desert. This is also the first record of Anacardiaceae as host plant for a Neotropical species of Iridopsis Warren, 1894.
First host plant records for Iridopsis hausmanni Vargas (Lepidoptera, Geometridae) in the coastal valleys of northern Chile. The trees Haplorhus peruviana Engl. and Schinus molle L. (Anacardiaceae) are mentioned as the first host plant records for the little known native moth Iridopsis hausmanni Vargas, 2007 (Lepidoptera, Geometridae, Ennominae) in the coastal valleys of the northern Chilean Atacama Desert. This is also the first record of Anacardiaceae as host plant for a Neotropical species...
Juana Martínez Gómez
Full Text Available El periodismo y la literatura son prácticas escriturales que interesan a Vargas Llosa desde muy temprana edad y que cultiva de forma simultánea durante toda su vida. Desde su concepción realista de la literatura, el autor no puede soslayar la presencia del ámbito periodístico en algunasde sus novelas como una faceta relevante del conglomerado social ficcionalizado. Este trabajo aborda las diferentes formas que el periodismo adopta en sus novelas empezando brevemente por Conversación en la Catedral, para repasar después otras novelas y detenerse con mayorprofundidad en la última, El sueño del celta, en la que el periodismo aparece como soporte narrativo de gran envergadura.Palabras claves: Mario Vargas Llosa, literatura, periodismo, narrativa peruana.
ABSTRACTO En este trabajo he investigado El hablador de Mario Vargas Llosa a la luz de tres vertientes teóricas con el fin de realizar un estudio integrado y sistemático del texto (narratología y oralidad) y de su relación con su contexto (teoría poscolonial). En relación a la primera hipótesis (¿Cómo se articulan la oralidad y la escritura en El hablador?), que concierne el análisis interno de la novela de Vargas Llosa, tomé como base los postulados narratológicos propuestos por Géra...
Claudia Saraí Fernández-López
Full Text Available This paper is a chronotopic interpretation of the novel The bad girl, by Mario Vargas Llosa. It emphasizes the functioning of different cities, where the plot takes place, as essential parts of the argumentative structure. The emotional load of these cities, ideologies and implied ethics, as well as the characters’ evolution, within the author’s context and represented events, were needed to know the text’s sense and intention.
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...
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...
Sierra-Merlano Rita Magola
Full Text Available The analysis of the discourses of the professionals constitutes a useful tool in the study of the medico-scientific production in the context of the medical historiography. It is emphasized in Hobsbawm´s words: “for the reconstruction of the environment and the temperament of an epoch” and of its actors, when nobody exists to remember them. A product of historical research is presented, part of the doctoral thesis “The medical professionals in the Universidad de Cartagena. Period 1908-1962. A Model of medical professional: state, centralist, anatomo-clinical and individual”. The medical discourse of Eusebio Vargas Vélez was searched in books of enrollments, tests of subjects, certificates and thesis, in the archives and libraries of the Facultad de Medicina of the Universidad de Cartagena, Colombia, in the publications of the Colombian medico-scientific societies, in hospitals in the city and in the personal archives of professors and graduates. Nine publications, seven scientific texts and five letters to education authorities were found. Five of them are related with urologic clinic. Eusebio Vargas Vélez although was educated under the medical French influence, he appropriated himself of the North American one. He was compromised with the advance of the science and the technology applied to the medicine, especially of the urology. He led the education and expansion of the discipline in the local and national area when the half of the 20th century was approaching. Rev. cienc.biomed. 2014;5(1:161-170 KEYWORDS History of Medicine, Urology; Prostate, Prostatectomy
Acevedo, Luz Stella
Este artículo muestra cómo se presentan el erotismo y la transgresión en la novela Elogio de la madrastra, de Mario Vargas Llosa, teniendo como texto base El erotismo, de Georges Bataille -- Mediante la lectura e interpretación de los apartados de la novela en los que se hacen manifiestos tanto el placer erótico como el desbordamiento de los límites establecidos en busca del disfrute sexual, se logra establecer que el erotismo en la novela tiene como fondo la exploración de las posibilidad...
Full Text Available Mario Vargas Llosa’s recent novel The Bad Girl centers around a sexually liberated woman whois in search of individual emancipation through transgressions of all social norms. The issue offemale sexuality and its relation with woman liberation occupies an important and debatableposition in Feminist discourse. Llosa’s own attitude to liberated female sexuality had been anambivalent one. In this paper I would like analyse and explore the question of woman’s liberationin the novel of Mario Vargas Llosa, taking into account the major conflicting Feminist discoursesas well as the presence and erasure of female sexuality in the history of Latin American novels.
Full Text Available The purpose of this study is to explore the relationship, from an intertextual perspective, between Las travesuras de la niña mala by Mario Vargas Llosa (2006, and the picaresque genre developed in Spain during the 16th and 17th century. In order to achieve this aim, I will take into account the filiation discourse and the appearance of the picaresque canon, as well as the female picaresque works ignored by the critics. Vargas Llosa draws the character of the «niña mala» gathering charateristics which belong both to male and female picaro.
Pedro Antonio Agudelo
Full Text Available Este artículo propone una relectura de la novela Los cuadernos de don Rigoberto de Mario Vargas Llosa, concentrando la atención en la figura retórica de la ecfrasis. Examina la arquitectura novelesca y la representación verbal y visual como pilares de lo que constituiría una genuina novela iconoverbal. El estudio está soportado en las estrategias de análisis provenientes de la semiótica literaria, la narratología y la retórica, que permiten una comprensión amplia del objeto de estudio. This paper proposes a different interpretation of the novel Los cuadernos de don Rigoberto by Mario Vargas Llosa, focusing on the rhetorical figure of ekphrasis. It examines the novelistic architecture and verbal and visual representation as pillars of what would constitute a genuine iconoverbal novel. The study is supported by the analysis strategies from literary semiotics, narratology and rhetoric, which allow a comprehensive understanding of subject matter.
Maia, Andréa Casa Nova
This article analyzes the control strategies in place at Morro Velho mine in the Brazilian state of Minas Gerais, and the changes after the implementation of labor legislation during the Vargas administration. The diseases common amongst mine workers, silicosis and arsenicosis, are investigated through statements given by former miners and a book by an anonymous author that discusses the diseases and the power relations between employers and employees, identifying the limitations of the legislation and the workers' struggles. The book presents a striking story of how for many years the British company side-stepped laws such as the insalubrity premium, a right which other mining companies, not only of British ownership, flouted and still flout in different parts of the world.
Lucero de Vivanco
Full Text Available Este artículo aborda cuatro textos narrativos del escritor peruano Mario Vargas Llosa relacionados con la violencia que se vivió en Perú en el contexto de la guerra entre Sendero Luminoso y el Estado: las novelas Historia de Mayta y Lituma en los Andes y los documentos Informe de Uchuraccay e Historia de una matanza. La lectura que hago parte problematizando los supuestos teóricos planteados por el escritor en La verdad de las mentiras en relación con la "verdad" de la literatura y su independencia con respecto a la realidad. Desde este lugar crítico, propongo que sus teorías no solo son problemáticas en sí mismas cuando se trata de narrar la violencia, sino que no son coincidentes con las prácticas culturales de sus lectores, razón por la cual los debates se encienden en la escena ideológica y la cuestión de la referencialidad se vuelve lucha política.The present article focuses on four narrative texts by Peruvian writer Mario Vargas Llosa that deal with the war between Shining Path and the Peruvian state: the novels Historia de Mayta and Lituma en los Andes, and the documents Informe de Uchuraccay and Historia de una matanza. My reading begins by discussing the writer's theories about "truth" in literature and its independence from reality as shown in La verdad de las mentiras. From this critical position, I propose that these theories are not only problematic in themselves when narrating violence, but also that they do not match with his readers' cultural practices. This point has led to incensed discussions in ideological debates, turning the question of referentiality into a problem of political struggle.
Full Text Available Uno de los medidores más concretos para dimensionar el impacto cultural y artístico de un autor en estos días es la cantidad de relecturas que generan sus obras (reescrituras, obras de teatro, películas, etc.. Cada una de estas reinterpretaciones genera nuevas perspectivas y lecturas sobre los textos originales, en un diálogo permanente. Al ser Mario Vargas Llosa uno de los autores latinoamericanos más adaptados en cine, se hace importante revisar críticamente las propuestas cinematográficas a partir de su obra. De este modo, este artículo revisa las tres principales adaptaciones de sus novelas, a saber, La ciudad y los perros, Pantaleón y las Visitadoras y La Fiesta del Chivo, analizando algunos aspectos centrales de cada una de éstas, ya sean estructurales o temáticos, para así iluminar algunas dimensiones no solo de cada adaptación en particular, sino de este intercambio discursivo en general.Nowadays, one of the most concrete ways to measure an author's cultural and artistic impact is the amount of reinterpretations over his works (in literature, theatre, cinema, etc.. Each one of these versions produces new interpretations and perspectives over the original texts, in a constant dialogue. One of the most adapted Latin-American authors to cinema is Mario Vargas Llosa, which reveals the importance of a critical study of the film versions of his works. Thus, this article reviews the three main adaptations of his novels (The Time of the Hero, Captain Pantoja and the Special Service, and The Feast of the Goat by analyzing central aspects pertaining either to structures or themes in order to elucidate certain dimensions relevant not only to each particular adaptation, but also to this discursive interchange in general.
Full Text Available En sus Apologías y discursos de las conquistas occidentales, Bernardo de Vargas Machuca, apoyándose en Juan Ginés de Sepúlveda, pretende justificar el dominio español americano. En sus planteamientos es posible constatar un cambio de la noción de bárbaro, que se puede interpretar como una ampliación del concepto de siervo por naturaleza, a partir de la caracterización del indio como alguien ya sometido pero que, de una u otra manera, trata de resistirse a un dominio impuesto y no querido. Así, las ideas de Vargas Machuca al respecto se pueden entender como un aporte para la comprensión filosófica de la construcción de la imagen tanto del indio como del indiano por el tiempo del inicio de la Colonia.
Larsen, Matthew C.; Wieczorek, Gerald F.; Eaton, L.S.; Torres-Sierra, Heriberto; Sylva, Walter F.
Large populations live on or near alluvial fans in locations such as Los Angeles, California, Salt Lake City, Utah, Denver, Colorado, and lesser known areas such as Sarno, Italy, and Vargas, Venezuela. Debris flows and flash floods occur episodically in these alluvial fan environments, and place many communities at high risk during intense and prolonged rainfall. In December 1999, rainstorms induced thousands of landslides along the Cordillera de la Costa, Vargas, Venezuela. Rainfall accumulation of 293 mm during the first 2 weeks of December was followed by an additional 911 mm of rainfall on December 14 through 16. Debris flows and floods inundated coastal communities resulting in a catastrophic death toll of as many as 30,000 people. Flash floods and debris flows caused severe property destruction on alluvial fans at the mouths of the coastal mountain drainage network. In time scales spanning thousands of years, the alluvial fans along this Caribbean coastline are dynamic zones of high geomorphic activity. Because most of the coastal zone in Vargas consists of steep mountain fronts that rise abruptly from the Caribbean Sea, the alluvial fans provide practically the only flat areas upon which to build. Rebuilding and reoccupation of these areas requires careful determination of hazard zones to avoid future loss of life and property. KEY TERMS: Debris flows, flash floods, alluvial fans, natural hazards, landslides, Venezuela
Adriane Vidal Costa
Full Text Available No final dos anos 1970 e início dos 80, Julio Cortázar e Mario Vargas Llosa compararam a Nicarágua sandinista com a Cuba de Fidel Castro, colocando em dia o debate sobre a revolução e o socialismo na América Latina. O presente trabalho analisa os artigos de Cortázar e Vargas Llosa para mostrar como eles compreenderam e traduziram a experiência sandinista. Em fins dos anos 1970, muitos intelectuais passaram a defender a Revolução Sandinista, como a possível revolução ideal ou uma nova chance para a experiência socialista na América Latina, como foi o caso de Cortázar. Vargas Llosa, desencantado com as esquerdas, apontava os "erros" do regime que poderiam levar a experiência sandinista a transformar o país centro-americano em uma "nova Cuba".
Full Text Available Cuando conocí a Mario Vargas Llosa, corría el año 1970; el escritor por aquel entoncesya había empezado su progresivo alejamiento de la izquierda canónica. Era elmomento del caso Padilla, el poeta cubano disidente de quien el futuro premio Nobel,primer peruano en ser galardonado, se erguía en valiente defensor. Mario, en esasfechas, vivía afincado en el barrio de Sarrià de Barcelona y, a pesar de su éxito literariotras las grandes novelas del exordio, desde La ciudad y los perros (1963 y La casaverde (1966 hasta Conversación en la catedral (1969, mantenía un apego sincero ycordial, desenfadado, en nada ostentoso. Se le consideraba, sin embargo, un autormuy afamado y brillante, algo más que una promesa. Sonriente y feliz, compartía eltrabajo meticuloso de escribir a diario con lecturas de amplio abanico, compromisossociales (pocos y vida familiar. Como revelaría pronto con su novela La tía Julia y elescribidor (1977, esa etapa existencial venía marcada por sentar familia con labellísima prima Patricia, y sus niños. Mario era además un guapo (belleza que no hamenguado con la madurez, ni siquiera con la entrada en una tercera edad biendisimulada; en aquel entonces era un joven capaz de fascinar a hombres y mujeres detodo tipo, incluidos los estudiantes. Con todo, estos últimos no dudaron en rebatirlede forma incisiva tras una conferencia dictada en la Universidad, al grito de«colonizado». Tardaría Mario muchos y muchos años en elegir la ciudadanía españolay tomar posesión de la silla en la Real Academia. Ello, cabe hacer memoria, ocurrió entodo caso ya muerto el Dictador y realizada la transición democrática, y tras el fracasodel proceso político en el Perú, que en lugar de elegir a Vargas Llosa para laPresidencia optó por otorgarle la mayoría al siniestro Fujimori.
Andressa Tanise Vooss
Full Text Available To evaluate the conditions of the services offered to the community regarding medications, the World Health Organization (WHO has developed the Medication Use Indicators, among them Prescription indicators. The objective of this study was to evaluate drug prescriptions in a Basic Health Care Center in Getúlio Vargas - RS, according to the Prescription Indicators recommended by the WHO. The data collection was performed with the use of a form and the prescriptions for June / July and November / December 2008 were evaluated. The average number of drugs prescribed was 2.03, and 72.8% of the drugs were prescribed by generic name, 80.3% were on the list of essential drugs, 21.7% were antibiotics and 2.4% were injectable drugs. The results were in accordance with WHO recommendations and were similar to those reported by other studies.Para avaliar as condições dos serviços prestados à população no que se refere aos medicamentos, a Organização Mundial da Saúde (OMS desenvolveu Indicadores do uso de Medicamentos, entre eles os de Prescrição. O objetivo da pesquisa foi avaliar prescrições medicamentosas de usuários de uma Unidade Básica de Saúde do município de Getúlio Vargas - RS conforme os Indicadores de Prescrição preconizados pela OMS. A coleta de dados foi realizada com uma ficha. Para isso houve acesso as prescrições atendidas no período de junho/julho e de novembro/dezembro de 2008. A média de medicamentos prescritos foi de 2,03, 72,8% dos medicamentos foram prescritos pelo nome genérico, 80,3% constavam na lista dos medicamentos essenciais, 21,7% eram antibióticos e 2,4% injetáveis. Observou-se que os resultados obtidos estão de acordo com os recomendados pela OMS e que foram similares a outros estudos.
Celso Pereira de Sá
Full Text Available O artigo trata da memória histórica de Getulio Vargas (1883-1954 - que governou o país de 1930 a 1945 e de 1951 a 1954 -, em sua estreita associação com o Palácio do Catete, no Rio de Janeiro, sede da Presidência da República naquele período. Tal memória foi investigada em termos das representações sociais de Getúlio manifestadas por 410 visitantes de uma exposição realizada no Palácio - hoje, Museu da República - em homenagem ao cinqüentenário da sua morte. Os resultados, obtidos a partir das respostas a uma tarefa de associação livre e a um questionário expedito, evidenciam que a memória construída a propósito da trajetória histórica de Vargas é complexa e controvertida, mas tende nitidamente para o pólo positivo, visto que predominam as avaliações de que Getúlio fez mais coisas boas do que ruins e de que merece ser lembrado como "pai dos pobres" e como "maior estadista do Brasil".The article deals with the historical memory of Getúlio Vargas (1883-1954 - who governed Brazil from 1930 to 1945 and from 1951 to 1954 -, in its close association to the Catete Palace, in Rio de Janeiro, which was the Republic Presidency's seat during that period. Such a memory was investigated in terms of the social representations about Getúlio which were manifested by 410 visitors to an exhibition held in the Palace - Republic Museum, nowadays - in honor to the fiftieth anniversary of his death. Results, which were obtained from responses to a free association task and to a concise questionnaire, evidence that the memory which was built about the historical trajectory of Vargas is a complex and controversial one, but it tends sharply for the positive pole, since the evaluations that Getúlio did more good than bad things and that he deserves to be remembered as "father of the poor people" and as "Brazil's greatest statesman" prevail.
Reverón, Rafael Romero
José María Vargas (1786-1854): Venezuelan medical doctor, surgeon, optician, anatomist, chemist, botanist, professor, geologist, mineralogist, and mathematician. Second President of Venezuela (1835-1836), First republican dean, he reformed medicine studies in 1827 establishing human anatomical dissection in the Universidad Central de Venezuela where he taught human anatomy between 1827 and 1853 along with surgery and chemistry. In 1838, he wrote Curso de Lecciones y demostraciones Anatómicas, the first book on the subject printed in Venezuela for the teaching of human anatomy. PMID:23650143
León Restrepo, Ana María
A partir de la lectura de la novela del escritor peruano Mario Vargas Llosa Los Cuadernos de Don Rigoberto, el presente artículo pretende hacer una breve descripción de la relación entre arte y literatura, en específico la intertextualidad pintura y producción verbal, presente en dicha obra -- Este artículo se divide en tres apartados: la contextualización de la novela, sus antecedentes y principales motivos de análisis literario, hasta el desarrollo de la relación mencionada en el párrafo an...
José Morales Saravia
Full Text Available Lo nuevo de la "nueva novela hispanoamericana", que La ciudad y los perros (1962 de Mario Vargas Llosa representa, se halla en el re-trabajo de las categorías suministradas por la tradición realista bajo premisas que buscan despertar en el lector vivencias directas de lo feo. Este artículo analiza ambas estéticas implicadas en ello: aquella que construye lo feo en toda su amplitud y aquella del efecto que hace vivenciar lo feo directamente por el lector.The new aspect of the "nueva novela hispanoamericana", represented by Vargas Llosa's 1962 The Time of Hero, lies in the rework of categories from the realistic tradition under premises that seek to awaken in readers direct experiences of ugliness. This article analyses the two aesthetics involved in this process: one that constructs a vast fiction world of ugliness (KarlRosenkranz's Asthetik des Hasslichen, and another that enables readers to experience ugliness directly (Wirkungsasthetik.
Camilo Rubén Fernández-Cozman
Full Text Available This article holds that there is a radical ethnocentrism in two essays of Mario Vargas Llosa, Archaic Utopia and Civilization of the Show. In this regard, the Peruvian writer does not recognize a mythical rationality and conceived that legal culture is superior to oral culture.
Full Text Available El estudio de Efraín Kiistal sobre las novelas de Mario VargasLlosa se centra en el análisis del proceso creativo del autor, en losdiálogos que entabla con otros trabajos literarios y en la transformaciónde la experiencia vital en sus textos ficcionales.
El etnocentrismo radical y las técnicas argumentativas en La utopía arcaica y La civilización del espectáculo, de Mario Vargas Llosa / The Radical Ethnocentrism and Argumentative Techniques in Vargas Llosa's The Archaic Utopia And Notes On The Death Of Culture: Essays On Spectacle And Society
Camilo Rubén Fernández-Cozman
Full Text Available Este artículo sustenta que hay un etnocentrismo radical en dos libros de ensayo de Mario Vargas Llosa: La utopía arcaica y La civilización del espectáculo. En tal sentido, el escritor peruano no reconoce una racionalidad mítica y concibe que la cultura letrada es superior a la cultura oral. This article holds that there is a radical ethnocentrism in two essays of Mario Vargas Llosa, Archaic Utopia and Civilization of the Show. In this regard, the Peruvian writer does not recognize a mythical rationality and conceived that legal culture is superior to oral culture.
Claudia Saraí Fernández-López
Full Text Available Se realizó una lectura cronotópica de la novela Travesuras de la niña mala, de Mario Vargas Llosa. Se hizo énfasis en el funcionamiento de las distintas ciudades en las que se desarrolla la trama como partes esenciales de la estructura argumentativa, la carga emotiva de estas urbes, las ideologías y las éticas implicadas, así como la evolución de los personajes según la metró- poli en la que van residiendo. También se analizó la relación entre la acción de los personajes, el contexto del autor y los acontecimientos representados, necesarios para conocer el sentido y la intención del texto.
María de las Mercedes Ortiz Rodríguez
Full Text Available In his novels The Green House (1966, The Storyteller (1989 and Death in the Andes (1996, Mario Vargas Llosa reinforces the dominant visions in which the Peruvian Andes and jungle are portrayed as the realms of barbarism and savagery respectively—as opposed to the Coast, which is considered the civilized center of the nation. I discuss how he resuscitates topics like cannibalism and the extirpation of idolatries in colonial times, clearly employing the linear evolutionism of the nineteenth century. He uses these familiar tropes and images to characterize, as did his predecessors, indigenous people as savages, cannibals and pagans who constitute an obstacle for the development of Peru in a neoliberal and global world.
Full Text Available En la novela La Guerra del fin del mundo Mario Vargas Llosa presenta una reescritura y ficcionalización del texto fundacional Os Sertdes de Euclides da Cunha. El presente artículo sitúa esta novela en el momento de un cambio radical de las convicciones ideológicas y políticas de Mario Vargas Llosa en la década de los 70 y se propone analizar de qué manera las nuevas posiciones neoliberales asumidas por el autor se reflejan en la poética de la novela. Como argumento central se sostiene que en el proceso de ficcionalización del texto referencial de Euclides da Cunha se dejan descubrir dos estrategias: la primera es la individualización de la Historia, es decir, la narración privilegia las experiencias subjetivas de los protagonistas para explicar sus disposiciones a la violencia; en la segunda, la ficcionalización asume una paradoja: finge representar lo irrepresentable advirtiendo al mismo tiempo al lector que se trata solamente de ficción, es decir, ella responsabiliza al propio lector en qué medida él está dispuesto a identificar la narración con la 'verdad' histórica. En los dos casos nos encontramos frente a una poética que valoriza la responsabilidad individual y lo subjetivo en vez de la dependencia individual de lo colectivo y del compromiso de la narración con la historia objetiva.In the novel The War of the End of the World (La guerra del fin del mundo Mario Vargas Llosa presents a rewriting and fictionalization of Euclides da Cunha's foundational text Os Sertdes. The article relates this novel to the radical change in Mario Vargas Llosa's ideological and political convictions in the 1970s and intends to analyze how the author's neo-liberal positions are reflected in the poetics of this novel. The central argument is that in this process of fictionalization of Euclides da Cunha's text, two strategies can be discovered: the first being the individualization of History, that is, the narrative privileges the subjective
Full Text Available Homme d'affaires, aviateur, journaliste et écrivain, Jean-Gérard Fleury (1905-2002 a vécu presque toute sa vie au Brésil. En 1940, il publie en France une biographie, la seule à ce jour, du président Getúlio Vargas. De nature ouvertement hagiographique, ce texte propose une lecture de la trajectoire politique de Vargas qui oscille entre démocratie et autoritarisme. De fait, cette biographie nous parle autant du Brésil que de la France : elle construit une image du président brésilien, et en même temps témoigne des aspirations idéologiques d'une certaine droite française dans l'entre-deux guerres. Elle a par conséquent sa place dans une étude des représentations du populisme au XXe siècle.Hombre de negocios, aviador, periodista y escritor, Jean-Gérard Fleury (1905-2002 vivió durante casi toda su vida en Brasil. En 1940, publica una corta biografía, la única hasta hoy en francés, del presidente Getúlio Vargas. De carácter francamente hagiográfico, este texto propone una lectura de la trayectoria de Vargas que oscila entre democracia y autoritarismo. De hecho, esta biografía nos habla tanto de Brasil como de Francia: construye una imagen del presidente brasileño y, al mismo tiempo, declara las aspiraciones populistas de cierta derecha francesa entre los dos guerras mundiales.Business man, aviator, journalist and writer, Jean-Gérard Fleury (1905-2002 lived almost all his life in Brazil. In 1940, he published a short biography, the only one to this day in French, of the president Getulio Vargas; openly pictorially outlined in nature, this text offers a reading of the political trajectory of Vargas, which oscillates between democracy and authoritarianism. In fact, this biography tells us as much about Brazil as about France: it constructs an image of the Brazilian president, and at the same time witnesses the popular aspirations of a certain French political right trend between the two wars.
Full Text Available Pour tout auteur, choisir d’écrire dans une langue ou dans la variante d’une langue qui n’est pas la sienne représente un défi de taille. Nous nous intéresserons au roman Sous les vents de Neptune, de l’écrivaine française Fred Vargas, qui a situé une partie de son intrigue au Québec, sans maîtriser la notion de variation linguistique. En analysant les réactions des lecteurs européens et québécois, de même que les caractéristiques de la langue québécoise de Vargas, nous aborderons la question de l’impérialisme linguistique et de son anachronisme au xxie siècle.
Muertes bajo sospecha: Investigación sobre el número de fallecidos en el desastre del estado Vargas, Venezuela, en 1999 Deaths under suspicion: Investigation on the number of deaths in the Vargas state disaster, Venezuela, in 1999
Full Text Available El desastre ocurrido en diciembre de 1999 en el estado Vargas, Venezuela, dio la vuelta al mundo como noticia espectacular, en donde el número de fallecidos siempre osciló entre decenas de miles. Muchas de estas cifras fueron el resultado de declaraciones inexpertas o irresponsables, desde las cuales se nubló toda posibilidad de precisión al respecto, contribuyendo con ello a que la noción sobre aquel evento alimentara la imaginería y no la interpretación. Este trabajo se concentró en la sistematización de la información existente en los servicios forenses que intervinieron en el levantamiento de los cadáveres, así como en otras instancias vinculadas al caso, acompañando los razonamientos con aproximaciones cualitativas a la zona del desastre. Los resultados ofrecidos a la vuelta de esta investigación, no sólo discuten las cifras ofrecidas desde aquel momento, sino que también evidencian la problemática resultante de la no aplicación de metodologías eficaces para el trato de cadáveres en desastres con muertes masivas, demostrando, del mismo modo, la necesidad de desarrollar investigaciones formales sobre casos similares.The disaster happened in December of 1999 in the Vargas state, Venezuela, run around the world like spectacular news, in which the number of deceases always oscillated between tens of thousands. Many of these numbers were the result of inexpert or irresponsible declarations, from which all possibility of precision became cloudy on the matter, contributing with it to that the notion on that event fed suppositions and not interpretations. This work are focused in the systematization of the existing information in the forensic offices that took part in the rise of corpses, as well as other instances to the case, accompanying the reasoning with qualitative approaches to the disaster zone. The results offered around this investigation, not only discuss the numbers offered from that moment, but that also demonstrate
Auluck, S. K. H., E-mail: email@example.com [HiQ TechKnowWorks Private Limited, Nerul, Navi Mumbai 400706 (India)
The Gratton-Vargas snowplow model, recently revisited and expanded [S. K. H. Auluck, Phys. Plasmas 20, 112501 (2013)], has given rise to significant new insights into some aspects of the Dense Plasma Focus (DPF), in spite of being a purely kinematic description having no reference to plasma phenomena. It is able to provide a good fit to the experimental current waveforms in at least 4 large facilities. It has been used for construction of a local curvilinear frame of reference, in which conservation laws for mass, momentum, and energy can be reduced to effectively-one-dimensional hyperbolic conservation law equations. Its utility in global parameter optimization of device parameters has been demonstrated. These features suggest that the Gratton-Vargas model deserves a closer look at its supposed limitations near the singular phase of the DPF. This paper presents a discussion of its development near the device axis, based on the original work of Gratton and Vargas, with some differences. It is shown that the Gratton-Vargas partial differential equation has solutions for times after the current singularity, which exhibit an expanding bounded volume (which can serve as model of an expanding plasma column) and decreasing dynamic inductance of the discharge, in spite of having no built-in hydrodynamics. This enables the model to qualitatively reproduce the characteristic shape of the current derivative in DPF experiments without reference to any plasma phenomena, such as instabilities, anomalous resistance, or reflection of hydrodynamic shock wave from the axis. The axial propagation of the solution exhibits a power-law dependence on the dimensionless time starting from the time of singularity, which is similar to the power-law relations predicted by theory of point explosions in ideal gases and which has also been observed experimentally.
@@ 巴尔加斯·略萨,这位1936年3月28日出生于秘鲁阿雷基帕市的文学天才,全名是豪尔赫·马里奥·佩德罗·巴尔加斯·略萨(Jorge Mario Pedro Vargas Llosa),其中"巴尔加斯"是父姓,而"略萨"是母姓.
Ronderos Gaitán, Paula
En este artículo seguiremos los rastros de Juan de Vargas, barbero, que ejerció en Santa Fe durante la primera mitad del siglo XVII. Se utilizarán los artefactos enunciados en su testamento como indicios para reconstruir las prácticas del oficio, aquellas cosas que estaba habilitado para realizar desde las relaciones entre la materia y la acción, el saber y el hacer.
Auluck, S K H
The Gratton-Vargas snowplow model, recently revisited and expanded (S K H Auluck, Physics of Plasmas, 20, 112501 (2013)), has given rise to significant new insights into some aspects of the Dense Plasma Focus (DPF), in spite of being a purely kinematic description having no reference to plasma phenomena. It is able to provide a good fit to the experimental current waveforms in at least 4 large facilities. It has been used for construction of a local curvilinear frame of reference, in which conservation laws for mass, momentum and energy can be reduced to effectively-one-dimensional hyperbolic conservation law equations. Its utility in global parameter optimization of device parameters has been demonstrated. These features suggest that the Gratton-Vargas model deserves a closer look at its supposed limitations near the singular phase of the DPF. This paper presents a discussion of its development near the device axis, based on the original work of Gratton and Vargas, with some differences. It is shown that the...
Pedro Cezar Dutra Fonseca
Full Text Available O segundo governo de Vargas (1951-54 e o governo de João Goulart (1961-64 são usualmente considerados como exemplos típicos do populismo no Brasil. A maior parte da literatura considera as políticas econômicas neles implementadas como "hesitantes", "irracionais" ou "ambíguas". Entretanto, a análise das políticas econômicas dos dois governos permite que sejam detectadas certas regularidades, que podem ser compreendidas como o resultado de equilíbrio em um modelo de credibilidade. Observa-se que a condução das políticas econômicas parte de uma mesma estratégia de convencer os agentes privados quanto à prioridade no combate à inflação. À medida que o tempo avança, essa prioridade vai gradualmente sendo afrouxada, iniciando-se uma segunda fase, de randomização. Essa política oscilatória contribui para abalar a credibilidade dos governos e inaugura uma terceira fase em que, vendo a crise aprofundar-se, estes acabam por abandonar a opção pela estabilidade.The Vargas' second administration (1951-54 and Goulart's administration (1961-64 are considered typical examples of populism in Brazil. Because of the political problems both presidents had to face, the literature usually defines their economic policies as "hesitating", "irrational" or "ambiguous". However, the analysis of the two periods indicates that there is a pattern in the way economic policies were conducted, which can be understood as a result of an equilibrium strategy in a model of credibility. The governments started with measures to fight against inflation that improved the credibility of the economic policies. As time goes on, though, the policies were random, alternating measures pro and against stabilization. Later, as a result of the costs associated with the policies, they abandoned the austerity and, in consequence, the credibility decreased and the attempts of stabilization failed.
Full Text Available Desde los tiempos de su candidatura a la presidencia de Perú, el Premio Nobel de Literatura Mario Vargas Llosa nunca renunció a su faceta política así como tampoco a la de observador de la sociedad. Algo que le ha procura- do numerosos detractores pero que no ha mermado sus dotes narrativas. Esta controversia provocó interpretaciones frontalmente encontradas a su discurso en la ceremonia de entrega de los galardones, celebrada en diciembre de 2010. Cuando observamos la interpretación que de aquel acontecimiento realizaron dos medios de comunicación escritos, queda reflejada, al aplicar en el más amplio sentido del término, el uso de las técnicas de comunicación periodística persuasiva. Se realiza así en este trabajo un análisis de diversos aspectos que influyen en esta forma de comunicación, desde la elección de la persona que ha de redactar la información o el comentario de fondo, hasta la selección de los textos originales, completos o fragmentados, que apoyan las opiniones vertidas en la información, pasando por el análisis formal, incluso, del tipo de imágenes elegidas para ilustrar la información y su apoyo en forma de texto de pie de foto.
Mutante espontâneo de Bacillus licheniformis bloqueado no estágio I da esporogênese, possuidor de metabolismo respiratório aumentado A spontaneous mutant of Bacillus licheniformis with increased respiratory metabolism, blocked in stage I of sporogenesis
Full Text Available Um mutante espontâneo de Bacillus licheniformis, derivado da amostra esporogênica 2390, foi estudado com vistas ao reconhecimento do estágio da evolução para esporo em que o mesmo se encontrava bloqueado. Eletronmicrografias sugeriram que as células desse mutante, colhidas durante a fase estacionária da curva de crescimento, não ultrapassaram o estágio I da esporogênese (i.e., permaneceram com o nucleóide disposto como filamento axial, enquanto a produção de antibiótico (bacitracina e a atividade proteolítica foram francamente detectadas. A linhagem mutante, designada Spolp-72, nas condições experimentais empregadas não biossintetizou esporos por estarvação em solução de sais inorgãnicos, mas evidenciou uma frequência de esporulação menor que 10*-7, após crescimento vegetativo em meio de cultura favorável á esporogênese. A amostra Spolp-72 externa um crescimento vegetativo inicial restringido, quando comparada com a amostra 2390, enquanto que, inversamente, sua atividade respiratória é significativamente mais elevada. Este último comportamento foi confirmado no presente trabalho, contrastando, nesse particular, com outros tipos de mutantes de esporulação já descritos, os quais se encontram bloqueados nos primeiros estágios da via esporogenética.A spontaneous mutant strain derived from the sporogenic B. licheniformis 2390 was studied with a view to determining at what developmental stage toward sporulation it was blocked. Electronmicrographs suggested that the mutant cells harvested during the stationary phase of the growth curve were unable to go beyond stage I of sporogenesis (i. e., their nucleoid remained as an axial filament. On the other hand, antibiotic production (bacitracin and proteolytic activity were easily detected. Under the present experimental conditions the mutant strain, named Spolp-72, did not synthesize spores by starvation in a solution of inorganic salts, in contrast with the parental
Esport e propaganda política: um estudo comparado dos governos de Vargas (1930-1945 e Perón (1946-1955 Deporte y propaganda política: un estudio comparado de los gobiernos de Vargas (1930-1945 Y Perón (1946-1955 = Sports and political propagand:a comparative study of the Vargas Government (1930-1945 and Peron (1946-1955
Victor Andrade de Melo
Full Text Available Este artigo tem por objetivo analisar a utilização do esporte como instrumento político durante e primeira Era Vargas, no Brasil, e durante os dois primeiros mandatos de Juan Domingo Perón, na Argentina. Tanto Vargas como Perón buscavam identificar o regime político com as vitórias obtidas no campo esportivo. Desta forma, o controle estatal sobre o esporte e sua utilização pelos meios de propaganda política visavam criar um elo de identificação nacional entre o esporte e os governos, ressaltando os novos modelos de nação e cidadãos engendrados pelo varguismo e pelo peronismo. Pretendeuse também analisar as diferenças na abordagem de cada governo sobre o esporte e seus modelos de intervenção na estrutura política interna do esporte. Esperase que este trabalho possa trazer contribuições significativas para o debate sobre a produção de um ideário político através do esporte, assim como sobre o processo de formação de identidades nacionais na América Latina, mais especificamente no Brasil e na Argentina.Este artículo tiene por objetivo analizarla utilización del deporte como instrumento político durante la primera etapa Vargas, en Brasil, y durante los dos primeros mandatos de Juan Domingo Perón, en Argentina. Tanto Vargas como Perón buscaban identificar su régimen político con las victorias obtenidas en los campos de deporte. De esta forma, el control estatal sobre el deporte y su utilización por los medios de propaganda política reafirmaban la identificación nacional entre el deporte y los gobiernos, resaltando los nuevos modelos de nación y ciudadanos creados por el varguismo y el peronismo. Se pretende también analizar las diferencias en la forma en que cada gobierno abordó el deporte y sus modelos de intervención en la estructura política interna del mismo. Se espera que este trabajo aporte contribuciones significativas para el debate sobre la producción de un ideario político a través del deporte
Alessandro Carvalho Bica
Full Text Available As primeiras décadas da chamada era Vargas podem ser caracterizadas por suas mudanças políticas, culturais, sociais ou pedagógicas. No que tange às transformações ou alterações no campo da escolarização, muitos pesquisadores tem se dedicado a pesquisas acerca dessa temática. Ademais, afirma-se que a preocupação com os rumos educacionais e os altos índices de analfabetismo da população brasileira, inflamou os discursos políticos no limiar da década de 1930. Nesta ótica, o Manifesto dos Pioneiros da Educação Nova consolidou a visão de um segmento da intelectualidade que, embora com diferentes posições, vislumbrava a possibilidade de interferir na organização da sociedade brasileira do ponto de vista da educação. Neste sentido, pelo decreto n. 21.731, de 15 de agosto de 1932, a Cruzada Nacional de Educação foi declarada de utilidade pública. Considerava-se que a alfabetização se constituía no elemento básico para a solução de todos os problemas políticos e sociais do Brasil. Em seus principais artigos, o decreto instituía anualmente a Semana da Alfabetização no Brasil, durante o mês de outubro. Esta campanha mobilizou vários setores da sociedade na possibilidade de abrir mais de 10.000 escolas primárias em todo o Brasil. No documento que segue, pode-se observar um discurso permeado de intenções cívicas e patrióticas.
Considerações clínicas e etiológicas das síndromes epilépticas sintomáticas com paroxismos occipitais bloqueados à abertura dos olhos Clinical and ethiological considerations about the symptomatic epileptic syndromes with occipital paroxism bloqued when the eyes open
Gilson Edmar Gonçalves e Silva
Full Text Available A síndrome da epilepsia parcial com paroxismos occipitais no eletrencefalograma (EEG mostra características clínicas heterogêneas. Visando descrever esta rara forma de epilepsia, investigamos a significância dos achados eletrofisiológicos e clínicos em oito pacientes com paroxismos occipitais bloqueados pela abertura dos olhos. Os pacientes foram submetidos a exames radiológicos de RNM do encéfalo e/ou TC de crânio. Houve concordância entre as alterações do EEG e do tipo de crise em 5 pacientes, e entre as anormalidades anatômicas na TC ou RNM com anormalidades focais no EEG em 7 casos. Nossos resultados confirmam que este padrão inusitado origina-se de uma expressão eletrográfica multifatorial.The syndrome of idiophatic partial epilepsy with occipital paroxysms in the EEG shows a considerable clinical heterogeneity. The present paper investigated the signficance of electrophysiologic and clinical characteristics in eigth patients with occipital paroxysms blocked by the eye opening. All patients were submitted to radiological exams including brain MRI and/or CT. There was agreement between EEG findings and type of seizures in 5 patients and between anatomical abnormalities in the MRI or CT and EEG focal abnormalities in 7 patients. Our results confirm that the unusual pattern comes from eletrographic multifactors origins.
Full Text Available This paper argues that Mario Vargas Llosa’s novel The Feast of the Goat (2000 uses the images of the bodies of three of its characters (Urania Cabral, Trujillo and Agustín Cabral to represent the mechanisms of state terrorism at the time of Trujillo’s dictatorship in the Dominican Republic. It is a traumatizing system, which leaves somatic marks in all the actors involved. We analyze the manners in which the Peruvian author uses the images of protagonists’ organic processes to sketch the psychical, emotional and ideological processes and states, linked to or generated by the policies of intimidation.
Full Text Available The modernization process is analyzed here in two peripheral realities of the world system - nineteenth-century Brazil and Sicily - as depicted in La guerra del fin del mundo and in Il gattopardo. In particular, we show how in the world that Vargas Llosa creates there is no social class capable of becoming the leader of the transition towards a modern society that responds to the needs and nature of an independent Brazil. This absence leads to resistances and catastrophic conflicts. Resistance and conflicts help explaining the phenomenon of opposition to the advance of modernity that we are witnessing today.
Navazo, Marta; Díez, J. Carlos
Los asentamientos del EIO 3 del Occidente europeo presentan unas cadenas operativas en donde los clásicos sistemas de explotación musterienses se intercambian, dando lugar, según nuestro método de análisis, a decenas de categorías diferentes. Estos núcleos, bien sobre lasca, bien sobre canto, originan morfotipos en gran variedad de soportes. En la Meseta norte hay al menos tres asentamientos que comparten estas características, Prado Vargas, Millán y Hundidero. Trataremos de conocer a través ...
Niño Cerinza, Sonia
Esta investigación constituye un estudio de caso en el que se busca realizar un balance de la implementación de la política de ciclos (RCC) en un Colegio Público de la ciudad de Bogotá, se abordó en la localidad cuarta de San Cristóbal el Colegio Técnico Tomás Rueda Vargas, por ser considerado desde la Secretaria de Educación, una de las propuestas exitosas en la implementación de la Reorganización Curricular por Ciclos. Lo que se persiguió principalmente en este ejercicio fue identificar los...
Jorge Valenzuela Garcés
Full Text Available En este artículo nos ocupamos de analizar el modo en que Mario Vargas Llosa construye, en el texto “La literatura es fuego”, la imagen del héroe intelectual a partir de la vida del poeta Carlos Oquendo de Amat. El texto “La literatura es fuego”, leído el 11 de agosto de 1967, en Caracas, a propósito de la concesión a Vargas Llosa del Premio Rómulo Gallegos, es uno de los más extraordinarios discursos dados por un escritor al momento de recibir un premio literario. El énfasis con el que se construye la imagen del escritor inconforme a partir del recuerdo de un poeta como Carlos Oquendo de Amat y la forma en que la literatura es presentada como una actividad crítica, corrosiva e indomeñable, convierte este discurso en una muestra del desarrollo que, entonces, el campo intelectual había alcanzado en relación a los niveles de conciencia que los escritores de la época tuvieron respecto a su propia condición, a su oficio y a sus relaciones con el poder. Para el análisis empleamos el marco de la crítica cultural y nos centramos en las relaciones que los intelectuales, a través del ejercicio de la literatura, establecen con el poder.
Jorge Valenzuela Garcés
Full Text Available El proyecto de “novela total” que concibieron y llevaron a la práctica connotados integrantes del “boom” de la novela hispanoamericana tuvo extraordinarias muestras en textos como Cien años de soledad o La casa verde. En este estudio nos ocupamos de describir el campo literario delos años sesenta y el modo en que este influye, a través de la figura del compromiso, en las demandas al escritor-intelectual de izquierda sobre la necesidad de proyectar, en los textos literarios, una imagen integral del proceso histórico y social del continente. El análisis se centra en la forma en que Vargas Llosa construye, a partir del análisis de una novela como Cien años de soledad, el proyecto de la novela total y el modo en que la novela del escritor colombiano representó esta totalidad respondiendoa las demandas del campo literario en un contexto marcado porun discurso que entonces explicaba la situación de retraso de nuestro continente debido a la dependencia del imperialismo.Palabras claves: Mario Vargas Llosa, novela total, campo intelectual, campo literario.
Auluck, S K H
Recent resurgence of interest in applications of dense plasma focus and doubts about the conventional view of dense plasma focus as a purely irrotational compressive flow have re-opened questions concerning device optimization. In this context, this paper re-appraises and extends the analytical snowplow model of plasma focus sheath evolution developed by F. Gratton and J.M. Vargas (GV) (Energy Storage, Compression and Switching, Ed. V. Nardi, H. Sahlin, and W. H. Bostick, Eds., vol. 2. New York: Plenum, 1983, p. 353) and shows its relevance to contemporary research. The GV model enables construction of a special orthogonal coordinate system in which the plasma flow problem can be simplified and a model of sheath structure can be formulated. The LPP plasma focus facility, which reports neutron yield better than global scaling law, is shown to be operating closer to an optimum operating point of the GV model as compared with PF-1000.
Eduardo Marks de Marques
Full Text Available The following article will present reflections about the character Urania in the novel The Feast of the Goat, originally published in 2000 by Peruvian writer Mario Vargas Llosa. To this analysis, the concept of historiographical metafiction, coined by Linda Hutcheon ( 1991 was used to discuss the relations between literature and history in the novel. In what concerns the analysis of the character Urania (core of this article, the lathing of memory and trauma is central, since the character suffered a traumatic experience in a difficult era of the Dominican Republic: the Trujillo Era (1930-1961. On the pathway between theory and practice, that is, the historical living experience and the historical knowledge, stands Urania and the power to recreate, using fiction, the consequences that dictatorships can have upon individuals. Besides, it is exactly in the movement between theory and practice that the reconstruction of Urania’s Dominican identity becomes possible.
Full Text Available La novela de Mario Vargas Llosa Lituma en los Andes1 poco tiene que ver, aparentemente, con el mundo narrativo de José María Arguedas: las nuevas aventuras de un personaje ficticio bien conocido de los lectores, presente en varias obras anteriores de aquel autor, en nada se asemejan a las del niño Ernesto ni a las de otro protagonista arguediano. Los Andes sirven de decorado para los dos relatos, pero entre la naturaleza y los pueblos que se suceden en Los ríos profundos2en toda su diversidad, y los paisajes hoscos y siempre peligrosos por los que cruza Lituma, apenas reconoce el lector aquella parte del sur peruano. Algunos detalles, sin embargo, al examinar bien el texto y el contexto de Lituma en los Andes, llaman la atención.
La relación entre teoría política y literatura quizás no pueda contarse entre las más fecundas si se la compara con el vínculo que han establecido disciplinas como la filosofía, la historia y la psicología. Si bien la política ha ocupado un lugar central en la literatura es difícil sostener que la teoría política haya obtenido un sitio destacado. Una notable excepción encontramos en la novela La guerra del fin del mundo de Mario Vargas Llosa, no porque el autor se dedique a la teoría política...
Auluck, S K H
Dense Plasma Focus (DPF) is known to produce highly energetic ions, electrons and plasma environment which can be used for breeding of short-lived isotopes, plasma nanotechnology and other material processing applications. Commercial utilization of DPF in such areas would need a design tool which can be deployed in an automatic search for the best possible device configuration for a given application. The recently revisited [S K H Auluck, Physics of Plasmas 20, 112501 (2013)] Gratton-Vargas (GV) two-dimensional analytical snowplow model of plasma focus provides a numerical formula for dynamic inductance of a Mather type plasma focus fitted to thousands of automated computations, which enables construction of such design tool. This inductance formula is utilized in the present work to explore global optimization, based on first-principles optimality criteria, in a 4-dimensional parameter-subspace of the zero-resistance GV model. The optimization process is shown to reproduce the empirically observed constancy ...
Santos, Tânia Cristina Franco; Gomes, Maria da Luz Barbosa; Oliveira, Alexandre Barbosa de; Almeida Filho, Antonio José de
This is a historical and social study, which aimed to describe the main characteristics of the Vargas and Franco dictatorships, and to analyze the implications of these to the institutionalization of nursing in Brazil and Spain. As fonts, it was used written documents located in the historical Brazilian and Spanish archives, in addition to the literature on the subject. Data analysis, supported by concepts of Pierre Bourdieu's World Social Theory, showed that, in Brazil and Spain, in referring to the social division of labor, the meeting point between Church and the State was the seclusion of women in private space. It is concluded that the feminine qualities were capitalized by the nurses to legitimize their actions in public space, even to reproduce in that space, consented to by the State and Church, occupations appropriate to femininity.
Héctor A. Vargas
Full Text Available The native tree Schinus molle (Anacardiacae is reported for the first time as a host plant for larvae of the little known geometrid moth Eupithecia yubitzae Vargas & Parra (Lepidoptera, Geometridae in the Atacama Desert of northern Chile, based on morphology and DNA barcodes. This discovery importantly expands the host range of E. yubitzae, as previous records were restricted to Fabaceae trees. Larvae were previously known as florivorous, while these were found to be folivorous on S. molle. Furthermore, host-associated cryptic larval polychromatism was detected, as larvae collected on S. molle were found to be mostly pale green, contrasting with the dark yellow ground color of the larvae typically collected on fabaceous host plants.
Osteossíntese das fraturas da extremidade proximal do úmero com sistema de placa de ângulo fixo com parafusos bloqueados: técnica e resultados Osteosynthesis of proximal humeral end fractures with fixed angle plate and locking screws: technique and results
Full Text Available OBJETIVO: Descrever os resultados do tratamento cirúrgico das fraturas da extremidade proximal do úmero com a placa de sistema bloqueado Philos. MÉTODOS: Entre março de 2003 e outubro de 2004 foram avaliados, de forma prospectiva, 24 de 26 pacientes com fratura da extremidade proximal do úmero tratados com a placa Philos. A média de seguimento foi de 12 meses e da idade dos pacientes, de 57 anos. Seis pacientes tinham fraturas em quatro partes, 11 em três partes e nove em duas partes. A avaliação clínica foi feita por meio dos critérios da University of California at Los Angeles (UCLA. RESULTADOS: A média do escore da UCLA foi de 30 pontos (17-35. Todas as fraturas consolidaram. Em três pacientes a fratura consolidou em varo. Nesses, o índice da UCLA médio foi de 27 pontos. CONCLUSÃO: A osteossíntese com a placa Philos permite fixação estável com bom resultado funcional.OBJECTIVE: Describe the results of proximal humeral fractures surgically treated with the Philos locking plate system. METHOD: Between March 2003 and October 2004 we prospectively reviewed 24 of 26 patients with proximal humerus fractures treated with a Philos plate. The mean follow-up time was 12 months and the mean age of patients was 57 years. Six patients had four-part proximal humerus fractures, 11 patients had three-part proximal humerus fractures, and nine patients had two-part proximal humerus fractures. Clinical evaluation was performed using the University of California at Los Angeles (UCLA criteria. RESULTS: The mean UCLA score was 30 points (17-34. All fractures showed union. Three patients showed fracture union at varus position. The mean UCLA score for these patients was 27 points. CONCLUSION: Osteosynthesis with Philos plate provides a stable fixation method with good functional outcome.
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...
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...
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....
Full Text Available The Irish revolutionary Roger Casement, executed in 1916, has spawned an army of books, articles, and news stories, more about his diaries and the authenticity controversy that still surrounds them than about his seminal work encouraging and arming Irish separatism or his humanitarian investigations in the Congo and the Peruvian Amazon. His aura and image in life, and more so in death, was Christ-like. A cult developed that required him to be sexless. The more he was said to be an active homosexual, as graphically revealed in his journals, ironically, the more he was revered as an icon by his Catholic nationalist supporters. The entry of Nobel prizewinning novelist Mario Vargas Llosa to the field and his adoption of a mixed, even contradictory, view of Casement’s sexuality in his Dream of the Celt (2010 has sparked a new round of disputation particularly from Angus Mitchell, the foremost proponent of the diary forgery theory. This emerges in his extensive Field Day Review articles, one of which provides a full history of the controversy.
Full Text Available Cet article s'ajoute à l'effort persistant et toujours actuel de déchiffrer l'énigme des inégalités persistantes, elles aussi, du Brésil. En reprenant l'interprétation du Brésil moderne proposée par Juarez Brandão Lopes dans les années 1960, on propose une révision de "l'Ère Vargas", de ses signification et portée historique, compte-tenu de la reproduction des inégalités au long du temps. On affirme que la "citoyenneté réglée" a fait naître chez les travailleurs une attente de protection sociale, nourrissant une promesse d'intégration citoyenne qui, même si elle ne s'est pas réalisée, a eu finalement pour tâche d'intégrer mais pas durablement, les travailleurs en tant qu'artisans du processus brésilien de construction de l'État.
Dos pais pobres ao pai dos pobres: cartas de pais e mães ao presidente Vargas e a política familiar do Estado Novo - doi: 10.4025/dialogos.v12i2e3.9 From poor parents to the father of the poor: letters to president Vargas from fathers and mothers and the family policies of the brazilian New State - doi: 10.4025/dialogos.v12i2e3.9 De los padres pobres al padre de los pobres: cartas de padres y madres al presidente Vargas y la política familiar del Estado Novo
Ana Paula Vosne Martins
Full Text Available Este artigo analisa cartas escritas por pessoas comuns para o presidente Getúlio Vargas com o objetivo de receber o abono familiar. Motivados pela política familiar do governo definida pela Constituição de 1937 e pelo Decreto-Lei 3200, de 1941, pais e mães enviavam cartas e fotografias para contar suas histórias de pobreza, mas também para provar como estavam adequados à política demográfica e social do governo.This article analyzes letters written by ordinary people to President Getúlio Vargas with the aim to receive the family allowance. Motivated by government’s family policy defined by the Constitution of 1937 and Decree no. 3200 of 1941, fathers and mothers sent letters and photographs to tell their stories of poverty, but also to prove they conformed to the government’s demographic and social policy.Este artículo analiza las cartas escritas por personas comunes al presidente Getúlio Vargas, con el objetivo de recibir el abono familiar.Estimulados por la política familiar del gobierno, definida por la Constitución de 1937 y por el Decreto Ley 3200 de 1941, padres y madres enviaron cartas y fotografías no sólo para contar sus historias de pobreza, sino también para mostrar cómo se habían adecuado a la política demográfica y social del gobierno.
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Full Text Available En una zona de alto crecimiento poblacional como el estado Vargas, levantar información con el propósito de elaborar escenarios de riesgo ambiental, se hace aplicar al geotecnologías que garanticen la validez y ubicación de los datos recuperados en campo. En este contexto, se desarrolló un estudio en las cuencas La Zorra, Tacagua y Mamo, las más densamente pobladas en el litoral central. Se construyó un sistema de información geográfica para gestionar datos del área de estudio a objeto de producir análisis espaciales que lleven a la generación de un mapa de vulnerabilidad urbana. Para ello se realizó una detección de cambios con imágenes Landsat de distintos años a fin de identificar áreas con cambios significativos. Posteriormente, la cartografía digital de coberturas urbanas se superpuso a los datos del satélite IKONOS y se combinaron con el mapa de amenaza hidrometeorológica para seleccionar áreas críticas. La información colectada de las estructuras dentro de las áreas críticas fue localizada utilizando sistemas de posicionamiento global (GPS. Finalmente, este procedimiento permitió identificar los niveles de daños que podrían sufrir las edificaciones a la hora de un evento extraordinario (aludes torrenciales así como establecer áreas con distintos grados de vulnerabilidad.
Full Text Available Tratando del estudio de la lectura de obras literarias para niños en el período de Vargas, este artículo examina el trabajo de la Comisión Nacional de Literatura Infantil (CNLI y su comprensión de este tipo de lectura. El análisis muestra cómo la perspectiva de aquelllos intelectuales fue determinada por la tensión entre lo lúdico y lo pedagógico. A continuación, el artículo discute la renovación pedagógica propuesta por la Escuela Nueva y sus conexiones con el concepto de la lectura de obras literarias propuestas por la CNLI. Por fin, el texto analiza la obra didáctica de Cecilia Meireles Rute e Alberto resolveram ser turistas (1938. Se há verificado que em esa obra de carácter eminentemente didáctico, la autora dejó clara su relación con los valores consagrados por la Escuela Nueva. Cecilia, en essa obra, intento utilizar recursos literarios, tales como la creación de personajes, espacios de ficción, el uso de diálogos y narraciones, sin obtener el equilibrio en la compleja dinámica entre la enseñanza y lo lúdico. El resultado es una obra que, en comparación con otras de la misma autora, no está a la altura de sus logros literarios.
Full Text Available The study examines three novels of apocalyptic character, Cien años de soledad by Gabriel García Márquez, La guerra del fin del mundo by Mario Vargas Llosa and Estrella distante by Roberto Bolaño.Both in Cien años de soledad and in La guerra del fin del mundo apocalypse is related to the sudden and forced graft of modernity in a backward society and to the inability of the ruling class to understand the disturbing and devastating aspects of such a graft and, more generally, to understand themselves, their own development, their own history.Through the metaliterary component that characterizes them, Garcia Marquez’s and Vargas Llosa’ novels represent literature as an instrument that as memory, as a form of processing and understanding of history, can help to prevent the repetition of the apocalypse they narrate.In Bolaño’s novel, on the contrary, writers seem not to have any cognitive power anymore and their literature not only doesn’t play any salvific role, but rather becomes one of the elements that contributes to the historical catastrophe.
Althausen, Peter L; Hill, Austin D; Mead, Lisa
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
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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.
Phipps, Alison; Barnett, Ronald
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…
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.
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.…
在西班牙语世界乃至全球文学界，马里奥·巴尔加斯·略萨被公认为“结构现实主义大师”，也是起源于二十世纪50年代左右的拉丁美洲文学“爆炸”时期最具代表性和较年轻的一位作家。自从2010年获诺贝尔文学奖，成为这一奖项的第107位得主之后，巴尔加斯·略萨及其作品也被更多中国读者所熟知。其作品中如实展现了拉丁美洲、尤其是秘鲁的社会现实。本文通过对其作品的解析，分析其中所体现出的结构现实主义特征，进而对巴尔加斯·略萨与结构现实主义小说进行更深一步的了解。%In the world of Spanish literature,and even in the whole world,Mario Vargas Llosa has been greatly considered as a "master of structural realism"by the public.He is a one of the most significant novelists and essayists,and one of the younger writers in the Latin American boom,which is started in the 1960s.Since Vargas Llosa became the No.107 winner of the Nobel Prize in Literature in 2010,he and his masterpiece has been known by more Chinese readers.In his works,Vargas Llosa shows the social reality of Latin America,especially in Peru.In the following article,it will embody the characteristics of structural realism by analyzing on Vargas Llosa's works,and then readers are able to have a further understanding of Vargas Llosa and his structural realism novels.
Yasmira González Tovar
Full Text Available En el presente artículo se examina la situación del abastecimiento de agua potable en la parroquia Carlos Soublette (Maiquetía, estado Vargas y, se analiza la distribución espacial del servicio de acueducto por sectores de la referida parroquia. Se destaca la influencia del medio físico local y subregional y el patrón de ocupación del territorio sobre el funcionamiento precario del servicio de acueducto. El estudio se basó en un diseño mixto (de campo y documental, con la aplicación de una encuesta a una muestra de 67 jefes de familia distribuidos, en los nueve sectores en que fue dividida el área de estudio a los fines de la investigación. Se evidencia un déficit crónico en la oferta de agua potable para la parroquia, que se agrava hacia las zonas de mayores altitud y pendiente, y de patrón de ocupación espontáneo, no consolidado y dentro de la poligonal correspondiente al Parque Nacional Waraira-Repano o El Ávila
Full Text Available El debate en torno al papel de los intelectuales tiene un lugar central en el Boom de la Literatura Latinoamericana. Por un lado, porque es un momento en que los escritores saltan a la esfera pública e intervienen en ámbitos que exceden o literario. Por otro, porque ha sido uno de los temas que ha ocupado a la crítica en su afán de adscribir el fenómeno al mercado o a las circunstancias políticas de América Latina. Bajo el supuesto de esa centralidad, el presente artículo busca desentrañar las representaciones del intelectual que aparecen en dos novelas del período: Conversación en la Catedral (1969 de Mario Vargas Llosa y Cien años de soledad (1967 de Gabriel García Márquez. En ellas aparecen elementos y problemáticas presentes en los debates que les son contemporáneos con una mirada más amplia que la que opone al escritor y el político (o al intelectual y el revolucionario. Las tareas propias del letrado y la relación con la esfera pública y con las masas definen a los dos personajes principales a partir de los que se puede reconstruir una definición del intelectual.
巴尔加斯·略萨获得2010年度诺贝尔文学奖对人们重新聚焦拉美文学具有重要的意义。略萨以文学介入生活、介入政治，具有小说家与政治家的双重文化身份。他如一只啄食社会腐肉的兀鹫，用文学对抗社会黑暗、腐朽的独裁政治。在对拉美社会权力结构精细的描绘中，他以虚构小说的方式将理想与现实两个世界对举连通；从而在立体的艺术世界中，扫荡着现实社会生活的荒谬，呼唤人类的尊严。%The Nobel Prize for Literature in 2010 is awarded to Vargas Llosa, which is greatly significant for people to refocus on Latin American literature. As Llosa＇ s literature involves life and politics, he has the dual cultural identity of both a novelist and a statesman. He is like a vulture pecking at the carrion of society, fighting against social darkness and corrupt dictatorship by means of his literature. In his vivid description of the social power structure in Latin America, Llosa manages to connect the worlds of idealism and reality in a fictional manner, thus having swept the social absurdity and called for human dignity in the stereoscopic world of art.
Pedagogies of dress and fashion during World War II: the looks of first lady Darcy Vargas as president of the brazilian legion of assistance (1942-1945 - doi: 10.4025/dialogos.v14i2.470 Pedagogías del vestir y de la moda durante la Segunda Guerra Mundial: las apariencias de la primera dama Darcy Vargas en la presidencia de la legión brasileña de asistencia (1942-1945 Pedagogias do vestir e da moda na Segunda Guerra Mundial: as aparências da primeira-dama Darcy Vargas na presidência da Legião Brasileira de Assistência (1942-1945 - 10.4025/dialogos.v14i2.470
Full Text Available This article proposes an analysis of the participation of First Lady Darcy Vargas as president of the Brazilian Legion of Assistance, in the scope of fashion. We examined the photographs that narrate her performances, looking to detect the dress codes in the appearances of the character, in order to obtain a description of Brazilian fashion during World War II. As such, we conceived and showed that the construction of the character was marked by a wardrobe that contains teachings on clothing trends and manners of composing a look (hair, hairstyle, makeup, which set the trends for fashion among women during that period.Este artículo propone el análisis sobre la actuación de la primera dama Darcy Vargas en la presidencia de la Legión Brasileña de Asistencia, enfocando la moda. Examinamos las fotografías que narran su desempeño, tratando de detectar los códigos de la indumentaria en las apariencias de la protagonista, con el objetivo de obtener una caracterización de la moda brasileña durante la Segunda Guerra Mundial. De este modo, concebimos y mostramos que la construcción de esta personalidad fue marcada por la producción de un guardarropa que contiene enseñanzas sobre las tendencias de ropas y las formas de crear un visual (cabellos, peinados, maquillaje que dictaron la moda femenina del período.Este artigo propõe uma análise sobre a atuação da primeira-dama Darcy Vargas na presidência da Legião Brasileira de Assistência, sob o foco da moda. Examinamos as fotografias que narram suas performances, procurando detectar, nas aparências da personagem, os códigos da indumentária, de modo a obter uma caracterização para a moda brasileira durante a Segunda Guerra Mundial. Deste modo, concebemos e mostramos que a construção da personagem foi marcada pela produção de um guarda-roupa que contém ensinamentos acerca de tendências de roupas e formas de compor o visual (cabelos, penteados, maquiagem que ditaram moda no per
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...
Sadat, Somayeh; Abouee-Mehrizi, Hossein; Carter, Michael W
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
... 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.
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...
... 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 ...
... 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 ...
... 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 ...
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...
Costello, M M
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
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...
Non-linear governing equations and some special non-linear static solutions. The influence of geometrical non-linearity on the linear theory of static subgrade reaction and surface wave motion of a Gibson soil.
Anderson, David W.
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…
Morrisey, M A; Jensen, G A
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
Wu, Ziqi; Robson, Stephani; Hollis, Brooke
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
Wu, Ziqi; Robson, Stephani; Hollis, Brooke
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.
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...
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...
Mark W. Westmoreland
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...
Mark W. Westmoreland
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.
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...
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.
Eastaugh, Steven R
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.
Prætorius, Thim; Hasle, Peter; Edwards, Kasper;
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...
UDAYSINH R. MANEPATIL
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.
Krishnamurthy, K; Venugopal, D; Alimchandani, A K
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
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…
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…
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...
Principais indicadores e ferramentas utilizados pelos gestores: uma análise estatística da percepção dos alunos de MBA da Fundação Getúlio Vargas Management indicators and tools: perceptions of MBA students
Marcelo Cauduro de Castro
Full Text Available O objetivo deste estudo foi identificar a relevância de indicadores e ferramentas de gestão na percepção dos alunos de MBA da Fundação Getúlio Vargas (FGV. Para isso, utilizou-se um questionário com 26 quesitos definidos a partir de pesquisas anteriores e uma escala de variação de importância do tipo Likert. A amostra foi composta de um total de 425 alunos. Desses, 97 entrevistados não selecionaram nenhum indicador ou ferramenta de gestão. Assim, 328 respostas foram analisadas e interpretadas. Os resultados demonstraram que o Fluxo de Caixa Projetado é o indicador de gestão mais relevante, seguido da Margem Líquida de Vendas. Os dados também apontaram, entre as cinco primeiras posições, indicadores considerados mais sofisticados, como, por exemplo, o Balanced Scorcard (BSC, o Earnings before Interest Taxes Depreciation and Amortization (EBITDA e o Economic Value Added (EVA®. Verificou-se também que as exigências relativas à informação contábil variavam de acordo com o perfil dos respondentes. Os resultados demonstram também que não existe um indicador ou ferramenta de gestão que seja considerado ótimo. Finalmente, há indícios apontados pela pesquisa de que, apesar de a contabilidade gerencial ser considerada uma disciplina global, suas especificidades e características podem ser locais ou regionais.The relevance of management indicators and tools, according to perception of 425 MBA students of the Fundação Getulio Vargas, was identified using a questionnaire with 26 queries based on previous surveys. Results from only 328 respondents were analyzed because 97 did not select any management indicator or tool. Project Cash Flow was the most relevant indicator followed by Net Revenues. In addition the three more sophisticated indicators of Balanced Scorecard (BSC, Earnings before Interest Taxes Depreciation and Amortization (EBITDA and Economic Value Added (EVA® were among the first five ranked. Since it was noted
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
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.
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....
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...
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...
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...
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....
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...
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
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...
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...
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...
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...
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...
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...
Germann Molz, Jennie
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...
Bittar, O J
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.
Boisen, Kirsten A; Boisen, Anne Bank; Thomsen, Stine Legarth;
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....
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....
van den Bergh-Braam, A H
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.
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.
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.
Edwards, Don; Kusel, Jim; Oxner, Tom
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.
Glenn A. Melnick PhD
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.
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...
Westley Consulting Ltd.,
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 ...
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...
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
Julie Clothier; 张琳
@@ 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.
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…
Greenglass, Esther R; Burke, Ronald J
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.
Poulsen, Signe; Jørgensen, Michael Søgaard
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...
Ryherd, Erica E; Moeller, Michael; Hsu, Timothy
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.
Greenglass, Esther R; Burke, Ronald J
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
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.
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
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.
Gómez Velásquez, Luis; Gómez Espinosa, Luis Néstor
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
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
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...
... 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 ...
Holst, Malene Kirstine; Kirkegaard, Poul Henning; Christoffersen, L.D.
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....
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.
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.
Powell y Moya, Aquitectos
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.
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...
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...
Zallocco, R L; Joseph, W B; Doremus, H
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.
... 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 - ...
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…
Johnson, Eric D. M.; Kazmer, Michelle M.
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…
Haswell, Janis; Haswell, Richard; Blalock, Glenn
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…
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…
Knoll, K H
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.
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...
Cuddy, Theresa M.; Marchok, Catherine
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...
Sihuin-Tapia, Elsa Yudy; Gómez-Quispe, Oscar Elisban; Ibáñez-Quispe, Vladimiro
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
Sihuin-Tapia, Elsa Yudy; Gómez-Quispe, Oscar Elisban; Ibáñez-Quispe, Vladimiro
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.
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.
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
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.
Meernik, Clare; Baker, Hannah M; Paci, Karina; Fischer-Brown, Isaiah; Dunlap, Daniel; Goldstein, Adam O
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.
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.
Longo, D R; Chase, G A
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.
Pilny, Adam; Mennicken, Roman
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...
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.
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...
Koys, Daniel J; Martin, Wm Marty; LaVan, Helen; Katz, Marsha
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
Danvers, Kreag; Nikolov, Pavel
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.
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
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.
Creteur, Muriel; POCHET, Yves
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. ...
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.
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...
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.
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 ...
TSUMOTO Yuko; TSUMOTO Shusaku
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.
Senagore, Anthony J
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
Wilson, Mark H; Habig, Karel; Wright, Christopher; Hughes, Amy; Davies, Gareth; Imray, Chirstopher H E
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
Strømgaard, Sofie; Rasmussen, Søren Wistisen; Schmidt, Thomas Andersen
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...
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, ...
Burwell, Rebecca; Huyser, Mackenzi
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…
Lynn, Christine; Hales, Jonathan A; Wiener, Paul
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…
Søbjerg, Lene Mosegaard; Noesgaard, Susanne; Henriksen, Jan Erik;
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....
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)
Dranove, D; White, W D; Wu, L
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.
Brotherton, Bob, Ed.; And Others
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…
Shortell, S M
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
Shortell, S M
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.
Henrik H Rasmussen
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
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.
Cooper, John; Black, Carol
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
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.
Neudeck, M M
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.
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...
Egeberg, Alexander; Thyssen, Jacob P; Gislason, Gunnar H;
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...
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
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.
O'Sullivan, E; Deasy, C
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.
Lee Roy Martin
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...
Ferraz, Valéria de Souza
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 ...
Brekke, Kurt Richard; Siciliani, Luigi; Straume, Odd Rune
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...
Bergenholtz, Heidi; Jarlbæk, Lene; Hølge-Hazelton, Bibi
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...
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...
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...
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...
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
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.
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.
Zarb, P; Amadeo, B; Muller, A;
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...
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...
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...
Raffaele Iannone; Alfredo Lambiase; Salvatore Miranda; Stefano Riemma; Debora Sarno
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...
Ríos-Morales, Ruth; Jenkins, Ian
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...
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...
Hankins, G. W.
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.
Bauerschmidt, A D; P. Jacobs
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...
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
Katoue, Maram Gamal; Al-Taweel, Dalal; Matar, Kamal Mohamed; Kombian, Samuel B
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
Eastaugh, S R
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.
Ali Zarei Mahmoudabadi
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.
Marilia Bense Othero
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.
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.
Deborah Chollet; Su Liu; Gilbert Gimm; Cheryl Fahlman; Laurie Felland; Anneliese Gerland; Michelle Banker; Allison Liebhaber
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...
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
Blue, George M.; Harun, Minah
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…
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.
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...
Traverso, G; Lu, C -C; Maa, R; Langer, R; Bourouiba, L
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.
Cormac, H D
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.
van Merode, Godefridus G; Groothuis, Siebren; Hasman, Arie
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
Gilden, D. J.; Scissors, K. N.; Reuler, J B
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...
Van Tuinen, M
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
Illés, S Tamás
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
... 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...
Groot, I.B. de; Otten, W.; Smeets, H.J.; Marang-van de Mheen, P.J.
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
QIAO Chun-yan; WANG Liang-hai; TANG Xin; WANG Tao; YANG Di-ya; WANG Ning-li
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.
Smeets Harm J
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.
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.
Li, Yuguo; Nielsen, Peter V.; Sandberg, Mats
Hospital differ from conventional buildings in terms of ventilation needs. Exhaled infectious droplets or droplet nuclei of an infected patient need to be removed in general wards, waiting areas and isolation rooms to minimize transmission to health-care workers, other patients and visitors...
In 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
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.
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.
Rognås, Leif Kåre; Christensen, Erika Frischknecht; Sloth, Erik;
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...
Harrison, Jeffrey P; Meyer, Sean
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.
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.
Shaffer, F A; Preziosi, P
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
Shaffer, F A; Preziosi, P
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.
Goes, J B; Zhan, C.
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...
Coddington, D C; Palmquist, L E; Trollinger, W V
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.
Marlos Victor Fonsêca de Lima
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.
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
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...
Fajardo-Ortiz, Guillermo; Salcedo-Alvarez, Rey Arturo
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.
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...
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...
... 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. ...
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...
... 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 ...
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...
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...
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...
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.
Heidaranlu, Esmail; Abbas EBADI; Khankeh, Hamid Reza; Ardalan, Ali
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...
Ghanem, Mohamed; Schnoor, Jörg; Heyde, Christoph-Eckhard; Kuwatsch, Sandra; Bohn, Marco; Josten, Christoph
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...
Guyon, Robert E
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
M Adib Hajbaghery; H. Akbari; GA. Mousavi
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...
Ponton, Kevin T; Sandrick, Karen M
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
Vanderbeke, Dave; Christiaens, Johan; Verbruggen, Sandra
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...
L Downey; Lloyd, Hilary
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...
Paice, B.; Gray, J M; McBride, D; Donnelly, T; Lawson, D H
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 ...
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...
Emily Felicia Jan Ee SHEN
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...
Escher, Achim; Hainc, Nicolin; Boll, Daniel
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.
Katona, Katalin; Canoy, Marcel
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.
The Surrey Section of the London Branch held a very successful meeting on Wednesday 9th September 1992 at which Mr Stephen Kirby BSc, CEng, Director of Estates, gave a talk and tour of the new Private Ward Unit and Ultra Clean Ventilation Theatre at Epsom General Hospital. The new Northey Ward, is a result of the refurbishment of what was a 31 bed section of the Hospital Surgical Block on the 5th floor. The new Ward provides a total of 18 single bed Wards, each complete with bathroom/WC, the Unit also accommodates a 5 bed Day Ward. All the facilities provided are of extremely high standard, which given the very tight building programme, detailed elsewhere, is indicative of the dedication of both the Designers and Contractors who are congratulated on their achievement. With regard to the UCV Theatre the following information was prepared by Aidan Hardy who is a Project Engineer with Epsom General Hospital. We are delighted to be able to print this report for our readers. PMID:10122458
Fink, Daniel J.
University teaching hospitals face increasing competition from community hospitals, expanding regulation of health care, consumerism, and a declining urban population base. New marketing strategies are seen as ways in which teaching hospitals can achieve better relationships with institutions, practitioners, and surrounding communities and…
... 27 Alcohol, Tobacco Products and Firearms 1 2010-04-01 2010-04-01 false Hospitals. 31.54 Section 31.54 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND TRADE BUREAU, DEPARTMENT OF... Registration And/or Recordkeeping § 31.54 Hospitals. Hospitals and similar institutions furnishing liquors...
Hospital CEOs say the Persian Gulf crisis could hit them hard where it counts. In fact, hospitals are already seeing some adverse impact from events in the Middle East. From fundraising to plant management to strategic planning, the confrontations in the Gulf are having an impact on the hospital's bottom line.
Radiological incidents present uniquely challenging scenarios for hospital emergency planning and response. Radiological terrorism has been recognized as a probable scenario with high impact and hospitals are being educated to deal with this threat. The purpose of this paper is to present the hospital's experience preparing staff and infrastructure for response to a Radiological Dispersal Device(RDD) explosion
Sylvia Gallegos Espinosa
Full Text Available Rationale: Hospital malnutrition is a global health problem affecting 30-50% of hospitalized patients. There are no estimates of the size of this problem in Ecuadorian hospitals. Hospital malnutrition might influence the quality of medical assistance provided to hospitalized populations. Objectives: To estimate the current frequency of malnutrition among patients admitted to Ecuadorian public hospitals. Materials and methods: The Ecuadorian Hospital Malnutrition Study was conducted between November 2011 and June 2012 with 5,355 patients (Women. 37.5%; Ages ≥ 60 years. 35.1%; Length of stay ≤ 15 days. 91.2% admitted to 36 public hospitals located in the prominent cities of 22 out of the 24 provinces of the country. Malnutrition frequency was estimated by means of the Subjective Global Assessment survey. Results: Malnutrition affected 37.1% of the surveyed patients. Malnutrition was dependent upon patient's age and education level; as well as the presence of cancer, sepsis, and chronic organic failure. Hospital areas showed different frequencies of hospital malnutrition. Health condition leading to hospital admission influenced negatively upon nutritional status. Malnutrition frequency increased as length of stay prolonged. Conclusions: Malnutrition currently affects an important proportion of patients hospitalized in public health institutions of Ecuador. Policies and actions are urgently required in order to successfully deal with this health problem and thus to ameliorate its negative impact upon quality of medical care
... Hospital Deductible and Hospital and Extended Care Services Coinsurance Amounts for CY 2014 AGENCY: Centers... inpatient hospital deductible and the hospital and extended care services coinsurance amounts for services... 21st through 100th day of extended care services in a skilled nursing facility in a benefit...
... Hospital Deductible and Hospital and Extended Care Services Coinsurance Amounts for CY 2011 AGENCY: Centers... inpatient hospital deductible and the hospital and extended care services coinsurance amounts for services... (c) $141.50 for the 21st through 100th day of extended care services in a skilled nursing facility...
... 42 Public Health 3 2010-10-01 2010-10-01 false Hospitals subject to the hospital outpatient..., DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM PROSPECTIVE PAYMENT SYSTEM FOR HOSPITAL OUTPATIENT DEPARTMENT SERVICES Categories of Hospitals and Services Subject to and Excluded From the...
... 42 Public Health 5 2010-10-01 2010-10-01 false Condition: Relationships with hospitals, critical access hospitals, and tissue banks. 486.322 Section 486.322 Public Health CENTERS FOR MEDICARE & MEDICAID... Measures § 486.322 Condition: Relationships with hospitals, critical access hospitals, and tissue banks....
Vaughan-Sarrazin Mary S
Full Text Available Abstract Background The emergence of physician owned specialty hospitals focusing on high margin procedures has generated significant controversy. Yet, it is unclear whether physician owned specialty hospitals differ significantly from non physician owned specialty hospitals and thus merit the additional scrutiny that has been proposed. Our objective was to assess whether physician owned specialty orthopedic hospitals and non physician owned specialty orthopedic hospitals differ with respect to hospital characteristics and patient populations served. Methods We conducted a descriptive study using Medicare data of beneficiaries who underwent total hip replacement (THR (N = 10,478 and total knee replacement (TKR (N = 15,312 in 29 physician owned and 8 non physician owned specialty orthopedic hospitals during 1999–2003. We compared hospital characteristics of physician owned and non physician owned specialty hospitals including procedural volumes of major joint replacements (THR and TKR, hospital teaching status, and for profit status. We then compared demographics and prevalence of common comorbid conditions for patients treated in physician owned and non physician owned specialty hospitals. Finally, we examined whether the socio-demographic characteristics of the neighborhoods where physician owned and non physician owned specialty hospitals differed, as measured by zip code level data. Results Physician owned specialty hospitals performed fewer major joint replacements on Medicare beneficiaries in 2003 than non physician owed specialty hospitals (64 vs. 678, P Conclusion Physician owned specialty orthopedic hospitals differ significantly from non physician owned specialty orthopedic hospitals and may warrant the additional scrutiny policy makers have proposed.
This work was carried out by a nursery licensed group in the Clinicas Hospital - Dr. Manuel Quintela.The nature and functioning of Services and the allocation of resources, are essential for the analysis of the Survey of the hospitalized oncology patients in the Institution. To develop a model of care that constitutes a health care as well as teaching and research in the country regarding the quality of care was defined the following topics: lower risks for the patient, safer care, personal trained and specialized to promote relationship between the offering and the person receiving the service. The assessment and management performance of the services involved in the operation are the result of the degree of user satisfaction. Objective: To determine the human and material necessary for the care of cancer resources users, considering their number, treatment, complications and nursing care derived from each pathology and stage of disease. Methodology: A comparative descriptive study of the same population was conducted in two transverse sections in relation to two different times which are based on the design of a form that allowed hospitalized to collect information on users 6/12/03 and 6/16/04. Other instruments used were the clinical history and the daily census staff Patients and Nursing Division. Results and conclusions: A comparative descriptive analysis already mentioned are: increased internships and cancer patients; between 50 and 64 is the highest number of patients; diagnoses Face and Neck and maintain the Digestive System more cases; the number of patients doubles and Hematology Neurological from one to another period. Chemotherapy is the treatment choice and there is a decrease in the surgical and medical; more patients in the study; in the origin, Montevideo has the largest number of patients followed by Canelones. Line of nursing intervention will be carried out in short, medium and long term
Hao, Aimin; Yi, Tao; Li, Xia; Wei, Lei; Huang, Pei; Xu, Xinzhou; Yi, Lihua
Purpose: The quality of medical services provided by competing public hospitals is the primary consideration of the public in determining the selection of a specific hospital for treatment. The main objective of strategic planning is to improve the quality of public hospital medical services. This paper provides an introduction to the history, significance, principles and practices of public hospital medical service strategy, as well as advancing the opinion that public hospital service strategy must not merely aim to produce but actually result in the highest possible level of quality, convenience, efficiency and patient satisfaction.
Hao, Aimin; Yi, Tao; Li, Xia; Wei, Lei; Huang, Pei; Xu, Xinzhou; Yi, Lihua
Purpose: The quality of medical services provided by competing public hospitals is the primary consideration of the public in determining the selection of a specific hospital for treatment. The main objective of strategic planning is to improve the quality of public hospital medical services. This paper provides an introduction to the history, significance, principles and practices of public hospital medical service strategy, as well as advancing the opinion that public hospital service strategy must not merely aim to produce but actually result in the highest possible level of quality, convenience, efficiency and patient satisfaction. PMID:27273960
Health care (Biomedical) waste is a term used for all waste arising from health care establishments. In most of health care centers of Pakistan, including Lahore, hospital wastes are simply mixed with the municipal waste in collecting bins at road-sides and disposed off similarly. Proper Management of biomedical waste, especially the hazardous one, being produced in hospital settings is important in terms of their ability to cause harm to the related per-sons and the environment as well. To Observe and compare the practices regarding Hospital Waste management of the public sector hospital with private sector hospital. Descriptive, Cross sectional. Methodology: Standardized checklist was used to assess the practices of nursing and sanitary staff. Practices regarding waste segregation were same at both hospitals. While practices regarding waste collection and transportation were better at The Children's Hospital. Public sector hospital has, paradoxically, better practices regarding hospital waste management in comparison to private sector hospital. (author)
Fabiana Rossi Varallo; Helaine Carneiro Capucho; Cleópatra da Silva Planeta; Patrícia de Carvalho Mastroianni
OBJECTIVES: Drug safety problems can lead to hospital admission. In Brazil, the prevalence of hospitalization due to adverse drug events is unknown. This study aims to estimate the prevalence of hospitalization due to adverse drug events and to identify the drugs, the adverse drug events, and the risk factors associated with hospital admissions. METHOD: A cross-sectional study was performed in the internal medicine ward of a teaching hospital in São Paulo State, Brazil, from August to Decemb...
Antonio Morra; Lorenzo Odetto; Pierangelo Bozzetto
The terms “disaster” or “surge capability”, referred to hospitals, are often used to define a massive casualty admission. This may be a misleading concept, because emergency may as well arise from inside hospitals, and the last years high figures related to fires in the about 2,000 italian hospitals should suggest a different point of view. In this article the authors describe their experience in hospital preparedness at Ospedale Martini in Turin. Hospital operators re...
Fajardo-Ortiz, Guillermo; Fajardo-Dolci, Germán
Until now the bed has been the basic physical resource in hospitals. This type of furniture has served to study and treat patients, through out the centuries it has undergone changes in the materials they are made of dimensions, functionality, accessories, aesthetic, and design. The hospital bed history is not well known, there are thousands of documents about the evolution of hospitals, but not enough is known about hospital beds, a link between the past and the present. The medical, anthropological, technological, social, and economic dynamics and knowledge have produced a variety of beds in general and hospital beds in particular. From instinctive, rustic, poor and irregular "sites" that have differed in shape and size they had evolved into ergonomic equipment. The history of the hospital bed reflects the culture, techniques and human thinking. Current hospital beds include several types: for adults, for children, for labor, for intensive therapy, emergency purposes, census and non census beds etc.
Stagelund, Søren; Lippert, Freddy Knudsen
INTRODUCTION: Documentation of and staff compliance with guidelines during in-hospital cardiac arrest are very important. The purpose of the study is to clarify to what extent treatment of cardiac arrest was documented and whether the staff followed the hospital's protocol for cardiac arrest...... treatment in 2005. MATERIALS AND METHOD: Medical records for 50 consecutive in-hospital cardiac arrests in 2005 were analysed and compared to 50 consecutive cardiac arrests in 2001. The hospital is a tertiary referral hospital with 1100 beds and all medical specialities available. INCLUSION CRITERIA: All in-hospital...... cardiac arrest calls. Essential data for the in-hospital Utstein-style was used as the golden standard for documentation when reviewing medical records. RESULTS: Results are expressed for 2005 (2001), Test: chi2 (Fisher). Treatment documented: Fully: 32 (22). (P=0.0704). Treatment complying with...
Clement, J P; D'Aunno, T A; Poyzer, B L
In the last decade, an important innovation in the organizational structure of acute care hospitals occurred. Many hospitals restructured by creating subsidiaries that segment assets or services into separate corporations. We know relatively little about the effects of such restructuring. This paper examines the association of restructuring with financial performance of not-for-profit hospital firms. The study uses data from all not-for-profit acute care hospital firms in Virginia, the only state for which the unique study data are available. We find that the consolidated financial performance of hospital firms is influenced by factors that affect the hospital's financial performance (i.e., payer-mix, staffing and service mix) but not the number or size of non-hospital subsidiaries. Future research should examine the effect of restructuring on other types of performance. PMID:8231338
Full Text Available Objectives: In this study, our aim was to evaluate and classify the voluntary error reports in the hospitals of Mashhad University of Medical Sciences. Patients have the right to receive health care in accordance to the best standards. Health care carries a risk of harm for patient safety, and with respect to today’s stressful systems with a large number of patients, it would be inevitable. The meaning of risk management is to predict adverse events and reduce their occurrence.Materials and Methods: A voluntary medical error reporting form was designed and approved by the clinical governance team of Mashhad Medical University. They were then distributed inside hospitals in the way in which everyone (health providers and patients could access them easily. The forms were collected and classified monthly in all wards. Classification was performed on the base of type, outcome and reporter. Data gathering took place from spring to autumn 2012. The data was analyzed by the SPSS software. Results: 2500 errors were extracted from 1000 voluntary error reporting forms of the 12 hospitals of Mashhad Medical University. The most frequent error type was treatment errors (36% related to drug administration, standard procedures and surgical events. Conclusions: Error reporting as a basic activity has an important role in discovering pitfalls of the health care system. To promote the reporting culture, its non punitive base must become clear for all professors and staff members, because this kind of reporting could lead to fewer medical errors and higher staff awareness about probable errors.
Amestoy, Simone Coelho; Trindade, Letícia de Lima; Waterkemper, Roberta; Heidman, Ivonete Teresinha Schülter; Boehs, Astrid Egged; Backes, Vânia Marli Schubert
The aim of this study is make a theorical-reflection about the importance of using dialogical leadership in hospital institutions through Freirean referencial. The dialogical leadership pattern differs from the coercive and autocratic methods, for being reasoned on the establishment of an efficient communicational process, able to stimulate autonomy, co-responsibility and appreciation of each member from nurse team. The dialogical leadership, unlike the directive one, is a management instrument, that pursuits to minimize the conflicts and stimulate the formation of healthy interpersonal relationships, which can contribute to the improvement of organizational atmosphere and quality care provided to health services users.
Barcie, Joseph S
Mexico is one of the richest countries in Latin America and over the last several decades there have been many changes in the healthcare delivery systems, from universal healthcare coverage for all Mexicans to the fast paced expansion of private healthcare. Like many countries, Mexico has both private and public health systems and hospital administrators are facing challenges on multiple fronts in addition to facing exciting new opportunities. In this article you will get a bird's eye view of this ever changing panorama. How the new growing middle class consumerism has impacted physicians, health insurance and private healthcare industry. PMID:26521381
integrated and detailed analysis and description model for hospital materials management data and tasks, which is able to tackle information from patient requirements to usage, from replenishment requests to supplying and handling activities. The model takes account of medical risk reduction, traceability and streamlined processes perspectives. Second, the paper translates this information into a business process model and mathematical formalization.The study provides a useful guide to the various relevant technology‐related, management and business issues, laying the foundations of an efficient reengineering of the supply chain to reduce healthcare costs and improve the quality of care.
Don Rosenthal, a former Ames Research Center computer scientist who helped design the Hubble Space Telescope's scheduling software, co-founded Allocade Inc. of Menlo Park, California, in 2004. Allocade's OnCue software helps hospitals reclaim unused capacity and optimize constantly changing schedules for imaging procedures. After starting to use the software, one medical center soon reported noticeable improvements in efficiency, including a 12 percent increase in procedure volume, 35 percent reduction in staff overtime, and significant reductions in backlog and technician phone time. Allocade now offers versions for outpatient and inpatient magnetic resonance imaging (MRI), ultrasound, interventional radiology, nuclear medicine, Positron Emission Tomography (PET), radiography, radiography-fluoroscopy, and mammography.
Escher, Achim; Hainc, Nicolin; Boll, Daniel
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. PMID:27514111
These guidelines have been drown up to assist all those involved in the management and maintenance of hospitals and health care establishments. Compliance with this guidance should minimise the risk of pollution occurring. The guidelines are jointly produced by the Environment Agency for England and Wales, the Scottish Environment Protection Agency and the Environment and Heritage Service for Northern Ireland, referred to as the Agency or Agencies. It includes guidelines on site drainage, sewage and waste water disposal, treatment of surface water drainage and waste management
Kirkland, Lisa L; Kashiwagi, Deanne T; Brantley, Susan; Scheurer, Danielle; Varkey, Prathibha
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.
Smith, J E; Phillips, D J; Meyer, G E
Several ways used by the pharmacy department of a large university hospital to generate revenue through diversification are described. The department offers its facilities and staff as a resource in training medical service representatives for several pharmaceutical manufacturers, which is projected to provide $85,000 in net income for fiscal year (FY) 1983-84. The pharmacy department also conducts a six-month program for training pharmacy technicians, which yields a small net profit. The pharmacy department actively participates in educational programs such as college courses and clerkships earning extra income. An apothecary-style outpatient pharmacy was set up under a for-profit corporation. Services have been expanded to include the preparation of i.v. solutions that support home care. A durable medical equipment (DME) business is planned. The ambulatory and home-care programs are expected to generate approximately $165,000 in net profit next year. Contract pharmaceutical services are provided to another hospital. The net income generated through diversification in this pharmacy department will exceed $250,000 in FY 1983-84.
Full Text Available Abstract Objective In-hospital mortality is an important performance measure for quality improvement, although it requires proper risk adjustment. We set out to develop in-hospital mortality prediction models for acute hospitalization using a nation-wide electronic administrative record system in Japan. Methods Administrative records of 224,207 patients (patients discharged from 82 hospitals in Japan between July 1, 2002 and October 31, 2002 were randomly split into preliminary (179,156 records and test (45,051 records groups. Study variables included Major Diagnostic Category, age, gender, ambulance use, admission status, length of hospital stay, comorbidity, and in-hospital mortality. ICD-10 codes were converted to calculate comorbidity scores based on Quan's methodology. Multivariate logistic regression analysis was then performed using in-hospital mortality as a dependent variable. C-indexes were calculated across risk groups in order to evaluate model performances. Results In-hospital mortality rates were 2.68% and 2.76% for the preliminary and test datasets, respectively. C-index values were 0.869 for the model that excluded length of stay and 0.841 for the model that included length of stay. Conclusion Risk models developed in this study included a set of variables easily accessible from administrative data, and still successfully exhibited a high degree of prediction accuracy. These models can be used to estimate in-hospital mortality rates of various diagnoses and procedures.
Bertoli, Paola; Grembi, Veronica
We assess the lifesaving effect of hospital proximity using data on fatality rates of road-traffic accidents. While most of the literature on this topic is based on changes in distance to the nearest hospital triggered by hospital closures and use OLS estimates, our identification comes from...... the exogenous variation in the proximity to cities that are allowed by law to have a hospital based on their population size. Our instrumental variable results, based on Italian municipalities data from 2000 to 2012, show that an increase by a standard deviation of distance to the nearest hospital (5 km......) increases the fatality rate by 13.84% on the sample average. This is equal to a 0.92 additional death per every 100 accidents. We show that OLS estimates provide a downward biased measure of the real effect of hospital proximity because they do not fully solve spatial sorting problems. Proximity matters...
Wright, Donald J
A soft budget constraint arises when a government is unable to commit to not 'bailout' a public hospital if the public hospital exhausts its budget before the end of the budget period. It is shown that if the political costs of a 'bailout' are relatively small, then the public hospital exhausts the welfare-maximising budget before the end of the budget period and a 'bailout' occurs. In anticipation, the government offers a budget to the public hospital that may be greater than or less than the welfare-maximising budget. In either case, the public hospital treats 'too many' elective patients before the 'bailout' and 'too few' after. The introduction of a private hospital reduces the size of any 'bailout' and increases welfare. Copyright © 2015 John Wiley & Sons, Ltd. PMID:25740723
Pharmaceutical expenditure growth has outpaced GDP and healthcare expenditure growth rates in Denmark as in most OECD countries for the last decade. A major part of this increase was due to high growth rates in specialist areas that are typically located in hospital settings. Yet the market for h...... and the introduction of new medicines in the hospital sector. Centralised tendering may therefore have important implications for competition and industry structure in the long run....... for hospital medicines and their procurement are still poorly understood. The present paper characterises the market for hospital medicines in Denmark in terms of its organisation and developments between 2005 and 2009. In Denmark hospital medicines are publicly financed and procurement is centrally organised....... 98% of all medicines administered at Danish public hospitals are purchased through a public procurement agency by means of public tenders. Using data on actual contract prices we decompose pharmaceutical expenditure growth into the contributions from newly introduced medicines, price and volume...
, is insight into how we can understand and explain how medical professionals adapt hospital management over time in relation to changing hospital management models that are global in their influence in hospital organizations. The aim of this dissertation is to understand and explain how medical professionals......Health care administration in many OECD countries has undergone substantial changes in recent years as a consequence of NPM reforms, rising costs, the pace of technological innovation, heightened competition for patients and resources, quality of managed care and demographic shifts. Hospitals...... especially have been reformed due to the high proportion of resources they absorb and the apparent difficulty of prioritizing and coordinating health care within hospitals. There is abundant research literature on the topic of reforming hospital management models. Lacking from the literature, however...
Xuzhou Center Hospital is in a competing medical market in Xuzhou city. This hospital has been dedicating to improve the medical skills and provide professional and individualized service to the patients in order to improve the patient's experience and increase the patient's satisfaction. On the other side, this hospital has provided an all-round marketing campaign to build up the social influence and public reputation through public-praise marketing, web marketing, media marketing, and scholar marketing. Besides, this hospital has been cooperating with foreign medical institutions and inviting foreign medical specialists to academic communication. With the combined effects of improving medical service and all-round marketing, the hospital's economic performance has been enhanced significantly and laid a solid foundation for its ambition to become the first-class hospital in Huaihai Economic Zone. PMID:25548007
This report documents the findings of a survey of Canadian hospitals conducted by Social Data Research Ltd. during the Spring and Summer, 1995. The main objective of the survey was to determine the state of readiness of Canadian hospitals in respect of radiation emergency planning. In addition, the AECB was interested in knowing the extent to which a report by the Group of Medical Advisors, 'GMA-3: Guidelines on Hospital Emergency Plans for the Management of Minor Radiation Accidents', which was sponsored and distributed in 1993, was received and was useful to hospital administrators and emergency personnel. A self-administered questionnaire was distributed to 598 acute care hospitals, and 274 responses were received. The main conclusion of this study is that, with the exception of a few large institutions, hospitals generally do not have specific action plans to handle minor radiation accidents. (author)
Rabøl, Louise Isager; McPhail, Mette Arnsfelt; Østergaard, Doris;
the common characteristics of team communication among multiprofessional teams at four Danish acute care university hospitals. Method: Four focus group interviews with multiprofessional hospital teams (N = 24). Results: Communication is particularly vulnerable during handover of patient information between...... distance, team structure, and hospital organization influence team communication and vary between settings and national cultures. These factors must be accounted for before developing or adapting team communication interventions to improve patient safety....
Higashiguchi, Kazuyo; Morikawa, Yuko; Miura, Katsuyuki; Nishijo, Muneko; Tabata, Masaji; Ishizaki, Masao; Nakagawa, Hideaki
Burnout and Related Factors among Hospital Nurses: Kazuyo HIGASHIGUCHI, et al. Department of Nursing, Kanazawa Medical University—The overall goal of this study is to examine the relationship between burnout in hospital nurses and three parameters: occupational factors, individual attributes, and workplace stressors. Two hundred and sixty-eight female nurses from two public general hospitals were surveyed. Three forms were used: first, a demographic data form to ascertain personal attributes;...
Đurišić Jasna; Marković-Denić Ljiljana N.; Ilić Slobodanka; Ramadani Ruždi
Introduction Sick newborn babies in the neonatal intensive care units (NICU) are al increased risk for hospital-acquired infections (HI). The aim of our study was to determine the incidence and localization of neonatal hospital infections in NICU. Material and methods A prospective, six-month study was carried out in a NICU. All patients hospitalized in NICU longer then 48 hours were examined according to their basic descriptive-epidemiological characteristics and the incidence of all hospita...
Pendergast, J F; Vogel, W B
This article presents a model for projecting future hospital bed requirements, based on clinical judgment and basic probability theory. Clinical judgment is used to define various categories of care, including a category for patients who are inappropriately hospitalized, for a large teaching hospital with a heavy indigent and psychiatric workload. Survey results and discharge abstract data are then used to calculate expected discharges and patient days for each clinical category. These expect...
Betzler, M; Haun, P
Hospitals are competing with each other for the limited financial resources available in the health care sector. Comparison of hospitals is legally required (BPf1V section 5) to improve financial efficiency in the health care sector and make competition between hospitals keener, while also objectivizing it. If comparison of the hospitals is really to enhance profitability or efficiency, and not just to reduce the prices for hospital stays regardless of quality, it must extend to far more than the global figures in the compilation summarizing performance and calculation and the hospital statistics (no. of cases, days of care, length of stay, case lump sums and special fees). Documentation of particular features of the patient population, the potentials of the hospital and description of the treatment processes yield valuable information on capacity and performance level. With rising costs, the danger is growing that the quality and risk dimension of the actual medical treatment will not be promoted with the same enthusiasm by those offering the service. Hospital audit does not only allow a check on the hospital's own situation with regard to performance, quality, efficiency and patient satisfaction, but can also provide a basis of structural planning. The fact is that all efforts made and steps taken by the responsible persons in the hospital to improve the quality of structures, processes and results can only be successful if they are also perceived by the patients, the doctors who refer them and the visitors. If hospital audit is restricted to the bed occupancy and the invoicing data, it is only realistic to expect cuts in performance level. This would be bad for the patient and, in view of the consequent costs, also for the overall costs in the health care sector. Against the backdrop of a future performance-related system of remuneration instead of the principle of covering one's own costs that has been in place hitherto, openness about treatment results gains
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...
The purpose of this dissertation has been to analyse the current and future scenario of the hospitality industry in India. With India shining, the hospitality sector is quickly growing and maturing with time. It is constantly reinventing itself to compete on an international level. This dissertation aims to fill in some gaps which are quite evident in the existing literature review on the hospitality industry in India. There is not much published on this prospering sector. With the Indian...
Dikeç, Mustafa; Clark, Nigel; Barnett, Clive
The recent revival of the theme of hospitality in the humanities and social sciences reflects a shared concern with issues of belonging, identity and placement that arises out of the experience of globalized social life. In this context, migration–or spatial dislocation and relocation–is often equated with demands for hospitality. There is a need to engage more carefully with the 'proximities' that prompt acts of hospitality and inhospitality; to attend more closely to their spatial and tempo...
Budak, Ezel Ezgi
Ankara : The Department of Industrial Engineering and the Graduate School of Engineering and Science of Bilkent University, 2012. Thesis (Master's) -- Bilkent University, 2012. Includes bibliographical refences. In this thesis, we study the call center operations of a particular hospital located in Ankara, namely Güven Hospital. The hospital call center takes role as a medical consulting and appointment center and also domestic call traffic flows over the call center. These ...
Ruitenberg, Claudia Wilhelmina
Hospitality, the reception of the other, is a perennial ethical demand, but one which is felt acutely in contemporary Western societies, because of increased ethnocultural diversity. In this dissertation, I argue that an important aim of education should be to shape students' identities in such a way that they have a capacity for hospitality. Educating for hospitable identity hinges on the conception of identity informing the educative efforts. Currently, identity is commonly conceived of as ...
Snail, T S; Robinson, J C
This paper outlines a conceptual framework of organizational diversification and assesses the state of empirical research on hospital organizational change. The literature on economic organization of hospitals, one of the most developed branches of health services research, still has only weak ties to economic theory. Evolving physician-hospital organizations do not fit into existing frameworks based on horizontal integration, vertical integration, or diversification. Empirical research has primarily focused on horizontal integration, and cause-effect relationships are often obscured by models that depart from economic theory and lack controls for self-selection bias. Recent empirical studies indicate that hospital mergers had moderate, rather than dramatic, effects on the rate of change in operating costs, staffing, and scale. Mergers rarely resulted in hospital closure, but were as likely to result in acute care consolidation and restructuring as in conversion to non-acute inpatient uses. While administrative costs were higher in for-profit than non-profit system hospitals, total costs were similar. System hospitals had lower marginal and average costs per stay than independent hospitals. Hospital vertical integration into subacute care was largely an artifact of the governmental uniform pricing system, which encouraged vertical integration. Hospitals that shared governance or financial risks with physicians outperformed those with high levels of physician governance and financial integration (e.g. stock ownership). Formal physician-hospital organizational arrangements often served to coordinate managed care contracting or to forge links with primary care group practices. Hospital diversification into related services improved short-term financial performance over unrelated diversification, although long-term performance was similar.
SUN Ziyong; LI Li; ZHU Xuhui; MA Yue; LI Jingyun; SHEN Zhengyi; JIN Shaohong
The distinction of antimicrobial resistance of clinical bacteria isolated from county hospitals and a teaching hospital was investigated. Disc diffusion test was used to study the antimicrobial resistance of isolates collected from county hospitals and a teaching hospital. The data was analyzed by WHONET5 and SPSS statistic software. A total of 655 strains and 1682 strains were collected from county hospitals and a teaching hospital, respectively, in the year of 2003. The top ten pathogens were Coagulase negative staphylococci (CNS), E. coli, Klebsiella spp. , S. areus, P. aeruginosa, Enterococcus spp. , Enterobacter spp. , otherwise Salmonella spp. , Proteus spp. , Shigella spp. in county hospitals and Streptococcus spp. , Acinetobacter spp. , X. maltophilia in the teaching hospital. The prevalence of multi-drug resistant bacteria was 5% (4/86) of methicillin-resistant S. areus (MRSA), 12% (16/133) and 15.8 % (9/57) of extended-spectrum β-lactamases producing strains of E. coli and Klebsiella spp. , respectively, in county hospitals. All of the three rates were lower than that in the teaching hospital and the difference was statistically significant (P＜0.01). However, the incidence of methicillin-resistant CNS (MRCNS) reached to 70 % (109/156) in the two classes of hospitals. Generally, the antimicrobial resistant rates in the county hospitals were lower than those in the teaching hospital, except the resistant rates of ciprofloxacin, erythromycin, clindamycin, SMZco which were similar in the two classes of hospitals. There were differences between county hospitals and the teaching hospital in the distribution of clinical isolates and prevalence of antimicrobial resistance. It was the basis of rational use of antimicrobial agents to monitor antimicrobial resistance by each hospital.
Hachesu, Peyman Rezaei; Zyaei, Leila; Hassankhani, Hadi
Background: Lack of attention to the proper barcode using leads to lack of use or misuse in the hospitals. The present research aimed to investigate the requirements and barrier for using barcode technology and presenting suggestions to use it. Methods: The research is observational-descriptive. The data was collected using the designed checklist which its validity was assessed. This check list consists of two parts: “Requirements” and “barrier” of using the barcodes. Research community included 10 teaching hospitals and a class of 65 participants included people in the hospitals. The collected data was analyzed using descriptive statistics. Results: Required changes of workflow processes in the hospital and compliance them with the hospital policy are such requirements that had been infringed in the 90 % of hospitals. Prioritization of some hospital processes for barcoding, system integration with Hospital Information system (HIS), training of staff and budgeting are requirements for the successful implementation which had been infringed in the 80% of hospitals. Dissatisfaction with the quality of barcode labels and lacks of adequate scanners both whit the rate of 100 %, and the lack of understanding of the necessary requirements for implementation of barcodes as 80% were the most important barrier. Conclusion: Integrate bar code system with clinical workflow should be considered. Lack of knowledge and understanding toward the infrastructure, inadequate staff training and technologic problems are considered as the greatest barriers. PMID:27482137
Rosolio, Charles E
Relationships with hospitals and outpatient medical facilities have always been an important part of the business model for private medical practices. As healthcare delivery to patients has evolved in the United States (much of it driven by the new government mandates, regulations, and the Affordable Care Act), the delivery of such services is becoming more and more centered on the hospital or institutional setting, thus making contractual relationships with hospitals even more important for medical practices. As a natural outgrowth of this relationship, attention to hospital contracts is becoming more important. PMID:27039636
Van Enk, A; Leeuw, R.
In a retrospective study over six years the incidence of phototherapy was examined in two groups of healthy neonates who were born spontaneously and at term in hospital. They were comparable in all respects except that one group was cared for at home and the other group was cared for in hospital. It appeared that the infants in hospital received phototherapy seven times more often than those at home, and surveillance at home was not inferior to that in hospital. There is no reason to assume t...
The hospital market is served by firms that are private for-profit, private not-for-profit, and government-owned and operated. I use a plausibly exogenous change in hospital financing that was intended to improve medical care for the poor to test three theories of organizational behavior. My results reveal that the critical difference between the three types of hospitals owes to the soft budget constraint of government-owned institutions. The decision-makers in private not-for-profit hospital...
Rayburn, J M; Rayburn, L G
This research traces the origins, development, and reasons for change in the power equation in the U.S. hospitals between physicians, administrators and accountants. The paper contains three major sections: a review of the literature concerning authority, power, influence, and institutional theory; a review of the development of the power of professions, especially physicians, accounting and healthcare administrators, and the power equilibrium of a hospital; and, a discussion of the social policy implications of the power struggle. The basis for physicians' power derives from their legal ability to act on which others are dependent, such as choosing which hospital to admit patients, order tests and procedures for their patients. The Federal Government's prospective payment system and the hospitals' related case-mix accounting systems appear to influence the power structure in hospitals by redistributing that power. The basis of the accountants' power base is control of financial information. Accountants have a definite potential for influencing which departments receive financial resources and for what purpose. This moves hospital accountants into the power equation. The basis of the hospital administrators' power is their formal authority in the organization. Regardless of what actions federal government agencies, hospital accountants, or hospital administrators take, physicians are expected to remain the dominant factor in the power equation. Without major environmental changes to gain control of physician services, only insignificant results in cost containment will occur. PMID:10163913
Dychtwald, K; Zitter, M
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.
Rosolio, Charles E
Relationships with hospitals and outpatient medical facilities have always been an important part of the business model for private medical practices. As healthcare delivery to patients has evolved in the United States (much of it driven by the new government mandates, regulations, and the Affordable Care Act), the delivery of such services is becoming more and more centered on the hospital or institutional setting, thus making contractual relationships with hospitals even more important for medical practices. As a natural outgrowth of this relationship, attention to hospital contracts is becoming more important.
This article explores the two paradigms available in anthropology to make a fuller sense of the ritual .One is“hospitality”, and the other is “sacrifice”.The author specially ana-lyses the complexity of Chinese “hospitality” and “hosting”, and draws upon certain contrasts between his and other views .He also outlines the role in China of personal self -sacrifice , and concludes that sacrifice as self -sacrifice is a historically specific expectation and a transforma-tion of filial self-sacrifice.Hospitality to the gods, on the contrary, is the offering of a sacrifi-cial victim in a sequence of ritual sacralisation , divined danger and lack leading to benign effica-cy and completed encompassment , and then withdrawal from that danger .
Stidsen, Lone Mandrup
Atmosphere’ is explored using methods in the practice of lighting design where qualitative and quantitative methods are used to qualify important aspects of a lighting design. Measurable parameters such as the amount of Lux, composition of CRI and degree of Kelvin is well described so the designer can handle......Sociocultural aspects of light are important for the user experience of the atmosphere in a ward. According to the Danish Regulation for light in hospitals (DS703, 1983), a home-like feeling is required to support the patients, as they needa pleasant environment for their recovery. The term ‘Light...... the requirements. What does it mean to create a 'home-like' and 'pleasant or appealing' light in this context? Does the composition of CRI and degree of Kelvin tell it all? Is it enough information to provide a proper illumination in which the patient can have a homely and pleasant experience? The 'Model of Light...
NSGIC GIS Inventory (aka Ramona) — HOSPITALS_CLINICS_ISDH_IN is a point shapefile showing the locations of 160 hospitals included in a "Hospital Directory" that appears on a Web page of the Indiana...
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.
Full Text Available Fire is one of the most dangerous phenomena in the world which yields main damages, healthy and economical, and is thus a major threat to hospitals. Since, most of the residents in hospitals are the individuals who cannot rescue themselves in such situations, fire in hospitals is more hazardous than any other public place; hence, it can endanger several sophisticated medical equipment. Therefore, security against fire plays a very vital role in hospitals and has to be taken into account by authorities. Among the personnel, hospital manager and the security guard supervisor are much more responsible. One of their responsibilities includes planning fire security scheme in hospitals to reduce the death rate caused by fire so that there is less threat to the building of hospital admits content. Due to the significance of this issue in hospitals, it seems necessary for the personnel to be aware of security measures against fire. Therefore, a study was carried out in Isfahan University of Medical Sciences teaching hospitals on all managers, their awareness about this issue was measured through a questionnaire. The results indicated that of a total of 60, the obtained average was (37.63+7.36 in the medium level. Also, most of the managers believed that proper and updated training by skillful trainers regarding hospital security measures and its application can be truly effective on their productivity. Thus, it is concluded that practical training the mentioned target group (hospital personnel especially clerks and the managers about the security plans can be effective in the control of fire and security measures, resulting in reduction of accidents and human and economic loss in the future.
Background: Hospital acquired infections continue to be an important cause of morbidity and mortality among hospitalized patients. Hospital acquired pneumonia (HAP) results in a significant increase in the cost of care of hospitalized patients. Its development prolongs a patient's stay in the Intensive Care Unit (ICU). Accurate information concerning the clinical profile of HAP is lacking in South India. This study was conducted prospectively to evaluate the clinical profile of HAP in ICU pat...
Gravelle, Hugh Stanley Emrys; Santos, Rita; Siciliani, Luigi
We examine whether a hospital's quality is affected by the quality provided by other hospitals in the same market. We first sketch a theoretical model with regulated prices and derive conditions on demand and cost functions which determine whether a hospital will increase its quality if its rivals increase their quality. We then apply spatial econometric methods to a sample of English hospitals in 2009–10 and a set of 16 quality measures including mortality rates, readmission, revision and re...
Vlayen, Annemie; Hellings, Johan; Claes, Neree; Schrooten, Ward
Objective To measure patient safety culture in Belgian hospitals and to examine the homogeneous grouping of underlying safety culture dimensions. Methods The Hospital Survey on Patient Safety Culture was distributed organisation-wide in 180 Belgian hospitals participating in the federal program on quality and safety between 2007 and 2009. Participating hospitals were invited to submit their data to a comparative database. Homogeneous groups of underlying safety culture dimensions were sou...
Hsieh, Hui-Min; Bazzoli, Gloria J.
This study examines the association between hospital uncompensated care (UC) and reductions in Medicaid Disproportionate Share Hospital (DSH) payments resulting from the 1997 Balanced Budget Act. Data on California hospitals from 1996 to 2003 were examined using two-stage least squares with a first-differencing model to control for potential feedback effects. Our findings suggest that not-for-profit hospitals did reduce UC provision in response to reductions in Medicaid DSH, but the response ...
Molinari, C; Morlock, L; Alexander, J; Lyles, C A
This study examined whether hospital governing boards that invest in board education and training are more informed and effective decision-making bodies. Measures of hospital financial viability (i.e., selected financial ratios and outcomes) are used as indicators of hospital board effectiveness. Board participation in educational programs was significantly associated with improved profitability, liquidity, and occupancy levels, suggesting that investment in the education of directors is likely to enhance hospital viability and thus increase board effectiveness.
Djalali, Ahmadreza; Hosseinijenab, Vahid; Peyravi, Mahmoudreza; NEKOEI-MOGHADAM, Mahmood; Hosseini, Bashir; Schoenthal, Lisa; Koenig, Kristi L.
Introduction: Effectiveness of hospital management of disasters requires a well-defined and rehearsed system. The Hospital Incident Command System (HICS), as a standardized method for command and control, was established in Iranian hospitals, but it has performed fairly during disaster exercises. This paper describes the process for, and modifications to HICS undertaken to optimize disaster management in hospitals in Iran. Methods: In 2013, a group of 11 subject matter experts participated in...
Watanabe, Reina; Shimoda, Tomoko; Yano, Rika; Hayashi, Yasuhiro; Nakamura, Shinji; Matsuo, Junji; Yamaguchi, Hiroyuki
Background Hospital cleanliness in hospitals with a tendency toward long-term care in Japan remains unevaluated. We therefore visualized hospital cleanliness in Japan over a 2-month period by two distinct popular methods: ATP bioluminescence (ATP method) and the standard stamp agar method (stamp method). Methods The surfaces of 752 sites within nurse and patient areas in three hospitals located in a central area of Sapporo, Japan were evaluated by the ATP and stamp methods, ...
Watanabe, Reina; Shimoda, Tomoko; Yano, Rika; Hayashi, Yasuhiro; Nakamura, Shinji; Matsuo, Junji; Yamaguchi, Hiroyuki
Background Hospital cleanliness in hospitals with a tendency toward long-term care in Japan remains unevaluated. We therefore visualized hospital cleanliness in Japan over a 2-month period by two distinct popular methods: ATP bioluminescence (ATP method) and the standard stamp agar method (stamp method). Methods The surfaces of 752 sites within nurse and patient areas in three hospitals located in a central area of Sapporo, Japan were evaluated by the ATP and stamp methods, and each surface w...
Flanders, Scott A.; Centor, Bob; Weber, Valerie; McGinn, Thomas; DeSalvo, Karen; Auerbach, Andrew
ABSTRACT BACKGROUND The field of hospital medicine is growing rapidly in academic medical centers. However, few organizations have explicitly considered the opportunities and barriers posed to hospital medicine’s development as an academic field in internal medicine. OBJECTIVE To develop consensus around key areas limiting or facilitating hospital medicine’s development as an academic discipline. DESIGN Consensus format conference of key stakeholders in academic hospital medicine. RESULTS The...
Jacobs, P; Hall, E M
Comparative financial and operating ratios in Canadian hospitals are examined to reveal sources of increased efficiency. The study involved 70 Alberta hospitals, which were divided into three groups: teaching hospitals, regional hospitals and smaller rural hospitals. Data were obtained from HS-1 and HS-2 reports. Hospitals across Canada can calculate their own ratios to give them a general idea of how they compare with the hospitals in this report.
Özkil, Ali Gürcan; Fan, Zhun; Dawids, Steen;
In this paper, the need for automated transportation systems for hospitals is investigated. Among other alternatives, mobile robots stand out as the most prominent means of automation of transportation tasks in hospitals. Existing transportation routines of a hospital are analyzed in order to ver...
Bossen, Claus; Foss, Martin
In this paper, we describe the collaborative work of hospital porters. The profession of hospital porter is understudied in sociology and in Computer Supported Cooperative Work, despite numerous studies of healthcare IT. We describe how a new IT system for hospital logistics provided porters with...
... Register citations affecting § 412.22, see the List of CFR Sections Affected, which appears in the Finding... 42 Public Health 2 2010-10-01 2010-10-01 false Excluded hospitals and hospital units: General... HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT HOSPITAL...
... 42 Public Health 2 2010-10-01 2010-10-01 false Special treatment: Inpatient hospital payment adjustment for low-volume hospitals. 412.101 Section 412.101 Public Health CENTERS FOR MEDICARE & MEDICAID... INPATIENT HOSPITAL SERVICES Special Treatment of Certain Facilities Under the Prospective Payment System...
... INFORMATION: I. Background In FR Doc. 2011-19719 of August 18, 2011 (76 FR 51476), the final rule entitled... Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Fiscal Year 2012 Rates; Corrections AGENCY: Centers...
Georges, Patrick M; Samson, Julien
Leadership methods can be understood and applied by hospital managers in the same way teachers and the seminar's participants respect certain conventions. Each method should be discussed and adapted, recognizing its limitations for use within hospitals. This article first presents what is taught in a traditional leadership course and then, discusses ways the course can be adapted for use by hospital managers. PMID:23342760
Zijlker-Jansen, Pauline Y.; Janssen, M. P.; van Tilborgh-de Jong, A. J W; Schipperus, M. R.; Wiersum-Osselton, J. C.
Background: The 2011 Dutch Blood Transfusion Guideline for hospitals incorporates seven internal quality indicators for evaluation of the hospital transfusion chain. The indicators aim to measure guideline compliance as shown by the instatement of a hospital transfusion committee and transfusion saf
Fleming, Jeanne Hmura
Hospital organization, administration and planning, and implementation program procedures are reviewed in this article. Hospitals and medical centers are changing their strategies in the area of wellness programming since they offer the appropriate facilities for these programs. Various types of wellness programs currently being promoted are…
Edwards, Janine C.; Kang, JungEun; Silenas, Rasa
Context and Purpose: Rural communities face substantial risks of natural disasters but rural hospitals face multiple obstacles to preparedness. The objective was to create and implement a simple and effective training and planning exercise to assist individual rural hospitals to improve disaster preparedness, as well as to enhance regional…
Folmann, Nana Bro; Bossen, Kristine Skovgaard; Willaing, Ingrid;
To quantify the association between obesity and somatic hospital costs and number of overall somatic hospital contacts--number of inpatient admissions, number of outpatient visits, and number of emergency department visits--based on anthropometric measurements of waist circumference (WC...
Constipation is a distressing disorder that is common among older patients in hospital. It is often underdiagnosed and undertreated, and can lead to increased morbidity and prolonged hospital stays. In most cases this common problem can be treated successfully if the correct management plan is adopted. This article reviews the prevention and management strategies available to address the issue.
Full Text Available Admission into hospital can be an anxious and unsettling time for a child, whether it is for a planned eye procedure or as a result of an eye injury. There is a lot you can do to make the hospital experience as positive as possible to reduce stress and anxiety for both child and parent.
Frølich, Anne; McNair, Peter; Nielsen, Bo Friis
, and increased to 83 and 89% at posterior probability levels higher than 60%. Transfer of the discrimination functions between the hospitals was followed by a decrease in diagnostic accuracy of 6-16%. At a posterior probability of 60% the diagnostic accuracies were 79% or more in the receiving hospital, in both...
Whitman, Marilyn V.; Harbison, Phillip Adam
Purpose: This paper aims to examine the level of smoke-free policies in general hospitals and the barriers faced in implementing restrictive policies banning smoking inside buildings and on surrounding grounds. Design/methodology/approach; A survey was developed to gather data on hospitals' current smoke-free policies, including the challenges…
Klingner, Jill; Moscovice, Ira; Tupper, Judith; Coburn, Andrew; Wakefield, Mary
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…
Full Text Available 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 definition of stakeholders and designed a questionnaire that integrated the following influence factors, which have relevant impact on hospital management: political/legal, economic, social, technological and environmental forces. These influence factors are examined to develop the so-called critical uncertainties. Thorough identification of uncertainties was based on a “Stakeholder Feedback”. Results: Two key uncertainties were identified and considered in this study: According to the developed scenarios, complementary education of the medical staff as well as of non-medical top executives and managers of hospitals was the recommended core strategy. Complementary scenario-specific strategic options should be considered whenever needed to optimize dealing with a specific future development of the health care environment. Conclusion: Strategic planning in hospitals is essential to ensure sustainable success. It considers multiple situations and integrates internal and external insights and perspectives in addition to identifying weak signals and “blind spots”. This flows into a sound planning for multiple strategic options. It is a state of the art tool that allows dealing with the increasing challenges facing hospital management.
Wabo Nero C; Örtenwall P; Khorram-Manesh A
Objective: Malfunction in hospitals´ complex internal systems, or extern threats, may result in a hospital evacuation. Factors contributing to such evacuation must be identified, analyzed and action plans should be prepared. Our aims in this study were 1) to evaluate the use of risk and vulnerability analysis as a basis for hospital evacuation plan, 2) to identify risks/hazards triggering an evacuation and evaluate the respond needed and 3) to propose a template with main key points for planning, performance and evaluation of such evacuation. Methods: A risk and vulnerability analysis at two county hospitals along with a systematic online literature search based on the following keywords; “evacuation/closure”, “hospitals/medical facilities” and“disaster/hazards” alone or with “planning”, was conducted. Results: We found that although all hospitals have a disaster plan, there is a lack of knowledge and appropriate instruments to plan, perform and evaluate a hospital evacuation. Risk and vulnerability analysis can be used to reveal threats leading to an evacuation (e.g. on-going climate changes and terror actions). These key points can later be used to plan, perform and evaluate such evacuation. Conclusion: There is a need for an elaborated evacuation planning for hospitals. An evacuation plan should continuously be drilled based on a risk and vulnerability analysis. A general guide can be used as foundation to plan, perform and evaluate such plan.
Rosko, M D; Broyles, R W
Hospitals may respond to the revenue constraints of prospective payment by altering their patient mix. This article provided a brief overview of marketing management and suggested that hospitals might change their patient mix by employing marketing strategies designed to attract patients to its services or to attract physicians who specialize in the appropriate medical disciplines.
Full Text Available Pharmaceutical expenditure growth has outpaced GDP and healthcare expenditure growth rates in Denmark as in most OECD countries for the last decade. A major part of this increase was due to high growth rates in specialist areas that are typically located in hospital settings. Yet the market for hospital medicines and their procurement are still poorly understood. The present paper characterises the market for hospital medicines in Denmark in terms of its organisation and developments between 2005 and 2009. In Denmark hospital medicines are publicly financed and procurement is centrally organised. 98% of all medicines administered at Danish public hospitals are purchased through a public procurement agency by means of public tenders. Using data on actual contract prices we decompose pharmaceutical expenditure growth into the contributions from newly introduced medicines, price and volume increases and use summary statistics to compare market performance in both sectors. The market for hospital medicine is more concentrated than the pharmaceutical retail sector and the share of generics and parallel imported products is significantly lower. Between 2005 and 2009 expenditures for hospital medicines more than doubled -accounting for almost 40% of the total Danish pharmaceutical market in 2009. Price increases however - although positive and higher than in the pharmaceutical retail sector - were only moderate. The majority of the expenditure growth was due to an increase in utilisation and the introduction of new medicines in the hospital sector. Centralised tendering may therefore have important implications for competition and industry structure in the long run.
Lynn, M L; Wertheim, P
An analysis of various financial ratios sampled from open and closed hospitals shows that certain leverage, liquidity, capital efficiency, and resource availability ratios can predict hospital closure up to two years in advance of the closure with an accuracy of nearly 75 percent.
This address traces the emergence of the hospital in the 18th century as a facility for combating disease and tending to the sick. Reference is made to the reports of Tenon and Howard on hospitals in several European countries, which instead of considering the hospital as a mere architectural object make recommendations based on the numbers of beds of an institution, its usable space, the dimensions of wards, mortaility rates, etc.; the result is a new functional concept of the medical and physical organization of the hospital. The author delves into the characteristics of the hospital and medical practice in the Middle Ages, the 17th and 18th centuries, and since the middle of the 18th. He brings out the direct relationship of hospital organization to the economic regulations that emerged with mercantilism. He stresses the importance of man for social and military development on the one hand, and, on the other hand, to the application of a technology that could be described as political: the discipline. He is of the view that the introduction of disciplinary mechanisms in the confused environment of the hospital permitted its "medicalization" and the development of the medical-therapeutic hospital.
Pink, G H; Knotts, U A; Parrish, L G; Shields, C A
The Canadian Hospital Executive Simulation System (CHESS) is a computer-based management decision-making game designed specifically for Canadian hospital managers. The paper begins with an introduction on the development of business and health services industry-specific simulation games. An overview of CHESS is provided, along with a description of its development and a discussion of its educational benefits. PMID:10109530
Walker, Susan S.
This teacher's guide is the core publication of a series of instructional materials developed for the hospitality and tourism industry. It includes the entry-level competencies students will need to enter any of the occupational areas identified in the four cluster areas of the hospitality and tourism industry: lodging, food service, travel and…
Roelsgaard Obling, Anne
different fields: a cancer department (located at a major teaching hospital); a rehabilitation castle (located on the countryside) and a cancer and health centre (located across the road of the teaching hospital). In the paper’s analyses a repeated truism coined in the case study is followed. The truism...
Weld, Tim; Klein, Gina
Proposed rules in accounting for defined benefit plans may affect hospitals' statement of operations and affect the time, effort, and cost to comply with periodic financial reporting requirements. The new standard would require immediate recognition of the full amount of plan amendments in determining operating income. Hospitals should consider the role of pension plans in their compensation programs.
Howard Feiertag, of Blacksburg, an instructor in hospitality and tourism management at Virginia Tech's Pamplin College of Business, received the inaugural Excellence in Sales and Marketing Strategy Award at the Hospitality Sales and Marketing Association/New York University Strategy Conference in New York recently.
E.K.A. van Doorslaer (Eddy); R.C.J.A. van Vliet (René)
textabstractIn this article we want to confront some of the results of the theoretical literature on aggregation with the empirical consequences of aggregation in the context of the analysis of demand for hospital care. There has been an evolution in the estimation of hospital demand functions from
Morrisey, M A
The issue of cost shifting has taken on enormous policy implications. It is estimated that unsponsored and undercompensated hospital costs--one measure of cost shifting--has totaled $21.5 billion in 1991. The health services research literature indicates that hospitals set different prices for different payers. However, the empirical evidence on hospitals' ability to raise prices to one payer to make up for unsponsored care or lower payments by other payers is mixed at best. No study has concluded that hospitals have raised prices to fully adjust for such actions. The extent of cost shifting is limited by the market. When a hospital has market power, it is able to set prices above marginal costs. However, when a buyer has enough patient/subscribers and a willingness to direct them to particular providers based on price considerations, hospitals have less flexibility in raising prices above costs. Thus, the extent of cost shifting is limited by the market. Cost shifting is not as easy as it may have been in the past because the nature of hospital and insurer competition has changed radically in the last decade. While hospital quality, services, and amenities still matter, some buyers are increasingly concerned about the price they pay. Evidence from studies of PPO and HMO negotiations with hospitals suggests that hospitals' market power is eroding, at least in some areas. In areas with relatively few hospital competitors and little PPO or HMO activity, Medicaid and Medicare price reductions and uncompensated care burdens will be partially absorbed by higher prices paid by private payers. In more price sensitive markets and in markets in which prices to private payers have risen to those commensurate with the market power of local hospitals, such cost shifting will not occur. A market-based approach in hospital pricing requires an explicit policy for the uninsured. In a competitive market, a hospital that traditionally cared for the uninsured by spending some of its
Beck, Anne Marie; Balknäs, Ulla N.; Camilo, Maria E.;
Disease-related undernutrition is significant in European hospitals but is seldom treated or prevented. In 1999, the Council of Europe decided to collect information regarding nutrition programs in hospitals, and for this purpose, a network consisting of national experts from 12 of the Partial...... Agreement member states was established. The aim was to review the current practices in Europe regarding hospital food provision, to highlight deficiencies, and to issue recommendations to improve the nutritional care and support of hospitalized patients. Five major common problems were identified: 1) lack...... of clearly defined responsibilities, 2) lack of sufficient education, 3) lack of influence and knowledge of the patients, 4) lack of cooperation between different staff groups, and 5) lack of involvement from the hospital management. To solve the problems highlighted, a combined timely and concerted effort...
Full Text Available Hospital-acquired infections (HAI are often seen as preventable incidents that result from unsafe practices or poor hospital hygiene. This however ignores the fact that transmissibility is not only a property of the causative organisms but also of the hosts who can translocate bacteria when moving between hospitals. In an epidemiological sense, hospitals become connected through the patients they share. We here postulate that the degree of hospital connectedness crucially influences the rates of infections caused by hospital-acquired bacteria. To test this hypothesis, we mapped the movement of patients based on the UK-NHS Hospital Episode Statistics and observed that the proportion of patients admitted to a hospital after a recent episode in another hospital correlates with the hospital-specific incidence rate of MRSA bacteraemia as recorded by mandatory reporting. We observed a positive correlation between hospital connectedness and MRSA bacteraemia incidence rate that is significant for all financial years since 2001 except for 2008-09. All years combined, this correlation is positive and significantly different from zero (partial correlation coefficient r = 0.33 (0.28 to 0.38. When comparing the referral pattern for English hospitals with referral patterns observed in the Netherlands, we predict that English hospitals more likely see a swifter and more sustained spread of HAIs. Our results indicate that hospitals cannot be viewed as individual units but rather should be viewed as connected elements of larger modular networks. Our findings stress the importance of cooperative effects that will have a bearing on the planning of health care systems, patient management and hospital infection control.
Jiang, Mengting; Abiola, Omolara
Having meals in hospital is a vital part of nursing care for hospitalized patients besides other medical treatments. The inpatient’s opinions about having meal in hospital should be put into consideration. The purpose of our research was to find out and present inpatients’ points of view about having meals in the hospital during their stay. The main goal of this research was to help nurses and other hospital staff to be aware of how the inpatients feel while eating food, during mealtimes ...
Olivera, J. M.; Rocha, L. A.; Rotger, V. I.; Herrera, M. C.
There are many different services within a hospital. This means different types of noise which can be considered as acoustic pollution. Knowing that preterm infants exposed to high amounts of noise in the NICU are at a much higher risk because of their neurologic immaturity and physiologic instability, that excessive levels of noise also affect the persons and it can also impede some studies on patients, it was proposed to evaluate the Sound Pressure Level in some services of the Instituto de Maternidad, Tucumán, Argentina. There were evaluated the Level III NICU, the laundry service, a physical space destined for a service of evoked potential and a neonatal incubator under working conditions. The measurements were performed with a type II sonometer (CENTER 322) and it was also used an incubator analyzer (FLUKE INCU) for the incubator. The average values obtained were of 63.6 dBA for the NICU, 82.5dBA for the laundry room, 52.7 dBA for the evoked potential room and 62.8 dBA in the inside of the incubator under 64 dBA in the outside. The reports were documented in compliance with the appropriate standards.
Martínez-Jiménez, S; Lluch-Colomer, A; Desongles-Corrales, T; Bernal-González, D; Santos-Rubio, M D; Alfaro-Lara, E R; Galván-Banqueri, M
Objetivo: Analizar el procedimiento de visado y su actividad en un hospital de tercer nivel. Material y métodos: Estudio descriptivo del procedimiento de visado durante el período abril 2011-abril 2012. Se diseñó una base de datos y se definieron categorías relativas a las variables de estudio: pacientes y recetas. Para los pacientes atendidos en la Unidad de Visado se registraron las incidencias detectadas en base a una clasificación previamente establecida. Resultados: Se incluyeron 6.738 pacientes (8.465 recetas visadas). Se visaron 170 medicamentos y productos de nutrición diferentes, siendo el mayoritario Tacrolimus. Se detectaron un total de 420 incidencias, siendo las más frecuentes la «Ausencia de documento clínico» (46,67 %) y los «Errores formales de cumplimentación» (28,57%). Conclusiones: El presente trabajo ha permitido un conocimiento más pormenorizado de la actividad, los tipos de incidencias y la identificación de áreas de mejora.
Grossman, I; Weiss, L M; Simon, D; Tanowitz, H B; Wittner, M
Several reports have appeared that either support or deny the importance of the protozoan Blastocystis hominis as an intestinal pathogen in humans. In this report, we describe the clinical characteristics of B. hominis and its response to therapy in hospital employees found to have the parasite on routine screening of stools. During the study, 49 patients with B. hominis were identified, and 413 stools were examined from these patients. Twenty-nine patients were asymptomatic (59%), and 20 had symptoms of bloating, flatulence, soft/loose stools, or constipation. Of these 20 patients, 10 had symptoms that correlated with the presence or absence of B. hominis, four had symptoms that were independent of B. homonis, and six had other intestinal parasites that could account for their symptoms. Nineteen percent of patients without treatment had eradication of B. hominis from stool on follow-up examination. Metronidazole did not increase this rate. Iodoquinol treatment eradicated the organism in 41% of patients (p less than 0.05), and resulted in the reduction or eradication of the parasite in 62%, as determined by follow-up examination. PMID:1590309
There are many different services within a hospital. This means different types of noise which can be considered as acoustic pollution. Knowing that preterm infants exposed to high amounts of noise in the NICU are at a much higher risk because of their neurologic immaturity and physiologic instability, that excessive levels of noise also affect the persons and it can also impede some studies on patients, it was proposed to evaluate the Sound Pressure Level in some services of the Instituto de Maternidad, Tucumán, Argentina. There were evaluated the Level III NICU, the laundry service, a physical space destined for a service of evoked potential and a neonatal incubator under working conditions. The measurements were performed with a type II sonometer (CENTER 322) and it was also used an incubator analyzer (FLUKE INCU) for the incubator. The average values obtained were of 63.6 dBA for the NICU, 82.5dBA for the laundry room, 52.7 dBA for the evoked potential room and 62.8 dBA in the inside of the incubator under 64 dBA in the outside. The reports were documented in compliance with the appropriate standards.
Whitener, L; Stevens, C; Cochran, K; Thompson, B G; Williams, M E
Telemedicine technology enabled this class to meet. The Chapel Hill instructor could not have traveled to Scotland Neck for the classes, and the class members could not have taken time away from their jobs to travel to Chapel Hill. The technology allowed the participants to fit the classes into their schedules. For the group of managers at this small, isolated hospital, the experience of participating in a management class with an expert was a positive one. They were introduced to standard management practices, learned new skills, and formed a support group/team onsite. The students felt close to the leader, yet the physical distance made her an outsider in a way that encouraged frankness. The technology seemed to foster the best of both worlds--intimacy, yet physical distance and, thus, safety. These new managers were able to take part in a course that taught tangible skills for improving their job performance and, more important, afforded access to resources outside of Halifax County. They were able to step away from their daily routine and interact with outsiders and each other in new ways, without the stress and expense of travel. The results of this pilot study indicate that distance learning is feasible for courses of this kind. Staff burnout and turnover are chronic problems in rural facilities, with isolation contributing to job dissatisfaction. Distance learning offers exciting possibilities for addressing these problems in healthcare settings across the country. PMID:10847928
Full Text Available Abstract Objectives To investigate whether the long term lease of public hospital owned land could be an additional financing mechanism for Greek public (mental health hospitals. Methods We performed a financial analysis of the official 2008 data of a case - study hospital (Mental Health Hospital of Chania. We used a capital budgeting approach to investigate whether value is created for the public hospital by engaging its assets in a project for the development of a private renal dialysis Unit. Results The development of the private unit in hospital owned land is a good investment decision, as it generates high project Net Present Value and Internal Rate of Return. When the project commences generating operating cash flows, nearly €400.000 will be paid annually to the Mental Health Hospital of Chania as rent, thereby gradually decreasing the annual deficit of the hospital. Conclusions Revenue generated from the long term lease of public hospital land is crucial to gradually eliminate hospital deficit. The Ministry of Health should encourage similar forms of Public Private Partnerships in order to ensure the sustainability of public (mental hospitals.
Lee, Bruce Y; Bartsch, Sarah M; Wong, Kim F; Yilmaz, S Levent; Avery, Taliser R; Singh, Ashima; Song, Yeohan; Kim, Diane S; Brown, Shawn T; Potter, Margaret A; Platt, Richard; Huang, Susan S
Efforts to control life-threatening infections, such as with methicillin-resistant Staphylococcus aureus (MRSA), can be complicated when patients are transferred from one hospital to another. Using a detailed computer simulation model of all hospitals in Orange County, California, we explored the effects when combinations of hospitals tested all patients at admission for MRSA and adopted procedures to limit transmission among patients who tested positive. Called "contact isolation," these procedures specify precautions for health care workers interacting with an infected patient, such as wearing gloves and gowns. Our simulation demonstrated that each hospital's decision to test for MRSA and implement contact isolation procedures could affect the MRSA prevalence in all other hospitals. Thus, our study makes the case that further cooperation among hospitals--which is already reflected in a few limited collaborative infection control efforts under way--could help individual hospitals achieve better infection control than they could achieve on their own.
Haley, D Rob; Zhao, Mei; Spaulding, Aaron
To better understand the relationship between a hospital's Total Performance Score (TPS) and unplanned readmissions, a multivariate linear regression analysis was used to examine the relationship between hospital TPS and readmission rates for acute myocardial infarction (AMI), heart failure (HF), and pneumonia (PN). Hospital TPS was significantly and inversely related to AMI, HF, and PN readmission rates. The higher the hospital TPS, the lower the readmission rates for patients with AMI, HF, and PN. Hospitals with higher Medicare and Medicaid patients had higher readmission rates for all three conditions. The TPS methodology will likely evolve to include additional measures or dimensions to assess hospital quality and payment. Policymakers and hospital administrators should consider other structure elements and process measures to assess and improve patient safety and quality. PMID:27439247
Babyak, Jonathan M; Sharp, Claire R
OBJECTIVE To describe the epidemiology of the systemic inflammatory response syndrome (SIRS) and sepsis in cats hospitalized in a veterinary teaching hospital. DESIGN Observational study. ANIMALS 246 client-owned cats. PROCEDURES During a 3-month period, daily treatment records were evaluated for all hospitalized cats. Information extracted included signalment, temperature, heart rate, respiratory rate, diagnostic test results, diagnosis, duration of hospitalization, and outcome (survival or death). Cats were classified into 1 of 4 disease categories (sepsis [confirmed infection and SIRS], infection [confirmed infection without SIRS], noninfectious SIRS [SIRS without a confirmed infection], and no SIRS [no SIRS or infection]). RESULTS Of the 246 cats, 26 and 3 were hospitalized 2 and 3 times, respectively; thus, 275 hospitalizations were evaluated. When SIRS was defined as the presence of ≥ 2 of 4 SIRS criteria, 17 cats had sepsis, 16 had infections, 81 had noninfectious SIRS, and 161 were classified in the no SIRS category at hospital admission. The prevalence of sepsis at hospital admission was 6.2 cases/100 admissions. Four cats developed sepsis while hospitalized, resulting in a sepsis incidence rate of 1.5 cases/100 hospital admissions. Four of 17 cats with sepsis at hospital admission and 3 of 4 cats that developed sepsis while hospitalized died or were euthanized, resulting in a mortality rate of 33.3% for septic cats; 239 hospitalizations resulted in survival, 28 resulted in euthanasia, and 8 resulted in death. CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that many hospitalized cats have evidence of SIRS and some have sepsis. In cats, sepsis is an important clinical entity with a high mortality rate. PMID:27308883
Mackay, J M; Lamb, C W
Marketing has become widely recognized as an important component of hospital management (Kotler and Clarke 1987; Ludke, Curry, and Saywell 1983). Physicians are becoming recognized as an important target market that warrants more marketing attention than it has received in the past (Super 1987; Wotruba, Haas, and Hartman 1982). Some experts predict that hospitals will begin focusing more marketing attention on physicians and less on consumers (Super 1986). Much of this attention is likely to take the form of practice management assistance, such as computer-based information system support or consulting services. The survey results reported here are illustrative only of how one hospital addressed the problem of physician need assessment. Other potential target markets include physicians who admit patients only to competitor hospitals and physicians who admit to multiple hospitals. The market might be segmented by individual versus group practice, area of specialization, or possibly even physician practice life cycle stage (Wotruba, Haas, and Hartman 1982). The questions included on the survey and the survey format are likely to be situation-specific. The key is the process, not the procedure. It is important for hospital marketers to recognize that practice management assistance needs will vary among markets (Jensen 1987). Therefore, hospitals must carefully identify their target physician market(s) and survey them about their specific needs before developing and implementing new physician marketing programs. Only then can they be reasonably confident that their marketing programs match their customers' needs.
Full Text Available Our paper empirically examines how the decision to purchase private insurance and hospitalization are made based on household income, socio-demographic factors, and private health insurance factors in both Japan and the USA. Using these two data-sets, we found some similarities and dissimilarities between Japan and the United States. As income of households rises, households have a positive effect on purchasing health insurance as a normal good. Another similarity between the two countries is seen in the income effect on risk of hospitalization, which is negative for both Japanese and US cases. For dissimilarity, the insurance premium effect on risk of hospitalization is positive for the Japanese case, while negative for the US case. Since the Japanese insurance data had variables such as payments per day of hospitalization if household gets hospitalized, insurance payments upon death of an insured person, and annuity payments at maturity, we tested to see if these characteristics affect the risk of hospitalization for households; we do not eliminate a possibility of adverse selection. For the US pure health issuance characteristics, an increase in premium of health insurance policies cause individuals to substitute more health capital investment which causes lower risk of hospitalization.
Full Text Available Context Over the past decade the number of accidents and disasters has been growing around the world. In addition to damaging communities and infrastructures, unexpected disasters also affect service providers. This study aimed to evaluate the readiness of hospitals when confronted with unexpected disasters. Evidence Acquisition The present study was a simple review article, which was conducted via searching different sites, such as: Web of Science, Scopus, Science Direct and PubMed, using different key words such as: Disasters, Crisis, Hospital and preparedness. The relationship between the articles found in relation to our subject was investigated through the title and abstract of articles. The relationship between the articles, which were found in relation to our subject, was investigated through the title and abstract of the articles. Our search included papers published during the period between 2007 and 2015 and we only considered studies that measured the preparedness of hospitals in critical conditions. Among the 30 articles, which were found, 17 were excluded from the study due to lack of relevant data. Hence, 15 papers, which were of proper design and robust data analysis, were included in the current study. Results Hospital preparedness in disaster was evaluated in three dimensions: structural, non-structural factors and vulnerability management performance. A total of readiness of hospitals in three dimensions was mediocre. Conclusions Overall, the results derived from these studies indicated that hospital safety levels in most of the surveyed hospitals were moderate. Although the situation in hospitals is not critical, there is a need to plan and take appropriate measures to improve the safety level of the hospitals.
Full Text Available Health is important and money is not matter, if people are concerned for the treatment of various ailments. A collective acceptance with regard to hospital usage is that most of the people prefer to use private hospitals even if the cost of private hospital tends to be high. Public hospitals are not preferred due to poorer quality of their services, even though these services are provided at low cost. At the time of independence, nearly 15% of the people used private sector. In a recent study by World Bank, it has been found that about 80% of the people use the private hospitals in India. In order to understand the preference of hospitals of ailing persons, we make use of the National Sample Survey Organization′s 60 th round data on morbidity and health-care conducted in 2004. Using this data, we first described the demographic, social and economic characteristics of person who use the hospitals. We have also used primary data collecting during May-September 2010 in Bundelkhand region, Uttar Pradesh. There were 360 farmers have interviewed from three villages from each Banda and Hamirpur districts. We have tried to understand the preference of hospital usage among the migrant and non-migrant households. We have found that migrant households preferred private hospital for any type of treatment whereas non-migrant households still have faith on herbal and magician for the treatment. Migrant household preferred institutional delivery and spent money on healthy food such as fruits and vegetables. Migrant households were more health conscious and more exposed about the health awareness programs such as polio, immunization and health check-up of the children. Interesting to note that migrants households have first aid box and some general medicine such paracetamol, B-complex table and syrup. Some of them have thermometer and they are able to measure the body temperature and apply medicine to control fever if any time appeared among the member of
Mogensen, Jeppe; Fisker, Anna Marie; Poulsen, Søren Bolvig
Hospitalised patients’ healing process, supported by stimulating architecture. In this regard, we address focus on the potential influence of the design principle, discussing how healing architecture may contribute in making the future hospital institutions more responsive to human needs. The main...... of some of the stakeholders involved in the design process? Relating to the Danish scene of hospital design, we introduce the research project “Smart Textiles in Future Hospitals”, stating the overall hypothesis that textiles in hospital interiors possess an unexploited architectural potential in relation...
Frank, W G
Variance analysis, an accounting technique, is applied to an eight-component model of hospital costs to determine the contribution each component makes to cost increases. The method is illustrated by application to data on total costs from 1950 to 1973 for all U.S. nongovernmental not-for-profit short-term general hospitals. The costs of a single hospital are analyzed and compared to the group costs. The potential uses and limitations of the method as a planning and research tool are discussed. PMID:965233
Kahn, Charles N
A specialty hospital joint venture between a health system and physician investors may implicate anti-kickback and tax laws when physicians self-refer patients to the hospital, raising the issue of conflict of interest. Physician self-referral can motivate behavior, such as cherry-picking patients and increased utilization, which in turn leads to windfall profits for physician owners and weakens classic community hospitals. Hopitals can best serve the interests of patients and improve performance by building enduring partnerships with physicians.
Rock, R.B. Jr.; Anderson, N.A.
Nurses and other health care professionals must be aware of the rationale and methodology for in-hospital health care product standardization, including consideration of the hospital standardization committee composition, pilot-study prerequisites, and general evaluation criteria. They must be familiar with the techniques of product sterilization, their effectiveness, and the materials required to maintain sterile product shelf-life until a product is used. Hospital standardization committees can assist in the product-use decisionmaking process. Product evaluation criteria should include considerations pertaining to cost, quality, service, and comparison to similar products.
Mohammad-Reza ESMAEELI; Reza ERFANI SAYAR; Ali SAGHEBI; ELMI, Saghi; Shagheyegh RAHMANI; Elmi, Sam; Akram RABBANI JAVADI
How to Cite This Article: Esmaeeli M, Erfani Sayar R, Saghebi A, Elmi Saghi, Rahmani Sh, Elmi S, Rabbani Javadi A. Screening for Depression in Hospitalized Pediatric Patients. Iran J Child Neurol. 2014 Winter; 8(1):47-51. ObjectiveIn chronically ill children who are hospitalized, many mood changes occur. For example, in children with cancer or renal failure, prolonged hospitalization and chemotherapy can lead to depression. With the improved survival of childhoodmalignancies, the effect of tr...
Karas, Albert; Kuehl, Bonnie
Hospital formularies, guided by the Pharmacy and Therapeutics Committee, exist to optimize medication use by identifying and designating drugs of choice to guide rational prescribing, ultimately reducing patient risk and costs and improving patient outcomes. Guidelines and a framework exist to guide critical evaluations of medications for formulary listing; however, there may be opportunities to improve and standardize how a formulary change could be instituted in Canadian hospitals. A formulary change at an Ontario hospital revealed that there are some key challenges to the formulary change process including the importance of a robust project plan, appropriate resources, healthcare staff education, and acceptance. PMID:25046967
... https://medlineplus.gov/news/fullstory_158884.html Rural Hospitals Often Safer, Cheaper for Common Surgeries: Study Major ... may be safer when done in a rural hospital compared to a suburban or city hospital, a ...
... National Technical Information Service NCHS Rural and Urban Hospitals' Role in Providing Inpatient Care, 2010 Recommend on ... Survey, inpatient hospital utilization What share of inpatient hospital care was delivered in rural compared with urban ...
HOSPITAL TO HOME Plan for a Smooth Transition R eturning home from a hospital stay can result in unexpected challenges for many seniors. Finding themselves back at home after a hospital stay, many older adults struggle to manage their ...
Fabiana Rossi Varallo
Full Text Available OBJECTIVES: Drug safety problems can lead to hospital admission. In Brazil, the prevalence of hospitalization due to adverse drug events is unknown. This study aims to estimate the prevalence of hospitalization due to adverse drug events and to identify the drugs, the adverse drug events, and the risk factors associated with hospital admissions. METHOD: A cross-sectional study was performed in the internal medicine ward of a teaching hospital in São Paulo State, Brazil, from August to December 2008. All patients aged ≥18 years with a length of stay ≥24 hours were interviewed about the drugs used prior to hospital admission and their symptoms/complaints/causes of hospitalization. RESULTS: In total, 248 patients were considered eligible. The prevalence of hospitalization due to potential adverse drug events in the ward was 46.4%. Overprescribed drugs and those indicated for prophylactic treatments were frequently associated with possible adverse drug events. Frequently reported symptoms were breathlessness (15.2%, fatigue (12.3%, and chest pain (9.0%. Polypharmacy was a risk factor for the occurrence of possible adverse drug events. CONCLUSION: Possible adverse drug events led to hospitalization in a high-complexity hospital, mainly in polymedicated patients. The clinical outcomes of adverse drug events are nonspecific, which delays treatment, hinders causality analysis, and contributes to the underreporting of cases.
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
U.S. Department of Health & Human Services — This table shows the Center for Disease Control and Prevention National Healthcare Safety Network (NHSN) standardized infection ratios (SIR) of hospital onset (HO)...
Presentation descibes results from two studies of water quality and pathogen occurrence in water and biofilm samples from two area hospitals. Includes data on the effectiveness of copper/silver ionization as a disinfectant.
U.S. Department of Health & Human Services — In FY 2016, 758 out of 3,308 hospitals subject to the HAC Reduction Program are in the worst performing quartile and will have a one percent payment reduction...
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...
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...
Serway, G D; Strum, D W; Haug, W F
This article explores the premise that the appropriateness and usefulness of typical hospital productivity measures have been affected by three changes in delivery: Organizational restructuring and other definition and data source changes that make full-time equivalent employee (FTE) measurements ambiguous. Transition to prospective payment (diagnosis-related groups). Increase in capitation (prepaid, at risk) programs. The effects of these changes on productivity management indicate the need for alternative productivity indicators. Several productivity measures that complement these changes in internal operations and the external hospital business environment are presented. These are based on an analysis of four hospitals within a multihospital system, and an illustration and interpretation of an array of measures, based on ten months of actual data, is provided. In conclusion, the recommendation is made for hospital management to collect an expanded set of productivity measures and review them in light of changing expense and revenue management schemes inherent in new payment modes. PMID:10312194
Richman, Alan P
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.
... do not see patients fall. But falls require attention right away to lessen the risk of injury. ... patient's breathing, pulse, and blood pressure. If the patient is ... a hospital emergency code and start CPR. Check for injury, such ...
Barra, Daniela Couto Carvalho; Waterkemper, Roberta; Kempfer, Silvana Silveira; Carraro, Telma Elisa; Radünz, Vera
Qualitative research whose purpose was to reflect and argue about the relationship between hospitality, care and nursing according to experiences of PhD students. The research was developed from theoretic and practical meeting carried through by disciplines "the care in Nursing and Health" of PhD nursing Program at Santa Catarina Federal University. Its chosen theoretical frame of Hospitality perspective while nursing care. Data were collected applying a semi-structured questionnaire at ten doctoral students. The analysis of the data was carried through under the perspective of the content analysis according to Bardin. Hospitality it is imperative for the individuals adaptation in the hospital context or any area where it is looking for health care. PMID:20520990
Serway, G D; Strum, D W; Haug, W F
This article explores the premise that the appropriateness and usefulness of typical hospital productivity measures have been affected by three changes in delivery: Organizational restructuring and other definition and data source changes that make full-time equivalent employee (FTE) measurements ambiguous. Transition to prospective payment (diagnosis-related groups). Increase in capitation (prepaid, at risk) programs. The effects of these changes on productivity management indicate the need for alternative productivity indicators. Several productivity measures that complement these changes in internal operations and the external hospital business environment are presented. These are based on an analysis of four hospitals within a multihospital system, and an illustration and interpretation of an array of measures, based on ten months of actual data, is provided. In conclusion, the recommendation is made for hospital management to collect an expanded set of productivity measures and review them in light of changing expense and revenue management schemes inherent in new payment modes.
Gómez de Lara, José Luis
The city of Zamora de Hidalgo is home to one of the most important hospitals in the region, built in 1841 and named the Civil Hospital of Zamora. Built following demand for municipal health needs and with the support of the City Council of Zamora and private donations, it functioned as a hostel for pilgrims, the destitute and the sick. It was administered and maintained by residents, subsequently by the mothers of the Sacred Heart of Jesus, and finally by the federal Government. It currently gives the Zamorano community services, and admits sick people from other locations such as Jacona, Jiquilpan, Patamban Ocumicho, Chavinda, Tangancicuaro, Chilchota, and Tangamandapio, among others. It was called the Civil hospital because as the only hospital that operated in Zamora, it ceased to be administered by the Ecclesiastic Chapter, and passed into the hands of the State. PMID:25739493
Sui Pheng, Low
This book examines the Facilities Management (FM) of hospitals and healthcare facilities, which are among the most complex, costly and challenging kind of buildings to manage. It presents and evaluates the FM service quality standards in Singapore’s hospitals from the patient’s perspective, and provides recommendations on how to successfully improve FM service quality and achieve higher patient satisfaction. The book also features valuable supplementary materials, including a checklist of 32 key factors for successful facilities management and another checklist of 24 service attributes for hospitals to achieve desirable service quality in connection with facilities management. The book adopts a unique approach of combining service quality and quality theory to provide a more holistic view of how FM service quality can be achieved in hospitals. It also integrates three instruments, namely the SERVQUAL model, the Kano model and the QFD model to yield empirical results from surveys for implementation in hosp...
U.S. Department of Health & Human Services — MedPAR consolidates Inpatient Hospital or Skilled Nursing Facility (SNF) claims data from the National Claims History (NCH) files into stay level records.
Teare, Richard, Ed.; And Others
A theme issue devoted to management development in hospitality and tourism includes nine articles on assessing human resource needs and priorities, management development and training, preparing managers, curriculum design, supervised work experience, manager role, and the current business environment. (JOW)
Types of influence on the delivery of medical care are divided into monetary and other. These incentives effect care at the system, hospital, care team, physician and patient levels. Selected examples, primarily from the USA, are discussed. PMID:10312075
U.S. Department of Health & Human Services — About 25 percent of the hospitalizations for dual eligible beneficiaries in 2005 were potentially avoidable. Medicare and Medicaid spending for those potentially...
Agarwal, Divya; Garg, Poonam
In a competitive healthcare sector, hospitals have to focus on their processes in order to deliver high-quality care while at the same time reducing costs. Many hospitals have decided to adopt one or another Enterprise Resource Planning (ERP) system to improve their businesses, but implementing an ERP system can be a demanding endeavour. The systems are so difficult to implement that some are successful; many have failed, causing multimillion dollar losses. The challenge of ERP solutions lie in implementation because they are complex, time consuming and expensive too. This paper describes the various process workflows and phases of ERP implementation at Fortis Hospital Cunningham Road, Bangalore, India. This knowledge will provide valuable insights for the researchers and practitioners to understand the different process workflows and to make informed decisions when implementing ERP in any hospital. PMID:23079029
This work deals with the implications of different French rules and regulations concerning the environmental protection in hospitals. A special place is given to listed installations for environmental protection, because of their importance. A summary of important regulatory texts is presented concerning these installations, and also an inventory of installations or activities concerned, and the definition of the necessary procedures. Some ideas are also given about the much needed creation of an 'environmental network' inside hospitals, in order to cope with these concerns. Then, we briefly deal with more recent developments concerning the environmental protection, which will, no doubt, extend to hospitals, such as the French water law, air law, and procedures for the management of medical waste. Finally, the stakes of environmental decisions in hospitals and the chemist's place in these decisions are debated. (authors)
Louisiana Geographic Information Center — Hospitals in the state of Louisiana. This database contains the responses provided by the hospitals to the "Emergency Response Hospital Data Verification Form" that...
Full Text Available Abstract How to Cite This Article: Esmaeeli M, Erfani Sayar R, Saghebi A, Elmi Saghi, Rahmani Sh, Elmi S, Rabbani Javadi A. Screening for Depression in Hospitalized Pediatric Patients. Iran J Child Neurol. 2014 Winter; 8(1:47-51. Objective In chronically ill children who are hospitalized, many mood changes occur. For example, in children with cancer or renal failure, prolonged hospitalization and chemotherapy can lead to depression. With the improved survival of childhood malignancies, the effect of treatment on child’s psychosocial well-being becomes increasingly relevant. In this study, we examined the prevalence of depression in hospitalized children with chronic and acute conditions in Dr Sheikh Pediatrics Hospital in Mashhad. Materials & Methods After receiving the approval from the Ethics Committee of Mashhad University of Medical Sciences, we did this cross-sectional descriptive study, from April to June 2012 in Dr Sheikh Pediatric Hospital in Mashhad. Ninety children, aged between 8 to 16 years, were screened for depression. The sampling method was census. Children with a history of depressive or other mental disorders were excluded. Three groups of children (children with chronic renal disease, malignancy, and acute disease were evaluated for depression using standard Children Depression Inventory Questionnaire (CDI. Two specifically trained nurses with the supervision of a psychiatrist filled out the questionnaires at patients’ bedside. Depression scores were then analyzed by SPSS software. Results Of 90 children, 43(47.7% were male and 47(52.2% were female. The Children’s mean age was 11±2.3 years, and the mean length of hospitalization was 8±5.3 days. Depression was detected in various degrees in 63% of patients (N=57, and 36.6% of children (N=32 had no symptoms of depression. Severe depression was not seen in any of the patients with acute illness. More than half of patients with cancer and chronic kidney disease had
Smith Brian J
Full Text Available Abstract Background Studies investigating adverse events have traditionally been principally undertaken from a medical perspective. The impact that experience of an adverse event has on consumer confidence in health care is largely unknown. The objectives of the study were to seek public opinion on 1 the rate and severity of adverse events experienced in hospitals; and 2 the perception of safety in hospitals, so that predictors of lack of safety could be identified. Methods A multistage, clustered survey of persons residing in South Australia (2001, using household interviews (weighted n = 2,884. Results A total of 67% of respondents aged over forty years reported having at least one member of their household hospitalised in the past five years; with the average being two hospital admissions in five years. Respondents stated that 7.0% (95%CI: 6.2% to 7.9% of those hospital admissions were associated with an adverse event; 59.7% of respondents (95% CI: 51.4% to 67.5% rated the adverse event as really serious and 48.5% (95% CI: 40.4% to 56.8% stated prolonged hospitalisation was required as a consequence of the adverse event. Perception of safety in hospitals was largely affected by the experience of an adverse event; really serious events were the most significant predictor of lack of safety in those aged 40 years and over (RR 2.38; p Conclusion The experience of adverse events negatively impacted on public confidence in hospitals. The consumer-reported adverse event rate in hospitals (7.0% is similar to that identified using medical record review. Based on estimates from other studies, self-reported claims of adverse events in hospital by consumers appear credible, and should be considered when developing appropriate treatment regimes.
Mª Paz Prendes Espinosa; Mª del Mar Sánchez Vera; José Luis Serrano Sánchez
The investigation presented has a conclusion of improving the educative attention that children who find themselves in the care of hospital receive during considerable amount of time (and that during this period, they attend classes overseen by the hospital) through the use of ICT and the design and validation a network protocol, which is based on the use of telematics tools Web 2.0. After undergoing the investigations and experiments related to the topic, we come to the conclusion that in th...
Jacobsen, Peter; Jørgensen, Pelle Morten Thomas
In order to cope with the future challenges of the health care sector, there is an urging need for improving efficiency at hospitals. The study presents a framework enabling health care managers of improving the in-house logistics. The distinctiveness of the framework is the way in which it relates...... at a Danish hospital. The framework is tested on the blood sample logistics between the emergency department and laboratory with the goal of enhancing the efficiency of the emergency department....
Cleverley, W O; Harvey, R K
Changes in healthcare economics now permit more meaningful financial comparisons between hospitals and other industries. A study focusing on return on equity and other financial ratios highlighted critical changes needed to improve the fiscal health of hospitals. These suggestions include increasing net prices on existing product lines, entering new markets, using short-term debt to relieve long-term debt burdens, and expanding uses of operating leases.
Kalisch, Beatrice J.; Tschannen, Dana; Lee, Hyunhwa; Friese, Christopher R.
Quality of nursing care across hospitals is variable, and this variation can result in poor patient outcomes. One aspect of quality nursing care is the amount of necessary care omitted. This paper reports on the extent and type of nursing care missed and the reasons for missed care. The MISSCARE Survey was administered to nursing staff (n = 4086) who provide direct patient care in ten acute care hospitals. Missed nursing care patterns, as well as reasons for missing care (labor resources, mat...
The object of this research thesis is focused mostly on green meetings in the hospitality industry to be environment friendlier. It concerns what the hospitality industry and especially hotels can do within their meeting facilities to be environment friendlier and sustainable. The research will start with an introduction and a first impression of the reasons for the appearance of green meetings. Then the theoretical framework starts with the summary of green meetings and green technology....
This paper deals with the area of loyalty programs, especially in the hospitality industry. The purpose of this thesis is to demonstrate an implementation of a loyalty program on a concrete example, since this topic has not been explored extensively before. The theoretical part delves into the history of and the basic terms from hospitality, marketing, communication mix and sales support, particularly customer loyalty programs. The second part covers the concrete loyalty program of Hotel Adri...
The hospitality and tourism industry is one of the largest industries in the world. Hospitality industry has emerged as one of the key industries of the service sector driving the country's economy. The industry encompasses a wide variety of sub-sectors including foodservice; lodging; meetings, conventions, and special events; attractions; and transportation such as air travel. Due to its substantial economic benefits and job creation that help to fuel economic and social deve...
Nuray Türker; Mehmet Uçar
The main aim of this study is to determine the views of employees and managers working at the hospitality industry in Safranbolu towards the social responsibility of tourism enterprises, social responsibility activities carried out by the hotel enterprises, and their views on the advantages and contributions of social responsibility projects to the hotel business. This study will make contributions to the related literature on social responsibility at the hospitality industry by means of i...
Claudia-Elena TUCLEA; Ana-Mihaela PADUREAN
In this paper is presented one of the important sectors of the national economy, at least from its potential for development perspective: the hospitality industry. The research interest is related to finding out the main factors of competitiveness in this field. This research attempts to identify the essential aspects of competitiveness in the hospitality industry. The objectives pursued refer to: discovering the degree to which the concept of competitiveness is understood and capitalized on ...
McClelland, C. R., and Holman, D
The aim of this report is to provide an overview of stakeholders‘ perspectives of work quality in the UK hospitality sector. Employing an estimated 2.4 million across a diverse range of occupations within hotels, restaurants, event management and catering, and with a turnover of around £90 billion a year, the hospitality sector makes a substantial contribution towards the UK economy (Oxford Economics, 2010). Catering, the selected subsector for the WALQING project, involves the provision of f...
Research Question (RQ): Are creativity and innovation encouraged in Hospital X? Does satisfaction of employees at the workplace depend on the length of their employment? Does employee satisfaction depend on innovation? Purpose: It is important that creativity and innovation of employees are noticed in Hospital X in a timely manner. Various approaches can be used to motivate their creative thinking (using different professional factors). Method: Qualitative method, questionnaire with 8 q...
Dorsey, William [Jackson Park Hospital Foundation, Chicago, IL (United States); Vasquez, Nelson [Jackson Park Hospital Foundation, Chicago, IL (United States)
Jackson Park Hospital completed the construction of a new Medical Office Building on its campus this spring. The new building construction has adopted the City of Chicago's recent focus on protecting the environment, and conserving energy and resources, with the introduction of green building codes. Located in a poor, inner city neighborhood on the South side of Chicago, Jackson Park Hospital has chosen green building strategies to help make the area a better place to live and work.
In a complex world, characterized by a multitude of risks, managers need to manage the risks they encounter, in an efficient way and in the shortest time possible. In the current economic crisis, the concept of hospital risk management, as the process in which is identified, analyzed, reduced, or avoided a risk that may affect the hospital, gained great importance. The Romanian health system, distinguished by: lack of transparency, poor funding, the loss of the valuable medical staff, lack of...
Undrum, Michael; Ebbesen, Andreas
Norwegian hospitals are challenged by demographic changes, an increasingly complex clinical picture and longer waiting lines. At the same time hospitals struggle with adopting process innovations aiming at improving efficiency and productivity at a satisfactory rate. This study is a specific contribution to an increased understanding of the diffusion of process innovations in public health care. The first question answered by this study is related to which specific determinants that affect th...
Stephenson, N.; Morgan, R.; Abdel-Rahman-Abdel-Wahab, E.; Turnbull, C. J.
Baseline spirometry is useful in diagnosing and managing pulmonary disease. In a questionnaire survey of 100 hospital doctors in two hospitals in the Mersey region, their views and ability to interpret baseline spirometry was assessed. Of the 70 doctors who responded, 65% felt they could accurately interpret baseline spirometry. However, only 12% accurately interpreted all five vitalographs in the questionnaire. The majority (72%) felt they had not had adequate teaching in interpretation of s...
Brooks, Jo Ann
This column is designed to provide a nursing perspective on new hospital quality measurements. Future articles will cover the various quality indicators hospitals face and the role of the nurse in meeting mandated benchmarks. Reader responses to this column are welcome and will help to make it more useful to nurses in meeting the challenges posed by health care reform and changing Medicare reimbursement programs.
Enyeart, Amanda L; Weaver, Debbie
This article explores relationship marketing as adopted by staff of the Forbes Medical Library at The Children's Hospital in Denver. It provides a broad overview of relationship marketing along with its applications in libraries, and a description of how the library staff has used specific relationships with different hospital groups to enhance library service. The examples illustrate the importance of persistence, patience, and flexibility when consciously developing relationships between a library and individuals or groups. PMID:16203704
Full Text Available In Italy a specific surveillance system for zoster does not exist, and thus updated and complete epidemiological data are lacking. The objective of this study was to retrospectively review the national hospital discharge forms database for the period 1999-2005 using the code ICD9-CM053. In the period 1999-2005, 35,328 hospital admissions have been registered with annual means of 4,503 hospitalizations and 543 day-hospital admissions. The great part of hospitalizations (61.9% involved subjects older than 65 years; the mean duration of stay was 8 days. These data, even if restricted to hospitalizations registered at national level, confirm the epidemiological impact of shingles and of its complications.
the understandings of the nurses which will contribute to the feeling of stigmatization of users of hard drugs when in contact with the health care system. By virtue of their profession and position nurses have a big influence on how citizens while admitted to hospital feel accepted and welcomed. Nurses are subdued...... advanced hospital care is necessary. Drug users have often bad experiences in their contact with the hospital system beyond these, experiences of conflicts during hospitalization and due to this they might postpone contact to the health care system. Apparently conflicts often break out when users of hard...... drugs are inpatients in somatic hospital wards. Aim: The project wants to enlighten the meeting between the drug user and the nurse in the hospital. Which roles do the nurses and the users carry and what will the meaning be of former experiences of the drug users of the health care system in the meeting...
Putu Wuri Handayani
Full Text Available Currently, hospitals are required to improve their quality of health services to meet the higher standards. This improvement is supported by Ministry of Health which has launched electronic health (e-health program. Under this program, hospitals are required to have Hospital Information System (HIS or Enterprise Resource Planning (ERP for healthcare. However, to date only a few hospitals have implemented an integrated HIS. The purpose of this research is to asses the Information Technology (IT maturity of a teaching hospital in implementing HIS. This IT assessment observes from four layers namely business process, Information System (IS, Information Technology (IT and IS/IT management and organization. The result of this research is that teaching hospitals should prepare a plan to restructure their network with adequate infrastructure, create IT blue print and policy, IT organization restructuring, IT staff competency development and build integrated HIS.
Osler, Merete; Iversen, Lene Hjerrild; Borglykke, Anders;
This study examines variation between hospitals in 30-day mortality after surgery for colorectal cancer (CRC) in Denmark and explores whether hospital volume and patient characteristics contribute to any variation between hospitals.......This study examines variation between hospitals in 30-day mortality after surgery for colorectal cancer (CRC) in Denmark and explores whether hospital volume and patient characteristics contribute to any variation between hospitals....
Leone, Andrew J; Van Horn, R Lawrence
We hypothesize that, unlike for-profit firms, nonprofit hospitals have incentives to manage earnings to a range just above zero. We consider two ways managers can achieve this. They can adjust discretionary spending [Hoerger, T.J., 1991. 'Profit' variability in for-profit and not-for-profit hospitals. Journal of Health Economics 10, 259-289.] and/or they can adjust accounting accruals using the flexibility inherent in Generally Accepted Accounting Principles (GAAP). To test our hypothesis we use regressions as well as tests of the distribution of earnings by Burgstahler and Dichev [Burgstahler, D., Dichev, I., 1997. Earnings management to avoid earnings decreases and losses. Journal of Accounting and Economics 24, 99-126.] on a sample of 1,204 hospitals and 8,179 hospital-year observations. Our tests support the use of discretionary spending and accounting accrual management. Like Hoerger (1991), we find evidence that nonprofit hospitals adjust discretionary spending to manage earnings. However, we also find significant use of discretionary accruals (e.g., adjustments to the third-party-allowance, and allowance for doubtful accounts) to meet earnings objectives. These findings have two important implications. First, the previous evidence by Hoerger that nonprofit hospitals show less variation in income may at least partly be explained by an accounting phenomenon. Second, our findings provide guidance to users of these financial statements in predicting the direction of likely bias in reported earnings. PMID:15896858
Ishii, Hideko; Odauchi, Satori; Funabashi, Kaori; Ohta, Kazuko; Yamashita, Takeko
Tuberculosis control in big cities should be focused on preventing defaulting from treatment, and the prevention of the emergence of multi-drug resistant tuberculosis, and the improvement of treatment success rate. Since it is needed to organize continued case management system starting from hospitalization, discharge, management of regular drug taking at outpatient clinics and final cure, close collaboration should be made between hospital nurses and public health nurses. For this purpose, there should be no difference about the understanding on tuberculosis control between clinical and public health nurses. This research was aimed to examine "How much interest and recognition do hospital nurses have about tuberculosis control." The Aichi Nursing Association cooperated with this research. The results showed that 60% of tuberculosis ward nurses were more than forty years old, and they have served more than ten years in TB word. The levels of understanding on tuberculosis among nurses working in tuberculosis hospitals were much higher than those in general hospitals. However, it is necessary to organize a collaboration system between hospitals and public health center to improve TB case management.
Bonney, R S
Survival strategies for hospitals and hospital pharmacy departments are presented, and one hospital's development into a health-services system is described. Financial and competitive pressures are forcing institutions to develop new strategies for survival. The primary institutional strategy is diversification--both horizontal and vertical. Diversification can assist in the hospital's growth, increase its asset and revenue bases, and lead to the development of a health-care delivery system. Marketing to physicians and developing information systems are also critical strategies under a prospective payment system. Institutions will need to know the cost of providing care for specific diagnosis-related groups. Strategies must be employed to develop incentives to reduce inpatient acute-care services and to increase productivity. Physicians should be involved in all of the institutional strategies. Strategies for the pharmacy department are basically the same. Pharmacy departments should develop programs to reduce drug use (especially antibiotic use) and information systems that show the actual cost of providing services by diagnosis. The major corporate restructuring and diversification efforts of one hospital are described. The future of hospitals and pharmacy departments will depend on the successful application of the strategies discussed.
Leone, Andrew J; Van Horn, R Lawrence
We hypothesize that, unlike for-profit firms, nonprofit hospitals have incentives to manage earnings to a range just above zero. We consider two ways managers can achieve this. They can adjust discretionary spending [Hoerger, T.J., 1991. 'Profit' variability in for-profit and not-for-profit hospitals. Journal of Health Economics 10, 259-289.] and/or they can adjust accounting accruals using the flexibility inherent in Generally Accepted Accounting Principles (GAAP). To test our hypothesis we use regressions as well as tests of the distribution of earnings by Burgstahler and Dichev [Burgstahler, D., Dichev, I., 1997. Earnings management to avoid earnings decreases and losses. Journal of Accounting and Economics 24, 99-126.] on a sample of 1,204 hospitals and 8,179 hospital-year observations. Our tests support the use of discretionary spending and accounting accrual management. Like Hoerger (1991), we find evidence that nonprofit hospitals adjust discretionary spending to manage earnings. However, we also find significant use of discretionary accruals (e.g., adjustments to the third-party-allowance, and allowance for doubtful accounts) to meet earnings objectives. These findings have two important implications. First, the previous evidence by Hoerger that nonprofit hospitals show less variation in income may at least partly be explained by an accounting phenomenon. Second, our findings provide guidance to users of these financial statements in predicting the direction of likely bias in reported earnings.
M Adib Hajbaghery
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
Is an increase in the quality of health services, as perceived by the hospital, appreciated by the consumers? If so, patients should respond positively to an increase in the quality of hospital services. Using two indicators to capture the quality of hospital services I investigate the relationship between these indicators and inpatients experiences. The health sector has increased substantially in most OECD countries over the last few decades. In Norway, total health care expenditures a...
Bolliger, Chris T; van Biljon, X.; Humair, Jean-Paul Luc André; El Fehri, V.; Cornuz, J.
QUESTIONS UNDER STUDY: Whether a 1-year nationwide, government supported programme is effective in significantly increasing the number of smoking cessation clinics at major Swiss hospitals as well as providing basic training for the staff running them. METHODS: We conducted a baseline evaluation of hospital services for smoking cessation, hypertension, and obesity by web search and telephone contact followed by personal visits between October 2005 and January 2006 of 44 major public hospitals...
The widespread diffusion and utilization of ICTs affords new forms of interaction and exchange to emerge between people on a global level. One such social form becoming increasingly popular is network hospitality, which refers visiting or accommodating someone, usually a person you do not know in advance, through hospitality exchange networks such as Couchsurfing. In this study I present a qualitative study on hospitality exchange in the context of Airbnb form the perspective of the users par...
Bathma Vishal; Likhar Swarn K; Mishra Mahesh K; Athavale Arvind V; Agarwal Sanjay; Shukla Uma S
Background: Biomedical waste (BMW) is waste generated during diagnosis, treatment or immunization of human beings or animals. Approximately 10-25% of the Bio-Medical waste is hazardous and can be injurious to humans or animals and deleterious to environment. It is estimated that annually about 0.33 million tones of hospital waste are generated in India. Objectives: To assess the knowledge regarding hospital waste management amongst hospital staff. Material and Methods: The study comprises of ...
Giacomino, Bria D; Cram, Peter; Vaughan-Sarrazin, Mary; Zhou, Yunshu; Girotra, Saket
Although prices for medical services are known to vary markedly between hospitals, it remains unknown whether variation in hospital prices is explained by differences in hospital quality or reimbursement from major insurers. We obtained "out-of-pocket" price estimates for coronary artery bypass grafting (CABG) from a random sample of US hospitals for a hypothetical patient without medical insurance. We compared hospital CABG price to (1) "fair price" estimate from Healthcare Bluebook data using each hospital's zip code and (2) Society of Thoracic Surgeons composite CABG quality score and risk-adjusted mortality rate. Of 101 study hospitals, 53 (52.5%) were able to provide a complete price estimate for CABG. The mean price for CABG was $151,271 and ranged from $44,824 to $448,038. Except for geographic census region, which was weakly associated with price, hospital CABG price was not associated with other structural characteristics or CABG volume (p >0.10 for all). Likewise, there was no association between a hospital's price for CABG with average reimbursement from major insurers within the same zip code (ρ = 0.07, p value = 0.6), Society of Thoracic Surgeoncomposite quality score (ρ = 0.08, p value = 0.71), or risk-adjusted CABG mortality (ρ = -0.03 p value = 0.89). In conclusion, the price of CABG varied more than 10-fold across US hospitals. There was no correlation between price information obtained from hospitals and the average reimbursement from major insurers in the same market. We also found no evidence to suggest that hospitals that charge higher prices provide better quality of care.
Wang, Wei-Yun; Ho, Shung-Tai; Wu, Shang-Liang; Chu, Chi-Ming; Sung, Chun-Sung; Wang, Kwua-Yun; Liang, Chun-Yu
Abstract Clinically significant pain (CSP) is one of the most common complaints among cancer patients during repeated hospitalizations, and the prevalence ranges from 24% to 86%. This study aimed to characterize the trends in CSP among cancer patients and examine the differences in the prevalence of CSP across repeated hospitalizations. A hospital-based, retrospective cohort study was conducted at an academic hospital. Patient-reported pain intensity was assessed and recorded in a nursing information system. We examined the differences in the prevalence of worst pain intensity (WPI) and last evaluated pain intensity (LPI) of ≥4 or ≥7 points among cancer inpatients from the 1st to the 18th hospitalization. Linear mixed models were used to determine the significant difference in the WPI and LPI (≥4 or ≥7 points) at each hospitalization. We examined 88,133 pain scores from the 1st to the 18th hospitalization among cancer patients. The prevalence of the 4 CSP types showed a trend toward a reduction from the 1st to the 18th hospitalization. There was a robust reduction in the CSP prevalence from the 1st to the 5th hospitalization, except in the case of LPI ≥ 7 points. The prevalence of a WPI ≥ 4 points was significantly higher (0.240-fold increase) during the 1st hospitalization than during the 5th hospitalization. For the 2nd, 3rd, and 4th hospitalizations, there was a significantly higher prevalence of a WPI ≥ 4 points compared with the 5th hospitalization. We also observed significant reductions in the prevalence of a WPI ≥ 7 points during the 1st to the 4th hospitalizations, an LPI ≥ 4 points during the 1st to the 3rd hospitalizations, and an LPI ≥ 7 points during the 1st to the 2nd hospitalization. Although the prevalence of the 4 CSP types decreased gradually, it is impossible to state the causative factors on the basis of this observational and descriptive study. The next step will examine the factors that determine the CSP prevalence among
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
Pugh, Greg L
Hospital social workers are in a unique context of practice, and one where the ethical environment has a profound influence on the ethical behavior. This study determined the ratings of ethical environment by hospital social workers in large nationwide sample. Correlates suggest by and compared to studies of ethical environment with nurses are explored. Positive ratings of the ethical environment are primarily associated with job satisfaction, as well as working in a centralized social work department and for a non-profit hospital. Religiosity and MSW education were not predictive. Implications and suggestions for managing the hospital ethical environment are provided.
Full Text Available Formulary is a continually revised compilation of pharmaceuticals (plus important ancillary information that reflects the current clinical judgment of medical staff. Kasturba Hospital is a 1400 bedded tertiary care teaching hospital with different specialties, having more than 3000 brands and ancillary products in use. The hospital does not have a formulary of any kind. Present study involved development of a formulary for the hospital and comparing it with WHO Model Formulary. Monographs of the drugs were prepared as per the recommendation of Pharmacy and Therapeutic Committee of the hospital. Prepared hospital formulary consisted of 476 generic drugs of various categories and 95 fixed dose combinations. Availability of brands varied from single to many. About 75 medicines recommended by the essential medicine list were not present in the prepared hospital formulary. The drugs to be avoided or used with caution in renal failure, hepatic failure and in pregnancy were categorized and included in the formulary as additional information. The prepared hospital formulary was recommended for implementation in the hospital, which could thereby help as a tool to promote rational drug use.
Delobelle, Peter; Onya, Hans; Langa, Cynthia; Mashamba, Joyce; Depoorter, Anne-Marie
This project aimed at transforming a rural District Hospital in the Limpopo Province of South Africa into a Health Promoting Hospital according to standards developed by WHO-Europe. The intervention used a diagnostic approach and baseline needs assessment of hospital staff, patients, and their relatives to identify health education and promotion needs. Activities included empowerment training and skills development, implementation of health education and promotion activities, and the integration of health-promoting standards and values in the hospital structure and culture. The project indicated applicability of the model in a resource-limited setting, based on staff empowerment, local leadership, and stakeholder engagement.
Full Text Available Objective To identify and analyze the significant networks of family, social and hospital support described by the family caregivers of hospitalized children 5-12 years during the hospital stay. Method Descriptive study, exploratory and qualitative study conducted with 20 caregivers of children hospitalized in a hospital in a city in southern Brazil, through semi-structured interviews and significant social networks maps, tailored to the hospital setting. Results Data analysis showed that the most active social network was comprised of families through emotional support, material aid and services. Relations with hospital health care team and the hospital context were cited as providing support to the caregivers of the hospitalized child. Conclusions The identification of social networks in the child’s hospitalization course enables equip professionals working in the institution aiming at better targeting of actions and care for the family and hospitalized children.
Paulo Cesar Sandler
Full Text Available O presente estudo cuida de pacientes "difíceis" da clínica psiquiátrica e psicoterápica: os pacientes que apresentam o fenômeno da atuação, cuja aproximação terapêutica tem se demonstrado problemática, mesmo com o advento das modernas técnicas de psicoterapia e das comunidades terapêuticas. Os diagnósticos psiquiátricos destes pacientes variam: são neuróticos, apresentam transtornos de pesonalidade, são psicóticos e quase sempre com graves doenças secundárias: alcoolismo e toxicomania (Códigos Classificação Internacional de Doenças 295 a 299, 300. 301, 303 e 304. Propõe-se, à luz da compreensão psicanalítica destas pessoas, um tratamento psicoterápico breve, focal, com o auxílio de uma hospitalização em regime fechado. Para a avaliação dos resultados do método psicoterápico diádico, criaram-se critérios de cura coerentes com a proposta terapêutica, e equiparam-se estes critérios clínicos a valores numéricos. Utilizando 36 pacientes internados, verificou-se até que ponto eles alcançavam estes critérios. Cada paciente recebeu um escore - valor numérico - que expressou o seu desempenho durante o tratamento em regime de internação, e sua conduta pós-alta hospitalar, durante um seguimento médio de 21 meses. Estes 36 pacientes puderam ser divididos em dois grupos: os de evolução favorável (obtivemos 36,1% e os de evolução desfavorável. Por meio de uma amostra sistemática composta por 41 pacientes que não foram submetidos ao método, internados no mesmo período de tempo, no mesmo hospital, e pareados com nossa casuística, fêz-se uma comparação estatística entre os percentis obtidos nas evoluções dos dois grupos. O valor do teste estatístico, o chi quadrado, não foi significante. O exame das proporções correspondentes a cada patologia em separado sugeriu fortemente que o tratamento estaria indicado nas neuroses e nas psicoses, mas que seria realmente ineficaz nos transtornos de
Full Text Available Institutional care is a growing component of health care costs in low- and middle-income countries, but local health planners in these countries have inadequate knowledge of the costs of different medical services. In India, greater utilisation of hospital services is driven both by rising incomes and by government insurance programmes that cover the cost of inpatient services; however, there is still a paucity of unit cost information from Indian hospitals. In this study, we estimated operating costs and cost per outpatient visit, cost per inpatient stay, cost per emergency room visit, and cost per surgery for five hospitals of different types across India: a 57-bed charitable hospital, a 200-bed private hospital, a 400-bed government district hospital, a 655-bed private teaching hospital, and a 778-bed government tertiary care hospital for the financial year 2010-11. The major cost component varied among human resources, capital costs, and material costs, by hospital type. The outpatient visit cost ranged from Rs. 94 (district hospital to Rs. 2,213 (private hospital (USD 1 = INR 52. The inpatient stay cost was Rs. 345 in the private teaching hospital, Rs. 394 in the district hospital, Rs. 614 in the tertiary care hospital, Rs. 1,959 in the charitable hospital, and Rs. 6,996 in the private hospital. Our study results can help hospital administrators understand their cost structures and run their facilities more efficiently, and we identify areas where improvements in efficiency might significantly lower unit costs. The study also demonstrates that detailed costing of Indian hospital operations is both feasible and essential, given the significant variation in the country's hospital types. Because of the size and diversity of the country and variations across hospitals, a large-scale study should be undertaken to refine hospital costing for different types of hospitals so that the results can be used for policy purposes, such as revising
Johnson, K F
Healthcare industry changes during the 1980s--increased competition and alterations in the Medicare payment methodology--place new and more complex demands on a hospital's information systems, which often fall short of meeting those demands. These systems were designed for financial reporting, billing, or providing clinical data, and few of them are capable of linking with other unrelated systems. Today's hospital manager needs timely and simultaneous access to data from a variety of sources within the hospital. All the elements to accomplish this are collected somewhere in the hospital, but finding them and bringing them together is difficult. The key to the efficient management and use of data bases is in understanding the fundamental concept of relational data bases, which is the capability of linking or joining separate data files through a common data element in each file. In this way, data files may be integrated into a "related" data base. Any number of separate files, or tables, may exist within a "relational" data base as long as a series of threads links them. A strategic management information data base includes the information necessary to analyze, understand, and manage the hospital's markets, products, resources, and profitability. The major components of this information system are the case mix and cost accounting, budgeting, and modeling systems. The case mix and cost accounting factors involve managing concrete pieces of data, whereas the budgeting and modeling factors manipulate data to create a scenario. The strategic management information data base is the foundation of a hospital's decision support system, which is rapidly moving into the category of a necessary tool of the hospital manager's trade.
Full Text Available Hospital readmission rates can be used as an indicator of the quality of health care services and can highlight high-priority research areas to ensure better health. A readmission is defined as when a patient is discharged from an acute care hospital and is admitted back to an acute care hospital in a set amount of days, with 30 days being the current national standard. On average, 19.6% of Medicare patients are readmitted to the hospital within 30 days of discharge and 56.1% within a year (Jencks, Williams, & Coleman, 2009. The hypothesis of this study was that the discharge location, or where a patient went immediately after discharge, would not have a significant effect on readmissions. A data set with all admission records was obtained from a major health provider. These data contain all hospital patients’ demographic and diagnosis information. General, women’s, and children’s hospitals were looked at from a system perspective to study the discharge location of patients as well as the effects of patient demographics on discharge location. By using a z-significance test in Microsoft Excel and SAS 9.2, it was discovered that patients discharged to home have a significantly lower likelihood of readmission. Generally, patients who are discharged to an extended care or intermediate care facility or patients with home health carerelated services had a significantly higher likelihood of being readmitted. The findings may indicate a possible need for an institution-to-institution intervention as well as institution-to-patient intervention. Future work will develop potential interventions in partnership with hospital staff.
Laura T. Eno
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.
Cofer, Joseph B; Petros, Tommy J; Burkholder, Hans C; Clarke, P Chris
Rural communities face an impending surgical workforce crisis. The purpose of this study is to describe perceptions of rural Tennessee hospital administrators regarding the importance of surgical services to their hospitals. In collaboration with the Tennessee Hospital Association, we developed and administered a 13-item survey based on a recently published national survey to 80 rural Tennessee hospitals in August 2008. A total of 29 responses were received for an overall 36.3 per cent response rate. Over 44 per cent of rural surgeons were older than 50 years of age, and 27.6 per cent of hospitals reported they would lose at least one surgeon in the next 2 years. The responding hospitals reported losing 10.4 per cent of their surgical workforce in the preceding 2 years. Over 53 per cent were actively recruiting a general surgeon with an average time to recruit a surgeon of 11.8 months. Ninety-seven per cent stated that having a surgical program was very important to their financial viability with the mean and median reported revenue generated by a single general surgeon being $1.8 million and $1.4 million, respectively. Almost 11 per cent of the hospitals stated they would have to close if they lost surgical services. Although rural Tennessee hospitals face similar difficulties to national rural hospitals with regard to retaining and hiring surgeons, slightly more Tennessee hospitals (54 vs 36%) were actively attempting to recruit a general surgeon. The shortage of general surgeons is a threat to the accessibility of comprehensive hospital-based care for rural Tennesseans.
Kamper-Jørgensen, Mads; Benn, Christine Stabell; Simonsen, Jacob;
To estimate how risk of acute respiratory infection (ARI) hospitalization in children attending childcare facilities with a recently (within 1 month) hospitalized child is affected by gender, age and other characteristics.......To estimate how risk of acute respiratory infection (ARI) hospitalization in children attending childcare facilities with a recently (within 1 month) hospitalized child is affected by gender, age and other characteristics....
... hospital care but is unable to obtain the agreement of the physician, it may request an expedited... the first full working day immediately following the day the hospital submits the request for review... hospital, and physician within 2 working days of the hospital's request and receipt of any...
... 42 Public Health 5 2010-10-01 2010-10-01 false Incentive payments to eligible hospitals. 495.104... hospitals. (a) General rule. A qualifying hospital (as defined in this subpart) must receive the special... and the payment formula specified in paragraph (c) of this section, qualifying hospitals may...
... 42 Public Health 2 2010-10-01 2010-10-01 false Special treatment: Sole community hospitals. 412.92... SERVICES MEDICARE PROGRAM PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT HOSPITAL SERVICES Special Treatment of... treatment: Sole community hospitals. (a) Criteria for classification as a sole community hospital....
... 42 Public Health 5 2010-10-01 2010-10-01 false Temporary waivers applicable to hospitals. 488.54... Requirements § 488.54 Temporary waivers applicable to hospitals. (a) General provisions. If a hospital is found to be out of compliance with one or more conditions of participation for hospitals, as specified...
... EXAMINATIONS HOSPITAL AND STATION MANAGEMENT General § 35.1 Hospital and station rules. The officer in charge of a station or hospital of the Service is authorized to adopt such rules and issue such instructions... 42 Public Health 1 2010-10-01 2010-10-01 false Hospital and station rules. 35.1 Section...
... EXAMINATIONS HOSPITAL AND STATION MANAGEMENT General § 35.2 Compliance with hospital rules. All patients and visitors in stations and hospitals of the Service are expected to comply with the rules and instructions... 42 Public Health 1 2010-10-01 2010-10-01 false Compliance with hospital rules. 35.2 Section...
... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Leasing of hospital. 242.72 Section... INSURANCE FOR HOSPITALS Miscellaneous Requirements § 242.72 Leasing of hospital. Leasing of a hospital in its entirety is prohibited. Notwithstanding this prohibition, any proposal in which leasing of...
Connors, E J
The future of the pathologist in the hospital setting can be speculated on in light of contemporary and predictable trends occurring in hospitals. From five of these trends--downsizing, restructuring, diversification, hospital-physician relations, and for-profit hospitals--eight implications for the practice of pathology are identified.