Carolina Franco Ricart
Full Text Available Objetivo: Describir la frecuencia de infecciones oportunistas y determinar cual es la más frecuente en pacientes VIH+ del Hospital Vargas de Caracas durante el período 2005 - 2006. Diseño: Estudio descriptivo, transversal, retrospectivo y observacional. Lugar: Hospital "José María Vargas" de Caracas, Venezuela. Participantes: Pacientes ingresados con historia de VIH+ e infección oportunista. Intervención: Revisión de Historias Clínicas de archivo entre los años 2005-2006. Principales medidas de Resultados : Porcentajes y Medidas de Tendencia Central, tabuladas en una base de datos con ayuda del programa Microsoft Excel 2003 para Windows ®. Resultados : Se revisaron 120 historias; 83 cumplían con los criterios de inclusión. El promedio de edad fue 36,87 años; 59,04% correspondían al sexo masculino y 40,96% al sexo femenino. El 44,4% fueron infecciones respiratorias, 31,88% infecciones del SNC. Las infecciones más frecuentes: 24,64% Mycobacterium tuberculosis, 19,87% Toxoplasma gondii, 15,94% Candida albicans y 10,14% Pneumocystis jiroveci. En el 63,86% de los casos se encontraron dos o más infecciones simultáneas. El 64% de estos pacientes recibía tratamiento y el 46% era heterosexual no promiscuo. Conclusiones : Las alteraciones respiratorias constituyen la infección oportunista más frecuente en pacientes VIH+.
Carolina Lissete Franco Ricart
Full Text Available Objetivo: Describir la frecuencia de infecciones oportunistas y determinar cual es la más frecuente en pacientes VIH+ del Hospital Vargas de Caracas durante el período 2005 – 2006. Diseño: Estudio descriptivo, transversal, retrospectivo y observacional. Lugar: Hospital “José María Vargas” de Caracas, Venezuela. Participantes: Pacientes ingresados con historia de VIH+ e infección oportunista. Intervención: Revisión de Historias Clínicas de archivo entre los años 2005-2006. Principales medidas de Resultados: Porcentajes y Medidas de Tendencia Central, tabuladas en una base de datos con ayuda del programa Microsoft Excel 2003 para Windows ®. Resultados: Se revisaron 120 historias; 83 cumplían con los criterios de inclusión. El promedio de edad fue 36,87 años; 59,04% correspondían al sexo masculino y 40,96% al sexo femenino. El 44,4% fueron infecciones respiratorias, 31,88% infecciones del SNC. Las infecciones más frecuentes: 24,64% Mycobacterium tuberculosis, 19,87% Toxoplasma gondii, 15,94% Candida albicans y 10,14% Pneumocystis jiroveci. En el 63,86% de los casos se encontraron dos o más infecciones simultáneas. El 64% de estos pacientes recibía tratamiento y el 46% era heterosexual no promiscuo. Conclusiones: Las alteraciones respiratorias constituyen la infección oportunista más frecuente en pacientes VIH+.
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.
Full Text Available 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, bioMérieux or the Microparticle Enzyme Immunoassay, MEIA, Axsym® system, Abbott, and IgM was determined using the ELFA, VIDAS® system, bioMérieux, 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.
Ángel Pérez Martínez
Full Text Available From the development of Literature Theory wich based on the analogy with Architecture the author analyze the relationships between Cervantes and Vargas Llosa works. Research on Cervantes reception in Latin America it is a work to keep doing. In Peru Vargas Llosa has received Cervantes works in a peculiar way. This paper tries to clarify what are the structural relations between these two literary architecture
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
Pereira,André Flávio Freire; Portela,Luiz Eduardo Duque; Lima,Guilherme Didier de Andrade; Carneiro,Wagner Cabral Gomes; Ferreira,Marcus André Costa; Rangel,Túlio Albuquerque de Moura; Santos,Ricardo Barreto Monteiro dos
INTRODUÇÃO: as fraturas da coluna torácica e lombar estão se tornando mais frequentes, devido ao aumento dos acidentes de alta energia. Elas apresentam um elevado índice de morbidade e mortalidade, acarretando grandes prejuízos socioeconômicos. OBJETIVO: analisar a epidemiologia das fraturas torácicas e lombares de pacientes atendidas no Serviço de Ortopedia e Traumatologia do Hospital Getúlio Vargas em Recife (PE). MÉTODOS: este estudo é uma análise epidemiológica dos pacientes com fraturas ...
Alfredo Jácome Roca
Full Text Available
El doctor Jorge Segura Vargas nació en Duitama, Boyacá, el 14 de agosto de 1924. Ingresó como estudiante fundador en 1942 a la naciente escuela de medicina de la Javeriana, la segunda facultad en Bogotá, que contó con no pocos enemigos que casi acaban con ella. El apoyo de algunos distinguidos profesores de la época –que además firmaron el acta de fundación- el tesón del Padre Félix Restrepo, a la sazón Rector Magnífico, y la perseverancia de alumnos como Segura, permitió que este finalizara sus estudios en 1947 en la primera promoción y se graduara en 1950 con la tesis “Vesícula no visible, intubación duodenal”. Con el título no terminaron los avatares, por la resistencia que generaban los egresados de la nueva escuela médica. Sin embargo, Jorge y algunos compañeros lograron ingresar al Hospital San José de Bogotá, donde llegaron a ser muy apreciados. El entrenamiento lo logró realizar en este tradicional centro hospitalario de la capital, con el profesor Hernando Anzola Cubides. Era Anzola un distinguido académico, miembro de la Sociedad de Cirugía de Bogotá, quien creó una importante escuela quirúrgica en la capital.
Fue Alumno Fundador y Profesor Distinguido de la Facultad de Medicina de la Universidad Javeriana, Jefe del Departamento Quirúrgico del Hospital San Ignacio, donde dejó un legado de habilidades y conocimientos quirúrgicos, bonhomía y lealtad con la Facultad, que acompañó de principio a fin, en las buenas y en las malas.
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".
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
Salomon, Herman P.
Full Text Available The team of Ferrara editors was headed by two former New Christians: an entrepreneur, a native of Spain, and a Latin scholar from Portugal who in the introductions to variant editions of their scriptural production alternately call themselves by their Christian names Jeronimo de Vargas and Duarte Pinel, and by their Jewish names Yom Tob Atias and Abraham Usque. This “editorial schizophrenia” is reflected in the Italian archives. Whereas the historian Renata Segre’s researches have documented that Duarte Pinel and Abraham Usque were one and the same person, she was unable to find archival proof uniting Jeronimo de Vargas and Yom Tob Atias. The researcher Aron Leoni came up with a Latin notarial deed in the Ferrara archives wherein “Joantu Athias” is called “ptrem ac legitimum administratorum Hieronimi Vargas” and also the latter’s “patre et legitimo administrator.” He supposed “ptrem” to be an abbreviation of “procuratorem” and “patre” to mean father. Thus he concluded that Yom Tob Atias was the father of Jeronimo de Vargas. Close examination of the document and comparison with two others which have recently come to light reveal, however, the incontrovertible identity of Yom Tob Atias and Jeronimo de Vargas. We are dealing with a typical case of ex-Marrano heteronomy: a former New Christian maintaining a separate onomastic Christian identity alongside his Jewish one.
El equipo de editores de Ferrara fue dirigido por dos antiguos cristianos nuevos, uno financiero, originario de España, y el otro, un latinista portugués. En las distintas introducciones a edición bíblica los dos se autodenominan alternativamente por sus nombres cristianos –Jerónimo de Vargas y Duarte Pinel– y por sus nombres judíos, Yom Tob Atías y Abraham Usque. Esta «esquizofrenia editorial» ha dejado huella en los archivos italianos. Mientras que las investigaciones de Renata Segre han documentado que Pinel y Usque eran la misma
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.
Ana Rosa Jorna Calixto
2006 without evidence of decrease in mortality despite the technological improvement of emergences services. OBJECTIVE: to characterize its behavior in the integral diagnostic centers of the Vargas State from June, 2006 to June, 2009. METHODS: a retrospective and descriptive study was conducted to characterize the behavior of myocardial acute infarction in urgency and emergency services of integral diagnostic centers using the Barrio Adentro's Statistics. RESULTS: a total of 186 patients were seen due to myocardial acute infarction with predominance of intensive therapy admissions (2,4 % on the hospitalization services. Those deceased from this cause included 35 persons the 17,1 % of total of deceased. The 39,2 % was thrombolized where the higher figure was achieved in 2008 with a 51,2 %. The mortality from myocardial acute infarction fluctuated between rates of 17,3 and 20 by each 100 patients treated. The crude mortality rate was of 9,58 by 100 000 inhabitants. CONCLUSIONS: the figure of cases seen due to infarction had a stable increasing behavior, accounting for the 0,7 % of total of admissions in these centers with predominance of intensive therapy admissions over the hospitalization services. Thrombolytic treatment was applied using recombinant streptokinase in a significant percentage of patients. In the hospitalization services mortality from this cause was higher. The death risk not decreased for patients presenting with this disease and the general mortality during the study period was of 35 patients for a rate of 9,58 x 100 000 inhabitants.
Boletin Cultural y Bibliográfico Banco de la República
Full Text Available Quince años hizo el 25 de julio que desapareció de entre nosotros don Tomás Rueda Vargas. Su nombre, ejemplar por muchos conceptos, viene siempre nimbado de las virtudes cardinales que conformaron su tarea y su vida. Escritor nato, sabía manejar el idioma con singular pericia sin caer en rebuscamientos ni en gongorismos. Su pensamiento era diáfano por lo cual no se perdía en el laberinto de las palabras. Apenas éstas eran el dócil instrumento para su dialéctica, para ese generoso razo namiento intelectual que constituía el Alfa y el Omega de su diario batallar.
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.
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.
Bakker, P.J.J.M.; Bercken, J.H.L. van den
This article examines the commentary on Aristotle’s De anima by Alphonsus Vargas Toletanus, OESA († 1366). The commentary has been preserved in one manuscript, Cremona, Biblioteca Statale, Ms. 113 (Nl-12193), written in Bologna in 1475, and in at least five editions printed between 1477 and 1609.
Ana María Escallón
Full Text Available Dijo la prensa que Germán Vargas, murió en Barranquilla el 21 de mayo de 1991. A quienes no aceptamos la evidencia del hecho, resulta imposible referirnos a él con nuestras propias palabras. Por esto, el Boletin Cultural y Bibliográfico transcribe lo que otros dijeron. D.J.A.
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.
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.
Agustín Prado Alvarado
Full Text Available The examination of Mario Vargas Llosa’s bachelor’s thesis (1958, published in book form in 2001 reveals his background as a literary critic. Vargas Llosa’s interest in the biographical aspects of the Nicaraguan poet lets us track the emergence of his literary vocation. The other interest demonstrated in this thesis is to prove the permanence of the life and work of the naturalist writer Emile Zola in the life of Darío. In this thesis, there are some features that Mario Vargas Llosa maintained throughout his production as a literary critic, especially the biographical review as a key to understand certain codes of literary creation of an author.
Godoy Cossío, Ana
Sin duda, investigar a dos escritores como Francisco Umbral y Mario Vargas Llosa ambos situados en el Olimpo de los grandes escritores del siglo XX, no ha sido tarea fácil, pero sí verdaderamente fascinante. Poseedores de talento, creatividad y de genio literario son portadores de una marca propia e indeleble en el periodismo, en el ensayo crítico y en la narrativa. Dos columnas equidistantes y equivalentes con voz propia que se han coronado por igual gracias a sus productivas vidas. En suma,...
Alberto Corradine Angulo
Full Text Available Varios autores se han detenido a estudiar la vida singularísima de don Pedro Fermín de Vargas, quien bien podría llevar con sobrados méritos el título de Precursor; testimonio de este aserto son sus escritos y su vida misma, llenas de la profundidad de sus observaciones, que presentaba a las autoridades virreinales con gran sencillez y naturalidad, aún cuando pretendía ocultar el verdadero alcance de sus planteamientos
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.
German Arce Ross
Full Text Available Se trata de poner en perspectiva la mayor parte de novelas de Mario Vargas Llosa en función del tema de la huída, partiendo del hecho que é1 solicitó la nacionalidad Española inmediatamente después de haber perdido las elecciones para la Presidencia del Perú y de haber escrito El pez en el agua. Nuestro análisis intenta demostrar la importancia de la figura paterna – principalmente en el sentido de su ausencia y de sus bruscas reapariciones – en la cristalización sintomática del tema de la fuga. Es por eso que una analogía con la posición fóbica, en relación al padre o a sus substitutos, nos ha parecido pertinente. Teniendo como pivot el análisis de la forma, del contexto y del contenido de su libro de memorias, este trabajo definiría así las bases de una contribución literaria de la obra de Vargas Llosa a la clinica de la fobia.
Full Text Available Lexistence de deux manuscrits différents du Journal de José Santos Vargas conduit à sinterroger sur la véracité de lauteur. La comparaison entre les deux textes incite à attribuer le premier à une rédaction très proche de la fin de la guerre, et le second à un travail de collecte et de réécriture qui sest étalé sur près de 30 ans. Entre le premier et le second manuscrit, se manifeste le changement du projet décriture de lauteur qui évolue dune conception individuelle de luvre à lidée de faire du Journal le recueil de toutes les traces de la guerre conservées dans les Vallées, et de le transformer en mémoire patriotique dun microcosme provincial. EL DIARIO DE JOSÉ SANTOS VARGAS (1814-1825 - 2: DOS MANUSCRITOS. La existencia de dos manuscritos distintos del Diario del guerrillero José Santos Vargas incita a dudar de la veracidad del autor. La comparación entre los dos textos permite atribuir al primero una redacción próxima al fin de la guerra, mientras el segundo resulta de un trabajo de recolección y de reescritura que duró cerca de treinta años. Entre el primer y el segundo manuscrito, se manifiesta un cambio de proyecto de escritura por parte del autor que evoluciona de una concepción individualista de la obra hacia la idea de transformar el Diario en el compendio de todas las huellas de la guerra que se habían conservado en los Valles, transformándole en memoria patriótica de un microcosmos provincial. THE DIARY OF JOSÉ SANTOS VARGAS (1814-1825 - 2: TWO MANUSCRIPTS. The existence of two different manuscripts of the guerilla leader José Santos Vargas's Diary raises doubts about the truthfulness of the author. After comparing the two texts, it is possible to situate the writing of the first version in the time just after the war and the second version during a thirty year period in which testimonies and information were collected, and then rewritten. A change in the writing project of
Pedro Cezar Dutra Fonseca
Full Text Available O artigo compara a política econômica de duas experiências desenvolvimentistas na América Latina: o primeiro período governamental de Vargas (Brasil, 1930-1945 e Perón (Argentina, 1946-1955. Embora aceite a semelhança entre ambas, comumente mais enfatizada pela literatura, procura mostrar certas diferenças entre elas em matéria de natureza econômica. Defende que, enquanto Vargas centravase em medidas para mudar a estrutura econômica do país, com ênfase à industrialização, Perón deu maior prioridade à redistribuição de renda do que a mudanças no modelo econômico, o qual já vinha sendo implementado na Argentina antes de seu governo.This paper compares economic policy characteristics of two developmentalist experiences in Latin America: the first Vargas administration (Brazil, 1930-1945 and the Perón administration (Argentina, 1946-1955. Although certain similarities exist between them (which are usually stressed in the literature, this article seeks to reveal some differences that are economic in nature. While Vargas focused on measures that would change the country's economic structure and with an emphasis on industrialization, Perón prioritized income distribution more than any changes to the economic model that had been implemented before his administration took office.
Full Text Available Government Programme 2013-2017 defines in higher education, the principles of the curriculum proposals of much public interest careers. In this regard the authorities of the Technical University "Luis Vargas Torres" of Esmeraldas, have taken the decision to evaluate its management and action against the development of the province and the country. Therefore, the objective of this research is the application of a survey of students of different specialties, Faculty of Engineering and Technology to explore their views on the educational process, research, outreach, culture and sport, stratified random sampling with results showing that key processes are completed by 66% on average is applied, indicating that the authority still has to set goals to overcome the short comings that have an emphasis on research.
Full Text Available As part of the transformative process that takes place in the ecuadorian university is research that aims to improve the outreach model at the Technical University Luis Vargas Torres Esmeraldas developed. The need of jobs forces people to venture into small businesses, however, this process is done in an empirical way, without sufficient technical and administrative knowledge that will enable the company to manage efficiently and obtain funding sources. Hence the relevance of the study, which allows guide and train the business sector in order to conduct an efficient management and create new businesses that operate as a means for the transformation of the productive matrix. The research results are: the structure and function of outreach model, the key elements that support the creation of the Center for Business Development and Entrepreneurship Support and the socioeconomic impact achieved from the development of relations among universities, businesses and government.
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.
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 Se cumple en el presente año –el 3 de julio exactamente-el bicentenario del nacimiento del notable Precursor de la Independencia D. Pedro Fermín de Vargas. Como anticipo de la biografía que para esa fecha verá la luz pública, nos permitimos publicar uno de los capítulos de la primera parte.
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".
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
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.
Full Text Available The role played by the administrative apparatus through the Department of Administrative Services in the Government policy Vargas is the object put in debate. Analyzes the theme from the the investigation of patrimonial, authoritarian and inefficient context which marks the formation and development of administrative bureaucracy, the tenders of professionalization and efficiency brought by the administrative reforms of the 1930s and 1940s with the contrast of the limitations of the import of the Weberian model in the Brazilian context and analysis of the establishment of the New State DASP and their assignments. Search the work demonstrate the control position he held directly and through the State Departments in the Brazilian Public Administration ensuring centralized and developmental policy of the government. For this is adopted as the research method of approach structuralism in order to identify the deconstruction of the phenomenon - of administrative reforms - in the superficial perception - the proposed impersonality and efficiency as the best way of achieving the public interest - its invariant structure - the search for the adequacy of the administrative apparatus and bureaucracy for pursuit of political ends pursued by the Government.
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.
José Jiménez Guerrero
Full Text Available Fue en el año 1967. Bajo el mecenazgo de una institución ya desaparecida, el Liceo de Málaga, se convocó la primera edición del «Premio Málaga de Investigación». Esta loable iniciativa tuvo una continuidad temporal ininterrumpida hasta 1999. Tras ocho años de silencio, y gracias al respaldo de la Real Academia de Bellas Artes de San Telmo y de la Academia Malagueña de Ciencias, y al patrocinio de la entidad Cajamar, este prestigioso premio fue de nuevo convocado. A ello se sumó en el año 2012 la decisión adoptada por la Diputación de Málaga de publicar los trabajos premia dos en las dos modalidades del referido premio: Humanidades y Ciencias. Los libros editados forman parte de la colección que lleva por título «Premios Málaga de Investigación». En la convocatoria del año 2013, el premio de la sección humanística recayó en el trabajo presentado por Dolores Vargas Jiménez, doctora en Historia del Arte, bajo el título de Picasso: iconografías del baile. Y siguiendo lo preestablecido, su obra fue editada por la entidad supramunicipal.
Acceleration of bioremediation of soil polluted with oil derivatives by using lad farming microorganisms from President Getulio Vargas refinery - REPAR/PETROBRAS, PR, Brazil; Aceleracao da biorremediacao de solo contaminado com derivados de petroleo com o uso de microorganismos do landfarming da Refinaria Presidente Getulio Vargas - PETROBRAS/REPAR
Krenczynski, Michele Cristine; Carvalho, Francisco Jose Pereira de Campos [Parana Univ., Curitiba, PR (Brazil). Curso de Pos-Graduacao em Ciencia do Solo]. E-mail: email@example.com
This work is part of the studies on bioremediation criteria of the oil wastes contaminated soil, which are being performed by the Presidente Getulio Vargas refinery - REPAR - PETROBRAS, Brazil. (author)
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...
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.
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
Carcellar, B. G., III
Museum exhibit management is one of the usual undertakings of museum facilitators. Art works must be strategically placed to achieve maximum viewing from the visitors. The positioning of the artworks also highly influences the quality of experience of the visitors. One solution in such problems is to utilize GIS and Agent-Based Modelling (ABM). In ABM, persistent interacting objects are modelled as agents. These agents are given attributes and behaviors that describe their properties as well as their motion. In this study, ABM approach that incorporates GIS is utilized to perform analyticcal assessment on the placement of the artworks in the Vargas Museum. GIS serves as the backbone for the spatial aspect of the simulation such as the placement of the artwork exhibits, as well as possible obstructions to perception such as the columns, walls, and panel boards. Visibility Analysis is also done to the model in GIS to assess the overall visibility of the artworks. The ABM is done using the initial GIS outputs and GAMA, an open source ABM software. Visitors are modelled as agents, moving inside the museum following a specific decision tree. The simulation is done in three use cases: the 10 %, 20 %, and 30 % chance of having a visitor in the next minute. For the case of the said museum, the 10 % chance is determined to be the closest simulation case to the actual and the recommended minimum time to achieve a maximum artwork perception is 1 hour and 40 minutes. Initial assessment of the results shows that even after 3 hours of simulation, small parts of the exhibit show lack of viewers, due to its distance from the entrance. A more detailed decision tree for the visitor agents can be incorporated to have a more realistic simulation.
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. Copyright © 2013 Wiley Periodicals, Inc.
León Madrigal, Marcela
Se retomó el estudio desarrollado por León y Vargas (2009) para adaptar la escala Rathus a una muestra de estudiantes de educación superior costarricense. Se utilizaron los mismos datos con el fin de someter a prueba la estructura multidimensional del constructo, propuesta por dichos autores en el estudio original. También, se aporta nueva evidencia, basado en el análisis de estructuras de covarianza, de la validez convergente y divergente de las puntuaciones de la escala. Se enfatiza la impo...
Sergio Elías Ortíz
Full Text Available Entre los papeles relacionados con la vida de Don Pedro Fermín de Vargas, que pueden consultarse en el Archivo General de Indias de Sevilla, hay una carta de él y una lista de libros que envía al Administrador de Correos de la Habana, Don José Fuertes, antiguo amigo suyo, luego su corresponsal y a la vez espía de sus pasos para aprisionarlo, con el objeto de que se los guardase “en algún rincón de sus casa”.
Lordelos, H.M.; Santin, J.L.
A description is given of the corrosion pits on ASTM A240, Type 405 steel cladded to carbon steel plates used in Petroleo Brasileiro S.A.'s Getulio Vargas Refinery Unit 2100 distillation towers; the repair procedure used, including sand blasting of the corroded surfaces, grinding of the pits, and welding of those pits whose depth was above a maximum limit, and the use of liquid penetrant to check the repairs made; and hydrostatic testing of the T2201 catalytic cracking unit, which used also cladded metals and on which the pits were much smaller in size and number than those on the distillation units.
Godoy Cossío, Ana
El artículo aborda la preeminencia de la niña-mujer como uno de los arquetipos femeninos predominantes en las narrativas de Francisco Umbral y Mario Vargas Llosa. Desde la perspectiva espacio-temporal, el estudio proyecta el doble microcosmos ficcional/no ficcional de la infancia/niñez, en cuyas etapas imperan los episodios obsesivos como marcas indelebles de la memoria individual y colectiva, restauradas por el narrador/protagonista/testigo. En sus textos, las niñas son el núcleo del paraíso...
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.
Gomez, A.; Berrio, J.C.; Hooghiemstra, H.; Becerra, M.; Marchant, R.
Holocene environments in the intra-Andean basin of Duitama (Eastern Cordillera of Colombia, 2510 m altitude) are presented based on the 620 cm long Vargas pollen and sediment record. Seven AMS radiocarbon dates show these lake and swamp sediments represent the period from 8800 to 2610 14C yr BP. We
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...... focus. It is not enough to consider only the factors of function within architecture, hygiene, economy and logistics. We also need to look at aspects of aesthetics, bringing nature into the building, art, color, acoustics, volume and space as we perceive them. Contemporary methods and advances...... placed, accessible, provided with plenty of greenery, and maximize sensory impressions, providing sounds, smells, sight and the possibility to be touched. This is a very well documented area I can say. Hygiene, in terms of architecture can give attention to hand wash facilities and their positioning...
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
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 [Energy Storage, Compression and Switching, edited by V. Nardi, H. Sahlin, and W. H. Bostick (Plenum, New York, 1983), Vol. 2, p. 353)] and shows its relevance to contemporary research. The Gratton-Vargas (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 Lawrenceville Plasma Physics (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
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.
This doctoral thesis is a psychoanalytic interpretation of the novels of the Peruvian author Mario Vargas Llosa, and it explores these novels from three different perspectives, here called readings. The first perspective focuses on the literary techniques and the importance these may have for the interpretation of the content of the novels. This first reading includes a summary of the reception of the works and reveals many aspects that have not been discovered in earlier studies. The second ...
Full Text Available Cuando a comienzos de marzo de 2000 la editorial Alfaguara lanzó al mercado español la nueva novela de Mario Vargas Llosa, anunciada desde hacía meses como evento editorial del año, la acogida por parte de la crítica fue unánimemente entusiasta, calificada la novela de “magistral” y “espléndida” o, para citar a Miguel García-Posada de El País (11-3-2000, de “narración poderosa”, escrita por Vargas Llosa “con su instinto de novelista nato”. Siguió una apretada campaña de promoción, con la presencia constante de Vargas Llosa en la prensa española y con una gira emprendida por el autor que lo llevó a Santo Domingo, Buenos Aires, Lima, México y hasta Miami.
Full Text Available La découverte du journal de guerre tenu par le guérillero José Santos Vargas a renouvelé nos connaissances sur lhistoire de la guerre dindépendance dans le Haut Pérou. Cependant, le fait quil existe deux manuscrits différents de ce document, publiés tous deux par les soins de don Gunnar Mendoza, lun en 1952 en Bolivie, lautre en 1982 au Mexique, pose aux historiens des problèmes que les choix effectués par léditeur ont obscurcis. Cette première livraison dun article qui devrait en comprendre deux remet en question la valeur scientifique de lédition de 1982. LOS DOS DIARIOS DE JOSÉ SANTOS VARGAS. 1: PROBLEMAS EDITORIALES. El descubrimiento del diario de guerra redactado por el guerrillero José Santos Vargas ha renovado el conocimiento de la guerra de independencia en el Alto Perú. Pero el hecho de que existen dos manuscritos distintos de este documento, ambos publicados por don Gunnar Mendoza, uno en Bolivia en 1952 y otro en México en 1982, plantea a los historiadores problemas que las decisiones del editor han obscurecido. Esta primera entrega de un artículo que constará de dos, pone en tela de juicio el valor científico de la edición de 1982. THE TWO DIARIES OF JOSÉ SANTOS VARGAS. 1: PROBLEMS OF EDITION. The discovery of the diary of the guerillero leader José Santos Vargas add to our knowledge of the history of the independence war in the Alto Peru. However, the existence of two different manuscripts, both published by don Gunnar Mendoza, the first in Bolivia, 1952, the second in Mexico, 1982, present historians with problems that have been obscured by the editors choices. In this first part of the two parts article, we question the scientific value of the edition of 1982.
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.
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.
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
como o paradoxo do governo Vargas que, depois da perseguição a Teixeira, adotou silenciosamente muitos dos projetos defendidos por Teixeira. Em particular, este artigo sugere que as visões progressistas e autoritárias do papel do Estado nas reformas sociais, em última instância, dividem a mesma visão pós-modernista e a mesma limitação desta visão.
Geise Brizotti Pasquotto
Full Text Available The present paper aims to compare the periods proposed by three authors “Vargas e Castilho” (2006, “Boyer” (1998 and “Simões Jr.” (1994. They did it to identify four significant moments of intervention in urban space from the period of modernity. It is noteworthy that, in this comparison, the most important thing is not to define a concept, but understanding the process and the paradigms that underpin each of these interventions.
Fernando Díaz Ruiz
Full Text Available En el año del sesquicentenario del nacimiento del escritor modernista más leído de su época, exiliado a Europa debido a sus ataques a los líderes de la Regeneración colombiana, la autora de La semilla de la ira (2008, novela sobre la vida de Vargas Vila, señala que sería importante elegir tres o cuatro libros suyos, los de mayor valor, y colocarlos en el lugar que les corresponde en nuestro sistema literario.
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.
Pouyllau , Michel
La Centrale thermo-électrique de Tacoa (connue actuellement comme Complejo Generador Josefina Joaquina Sánchez de Tacoa) a été construite en plusieurs étapes sur le littoral caraïbe de Catia La Mar (quartier Arrecife). Elle participe à l'approvisionnement électrique du Littoral de l'Etat de Vargas (villes de La Guaira, Maiquetia) ainsi que, pour partie, de la capitale Caracas. L'image correspond à une extension réalisée à la fin des années 1970 par Electricidad de Caracas et la compagnie belg...
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.
Full Text Available It can be said that the relation between literature and political theory is not as prolific as that established by other disciplines such as philosophy, history and psychology. Although politics has held a central role in literature it is difficult to assert the prominence of political theory. A remarkable exception to this can be found in the novel La guerra del fin del mundo by Mario Vargas Llosa, not because the author dedicates himself to political theory but because of the complicity the plot shares with some contemporary theoretical perspectives. Within this horizon, the article proposes a reading of La guerra del fin del mundo in the light of its relation with key categories from post foundational political thought such as Heterogeneity, Antagonism, constitutive outside, empty signifier, discourse and hegemony. The article thus aims to contribute to the discussion of theoretical categories whose abstraction has often turned them difficult to assimilate. It also offers some reading clues to approach Vargas Llosa?s novel in the light of present political theory
Leonardo de Araujo e Mota
Full Text Available No Brasil, a partir dos anos 1930, com a criação do Ministério do Trabalho, Indústria e Comércio e a elaboração da legislação trabalhista, o mercado de trabalho brasileiro regulamentou-se com a criação das leis de proteção ao trabalhador, conferindo ao Estado o objetivo de inserção do trabalhador na organização das políticas de emprego. A partir dos anos 1990, porém, evidenciou-se a redução da intervenção do Estado nas relações capital-trabalho, explicação possível para a limitação de políticas públicas de geração de emprego e renda. Este artigo tem como objetivo efetuar uma síntese sócio-histórica das políticas de emprego no Brasil comparando a Era Vargas ao Neoliberalismo, considerando as relações capital-trabalho na perspectiva da intervenção do Estado, das mudanças tecnológicas, dos cenários macroeconômicos e da organização da produção no mundo do trabalho contemporâneo. A pesquisa bibliográfica foi o método de pesquisa utilizado, tendo como referências livros, artigos e publicações em meio digital. Concluiu-se que, embora políticas de emprego ainda existam e tenham como finalidade criar condições favoráveis de acesso ao mercado de trabalho para os trabalhadores, o Estado neoliberal tornou-se refém de conjunturas macroeconômicas cada vez mais competitivas em nível global para a criação de novos postos de trabalho, fato que precipita os trabalhadores em empregos cada vez mais precários, flexíveis e de baixa remuneração.
In vitro use characterization of the microorganism from land farming of the Presidente Getulio Vargas Refinery, Brazil, for soils decontamination; Caracterizacao in vitro do uso de microorganismos do landfarming da Refinaria Presidente Getulio Vargas - PETROBRAS-REPAR para a descontaminacao de solos
Krenczynski, Michele Cristine; Goncalves, Claudia Martins; Castro, Rodrigo Azevedo; Nascimento Neto, Durval [Parana Univ., Curitiba (Brazil). Pos-graduacao em Ciencia do Solo; Carvalho, Francisco Jose Pereira de Campos [Parana Univ., Curitiba (Brazil); Grube, Karl; Coelho, Ibirajara Jorge Evangelista [PETROBRAS, Rio de Janeiro, RJ (Brazil)
In the present work, a set of experiments are reported from the evaluation of commercial use of the microorganisms of the Refinaria Presidente Getulio Vargas PETROBRAS land farming as inoculants for accelerating the bioremediation of contaminated soil with petroleum sludge, light naphtha, shale naphtha, toluene, heavy refinery oily waste, solp oil, sludge from the oily swage treatment plant, oily swage sludge and mixed oily wastes. These results are presented and discussed comparatively, and the characterization of the biodegradation activity of the land farming microorganisms for use in acceleration of bioremediation is discussed. (author)
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.
Tânia Cristina Franco Santos; Ieda de Alencar Barreira; Antonio José de Almeida Filho; Alexandre Barbosa de Oliveira
Este estudio tuvo como objetivo describir las características históricas y sociales de Brasil y España en el contexto de los regímenes dictatoriales instaurados por Vargas y Franco, y analizar las representaciones sobre la maternidad en el contexto de esos regímenes y sus implicaciones para la enfermería. Es un estudio histórico y social cuyo método consideró como fuentes: documentos escritos brasileños y españoles. La recolección de los datos se hizó en el período de 13 de mayo a 29 de agost...
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.
Full Text Available A new species of the genus Spinaethorax Papáč & Palacios-Vargas, 2016, recently erected for two cave species of Mexico, is described from a Vietnamese cave. It differs from the Mexican species most noticeably by the dorsal chaetotaxy of the head (number and morphology of chaetae, the shape of S-chaetae on the third antennomere, the dorsal chaetotaxy of the abdomen and the chaetotaxy of the dens. The pattern of special τ-chaetae is described for the first time in the genus. The affinities between Spinaethorax and the other genera of Neelipleona are discussed. Spinaethorax is probably closely related to Neelus Folsom, 1896. A table of the differential characters is provided for the three known species of Spinaethorax. Spinaethorax appears to be restricted to caves, but its presence in Vietnam indicates that this genus has a much larger distribution than previously recognized.
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.
Mario G. Losano
Full Text Available Il corporativismo fu uno degli elementi caratterizzanti dello Stato fascista, che con esso intendeva ricollegarsi alla tradizione medievale italiana. Oscillando tra storia e «invented tradition», con esso il governo fascista proponeva una soluzione alla crisi economica degli anni Trenta e un’alternativa allo Stato tanto liberale quanto comunista, cioè una «terza via». Del corporativismo italiano vengono sinteticamente esaminate le origini, l’evoluzione e la struttura, dedicando particolare attenzione alla Carta del Carnaro del 1920, il documento che lo preparò durante l’avventura di Fiume di Gabriele d’Annunzio. Il corporativismo, come modello di gestione economica che negava la lotta di classe, si diffuse in Europa e fuori di essa nell’epoca delle dittature. L’attenzione si concentra sul Brasile, nella sua transizione dalla República Velha alla dittatura di Getúlio Vargas, iniziata nel 1930 e durata fino al 1954, anche se in modo istituzionalmente non unitario. All’interno del movimento che l’accompagnò, l’«Integralismo», il filosofo Miguel Reale (1910–2006 propugnò un corporativismo democratico. Il modello corporativo italiano si riflette in alcune parti della vasta «Consolidação das Leis do Trabalho», emanata da Vargas nel 1943. Essa costituisce un chiaro esempio della legislazione sociale che accompagnò molte dittature del XX secolo e che, nel caso del Brasile, ebbe effetti anche dopo la caduta del regime. La «Consolidação» riguardava però soltanto i lavoratori urbani, mentre il Brasile era una società prevalentemente agraria. Per questo vengono passare in rassegna le misure a favore dei diritti sociali dei lavoratori urbani e agrari prese dai governi di Juscelino Kubitschek (1902–1976 e di João Goulart (1919–1976, nonché, infine, la tutela accordata nel 1964 ai lavoratori agrari dallo Statuto della Terra.
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.
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 short-lived isotopes, plasma nanotechnology and other material processing applications. Commercial utilization of DPF in such areas would need a design tool that can be deployed in an automatic search for the best possible device configuration for a given application. The recently revisited (Auluck 2013 Phys. Plasmas 20 112501) 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 the construction of such a design tool. This inductance formula is utilized in the present work to explore global optimization, based on first-principles optimality criteria, in a four-dimensional parameter-subspace of the zero-resistance GV model. The optimization process is shown to reproduce the empirically observed constancy of the drive parameter over eight decades in capacitor bank energy. The optimized geometry of plasma focus normalized to the anode radius is shown to be independent of voltage, while the optimized anode radius is shown to be related to capacitor bank inductance. (paper)
Tânia Cristina Franco Santos
Full Text Available Este estudio tuvo como objetivo describir las características históricas y sociales de Brasil y España en el contexto de los regímenes dictatoriales instaurados por Vargas y Franco, y analizar las representaciones sobre la maternidad en el contexto de esos regímenes y sus implicaciones para la enfermería. Es un estudio histórico y social cuyo método consideró como fuentes: documentos escritos brasileños y españoles. La recolección de los datos se hizó en el período de 13 de mayo a 29 de agosto de 2008. Para el análisis se realizaron las etapas de organización y clasificación de las fuentes elegidas. Como resultado, se evidencio que la glorificación de la mujer por sus virtudes físicas como la maternidad y por sus atributos morales legitimó su inserción honorable en el espacio público, para reproducir en ese espacio, como enfermeras, las cualidades femeninas necesarias al cuidado. Se concluye que la consagración de la maternidad ha determinado posibilidades y límites para la enfermera.
Full Text Available 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, sino por la complicidad de la trama de la novela con ciertas perspectivas teóricas contemporáneas. En este horizonte, el artículo tiene como objetivo realizar una lectura de La guerra del fin del mundo y sugerir su relación con categorías centrales de la teoría política de inspiración posfundacional como Heterogeneidad, Antagonismo, exterior constitutivo, significante vacío, discurso y hegemonía. El trabajo que presentamos, de este modo, pretende aportar a la discusión de ciertas categorías teórico políticas que muchas veces por su grado de abstracción han suscitado dificultades pero también ofrecer claves de lectura de esta novela desde la teoría política actual
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.
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...
Efraim Otero Ruiz
Full Text Available
La Segunda Edición de un Libro Admirable (Comentario a la 2ª Edición del libro “Antonio Vargas Reyes-La Medicina del Siglo XIX en Colombia” por el Académico Roberto de Zubiría C.-Febrero 2003
Circunstancias ajenas a la voluntad de los protagonistas hicieron que la presentación de este libro ante la Academia Nacional de Medicina tuviera que ser postergada hasta la fecha actual. De todas maneras, persiste mi vivo agradecimiento ante las directivas de la Academia y ante el mismo autor por haberme distinguido con el honor de ser yo quien presente ante ustedes esta obra, en el momento ya con varios meses de haber sido publicada por Editorial Kimpres, en un elegante volumen de 212 páginas y que marca un hito entre los libros de historia médica publicados en el país en el año 2002.
Efectivamente, en sus 20 capítulos, seguidos de un apéndice y del testamento del personaje aquí biografiado, además de una extensa bibliografía curiosamente referida con números romanos, Roberto de Zubiría nos entrega una visión panorámica de lo que fue, como reza el subtítulo, la medicina del siglo XIX en Colombia. Medicina que estuvo rubricada y marcada por los sucesos de la independencia, en su segunda década, a la que se siguió el cambio intelectual necesario y obligatorio que nos trocaba de un pensamiento de colonos y súbditos al de seres independientes, que debían crear o transformar las nuevas instituciones de la patria. Como lo ha dicho el historiador médico español García-Valdés a propósito de Europa, podría decirse que el siglo XIX sólo llega a la medicina colombiana a partir de 1820. Por eso el primer capítulo hace un inventario de lo que era el ambiente y las escuelas iniciales de la primera mitad de ese siglo, con los primeros intentos de establecer una cátedra por José Celestino Mutis y Miguel de Isla, a quienes el autor señala justamente como los verdaderos precursores
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.
Full Text Available This paper focuses the Health Services wastes management of 70 Brazilian hospitals. As the outcome of a distance course, in 2003, each hospital was required to describe its existing Health Services wastes system and its Plan for improvement.The project was administered by an association of two leading Brazilian educational entities, the Fundação Getulio Vargas and the Universidade Federal de Santa Catarina. Data concerning collection, disposal and final treatment of infectious, hazardous, chemical, radioactive and common wastes were tabulated and analysed. Water supply, liquid effluents and gaseous emissions were also investigated..Their technical and economical aspects were appraised. The research indicates that the sampled hospitals are still in an incipient stage of wastes management. An extensive gap exists between the present situation and the legal and acceptable requirements they should comply with, both on health care and on environmental standpoints.
Williams José Méndez Mata
Full Text Available The morphological features of the relief and its quantitative morphometric quantification are essential elements in interpreting its influence on the hydrogeomorphological dynamics of watersheds in mountainous environments. This is particularly important when studying small spatial units (micro watersheds and torrential regimes, as this influences the sudden and aggressive hydrological responses of these systems and the likelihood of activation of mass removal processes. In the study region (Vargas State, Venezuela the most important debris flow recorded in Venezuela’s history occurred on December 14, 15 and 16, 1999, as a consequence of extremely heavy rainfall in those dates associated with a very particular weather. For the above reasons, this research conducted a quantitative analysis of the relief features in watersheds of “El Ávila” massive northern hillside and their impact on the local hydrogeomorphological dynamics, aimed at identifying the main attributes influencing these dynamics. The study area is located in the northern-central region of Venezuela, in the central part of Vargas state, delimited by 10º32’25”-10º37’35”N and 66º40’08”- 66º59’12”W, and comprises thirteen micro watersheds of mountainous environment. The methodology consisted of (a the geomorphological characterization of the area, from the review and interpretation of digitized base maps at scales 1:5 000 and 1:25 000, the digital elevation model (DEM, aerial photographs at scale 1:5 000, orthophotomaps at scale 1:25 000, satellite images, Google Earth and Google Maps images, and geomorphological maps (landforms and geomorphological processes at scale 1:25 000; (b measurements and calculations of basic morphometric parameters of watershed relief on digital mapping using the ArcGIS 9.2 and their Spatial Analysis and ArcHydro modules, and the mathematical equations that define the other parameters using MS Excel; (c descriptive statistical
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 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.
Eimeria atlapetesi nom. nov., a replacement name for Eimeria pileata Soriano-Vargas et al., 2015 (Apicomplexa: Eimeriidae), preoccupied by Eimeria pileata Straneva and Kelley, 1979 (Apicomplexa: Eimeriidae), with observations on histopathology and phylogenetic analysis.
Soriano-Vargas, Edgardo; Salgado-Miranda, Celene; Zepeda-Velázquez, Andrea Paloma; Medina, Juan Pablo; Janczur, Mariusz Krzysztof; González-Gómez, Maricruz; Flores-Valle, Izanami Tereira; Berto, Bruno Pereira; Lopes, Carlos Wilson Gomes
Eimeria pileata Soriano-Vargas, Medina, Salgado-Miranda, García-Conejo, Galindo-Sánchez, Janczur, Berto and Lopes, 2015 is a junior homonym of Eimeria pileata Straneva and Kelley, 1979 and needs to be replaced. This coccidium was described from a rufous-capped brush finch Atlapetes pileatus Wagler in the Nevado de Toluca Natural Protected Area, Mexico. Thus, to maintain the original intent of the specific epithet derived from the scientific name of the type-host, the name Eimeria atlapetesi nom. nov. is proposed as a replacement name. Additionally, the current work reports another rufous-capped brush finch A. pileatus parasitized by E. atlapetesi in co-infection with an Isospora sp., providing observations of histopathology and phylogenetic analysis of 18S ribosomal RNA (rRNA) gene from E. atlapetesi. Endogenous forms of E. atlapetesi and Isospora sp. were observed in intestinal sections. Few oocysts of Isospora sp. were observed; therefore they were not morphologically or molecularly identified. In return, E. atlapetesi was identified and it was phylogenetically close to Eimeria dispersa Tyzzer, 1929 from the domestic turkey Meleagris gallopavo Linnaeus.
Use of bioremediation and treatment of wetland for remediation of the accidental crude-oil spill of July 16, 2000 at the Petrobras Refinery Refinaria Presidente Getulio Vargas (REPAR), Araucaria, PR, Brazil
Millette, D. [Hydrogeo Plus Inc., Montreal, PQ (Canada); Falkiewicz, F.; Zamberlan, E. [Petrobras-REPAR, Araucaria (Brazil); Campos Carvalho, F.J.P. de [Universidade Federal do Parana, Curifiba (Brazil). Dept. de Solos; Neto, A.C.B.; Caicedo, N.O.L.; Motta Marques, D. [Universidad Federal do Rio Grande do Sul, Porto Alegre (Brazil). Instituto de pesquisas hidraulicas; Linhares, M. [Petrobras, Rio de Janeiro (Brazil)
On July 16, 2000, a pipeline supplying oil to the PETROBRAS refinery Refinaria Presidente Getulio Vargas-REPAR, located in Araucaria, Brazil, ruptured. The resulting oil spill involved approximately 4 million litres of crude oil. Workers managed to retain a vast quantity of oil within a two-kilometre area called Ponto O. The banks and floodplain of a small stream, the Arroio Saldanha, were contaminated, as well as the soil of four small wetlands. The authors presented an overview of the remediation program implemented. They focused on the soil bioremediation and treatment of wetland programs. Some of the remediation technologies used were: in situ bioremediation, injection and recovery trenches, and treatment of wetland in the vicinity of the discharge. Most of the free product from the sector adjacent to the spill site seems to have been removed by the recovery trenches. The preliminary data obtained from soil monitoring points to the efficiency of in situ bioremediation. Wetland vegetation was successfully restored and hydrocarbons appear to have been removed from the groundwater. 2 figs.
U.S. Department of Health & Human Services — Hospital Compare has information about the quality of care at over 4,000 Medicare-certified hospitals across the country. You can use Hospital Compare to find...
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...
Auluck, S. K. H.
Recent work on the revised Gratton-Vargas model (Auluck, Phys. Plasmas 20, 112501 (2013); 22, 112509 (2015) and references therein) has demonstrated that there are some aspects of Dense Plasma Focus (DPF), which are not sensitive to details of plasma dynamics and are well captured in an oversimplified model assumption, which contains very little plasma physics. A hyperbolic conservation law formulation of DPF physics reveals the existence of a velocity threshold related to specific energy of dissociation and ionization, above which, the work done during shock propagation is adequate to ensure dissociation and ionization of the gas being ingested. These developments are utilized to formulate an algorithmic definition of DPF optimization that is valid in a wide range of applications, not limited to neutron emission. This involves determination of a set of DPF parameters, without performing iterative model calculations, that lead to transfer of all the energy from the capacitor bank to the plasma at the time of current derivative singularity and conversion of a preset fraction of this energy into magnetic energy, while ensuring that electromagnetic work done during propagation of the plasma remains adequate for dissociation and ionization of neutral gas being ingested. Such a universal optimization criterion is expected to facilitate progress in new areas of DPF research that include production of short lived radioisotopes of possible use in medical diagnostics, generation of fusion energy from aneutronic fuels, and applications in nanotechnology, radiation biology, and materials science. These phenomena are expected to be optimized for fill gases of different kinds and in different ranges of mass density compared to the devices constructed for neutron production using empirical thumb rules. A universal scaling theory of DPF design optimization is proposed and illustrated for designing devices working at one or two orders higher pressure of deuterium than the current
Andrew, R R
A comparative study of costs per bed per day in teaching hospitals affiliated with Monash University compared with large non-teaching metropolitan hospitals (1964 to 1974) shows they are much higher in teaching hospitals. There is no evidence that this is due to the additional costs arising from the clinical schools. Research in the teaching hospitals and the accompanying high professional standards and demands on services are major factors accounting for the difference. Over the decade studied, the resident staff have increased by 77% and other salaried staff by 24%. The index of expenditure for the three teaching hospitals in the decade has increased by 386%.
U.S. Department of Health & Human Services — Welcome to hospitalinspections.org, a website run by the Association of Health Care Journalists (AHCJ) that aims to make federal hospital inspection reports easier...
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…
Jensen, Tina Blegind; Aanestad, Margunn
The purpose of this paper is to discuss the adoption of healthcare information systems (HIS) from a user perspective. Our case study concerns how a group of orthopaedic surgeons experienced and reacted to the adoption and mandatory use of an Electronic Patient Record system in a Danish hospital. We...... propose to use the concepts of hospitality and hostility to turn our attention to the interaction between the host (the surgeons) and the guest (the information system) and consider how the boundaries between them evolved in the everyday work practices. As an alternative to previous studies on technology...
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. This record was migrated from the OpenDepot repository service in June, 2017 before shutting down.
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
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.
... this page: //medlineplus.gov/ency/patientinstructions/000618.htm Help prevent hospital errors To use the sharing features ... in the hospital. If You Are Having Surgery, Help Keep Yourself Safe Go to a hospital you ...
Latitudes, el ancho mundo de la investigación social: Bolivianos, paraguayos y argentinos en la obra : Una investigación de la antropóloga Patricia Vargas sobre la relación entre la migración de países limítrofes y el mercado de trabajo en la construcción en el área metropolitana
Mendivil, Adrián; Vargas, Patricia
Latitudes es un ciclo de programas especiales, idea y conducción del periodista Adrián Mendivil, basado en la investigación en ciencias sociales. En esta entrega, se entrevista a la antropóloga Patricia Vargas sobre el impacto de inmigración de países limítrofes en el mercado de trabajo en la construcción en el área metropolitana argentina. Explica el concepto de "etnografía" y su aplicación para comprender la temática: la llegada de bolivianos y paraguayos y su relación con los trabajadores ...
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.
The objectives of a hospital are to improve patient care, while the objectives of a hospital library are to improve services to the staff which will support their efforts. This handbook dealing with hospital administration is designed to aid the librarian in either implementing a hospital library, or improving services in an existing medical…
Maximiliano Emanuel Korstanje
Modern studies emphasized on the needs of researching the hospitality as relevant aspects of tourism and hospitality fields. Anyway, these approaches are inextricably intertwined to the industry of tourism and do not take seriously the anthropological and sociological roots of hospitality. In fact, the hotel seems to be a partial sphere of hospitality at all. Under this context, the present paper explores the issue of hospitality enrooted in the political and economic indo-European principle ...
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…
Courtney Suess Raeisinafchi
Full Text Available What comes to mind when you think of a hospital room? Stark. Sterile. Bare. Clinical. What might it mean for patients if the association with the environment shifted to something like: Comforting. Bright. Elegant. Personal?
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.
The Community Hospital Telehealth Consortium is a unique, forward-thinking, community-based healthcare service project organized around 5 not-for-profit community hospitals located throughout Louisiana and Mississippi...
School of Hospitality and Tourism, Anhembi Morumbi University, São Paulo, Brazil ... aspects of hospitality, and the approach of the social sciences, which study the dynamics of ..... in the virtual media, the ritual always begins with an invitation.
The Community Hospital Telehealth Consortium is a unique, forward-thinking, community-based healthcare service project organized around 5 not-for-profit community hospitals located throughout Louisiana and Mississippi...
U.S. Department of Health & Human Services — Unplanned Hospital Visits – national data. This data set includes national-level data for the hospital return days (or excess days in acute care) measures, the...
Justesen, Lise; Overgaard, Svend Skafte
This article presents an analytical model that aims to conceptualize how meal experiences are framed when taking into account a dynamic understanding of hospitality: the meal model is named The Hospitable Meal Model. The idea behind The Hospitable Meal Model is to present a conceptual model...... that can serve as a frame for developing hospitable meal competencies among professionals working within the area of institutional foodservices as well as a conceptual model for analysing meal experiences. The Hospitable Meal Model transcends and transforms existing meal models by presenting a more open......-ended approach towards meal experiences. The underlying purpose of The Hospitable Meal Model is to provide the basis for creating value for the individuals involved in institutional meal services. The Hospitable Meal Model was developed on the basis of an empirical study on hospital meal experiences explored...
U.S. Department of Health & Human Services — A list of hospitals and the structural measures they report. A structural measure reflects the environment in which hospitals care for patients, for example, whether...
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 help...
Research in Hospitality Management (RHM) is a peer-reviewed journal ... to the quintessential managerial areas of Finance, Human Resources, Operations, ... competency and career development of hospitality management students · EMAIL ...
Williams, Jr, Elton L
The Community Hospital Telehealth Consortium is a unique, forward-thinking, community-based healthcare service project organized around 5 not-for-profit community hospitals located throughout Louisiana and Mississippi...
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...
Research in Hospitality Management. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 5, No 1 (2015) >. Log in or Register to get access to full text downloads.
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......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...... 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...
Justesen, Lise; Strøjer, Anna-Lise
Abstract: There is a growing interest in articulating institutional meal serving practices as a hospitality activity involving host and guest interactions. This study aims to qualify institutional hospitality and meal activities by exploring private hospitality events. The study is based......-structured interview, students reflected on their hospitality experiences. The interviews were transcribed and analyzed using a thematic analysis method. The emerging themes on hospitality activities were identified. It was found that hospitality activities could be characterized as a process where the individual...... was transformed into a guest. Information on purpose of the event and other information given in the invitation were part of this process. Furthermore, hospitality activities could be characterized by blurred host-guest relations and by being able to embrace unexpected events as well. The activities were...
Despite reports of higher profitability in recent years, hospitals are failing at a faster rate than ever before. Although many hospitals leave decisions regarding revenues and costs to chief financial officers and their staff, this is a recipe for disaster. From research conducted over the last 4 years on hospital bankruptcies and turnarounds, the author found that a common series of actions will help organizations evade collapse. The author explored these turnaround strategies through research and analysis of a variety of hospitals and health systems that had a high probability of immediate financial crisis or collapse. His continued observation and analysis of these hospitals in subsequent years showed that most hospitals never emerge from their bleak financial conditions. However, a few hospital administrations have successfully turned around their organizations.
Maximiliano Emanuel Korstanje
Full Text Available Modern studies emphasized on the needs of researching the hospitality as relevant aspects of tourism and hospitality fields. Anyway, these approaches are inextricably intertwined to the industry of tourism and do not take seriously the anthropological and sociological roots of hospitality. In fact, the hotel seems to be a partial sphere of hospitality at all. Under this context, the present paper explores the issue of hospitality enrooted in the political and economic indo-European principle of free-transit which is associated to a much broader origin. Starting from the premise etymologically hostel and hospital share similar origins, we follow the contributions of J Derrida to determine the elements that formed the hospitality up to date.
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.
Fox, Lindy P
Inpatient dermatology is emerging as a distinct dermatology subspecialty where dermatologists specialize in caring for patients hospitalized with skin disease. While the main focus of inpatient dermatology is the delivery of top-quality and timely dermatologic care to patients in the hospital setting, the practice of hospital-based dermatology has many additional components that are critical to its success. ©2017 Frontline Medical Communications.
Graham, J C; Lanser, S; Bignardi, G; Pedler, S; Hollyoak, V
We report four cases of listeriosis that occurred over a two-month period in north east England. Due to the apparent nosocomial acquisition of infection and the clustering of cases in time and place, extended epidemiological investigation was performed and the outbreak was traced to a caterer who was providing sandwiches for hospital shops. We discuss the difficulties in preventing food-borne listeriosis in the hospital setting. Copyright 2002 The Hospital Infection Society.
The purpose of this thesis was to implement a hospital management software which is suitable for small private hospitals in Nigeria, especially for the ones that use a file based system for storing information rather than having it stored in a more efficient and safer environment like databases or excel programming software. The software developed within this thesis project was specifically designed for the Rainbow specialist hospital which is based in Lagos, the commercial neurological cente...
Musau, Steve; Vian, Taryn
Hospitals are vulnerable to corruption. In the U.S., health care fraud has been stimated to cost $60 billion per year, or 3% of total health care expenditures - much of it in the hospital sector. Hospitals account for 50% or more of health care pending in many countries. Fraud and corruption in hospitals negatively affect access and quality, as public servants make off with resources which could have been used to reduce out-of-pocket expenditures for patients, or improve needed services. This...
Full Text Available Es siempre curioso y en grado sumo instructivo, indagar las primicias literarias de los grandes escritores. Bien pueden no ser sus primeras producciones las más importantes y valiosas muestras de su ingenio en el conjunto total de sus obras; pero esas páginas, que generalmente suelen olvidar cuando ya son famosos, tienen singulares características para la comprensión sicológica de sus autores.
Pérez Sosa, Isacó
El proyecto propone realizar un centro internacional que reúna tanto las instalaciones necesarias para realizar competiciones de windsurf como un albergue, un gimnasio de mantenimiento e instalaciones para otras actividades acuáticas o de ocio complementarias. El edificio se desarrollará en tres construcciones bajas longitudinales que se adaptaran al terreno empotrándose a él y abriéndose hacia el mar. Originando éstas terrazas se sigue la forma común tradicional de asentamiento sobre el ter...
... and therapists will show you how to use pieces of equipment, like crutches, if you need them. Some hospitals have child life specialists. Their job is to make sure kids in the hospital understand what's going on around them and help them feel more ...
Texas Tech Univ., Lubbock. Home Economics Curriculum Center.
This reference book provides information needed by employees in hospitality services occupations. It includes 29 chapters that cover the following topics: the hospitality services industry; professional ethics; organization and management structures; safety practices and emergency procedures; technology; property maintenance and repair; purchasing…
In recent years in South Africa the position of the general practi- tioner in hospitals has ... ments, and it is in these hospitals that difficulties have arisen. On the other hand, ... great extent deprived of contact with his colleagues. He comes to ... eventually lose interest in the results of treatment and advances in medicine. In fact ...
Giraldo Valencia, Juan Carlos; Delgado, Liliana Claudia
There are forces that are greater than the individual performance of each hospital institution and of the health system structural of each country. The world is changing and to face up to the future in the best possible way, we need to understand how contexts and emerging trends link up and how they affect the hospital sector. The Columbian Association of Hospitals and Clinics, ACHC, has thus come up with the Hospital 360° concept which uses hospitals capable of anticipating changing contexts by means of the transition between present and future and takes on board the experience of global, socio-economic, demographic, political, environmental and technological fields as its model. Hospital 360° is an invitation to reinvent processes and institution themselves allowing them to adapt and incorporate a high degree of functional flexibility. Hospital 360° purses goals of efficiency, effectiveness and relevance, but also of impact and sustainability, and is coherent with the internal needs of hospital institutions and society for long-term benefits.
An increasing number of hospitals are undertaking external revenue-generating activities to supplement their shrinking budgets. Written at the request of Leadership, this article outlines an example of a successful catering service -- a money-generating business that more Canadian hospitals could profitably consider.
... Thoracopaedia - An Imaging Encyclopedia of Pediatric Thoracic Disease Virtual Pediatric Hospital is the Apprentice's Assistant Last revised ... pediatric resources: GeneralPediatrics.com | PediatricEducation.org | SearchingPediatrics.com Virtual Pediatric Hospital is curated by Donna M. D' ...
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…
California State Dept. of Education, Sacramento. Bureau of Homemaking Education.
This curriculum guide on the hospitality occupations was developed to help secondary and postsecondary home economics teachers prepare individuals for entry-level jobs in the hospitality industry. The content is in seven sections. The first section presents organizational charts of a medium-size hotel, food and beverage division, housekeeping and…
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...... 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...
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 guest and the host. This has provided a much-needed rethinking of how to understand hospitality as a way of relating, as an ethics and as a politics. Within this work, there have often appeared discussions of ‘spaces of hospitality’, but these spaces have remained largely abstract. This is where...... this paper comes in: It will re open discussions of spaces of hospitality with an introduction into an on-going research project that studies the performative, structural and social dynamics of cultural encounters focusing on forms of hospitality that are related to particular sites in the city, namely...
Frandsen, F; Nielsen, J R; Gram, L
During the period 1.10.1986-30.9.1987, all patients with cardiac arrest outside hospital brought to the casualty department in Odense Hospital were registered. Out of 160 patients, 133 (83%) could be primarily resuscitated, 19 (12%) were resuscitated but died later in hospital and eight patients (5......%) were resuscitated and could be discharged alive from hospital. Out of the eight patients who were discharged alive, only two (1%) had retained reasonable cerebral function as assessed by dementia testing. Treatment of the cardiac arrest prior to the arrival of the ambulance, duration of the cardiac...... arrest for less than six minutes and staffing of the ambulance with three first-aid men were factors of decisive importance for survival of the patients. The results of this investigation demonstrate that treatment of cardiac arrest outside hospital is unsatisfactory. Proposals for improvement...
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...
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...
Klimov, A S; Gromov, M F
In December 2011 marked 80 years of the founding of the Ryazan garrison hospital, originally housed in two buildings: "Redut housed"--a monument of architecture of the XVIII century and the former almshouses room "for the maimed in the war", was built in 1884 now Ryazan garrison hospital (from 2010--Branch No 6 FSI "in 1586 the district military hospital in the Western Military District", the Defense Ministry of Russia)--a multi-field medical preventive institution on the basis of which soldiers, military retirees, family members and military retirees from Ryazan, Moscow, Tambov regions are treated. Every year more than 7 thousand patients get treatment here. During the counterterrorism operations in Chechnya over 800 wounded were brought to the hospital from the battle area.
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 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...
Vermont Center for Geographic Information — (Link to Metadata) This data layer contains point locations of all major community, regional, comprehensive health, and healthcare provider hospitals in the state of...
... for Success Am I Rural? Evidence-based Toolkits Economic Impact Analysis Tool Community Health Gateway Sustainability Planning ... hospitals and improve access to healthcare by keeping essential services in rural communities. To accomplish this goal, ...
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...
... offer discounts to healthy activities in the area: Biking, hiking, or walking tours Museums Fitness clubs Farms Festivals Your hospital may offer discounts for: Retail stores such as sporting goods, health food, and art stores Acupuncture Skin care Eye ...
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...
Research in Hospitality Management. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 5, No 1 (2015) >. Log in or Register to get access to full text downloads.
Allegheny County / City of Pittsburgh / Western PA Regional Data Center — The data on health care facilities includes the name and location of all the hospitals and primary care facilities in Allegheny County. The current listing of...
... Home For Consumers Consumer Updates Practice Hospital Bed Safety Share Tweet Linkedin Pin it More sharing options ... It depends on the complexity of the bed." Safety Tips CDRH offers the following safety tips for ...
Blok, K.; Ginkel, G. van; Leun, K. van der; Muller, H.; Oude Elferink, J.; Vesseur, A.
This booklet dels with the risks of the use of ionizing radiation for people working in a hospital. It is subdivided in three parts. Part 1 treats the properties of ionizing radiation in general. In part 2 the various applications are discussed of ionizing radiation in hospitals. Part 3 indicates how a not completely safe situation may be improved. (H.W.). 14 figs.; 4 tabs
Essential facts Falls are the most frequent adverse event reported in hospitals, usually affecting older patients. Every year, more than 240,000 falls are reported in acute hospitals and mental health trusts in England and Wales, equivalent to more than 600 a day, according to the Royal College of Physicians (RCP). But research shows that when nurses, doctors and therapists work together, falls can be reduced by 20-30%.
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....
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.
Manish Kumar Manar
Full Text Available Objective: To assess hospital waste management in nonteaching hospitals of Lucknow city. Materials and Methods: A cross-sectional, descriptive study was conducted on the staffs of nonteaching hospitals of Lucknow from September 2012 to March 2013. A total of eight hospitals were chosen as the study sample size. Simple random sampling technique was used for the selection of the nonteaching hospitals. A pre-structured and pre-tested interview questionnaire was used to collect necessary information regarding the hospitals and biomedical waste (BMW management of the hospitals. The general information about the selected hospitals/employees of the hospitals was collected. Results: Mean hospital waste generated in the eight nonteaching hospitals of Lucknow was 0.56 kg/bed/day. About 50.5% of the hospitals did not have BMW department and colored dustbins. In 37.5% of the hospitals, there were no BMW records and segregation at source. Incinerator was used only by hospital A for treatment of BMW. Hospital G and hospital H had no facilities for BMW treatment. Conclusion: There is a need for appropriate training of staffs, strict implementation of rules, and continuous surveillance of the hospitals of Lucknow to improve the BMW management and handling practices.
Hospitals that hire contract service firms to manage one or all aspects of their hospitality service departments increasingly expect those firms to help meet total quality management goals as well as offer the more traditional cost reduction, quality improvement and specialized expertise, finds the 1992 Hospital Contract Services Survey conducted by Hospitals.
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.
Haberey-Knuessi, Véronique; Heeb, Jean-Luc; De Morgan, Paula Emilie
New management styles imposed on hospital institutions in recent years, have fundamentally changed the organization of the latter. Many texts discuss the consequences, specifically on the field of communication. The aim of this study was to understand the real impact of new management methods on communication by managers in hospital, but also on care teams in termes of satisfaction and/or stress. This two-year study was conducted among 900 executives in hospitals in Western Switzerland using a mixed methodology. A first phase of questionnaires highlighted the problematic areas, while a second phase in the form of organized group interviews in each hospital, had the objective of achieving a better understanding of the relationship between management and communication. The latter proved to be particularly significant in terms of results, and this is the one we focused on in this article.These results indeed show that a crucial role is given to communication by carers, and, at the same time a lessening of the time devoted to relationships, both among peers and with patients. Frustration then arises, which is not without consequences both for the management of patients and the institutions themselves. It is by means of these results that awareness is raised of the omnipresence of communication at all levels and the major advantages that positive dynamic supports. And, on the contrary, of the serious problems which may arise from management practice that do not give due importance to the dimension of communication, present in all sectors of the hospital.
Hendricks, Ann M.
Average fiscal year 1982 wages from 2,302 rural American hospitals were used to test for a gradient descending from hospitals in counties adjacent to metropolitan areas to those not adjacent. Considerable variation in the ratios of adjacent to nonadjacent averages existed. No statistically significant difference was found, however. Of greater importance in explaining relative wages within States were occupational mix, mix of part-time and full-time workers, case mix, presence of medical residencies, and location in a high-rent county within the State. Medicare already adjusts payments for only two of these variables. PMID:10313454
Hospital mergers in Europe and North America have been launched to scale down expenditure, enhance the delivery of health care and elevate quality. However, the outcome of mergers suggest that they neither generated cost savings nor improved the quality of care. Almost all consolidations fall short, since those in leadership positions lack the necessary understanding and appreciation of the differences in culture, values and goals of the existing facilities. In spite of these shortcomings, hospital mergers will continue to be pursued in order to improve market share, eliminate excess capacity, gain access to capital and enhance the personal egos of the organizations' leaders.
Curtis, Lori Jane; Bernier, Paule; Jeejeebhoy, Khursheed; Allard, Johane; Duerksen, Donald; Gramlich, Leah; Laporte, Manon; Keller, Heather H
Hospital malnutrition has been established as a critical, prevalent, and costly problem in many countries. Many cost studies are limited due to study population or cost data used. The aims of this study were to determine: the relationship between malnutrition and hospital costs; the influence of confounders on, and the drivers (medical or surgical patients or degree of malnutrition) of the relationship; and whether hospital reported cost data provide similar information to administrative data. To our knowledge, the last two goals have not been studied elsewhere. Univariate and multivariate analyses were performed on data from the Canadian Malnutrition Task Force prospective cohort study combined with administrative data from the Canadian Institute for Health Information. Subjective Global Assessment was used to assess the relationship between nutritional status and length of stay and hospital costs, controlling for health and demographic characteristics, for 956 patients admitted to medical and surgical wards in 18 hospitals across Canada. After controlling for patient and hospital characteristics, moderately malnourished patients' (34% of surveyed patients) hospital stays were 18% (p = 0.014) longer on average than well-nourished patients. Medical stays increased by 23% (p = 0.014), and surgical stays by 32% (p = 0.015). Costs were, on average, between 31% and 34% (p-values < 0.05) higher than for well-nourished patients with similar characteristics. Severely malnourished patients (11% of surveyed patients) stayed 34% (p = 0.000) longer and had 38% (p = 0.003) higher total costs than well-nourished patients. They stayed 53% (p = 0.001) longer in medical beds and had 55% (p = 0.003) higher medical costs, on average. Trends were similar no matter the type of costing data used. Over 40% of patients were found to be malnourished (1/3 moderately and 1/10 severely). Malnourished patients had longer hospital stays and as a result cost more than well
Holst, Malene Kirstine
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...... a correlation matrix. The correlation factor defines the framework for conceptual design, whereby the design considers functionalities and their requirements and preferences. It facilitates implementation of evidence-based design as it is prepared for ongoing update and it is based on actual data. Hence......, this contribution is a model for hospital design, where design derives as a response to the defined variables, requirements and preferences....
Stephen W. Litvin
Full Text Available Government policy has a significant impact on the hospitality and tourism industry, but it is unclear if political leaders fully understand this economic sector when crafting policies. This article offers new research about the direct involvement of industry practitioners in the political process, by analyzing the backgrounds of legislators in the six New England states. The data indicate that only 3% of these legislators have current or former careers related to hospitality and tourism. The author suggests that practitioners should seek election to political office, to better influence government policy.
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.
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...
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
Dzhandzhugazova, Elena A.; Blinova, Ekaterina A.; Orlova, Liubov N.; Romanova, Marianna M.
The article focuses on the study of the role and importance of innovation, its classification, the problems of its application in the hotel industry with emphasis on the application of sensory marketing tools in the development of the innovative marketing mix within the hospitality industry. The article provides an analysis of the "seven…
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...
Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives. Journal Homepage Image. The aim of the Nigerian Hospital Practice Journal is to aid in enhancing the advancement of medicine globally by acting as a medium for disseminating information on current clinical and drug practices in ...
... Central Office-Coding Resources AHA Team Training Health Career Center Health Forum Connect More Regulatory Relief The regulatory burden faced by hospitals is substantial and unsustainable. Read the report . More AHA Opioid Toolkit Stem the Tide: Addressing the Opioid Epidemic More ...
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…
It also publishes miscellaneous articles – hospital administration, business practice, accounting, Law for health practitioners and letters about published papers. All manuscript will be subject to blinded peer-review and the decision of the editor would be final. Articles submitted for consideration by the author should not have ...
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...
haematocrit, cord bilirubin, number of liveborn babies, birth weight, neonatal death, hyaline membrane disease .... report the outcome of babies of mothers with severe. Rh disease treated at Tygerberg Hospital since 1980 by ..... Walker W. Haemolytic disease of the newborn. In: Gairdner D, Hull 0, eds. Recent Advances iD ...
Wagenaar, C.; Mens, N.
Hospitals as a building type have undergone a substantial evolution in the past years. Changes in healthcare, the impact of evidence-based medicine and aspects of healthcare economics (such as the clustering of diagnostic procedures in specialized clinics) pose new and different challenges for the
... involved in your hospital care that you have Sjögren’s syndrome. • Share information about your dryness symptoms and routine ... neck, jaw, or back. For more information on Sjögren’s syndrome, visit the SSF Web site at www.sjogrens. ...
Goodman, Judith; Prosperi, Mario
Explores the use of drama as a therapeutic tool at various hospitals and records specific therapy groups dialogues. Available from: The Drama Review, 51 West 4th Street, Room 300, New York, N.Y. 10012. Subscription Rates: $12.50 per year. (MH)
Approved by the Management Executive Committee. - 1 -. Version 3.1.0 effective 2017-06-28. Official Centre Hospitality. 1. Objective. 2. Application. 3. Definitions. 4. Roles and Responsibilities. 5. Authorization. 6. Consultants and Contractors. 7. Reimbursement. 1. Objective. To define the circumstances under which ...
van Hulst, B.L.
Healthcare expenditure in Western countries is substantial and outpaces economic growth, therefore cost containment in healthcare is high on the political agenda. One option is to increase productivity in healthcare, do more with less. This thesis uses the Dutch hospitals as a case-study and
to make informed decisions about prioritising hazards in view of limited resources ... contingency plan, for instance, the Oshikoto Regional Council has identified ..... hospital relies on exercises conducted by the Namibia Airports Company (NAC) ... Small scale exercises can also be done in which certain elements of the plan ...
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.
José Félix Patiño-Restrepo
Full Text Available Según el Diccionario de la Real Academia Española (1, el vocablo hospital viene del latín hospitālis y en su primera acepción se define como: “1. m. Establecimiento destinado al diagnóstico y tratamiento de enfermos, donde a menudo se practican la investigación y la docencia”. Sin embargo, las otras acepciones se refieren a sus orígenes medievales: “2. m. Casa que servía para recoger pobres y peregrinos por tiempo limitado. 3. adj. ant. Afable y caritativo con los huéspedes. 4. adj. ant. Perteneciente o relativo al buen hospedaje”. El hospital moderno, en realidad, es la combinación de ciencia, tecnología, hospedaje y humanitarismo. ¿Cuándo nació el hospital y cuál es su historia? En la Edad Media temprana surgieron los xenodochia, albergues para pobres y peregrinos fundados por la iglesia católica en el marco del sentido humanitario del cristianismo. En los comienzos del siglo XIII, cuando las ciudades acumularon riqueza para sostener sus propios ejércitos, se presentó un fenómeno de crecimiento en el número de albergues y estos empezaron a caracterizarse por atender enfermos; ya para esta época no eran solo fundados por la iglesia, sino también por autoridades civiles. Aunque se siguió el modelo del Hospital del Santo Spirito de Roma, construido por orden del papa Inocencio III (1161-1216, en Francia se fundaron los Hôtel-Dieu, generalmente en la vecindad de las catedrales, que aún conservaban la característica de ser más bien albergues para los más necesitados y desamparados.
Full Text Available This year Zemun Hospital - Clinical Hospital Center Zemun celebrates 230th anniversary of continuous work, thus becoming the oldest medical facility in Serbia. The exact date of the hospital founding has been often questioned in history. Various dates appeared in the literature, but the most frequent one was 25th of February 1784. Until now, the document which confirms this has never been published. This article represents the first official publication of the document which confirms that Zemun Hospital was indeed founded on this date. The first hospitals started emerging in Zemun when the town became a part of the Habsburg Monarchy. The first sanitary facility ever formed was the “Kontumac” - a quarantine established in 1730. Soon after, two more confessional hospitals were opened. The Serbian (Orthodox Hospital was founded before 1769, whereas the German (Catholic Hospital started working in 1758. Both hospitals were financed, amongst others, by the Town Hall - the Magistrate. In order to improve efficiency of these hospitals, a decision was made to merge them into a single City Hospital. It was founded on 25th February 1784, when the General Command ordered the Magistrate of Zemun to merge the financess of all existing hospitals and initiate the construction of a new building. Although financially united, the hospitals continued working in separate buildings over a certain period of time. The final, physical merging of these hospitals was completed in 1795. [Projekat Ministarstva nauke Republike Srbije, br. 47030
Santos, Thiago R; Penm, Jonathan; Baldoni, André O; Ayres, Lorena Rocha; Moles, Rebekah; Sanches, Cristina
This study aims to describe the distribution of the hospital pharmacy workforce in Brazil. Data were acquired, during 2016, through the Brazilian National Database of Healthcare Facilities (CNES). The following variables were extracted: hospital name, registry number, telephone, e-mail, state, type of institution, subtype, management nature, ownership, presence of research/teaching activities, complexity level, number of hospital beds, presence of pharmacists, number of pharmacists, pharmacist specialization. All statistical analyses were performed by IBM SPSS v.19. The number of hospitals with a complete registry in the national database was 4790. The majority were general hospitals (77.9%), managed by municipalities (66.1%), under public administration (44.0%), had no research/teaching activities (90.5%), classified as medium complexity (71.6%), and had no pharmacist in their team (50.6%). Furthermore, almost 60.0% of hospitals did not comply with the minimum recommendations of having a pharmacist per 50 hospital beds. The Southeast region had the highest prevalence of pharmacists, with 64.4% of hospitals having a pharmaceutical professional. This may have occurred as this region had the highest population to hospital ratio. Non-profit hospitals were more likely to have pharmacists compared to those under public administration and private hospitals. This study mapped the hospital pharmacy workforce in Brazil, showing a higher prevalence of hospital pharmacists in the Southeast region, and in non-profit specialized hospitals.
Justesen, Lise; Gyimóthy, Szilvia; Mikkelsen, Bent E.
Hospital meals and their role in nutritional care have been studied primarily from a life and natural science perspective. This article takes a different approach and explores the idea of hospitality inspired by Jacques Derrida’s work on the ontology of hospitality. By drawing on ethnographic fie...... and management involved in hospital food service and in nutritional care to work more systematically with the environment for improved hospital meal experiences in the future......Hospital meals and their role in nutritional care have been studied primarily from a life and natural science perspective. This article takes a different approach and explores the idea of hospitality inspired by Jacques Derrida’s work on the ontology of hospitality. By drawing on ethnographic...
Tile HOspital Information Plan- ning Study ... Hospital, and based on. the Business Systems Plan- ... technology can be of considerable benefit in dealing with these issues. .... coherenr, flexible information systems with a minimum of data.
Younis, Mustafa Z; Rivers, Patrick A; Fottler, Myron D
This study examines the impact of HMO penetration and competition on health system performance, as measured by hospital cost per adjusted admissions. The study population consisted of acute-care hospitals in the United States. The findings of this study suggest that there is no relationship between HMO competition and hospital cost per adjusted admission. Governmental efforts to stimulate competition in the hospital market, if focused on promoting HMOs, are not likely to produce cost-containing results quickly.
Background: Out-of-hospital death among children living in resource poor settings occurs frequently. Little is known about the location and circumstances of child death following a hospital discharge. Objectives: This study aimed to understand the context surrounding out-of-hospital deaths and the barriers to accessing ...
Information is an increasingly important resource in an academic hospital. Effective planning and control of this resource are essential in order to maximize its usefulness. Tile HOspital Information Planning Study (HIPS) undertaken at Groote Schuur Hospital, and based on. the Business Systems Planning (BSP) ...
Tudela, Pere; Mòdol, Josep Maria
Overuse of hospital emergency rooms (HERs) is parallel to their controversy. To understand this problem, some concepts should be first clarified. In HERs, there are some intrinsic aspects which are directly related to the emergency itself and thus cannot be modified (intermittent patient flow, need to prioritize, difficulty to achieve a rapid diagnosis, influence of time on treatment, value of clinical follow up, patient's expectations, impact of HER on the overall hospital working dynamics). On the other hand, there are some extrinsic aspects which indeed are not related to HER itself but are rather historically associated with it (precarious structure, delay on admission, lack of privacy, inadequate triage of cases, lack of professionalization); these latter aspects may be potentially modified and should be reconsidered.
Ray F. IUNIUS
Full Text Available As a wise man once said, “Don’t worry about what you don’t know. Be worried about what you think you know, but don’t.” Regarding different ways “hospitality” is understood, the root of the problem lies in part in the different interpretations that hospitality has in different cultures and languages. In American English, for example, when we speak about “hospitality” we first think of it as an industry and only secondarily as an attribute of an individual or community. In other cultures, the primary meaning of hospitality is more a characteristic of people, or of a country or city, etc., and encompasses such ideas as welcome, reception, amiability, generosity, etc. – not an industry! Even in American English, other words are sometimes used to describe the same economic activity: lodging, accommodation, etc.
Gold, Katharina; Grothues, Dirk; Leitzmann, Michael; Gruber, Hans; Melter, Michael
The following article presents an overview of current research studies on play therapy in the hospital. It highlights individual diagnoses for which play therapy has shown reasonable success. The aim of this review is to describe the current status of the scientific debate on play therapy for sick children in order to allow conclusions regarding the indications for which play therapy is or might be useful.
Toode, Kristi; Routasalo, Pirkko; Helminen, Mika; Suominen, Tarja
The knowledge surrounding nurses' work motivation is currently insufficient, and previous studies have rarely taken into account the role of many influential background factors. This study investigates the motivation of Estonian nurses in hospitals, and how individual and organisational background factors influence their motivation to work. The study is quantitative and cross-sectional. An electronically self-reported questionnaire was used for data collection. The sample comprised of 201 Registered Nurses working in various hospital settings in Estonia. Data were analysed using descriptive statistics, two-sample Wilcoxon rank-sum (Mann-Whitney) test, Kruskal-Wallis equality-of-populations rank test and Spearman's correlation. Both extrinsic and intrinsic motivations were noted among hospital nurses. Nurses were moderately externally motivated (M = 3.63, SD = 0.89) and intrinsically strongly motivated (M = 4.98, SD = 1.03). A nurses' age and the duration of service were positively correlated with one particular area of extrinsic work motivation, namely introjected regulation (p extrinsic motivation (p = 0.016) and intrinsic work motivation (p = 0.004). The findings expand current knowledge of nurses' work motivation by describing the amount and orientation of work motivation among hospital nurses and highlighting background factors which should be taken into account in order to sustain and increase their intrinsic work motivation. The instrument used in the study can be an effective tool for nurse managers to determine a nurse's reasons to work and to choose a proper motivational strategy. Further research and testing of the instrument in different countries and in different contexts of nursing is however required. © 2014 Nordic College of Caring Science.
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...... are created through stories about three roughly framed aspects of hospitalisation: A. Being together with fellow patients entails a constant dilemma, B. Relationships between patients are restricted and extended and C. Shifting perspectives in solidarity. Conclusion Patients' hospitalisation is strongly...
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.
Vecina Neto, Gonzalo; Malik, Ana Maria
This paper analyses trends in the delivery of hospital services in Brazil, considering the setting, the current situation and its challenges, examining what still remains to be done. The variables studied for the analysis of the setting are: demography, epidemiological profile, human resources, technology, medicalization, costs, review of the role of the citizen, legislation, equity, hospital-centricity and regionalization, care fractioning and bed availability. The Brazilian setting was studied through the supplementary healthcare model, financing and the healthcare area production chain. The observations of the current situation present external evaluation models, outsourcing, public-private relationships, de-hospitalization and financing. The analysis of the challenges examines the need for long range planning, the quest for new legal models for the 'business', the use of information and information systems, cost controls and the need for enhanced efficiency and compliance with legal directives, guaranteed universal access to full healthcare facilities, the inclusion of primary prevention in healthcare procedures, integrating the public and private sectors and engaging physicians in solving problems.
... statistics show that hospitals are still relatively hazardous workplaces, and they have much room to improve. OSHA has developed this factbook to help hospital safety managers and other stakeholders understand the challenges of worker ...
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...
Full Text Available Hospital acquired infection is an additional affliction to the patient admitted to the hospital for some serious illness and is caused by pathogens which are prevalent in hospital environment. In the hospital, microbes are ubiquitous; and can reach the sick patient through various sources, such as air, water, food, contaminated equipments, linen, catheters, scopes, ventilators, contaminated disinfectants and other preparations used for treatment, visitors, infected patients, etc.
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....
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...
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...
Research indicates that hospitals manage their earnings. However, these findings might be influenced by methodological issues. In this study, I exploit specific features of Dutch hospitals to study income smoothing while limiting these methodological issues. The managers of Dutch hospitals have the
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…
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…
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…
Full Text Available Background: There has been conflicting data on whether Nursing Magnet Hospitals (NMH provide better care. Methods: NMH in the Southwest USA (Arizona, California, Colorado, Hawaii, Nevada, and New Mexico were compared to hospitals not designated as NMH using the Centers for Medicare and Medicaid (CMS hospital compare star designation. Results: NMH had higher star ratings than non-NMH hospitals (3.34 + 0.78 vs. 2.86 + 0.83, p<0.001. The hospitals were mostly large, urban non-critical access hospitals. Academic medical centers made up a disproportionately large portion of the NMH. Conclusions: Although NMH had higher hospital ratings, the data may favor non-critical access academic medical centers which are known to have better outcomes.
Sosunov, Eugene A; Egorova, Natalia N; Lin, Hung-Mo; McCardle, Ken; Sharma, Vansh; Gelijns, Annetine C; Moskowitz, Alan J
The Centers for Medicare & Medicaid Services (CMS) profile hospitals using a set of 30-day risk-standardized mortality and readmission rates as a basis for public reporting. These measures are affected by hospital patient volume, raising concerns about uniformity of standards applied to providers with different volumes. To quantitatively determine whether CMS uniformly profile hospitals that have equal performance levels but different volumes. Retrospective analysis of patient-level and hospital-level data using hierarchical logistic regression models with hospital random effects. Simulation of samples including a subset of hospitals with different volumes but equal poor performance (hospital effects=+3 SD in random-effect logistic model). A total of 1,085,568 Medicare fee-for-service patients undergoing 1,494,993 heart failure admissions in 4930 hospitals between July 1, 2005 and June 30, 2008. CMS methodology was used to determine the rank and proportion (by volume) of hospitals reported to perform "Worse than US National Rate." Percent of hospitals performing "Worse than US National Rate" was ∼40 times higher in the largest (fifth quintile by volume) compared with the smallest hospitals (first quintile). A similar gradient was seen in a cohort of 100 hospitals with simulated equal poor performance (0%, 0%, 5%, 20%, and 85% in quintiles 1 to 5) effectively leaving 78% of poor performers undetected. Our results illustrate the disparity of impact that the current CMS method of hospital profiling has on hospitals with higher volumes, translating into lower thresholds for detection and reporting of poor performance.
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...
Strategic management is concerned with strategic choices and strategic implementation; it provides the means by which organizations meet their objectives. In the case of hospitals it helps executives and all employees to understand the real purpose and long term goals of the hospital. Also, it helps the hospital find its place in the health care service provision chain, and enables the hospital to coordinate its activities with other organizations in the health care system. Strategic management is a tool, rather than a solution, that helps executives to identify root causes of major problems in the hospital.
Chandrasiri, Singithi Sidney
Purpose The purpose of this paper is to explore a novel overarching strategy in tackling the key issues raised by the recent inquiry into bullying, harassment and discrimination in surgical practice and surgical training in Australian and New Zealand hospitals. Design/methodology/approach The approach taken is an analysis of the available evidence-based literature to inform the proposed viewpoint. The theoretical subject scope presented is a discussion of how and why the various strategies put forward in this paper should be integrated into and led from an overarching workforce engagement platform. Findings The key themes isolated from the Inquiry into Australian and New Zealand surgical practice ranged from abuse of power by those in leadership positions, gender inequity in the surgical workforce, opaque and corrupt complaints handling processes, excessive surgical trainee working hours to bystander silence secondary to a fear of reprisal. A workforce engagement perspective has elicited the potential to counter various impacts, that of clinical ineffectiveness, substandard quality and safety, inefficient medical workforce management outcomes, adverse economic implications and the operational profitability of a hospital. Generic strategies grounded in evidence-based literature were able to then be aligned with specific action areas to provide a new leadership framework for addressing these impacts. Originality/value To the author's knowledge, this is one of the first responses providing a framework on how medical managers and hospital executives can begin to lead a comprehensive and practical strategy for changing the existing culture of bullying, harassment and discrimination in surgical practice by using a staff engagement framework.
East Jefferson General Hospital in Metairie, La., launched a new Web site in October 2001. Its user-friendly home page offers links to hospital services, medical staff, and employer information. Its jobline is a powerful tool for recruitment. The site was awarded the 2002 Pelican Award for Best Consumer Web site by the Louisiana Society for Hospital Public Relations & Marketing.
A book on radiation protection in hospitals has been written to cater for readers with different backgrounds, training and needs by providing an elementary radiation physics text in Part I and an advanced, comprehensive Part II relating to specific medical applications of X-rays and of radioactivity. Part I includes information on basic radiation physics, radiation risk, radiation absorption and attenuation, radiation measurement, radiation shielding and classification of radiation workers. Part II includes information on radiation protection in external beam radiotherapy, interstitial source radiotherapy, intracavitary radiotherapy, radioactive iodine-131 radiotherapy, nuclear medicine diagnostics and diagnostic radiology. (U.K.)
serious contender. Although it is a proven hull design for stability, integrating the ability to quickly transfer patients aboard is challenging . The...Waste management afloat is a constant challenge for the Navy. It is even more so when designing a hospital ship. In addition to the typical waste...0.97 Optbrs: Corrmon rail fuellrijacllon,crude oil. Rated power generating sets 61:ili:ln()q;to~ 50Htl760rpm &.gne type -1801.\\ Vlc )l ~W.’/cyl SI;O k
McCue, Michael J; Thompson, Jon M; Kim, Tae Hyun
The hospital industry has experienced increased consolidation in the past 20 years. Since 2010, in particular, there has been a large rise in the number of hospital acquisitions, and observers have suggested this is due in part to the expected impact of federal healthcare reform legislation. This article reports on a study undertaken to identify the market, management, and financial factors affecting acute care, community hospitals acquired between 2010 and 2012. We identified 77 such hospitals and compared them to other acute care facilities. To assess how different factors were associated with acquisitions, the study used multiple logistic regressions whereby market factors were included first, followed by management and financial factors. Study findings show that acquired hospitals were located in markets with lower rates of preferred provider organization (PPO) penetration compared with nonacquired hospitals. Occupancy rate was found to be inversely related to acquisition rate; however, case-mix index was significantly and positively related to a hospital's being acquired. Financial factors negatively associated with a hospital's being acquired included age of plant and cash flow margin. In contrast to the findings from earlier studies of hospital acquisitions, our results showed that acquired hospitals possessed newer assets. However, similar to the findings of other studies, the cash flow margin of acquired hospitals was lower than that of nonacquired facilities.
Martha Isabel Riaño-Casallas
Full Text Available Introduction: There are several approaches and schools that support strategic management processes. University hospitals require the implementation of a strategic approach to their management, since they are a particular type of organization with the triple mission of providing health care, education and research. Objective: To propose a strategic profile for a university hospital. Materials and methods: The theoretical framework of strategic management was analyzed and some particular components of hospital management were studied; based on these criteria, the strategic management process in three high complexity hospitals of Bogotá, D.C. was examined and a profile of both the objectives and the functional strategies for the hospital was proposed. Results: The main strategic thinking schools are presented; the processes and components of strategic management are described, and a strategic management profile for a university hospital is proposed. Conclusion: The strategic orientation of management for an institution with the characteristics of a university hospital facilitates achieving organizational objectives.
NSGIC State | GIS Inventory — HOSPITALS_HAZUS_IN is a point shapefile that shows locations of hospitals and clinics in Indiana. HOSPITALS_HAZUS_IN was derived from the shapefile named "HOSPITAL."...
Plancke, L; Amariei, A
Long-term hospitalizations in psychiatry raise the question of desocialisation of the patients and the inherent costs. Individual indicators were extracted from a medical administrative database containing full-time psychiatric hospitalizations for the period 2011-2013 of people over 16 years old living in the French region of Nord-Pas-de-Calais. We calculated the proportion of people who had experienced a hospitalization with a duration of 292 days or more during the study period. A bivariate analysis was conducted, then ecological data (level of health-care offer, the deprivation index and the size of the municipalities of residence) were included into a multilevel regression model in order to identify the factors significantly related to variability of long-term hospitalization rates. Among hospitalized individuals in psychiatry, 2.6% had had at least one hospitalization of 292 days or more during the observation period; the number of days in long-term hospitalization represented 22.5% of the total of days of full-time hospitalization in psychiatry. The bivariate analysis revealed that seniority in the psychiatric system was strongly correlated with long hospitalization rates. In the multivariate analysis, the individual indicators the most related to an increased risk of long-term hospitalization were: total lack of autonomy (OR=9.0; 95% CI: 6.7-12.2; P<001); diagnoses of psychological development disorders (OR=9.7; CI95%: 4.5-20.6; P<.001); mental retardation (OR=4.5; CI95%: 2.5-8.2; P<.001): schizophrenia (OR=3.0; CI95%: 1.7-5.2; P<.001); compulsory hospitalization (OR=1.7; CI95%: 1.4-2.1; P<.001); having experienced therapeutic isolation (OR=1.8; CI95%: 1.5-2.1; P<.001). Variations of long-term hospitalization rates depending on the type of establishment were very high, but the density of hospital beds or intensity of ambulatory activity services were not significantly linked to long-term hospitalization. The inhabitants of small urban units had
Blanco Meza, A.; Bonilla Jimenez, S.
The main objective of this investigation is the characterization of the solid residuals. A description of the handling of the liquid and gassy waste generated in hospitals is also given, identifying the source where they originate. To achieve the proposed objective the work was divided in three stages: The first one was the planning and the coordination with each hospital center, in this way, to determine the schedule of gathering of the waste can be possible. In the second stage a fieldwork was made; it consisted in gathering the quantitative and qualitative information of the general state of the handling of residuals. In the third and last stage, the information previously obtained was organized to express the results as the production rate per day by bed, generation of solid residuals for sampled services, type of solid residuals and density of the same ones. With the obtained results, approaches are settled down to either determine design parameters for final disposition whether for incineration, trituration, sanitary filler or recycling of some materials, and storage politics of the solid residuals that allow to determine the gathering frequency. The study concludes that it is necessary to improve the conditions of the residuals handling in some aspects, to provide the cleaning personnel of the equipment for gathering disposition and of security, minimum to carry out this work efficiently, and to maintain a control of all the dangerous waste, like sharp or polluted materials. In this way, an appreciable reduction is guaranteed in the impact on the atmosphere. (Author) [es
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.
Bennett, John B.
Explains a collegial ethic of hospitality as a cardinal academic virtue and suggests a way of building a "collegium," the covenantal community of academe. Discusses how academicians can develop hospitable teaching, hospitable scholarship, and hospitable service. (Author/SLD)
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.
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.
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 libraries control their theft. Through regularly scheduling inventories, monitoring items, advertising, and using specific security measures, we have successfully controlled the library theft. The January 2002 inventory resulted in meeting our goal of zero missing books and videocassettes. We work to maintain that goal.
In this paper we outline the possibilities of an ethic of care based on our self-affection and subjectivity in the ethical spaces between-two. In this we first refer to three Irigarayan concepts - breath, silence and listening from the third phase of her philosophy, and discuss them within the methodological framework of an ethics of intersubjectivity and interiority. Together with attentiveness, we analyse them as four categories of our ethical becoming. Furthermore, we argue that self-affection is based on our inchoate receptivity for the needs of the other(s) and is thus dialectical in its character. In this we critically confront some epistemological views of our ethical becoming. We wind up this paper with a proposal for an ethics towards two autonomous subjects, based on care and our shared ethical becoming - both as signs of our deepest hospitality towards the other.
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.
McHugh, Matthew D.; Kelly, Lesly A.; Smith, Herbert L.; Wu, Evan S.; Vanak, Jill M.; Aiken, Linda H.
Background Although there is evidence that hospitals recognized for nursing excellence—Magnet hospitals—are successful in attracting and retaining nurses, it is uncertain whether Magnet recognition is associated with better patient outcomes than non-Magnets, and if so why. Objectives To determine whether Magnet hospitals have lower risk-adjusted mortality and failure-to-rescue compared with non-Magnet hospitals, and to determine the most likely explanations. Method and Study Design Analysis of linked patient, nurse, and hospital data on 56 Magnet and 508 non-Magnet hospitals. Logistic regression models were used to estimate differences in the odds of mortality and failure-to-rescue for surgical patients treated in Magnet versus non-Magnet hospitals, and to determine the extent to which differences in outcomes can be explained by nursing after accounting for patient and hospital differences. Results Magnet hospitals had significantly better work environments and higher proportions of nurses with bachelor's degrees and specialty certification. These nursing factors explained much of the Magnet hospital effect on patient outcomes. However, patients treated in Magnet hospitals had 14% lower odds of mortality (odds ratio 0.86; 95% confidence interval, 0.76–0.98; P = 0.02) and 12% lower odds of failure-to-rescue (odds ratio 0.88; 95% confidence interval, 0.77–1.01; P = 0.07) while controlling for nursing factors as well as hospital and patient differences. Conclusions The lower mortality we find in Magnet hospitals is largely attributable to measured nursing characteristics but there is a mortality advantage above and beyond what we could measure. Magnet recognition identifies existing quality and stimulates further positive organizational behavior that improves patient outcomes. PMID:24022082
Becker, Edmund R.; Steinwald, Bruce
Using the Commission on Professional and Hospital Activities' Resource Need Index as a measure of casemix complexity, this paper examines the relative contributions of teaching commitment and other hospital characteristics, hospital service and insurer distributions, and area characteristics to variations in casemix complexity. The empirical estimates indicate that all three types of independent variables have a substantial influence. These results are discussed in light of recent casemix research as well as current policy implications. PMID:6799430
Merridew, C G
"Those wonderful huts…" (Florence Nightingale). This is the story of the British Civil Hospital, erected in 1855 at Renkioi on the south Dardanelles coast of Turkey. The spectacular hospital was a portable one designed by British engineer IK Brunel. It was his only health-related project, and it was known as a Civil Hospital because its staff were all civilians, despite its patients being military.
Hospital wastes comprises approximately 80% domestic waste components, also known as non-risk waste and 20% hazardous or risk waste. The 20% of the hospital waste stream or the risk waste (also known as infectious, medical, clinical wastes) comprises components which could be potentially contaminated with infections, chemical or radioactive agents. Therefore, it should be handled and disposed of in such a manner as to minimize potential human exposure and cross-contamination. Hospital risk waste and be subdivided into seven general categories as follows: infections, anatomical/pathological, chemical, pharmaceutical, radioactive waste, sharps and pressurised containers. These waste categories are generated by many types of health care establishments, including hospitals, clinics, infirmaries.... The document presents also tables of number of hospitals and estimated bed number in different regions in Lebanon; estimated hospital risk and non-risk waste generation per tonnes per day for the years 1998 until 2010 and finally sensitivity analysis of estimated generation of hospital risk waste in Lebanon per tonnes per day for the years 1998 until 2010. The management, treatment and disposal of hospital risk waste constitute important environmental and public safety issues. It is recognised that there is alack of infrastructure for the safe and environmentally acceptable disposal of hospital waste in Lebanon
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 w...
Shafik, Magdy H; Seoudi, Tarek M M; Raway, Tarek S; Al Harbash, Nowair Z; Ahmad, Meshal M A; Al Mutairi, Hanan F
To determine the rate of inappropriate pediatric admissions using the Pediatric Appropriateness Evaluation Protocol (PAEP) and to examine variables associated with inappropriateness of admissions. A prospective study was conducted in the Department of Pediatrics, Farwania General Hospital, Kuwait, to examine successive admissions for appropriateness of admission as well as several sociodemographic characteristics over a 5-month period (August 2010 to December 2010). A total of 1,022 admissions were included. Of the 1,022 admissions, 416 (40.7%) were considered inappropriate. Factors associated with a higher rate of inappropriate admission included older age of patients and self-referral. The rate of inappropriate hospitalization of children was high in Farwania Hospital, Kuwait, probably due to the relatively free health care services, parental preference for hospital care, easy access to hospital services, and insufficient education about the child's condition. Copyright © 2012 S. Karger AG, Basel.
Scanlon, Dennis P; Lindrooth, Richard C; Christianson, Jon B
To determine if a tiered hospital benefit and safety incentive shifted the distribution of admissions toward safer hospitals. A large manufacturing company instituted the hospital safety incentive (HSI) for union employees. The HSI gave union patients a financial incentive to choose hospitals that met the Leapfrog Group's three patient safety "leaps." The analysis merges data from four sources: claims and enrollment data from the company, the American Hospital Association, the AHRQ HCUP-SID, and a state Office of the Insurance Commissioner. Changes in hospital admissions' patterns for union and nonunion employees using a difference-in-difference design. We estimate the probability of choosing a specific hospital from a set of available alternatives using conditional logistic regression. Patients affiliated with the engineers' union and admitted for a medical diagnosis were 2.92 times more likely to select a hospital designated as safer in the postperiod than in the preperiod, while salaried nonunion (SNU) patients (not subject to the financial incentive) were 0.64 times as likely to choose a compliant hospital in the post- versus preperiod. The difference-in-difference estimate, which is based on the predictions of the conditional logit model, is 0.20. However, the machinists' union was also exposed to the incentive and they were no more likely to choose a safer hospital than the SNU patients. The incentive did not have an effect on patients admitted for a surgical diagnosis, regardless of union status. All patients were averse to travel time, but those union patients selecting an incentive hospital were less averse to travel time. Patient price incentives and quality/safety information may influence hospital selection decisions, particularly for medical admissions, though the optimal incentive level for financial return to the plan sponsor is not clear.
Haverkort, J. J Mark; Biesheuvel, Tessa H.; Bloemers, Frank W.; de Jong, MB; Hietbrink, Falco; van Spengler, Lukas L.; Leenen, Luke P H
Introduction: The Dutch Major Incident Hospital (MIH) is a standby, highly prepared, 200-bed hospital strictly reserved to provide immediate, large-scale, and emergency care for victims of disasters and major incidents. It has long-standing experience training for various major incident scenarios,
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, ...
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.
the best outcome in patients with Cervical Spine injury ICSI}. ... which indicates the likely level and pattern of injury ... All trauma patients with altered level ... from arrival In hospital to review bya clinician. ... one ofthe 29 patierns had an op-en mouth view taken. .... Domeier, H_ M. Time reliability of pre-hospital c inical.
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…
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...
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...
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…
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…
Burr, T.L.; Rivenburgh, R.D.; Scovel, J.C.; White, J.M.
We present graphical and analytical methods that focus on multivariate outlier detection applied to the hospital report cards data. No two methods agree which hospitals are unusually good or bad, so we also present ways to compare the agreement between two methods. We identify factors that have a significant impact on the scoring.
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.
Sylvia Gallegos Espinosa; Marcelo Nicolalde Cifuentes; Sergio Santana Porbén
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 No...
Ream, Priscilla Santos Ferreira; Tipple, Anaclara Ferreira Veiga; Barros, Dayane Xavier; Souza, Adenícia Custódia Silva; Pereira, Milca Severino
Although not directly responsible for patient care, hospital housekeepers are still susceptible to accidents with biological material. The objectives of this study were to establish profile and frequency of accidents among hospital housekeepers, describe behaviors pre- and postaccident, and risk factors. This was a cross-sectional study with hospital housekeepers in Goiania, Brazil. Data were obtained from interviews and vaccination records. The observations were as follows: (1) participating workers: 94.3%; (2) incomplete hepatitis B vaccination: 1 in 3; and (3) accident rate: 26.5%, mostly percutaneous with hypodermic needles, and involved blood from an unknown source; roughly half occurred during waste management. Upon review, length of service less than 5 years, completed hepatitis B vaccination, and had been tested for anti-HBs (hepatitis B surface antigen) influenced frequency of accidents. These findings suggest that improper disposal of waste appears to enhance the risk to hospital housekeepers. All hospital workers should receive continued training with regard to waste management.
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...... 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...... limited. Concerned with the design potentials of using textiles in hospital interiors, the purpose of the PhD project has been to explore the possibilities and design qualities of using these materials in hospital design. Relating to both technical and aesthetic aspects of using functional textiles...
Özkil, Ali Gürcan
services to maintain the quality of healthcare provided. Logistics is the most resource demanding service in a hospital. The scale of the transportation tasks is huge and the material flow in a hospital is comparable to that of a factory. We believe that these transportation tasks, to a great extent, can...... be and will be automated using mobile robots. This talk consequently addresses the key technical issues of implementing service robots in hospitals. In simple terms, a robotic system for automating hospital logistics has to be reliable, adaptable and scalable. Robots have to be semi-autonomous, and should reliably...... navigate in large and dynamic environments in the hospital. The complexity of the problem has to be manageable, and the solutions have to be flexible, so that the system can be applicable in real world settings. This talk summarizes the efforts to address these issues. Upon the analysis...
Kwong Wah Hospital was founded by the charity organisation Tung Wah Group of Hospitals some 88 years ago, with management transfer to the Hong Kong Hospital Authority in 1991. Capitalizing both from the traditional caring culture of its founder, as well as opportunities in the new management environment, the hospital has scored remarkable successes in service quality, community partnership, organisational effectiveness, and staff development. Underpinning these transformations were Structure, Process, People, and Culture strategies. The learning imperative is heavily mandated or the success of each of these strands of development. Indeed, the embodiment of a learning organisation culture provides the impetus in sustaining the change momentum, towards achieving the Vision of becoming a 'Most Preferred Hospital' in Hong Kong.
Gonçalves-Bradley, Daniela C; Iliffe, Steve; Doll, Helen A; Broad, Joanna; Gladman, John; Langhorne, Peter; Richards, Suzanne H; Shepperd, Sasha
Early discharge hospital at home is a service that provides active treatment by healthcare professionals in the patient's home for a condition that otherwise would require acute hospital inpatient care. This is an update of a Cochrane review. To determine the effectiveness and cost of managing patients with early discharge hospital at home compared with inpatient hospital care. We searched the following databases to 9 January 2017: the Cochrane Effective Practice and Organisation of Care Group (EPOC) register, Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, CINAHL, and EconLit. We searched clinical trials registries. Randomised trials comparing early discharge hospital at home with acute hospital inpatient care for adults. We excluded obstetric, paediatric and mental health hospital at home schemes. DATA COLLECTION AND ANALYSIS: We followed the standard methodological procedures expected by Cochrane and EPOC. We used the GRADE approach to assess the certainty of the body of evidence for the most important outcomes. We included 32 trials (N = 4746), six of them new for this update, mainly conducted in high-income countries. We judged most of the studies to have a low or unclear risk of bias. The intervention was delivered by hospital outreach services (17 trials), community-based services (11 trials), and was co-ordinated by a hospital-based stroke team or physician in conjunction with community-based services in four trials.Studies recruiting people recovering from strokeEarly discharge hospital at home probably makes little or no difference to mortality at three to six months (risk ratio (RR) 0.92, 95% confidence interval (CI) 0.57 to 1.48, N = 1114, 11 trials, moderate-certainty evidence) and may make little or no difference to the risk of hospital readmission (RR 1.09, 95% CI 0.71 to 1.66, N = 345, 5 trials, low-certainty evidence). Hospital at home may lower the risk of living in institutional setting at six months (RR 0.63, 96% CI
Hirsh, H L
The liability of hospitals in tort law has been a fairly recent development. Formerly, hospitals were protected from liability under the doctrine of charitable immunity. Legal "immunity" avoids liability in tort essentially under all circumstances. It is conferred not because of the particular facts of the situation but because of the status or position of the favored defendant. It does not deny the tort, merely the resulting liability. Such immunity does not mean that conduct that would amount to a tort on the part of other defendants is not still equally tortious in character, but merely that for the protection of the particular defendant, or of the interests which he represents, he is given absolution from liability. Similarly, the "captain-of-the-ship" and the attendant "borrowed or lent servant" doctrine is being abandoned. As medical technology continues to advance, the modern hospital will undoubtedly assume a greater responsibility toward its patients--with amplified medical-legal implications. The hospital is no longer a hotel where patients stay, awaiting treatment by their private physicians. The theory that the hospital does not act through its employees--physicians, nurses, and others--no longer reflects the trend in judicial philosophy. The decisions cited reflect the current trend in judicial analysis and thinking. Medical science has provided numerous benefits to humankind, but along with those benefits, numerous risks have accrued. Whether hospitals should have to bear the responsibilities inherent in such risks is a much-argued matter. However, hospital liability, in fact, is the trend of our judicial determination. The ramifications of this trend have been many. Hospitals and physicians will closely scrutinize surgical operations and other hospitals procedures and practices. The fact remains clear that responsibility for every patient is now shared by both the physicians and the hospital--share and share alike. The present thinking is that the
De Cauwer, Harald; Somville, Francis; Sabbe, Marc; Mortelmans, Luc J
In recent years, the world has been rocked repeatedly by terrorist attacks. Arguably, the most remarkable were: the series of four coordinated suicide plane attacks on September 11, 2001 on buildings in New York, Virginia, and Pennsylvania, USA; and the recent series of two coordinated attacks in Brussels (Belgium), on March 22, 2016, involving two bombings at the departure hall of Brussels International Airport and a bombing at Maalbeek Metro Station located near the European Commission headquarters in the center of Brussels. This statement paper deals with different aspects of hospital policy and disaster response planning that interface with terrorism. Research shows that the availability of necessary equipment and facilities (eg, personal protective clothing, decontamination rooms, antidotes, and anti-viral drugs) in hospitals clearly is insufficient. Emergency teams are insufficiently prepared: adequate and repetitive training remain necessary. Unfortunately, there are many examples of health care workers and physicians or hospitals being targeted in both political or religious conflicts and wars. Many health workers were kidnapped and/or killed by insurgents of various ideology. Attacks on hospitals also could cause long-term effects: hospital units could be unavailable for a long time and replacing staff could take several months, further compounding hospital operations. Both physical and psychological (eg, posttraumatic stress disorder [PTSD]) after-effects of a terrorist attack can be detrimental to health care services. On the other hand, physicians and other hospital employees have shown to be involved in terrorism. As data show that some offenders had a previous history with the location of the terror incident, the possibility of hospitals or other health care services being targeted by insiders is discussed. The purpose of this report was to consider how past terrorist incidents can inform current hospital preparedness and disaster response planning
Pirlich, Matthias; Schütz, Tatjana; Norman, Kristina; Gastell, Sylvia; Lübke, Heinrich Josef; Bischoff, Stephan C; Bolder, Ulrich; Frieling, Thomas; Güldenzoph, Helge; Hahn, Kristian; Jauch, Karl-Walter; Schindler, Karin; Stein, Jürgen; Volkert, Dorothee; Weimann, Arved; Werner, Hansjörg; Wolf, Christiane; Zürcher, Gudrun; Bauer, Peter; Lochs, Herbert
Malnutrition is frequently observed in chronic and severe diseases and associated with impaired outcome. In Germany general data on prevalence and impact of hospital malnutrition are missing. Nutritional state was assessed by subjective global assessment (SGA) and by anthropometric measurements in 1,886 consecutively admitted patients in 13 hospitals (n=1,073, university hospitals; n=813, community or teaching hospitals). Risk factors for malnutrition and the impact of nutritional status on length of hospital stay were analyzed. Malnutrition was diagnosed in 27.4% of patients according to SGA. A low arm muscle area and arm fat area were observed in 11.3% and 17.1%, respectively. Forty-three % of patients 70 years old were malnourished compared to only 7.8% of patients malnutrition was observed in geriatric (56.2%), oncology (37.6%), and gastroenterology (32.6%) departments. Multivariate analysis revealed three independent risk factors: higher age, polypharmacy, and malignant disease (all PMalnutrition was associated with an 43% increase of hospital stay (PMalnutrition is associated with increased length of hospital stay. Higher age, malignant disease and major comorbidity were found to be the main contributors to malnutrition. Adequate nutritional support should be initiated in order to optimize the clinical outcome of these patients.
This paper examines the contested organizational legitimacy of hospital reconfiguration, which continues to be a central issue in health care management. A qualitative study which focuses on the controversial downsizing of Kidderminster Hospital, a highly publicized landmark case of district general hospital closure. Rhetorical strategies are analysed to examine how legitimacy was constructed by stakeholder groups and how these strategies were used to support or resist change. Stakeholders promoting change legitimized re-organization pragmatically and morally arguing the need for centralization as a rational necessity. Stakeholders resisting change argued for cognitive and moral legitimacy in current service arrangements, contrasting local versus regionalized aspects of safety and provision. Groups managed to talk past each other, failing to establish a dialogue, which led to significant conflict and political upheaval. Stakeholders value hospitals in different ways and argue for diverse accounts of legitimacy. Broader discourses of medical science and democratic participation were drawn into rhetorical texts concerning regionalization to render them more powerful.
de Micheli, Alfredo
The predecessor institutions of modern hospitals--Byzantine nosocómeion, European hospitale and Islamic maristan--were dissimilar both in their patients and their aims. The first charitable organizations in West Europe (Rome) and in the East (Cesarea in Cappadocia) were rather hospices. After the collapse of the Western Roman Empire (476 A.D.), some monastic centers were prepared to provide medical assistance to religious and secular patients. Since the XI and XII Centuries in all of Christian Europe the charitable institutions, designated as hospitale, multiplied. Among the Italian ones, the Roman Santo Spirito (Holy Ghost) Hospital, built in the 1201-1204 period, reached a preeminet position. This one soon became the most important of the entire Christendom (archihospital), with a lot of affiliated hospitals in Europe and later in America. The first American hospital, Saint Nicholas Hospital, opened on December 29, 1503 in Santo Domingo, obtained in 1541 its affiliation to the Santo Spirito archihospital. Regarding continental America, the first health centers were established in Mexico: the Immaculate Conception Hospital and the Saint Lazarus Hospital, both established by Hernán Cortés. For its part, clinical teaching was systematized at the Saint Francis Hospital in Padua and by there moved to Leyden. In Mexico, the chair of medical clinics or practical medicine was established in 1806 at the Saint Andrew Hospital. During the XX century, Dr. Ignacio Chávez was the driving force behind the creation of the modern Mexican Health Institutes. These ones are dedicated to the treatment of poor patients, as well as to medical teaching and research.
The spreading cult of Christ the Healer during the Medieval period led to sick-nursing being viewed as a Christian duty. This encouraged royal dignitaries and philantrophic individuals to donate funds towards the institution and maintenance of a hospital or hospice, the management of these institutions being often shared with religious authorities. The Maltese Islands have been serviced by a series of hospitals, the earliest dating to the fourteenth century. In line with the ch...
Haghighathoseini, Atefehsadat; Bobarshad, Hossein; Saghafi, Fatehmeh; Rezaei, Mohammad Sadegh; Bagherzadeh, Nader
Nowadays developing smart and fast services for patients and transforming hospitals to modern hospitals is considered a necessity. Living in the world inundated with information systems, designing services based on information technology entails a suitable architecture framework. This paper aims to present a localized enterprise architecture framework for the Iranian university hospital. Using two dimensions of implementation and having appropriate characteristics, the best 17 enterprises frameworks were chosen. As part of this effort, five criteria were selected according to experts' inputs. According to these criteria, five frameworks which had the highest rank were chosen. Then 44 general characteristics were extracted from the existing 17 frameworks after careful studying. Then a questionnaire was written accordingly to distinguish the necessity of those characteristics using expert's opinions and Delphi method. The result showed eight important criteria. In the next step, using AHP method, TOGAF was chosen regarding having appropriate characteristics and the ability to be implemented among reference formats. In the next step, enterprise architecture framework was designed by TOGAF in a conceptual model and its layers. For determining architecture framework parts, a questionnaire with 145 questions was written based on literature review and expert's opinions. The results showed during localization of TOGAF for Iran, 111 of 145 parts were chosen and certified to be used in the hospital. The results showed that TOGAF could be suitable for use in the hospital. So, a localized Hospital Enterprise Architecture Modelling is developed by customizing TOGAF for an Iranian hospital at eight levels and 11 parts. This new model could be used to be performed in other Iranian hospitals. Copyright © 2018 Elsevier B.V. All rights reserved.
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
Broom, Kevin; Elliott, Michael; Lee, Jen-Fu
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 NFP and IO
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 purpose....... The literature concerning the potential use of emergency US in the pre-hospital setting is evaluated. Evidence from both Europe and the USA indicates that pre-hospital US improves diagnosis and visitation of acutely ill or traumatized patients. Udgivelsesdato: 2009-Aug-31...
Full Text Available Aim: The purpose of this study is to identify the level of job satisfaction among hospital pharmacists in Romania in relation to environmental, socio-demographic, and individual factors. Material and Methods: Seventy-eight hospital pharmacists were included in the research. The Job Satisfaction Scale was used to measure the level of satisfaction with their current jobs, and the TAS-20 was used to evaluate emotional experience and awareness. Additionally, 12 items were formulated in order to identify the reasons for dissatisfaction with jobs, such as budget, number of working hours, legislation, relationships with colleagues, hospital departments, or stakeholders. Data were analyzed using IBM SPSS Statistics version 23. Results: The analyses of the data revealed a low level of satisfaction regarding the pay–promotion subscale, a high level of satisfaction with the management–interpersonal relationship dimension, and a high level of satisfaction regarding the organization–communication subscale. Seventy-four percent of subjects are dissatisfied about the annual budget, and 86.3% are not at all satisfied with present legislation. Conclusions: These results are important for hospital pharmacists and hospital management in order to focus on health policies, management, and environmental issues, with the purpose of increasing the level of satisfaction among hospital pharmacists.
Pan, Zhi Xiong; Pokharel, Shaligram
The purpose of this paper is to investigate logistics activities in Singapore hospitals. It defines various types of activities handled by a logistics division. Inventory management policy and the use of information and communication technologies (ICT) for logistics purposes are also discussed. The study identifies the nature of strategic alliances in Singapore's health care industry. This study was conducted by utilizing a framework for data collection, pre-testing the questionnaire and conducting interviews. Various relevant literature was reviewed to design the questionnaire. This study finds that logistics division carry out many related activities and some of them also provide engineering services. The hospitals make use of ICT. The hospitals are clustered under various groups to minimize the cost of operation, including the logistics related costs. However, hospitals do not see alliances with suppliers as a strategic option; rather they focus on outsourcing of logistics services. The findings also show that Singapore hospitals have a good stocking policy for both medical and non-medical items so that changes in patient mix can be easily handled. Singapore is continuously improving its health care industry and therefore, the findings will help hospitals in other regions to adopt some of the practices, like concentrating on local vendors, outsourcing, clustering, and maximum use of information technology as competitive factors that can improve the service and reduce the cost of operation. The paper suggests motivators and barriers to the use of ICT in logistics in the health care industry.
Iorga, Magdalena; Dondaș, Corina; Soponaru, Camelia; Antofie, Ioan
Aim : The purpose of this study is to identify the level of job satisfaction among hospital pharmacists in Romania in relation to environmental, socio-demographic, and individual factors. Material and Methods : Seventy-eight hospital pharmacists were included in the research. The Job Satisfaction Scale was used to measure the level of satisfaction with their current jobs, and the TAS-20 was used to evaluate emotional experience and awareness. Additionally, 12 items were formulated in order to identify the reasons for dissatisfaction with jobs, such as budget, number of working hours, legislation, relationships with colleagues, hospital departments, or stakeholders. Data were analyzed using IBM SPSS Statistics version 23. Results : The analyses of the data revealed a low level of satisfaction regarding the pay-promotion subscale, a high level of satisfaction with the management-interpersonal relationship dimension, and a high level of satisfaction regarding the organization-communication subscale. Seventy-four percent of subjects are dissatisfied about the annual budget, and 86.3% are not at all satisfied with present legislation. Conclusions : These results are important for hospital pharmacists and hospital management in order to focus on health policies, management, and environmental issues, with the purpose of increasing the level of satisfaction among hospital pharmacists.
Full Text Available No abstract available. Article truncated after 150 words. The Centers for Medicare and Medicaid Services (CMS is penalizing 758 hospitals with higher rates of patient safety incidents, and more than half of those were also fined last year, as reported by Kaiser Health News (1. Among the hospitals being financially punished are some well-known institutions, including Yale New Haven Hospital, Medstar Washington Hospital Center in DC, Grady Memorial Hospital, Northwestern Memorial Hospital in Chicago, Indiana University Health, Brigham and Womens Hospital, Tufts Medical Center, University of North Carolina Hospital, the Cleveland Clinic, Hospital of the University of Pennsylvania, Parkland Health and Hospital, and the University of Virginia Medical Center (Complete List of Hospitals Penalized 2016. In the Southwest the list includes Banner University Medical Center in Tucson, Ronald Reagan UCLA Medical Center, Stanford Health Care, Denver Health Medical Center and the University of New Mexico Medical Center (for list of Southwest hospitals see Appendix 1. In total, CMS ...
Norotte, C; Omnès, C; Crozier, C; Verlyck, C; Romanos, M
The availability of short-stay beds for brief admission (less than 72hours) of crisis patients presenting to the emergency room is a model that has gained a growing interest because it allows time for developing alternatives to psychiatric hospitalization and favors a maintained functioning in the community. Still, the determinants influencing the disposition decision at discharge after crisis intervention remain largely unexplored. The primary objective of this study was to determine the factors predicting aftercare dispositions at crisis unit discharge: transfer for further hospitalization or return to the community. Secondary objectives included the description of clinical and socio-demographic characteristics of patients admitted to the crisis unit upon presentation to the emergency room. All patients (n=255) admitted to the short-stay unit of the emergency department of Rambouillet General Hospital during a one-year period were included in the study. Patient characteristics were collected in a retrospective manner from medical records: patterns of referral, acute stressors, presenting symptoms, initial patient demand, Diagnostic and Statistical Manual, 5th edition (DSM-5) disorders, psychiatric history, and socio-demographic characteristics were inferred. Logistic regression analysis was used to determine the factors associated with hospitalization decision upon crisis intervention at discharge. Following crisis intervention at the short-stay unit, 100 patients (39.2%) required further hospitalization and were transferred. Statistically significant factors associated with a higher probability of hospitalization (P<0.05) included the patient's initial wish to be hospitalized (OR=4.28), the presence of a comorbid disorder (OR=3.43), a referral by family or friends (OR=2.89), a history of psychiatric hospitalization (OR=2.71) and suicidal ideation on arrival in the emergency room (OR=2.26). Conversely, significant factors associated with a lower probability of
Walther-Larsen, S; Pedersen, M T; Friis, S M
admitted the same day. The single most common painful procedure named by the children was needle procedures, such as blood draw and intravenous cannulation. CONCLUSION: This study reveals high pain prevalence in children across all age groups admitted to four Danish university hospitals. The majority......BACKGROUND: Pain management in hospitalized children is often inadequate. The prevalence and main sources of pain in Danish university hospitals is unknown. METHODS: This prospective mixed-method cross-sectional survey took place at four university hospitals in Denmark. We enrolled 570 pediatric...... patients who we asked to report their pain experience and its management during the previous 24 hours. For patients identified as having moderate to severe pain, patient characteristics and analgesia regimes were reviewed. RESULTS: Two hundred and thirteen children (37%) responded that they had experienced...
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...
Full Text Available How do European governments conceptualize what they call "hospitality" when they draft immigration laws and when they allow the concepts of asylum, of illegal immigrants, to change according to a constantly evolving political context? What consequences…
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...
... ency/patientinstructions/000499.htm Latex allergies - for hospital patients To use the sharing features on this page, ... ADAM Health Solutions. About MedlinePlus Site Map FAQs Customer Support Get email updates Subscribe to RSS Follow ...
Principal Contact. Dr Sjoerd A Gehrels Editor-in-Chief Stenden Hotel Management School, Academy of International Hospitality Research, Leeuwarden, The Netherlands Email: firstname.lastname@example.org ...
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
Full Text Available The importance of waste management in hospitals is indisputable in preserving the environment and protecting public health, but management models are rarely discussed. This study presents the legal and conceptual frameworks of good waste management practices applicable to hospitals and associated indicators. As a case study, the overall performance of Hospital Centre of São João, in Porto, was analysed based on published reports. Data on the production of waste in their different typologies were collected from 2010 to 2016, enabling a correlation of the waste production with the kg/bed/day indicator. The aim of this study was to gather data and discuss trends in a real scenario of evolution over a six-year period in order to contribute to a future research proposal on indicators that can be used as reference for benchmarking the construction of methodological guides for hospital waste management.
Unger, W J
This report describes how acute-care community hospitals in the United States get paid for services when their patients either are entitled to Medicare or Medicaid benefits or subscribe to a Blue Cross or Blue Shield plan, a commercial insurance plan, a health maintenance organization, a preferred provider organization, or some other third-party payment mechanism. The focus of this report is on cardiac services, which are the most common type of inpatient services provided by acute-care community hospitals. Over the past three decades, extraordinary advances in medical and surgical technologies as well as healthier life-styles have cut the annual death rate for coronary heart disease in half. Despite this progress, cardiovascular disease remains the number one cause of hospitalization. On average nationwide, diseases and disorders of the circulatory system are the primary reason for 17 percent of all patient admissions, and among the nation's 35 million Medicare beneficiaries they are the primary reason for 25 percent of all admissions. In the United States heart disease is the leading cause of death and a major cause of morbidity. Its diagnosis and treatment are often complex and costly, often requiring multiple hospitalizations and years of medical management. To focus management attention and resources on the immense cardiology marketplace, many hospitals have hired individuals with strong clinical backgrounds to manage their cardiology programs. These "front-line" managers play a key role in coordinating a hospital's services for patients with cardiovascular disease. Increasingly, these managers are being asked to become active participants in the reimbursement process. This report was designed to meet their needs. Because this report describes common reimbursement principles and practices applicable to all areas of hospital management and because it provides a "tool kit" of analytical, planning, and forecasting techniques, it could also be useful to hospital
Bauerschmidt, A D; Jacobs, P
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...
Ruth Rios-Morales; Ian Jenkins
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...
Schmidt-Wilcke, Heinrich Alyosius
The self-concept of hospitals today includes the role of service providers, and so they act accordingly. This attitude is chiefly held by hospital administrators. It means that at management level there is a shift of values toward business ethics. However, hospital management is responsible not only for the business aspects of the hospital but also for the provision of adequate medical care to patients. Therefore, hospitals as service providers must be governed by the principles of medical as well as of business ethics. These principles, although from different areas, can be made to largely coincide, but can also lead to divergent positions within a hospital. The result is what within the scope of medical ethics, too, is experienced as a conflict of principles, e.g., the principle of beneficence versus the principle of autonomy. A reconciliation of such divergent moral positions can often be effected by analyzing the actual conflict situation and thus reaching consensus. The conflict between the principles of medical ethics and business ethics takes place chiefly within the sphere of activity of those providing medical and nursing care. As a consequence, a necessary business decision taken by the management to improve the productivity of medical and nursing activities can lead to serious deficits on the staff side. In terms of business ethics, this is a lack of beneficence toward individual staff members that are perhaps overtaxed, and at the same time, in terms of medical ethics, a potential lack of beneficence toward hospital patients is implicitly accepted. In general, management has the responsibility for bringing about, in the day-to-day operation of a hospital, a plausible reconciliation of the ethical principles of two spheres of activity that are only apparently independent of each other.
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...
... Payment Systems for Acute Care Hospitals and the Long Term Care Hospital Prospective Payment System and... Register entitled ``Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long Term Care Hospital Prospective Payment System and Fiscal Year 2013 Rates; Hospitals...
Fara, G M; Barni, M
The paper explains the reasons according to which the newly-planned hospitals must adopt the concept of advanced flexibility (structural, technological, organizational, diagnostic and therapeutic), in order to avoid the risk of being already obsolete at the moment of their opening, and this due to the fact that too much time elapses in this Country between the moment of planning a new hospital and the moment of the start of its activity. Flexibility is needed at different levels: at low or medium levels for what concerns administrative spaces and also patient rooms (except, in this latter case, when differential intensity of care is adopted); at advanced levelfor what concerns diagnostic and therapeutic areas, which must be rapidly adaptable to new solutions offered by advances in technology and organization. From a different standpoint, flexibility applies also to the fact that hospital must increasingly become a node of a large net including territorial health services: the latter devoted to take care of chronicity, while hospitals should concentrate on acute pathology. Of course the territory surrounding the hospital, through its outpatient service and consultories, is in charge also for first level diagnosy and therapy, leaving the hospital to more sophisticated activities.
Kjekshus, L E
The motivation to identify the causes of rising health care cost and variations across providers has intensified in all industrialized countries. These countries have an ongoing debate on efficiency and effectiveness in hospital production. In this debate, national and international comparative studies are important. There are very few international comparative studies that include Norwegian hospitals. Actually we know very little about how Norwegian hospitals are performing compared to others. This paper gives an introduction to comparative studies and to the DEA model which is often used in such studies and also a multilevel model which is not so common. A short review is given of a comparative study of Norwegian and North American hospitals. I also discuss the feasibility of comparative studies of hospitals from the Nordic countries, with references to several comparative studies performed in these countries. Comparative studies are often closely linked to national health politics, policy making and reforms; thus the outcome of such studies is important for the hospitals included. This makes such studies a sensitive field of research. It is important to be aware of the strength and weaknesses of comparative studies and acknowledge their importance beyond the development of new knowledge.
Silk, Benjamin J; McCoy, Morgan H; Iwamoto, Martha; Griffin, Patricia M
Listeriosis is characterized by bacteremia or meningitis. We searched for listeriosis case series and outbreak investigations published in English by 2013, and assessed the strength of evidence for foodborne acquisition among patients who ate hospital food. We identified 30 reports from 13 countries. Among the case series, the median proportion of cases considered to be hospital-acquired was 25% (range, 9%-67%). The median number of outbreak-related illnesses considered to be hospital-acquired was 4.0 (range, 2-16). All patients were immunosuppressed in 18 of 24 (75%) reports with available data. Eight outbreak reports with strong evidence for foodborne acquisition in a hospital implicated sandwiches (3 reports), butter, precut celery, Camembert cheese, sausage, and tuna salad (1 report each). Foodborne acquisition of listeriosis among hospitalized patients is well documented internationally. The number of listeriosis cases could be reduced substantially by establishing hospital policies for safe food preparation for immunocompromised patients and by not serving them higher-risk foods. Published by Oxford University Press on behalf of the Infectious Diseases Society of America 2014. This work is written by (a) US Government employee(s) and is in the public domain in the US.
Zarei-Mahmoudabadi, A; Zarrin, M; Ghanatir, F; Vazirianzadeh, B
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. 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. 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%). 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.
Bravi, F; Gibertoni, D; Marcon, A; Sicotte, C; Minvielle, E; Rucci, P; Angelastro, A; Carradori, T; Fantini, M P
Hospital networks are an emerging organizational form designed to face the new challenges of public health systems. Although the benefits introduced by network models in terms of rationalization of resources are known, evidence about stakeholders' perspectives on hospital network performance from the literature is scanty. Using the Competing Values Framework of organizational effectiveness and its subsequent adaptation by Minvielle et al., we conducted in 2009 a survey in five hospitals of an Italian network for oncological care to examine and compare the views on hospital network performance of internal stakeholders (physicians, nurses and the administrative staff). 329 questionnaires exploring stakeholders' perspectives were completed, with a response rate of 65.8%. Using exploratory factor analysis of the 66 items of the questionnaire, we identified 4 factors, i.e. Centrality of relationships, Quality of care, Attractiveness/Reputation and Staff empowerment and Protection of workers' rights. 42 items were retained in the analysis. Factor scores proved to be high (mean score>8 on a 10-item scale), except for Attractiveness/Reputation (mean score 6.79), indicating that stakeholders attach a higher importance to relational and health care aspects. Comparison of factor scores among stakeholders did not reveal significant differences, suggesting a broadly shared view on hospital network performance. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.
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.
de Korne, Dirk F; van Wijngaarden, Jeroen D H; Sol, Kees J C A; Betz, Robert; Thomas, Richard C; Schein, Oliver D; Klazinga, Niek S
Benchmarking is increasingly considered a useful management instrument to improve quality in health care, but little is known about its applicability in hospital settings. The aims of this study were to assess the applicability of a benchmarking project in U.S. eye hospitals and compare the results with an international initiative. We evaluated multiple cases by applying an evaluation frame abstracted from the literature to five U.S. eye hospitals that used a set of 10 indicators for efficiency benchmarking. Qualitative analysis entailed 46 semistructured face-to-face interviews with stakeholders, document analyses, and questionnaires. The case studies only partially met the conditions of the evaluation frame. Although learning and quality improvement were stated as overall purposes, the benchmarking initiative was at first focused on efficiency only. No ophthalmic outcomes were included, and clinicians were skeptical about their reporting relevance and disclosure. However, in contrast with earlier findings in international eye hospitals, all U.S. hospitals worked with internal indicators that were integrated in their performance management systems and supported benchmarking. Benchmarking can support performance management in individual hospitals. Having a certain number of comparable institutes provide similar services in a noncompetitive milieu seems to lay fertile ground for benchmarking. International benchmarking is useful only when these conditions are not met nationally. Although the literature focuses on static conditions for effective benchmarking, our case studies show that it is a highly iterative and learning process. The journey of benchmarking seems to be more important than the destination. Improving patient value (health outcomes per unit of cost) requires, however, an integrative perspective where clinicians and administrators closely cooperate on both quality and efficiency issues. If these worlds do not share such a relationship, the added
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.
Weinstein, Henry C
The term 'security hospital' is used for a variety of facilities including forensic hospitals and prison hospitals, which, because of their mission, the nature of their work, and the populations they serve-or because of the authority under which they operate-place the staff at considerable risk of ethical violations related to either clinical care or to forensic activities. The problem of divided loyalties is of special concern in security hospitals. Ethics principles particularly at risk are confidentiality and informed consent. Where there are cultural disparities between the staff and the patients, differences in background, socioeconomic class, education, and other types of diversity, cultural awareness is required and must be reflected in appropriate treatment and evaluation. To counteract the risks of ethical violations, a security hospital should create an ethical climate and develop means to anticipate, prevent, and deal with ethical violations. These might include detailed and specific policies and procedures, programs of orientation, education, consultation, and liaison as well as its own ethics committee. Copyright 2002 John Wiley & Sons, Ltd.
Full Text Available Hospital ships are operated by the Naval forces in or near war zones to provide medical assistance to the wounded personnel of all nationalities and not be used for any military purpose. Hospital ships possibly existed in ancient times and the Athenian Navy had a ship named Therapia. However, it was only during the 17th century that it became a common practice for the naval squadrons to be accompanied by large ships with the facilities of carrying the wounded after each engagement. In 1860, the steamships HMS Melbourne and HMS Mauritius were equipped with genuine medical facilities. They were manned by the Medical Staff Corps and provided services to the British expedition to China. During the World War I and World War II, passenger ships were converted for use as hospital ships and were started to be used on a massive scale. RMS Aquitania and HMHS Britannic were two famous examples of hospital ships used extensively. Modern US hospital ships USNS Mercy and USNS Comfort are operated by Military Sealift Command of the US Navy. Their primary mission is to provide emergency on-site care for US combatant forces deployed in war or other operations.
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
Vessey, Judith A
The data-based literature addressing children's psychological responses to hospitalization was reviewed using methods outlined by Cooper (1989). Using a developmental science perspective, early research was reviewed and a model of variables that contribute to children's responses was constructed. This model consists of three major foci, including maturational and cognitive variables (developmental level, experience, coping style), ecological variables (family and hospital milieu), and biological variables (inborn factors and pathophysiology). Coping serves as the overarching framework for examining these variables and their contributions to children's responses to hospitalization. A variety of theoretical perspectives from the social sciences have been used, with psychoanalytic and stress and adaptation theories predominating. The majority of the research used simple case study, descriptive, or pre- and post-test designs. Methodologic issues were common. Little qualitative work has been done. Future research directions call for studies to adopt new theoretical and empirical models that are methodologically rigorous and clinically relevant and that embrace the precepts of developmental science.
Nissen, Nina Konstantin; Madsen, Mette; Kjøller, Mette
at relatives of patients with cardiac diseases is sparse. This study aimed to survey the prevalence of health services for relatives of cardiac patients in Denmark. METHODS: We surveyed activities offered by Danish hospitals to the relatives of cardiac patients. Data were obtained from an Internet-based survey...... and 50 of 55 invited hospital departments participated. RESULTS: Almost all departments offer activities to relatives of cardiac patients, but only one-quarter have activities specifically aimed at supporting relatives. Large departments offer activities for relatives more often than smaller departments....... Participation rates for relatives are generally low, and the departments experience numerous barriers in providing activities for relatives of heart patients. CONCLUSIONS: Danish hospitals focus very little on relatives of cardiac patients, and this seems to be due to several factors, including lack...
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...
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.
Clement, J P; Grazier, K L
The purpose of this study is to determine the extent to which health maintenance organization (HMO) penetration within the public hospitals' market area affects the financial performance and viability of these institutions, relative to private hospitals. Hospital- and market-specific measures are examined in a fully interacted model of over 2,300 hospitals in 321 metropolitan statistical areas (MSAs) in 1995. Although hospitals located in markets with higher HMO penetration have lower financial performance as reflected in revenues, expenses and operating margin, public hospitals are not more disadvantaged than other hospitals by managed care.
Sweigart, Joseph R; Tad-Y, Darlene; Kneeland, Patrick; Williams, Mark V; Glasheen, Jeffrey J
Hospital medicine (HM) is rapidly evolving into new clinical and nonclinical roles. Traditional internal medicine (IM) residency training likely does not optimally prepare residents for success in HM. Hospital medicine residency training tracks may offer a preferred method for specialized HM education. Internet searches and professional networks were used to identify HM training tracks. Information was gathered from program websites and discussions with track directors. The 11 HM tracks at academic medical centers across the United States focus mostly on senior residents. Track structure and curricular content are determined largely by the structure and curricula of the IM residency programs in which they exist. Almost all tracks feature experiential quality improvement projects. Content on healthcare economics and value is common, and numerous track leaders report this content is expanding from HM tracks into entire residency programs. Tracks also provide opportunities for scholarship and professional development, such as workshops on abstract creation and job procurement skills. Almost all tracks include HM preceptorships as well as rotations within various disciplines of HM. HM residency training tracks focus largely on quality improvement, health care economics, and professional development. The structures and curricula of these tracks are tightly linked to opportunities within IM residency programs. As HM continues to evolve, these tracks likely will expand to bridge clinical and extra-clinical gaps between traditional IM training and contemporary HM practice. Journal of Hospital Medicine 2017;12:173-176. © 2017 Society of Hospital Medicine
Kuntz, Ludwig; Vera, Antonio
The concept of modularization represents a modern form of organization, which contains the vertical disaggregation of the firm and the use of market mechanisms within hierarchies. The objective of this paper is to examine whether the use of modular structures has a positive effect on hospital performance. The empirical section makes use of multiple regression analyses and leads to the main result that modularization does not have a positive effect on hospital performance. However, the analysis also finds out positive efficiency effects of two central ideas of modularization, namely process orientation and internal market mechanisms.
Ian Campbell's paper, originally delivered at a conference on the development of 'The reflective practitioner' while he was Unit General Manager of Sunderland Royal Infirmary, describes the liaison between general and nurse managers in the hospital. Management must give a hospital organisation direction and must set the parameters of corporate and individual performance, but it must also be responsive to the feedback received from practising clinicians. The key concept is quality of service, and in this managers and practitioners can work together towards a common goal.
Kini, K.S.; Gaur, P.K.
Short-lived radiopharmaceuticals, such as 99m Tc labelled compounds, are prepared in the in-house pharmacy of the hospital. In addition, preparation of smaller doses for administration from the bulk material of the finished product received from the manufacturers, also involves considerable work for the radiopharmacist in the hospital. Hence they should be well informed about the radiation hazards and should be aware of the protective measures to be taken while handling radioactive materials for keeping the radiation levels in the laboratory and their personnel doses well within the specified limits. 3 refs., 5 tabs
Henríquez Martínez, T; Armero Fuster, M
A review of the following points was performed: Factors favouring the development and presence of malnutrition among hospitalized patients. Useful parameters in nutritional evaluation. Types of malnutrition. The Chang nutritional evaluation protocol is used in our Hospital, which is simple, inexpensive, reliable, specific and easily reproduced. This is based on five variables (three anthropometric and two biochemical), randomized and based on reference tables and values. A study was made on data corresponding to 70 patients, in whom a prevalence of malnutrition was observed in critical patients. The patients were classified based on three different definitive possibilities (Marasmo, Kwashiorkor and combined), and three grades of malnutrition (slight, moderate and severe).
Full Text Available Responsible management of global hospitality companies increasingly recognizes how important are concerns about the society, the environment as well as all stakeholders in maintaining a good market position. In Serbia, the concept of corporate social responsibility is relatively unknown and insufficiently researched in all business areas, especially in the hospitality industry where small businesses are dominated. The papers task is to present particular activities that demonstrate social responsibility to employees, customers-guests, local communities as well as the environment. The paper aims to highlight the benefits of adopting the principles of corporate social responsibility and innovation applied in catering enterprises as an example of good corporate social responsibility practices.
Haindl, Friedrich F.
Full Text Available It consists of: the actual hospital, one house for the staff, one service yard and underground garage. The hospital comprises four storeys and two basements, whilst the other building only has three floors. On the ground floor of the hospital are we located: the entrance; the nucleus of vertical communication; work rooms for the doctors and nurses; the administration section; X-ray and cobalt installations; and a small chapel. The three remaining upper floors contain 160 beds distributed over 6 wards and in single, double or triple rooms. Each floor is equipped with a service section. The first basement includes the ambulance entrance, the medical wards of the hospital, the staff dining-room, a kitchen and the heating installation. The second basement is reserved for kitchen storage rooms and the remaining installations of the building. Structure of reinforced concrete and outer walls of brick covered with panels of washed concrete.Está formado por: el hospital propiamente dicho, un edificio destinado a viviendas para el personal, patio de servicio y garaje subterráneo. El hospital consta de cuatro plantas y dos sótanos, mientras que el otro edificio sólo tiene tres plantas. En la planta baja del hospital se encuentran: la entrada; el núcleo de comunicación vertical; las salas de trabajo de médicos y enfermeras; la zona de administración; las instalaciones de rayos X y bomba de cobalto; y una pequeña capilla. En las tres plantas superiores se distribuyen 160 camas repartidas en seis unidades de hospitalización, con habitaciones de 1, 2 ó 3 camas. Cada planta cuenta, además, con una zona de servicio. En el primer sótano se hallan, además de la entrada de ambulancias, los servicios médicos del hospital, los comedores del personal, una cocina, y la instalación de calefacción. El segundo sótano se dedica, en su totalidad, a almacenes de la cocina y del resto de las instalaciones del edificio. Estructura de
Bricknell, M C M
This paper examines the challenges involved in commanding a field hospital. There are frequent, dynamic tensions between the military culture that is based on a task-focussed, hierarchical structure and the clinical culture that is based on flat, process-focussed, multidisciplinary teams. The paper outlines the cultural environment of the field hospital and then examines the deployment sequence whereby a functioning clinical facility may be created from a group of disparate individuals. There are a number of tools that may assist with this including the personality of the Commanding Officer, individual skills, the creation of an organizational identity and the choice of command structure.
Ferrier, Maud; Lariviere, David; Laurent, Claire; Roque, Eric
This article was written by four French hospital director students at the Ecole des Hautes Etudes en Santé Publique (EHESP-School of Public Health) from a study conducted jointly with students at the Grenoble School of Management to present an international overview of hospital procurement methods in ten countries. An analysis of these methods showed that there was a general trend towards group purchasing, with some common aims in terms of costs and performance and some differences in legislation (competition), size of the public sector and centralization or decentralization.
Computers have been used to automate complex and repetitive tasks in veterinary hospitals since the 1960s. Early systems were expensive, but their use was justified because they performed jobs which would have been impossible or which would have required greater resources in terms of time and personnel had they been performed by other methods. Systems found in most veterinary hospitals today are less costly, magnitudes more capable, and often underused. Modern multitasking operating systems and graphical interfaces bring many opportunities for automation. Commercial and custom programs developed and used in a typical multidoctor mixed species veterinary practice are described.
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...
Reddy, Madhu C; Purao, Sandeep; Kelly, Mary
This article presents a study identifying benefits and challenges of a novel hospital-to-hospital information technology (IT) outsourcing partnership (HHP). The partnership is an innovative response to the problem that many smaller, rural hospitals face: to modernize their IT infrastructure in spite of a severe shortage of resources. The investigators studied three rural hospitals that outsourced their IT infrastructure, through an HHP, to a larger, more technologically advanced hospital in the region. The study design was based on purposive sampling and interviews of senior managers from the four hospitals. The results highlight the HHP's benefits and challenges from both the rural hospitals' and vendor hospital's perspectives. The HHP was considered a success: a key outcome was that it has improved the rural hospitals' IT infrastructure at an affordable cost. The investigators discuss key elements for creating a successful HHP and offer preliminary answers to the question of what it takes for an HHP to be successful.
...; RIN 0938-AP33 Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System Changes and FY 2011 Rates; Provider... Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective...
... Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Fiscal... 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...
... Payment Systems for Acute Care Hospitals and the Long Term Care Hospital Prospective Payment System and... Federal Register entitled ``Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long Term Care Hospital Prospective Payment System and Fiscal Year 2013 Rates...
... other than psychiatric hospitals. 424.13 Section 424.13 Public Health CENTERS FOR MEDICARE & MEDICAID... other than psychiatric hospitals. (a) Content of certification and recertification. Medicare Part A pays for inpatient hospital services of hospitals other than psychiatric hospitals only if a physician...
Since 1994, hospital pharmaceutical teams have been in charge of pharmaceutical tasks in "unités de consultation et de soins ambulatoires" (UCSA), which are hospital consulting care units in French prisons. In 2008, pharmaceutical team in Parisian prisons received 6500 prescriptions and prepared 85,000 nominative bags containing drugs. Prisoners were 1.3% to receive treatments against HIV, 8.2% cardiovascular drugs, 7.2% opioid substitution treatments, and 52.9% psychoactive drugs, including 39.3% hypnotics, 40.5% anxiolytics, 11.3% antidepressants and 12.2% neuroleptics. In prison, the dichotomy between somatic and mental care is marked, attitudes of prisoners about their medicines are complex (important claims, embezzlement, etc.) and it is difficult for law defendants to maintain treatment confidentiality and to prepare prison outing in terms of health. To attenuate the heterogeneity of drug distribution systems in French prisons, we propose pharmaceutical analysis of prescriptions and nominative dispensation, computerization in UCSA in coordination with hospitals, a better contribution of prison medical and pharmaceutical staff in hospital "drug committees" and the redaction of pharmaceutical guidelines. Acting in concert with multidisciplinary medical staff in UCSA, pharmaceutical teams have to develop epidemiological studies to improve knowledge in prisoner's health and also prevention and health care in prison. Copyright © 2010 Elsevier Masson SAS. All rights reserved.
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
Turnbull, Angus; Osborn, Michael; Nicholas, Nick
To determine the hospital autopsy rate for the UK in 2013. A study of data from a 'Freedom of Information' request to all (n=186) acute NHS Trusts within England (n=160), NHS Boards in Scotland (n=14) and Wales (n=7) and Social Care Trusts in Northern Ireland (n=5). Hospital autopsy rates were calculated from the number of hospital autopsies performed in 2013 as a percentage of total inpatient deaths in the Trust that year. The UK response rate was 99% (n=184), yielding a mean autopsy rate of 0.69%. The mean rates were 0.51% (England), 2.13% (Scotland), 0.65% (Wales) and 0.46% (Northern Ireland). 23% (n=38) of all included respondents had a rate of 0% and 86% (n=143) a rate less than 1%. The decline in hospital autopsy has continued relentlessly and, for better or for worse, the practice is on the verge of extinction in the UK. The study highlights to health professionals and policy makers the magnitude of this decline. Further research should investigate the impact of this on patient safety, clinical audit, public health and medical education. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Hospitality customers are looking for systems that involve more than just turning the light on and off. They want lighting solutions that are energy-efficient, flexible and that will help enhance the guest experience. Based on on-going research about the impact that light can have in different
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...
Is there something distinct about the traditional Hospitality Management curriculum? First offered in 1893 at the Ecole Hoteliere Lausanne in Switzerland and launched in the United States at The School of Hotel Administration at Cornell University in 1922, has this course of study evolved over time to focus on both of Meyer's skills - originally based on technical skills but now transforming to emotional skills?
Papas, Anne; Dérémience, Virginie; Tettiravou, Lucia; De Poix, Alix Tyrel
A hospital stay without bedsores. The skin of elderly people is thin and fragile. After extended bed-rest, the skin's resources are rapidly depleted. The risk of bedsores becomes imminent. But a high-quality multi-disciplinary partnership can prevent bedsores in elderly patients with multiple illnesses. Example around a clinical case.
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. Copyright 2015, SLACK Incorporated.
HEJ reports on the major benefits seen at Basildon University Hospital in Essex through the installation of a sophisticated building energy management system, which also integrates features such as access control, security, and lighting control, and whose advantages are increasingly being experienced by an ever broader range of Trust users.
Before submitting a manuscript, authors should peruse and consult a recent issue of the Journal for format and style. ... The submission of a manuscript by the authors implies that they automatically agree to assign exclusive copyright to the publishers of the Research in Hospitality Management, NISC (Pty) Ltd. There are no ...
. Transparency in Medicine See How We're Doing Compare Military Health System Hospitals and Clinics TRICARE Online | ICE | OWA | Suicide Prevention Lifeline | 1-800-USA-NAVY | Navy Medicine | Military Health Child Street, Jacksonville, Florida 32214 This is an official U.S. Navy website. This is a Department of
from arrival in hospital to review by a clinician. Figure i of adequate cervical spine X-rays(22, 25). High pick-up summarizes our findings. rates are only attained with adequate X-rays. Studies done elsewhere have shown that up to 45% of initial. Clinical evaluation: Not all patients were assessed for. X-rays are inadequate.
Merode, van G.G.; Groothuis, S.; Hasman, A.
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
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.
Hospital capital investment is important for acquiring and maintaining technology and equipment needed to provide health care. Reduction in capital investment by a hospital has negative implications for patient outcomes. Most hospitals rely on debt and internal cash flow to fund capital investment. The great recession may have made it difficult for hospitals to borrow, thus reducing their capital investment. I investigated the impact of the great recession on capital investment made by California hospitals. Modeling how hospital capital investment may have been liquidity constrained during the recession is a novel contribution to the literature. I estimated the model with California Office of Statewide Health Planning and Development data and system generalized method of moments. Findings suggest that not-for-profit and public hospitals were liquidity constrained during the recession. Comparing the changes in hospital capital investment between 2006 and 2009 showed that hospitals used cash flow to increase capital investment by $2.45 million, other things equal.
Hospital capital investment is important for acquiring and maintaining technology and equipment needed to provide health care. Reduction in capital investment by a hospital has negative implications for patient outcomes. Most hospitals rely on debt and internal cash flow to fund capital investment. The great recession may have made it difficult for hospitals to borrow, thus reducing their capital investment. I investigated the impact of the great recession on capital investment made by California hospitals. Modeling how hospital capital investment may have been liquidity constrained during the recession is a novel contribution to the literature. I estimated the model with California Office of Statewide Health Planning and Development data and system generalized method of moments. Findings suggest that not-for-profit and public hospitals were liquidity constrained during the recession. Comparing the changes in hospital capital investment between 2006 and 2009 showed that hospitals used cash flow to increase capital investment by $2.45 million, other things equal. PMID:28617202
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
Guzmán Laura, K P; Periañez Vasco, A; Falcón Neyra, M D; Croche Santander, B
Varicella (chickenpox) can cause serious complications and admission to hospital. Several countries included the varicella vaccine in their immunization schedules. A descriptive and retrospective study of hospitalizations due to varicella and its complications was conducted in a referral center from 2005 to 2011. A total of 1192 children with varicella were seen in the emergency room, of which 99 (8.5%) required admission. The annual incidence of admissions due to varicella and varicella complications was, 19.4 and 15.3 cases per 100,000 children under 14 years, respectively. Complications were more common in children under 5 years (79.5%), and with no underlying disease (78.2%). Infection of skin and soft tissue was the most common complication (62%). The mean hospital stay was 4.5 days (SD 4). Varicella causes high morbidity, and is more frequent in absolute terms in healthy children under 5 years of age. Therefore, routine vaccination recommended by the Immunization Advisory Committee should be mandatory. Copyright © 2013 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.
Sanchez, P M
In recent years, hospital website marketing has witnessed explosive growth. Industry experts cite an almost 100% growth in hospital website marketing over the last several years. At one time lagging in the adoption of Internet technology, hospitals have now begun making significant strides in catching up with other industries. In spite of the general proliferation of hospital websites, however, the full potential of the Internet with its unique characteristics has yet to be realized. In this paper, current trends fueling the growth of hospital website marketing are first explored. Secondly, barriers to realizing the potential of website marketing are investigated. Finally, recommendations for improving hospital website marketing are developed.
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.
Full Text Available The aim of this work was to analyse the medication process and the potential for errors during the process steps. For this purpose, a literature review was conducted and a questionnaire was developed to compare the results from the literature with the current medication process in Styrian hospitals. The questionnaire was divided into four different parts with a total of 29 questions. For the survey all 37 Styrian hospitals were contacted whereas 11 filled out the questionnaire. The survey showed that there is no standardized medication process defined and that the rate of medication errors is generally underestimated. In addition, technical solutions may help to reduce errors but are expected to be hardly used in clinical practice.
Full Text Available Hospitality industry is a complex product-service economic activity which besides accommodation, food and beverages offers a variety of complementary and ancillary services in order to meet modern needs, demands and desires of tourists consumers. Contemporary needs, demands and desires of tourists consumers (increased need for security and preservation of health; emphasis on ecology and healthy food; pure nature stay; growing demand for adventure activities and excitement; convention facilities and incentive offerings; visits to towns, big sports, cultural, religious, business events; new travel motivation have led to the emergence of new trends in hospitality offering design. Wellness and spa hotels, boutique hotels, all inclusive hotels, slow-food restaurants, and wine and lounge bars are just some of the main trends, and successful hoteliers and caterers will examine each of the trends and devise development politics in accordance with the new requirements and global market needs.
Millsap, P; Brown, E; Kiser, L; Pruitt, D
Health-care professionals are currently operating in the context of a rapidly changing health-care delivery system, including the move away from inpatient services to outpatient services in order to control costs. Those who practice in partial-hospital settings are in a position to offer effective, cost-efficient services; however, there continue to be obstacles which hinder appropriate utilization of the modality. The development and use of a well-designed marketing plan is one strategy for removing these obstacles. This paper presents a brief overview of the marketing process, ideas for developing a marketing plan, and several examples of specific marketing strategies as well as ways to monitor their effectiveness. Partial-hospital providers must take an active role in answering the calls for alternative sources of psychiatric care. A comprehensive, education-oriented marketing approach will increase the public's awareness of such alternatives and enable programs to survive in a competitive environment.
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 m....... In most health-care environments, harmful microorganisms and infectious aerosols may exist in relatively high concentration. They are particularly harmful to patients due to reduced immunity, and to those with open wounds.......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...
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.
Herrick, J D
Some theories of how management can motivate employees to perform effectively, and the application of these theories to hospital pharmacy practice, are discussed. Types of extrinsic and intrinsic rewards and how they can best be allocated to encourage greater productivity are described. Management must be consistent and credible in its reward allocations in order to maintain the expectation of employees that increased effort will result in rewards. It is important also that management ascertains what employees interpret as desirable rewards.
Full Text Available Is there something distinct about the traditional Hospitality Management curriculum? First offered in 1893 at the Ecole Hoteliere Lausanne in Switzerland and launched in the United States at The School of Hotel Administration at Cornell University in 1922, has this course of study evolved over time to focus on both of Meyer's skills - originally based on technical skills but now transforming to emotional skills?
The experience and practice of the author is described in her appointment as a breast feeding advisor to the paediatric and obstetric units at University College Hospital with special responsibility for supervising infant feeding, especially breast feeding in the maternity unit. During 1980-5 there were 13,185 mothers whose babies fed. The feeding method of 12,842 mothers was recorded on discharge from the postnatal wards and 77% were breast feeding; only 3% of these mothers gave complement f...
Woo, Gon Kima, 1,; Hyunjung, Limb,; Robert, A. Brymerc, 2,
This paper investigates how managing online reviews affects hotel performance. An international hotel chain provided the hotel performance data and the online review data. A leading social media firm for the hospitality industry collected the online review data, which the hotel company purchased. The results indicate that overall ratings are the most salient predictor of hotel performance, followed by response to negative comments. The better the overall ratings and the higher the response ra...
The general structure of a regulatory scheme for the management of hospital radioactive wastes is presented. The responsabilities of an institution in the radioactive waste management, and storage conditions are defined. The radioactive wastes are classified in physical terms, and the criteria for evaluating the activity of solid wastes are described. The container characteristics and, the types of treatments given to the wastes are specified. (M.C.K.) [pt
Kumar, Sameer; Steinebach, Marc
Healthcare costs in the USA have continued to rise steadily since the 1980s. Medical errors are one of the major causes of deaths and injuries of thousands of patients every year, contributing to soaring healthcare costs. The purpose of this study is to examine what has been done to deal with the medical-error problem in the last two decades and present a closed-loop mistake-proof operation system for surgery processes that would likely eliminate preventable medical errors. The design method used is a combination of creating a service blueprint, implementing the six sigma DMAIC cycle, developing cause-and-effect diagrams as well as devising poka-yokes in order to develop a robust surgery operation process for a typical US hospital. In the improve phase of the six sigma DMAIC cycle, a number of poka-yoke techniques are introduced to prevent typical medical errors (identified through cause-and-effect diagrams) that may occur in surgery operation processes in US hospitals. It is the authors' assertion that implementing the new service blueprint along with the poka-yokes, will likely result in the current medical error rate to significantly improve to the six-sigma level. Additionally, designing as many redundancies as possible in the delivery of care will help reduce medical errors. Primary healthcare providers should strongly consider investing in adequate doctor and nurse staffing, and improving their education related to the quality of service delivery to minimize clinical errors. This will lead to an increase in higher fixed costs, especially in the shorter time frame. This paper focuses additional attention needed to make a sound technical and business case for implementing six sigma tools to eliminate medical errors that will enable hospital managers to increase their hospital's profitability in the long run and also ensure patient safety.
Anderson, W.; Trott, N.G.
The special problems of applying the basic principles of radiological protection in the environment of a hospital are outlined, the hospital being not only a workplace but also the temporary home of the patients. In these circumstances, close co-operation is needed between all groups of hospital staff. Many technical innovations have been made over the past 50 years in the applications of both ionizing and non-ionizing radiation for diagnosis and therapy and, at the present time, an intensive development of these applications is in progress. Within that context, the role of health physics has become a major one. There is the need to provide high standards in radiological protection of the staff, of members of the public, and increasingly, of the patient. At the same time, there is the need to provide sound perspective on hazards arising from exposure to various forms of radiation, whether ionizing or non-ionizing, for that perspective will influence future developments in this field. (author)
Brzović, Z; Richter, D; Simunić, S; Bozić, R; Hadjina, N; Piacun, D; Harcet, B
The periodic income and expenditure accounts produced at the hospital and departmental level enable successful short term management, but, in the long run do not help remove tensions between health care demand and limited resources, nor do they enable optimal medical planning within the limited financial resources. We are trying to estabilish disease category costs based on case mixing according to diagnostic categories (diagnosis related groups, DRG, or health care resource groups, HRG) and calculation of hospital standard product costs, e.g., radiology cost, preoperative nursing cost etc. The average DRG cost is composed of standard product costs plus any costs specific to a diagnostic category. As an example, current costing procedure for hip artheroplasty in the University Hospital Center Zagreb is compared to the management accounting approach based on British Health Care Resource experience. The knowledge of disease category costs based on management accounting requirements facilitates the implementation of medical programs within the given financial resources and devolves managerial responsibility closer to the clinical level where medical decisions take place.
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.
Jones, D A
Any effort to control the rise in health care costs must start with analyzing the causes, which are really quite simple. Most cost control efforts fail because they do not address the causes. The causes are large subsidies in several forms that send a false message that health care is free and should be used abundantly, and expansive reimbursement programs that reward inefficient providers with higher payments. This combination of demand stimulation and cost-plus reimbursement produced the world's most expensive health care delivery system and strident calls for reform. A long overdue change in public policy took effect October 1, 1983, when Medicare payments moved from cost-plus reimbursement to fixed, prospectively determined prices. Because it addressed one of the causes of medical inflation, this change has been effective in slowing the rise in Medicare expenditures. Sponsorship of a hospital is not a determinant of its cost-effectiveness. There are examples of efficient and inefficient hospitals in both the voluntary and the investor-owned or taxpaying hospitals. The determining factor is the will of management to keep costs under control.
Hornik, Christoph P; Graham, Eric M; Hill, Kevin; Li, Jennifer S; Ofori-Amanfo, George; Clark, Reese H; Smith, P Brian
Hospitalized infants requiring cardiopulmonary resuscitation (CPR) represent a high-risk group. Recent data on risk factors for mortality following CPR in this population are lacking. We hypothesized that infant demographic characteristics, diagnoses, and levels of cardiopulmonary support at the time of CPR requirement would be associated with survival to hospital discharge following CPR. Retrospective cohort study. All infants receiving CPR on day of life 2 to 120 admitted to 348 Pediatrix Medical Group neonatal intensive care units from 1997 to 2012. We collected data on demographics, interventions, center volume, and death prior to NICU discharge. We evaluated predictors of death after CPR using multivariable logistic regression with generalized estimating equations to account for clustering of the data by center. Our cohort consisted of 2231 infants receiving CPR. Of these, 1127 (51%) survived to hospital discharge. Lower gestational age, postnatal age, 5-min APGAR, congenital anomaly, and markers of severity of illness were associated with higher mortality. Mortality after CPR did not change significantly over time (Cochran-Armitage test for trend p=0.35). Mortality following CPR in infants is high, particularly for less mature, younger infants with congenital anomalies and those requiring cardiopulmonary support prior to CPR. Continued focus on at risk infants may identify targets for CPR prevention and improve outcomes. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
Falstie-Jensen, Anne Mette; Bogh, Søren Bie; Johnsen, Søren Paaske
Objective: To examine the association between compliance with consecutive cycles of accreditation and patient-related outcomes. Design: A Danish nationwide population-based study from 2012 to 2015. Setting: In-patients admitted with one of the 80 diagnoses at public, non-psychiatric hospitals....... Participants: In-patients admitted with one of 80 primary diagnoses which accounted for 80% of all deaths occuring within 30 dyas after admission. Intervention: Admission to a hospital with high (n = 125 485 in-patients) or low compliance (n = 152 074 in-patients) in both cycles of accreditation by the Danish...... admission (adjusted OR: 1.26 (95% CI: 1.11-1.43) and a longer LOS (adjusted HR of discharge: 0.89 (95% CI: 0.82-0.95) than in-patients at high compliant hospitals. No difference was seen for acute readmission (adjusted HR: 0.98 (95% CI: 0.90-1.06)). Focusing on the second cycle alone, in...
Schuurman, B.; IJtsma, D.; Zwigt, A.
Interviews were made with radiation experts working at hospitals about the treatment and limiting of radioactive wastes. The authors conclude that with the aid of hospital personnel a decrease of the volume of radioactive waste is possible. 25 refs
Reducing operational inefficiencies represents one of the most promising sources of potential savings in hospitals today. Health Forum convened a panel of hospital executives and industry experts to discuss the daunting challenges and big opportunities that lie ahead.
Greenfield, Simon M
This article reviews the causes of constipation in hospital and how it can be prevented with simple measures. A review of laxatives available on hospital words is provided for the reader and recommendations are made.
... Educators Search English Español Birthing Centers and Hospital Maternity Services KidsHealth / For Parents / Birthing Centers and Hospital Maternity Services What's in this article? Giving Birth at ...
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...
Relation Between Demographic Factors And Hospitalization In Patients With Gastrointestinal Disorders, Using Quantail Regression Analysis. ... East African Journal of Public Health ... Objective: The aim of this study is to investigate relation between demographic factors and hospitalization in gastrointestinal disorders.
Research in Hospitality Management is a peer-reviewed journal publishing papers that ... financial management, marketing, strategic management, economics, ... Articles covering social theory and the history and politics of the hospitality ...
Rural hospitals serve as major sources of health care and employment for their communities, but recently they have been under increased financial stress. What are the causes of this stress, and how have hospitals and their communities responded?
tary Hospital. ... in collaboration with clinical faculty, were present at all times. ... Based on the approval of both students and clinical instructors, we have ... structured learning environment during clinical rotations at Rwanda Military Hospital.
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...
... patientinstructions/000867.htm Leaving the hospital - your discharge plan To use the sharing features on this page, ... once you leave. This is called a discharge plan. Your health care providers at the hospital will ...
Wissow, Lawrence S.; And Others
Examination of Maryland hospital discharge data for 1979 to 1982 reveals that Black children are three times more likely to be hospitalized for asthma than are White children. This, however, is due to poverty, not race. (Author/BJV)
Ahmed, Mohamed; Jones, Eleri; Redmond, Elizabeth; Hewedi, Mahmoud; Wingert, Andreas; Gad El Rab, Mohamed
The purpose of this paper is to apply value stream mapping holistically to hospital food production/service systems focused on high-quality food. Multiple embedded case study of three (two private-sector and one public-sector) hospitals in the UK. The results indicated various issues affecting hospital food production including: the menu and nutritional considerations; food procurement; food production; foodservice; patient perceptions/expectations. Value stream mapping is a new approach for food production systems in UK hospitals whether private or public hospitals. The paper identifies opportunities for enhancing hospital food production systems. The paper provides a theoretical basis for process enhancement of hospital food production and the provision of high-quality hospital food.
Nigerian Quarterly Journal of Hospital Medicine: Submissions. Journal Home > About the Journal > Nigerian Quarterly Journal of Hospital Medicine: Submissions. Log in or Register to get access to full text downloads.
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 within...
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...
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 — The National Hospital Ambulatory Medical Care Survey (NHAMCS) is designed to collect data on the utilization and provision of ambulatory care services in hospital...
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.
Brown, Thomas C; Werling, Krist A; Walker, Barton C; Burgdorfer, Rex J; Shields, J Jordan
Healthcare reform will impact hospital consolidation in three key areas: Payment rates will decrease, indirectly encouraging consolidation by forcing hospitals to find new ways to reduce costs and increase negotiating clout with suppliers and payers. The cost of doing business will increase as hospitals spend more on compliance, technology, and physician employment. The ACO model will encourage hospital network formation by rewarding integrated healthcare systems that can reduce costs and improve quality.
C. L. Chua; Alfons Palangkaraya; Jongsay Yong
This paper studies the link between competition and technical efficiency of public hospitals in the State of Victoria, Australia by accounting both quantity and quality of hospital output using a two-stage semi-parametric model of hospital production and Data Envelopment Analysis. On the one hand, it finds a positive relationship between efficiency and competition measured by the Hirschman-Herfindahl Index (HHI). On the other, it finds that efficiency and the number of competing hospitals, in...
Maslow, Katie; Mezey, Mathy
Many hospital patients with dementia have no documented dementia diagnosis. In some cases, this is because they have never been diagnosed. Recognition of Dementia in Hospitalized Older Adults proposes several approaches that hospital nurses can use to increase recognition of dementia. This article describes the Try This approaches, how to implement them, and how to incorporate them into a hospital's current admission procedures. For a free online video demonstrating the use of these approaches, go to http://links.lww.com/A216.
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...
Arostegui, M.; Borba, M.; Caldarelli, D.; Eguiia, A.; Fernandez, E.; Peleteiro, M.; Pereira, C.; Vico, M.
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
Since 1989 there has been a burgeoning of the visual arts in Northern Ireland hospitals. This paper compares the three organisational models for hospital arts currently operating within the Province and in an overview discusses ways to coordinate working practice for future development of the visual arts in local hospitals.
... Pharmacy (40.7%) and Theatre (18.5%). This study showed that Kwale General Hospital environment is heavily contaminated and therefore underlies the necessity for regular evaluation of the hospital environment. Keywords: Bacteriological evaluation, hospital, environment. Journal of Medical Laboratory Sciences Vol.
Since 1989 there has been a burgeoning of the visual arts in Northern Ireland hospitals. This paper compares the three organisational models for hospital arts currently operating within the Province and in an overview discusses ways to coordinate working practice for future development of the visual arts in local hospitals. Images Fig 1 Fig 2 Fig 3 PMID:8533183
Cheng, T C
This paper discusses a study to investigate various operations management problems in a newly opened, modern regional hospital in Hong Kong. The findings of the study reveal that there exist in the hospital a number of current and potential problem areas. Recommendations for solving these problems are suggested with a view to improving the overall operational efficiency and effectiveness of the hospital.
Full Text Available This is a retrospective study of the factors which contributed to accidental injuries sustained by those patients who fell in a White provincial hospital in die period 1 January to 30 June 1982. The research study was undertaken by Diploma in Nursing Administration students during their 3-week hospital practice at a White provincial hospital.
Adan, I.J.B.F.; Vissers, J.M.H.; Vissers, J.M.H.; Beech, R.
The ‘traditional’ service philosophy underlying hospital admission planning has been one of optimising the use of scarce hospital resources without paying much attention to the level of service offered to patients. As patients nowadays do not accept long waiting times for hospital admission, it
Pijls-Hoekstra, Ruth; Groen, Brenda H.; Galetzka, Mirjam; Pruyn, Ad T.H.
Hospitality is a much-researched topic, but its definition is still debated. This paper is part of a larger research project into the perception of hospitality. Previous research using the Delphi-method (hospitality providers and experts) and the Critical Incident Technique (guests and consumers)
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...
Messerly, Sally; King, Michalene A; Hughes, Suzanne
A Faith Community Nurse (FCN) Program was initiated by a Magnet hospital and developed through collaboration between hospital departments and a university nurse educator. This article describes the program's development and activities that offer FCNs networking, free continuing education, and are an extension of the hospital's mission and values.
Gallegos Espinosa, Sylvia; Nicolalde Cifuentes, Marcelo; Santana Porbén, Sergio
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. To estimate the current frequency of malnutrition among patients admitted to Ecuadorian public hospitals. 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. 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. 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. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.
Ben Teeuwen; Thuy Ngo; Frans Nauta
The Hospital Standardized Mortality Ratio (HSMR) is a measurement tool that shows hospitals’ death rates. The HSMR compares deaths that occur in hospitals with death ratios that one would normally expect based on patients’ diseases. It is used as a benchmark for adjusted hospital death rates. These
Abraham, Jean; Jerome-D'Emilia, Bonnie; Begun, James W
Magnet recognition is promoted by many in the practice community as the gold standard of nursing care quality. The Magnet hospital population has exploded in recent years, with about 8% of U.S. general hospitals now recognized. The purpose of this study was to identify the characteristics that distinguish Magnet-recognized hospitals from other hospitals within the framework of diffusion theory. We conceptualize Magnet recognition as an organizational innovation and Magnet-recognized hospitals as adopters of the innovation. We hypothesize that adoption is associated with selected characteristics of hospitals and their markets. The study population consists of the 3,657 general hospitals in the United States in 2008 located in metropolitan or micropolitan areas. We used logistic regression analysis to estimate the association of Magnet recognition with organizational and market characteristics. Empirical results support hypotheses that adoption is positively associated with hospital complexity and specialization, as measured by teaching affiliation, and with hospital size, slack resources, and not-for-profit or public ownership (vs. for-profit). Adopters also are more likely to be located in markets that are experiencing population growth and are more likely to have competitor hospitals within the market that also have adopted Magnet status. A positive association of adoption with baccalaureate nursing school supply is contrary to the hypothesized relationship. Because of its rapid recent growth, consideration of Magnet program recognition should be on the strategic planning agenda of hospitals and hospital systems. Hospital administrators, particularly in smaller, for-profit hospitals, may expect more of their larger not-for-profit competitors, particularly teaching hospitals, to adopt Magnet recognition, increasing competition for baccalaureate-prepared registered nurses in the labor market.
McCarthy, Aidan; Maor, Dorit; McConney, Andrew
The aim of this study was to identify hospital teachers' professional learning needs to enable effective use of mobile technology in hospital schools. Hospitalized students cannot attend their regular schools and as a result their educational progress and development can suffer. In an attempt to address this, hospital schools provide learning…
Ramamoorthy, N.; Shivarudrappa, V.; Bhelose, Amita A.
This manual on hospital radiopharmaceuticals and hospital radiopharmacy practices contains information and recommendations that could be of use to hospital radiopharmacists while the main focus of the book is to impart adequate exposure to basics of radiopharmaceuticals and purity and safety aspects of formulations to be made in hospital radiopharmacy. Papers relevant to INIS are indexed separately
... Systems for Acute Care Hospitals and the Long Term Care Hospital Prospective Payment System and Proposed... Payment Systems for Acute Care Hospitals and the Long Term Care Hospital Prospective Payment System and... regarding MS-DRG classifications and new technology add-on payments. Eva Fung (410) 786-7539, for...
... Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and Fiscal Year 2010 Rates and to the Long- Term Care Hospital Prospective Payment System and Rate Year 2010 Rates... Prospective Payment Systems for Acute Care Hospitals and Fiscal Year 2010 Rates and to the Long-Term Care...
... [CMS-1588-F2] RIN 0938-AR12 Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Fiscal Year 2013 Rates..., 2012 Federal Register entitled ``Medicare Program; Hospital Inpatient Prospective Payment Systems for...
Tanner, L M; Blackmon, H E; Stanley, I; English, N K
Guidelines are given for nurses and social workers involved in abortion care before and after the in-hospital procedure. The California Nurses' Association Maternity Conference Group established guidelines for such care in October, 1970 as follows. The nurse should keep the patient informed of all aspects of the procedure, provide a supportive presence, perform standard physical monitoring during the operation and afterwards, provide contraceptive counseling, and act as a sounding board for discussion of interpersonal relationships and future plans. High quality nursing requires understanding the physical and psychosocial aspects of abortion reflecting the nurse's recognition of the cultural, religious, and socioeconomic factors involved. This requires a nurse who is fully aware of her own feelings and can adapt or defer them to the patient's needs. In cases of suction or dilation abortions, these actions are particularly important, since the patient is in the hospital only a short time and can be easily ignored. In cases of saline infusion, the nurse should be fully aware of possible complications, including retained placentae, hemorrhage, infection, or uterine perforation. If the patient is readmitted for any of these complications, the nurse should continue to play the informative, supportive role. The nurse and social worker should also be aware of the possible psychological sequelae of abortion and watch for mental health problems. It is concluded that postabortion counseling is the best time for contraceptive counseling. Conscientious professional support along these guidelines should insure a positive experience for the abortion patient.
Full Text Available Large institutions housed in large buildings are frequently regarded as the antithesis of personalised, small scale, domestic, home environments. However the attribute of ‘homeliness’ appears to be used more broadly to describe places where people feel a sense of attachment, control and identification. In a large multi-disciplinary study of a hospital rebuilding project in northern England a range of users were interviewed to ascertain their responses to the original older buildings and later the new purpose built hospital. We found both staff and patients retained a strong sense of affection for the older buildings and frequently used the language of home to describe their responses. In contrast, the newer buildings were generally recognised as efficient but impersonal, lacking many of the positive qualities they were familiar with. In addition some respondents suggested that despite efforts to include art projects, the new architectural language was inappropriate for healthcare, believing that small scale, ‘home-like’ environments were more conducive to health and well-being. The authors will draw on anthropological and architectural frameworks to analyse the data which consists of extensive interview transcripts complemented by photographs. The paper aims to understand the conceptualisations which underpin the various user responses and to offer a critique of the design language of the current healthcare building programme.
Alkibay, Sanem; Ozdogan, F Bahar; Ermec, Aysegul
This paper aims to present a perspective to better understand corporate identity through examining the perceptions of Turkish patients and develop a corporate visual identity scale. While there is no study related to corporate identity research on hospitals in Turkey as a developing country, understanding consumer's perceptions about corporate identity efforts of hospitals could provide different perspectives for recruiters. When the hospitals are considered in two different groups as university and state hospitals, the priority of the characteristics of corporate visual identity may change, whereas the top five characteristics remain the same for all the hospitals.
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.
Wig, Eldon D.
The information processing needs of a hospital are many, with varying degrees of complexity. The prime concern in providing an integrated hospital information management system lies in the ability to process the data relating to the single entity for which every hospital functions - the patient. This paper examines the PRIMIS computer system developed to accommodate hospital needs with respect to a central patient registry, inpatients (i.e., Admission/Transfer/Discharge), and out-patients. Finally, the potential for expansion to permit the incorporation of more hospital functions within PRIMIS is examined.
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.
Perdelli, F; Cristina, M L; Sartini, M; Spagnolo, A M; Dallera, M; Ottria, G; Lombardi, R; Grimaldi, M; Orlando, P
To assess the degree of fungal contamination in hospital environments and to evaluate the ability of air conditioning systems to reduce such contamination. We monitored airborne microbial concentrations in various environments in 10 hospitals equipped with air conditioning. Sampling was performed with a portable Surface Air System impactor with replicate organism detection and counting plates containing a fungus-selective medium. The total fungal concentration was determined 72-120 hours after sampling. The genera most involved in infection were identified by macroscopic and microscopic observation. The mean concentration of airborne fungi in the set of environments examined was 19 +/- 19 colony-forming units (cfu) per cubic meter. Analysis of the fungal concentration in the different types of environments revealed different levels of contamination: the lowest mean values (12 +/- 14 cfu/m(3)) were recorded in operating theaters, and the highest (45 +/- 37 cfu/m(3)) were recorded in kitchens. Analyses revealed statistically significant differences between median values for the various environments. The fungal genus most commonly encountered was Penicillium, which, in kitchens, displayed the highest mean airborne concentration (8 +/- 2.4 cfu/m(3)). The percentage (35%) of Aspergillus documented in the wards was higher than that in any of the other environments monitored. The fungal concentrations recorded in the present study are comparable to those recorded in other studies conducted in hospital environments and are considerably lower than those seen in other indoor environments that are not air conditioned. These findings demonstrate the effectiveness of air-handling systems in reducing fungal contamination.
Mahmood, S.; Din, N.U.; Mohsin, J.
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)
Stidsen, Lone Mandrup
by the patients in the ward. The project is based on the Danish Regulation for light in hospitals (DS703), which is a supplement to the regulation of artificial lighting in workplaces (DS700). The kick-off to the project was reading the DS703, second paragraph, chapter 2 about general requirements for lighting...... group has quite diverse needs and preferences, while the staff needs task lighting and the patient a space experienced as homely and pleasant. Categories such as ‘pleasure’ and ‘activities’ are also a part of the user aspect. The space is divided into subcategories as ‘location of the space...
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.
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
Moss, Hilary; Donnellan, Claire; O'Neill, Desmond
To assess the impact of hospitalization on arts engagement among older people; and to assess perceptions of whether hospitals are aesthetically deprived environments. A Survey of Aesthetic and Cultural Health was developed to explore the role of aesthetics before, during and after hospital. Study participants were n = 150 hospital in-patients aged >65. Descriptive and inferential statistics were used to analyze the data. Attendance at arts events was an important part of life for this sample and a large drop off was noted in continuation of these activities in the year post-hospital stay. Physical health issues were the main causes but also loss of confidence and transport issues. Film, dance, and music were the most popular arts for this sample prior to hospital stay. Noise pollution caused by other patients, lack of control over TV/radio, and access to receptive arts in hospital (reading and listening to music) were important issues for patients in hospital. This study identifies a trend for decreasing exposure to arts beginning with a hospital stay and concludes that older people may need encouragement to resume engagement in arts following a hospital stay. There is relatively limited evidence regarding the nature of, and potential benefit from, aesthetics in healthcare and limited studies with rigorous methodology, and further research is needed to understand the aesthetic preferences of older people in hospital. Copyright © 2015 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.
Full Text Available A prospective study was undertaken to compare the patterns of psychiatric referrals in two general hospitals in Bombay viz. the King Edward Memorial Hospital (64 cases and the Jaslok Hospital and Research Centre (62 cases. It was observed that depressive symptoms were the most common presenting symptoms in these patients attending either of the hospitals. Similarly, the commonest diagnoses were depression and organic mental disorder. Attempted suicide with organophosphorous compounds was the commonest reason for hospitalization at K.E.M. Hospital (p less than 0.001. A significant number of these patients were females (p less than 0.05. The psychiatric referrals at Jaslok had been hospitalized mainly for suspected medical or neurological illness (p less than 0.001. These patients belonged to higher economic strata and hence had a better paying capacity compared to patients at KEM hospital, a significant number of whom were unemployed (p less than 0.001. The duration of pre-referred illness of patients and their stay at Jaslok hospital were longer as compared to those at KEM Hospital (p less than 0.01. The number of non-relevant special investigations carried out on patients in Jaslok was more (p less than 0.01. Further analysis of diagnoses revealed that a significant number of patients at KEM Hospital were admitted as primary psychiatric illness (p less than 0.05.
Ernst, D F
With the increasing demands on hospitals for improved quality and lower costs, hospitals have been forced to reevaluate their manner of operation and quality assurance (QA) programs. Hospitals have been faced with customer dissatisfaction with services, escalating costs, intense competition, and reduced reimbursement for services. As a result, many hospitals have incorporated total quality management (TQM), also known as continuous quality improvement (CQI) and quality improvement (QI), to improve quality care and decrease costs. This article examines the concept of TQM, its rationale, and how it can be implemented in a hospital. A comparison of TQM and QA is made. Examples of hospital implementation of TQM and problems and issues associated with TQM in the hospital setting are explored.
Full Text Available Abstract Background The aim of the present study is to analyze the incidence of hip fracture as a complication of admissions to internal medicine units in Spain. Methods We analyzed the clinical data of 2,134,363 adults who had been admitted to internal medicine wards. The main outcome was a diagnosis of hip fracture during hospitalization. Outcome measures included rates of in-hospital fractures, length of stay and cost. Results A total of 1127 (0.057% admittances were coded with an in-hospital hip fracture. In hospital mortality rate was 27.9% vs 9.4%; p Conclusions In-hospital hip fracture notably increased mortality during hospitalization, doubling the mean length of stay and mean cost of admission. These are reasons enough to stress the importance of designing and applying multidisciplinary plans focused on reducing the incidence of hip fractures in hospitalized patients.
Hook, Joshua N; Boan, David; Davis, Don E; Aten, Jamie D; Ruiz, John M; Maryon, Thomas
Hospital safety culture is an integral part of providing high quality care for patients, as well as promoting a safe and healthy environment for healthcare workers. In this article, we explore the extent to which cultural humility, which involves openness to cultural diverse individuals and groups, is related to hospital safety culture. A sample of 2011 hospital employees from four hospitals completed measures of organizational cultural humility and hospital safety culture. Higher perceptions of organizational cultural humility were associated with higher levels of general perceptions of hospital safety, as well as more positive ratings on non-punitive response to error (i.e., mistakes of staff are not held against them), handoffs and transitions, and organizational learning. The cultural humility of one's organization may be an important factor to help improve hospital safety culture. We conclude by discussing potential directions for future research.
Full Text Available Background: Organizational culture influences employees’ job satisfaction, commitment and performance. A strong corporate culture enhances organizational performance. Objective: The aim of this study was to determine the type of organizational culture in Qazvin hospitals. Methods: A descriptive and cross-sectional study was conducted by a survey questionnaire in Qazvin (2013 that was distributed among 800 hospital employees and managers based on stratified random sampling. Findings: The mean of hospitals’ organizational culture was 2.95 out of 5 score. Hospitals' organizational cultures were evaluated as strong in attention to details and stability dimensions and moderate in creativity, risk taking, team working and power distance dimensions. Attention to details in public hospitals was higher than private and social security hospitals. Conclusion: Organizational culture of Qazvin hospitals was evaluated as moderate. Managers for improving hospitals' performance and enhancing employees' and patients' satisfaction should create a culture of higher creativity, innovation, team working and risk taking and lower power distance.
Shih, Terry; Ryan, Andrew M; Gonzalez, Andrew A; Dimick, Justin B
To project readmission penalties for hospitals performing cardiac surgery and examine how these penalties will affect minority-serving hospitals. The Hospital Readmissions Reduction Program will potentially expand penalties for higher-than-predicted readmission rates to cardiac procedures in the near future. The impact of these penalties on minority-serving hospitals is unknown. We examined national Medicare beneficiaries undergoing coronary artery bypass grafting in 2008 to 2010 (N = 255,250 patients, 1186 hospitals). Using hierarchical logistic regression, we calculated hospital observed-to-expected readmission ratios. Hospital penalties were projected according to the Hospital Readmissions Reduction Program formula using only coronary artery bypass grafting readmissions with a 3% maximum penalty of total Medicare revenue. Hospitals were classified into quintiles according to proportion of black patients treated. Minority-serving hospitals were defined as hospitals in the top quintile whereas non-minority-serving hospitals were those in the bottom quintile. Projected readmission penalties were compared across quintiles. Forty-seven percent of hospitals (559 of 1186) were projected to be assessed a penalty. Twenty-eight percent of hospitals (330 of 1186) would be penalized less than 1% of total Medicare revenue whereas 5% of hospitals (55 of 1186) would receive the maximum 3% penalty. Minority-serving hospitals were almost twice as likely to be penalized than non-minority-serving hospitals (61% vs 32%) and were projected almost triple the reductions in reimbursement ($112 million vs $41 million). Minority-serving hospitals would disproportionately bear the burden of readmission penalties if expanded to include cardiac surgery. Given these hospitals' narrow profit margins, readmission penalties may have a profound impact on these hospitals' ability to care for disadvantaged patients.
Jiménez-Buñuales, M T; Martínez-Sáenz, M S; González-Diego, P; Vallejo-García, M; Gallardo-Anciano, J; Cestafe-Martínez, A
The purpose of this study is to know the incidence rate of medication reconciliation at admission and discharge in patients of La Rioja and to improve the patient safety on medication reconciliation. An observational prospective study, part of the Joint Action PaSQ, Work Package 5, European Union Network for Patient Safety and Quality of Care. The study has taken into account the definitions of the Institute for Safe Medication Practices. Any unintended discrepancy in medication between chronic treatment and the treatment prescribed in the hospital was considered as a reconciliation error. A total of 750 patients were included, 9 (1.2%) of whom showed at least one discrepancy. The patients had a total of 3,156 mediations registered: 2,313 prescriptions (73.4%) showed no differences, while 821 prescriptions (26%) were intended discrepancies and 21 prescriptions (0.6%) unintended discrepancies were considered by the physician as reconciliation errors. A percentage of 1.2 of the patients, which represents 0.6% of the medicines (one in 166 medications registered) had reconciliation errors during their hospital stay. A proceeding has been implemented by means of the physician doing the medication reconciliation and reviewing it with the help of a medication reconciliation form. The medication reconciliation is a priority strategic objective to improve the safety of patients. Copyright © 2016 SECA. Published by Elsevier Espana. All rights reserved.
It is known that there is a large extent of working dissatisfaction within some professional groups of the health service system. Especially in the hospital sector, many "struggles for power" take place. Unfortunately, these struggles are often only examined with regard to individual points of view without considering the system-oriented background. The following text will reflect the discussion in social sciences as to the distribution of power within the health service system. The double meaning of the distribution of power will be explained and, by means of decisive phenomenons, the development of cost and efficiency structures on the one hand as well as the development of health political processes in decision-making on the other hand will be described. In the section "The Hospital in the 20th Century", the structures that still can be widely found nowadays will be specified and examined as to aspects in behavioural sciences. Finally, as a logical consequence, an urgently needed reorientation from administration towards management will be pointed out.
Full Text Available The continuous growth of competition in the hospitality sector has created the need to retain guests and prevent them from switching company due to better offer or saturation. Loyal customers are a valuable asset for catering companies, not only because of the awareness of the effects of customer loyalty. They tend to spread word-of-mouth advertising, more tolerant to price changes, as well as they casually create a linkage to their friends, relatives, colleagues, and other probable consumers and thus enable businesses to uphold a guest's base. By recognizing loyalty guests' importance, the global hospitality industry created monetary and non-monetary rewards for loyal visitors, delayed gratification (points collection and immediate rewards, as well as numerous other reward systems that try to keep them. To win customer loyalty, together with all benefits arising from it, caterers need to become familiar with factors, which determine guests' loyalty. The paper will show the results of research regarding the impact of the service quality and guests' satisfaction to their loyalty. Many authors have confirmed that employees' satisfaction affected customers' satisfaction, so this paper will give an answer does it influence on customers' loyalty as well.
Ternák, G; Almási, I
The authors publish the results of a survey conducted among hospital records of patients discharged from eight inpatient's institutes between 1-31st of January 1995 to gather information on the indications and usage of antibiotics. The institutes were selected from different part of the country to represent the hospital structure as much as possible. Data from the 13,719 documents were recorded and analysed by computer program. It was found that 27.6% of the patients (3749 cases) received antibiotic treatment. 407 different diagnosis and 365 different surgical procedures (as profilaxis) were considered as indications of antibiotic treatment (total: 4450 indications for 5849 antibiotic treatment). The largest group of patients receiving antibiotics was of antibiotic profilaxis (24.56%, 1093 cases), followed by lower respiratory tract infections (19.89%, 849 cases), uroinfections (10.53%, 469 cases) and upper respiratory tract infections. Relatively large group of patients belonged to those who had fever or subfebrility without known reason (7.35%, 327 cases) and to those who did not have any proof in their document indicating the reasons of antibiotic treatment (6.4%, 285 cases). We can not consider the antibiotic indications well founded in those groups of patients (every sixth or every fifth cases). The most frequently used antibiotics were of [2-nd] generation cefalosporins. The rate of nosocomial infections were found as 6.78% average. The results are demonstrated on diagrams and table.
Sánchez Bisonó, J R; Gómez Rosich, A; Amor Gea, J F; García Sánchez, M J; Campoy Domene, L F; Peña Migallón-Sánchez, P
The hospital mortality rate in our centre es 2.34% (264 deaths from a total of 11,336 discharges between 1991 and 1993). The most frequent causes are acute myocardial infarction and cerebrovascular accidents, followed in descending order by pneumonia, chronic bronchitis, congestive heart failure, upper GI haemorrhage, GI tumours, liver cirrhosis, lung tumours and arrhythmias. Our analysis reflects a mortality pattern of a rural population with an age pyramid in which 52% of the patients are older than 45 years. The pattern also reflects the little impact of accidents on our mortality. A 87% of the deaths were older than 65 years with a male to female ratio of 1, 6 and a Swaroop index of 93% and 94% for males and females respectively.
Shazim Ali Memon
Full Text Available Hospital waste management is a huge problem in Pakistan. The annual production of medical waste produced from health care facilities, in Pakistan, is around 250,000 tons. This research paper is intended to evaluate the feasibility of using of hospital waste ash obtained from Pakistan Institute of Medical Sciences, Rawalpindi, Pakistan, as partial replacement of cement. The main variable in this research is the amount of hospital waste ash (2, 4, 6 and 8% by weight of cement while the amount of cementitious material, water to cementitious material ratio, fine and coarse aggregate content were kept constant. Test results substantiate that hospital waste ash can be used in concrete. XRD (X-Ray Diffraction of hospital waste ash showed that it is rich in calcite while scanning electron micrographs indicated that the particles of hospital waste ash have highly irregular shape. The slump value, density of fresh concrete and water absorption decreased with the increase in the quantity of hospital waste ash in the mix. At 3 days of testing, the compressive strength of mixes with hospital waste ash was higher than the control mix while at 7 and 28 days the CM (Control Mix showed higher strength than the hospital waste ash mixes except the mix containing 2% hospital waste ash by weight of cement.
Hansen, S; Zingg, W; Ahmad, R; Kyratsis, Y; Behnke, M; Schwab, F; Pittet, D; Gastmeier, P
The Prevention of Hospital Infections by Intervention and Training (PROHIBIT) survey was initiated to investigate the status of healthcare-associated infection (HCAI) prevention across Europe. This paper presents the methodology of the quantitative PROHIBIT survey and outlines the findings on infection control (IC) structure and organization including management's support at the hospital level. Hospitals in 34 countries were invited to participate between September 2011 and March 2012. Respondents included IC personnel and hospital management. Data from 309 hospitals in 24 countries were analysed. Hospitals had a median (interquartile range) of four IC nurses (2-6) and one IC doctor (0-2) per 1000 beds. Almost all hospitals (96%) had defined IC objectives, which mainly addressed hand hygiene (87%), healthcare-associated infection reduction (84%), and antibiotic stewardship (66%). Senior management provided leadership walk rounds in about half of hospitals, most often in Eastern and Northern Europe, 65% and 64%, respectively. In the majority of hospitals (71%), sanctions were not employed for repeated violations of IC practices. Use of sanctions varied significantly by region (P hospitals should be a public health priority. Copyright © 2015. Published by Elsevier Ltd.
Memon, S.; Sheikh, M.
Hospital waste management is a huge problem in Pakistan. The annual production of medical waste produced from health care facilities, in Pakistan, is around 250,000 tons. This research paper is intended to evaluate the feasibility of using of hospital waste ash obtained from Pakistan Institute of Medical Sciences, Rawalpindi, Pakistan, as partial replacement of cement. The main variable in this research is the amount of hospital waste ash (2, 4, 6 and 8% by weight of cement) while the amount of cementitious material, water to cementitious material ratio, fine and coarse aggregate content were kept constant. Test results substantiate that hospital waste ash can be used in concrete. XRD (X-Ray Diffraction) of hospital waste ash showed that it is rich in calcite while scanning electron micrographs indicated that the particles of hospital waste ash have highly irregular shape. The slump value, density of fresh concrete and water absorption decreased with the increase in the quantity of hospital waste ash in the mix. At 3 days of testing, the compressive strength of mixes with hospital waste ash was higher than the control mix while at 7 and 28 days the CM (Control Mix) showed higher strength than the hospital waste ash mixes except the mix containing 2% hospital waste ash by weight of cement. (author)
Dong, Gang Nathan
This paper examines the hospital management practices of manipulating financial earnings within the bounds of generally accepted accounting principles (GAAP). We conduct regression analyses that relate earnings management to hospital characteristics to assess the economic determinants of hospital earnings management behavior. From the CMS Cost Reports we collected hospital financial data of all U.S. hospitals that request reimbursement from the federal government for treating Medicare patients, and regress discretionary accruals on hospital size, profitability, asset liquidity, operating efficiency, labor cost, and ownership. Hospitals with higher profit margin, current ratio, working capital, days of patient receivables outstanding and total wage are associated with more earnings management, whereas those with larger size and higher debt level, asset turnover, days cash on hand, fixed asset age are associated with lower level of earnings manipulation. Additionally, managers of non-profit hospitals are more likely to undertake some form of window-dressing by manipulating accounting accruals without changing business models or pricing strategies than their public hospital counterparts. We provide direct evidence of the use of discretionary accruals to manage financial earnings among U.S. hospitals and the finding has profound policy implications in terms of assessing the pervasiveness of accounting manipulation and the overall integrity of financial reporting in this very special public and quasi-public service sector.
Plet, H. T.; Hallas, J.; Kjeldsen, L. J.
PURPOSE: To investigate adherence rates to hospital drug formularies (HDFs) and cost of drugs in hospitals. METHODS: Data on drugs used during 2010 were analyzed for ten hospitals (two hospitals from each of the five regions), constituting 30 % of hospitals and 45 % of hospital beds in Denmark....... Drug use data from individual hospitals were retrieved from the hospital pharmacies. Adherence to the HDFs was analyzed for selected substances characterised by extensive use both in primary and secondary sectors (ATC codes A10, B03, C03, C07, C08, C09, C10, J01, N02, N05 and R03). Within each group......, we also identified the drugs constituting 90 % of the volume (= DU90%) and the adherence to the HDF in this segment (Index of Adherence). RESULTS: Substances used by hospitals varied between 598 and 1,093. The proportion of used substances that were on the HDF varied between 14 % and 44 %. University...
Cho, Na-Eun; Chang, Jongwha; Atems, Bebonchu
To determine the impact of health information technology (HIT) adoption and hospital-physician integration on hospital efficiency. Using 2010 data from the American Hospital Association's (AHA) annual survey, the AHA IT survey, supplemented by the CMS Case Mix Index, and the US Census Bureau's small area income and poverty estimates, we examined how the adoption of HIT and employment of physicians affected hospital efficiency and whether they were substitutes or complements. The sample included 2173 hospitals. We employed a 2-stage approach. In the first stage, data envelopment analysis was used to estimate technical efficiency of hospitals. In the second stage, we used instrumental variable approaches, notably 2-stage least squares and the generalized method of moments, to examine the effects of IT adoption and integration on hospital efficiency. We found that HIT adoption and hospital-physician integration, when considered separately, each have statistically significant positive impacts on hospital efficiency. Also, we found that hospitals that adopted HIT with employed physicians will achieve less efficiency compared with hospitals that adopted HIT without employed physicians. Although HIT adoption and hospital-physician integration both seem to be key parts of improving hospital efficiency when one or the other is utilized individually, they can hurt hospital efficiency when utilized together.
Yang, Lianping; Liu, Chaojie; Huang, Cunrui; Mukamel, Dana B
Reducing 30-day hospital readmissions has become a focus of the current national payment policies. Medicare requires that hospitals collect and report patients' experience with their care as a condition of payment. However, the extent to which patients' experience with hospital care is related to hospital readmission is unknown. We established multivariate regression models in which 30-day risk-adjusted readmission rates were the dependent variables and patients' perceptions of the responsiveness of the hospital staff and communication (as measured by the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores) were the independent variables of interest. We selected six different clinical conditions for analyses, including acute myocardial infarction (AMI), chronic obstructive pulmonary disease (COPD), heart failure, hip/knee surgery, pneumonia, and stroke. Data included all acute care hospitals reporting in Hospital Compare in 2014. The number of hospitals with reported readmissions ranged from 2234 hospitals for AMI to 3758 hospitals for pneumonia. The average 30-day readmission rates ranged from 5.19% for knee/hip surgery to 22.7% for COPD. Patient experience of hospital-staff responsiveness as "top-box" ranged from 64% to 67% across the six clinical conditions, communication with nurses ranged from 77% to 79% and communication with doctors ranged from 80% to 81% (higher numbers are better). Our finding suggests that hospitals with better staff responsiveness were significantly more likely to have lower 30-day readmissions for all conditions. The effect size depended on the baseline readmission rates, with the largest effect on hospitals in the upper 75th quartile. A ten-percentage-point increase in staff responsiveness led to a 0.03-0.18 percentage point decrease in readmission rates. We found that neither communication with physicians nor communication with nurses was significantly associated with hospital readmissions. Our findings
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.
Jalali, Mohammad S; Kaiser, Jessica P
Cybersecurity incidents are a growing threat to the health care industry in general and hospitals in particular. The health care industry has lagged behind other industries in protecting its main stakeholder (ie, patients), and now hospitals must invest considerable capital and effort in protecting their systems. However, this is easier said than done because hospitals are extraordinarily technology-saturated, complex organizations with high end point complexity, internal politics, and regulatory pressures. The purpose of this study was to develop a systematic and organizational perspective for studying (1) the dynamics of cybersecurity capability development at hospitals and (2) how these internal organizational dynamics interact to form a system of hospital cybersecurity in the United States. We conducted interviews with hospital chief information officers, chief information security officers, and health care cybersecurity experts; analyzed the interview data; and developed a system dynamics model that unravels the mechanisms by which hospitals build cybersecurity capabilities. We then use simulation analysis to examine how changes to variables within the model affect the likelihood of cyberattacks across both individual hospitals and a system of hospitals. We discuss several key mechanisms that hospitals use to reduce the likelihood of cybercriminal activity. The variable that most influences the risk of cyberattack in a hospital is end point complexity, followed by internal stakeholder alignment. Although resource availability is important in fueling efforts to close cybersecurity capability gaps, low levels of resources could be compensated for by setting a high target level of cybersecurity. To enhance cybersecurity capabilities at hospitals, the main focus of chief information officers and chief information security officers should be on reducing end point complexity and improving internal stakeholder alignment. These strategies can solve cybersecurity
Guerci, Alba M.; Pinero, Adalberto; Zubiria, M. Guillermina; Sanz, Vanesa; Larragueta, Nicolas; Puntigliano, Diego
Full text: Previous studies realized by our group have demonstrated radio-induction of genotoxic damage in peripheral blood of hospital workers exposed to chronic X-ray. The cytogenetic and cytomolecular damage was significant in the radiologists evaluated. Accordingly, we have researched the knowledge of risk radiation in 57 workers to different health centres, private and public, in La Plata city. Most of respondents (96.4%) answered to know the risk of working with radiation ionizing, but a large portion do not carry out with the appropriate safety rules. The workers have not interest in this rules, it is evidenced by negligence in the use of protective clothing and personal dosimeters. These results suggested that individuals could be sensitising to minimize their risk. For this purpose we are working in scientific literacy conferences which are organized by 'Asociacion de Tecnicos Radiologos y de Diagnostico por Imagenes de La Plata (ASTEDIRLP)'. (author)
Gervais, Pierre; Pooler, Charlotte; Merryweather, Andrew; Doig, Alexa K.; Bloswick, Donald
To explore the safety of the standard and the low hospital bed, we report on a microanalysis of 15 patients’ ability to ingress, move about the bed, and egress. The 15 participants were purposefully selected with various disabilities. Bed conditions were randomized with side rails up or down and one low bed with side rails down. We explored the patients’ use of the side rails, bed height, ability to lift their legs onto the mattress, and ability to turn, egress, and walk back to the chair. The standard bed was too high for some participants, both for ingress and egress. Side rails were used by most participants when entering, turning in bed, and exiting. We recommend that side rails be reconsidered as a means to facilitate in-bed movement, ingress, and egress. Furthermore, single deck height settings for all patients are not optimal. Low beds as a safety measure must be re-evaluated. PMID:28462302
Lucélia Ferreira Lima
Full Text Available Objective: To identify the risks reported at a public institution andto know the main patient risks from the nursing staff point of view.Methods: A retrospective, descriptive and exploratory study. Thesurvey was developed at a hospital in the city of Taboão da Serra, SãoPaulo, Brazil. The study included all nurses working in care areas whoagreed to participate in the study. At the same time, sentinel eventsoccurring in the period from July 2006 to July 2007 were identified.Results: There were 440 sentinel events reported, and the main risksincluded patient falls, medication errors and pressure ulcers. Sixty-fivenurses were interviewed. They also reported patient falls, medicationerrors and pressure ulcers as the main risks. Conclusions: Riskassessment and implementation of effective preventive actions arenecessary to ensure patient’s safety. Involvement of a multidisciplinaryteam is one of the steps for a successful process.
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...... and evaluations, can be fed into briefing and design processes. This PhD thesis proposes methods for usability briefing.Usability is a concept similar to functionality, but usability depends on: subjective view of users, context, culture, situation and experience. Understanding usability is achieved by involving...... users. This PhD thesis extends the research in usability of buildings to include all building design phases, therefore not only proposes usability evaluations, but also defines usability briefing. Briefing, also called architectural programming, is usually understood as one of the first phases...
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.
Full Text Available After the liberation of Nis from the Turks which took place on January 11th, 1878, there were two military hospitals: one was next to The Skull Tower and the other on the road to Leskovac and there was Islahana the civil institution which was not the forerunner of the district hospital in Nis. At first, they founded the military hospital in Nis in 1878 and then they founded The District Hospital on July 17th in 1881. The first director of the District hospital was Anton Zajicek. He is also the first graduated medical doctor in Nis. The District Hospital was situated on the left bank of the Nisava river in a private house.
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......, 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...
Davis, C [Social Data Research Ltd./The Flett Consulting Group, Inc., Ottawa, ON (Canada)
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).
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.
Unluturk, Mehmet S
Hospital staff assignments are the instructions that allocate the hospital staff members to the hospital beds. Currently, hospital administrators make the assignments without accessing the information regarding the occupancy of the hospital beds and the acuity of the patient. As a result, administrators cannot distinguish between occupied and unoccupied beds, and may therefore assign staff to unoccupied beds. This gives rise to uneven and inefficient staff assignments. In this paper, the hospital admission-discharge-transfer (ADT) system is employed both as a data source and an assignment device to create staff assignments. When the patient data is newly added or modified, the ADT system updates the assignment software client with the relevant data. Based on the relevant data, the assignment software client is able to construct staff assignments in a more efficient way. © 2013 Elsevier Ltd. All rights reserved.
Smith, H L; Haley, D; Piland, N F
Rural hospitals confront an inauspicious environment due to changes in patient reimbursement and medical practice. Facing a situation of declining revenues, marketing presents an option for rural hospitals to adapt to the growing constraints. This paper analyzes the determinants of marketing strategy emphasis in rural hospitals. The conceptual model adopted in this study predicts that prior performance and contextual variables explain marketing strategy emphasis. The relationships are examined in a case study of rural New Mexico hospitals. Results suggest that prior performance and several contextual variables explain variations in marketing strategy emphasis. In particular, higher gross patient revenues are associated with more emphasis on television and radio advertising. Furthermore, rural New Mexico hospitals with high numbers of licensed beds and medical staff members, or that are affiliated with a chain organization, place greater emphasis on market research and market planning. The implications for marketing practice in rural hospitals are discussed.
Bhatti, A.Q.; Memon, A.A.; Mahar, R.B.
Hazardous hospital waste is a unique in several ways. There are a large variety of wastes but volume is a small relative to industrial wastes. Hospital infections solid waste is getting to be serious problem day by day. This waste contribute to the overall pollution in the city; much of it is also hazardous, thus putting at risk the health of those who come into contact with it. This paper addresses the various aspects of incineration, recycling and landfill process with detailed illustration. Hospital waste management in rural hospitals of Pakistan with particular reference to Gambat Hospital is discussed in this paper, including study of existing waste management system, estimation of waste production per day from different sources of Hospital and suitable waste management system is recommended. (author)
Lu, Xudong; Duan, Huilong; Li, Haomin; Zhao, Chenhui; An, Jiye
Because of the complexity of the hospital environment, there exist a lot of medical information systems from different vendors with incompatible structures. In order to establish an enterprise hospital information system, the integration among these heterogeneous systems must be considered. Complete integration should cover three aspects: data integration, function integration and workflow integration. However most of the previous design of architecture did not accomplish such a complete integration. This article offers an architecture design of the enterprise hospital information system based on the concept of digital neural network system in hospital. It covers all three aspects of integration, and eventually achieves the target of one virtual data center with Enterprise Viewer for users of different roles. The initial implementation of the architecture in the 5-year Digital Hospital Project in Huzhou Central hospital of Zhejiang Province is also described.
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)
Daniel Henrique Diniz Barbosa
Full Text Available Este texto aborda o processo de desenvolvimento regional encetado em Minas Gerais, com particular ênfase na participação do corpo técnico regional ao longo das décadas de 1930 e 1940. Trata-se de um período de relevantes transformações no âmbito do poder público, sobretudo no tocante ao papel desempenhado pela ideologia e prática do planejamento e intervencionismo do Estado na esfera econômica, o que permitiu, no caso mineiro, a ascensão da categoria profissional do engenheiro às arenas decisórias do Estado, com repercussão na elaboração e tentativa de implantação de projetos voltados para o desenvolvimento econômico regional, notadamente nas áreas de agricultura e siderurgia. Este texto priorizará, para tanto, dois grupos específicos dentre essa elite técnica mineira: os ex-alunos da Escola de Minas de Ouro Preto e os alunos e professores da Escola Superior de Agricultura e Veterinária, de Viçosa.
Resumo: Na primeira metade do século XX Porto Alegre, capital do estado do Rio Grande do Sul, xperimentou um acelerado processo de crescimento urbano e expansão industrial, consolidando-se como o terceiro parque industrial do Brasil. Esse processo deu origem a um conjunto de bairros operários conhecido genericamente como 'Quarto Distrito'. A população destes bairros formou-se, basicamente, a partir da confluência de uma grande diversidade de fluxos migratórios internos e externos. Como a gran...
Roberto de Zubiria
Full Text Available Para el estudioso de la Medicina Colombiana, la segunda mitad del siglo XIX presenta una serie de características peculiares. En esta época emergen valores básicos en la literatura, el arte y la política. Época en la cual hacen eclosión nuevas tendencias y concepciones artísticas y científicas. El campo de la medicina, en evolución paralela muestra la formación de las grandes escuelas del siglo XIX, las cuales inician una serie de cambios básicos influidos por los grandes descubrimientos de la medicina de la época. El advenimiento de la anatomía patológica, sirve de eje central a la formación de la medicina organicística, en la cual pueden localizarse en los diversos órganos y aparatos todas las enfermedades. Los grandes avances en el campo de la bacteriología y parasitología permiten el entendimiento de la fisiopatología de una buena cantidad de enfermedades y particularmente las dolencias tropicales.
Cleverley, W O; Harvey, R K
Comparisons are continuously being made between the financial performance, products and services, of the healthcare industry and those of non-healthcare industries. Several useful measures of financial performance--profitability, liquidity, financial risk, asset management and replacement, and debt capacity, are used by the authors to compare the financial performance of the hospital industry with that of the industrial, transportation and utility sectors. Hospitals exhibit weaknesses in several areas. Goals are suggested for each measure to bring hospitals closer to competitive levels.
Quality control analysis is an integral part of quality assurance. In a system as with radiopharmaceuticals where part of the finishing of the product takes place at individual hospitals, the need for quality control analysis at the hospital can be discussed. Data are presented that stresses the importance of quality control by the manufacturer as a basis for limitation of such work at hospitals. A simplified programme is proposed
Pappas, Nikolaos; Bregoli, Ilenia
Worldwide, tourism is the third largest economic activity in direct earnings after petroleum and automobile industries, and by far the largest one if indirect earnings are also taken into consideration. Taking into account the profound economic impact the tourism and hospitality industries can have on regions and cities around the world, further research in this area is critical.\\ud \\ud Global Dynamics in Travel, Tourism, and Hospitality takes a holistic approach to tourism and hospitality op...
Handayani, P W; Hidayanto, A N; Pinem, A A; Hapsari, I C; Sandhyaduhita, P I; Budi, I
The purpose of this study is to develop a model of Hospital Information System (HIS) user acceptance focusing on human, technological, and organizational characteristics for supporting government eHealth programs. This model was then tested to see which hospital type in Indonesia would benefit from the model to resolve problems related to HIS user acceptance. This study used qualitative and quantitative approaches with case studies at four privately owned hospitals and three government-owned hospitals, which are general hospitals in Indonesia. The respondents involved in this study are low-level and mid-level hospital management officers, doctors, nurses, and administrative staff who work at medical record, inpatient, outpatient, emergency, pharmacy, and information technology units. Data was processed using Structural Equation Modeling (SEM) and AMOS 21.0. The study concludes that non-technological factors, such as human characteristics (i.e. compatibility, information security expectancy, and self-efficacy), and organizational characteristics (i.e. management support, facilitating conditions, and user involvement) which have level of significance of p<0.05, significantly influenced users' opinions of both the ease of use and the benefits of the HIS. This study found that different factors may affect the acceptance of each user in each type of hospital regarding the use of HIS. Finally, this model is best suited for government-owned hospitals. Based on the results of this study, hospital management and IT developers should have more understanding on the non-technological factors to better plan for HIS implementation. Support from management is critical to the sustainability of HIS implementation to ensure HIS is easy to use and provides benefits to the users as well as hospitals. Finally, this study could assist hospital management and IT developers, as well as researchers, to understand the obstacles faced by hospitals in implementing HIS. Copyright © 2016
Kansakar, Prasanna; Munir, Arslan; Shabani, Neda
The leisure and hospitality industry is one of the driving forces of the global economy. The widespread adoption of new technologies in this industry over recent years has fundamentally reshaped the way in which services are provided and received. In this paper, we explore some of the state-of-the-art technologies currently employed in the hospitality industry and how they are improving guest experiences and changing the hospitality service platform. We also envision some potential future hos...
Brotman, Billie Ann
This article examines demand factors for sophisticated medical treatments offered by private hospitals operating in India. Three types of medical tourism exist: Outbound, Inbound, and Intrabound. Increased profitability and positive growth trends by private hospital chains can be attributed to rising domestic income levels within India. Not all of the chains examined were financially solvent. Some of the hospital groups in this sample that advertised directly to potential Inbound medical tourists appear to be experiencing negative cash flows.
Nero C Wabo; P Örtenwall; A Khorram-Manesh
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 plann...
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.
Hoffmann, Ida Ørduk; Zapata Rodriguez, Valentina; Jeong, Cheol-Ho
time (EDT) and T20, and the sound pressure level metrics, namely the equivalent level and peak level. In addition, the staff at the hospitals is asked about their personal perception of the acoustic and noise conditions and the correlation between their subjective disturbances......This project aims to compare room acoustic parameters and noise levels in various Danish hospitals: Odense, Gentofte, Bispebjerg, Hillerød and Aarhus Hospitals. Room acoustic conditions are measured in audiometric rooms at Odense, Gentofte, Bispebjerg and Aarhus hospitals. The noise levels...
Historically, art has served a significant purpose within hospital waiting rooms. However, in recent times we have experienced cuts in funding and less interest in improving the aesthetic of art displayed in Australian hospitals. This article briefly discusses the history of art in hospitals and explores a methodology for researching the preference of Australian patients today. Potentially, Australians waiting in hospitals and medical clinics could benefit from art works that reflect their preferences; this may help to ease the pain, anxiety, and boredom of waiting.
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.
Beck, Anne Marie; Balknäs, Ulla N.; Camilo, Maria E.
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...... is required from national authorities and hospital staff, including managers, to ensure appropriate nutritional care and support.......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...
Layde, Peter M; Meurer, Linda N; Guse, Clare; Meurer, John R; Yang, Hongyan; Laud, Prakash; Kuhn, Evelyn M; Brasel, Karen J; Hargarten, Stephen W
.... The development, validation, and testing of screening criteria for medical injury was based on International Classification of Disease code discharge diagnoses using 2001 patient data from Wisconsin hospitals...
Hachesu, Peyman Rezaei; Zyaei, Leila; Hassankhani, Hadi
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. 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. 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. 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.
Adwell, James P
.... This paper reviews personnel attitudes towards preparedness at Johns Hopkins Hospital, types of training used in disaster preparedness and their effectiveness, the use of individual and family...
Department of Veterans Affairs — Strategic Analytics for Improvement and Learning Value Model or SAIL, is a system for summarizing hospital system performance within Veterans Health Administration...
Galvin, Eileen Catherine; Wills, Teresa; Coffey, Alice
To report on an analysis on the concept of 'readiness for hospital discharge'. No uniform operational definition of 'readiness for hospital discharge' exists in the literature; therefore, a concept analysis is required to clarify the concept and identify an up-to-date understanding of readiness for hospital discharge. Clarity of the concept will identify all uses of the concept; provide conceptual clarity, an operational definition and direction for further research. Literature review and concept analysis. A review of literature was conducted in 2016. Databases searched were: Academic Search Complete, CINAHL Plus with Full Text, PsycARTICLES, Psychology and Behavioural Sciences Collection, PsycINFO, Social Sciences Full Text (H.W. Wilson) and SocINDEX with Full Text. No date limits were applied. Identification of the attributes, antecedents and consequences of readiness for hospital discharge led to an operational definition of the concept. The following attributes belonging to 'readiness for hospital discharge' were extracted from the literature: physical stability, adequate support, psychological ability, and adequate information and knowledge. This analysis contributes to the advancement of knowledge in the area of hospital discharge, by proposing an operational definition of readiness for hospital discharge, derived from the literature. A better understanding of the phenomenon will assist healthcare professionals to recognize, measure and implement interventions where necessary, to ensure patients are ready for hospital discharge and assist in the advancement of knowledge for all professionals involved in patient discharge from hospital. © 2017 John Wiley & Sons Ltd.
Kristensen, Troels; Bogetoft, Peter; Pedersen, Kjeld Moeller
The Danish hospital sector faces a major rebuilding program to centralize activity in fewer and larger hospitals. We aim to conduct an efficiency analysis of hospitals and to estimate the potential cost savings from the planned hospital mergers. We use Data Envelopment Analysis (DEA) to estimate a cost frontier. Based on this analysis, we calculate an efficiency score for each hospital and estimate the potential gains from the proposed mergers by comparing individual efficiencies with the efficiency of the combined hospitals. Furthermore, we apply a decomposition algorithm to split merger gains into technical efficiency, size (scale) and harmony (mix) gains. The motivation for this decomposition is that some of the apparent merger gains may actually be available with less than a full-scale merger, e.g., by sharing best practices and reallocating certain resources and tasks. Our results suggest that many hospitals are technically inefficient, and the expected "best practice" hospitals are quite efficient. Also, some mergers do not seem to lower costs. This finding indicates that some merged hospitals become too large and therefore experience diseconomies of scale. Other mergers lead to considerable cost reductions; we find potential gains resulting from learning better practices and the exploitation of economies of scope. To ensure robustness, we conduct a sensitivity analysis using two alternative returns-to-scale assumptions and two alternative estimation approaches. We consistently find potential gains from improving the technical efficiency and the exploitation of economies of scope from mergers.
Schoenfeldt, R C; Seale, W B; Hale, A W
Because of rapidly changing developments in the healthcare field, more emphasis is being placed on marketing of hospital services. A hospital's success will depend more and more on strategic planning based on timely and accurate information. In light of this, Lourdes Hospital, Paducah, KY, undertook a survey to evaluate its current performance and to determine a path for the future. The survey found, among other discoveries, that patients want more voice in determining their own treatment; they prefer outpatient treatment when possible, even if it is not covered by insurance; and stress management and health assessment clinics are the most popular extra services a hospital could offer. Physicians surveyed said they wanted more input into the evaluation of new services and equipment at the hospital. The survey also found that most patients either select a hospital in conjunction with their physician or have their physician choose the hospital. The findings led to some major changes at the hospital, including a restructuring of the planning process to get physicians more involved, a new marketing strategy to enhance communication with consumers, and increased outpatient services. The results have given direction to the hospital administration, helped shape advertising, and provided support for certificate-of-need requests.
Weil, T P; Pearl, G M
A review of America's "best" teaching hospitals shows a huge disparity in their fiscal positions. Among the 15 hospitals studied, roughly half experience some fiscal distress. However, a somewhat similar fiscal analysis of the nation's largest investor-owned hospital chains, HMOs, and physician practice management corporations shows an even more serious weakness in operating margins and debt-equity ratios. Aside from raising possible ethical, quality, and cost issues, this financial analysis suggests that conversion from nonprofit to for-profit ownership of America's top teaching hospitals might not guarantee an improvement in their long-term fiscal outlook.
Harris, Donna L; Lloyd, James W; Marrinan, Mike
The Skills, Knowledge, Aptitude, and Attitude (SKA) Subcommittee of the National Commission on Veterinary Economic Issues (NCVEI) has identified the need for veterinary teaching hospitals (VTH) to be at the forefront of progressive business management to serve as a model for both students and practitioners to emulate. To provide a foundation for developing a model, this study reviewed pertinent literature applicable to the management of a VTH. Much of the literature relevant to VTH management relates to work completed for the human side of medicine (academic health centers, or AHCs) or to the private sector. This review explores management practices in strategic planning, financial management, human resource management, marketing, pricing, operations, and legal issues. It is concluded that strategic management is important to provide the foundation for success in the VTH. In addition, periodic financial reports are recommended, as are the development and use of benchmarks for financial management. Establishing positive, motivating human resource practices is also suggested, along with development of a marketing plan based on a clear understanding of VTH core competencies and the market's specific needs.
Moriya, Asako S; Vogt, William B; Gaynor, Martin
There has been substantial consolidation among health insurers and hospitals, recently, raising questions about the effects of this consolidation on the exercise of market power. We analyze the relationship between insurer and hospital market concentration and the prices of hospital services. We use a national US dataset containing transaction prices for health care services for over 11 million privately insured Americans. Using three years of panel data, we estimate how insurer and hospital market concentration are related to hospital prices, while controlling for unobserved market effects. We find that increases in insurance market concentration are significantly associated with decreases in hospital prices, whereas increases in hospital concentration are non-significantly associated with increases in prices. A hypothetical merger between two of five equally sized insurers is estimated to decrease hospital prices by 6.7%.
Nurenberg, Jeffry R; Schleifer, Steven J; Kennedy, Cheryl; Walker, Mary O; Mayerhoff, David
State hospitals may be underutilized in medical education. US state psychiatric hospitals were surveyed on current and potential psychiatry medical student education. A 10-item questionnaire, with multiple response formats, was sent to identified hospitals in late 2012. Ninety-seven of 221 hospitals contacted responded. Fifty-three (55%) reported current medical student education programs, including 27 clinical clerkship rotations. Education and training in other disciplines was prevalent in hospitals both with and without medical students. The large majority of responders expressed enthusiasm about medical education. The most frequent reported barrier to new programs was geographic distance from the school. Limited resources were limiting factors for hospitals with and without current programs. Only a minority of US state hospitals may be involved in medical student education. While barriers such as geographic distance may be difficult to overcome, responses suggest opportunities for expanding medical education in the state psychiatric hospitals.
Holmes, George M; Pink, George H; Friedman, Sarah A
To compare the financial performance of rural hospitals with Medicare payment provisions to those paid under prospective payment and to estimate the financial consequences of elimination of the Critical Access Hospital (CAH) program. Financial data for 2004-2010 were collected from the Healthcare Cost Reporting Information System (HCRIS) for rural hospitals. HCRIS data were used to calculate measures of the profitability, liquidity, capital structure, and financial strength of rural hospitals. Linear mixed models accounted for the method of Medicare reimbursement, time trends, hospital, and market characteristics. Simulations were used to estimate profitability of CAHs if they reverted to prospective payment. CAHs generally had lower unadjusted financial performance than other types of rural hospitals, but after adjustment for hospital characteristics, CAHs had generally higher financial performance. Special payment provisions by Medicare to rural hospitals are important determinants of financial performance. In particular, the financial condition of CAHs would be worse if they were paid under prospective payment. © 2012 National Rural Health Association.
Torun, Nazan; Celik, Yusuf; Younis, Mustafa Z
The level of competition among hospitals in Turkey was analyzed for the years 1990 through 2006 using the Herfindahl-Hirschman Index (HHI). Multiple and simple regression analyses were run to observe the development of competition among hospitals over this period of time, to examine likely determinants of competition, and to calculate the effects of competition on efficiency and quality in individual hospitals. This study found that the level of competition among hospitals in Turkey has increased throughout the years. Also, competition has had a positive effect on the efficiency of hospitals; however, it did not have a significant positive effect on their quality. Moreover, there are important differences in the level of competition among hospitals that vary according to the geographical region, the type of ownership, and the type of hospital. This study is one of the first to evaluate the effects of health policies on competition as well as the effects of increasing competition on hospital quality and efficiency in Turkey.
McHugh, Matthew D; Berez, Julie; Small, Dylan S
The Affordable Care Act's Hospital Readmissions Reduction Program (HRRP) penalizes hospitals based on excess readmission rates among Medicare beneficiaries. The aim of the program is to reduce readmissions while aligning hospitals' financial incentives with payers' and patients' quality goals. Many evidence-based interventions that reduce readmissions, such as discharge preparation, care coordination, and patient education, are grounded in the fundamentals of basic nursing care. Yet inadequate staffing can hinder nurses' efforts to carry out these processes of care. We estimated the effect that nurse staffing had on the likelihood that a hospital was penalized under the HRRP. Hospitals with higher nurse staffing had 25 percent lower odds of being penalized compared to otherwise similar hospitals with lower staffing. Investment in nursing is a potential system-level intervention to reduce readmissions that policy makers and hospital administrators should consider in the new regulatory environment as they examine the quality of care delivered to US hospital patients.
Salahuddin, Lizawati; Ismail, Zuraini; Hashim, Ummi Rabaah; Raja Ikram, Raja Rina; Ismail, Nor Haslinda; Naim Mohayat, Mohd Hariz
The objective of this study is to identify factors influencing unsafe use of hospital information systems in Malaysian government hospitals. Semi-structured interviews with 31 medical doctors in three Malaysian government hospitals implementing total hospital information systems were conducted between March and May 2015. A thematic qualitative analysis was performed on the resultant data to deduce the relevant themes. A total of five themes emerged as the factors influencing unsafe use of a hospital information system: (1) knowledge, (2) system quality, (3) task stressor, (4) organization resources, and (5) teamwork. These qualitative findings highlight that factors influencing unsafe use of a hospital information system originate from multidimensional sociotechnical aspects. Unsafe use of a hospital information system could possibly lead to the incidence of errors and thus raises safety risks to the patients. Hence, multiple interventions (e.g. technology systems and teamwork) are required in shaping high-quality hospital information system use.
Cohen, R D; Larson, L R; Roth, J M; Becker, R V; Mummert, L L
The aim of this study was to evaluate the demographics, resource use, and costs associated with hospitalization of Crohn's disease patients. All patients hospitalized at our institution from 7/1/96 to 6/30/97 with a primary diagnosis of "Crohn's Disease" were analyzed using a computerized database. Data are presented "per hospitalization." A total of 175 hospitalizations (147 patients) were identified. Mean patient age was 36.5 yr; 61% were female; 82% Caucasian. Payer mix was most commonly contracted (57%), commercial (21%), or Medicare (13%). 57% of hospitalizations had a primary surgical procedure; the remainder were medical. Average length of stay was 8.7 days (surgical, 9.6 days; medical, 7.5 days). The average cost of hospitalization, excluding physician fees, was $12,528 (surgical, $14,409; medical, $10,020), whereas average charges were $35,378 (surgical, $46,354; medical, $20,744), including physician fees, which averaged $7,249 (surgical, $11,217; medical, $1,959). Mean reimbursements were $21,968 (surgical, $28,946; medical, $12,666) with average weighted reimbursement rates of 60.17% of hospital charges, 69.57% of physician fees. The distribution of costs across subcategories was: Surgery (39.6%), Pharmacy (18.6%), Laboratory (3.8%), Radiology (2.1%), Pathology (0.8%), Endoscopy (0.3%), and Other Hospital Costs (34.9%). Of the hospitalizations, 87% included treatment with steroids, 23% with immunomodulators, and 14% with aminosalicylates; 27% included the administration of total parenteral nutrition, which accounted for 63% of the total pharmacy costs. Surgery accounts for the majority of hospitalizations, nearly 40% of their total costs, and 75% of overall charges and reimbursements. Therapy that decreases the number of surgical hospitalizations should substantially reduce inpatient Crohn's disease costs, as well as overall costs.
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.
Trinh, Hieu T; Nguyen, Huong T L; Pham, Van T T; Ba, Hai L; Dong, Phuong T X; Cao, Thao T B; Nguyen, Hanh T H; Brien, Jo-Anne
Background Clinical pharmacy is key to the quality use of medicines. While there are different approaches in different countries, international perspectives may inform health service development. The Vietnamese Ministry of Health introduced a legal regulation of clinical pharmacy services in December 2012. Objective To describe the services, and to explore reported barriers and facilitators in implementing clinical pharmacy activities in Vietnamese hospitals after the introduction of Vietnamese Ministry of Health legal regulation. Setting Thirty-nine hospitals in Hanoi, Vietnam, including 22 provincial and 17 district hospitals. Method A mixed methods study was utilized. An online questionnaire was sent to the hospitals. In-depth interviews were conducted with pairs of nominated pharmacists at ten of these hospitals. The questionnaire focused on four areas: facilities, workforce, policies and clinical pharmacy activities. Main outcome measure Proportion of clinical pharmacy activities in hospitals. Themes in clinical pharmacy practice. Results 34/39 (87%) hospitals had established clinical pharmacy teams. Most activities were non-patient-specific (87%) while the preliminary patient-specific clinical pharmacy services were available in only 8/39 hospitals (21%). The most common non-patient-specific activities were providing medicines information (97%), reporting adverse drug reactions (97%), monitoring medication usage (97%). The patient specific activities varied widely between hospitals and were ad hoc. The main challenges reported were: lack of workforce and qualified clinical pharmacists. Conclusion While most hospitals had hospital-based pharmacy activities, the direct patient care was limited. Training, education and an expanded work forces are needed to improve clinical pharmacy services.
Houy, J.C.; Rimbert, J.C.; Bouvet, C.; Laugle, S.
The hospital radioactive wastes are of three types: solid, liquid and gaseous. Prior to final evacuation all these wastes are checked by a detector the threshold of which is lower than the standard. This system allows detecting activities very low under the daily recommended threshold of 37 kBq (1μ Ci), for the group II. In metabolic radiotherapy the unsealed sources of iodine 131 will form mainly the wastes arising from the rooms contaminated by the patient himself. In this service anything touching the patient's room most by systematically checked. All the rooms are provided with toilette with two compartments, one connected traditionally to the sewerage system for faeces and the other coupled to tanks for urine storing. The filled reservoirs waits around 10 month span prior to being emptied, after checking, into the sewerage system. The volume activity most be lower than 7 Bq per liter (standard). For the hot labs, injection room and in-vitro lab, the liquid waste retrieved from dedicated stainless sinks are stored in storage tanks and will waits for 2 years before evacuation. The undies coming from the metabolic radiotherapy service are possible contaminated by the patient sheets, pillow cases, etc. These undies freshly contaminated may be contaminating if the contamination is non fixated. All the undies coming from this service are checked like all the wastes by means of the fixed detector. For the solid wastes two evacuation channels are possible: the urban garbage repository for household wastes and the Brest waste repository for hospital wastes. For the liquid waste arising for urines, used washing water, etc, the evacuation will be done towards city sewerage system after storing or dilution. Concerning the liquid wastes presenting chemical risks, they will be evacuated in cans by NETRA. Concerning the gaseous wastes, trapped on active carbon filters, they will be handled like solid wastes and will be directed to the waste repository of Brest. The other
Lin, Chih-Yuan; Huang, Ai-Ling; Minas, Harry; Cohen, Alex
Abstract Background Yuli Veterans Hospital (YVH) has been the largest mental hospital for the patients with chronic and severe mental illness in Taiwan for the past 50 years. While this hospital used to be a symbol of hopelessness among patients and their families and an unspoken shame among Taiwan psychiatry and mental health circles it now represents an example of how an old, custodial hospital can be transformed into a very different institution. In this case study we will describe the fea...
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.
Saint, Sanjay; Kowalski, Christine P; Forman, Jane; Damschroder, Laura; Hofer, Timothy P; Kaufman, Samuel R; Creswell, John W; Krein, Sarah L
Although urinary tract infection (UTI) is the most common hospital-acquired infection, there is little information about why hospitals use or do not use a range of available preventive practices. We thus conducted a multicenter study to understand better how US hospitals approach the prevention of hospital-acquired UTI. This research is part of a larger study employing both quantitative and qualitative methods. The qualitative phase consisted of 38 semistructured phone interviews with key personnel at 14 purposefully sampled US hospitals and 39 in-person interviews at 5 of those 14 hospitals, to identify recurrent and unifying themes that characterize how hospitals have addressed hospital-acquired UTI. Four recurrent themes emerged from our study data. First, although preventing hospital-acquired UTI was a low priority for most hospitals, there was substantial recognition of the value of early removal of a urinary catheter for patients. Second, those hospitals that made UTI prevention a high priority also focused on noninfectious complications and had committed advocates, or "champions," who facilitated prevention activities. Third, hospital-specific pilot studies were important in deciding whether or not to use devices such as antimicrobial-impregnated catheters. Finally, external forces, such as public reporting, influenced UTI surveillance and infection prevention activities. Clinicians and policy makers can use our findings to develop initiatives that, for example, use a champion to promote the removal of unnecessary urinary catheters or exploit external forces, such public reporting, to enhance patient safety.
Li, Yongjun; Lei, Xiyang; Morton, Alec
Throughout the world, hospitals are under increasing pressure to become more efficient. Efficiency analysis tools can play a role in giving policymakers insight into which units are less efficient and why. Many researchers have studied efficiencies of hospitals using data envelopment analysis (DEA) as an efficiency analysis tool. However, in the existing literature on DEA-based performance evaluation, a standard assumption of the constant returns to scale (CRS) or the variable returns to scale (VRS) DEA models is that decision-making units (DMUs) use a similar mix of inputs to produce a similar set of outputs. In fact, hospitals with different primary goals supply different services and provide different outputs. That is, hospitals are nonhomogeneous and the standard assumption of the DEA model is not applicable to the performance evaluation of nonhomogeneous hospitals. This paper considers the nonhomogeneity among hospitals in the performance evaluation and takes hospitals in Hong Kong as a case study. An extension of Cook et al. (2013)  based on the VRS assumption is developed to evaluated nonhomogeneous hospitals' efficiencies since inputs of hospitals vary greatly. Following the philosophy of Cook et al. (2013) , hospitals are divided into homogeneous groups and the product process of each hospital is divided into subunits. The performance of hospitals is measured on the basis of subunits. The proposed approach can be applied to measure the performance of other nonhomogeneous entities that exhibit variable return to scale.
Kamp-Hopmans, Titia E. M.; Blok, Hetty E. M.; Troelstra, Annet; Gigengack-Baars, Ada C. M.; Weersink, Annemarie J. L.; Vandenbroucke-Grauls, Christina M. J. E.; Verhoef, Jan; Mascini, Ellen M.
OBJECTIVES: To determine incidence rates of hospital-acquired infections and to develop preventive measures to reduce the risk of hospital-acquired infections. METHODS: Prospective surveillance for hospital-acquired infections was performed during a 5-year period in the wards housing general and
Derrick, Jennifer Willahan; Bellini, Sarah Gunnell; Spelman, Julie
Health-promoting environments advance health and prevent chronic disease. Hospitals have been charged to promote health and wellness to patients, communities, and 5.3 million adults employed in United States health care environments. In this cross-sectional observational study, the Hospital Nutrition Environment Scan (HNES) was used to measure the nutrition environment of hospital cafeterias and evaluate the influence of the LiVe Well Plate health initiative. Twenty-one hospitals in the Intermountain West region were surveyed between October 2013 and May 2014. Six hospitals participated in the LiVe Well Plate health initiative and were compared with 15 hospitals not participating. The LiVe Well Plate health initiative identified and promoted a healthy meal defined as health initiative branding were also posted at point of purchase. Hospital cafeterias were scored on four subcategories: facilitators and barriers, grab-and-go items, menu offerings, and selection options at point of purchase. Overall, hospitals scored 35.3±13.7 (range=7 to 63) points of 86 total possible points. Cafeterias in health initiative hospitals had significantly higher mean nutrition composite scores compared with non-health initiative hospitals (49.2 vs 29.7; Penvironment of hospital cafeterias. Additional research is needed to quantify and strategize ways to improve nutrition environments within hospital cafeterias and assess the influence on healthy lifestyle behaviors. Copyright © 2015 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.
Pijls-Hoekstra, Ruth; Groen, Brenda H.; Galetzka, Mirjam; Pruyn, Ad T.H.
What is hospitality? Only few academic articles tap into the meaning of the concept of hospitality. Especially academic investigation of hospitality from a guest perspective is scarce; the combination of ‘hospitality’ and ‘experience’ has received hardly any attention. The present paper describes a
Baptist Hospital Inc., Pensacola, Fla.; and Saint Luke's Hospital, Kansas City, Mo., have received the prestigious Malcolm Baldrige National Quality Award in the category of healthcare. Named for a former secretary of commerce, the award recognizes efficiency, effectiveness and excellence. The two hospitals are among only seven companies in the U.S. to be so recognized this year.
... Readmission 5. MDC 8 (Diseases and Disorders of the Musculoskeletal System and Connective Tissue) a. Reverse... hospitals, PPS-exempt cancer hospitals, LTCHs, and inpatient psychiatric facilities (IPFs)) that are..., (410) 786-2261, PPS-Exempt Cancer Hospital Quality Reporting Issues. Allison Lee, (410) 786-8691 and...
... Connective Tissue) a. Reverse Shoulder Procedures b. Total Ankle Replacement Procedures 6. MDC 15 (Newborns... specific providers (acute care hospitals, PPS-exempt cancer hospitals, LTCHs, and inpatient psychiatric... Issues. James Poyer, (410) 786-2261, PPS-Exempt Cancer Hospital Quality Reporting Issues. Allison Lee...
... prospective payment system. 419.20 Section 419.20 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM PROSPECTIVE PAYMENT SYSTEM FOR HOSPITAL... Outpatient Prospective Payment System § 419.20 Hospitals subject to the hospital outpatient prospective...
Herklots, T.; Acht, L. van; Meguid, T.; Franx, A.; Jacod, B.C.
OBJECTIVE: to analyse the impact of in-hospital care on severe maternal morbidity using WHO's near-miss approach in the low-resource, high mortality setting of Zanzibar's referral hospital. SETTING: Mnazi Mmoja Hospital, a tertiary care facility, in Zanzibar, Tanzania. METHODS: We identified all
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.
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.
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…
Zahedpisheh, Nahid; Abu Bakar, Zulqarnain B.; Saffari, Narges
The quick development of the tourism and hospitality industry can straightly influence the English language which is the most widely used and spoken language in international tourism in the twenty-first century. English for tourism has a major role in the delivery of quality service. Employees who work in the tourism and hospitality industry are…
Dunne, T; Davis, S
Very little has been published about the effects of hospital closure in terms of the service, financial or management issues of the process. Attempts through a case-study format to redress the balance and as such represents the reflections of practitioners who have recently undergone the experience of hospital closure and the often neglected issues arising both during and after the process.
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.
Anunciação, Alan Lira da; Zoboli, Elma
The hospital, as a unique type of social organization requires elevated values for management. This paper shows the result of a documented, qualitative, exploratory and descriptive survey about hospitals and their value statements. Identify values expected for hospitals by a search of literature; identify values expressed by hospitals on their web pages and compare results of both. Critical reading of theses, books and articles. A bibliographic search was carried out on BVS (Health Virtual Library) using keywords such as ethics and healthcare management. The values stated by hospitals on web pages were found in sections such as social responsibility, mission, view, principles, and our values. The categories care, healthcare management and accountability were defined after content analysis of empirical data. Values stated by hospitals on web pages express social expectations for an organization that deals with issues as elevated as health and life. Although hospitals have a bureaucratic and organizational structure that resembles those of business enterprises, they are different due to their 'duties to patients' rights and life. Healthcare managers, as well as health professionals, must imprint an ethical attitude on their job and daily work. Only such an attitude will permit patients to trust the hospital and its services.
Norwegian hospitals have been characterised by increasing activity, expansion of services and increasing costs for a long time. Differences in quality and accessibility have been documented between hospitals in various geographic locations. Transferral of hospital ownership to the state (from 2002) aimed at increasing capacities and improving quality of services, but also at restricting the increase of costs. These goals have only been partly met. The structure of hospital trusts and organisation of services are therefore continuously debated. This literature review aims at examining whether hospital mergers can reduce costs and at the same time increase the quality of services offered. Literature was identified through a Medline search using the terms "hospital", "merger" and "cost saving". The results are summarized and discussed. Seven original studies of totally 476 hospital mergers (in the USA, Great Britain and Norway) were identified in the period 1982 - 2000. The literature indicates that hospital mergers have a potential to reduce costs by about 10 % if the process achieves complete fusion of previously independent organisations, with a more optimal dimensioning of services and development of a common organizational culture. Collaboration between top management and the professional bureaucracy are prerequisites for success. Mergers are associated with a significant risk of unexpected problems and temporary reduced quality of the services.
Chetty, Veerappa K; Culpepper, Larry; Phillips, Robert L; Rankin, Jennifer; Xierali, Imam; Finnegan, Sean; Jack, Brian
Hospital readmission after discharge is often a costly failing of the U.S. health care system to adequately manage patients who are ill. Increasing the numbers of family physicians (FPs) is associated with significant reductions in hospital readmissions and substantial cost savings.