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Sample records for centralized hospital services

  1. Professional Nursing Duties in the Central Services: Hospital Pharmacy Nurses

    Directory of Open Access Journals (Sweden)

    Inmaculada Gómez-Villegas

    2015-01-01

    Full Text Available Introduction. The new demands of a fast changing world necessitate expanding the traditional concepts of nursing, extending the classical aspects to cover new areas. Purpose. Based on their professional duties, the nursing team in the pharmacy of a second-level hospital aimed to establish a theoretical and situational framework for nurses working in the central services. Material and Methods. Application of the nursing process to nursing work in an area with no direct contact with patients. Results and Discussion. The application of the NANDA diagnoses to professional practice enabled the establishment of a nursing diagnosis with the implementation of measures designed to overcome a stressful situation with a risk of becoming unmotivated. Main Conclusion. The capacity to adapt the nursing profession to undertake new roles in the field of healthcare and the power of nursing own methodological resources permit the indirect care of “faceless” patients to be complemented with the inclusion of nurses from other services as clients, forming the focus of care, who can thus be helped with their daily care work.

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

    Science.gov (United States)

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

    2015-04-01

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

  3. Central line infections - hospitals

    Science.gov (United States)

    ... infection; Central venous catheter - infection; CVC - infection; Central venous device - infection; Infection control - central line infection; Nosocomial infection - central line infection; Hospital acquired ...

  4. Central Laboratories Services

    Data.gov (United States)

    Federal Laboratory Consortium — The TVA Central Laboratories Services is a comprehensive technical support center, offering you a complete range of scientific, engineering, and technical services....

  5. Service Robots for Hospitals

    DEFF Research Database (Denmark)

    Özkil, Ali Gürcan

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

  6. Centralized administrative services management.

    Science.gov (United States)

    Freed, D H

    1994-06-01

    Virtually every hospital has imposed guidelines or controls on one or more administrative service expenses. However, the actual deployment of such strategies is often voluntary, decentralized, disjointed and episodic. An alternative approach is to cluster administrative elements across hospital departments and make them the responsibility of a dedicated manager. This approach treats administrative services as an organizing principle with uniform, predictable standards of service and cost. Customer requirements for products and services are met without the need for them to physically manage that process. Materiel managers can demonstrate a leadership role by applying their professionalism and know-how to a set of products and services traditionally ignored or dealt with in an uncoordinated manner. While some initial resistance can be expected as traditional barriers are disassembled, the results should be very rewarding for the hospital and materiel manager alike.

  7. VT - Vermont Hospital Service Areas

    Data.gov (United States)

    Vermont Center for Geographic Information — Hospital service areas (HSAs) are organized by towns and are based on inpatient discharges where the diagnosis indicated the need for immediate care. Plurality...

  8. Strategic management of Public Hospitals' medical services.

    Science.gov (United States)

    Hao, Aimin; Yi, Tao; Li, Xia; Wei, Lei; Huang, Pei; Xu, Xinzhou; Yi, Lihua

    2016-01-01

    Purpose: The quality of medical services provided by competing public hospitals is the primary consideration of the public in determining the selection of a specific hospital for treatment. The main objective of strategic planning is to improve the quality of public hospital medical services. This paper provides an introduction to the history, significance, principles and practices of public hospital medical service strategy, as well as advancing the opinion that public hospital service strategy must not merely aim to produce but actually result in the highest possible level of quality, convenience, efficiency and patient satisfaction.

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

    Science.gov (United States)

    Jajko, P

    1992-01-01

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

  10. Service quality for facilities management in hospitals

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    Sui Pheng, Low

    2016-01-01

    This book examines the Facilities Management (FM) of hospitals and healthcare facilities, which are among the most complex, costly and challenging kind of buildings to manage. It presents and evaluates the FM service quality standards in Singapore’s hospitals from the patient’s perspective, and provides recommendations on how to successfully improve FM service quality and achieve higher patient satisfaction. The book also features valuable supplementary materials, including a checklist of 32 key factors for successful facilities management and another checklist of 24 service attributes for hospitals to achieve desirable service quality in connection with facilities management. The book adopts a unique approach of combining service quality and quality theory to provide a more holistic view of how FM service quality can be achieved in hospitals. It also integrates three instruments, namely the SERVQUAL model, the Kano model and the QFD model to yield empirical results from surveys for implementation in hosp...

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

    Directory of Open Access Journals (Sweden)

    Dharmesh, MOTWANI

    2014-07-01

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

  12. eServices for Hospital Equipment

    NARCIS (Netherlands)

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

    2007-01-01

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

  13. UHS development and hospital services rationing.

    Science.gov (United States)

    Ribeiro, José Mendes

    2009-01-01

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

  14. 42 CFR 440.140 - Inpatient hospital services, nursing facility services, and intermediate care facility services...

    Science.gov (United States)

    2010-10-01

    ... Definitions § 440.140 Inpatient hospital services, nursing facility services, and intermediate care facility... 42 Public Health 4 2010-10-01 2010-10-01 false Inpatient hospital services, nursing facility services, and intermediate care facility services for individuals age 65 or older in institutions...

  15. Perforated duodenal ulcer in Asir central hospital

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    Jastaniah Suleiman

    1997-01-01

    Full Text Available In a study of 27 cases of perforated duodenal ulcer seen at Asir Central Hospital over a period of seven years, two patients were females and 25 males. The highest incidence was in the fourth decade and the average age was 36.3 years. The Saudi-foreigner ratio was 1:2.9 in an area where the Saudi-foreigner population ratio was 1:3. Nine patients (33.3% were previously diagnosed as having peptic ulcer and had received treatment at one time or the other before perforation. Eighteen patients (66.7% were first diagnosed to peptic ulcer after the perforation. All the identified perforations were located anteriorly and anterosuperiorly. Only one case occurred in the second part of duodenum. The rest occurred in the first part. Two patients were treated successfully conservatively. The month perforations occurred most was the month of Shaaban. The fasting period during the month of Ramadhan did not show any increase in the prevalence of perforation in this hospital.

  16. 75 FR 68799 - Medicare Program; Inpatient Hospital Deductible and Hospital and Extended Care Services...

    Science.gov (United States)

    2010-11-09

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

  17. Centralization of Intensive Care Units: Process Reengineering in a Hospital

    Directory of Open Access Journals (Sweden)

    Arun Kumar

    2010-03-01

    Full Text Available Centralization of intensive care units (ICUs is a concept that has been around for several decades and the OECD countries have led the way in adopting this in their operations. Singapore Hospital was built in 1981, before the concept of centralization of ICUs took off. The hospital's ICUs were never centralized and were spread out across eight different blocks with the specialization they were associated with. Coupled with the acquisitions of the new concept of centralization and its benefits, the hospital recognizes the importance of having a centralized ICU to better handle major disasters. Using simulation models, this paper attempts to study the feasibility of centralization of ICUs in Singapore Hospital, subject to space constraints. The results will prove helpful to those who consider reengineering the intensive care process in hospitals.

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

    Science.gov (United States)

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

    2006-01-01

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

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

    OpenAIRE

    Chen, Yongyi; LIU, JINGSHI; Xiao, Shuiyuan; Liu, Xiangyu; Tang, Xinhui; Zhou, Yujuan

    2014-01-01

    This study aims to construct a satisfaction model on nursing service in hospitalized tumor patients. Using questionnaires, data about hospitalized tumor patients’ expectation, quality perception and satisfaction of hospital nursing service were obtained. A satisfaction model of nursing service in hospitalized tumor patients was established through empirical study and by structural equation method. This model was suitable for tumor specialized hospital, with reliability and validity. Patient s...

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

    Science.gov (United States)

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

    2015-01-01

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

  1. 42 CFR 419.22 - Hospital outpatient services excluded from payment under the hospital outpatient prospective...

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Hospital outpatient services excluded from payment under the hospital outpatient prospective payment system. 419.22 Section 419.22 Public Health CENTERS... PROSPECTIVE PAYMENT SYSTEM FOR HOSPITAL OUTPATIENT DEPARTMENT SERVICES Categories of Hospitals and...

  2. Manchester Protocol at a school hospital emergency service

    Directory of Open Access Journals (Sweden)

    Mayara Raphaela Morais Rezende

    2016-01-01

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

  3. Computerized system for hospital engineering service management

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    Centeno, C A; Gonzalez, E A; Cagnolo, F J; Olmos, C E [Clinical Engineering Group, National Technological University, Cordoba Regional Faculty, Maestro M Lopez St and Cruz Roja Argentina St, Cordoba (Argentina)

    2007-11-15

    When a Hospital Engineering Service (HES) is implemented within a health care environment, the idea is to improve service conditions and costs as well as to provide timely responses to equipment preventive maintenance and infrastructure requirements. An HES must, within the shortest possible period of time, meet the above requirements at the cost necessary to provide the service quality sought. In many cases there is a lack of minimal materials and staff who are qualified to attain the objectives that have been set. Therefore, external assistance becomes necessary. In this context, actions are often taken which, because they are not recorded, cannot be assessed in order to evaluate the HES. Since all action taken is appraised from the purely economic point of view, in the final analysis the contributions from staff remain invisible. This situation works against the possibility of quantifying the convenience of possessing an internal HES. The software support system we have developed here is oriented toward providing all the necessary data to address this issue.

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

    Science.gov (United States)

    Chen, Yongyi; Liu, Jingshi; Xiao, Shuiyuan; Liu, Xiangyu; Tang, Xinhui; Zhou, Yujuan

    2014-01-01

    This study aims to construct a satisfaction model on nursing service in hospitalized tumor patients. Using questionnaires, data about hospitalized tumor patients' expectation, quality perception and satisfaction of hospital nursing service were obtained. A satisfaction model of nursing service in hospitalized tumor patients was established through empirical study and by structural equation method. This model was suitable for tumor specialized hospital, with reliability and validity. Patient satisfaction was significantly affected by quality perception and patient expectation. Patient satisfaction and patient loyalty was also affected by disease pressure. Hospital brand was positively correlated with patient satisfaction and patient loyalty, negatively correlated with patient complaint. Patient satisfaction was positively correlated with patient loyalty, patient complaints, and quality perception, and negatively correlated with disease pressure and patient expectation. The satisfaction model on nursing service in hospitalized tumor patients fits well. By this model, the quality of hospital nursing care may be improved.

  5. Unit cost of medical services at different hospitals in India.

    Directory of Open Access Journals (Sweden)

    Susmita Chatterjee

    Full Text Available Institutional care is a growing component of health care costs in low- and middle-income countries, but local health planners in these countries have inadequate knowledge of the costs of different medical services. In India, greater utilisation of hospital services is driven both by rising incomes and by government insurance programmes that cover the cost of inpatient services; however, there is still a paucity of unit cost information from Indian hospitals. In this study, we estimated operating costs and cost per outpatient visit, cost per inpatient stay, cost per emergency room visit, and cost per surgery for five hospitals of different types across India: a 57-bed charitable hospital, a 200-bed private hospital, a 400-bed government district hospital, a 655-bed private teaching hospital, and a 778-bed government tertiary care hospital for the financial year 2010-11. The major cost component varied among human resources, capital costs, and material costs, by hospital type. The outpatient visit cost ranged from Rs. 94 (district hospital to Rs. 2,213 (private hospital (USD 1 = INR 52. The inpatient stay cost was Rs. 345 in the private teaching hospital, Rs. 394 in the district hospital, Rs. 614 in the tertiary care hospital, Rs. 1,959 in the charitable hospital, and Rs. 6,996 in the private hospital. Our study results can help hospital administrators understand their cost structures and run their facilities more efficiently, and we identify areas where improvements in efficiency might significantly lower unit costs. The study also demonstrates that detailed costing of Indian hospital operations is both feasible and essential, given the significant variation in the country's hospital types. Because of the size and diversity of the country and variations across hospitals, a large-scale study should be undertaken to refine hospital costing for different types of hospitals so that the results can be used for policy purposes, such as revising

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

    OpenAIRE

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

    2016-01-01

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

  7. Birthing Centers and Hospital Maternity Services

    Science.gov (United States)

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

  8. Cloud-based hospital information system as a service for grassroots healthcare institutions.

    Science.gov (United States)

    Yao, Qin; Han, Xiong; Ma, Xi-Kun; Xue, Yi-Feng; Chen, Yi-Jun; Li, Jing-Song

    2014-09-01

    Grassroots healthcare institutions (GHIs) are the smallest administrative levels of medical institutions, where most patients access health services. The latest report from the National Bureau of Statistics of China showed that 96.04 % of 950,297 medical institutions in China were at the grassroots level in 2012, including county-level hospitals, township central hospitals, community health service centers, and rural clinics. In developing countries, these institutions are facing challenges involving a shortage of funds and talent, inconsistent medical standards, inefficient information sharing, and difficulties in management during the adoption of health information technologies (HIT). Because of the necessity and gravity for GHIs, our aim is to provide hospital information services for GHIs using Cloud computing technologies and service modes. In this medical scenario, the computing resources are pooled by means of a Cloud-based Virtual Desktop Infrastructure (VDI) to serve multiple GHIs, with different hospital information systems dynamically assigned and reassigned according to demand. This paper is concerned with establishing a Cloud-based Hospital Information Service Center to provide hospital information software as a service (HI-SaaS) with the aim of providing GHIs with an attractive and high-performance medical information service. Compared with individually establishing all hospital information systems, this approach is more cost-effective and affordable for GHIs and does not compromise HIT performance.

  9. Comparing public and private hospital care service quality.

    Science.gov (United States)

    Camilleri, D; O'Callaghan, M

    1998-01-01

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

  10. Service Robots for Hospitals: A Case Study of Transportation Tasks in a Hospital

    DEFF Research Database (Denmark)

    Özkil, Ali Gürcan; Fan, Zhun; Dawids, Steen

    2009-01-01

    In this paper, the need for automated transportation systems for hospitals is investigated. Among other alternatives, mobile robots stand out as the most prominent means of automation of transportation tasks in hospitals. Existing transportation routines of a hospital are analyzed in order to ver...... for implementing mobile service robots for transportation tasks in hospitals.......In this paper, the need for automated transportation systems for hospitals is investigated. Among other alternatives, mobile robots stand out as the most prominent means of automation of transportation tasks in hospitals. Existing transportation routines of a hospital are analyzed in order...

  11. Improving Financial Services of China's Central Bank

    Institute of Scientific and Technical Information of China (English)

    Yang Wei

    2007-01-01

    @@ On August 29,Deputy Governor of People's Bank of China,Mr.Su Ning,held a press conference at State Council Information Office,and answered questions from media.The press conference mainly focused on the progress the central bank has made in improving financial services,which raised a lot of concern from public.At the conference,Mr. Su Ning fullv illustrated that China has achieved great progress in the recent years,and would perform better in future.

  12. Obesity, hospital services use and costs

    DEFF Research Database (Denmark)

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

    2007-01-01

    To quantify the association between obesity and somatic hospital costs and number of overall somatic hospital contacts--number of inpatient admissions, number of outpatient visits, and number of emergency department visits--based on anthropometric measurements of waist circumference (WC) and info......To quantify the association between obesity and somatic hospital costs and number of overall somatic hospital contacts--number of inpatient admissions, number of outpatient visits, and number of emergency department visits--based on anthropometric measurements of waist circumference (WC...

  13. Centralization of a regional clinical microbiology service: The Calgary experience.

    Science.gov (United States)

    Church, D L; Hall, P

    1999-11-01

    Diagnostic laboratory services in Alberta have been dramatically restructured over the past five years. In 1994, Alberta Health embarked on an aggressive laboratory restructuring that cut back approximately 30% of the overall monies previously paid to the laboratory service sector in Calgary. A unique service delivery model consolidated all institutional and community-based diagnostic testing in a company called Calgary Laboratory Services (CLS) in late 1996. CLS was formed by a public/private partnership between the Calgary Regional Health Care Authority (CRHA) and MDS-Kasper Laboratories. By virtue of its customer service base and scope of testing, CLS provides comprehensive regional laboratory services to the entire populace. Regional microbiology services within CLS have been successfully consolidated over the past three years into a centralized high volume laboratory (HVL). Because the HVL is not located in a hospital, rapid response laboratories (RRLs) are operated at each acute care site. Although the initial principle behind the proposed test menus for the RRLs was that only procedures requiring a clinical turnaround time of more than 2 h stay on-site, many other principles had to be used to develop and implement an efficient and clinically relevant RRL model for microbiology. From these guiding principles, a detailed assessment of the needs of each institution and extensive networking with user groups, the functions of the microbiology RRLs were established and a detailed implementation plan drawn up. The experience at CLS with regards to restructuring a regional microbiology service is described herein. A post-hoc analysis provides the pros and cons of directing and operating a regionalized microbiology service.

  14. Centralization of a Regional Clinical Microbiology Service: The Calgary Experience

    Directory of Open Access Journals (Sweden)

    Deirdre L Church

    1999-01-01

    Full Text Available Diagnostic laboratory services in Alberta have been dramatically restructured over the past five years. In 1994, Alberta Health embarked on an aggressive laboratory restructuring that cut back approximately 30% of the overall monies previously paid to the laboratory service sector in Calgary. A unique service delivery model consolidated all institutional and community-based diagnostic testing in a company called Calgary Laboratory Services (CLS in late 1996. CLS was formed by a public/private partnership between the Calgary Regional Health Care Authority (CRHA and MDS-Kasper Laboratories. By virtue of its customer service base and scope of testing, CLS provides comprehensive regional laboratory services to the entire populace. Regional microbiology services within CLS have been successfully consolidated over the past three years into a centralized high volume laboratory (HVL. Because the HVL is not located in a hospital, rapid response laboratories (RRLs are operated at each acute care site. Although the initial principle behind the proposed test menus for the RRLs was that only procedures requiring a clinical turnaround time of more than 2 h stay on-site, many other principles had to be used to develop and implement an efficient and clinically relevant RRL model for microbiology. From these guiding principles, a detailed assessment of the needs of each institution and extensive networking with user groups, the functions of the microbiology RRLs were established and a detailed implementation plan drawn up. The experience at CLS with regards to restructuring a regional microbiology service is described herein. A post-hoc analysis provides the pros and cons of directing and operating a regionalized microbiology service.

  15. Magnet® Hospital Recognition Linked to Lower Central Line-Associated Bloodstream Infection Rates.

    Science.gov (United States)

    Barnes, Hilary; Rearden, Jessica; McHugh, Matthew D

    2016-04-01

    Central-line-associated bloodstream infections (CLABSI) are among the deadliest heathcare-associated infections, with an estimated 12-25% mortality rate. In 2014, the Centers for Medicare and Medicaid Services (CMS) began to penalize hospitals for poor performance with respect to selected hospital-acquired conditions, including CLABSI. A structural factor associated with high-quality nursing care and better patient outcomes is The Magnet Recognition Program®. The purpose of this study was to explore the relationship between Magnet status and hospital CLABSI rates. We used propensity score matching to match Magnet and non-Magnet hospitals with similar hospital characteristics. In a matched sample of 291 Magnet hospitals and 291 non-Magnet hospitals, logistic regression models were used to examine whether there was a link between Magnet status and CLABSI rates. Both before and after matching, Magnet hospital status was associated with better (lower than the national average) CLABSI rates (OR = 1.60, 95%CI: 1.10, 2.33 after matching). While established programs such as Magnet recognition are consistently correlated with high-quality nursing work environments and positive patient outcomes, additional research is needed to determine whether Magnet designation produces positive patient outcomes or rewards existing excellence.

  16. Health science library and information services in the hospital.

    Science.gov (United States)

    Wakeley, P J; Marshall, S B; Foster, E C

    1985-01-01

    In an increasingly information-based society, hospitals need a variety of information for multiple purposes--direct patient care, staff development and training, continuing education, patient and community education, and administrative decision support. Health science library and information services play a key role in providing broad-based information support within the hospital. This guide identifies resources that will help administrators plan information services that are appropriate to their needs.

  17. Centralized Library Services for Audiovisual Media. AV in Action 4.

    Science.gov (United States)

    Nederlands Bibliotheek en Lektuur Centrum, The Hague (Netherlands).

    Designed to provide assistance to countries in developing centralized services to their libraries for nonbook materials, this pamphlet contains examples from five countries that have succeeded in establishing such services. Those examples include: (1) "The Central Library Service for AV-Materials in Denmark" (Suzanne Hemmeth…

  18. OBESITY, HOSPITAL SERVICES USE AND COSTS

    DEFF Research Database (Denmark)

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

    2007-01-01

    . When using WC as an indicator for obesity, mean hospital costs were 33.8% greater among obese women and 45.3% greater among obese men in a 3-year period but the differences were not significant. When using BMI to measure obesity, obese men had significantly greater costs (57.5%) than normal weight men...

  19. Service quality of private hospitals: The Iranian Patients' perspective

    Directory of Open Access Journals (Sweden)

    Zarei Asghar

    2012-02-01

    Full Text Available Abstract Background Highly competitive market in the private hospital industry has caused increasing pressure on them to provide services with higher quality. The aim of this study was to determine the different dimensions of the service quality in the private hospitals of Iran and evaluating the service quality from the patients' perspective. Methods A cross-sectional study was conducted between October and November 2010 in Tehran, Iran. The study sample was composed of 983 patients randomly selected from 8 private general hospitals. The study questionnaire was the SERVQUAL questionnaire, consisting of 21 items in service quality dimensions. Results The result of factor analysis revealed 3 factors, explaining 69% of the total variance. The total mean score of patients' expectation and perception was 4.91(SD = 0.2 and 4.02(SD = 0.6, respectively. The highest expectation and perception related to the tangibles dimension and the lowest expectation and perception related to the empathy dimension. The differences between perception and expectation were significant (p Conclusion The results showed that SERVQUAL is a valid, reliable, and flexible instrument to monitor and measure the quality of the services in private hospitals of Iran. Our findings clarified the importance of creating a strong relationship between patients and the hospital practitioners/personnel and the need for hospital staff to be responsive, credible, and empathetic when dealing with patients.

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

    Science.gov (United States)

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

    2016-08-01

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

  1. Embedded ubiquitous services on hospital information systems.

    Science.gov (United States)

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

    2012-11-01

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

  2. Adapting the SERVQUAL scale to hospital services: an empirical investigation.

    Science.gov (United States)

    Babakus, E; Mangold, W G

    1992-02-01

    Defining and measuring the quality of service has been a major challenge for health care marketers. A comprehensive service quality measurement scale (SERVQUAL) is empirically evaluated for its potential usefulness in a hospital service environment. Active participation by hospital management helped to address practical and user-related aspects of the assessment. The completed expectations and perceptions scales met various criteria for reliability and validity. Suggestions are provided for the managerial use of the scale, and a number of future research issues are identified.

  3. Measuring patient-perceived hospital service quality: a conceptual framework.

    Science.gov (United States)

    Pai, Yogesh P; Chary, Satyanarayana T

    2016-04-18

    Purpose - Although measuring healthcare service quality is not a new phenomenon, the instruments used to measure are timeworn. With the shift in focus to patient centric processes in hospitals and recognizing healthcare to be different compared to other services, service quality measurement needs to be tuned specifically to healthcare. The purpose of this paper is to design a conceptual framework for measuring patient perceived hospital service quality (HSQ), based on existing service quality literature. Design/methodology/approach - Using HSQ theories, expanding existing healthcare service models and literature, a conceptual framework is proposed to measure HSQ. The paper outlines patient perceived service quality dimensions. Findings - An instrument for measuring HSQ dimensions is developed and compared with other service quality measuring instruments. The latest dimensions are in line with previous studies, but a relationship dimension is added. Practical implications - The framework empowers managers to assess healthcare quality in corporate, public and teaching hospitals. Originality/value - The paper helps academics and practitioners to assess HSQ from a patient perspective.

  4. Costing hospital surgery services: the method matters.

    Directory of Open Access Journals (Sweden)

    Gregoire Mercier

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

  5. Providing Support Services in Selected Decentral¬ized Hospital

    Directory of Open Access Journals (Sweden)

    R Hafezi

    2009-03-01

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

  6. The seven common pitfalls of customer service in hospitals.

    Science.gov (United States)

    Domingo, Rene T

    2015-01-01

    Operating simultaneously like a repair shop, prison, and hotel, hospitals are prone to seven common pitfalls in customer service. Patient care is often fragmented, inscrutable, inflexible, insensitive, reactive, myopic, and unsafe. Hospitals are vying to be more high-tech, rather than high-touch even though staff engagement with patients rather than facilities and equipment strongly influence patient satisfaction. Unless processes, policies, and people are made customer-centered, the high quality of the hospital's human and hardware resources will not translate into high patient satisfaction and patient loyalty.

  7. Evolution of a youth work service in hospital.

    Science.gov (United States)

    Hilton, Donna; Jepson, Shelley

    2012-07-01

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

  8. 42 CFR 409.12 - Nursing and related services, medical social services; use of hospital or CAH facilities.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Nursing and related services, medical social... Inpatient Hospital Services and Inpatient Critical Access Hospital Services § 409.12 Nursing and related... (b) of this section, Medicare pays for nursing and related services, use of hospital or...

  9. Predictors of Language Service Availability in U.S. Hospitals

    Directory of Open Access Journals (Sweden)

    Melody K. Schiaffino

    2014-10-01

    Full Text Available Background Hispanics comprise 17% of the total U.S. population, surpassing African-Americans as the largest minority group. Linguistically, almost 60 million people speak a language other than English. This language diversity can create barriers and additional burden and risk when seeking health services. Patients with Limited English Proficiency (LEP for example, have been shown to experience a disproportionate risk of poor health outcomes, making the provision of Language Services (LS in healthcare facilities critical. Research on the determinants of LS adoption has focused more on overall cultural competence and internal managerial decision-making than on measuring LS adoption as a process outcome influenced by contextual or external factors. The current investigation examines the relationship between state policy, service area factors, and hospital characteristics on hospital LS adoption. Methods We employ a cross-sectional analysis of survey data from a national sample of hospitals in the American Hospital Association (AHA database for 2011 (N= 4876 to analyze hospital characteristics and outcomes, augmented with additional population data from the American Community Survey (ACS to estimate language diversity in the hospital service area. Additional data from the National Health Law Program (NHeLP facilitated the state level Medicaid reimbursement factor. Results Only 64%of hospitals offered LS. Hospitals that adopted LS were more likely to be not-for-profit, in areas with higher than average language diversity, larger, and urban. Hospitals in above average language diverse counties had more than 2-fold greater odds of adopting LS than less language diverse areas [Adjusted Odds Ratio (AOR: 2.26, P< 0.01]. Further, hospitals with a strategic orientation toward diversity had nearly 2-fold greater odds of adopting LS (AOR: 1.90, P< 0.001. Conclusion Our findings support the importance of structural and contextual factors as they relate to

  10. 我院手术支持中心的药事管理模式探索%Exploration on the New Pharmaceutical Administration Pattern of Central Surgery Service Department in Our Hospital

    Institute of Scientific and Technical Information of China (English)

    戴春雷; 缪旭东; 朱元琴; 卜晓光; 陈金凤

    2012-01-01

    目的:加强手术药品的管理.方法:成立手术支持中心,从工作流程改造、运用信息技术等各环节入手,对其药事管理模式进行探索.结果:该药事管理模式大大减少了医护人员手术准备时间和患者等待时间;保证了手术期间麻醉和精神药品使用情况能及时、准确地登记,便于统一管理;能做好药品数量与金额的双重管理,做到账物相符.结论:该管理模式能保证手术药品供应质量,避免差错.%OBJECTIVE: To strengthen the management of surgical drugs. METHODS: The management of the central surgery service department was guided through drug position, workflow reform and information management to explore the pattern of pharmaceutical administration. RESULTS: The new pharmaceutical administration pattern had reduced the operator's preparing time and the patient's waiting time, ensured that the cases of using narcotic and psychotropic drugs could be booked exactly in time, and manage the amount and sum of drugs to make the account fit the contents. CONCLUSIONS: The pattern can ensure efficiency and quality of drug supply and avoid errors.

  11. Organization structure and the performance of hospital emergency services.

    Science.gov (United States)

    Georgopoulos, B S

    1985-07-01

    A comparative study of 30 hospital emergency departments (EDs) and nearly 1,500 individuals associated with them was conducted. Data were obtained from institutional records, physicians, patients, and other sources. The object was to investigate the relationship between the organization and performance of these health service systems. The study assessed the quality of medical care, the quality of nursing care, and the economic efficiency of hospital EDs. The results show substantial interinstitutional differences in these criteria. They also show a significant relationship between medical and nursing care, but not between the quality of care and economic efficiency. Differences in ED performance are related to medical staffing patterns, medical teaching affiliation, personnel training, scope of emergency services, number of patient visits processed, and hospital size and complexity. Not all of these variables, however, correlate positively with all three criteria of performance, nor are they equally important to each.

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

    Science.gov (United States)

    Noble, Vanessa; Parle, Julie

    2014-04-01

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

  13. Perceived nursing service quality in a tertiary care hospital, Maldives.

    Science.gov (United States)

    Nashrath, Mariyam; Akkadechanunt, Thitinut; Chontawan, Ratanawadee

    2011-12-01

    The present study explored nurses' and patients' expectations of nursing service quality, their perception of performance of nursing service quality performed by nurses, and compared nursing service quality, as perceived by nurses and patients. The sample consisted of 162 nurses and 383 patients from 11 inpatient wards/units in a tertiary care hospital in the Maldives. Data were collected using the Service Quality scale, and analyzed using descriptive statistics and the Mann-Whitney U-test. The results indicated that the highest expected dimension and perceived dimension for nursing service quality was Reliability. The Responsiveness dimension was the least expected dimension and the lowest performing dimension for nursing service quality as perceived by nurses and patients. There was a statistically significant difference between nursing service quality perceived by nurses and patients. The study results could be used by nurse administrators to develop strategies for improving nursing service quality so that nursing service delivery process can be formulated in such a way as to reduce differences of perception between nurses and patients regarding nursing service quality.

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

    Science.gov (United States)

    2010-10-01

    ... Conditions: Services Furnished in a Foreign Country § 424.122 Conditions for payment for emergency inpatient hospital services. Medicare Part A pays for emergency inpatient hospital services furnished by a foreign... conditions for payment for emergency services set forth in § 424.103 are met. (d) The hospital is a...

  15. Hospitality: transformative service to children, families, and communities.

    Science.gov (United States)

    Melton, Gary B

    2014-11-01

    Hospitality is an ancient moral practice that was deeply embedded in early Judaism, Christianity, and Islam. Hospitality requires acceptance of, service to, and respect for people who lack a place in the community. The contemporary importance of this practice reflects the social disconnection and economic disadvantage of many young parents and the high frequency of separation of young people, including many young parents, from their communities. Such social deterioration substantially increases the risk of child maltreatment. Building on the proposals of the U.S. Advisory Board on Child Abuse and Neglect, Strong Communities for Children demonstrated the effectiveness of community building in reducing such risk. It further suggested the importance of both relying on and learning from hospitable people in strengthening support for children and their parents.

  16. Provision of general paediatric surgical services in a regional hospital.

    LENUS (Irish Health Repository)

    Zgraj, O

    2012-01-31

    BACKGROUND: In Ireland, specialist paediatric surgery is carried out in paediatric hospitals in Dublin. General surgeons\\/consultants in other surgical specialities provide paediatric surgical care in regional centres. There has been a failure to train general surgeons with paediatric skills to replace these surgeons upon retirement. AIM: To assess paediatric surgical workload in one regional centre to focus the debate regarding the future provision of general paediatric surgery in Ireland. METHODS: Hospital in-patient enquiry (HIPE) system was used to identify total number of paediatric surgical admissions and procedures. Cases assessed requiring hospital transfer. RESULTS: Of 17,478 surgical patients treated, 2,584 (14.8%) were under 14 years. A total of 2,154 procedures were performed. CONCLUSION: Regional centres without dedicated paediatric surgeons deliver care to large numbers of paediatric patients. The demand for care highlights the need for formal paediatric services\\/appropriate surgical training for general surgical trainees.

  17. Service users' perceptions about their hospital admission elicited by service user-researchers or by clinicians.

    LENUS (Irish Health Repository)

    O'Donoghue, Brian

    2013-05-01

    OBJECTIVE Service users may express positive, ambivalent, or negative views of their hospital admission. The objective of this study was to determine whether the background of the interviewer-service user-researcher or clinician-influences the information elicited. The primary outcome was the level of perceived coercion on admission, and secondary outcomes were perceived pressures on admission, procedural justice, perceived necessity for admission, satisfaction with services, and willingness to consent to participate in the study. METHODS Participants voluntarily and involuntarily admitted to three hospitals in Ireland were randomly allocated to be interviewed at hospital discharge by either a service user-researcher or a clinician. Interviewers used the MacArthur Admission Experience Survey and the Client Satisfaction Questionnaire. RESULTS A total of 161 participants were interviewed. No differences by interviewer status or by admission status (involuntary or voluntary) were found in levels of perceived coercion, perceived pressures, procedural justice, perceived necessity, or satisfaction with services. Service users were more likely to decline to participate if their consent was sought by a service user-researcher (24% versus 8%, p=.003). CONCLUSIONS Most interviewees gave positive accounts of their admission regardless of interviewer status. The findings indicate that clinicians and researchers can be more confident that service users\\' positive accounts of admissions are not attributable to a response bias. Researchers can also feel more confident in directly comparing the results of studies undertaken by clinicians and by service user-researchers.

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

    Science.gov (United States)

    King, D N

    1987-10-01

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

  19. Centralized Debtor Database for Instant Loan Creditors - New Service Concept

    OpenAIRE

    Porko, Pia

    2009-01-01

    This thesis was conducted to evaluate and clarify a service idea regarding a centralized data-base collecting credit information about instant loan applicants to be shared with instant loan creditors as a means to decrease credit losses. The initial idea was formulated by Tentacle Networks Oy and generated into a ready-to-launch service concept along the process of this thesis. The number of instant loans granted yearly has only accelerated since 2005 when the first service provider pene...

  20. The marketing concept of customer value of hospitality service

    Directory of Open Access Journals (Sweden)

    O.V. Gerasimenko

    2015-12-01

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

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

    Science.gov (United States)

    Smith, S M; Clark, M

    1990-09-01

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

  2. 42 CFR 410.172 - Payment for partial hospitalization services in CMHCs: Conditions.

    Science.gov (United States)

    2010-10-01

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

  3. Centralized and distributed architectures of scalable video conferencing services

    OpenAIRE

    Le, Tien Anh; Nguyen, Hang

    2010-01-01

    International audience; The Multipoint Control Unit-based centralized architecture and Application Layer Multicast-based distributed architecture are mainly used for data distribution in video conferencing services. With the contribution of Scalable Video Coding, the latest extension of Advanced Video Coding, video conferencing services are being further researched to support terminals' scalability. The main contribution of this research is to answer a fundamental question before a video conf...

  4. 48 CFR 831.7001-4 - Medical services and hospital care.

    Science.gov (United States)

    2010-10-01

    ... hospital care. 831.7001-4 Section 831.7001-4 Federal Acquisition Regulations System DEPARTMENT OF VETERANS... and Procedures 831.7001-4 Medical services and hospital care. (a) VA may pay the customary student... Government. (b) When the customary student's health fee does not cover medical services or hospital care,...

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

    Science.gov (United States)

    Parkum, K H

    1985-09-01

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

  6. 14 CFR 135.271 - Helicopter hospital emergency medical evacuation service (HEMES).

    Science.gov (United States)

    2010-01-01

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

  7. Handheld Versus Wearable Interaction Design for Professionals - A Case Study of Hospital Service Work

    DEFF Research Database (Denmark)

    Stisen, Allan; Blunck, Henrik; Kjærgaard, Mikkel Baun;

    2014-01-01

    service work. This explorative study was conducted with 4 experienced hospital orderlies who interacted with an application across two wearable concepts, and one handheld smartphone in five scenarios in a hospital environment. The interaction was video recorded with a chest-mounted video afterwards semi...... aspects to aid designers of next generation wearable designs for hospital service work....

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

    Directory of Open Access Journals (Sweden)

    Ristrini Ristrini

    2014-08-01

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

  9. 26 CFR 1.513-6 - Certain hospital services not unrelated trade or business.

    Science.gov (United States)

    2010-04-01

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

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

    Directory of Open Access Journals (Sweden)

    Fernando Campaña Castillo

    2013-09-01

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

  11. 42 CFR 403.321 - State systems for hospital outpatient services.

    Science.gov (United States)

    2010-10-01

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

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

    Directory of Open Access Journals (Sweden)

    Catharina J van Oostveen

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

  13. Clinical course, management and in-hospital outcomes of acute coronary syndrome in Central Asian women

    Directory of Open Access Journals (Sweden)

    Ravshanbek Kurbanov

    2011-03-01

    Full Text Available The paper describes features history, risk factors and hospital management of acute coronary syndrome (ACS in women of the Central Asia (829 ACS patients are included, and also comparison of hospital outcomes of ACS in groups of men and women.ACS in women in the Central Asia comprises features as more non Q-wave myocardial infarction frequency, smaller adherence to treatment of dyslipidemia, more obesity degrees. Women arrive to hospital average in 4 hours after men; have more percent of the atypical form. In-hospital outcomes in men and women significantly did not differ because of general tendency to late arriving to the hospital and small quantity of revascularization procedures. The reasons of differences between men and women in the region are mostly connected to social sphere (late arriving, non-treated dyslipidemia than to physiological peculiarities.

  14. Determinants of hospital choice of rural hospital patients: the impact of networks, service scopes, and market competition.

    Science.gov (United States)

    Roh, Chul-Young; Lee, Keon-Hyung; Fottler, Myron D

    2008-08-01

    Among 10,384 rural Colorado female patients who received MDC 14 (obstetric services) from 2000 to 2003, 6,615 (63.7%) were admitted to their local rural hospitals; 1,654 (15.9%) were admitted to other rural hospitals; and 2,115 (20.4%) traveled to urban hospitals for inpatient services. This study is to examine how network participation, service scopes, and market competition influences rural women's choice of hospital for their obstetric care. A conditional logistic regression analysis was used. The network participation (p market competition had a positive and significant relationship with patients' choice to receive obstetric care. That is, rural patients prefer to receive care from a hospital that participates in a network, that provides more number of services, and that has a greater market share (i.e., a lower level of market competition) in their locality. Rural hospitals could actively increase their competitiveness and market share by increasing the number of health care services provided and seeking to network with other hospitals.

  15. 42 CFR 482.2 - Provision of emergency services by nonparticipating hospitals.

    Science.gov (United States)

    2010-10-01

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

  16. On a hiding to nothing? Assessing the corporate governance of hospital and health services in New Zealand 1993-1998.

    Science.gov (United States)

    Barnett, P; Perkins, R; Powell, M

    2001-01-01

    In New Zealand the governance of public sector hospital and health services has changed significantly over the past decade. For most of the century hospitals had been funded by central government grants but run by locally elected boards. In 1989 a reforming Labour government restructured health services along managerialist lines, including changing governance structures so that some area health board members were government appointments, with the balance elected by the community. More market oriented reform under a new National government abolished this arrangement and introduced (1993) a corporate approach to the management of hospitals and related services. The hospitals were established as limited liability companies under the Companies Act. This was an explicitly corporate model and, although there was some modification of arrangements following the election of a more politically moderate centre-right coalition government in 1996, the corporate model was largely retained. Although significant changes occurred again after the election of a Labour government in 1999, the corporate governance experience in New Zealand health services is one from which lessons can, nevertheless, be learnt. This paper examines aspects of the performance and process of corporate governance arrangements for public sector health services in New Zealand, 1993-1998.

  17. Comparison of Services of Public, Private and Foreign Hospitals from the Perspective of Bangladeshi Patients

    Science.gov (United States)

    Siddiqui, Nazlee; Khandaker, Shahjahan Ali

    2007-01-01

    Despite recent developments in the Bangladesh healthcare sector, there is still great concern about the quality of healthcare services in the country. This study compared the quality of healthcare services by different types of institutions, i.e. public and private hospitals, from the perspective of Bangladeshi patients to identify the relevant areas for development. A survey was conducted among Bangladeshi citizens who were in-patients in public or private hospitals in Dhaka city or in hospitals abroad within the last one year. About 400 exit-interviews were conducted using a structured questionnaire that addressed the probable factors of the quality of healthcare services in 5-point interval scales. The results gave an overview of the perspectives of Bangladeshi patients on the quality of service in three types of hospitals. The quality of service in private hospitals scored higher than that in public hospitals for nursing care, tangible hospital matters, i.e. cleanliness, supply of utilities, and availability of drugs. The overall quality of service was better in the foreign hospitals compared to that in the private hospitals in Bangladesh in all factors, even the ‘perceived cost’ factor. This paper provides insights into the specific factors of the quality of hospital services that need to be addressed to meet the needs of Bangladeshi patients. PMID:17985824

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

    OpenAIRE

    Seyhan Çil Koçyiğit

    2011-01-01

    As known, service is an intangible concept. This prevents services to be stored and makes them impossible to be used in another time in the future. Thus, it is a matter of discussion to suppose the services (which occur in the hospitals as an intangible concept) as inventory. There are some differences between Turkish uniform accounting system and Turkish accounting standards in stockpiling the service producing costs in hospitals. In this study, especially Turkish Accounting Standard-2 I...

  19. 42 CFR 410.66 - Emergency outpatient services furnished by a nonparticipating hospital and services furnished in...

    Science.gov (United States)

    2010-10-01

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

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

    Science.gov (United States)

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

    2009-01-01

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

  1. The 2012 derecho: emergency medical services and hospital response.

    Science.gov (United States)

    Kearns, Randy D; Wigal, Mark S; Fernandez, Antonio; Tucker, March A; Zuidgeest, Ginger R; Mills, Michael R; Cairns, Bruce A; Cairns, Charles B

    2014-10-01

    During the early afternoon of June 29, 2012, a line of destructive thunderstorms producing straight line winds known as a derecho developed near Chicago (Illinois, USA). The storm moved southeast with wind speeds recorded from 100 to 160 kilometers per hour (kph, 60 to 100 miles per hour [mph]). The storm swept across much of West Virginia (USA) later that evening. Power outage was substantial as an estimated 1,300,000 West Virginians (more than half) were without power in the aftermath of the storm and approximately 600,000 citizens were still without power a week later. This was one of the worst storms to strike this area and occurred as residents were enduring a prolonged heat wave. The wind damage left much of the community without electricity and the crippling effect compromised or destroyed critical infrastructure including communications, air conditioning, refrigeration, and water and sewer pumps. This report describes utilization of Emergency Medical Services (EMS) and hospital resources in West Virginia in response to the storm. Also reported is a review of the weather phenomena and the findings and discussion of the disaster and implications.

  2. Dimensions of managerial work in hospital dietetic services.

    Science.gov (United States)

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

    1985-07-01

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

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

    Science.gov (United States)

    Leman, Hope

    2010-04-01

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

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

    Science.gov (United States)

    Peay, Moiselle

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

  5. 42 CFR 136.30 - Payment to Medicare-participating hospitals for authorized Contract Health Services.

    Science.gov (United States)

    2010-10-01

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

  6. The Likelihood of Hospital Readmission among Patients with Hospital-Onset Central Line-Associated Bloodstream Infections

    Science.gov (United States)

    Khong, Carolyn; Baggs, James; Kleinbaum, David; Cochran, Ronda; Jernigan, John A.

    2015-01-01

    Objective We sought to determine whether central line-associated bloodstream infections (CLABSI) increase the likelihood of readmission. Design Retrospective matched cohort study for the years 2008–2009. Setting Acute care hospitals. Participants Medicare recipients. CLABSI and readmission status were determined by linking National Healthcare Safety Network surveillance data to the Centers for Medicare & Medicaid Services’ Medical Provider and Analysis Review in eight states. Frequency matching was used on ICD-9-CM procedure code category and intensive care unit status. Methods We compared the rate of readmission among patients with and without CLABSI during an index hospitalization. Cox proportional hazard analysis was used to assess rate of readmission (the first hospitalization within 30 days post-index discharge). Multivariate models included the following covariates: race, sex, length of index hospitalization stay central line procedure code, GAGNE co-morbidity score, and individual chronic conditions. Results Of the 8,097 patients, 2,260 were readmitted within 30 days (27.9%). The rate of first readmission was 7.1 events/person-year (PY) for CLABSI patients and 4.3 events/PY for non-CLABSI patients (p <0.001). The final model revealed a small but significant increase in the rate of 30 day readmissions for patients with a CLABSI compared to similar non-CLABSI patients. In the first readmission for CLABSI patients, we also observed an increase in diagnostic categories consistent with CLABSI including septicemia and complications of a device. Conclusions Our analysis found a statistically significant association between CLABSI status and readmission, suggesting that CLABSI may have adverse health impact that extends beyond hospital discharge. PMID:25990620

  7. [The Central Military Hospital of the People's Commissariat for Defence during the Great Patriotic War].

    Science.gov (United States)

    Simonenko, V B; Abashin, V G; Polovinka, V S

    2014-05-01

    The article is devoted to activity of the Central Military Hospital of the People's Commissariat for Defence during the Great Patriotic War. The research is based on declassified orders of PCD and orders of the chef of hospital. Authors presented the role of the hospital in organization of medical aid for officers of PCD, members of their families, Red Army soldiers, junior and senior Red Army commanders; the role of the hospital in organization of medical facilities for combat army; medical supply for evacuation of family members of PCD's officers ( en route and in evacuation places); delivery of child health care to children of officers of PCD in the hospital and education in kindergartens of PCD.

  8. The Impact of Quality Service Provided by SRM Hospital on Outpatients

    Directory of Open Access Journals (Sweden)

    Kenneth Amoah-Binfoh

    2015-04-01

    Full Text Available Consumer’s perceptions about the health care services play an important role when choosing a hospital. The quality of service is crucial to both the outpatients and the service providers. The dimensions of the service quality are reliability, responsiveness, assurance, empathy, and tangibles. Customer’s expectations and experiences vary with services. When there is a shortfall between expectation of service level and perception of actual service delivery, it is called customer gap. The causes of customer gap include; not knowing what customers expect, not selecting the right service designs and standards, not delivering to service standards and not matching performance to promises. This paper focuses on the level of service quality rendered by SRM’s hospital, the patient-physicians’ relationship and to examine the pre and post service of outpatients in the SRM’s hospital. A structured questionnaires and interviews were constructed to provide answers to the research questions using a sample size of 50 [employees and outpatients]. It was found out that some outpatients were satisfied with the services rendered by the hospital with reservations for more improvement. It was also found out that, there were gaps between the outpatients’ expectation and perception about the service rendered by the hospital. It was recommended that a competent marketing executive should be employed since marketing is the voice of the healthcare industry.

  9. Hospital customer service in a changing healthcare world: does it matter?

    Science.gov (United States)

    Howard, J

    1999-01-01

    The healthcare industry is undergoing a rapid transformation to meet the ever-increasing needs and demands of the patient population. Employers and health plans such as HMOs are demanding better service and higher quality care, and hospitals are trying to tackle reimbursement cutbacks, streamline services, and serve a diverse population. Hospitals have begun to realize that to overcome these obstacles and meet the needs of the health care plans and consumers, they must focus on the demands of the customer. Customer service initiatives increase patient satisfaction and loyalty and overall hospital quality, and many hospitals have found that consumer demands can be met through initiating and maintaining a customer service program. This article describes how the administrator can create, implement, and manage customer service initiatives within the hospital.

  10. Hospital ownership and medical services: market mix, spillover effects, and nonprofit objectives.

    Science.gov (United States)

    Horwitz, Jill R; Nichols, Austin

    2009-09-01

    Hospitals operate in markets with varied demographic, competitive, and ownership characteristics, yet research on ownership tends to examine hospitals in isolation. Here we examine three hospital ownership types -- nonprofit, for-profit, and government -- and their spillover effects. We estimate the effects of for-profit market share in two ways, on the provision of medical services and on operating margins at the three types of hospitals. We find that nonprofit hospitals' medical service provision systematically varies by market mix. We find no significant effect of market mix on the operating margins of nonprofit hospitals, but find that for-profit hospitals have higher margins in markets with more for-profits. These results fit best with theories in which hospitals maximize their own output.

  11. Factors influencing inpatients’ satisfaction with hospitalization service in public hospitals in Shanghai, People’s Republic of China

    Directory of Open Access Journals (Sweden)

    Chen H

    2016-04-01

    Full Text Available Haiping Chen,1 Meina Li,1 Jingrui Wang,1 Chen Xue,1 Tao Ding,1 Xin Nong,2 Yuan Liu,1 Lulu Zhang11Department of Military Health Management, College of Health Service, Second Military Medical University, Shanghai, 2Department of Medical Research, Rizhao Maternity and Infant Hospital, Shandong, People’s Republic of ChinaObjective: The aim of this study was to observe the current status of inpatient satisfaction and analyze the possible factors influencing patient satisfaction during hospitalization.Methods: A cross-sectional investigation was conducted to obtain basic information about inpatient satisfaction, and statistical methods were used to describe and analyze the data. A total of 878 questionnaires were included in this study. A 5-point Likert scale rating was employed to assess items related to hospitalization care. Nonparametric tests and ordinal logistic analysis were used to explore the relationship between predictors and the patients’ overall satisfaction.Results: Among the respondents, 89.75% were satisfied overall with the service they received during hospitalization, while 0.57% reported dissatisfaction. Inpatient demographic characteristics such as sex of the patients, occupation, age, and residence had significant associations with satisfaction, while monthly income and marital status did not. Additionally, the statistical outcome indicated that doctors’ and nurses’ service attitudes, and expenditure and environment were found to have an impact on the inpatient satisfaction ratings, with odds ratio of 2.43, 3.19, and 2.72, respectively.Conclusion: This study emphasizes the influence of sex of the patients, the service attitudes of the doctors and nurses, and expenditure and environment on inpatient satisfaction. An increase in satisfaction ratings concerning the areas of doctors’ and nurses’ service attitudes, and expenditure and environment can improve the overall satisfaction levels. Responsible health management

  12. Specialized consulting in radiological safety to the south central hospital of high specialty, PEMEX. VI. December of 2001; Asesoria especializada en seguridad radiologica al hospital central sur de alta especialidad. PEMEX. VI. Diciembre de 2001

    Energy Technology Data Exchange (ETDEWEB)

    Angeles C, A.; Vizuet G, J.; Benitez S, J.A.; Garcia A, J.; Rodriguez A, F. [ININ, 52045 Ocoyoacac, Estado de Mexico (Mexico)

    2002-01-15

    It is a report of a specialized consulting in radiological safety that to be carried the ININ to PEMEX for the South Central Hospital of High Specialty, to maintain the sanitary license for the use of X-ray equipment of medical diagnostic, and guarantee these services with a program of quality assurance. To give fulfilment to that requests it is programmed a technical assistance monthly, with reports of results during the development of the service. In this document it is carried a report of the advances and results in the month of december of the 2001, where the following documents are analyzed: Manual of radiological safety, program of quality assurance, operation procedures, procedure of maintenance team, procedure of medical radiological control of the specialized personnel; also are annotate the obtained results and their observations. (Author)

  13. Specialized consulting in radiological safety to the North Central Hospital of high specialty, PEMEX. V. November of 2001; Asesoria especializada en seguridad radiologica al Hospital Central Norte de alta especialidad, PEMEX. V. Noviembre de 2001

    Energy Technology Data Exchange (ETDEWEB)

    Angeles C, A.; Vizuet G, J.; Benitez S, J. A.; Garcia A, J.; Rodriguez A, F. [ININ, 52045 Ocoyoacac, Estado de Mexico (Mexico)

    2002-01-15

    It is a report of a specialized consulting in radiological safety that to be carried the ININ to PEMEX for the North Central Hospital of High Specialty, to maintain the sanitary license for the use of X ray equipment of medical diagnostic, and guarantee these services with a program of quality assurance. To give fulfilment to that requests it is programmed a technical assistance monthly, with reports of results during the development of the service. In this document it is carried a report of the advances and results in the month of November of the 2001, where the following documents are analyzed: Manual of radiological safety, program of quality assurance, operation procedures, procedure of maintenance team, procedure of medical radiological control of the specialized personnel; also are annotate the obtained results and their observations. (Author)

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

    Science.gov (United States)

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

    2014-12-30

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

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

    OpenAIRE

    Iulian Bogdan DOBRA

    2011-01-01

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

  16. Student-Led Services in a Hospital Aged Care Temporary Stay Unit: Sustaining Student Placement Capacity and Physiotherapy Service Provisions

    Science.gov (United States)

    Nicole, Madelyn; Fairbrother, Michele; Nagarajan, Srivalli Vilapakkam; Blackford, Julia; Sheepway, Lyndal; Penman, Merrolee; McAllister, Lindy

    2015-01-01

    Through a collaborative university-hospital partnership, a student-led service model (SLS-model) was implemented to increase student placement capacity within a physiotherapy department of a 150 bed Sydney hospital. This study investigates the perceived barriers and enablers to increasing student placement capacity through student-led services…

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

    Science.gov (United States)

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

    2013-01-01

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

  18. Carbapenem Resistance among Enterobacter Species in a Tertiary Care Hospital in Central India

    OpenAIRE

    Atul Khajuria; Ashok Kumar Praharaj; Mahadevan Kumar; Naveen Grover

    2014-01-01

    Objective. To detect genes encoding carbapenem resistance among Enterobacter species in a tertiary care hospital in central India. Methods. Bacterial identification of Enterobacter spp. isolates from various clinical specimens in patients admitted to intensive care units was performed by routine conventional microbial culture and biochemical tests using standard recommended techniques. Antibiotic sensitivity test was performed by standard Kirby Bauer disc diffusion technique. PCR amplificat...

  19. Factors impacting the use of antenatal care and hospital child delivery services: a case study of rural residents in the Enshi Autonomous Prefecture, Hubei Province, China.

    Science.gov (United States)

    Zhang, Yin; Chen, Minxing; Lu, Jun; Hao, Mo; Zhang, Changli; Sun, Mei; Li, Xiaohong; Chang, Fengshui

    2015-01-01

    This study was undertaken to understand the factors that impact whether rural women obtain antenatal care (ANC) and choose to use hospital delivery services in central and western China. We chose to conduct field research with the rural residents in Hubei Province through a combination of random sampling and purposive sampling methods. A mixed method approach was taken to analyze the factors impacting the use of ANC and hospital delivery services from the perspective of the villagers. Our results indicate that the quality of the available ANC services is poor. In particular, women who have special circumstances and unplanned pregnancies or who become pregnant prior to marriage are confronted with inadequate ANC and hospital child delivery services. The factors that impact whether women use or not use ANC and hospital delivery services and that cause women to choose hospital or home delivery can be understood at three levels: macro, middle, and micro. We strongly suggest that the policies and projects that promote maternal healthcare in rural areas be sustained with an added focus on including women with special circumstances. Village doctors can be enlisted to regularly visit pregnant women at home and to provide extra explanation about the ANC services available and the purpose of maternal healthcare. These findings and suggestions can be used by local health providers and decision-makers to improve the quality of ANC and hospital delivery services.

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

    Science.gov (United States)

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

    1981-07-01

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

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

    Directory of Open Access Journals (Sweden)

    Gholamreza Shahbazi Moghadam

    2016-04-01

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

  2. Hospital-wide multidisciplinary, multimodal intervention programme to reduce central venous catheter-associated bloodstream infection.

    Directory of Open Access Journals (Sweden)

    Walter Zingg

    Full Text Available Central line-associated bloodstream infection (CLABSI is the major complication of central venous catheters (CVC. The aim of the study was to test the effectiveness of a hospital-wide strategy on CLABSI reduction. Between 2008 and 2011, all CVCs were observed individually and hospital-wide at a large university-affiliated, tertiary care hospital. CVC insertion training started from the 3rd quarter and a total of 146 physicians employed or newly entering the hospital were trained in simulator workshops. CVC care started from quarter 7 and a total of 1274 nurses were trained by their supervisors using a web-based, modular, e-learning programme. The study included 3952 patients with 6353 CVCs accumulating 61,366 catheter-days. Hospital-wide, 106 patients had 114 CLABSIs with a cumulative incidence of 1.79 infections per 100 catheters. We observed a significant quarterly reduction of the incidence density (incidence rate ratios [95% confidence interval]: 0.92 [0.88-0.96]; P<0.001 after adjusting for multiple confounders. The incidence densities (n/1000 catheter-days in the first and last study year were 2.3/1000 and 0.7/1000 hospital-wide, 1.7/1000 and 0.4/1000 in the intensive care units, and 2.7/1000 and 0.9/1000 in non-intensive care settings, respectively. Median time-to-infection was 15 days (Interquartile range, 8-22. Our findings suggest that clinically relevant reduction of hospital-wide CLABSI was reached with a comprehensive, multidisciplinary and multimodal quality improvement programme including aspects of behavioural change and key principles of good implementation practice. This is one of the first multimodal, multidisciplinary, hospital-wide training strategies successfully reducing CLABSI.

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

    Science.gov (United States)

    Ben Oumlil, A; Rao, C P

    1992-01-01

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

  4. 42 CFR 440.10 - Inpatient hospital services, other than services in an institution for mental diseases.

    Science.gov (United States)

    2010-10-01

    ... an institution for mental diseases. 440.10 Section 440.10 Public Health CENTERS FOR MEDICARE... for mental diseases. (a) Inpatient hospital services means services that— (1) Are ordinarily furnished... and treatment of patients with disorders other than mental diseases; (ii) Is licensed or...

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

    Science.gov (United States)

    Cid P, Camilo; Bastías S, Gabriel

    2014-02-01

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

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

    Science.gov (United States)

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

    2011-06-01

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

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

    Directory of Open Access Journals (Sweden)

    Mariana Boaro Fernandez Canon

    2014-09-01

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

  8. Tourist Satisfaction with Hospitality Services on River Ship “Ms River Aria”

    Directory of Open Access Journals (Sweden)

    Nikola Vuksanović

    2013-07-01

    Full Text Available The main prerequisite for a successful business of hospitality services and building customer loyalty is to develop measures for improving and development hospitality services and offer. This paper presents the results of tourists satisfaction surveys based on the measurement of expected and perceived levels of quality hospitality services on a river ship “MS River Aria” company “Grand Circle Cruise Line”. The survey was conducted between March and September 2012 on the itinerary: Amsterdam - Vienna (SGE, Amsterdam - Antwerp (SHH, Linz - Budapest (EDR and Budapest - Constanta (LBS. A model for measuring hospitality services was developed by the company itself. During statistical data analysis, only the highest ratings, whose share was shown as percentage, were taken into account. The obtained results may be relevant for other cruise companies and contribute to the improvement of business and pleasure tourist.

  9. Saint Anthony Hospital: Infusing Developmental and Family Support Services in Community-Based Medical Practice

    Science.gov (United States)

    Casas, Paula; Isarowong, Nucha

    2015-01-01

    Physicians affiliated with small community hospitals face numerous barriers to using developmentally oriented best practices in primary care with young children. Saint Anthony Hospital's Developmental Support Project model promotes improved developmental outcomes for children through two complementary strands of services: (a) training and…

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

    Directory of Open Access Journals (Sweden)

    Made Nopy Diah Sundari

    2015-04-01

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

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

    OpenAIRE

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

    2016-01-01

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

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

    OpenAIRE

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

    2012-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Jeou-Shyan Horng

    2016-03-01

    Full Text Available The purpose of this study was to examine the key characteristics of sustainable service innovation in the hospitality industry. We conducted a content analysis based on the interview records for 17 experts (including three academic scholars, three government officers and 11 top-level managers with an average of 20 years of experience in the hospitality management domain in Taiwan. The analytical results conform to Amabile’s (1988 componential theory of creativity and innovation and show that 11 characteristics are major indicators of sustainable service innovation in the hotel management field. These include the following characteristics: market position, customer satisfaction, service orientation, environmental thinking, employee involvement, incentive mechanism, human resource development, environmental services, cultural resource management, government policy and school education. Accordingly, using the integrated theory of sustainable service innovation and professional opinions from experts, we provide theoretical and practical implications for current and future trends on sustainability and innovation in the hospitality industry.

  14. Pharmacy services at admission and discharge in adult, acute, public hospitals in Ireland.

    LENUS (Irish Health Repository)

    Grimes, Tamasine

    2012-02-01

    OBJECTIVES: to describe hospital pharmacy involvement in medication management in Ireland, both generally and at points of transfer of care, and to gain a broad perspective of the hospital pharmacy workforce. METHODS: a survey of all adult, acute, public hospitals with an accident and emergency (A&E) department (n = 36), using a semi-structured telephone interview. KEY FINDINGS: there was a 97% (n = 35) response rate. The majority (n = 25, 71.4%) of hospitals reported delivery of a clinical pharmacy service. On admission, pharmacists were involved in taking or verifying medication histories in a minority (n = 15, 42.9%) of hospitals, while few (n = 6,17.1%) deployed staff to the A&E\\/acute medical admissions unit. On discharge, the majority (n = 30,85.7%) did not supply any take-out medication, a minority (n =5,14.3%) checked the discharge prescription, 51.4% (n = 18) counselled patients, 42.9% (n = 15) provided medication compliance charts and one hospital (2.9%) communicated with the patient\\'s community pharmacy. The number of staff employed in the pharmacy department in each hospital was not proportionate to the number of inpatient beds, nor the volume of admissions from A&E. There were differences identified in service delivery between hospitals of different type: urban hospitals with a high volume of admissions from A&E were more likely to deliver clinical pharmacy. CONCLUSIONS: the frequency and consistency of delivering pharmacy services to facilitate medication reconciliation at admission and discharge could be improved. Workforce constraints may inhibit service expansion. Development of national standards of practice may help to eliminate variation between hospitals and support service development.

  15. Improving service quality in NHS Trust hospitals: lessons from the hotel sector.

    Science.gov (United States)

    Desombre, T; Eccles, G

    1998-01-01

    This article looks to review recent practice undertaken within the UK hotel sector to improve customer service, and suggests ideals that could be implemented within National Health (NHS) Trust hospitals. At a time of increasing competition, hotel firms are using service enhancement as a means to gain competitive advantage, and therefore developing a range of techniques to measure levels of service quality improvement. With continued change in the health service, where greater focus now lies with patient satisfaction, so there is a requirement for managers to adapt techniques presently being offered in other service industries to improve levels of customer service and ensure patients are targeted to define their levels of satisfaction.

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

    Directory of Open Access Journals (Sweden)

    Renata Cristina Antonelli

    2014-12-01

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

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

    Directory of Open Access Journals (Sweden)

    Seyhan Çil Koçyiğit

    2011-03-01

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

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

    Science.gov (United States)

    Park, Arum; Chang, Hyejung

    2017-01-01

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

  19. A review of governance of maternity services at South Tipperary general hospital

    LENUS (Irish Health Repository)

    Flory, David

    2015-09-01

    This review of the governance of maternity services at South Tipperary General Hospital has focussed on the systems and processes for assurance of service quality, risk management and patient safety primarily inside the hospital but also in the Hospital Group structure within which it operates. The effectiveness of the governance arrangements is largely determined by the quality of the leadership and management – both clinical and general – which designs, implements, and oversees those systems and processes and is ultimately responsible and accountable.\\r\

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

    Science.gov (United States)

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

    1983-10-01

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

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

    Directory of Open Access Journals (Sweden)

    Nancy L. Weaver

    2014-10-01

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

  2. Patient Views on Three Key Service Areas within Hospital COPD Care

    Science.gov (United States)

    Roberts, C. Michael; Seiger, Anil; Ingham, Jane

    2009-01-01

    Objective: The views of patients with Chronic Obstructive Pulmonary Disease (COPD) about three key services (non-invasive ventilation [NIV], early discharge schemes and rehabilitation) were sought in order to inform recommendations for the delivery of optimum care within a national programme of hospital COPD service development. Design: Four focus…

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

    Science.gov (United States)

    Tan, Kar Way; Shankararaman, Venky

    2014-01-01

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

  4. 42 CFR 413.122 - Payment for hospital outpatient radiology services and other diagnostic procedures.

    Science.gov (United States)

    2010-10-01

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

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

    Science.gov (United States)

    1997-06-01

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

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

    Science.gov (United States)

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

    2014-01-01

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

  7. POSSIBILITIES OF THE PROFESSIONAL OF TOURISM HELPING AT THE HOSPITALITY IN HOSPITAL’S SERVICES: CASE OF HOSPITAL NILZA DE OLIVEIRA PIPINO, UBIRATÃ-PR

    Directory of Open Access Journals (Sweden)

    Patricia Regina Cenci Queiroz

    2006-05-01

    Full Text Available This article aims to discuss some aspects which can be improved concerning the Hospital e Maternidade Nilza de Oliveira Pipino services, through the work of a professional of tourism, implanting some services of hospitality in hospitals. By observing, we could identify some problems due to the lack of organization, human resource management, professional training about the reception of the hospital which can cause disastrous consequences for the patients recovery process. Our main goal is making notes and thinks about the useful help of a professional of tourism for the hospital humanization process.

  8. 78 FR 64953 - Medicare Program; Inpatient Hospital Deductible and Hospital and Extended Care Services...

    Science.gov (United States)

    2013-10-30

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

  9. [Supporting system for regional medical liaison and role of a central hospital].

    Science.gov (United States)

    Kitano, Seigo

    2003-04-01

    The current status and future development of the supporting system for regional medical liaison and a role of the central hospital in the network were outlined. One of such supportive systems for regional medical network would be tele-medicine or tele-mentoring that include radiological and pathological diagnoses in distance, tele-surgery, and tele-education. Most of these systems are facilitated in the universities and affiliated hospitals and generally need high-cost communication equipment. Another approach is the information sharing system through the modern telecommunication network. Electronic patient record (EPR) systems are the key to achieving this and currently active in several areas. Since the recent progress in information technology (IT) is astonishing, community-based EPR systems are practical with the capability of clinical information exchange between different institutions and even with patients. The role of a central hospital in these systems must be capacious. Management and continuous operation of the system would be the most important affairs. For extending these supporting systems to the ones working in a broader area, the establishment of a "one ID for one patient" system is crucial. Strict security management of the data base and legal institution for distant medical practice still remain as the future tasks.

  10. The perception of safety culture among nurses in a tertiary hospital in Central Saudi Arabia

    Science.gov (United States)

    Alonazi, Aisha A; Saeed, Elshazaly; Mohamed, Sarar

    2016-01-01

    Developing a patient safety culture was one of the recommendations made by the Institute of Medicine (IOM) to assist hospitals in improving patient safety. Nurses are the key to safety improvements in hospitals. It is necessary to know their awareness and perception regarding institutional safety climate. The aim of this study is to explore perceptions of patient safety among nursing staff in a tertiary hospital in Central Saudi Arabia in different discipline units. The current study was conducted at Prince Sultan Military Medical City (PSMMC), a tertiary center in Riyadh, Central Saudi Arabia. In November 2014, five hundred nurses were randomly selected to participate in this study. A survey questionnaire with Likert scale was adopted covering characteristics of participants together with their views on patient safety issues. Two hundred and twenty-four participants filled the questionnaire with a response rate of 44.8%. The overall perception of patient safety among participants was (57.9%). The majority (74.1%) thought that the existing system is good at preventing errors and only one third indicated that they have patient safety problems. Most of the participants were happy with the existing patient safety culture including organizational learning/continuous improvement (95.5%), and errors feedback and communication (76.64%). In conclusion, this study showed that perception of patient safety was sub-optimal among nurses and there are several areas for improvement regarding safety culture. PMID:28096559

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

    OpenAIRE

    Kanwal Nasim; Saquib Yusaf Janjua

    2014-01-01

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

  12. An investigation Into Traditional Chinese Medicine Hospitals in China: Development Trend and Medical Service Innovation

    Science.gov (United States)

    Wang, Liang; Suo, Sizhuo; Li, Jian; Hu, Yuanjia; Li, Peng; Wang, Yitao; Hu, Hao

    2017-01-01

    Background: This paper aims to investigate the development trend of traditional Chinese medicine (TCM) hospitals in China and explore their medical service innovations, with special reference to the changing co-existence with western medicine (WM) at TCM hospitals. Methods: Quantitative data at macro level was collected from official databases of China Health Statistical Yearbook and Extracts of Traditional Chinese Medicine Statistics. Qualitative data at micro level was gathered through interviews and second-hand material collection at two of the top-level TCM hospitals. Results: In both outpatient and inpatient sectors of TCM hospitals, drug fees accounted for the biggest part of hospital revenue. Application of WM medical exanimation increased in both outpatient and inpatient services. Even though the demand for WM drugs was much higher in inpatient care, TCM drugs was the winner in the outpatient. Also qualitative evidence showed that TCM dominated the outpatient hospital service with WM incorporated in the assisting role. However, it was in the inpatient medical care that WM prevailed over TCM which was mostly applied to the rehabilitation of patients. Conclusion: By drawing on WM while keeping it active in supporting and strengthening the TCM operation in the TCM hospital, the current system accommodates the overriding objective which is for TCM to evolve into a fully informed and more viable medical field. PMID:28005539

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

    Directory of Open Access Journals (Sweden)

    A Dabiri

    2012-04-01

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

  14. Patient satisfaction with the dental services offered by a dental Hospital in India

    Directory of Open Access Journals (Sweden)

    N Nagappan

    2014-01-01

    Full Text Available Introduction: A major component of quality of health care is patient satisfaction. Patient satisfaction is multifaceted and a very challenging outcome to define. Patient expectations of care and attitudes greatly contribute to the satisfaction; other psychosocial factors, including facilities and treatments services are also known to contribute to patient satisfaction scores. Aim: To measure patient satisfaction about facilities, services and treatments offered by a dental hospital in India. Materials and Methods: Self administrated questionnaire was distributed to outpatients reporting to the dental hospital for treatment. The questionnaire consisted of 30 items that included information about personal data of the patients and their satisfaction with the facilities, services and treatment received in the hospital. Results: About 89.9% of patients felt that the cost of dental hygiene services were reasonable, 57.6% of patients felt that drinking water facilities were enough in the hospital, 31.9% of patients felt that they have problem with scheduling appointments, 86% of patients felt that they had problem in contacting student dentist. Conclusion: The majority of the patients were satisfied with the facilities, services and treatment received at hospital except for facilities such as water supply and scheduling appointments with patient convenience.

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

    Science.gov (United States)

    Ramani, K V

    2004-01-01

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

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

    Science.gov (United States)

    2009-09-01

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

  17. Using creative problem solving (TRIZ) in improving the quality of hospital services.

    Science.gov (United States)

    LariSemnani, Behrouz; Mohebbi Far, Rafat; Shalipoor, Elham; Mohseni, Mohammad

    2014-08-14

    TRIZ is an initiative and SERVQUAL is a structured methodology for quality improvement. Using these tools, inventive problem solving can be applied for quality improvement, and the highest quality can be reached using creative quality improvement methodology. The present study seeks to determine the priority of quality aspects of services provided for patients in the hospital as well as how TRIZ can help in improving the quality of those services. This Study is an applied research which used a dynamic qualitative descriptive survey method during year 2011. Statistical population includes every patient who visited in one of the University Hospitals from March 2011. There existed a big gap between patients' expectations from what seemingly is seen (the design of the hospital) and timely provision of services with their perceptions. Also, quality aspects of services were prioritized as follows: keeping the appearance of hospital (the design), accountability, assurance, credibility and having empathy. Thus, the only thing which mattered most for all staff and managers of studied hospital was the appearance of hospital as well as its staff look. This can grasp a high percentage of patients' satisfaction. By referring to contradiction matrix, the most important principles of TRIZ model were related to tangible factors including principles No. 13 (discarding and recovering), 25 (self-service), 35 (parameter changes), and 2 (taking out). Furthermore, in addition to these four principles, principle No. 24 (intermediary) was repeated most among the others. By utilizing TRIZ, hospital problems can be examined with a more open view, Go beyond The conceptual framework of the organization and responded more quickly to patients ' needs.

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

    Directory of Open Access Journals (Sweden)

    Agus Agus

    2017-02-01

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

  19. Using Creative Problem Solving (TRIZ) in Improving the Quality of Hospital Services

    Science.gov (United States)

    LariSemnani, Behrouz; Far, Rafat Mohebbi; Shalipoor, Elham; Mohseni, Mohammad

    2015-01-01

    TRIZ is an initiative and SERVQUAL is a structured methodology for quality improvement. Using these tools, inventive problem solving can be applied for quality improvement, and the highest quality can be reached using creative quality improvement methodology. The present study seeks to determine the priority of quality aspects of services provided for patients in the hospital as well as how TRIZ can help in improving the quality of those services. This Study is an applied research which used a dynamic qualitative descriptive survey method during year 2011. Statistical population includes every patient who visited in one of the University Hospitals from March 2011. There existed a big gap between patients’ expectations from what seemingly is seen (the design of the hospital) and timely provision of services with their perceptions. Also, quality aspects of services were prioritized as follows: keeping the appearance of hospital (the design), accountability, assurance, credibility and having empathy. Thus, the only thing which mattered most for all staff and managers of studied hospital was the appearance of hospital as well as its staff look. This can grasp a high percentage of patients’ satisfaction. By referring to contradiction matrix, the most important principles of TRIZ model were related to tangible factors including principles No. 13 (discarding and recovering), 25 (self-service), 35 (parameter changes), and 2 (taking out). Furthermore, in addition to these four principles, principle No. 24 (intermediary) was repeated most among the others. By utilizing TRIZ, hospital problems can be examined with a more open view, Go beyond The conceptual framework of the organization and responded more quickly to patients ’ needs. PMID:25560360

  20. The Frederic Joliot hospital department; Le service hospitalier Frederic Joliot

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1999-02-01

    The Service Hospitalier Frederic Joliot (SHFJ) of the CEA, has got a scientific and a medical mission: to develop techniques allowing the functional study of human organs. The paper presents the main activities of this department: the positron emission tomography to visualize in real time markers in the organism in neurology and cardiology, researches on epilepsy to localize the epileptic centre, the nuclear medicine in cardiology with the use of the gamma photon emission tomography and the radiopharmacology to visualize the drugs effects in the organism. (A.L.B.)

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

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    Ali Dehghani Ahmadabad

    2016-06-01

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

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

    Science.gov (United States)

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

    2006-01-01

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

  3. Service quality assessment of a referral hospital in Southern Iran with SERVQUAL technique: patients’ perspective

    Science.gov (United States)

    2014-01-01

    Background Providing services to patients according to their expectations and needs is necessary for the success of an organization in order to remain in the competitive market. Recognizing these needs and expectations is an important step in offering high quality services. This study was designed to determine the service quality gap of the main hospital of Hormozgan province. Methods This cross sectional study was conducted in 2013 in Bandar Abbas ShahidMohammadi Hospital in the south of Iran. All 96 participants of this study were provided by SERVQUAL questionnaire. Data was analyzed by Wilcoxon and Kruskal-Wallis tests. Results Service quality gaps were seen in all five service quality dimensions and the overall quality of service. The mean of quality perception score and quality expectation score was 3.44 ± 0.693 and 4.736 ± 0.34, respectively. The highest perception was in assurance dimension and the highest expectation was in Responsiveness and assurance dimensions. Also, the lowest perception was in responsiveness dimension and the lowest expectation was about empathy. In this study, 56.1% of participants defined the quality of services as average. Conclusion According to the results, this hospital was not able to meet patients’ expectations completely. Therefore, action must be taken to decrease the gap between the perception and expectation of the patients. PMID:25064475

  4. Global Shared Service Trends in the Central and Eastern European Markets

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    Róbert MARCINIAK

    2014-10-01

    Full Text Available The main objective of the research is to disclose what kind of trends are present in the global business service markets and which appear in the Central and Eastern European (CEE business market. The research determines the most important business service trends that emerged in shared service organizations in the CEE region.

  5. Depression in chronic respiratory disorders in a tertiary rural hospital of Central India

    Institute of Scientific and Technical Information of China (English)

    Sameer singhal; Pankaj Banode; Nitish Baisakhiya

    2009-01-01

    Objective: To determine prevalence of depression in chronic respiratory disorders in a tertiary rural hospital of Central India. Various studies done in past have shown that prevalence of depression in diabetes and hypertension is around 40%-57%. Few studies have been done to screen depression in chronic respiratory disorders. This study was conducted in a tertiary rural hospital of Central India to find out prevalence of depression in indoor patients suffering from chronic respiratory disorders. Methods: Total 68 patients were evaluated for depression. Patients suffering from chronic respiratory disorders (total duration of illness >3 months) were evaluated using Prime MD Questionnaire. Patients suffering from diabetes, heart diseases, stroke, having past history of psychiatric illness, drug abusers, having lack of social support and suffering from chronic upper respiratory tract infections were excluded from this study. Questionnaire was asked when treatment for acute phase of illness is over. Results: Out of 68 patients evaluated, 36 (53%) were found out to be suffering from depression. Female gender (80%) was more prone to depression, inspite of the fact that all alcoholics were male. 39% of all chronic obstructive pulmonary disease (COPD) patients were suffering from depression in comparison to 65% for pulmonary tuberculosis and 44% for other chronic respiratory illness. 54% of patients suffering from depression are 60 yrs of age, suggesting that age has no relation with depression. No association was seen between alcoholism and depression. Conclusion: Prevalence of depression in patients of chronic respiratory illness is very high, like in cases of diabetes and hypertension. Further community and hospital based studies are needed to find out exact prevalence of depression in chronic respiratory illnesses.

  6. Biopsy case mix and diagnostic yield at a Malawian central hospital.

    Science.gov (United States)

    Mtonga, P; Masamba, L; Milner, D; Shulman, L N; Nyirenda, R; Mwafulirwa, K

    2013-09-01

    Cancer is a major disease burden worldwide resulting in high morbidity and mortality. It is the leading cause of mortality in developed countries and is one of the three leading causes of death for adults in developing countries. Pathological examination of tissue biopsies with histological confirmation of a correct cancer diagnosis is central to cancer care. Without an accurate and specific pathologic diagnosis, effective treatment cannot be planned or delivered. In addition, there are marked geographical variations in incidence of cancer overall, and of the specific cancers seen. Much of the published literature on cancer incidence in developing countries reflects gross estimates and may not reflect reality. Performing baseline studies to understand these distributions lays the groundwork for further research in this area of cancer epidemiology. Our current study surveys and ranks cancer diagnoses by individual anatomical site at Queen Elizabeth Central Hospital (QECH) which is the largest teaching and referral hospital in Malawi. A retrospective study was conducted reviewing available pathology reports over a period of one full year from January 2010 to December 2010 for biopsies from patients suspected clinically of having cancer. There were 544 biopsies of suspected cancer, taken from 96 anatomical sites. The oesophagus was the most common biopsied site followed by breast, bladder, bone, prostate, bowel, and cervical lymph node. Malignancies were found in biopsies of the oesophagus biopsies (squamous cell carcinoma, 65.1%; adenocarcinoma, 11.6%), breast (57.5%), bladder (squamous cell carcinoma, 53.1%) and stomach (37.6%). Our study demonstrates that the yield of biopsy for clinically suspected malignancy was greater than 50% for the 11 most common sites and provides a current survey of cancer types by site present in the population reporting to our hospital.

  7. Application of Quality Assurance Strategies in Diagnostics and Clinical Support Services in Iranian Hospitals

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    Asgar Aghaei Hashjin

    2015-10-01

    Full Text Available Background Iran has a widespread diagnostics and clinical support services (DCSS network that plays a crucial role in providing diagnostic and clinical support services to both inpatient and outpatient care. However, very little is known on the application of quality assurance (QA policies in DCSS units. This study explores the extent of application of eleven QA strategies in DCSS units within Iranian hospitals and its association with hospital characteristics. Methods A descriptive cross-sectional study was conducted in 2009/2010. Data were collected from 554 DCSS units among 84 hospitals. Results The average reported application rate for the QA strategies ranged from 57%-94% in the DCSS units. Most frequently reported were checking drugs expiration dates (94%, pharmacopoeia availability (92%, equipment calibration (87% and identifying responsibilities (86%. Least reported was external auditing of the DCSS (57%. The clinical chemistry and microbiology laboratories (84%, pharmacies, blood bank services (83% reported highest average application rates across all questioned QA strategies. Lowest application rates were reported in human tissue banks (50%. There was no significant difference between the reported application rates in DCSS in the general/specialized, teaching/research, nonteaching/research hospitals with the exception of pharmacies and radiology departments. They reported availability of a written QA plan significantly more often in research hospitals. Nearly all QA strategies were reported to be applied significantly more often in the DCSS of Social Security Organization (SSO and private-for-profit hospitals than in governmental hospitals. Conclusion There is still room for strengthening the managerial cycle of QA systems and accountability in the DCSS in Iranian hospitals. Getting feedback, change and learning through application of specific QA strategies (eg, external/internal audits can be improved. Both the effectiveness of QA

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

    OpenAIRE

    Ana Stranjancevic; Iva Bulatovic

    2015-01-01

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

  9. Willingness to pay for municipality hospital services in rural Japan: a contingent valuation study

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    Nakamura Toshihito

    2011-06-01

    Full Text Available Abstract Background The Japanese healthcare system has undergone reforms to address the struggles that municipality hospitals face. Reform guidelines clearly define criteria for administrative improvement. However, criteria to evaluate the demand for healthcare provisions in rural Japan, including the needs of rural residents for municipality hospitals in particular have not been specified. The purpose of this paper is to measure residents' willingness to pay (WTP for municipality hospital services using the contingent valuation method, and to evaluate municipality hospital valuation on the basis of WTP. K town, located in the Hokkaido prefecture of Japan, was selected as the location for this study. Participants were recruited by a town hall healthcare administrator, hospital and clinic staff, and a local dentist. Participants were asked what amount they would be willing to pay as taxes to continue accessing the services of the municipality hospital for one year by using open-ended questions in face-to-face interviews. Findings Forty-eight residents were initially recruited, and 40 participants were selected for the study (response rate 83%. As compared to K town's population, this data slanted toward the elderly, although there was no significant difference in frequency among the characteristics. The median WTP was estimated at 39,484 yen ($438.71, with a 95% confidence interval 27,806-55,437 yen ($308.95-615.96. Logistic regression revealed no significant factors affecting WTP. Conclusions If the total amount of residents' WTP for the municipality hospital were to be estimated by this result, it would calculate with 129,586,000 yen ($1,439,844. This is approximately equal to the amount of money to be transferred from the general account of the government of K town, more than one-half of the town tax of K town, and about two-fold in comparison to Japan as a whole. This showed that K town's residents placed a high valuation on the municipality

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

    Science.gov (United States)

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

    1993-12-01

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

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

    Science.gov (United States)

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

    1993-01-01

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

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

    Science.gov (United States)

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

    2001-04-01

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

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

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    Emmanuel Olateju Oyatoye

    2016-07-01

    Full Text Available Introduction: Patients are recently more aware and conscious. This is because of the belief that a high level of quality can translate into patient satisfaction. This is critical for healthcare providers as they deal with life. This recognition by both the service provider and service receivers made the government to establish units of service commission (SERVICOM in each of the governmental agencies including hospitals in Nigeria to monitor the level of quality of service delivery. However, to what extent do patients’ perceptions about health services seem to have been largely recognized remain unclear by health care providers, despite the (SERVICOM units in public institutions in Nigeria? Method: A cross-sectional analytical study using convenient sample method, based on the fact that not every patient of the selected hospitals can be chosen, was performed on 400 patients who received health services at four different public hospitals in Ogun state Nigeria. The selection of these hospitals was based on the zones in the state (Egba, Ijebu, Remo and Yewa area of Ogun-state. The instrument was a valid and reliable analytical hierarchy process based questionnaire containing five service quality dimensions. Data were analyzed using SPSS, Expert choice and Microsoft Excel software to determine the perception of patients towards service quality delivery in pairwise comparison of judgment consistent at less than 10%. Results:The results showed the composite priorities of the patients’ perception with respect to determinants of the patients’ perception towards quality of services delivered in the public hospitals in Nigeria. The most important factor to patients was the reliability dimension with composite priority 0.24 or 24% followed by the responsiveness dimension with 0.22 assurance dimension 0.21, tangibility dimension with 0.21, and the least determinant factor was the empathy dimension with 0.1101. Conclusion: Based on the results, the

  14. Convergence of PPTCT with RCH Services in a District Hospital, Haryana

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    Puneet Bhagat

    2014-03-01

    Full Text Available Background: The integration of PPTCT and RCH activities is an important strategy for universal screening of ANC mothers through available government health infrastructure in a district. The objective of this study was to understand process and analyzing outcome of convergence of PPTCT & RCH services in a District Hospital. Methods: The study was a descriptive study conducted in district hospital, Gurgaon. Results: In the district hospital Gurgaon percentage of women counseled at ICTC has increased from 77% to 89.4% and percentage of women tested has increased from 75% to 87.8% during 2010 and 2011. However, not all women tested positive delivered at hospital. Only 6.7% women were knowing about transmission of HIV from mother to baby. About 60% ANC registration are delayed primarily due to lack of family support (71%. Majority of ANC women got HIV screening at district hospital due to non-availability of facility at CHC/PHC levels. About 58% of Institutional deliveries in the State are in private hospitals, but they still need to be involved in PPTCT. Conclusion: Currently, convergence of PPTCT and RCH services seems to be fragmented and at initial stage. Convergence need to be taken up at policy, planning, implementation, capacity building, resource mobilization and monitoring for success of the initiative in the state.

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

    Science.gov (United States)

    Bardyn, Tania P; Young, Caroline S

    2007-01-01

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

  16. Enhancing Experiment Central Service Reliability: from delivery to security and virtualization

    CERN Document Server

    Donno, Flavia; Buzykaev, Alexey; Saiz Santos, Maria Dolores

    2011-01-01

    The four LHC experiments rely on experiment specific services running on machines mainly located at CERN. Some of these services have been rated by the experiments as very critical: any loss or degradation of performance has a major impact on the experiment's production and analysis activities. It is therefore important to provide a reliable and robust operational environment. In this work we describe the strategy based on service deployment, security and virtualization adopted to enhance the reliability of ATLAS and CMS central services.

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

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    Shahrokh Alinia

    2015-10-01

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

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

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

    2011-01-01

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

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

    NARCIS (Netherlands)

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

    1997-01-01

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

  20. 42 CFR 415.162 - Determining payment for physician services furnished to beneficiaries in teaching hospitals.

    Science.gov (United States)

    2010-10-01

    ... furnished to beneficiaries in teaching hospitals. 415.162 Section 415.162 Public Health CENTERS FOR MEDICARE... BY PHYSICIANS IN PROVIDERS, SUPERVISING PHYSICIANS IN TEACHING SETTINGS, AND RESIDENTS IN CERTAIN SETTINGS Physician Services in Teaching Settings § 415.162 Determining payment for physician...

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

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    Lize STANGARLIN-FIORI

    2016-01-01

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

  2. Measuring innovation in a 'low-tech' service industry: the case of the Dutch hospitality industry

    NARCIS (Netherlands)

    den Hertog, P.; Gallouj, F.; Segers, J.

    2011-01-01

    This article presents the findings of a survey among 613 firms in the Dutch hospitality industry adopting a demarcation perspective. The paper illustrates that innovation in this service industry is much higher and more varied than regularly reported. It further indicates that innovation activities

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

    Science.gov (United States)

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

    2011-05-01

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

  4. Using Multimedia to Enhance Knowledge of Service Attitude in the Hospitality Industry

    Science.gov (United States)

    Kuo, Chun Min

    2012-01-01

    Having used a quasi-experimental research model and the ADDIE (Analyze, Design, Develop, Implement, and Evaluate) calibration method to gather and implement data, the researcher developed an interactive multimedia assisted learning (MAL) program promoting proper service attitudes in the hospitality industry. In order to gauge MAL program's…

  5. Occupational exposure in services of Oncological Hospital of Camaguey; Exposicion ocupacional en los servicios del Hospital Oncologico de Camaguey, Cuba

    Energy Technology Data Exchange (ETDEWEB)

    Barreras, C.A.; Brigido, F.O.; Naranjo, L.A. [Centro de Atencion a la Actividad Nuclear, Camaguey (Cuba)]. E-mail: sean@caonao.cmw.inf.cu; Sanches, M.P. [Instituto de Pesquisas Energeticas e Nucleares (IPEN), Sao Paulo, SP (Brazil)]. E-mail: msanches@net.ipen.br; Lasserra, S.O.; Hernandez, G.J. [Hospital Oncologico Marie Curie, Camaguey (Cuba)

    2001-07-01

    The Nuclear Medicine Service of the Cancer Hospital at Camaguey presents data on the occupationally exposure workers, during 1990-1999, obtained from film dosimetry. The outcomes show that: the average of annual effective equivalent dose for nuclear medical personnel was 2.47 mSv, while 2.13 mSv were to represent radiotherapy and 1.11 mSv were to represent the personnel tied to the others radiodiagnostic services, in the same period; 88,3% of the nuclear medicine personnel and the 94.9% of the radiotherapy personnel have received doses inferior to 3 mSv/year; the total collective dose for the studied period were 212.5, 189.8 and 22.3 mSv.man for nuclear medicine and radiotherapy and other medical users respectively. In this work, the annual behavior of the total collective doses is described based on the evaluation of the contribution of different radiodiagnostic procedures carried out at the Hospital. Others aspects related to biological radiation effects of occupational exposure and some outcomes are compared with those from the data of the other countries.

  6. The relationship of centralization, organizational culture and performance indexes in teaching hospitals affiliated to Tehran University of Medical Sciences.

    Science.gov (United States)

    Nasirpour, Amir Ashkan; Gohari, Mahmoud Reza; Moradi, Saied

    2010-01-01

    One of the main problems in the efficiency and efficacy of an organization is its structural issue. Organizational culture is also considered as an effective factor in the performance of many organizations. The main goal of the present study was to determine the relationship of Centralization and organizational culture and performance indexes in Teaching Hospitals affiliated to Tehran University of Medical Sciences. This correlation study was performed in the year 2007. The population studied consisted of 4408 personnel from 13 hospitals among whom 441 subjects were selected and studied via a class sampling method. Data was compiled using a check list concerning the evaluation status of Centralization and another form concerning performance indexes as well as Robbin's organizational culture questionnaire. Data were obtained from the subjects by self answering and analyzed by using descriptive statistical indexes, T- test and Fisher's exact tests. Among the organizational culture indexes of the hospitals studied, control and organizational identity was better as compared to others (mean=3.32 and 3.30). Concerning the extent of Centralization in the hospitals studied, 53.85 % and 46.15 % were reported to have upper and lower organizational Centralization, respectively. Mean ratio of surgical operations to inpatients was 40%, the mean rate of admissions per active bed was 60.83, mean bed occupancy coefficient was 70.79%, average length of stay was 6.96 days, and mean net death rate was 1.41%. No significant correlation was seen between Centralization degree, organizational culture and performance indexes in teaching hospitals Tehran university of medical sciences. (with 95% confidence interval). Due to the fact that first grade Teaching hospitals use board certified members, expert personnel, and advanced equipments and because of the limitation of patients choice and, the extent of Centralization and many organizational culture components have no significant

  7. The Relationship of Centralization, Organizational Culture and Performance Indexes in Teaching Hospitals Affiliated to Tehran University of Medical Sciences

    Directory of Open Access Journals (Sweden)

    Amir Ashkan Nasirpour

    2010-10-01

    Full Text Available One of the main problems in the efficiency and efficacy of an organization is its structural issue. Organizational culture is also considered as an effective factor in the performance of many organizations. The main goal of the present study was to determine the relationship of Centralization and organizational culture and performance indexes in Teaching Hospitals affiliated to Tehran University of Medical Sciences. This correlation study was performed in the year 2007. The population studied consisted of 4408 personnel from 13 hospitals among whom 441 subjects were selected and studied via a class sampling method. Data was compiled using a check list concerning the evaluation status of Centralization and another form concerning performance indexes as well as Robbin's organizational culture questionnaire. Data were obtained from the subjects by self answering and analyzed by using descriptive statistical indexes, T- test and Fisher's exact tests. Among the organizational culture indexes of the hospitals studied, control and organizational identity was better as compared to others (mean=3.32 and 3.30. Concerning the extent of Centralization in the hospitals studied, 53.85 % and 46.15 % were reported to have upper and lower organizational Centralization, respectively. Mean ratio of surgical operations to inpatients was 40%, the mean rate of admissions per active bed was 60.83, mean bed occupancy coefficient was 70.79%, average length of stay was 6.96 days, and mean net death rate was 1.41%. No significant correlation was seen between Centralization degree, organizational culture and performance indexes in teaching hospitals tehran university of medical sciences. (with 95% confidence interval. Due to the fact that first grade Teaching hospitals use board certified members, expert personnel, and advanced equipments and because of the limitation of patients choice and, the extent of Centralization and many organizational culture components have no

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

    Directory of Open Access Journals (Sweden)

    Edem Max Azila-Gbettor

    2013-09-01

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

  9. Specialized consultant in radiological safety to the north central hospital of high speciality, PEMEX. III. - September of 2001; Asesoria especializada en seguridad radiologica al hospital central norte de alta especialidad, PEMEX III.- Septiembre de 2001

    Energy Technology Data Exchange (ETDEWEB)

    Angeles C, A.; Vizuet G, J.; Benitez S, J. A.; Rodriguez A, F.; Garcia A, J

    2001-12-15

    The north central hospital of high speciality, dependent of PEMEX, It request consultant of the ININ to be able to maintain their sanitary license for the use of X-ray equipment for the radiologic diagnostic.The proposal of the ININ was to be a program of technical attendance, schedule monthly to be able to solve the observations that are presented in the use of those equipment, and that the hospital can conserve its respective sanitary license.(Author)

  10. Specialized consultant in radiological safety to the south central hospital of high speciality, PEMEX. III.- September of 2001; Asesoria especializada en seguridad radiologica al hospital central sur de alta especialidad, PEMEX III.- Septiembre de 2001

    Energy Technology Data Exchange (ETDEWEB)

    Angeles C, A.; Vizuet G, J.; Benitez S, J. A.; Rodriguez A, F.; Garcia A, J

    2001-12-15

    The south central hospital of high speciality, dependent of PEMEX, It request consultant of the ININ to be able to maintain their sanitary license for the use of X-ray equipment for the radiologic diagnostic.The proposal of the ININ was to be a program of technical attendance, schedule monthly to be able to solve the observations that are presented in the use of those equipment, and that the hospital can conserve its respective sanitary license.(Author)

  11. Specialized consultant in radiological safety to the south central hospital of high speciality, PEMEX. V. - November of 2001; Asesoria especializada en seguridad radiologica al hospital central sur de alta especialidad, PEMEX. V.- Noviembre de 2001

    Energy Technology Data Exchange (ETDEWEB)

    Angeles C, A.; Vizuet G, J.; Benitez S, J. A.; Garcia A, J.; Rodriguez A, F

    2002-01-15

    The south central hospital of high speciality, dependent of PEMEX, It request consultant of the ININ to be able to maintain their sanitary license for the use of X-ray equipment for the radiologic diagnostic.The proposal of the ININ was to be a program of technical attendance, schedule monthly to be able to solve the observations that are presented in the use of those equipment, and that the hospital can conserve its respective sanitary license.(Autho000.

  12. Specialized consultant in radiological safety to the north central hospital of high speciality, PEMEX. I. - May-June of 2003; Asesoria especializada en seguridad radiologica al hospital central norte de alta especialidad, PEMEX I.- Mayo-Junio de 2003

    Energy Technology Data Exchange (ETDEWEB)

    Angeles C, A.; Camacho V, B.; Rodriguez A, F

    2003-09-15

    The north central hospital of high speciality, dependent of PEMEX, It request consultant of the ININ to be able to maintain their sanitary license for the use of X-ray equipment for the radiologic diagnostic.The proposal of the ININ was to be a program of technical attendance, schedule monthly to be able to solve the observations that are presented in the use of those equipment, and that the hospital can conserve its respective sanitary license.(Author)

  13. Specialized consultant in radiological safety to the south central hospital of high speciality, PEMEX. IV. - October of 2001; Asesoria especializada en seguridad radiologica a la clinica al hospital central sur de alta especialidad, PEMEX. IV.- Octubre de 2001

    Energy Technology Data Exchange (ETDEWEB)

    Angeles C, A.; Vizuet G, J.; Benitez S, J. A.; Garcia A, J.; Rodriguez A, F

    2002-01-15

    The south central hospital of high speciality, dependent of PEMEX, It request consultant of the ININ to be able to maintain their sanitary license for the use of X-ray equipment for the radiologic diagnostic.The proposal of the ININ was to be a program of technical attendance, schedule monthly to be able to solve the observations that are presented in the use of those equipment, and that the hospital can conserve its respective sanitary license.(Author)

  14. Specialized consultant in radiological safety to the clinical north central hospital of high speciality, PEMEX. IV. - December of 2001; Asesoria especializada en seguridad radiologica a la clinica hospital central norte de alta especialidad, PEMEX. IV.- Diciembre de 2001

    Energy Technology Data Exchange (ETDEWEB)

    Angeles C, A.; Vizuet G, J.; Benitez S, J. A.; Garcia A, J.; Rodriguez A, F

    2002-01-15

    The clinical north central hospital of high speciality, dependent of PEMEX, It request consultant of the ININ to be able to maintain their sanitary license for the use of X-ray equipment for the radiologic diagnostic.The proposal of the ININ was to be a program of technical attendance, schedule monthly to be able to solve the observations that are presented in the use of those equipment, and that the hospital can conserve its respective sanitary license.(Author)

  15. Specialized consultant in radiological safety to the north central hospital of high speciality, PEMEX. I. - July of 2001; Asesoria especializada en seguridad radiologica al hospital central norte de alta especialidad, PEMEX I.- Julio de 2001

    Energy Technology Data Exchange (ETDEWEB)

    Angeles C, A.; Vizuet G, J.; Benitez S, J. A

    2001-09-15

    The north central hospital of high speciality, dependent of PEMEX, It request consultant of the ININ to be able to maintain their sanitary license for the use of X-ray equipment for the radiologic diagnostic.The proposal of the ININ was to be a program of technical attendance, schedule monthly to be able to solve the observations that are presented in the use of those equipment, and that the hospital can conserve its respective sanitary license.(Author)

  16. Specialized consultant in radiological safety to the north central hospital of high speciality, PEMEX. II. - August of 2001; Asesoria especializada en seguridad radiologica al hospital central norte de alta especialidad, PEMEX II.- Agosto de 2001

    Energy Technology Data Exchange (ETDEWEB)

    Angeles C, A.; Vizuet G, J.; Benitez S, J. A.; Rodriguez A, F.; Garcia A, J

    2001-10-15

    The north central hospital of high speciality, dependent of PEMEX, It request consultant of the ININ to be able to maintain their sanitary license for the use of X-ray equipment for the radiologic diagnostic.The proposal of the ININ was to be a program of technical attendance, schedule monthly to be able to solve the observations that are presented in the use of those equipment, and that the hospital can conserve its respective sanitary license.(Author)0.

  17. Specialized consultant in radiological safety to the south central hospital of high speciality, PEMEX. I. - July of 2001; Asesoria especializada en seguridad radiologica al hospital central sur de alta especialidad, PEMEX I.- Julio de 2001

    Energy Technology Data Exchange (ETDEWEB)

    Angeles C, A.; Vizuet G, J

    2001-09-15

    The south central hospital of high speciality, dependent of PEMEX, It request consultant of the ININ to be able to maintain their sanitary license for the use of X-ray equipment for the radiologic diagnostic.The proposal of the ININ was to be a program of technical attendance, schedule monthly to be able to solve the observations that are presented in the use of those equipment, and that the hospital can conserve its respective sanitary license.(Author)

  18. Specialized consultant in radiological safety to the south central hospital of high speciality, PEMEX. II.- August of 2001; Asesoria especializada en seguridad radiologica al hospital central sur de alta especialidad, PEMEX II.- Agosto de 2001

    Energy Technology Data Exchange (ETDEWEB)

    Angeles C, A.; Vizuet G, J.; Benitez S, J. A.; Rodriguez A, F.; Garcia A, J

    2001-12-15

    The south central hospital of high speciality, dependent of PEMEX, It request consultant of the ININ to be able to maintain their sanitary license for the use of X-ray equipment for the radiologic diagnostic.The proposal of the ININ was to be a program of technical attendance, schedule monthly to be able to solve the observations that are presented in the use of those equipment, and that the hospital can conserve its respective sanitary license.(Author)

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

    OpenAIRE

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

    2016-01-01

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

  20. Assessment of service delays and impact on bed utilisation in a major teaching hospital.

    LENUS (Irish Health Repository)

    Conway, R

    2010-12-14

    BACKGROUND: Increasing economic pressures coupled with an expanding and ageing population and a hostile economic climate have led to growing interest in the optimisation of bed usage within hospitals. There are many causes for delay in a patient\\'s discharge. METHODS: This prospective observational study assessed consecutive patients admitted and discharged from hospital within a 52-day period for waiting times in the provision of requested diagnostic tests and services. RESULTS: Seventy patients were included in the study. There were median delays of 2 and 3 days for an MRI and colonoscopy, a delay of 3 days for a Holter monitor report, and 9 days for an occupational therapy referral. The median wait for consults was 1 day across all three services. CONCLUSIONS: Significant remediable delays exist during the course of many acute medical admissions. Addressing these factors will enable the provision of a faster and more cost-efficient service.

  1. 42 CFR 409.68 - Guarantee of payment for inpatient hospital or inpatient CAH services furnished before...

    Science.gov (United States)

    2010-10-01

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

  2. Hospitals

    Data.gov (United States)

    Department of Homeland Security — This database contains locations of Hospitals for 50 states and Washington D.C. , Puerto Rico and US territories. The dataset only includes hospital facilities and...

  3. CAPD in Dammam Central Hospital, Saudi Arabia: A Five-Year Experience

    Directory of Open Access Journals (Sweden)

    Youmbissi Joseph

    2001-01-01

    Full Text Available Thirty-one patients with end-stage renal disease (ESRD were offered continuous ambulatory peritoneal dialysis (CAPD at the Dammam Central Hospital, Dammam, Saudi Arabia over a period of five years. The group included 21 women and 10 men with a mean age of 41.3 ± 17.2 years. The main indication for CAPD was poor or failed vascular access (51.4%. Peritonitis remained the major complication with an overall incidence of 0.62 episode per patient year. Staphylococcus epidermidis was the main causative organism. Therapy with CAPD lasted a mean of 26 ± 7.4 months. Our results, showing good technique survival and low peritonitis rate, suggest that CAPD should be promoted to become a full arm of the integrated care of ESRD in Saudi Arabia.

  4. Neurocognitive sequelae of cerebral malaria in adults:A pilot study in Benguela Central Hospital, Angola

    Institute of Scientific and Technical Information of China (English)

    Bruno Peixoto; Isabel Kalei

    2013-01-01

    Objective: To characterize the neurocognitive sequelae of cerebral malaria (CM) in an adult sample of the city of Benguela, Angola. Methods:A neuropsychological assessment was carried out in 22 subjects with prior history of CM ranging from 6 to 12 months after the infection. The obtained results were compared to a control group with no previous history of cerebral malaria. The study was conducted in Benguela Central Hospital, Angola in 2011. Results: CM group obtained lower results on the two last trials of a verbal learning task and on an abstract reasoning test. Conclusions: CM is associated to a slower verbal learning rate and to difficulties in the ability to discriminate and perceive relations between new elements.

  5. A Review on influencing criteria for selecting supplier of information technology services in the hospital.

    Science.gov (United States)

    Ajami, Sima; Rajabzadeh, Ahmad; Ketabi, Saeedeh

    2014-01-01

    Organizations try to outsource their activities as much as possible in order to prevent the problems and use organizational capabilities in Information Technology (IT) field. The purpose of this paper was first, to express the effective criteria for selecting suppliers of IT services, second, to explain the advantages and disadvantages of outsourcing IT in hospitals. This study was narrative review, which search was conducted with the help of libraries, books, conference proceedings, and databases of Science Direct, PubMed, Proquest, Springer, and SID (Scientific Information Database). In our searches, we employed the following keywords and their combinations: Outsourcing, information technology, hospital, decision making, and criteria. The preliminary search resulted in 120 articles, which were published between 2000 and 2013 during July 2013. After a careful analysis of the content of each paper, a total of 46 papers were selected based on their relevancy. The criteria and sub-criteria influencing outsourcing decisions in Iranian hospitals were identified in six major categories including administrative issues, issues related to the service/product, technology factors, environmental factors, risks, and economic factors associated with 15 sub-criteria containing business integration, dependence on suppliers, human resources, focus on core competencies, facilities and physical capital, innovation, quality, speed of service delivery, flexibility, market capabilities, geographical location, security, management control, cost, and financial capability. Identify the advantages and disadvantages of outsourcing and effective criteria in IT services supplier selection causes the managers be able to take the most appropriate decision to select supplier of IT services. This is a general review on influencing criteria for electing of supplier of information technology services in hospitals.

  6. A Review on influencing criteria for selecting supplier of information technology services in the hospital

    Science.gov (United States)

    Ajami, Sima; Rajabzadeh, Ahmad; Ketabi, Saeedeh

    2014-01-01

    Organizations try to outsource their activities as much as possible in order to prevent the problems and use organizational capabilities in Information Technology (IT) field. The purpose of this paper was first, to express the effective criteria for selecting suppliers of IT services, second, to explain the advantages and disadvantages of outsourcing IT in hospitals. This study was narrative review, which search was conducted with the help of libraries, books, conference proceedings, and databases of Science Direct, PubMed, Proquest, Springer, and SID (Scientific Information Database). In our searches, we employed the following keywords and their combinations: Outsourcing, information technology, hospital, decision making, and criteria. The preliminary search resulted in 120 articles, which were published between 2000 and 2013 during July 2013. After a careful analysis of the content of each paper, a total of 46 papers were selected based on their relevancy. The criteria and sub-criteria influencing outsourcing decisions in Iranian hospitals were identified in six major categories including administrative issues, issues related to the service/product, technology factors, environmental factors, risks, and economic factors associated with 15 sub-criteria containing business integration, dependence on suppliers, human resources, focus on core competencies, facilities and physical capital, innovation, quality, speed of service delivery, flexibility, market capabilities, geographical location, security, management control, cost, and financial capability. Identify the advantages and disadvantages of outsourcing and effective criteria in IT services supplier selection causes the managers be able to take the most appropriate decision to select supplier of IT services. This is a general review on influencing criteria for electing of supplier of information technology services in hospitals. PMID:25540781

  7. 38 CFR 17.51 - Emergency use of Department of Defense, Public Health Service or other Federal hospitals.

    Science.gov (United States)

    2010-07-01

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

  8. Tuberculosis among HIV-positive patients at Butajira Hospital, South-Central Ethiopia

    Directory of Open Access Journals (Sweden)

    Seada Mohammed

    2015-12-01

    Full Text Available Background: Tuberculosis (TB is the leading cause of morbidity and mortality among people living with Human Immunodeficiency Virus (HIV. This study was carried out to determine the prevalence of tuberculosis and its associated factors among HIV-positive patients at Butajira Hospital, South-Central Ethiopia. Methods: A retrospective review of standardized 222 HIV-positive patient records between July 2011 and June 2012 was conducted. A data sheet was used to collect relevant variables. Data were entered, organized and analysed using SPSS Version 16.0 Software. A p-value 15 years (18.95%. Among 45 TB/HIV cases, 26.7% had smear-positive pulmonary TB; 62.2% had smear-negative pulmonary TB; and 11.1% had extra-pulmonary TB. Malnutrition (OR= 45.7, CD4+ T-cell count <200/μl (OR= 5.4 and WHO clinical stage III or IV (OR= 4.12 were associated with tuberculosis in HIV-positive patients. Conclusion: In conclusion, the prevalence of TB/HIV co-infection at Butajira Zonal Hospital, South-Central Ethiopia was high. The co-infection was associated with malnutrition, low CD4 + T-cell count and WHO clinical stage III or IV. Therefore, compulsory TB screening among HIV-positive patients is mandatory. Besides, public awareness, community mobilization should be encouraged. Moreover, large scale studies on the trends in TB/HIV co-infection and associated factors should also be implemented across the country.

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

    Directory of Open Access Journals (Sweden)

    Kanwal Nasim

    2014-09-01

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

  10. Koeajossa EBSCO Discovery Service versus Primo Central Index

    OpenAIRE

    2015-01-01

    Laurean ja Metropolian kirjastot aloittivat lokakuussa 2015 EBSCO Discovery Servicen (EDS) koekäyttöjakson. Kirjastot tutkivat omalle organisaatiolle lisensioitujen artikkelitietokantojen sisältöjen löytyvyyttä EDS:ssä ja vertailivat tuloksia omien Finna-näkymiensä Primo Central Index (PCI) -haun kautta saatuihin tuloksiin. Löytyikö eroja ja kuinka finnat pärjäsivät EDS:lle?

  11. Interventions on central computing services during the weekend of 21 and 22 August

    CERN Multimedia

    2004-01-01

    As part of the planned upgrade of the computer centre infrastructure to meet the LHC computing needs, approximately 150 servers, hosting in particular the NICE home directories, Mail services and Web services, will need to be physically relocated to another part of the computing hall during the weekend of the 21 and 22 August. On Saturday 21 August, starting from 8:30a.m. interruptions of typically 60 minutes will take place on the following central computing services: NICE and the whole Windows infrastructure, Mail services, file services (including home directories and DFS workspaces), Web services, VPN access, Windows Terminal Services. During any interruption, incoming mail from outside CERN will be queued and delivered as soon as the service is operational again. All Services should be available again on Saturday 21 at 17:30 but a few additional interruptions will be possible after that time and on Sunday 22 August. IT Department

  12. Development of a nurse case management service: a proposed business plan for rural hospitals.

    Science.gov (United States)

    Adams, Marsha Howell; Crow, Carolyn S

    2005-01-01

    The nurse case management service (NCMS) for rural hospitals is an entrepreneurial endeavor designed to provide rural patients with quality, cost-effective healthcare. This article describes the development of an NCMS. A detailed marketing and financial plan, a review of industry trends, and the legal structure and risks associated with the development of the venture are presented. The financial plan projects a minimum savings of 223,200 dollars for rural institutions annually. To improve quality and reduce cost for rural hospitals, the authors recommend implementation of an NCMS.

  13. Analysis of the Service Quality of Medical Centers Using Servqual Model (Case:Shaheed Rahnemoon Hospital

    Directory of Open Access Journals (Sweden)

    H Zare Ahmadabadi

    2007-07-01

    Full Text Available Introduction: Many organizations, especially service oriented ones, relative to their goals and mission, have a special view towards quality phenomena and its management. Methods: This paper analyzes medical service quality in one case; The internal section of Shaheed Rahnemoon Hospital Based on the basis of gap analysis model and Servqual technique. A questionnaire was designed and applied to measure expectations and perceptions of patients and personnel of the hospital. Results: On application of non-parametric statistical tests, we propose certain recommendations. These tests drive on five conceptual dimensions of service quality including intangibility, responsiveness, reliability, assurance and empathy. Results show that patients in this section were satisfied from the service provider’s responsiveness, but there are significant differences between expectations and perceptions in other dimensions. Conclusion: The service quality analysis models are useful for managers of medical centers to distinguish gaps between the two sides of service representation; patients and medical centers personnel. Ultimately, they can reinforce strengths and control weaknesses.

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

    Science.gov (United States)

    Blank, Jos L T; van Hulst, Bart

    2015-01-01

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

  15. Alternative Models of Service, Centralized Machine Operations. Phase II Report. Volume II.

    Science.gov (United States)

    Technology Management Corp., Alexandria, VA.

    A study was conducted to determine if the centralization of playback machine operations for the national free library program would be feasible, economical, and desirable. An alternative model of playback machine services was constructed and compared with existing network operations considering both cost and service. The alternative model was…

  16. Relocation of Business Services into Central and Eastern Europe (Evidence from Trade and Location Statistics

    Directory of Open Access Journals (Sweden)

    ZOLTÁN GÁL

    2014-06-01

    Full Text Available Relocation of business service offshoring-related activities measured by foreign direct investments and exports in services have grown rapidly after the Millennium in the new EU member states of Central and Eastern Europe (CEE. Besides Foreign Direct Investment (FDI, trade statistics support the assumption that an expanding export in business and in ICT services has been associated with relocation of shared services centres created by FDI in the six new member states (NMS. The service export data collected between 1996/2002 and 2012 gives a good proxy to identify those segments of service trade, which are considered to be offshorable. The paper examines the additional location factors selecting Central and Eastern European locations and summarises the effect of crisis on this industry. It concludes that the sector has demonstrated market resilience in the NMS and continued to expand rapidly.

  17. ANALYSIS OF DISCARD OF WHOLE BLOOD AND BLOOD COMPONENTS IN GOVERNMENT HOSPITAL BLOOD BANK IN CENTRAL INDIA

    Directory of Open Access Journals (Sweden)

    Vedita Bobde

    2015-02-01

    Full Text Available BACKGROUND: Transfusion requests are always more than the supply due to advances in health care delivery . Injudicious use of whole blood and blood components strains the transfusion services. This mandates the proper analysis of real need of transfusion and the discard of this scarce resource. MATERIALS & METHODS: Total 31143 voluntary and replacement donors donated blood during January 2012 to December 2014 in blood bank of tertiary care Government hospital in Central India. The donors record, transfusion transmitted infections (TTI testing record, component preparation record & discard record during the same period were screened for analysis. RESULT: Out of total 31143 blood collection during study period TTI positive blood were 377 (1.21% comprising of 13.4% of total discarded blood bags. Components prepared 19545 and discarded 1610 (8.2%. Among components discarded most common units were platelets due to date expiry followed by FFP discarded due to leakage of bag. CONCLUSION: Analysis of reasons of discard of whole blood and blood components helps in forming policies to reduce the gap between demand and supply at local as well as national level

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

    Science.gov (United States)

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

    2008-06-01

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

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

    Science.gov (United States)

    2016-06-01

    identify a military treatment facility and if one is not available then they refer to a facility contracted with the MHS network . 22Military service ...DEFENSE HEALTH CARE Availability and Quality Measurement of Women’s Health Care Services in U.S. Military Hospitals...committees June 2016 DEFENSE HEALTH CARE Availability and Quality Measurement of Women’s Health Care Services in U.S. Military Hospitals What GAO Found

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

    Directory of Open Access Journals (Sweden)

    Fereshteh Farzianpour

    2011-01-01

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

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

    Science.gov (United States)

    Mayhew, Leslie; Lawrence, David

    2006-05-01

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

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

    Science.gov (United States)

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

    2014-01-01

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

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

    Science.gov (United States)

    1978-10-01

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

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

    Science.gov (United States)

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

    2009-01-01

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

  5. Therapeutic activities in mental health extra-hospital services: the inclusion of psychosocial actions

    Directory of Open Access Journals (Sweden)

    Regina Célia Fiorati

    2012-09-01

    Full Text Available Two studies were carried out in Ribeirao Preto, State of Sao Paulo, Brazil, in two extra-hospital mentalhealth services: one regional mental health outpatient clinic and one psychosocial care center. The purpose of thisresearch was to study the organization of the extra-hospital and therapeutic projects of these services, and theinclusion of psychosocial rehabilitation in such projects. The study was based on qualitative methodology and usedsemi-directive interviews and focal groups to collect data. Data analysis was based on the hermeneutic dialecticphilosophy of Jürgen Habermas according to the interpretative technique of reconstruction. Results indicated thatthese services are organized focusing on the clinical-psychiatric work, emphasizing the diagnosis, pathology andmedication treatment; while psychosocial actions have a secondary role in the therapeutic project. This articlediscusses part of this study in relation to the therapeutic activities and how they are implemented. Therapeuticactions are extremely technical, individually applied and imposed to an interdisciplinary field aiming to integratehealth actions. From a complementary perspective, as the therapeutic activities are mainly implemented in theinternal areas of the services and minimize territorial and community actions, they do not include individuals withpsychological distress in society; rather, they include these individuals in the service itself.

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

    OpenAIRE

    Renata Cristina Antonelli; José Aparecido Bellucci Junior

    2014-01-01

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

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

    OpenAIRE

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

    2014-01-01

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

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

    Science.gov (United States)

    McCleary, D

    1977-09-01

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

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

    Science.gov (United States)

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

    2007-01-01

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

  10. CERN'S TECHNICAL CONTROL ROOM (TCR) A CENTRAL SERVICE FOR EVERYONE

    CERN Multimedia

    Mario Batz

    2002-01-01

    The Technical Control Room (TCR) monitors and operates the entire technical infrastructure of CERN 24 hours a day, 365 days a year. It registers and dispatches troubleshooting requests to the appropriate equipment services. In addition, the TCR executes first-line interventions on the entire CERN site. Troubleshooting requests are transmitted to the TCR either via a computerised control system or via the phone number '72201'. More than 10'000 such requests are dispatched and dealt with every year. The TCR's diverse field of activity concerns the following systems: electrical and fluid distribution networks, heating, cooling, ventilation, air-conditioning and gas equipment, safety and communication installations, electromechanical systems (e.g. lifts, cranes, machine tools, motorised doors), sanitary systems (leaks, sewage), control and monitoring infrastructure equipment, buildings. These systems can either be part of the administrative infrastructure, such as offices or restaurants, or part of the t...

  11. CERN'S TECHNICAL CONTROL ROOM (TCR) A CENTRAL SERVICE FOR EVERYONE

    CERN Multimedia

    Mario Batz

    2001-01-01

    The Technical Control Room (TCR) monitors and operates the entire technical infrastructure of CERN 24 hours a day, 365 days a year. It registers and dispatches troubleshooting requests to the appropriate equipment services. In addition, the TCR executes first-line interventions on the entire CERN site. Troubleshooting requests are transmitted to the TCR either via a computerised control system or via the phone number '72201'. More than 10'000 such requests are dispatched and dealt with every year. The TCR's diverse field of activity concerns the following systems: electrical and fluid distribution networks, heating, cooling, ventilation, air-conditioning and gas equipment, safety and communication installations, electromechanical systems (e.g. lifts, cranes, machine tools, motorised doors), sanitary systems (leaks, sewage), control and monitoring infrastructure equipment, buildings. These systems can either be part of the administrative infrastructure, such as offices or restaurants, or part of the t...

  12. CERN'S TECHNICAL CONTROL ROOM (TCR) A CENTRAL SERVICE FOR EVERYONE

    CERN Multimedia

    Mario Batz

    2002-01-01

    The Technical Control Room (TCR) monitors and operates the entire technical infrastructure of CERN 24 hours a day, 365 days a year. It registers and dispatches troubleshooting requests to the appropriate CERN equipment services or contractors. In addition, the TCR executes first-line interventions on the entire CERN site. Troubleshooting requests are transmitted to the TCR either via a computerised control system or via the phone number '72201'. More than 10'000 such requests are dispatched and dealt with every year. The TCR's diverse field of activity covers the following systems: electrical and fluid distribution networks, heating, cooling, ventilation, air-conditioning and gas equipment, safety and communication installations, electromechanical systems (e.g. lifts, cranes, machine tools, motorised doors), sanitary systems (leaks, sewage), control and monitoring infrastructure equipment, and buildings. These systems can either be part of the administrative infrastructure, such as offices or restaur...

  13. CERN'S TECHNICAL CONTROL ROOM (TCR) A CENTRAL SERVICE FOR EVERYONE

    CERN Multimedia

    Mario Batz / TCR Responsible

    2000-01-01

    The Technical Control Room (TCR) monitors and operates the entire technical infrastructure of CERN 24 hours a day, 365 days a year. It registers and dispatches troubleshooting requests to the appropriate equipment services. In addition, the TCR executes first-line interventions on the entire CERN site. Troubleshooting requests are transmitted to the TCR either via a computerised control system or via the phone number 72201. More than 10'000 such requests are dispatched and dealt with every year. The TCR's diverse field of activity concerns the following systems: electrical and fluid distribution networks, heating, cooling, ventilation, air-conditioning and gas equipment, safety and communication installations, electromechanical systems (e.g. lifts, cranes, machine tools, motorised doors), sanitary systems (leaks, sewage), control and monitoring infrastructure equipment, buildings. These systems can either be part of the administrative infrastructure, such as offices or restaurants, or part of the tec...

  14. CERN'S TECHNICAL CONTROL ROOM (TCR) A CENTRAL SERVICE FOR EVERYONE

    CERN Multimedia

    Mario Batz (TCR Responsible)

    2001-01-01

    The Technical Control Room (TCR) monitors and operates the entire technical infrastructure of CERN 24 hours a day, 365 days a year. It registers and dispatches troubleshooting requests to the appropriate equipment services. In addition, the TCR executes first-line interventions on the entire CERN site. Troubleshooting requests are transmitted to the TCR either via a computerised control system or via the phone number 72201. More than 10'000 such requests are dispatched and dealt with every year. The TCR's diverse field of activity concerns the following systems: electrical and fluid distribution networks, heating, cooling, ventilation, air-conditioning and gas equipment, safety and communication installations, electromechanical systems (e.g. lifts, cranes, machine tools, motorised doors), sanitary systems (leaks, sewage), control and monitoring infrastructure equipment, buildings. These systems can either be part of the administrative infrastructure, such as offices or restaurants, or part of the tec...

  15. CERN's Technical Control Room (TCR) A Central Service for Everyone

    CERN Multimedia

    Mario Batz

    2001-01-01

    The Technical Control Room (TCR) monitors and operates the entire technical infrastructure of CERN 24 hours a day, 365 days a year. It registers and dispatches troubleshooting requests to the appropriate equipment services. In addition, the TCR executes first-line interventions on the entire CERN site. Troubleshooting requests are transmitted to the TCR either via a computerised control system or via the phone number '72201'. More than 10'000 such requests are dispatched and dealt with every year. The TCR's diverse field of activity concerns the following systems: electrical and fluid distribution networks, heating, cooling, ventilation, air-conditioning and gas equipment, safety and communication installations, electromechanical systems (e.g. lifts, cranes, machine tools, motorised doors), sanitary systems (leaks, sewage), control and monitoring infrastructure equipment, buildings. These systems can either be part of the administrative infrastructure, such as offices or restaurants, or part of the t...

  16. Implementation of the WHO multimodal Hand Hygiene Improvement Strategy in a University Hospital in Central Ethiopia

    Directory of Open Access Journals (Sweden)

    Frieder Pfäfflin

    2017-01-01

    Full Text Available Abstract Background The burden of health-care associated infections in low-income countries is high. Adequate hand hygiene is considered the most effective measure to reduce the transmission of nosocomial pathogens. We aimed to assess compliance with hand hygiene and perception and knowledge about hand hygiene before and after the implementation of a multimodal hand hygiene campaign designed by the World Health Organization. Methods The study was carried out at Asella Teaching Hospital, a university hospital and referral centre for a population of about 3.5 million in Arsi Zone, Central Ethiopia. Compliance with hand hygiene during routine patient care was measured by direct observation before and starting from six weeks after the intervention, which consisted of a four day workshop accompanied by training sessions and the provision of locally produced alcohol-based handrub and posters emphasizing the importance of hand hygiene. A second follow up was conducted three months after handing over project responsibility to the Ethiopian partners. Health-care workers’ perception and knowledge about hand hygiene were assessed before and after the intervention. Results At baseline, first, and second follow up we observed a total of 2888, 2865, and 2244 hand hygiene opportunities, respectively. Compliance with hand hygiene was 1.4% at baseline and increased to 11.7% and 13.1% in the first and second follow up, respectively (p < 0.001. The increase in compliance with hand hygiene was consistent across professional categories and all participating wards and was independently associated with the intervention (adjusted odds ratio, 9.18; 95% confidence interval 6.61-12.76; p < 0.001. After the training, locally produced alcohol-based handrub was used in 98.4% of all hand hygiene actions. The median hand hygiene knowledge score overall was 13 (interquartile range 11–15 at baseline and increased to 17 (15–18 after training (p < 0.001. Health

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

    Science.gov (United States)

    Kassaye, W W; Tseng, K C

    1990-01-01

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

  18. Analysis of 126 hospitalized elder maxillofacial trauma victims in central China

    Science.gov (United States)

    Zhang, Rui; Li, Wenlu; Pei, Fei; He, Wei

    2015-01-01

    Background The aim of this study was to analyzed the characteristics and treatment of maxillofacial injuries in the elder patients with maxillofacial injuries in central China. Material and Methods We retrospectively analyzed the characteristics and treatment of maxillofacial injuries in the patients over the age of 60 to analyze the trends and clinical characteristics of maxillofacial trauma in elder patients from the First Affiliated Hospital of Zhengzhou University (from 2010 to 2013) in central China and to present recommendations on prevention and management. Results Of the 932 patients with maxillofacial injuries, 126 aged over 60 years old accounting for 13.52% of all the patients (male:female, 1.74:1; mean age, 67.08 years old). Approximately 52% of the patients were injured by falls. The most frequently observed type of injuries was soft tissue injuries (100%), followed by facial fractures (83.05%). Of the patients with soft tissue injuries, the abrasions accounted the most, followed by lacerations. The numbers of patients of midface fracture (60 patients) were almost similar to the number of lower face fractures (66 patients). Eighty two patients (65.08%%) demonstrated associated injuries, of which craniocerebral injuries were the most prevalent. One hundred and four patients (82.54%) had other systemic medical conditions, with cardiovascular diseases the most and followed by metabolic diseases and musculoskeletal conditions. Furthermore, the study indicated a relationship between maxillofacial fractures and musculoskeletal conditions. Only 13 patients (10.32%) sustained local infections, of whom had other medical conditions. Most of the facial injuries (85.71%) in older people were operated including debridement, fixing loose teeth, reduction, intermaxillary fixation and open reduction and internal fixation (ORIF). Conclusions Our analysis of the characteristics of maxillofacial injuries in the elder patents may help to promote clinical research to

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

    Science.gov (United States)

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

    2010-07-01

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

  20. Etiologic agents of central nervous system infections among febrile hospitalized patients in the country of Georgia.

    Directory of Open Access Journals (Sweden)

    Tamar Akhvlediani

    Full Text Available OBJECTIVES: There is a large spectrum of viral, bacterial, fungal, and prion pathogens that cause central nervous system (CNS infections. As such, identification of the etiological agent requires multiple laboratory tests and accurate diagnosis requires clinical and epidemiological information. This hospital-based study aimed to determine the main causes of acute meningitis and encephalitis and enhance laboratory capacity for CNS infection diagnosis. METHODS: Children and adults patients clinically diagnosed with meningitis or encephalitis were enrolled at four reference health centers. Cerebrospinal fluid (CSF was collected for bacterial culture, and in-house and multiplex RT-PCR testing was conducted for herpes simplex virus (HSV types 1 and 2, mumps virus, enterovirus, varicella zoster virus (VZV, Streptococcus pneumoniae, HiB and Neisseria meningitidis. RESULTS: Out of 140 enrolled patients, the mean age was 23.9 years, and 58% were children. Bacterial or viral etiologies were determined in 51% of patients. Five Streptococcus pneumoniae cultures were isolated from CSF. Based on in-house PCR analysis, 25 patients were positive for S. pneumoniae, 6 for N. meningitidis, and 1 for H. influenzae. Viral multiplex PCR identified infections with enterovirus (n = 26, VZV (n = 4, and HSV-1 (n = 2. No patient was positive for mumps or HSV-2. CONCLUSIONS: Study findings indicate that S. pneumoniae and enteroviruses are the main etiologies in this patient cohort. The utility of molecular diagnostics for pathogen identification combined with the knowledge provided by the investigation may improve health outcomes of CNS infection cases in Georgia.

  1. Carbapenem Resistance among Enterobacter Species in a Tertiary Care Hospital in Central India

    Directory of Open Access Journals (Sweden)

    Atul Khajuria

    2014-01-01

    Full Text Available Objective. To detect genes encoding carbapenem resistance among Enterobacter species in a tertiary care hospital in central India. Methods. Bacterial identification of Enterobacter spp. isolates from various clinical specimens in patients admitted to intensive care units was performed by routine conventional microbial culture and biochemical tests using standard recommended techniques. Antibiotic sensitivity test was performed by standard Kirby Bauer disc diffusion technique. PCR amplification and automated sequencing was carried out. Transfer of resistance genes was determined by conjugation. Results. A total of 70/130 (53.84% isolates of Enterobacter spp. were found to exhibit reduced susceptibility to imipenem (diameter of zones of inhibition ≤13 mm by disc diffusion method. Among 70 isolates tested, 48 (68.57% isolates showed MIC values for imipenem and meropenem ranging from 32 to 64 mg/L as per CLSI breakpoints. All of these 70 isolates were found susceptible to colistin in vitro as per MIC breakpoints (<0.5 mg/L. PCR carried out on these 48 MBL (IP/IPI E-test positive isolates (12 Enterobacter aerogenes, 31 Enterobacter cloacae, and 05 Enterobacter cloacae complex was validated by sequencing for beta-lactam resistance genes and result was interpreted accordingly. Conclusion. The study showed MBL production as an important mechanism in carbapenem resistance in Enterobacter spp. and interspecies transfer of these genes through plasmids suggesting early detection by molecular methods.

  2. Molecular epidemiology of Acinetobacter baumannii in central intensive care unit in Kosova teaching hospital

    Directory of Open Access Journals (Sweden)

    Lul Raka

    2009-12-01

    Full Text Available Infections caused by bacteria of genus Acinetobacter pose a significant health care challenge worldwide. Information on molecular epidemiological investigation of outbreaks caused by Acinetobacter species in Kosova is lacking. The present investigation was carried out to enlight molecular epidemiology of Acinetobacterbaumannii in the Central Intensive Care Unit (CICU of a University hospital in Kosova using pulse field gel electrophoresis (PFGE. During March - July 2006, A. baumannii was isolated from 30 patients, of whom 22 were infected and 8 were colonised. Twenty patients had ventilator-associated pneumonia, one patient had meningitis, and two had coinfection with bloodstream infection and surgical site infection. The most common diagnoses upon admission to the ICU were politrauma and cerebral hemorrhage. Bacterial isolates were most frequently recovered from endotracheal aspirate (86.7%. First isolation occurred, on average, on day 8 following admission (range 1-26 days. Genotype analysis of A. baumannii isolates identified nine distinct PFGE patterns, with predominance of PFGE clone E represented by isolates from 9 patients. Eight strains were resistant to carbapenems. The genetic relatedness of Acinetobacter baumannii was high, indicating cross-transmission within the ICU setting. These results emphasize the need for measures to prevent nosocomial transmission of A. baumannii in ICU.

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

    Science.gov (United States)

    Moser, H Ronald; Freeman, Gordon L

    2014-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Gonsaga Ricardo

    2012-08-01

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

  5. Wait and consult times for primary healthcare services in central Mozambique: a time-motion study

    Directory of Open Access Journals (Sweden)

    Bradley H. Wagenaar

    2016-08-01

    Full Text Available Background: We describe wait and consult times across public-sector clinics and identify health facility determinants of wait and consult times. Design: We observed 8,102 patient arrivals and departures from clinical service areas across 12 public-sector clinics in Sofala and Manica Provinces between January and April 2011. Negative binomial generalized estimating equations were used to model associated health facility factors. Results: Mean wait times (in minutes were: 26.1 for reception; 43.5 for outpatient consults; 58.8 for antenatal visits; 16.2 for well-child visits; 8.0 for pharmacy; and 15.6 for laboratory. Mean consultation times (in minutes were: 5.3 for outpatient consults; 9.4 for antenatal visits; and 2.3 for well-child visits. Over 70% (884/1,248 of patients arrived at the clinic to begin queuing for general reception prior to 10:30 am. Facilities with more institutional births had significantly longer wait times for general reception, antenatal visits, and well-child visits. Clinics in rural areas had especially shorter wait times for well-child visits. Outpatient consultations were significantly longer at the smallest health facilities, followed by rural hospitals, tertiary/quaternary facilities, compared with Type 1 rural health centers. Discussion: The average outpatient consult in Central Mozambique lasts 5 min, following over 40 min of waiting, not including time to register at most clinics. Wait times for first antenatal visits are even longer at almost 1 h. Urgent investments in public-sector human resources for health alongside innovative operational research are needed to increase consult times, decrease wait times, and improve health system responsiveness.

  6. Patients’ Expectations and Perceptions of Service Quality in the Selected Hospitals

    Science.gov (United States)

    Nadi, Aliasghar; Shojaee, Jalil; Abedi, Ghassem; Siamian, Hasan; Abedini, Ehsan; Rostami, Farideh

    2016-01-01

    Background: Hospital’s success depends on patients’ expectations, perceptions, and judgment on the quality of services provided by hospitals. This study was conducted to assess the patients’ perceptions and expectations from the quality of inpatient health care in Vali-Asr hospital, Ghaemshahr, and Imam Khomeini and Shafa Hospitals, Sari. Materials and Methods: This study is applied regarding the objective of the study. Considering the research methodology, it is a descriptive – analytical study. The sample of this study consists of 600 patients with at least 24 hours of being hospitalized in internal, surgery, women, and children sectors of Vali-Asr, Ghaemshahr, Imam Khomeini, and Shafa Hospitals. Using random sampling method, the classifications relevant to the size of each class were selected. The data required was collected through the standard SERVQUAL questionnaire and then it was analyzed using the SPSS software. Results: The overall mean value and standard deviation of expectations were equal to 10.4 and 28, respectively. The mean value for the field of perception was 69.2 and the relevant standard deviation was 26. In terms of patients and hospital visits in concrete cases, the highest priority is related to empathy. The second priority is related to physical appearance, the third priority is related to responsiveness, the fourth priority is related to assurance, and the lowest priority is related to the reliability of the SERVQUAL approach. Examining the gap between patients’ perceptions and expectations, the widest gap was observed in the Vali-Asr Hospital with the mean and SD (-92.0±39.0) and the lowest gap was observed in Shafa Hospital with the mean value of (-39.9±44.0). According to The Kruskal–Wallis test, the difference observed in these three hospitals were significant. Conclusion: The results showed that patients’ expectations had not been met in any of the examined dimensions and their consent has not been achieved. It seemed

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

    Science.gov (United States)

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

    1987-05-01

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

  8. [A guide to successful public relations for hospitals and emergency medical services].

    Science.gov (United States)

    Ausserer, J; Schwamberger, J; Preloznik, R; Klimek, M; Paal, P; Wenzel, V

    2014-04-01

    Tragic accidents, e.g. involving celebrity patients or severe incidents in hospital occur suddenly without any advance warning, often produce substantial interest by the media and quickly overburden management personnel involved in both hospitals and emergency medical services. While doctors, hospitals and emergency medical services desire objective media reports, the media promote emotionalized and dramatized reports to ensure maximum attention and circulation. When briefing the media, the scales may quickly tilt from professional, well-deliberated information to unfortunate, often unintended disinformation. Such phenomena may result in continuing exaggerated reports in the tabloid press, which in the presence of aggressive lawyers and a competitive hospital environment can turn into image and legal problems. In this article, several aspects are discussed in order to achieve successful public relations.Interviews should be given only after consultation with the responsible press officer and the director of the respective department or hospital director. Requests for information by the media should always be answered as otherwise one-sided, unintentional publications can result that are extremely difficult to correct later. One should be available to be contacted easily by journalists, regular press conferences should be held and critics should be taken seriously and not be brushed off. Questions by journalists should be answered in a timely manner as journalists are continuously under time pressure and do not understand unnecessary delays. Information for the media should always be provided at the same time, no publication should be given preference and an absolutely current list of E-mail contacts is required. When facing big events a press conference is preferred as many questions can be answered at once. Always be well prepared for an interview or even for just a statement. Each interview should be regarded as an opportunity to put a story forward which you

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

    Science.gov (United States)

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

    1985-07-01

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

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

    Science.gov (United States)

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

    2016-01-01

    Introduction The main mission of hospitals in any health system is to deliver high quality healthcare for patients and meet their needs and expectations. The aim of the current study was to assess the quality of the service of educational hospitals affiliated with Kermanshah University of Medical Sciences in 2015, from the perspective of patients. Methods In this cross-sectional study, the perspectives of 400 patients were assessed about the quality of the services provided by educational hospitals in Kermanshah (western Iran) in 2015. The quality was assessed by the SERVQUAL questionnaire with five dimensions, i.e., tangibility, reliability, responsiveness, assurance, and empathy. In addition, the Wilcoxon test and the Kruskal-Wallis test were used to explore any association between the dependent variable and explanatory variables. The data were analyzed using Stata V.12 software. Results There were negative gaps in all five dimensions. The highest and lowest gaps in the mean score were found in the assurance (−0.88) and responsiveness (−0.56) dimensions. The patients ranked responsiveness as the most important dimension of the quality of healthcare. Conclusion There were gaps between the patients’ perceptions and their expectation about the five dimensions that were studied based on the SERVQUAL model. Also, it is recommended that improving the quality of healthcare is possible by various policies, such as good responsiveness, access to health workers, and delivering healthcare in less time. PMID:27123218

  11. Percutaneous retrieval of dislodged totally implantable central venous access system in 92 cases: Experience in a single hospital

    Energy Technology Data Exchange (ETDEWEB)

    Cheng, C.-C.; Tsai, T.-N. [Division of Cardiology, Department of Medicine, Tri-Service General Hospital, Taipei, Taiwan (China); Yang, C.-C. [Department of Medicine, Armed Forces Tao-Yuan General Hospital, Taoyuan, Taiwan (China); Han, C.-L. [Division of Cardiology, Department of Medicine, Tri-Service General Hospital, Taipei, Taiwan (China)], E-mail: allexll.cheng@msa.hinet.net

    2009-02-15

    Objective: To investigate the clinical presentation of dislodged totally implantable central venous access system (central venous port-catheter) fragments and the efficacy and safety of percutaneous retrieval of them in our hospital. Materials and methods: Ninety-two cancer patients, mean age of 53.8 years old with 51.1% male, were enrolled from January 2005 to March 2007. They were referred to our catheterization laboratory for retrieval of fractured central venous port-catheter in our hospital. All patients were followed in the outpatient department for at least 1 month after surgical insertion. The characteristics of disrupted central venous port-catheter were recorded. The procedure-related clinical condition was evaluated. Results: The most common presentation of central venous port-catheter dislodgement is irrigation resistance to infusion (51/92). The most common location of fractured fragments is between superior vena cava and right atrium (i.e. proximal end remained in superior vena cava and distal end in right atrium) (22/92). The most common fracture site of the catheter is at the anastomosis between injection port and catheter (77/92). The retrieval set used mostly is loop snare. The success rate of the percutaneous retrieval of dislodged fragment was 97.8% and the complication rate was 3.3% only. Conclusion: The faulty connection between catheter and injection port contributes mainly to dislodgement of central venous port-catheter. Percutaneous retrieval of dislodged catheter is a highly successful, safe and efficient method.

  12. Aetiologies of central nervous system infection in Viet Nam: a prospective provincial hospital-based descriptive surveillance study.

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    Nghia Ho Dang Trung

    Full Text Available BACKGROUND: Infectious diseases of the central nervous system (CNS remain common and life-threatening, especially in developing countries. Knowledge of the aetiological agents responsible for these infections is essential to guide empiric therapy and develop a rational public health policy. To date most data has come from patients admitted to tertiary referral hospitals in Asia and there is limited aetiological data at the provincial hospital level where most patients are seen. METHODS: We conducted a prospective Provincial Hospital-based descriptive surveillance study in adults and children at thirteen hospitals in central and southern Viet Nam between August 2007-April 2010. The pathogens of CNS infection were confirmed in CSF and blood samples by using classical microbiology, molecular diagnostics and serology. RESULTS: We recruited 1241 patients with clinically suspected infection of the CNS. An aetiological agent was identified in 640/1241 (52% of the patients. The most common pathogens were Streptococcus suis serotype 2 in patients older than 14 years of age (147/617, 24% and Japanese encephalitis virus in patients less than 14 years old (142/624, 23%. Mycobacterium tuberculosis was confirmed in 34/617 (6% adult patients and 11/624 (2% paediatric patients. The acute case fatality rate (CFR during hospital admission was 73/617 (12% in adults and to 42/624 (7% in children. CONCLUSIONS: Zoonotic bacterial and viral pathogens are the most common causes of CNS infection in adults and children in Viet Nam.

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

    Science.gov (United States)

    Fischer, W W; Reel, L B

    1992-10-01

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

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

    Directory of Open Access Journals (Sweden)

    Cordell-Smith James

    2007-11-01

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

  15. Selected aspects of the logistics network of public hospitals in the competitive market of health services

    Directory of Open Access Journals (Sweden)

    Justyna Majchrzak-Lepczyk

    2016-12-01

    Full Text Available Background: The below considerations provide an overview of the issues of sustainable development, logistics, to financial engineering instruments and the role of intellectual capital in the process of transformation of public hospitals. The aim of this research was to assess the competitiveness of the network of public hospitals in the market of health services based on literature studies, as well as empirical research. Methods: Empirical study using a questionnaire survey was conducted in the period from January 2007 to December 2011, in the area of Warmia and Mazury, Pomerania and Wielkopolska. The goal of this questionnaire survey was to know the medical staff reviews issues related to adaptation to the nature of the network of public hospitals methods and logistics tools, sustainable development, corporate social responsibility - CSR. The study was carried out in 104 public hospitals, on a sample of 8975 respondents. Results and conclusions: Analysis of the completed study showed that the logistic processes and their improvement in the health sector play a significant role. The surveyed entities explicitly draw attention to the need for information systems,  pro-environment activities, access to information, or the use of GS1 global standards. These tools allow you to increase the efficiency of supply chains, ensuring not only tracking and tracing of products from the manufacturer to the patient, but also enabling better protection against making a mistake or counterfeit products.

  16. A multi-criteria assessment of scenarios on thermal processing of infectious hospital wastes: a case study for Central Macedonia.

    Science.gov (United States)

    Karagiannidis, A; Papageorgiou, A; Perkoulidis, G; Sanida, G; Samaras, P

    2010-02-01

    In Greece more than 14,000 tonnes of infectious hospital waste are produced yearly; a significant part of it is still mismanaged. Only one off-site licensed incineration facility for hospital wastes is in operation, with the remaining of the market covered by various hydroclave and autoclave units, whereas numerous problems are still generally encountered regarding waste segregation, collection, transportation and management, as well as often excessive entailed costs. Everyday practices still include dumping the majority of solid hospital waste into household disposal sites and landfills after sterilization, still largely without any preceding recycling and separation steps. Discussed in the present paper are the implemented and future treatment practices of infectious hospital wastes in Central Macedonia; produced quantities are reviewed, actual treatment costs are addressed critically, whereas the overall situation in Greece is discussed. Moreover, thermal treatment processes that could be applied for the treatment of infectious hospital wastes in the region are assessed via the multi-criteria decision method Analytic Hierarchy Process. Furthermore, a sensitivity analysis was performed and the analysis demonstrated that a centralized autoclave or hydroclave plant near Thessaloniki is the best performing option, depending however on the selection and weighing of criteria of the multi-criteria process. Moreover the study found that a common treatment option for the treatment of all infectious hospital wastes produced in the Region of Central Macedonia, could offer cost and environmental benefits. In general the multi-criteria decision method, as well as the conclusions and remarks of this study can be used as a basis for future planning and anticipation of the needs for investments in the area of medical waste management.

  17. Development of a web service of vehicle inspection in central credit risk

    OpenAIRE

    Santos López, Félix Melchor; PUCP

    2014-01-01

    The central credit risk companies in Peru collect much information from different external sources and they offer various services to the others enterprises, entities and citizens. Therefore, their information systems are updated constantly. In the world there are many different technologies developed in different language programming, thus it was considered a pain in the neck for software engineers. Fortunately, nowadays there is a framework called Web Service that allows communication, inte...

  18. Factors that determine use of breeding services by smallholder dairy farmers in Central Kenya.

    Science.gov (United States)

    Murage, Alice W; Ilatsia, Evans D

    2011-01-01

    This study examined the determinants of smallholder dairy farmers' use of breeding services in Nyandarua and Kiambu districts, Central Kenya. Data was collected through semi-structured interviews with 140 randomly selected respondents. The breeding services considered were artificial insemination (AI), natural bull service, or a combination of AI and bull services. A multinomial logit econometric model was used fitting AI as the base category. There was a negative relationship between higher levels of education, herd size, and location and the use of bull service. However, education, herd size, and credit were positively related to the combined option. The results indicate that uptake of AI services after the liberalization of the sector is influenced by other factors besides cost-related factors. Factors such as accessibility to breeding services and product markets had influence on the farmer decision to choose among the available breeding services. The effectiveness of the breeding services in terms of successful conception also plays a big role in the choice. A need for concerted efforts to increase farmer's knowledge base on utilization and effectiveness of available breeding services is imperative. Furthermore, smallholder dairy farming could be made more sustainable and economically viable by implementing initiatives geared towards enhancing access to breeding services that would guarantee access to quality genetic material.

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

    OpenAIRE

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

    2016-01-01

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

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

    OpenAIRE

    2015-01-01

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

  1. Peripherally Inserted Central Catheter-Related Infections in a Cohort of Hospitalized Adult Patients

    Energy Technology Data Exchange (ETDEWEB)

    Bouzad, Caroline, E-mail: caroline.bouzad@gmail.com [Percy Military Teaching Hospital, Radiology Department (France); Duron, Sandrine, E-mail: duronsandrine@yahoo.fr [GSBdD, Military Centre for Epidemiology and Public Health (CESPA) (France); Bousquet, Aurore, E-mail: aurorebousquet@yahoo.fr [Begin Military Teaching Hospital, Bacteriology Department (France); Arnaud, François-Xavier, E-mail: fxa0160@hotmail.com [Percy Military Teaching Hospital, Radiology Department (France); Valbousquet, Laura, E-mail: laura.valbousquet@gmail.com [Begin Military Teaching Hospital, Radiology Department (France); Weber-Donat, Gabrielle, E-mail: weberdonatgabrielle@yahoo.fr; Teriitehau, Christophe, E-mail: cteriitehau@me.com; Baccialone, Jacques, E-mail: jacques.baccialone@wanadoo.fr; Potet, Julien, E-mail: potet-julien@yahoo.fr [Percy Military Teaching Hospital, Radiology Department (France)

    2016-03-15

    PurposeTo determine the incidence and the risks factors of peripherally inserted central catheter (PICC)-related infectious complications.Materials and MethodsMedical charts of every in-patient that underwent a PICC insertion in our hospital between January 2010 and October 2013 were reviewed. All PICC-related infections were recorded and categorized as catheter-related bloodstream infections (CR-BSI), exit-site infections, and septic thrombophlebitis.ResultsNine hundred and twenty-three PICCs were placed in 644 unique patients, mostly male (68.3 %) with a median age of 58 years. 31 (3.4 %) PICC-related infections occurred during the study period corresponding to an infection rate of 1.64 per 1000 catheter-days. We observed 27 (87.1 %) CR-BSI, corresponding to a rate of 1.43 per 1000 catheter-days, 3 (9.7 %) septic thrombophlebitis, and 1 (3.2 %) exit-site infection. Multivariate logistic regression analysis showed a higher PICC-related infection rate with chemotherapy (odds ratio (OR) 7.2–confidence interval (CI) 95 % [1.77–29.5]), auto/allograft (OR 5.9–CI 95 % [1.2–29.2]), and anti-coagulant therapy (OR 2.2–95 % [1.4–12]).ConclusionChemotherapy, auto/allograft, and anti-coagulant therapy are associated with an increased risk of developing PICC-related infections.Clinical AdvanceChemotherapy, auto/allograft, and anti-coagulant therapy are important predictors of PICC-associated infections. A careful assessment of these risk factors may be important for future success in preventing PICC-related infections.

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

    Science.gov (United States)

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

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

  3. Implementation of CMS Central DAQ monitoring services in Node.js

    CERN Document Server

    Vougioukas, Michail

    2015-01-01

    This report summarizes my contribution to the CMS Central DAQ monitoring system, in my capacity as a CERN Summer Students Programme participant, from June to September 2015. Specifically, my work was focused on rewriting – from Apache/PHP to Node.js/Javascript - and optimizing real-time monitoring web services (mostly Elasticsearch-based but also some Oracle-based) for the CMS Data Acquisition (Run II Filterfarm). Moreover, it included an implementation of web server caching, for better scalability when simultaneous web clients use the services. Measurements confirmed that the software developed during this project has indeed a potential to provide scalable services.

  4. Cost of drugs manufactured by the University Hospital - role of the Central Pharmacy Custo de medicamentos produzidos pelo Hospital Universitário, papel da Farmácia Central

    Directory of Open Access Journals (Sweden)

    Marcia Lucia M. Marin

    2001-04-01

    Full Text Available The hospital pharmacy in large and advanced institutions has evolved from a simple storage and distribution unit into a highly specialized manipulation and dispensation center, responsible for the handling of hundreds of clinical requests, many of them unique and not obtainable from commercial companies. It was therefore quite natural that in many environments, a manufacturing service was gradually established, to cater to both conventional and extraordinary demands of the medical staff. That was the case of Hospital das Clinicas, where multiple categories of drugs are routinely produced inside the pharmacy. However, cost-containment imperatives dictate that such activities be reassessed in the light of their efficiency and essentiality. METHODS: In a prospective study, the output of the Manufacturing Service of the Central Pharmacy during a 12-month period was documented and classified into three types. Group I comprised drugs similar to commercially distributed products, Group II included exclusive formulations for routine consumption, and Group III dealt with special demands related to clinical investigations. RESULTS: Findings for the three categories indicated that these groups represented 34.4%, 45.3%, and 20.3% of total manufacture orders, respectively. Costs of production were assessed and compared with market prices for Group 1 preparations, indicating savings of 63.5%. When applied to the other groups, for which direct equivalent in market value did not exist, these results would suggest total yearly savings of over 5 100 000 US dollars. Even considering that these calculations leave out many components of cost, notably those concerning marketing and distribution, it might still be concluded that at least part of the savings achieved were real. CONCLUSIONS: The observed savings, allied with the convenience and reliability with which the Central Pharmacy performed its obligations, support the contention that internal manufacture of

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

    Science.gov (United States)

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

    2007-01-01

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

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

    Science.gov (United States)

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

    1994-03-01

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

  7. "Feed from the Service": Corruption and Coercion in State-University Relations in Central Eurasia

    Science.gov (United States)

    Osipian, Ararat L.

    2009-01-01

    Education in Central Eurasia has become one of the services most affected by corruption. Corruption in academia, including bribery, extortion, embezzlement, nepotism, fraud, cheating, and plagiarism, is reflected in the region's media and addressed in a few scholarly works. This article considers corruption in higher education as a product of…

  8. 77 FR 59679 - Central Vermont Public Service Corporation (Millstone Power Station, Unit 3); Order Approving...

    Science.gov (United States)

    2012-09-28

    .... (DNC), Central Vermont Public Service Corporation (CVPS) and Massachusetts Municipal Wholesale Electric Company (MMWE) (collectively ``the licensees'' or ``DNC, Inc., et al.'') are the co-holders of the Renewed... Power Station, Unit 3 (MPS3). CVPS is a non-operating owner of a 1.7303% interest in MPS3. DNC is...

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

    Science.gov (United States)

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

    2015-01-01

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

  10. Hospitals

    DEFF Research Database (Denmark)

    Mullins, Michael

    2013-01-01

    in the navigation experience and wasted time of medical staff in providing directions. Space in hospitals: space can be divided into personal, social and outdoor space. Personal space: single rooms have been well documented in: admission length, mortality rates, comfort levels, sense of privacy, all users...

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

    CERN Document Server

    Santos, Carlos; Ferreira, Carla; Tribolet, José

    2011-01-01

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

  12. 18 CFR 366.23 - FERC Form No. 60, Annual reports of centralized service companies, and FERC-61, Narrative...

    Science.gov (United States)

    2010-04-01

    ..., Annual reports of centralized service companies, and FERC-61, Narrative description of service company... companies, and FERC-61, Narrative description of service company functions. (a) General. (1) FERC Form No... 1 each year thereafter, a narrative description, FERC-61, of the service company's functions...

  13. Implementation of a children's hospital-wide central venous catheter insertion and maintenance bundle

    NARCIS (Netherlands)

    K. Helder MScN (Onno); R.F. Kornelisse (René); C. van der Starre (Cynthia); D. Tibboel (Dick); C.W.N. Looman (Caspar); R.M.H. Wijnen (René); M.J. Poley (Marten); E. Ista (Erwin)

    2013-01-01

    textabstractBackground: Central venous catheter-associated bloodstream infections in children are an increasingly recognized serious safety problem worldwide, but are often preventable. Central venous catheter bundles have proved effective to prevent such infections. Successful implementation requir

  14. 42 CFR 413.118 - Payment for facility services related to covered ASC surgical procedures performed in hospitals...

    Science.gov (United States)

    2010-10-01

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

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

    Directory of Open Access Journals (Sweden)

    Pallavi Sarji Uthkarsh

    2016-04-01

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

  16. Quality of Care and Services of a Public Hospital: Awareness and Assessment

    Directory of Open Access Journals (Sweden)

    Abdel-ilah Aziane

    2015-04-01

    Full Text Available In order to give everyone access to quality care, this study attempts to make quality awareness, highlighting the importance of the implementation of the quality management system in health care facilities. The objective of our work is to make a quality awareness, to analyze the current situation and to provide recommendations. The analysis of the existing situation consists of identifying, describing, and analyzing the key processes implemented, listing the dysfunctions, classifying them, deciding on the corresponding actions and putting in place indicators and dashboards, which will help track improvements. The overall situation of the hospital regarding the requirements of ISO 9001 indicated a respect of about 28% of the requirements of the standard. The state of the premises of the establishment does not indicate a clear organization at the hospital. The hospital environment is a prerequisite to the establishment of a system of quality management that enables you to deploy a clear and shared policy to improve the quality of care and services.

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

    Directory of Open Access Journals (Sweden)

    L'Heureux Randy

    2009-05-01

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

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

    Directory of Open Access Journals (Sweden)

    Ana Stranjancevic

    2015-12-01

    Full Text Available One of the greatest challenges for stakeholders is to ensure customer satisfaction, especially in service industries such as tourism and hospitality. The aim of this paper is to show that restaurant guest satisfaction depends on numerous factors as well as to show the connection between satisfaction and loyalty. Customer satisfaction and loyalty are excellent indicators of service quality. For the purpose of this paper, empirical survey was conducted and the results of the research were analyzed by statistical method. Factors which affect customer satisfaction are: kind staff, professionalism, speed of service, food quality, ambience and comfort. This implicates a special need for the introduction of strong Human Resource Management, food safety standards (e.g. HACCP and effective space planning. The study implies that the care for quality of products and services is necessary at all levels and that it is impossible to ensure the customer satisfaction or create customer loyalty without strong management system (including space projecting and without controlling it.

  19. Quality assessment of clinical education services in teaching hospitals located in Kerman, Iran

    Science.gov (United States)

    Yazdi-Feyzabadi, Vahid; Gozashti, Mohammad Hossein; Komsari, Samane; Mohammadtaghizadeh, Sedigheh; Amiresmaili, Mohammadreza

    2015-01-01

    Introduction Clinical education is one of the most important components of the resource generation function of health systems, and it has a very important role in graduates’ competency with respect to effective, practical education. This study aimed to assess the quality of clinical services in Kerman’s teaching hospitals located in southeastern Iran. Methods This cross-sectional study was conducted in 2011 on 303 medical students at different levels of medical education at Kerman’s teaching hospitals. A modified SERVQUAL instrument was used to collect the data after its validity and reliability were checked. The data were analyzed by SPSS 18.0 using the paired t-test, Kruskal-Wallis, and post hoc tests, when appropriate. Results In all five dimensions of quality, gaps were observed between students’ perceptions and expectations as follows: Assurance (mean = −1.18), Responsiveness (−1.56), Empathy (−1.4), Reliability (−1.27), and Tangibles (−1.21). There was a significant difference between the quality perceptions and expectations of the medical students (p < 0.001). A significant difference was observed between three educational levels, including externships, internships, and assistantships regarding the dimensions of the quality gaps (p < 0.001). Conclusion The clinical services provided by teaching hospitals in the study did not meet the students’ expectations at any of the three educational levels. As we precisely assessed the dimensions and items that had the higher quality gaps, it was apparent that, for most part, clinical education officials could improve the quality by designing interventions, which would not be very difficult to do. PMID:26767094

  20. [Outsourcing: theory and practice at a clinical hospital in Szczecin exemplified by medical waste transport and treatment service].

    Science.gov (United States)

    Kotlega, Dariusz; Nowacki, Przemysław; Lewiński, Dariusz; Chmurowicz, Ryszard; Ciećwiez, Sylwester

    2011-01-01

    Outsourcing proves to be a useful tool in the difficult process of improving the financial result of hospitals. Outsourcing means separation of some functions and services in one entity and their transfer to another. The aim of this study was to analyze the use of outsourcing at the Second Independent Public University Hospital of the Pomeranian Medical University (SPSK 2 PUM) in Szczecin. We studied the transport and treatment of medical waste. Outsourcing of waste treatment services led to financial savings. The cost of treatment of one kilogram of waste by an external company was PLN 2.53. The same service provided by the hospital would cost approximately PLN 7 per kilogram. Appropriate attention should be paid to the quality of services. It seems useful to have appropriate tools for quality control and monitoring. SPSK 2 PUM can serve as a good example of effective use of outsourcing.

  1. Psychosocial risk factors for hospital readmission in COPD patients on early discharge services: a cohort study

    Directory of Open Access Journals (Sweden)

    Todd Christopher J

    2011-11-01

    Full Text Available Abstract Background Hospital readmission for acute exacerbation of COPD (AECOPD occurs in up to 30% of patients, leading to excess morbidity and poor survival. Physiological risk factors predict readmission, but the impact of modifiable psychosocial risk factors remains uncertain. We aimed to evaluate whether psychosocial risk factors independently predict readmission for AECOPD in patients referred to early discharge services (EDS. Methods This prospective cohort study included 79 patients with AECOPD cared for by nurse led EDS in the UK, and followed up for 12 months. Data on lung function, medical comorbidities, previous hospital admissions, medications, and sociodemographics were collected at baseline; St George's Respiratory Questionnaire (SGRQ, Hospital Anxiety and Depression Scale (HADS, and social support were measured at baseline, 3 and 12-months. Exploratory multivariate models were fitted to identify psychosocial factors associated with readmission adjusted for known confounders. Results 26 patients were readmitted within 90 days and 60 patients were readmitted at least once during follow-up. Depression at baseline predicted readmission adjusted for sociodemographics and forced expiratory volume in 1 second (odds ratio 1.30, 95% CI 1.06 to 1.60, p = 0.013. Perceived social support was not significantly associated with risk of readmission. Home ownership was associated with the total number of readmissions (B = 0.46, 95% CI -0.86 to -0.06, p = 0.024. Compared with those not readmitted, readmitted patients had worse SGRQ and HADS scores at 12 months. Conclusion Depressive symptoms and socioeconomic status, but not perceived social support, predict risk of readmission and readmission frequency for AECOPD in patients cared for by nurse-led EDS. Future work on reducing demand for unscheduled hospital admissions could include the design and evaluation of interventions aimed at optimising the psychosocial care of AECOPD patients managed at

  2. Hospital Compare

    Data.gov (United States)

    U.S. Department of Health & Human ServicesHospital Compare has information about the quality of care at over 4,000 Medicare-certified hospitals across the country. You can use Hospital Compare to find...

  3. HCAHPS - Hospital

    Data.gov (United States)

    U.S. Department of Health & Human Services — A list of hospital ratings for the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS). HCAHPS is a national, standardized survey of hospital...

  4. 78 FR 41954 - TA-W-82,634, Prudential Global Business Technology Solutions Central Security Services Dresher...

    Science.gov (United States)

    2013-07-12

    ... Employment and Training Administration TA-W-82,634, Prudential Global Business Technology Solutions Central Security Services Dresher, Pennsylvania; TA-W-82,634A, Prudential Global Business Technology Solutions Central Security Services Iselin, New Jersey; TA-W-82,634B, Prudential Global Business...

  5. Breeding Services and the Factors Influencing Their Use on Smallholder Dairy Farms in Central Uganda

    Directory of Open Access Journals (Sweden)

    Anthony Mugisha

    2014-01-01

    Full Text Available Dairy cattle breeding is an important technology in the enhancement and promotion of dairy production in Uganda. The introduction of germplasm through AI is crucial to enhance the production potential of the local breeds. A study was conducted in six districts of Uganda in the central region using a questionnaire survey involving 450 randomly selected households to profile the dairy breeding services in use and investigate the factors that affect the success of dairy breeding focusing on AI. Adoption of the AI service was highly (P0.05. Use or nonuse of AI did not significantly (P>0.05 influence the sex of the calf born. While preference for AI was marked, very few farmers actually used it. This implies that focus should be put on improved AI service delivery alongside improved extension services.

  6. Developing Indicators of Service Quality Provided for Cardiovascular Patients Hospitalized in Cardiac Care Unit

    Directory of Open Access Journals (Sweden)

    Saber Azami-Aghdash

    2013-03-01

    Full Text Available Introduction: Cardiovascular diseases are among the most prevalent chronic diseases leading to high degrees of mortality and morbidity worldwide and in Iran. The aim of the current study was to determine and develop appropriate indicators for evaluating provided service quality for cardiovascular patients admitted to Cardiac Care Units (CCU in Iran. Methods: In order to determine the indicators for evaluating provided service quality, a four-stage process including reviewing systematic review articles in premier bibliographic databases, interview, performing two rounds of Delphi technique, and holding experts panel by attendance of experts in different fields was adopted. Finally, after recognizing relevant indicators in resources, these indicators were finalized during various stages using ideas of 27 experts in different fields. Results: Among 2800 found articles in the text reviewing phase, 21 articles, which had completely mentioned relevant indicators, were studied and 48 related indicators were extracted. After two interviews with a cardiologist and an epidemiologist, 32 items of the indicators were omitted and replaced by 27 indicators coping with the conditions of Iranian hospitals. Finally, 43 indicators were added into the Delphi phase and after 2 rounds of Delphi with 18 specialists, 7 cases were excluded due to their low scores of applicability. In the experts’ panel stage, 6 items were also omitted and 10 new indicators were developed to replace them. Eventually, 40 indicators were finalized. Conclusion: In this study, some proper indicators for evaluating provided service quality for CCU admissions in Iran were determined. Considering the informative richness of these indicators, they can be used by managers, policy makers, health service providers, and also insurance agencies in order to improve the quality of services, decisions, and policies.

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

    Directory of Open Access Journals (Sweden)

    Lize Stangarlin

    2013-09-01

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

  8. Mapping ecosystem services for land use planning, the case of Central Kalimantan.

    Science.gov (United States)

    Sumarga, Elham; Hein, Lars

    2014-07-01

    Indonesia is subject to rapid land use change. One of the main causes for the conversion of land is the rapid expansion of the oil palm sector. Land use change involves a progressive loss of forest cover, with major impacts on biodiversity and global CO2 emissions. Ecosystem services have been proposed as a concept that would facilitate the identification of sustainable land management options, however, the scale of land conversion and its spatial diversity pose particular challenges in Indonesia. The objective of this paper is to analyze how ecosystem services can be mapped at the provincial scale, focusing on Central Kalimantan, and to examine how ecosystem services maps can be used for a land use planning. Central Kalimantan is subject to rapid deforestation including the loss of peatland forests and the provincial still lacks a comprehensive land use plan. We examine how seven key ecosystem services can be mapped and modeled at the provincial scale, using a variety of models, and how large scale ecosystem services maps can support the identification of options for sustainable expansion of palm oil production.

  9. The changing student profile at Service, Hospitality and Tourism Management Programme in Denmark

    DEFF Research Database (Denmark)

    Hammershøy, Anna

    2014-01-01

    of a short-cycle higher education programme in Hospitality and Tourist management in Denmark. The findings indicate that the international students (originating from countries of East Central Europe and the Baltics) demonstrate more passive classroom behaviour and experience more challenges in implementing......Using Hofstede’s cultural dimensions (Power Distance and Uncertainty Avoidance) as a theoretical foundation, this paper presents a two-phase qualitative research which aims to identify the reasons of different classroom and study behaviours of international and Danish students in the context...... principles of problem based learning, in particular group work, due to exposure to different didactic approaches in their home countries. It is suggested that these differences should be recognized on the part of the study programme, and culture training and academic support with focus on PBL should...

  10. Hospital administration team development and support in a children's cancer service.

    Science.gov (United States)

    Slater, Penelope J

    2011-11-01

    The administration team in the Queensland Children's Cancer Centre at the Royal Children's Hospital, Brisbane, included a team of 16 administration staff supporting the service and the state-wide clinical network. Shortly after the creation of a new expanded service, issues became apparent in administration team morale, relationships, communication, processes, leadership, support and training. The analysis of these issues included team interviews and surveys, consultation with senior administration staff and monthly sick leave monitoring. Strategies implemented included providing information; the joint development of a team business plan and individual performance plans; a review of the team's structure, workload and business processes; engaging staff in quality improvements; and the development of relationships and leadership. As a result, the team reported being more comfortable and supported in their roles, had improved morale and worked better together with more consistent and improving business processes. They had clear purpose and expectations of their roles, displayed better customer service and had reduced sick leave. The study shows that in a high stress environment, such as a children's cancer centre, attention to the team's culture, vision and purpose, providing information and improving communication and relationships, when combined with a team's enthusiasm, will improve the team's growth, cooperation and work outcomes.

  11. Opinion On Drug Information Services Provided In A Multi- Specialty Teaching Hospital

    Directory of Open Access Journals (Sweden)

    Vijayakumar TM, Poovi G & Dhanaraju MD

    2011-05-01

    Full Text Available Objective: To evaluate the various drug information queriesreceived, and to access the drug information services providedby the pharmacy practice department.Method: Drug information queries received during wardrounds, direct communication, telephone or internet etc. weredocumented in the drug information request anddocumentation forms prepared by the department over theperiod of January 2010 to June 2010. Various parameters likestatus of enquirer, their specialty, mode of receipt of query,purpose of query, type of query etc. were consider forevaluation.Results: Out of 208 queries received, major 56 (26.9% frommale medical ward. Maximum [82 (39.4 %] queries were fromthe physicians. 73 (35.0 % of the queries were about therecent advances and the updating of the information, It wasfound that mostly the mode of request was during wardrounds 85 (40.9%. Most of the queries [126 (60.6%] wereanswered by written or printout format. Majority of thequeries [195 (93.8 %] were answered directly to theenquirers through direct access. Most of the queries wereanswered through books in the department [86 (41.3 %].Conclusion: Results of the external auditing revealed thatrequestors were generally satisfied with the service provided.The drug information services provided by clinical pharmacistsat the hospital were found to be useful and beneficial to thehealthcare professionals and patients.

  12. The application of hospitality elements in hospitals.

    Science.gov (United States)

    Wu, Ziqi; Robson, Stephani; Hollis, Brooke

    2013-01-01

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

  13. Inequity in Hospitalization Care: A Study on Utilization of Healthcare Services in West Bengal, India

    Directory of Open Access Journals (Sweden)

    Montu Bose

    2015-01-01

    Full Text Available Background Out of eight commonly agreed Millennium Development Goals (MDG, six are related to the attainment of Universal Health Coverage (UHC throughout the globe. This universalization of health status suggests policies to narrow the gap in access and benefit sharing between different socially and economically underprivileged classes with that of the better placed ones and a consequent expansion of subsidized healthcare appears to be a common feature for most of the developing nations. The National Health Policy in India (2002 suggests expansion of market-based care for the affording class and subsidized care for the deserving class of the society. So, the benefit distribution of this limited public support in health sector is important to examine to study the welfare consequences of the policy. This paper examines the nature of utilizationto inpatient care by different socio-economic groups across regions and gender in West Bengal (WB, India. The benefit incidence of public subsidies across these socio-economic groups has also been verified for different types of services like medicines, diagnostics and professional care etc. Methods National Sample Survey Organization (NSSO has collected information on all hospitalized cases (60th round, 2004 with a recall period of 365 days from the sampled households through stratified random sampling technique. The data has been used to assess utilization of healthcare services during hospitalization and the distribution of public subsidies among the patients of different socio-economic background; a Benefit Incidence Analysis (BIA has also been carried out. Results Analysis shows that though the rate of utilization of public hospitals is quite high, other complementary services like medicine, doctor and diagnostic tests are mostly purchased from private market. This leads to high Out-of-Pocket (OOP expenditure. Moreover, BIA reveals that the public subsidies are mostly enjoyed by the relatively better

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

    Science.gov (United States)

    2014-01-01

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

  15. Medicare Program; hospital inpatient prospective payment systems for acute care hospitals and the long-term care hospital prospective payment system changes and FY2011 rates; provider agreements and supplier approvals; and hospital conditions of participation for rehabilitation and respiratory care services; Medicaid program: accreditation for providers of inpatient psychiatric services. Final rules and interim final rule with comment period.

    Science.gov (United States)

    2010-08-16

    : We are revising the Medicare hospital inpatient prospective payment systems (IPPS) for operating and capital-related costs of acute care hospitals to implement changes arising from our continuing experience with these systems and to implement certain provisions of the Affordable Care Act and other legislation. In addition, we describe the changes to the amounts and factors used to determine the rates for Medicare acute care hospital inpatient services for operating costs and capital-related costs. We also are setting forth the update to the rate-of-increase limits for certain hospitals excluded from the IPPS that are paid on a reasonable cost basis subject to these limits. We are updating the payment policy and the annual payment rates for the Medicare prospective payment system (PPS) for inpatient hospital services provided by long-term care hospitals (LTCHs) and setting forth the changes to the payment rates, factors, and other payment rate policies under the LTCH PPS. In addition, we are finalizing the provisions of the August 27, 2009 interim final rule that implemented statutory provisions relating to payments to LTCHs and LTCH satellite facilities and increases in beds in existing LTCHs and LTCH satellite facilities under the LTCH PPS. We are making changes affecting the: Medicare conditions of participation for hospitals relating to the types of practitioners who may provide rehabilitation services and respiratory care services; and determination of the effective date of provider agreements and supplier approvals under Medicare. We are also setting forth provisions that offer psychiatric hospitals and hospitals with inpatient psychiatric programs increased flexibility in obtaining accreditation to participate in the Medicaid program. Psychiatric hospitals and hospitals with inpatient psychiatric programs will have the choice of undergoing a State survey or of obtaining accreditation from a national accrediting organization whose hospital accreditation

  16. Tumores del estroma gastrointestinal (GIST: serie del Hospital Central de la Defensa Gómez Ulla

    Directory of Open Access Journals (Sweden)

    I. Bodega Quiroga

    2013-09-01

    Full Text Available Objetivo: Los tumores del estroma gastrointestinal (GIST se han diferenciado hace poco más de una década de los tumores de músculo liso y de origen neural gracias a métodos de identificación inmunohistoquímica (CD117. Al mismo tiempo, la introducción del Mesylato de Imatinib, fármaco empleado en el tratamiento de la leucemia mieloide crónica (LMC, ha mejorado la expectativa de vida, no sólo en GIST irresecables o metastáticos, sino también para aquéllos de intermedio o alto grado de malignidad como terapia adyuvante e incluso se plantea como tratamiento neoadyuvante. El objetivo de esta comunicación es estudiar los GIST diagnosticados e intervenidos quirúrgicamente en el Servicio de Cirugía General y del Aparato Digestivo del Hospital Central de la Defensa «Gómez Ulla» (Madrid en un periodo de 9 años y realizar una revisión de la literatura enfocada fundamentalmente a los avances en el tratamiento. Material y métodos: Estudio retrospectivo observacional de los pacientes diagnosticados de GIST e intervenidos quirúrgicamente en nuestro Servicio de 2003 a 2012. Se estudia el motivo de consulta inicial, la localización, el grado histológico y el tipo de intervención quirúrgica realizado. Resultados: Se encontraron 11 pacientes entre Noviembre de 2003 y Abril de 2012, todos hombres. La edad media fue de 65´17 años (rango, 53-84. Hay que destacar que en 8 casos (72´7 % el hallazgo fue incidental, sin ninguna sintomatología previa. La localización más frecuente fue el estómago en 6 casos (54´5%, y en el intestino delgado en 5 (45´5%. En cuanto al riesgo de malignidad, 5 casos (45´5% fueron de bajo grado, 4 (36´4% de grado intermedio, 1 (9% de muy bajo grado y 1 (9´1% de alto grado de malignidad. La técnica quirúrgica empleada fue la gastrectomía parcial en 6 casos (54´5% seguida de la resección intestinal segmentaria en 5 casos (45´5%. Conclusiones: La incidencia anual de tumores GIST intervenidos en nuestro

  17. IDENTIFYING ELEVEN FACTORS OF SERVICE MARKETING MIX (4PS) EFFECTIVE ON TENDENCY OF PATIENTS TOWARD PRIVATE HOSPITAL

    OpenAIRE

    Hosseini, Seyed Mojtaba; Etesaminia, Samira; Jafari, Mehrnoosh

    2016-01-01

    Introduction: One of the important factors of correct management is to identify the reasons for patient tendency toward private hospitals. This study measures these factors based on service marketing mixes. Patients and methods: This study used a cross sectional descriptive methodology. The study was conducted during 6 months in 2015. The studied population included patients of private hospitals in Tehran. Random sampling was used (n = 200). Data was collected by an author-made questionnaire ...

  18. First year's experience with an acute pain service--University Hospital Kuala Lumpur.

    Science.gov (United States)

    Vijayan, R; Delilkan, A E

    1994-12-01

    An Acute Pain Service (APS) was started in University Hospital, Kuala Lumpur by the Department of Anaesthesiology in October 1992 for more effective control of postoperative pain. The main modalities of treatment included patient controlled analgesia (PCA) using morphine or pethidine with PCA devises, epidural opiate analgesia (EOA) using tramadol or fentanyl/bupivacaine mixture and subcutaneous administration of morphine or pethidine. Five hundred and fifty-one patients were managed in the first year, with an overall patient satisfaction score of 83%. The majority (98.5%) of them were after abdominal or major orthopaedic surgery. Eighty per cent of patients scored < 3 on the verbal numeric pain scale, where 0 is no pain and 10 is the worst imaginable pain, on the first postoperative day. Nausea and vomiting was an unpleasant side effect in 20% of patients.

  19. Services quality in emergency department of Nemazee Hospital: Using SERVQUAL model

    Directory of Open Access Journals (Sweden)

    Maryam Gholami

    2016-10-01

    Full Text Available Introduction: Patient satisfaction is crucial to the long-run success in health care center. With regard to the highest patients’ referral to the emergency department and the existing challenges due to the patient’s need to urgent care, we aimed to evaluate health care services quality in this unit to find out whether the patients have different expectations from health care providers and if they perceive some dimensions of care more important than others. Method: The SERVQUAL scale method was used in this cross-sectional study on 100 patients in June 2015. Patient satisfaction questionnaire based on SERVQUAL model was evaluated with high content validity and the reliability was 0.97 and 0.81. The data collected were analyzed using SPSS, version 20.0 (IBM, USA. Statistical analyses included descriptive statistics, paired and independence sample t-test and ANOVA at the significance level 0.05. Results:The results showed that the quality gap in all dimensions was significant (P<0.001. The largest quality gap was related to responsiveness (-1.08 and the lowest belonged to assurance (-0.8. Demographic characteristics were analyzed and the number of referrals was significant in tangibility and assurance dimensions (P = 0.04; also, in all cases the patients’ expectations (total Mean=4.35 were higher than their perception (total Mean = 3.295. Conclusion: In order to improve emergency services, it is recommended that the hospital management should provide appropriate facilities, reduce waiting time, increase in attention to ordering system based on the patients’ condition, and improve the behavior of health care personnel to patient is placed on the agenda of hospital management.

  20. Implementing ward based clinical pharmacy services in an Ethiopian University Hospital

    Directory of Open Access Journals (Sweden)

    Mekonnen AB

    2013-03-01

    Full Text Available Background: Clinical pharmacy practice has developed internationally to expand the role of a pharmacist well beyond the traditional roles of compounding, dispensing and supplying drugs to roles more directly in caring for patients. Studies on the activities of the clinical pharmacist in an inpatient ward in resource constrained settings are scarce, however.Objective: To assess ward based clinical pharmacy services in an internal medicine ward of Jimma University Specialized Hospital. Methods: The study was carried out in the internal medicine ward from March to April, 2011 at Jimma University Specialized Hospital. The study design was a prospective observational study where pharmaceutical care services provided by clinical pharmacists for inpatients were documented over a period of two months. Interventions like optimization of rational drug use and physician acceptance of these recommendations were documented. Clinical significance of interventions was evaluated by an independent team (1 internist, 1 clinical pharmacologist using a standardized method for categorizing drug related problems (DRPs. Results: A total of 149 drug related interventions conducted for 48 patients were documented; among which 133(89.3% were clinical pharmacists initiated interventions and 16(10.7% interventions were initiated by other health care professionals. The most frequent DRPs underlying interventions were unnecessary drug therapy, 36(24.2%; needs additional drug therapy, 34(22.8% and noncompliance, 29(19.5%. The most frequent intervention type was change of dosage/instruction for use, 23(15.4%. Acceptance rate by physicians was 68.4%. Among the interventions that were rated as clinically significant, 46(48.9% and 25(26.6% had major and moderate clinical importance respectively. Conclusion: Involving trained clinical pharmacists in the healthcare team leads to clinically relevant and well accepted optimization of medicine use in a resource limited settings. This

  1. Facility management in German hospitals.

    Science.gov (United States)

    Gudat, H

    2000-04-01

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

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

    Science.gov (United States)

    Holder, Reynaldo; Fabrega, Ricardo

    2015-01-01

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

  3. Who Benefits from Ecosystem Services? A Case Study for Central Kalimantan, Indonesia

    Science.gov (United States)

    Suwarno, Aritta; Hein, Lars; Sumarga, Elham

    2016-02-01

    There is increasing experience with the valuation of ecosystem services. However, to date, less attention has been devoted to who is actually benefiting from ecosystem services. This nevertheless is a key issue, in particular, if ecosystem services analysis and valuation is used to support environmental management. This study assesses and analyzes how the monetary benefits of seven ecosystem services are generated in Central Kalimantan Province, Indonesia, are distributed to different types of beneficiaries. We analyze the following ecosystem services: (1) timber production; (2) rattan collection; (3) jelutong resin collection; (4) rubber production (based on permanent agroforestry systems); (5) oil palm production on three management scales (company, plasma farmer, and independent smallholder); (6) paddy production; and (7) carbon sequestration. Our study shows that the benefits generated from these services differ markedly between the stakeholders, which we grouped into private, public, and household entities. The distribution of these benefits is strongly influenced by government policies and in particular benefit sharing mechanisms. Hence, land-use change and policies influencing land-use change can be expected to have different impacts on different stakeholders. Our study also shows that the benefits generated by oil palm conversion, a main driver for land-use change in the province, are almost exclusively accrued by companies and at this point in time are shared unequally with local stakeholders.

  4. Who Benefits from Ecosystem Services? A Case Study for Central Kalimantan, Indonesia.

    Science.gov (United States)

    Suwarno, Aritta; Hein, Lars; Sumarga, Elham

    2016-02-01

    There is increasing experience with the valuation of ecosystem services. However, to date, less attention has been devoted to who is actually benefiting from ecosystem services. This nevertheless is a key issue, in particular, if ecosystem services analysis and valuation is used to support environmental management. This study assesses and analyzes how the monetary benefits of seven ecosystem services are generated in Central Kalimantan Province, Indonesia, are distributed to different types of beneficiaries. We analyze the following ecosystem services: (1) timber production; (2) rattan collection; (3) jelutong resin collection; (4) rubber production (based on permanent agroforestry systems); (5) oil palm production on three management scales (company, plasma farmer, and independent smallholder); (6) paddy production; and (7) carbon sequestration. Our study shows that the benefits generated from these services differ markedly between the stakeholders, which we grouped into private, public, and household entities. The distribution of these benefits is strongly influenced by government policies and in particular benefit sharing mechanisms. Hence, land-use change and policies influencing land-use change can be expected to have different impacts on different stakeholders. Our study also shows that the benefits generated by oil palm conversion, a main driver for land-use change in the province, are almost exclusively accrued by companies and at this point in time are shared unequally with local stakeholders.

  5. Centralized automated cataloging of health science materials in the MLC/SUNY/OCLC shared cataloging service.

    Science.gov (United States)

    Raper, J E

    1977-04-01

    Since February 1976, The Medical Library Center of New York, with the assistance of the SUNY/OCLC Network, has offered, on a subscription basis, a centralized automated cataloging service to health science libraries in the greater metropolitan New York area. By using workforms and prints of OCLC record (amended by the subscribing participants), technical services personnel at the center have fed cataloging data, via a CRT terminal, into the OCLC system, which provides (1) catalog cards, received in computer filing order; (2) book card, spine, and pocket labels; (3) accessions lists; and (4) data for eventual production of book catalogs and union catalogs. The experience of the center in the development, implementation, operation, and budgeting of its shared cataloging service is discussed.

  6. Availability and use of emergency obstetric care services in public hospitals in Laos PDR: a systems analysis.

    Science.gov (United States)

    Douangphachanh, Xaysomphou; Ali, Moazzam; Outavong, Phathammavong; Alongkon, Phengsavanh; Sing, Menorath; Chushi, Kuroiwa

    2010-12-01

    The maternal mortality ratio in Laos in 2005 was 660 per 100,000 lives birth which was the third highest in Asia-Pacific Region. The objective was to determine the availability and use of emergency obstetric care (EmOC) in provincial and district hospitals in Borikhamxay, Khammouane, and Savannakhet provinces using UN guidelines. A hospital-based cross sectional survey was conducted from January to March 2008. All district (30) and provincial hospitals (3) from three provinces were included. Analysis was based on hospital records reflecting 12 months of facility data. Data indicates that only 14 hospitals (42.4%) were providing EmOC services, i.e., 9 basic, 5 comprehensive services. The proportion of births in EmOC facilities was only 11.2%, the met need was a very low 14.5%, and the cesarean section rate was only 0.9%. The case fatality rate in Borikhanxay province was 2.8%; in Khammouane and in Savannakhet provinces it was less than 1%. Record keeping at hospitals was poor. Signal functions provided in the last three months showed only 48.5% of the facilities performed assisted vaginal delivery. This is the first study in Lao PDR to assess EmOC services. Almost all the indicators were below the UN recommendations. Health planners must take evidence-based decisions to rectify and improve the situation in the hospitals regarding EmOC services. These data can therefore help government to assign and allocate budgets appropriately, and help policymakers and planners to identify systemic bottlenecks and prioritize solutions and will help in improving maternal health.

  7. 38 CFR 4.29 - Ratings for service-connected disabilities requiring hospital treatment or observation.

    Science.gov (United States)

    2010-07-01

    ... effective the last day of the month of hospital discharge (regular discharge or release to non-bed care) or... Department of Veterans Affairs or an approved hospital for a period in excess of 21 days or hospital... hospital discharge effective the first day of such authorized absence. An authorized absence of 4 days...

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

    NARCIS (Netherlands)

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

    2014-01-01

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

  9. Health and economic effects from linking bedside and outpatient tobacco cessation services for hospitalized smokers in two large hospitals: study protocol for a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Fellows Jeffrey L

    2012-08-01

    Full Text Available Abstract Background Extended smoking cessation follow-up after hospital discharge significantly increases abstinence. Hospital smoke-free policies create a period of ‘forced abstinence’ for smokers, thus providing an opportunity to integrate tobacco dependence treatment, and to support post-discharge maintenance of hospital-acquired abstinence. This study is funded by the National Heart, Lung, and Blood Institute (1U01HL1053231. Methods/Design The Inpatient Technology-Supported Assisted Referral study is a multi-center, randomized clinical effectiveness trial being conducted at Kaiser Permanente Northwest (KPNW and at Oregon Health & Science University (OHSU hospitals in Portland, Oregon. The study assesses the effectiveness and cost-effectiveness of linking a practical inpatient assisted referral to outpatient cessation services plus interactive voice recognition (AR + IVR follow-up calls, compared to usual care inpatient counseling (UC. In November 2011, we began recruiting 900 hospital patients age ≥18 years who smoked ≥1 cigarettes in the past 30 days, willing to remain abstinent postdischarge, have a working phone, live within 50 miles of the hospital, speak English, and have no health-related barriers to participation. Each site will randomize 450 patients to AR + IVR or UC using a 2:1 assignment strategy. Participants in the AR + IVR arm will receive a brief inpatient cessation consult plus a referral to available outpatient cessation programs and medications, and four IVR follow-up calls over seven weeks postdischarge. Participants do not have to accept the referral. At KPNW, UC participants will receive brief inpatient counseling and encouragement to self-enroll in available outpatient services. The primary outcome is self-reported thirty-day smoking abstinence at six months postrandomization for AR + IVR participants compared to usual care. Additional outcomes include self-reported and biochemically confirmed

  10. Factors associated with hospital service satisfaction in a sample of Arab subjects with schizophrenia

    Directory of Open Access Journals (Sweden)

    Al-Zayed Adel A

    2010-10-01

    Full Text Available Abstract Background Assessment of patients' satisfaction with health care services could help to identify the strengths and weaknesses of the system and provide guidance for further development. The study's objectives were to: (i assess the pattern of satisfaction with hospital care for a sample of people with schizophrenia in Kuwait, using the Verona Service Satisfaction Scale (VSSS-EU; ii compare the pattern of satisfaction with those of similar studies; and iii assess the association of VSSS seven domains with a number of variables representing met and unmet needs for care, family caregiver burden, severity of psychopathology, level of psychosocial functioning, socio-demographic characteristics, psychological well-being and objective quality of life. Methods Consecutive outpatients in stable condition and their family caregivers were interviewed with the VSSS-EU and measures of needs for care, caregiver burden, quality of life and psychopathology. Results There were 130 patients (66.1%m, mean age 36.8. While over two-thirds expressed satisfaction with the domains of "overall satisfaction", "professionals' skills", "access", "efficacy", and "relatives' involvement", only about one-third were satisfied with the domains of "information" and "types of intervention". The later two domains were the areas in which European patients had better satisfaction than our patients, while our patients expressed better satisfaction than the Europeans in the domain of "relatives' involvement". In multiple regression analyses, self-esteem, positive and negative affect were the most important correlates of the domains of service satisfaction, while clinical severity, caregiver burden and health unmet needs for care played relatively minor roles. Conclusion The noted differences and similarities with the international data, as well as the predictive power of self-esteem and affective state, support the impression that patients' attitudes towards psychiatric care

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

    Directory of Open Access Journals (Sweden)

    Odette Newman

    2008-01-01

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

  12. An examination of blood center structure and hospital customer satisfaction: what can centralized and decentralized blood centers learn from each other?

    Science.gov (United States)

    Carden, Robert; DelliFraine, Jami L

    2005-01-01

    The cost of blood and blood products has increased rapidly over the last several years while the supply of available blood donors has simultaneously decreased. Higher blood costs and donor shortages have put a strain on the relationship between blood suppliers and their hospital customers. This study examines the association between blood center centralization or decentralization and several aspects of hospital satisfaction. Centralized and decentralized blood centers have significant differences in various aspects of hospital customer satisfaction. Advantages and disadvantages of the two structures are discussed, as well as areas for future research.

  13. Socio-economic and Demographic Determinants of Antenatal Care Services Utilization in Central Nepal

    Directory of Open Access Journals (Sweden)

    Srijana Pandey, PhD

    2014-09-01

    Full Text Available Background/Objective: The importance of maternal health services in lessening maternal mortality and morbidity as well as neonatal deaths has received substantial recognition in the past decade. The lack of antenatal care has been identified as a risk factor for maternal mortality and other adverse pregnancy outcomes. The purpose of this study was to determine the factors affecting attendance of antenatal care services in Nepal. Methods: This is a cross-sectional descriptive study carried out in Central Nepal. Using semi-structured questionnaire, interviews were conducted with married women aged between 15-49 years, who had delivered their babies within one year. Systematic random sampling method was used to select the sample. Results were obtained by frequency distribution and cross-tabulation of the variables. Results: More than half of the women were not aware of the consequences of lack of antenatal care. Age, education, income, type of family were strongly associated with the attendance at antenatal care service. Conclusions and Public Health Implications: In Nepal and in other developing countries, maternal mortality and morbidity continue to pose challenges to the health care delivery system. Variety of factors including socio-demographic, socio-economic, cultural and service availability as well as accessibility influences the use of maternal health services.

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

    Directory of Open Access Journals (Sweden)

    Reddaiah V.P

    1995-01-01

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

  15. The effect of certification and accreditation on quality management in 4 clinical services in 73 European hospitals.

    NARCIS (Netherlands)

    Shaw, C.D.; Groene, O.; Botje, D.; Suñol, R.; Kutryba, B.; Klazinga, N.; Bruneau, C.; Hammer, A.; Wang, A.; Arah, O.A.; Wagner, C.

    2014-01-01

    Objective: To investigate the relationship between ISO 9001 certification, healthcare accreditation and quality management in European hospitals. Design: A mixed method multi-level cross-sectional design in seven countries. External teams assessed clinical services on the use of quality management s

  16. Magnet status as a competitive strategy of hospital organizations: marketing a culture of excellence in nursing services.

    Science.gov (United States)

    Tropello, Paula Grace Dunn

    2003-01-01

    With issues of patient safety, the nursing shortage, and managed care fiscal constraints, hospital organizations can strategically capture market share, while insuring best care practices, if they adopt the "Magnet Status" accreditation model. This quality indicator signifies to the consumer a culture of excellence in nursing services and fulfills the priority of customer satisfaction as a marketing strategy objective.

  17. Molecular Epidemiology of Brucella Genotypes in Patients at a Major Hospital in Central Peru

    NARCIS (Netherlands)

    K. Noeckler; R. Maves; D. Cepeda; A. Draeger; A. Mayer-Scholl; J. Chacaltana; M. Castaneda; B. Espinosa; R. Castillo; E. Hall; S. Al Dahouk; R.H. Gilman; F. Cabeza; H.L. Smits

    2009-01-01

    The multiple-locus variable-number repeat analysis of 90 human Brucella melitensis isolates from a large urban area in central Peru revealed variations at 4 (Bruce07, Bruce09, Bruce18, and Bruce42) out of 16 loci investigated, of which 1 (Bruce42) also is used for species identification. Ten genotyp

  18. IDENTIFYING ELEVEN FACTORS OF SERVICE MARKETING MIX (4PS) EFFECTIVE ON TENDENCY OF PATIENTS TOWARD PRIVATE HOSPITAL

    Science.gov (United States)

    Hosseini, Seyed Mojtaba; Etesaminia, Samira; Jafari, Mehrnoosh

    2016-01-01

    Introduction: One of the important factors of correct management is to identify the reasons for patient tendency toward private hospitals. This study measures these factors based on service marketing mixes. Patients and methods: This study used a cross sectional descriptive methodology. The study was conducted during 6 months in 2015. The studied population included patients of private hospitals in Tehran. Random sampling was used (n = 200). Data was collected by an author-made questionnaire for service marketing factors. Reliability and validity of the questionnaire were confirmed. Data analysis was done using factor analysis test in SPSS 20. Results: The results showed that constant attendance of physicians and nurses has the highest effect (0.707%) on patient tendency toward private hospitals. PMID:27999486

  19. Use of selected ambulatory dental services in Taiwan before and after global budgeting: a longitudinal study to identify trends in hospital and clinic-based services

    Directory of Open Access Journals (Sweden)

    Lin Chienhung

    2012-09-01

    Full Text Available Abstract Background The Taiwan government adopted National Health Insurance (NHI in 1995, providing universal health care to all citizens. It was financed by mandatory premium contributions made by employers, employees, and the government. Since then, the government has faced increasing challenges to control NHI expenditures. The aim of this study was to determine trends in the provision of dental services in Taiwan after the implementation of global budgeting in 1998 and to identify areas of possible concern. Methods This longitudinal before/after study was based on data from the National Health Insurance Research Database from 1996 to 2001. These data were subjected to logistic regression analysis. Linear regression analysis was used to examine changes in delivery of specific services after global budgeting implementation. Utilization of hospital and clinic services was compared. Results Reimbursement for dental services increased significantly while the number of visits per patient remained steady in both hospitals and clinics. In hospitals, visits for root canal procedures, ionomer restoration, tooth extraction and tooth scaling increased significantly. In dental clinics, visits for amalgam restoration decreased significantly while those for ionomer restoration, tooth extraction, and tooth scaling increased significantly. After the adoption of global budgeting, expenditures for dental services increased dramatically while the number of visits per patient did not, indicating a possible shift in patients to hospital facilities that received additional National Health Insurance funding. Conclusions The identified trends indicate increased utilization of dental services and uneven distribution of care and dentists. These trends may be compromising the quality of dental care delivered in Taiwan.

  20. Hospitality Industry

    Directory of Open Access Journals (Sweden)

    Marian Ionel

    2017-03-01

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

  1. Impact of a major hurricane on surgical services in a university hospital.

    Science.gov (United States)

    Norcross, E D; Elliott, B M; Adams, D B; Crawford, F A

    1993-01-01

    Hurricane Hugo struck Charleston, South Carolina, on September 21, 1989. This report analyzes the impact this storm had upon surgical care at a university medical center. Although disaster planning began on September 17, hurricane damage by high winds and an 8.7-foot tidal surge led to loss of emergency power and water. Consequently, system failures occurred in air conditioning, vacuum suction, steam and ethylene oxide sterilization, plumbing, central paging, lighting, and refrigeration. The following surgical support services were affected. In the blood bank, lack of refrigeration meant no platelet packs for 2 days. In radiology, loss of electrical power damaged CT/MRI scanners and flooding ruined patient files, resulting in lost information. In the intensive care unit, loss of electricity meant no monitors and hand ventilation was used for 4 hours. In the operating room, lack of temperature and humidity control (steam, water, and suction supply) halted elective surgery until October 2. Ground and air transportation were limited by unsafe landing sites, impassable roads, and personnel exhaustion. Surgical planning for a major hurricane should include: 1) a fail-safe source of electrical power, 2) evacuation of as many critically ill patients as possible before the storm, 3) cancellation of all elective surgery, and 4) augmented ancillary service staffing with some, although limited, physician support.

  2. 医院集团财务集中管理探讨%Discussion into the Centralization of Financial Management of Hospital Group

    Institute of Scientific and Technical Information of China (English)

    罗庆华

    2015-01-01

    In order to configure the hospital asset rationally, exert the advantage of group and enhance the efficiency of capital operations, the financial management of hospital group must be centralized. The advantages of centralization of financial management were analyzed. The feasible schemes for centralization of financial management of hospital group were put forward. The attentive questions in the course of centralization of financial management were pointed out.%医院集团财务集中管理能更合理地配置医院资产、发挥集团优势及提高资本运营效率。该文分析财务集中管理的优点,提出医院集团财务集中管理的切实可行的实施方案,指出实行财务集中管理中应注意的问题。

  3. A consensus-based template for documenting and reporting in physician-staffed pre-hospital services

    DEFF Research Database (Denmark)

    Kruger, Andreas J; Lockey, David; Kurola, Jouni

    2011-01-01

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

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

    Science.gov (United States)

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

    2016-02-25

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

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

    Science.gov (United States)

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

    2010-03-01

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

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

    Science.gov (United States)

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

    2008-07-29

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

  7. Effectiveness of low vision services in improving patient quality of life at Aravind Eye Hospital

    Directory of Open Access Journals (Sweden)

    Anna T Do

    2014-01-01

    Full Text Available Context: In India, where the heavy burden of visual impairment exists, low vision services are scarce and under-utilized. Aims: Our study was designed to survey the effectiveness of low vision exams and visual aids in improving patient quality of life in southern rural India. Subjects and Methods: The low vision quality of life (LVQOL questionnaire measures vision-related quality of life through 25 questions on a Likert scale of 0-5 that pertain to (1 mobility, distance vision, and lighting; (2 psychological adjustment; (3 reading and fine work; and (4 activities of daily living. This tool was translated into Tamil and verbally administered to 55 new low vision referral patients before their first visit at the low vision clinic at Aravind Eye Hospital. Low vision aids (LVAs were prescribed at the discretion of the low vision specialist. 1-month later, the same questionnaire was administered over the phone. Results: About 44 of 55 low vision patients completed baseline and follow-up LVQOL surveys, and 30 normal vision controls matched for age, gender, and education were also surveyed (average 117.34 points. After the low vision clinic visit, the low vision group demonstrated a 4.55-point improvement in quality of life (from 77.77 to 82.33 points, P = 0.001. Adjusting for age, gender, and education, the low vision patients who also received LVAs (n = 24 experienced an even larger increase than those who did not (n = 20 (8.89 points, P < 0.001. Conclusion: Low vision services and visual aids can improve the quality of life in South Indian rural population regardless of age, gender, and education level. Thus, all low vision patients who meet the criteria should be referred for evaluation.

  8. New Bangalores? The role of Central and Eastern Europe in business and IT services offshoring

    Directory of Open Access Journals (Sweden)

    Zoltan Gal

    2013-09-01

    Full Text Available The paper discusses how the second global shift in business services provision and corporate restructuring open up new offshoring opportunities into Central and Eastern Europe (CEE. It explores three issues: First, it builds upon the theoretical framework of the ‘new paradigm of globalization, which considers offshoring as one of the most important globalizing forces of recent time. This results in a shift in global trade, namely from ‘trade in goods’ to ‘trade in tasks’ determined by the changing trends in the division of labour. Second, the paper gives an overview of services relocation into CEE in comparison with its Asian counterparts. As the EU expanded eastwards, the opportunities for European corporations to offshore their business services to these ‘nearshore’ locations increased. Building on the region’s nearshoring advantages such as geographical-cultural proximity and on their multilingual graduate sup ply, CEE is likely to utilise more value added quality-driven BPO and KPO services. Third, the paper examines the implications of offshoring for the home markets in CEE assessing its impact on their locations. It reveals the role of offshoring activities in the metropolitan transformation and discusses the factors that make the capital cities an increasingly attractive option for companies to relocate their services. Despite CEE has taken advantage on the trend supported by the global service delivery models reducing dependency on any single location, its further growth may be influenced by the worsening macro-conditions, and future prospect of the region depends largely on government incentives and on the success of exploiting talent pools offered by its provincial cities.

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

    Directory of Open Access Journals (Sweden)

    J Conry

    2008-02-01

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

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

    Directory of Open Access Journals (Sweden)

    Anna Rybarczyk-Szwajkowska

    2016-06-01

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

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

    Science.gov (United States)

    Mort, Alasdair J; Rushworth, Gordon F

    2013-12-01

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

  12. CLINICAL AND ANTIMICROBIAL PROFILE OF ACINETOBACTER SPECIES AT TERTIARY CARE HOSPITAL IN CENTRAL INDIA

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    Apoorva

    2014-07-01

    Full Text Available BACKGROUND: Acinetobacter are the “superbugs” of the modern hospital environment causing significant proportion of infections and in particular nosocomial infections with high mortality rates. The aim of this study was to isolate Acinetobacter species from clinical specimens and to study the antimicrobial susceptibility pattern of Acinetobacter isolates. MATERIAL AND METHODS: Two hundred and four clinical isolates of Acinetobacter species were processed for species identification by standard microbiological procedures. Antimicrobial susceptibility of these isolates was performed by Kirby-Bauer disc diffusion method. RESULTS: Out of 204 Acinetobacter isolates, 125(61.27% isolates were from ICU and 79(38.72% were from general wards. A baumannii was the most common species isolated (74.50%, followed by A.lwoffii (24.50% and A.haemolyticus (0.98%. A.baumannii showed maximum sensitivity to IPM (52.63% followed by MRP(36.18%, AK(28.28%, PIT(26.31%, TCC(21.71%, CIP(21.05% G(17.76% and COT(05.26%. Maximum resistance was observed to CTX(1.31% followed by CAZ(1.97%, CTR(1.97% and CPM(1.97% respectively. A.lwoffii showed maximum sensitivity to IPM(94% followed by AK(90%, and MRP(84%. Statistically significant difference (p value <0.001 was noticed between antibiotic resistance of A.baumannii and A.lwoffii. CONCLUSION: Continued surveillance of drug resistant strains in ICUs, combined with preventive measures remains absolutely essential to prevent or limit the spread of Acinetobacter species in hospital.

  13. Motorcycle-related injuries at a university teaching hospital in north central Nigeria

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    Itodo C Elachi

    2014-01-01

    Full Text Available Background: Motorcycle-related injuries lead to considerable morbidity and mortality. The aim of this study is to determine the pattern and outcome of motorcycle-related injuries at Benue State University Teaching Hospital, Makurdi, Nigeria. Patients and Methods: Case records of all patients who presented to the accident and emergency department with motorcycle-related injuries between July 2012 and June 2013 were analysed for age, gender, injury host status (i.e. rider, pillion or pedestrian, nature of collision (motorcycle versus other vehicles, motorcycle versus motorcycle, motorcycle versus pedestrian or lone riders, body region injured, injury severity score (ISS at arrival, length of hospital stay (LOS and mortality. Results: Seventy - nine patients with motorcycle-related injuries were included in the study. They consisted of 63 males (61.8% and 16 females (15.7%. The age range was 5-65 years with a mean of 32.4 ± 14.0. Motorcycle versus vehicle collisions were the most common mechanism of injury (n = 46, 58.2%. Musculoskeletal injuries constituted the most common injuries sustained (n = 50, 47.6% and the tibia was the most frequently fractured bone (n = 14, 35.9%. The majority of patients (57.0% sustained mild/moderate injuries ( ISS ≤ 15. There was no statistically significant difference between the sexes for sustaining mild/moderate injuries or severe/profound injuries (P > 0.05. Mortality rate was 6.3% with head injuries being involved in all cases. Conclusion: Young males were mostly injured in motorcycle-related trauma. Musculoskeletal injuries were the most common injuries sustained and head injuries were involved in all the deaths. Enforcement of motorcycle crash bars and helmet usage is recommended.

  14. Exploring the central characteristics of HR shared services: evidence from a critical case study in the Netherlands

    NARCIS (Netherlands)

    Meijerink, J.G.; Bondarouk, T.V.

    2012-01-01

    Human resource shared service centers (HR SSCs) are foreseen as improving HR service delivery for their end-users: employees, line managers and decentralized HR professionals. Although the concept expects the benefits of HR SSCs to come from centralizing knowledge and decentralizing the control exer

  15. Ocular biometry and central corneal thickness in children: a hospital-based study

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    Adem Gul

    2014-06-01

    Full Text Available Objetivo: Investigar a distribuição do comprimento axial, profundidade da câmara anterior, espessura do cristalino, profundidade da câmara vítrea e espessura corneal central em crianças em diferentes faixas etárias. Métodos: Foram estudados 364 olhos de 182 crianças entre 1 e 12 anos de idade. O comprimento axial, a profundidade da câmara anterior , a espessura do cristalino e a profundidade da câmara vítrea foram medidos por biometria ultrassônica. A espessura corneal central foi medida por paquimetria ultrassônica em todas as crianças. Resultados: A idade média foi de 6,54 ± 3,42 anos. O comprimento axial foi 20,95 mm no grupo de 1-2 anos de idade e 22,95 mm no grupo de 11-12 anos de idade. A espessura corneal central foi 556 µm no grupo de 1-2 anos de idade e 555 µm no grupo de 11-12 anos de idade. A profundidade da câmara anterior média e profundidade da câmara vítrea aumentou com a idade (3,06 mm a 3,44 mm de profundidade da câmara anterior, 13,75 mm a 15,99 mm de profundidade da câmara vítrea e da espessura do cristalino diminuiu com o aumento da idade (3,67 mm a 3,51 mm. Conclusões: Em nosso estudo, os valores do comprimento axial aumentou com a idade e atingiu os níveis adultos aos 9-10 anos de idade. A espessura do cristalino diminuiu gradualmente até os 12 anos de idade. As medições de espessura corneal central não seguiu um algoritmo linear.

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

    Science.gov (United States)

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

    2001-11-01

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

  17. Medical store management: an integrated economic analysis of a tertiary care hospital in central India.

    Science.gov (United States)

    Mahatme, Ms; Dakhale, Gn; Hiware, Sk; Shinde, At; Salve, Am

    2012-04-01

    Economic analysis plays a pivotal role in the management of medical store. The main objectives of this study were to consider always better control-vital, essential and desirable (ABC-VED) analysis with economic order quantity (EOQ), comparison of indexed cost and the actual cost, and to assess the expenditure for the forthcoming years. Based on cost and criticality, a matrix of nine groups by combining ABC and VED analysis was formulated. Drug categories were narrowed down for prioritization to direct supervisory monitoring. The subgroups AE and AV of the categories category I and II should be ordered based on EOQ. The difference between the actual annual drug expenditure (ADE) and the derived indexed cost using the cost inflation index (CII) was calculated. Linear regression was used to assess the expenditure for the forth coming years. The total ADE for the financial year of 2010-2011 was Rs. 1,91,44,253 which was only 7.68% of annual hospital expenditure. Using the inflation index, the indexed cost of acquisition of ADE for year 2010-2011 was Rs. 1,95,10,387. The difference between the two was estimated to be 2.11%. Thus, the CII justifies the demand of increased budget for next year and prompts us for cautious use of drugs. By taking into consideration the ADE of last 10 years, we have forecasted the budget for forthcoming years which will help significantly for making policies according to the available budget.

  18. Evaluation of prescribing indicators and pattern among dermatological outpatients in a teaching hospital of central Nepal

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    Manohar Pradhan

    2016-08-01

    Full Text Available Background: Evaluation of prescribing indicators by proper analysis of prescriptions under the guidelines of World Health Organization enables us to detect some of the common problems of prescribing.Methodology: This study was conducted on randomly selected 325 prescriptions of dermatological outpatients of teaching hospital of College of Medical Sciences Bharatpur (Nepal with an objective to detect the problems of prescribing as well as to delineate the pattern of medicines prescribing.Results: Total number of medicines prescribed on these prescriptions was 743. The average number of medicines per encounter was 2.28. Antihistamines, antifungals, corticosteroids and antibiotics were four most frequently prescribed therapeutic classes. One systemic as well as one topical medicine belonging to same therapeutic class was prescribed on about one-third of totally analyzed prescriptions. Cetrizine was the most common individually prescribed medicine and fluconazole was the most commonly prescribed antifungal. Medicines prescribed by their generic name were 15.07% and those prescribed from national essential medicines list were 23.42%.Conclusion: This study reveals polypharmacy, inclination of prescribers for branded medicines and prescribing out of national formulary as problems. Educational and managerial interventions are required to rationalize the prescribing practice.JCMS Nepal. 2016;12(2:44-9.

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

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    Surajit

    2014-07-01

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

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

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    Katz J

    2015-10-01

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

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

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    Wilson Sue

    2008-08-01

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

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

    Science.gov (United States)

    Stoimenova, Assena; Stoilova, Ani; Petrova, Guenka

    2014-03-04

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

  3. Suicide in rural central India: Profile of attempters of deliberate self harm presenting to padhar hospital in Madhya Pradesh

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    Johann Alex Ebenezer

    2016-01-01

    Full Text Available Background: Suicide is a significant public health issue. India currently has the largest number of suicides in the world and has a disproportionate number of youth suicides including young women. The studies on patterns of suicide in rural central India are sparse, particularly among tribal communities. Aims: The aim of this study is to describe the profile of suicide attempters presenting to a secondary-level hospital in rural central India and identify areas for potential future research toward preventive strategies. Materials and Methods: A retrospective chart review was carried out of eighty patients who were admitted with presenting complaints of deliberate self-harm and survived until psychiatric consultation. Descriptive statistics was employed to generate the results. Results and Conclusions: 86% of the attempts were isolated impulsive attempts following triggers, the most common of which was interpersonal disputes (71%. Only 67% of patients had a mental health condition, the most common syndrome being alcohol use disorder, followed by depression, and personality disorders. Although 45% of attempters had background interpersonal conflicts, only 5% reported financial stressors as contributory. Psychosocial stressors, especially interpersonal conflicts within the family, appear to be at least as important factors as mental illnesses in contributing to suicide attempts in the area.

  4. Infecciones del sistema nervioso central por enterovirus en niños atendidos en un hospital de Lima, Perú Enteroviral central nervous system infections in children treated at a hospital in Lima, Peru

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    Iván O Espinoza

    2011-12-01

    Full Text Available Objetivos. Determinar la frecuencia y las características clínicas de las infecciones del sistema nervioso central por enterovirus en niños atendidos en el Hospital Nacional Cayetano Heredia de Lima, Perú. Materiales y métodos. Se realizó un estudio prospectivo y descriptivo desde abril 2008 hasta marzo 2010. Se enrolaron pacientes de un mes a 14 años con diagnóstico clínico de encefalitis o meningitis asépticas. Se investigó la presencia de enterovirus, virus herpes simple 1 (VHS-1, virus herpes simple 2 (VHS-2 y virus varicela-zoster (VZV mediante reacción en cadena de polimerasa (PCR. Resultados. Se enrolaron 97 pacientes de los cuales 69 % presentaron encefalitis aguda y 31 % meningitis aguda. Se identificó enterovirus en 52,6 % del total de infecciones agudas no bacterianas del sistema nervioso central; encontrándose en 83,3 % de las meningitis y en 38,8 % de las encefalitis. No hubo casos de infección por VHS-1, VHS-2 ni VZV. Las infecciones por enterovirus alcanzaron el 82,9 % en los meses cálidos de noviembre a enero y el 28,6 % en los meses fríos de mayo a julio. Conclusiones. Los enterovirus fueron los principales agentes etiológicos en las encefalitis y meningitis asépticas agudas en pacientes pediátricos de Lima, Perú. Los enterovirus tienen un comportamiento epidemiológico estacional con un claro aumento del número de casos en los meses de verano. Resulta útil tener disponible un método de diagnóstico rápido, como una ayuda para el manejo de las infecciones agudas del sistema nervioso.Objectives. To determine the frequency and clinical features of central nervous system infections caused by enterovirus in children treated at the Hospital Nacional Cayetano Heredia in Lima, Peru. Materials and methods. A prospective, descriptive study was performed from April 2008 to March 2010. Patients aged 1 month - 14 years with clinical diagnosis of encephalitis or aseptic meningitis were included. We investigated the

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

    Science.gov (United States)

    Kulesher, Robert R; Wilder, Margaret G

    2008-01-01

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

  6. Vascular malformations of central nervous system: A series from tertiary care hospital in South India

    Science.gov (United States)

    Karri, Sudhir Babu; Uppin, Megha S.; Rajesh, A.; Ashish, K.; Bhattacharjee, Suchanda; Rani, Y. Jyotsna; Sahu, B. P.; Saradhi, M Vijaya; Purohit, A. K.; Challa, Sundaram

    2016-01-01

    Aims and Objectives: To describe clinicopathological features of surgically resected vascular malformations (VMs) of central nervous system (CNS). Materials and Methods: Histologically diagnosed cases of VMs of CNS during April 2010–April 2014 were included. Demographic data, clinical and radiological features were obtained. Hematoxylin and eosin slides were reviewed along with Verhoeff-Van Gieson (VVG), Masson's trichrome, periodic acid-Schiff, and Perls' stains. Morphologically, cavernomas and arteriovenous malformations (AVMs) were distinguished on the basis of vessel wall features on VVG and intervening glial parenchyma. Results: Fifty cases were diagnosed as VMs of CNS with an age range of 14–62 years. These included 36 cavernomas, 12 AVMs, 2 mixed capillary-cavernous angiomas. Most of the cavernoma patients (15/36) presented with seizures, whereas AVM patients (8/12) had a headache as the dominant symptom. Twenty-nine patients were reliably diagnosed on radiological features. Microscopic evidence of hemorrhage was seen in 24/36 cavernomas and 6/12 AVMs, as opposed to radiologic evidence of 10 and 4, respectively. Reactive gliosis was seen in 16 cavernomas. Conclusions: Histological features are important for classifying the VMs of CNS as there are no specific clinical and radiological features. Type of VM has a bearing on management, prognosis, and risk of hemorrhage. PMID:27114659

  7. Vascular malformations of central nervous system: A series from tertiary care hospital in South India

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    Sudhir Babu Karri

    2016-01-01

    Full Text Available Aims and Objectives: To describe clinicopathological features of surgically resected vascular malformations (VMs of central nervous system (CNS. Materials and Methods: Histologically diagnosed cases of VMs of CNS during April 2010–April 2014 were included. Demographic data, clinical and radiological features were obtained. Hematoxylin and eosin slides were reviewed along with Verhoeff-Van Gieson (VVG, Masson's trichrome, periodic acid-Schiff, and Perls' stains. Morphologically, cavernomas and arteriovenous malformations (AVMs were distinguished on the basis of vessel wall features on VVG and intervening glial parenchyma. Results: Fifty cases were diagnosed as VMs of CNS with an age range of 14–62 years. These included 36 cavernomas, 12 AVMs, 2 mixed capillary-cavernous angiomas. Most of the cavernoma patients (15/36 presented with seizures, whereas AVM patients (8/12 had a headache as the dominant symptom. Twenty-nine patients were reliably diagnosed on radiological features. Microscopic evidence of hemorrhage was seen in 24/36 cavernomas and 6/12 AVMs, as opposed to radiologic evidence of 10 and 4, respectively. Reactive gliosis was seen in 16 cavernomas. Conclusions: Histological features are important for classifying the VMs of CNS as there are no specific clinical and radiological features. Type of VM has a bearing on management, prognosis, and risk of hemorrhage.

  8. Molecular epidemiology of Brucella genotypes in patients at a major hospital in central Peru.

    Science.gov (United States)

    Nöckler, Karsten; Maves, Ryan; Cepeda, David; Draeger, Angelika; Mayer-Scholl, Anne; Chacaltana, Jesus; Castañeda, María; Espinosa, Benjamin; Castillo, Rosa; Hall, Eric; Al Dahouk, Sascha; Gilman, Robert H; Cabeza, Franco; Smits, Henk L

    2009-10-01

    The multiple-locus variable-number repeat analysis of 90 human Brucella melitensis isolates from a large urban area in central Peru revealed variations at 4 (Bruce07, Bruce09, Bruce18, and Bruce42) out of 16 loci investigated, of which 1 (Bruce42) also is used for species identification. Ten genotypes were identified, separated by the number of Bruce42 repeats into two groups that may have distinct phenotypic characteristics. Whereas genotypes with five or six Bruce42 repeats were cultured mainly from adult patients, genotypes with three Bruce42 repeats were isolated from children and young adolescents as well as from adults. In addition, the isolates with three Bruce42 repeats were obtained more often from patients with splenomegaly (P = 0.02) or hepatomegaly (P = 0.006). An annual variation in the diversity of genotypes was observed, possibly reflecting changes in sources of fresh dairy products, supply routes to city shops and markets, and the movement of infected dairy goat herds.

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

    Science.gov (United States)

    2010-07-01

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

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

    Science.gov (United States)

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

    1992-06-01

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

  11. The cost of antiretroviral treatment service for patients with HIV/AIDS in a central outpatient clinic in Vietnam

    Directory of Open Access Journals (Sweden)

    Nguyen LT

    2014-02-01

    Full Text Available Long Thanh Nguyen,1 Bach Xuan Tran,2 Cuong Tuan Tran,1 Huong Thi Le,1 Son Van Tran1 1Authority of HIV/AIDS Control, Ministry of Health, Hanoi, Vietnam; 2Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam Introduction: Antiretroviral treatment (ART services are estimated to account for 30% of the total resources needed for human immunodeficiency virus (HIV/acquired immunodeficiency syndrome (AIDS control and prevention in Vietnam during the 2011–2020 timeframe. With international funding decreasing, determining the total cost of HIV/AIDS treatment is necessary in order to develop a master plan for the transition of ART services delivery and management. We analyzed the costs of HIV/AIDS treatment paid by both HIV programs and patients in a central outpatient clinic, and we explored factors associated with the capacity of patients to pay for this service. Methods: Patients (n=315 receiving ART in the Department of Infectious Diseases at Bach Mai Hospital, Hanoi, Vietnam, were interviewed. Patient records and expenses were reviewed. Results: The total cost of ART per patient was US$611 (75% from health care providers, 25% from patients or their families. The cost of a second-line regimen was found to be 2.7 times higher than the first-line regimen cost. Most outpatients (73.3% were able to completely pay for all of their ART expenses. Capacity to pay for ART was influenced by five factors, including marital status, distance from house to clinic, patient's monthly income, household economic condition, and health insurance status. Most of the patients (84.8% would have been willing to pay for health insurance if a copayment scheme for ART were to be introduced. Conclusion: This study provides evidence on payment capacity of HIV/AIDS patients in Vietnam and supplies information on ART costs from both provider and patient perspectives. In particular, results from this study suggest that earlier access to ART

  12. [AIDS at Central University Hospital of Brazzaville: experience of the "Grands Enfants" pediatric department].

    Science.gov (United States)

    Loufoua-Lemay, A M'Pemba B; Nzingoula, S

    2003-11-01

    The epidemiological factors, clinical aspects and short term evolution of children infected by aids were assessed over a period of five years in "Grands Enfants" paediatric service of Brazzaville CHU. The medical reports of 81 patients have been collected, their average age was 9 years old +/- 3.5. The HIV 1 was the only identified virus. 59% of children's parents were divorced, and 7% were single. The infection transmission was vertical in 70% of cases, transfusional in 28% of cases and indeterminate in 1% of cases. The symptoms were: the impairment of body status in 90% of cases, shown by a weight loss in 89% of cases; a long-term fever was observed in 56% of cases and a chronic diarrhoea was noticed in 54% of cases. The lymphadenopathies and digestive Candida were observed in 26% and 36% of cases. 6% of the patients had a psychomotor retardation. The respiratory infections and the diarrhoea were pathologies the most frequently noticed. The associated infections were essentially pulmonary tuberculosis 40% of cases, the otitis, the pneumococcal and cryptococcal meningia 2% of cases. The Burkitt lymphoma and the Kaposi sarcoma were shown in 1% of cases. The evolution was shown by a high mortality due to a dehydration in 59% of cases, a respiratory pathology in 22% of cases and anaemia in 15% of cases. This high mortality points out the problem of the treatment of patients, a problem increased by family poverty.

  13. How to move things around a hospital: transport logistics at St. Michael's.

    Science.gov (United States)

    Yau, A; Zorn, R; McLaughlin, J

    1998-01-01

    Ongoing fiscal restraint challenges hospitals to focus their resources primarily on core services. Support services receive much less attention. This article describes the experience of Toronto's St. Michael's Hospital when it re-engineered its transport logistics by consolidating centralized support services into a logistics department and creating new roles and processes to enhance patient care.

  14. Public and Private Hospital Services Reform Using Data Envelopment Analysis to Measure Technical, Scale, Allocative, and Cost Efficiencies

    Directory of Open Access Journals (Sweden)

    Ali Emrouznejad

    2012-07-01

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

  15. The effect of internal marketing on job satisfaction in health services: a pilot study in public hospitals in Northern Greece

    Directory of Open Access Journals (Sweden)

    Priporas Constantinos-Vasilios

    2011-10-01

    Full Text Available Abstract Background The purpose of this study was to explore the effect of internal marketing on job satisfaction in health services, particularly in public hospitals in Northern Greece. Methods A questionnaire with three sections was used. The first one referred to internal marketing by using Foreman and Money's scale, while the second one contained questions on job satisfaction based on Stamps and Piermonte's work. The last section included demographic questions. Three categories of health care professionals, nurses, doctors and paramedic personnel working in public hospitals have participated. Results Doctors tend to be more satisfied with their job than nurses in the same hospitals. Male personnel also tend to be more satisfied with their job than female. Time-defined work contract personnel have a greater level of job satisfaction than permanent personnel. Marital status, position, and educational level have no statistically significant impact on job satisfaction. A slight decline in job satisfaction occurs as the personnel age. Conclusions Internal marketing has a positive effect on the job satisfaction of hospital staff in Northern Greece. Also, doctors and male personnel seem to have greater levels of job satisfaction. Staff with time-defined work contracts with the hospital are more satisfied than permanent staff, and as the staff age, there is a slight decline in job satisfaction.

  16. The effect of internal marketing on job satisfaction in health services: a pilot study in public hospitals in Northern Greece

    Science.gov (United States)

    2011-01-01

    Background The purpose of this study was to explore the effect of internal marketing on job satisfaction in health services, particularly in public hospitals in Northern Greece. Methods A questionnaire with three sections was used. The first one referred to internal marketing by using Foreman and Money's scale, while the second one contained questions on job satisfaction based on Stamps and Piermonte's work. The last section included demographic questions. Three categories of health care professionals, nurses, doctors and paramedic personnel working in public hospitals have participated. Results Doctors tend to be more satisfied with their job than nurses in the same hospitals. Male personnel also tend to be more satisfied with their job than female. Time-defined work contract personnel have a greater level of job satisfaction than permanent personnel. Marital status, position, and educational level have no statistically significant impact on job satisfaction. A slight decline in job satisfaction occurs as the personnel age. Conclusions Internal marketing has a positive effect on the job satisfaction of hospital staff in Northern Greece. Also, doctors and male personnel seem to have greater levels of job satisfaction. Staff with time-defined work contracts with the hospital are more satisfied than permanent staff, and as the staff age, there is a slight decline in job satisfaction. PMID:21981753

  17. Evaluation Management of Drugs and Relations with Quality of Outpatient Pharmacy Services in One of Hospital Pontianak City

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    Enggy Erwansani

    2016-04-01

    Full Text Available Nowadays government policy which embodies the National Social Security System (SJSN where the presence of this system that every Indonesian people entitled to social security to be able to meet the basic needs of living. This study aims to describe the pharmaceutical drug outpatient management Hospital X Pontianak City and analyze the relationship management with the quality of pharmaceutical care medicine outpatient Hospital X Pontianak. This medication management including planning, organizing, directing, and monitoring. This study uses a quantitative approach which is an observational analytic research using cross sectional study with a sample of outpatient pharmacy customer research in Hospital X Pontianak. Collecting data using questionnaires from 100 customers outpatient with consecutive sampling method. The results using Pearson Correlation analysis showed the drug management relationship with the quality of outpatient pharmacy services which means the value of aspects planning (r=0.626; p<0,001, organizing (r=0.409; p<0,001, directing (r=0.359; p<0,001, and controlling (r=0.426; p<0,001 with R2 multiple 66.80%. The description of pharmaceutical drug management in outpatient Hospital X produce an average value 96.90% so as to be in very good category, there by proving the existence of a strong relationship between the four functions of management of the quality of pharmaceutical care medicine outpatient Hospital X.

  18. Bureaucrats as Innovators? Statistical Analysis on Innovative Capacity within the Hungarian Central Civil Service

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    Marton GELLÉN

    2016-12-01

    Full Text Available What makes a public administration innovative if it is strongly legalistic and profoundly bureaucratic? Are there innovators in such a setting who would be able to elaborate strategies in accordance with public demands? If yes, who are the innovators and what are they like? Are they among the leaders? The article offers an answer to these questions based on an empirical research conducted in Hungary where public administration is not only legalistic but has a strong culture of topdown domination. The current study targets the key element of innovativeness namely: managerial and cultural prerequisites of innovation within central public administration. The empirical research was carried out in the Hungarian central civil service. The article also discusses whether such an environment would have an impact on innovations. According to the fi ndings of the article, certain prerequisites of an innovative environment exist in the given strictly hierarchic, traditionally stiff setting; however, traits of innovativeness can be identifi ed in innovators who are genuine bureaucrats at the same time.

  19. Appraisal of HIV Counseling and Testing Services Provided for Pregnant Women in Selected Government Hospitals in Ibadan Metropolis, Nigeria

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    Olanipekun Asiyanbola

    2016-04-01

    Full Text Available HIV counseling and testing (HCT is a critical gateway to treatment, care, and support services. For pregnant women, it is to access prevention of mother-to-child-transmission (PMTCT services. However, not much has been done to appraise this service from the perspective of the recipients in Nigeria. This study documents the appraisal of the HCT services received at the antenatal care (ANC services in three government hospitals in Ibadan, Nigeria, from the perspectives of pregnant women. Data were collected using focus group discussion guide among purposively selected 40 (21 primigravida and 19 multigravida pregnant women. Observation and inventory checklists were used to collect data on procedures and basic requirements of HCT. Content analysis was used to analyze the data. Participants were neither counseled nor given opportunity to voluntarily participate in HCT services as it was made compulsory before accessing ANC. Test results were reportedly handed over directly to participants without post-test counseling. Observation of HCT procedure showed that guidelines for counseling were not strictly adhered to. Inventory of facilities, staff, and materials revealed inadequate staffing, lack of a dedicated counseling room, and inadequate antiretroviral drugs and test kits. The HCT services as provided for pregnant women are fraught with procedural inadequacies. Training and supervision of health care workers as well as provision of resources are needed to address the situation.

  20. Influence Service Quality and Customer Satisfaction towards Drug Purchase Intention in Anggrek Outpatient Pharmacy Depo at Hasan Sadikin Hospital

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    Pratiwi

    2016-04-01

    Full Text Available The quality of service is an evaluation which focused on customer’s awareness about a structural construction of a service or product that involves 5 main aspects which are tangibility, empathy, responsiveness, reliability and assurance. Based on monthly reports of pharmacy installation only about 30% of patients buy drugs in the Anggrek out patient depo out off patients visiting Anggrek out patient specialist clinic in Dr. Hasan Sadikin Hospital. The aim of this study is to determine the effect of service quality and customer satisfaction to purchase intention in the Anggrek out patient depo Hasan Sadikin hospital at Bandung. The method used in this study is analytical survey with cross sectional design. The samples used were 200 patients, consist of 104 customers who have visited more than one times and 96 first visit costumer to this clinic. Data was collected using a questionnaire and analyzed using Smart PLS V 2.0 software. The results of this study showed that the service quality with tangible dimensions, reliability, responsiveness, assurance, and empathy are affecting the customer satisfaction with a score of 12.755 t-count (greater than t-table 1.983 and a positive value of the original sample of 0.800. Customer satisfaction affecting the customer purchase intentions with t-count is greater than t-table values of 5.012 and 0.726 of the original positive sample. While the service quality does not directly influence customer purchase intention with the t-test is smaller than t-table is 1.455 and the negative of the original sample -0.287. Some of service quality influence customers that causes not purchasing drugs from the out patient depo there are effect of unavailability of counseling, long waiting time of service, the need for special counseling room, a spacious waiting room, and the completeness of drug availability.

  1. Sociodemographic Correlates of Choice of Health Care Services in Six Rural Communities in North Central Nigeria

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    Onyemocho Audu

    2014-01-01

    Full Text Available Household expenditure on health has increasingly remained a major source of health care financing in Nigeria despite the introduction of several social health scheme policies provided by the government for meeting the health care costs of patients. Recognizing these limitations, this study assessed the type of health care services people commonly use in various illnesses and the sociodemographic correlates of the preferred health care services by household heads in six rural communities of North Central Nigeria. A cross-sectional community-based descriptive study design was used to study 154 household heads in the settlements using a multistage sampling method. Multiple logistic regressions were performed to investigate independent predictors that had significant chi-square at P<0.05. The leading causes of illness experienced by respondents were medical conditions (42.0% and 41.7% of them sought treatment from patent medicine vendors. The dominant reasons for health-seeking preferences were financial access (53.7% and proximity (48.6%. Age had a higher impact (Beta = 0.892 on the health-seeking preferences of the respondents as compared to their occupation and religion (Beta = 0.368 and −0.746, resp.. Therefore, in order to meet the health care of patients, it is pertinent that the unmet needs of patients are properly addressed by appropriate agencies.

  2. Principal factors of soil spatial heterogeneity and ecosystem services at the Central Chernozemic Region of Russia

    Science.gov (United States)

    Vasenev, Ivan; Valentini, Riccardo

    2013-04-01

    The essential spatial heterogeneity is mutual feature for most natural and man-changed soils at the Central Chernozemic Region of Russia which is not only one of the biggest «food baskets» in RF but very important regulator of ecosystem principal services at the European territory of Russia. The original spatial heterogeneity of dominated here forest-steppe and steppe Chernozems and the other soils has been further complicated by a specific land-use history and different-direction soil successions due to environmental changes and more than 1000-year history of human impacts. The carried out long-term researches of representative natural, rural and urban landscapes in Kursk, Orel, Tambov and Voronezh oblasts give us the regional multi-factorial matrix of elementary soil cover patterns (ESCP) with different land-use practices and history, soil-geomorphologic features, environmental and microclimate conditions. The validation and ranging of the limiting factors of ESCP regulation and development, ecosystem principal services, land functional qualities and agroecological state have been done for dominating and most dynamical components of ESCP regional-typological forms - with application of regional and local GIS, soil spatial patterns mapping, traditional regression kriging, correlation tree models. The outcomes of statistical modeling show the essential amplification of erosion, dehumification and CO2 emission, acidification and alkalization, disaggregation and overcompaction processes due to violation of agroecologically sound land-use systems and traditional balances of organic matter, nutrients, Ca and Na in agrolandscapes. Due to long-term intensive and out-of-balance land-use practices the famous Russian Chernozems begin to lose not only their unique natural features of (around 1 m of humus horizon, 4-6% of Corg and favorable agrophysical features), but traditional soil cover patterns, ecosystem services and agroecological functions. Key-site monitoring

  3. Ecosystem service trade-offs, perceived drivers, and sustainability in contrasting agroecosystems in central Mexico

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    Carlos E. González-Esquivel

    2015-03-01

    Full Text Available The ability of agroecosystems to provide food ultimately depends on the regulating and supporting ecosystem services that underpin their functioning, such as the regulation of soil quality, water quality, soil erosion, pests, and pollinators. However, there are trade-offs between provisioning and regulating or supporting services, whose nature at the farm and plot scales is poorly understood. We analyzed data at the farm level for two agroecosystems with contrasting objectives in central Mexico: one aimed at staple crop production for self-subsistence and local markets, the other directed to a cash crop for export markets. Bivariate and multivariate trade-offs were analyzed for different crop management strategies (conventional, organic, traditional, crop rotation and their underpinning socioeconomic drivers. There was a clear trade-off between crop yield and soil quality in self-subsistence systems. However, other expected trade-offs between yields and soil quality did not always occur, likely because of the overall good soils of the region and the low to medium input profile of most farms. Trade-offs were highly dependent on farm-specific agricultural practices; organic, traditional, and rotation management systems generally showed smaller trade-offs between yield and soil quality, pest control, and biodiversity than did conventional management systems. Perceived drivers reported by farmers included increasing prices for cash crops, rising costs of inputs, and extreme climatic events (e.g., drought, hail, frost. Farmers did not identify the regulation of soil quality, water quality, soil erosion, pests, or pollinators as important constraints. Although acceptable yields could be maintained irrespective of key regulating and supporting services according to these perceptions, current levels of soil erosion and nutrient runoff are likely to have important negative effects at the watershed scale. Sustainability in both agroecosystems could be

  4. Foreign Bodies in the Ear, Nose and Throat: An Experience in a Tertiary Care Hospital in Central Nepal

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    Parajuli, Ramesh

    2015-01-01

    Full Text Available Introduction A foreign body (FB is an object or substance foreign to the location where it is found. FBs in the ear, nose, and throat are a common problem frequently encountered in both children and adults. Objective To analyze FBs in terms of type, site, age, and gender distribution and method of removal. Methods A retrospective study was performed in a tertiary care hospital in the central part of Nepal. The study period was from June 2013 to May 2014. The information was obtained from hospital record books. Results A total of 134 patients had FBs in the ear, nose, or throat; 94 were males and 40 were females. Of the 134 patients, 70 (52.23% had FB in the ear, 28 (20.89% in the nose, and 36 (26.86% in the throat. The FB was animate (living in 28 (40% patients with FB in the ear and 1 (3.5% patient with FB in the nose, but the FB was inanimate (nonliving in any patient with FB in the throat, in 42 (60% patients with FB in the ear FB, and in 27 (96.4% patients with FB of the nose. The FB was removed with or without local anaesthesia (LA in 98 (73.13% patients, and only 36 patients (26.86% required general anaesthesia (GA. The most common age group affected was <10 years. Conclusion FBs in the ear and nose were found more frequently in children, and the throat was the most common site of FB in adults and elderly people. Most of the FBs can be easily removed in emergency room or outpatient department.

  5. Blue Ocean Strategy of Current Hospital Expansion: Health Service Clique of Comprehensive Hospitals Annexing Primary Hospitals%大型综合医院面向基层的集团化蓝海战略探讨

    Institute of Scientific and Technical Information of China (English)

    范靖; 徐幻; 胡新勇

    2012-01-01

    To explore the methods and strategies of the large-scale comprehensive hospitals and primary hospitals jointly set up hospital group. Methods Citing the ideology of the "Blue Ocean Strategy", according to the needs of patients, according to residents' demand, altering large-scale comprehensive hospital expansion orient from their own size expansion to regional grass-roots development mode, to format the regional hospital group, and to open up the "Blue Ocean7' of the health market. Results The united management in health service, education, and researching could fill the flaws of each, lead health resources fully utilized, and make patients seek treatment conveniently. The novels manage method, basing on the warrant of service quality, was likely to improve the service efficiency and the patient's satisfaction. Conclusions "Blue Ocean Strategy", for health market, could effectively guide large hospitals convert perspective, to create a unique, efficient group management mode, help them dominate in the competition of the market.%目的 探索大型综合医院与基层医院联合组建医院集团的方法与策略.方法 引入"蓝海战略"思想,根据患者需求,将大型综合医院扩张方向从自身规模扩张向区域基层方向发展,组建区域医院集团,开拓医疗市场的"蓝海".结果 区域医疗集团内统一管理,医疗、教学、科研等优势互补;集团化充分利用医疗资源,方便患者就近诊治,在保证医疗质量的同时,能够提高医疗效率和患者满的意度.结论 医疗市场 "蓝海战略"能够有效引导大型医院转换视角,创建独特、高效的集团化管理模式,使其在市场竞争中占据主动.

  6. 42 CFR 410.42 - Limitations on coverage of certain services furnished to hospital outpatients.

    Science.gov (United States)

    2010-10-01

    ... that particular service to its patients. As used in this paragraph, the term “hospital” includes a CAH...)(2)(K)(ii) of the Act. (4) Certified nurse mid-wife services, as defined in section 1861(gg) of...

  7. A case study: measuring service quality of a private hospital using SERVQUAL method

    OpenAIRE

    1995-01-01

    Ankara : The Graduate School of Business Administration of Bilkent Univ., 1995. Thesis (Master's) -- Bilkent University, 1995. Includes bibliographical references leaves 80-82. For a long time definitions of quality mostly referred to the manufacturing world, not the service sector. However, today more and more leaders of service organizations are discovering that quality is a critical issue for services too. They are aware that improving service in the eyes o f customers is...

  8. Makerere University College of Health Sciences’ role in addressing challenges in health service provision at Mulago National Referral Hospital

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    Sekandi Juliet

    2011-03-01

    Full Text Available Abstract Background Mulago National Referral Hospital (MNRH, Uganda’s primary tertiary and teaching hospital, and Makerere University College of Health Sciences (MakCHS have a close collaborative relationship. MakCHS students complete clinical rotations at MNRH, and MakCHS faculty partner with Mulago staff in clinical care and research. In 2009, as part of a strategic planning process, MakCHS undertook a qualitative study to examine care and service provision at MNRH, identify challenges, gaps, and solutions, and explore how MakCHS could contribute to improving care and service delivery at MNRH. Methods Key informant interviews (n=23 and focus group discussions (n=7 were conducted with nurses, doctors, administrators, clinical officers and other key stakeholders. Interviews and focus groups were tape recorded and transcribed verbatim, and findings were analyzed through collaborative thematic analysis. Results Challenges to care and service delivery at MNRH included resource constraints (staff, space, equipment, and supplies, staff inadequacies (knowledge, motivation, and professionalism, overcrowding, a poorly functioning referral system, limited quality assurance, and a cumbersome procurement system. There were also insufficiencies in the teaching of professionalism and communication skills to students, and patient care challenges that included lack of access to specialized services, risk of infections, and inappropriate medications. Suggestions for how MakCHS could contribute to addressing these challenges included strengthening referral systems and peripheral health center capacity, and establishing quality assurance mechanisms. The College could also strengthen the teaching of professionalism, communication and leadership skills to students, and monitor student training and develop courses that contribute to continuous professional development. Additionally, the College could provide in-service education for providers on professionalism

  9. Crisis & commitment: 150 years of service by Los Angeles county public hospitals.

    Science.gov (United States)

    Cousineau, Michael R; Tranquada, Robert E

    2007-04-01

    The Los Angeles County University of Southern California Medical Center will open soon, replacing the county's current 74-year-old facility with a modern, although smaller, facility. Los Angeles County has provided hospital care to the indigent since 1858, during which time, the operation of public hospitals has shifted from a state-mandated welfare responsibility to a preeminent part of the county's public health mission. As this shift occurred, the financing of Los Angeles County hospitals changed from primarily county support to state and federal government sources, particularly Medicaid. The success of the new hospital will depend on whether government leaders at all levels provide the reforms needed to help the county and its partners stabilize its funding base.

  10. Maslow's needs hierarchy as a framework for evaluating hospitality houses' resources and services.

    Science.gov (United States)

    Duncan, Mary Katherine Waibel; Blugis, Ann

    2011-08-01

    As hospitality houses welcome greater numbers of families and families requiring longer stays, they do so in the absence of a widely accepted theory to guide their understanding of guests' needs and evaluations of how well they meet those needs. We propose A. Maslow's (1970) Hierarchy of Needs as a conceptual framework for understanding what makes a hospitality house a home for families of pediatric patients and for guiding the activities of hospitality houses' boards of directors, staff, volunteers, and donors. This article presents findings from a theory-driven evaluation of one hospitality house's ability to meet guests' needs, describes the house's best practice standards for addressing guests' needs, and suggests areas for future research.

  11. TQM is key to improving services, but it's not for every hospital.

    Science.gov (United States)

    McCarthy, G J

    1991-11-01

    Total Quality Management (TQM) is a term that has been known to the manufacturing industry for years. Now the concept is finding its way into the vocabulary of the hospital industry as well. How can TQM positively affect systems in a health care institution? What can administrators expect from it? In the following article, the vice president of medical affairs at a Milwaukee hospital discusses the pros and cons of TQM.

  12. Identifying geographical regions serviced by hospitals to assess laboratory-based outcomes

    Science.gov (United States)

    Gandhi, Sonja; Shariff, Salimah Z; Beyea, Michael M; Weir, Matthew A; Hands, Theresa; Kearns, Glen; Garg, Amit X

    2013-01-01

    Objective To define geographical regions (forward sortation areas; FSAs) in Southwestern Ontario, Canada from which patients would reliably present to a hospital with linked laboratory data if they developed adverse events related to medications dispensed in outpatient pharmacies. Design Descriptive research. Setting Forty-five hospitals in Southwestern Ontario, Canada, from 2003 to 2009. Participants Patients aged 66 years and older who received an outpatient prescription for any drug and presented to the emergency department in the subsequent 120 days. Main outcome measure The proportion of patients in a given FSA presenting to an emergency department at a hospital with linked laboratory data versus a hospital without linked laboratory data. To be included in the catchment area at least 90% of emergency department visits in an FSA must have occurred at laboratory-linked hospitals in a given year. Results Over the study period, there were 649 713 emergency department visits by patients with recent prescription claims from pharmacies in 1 of 118 FSAs. In total, 141 302 of these patients presented to an emergency department at a laboratory-linked hospital. For the year 2003, 12 FSAs met our criteria to be in the catchment area and this number grew to 25 FSAs by the year 2009. Conclusions The relevant geographical regions for hospitals with linked laboratory data have been successfully identified. Studies can now be conducted using these well-defined areas to obtain reliable information on the incidence and absolute risk of presenting to hospital with laboratory abnormalities in older adults dispensed commonly prescribed medications in outpatient pharmacies. PMID:23293246

  13. Bloodstream infection in patients with end-stage renal disease in a teaching hospital in central-western Brazil

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    Tamara Trelha Gauna

    2013-08-01

    Full Text Available Introduction Vascular access in patients undergoing hemodialysis is considered a critical determinant of bloodstream infection (BSI and is associated with high morbidity and mortality. The purpose of this study was to investigate the occurrence of BSI in patients with end-stage renal disease using central venous catheters for hemodialysis. Methods A cohort study was conducted in a public teaching hospital in central-western Brazil from April 2010 to December 2011. For every patient, we noted the presence of hyperemia/exudation upon catheter insertion, as well as fever, shivering, and chills during hemodialysis. Results Fifty-nine patients were evaluated. Thirty-five (59.3% patients started dialysis due to urgency, 37 (62.7% had BSI, and 12 (20% died. Hyperemia at the catheter insertion site (64.9% was a significant clinical manifestation in patients with BSI. Statistical analysis revealed 1.7 times more cases of BSI in patients with hypoalbuminemia compared with patients with normal albumin levels. The principal infective agents identified in blood cultures and catheter-tip cultures were Staphylococcus species (24 cases, non-fermentative Gram-negative bacilli (7 cases of Stenotrophomonas maltophilia and 5 cases of Chryseobacterium indologenes, and Candida species (6. Among the Staphylococci identified, 77.7% were methicillin-resistant, coagulase-negative Staphylococci. Of the bacteria isolated, the most resistant were Chryseobacterium indologenes and Acinetobacter baumannii. Conclusions Blood culture was demonstrated to be an important diagnostic test and identified over 50% of positive BSI cases. The high frequency of BSI and the isolation of multiresistant bacteria were disturbing findings. Staphylococcus aureus was the most frequently isolated microorganism, although Gram-negative bacteria predominated overall. These results highlight the importance of infection prevention and control measures in dialysis units.

  14. Profile of adults seeking voluntary HIV testing and counseling in rural Central India: results from a hospital-based study.

    Science.gov (United States)

    Pai, Nitika Pant; Joshi, Rajnish; Moodie, Erica E M; Taksande, Bharati; Kalantri, S P; Pai, Madhukar; Tulsky, Jacqueline P; Reingold, Arthur

    2009-03-01

    Rural India has an undetected load of HIV-positive individuals. Few rural adults present for HIV testing and counseling due to stigma, discrimination, and fear of social ostracization. In this rural hospital clinic-based study, we document profiles of rural adults seeking voluntary testing and counseling, and analyze correlates of HIV seropositivity. This cross-sectional study was conducted in 450 participants presenting to the outpatient clinics of Mahatma Gandhi Institute of Medical Sciences, Sevagram, Central India. After informed consent, pre- and post-test counseling, HIV testing, and face-to-face interviews were conducted. Data were collected using a structured questionnaire. The median age of the 450 study participants was 34 years (range 18-88 years); the majority (74%) was married. The overall proportion of HIV seropositivity was 32% [95% CI 28%, 37%]. The proportions of HIV seropositivity in married women, married men, and single men were 41%, 37%, 18%, respectively. No single woman was found seropositive in the study. Very few married women were aware of their husbands' HIV status. In a multivariate analysis, correlates of HIV seropositivity in men were: age 30-39 years, being married, having sex with multiple partners, use of alcohol before sex, and testing positive for HIV in the past. In married women, the only predictor of seropositivity was being married. Although limited by the non-random nature of the sampling method, this pilot study is unique in that it is the first from this rural region of Central India. It provides baseline data on marginalized, largely unstudied populations that may aid in designing probabilistic community-based surveys in this neglected population.

  15. Designing a modern hospital pharmacy.

    Science.gov (United States)

    Kay, B G; Boyar, R L; Raspante, P S

    1986-02-01

    Cooperation between the pharmacy director and the hospital's architects in planning a modern hospital pharmacy is described. The pharmacy director at an 870-bed voluntary nonprofit institution and the hospital's architects planned the design for a new 3250-square foot pharmacy department. They developed a preliminary floor plan based on the following functions that the pharmacy would perform: centralized unit dose drug distribution; compounding; bulk and unit dose prepackaging; preparation of sterile products; controlled substance storage; outpatient and employee prescription dispensing; reserve stock storage; purchasing, receiving, and inventory control; drug information services; and administrative services. A final floor plan was designed that incorporated these functions with structural and utility requirements, such as placement of the computer system and dispensing and lighting fixtures. By integrating modern material management concepts with contemporary hospital pharmacy practice, the pharmacy director and the hospital's architects were able to plan and construct a pharmacy that receives, processes, and dispenses medication efficiently.

  16. Development of the self-service library : the case of the Central technological library at the University of Ljubljana

    Directory of Open Access Journals (Sweden)

    Matjaž Žaucer

    2000-01-01

    Full Text Available The article describes the importance of self-service in libraries. Individual phases of library services and probability for self-service are analysed. The author gives the ex¬ample of the Central Technological Library at the University of Ljubljana, which made some improvements based on diagnostic evaluation and detection of poor performance of some services. Advantages, disadvantages, and economical aspect of self-service loan unit are given. The application of self-renewals and information on loan transactions by phone, with interactive voice response, is described. The library also plans to enable the self-pick up of books ordered by phone. Some ideas for further develop¬ment of self-service in the library and its impact on the new library building plans are mentioned.

  17. Patient satisfaction and non-UK educated nurses: a cross-sectional observational study of English National Health Service Hospitals

    Science.gov (United States)

    Griffiths, Peter; Sloane, Douglas M; Rafferty, Anne Marie; Ball, Jane E; Aiken, Linda H

    2015-01-01

    Objectives To examine whether patient satisfaction with nursing care in National Health Service (NHS) hospitals in England is associated with the proportion of non-UK educated nurses providing care. Design Cross-sectional analysis using data from the 2010 NHS Adult Inpatient Survey merged with data from nurse and hospital administrator surveys. Logistic regression models with corrections for clustering were used to determine whether the proportions of non-UK educated nurses were significantly related to patient satisfaction before and after taking account of other hospital, nursing and patient characteristics. Setting 31 English NHS trusts. Participants 12 506 patients 16 years of age and older with at least one overnight stay that completed a satisfaction survey; 2962 bedside care nurses who completed a nurse survey; and 31 NHS trusts. Main outcome measure Patient satisfaction. Results The percentage of non-UK educated nurses providing bedside hospital care, which ranged from 1% to 52% of nurses, was significantly associated with patient satisfaction. After controlling for potential confounding factors, each 10-point increase in the percentage of non-UK educated nurses diminished the odds of patients reporting good or excellent care by 12% (OR=0.88), and decreased the odds of patients agreeing that they always had confidence and trust in nurses by 13% (OR=0.87). Other indicators of patient satisfaction also revealed lower satisfaction in hospitals with higher percentages of non-UK educated nurses. Conclusions Use of non-UK educated nurses in English NHS hospitals is associated with lower patient satisfaction. Importing nurses from abroad to substitute for domestically educated nurses may negatively impact quality of care. PMID:26634400

  18. Using caregivers’ perceptions of rehabilitation services for children with Cerebral Palsy at public sector hospitals to identify the components of an appropriate service

    Directory of Open Access Journals (Sweden)

    G.M. Saloojee

    2011-02-01

    Full Text Available Despite  a  growing  body  of  evidence  favouring  a  family-centred approach to rehabilitation services for children with cerebral palsy (cp, the essential components for a quality service for children with disabilities and their families living in poorly-resourced South African (SA settings  remains unknown.  The  study  aimed  to  identify  key  components of  an appropriate  rehabilitation  service  which  would  meet  the  needs of children  with  CP  and  their  caregivers  at  SA  public  sector  hospitals. This cross-sectional descriptive study used the modified Measure of processes of care (Mpoc-20 questionnaire together with two open-endedquestions with  a  convenience  sample  of  caregivers attending therapy  at  CP  Clinics in gauteng and limpopo hospitals. A total of 263 caregivers attending cerebral palsy clinics at 31 public sector hospitals in gauteng and limpopo were interviewed. Kind and caring attitudes, exercises or “training” for the child,  and  practical  assistance  (handling  ideas  and suggestions,  assistive devices, food supplements, nappies, advice were components of care most valued. The most frustration was caused by long queues waiting for files or at the pharmacy and being treated disrespectfully whilst providing caregivers with information and explanations regarding treatment choice were services that could be improved.  Key components for  an  appropriate  therapy  service  include  caring  and respectful  attitudes,  hands-on  therapy,  handling  suggestions and practical assistance. Logistical and administrative procedures together with disrespectul and unhelpful attitudes negatively impact rehabilitation service delivery.

  19. External radiation protection audit in National Health Service hospitals. Radiation protecgtion advisors (RPA) of the Nottingham City Hospital NHS Trust and the Oxford Radcliffe Hospital NHS Trust.

    Science.gov (United States)

    Rogers, A T; Crawley, M T; Dixon-Brown, A; Dudley, N J; Nicholas, D; Pearson, D; Przeslak, A; Weatherburn, H

    1996-11-01

    Radiation protection advisers are accustomed to carrying out internal audit in organizations for which they provide services but, traditionally, external audit has not been a part of the radiation protection adviser function. To provide an external audit function, two teams of radiation protection advisers undertook external radiation protection audits of their respective organizations, including the radiation protection adviser function itself. These audits were more representative of audits or inspections carried out by government agencies, for example the Health and Safety Executive and the former Inspectorate of Pollution, now the Environment Agency. Subsequently, reports, including recommendations for remedial action, were prepared for each management by the external auditors. The process of setting up and carrying out the external audits is described. Guidelines are suggested for those seeking to carry out an external audit.

  20. Frequency of use of the digital services in the library of the university polyclinic “Central Electronuclear”

    Directory of Open Access Journals (Sweden)

    María de los Reyes González Ramos

    2010-08-01

    Full Text Available Background: Information and Communication Technologies (ICT have pushed the evolution of library services and encouraged the development of libraries in the Primary Health Care System in Cuba, with the establishment of digital services. Objective: To determine the frequency of use of the digital services provided by the library of the university polyclinic " Central Electronuclear " in Cienfuegos. Methods: A descriptive study conducted during 2007, including a sample of 141 potential users of the library. The following variables were measured: users categories and use of the different digital services and perception of quality of those services. Results: the category of users who mostly use the digital services proved to be the professionals with 50%. The most commonly used digital services are the health intranet and the e-mail, with 97, 9 and 96%, 5%, in that order. The least used is the online reference, with 85.1%. Conclusions: the digital services of the library of the university polyclinic "Central Electronuclear " reach a high use frequency.

  1. Impact of a medical university on laparoscopic surgery in a service-oriented public hospital in the Caribbean

    Directory of Open Access Journals (Sweden)

    Cawich SO

    2016-11-01

    Full Text Available Shamir O Cawich,1 Suresh Pooran,2 Barbara Amow,2 Ernest Ali,2 Fawwaz Mohammed,1 Marlon Mencia,1 Samuel Ramsewak,1 Seetharaman Hariharan,1 Vijay Naraynsingh1 1Department of Clinical Surgical Sciences, University of the West Indies, St Augustine, 2North West Regional Health Authority, Port of Spain General Hospital, Port of Spain, Trinidad and Tobago Introduction: The Caribbean lags behind global trends for volume and complexity of laparoscopic operations. In an attempt to promote laparoscopy at a single facility, a partnership was formed between the University of the West Indies (UWI and the Port of Spain General Hospital in Trinidad and Tobago. This study seeks to document the effect of this partnership on laparoscopic practice.Materials and methods: In this partnership, the UWI took the bold step of volunteering to staff a surgical team if the Ministry of Health provided the necessary legislative changes. On August 1, 2013, a UWI team was introduced with a mandate to optimize teaching and promote laparoscopic surgery. The UWI team had a similar staff complement to the existing service-oriented teams. There was no immediate investment in equipment, hospital beds, ICU beds, or operating room space. Therefore, the new team was introduced with limited change in existing conditions, resources, and equipment.Results: There were 252 laparoscopic operations performed over the study period. After introduction of the UWI team, there was an increase in the mean number of unselected laparoscopic operations (3.17 vs 10.83 cases per month; P<0.001; 95% confidence interval [95% CI] −8.5 to −6.84; standard error of the difference [SED] 0.408, the mean number of basic laparoscopic operations (3.17 vs 6.94 cases per month; P<0.0001; 95% CI −4.096 to −3.444; SED 0.165, the mean number of advanced laparoscopic operations (0 vs 3.89; P<0.0001, the number of teams undertaking unselected laparoscopic operations (2 vs 5, and the number of teams independently

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

    Directory of Open Access Journals (Sweden)

    Beatriz Sabina Roméu

    2016-06-01

    Full Text Available Background: the mental health services of the Pediatric Hospital of Cienfuegos receive all patients in the province that need to be hospitalized. Among them, children and adolescents functioning at the psychotic level are of great clinical and social importance. Objective: to describe the clinical characteristics and pharmacological treatment of psychotic patients treated in the mental health services. Methods: a case series study of 35 psychotic patients admitted to the mental health unit of the Pediatric Hospital of Cienfuegos was conducted between 2008 and 2012. Demographic variables, in addition to variables related to clinical data and pharmacotherapeutic aspects were analyzed. Results: sixty five point seven percent of patients were adolescents and 77.1% were of urban origin. The most common diagnoses were acute and transient psychotic disorder and schizophrenia. Sixty three percent had a family history of psychiatric disorder. Forty percent were treated with trifluoperazine and an equal percent took haloperidol. Psychotic symptoms were controlled in 58% of patients during the first weeks. Conclusion: white adolescent patients from urban areas with a family history of psychiatric illness predominated. They received regular psychiatric attention and experienced the symptoms for a short time before being treated. The most frequently prescribed medications were typical antipsychotic drugs, which caused adverse reactions in a third of the patients. In the first few weeks, psychotic symptoms were controlled in most patients, although half of them experienced a recurrence of symptoms, which evolved into conditions with worse prognosis.

  3. [Determination of serologic markers of hepatitis B virus in high risk areas at the Central Air Force Hospital of Peru].

    Science.gov (United States)

    Valladares Alvarez, G; Galarza, J; Espinoza, J; Nieri, A; Makino, R; Berrocal, A; Grados, N

    1989-01-01

    In the present paper, the serologic markers of Hepatitis B virus were studied in 123 people belonging to the Hospital Central de la Fuerza Aérea del Perú that had been working in areas of high risk to get contact with this virus. The determination was done with the enzimo inmuno assay (EIA Abbot) and the results were the following: In 15 individuals (12.1%), at least one positive marker was found, evidence which proved to have been in contact with the virus in some moment of his life. Only one carrier (0.8%) was found, in 6 (4.8%) the presence of anti-HBc as only marker was found and in 8 (6.5%) the presence of Anti-HBc and Anti-HBs was observed which means post infection immunity. The great number of the individuals in which the markers were found, were male: 13 (16.0%) against only 2 (4.7%) female. There wasn't great difference with relation to the prevalency of markers according to the years of work like there has been observed in other greater series. It can be concluded that in this group the incidence of infection due to VHB was no greater than that of general population, which indicates us the little contact that they have had with the contaminating material during their professional life.

  4. The Role of Necropsy in Diagnostic Dilemmas as Seen in a Tertiary Hospital in North Central Nigeria

    Directory of Open Access Journals (Sweden)

    Olugbenga A. Silas

    2009-01-01

    Full Text Available Background. Necropsy (autopsy has helped medical science and law. It has given rise to numerous diagnostic surprises as it explains cause of death, pathogenesis of diseases, and circumstances of death. It also explains reasons for most therapeutic failures. In spite of its usefulness, the rate has dropped worldwide and Africa is worse hit. This work aims to highlight the role autopsy (Necropsy plays in demystifying diagnostic dilemmas and to encourage its patronage by medical practitioners, law enforcement agents and society. Methods. This is a retrospective review of autopsy and clinical reports of cases seen by pathologists and physicians in the Jos University Teaching Hospital (JUTH, Jos, North central Nigeria. Results. A total 166 cases were studied out of which 52 had same diagnosis for both attending physician and pathologist, 106 had different diagnoses and in eight cases diagnoses remained unknown even after autopsy was performed. Conclusions. Autopsy remains an important tool for obtaining definitive diagnosis, determining cause of death to explain pathogenesis of diseases, medical auditing and a vital source of data for health statistics and planning.

  5. Experiences of the Implementation of a Learning Disability Nursing Liaison Service within an Acute Hospital Setting: A Service Evaluation

    Science.gov (United States)

    Castles, Amy; Bailey, Carol; Gates, Bob; Sooben, Roja

    2014-01-01

    It has been well documented that people with learning disabilities receive poor care in acute settings. Over the last few years, a number of learning disability liaison nurse services have developed in the United Kingdom as a response to this, but there has been a failure to systematically gather evidence as to their effectiveness. This article…

  6. Public and private maternal health service capacity and patient flows in southern Tanzania: using a geographic information system to link hospital and national census data

    Directory of Open Access Journals (Sweden)

    Patrik Tabatabai

    2014-01-01

    Full Text Available Background: Strategies to improve maternal health in low-income countries are increasingly embracing partnership approaches between public and private stakeholders in health. In Tanzania, such partnerships are a declared policy goal. However, implementation remains challenging as unfamiliarity between partners and insufficient recognition of private health providers prevail. This hinders cooperation and reflects the need to improve the evidence base of private sector contribution. Objective: To map and analyse the capacities of public and private hospitals to provide maternal health care in southern Tanzania and the population reached with these services. Design: A hospital questionnaire was applied in all 16 hospitals (public n=10; private faith-based n=6 in 12 districts of southern Tanzania. Areas of inquiry included selected maternal health service indicators (human resources, maternity/delivery beds, provider-fees for obstetric services and patient turnover (antenatal care, births. Spatial information was linked to the 2002 Population Census dataset and a geographic information system to map patient flows and socio-geographic characteristics of service recipients. Results: The contribution of faith-based organizations (FBOs to hospital maternal health services is substantial. FBO hospitals are primarily located in rural areas and their patient composition places a higher emphasis on rural populations. Also, maternal health service capacity was more favourable in FBO hospitals. We approximated that 19.9% of deliveries in the study area were performed in hospitals and that the proportion of c-sections was 2.7%. Mapping of patient flows demonstrated that women often travelled far to seek hospital care and where catchment areas of public and FBO hospitals overlap. Conclusions: We conclude that the important contribution of FBOs to maternal health services and capacity as well as their emphasis on serving rural populations makes them promising

  7. Public and private maternal health service capacity and patient flows in southern Tanzania: using a geographic information system to link hospital and national census data

    Science.gov (United States)

    Tabatabai, Patrik; Henke, Stefanie; Sušac, Katharina; Kisanga, Oberlin M. E.; Baumgarten, Inge; Kynast-Wolf, Gisela; Ramroth, Heribert; Marx, Michael

    2014-01-01

    Background Strategies to improve maternal health in low-income countries are increasingly embracing partnership approaches between public and private stakeholders in health. In Tanzania, such partnerships are a declared policy goal. However, implementation remains challenging as unfamiliarity between partners and insufficient recognition of private health providers prevail. This hinders cooperation and reflects the need to improve the evidence base of private sector contribution. Objective To map and analyse the capacities of public and private hospitals to provide maternal health care in southern Tanzania and the population reached with these services. Design A hospital questionnaire was applied in all 16 hospitals (public n=10; private faith-based n=6) in 12 districts of southern Tanzania. Areas of inquiry included selected maternal health service indicators (human resources, maternity/delivery beds), provider-fees for obstetric services and patient turnover (antenatal care, births). Spatial information was linked to the 2002 Population Census dataset and a geographic information system to map patient flows and socio-geographic characteristics of service recipients. Results The contribution of faith-based organizations (FBOs) to hospital maternal health services is substantial. FBO hospitals are primarily located in rural areas and their patient composition places a higher emphasis on rural populations. Also, maternal health service capacity was more favourable in FBO hospitals. We approximated that 19.9% of deliveries in the study area were performed in hospitals and that the proportion of c-sections was 2.7%. Mapping of patient flows demonstrated that women often travelled far to seek hospital care and where catchment areas of public and FBO hospitals overlap. Conclusions We conclude that the important contribution of FBOs to maternal health services and capacity as well as their emphasis on serving rural populations makes them promising partners in health

  8. Practice and Exploration of Promoting Human Resource Optimization in Hospital through Outsourcing Hospital Logistic Service%后勤社会化促进医院人力资源优化的实践与探讨

    Institute of Scientific and Technical Information of China (English)

    张冬娟; 陈源; 王晶桐; 王杉

    2015-01-01

    后勤服务社会化是医院改革深入发展的必然,后勤服务社会化对于优化医院人力资源结构、降低后勤服务成本等都具有重要意义。医院后勤服务社会化改革没有固定模式可依,笔者所在医院在后勤社会化改革过程中经过近十年的探索实践,逐步形成了适合医院发展的科学化、精细化、集约化的后勤服务社会化模式,从而有效优化了医院人力资源结构,降低了后勤服务成本,提高了工作绩效,促进了医院发展。%Outsourcing hospital logistic service is an inevitable result of the deepening of hospital reform, and it plays an important role in optimizing the structure of human resource in hospital and reducing the cost of logistics service. There was no uniform mode for the reform of outsourcing hospital logistic service in hospital. After nearly ten years' exploration and practice of outsourcing of hospital logistic services, Peking University People's Hospital has formed a scientific, delicate and intensive mode of logistics outsourcing. The mode has optimized hospital's human resource structure, reduced service costs, improved the work performance and promoted the development of hospital.

  9. Primary Care Sensitive Hospitalization: users detect flaws on the access to services

    Directory of Open Access Journals (Sweden)

    Tania Cristina Morais Santa Barbara Rehem

    2014-12-01

    Full Text Available The aim of this study is to analyze and understand the reasons for the occurrence of sensitive hospitalizations in accordance with users. Qualitative study conducted with users who were admitted to Pedreira General Hospital, in São Paulo. The data was collected through semi structured interviews and thereafter, transcribed and processed in the electronic program Alceste. When analyzing the content, the access was seized fundamentally as an empirical category, bringing up problems that later deserved, from the Brazilian Ministry of Health, a specific Program to improve the quality and access to primary care. The hierarchical and pyramidal organization shape from the health system in the city of São Paulo can be one of the important aspects for the access matter and established as an important restricting factor in the primary care role in reducing or even preventing the occurrence of these hospitalizations.

  10. Interactions Between Alternative Therapies and Mental Health Services in Public Hospitals of Argentina

    Directory of Open Access Journals (Sweden)

    Mercedes Saizar

    2012-07-01

    Full Text Available In this article, the authors describe the phenomenon of therapeutic complementarity between alternatives therapies and biomedicine in public hospitals of Buenos Aires (Argentina. They contextualize the phenomenon in a global and local field. Features specific to Argentina make this phenomenon interesting. The first of these is that biomedicine is the only type of medicine that is legally authorized to act on the body; nevertheless, alternative practices have flourished not only in the private health sector but also in the public hospitals run by the state. A second feature refers to the alternative practices in the Mental Health Area that bring about a singular interaction between two different therapeutic models. Based on a qualitative study in public hospitals, the authors look into the reasons that generate the phenomenon, underlining the forms in which it expresses itself and the complexity of a field under construction that implies the resignification of the concepts related to health and disease.

  11. Assessing the value of the Central Everglades Planning Project (CEPP) in Everglades restoration: an ecosystem service approach

    Science.gov (United States)

    Richardson, Leslie A.; Keefe, Kelly; Huber, Christopher C.; Racevskis, Laila; Gregg, Reynolds; Thourot, Scott; Miller, Ian

    2014-01-01

    This study identifies a full range of ecosystem services that could be affected by a restoration project in the central Everglades and monetizes the economic value of a subset of these services using existing data. Findings suggest that the project will potentially increase many ecosystem services that have considerable economic value to society. The ecosystem services monetized within the scope of this study are a subset of the difference between the future-with the Central Everglades Planning Project (CEPP) and the future-without CEPP, and they totaled ~ $1.8 billion USD at a 2.5% discount rate. Findings suggest that the use of ecosystem services in project planning and communications may require acknowledgment of the difficulty of monetizing important services and the limitations associated with using only existing data and models. Results of this study highlight the need for additional valuation efforts in this region, focused on those services that are likely to be impacted by restoration activities but were notably challenging to value in this assessment due to shortages of data.

  12. The feature service of hospital library%医院图书馆特色服务

    Institute of Scientific and Technical Information of China (English)

    张园

    2014-01-01

    Developing feature service is a way for library improving service quality and special collections is the basic for carrying out feature service. Feature service team has been established by discipline librarian system. Practice of developing feature service are introduced in aspects of topic selection, extending information service, consulting service, special information navigation service, literature review training and discipline information service. It shows that the trends on developing feature service are mobile information service, resources allocation and sharing and developing IP distance visit system.%医院图书馆发展特色服务是图书馆提高服务质量的路径抉择,而特色馆藏建设是开展特色服务的基础,通过建立学科馆员制度,打造特色服务团队。笔者从开展定题服务、依托科技查新工作拓展信息服务、参考咨询服务、特色化的信息导航服务、文献检索培训、学科化信息服务等方面阐述了医院图书馆特色信息服务实践,指出医院图书馆特色服务的发展方向是移动信息服务、加强馆藏资源整合及区域间医院图书馆文献资源共建共享、开通IP通远程访问系统。

  13. "When are you seeing my patient?"--an analysis of the cardiology consultation service in a teaching hospital.

    LENUS (Irish Health Repository)

    Cronin, E

    2010-05-01

    The provision of an efficient consultation service is essential to the efficient functioning of any hospital. Surprisingly little is known about this activity. We present the first reported evaluation of a cardiology consultation service in an attempt to determine the characteristics, efficiency and workload implications of such a service. We performed an audit of the in-patient cardiology consultation service over a four week period. During this period, 125 consultations were seen, of which 85 (68%) were requested by medical specialties. Consultations were seen in a timely fashion, with 76 (61%) being seen on the same day that the request was received. The most common problem was chest pain, (49 patients; 38%) which was felt to be of cardiac origin in only a minority (20; 40%) of cases. Consultations had significant resource implications for our department, with 35 (28%) procedures being performed, 25 (20%) patients\\' care being taken over, and a further 27 (21.6%) new out-patient referrals generated. Our results indicate that the consultation service considered was efficiently delivered but contributed significantly to the department\\'s workload. The most frequent consultation request was for chest pain that was often non-cardiac in nature.

  14. Ecosystem Services Mapping for Sustainable Agricultural Water Management in California's Central Valley.

    Science.gov (United States)

    Matios, Edward; Burney, Jennifer

    2017-02-24

    Accurate information on agricultural water needs and withdrawals at appropriate spatial and temporal scales remains a key limitation to joint water and land management decision-making. We use InVEST ecosystem service mapping to estimate water yield and water consumption as functions of land use in Fresno County, a key farming region in California's Central Valley. Our calculations show that in recent years (2010-2015), the total annual water yield for the county has varied dramatically from ∼0.97 to 5.37 km(3) (all ±17%; 1 MAF ≈ 1.233 km(3)), while total annual water consumption has changed over a smaller range, from ∼3.37 to ∼3.98 km(3) (±20%). Almost all of the county's water consumption (∼96% of total use) takes place in Fresno's croplands, with discrepancy between local annual surface water yields and crop needs met by surface water allocations from outside the county and, to a much greater extent, private groundwater irrigation. Our estimates thus bound the amount of groundwater needed to supplement consumption each year (∼1.76 km(3) on average). These results, combined with trends away from field crops and toward orchards and vineyards, suggest that Fresno's land and water management have become increasingly disconnected in recent years, with the harvested area being less available as an adaptive margin to hydrological stress.

  15. JAliEn - A new interface between the AliEn jobs and the central services

    Science.gov (United States)

    Grigoras, A. G.; Grigoras, C.; Pedreira, M. M.; Saiz, P.; Schreiner, S.

    2014-06-01

    Since the ALICE experiment began data taking in early 2010, the amount of end user jobs on the AliEn Grid has increased significantly. Presently 1/3 of the 40K CPU cores available to ALICE are occupied by jobs submitted by about 400 distinct users, individually or in organized analysis trains. The overall stability of the AliEn middleware has been excellent throughout the 3 years of running, but the massive amount of end-user analysis and its specific requirements and load has revealed few components which can be improved. One of them is the interface between users and central AliEn services (catalogue, job submission system) which we are currently re-implementing in Java. The interface provides persistent connection with enhanced data and job submission authenticity. In this paper we will describe the architecture of the new interface, the ROOT binding which enables the use of a single interface in addition to the standard UNIX-like access shell and the new security-related features.

  16. JAliEn - A new interface between the AliEn jobs and the central services

    CERN Document Server

    Grigoras, A G; Pedreira, M M; Saiz, P; Schreiner, S

    2014-01-01

    Since the ALICE experiment began data taking in early 2010, the amount of end user jobs on the AliEn Grid has increased signif icantly. Presently 1/3 of the 40K CPU cores available to ALICE are occupied by jobs submitted by about 400 distinct users, individually or in organized analysis trains. The overall stability of the AliEn middleware has been excellent throughout the 3 years of running, but the massive amount of end-user analysis and its specific requirements and load has revealed few components which can be improved. One of them is the interface between users and central AliEn services (catalogue, job submission system) which we are currently re-implementing in Java . The interface provides persistent connection with enhanced data and job submission authenticity. In this paper we will describe the architecture of the new interface, the ROOT binding which enables the use of a single interface in addition to the standard UN IX-like access shell and the new security-related features.

  17. Hospital nursing service reform is necessary%医院护理改革势在必行

    Institute of Scientific and Technical Information of China (English)

    郭燕红

    2011-01-01

    The essence of launching the high quality nursing service in hospitals is the implementation of clinical nursing mode and nurse management reform. The paper analyzed the importance of the high quality nursing service in hospitals, and it indicates that the implement of the High Quality Nursing Service is an activity of public hospital reform. In the nursing reform, the nursing care model must be improved, and provide the continuing, comprehensive and professional nursing care, which is according to the patients needs. On the other hand, the nursing management should be improved, including nursing resource management , performance evaluation of nursing staffs, the motivation and nursing career ladder establishment ,in order to enhance the nursing workforce.%医院推行优质护理服务的实质是临床护理服务模式和护士队伍管理的改革.分析了优质护理服务在医院工作中的重要性,提出实施优质护理服务是公立医院改革诸多举措在护理领域的实践,是公立医院改革的重要内容.在护理改革中,一方面要改革护理服务模式,在责任制整体护理工作模式下,为患者提供人性化、专业化、规范化的护理服务;另一方面,在护士岗位管理、人事管理、绩效考核、建立激励机制等护理管理问题中进行改革和探索.

  18. Providing a Seamless Service System from Hospital to Home: The NICU Training Project.

    Science.gov (United States)

    Wyly, M. Virginia; And Others

    1996-01-01

    A training model is described that promotes collaboration between neonatal intensive care unit professionals and early intervention staff regarding the care of premature infants. The goal is to train service providers to implement a seamless system of family-centered interventions and to transition from inpatient to community services. (Author/SW)

  19. Emergency Psychiatric Services for Individuals with Intellectual Disabilities: Perspectives of Hospital Staff

    Science.gov (United States)

    Lunsky, Yona; Gracey, Carolyn; Gelfand, Sara

    2008-01-01

    Strains on the mainstream mental health system can result in inaccessible services that force individuals with intellectual disabilities into the emergency room (ER) when in psychiatric crisis. The purpose of this study was to identify clinical and systemic issues surrounding emergency psychiatry services for people with intellectual disabilities,…

  20. Children admitted to hospital following unintentional injury: perspectives of health service providers in Aotearoa/New Zealand

    Directory of Open Access Journals (Sweden)

    Asiasiga Lanuola

    2010-12-01

    Full Text Available Abstract Background Unintentional injuries are the leading cause of death and hospitalisation among New Zealand children, with indigenous Māori and ethnic minority Pacific children significantly over represented in these statistics. International research has shown that many children hospitalised for injury, as well as their families experience high levels of stress, and ethnic disparities in the quality of trauma care are not uncommon. The research on which this paper is based sought to identify key issues and concerns for New Zealand's multi-ethnic community following hospitalisation for childhood injury in order to inform efforts to improve the quality of trauma services. This paper reports on service providers' perspectives complementing previously published research on the experiences of families of injured children. Methods A qualitative research design involving eleven in-depth individual interviews and three focus groups was used to elicit the views of 21 purposefully selected service provider key informants from a range of professional backgrounds involved in the care and support of injured children and their families in Auckland, New Zealand. Interviews were transcribed and data were analysed using thematic analysis. Results Key issues identified by service providers included limited ability to meet the needs of children with mild injuries, particularly their emotional needs; lack of psychological support for families; some issues related to Māori and Pacific family support services; lack of accessible and comprehensive information for children and families; poor staff continuity and coordination; and poor coordination of hospital and community services, including inadequacies in follow-up plans. There was considerable agreement between these issues and those identified by the participant families. Conclusions The identified issues and barriers indicate the need for interventions for service improvement at systemic, provider and

  1. Hospital Performance Indicators and Their Associated Factors in Acute Child Poisoning at a Single Poison Center, Central Saudi Arabia.

    Science.gov (United States)

    Alanazi, Menyfah Q; Al-Jeriasy, Majed I; Al-Assiri, Mohammed H; Afesh, Lara Y; Alhammad, Fahad; Salam, Mahmoud

    2015-12-01

    Admission rate and length of stay (LOS) are two hospital performance indicators that affect the quality of care, patients' satisfaction, bed turnover, and health cost expenditures. The aim of the study was to identify factors associated with higher admission rates and extended average LOS among acutely poisoned children at a single poison center, central Saudi Arabia.This is a cross-sectional, poison and medical chart review between 2009 and 2011. Exposures were child characteristics, that is, gender, age, body mass index (BMI), health history, and Canadian 5-level triage scale. Poison incident characteristics were, that is, type, exposure route, amount, form, home remedy, and arrival time to center. Admission status and LOS were obtained from records. Chronic poisoning, plant allergies, and venomous bites were excluded. Bivariate and regression analyses were applied. Significance at P Poison substances were pharmaceutical drugs (63%) versus chemical products (37%). Main exposure route was oral (98%). Home remedy was observed in (21.9%), which were fluids, solutes, and/or gag-induced vomiting. Almost (52%) arrived to center >1 h. Triage levels: non-urgent cases (58%), less urgent (11%), urgent (18%), emergency (12%), resuscitative (1%). Admission rate was (20.6%) whereas av. LOS was 13 ± 22 h. After adjusting and controlling for confounders, older children (adj.OR = 1.19) and more critical triage levels (adj.OR = 1.35) were significantly associated with higher admission rates compared to younger children and less critical triage levels (adj.P = 0.006) and (adj.P = 0.042) respectively. Home remedy prior arrival was significantly associated with higher av. LOS (Beta = 9.48, t = 2.99), compared to those who directly visited the center, adj.P = 0.003.Hospital administrators are cautioned that acutely poisoned children who received home remedies prior arrival are more likely to endure an extended LOS. This non-conventional practice

  2. A lean case study in an oncological hospital: implementation of a telephone triage system in the emergency service.

    Science.gov (United States)

    de Carvalho, José Crespo; Ramos, Madalena; Paixão, Carina

    2013-01-01

    Lean practices and thinking have increased substantially in the last few years. Applications of lean practices to health care are found worldwide. Despite that, new contributions are required because the application of lean thinking to hospitals has a long way to go. Lean practices and thinking do not include, in the literature or practice programs, any references to triage systems in health care units. The common triage systems require physical presence, but there are alternative methods to avoid the need to move patients: these alternative triage systems, given their characteristics, may be included in the spectrum of lean practices. Currently, patients that are already known to suffer from cancer are encouraged to go to hospital (public or private, with an oncological focus) when facing side effects from chemotherapy or radiation treatments; they are then submitted to a triage system (present themselves to the hospital for examination). The authors of this paper propose the introduction of telephone or email triage for impaired patients as a valid substitute for moving them physically, thereby often avoiding several unnecessary moves. This approach has, in fact, characteristics similar to a lean practice in that it reduces costs and maintains, if done properly, the overall service offered. The proposed 'remote' triage emerged from the results of a large survey sent to patients and also as the outcome of a set of semistructured interviews conducted with hospital nurses. With the results they obtained, the authors felt comfortable proposing this approach both to public and private hospitals, because the study was conducted in the most important, largest, and best-known oncological unit in Spain. As a final result, the health care unit studied is now taking the first steps to implement a remote triage system by telephone, and has begun to reduce the previously necessary movement of impaired patients.

  3. Teams and working conditions in mobile pre-hospital care services: an integrative review

    OpenAIRE

    2015-01-01

    Study to identify, analyze and summarize the findings available in the literature on the composition of teams and working conditions in Mobile  Pre-Hospital Care Services  (PHC).  Integrative review to search the Base  de Dados  de  Enfermagem [Nursing Database] (BDEnf), the Cumulative  Index  to  Nursing  and  Allied  Health  Literature (CINAHL),  the Latin American and Caribbean Health Sciences Literature (LILACS), PubMed,  SCOPUS,  Web  of  Science and the portal of journals from the Scien...

  4. Can Low-Price Hospitals Ease The High Cost of Medical Services?

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    Going to a hospital is not an easy matter for most Chinese people, with overcrowding and soaring medical costs having become two focuses of public complaint. China's medical system has been on a marketization drive since the 1980s. A July 2005 report by the Development Research Center of the State Council, a think tank under China's cabinet, however, came to a

  5. Palliative care consultation services in hospitals in the Netherlands: The design of the COMPASS study

    NARCIS (Netherlands)

    A. Brinkman-Stoppelenburg (Arianne); S. Polinder (Suzanne); Y. Vergouwe (Yvonne); A. van der Heide (Agnes)

    2015-01-01

    textabstractBackground: Patients with an advanced incurable disease are often hospitalised for some time during the last phase of life. Care in hospitals is generally focussed at curing disease and prolonging life and may therefore not in all cases adequately address the needs of such patients. We p

  6. Child Abuse Services at a Children's Hospital in Cape Town, South Africa.

    Science.gov (United States)

    Argent, Andrew C.; And Others

    1995-01-01

    All child abuse-related patients (n=503) seen at 1 Cape Town (South Africa) hospital over a 1-year period were reviewed. Abuse was confirmed in 389 cases (160 physical abuse and 229 sexual abuse). Most (81 percent) of the young children were seen by residents with minimal pediatric training. Lack of staff speaking Xhosa (spoken by 134 of the…

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

    NARCIS (Netherlands)

    Kruisinga, F.H.; Heinen, R.C.; Heymans, H.S.A.

    2010-01-01

    The information centre of the Emma Children's Hospital AMC (EKZ AMC) is a specialised information centre where paediatric patients and persons involved with the patient can ask questions about all aspects of disease and its social implications. The aim of the study was to evaluate the question-answe

  8. Research on Service Modeling Method of Digital Hospital based on SOMA%SOMA数字化医院服务模型构建方法探析

    Institute of Scientific and Technical Information of China (English)

    樊嫚; 陈敏

    2011-01-01

    数字化医院已经成为医疗管理现代化的必然趋势,数字化医院服务模型是构建数字化医院的重要组成部分.以医院检验业务为例,通过服务发现、服务规约、服务实现等过程,着重分析面向服务建模和架构设计,探讨数字化医院服务模型的构建方法.%Digital Hospital has become the inevitable trend of modern medical management. Digital hospital service model is an important part of the digital hospital. Based on Service-Oriented Modeling and Architecture, this article takes hospital inspection service as an example, and discusses building method of Digital hospital service model through three processes such as service discovery, service protocol, and service implementation.

  9. Drug information service awareness program and its impact on characteristics of inquiries at DIS unit in Malaysian public hospital

    Directory of Open Access Journals (Sweden)

    Aida Azlina Ali

    2013-01-01

    Full Text Available Objectives : To study the Drug Information Service (DIS awareness program organized by a DIS unit in Malaysian hospital through utilization of provided services by the healthcare professionals, allied healthcare providers, patients and the public, and to identify the characteristics of inquiries received. Materials and Methods : An awareness program to promote the services of the DIS unit was held throughout the month of March in 2010. Drug information queries forms that have been documented six months prior to (September 2009-February 2010 and six months after (April-September 2010 the awareness program were collected and assessed. Mean monthly inquiries volumes pre- and post-program were compared to evaluate the effectiveness of the program. Types of information requestors, inquiries, reference sources, and drug class information were identified and evaluated. Results: A total of 747 drug information queries forms were received during the study period. The mean total utilization of the DIS unit services after (63.67 ± 18.24 the DIS awareness program was increased but not significant (P < 0.05 when compared to records before (60.83 ± 21.49 the program. Majority of the DIS service users were the pharmacist (67.5%, followed by the doctors (24.9%. Most inquiries were regarding the dosage and route of administration of drugs (61.4%. The most frequently referred sources of information were the Micromedex and the Internet (37.3%. The most common inquiries were related to the anti-infective agents (37.8%. Conclusion: Provision of sufficient and accurate drug information to the healthcare professionals, patients, and the public is crucial to ensure optimization of therapy. The utilization of services provided by the DIS unit should be supported. Frequent DIS awareness program should be undertaken to promote and encourage the use of services.

  10. Developing a Marketing Orientation in Hospital Library Services: A Case Report.

    Science.gov (United States)

    Delawska-Elliott, Basia; Grinstead, Carrie; Martin, Heather J

    2015-01-01

    When the four Providence Health & Services libraries in Oregon regionalized services and resources, the transition, which was originally met with apprehension from some library users, turned out to be a resounding success. Despite a loss of two-thirds of the professional staff and a decreased budget, the new regionalized library experienced an increase in business and recognition. While many factors contributed to the success, a creative marketing and outreach campaign was a key component. This column describes the steps taken to promote regionalized library reference services and online resources.

  11. Risk factors of Acute Respiratory Infection (ARI in under-fives in a rural hospital of Central India

    Directory of Open Access Journals (Sweden)

    Amar M. Taksande

    2015-11-01

    Full Text Available Introduction: Acute Respiratory Infection (ARI is a major cause of morbidity and mortality in developing countries in children especially in under-fives. Every year in the world, about 13 million under-5 children dies, 95% from developing countries; one third of total deaths are due to ARI. The aim of this study was to identify the significant risk factors for ARI in children less than five years of age living in rural areas of Central India.Methods: A hospital based case control study was undertaken to determine risk factors associated with respiratory tract infections in children. Children less than 5 years admitted in a pediatric ward with diagnosis of ARI were enrolled in the study as cases (n = 300 while the same number of controls (n = 300 were selected from neighborhood and were matched for age, sex and religion. Details of risk factors in cases and controls were recorded in pre-designed proforma. Results: A significant association was found between ARI and lack of breastfeeding, nutritional status, immunization status, delayed weaning, prelactal feeding, living in overcrowded conditions, mothers’ literacy status, low birth weight and prematurity. Among the environmental variables, inadequate ventilation, improper housing condition, exposure to indoor air pollution in form of combustion from fuel used for cooking were found as significant risk factors for ARI in under-fives.Conclusions: ARIs are affected by socio-demographic and socio-cultural risk factors, which can be modified with simple interventions. The various risk factors identified in this study were lack of breastfeeding, undernutrition, delayed weaning, overcrowding and prelactal feeding.

  12. Clinical characteristics of patients with atrial fibrillation at a tertiary care hospital in the central region of Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Salih A Bin Salih

    2011-01-01

    Full Text Available Objective: To report on the clinical presentation, etiology, and laboratory features of acute and chronic atrial fibrillation (AF in a tertiary hospital in Riyadh, Saudi Arabia. Materials and Methods: We retrospectively studied records of 720 patients with AF seen in outpatients and inpatients departments at King Abdulaziz Medical City, Riyadh, during the period of 1 January 2002 to 31 August 2008. Results: Documented acute and chronic AF was present in 157 (21.8% and 563 (78.1% patients, respectively. Palpitations, dizziness and syncope were the most frequent symptoms in acute AF, while dyspnea and palpitations were the most common symptoms in the chronic type. Acute respiratory problems and acute myocardial infarction were significantly more common in acute AF, while congestive heart failure and acute respiratory problems (chest infection, bronchial asthma, and pulmonary embolism were significantly more common in chronic AF. The most common causes of both types of AF were diabetes mellitus (DM in 68.8%, hypertension (HTN in 59.3%, chronic lung diseases (bronchial asthma, chronic obstructive pulmonary disease and interstitial lung disease in 31.8%, valvular heart disease in 23.6%, and ischemic heart disease (IHD in 23.1%. In 9 (1.3% patients, no cause was detected. The echocardiographic findings of left ventricular hypertrophy, valve lesions, and depressed left ventricular function were significantly more common in chronic AF (P<0.01. Conclusions : Nowadays, DM, HTN, and IHD are becoming the most common predisposing factors for AF in the central region of Saudi Arabia and require prevention and control

  13. Prevalence of hemolytic anemia and hemoglobinopathies among the pregnant women attending a tertiary hospital in central India

    Directory of Open Access Journals (Sweden)

    Ranbir S. Balgir

    2015-10-01

    Full Text Available Anemia in pregnancy is one of the causes of maternal morbidity and, maternal and fetal mortality in India. Hemoglobin transports oxygen to different parts of the body. Any defect in hemoglobin structure leads to its adverse functions. Screening of pregnant women for hemoglobinopahties helps in early intervention for reducing morbidity and mortality. Although the prevalence of hemoglobinopathies especially of the sickle cell disorders is high in Madhya Pradesh but any study on pregnant women is lacking. This study had set the objectives to find the prevalence of anemia and hemoglobin disorders in pregnant women, and to determine the health status through hematological indices profile in central India. Hospital based a cross-sectional study showed 12.26% prevalence of hemoglobinopathies among 416 pregnant women, the sickle cell trait being 7.45%, followed by β-thalassemia trait (2.89%, hemoglobin E trait (0.24%, and sickle cell disease (1.68%. About 88% of the pregnant women were found free of hemoglobinopathies. Of the 9.13% pregnant women included in the study were suffering from sickle cell disorders. However, the overall 47.11% anemia was observed in pregnant women, ranging in between 45% to 66% and seemed to show a reduction in anemia after nutritional supplementations and improvement in maternal health care at antenatal check up due to accessibility to medical health facilities. A comparison of hematological indices of pregnant women afflicted with and without sickle cell disorders have revealed much reduced hemoglobin level, red blood cells count, mean corpuscular volume, hematocrit, and mean corpuscular hemoglobin; and raised leucocytosis in sickle cell disorder cases than among the normal pregnant women. A more vigorous and realistic campaign of prophylactic regime of supplementations for these pregnant women and child health care is suggested.

  14. Organisation and features of hospital, intermediate care and social services in English sites with low rates of delayed discharge.

    Science.gov (United States)

    Baumann, Matt; Evans, Sherrill; Perkins, Margaret; Curtis, Lesley; Netten, Ann; Fernandez, Jose-Luis; Huxley, Peter

    2007-07-01

    In recent years, there has been significant concern, and policy activity, in relation to the problem of delayed discharges from hospital. Key elements of policy to tackle delays include new investment, the establishment of the Health and Social Care Change Agent Team, and the implementation of the Community Care (Delayed Discharge) Act 2003. Whilst the problem of delays has been widespread, some authorities have managed to tackle delays successfully. The aim of the qualitative study reported here was to investigate discharge practice and the organisation of services at sites with consistently low rates of delay, in order to identify factors supporting such good performance. Six 'high performing' English sites (each including a hospital trust, a local authority, and a primary care trust) were identified using a statistical model, and 42 interviews were undertaken with health and social services staff involved in discharge arrangements. Additionally, the authors set out to investigate the experiences of patients in the sites to examine whether there was a cost to patient care and outcomes of discharge arrangements in these sites, but unfortunately, it was not possible to secure sufficient patient participation. Whilst acknowledging the lack of patient experience and outcome data, a range of service elements was identified at the sites that contribute to the avoidance of delays, either through supporting efficiency within individual agencies or enabling more efficient joint working. Sites still struggling with delays should benefit from knowledge of this range. The government's reimbursement scheme appears to have been largely helpful in the study sites, prompting efficiency-driven changes to the organisation of services and discharge systems, but further focused research is required to provide clear evidence of its impact nationally, and in particular, how it impacts on staff, and patients and their families.

  15. Improving Finance Service Level in Hospitals by Construction of ISO system%借助ISO体系建设提升医院财务服务水平

    Institute of Scientific and Technical Information of China (English)

    肖立萱

    2011-01-01

    在医院为病人提供服务的主体是医护人员,但财务人员也在为病人提供各种相关服务,医院财务人员的服务水平与工作质量需要提升.医院服务水平与ISO认证之间存在关联,医院通过引入ISO认证,建立ISO质量管理体系,可以改善财务工作质量,提升医院财务人员的服务水平.%The medical care personnel provide hospital service for most of the part, while the finance staff in hospital offer various related services as well.Therefore, it is necessary to improve the service level and working quality of the hospital finance staff.The analysis of the relationship between the hospital services and the ISO certification supports that through the introduction of ISO certification and construction of ISO quality management system, the hospital can improve financial management quality and the service level of hospital finance staff.

  16. [Shortage of doctors in psychiatric hospitals--providing for the future by reorganizing medical services].

    Science.gov (United States)

    Jordan, Wolfgang; Adler, Lothar; Bleich, Stefan; von Einsiedel, Regina; Falkai, Peter; Grosskopf, Volker; Hauth, Iris; Steiner, Johann; Cohrs, Stefan

    2011-11-01

    Increasing psychiatric disorder treatment need, increased work load, changes in the working hour regulations, the nation-wide shortage of physicians, efficiency principle and economisation can necessitate a reorganisation of medical services. The essential steps and instruments of process optimisation in medical services for a psychiatric clinic are elucidated and discussed in the context of demographic changes, generation change, and a new concept of values.

  17. Patient and family perceptions of hospice services: 'I knew they weren't like hospitals'

    Directory of Open Access Journals (Sweden)

    Bray Y

    2013-09-01

    Full Text Available INTRODUCTION: The vision for palliative care service provision in New Zealand is for all people who are dying and their families to have timely access to culturally appropriate, quality palliative care services. An Auckland hospice's records show that the ethnically diverse population statistics were not reflected in the referrals for hospice services. The aim of this research was to gain a patient-and-their-family perspective on the hospice, including exploration of components of service care that could be improved for various cultural groups. METHODS: Patients currently under the care of the hospice and family members were recruited from hospice records. Semi-structured interviews were conducted to explore the emerging issues. The study collected data from a purposive sample of 18 palliative care patients or carer family members, ranging in age from 39 to 81 years, who reflected the ethnic diversity of the population of the region. Interviewing was carried out by an experienced research assistant and continued until data saturation was reached. FINDINGS: Four key themes emerged-hospice personnel's approach to patients, quality of service, cultural barriers, and strategies for future improvement. It was determined that the latter two were the most significant to address in this article. CONCLUSION: The study revealed the need for information-giving and education, including public profiling of the hospice to strengthen community involvement. Strategies to reduce ethnic disparities include strengthening the awareness of, and access to, services by connecting with cultural groups through churches, community and specific cultural media.

  18. Notes from the field: hospitalizations for respiratory disease among unaccompanied children from Central America - multiple States, June-July 2014.

    Science.gov (United States)

    Nyangoma, Edith N; Arriola, Carmen Sofia; Hagan, Jose; Socias, Christina; Tomczyk, Sara; Watkins, Louise Francois; Westercamp, Matthew; Kim, Curi

    2014-08-15

    During October 2013-June 2014, approximately 54,000 unaccompanied children, mostly from the Central American countries of El Salvador, Guatemala, and Honduras, were identified attempting entry into the United States from Mexico, exceeding numbers reported in previous years. Once identified in the United States, U.S. Customs and Border Protection, an agency of the U.S. Department of Homeland Security, processes the unaccompanied children and transfers them to the Office of Refugee Resettlement (ORR), an office of the Administration for Children and Families, U.S. Department of Health and Human Services. ORR cares for the children in shelters until they can be released to a sponsor, typically a parent or relative, who can care for the child while their immigration case is processed. In June 2014, in response to the increased number of unaccompanied children, U.S. Customs and Border Protection expanded operations to accommodate children at a processing center in Nogales, Arizona. ORR, together with the U.S. Department of Defense, opened additional large temporary shelters for the children at Lackland Air Force Base, Texas; U.S. Army Garrison Ft. Sill, Oklahoma; and Naval Base Ventura County, California.

  19. Variability in Criteria for Emergency Medical Services Routing of Acute Stroke Patients to Designated Stroke Center Hospitals

    Science.gov (United States)

    Dimitrov, Nikolay; Koenig, William; Bosson, Nichole; Song, Sarah; Saver, Jeffrey L.; Mack, William J.; Sanossian, Nerses

    2015-01-01

    Introduction Comprehensive stroke systems of care include routing to the nearest designated stroke center hospital, bypassing non-designated hospitals. Routing protocols are implemented at the state or county level and vary in qualification criteria and determination of destination hospital. We surveyed all counties in the state of California for presence and characteristics of their prehospital stroke routing protocols. Methods Each county’s local emergency medical services agency (LEMSA) was queried for the presence of a stroke routing protocol. We reviewed these protocols for method of stroke identification and criteria for patient transport to a stroke center. Results Thirty-three LEMSAs serve 58 counties in California with populations ranging from 1,175 to nearly 10 million. Fifteen LEMSAs (45%) had stroke routing protocols, covering 23 counties (40%) and 68% of the state population. Counties with protocols had higher population density (1,500 vs. 140 persons per square mile). In the six counties without designated stroke centers, patients meeting criteria were transported out of county. Stroke identification in the field was achieved using the Cincinnati Prehospital Stroke Screen in 72%, Los Angeles Prehospital Stroke Screen in 7% and a county-specific protocol in 22%. Conclusion California EMS prehospital acute stroke routing protocols cover 68% of the state population and vary in characteristics including activation by symptom onset time and destination facility features, reflecting matching of system design to local geographic resources. PMID:26587100

  20. Variability in Criteria for Emergency Medical Services Routing of Acute Stroke Patients to Designated Stroke Center Hospitals

    Directory of Open Access Journals (Sweden)

    Nikolay Dimitrov

    2015-10-01

    Full Text Available Introduction: Comprehensive stroke systems of care include routing to the nearest designated stroke center hospital, bypassing non-designated hospitals. Routing protocols are implemented at the state or county level and vary in qualification criteria and determination of destination hospital. We surveyed all counties in the state of California for presence and characteristics of their prehospital stroke routing protocols. Methods: Each county’s local emergency medical services agency (LEMSA was queried for the presence of a stroke routing protocol. We reviewed these protocols for method of stroke identification and criteria for patient transport to a stroke center. Results: Thirty-three LEMSAs serve 58 counties in California with populations ranging from 1,175 to nearly 10 million. Fifteen LEMSAs (45% had stroke routing protocols, covering 23 counties (40% and 68% of the state population. Counties with protocols had higher population density (1,500 vs. 140 persons per square mile. In the six counties without designated stroke centers, patients meeting criteria were transported out of county. Stroke identification in the field was achieved using the Cincinnati Prehospital Stroke Screen in 72%, Los Angeles Prehospital Stroke Screen in 7% and a county-specific protocol in 22%. Conclusion: California EMS prehospital acute stroke routing protocols cover 68% of the state population and vary in characteristics including activation by symptom onset time and destination facility features, reflecting matching of system design to local geographic resources.

  1. Military Hospitalizations among Deployed US Service Members Following Anthrax Vaccination, 1998-2001

    Science.gov (United States)

    2006-04-01

    and hospitalizations for a wide range of outcomes. Cox propor- tional hazards models could not be run for systemic lupus erythematosus , fibromyalgia...sclerosis, systemic lupus erythematosus , or fibromyalgia. Vaccine safety within military populations remains an important issue, and further study is...Reporting System (VAERS). Pharmacoepidemiol Drug Saf 2004; 13:825-40. 14. Lange JL, Lesikar SE, Rubertone MV, Brundage JF. Comprehensive systematic

  2. Propuesta de mejora para el Complejo Hospitalario de Navarra, Hospital D: manual de procedimientos para la Central de Esterilización

    OpenAIRE

    2014-01-01

    La esterilización es una ciencia en la que se emplean tecnologías muy variadas con el fin de lograr la destrucción de todos los microorganismos. Una vez que se ha esterilizado todo el material, debe mantenerse esa condición hasta el momento de “uso” de los equipos. La central de esterilización (en adelante CE o Central), es una unidad de vital importancia dentro de la estructura de un hospital. Recibe una enorme cantidad y variedad de instrumental quirúrgico que debe ser recogido, limpiad...

  3. Correspondence: risk factors of acute respiratory infection in under-fives in a rural hospital of Central India – Authors’ reply

    Directory of Open Access Journals (Sweden)

    Amar Taksande

    2016-07-01

    Full Text Available Dear Editor,We thank the authors for their interest and comments on our paper. They have raised some very valid points. This corrispondence refers to the following article:Taksande AM, Yeole M. Risk factors of Acute Respiratory Infection (ARI in under-fives in a rural hospital of Central India. J Pediatr Neonat Individual Med. 2016;5(1:e050105. doi: 10.7363/050105 br />Comments can be found in the following article:Mandal A, Sahi PK. Correspondence: risk factors of acute respiratory infection in under-fives in a rural hospital of Central India. J Pediatr Neonat Individual Med. 2016;5(2:e050207. doi: 10.7363/050207

  4. Does health insurance ensure equitable health outcomes? An analysis of hospital services usage in urban India.

    Science.gov (United States)

    Dutta, Mousumi; Husain, Zakir

    2013-01-01

    In this paper, we examine the relationship between socio-economic status (SES) and the usage of in-patient services, and analyze the impact of introducing health insurance in India - a major developing country with poor health outcomes. In contrast to results of similar works undertaken for developed countries, our results reveal that the positive relation between usage of in-patient services and SES persists even in the presence of health insurance. This implies that health insurance is unable to eliminate the inequities in accessing healthcare services that stem from disparities in SES. In fact, insurance aggravates inequity in the healthcare market. The study is based on unit-level data from the 2005-06 Morbidity and Health Care Survey undertaken by National Sample Survey Organization.

  5. [Hospital structure and control measures].

    Science.gov (United States)

    Gürkan, I

    1995-01-01

    A new legislation concerning financial matters of hospitals in Germany requires fundamental changes and adjustment. Formerly grown structures of a high-grade centralization erode into a process of change. Despite hospitals will maintain their non-profit character in public health services, modifications of medical care processes will promote elements of cost-centres. All medical care units as well as hospital management are confronted with rising requirements concerning performance and transparency. Increasingly patients and social health insurances behave like self-confident customers not willing to accept rising costs. Public health services loose their character of a planned economy. Hospitals with features of health-entrepreneurship are on the incline. A process of quality-planning and efficient management has been evoqued.

  6. Factors influencing specialist outreach and support services to rural populations in the Eden and Central Karoo districts of the Western Cape

    Directory of Open Access Journals (Sweden)

    Johan Schoevers

    2015-02-01

    Full Text Available Background: Access to health care often depends on where one lives. Rural populations have significantly poorer health outcomes than their urban counterparts. Specialist outreach to rural communities is one way of improving access to care. A multifaceted style of outreach improves access and health outcomes, whilst a shifted outpatients style only improves access. In principle, stakeholders agree that specialist outreach and support (O&S to rural populations is necessary. In practice, however, factors influence whether or not O&S reaches its goals, affecting sustainability.Aim and setting: Our aim was to better understand factors associated with the success or failure of specialist O&S to rural populations in the Eden and Central Karoo districts in the Western Cape.Methods: An anonymous parallel three-stage Delphi process was followed to obtain consensus in a specialist and district hospital panel.Results: Twenty eight specialist and 31 district hospital experts were invited, with response rates of 60.7% – 71.4% and 58.1% – 74.2% respectively across the three rounds. Relationships, communication and planning were found to be factors feeding into a service delivery versus capacity building tension, which affects the efficiency of O&S. The success of the O&S programme is dependent on a site-specific model that is acceptable to both the outreaching specialists and the hosting district hospital.Conclusion: Good communication, constructive feedback and improved planning may improve relationships and efficiency, which might lead to a more sustainable and mutually beneficial O&S system.

  7. BACTERIAL CAUSES OF LOWER RESPIRATORY TRACT INFECTIONS IN PATIENTS ATTENDING CENTRAL REFERRAL HOSPITAL, GANGTOK WITH REFERENCE TO ANTIBIOTIC RESISTANCE PATTERN

    OpenAIRE

    Priyanka Paul; Tukaram Prabhu

    2013-01-01

    ABSTRACT: BACKGROUND: There is inadequate information from India on various lower respiratory tract pathogens and their resistance pattern in hospital settings. The present study was undertaken to see the bacteriological profile an d the antibiotic resistance pattern of the isolates causing LRTI from this geographic region. OBJECTIVE: To identify and characterize bacterial pathogens causing community acquired and hospital acquired infections with reference to ant...

  8. 17 CFR 256.01-4 - Construction or service contracts, and centralized procurement accounting.

    Science.gov (United States)

    2010-04-01

    ... classification of expenditures relating to projects as will meet the accounting requirements of the company for... COMPANIES AND SUBSIDIARY SERVICE COMPANIES, PUBLIC UTILITY HOLDING COMPANY ACT OF 1935 General Instructions... or service contracts, under which the service company undertakes projects to construct...

  9. Who Benefits from Ecosystem Services? A Case Study for Central Kalimantan, Indonesia

    NARCIS (Netherlands)

    Suwarno, Aritta; Hein, Lars; Sumarga, Elham

    2015-01-01

    There is increasing experience with the valuation of ecosystem services. However, to date, less attention has been devoted to who is actually benefiting from ecosystem services. This nevertheless is a key issue, in particular, if ecosystem services analysis and valuation is used to support enviro

  10. The association of willingness-to-pay and patient attributes: a cost-volume-profit analysis of cardiac catheter unit services in Ramallah Hospital, Palestine.

    Science.gov (United States)

    Jabr, Samer F K; Younis, Mustafa Mike Z; Forgione, Dana A

    2009-01-01

    The purpose of this study is to examine the association of willingness-to-pay and patient attributes in relation to the multi-service cost-volume-profit structure of a cardiac catheter unit in Ramallah Hospital. This article contributes to the literature by providing primary evidence on patient willingness-to-pay, by identifying the specific break-even parameters of three hospital cardiac catheter unit service types (diagnosis, balloon, and pacemaker), and by demonstrating the cross-subsidization of patient income groups that is inherent in the existing hospital rate structure. Our results provide information useful for (1) evidence-based policy making with respect to hospital rate setting and cross-subsidies of patient income groups; (2) the advancement of hospital management, by demonstrating the estimated variable and fixed cost parameters and the impact of patient revenue mix on the profitability of cardiac catheter unit services; and (3) the advancement of theory, by documenting the relationship of patient demand and the cost of supply in a multi-patient-group, multi-service hospital setting.

  11. Institutional Effectiveness Assessment Process, 1993-94. Executive Summary. Hospitality and Service Occupations Division, Cosmetology Department.

    Science.gov (United States)

    South Seattle Community Coll., Washington.

    A study was conducted to evaluate student and student employer satisfaction with the services provided by the South Seattle Community College (SSCC) Cosmetology Department. Specifically, the study gathered data related to four outcomes: that students receive an educational experience allowing them to meet their goals; that former and current…

  12. Demonstrating a Conceptual Framework to Provide Efficient Wound Management Service for a Wound Care Center in a Tertiary Hospital.

    Science.gov (United States)

    Chen, Yu-Tsung; Chang, Chang-Cheng; Shen, Jen-Hsiang; Lin, Wei-Nung; Chen, Mei-Yen

    2015-11-01

    Although the benefits of wound care services and multidisciplinary team care have been well elaborated on in the literature, there is a gap in the actual practice of wound care and the establishment of an efficient referral system. The conceptual framework for establishing efficient wound management services requires elucidation.A wound care center was established in a tertiary hospital in 2010, staffed by an integrated multidisciplinary team including plastic surgeons, a full-time coordinator, a physical therapist, occupational therapists, and other physician specialists. Referral patients were efficiently managed following a conceptual framework for wound care. This efficient wound management service consists of 3 steps: patient entry and onsite immediate wound debridement, wound re-evaluation, and individual wound bed preparation plan. Wound conditions were documented annually over 4 consecutive years.From January 2011 to December 2014, 1103 patients were recruited from outpatient clinics or inpatient consultations for the 3-step wound management service. Of these, 62% of patients achieved healing or improvement in wounds, 13% of patients experienced no change, and 25% of patients failed to follow-up. The outcome of wound treatment varied by wound type. Sixty-nine percent of diabetic foot ulcer patients were significantly healed or improved. In contrast, pressure ulcers were the most poorly healed wound type, with only 55% of patients achieving significantly healed or improved wounds.The 3-step wound management service in the wound care center efficiently provided onsite screening, timely debridement, and multidisciplinary team care. Patients could schedule appointments instead of waiting indefinitely for care. Further wound condition follow-up, education, and prevention were also continually provided.

  13. Demonstrating a Conceptual Framework to Provide Efficient Wound Management Service for a Wound Care Center in a Tertiary Hospital

    Science.gov (United States)

    Chen, Yu-Tsung; Chang, Chang-Cheng; Shen, Jen-Hsiang; Lin, Wei-Nung; Chen, Mei-Yen

    2015-01-01

    Abstract Although the benefits of wound care services and multidisciplinary team care have been well elaborated on in the literature, there is a gap in the actual practice of wound care and the establishment of an efficient referral system. The conceptual framework for establishing efficient wound management services requires elucidation. A wound care center was established in a tertiary hospital in 2010, staffed by an integrated multidisciplinary team including plastic surgeons, a full-time coordinator, a physical therapist, occupational therapists, and other physician specialists. Referral patients were efficiently managed following a conceptual framework for wound care. This efficient wound management service consists of 3 steps: patient entry and onsite immediate wound debridement, wound re-evaluation, and individual wound bed preparation plan. Wound conditions were documented annually over 4 consecutive years. From January 2011 to December 2014, 1103 patients were recruited from outpatient clinics or inpatient consultations for the 3-step wound management service. Of these, 62% of patients achieved healing or improvement in wounds, 13% of patients experienced no change, and 25% of patients failed to follow-up. The outcome of wound treatment varied by wound type. Sixty-nine percent of diabetic foot ulcer patients were significantly healed or improved. In contrast, pressure ulcers were the most poorly healed wound type, with only 55% of patients achieving significantly healed or improved wounds. The 3-step wound management service in the wound care center efficiently provided onsite screening, timely debridement, and multidisciplinary team care. Patients could schedule appointments instead of waiting indefinitely for care. Further wound condition follow-up, education, and prevention were also continually provided. PMID:26554805

  14. Social and Ecological Drivers of the Economic Value of Pollination Services Delivered to Coffee in Central Uganda

    Directory of Open Access Journals (Sweden)

    Bin Mushambanyi Théodore Munyuli

    2014-01-01

    Full Text Available On-farm pollination experiments were conducted in 30 different small-scale coffee fields to determine monetary value attributable to pollination services in coffee production and to identify the degree of influences of various socio-ecological drivers in Uganda. Ecological-economic approaches were applied to determine the economic value of pollinating services. Economic value of bees increased significantly with increase in coffee farm size, bee diversity, and cover of seminatural habitats. The value of bees declined sharply (P<0.05 with forest distance and cultivation intensity. Economic values of pollinating services associated with coffee fields established in regions with low intensity were found to be high. Organically managed small-scale coffee fields were 2 times more profitable than commercially managed farms. The annual value of pollinating services delivered by wild bees oscillated between US$67.18 and US$1431.36. Central Uganda produces in total 0.401 million tons of coffee beans for an approximate economic value of US$214 million from which US$149.42 million are attributable to pollination services. Policy makers should strengthen environmental/agricultural extension service systems to better serve farmers. Farmers are recommended to protect/increase the cover of natural and semi-natural habitats in the vicinity of their coffee fields to receive high economic benefits from pollinating services delivered by bees.

  15. Evaluation and appraisal of drug information services in a rural secondary level care hospital, Anantapur, AP

    Directory of Open Access Journals (Sweden)

    Rohit Bhavsar

    2012-01-01

    Full Text Available Background: Drug Information Center (DIC is an information center which provides drug information (DI to healthcare professionals. The aim was to evaluate the performance of DIC for improving the quality and quantity of information services provided to the healthcare professionals. The service was provided free of cost to the customers. Materials and Methods: This descriptive study was conducted for the period of 6 months from February to August 2011 excluding May due to vacation. Customers were asked: how did they find the service provided to them? Was it good, satisfactory, or need improvement? There were written feedback forms to be filled by the customers, including customer satisfaction questions. The official publication of the DIC, RIPER PDIC Bulletin was screened for its types of articles/number of drug news published. The bulletin is circulated for free to the healthcare professionals electronically. Results and Discussion: A total of 232 queries were obtained during the study period of 6 months. Average number of queried received to the DIC was 39 per month. Most preferred mode of queries was personal access (89%. Majority of queries were received from nurses, i.e., 162 (70% queries and 81% of all queries were drug oriented for improving knowledge. There were only 19% of the queries for individual patients; doctors asked most of those queries. Only 3% queries answered were rated as need improvement by the healthcare professionals. Rest were considered as either Good (56% or satisfactory (49%. Range of drug news published in each bulletin was 3-4 and most of the other articles include expert opinion to improve practice or training. Conclusion: The DI services were satisfactorily used for academic interests. Nurses used the service for the highest compared to other health care professionals. Future studies should plan to establish the usefulness of DI to improve healthcare practice.

  16. Pattern and prevalence of tobacco use and associated oral mucosal lesions: a hospital based cross sectional study at a tertiary care hospital in central India

    Directory of Open Access Journals (Sweden)

    Ambrish Mishra

    2015-09-01

    Conclusions: The number of tobacco users visiting the dental hospital is reasonably high; Tobacco consumption is a common cause of addiction, preventable illness, disability and death. The public health system should be strengthened for effectively designing, implementing and evaluating tobacco control and prevention programs. All health care professionals should be sensitized and educated for implementing measures for tobacco control and cessation. [Int J Res Med Sci 2015; 3(9.000: 2169-2173

  17. The effect on patient loyalty of service quality, patient visit experience and perceived switching costs: lessons from one Taiwan university hospital.

    Science.gov (United States)

    Wang, Hsiu-Ling; Huang, Jun-Ying; Howng, Shen-Long

    2011-02-01

    The reimbursement system changed from fee-for-service to fixed prospective payments in Taiwan, the effect on the physician-patient's relationship is worth being studied. We examined the relationship between patient visit experience, cost perceptions and the two important aspects of quality of care, curing and interpersonal performance, and patients' loyalty to the hospital physicians. A total of 404 patients from an acute care hospital in Taiwan, Kaohsiung Medical University Hospital (KMUH), were investigated using a self-administered mailing survey. All measures including patient loyalty (PL), curing service quality (CSQ), interpersonal service quality (ISQ), visit experience (VE) and perceived switching costs (PSC), were adapted and modified from existing scales. Our results showed that the physician's CSQ and ISQ positively affected patients' loyalty to KMUH. The interaction between the main effects of service quality, patients' VE and three types of switching visit costs, yielded additional insights into the importance of service quality for patient retention. The CSQ of physicians becomes a more important determinant of loyalty than ISQ as patients' VE increases. The importance of CSQ and ISQ increases in relation to PL as the perceived procedural and relational costs of changing care providers increases. Neither CSQ nor ISQ has a reduced relationship with PL as the perceived financial costs of switching hospitals increase. Our study indicates that the impact of CSQ and ISQ on loyalty varies according to the perceived visit costs of changing hospitals and the patients' VE.

  18. 医院医德医风窗口评价系统%Hospital Medical Ethics Windows Service Evaluation System

    Institute of Scientific and Technical Information of China (English)

    王亚军

    2014-01-01

    目的:践行以病人为中心的服务理念,构建一套易行、可行、科学、客观、公正的评价体系,以提高医院为患服务质量.方法:以军卫一号平台及HIS数据库为基础,应用JAVA、Eclipse技术进行系统搭建.结果:系统上线运行30个月以来,起到了很好的监管作用,我院患者综合满意度提升了4.35%.结论:本系统有助于提升医务人员为患服务意识,有助于提升医院的社会、公益形象,有助于缓解日益突出的医患矛盾,构建和谐医患关系,有较高的推广普及价值.%The object of our work is to fulfil the philosophy that patients are the core of the service and construct a practical, feasible, scientific, objective and fair valuation system so as to improve the service quality of hospital. The methods we use in this paper are based on the military healthy No.1 platform and HIS database and systematically supported by JAVA and Eclipse technology. The system has been being operated for 30 months, during this interval. It has a great performance on the supervisor function which made the patients comprehensive stasfication degree increase 4.35%. This system facilitate the service awareness of medical service pesonel, the improvement of public and social images and the alleviation of gradually increasing contradicts between medical service and patients, which builds a harmonious relationship between hospital and patierntes and has a higher value that needs to be promoted.

  19. Evaluating patients’ perception of service quality at hospitals in nine Chinese cities by use of the ServQual scale

    Institute of Scientific and Technical Information of China (English)

    Min; Li; Douglas; Bruce; Lowrie; Cheng-Yu; Huang; Xiang-Chan; Lu; Ying-Chu; Zhu; Xing-Hua; Wu; Mayila; Shayiti; Qiong-Zhen; Tan; Hua-Ling; Yang; Si-Yuan; Chen; Pan; Zhao; Sheng-Hua; He; Xiu-Rong; Wang; Hong-Zhou; Lu

    2015-01-01

    Objective: To investigate patients’ perception of service quality at hospitals in nine Chinese cities and propose some measures for improvement. Methods: The ServQ ual scale method was used in a survey involving patients at out-patient and in-patient facilities in Shanghai, Chongqing, Chengdu, Nanning, Guilin and Laibin of Guangxi, Honghezhou of Yunnan, Wulumuqi of Xinjiang and Zhongshan of Guangdong. The data collected were entered and analyzed using SPSS 20.0. Statistical analyses included descriptive statistics, factor analyses, reliability analyses, product-moment correlations, independent-sample t-tests, One-way ANOVA and regression analyses. Results: The Kaiser-Meyer-Olkin value for the factor analysis of the scale was 0.979. The Cronbach’s α for the reliability analysis was 0.978. All the Pearson correlation coei cients were positive and statistically signii cant. Visitors to out-patient facilities reported more positive perception tacilities on tangibles(t = 4.168, P(t = 1.979, P service quality, followed by patients in Shanghai. On the other hand, patients in Chongqing and Nanning and Guilin of Guangxi reported relatively poor perceptions of service quality. Standardized regression coei cients showed statistically significant(P < 0.001) positive values for all Serv Qual dimensions. Empathy(β = 0.267) and reliability(β uality. = 0.239) most strongly predicted perception of service qConclusions: Chinese patients perceived service quality as satisfactory. Hospitals in various regions of China should enhance their awareness and ability to serve their patients.

  20. Desenvolvimento do sus e racionamento de serviços hospitalares SUS evolution and hospital services rationing

    Directory of Open Access Journals (Sweden)

    José Mendes Ribeiro

    2009-06-01

    Full Text Available Analisamos o sistema de saúde brasileiro em perspectiva comparada. A migração de clientelas de renda média para operadoras pré-pagas privadas aproxima o caso brasileiro do norte-americano. A produção de serviços hospitalares no SUS demonstra importante redução da oferta agravada pelo crescimento demográfico e por expectativas definidas por disposições constitucionais. A redução é seletiva e concentrada em serviços obstétricos e de clínica médica e nos serviços privados lucrativos. Para se garantir acesso equitativo é necessário: ampliação de gastos públicos; redução dos gastos por desembolso direto; reformas organizacionais; ampliação da capacidade de governo.We analyze Brazilian health system in comparative perspective. Middle income beneficiaries migration to pre-paid private insurance makes Brazilian case similar to United States. Public hospital services delivery shows an important retrenchment enhanced by demographic growth and new expectations due to constitutional definitions. Retrenchment is selective and concentrates on obstetric and clinic services and private for-profit services. To ensure equal access it is necessary to improve public spending; diminish out-of-pocket spending; develop organizational reforms; improve government capacity.

  1. Service delivery in Kenyan district hospitals – what can we learn from literature on mid-level managers?

    Science.gov (United States)

    2013-01-01

    Background There is a growing emphasis on the need to tackle inadequate human resources for health (HRH) as an essential part of strengthening health systems; but the focus is mostly on macro-level issues, such as training, recruitment, skill mix and distribution. Few attempts have been made to understand the capability of health workers, their motivation and other structural and organizational aspects of systems that influence workforce performance. We have examined literature on the roles of mid-level managers to help us understand how they might influence service delivery quality in Kenyan hospitals. In the Kenyan hospital settings, these are roles that head of departments who are also clinical or nursing service providers might play. Methods A computerized search strategy was run in Pub Med, Cochrane Library, Directory of Open Access Journals Social Science Research Network, Eldis, Google Scholar and Human Resources for Health web site databases using both free-text and MeSH terms from 1980 to 2011. In addition, citation searching from excluded and included articles was used and relevant unpublished literature systematically identified. Results and discussion A total of 23 articles were finally included in the review from over 7000 titles and abstracts initially identified. The most widely documented roles of mid-level managers were decision-making or problem-solving, strategist or negotiator and communicator. Others included being a therapist or motivator, goal setting or articulation and mentoring or coaching. In addition to these roles, we identified important personal attributes of a good manager, which included interpersonal skills, delegation and accountability, and honesty. The majority of studies included in the review concerned the roles that mid-level managers are expected to play in times of organizational change. Conclusion This review highlights the possible significance of mid-level managers in achieving delivery of high-quality services in Kenyan

  2. Reconstructive Surgery Camp for Leprosy Deformities in a Tertiary Hospital: An Example of Service Delivery at Low Costs

    Science.gov (United States)

    Bhatt, Nikita R.; Vyas, Kinnari; Merchant, Rajiv

    2016-01-01

    Introduction Seventy percent of all cases of leprosy in the world occur in India. 8,462 new cases of disability were reported in India between 2010-11. Reconstructive Surgery Camps (RSC) provide free of cost plastic surgical expertise to patients of leprosy with deformity. Aim The aim of this article was to report the outcomes of a RSC in a tertiary level university hospital in India. We also described the types of deformities in the patient group and the cost of conducting such a camp. Materials and Methods The RSC involved 130 patients with leprosy related deformities operated by a team of plastic surgeons in a tertiary university hospital over 5 days. Health workers of the National Leprosy Elimination Program identified patients at community level. The camp was funded by the central government of India and the patients were provided incentives for undergoing treatment. Results Plantar ulcer was the commonest deformity (51.5%) while lagopthalmos (9.2%) was the least common deformity in the patient group. The overall complication rate in our study was around 10.6% (n=11). The total cost of this camp was 730,000 rupees (£7029.9). Conclusion Reconstructive surgery in a camp setup is a low cost alternative of correcting leprosy related deformity. It also provides valuable practical experience in reconstructive surgery to surgical trainees. Tertiary hospital based camps for conducting large-scale surgeries may be a cost effective alternative to reduce waiting lists in public health sectors. Long-term studies monitoring patients operated in a camp setting would be worthwhile. PMID:27630868

  3. Impact of the new handling recommendations for hazardous drugs in a hospital pharmacy service.

    Science.gov (United States)

    García-Alcántara, Beatriz G; Perelló Alomar, Catalina; Moreno Centeno, Elena; Modamio, Pilar; Mariño, Eduardo L; Delgado Sánchez, Olga

    2017-03-01

    Objetivo: Describir las actuaciones realizadas en el Servicio de Farmacia de un hospital de tercer nivel para adaptarse a las recomendaciones establecidas en NIOSH 2014 para el manejo de medicamentos peligrosos. Método: Estudio observacional retrospectivo. Se elaboró una lista de los medicamentos peligrosos según NIOSH 2014 disponibles en el hospital como comercializados, extranjeros o utilizados en ensayos clínicos y se revisaron los procesos de adquisición, re-envasado, preparación, circuitos organizativos, dispensación e identificación.Resultados: Tras el análisis se redactó y envió un informe de las necesidades a la gerencia del hospital. Se incluyó en el sistema informático de prescripción la información pertinente sobre la manipulación y la administración de medicamentos peligrosos. Hubo cambios en la adquisición de dos medicamentos para evitar el fraccionamiento y la presentación multidosis. De las 75.779 unidades de medicamentos peligrosos re-envasadas en un año, se encontró alternativa o mejora para 35.253. El Servicio de Farmacia asumió la preparación de cuatro medicamentos no estériles, así como de todos los medicamentos parenterales estériles de las listas 1 y 2 que no se preparaban allí con anterioridad y uno de la lista 3. También se incluyó información en los procedimientos de elaboración de fórmulas magistrales que implicaban medicamentos peligrosos de las listas 2 y 3.Conclusión: La adaptación a las recomendaciones NIOSH 2014 ha supuesto un cambio, pero también una minimización significativa de la manipulación de medicamentos peligrosos por parte del personal sanitario, reduciéndose de esta manera el riesgo de exposición ocupacional.

  4. Diagnosis Related Groups System - Managerial Tool for Estimating the Cost of Hospital Services (Empirical Study

    Directory of Open Access Journals (Sweden)

    Carmen-Mihaela Creţu

    2012-05-01

    Full Text Available Public health services in Romania are in a complex and continuous process of reform, a majorpriority of government. In the light of future trends of development of health care, we can say that healthcareis becoming more and more a "market" operating on the principle of supply and demand. The patientbecomes a consumer; he is interested in health care and wants to be adept at maintaining and improving hishealth. Therefore, the Romanian health sector must intensify efforts to develop management because successand even its existence depend exclusively on an appropriate management system that continuously improvesto the needs of the patient (customer and to the market economy. Thus, we considered it necessary forcosting approach in the health sector in Romania due to the high complexity of health services and the highconsumption of resources.

  5. A lean case study in an oncological hospital: implementation of a telephone triage system in the emergency service

    Directory of Open Access Journals (Sweden)

    Crespo de Carvalho J

    2013-12-01

    Full Text Available José Crespo de Carvalho,1 Madalena Ramos,1 Carina Paixão2 1Business School, University Institute of Lisbon, Lisbon, Portugal; 2Instituto Português de Oncologia, Lisbon, Portugal Abstract: Lean practices and thinking have increased substantially in the last few years. Applications of lean practices to health care are found worldwide. Despite that, new contributions are required because the application of lean thinking to hospitals has a long way to go. Lean practices and thinking do not include, in the literature or practice programs, any references to triage systems in health care units. The common triage systems require physical presence, but there are alternative methods to avoid the need to move patients: these alternative triage systems, given their characteristics, may be included in the spectrum of lean practices. Currently, patients that are already known to suffer from cancer are encouraged to go to hospital (public or private, with an oncological focus when facing side effects from chemotherapy or radiation treatments; they are then submitted to a triage system (present themselves to the hospital for examination. The authors of this paper propose the introduction of telephone or email triage for impaired patients as a valid substitute for moving them physically, thereby often avoiding several unnecessary moves. This approach has, in fact, characteristics similar to a lean practice in that it reduces costs and maintains, if done properly, the overall service offered. The proposed 'remote' triage emerged from the results of a large survey sent to patients and also as the outcome of a set of semistructured interviews conducted with hospital nurses. With the results they obtained, the authors felt comfortable proposing this approach both to public and private hospitals, because the study was conducted in the most important, largest, and best-known oncological unit in Spain. As a final result, the health care unit studied is now taking

  6. Top 4 sources of savings in support services.

    Science.gov (United States)

    Nugent, Brian; Emmerich, Conrad

    2014-12-01

    Examples of ways that a hospital can reduce support-service costs include: Incorporating more comprehensive performance metrics as part of its contract renewal process for food services. Managing equipment service contracts centrally and reexamining existing contracts. Converting from heavy-weight to lighter-weight linens. Providing rigorous training for environmental services staff on critical touch points in patient room cleaning.

  7. Integrated Medical Information Services: A Resource Management View of Automated Hospital Information Systems

    OpenAIRE

    Melrose, J. Peter; Ericson, R. Peter

    1981-01-01

    Rapid changes in information processing technology have made the problems of administrative and technical planning and integration difficult. Vendor-inspired terms such as “office of the future” have created confusion rather than clarification. However, the term “information resource management” (IRM) that has evolved in the private sector has potential merit. From the idea of IRM, the authors have developed the planning concept of Integrated Medical Information Services (IMIS) as a common ad...

  8. Clinical audit of structured pharmaceutical care plans recorded within a hospital pharmaceutical care service

    OpenAIRE

    Christensen, Marit Bergheim

    2008-01-01

    Background Pharmaceutical care as a health care service has already made its mark and been shown to make an important contribution to the health care system. However, there is still a demand from the NHS among others, that pharmacist to a greater extent must document their provision of pharmaceutical care. Tested out in this project, is the application of a Care Issue Categorisation System. Aims To compare two clinical settings in terms of the profile of pharmaceutical care deli...

  9. [A new scale for the assessment of the quality of hospitality services].

    Science.gov (United States)

    Varela Mallou, Jesús; Prat Santaolària, Remei; Voces López, Carmen; Rial Boubeta, Antonio

    2006-02-01

    In the last 20 years the services sector has experienced a highly significant growth, being currently one of the most important economic sectors in our country. Inside the touristic sector, a strong competence has being experienced among the lodging and restoration establishments. In a scenario characterized by competitiveness, the bet for quality represents a difficult competitive advantage to surpass (García-Buedes, 2001). The objective of this study is to carry out an approach to the evaluation of the perceived quality of the restaurants. As a result of bibliographic revision, and also a first approach of a qualitative nature, we started from a scale of 31 items that included 5 dimensions: access, personal, service, product and installations. The results obtained applying the questionnaire to more than 2400 clients of 180 establishments of Santiago de Compostela and region, by means of structured interviews, confirmed that not all these dimensions had the same importance as predictors of customer satisfaction. Specifically, the product emerges as the most important dimension. Likewise, the elimination of the dimension service and a more exhaustive selection of the items, based on psychometric criteria, has permitted to define a brief scale, consisting of only 15 items, which makes it very attractive as a management tool. The final scale proposed to evaluate the perceived quality in the restaurant sector includes four fundamental and non-independent dimensions. These are, ordered by importance: product, personal, installations and access.

  10. The Role of a Hospital Ethics Consultation Service in Decision-Making for Unrepresented Patients.

    Science.gov (United States)

    Courtwright, Andrew M; Abrams, Joshua; Robinson, Ellen M

    2017-03-06

    Despite increased calls for hospital ethics committees to serve as default decision-makers about life-sustaining treatment (LST) for unrepresented patients who lack decision-making capacity or a surrogate decision-maker and whose wishes regarding medical care are not known, little is known about how committees currently function in these cases. This was a retrospective cohort study of all ethics committee consultations involving decision-making about LST for unrepresented patients at a large academic hospital from 2007 to 2013. There were 310 ethics committee consultations, twenty-five (8.1 per cent) of which involved unrepresented patients. In thirteen (52.0 per cent) cases, the ethics consultants evaluated a possible substitute decision-maker identified by social workers and/or case managers. In the remaining cases, the ethics consultants worked with the medical team to contact previous healthcare professionals to provide substituted judgement, found prior advance care planning documents, or identified the patient's best interest as the decision-making standard. In the majority of cases, the final decision was to limit or withdraw LST (72 per cent) or to change code status to Do Not Resuscitate/Do Not Intubate (12 per cent). Substitute decision-makers who had been evaluated through the ethics consultation process and who made the final decision alone were more likely to continue LST than cases in which physicians made the final decision (50 per cent vs 6.3 per cent, p = 0.04). In our centre, the primary role of ethics consultants in decision-making for unrepresented patients is to identify appropriate decision-making standards. In the absence of other data suggesting that ethics committees, as currently constituted, are ready to serve as substitute decision-makers for unrepresented patients, caution is necessary before designating these committees as default decision-makers.

  11. Structural Measures - Hospital

    Data.gov (United States)

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

  12. Patient survey (HCAHPS) - Hospital

    Data.gov (United States)

    U.S. Department of Health & Human Services — A list of hospital ratings for the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS). HCAHPS is a national, standardized survey of hospital...

  13. Hospitality within hospital meals –

    DEFF Research Database (Denmark)

    Justesen, Lise; Gyimóthy, Szilvia; Mikkelsen, Bent Egberg

    2016-01-01

    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...... fieldwork in a Danish hospital, hospitality practices were studied using a socio-material assemblage approach. The study showed that rethinking the meal event could change the wards into temporary “pop-up-restaurants,” transcending the hospital context and providing a scene for shifting host...... 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...

  14. Modelos de serviços hospitalares para casos agudos em idosos Hospital services for acute care of elderly people

    Directory of Open Access Journals (Sweden)

    João Macedo Coelho Filho

    2000-12-01

    patients in the hospital setting. The objective was to review some models of acute hospital care for elderly people, focusing on the role of geriatric medicine and its relationship with other specialities. Medline database (1989-1999, textbooks of geriatrics and gerontology, and other health publications were consulted in an attempt to identify all relevant publications about hospital services providing acute care to elderly people. The features of each model were compiled and discussed taking into account their suitability to the Brazilian health system. Some examples of interventions, with their effectiveness demonstrated by systematic reviews, were also mentioned. The models more frequently described were: long-time traditional, age-defined, unspecialized and integrated care. Variants of such models were frequently reported. There is no evidence pointing to one as the best model, but models favoring the integration of geriatrics with general medicine seemed to be particularly suitable to the Brazilian setting. With the aging of the population, there is a need to restructure the health services to face the increasing demands of elderly people. Given that the design of hospital services is an important factor for the effectiveness of geriatric care, this issue should be studied as priority in Brazil.

  15. Status of pre-hospital emergency medical service in China and abroad%国内外院前急救的现状

    Institute of Scientific and Technical Information of China (English)

    何美娟; 许玲玲; 马明丹; 帅先洁; 刘勇

    2016-01-01

    文章综述了国内外院前急救的模式、人员、物品管理、公众急救知识等方面的现状,分析了国外院前急救优势,为发展我国院前急救事业提供借鉴与参考。%The paper reviewed the status of domestic and overseas pre - hospital emergency medical service(EMS),including the models,staffing,item management,and general knowledge of the public. Then the paper analyzed the advantage of overseas pre - hospital emergency medical service,so as to provide suggestions and references for developing domestic pre - hospital emergency medical services.

  16. [Children's department and child care institutions of the Central military, hospital of People's commissariat during the Great Patriotic War].

    Science.gov (United States)

    Simonenko, V B; Krainyukov, P E; Abashin, V G

    2016-01-01

    The article presents historical data about paediatric health care delivery and escort of children of the Command of the Red Army during their evacuation from Moscow in 1941. Data on foundation of kindergartens of People's commissariat in 1942-1943, their support and foundation of children's department in the hospital is given. Special subdivision governed by the head of child care institutions of the hospital was formed for managing child care institutions.

  17. Heparin-induced thrombocytopenia: reducing misdiagnosis via collaboration between an inpatient anticoagulation pharmacy service and hospital reference laboratory.

    Science.gov (United States)

    Burnett, Allison E; Bowles, Harmony; Borrego, Matthew E; Montoya, Tiffany N; Garcia, David A; Mahan, Charles

    2016-11-01

    Misdiagnosis of heparin-induced thrombocytopenia (HIT) is common and exposes patients to high-risk therapies and potentially serious adverse events. The primary objective of this study was to evaluate the impact of collaboration between an inpatient pharmacy-driven anticoagulation management service (AMS) and hospital reference laboratory to reduce inappropriate HIT antibody testing via pharmacist intervention and use of the 4T pre-test probability score. Secondary objectives included clinical outcomes and cost-savings realized through reduced laboratory testing and decreased unnecessary treatment of HIT. This was a single center, pre-post, observational study. The hospital reference laboratory contacted the AMS when they received a blood sample for an enzyme-linked immunosorbent HIT antibody (HIT Ab). Trained pharmacists prospectively scored each HIT Ab ordered by using the 4T score with subsequent communication to physicians recommending for or against processing and reporting of lab results. Utilizing retrospective chart review and a database for all patients with a HIT Ab ordered during the study period, we compared the incidence of HIT Ab testing before and after implementation of the pharmacy-driven 4T score intervention. Our intervention significantly reduced the number of inappropriate HIT Ab tests processed (176 vs. 63, p < 0.0001), with no increase in thrombotic or hemorrhagic events. Overall incidence of suspected and confirmed HIT was <3 and <0.005 %, respectively. Overall cost savings were $75,754 (US) or 62 % per patient exposed to heparin between the pre and post intervention groups. Collaboration between inpatient pharmacy AMS and hospital reference laboratories can result in reduction of misdiagnosis of HIT and significant cost savings with similar safety.

  18. Survey of patient satisfaction with the Breastfeeding Education and Support Services of The Royal Women's Hospital, Melbourne

    Directory of Open Access Journals (Sweden)

    Amir Lisa H

    2008-04-01

    Full Text Available Abstract Background The Breastfeeding Education and Support Services (BESS is a unit of The Royal Women's Hospital in Melbourne, Australia, staffed by International Board Certified Lactation Consultants (IBCLCs, providing day/short-stay and an outpatient clinic for mothers and infants with breastfeeding problems. It is important to measure women's experience of visiting the service as part of quality assurance. The aim of this project was to conduct an anonymous postal survey of clients' satisfaction with BESS. Methods An anonymous survey was posted on 16 November 2005 and again on 31 January 2006, to all women who had attended BESS in September 2005. Results The response rate was 60.5% (78/129. Eighty percent (62/78 of respondents attended day-stay, 33% (26/78 attended short-stay and 15% (12/78 attended the outpatient clinic. The percentage of women who responded "strongly agree" to the statement "Overall, I am satisfied with the services" was 49% (35/72 and 50% (6/12 for those who went to day/short-stay and the outpatient clinic respectively. Overall, 56% of all respondents responded that the quality of BESS was "better than expected". The most common breastfeeding problem reported was difficulty attaching the baby to the breast, followed by nipple damage, low milk supply and painful feeding. Conclusion BESS seems to have provided a satisfactory service to most clients. Most respondents were clearly satisfied with the support given by the IBCLCs and have also responded that the staff were professional and knowledgeable in their field of work.

  19. A Model for Provision of ENT Health Care Service at Primary and Secondary Hospital Level in a Developing Country

    Directory of Open Access Journals (Sweden)

    Lingamdenne Paul Emerson

    2013-01-01

    Full Text Available ENT problems are the most common reason for a visit to a doctor in both rural and urban communities. In many developing countries, there is a lack of ENT specialists and overburdened hospital facilities. To date, there is no comprehensive study that has evaluated the spectrum of ENT disorders in a rural community. Methods. A prospective study was done for a period of three years to profile the cases presenting to the outpatient clinic in a secondary care hospital and in the camps conducted in tribal areas in Vellore District of Tamil Nadu, India. Trained community volunteers were used to identify ENT conditions and refer patients. Results. A total of 2600 patients were evaluated and treated. Otological symptoms were the most commonly reported with allergic rhinitis being the second most commonly reported. Presbycusis was the most common disability reported in the rural community. The other symptoms presented are largely related to hygiene and nutrition. Conclusion. Using trained community workers to spread the message of safe ENT practices, rehabilitation of hearing loss through provision of hearing aids, and the evaluation and surgical management by ENT specialist helped the rural community to access the service.

  20. The effect of certification and accreditation on quality management in 4 clinical services in 73 European hospitals

    Science.gov (United States)

    Shaw, Charles D.; Groene, Oliver; Botje, Daan; Sunol, Rosa; Kutryba, Basia; Klazinga, Niek; Bruneau, Charles; Hammer, Antje; Wang, Aolin; Arah, Onyebuchi A.; Wagner, Cordula; Klazinga, N; Kringos, DS; Lombarts, K; Plochg, T; Lopez, MA; Secanell, M; Sunol, R; Vallejo, P; Bartels, P; Kristensen, S; Michel, P; Saillour-Glenisson, F; Vlcek, F; Car, M; Jones, S; Klaus, E; Garel, P; Hanslik, K; Saluvan, M; Bruneau, C; Depaigne-Loth, A; Shaw, C; Hammer, A; Ommen, O; Pfaff, H; Groene, O; Botje, D; Wagner, C; Kutaj-Wasikowska, H; Kutryba, B; Escoval, A; Franca, M; Almeman, F; Kus, H; Ozturk, K; Mannion, R; Arah, OA; Chow, A; DerSarkissian, M; Thompson, C; Wang, A; Thompson, A

    2014-01-01

    Objective To investigate the relationship between ISO 9001 certification, healthcare accreditation and quality management in European hospitals. Design A mixed method multi-level cross-sectional design in seven countries. External teams assessed clinical services on the use of quality management systems, illustrated by four clinical pathways. Setting and Participants Seventy-three acute care hospitals with a total of 291 services managing acute myocardial infarction (AMI), hip fracture, stroke and obstetric deliveries, in Czech Republic, France, Germany, Poland, Portugal, Spain and Turkey. Main Outcome Measure Four composite measures of quality and safety [specialized expertise and responsibility (SER), evidence-based organization of pathways (EBOP), patient safety strategies (PSS) and clinical review (CR)] applied to four pathways. Results Accreditation in isolation showed benefits in AMI and stroke more than in deliveries and hip fracture; the greatest significant association was with CR in stroke. Certification in isolation showed little benefit in AMI but had more positive association with the other conditions; greatest significant association was in PSS with stroke. The combination of accreditation and certification showed least benefit in EBOP, but significant benefits in SER (AMI), in PSS (AMI, hip fracture and stroke) and in CR (AMI and stroke). Conclusions Accreditation and certification are positively associated with clinical leadership, systems for patient safety and clinical review, but not with clinical practice. Both systems promote structures and processes, which support patient safety and clinical organization but have limited effect on the delivery of evidence-based patient care. Further analysis of DUQuE data will explore the association of certification and accreditation with clinical outcomes. PMID:24615598

  1. Hospital Inspections

    Data.gov (United States)

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

  2. Optical services through outreach in South India: a case study from Aravind Eye Hospitals

    Directory of Open Access Journals (Sweden)

    Ramasamy Meenakshi Sundaram

    2006-06-01

    Full Text Available The need to correct refractive errors Refractive errors are a priority within the global initiative for the elimination of avoidable blindness, VISION 2020: The Right to Sight.1,4 Until recently, refractive errors never figured as a cause of vision impairment or blindness in the surveys; this was probably due to WHO’s categorisation of visual acuity as based on best corrected vision, presumably because of the ease (from a technical perspective with which it can be addressed. Thus refractive errors had not grabbed the attention of policymakers and service providers.

  3. Study on the Performance Evaluation of Modern Hospital Service Management%现代医院服务管理的绩效评价研究

    Institute of Scientific and Technical Information of China (English)

    秦敏春

    2015-01-01

    Objective In the increasingly severe market competition, improve the service management level, enhance the hospital's market competitiveness. MethodsTo establish a set of scientific and effective service management system, which is suitable for the hospital, and can meet the new chalenges and opportunities. ResultsAccording to the hospital's own design of service performance evaluation system, the hospital managers in improving the quality of medical service, strengthening hospital management level, and enhance the hospital's competitiveness has important reference value. Conclusion Strengthening the service management system, the establishment of the service brand, the relationship between doctors and patients can be effectively improved.%目的:在日益严峻的市场竞争中,提高医院的服务管理水平,增强医院的市场竞争力。方法建立一套符合医院实际的完善而科学有效的服务管理体系,才可应对新的挑战与机遇。结果根据医院自身的状况设计的服务绩效评价系统,对医院的管理者在提高医疗服务质量、加强医院管理水平,增强医院的竞争力上具有重要的参考价值。结论加强医院的服务管理体系,创立服务品牌,有效改善医生与患者的关系,才可使医院具有可持续发展性。

  4. Refueling outage services in Spanish Nuclear Power Plants; Servicios en recargas de centrales nucleares

    Energy Technology Data Exchange (ETDEWEB)

    Landete, J. L.; Soto, M.; Nunuez, A.

    2007-07-01

    DOMINGUIS Group, through its 75 years of business development, has positioned as the Spanish leader Group in Services for the Nuclear Energy and Petrochemical Sectors. In this article, we present the most significant services summary that, through the companies that constitute DOMINGUIS Group, we have developed in Refueling Outage in Spanish Nuclear Power Plants. (Author)

  5. Hospital costs of central line-associated bloodstream infections and cost-effectiveness of closed vs. open infusion containers. The case of Intensive Care Units in Italy

    Directory of Open Access Journals (Sweden)

    Torbica Aleksandra

    2010-05-01

    Full Text Available Abstract Objectives The aim was to evaluate direct health care costs of central line-associated bloodstream infections (CLABSI and to calculate the cost-effectiveness ratio of closed fully collapsible plastic intravenous infusion containers vs. open (glass infusion containers. Methods A two-year, prospective case-control study was undertaken in four intensive care units in an Italian teaching hospital. Patients with CLABSI (cases and patients without CLABSI (controls were matched for admission departments, gender, age, and average severity of illness score. Costs were estimated according to micro-costing approach. In the cost effectiveness analysis, the cost component was assessed as the difference between production costs while effectiveness was measured by CLABSI rate (number of CLABSI per 1000 central line days associated with the two infusion containers. Results A total of 43 cases of CLABSI were compared with 97 matched controls. The mean age of cases and controls was 62.1 and 66.6 years, respectively (p = 0.143; 56% of the cases and 57% of the controls were females (p = 0.922. The mean length of stay of cases and controls was 17.41 and 8.55 days, respectively (p Conclusions CLABSI results in considerable and significant increase in utilization of hospital resources. Use of innovative technologies such as closed infusion containers can significantly reduce the incidence of healthcare acquired infection without posing additional burden on hospital budgets.

  6. Gastroenterology service in a teaching hospital in rural New Zealand, 1991-2003

    Institute of Scientific and Technical Information of China (English)

    Michael Schultz; Andrew Davidson; Sarah Donald; Bogna Targonska; Angus Turnbull; Susan Weggery; Vicki Livingstone; John D Dockerty

    2009-01-01

    AIM: To retrospectively collect inpatient and outpatient data and to assess the use of endoscopic procedures during the years 1991, 1997 and 2003 to analyse for trends.METHODS: This retrospective survey was conducted in a University-associated Gastroenterology Unit offering secondary and tertiary health care services for a population of approximately 182 000 people in Southern New Zealand. Data collected included patient contacts (in- and outpatients), gastroscopic and colonoscopic investigations. RESULTS: We observed a significant increase in the absolute numbers of patient contacts over the years (1991: 2308 vs 1997: 2022 vs 2003: 2783, P < 0.0001)with inflammatory bowel disease, other diseases of the colon, anus and rectum and iron studies related disorders decreasing significantly but liver disease and constipation increasing linearly over time. The use of endoscopy services remained relatively stable but colonoscopic investigations for a positive family history of colorectal cancer increased significantly while more gastroscopies were performed for unexplained anaemia.CONCLUSION: The whole spectrum of gastroenterology contacts was studied. A substantial proportion of colonoscopies and outpatient consultations were undertaken to screen for colorectal cancer. This proportion is likely to grow further. Our findings have implications for the recruitment and training of the next generation of gastroenterologists.

  7. Quality Service Analysis and Improvement of Pharmacy Unit of XYZ Hospital Using Value Stream Analysis Methodology

    Science.gov (United States)

    Jonny; Nasution, Januar

    2013-06-01

    Value stream mapping is a tool which is needed to let the business leader of XYZ Hospital to see what is actually happening in its business process that have caused longer lead time for self-produced medicines in its pharmacy unit. This problem has triggered many complaints filed by patients. After deploying this tool, the team has come up with the fact that in processing the medicine, pharmacy unit does not have any storage and capsule packing tool and this condition has caused many wasting times in its process. Therefore, the team has proposed to the business leader to procure the required tools in order to shorten its process. This research has resulted in shortened lead time from 45 minutes to 30 minutes as required by the government through Indonesian health ministry with increased %VA (valued added activity) or Process Cycle Efficiency (PCE) from 66% to 68% (considered lean because it is upper than required 30%). This result has proved that the process effectiveness has been increase by the improvement.

  8. Soil and water related forest ecosystem services and resilience of social ecological system in the Central Highlands of Ethiopia

    Science.gov (United States)

    Tekalign, Meron; Muys, Bart; Nyssen, Jan; Poesen, Jean

    2014-05-01

    In the central highlands of Ethiopia, deforestation and forest degradation are occurring and accelerating during the last century. The high population pressure is the most repeatedly mentioned reason. However, in the past 30 years researchers agreed that the absence of institutions, which could define the access rights to particular forest resources, is another underlying cause of forest depletion and loss. Changing forest areas into different land use types is affecting the biodiversity, which is manifested through not proper functioning of ecosystem services. Menagesha Suba forest, the focus of this study has been explored from various perspectives. However the social dimension and its interaction with the ecology have been addressed rarely. This research uses a combined theoretical framework of Ecosystem Services and that of Resilience thinking for understanding the complex social-ecological interactions in the forest and its influence on ecosystem services. For understanding the history and extent of land use land cover changes, in-depth literature review and a GIS and remote sensing analysis will be made. The effect of forest conversion into plantation and agricultural lands on soil and above ground carbon sequestration, fuel wood and timber products delivery will be analyzed with the accounting of the services on five land use types. The four ecosystem services to be considered are Supporting, Provisioning, Regulating, and Cultural services as set by the Millennium Ecosystem Assessment. A resilience based participatory framework approach will be used to analyze how the social and ecological systems responded towards the drivers of change that occurred in the past. The framework also will be applied to predict future uncertainties. Finally this study will focus on the possible interventions that could contribute to the sustainable management and conservation of the forest. An ecosystem services trade-off analysis and an environmental valuation of the water

  9. Benefit of hospital pharmacy intervention on the current status of dry powder inhaler technique in patients with asthma and COPD: a study from the Central Development Region, Nepal

    Directory of Open Access Journals (Sweden)

    Poudel RS

    2016-12-01

    Full Text Available Ramesh Sharma Poudel,1 Rano Mal Piryani,2 Shakti Shrestha,3 Aastha Prajapati1 1Hospital Pharmacy, 2Department of Internal Medicine, Chitwan Medical College Teaching Hospital, 3Department of Pharmacy, Shree Medical and Technical College, Chitwan, Nepal Background: The majority of patients with asthma and chronic obstructive pulmonary disease (COPD have been known to perform inhaler technique inadequately. We aimed to evaluate the benefit of hospital pharmacy intervention on the current status of dry powder inhaler (Rotahaler® technique in such patients and the factors associated with the correct use. Methods: A pre–post interventional study was conducted at the outpatient pharmacy in a teaching hospital of the Central Development Region, Nepal, in patients with asthma and COPD currently using a Rotahaler device. Patients’ demographics and Rotahaler technique were assessed before intervention. Those who failed to demonstrate the correct technique were educated and trained by the pharmacist, and their technique was reassessed after 2 weeks of intervention. Descriptive statistics, including Wilcoxon signed rank test, Mann–Whitney U test, Spearman’s correlations and Kruskal–Wallis test, were performed for statistical analysis. Results: Before intervention, only 5.7% (10 of 174 of the patients demonstrated the correct Rotahaler technique and the most common errors observed were failure to breathe out gently before inhalation (98.8% and failure to hold breath for about 10 seconds after inhalation (84.8%. After the intervention (n=164, 67.1% of the patients showed their technique correctly (p≤0.001 and failure to breathe out gently before inhalation was the most common error (27.44%. Age (p=0.003, previous instruction (p=0.007, patient’s education level (p=0.013 and source of instruction (p<0.001 were associated with an appropriate technique before intervention, while age (p=0.024, duration of therapy (p=0.010 and gender (p=0.008 were

  10. Tenosinovitis piógena flexora de la mano: experiencia en el Hospital Universitario Central de Asturias

    Directory of Open Access Journals (Sweden)

    Irene García-Martínez

    Full Text Available Introducción y Objetivos. La tenosinovitis piógena flexora de la mano es una infección severa de los tejidos blandos de la mano. Se asocia a secuelas funcionales graves que varían desde rigideces de las articulaciones interfalángicas y metacarpofalángicas hasta la necesidad de amputaciones digitales. La rapidez en la instauración de tratamiento antibiótico endovenoso de amplio espectro y el drenaje quirúrgico urgente son las claves para minimizar la aparición de secuelas. Nuestro objetivo es estudiar las características de los pacientes con dicha patología en nuestro medio. Material y método. Presentamos un estudio retrospectivo de 24 casos de infección de la vaina sinovial flexora diagnosticados y tratados por el Servicio de Cirugía Plástica del Hospital Universitario Central de Asturias (Oviedo, España durante un periodo de 8 años. Resultados. Los dedos más afectados fueron el índice y el medio y en todos los casos estuvo presente alguno de los 4 signos de Kanavel. Un 71% de nuestros pacientes precisó intervención quirúrgica urgente: 88% drenaje abierto, 76% abordaje volar tipo Bruner, 6% abordaje mediolateral longitudinal, y otro 6% desbridamiento amplio incluyendo piel. Los demás fueron tratados con antibioticoterapia endovenosa de amplio espectro, inmovilización y elevación de la extremidad afecta. En todos los casos se realizó lavado intraoperatorio con suero salino y/o antiséptico, y en el 65% irrigación postoperatoria continua. El germen más frecuénteme aislado fue Staphylococus aureus si bien en el 75% de los casos no se obtuvo crecimiento microbiológico. La media de estancia hospitalaria fue de 7.3 días. Todos siguieron rehabilitación precoz; el 42% lograron recuperación completa, el 29% sufrió limitación de extensión y el 16% déficit de flexio-extensión del dedo afecto. Conclusiones. Nuestros hallazgos ponen de manifiesto que la tenosinovitis piógena flexora es una patología poco frecuente en

  11. Patologías tratadas con oxigenoterapia hiperbárica en el Hospital Central de la Defensa

    Directory of Open Access Journals (Sweden)

    J.M. Torres León

    2015-06-01

    Full Text Available Introducción: La oxigenoterapia hiperbárica (OHB es una modalidad terapéutica que se fundamenta en la obtención de presiones parciales de oxígeno elevadas en sangre, al respirar oxígeno puro, en el interior de una cámara hiperbárica a una presión superior a la atmosférica. Sus acciones incluyen efectos hemodinámicos, acciones sobre la inmunidad y el transporte de O2. Este amplio espectro de efectos facilita que sus recomendaciones puedan incluir una gran variedad de indicaciones, algunas de ellas controvertidas. Objetivos: Conocer las patologías de los pacientes tratados con OHB en la Comunidad Autónoma de Madrid (CAM y revisar la evidencia científica al respecto. Método: En la actualidad la cámara hiperbárica del Servicio de MSB (Medicina Subacuática del HCD (Hospital Central de la Defensa es la de referencia en la CAM. Se revisaron las historias clínicas de los pacientes atendidos entre Febrero 2013 y Junio 2014. Se recogieron las siguientes variables: 1 Enfermos aceptados y desestimados para el tratamiento. 2 Edad y sexo de los pacientes tratados. 3 Patología por la que se indicaba el tratamiento. 4 Complicaciones observadas en relación con la OHB. Resultados: Se aceptaron para tratamiento 113 enfermos procedentes de 15 Hospitales de la CAM. Se desestimaron para tratamiento con OHB a 22 pacientes por patologías o tratamientos activos que no hacían aconsejable el tratamiento con OHB en ese momento. El 59,82 % eran hombres y el 40,18 % mujeres. Edad media 64,72 años. Las indicaciones principales de tratamiento fueron las lesiones radio inducidas 52,21 % de los casos (n=59 y las úlceras y heridas de evolución tórpida con mala respuesta a tratamiento convencional 23 % de los casos (n=26. El tratamiento tuvo que ser suspendido en 8 pacientes (7,14 % de los tratados por mala tolerancia o complicaciones leves. Discusión y conclusiones: Las indicaciones de OHB en nuestra muestra comprenden un amplio número de patolog

  12. Discussion on a Public Hospital's Practice in Culture Shaping and Innovative Development.

    Science.gov (United States)

    Zhang, Peiying

    2015-05-01

    Culture shaping is an important part of a hospital's quality management to enhance its medical service, improve doctor-patient relations, and cement its brand image (Jianping and Hong in Chinese Hospital Management 29(1):36-37, 2009). First built in 1953, Xuzhou Central Hospital is a tertiary general hospital in the Huaihai Economic Zone and has won a series of honorary titles for its reforms, innovations, and the level of medical services provided. In recent years, the hospital has increased its efforts in culture shaping through the construction of special departments, medical services, hospital culture, and professional ethics. This has resulted in substantial progress in the hospital's medical capabilities and service quality, and laid a solid foundation to achieve its ambitious goal of becoming a nationally prestigious hospital, among the best in Jiangsu and a regional healthcare center in the Huaihai Economic Zone.

  13. [Hi-tech center of outpatient care (To the 40th anniversary of the Branch N 6 of the Vishnevsky Central military clinical hospital N 3)].

    Science.gov (United States)

    Popov, A P

    2015-10-01

    The authors present the history of the branch N 6 of the Federal States Organization "the Vishnevsky Central Military Clinical Hospital N 3" of the Ministry of Defense of the Russian Federation, which dates back to November 1, 1974. Over the past years, organizational and staff structure; and the name of the clinic (45th central polyclinic, 45th central consultative-diagnostic polyclinic, 52nd Advisory Diagnostic Center of Defense) has repeatedly changed, but the core the work stays unchangeable--to continually improve patient care technology, to be the leader in the outpatient care for soldiers, reserve officers (retired), members of their families. The. branch consists of 58 medical and 19 specialized diagnostic departments, including 4 hospital departments, 1845 employee work at the branch. Among them 4 doctors of medical science and 43 candidates of medical sciences, 20 honoured physicians and 10 honoured health workers of republic. 70% of doctors and 93% of nurses have the highest qualification category. To health care in the Branch are more than 110 thousand people.

  14. The evaluation of time performance in the emergency response center to provide pre-hospital emergency services in Kermanshah.

    Science.gov (United States)

    Mohammadi, Mohsen; Nasiripour, Amir Ashkan; Fakhri, Mahmood; Bakhtiari, Ahad; Azari, Samad; Akbarzadeh, Arash; Goli, Ali; Mahboubi, Mohammad

    2014-09-28

    This study evaluated the time performance in the emergency response center to provide pre-hospital emergency services in Kermanshah. This study was a descriptive retrospective cross-sectional study. In this study 500 cases of patients from Shahrivar (September) 2012 to the end of Shahrivar (September) 2013 were selected and studied by the non-probability quota method. The measuring tool included a preset cases record sheet and sampling method was completing the cases record sheet by referring to the patients' cases. Data were analyzed using SPSS version 18 and the concepts of descriptive and inferential statistics (Kruskal-Wallis test, benchmark Eta (Eta), Games-Howell post hoc test). The results showed that the interval mean between receiving the mission to reaching the scene, between reaching the scene to moving from the scene, and between moving from the scene to a health center was 7.28, 16.73 and 7.28 minutes. The overall mean of time performance from the scene to the health center was 11.34 minutes. Any intervention in order to speed up service delivery, reduce response times, ambulance equipment and facilities required for accuracy, validity and reliability of the data recorded in the emergency dispatch department, Continuing Education of ambulance staffs, the use of manpower with higher specialize levels such as nurses, supply the job satisfaction, and increase the coordination with other departments that are somehow involved in this process can provide the ground for reducing the loss and disability resulting from traffic accidents.

  15. Quality assessment of child care services in primary health care settings of Central Karnataka (Davangere District

    Directory of Open Access Journals (Sweden)

    Rashmi

    2010-01-01

    Full Text Available Background: Infectious disease and malnutrition are common in children. Primary health care came into being to decrease the morbidity. Quality assessment is neither clinical research nor technology assessment. It is primarily an administrative device used to monitor performance to determine whether it continues to remain within acceptable bounds. Aims and Objectives: To assess the quality of service in the delivery of child health care in a primary health care setting. To evaluate client satisfaction. To assess utilization of facilities by the community. Materials and Methods: Study Type: Cross-sectional community-based study. Quality assessment was done by taking 30-50%, of the service provider. Client satisfaction was determined with 1 Immunization and child examination-90 clients each. Utilization of services was assessed among 478 households. Statistical Analysis: Proportions, Likert′s scale to grade the services and Chi-square. Results: Immunization service: Identification of needed vaccine, preparation and care was average. Vaccination technique, documentation, EPI education, maintenance of cold chain and supplies were excellent. Client satisfaction was good. Growth monitoring: It was excellent except for mother′s education andoutreach educational session . Acute respiratory tract infection care: History, physical examination, ARI education were poor. Classification, treatment and referral were excellent. Client satisfaction was good. Diarrheal disease care: History taking was excellent. But examination, classification, treatment, ORT education were poor. Conclusion: Mothers education was not stressed by service providers. Service providers′ knowledge do not go with the quality of service rendered. Physical examination of the child was not good. Except for immunization other services were average.

  16. Prevalence of delirium in hospitalized patients from an internal medicine service

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    Ana Carolina González Pezoa

    2015-12-01

    Full Text Available INTRODUCCIÓN El delirium es un síndrome neurocognitivo frecuente en pacientes hospitalizados, que se asocia en forma categórica e independiente a peores resultados globales en quienes lo presentan. A pesar de esto, suele ser subvalorado y no reconocido como un cuadro que requiere un manejo específico, independiente de la causa que lo origina. OBJETIVOS Determinar la tasa de prevalencia de delirium en los pacientes ingresados a un servicio de medicina y, secundariamente, el subdiagnóstico del cuadro por parte del médico tratante, residente o interno de medicina. MÉTODOS Estudio observacional descriptivo realizado en el Servicio de Medicina del Hospital Dr. Eduardo Pereira a los 125 pacientes ingresados entre el 12 de abril y 12 mayo de 2014. A través de la herramienta diagnóstica Confusion Assessment Method Instrument, se determinó la tasa de prevalencia del delirium y de casos subdiagnosticados. RESULTADOS Ciento dos pacientes cumplieron los criterios de inclusión. De éstos, 19 (18,6% pacientes fueron diagnosticados con delirium. En el grupo de pacientes diagnosticados, 13 (68,4% eran de sexo femenino. El subdiagnóstico se presentó en ocho pacientes (42,1%. CONCLUSIONES La prevalencia de delirium en este centro está dentro de lo esperable, según la literatura. Considerando la disponibilidad de herramientas para realizar su diagnóstico, es necesario instruir al equipo de salud para mejorar el reconocimiento y manejo de este cuadro dada su importancia pronóstica.

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

    Directory of Open Access Journals (Sweden)

    Slimane Semghouli

    2015-09-01

    Full Text Available Purpose: To evaluate the effective dose received per radiological examination per patient and the additional cancer risk factor in the Radiological Service of Al Faraby Hospital in 2012. Methods: From the number of radiological procedures (NX made in 2012 in the radiology service of Al Faraby Hospital and the average effective dose DEX associated with each type of act exam X, it is possible to calculate the effective dose collective [S =∑ DEX * NX]. The additional cancer risk factor is calculated by the X-ray risk software promoting responsible imaging through patient and provider education. It is function of the effective dose received, the age at the time of exam, and gender of patient. Results: The radiological average effective dose received per act exam is 1 millisievert (mSv, whereas it is 4.45 mSv and 0.21 mSv for the computed tomography (CT scan and conventional radiological examinations, respectively. As for the average number of acts per patient 2.66, the effective dose is 1.16 mSv and 3.8 mSv for CT scan and conventional radiological examinations, respectively. As for the average effective dose per patient 2.69 mSv, it is 5.16 mSv and 0.81 mSv for CT scan and conventional radiological examinations, respectively. As for the additional cancer risk in 40 years at the time of exam, the average additional cancer risk is equal to 2.17 × 10-4, wheras the risk is 4.17 × 10-4 and 6.54 × 10-5 for CT scan and conventional radiological examinations, respectively. Conclusion: Medical exposure related to the diagnosis of patients in the radiology service in 2012 can be characterized by: (a 2.66 Act exams on average per patient diagnosis corresponding to a mean effective dose equal to 2.69 mSv per patient, (bfrequency of conventional radiology and CT scan was 81% and 19%, respectively. These act exams contribute to the collective effective dose by 17% and 83%, respectively, and (c radiological acts can be divided into three levels of exposures

  18. Political and cultural factors in achieving continuity with a primary health care provider at an Indian Health Service hospital.

    Science.gov (United States)

    Dietrich, A J; Olson, A L

    1981-01-01

    A primary care system was established at Zuni-Ramah Indian Health Service Hospital and clinic in New Mexico. Continuity and coordination of care were added to a health care system that was already accountable, accessible, and comprehensive. The new system offered each patient a personal health care provider who worked as a member of a multidisciplinary team. In changing the health care system, special attention was given to its cultural and political setting, the village of Zuni. After thorough discussion with community and staff, community members' concerns about patients' privacy and free choice were better understood, and special efforts were made to safeguard them. Ongoing evaluation is essential to maintain continuity. Eight months after the primary care system was begun, 64 percent of patients who came for care had established a personal relationship with a health care provider. For 59 percent of the visits during the 1-month evaluation period, patients saw their regular provider and, for 82 percent, patients saw their provider or one of his or her team colleagues. These percentages include night and walk-in visits. The system required no extra funding or staff. The political process of planning and consultation helped anticipate and alleviate the community's concerns, but resistance from physician's assistants and some physicians was unexpected. A flexible approach has led to a gradual acceptance of this voluntary system. This experience with the people of Zuni village shows that a primary care system can be started in a rural Indian Health Service facility with minimal outside help. Apparent improvements in quality of care make the continuity of primary care worthy of further consideration in the IHS and similar health services systems.

  19. Role of Surgical Services in Profitability of Hospitals in California: An Analysis of Office of Statewide Health Planning and Development Annual Financial Data.

    Science.gov (United States)

    Moazzez, Ashkan; de Virgilio, Christian

    2016-10-01

    With constant changes in health-care laws and payment methods, profitability, and financial sustainability of hospitals are of utmost importance. The purpose of this study is to determine the relationship between surgical services and hospital profitability. The Office of Statewide Health Planning and Development annual financial databases for the years 2009 to 2011 were used for this study. The hospitals' characteristics and income statement elements were extracted for statistical analysis using bivariate and multivariate linear regression. A total of 989 financial records of 339 hospitals were included. On bivariate analysis, the number of inpatient and ambulatory operating rooms (ORs), the number of cases done both as inpatient and outpatient in each OR, and the average minutes used in inpatient ORs were significantly related with the net income of the hospital. On multivariate regression analysis, when controlling for hospitals' payer mix and the study year, only the number of inpatient cases done in the inpatient ORs (β = 832, P = 0.037), and the number of ambulatory ORs (β = 1,485, 466, P = 0.001) were significantly related with the net income of the hospital. These findings suggest that hospitals can maximize their profitability by diverting and allocating outpatient surgeries to ambulatory ORs, to allow for more inpatient surgeries.

  20. Revisiting the role of a service-Day Hospital in infectious diseases, based on the natural history of HIV infection in the era of potent antiretroviral combination therapy

    Directory of Open Access Journals (Sweden)

    Roberto Manfredi

    2010-03-01

    Full Text Available On the ground of the analysis of health care assistance performed by an Infectious Diseases Day-Hospital outpatient service operating in a metropolitan area during a 15-year-old time, we assess the evolution of referred disorders, in order to plan eventual future remodeling of the service and structure organization and performances, based one the present and evolving epidemiology of infectious diseases.

  1. Serviço de Emergência Psiquiátrica em hospital geral: estudo retrospectivo Servicio de emergencia psiquiátrica en hospital general: estudio retrospectivo Emergency psychiatric service in general hospitals: a retrospective study

    Directory of Open Access Journals (Sweden)

    Fernando Sérgio Pereira de Sousa

    2010-09-01

    SEPHG, 43,45% de tales pacientes fueron derivados al CAPS-ad. Se desprende de los resultados cuán imprescindibles son los servicios de salud mental.The Emergency Psychiatric Service in General Hospitals (SEPHG, acronym in Portuguese is a service included in the psychiatric reform movement. The purpose of the present study was to characterize patients with psychological distress treated at the Dr. Estevam SEPHG, located in Sobral, Ceará state. This exploratory study was performed using documental analyses with a quantitative approach, and involved 191 clients treated at the referred SEPHG from January to December 2007. Data collection was performed using a client register book, which contained information obtained from the patients' medical record. There was a predominance of male patients (70.15%, aged 30-49 years (48.71% and single (74.86%. Most patients were from the city of Sobral (69.64%. In 42.40% of cases, the diagnosis was of alcohol use/abuse. Most clients (66.50% sought the service voluntarily. After being evaluated at the SEPHG, 43.45% of patients were referred to the local Center for Psychosocial Care -Alcohol and other Drugs. The results emphasize the importance of mental health.

  2. Immediate impact of 'penalty points legislation' on acute hospital trauma services.

    LENUS (Irish Health Repository)

    Lenehan, Brian

    2012-02-03

    Road traffic accident (RTA) related mortality and injury may be reduced by up to 40% with the introduction of \\'road safety\\' legislation. Little is known regarding changes in pattern of injury and overall resource impact on acute trauma services. This prospective study examines RTA related admissions, injuries sustained and resultant sub-speciality operative workload in a Level 1 Trauma Centre during the 12 months immediately prior to and following the introduction of \\'penalty points\\' legislation. Eight hundred and twenty RTA related admissions were identified over the 24-month period from 01\\/11\\/2001 to 31\\/10\\/2003. There was a 36.7% decrease in RTA related admissions subsequent to the introduction of new legislation. Bed occupancy was almost halved. However, the relative Orthopaedic workload increased from 34% to 41% with a 10% increase in relative bed occupancy. The pattern of orthopaedic injury was significantly altered with a >50% absolute reduction in high velocity injuries. Curiously, there was no change in the absolute number of spinal fractures seen. This favourable early Irish experience of \\'penalty points\\' legislation mirrors that of worldwide published literature. Our findings demonstrate that the injury reduction effects were primarily enjoyed by non-orthopaedic sub-specialities. Such findings mandate consideration when allocating vital resources to sub-specialities within busy trauma units.

  3. Sulfato de magnesio y respuesta hemodinámica en laringoscopia e intubación endotraqueal. Hospital Militar Central 2015

    OpenAIRE

    Rojas Farfán, Gissela Roxana

    2015-01-01

    Objetivos: Identificar los efectos del sulfato de magnesio en la respuesta hemodinámica durante la laringoscopia e intubación endotraqueal en pacientes sometidos a anestesia general en el Hospital Militar Central del Perú durante el periodo setiembre - octubre del 2015. Material y Métodos: Estudio de cohortes, retrospectivo, analítico, cuantitativo y no experimental en 60 pacientes sometidos a cirugía electiva bajo anestesia general; divididos en dos grupos: un grupo recibió 10 mg/kg de sulfa...

  4. Urban women's socioeconomic status, health service needs and utilization in the four weeks after postpartum hospital discharge: findings of a Canadian cross-sectional survey

    Directory of Open Access Journals (Sweden)

    Ciliska Donna

    2008-10-01

    Full Text Available Abstract Background Postpartum women who experience socioeconomic disadvantage are at higher risk for poor health outcomes than more advantaged postpartum women, and may benefit from access to community based postpartum health services. This study examined socioeconomically disadvantaged (SED postpartum women's health, and health service needs and utilization patterns in the first four weeks post hospital discharge, and compared them to more socioeconomically advantaged (SEA postpartum women's health, health service needs and utilization patterns. Methods Data collected as part of a large Ontario cross-sectional mother-infant survey were analyzed. Women (N = 1000 who had uncomplicated vaginal births of single 'at-term' infants at four hospitals in two large southern Ontario, Canada cities were stratified into SED and SEA groups based on income, social support and a universally administered hospital postpartum risk screen. Participants completed a self-administered questionnaire before hospital discharge and a telephone interview four weeks after discharge. Main outcome measures were self-reported health status, symptoms of postpartum depression, postpartum service needs and health service use. Results When compared to the SEA women, the SED women were more likely to be discharged from hospital within the first 24 hours after giving birth [OR 1.49, 95% CI (1.01–2.18], less likely to report very good or excellent health [OR 0.48, 95% CI (0.35–0.67], and had higher rates of symptoms of postpartum depression [OR 2.7, 95% CI(1.64–4.4]. No differences were found between groups in relation to self reported need for and ability to access services for physical and mental health needs, or in use of physicians, walk-in clinics and emergency departments. The SED group were more likely to accept public health nurse home visits [OR 2.24, 95% CI(1.47–3.40]. Conclusion Although SED women experienced poorer mental and overall health they reported similar

  5. A mixed-methods approach to conducting Internal Revenue Service-compliant community health needs assessments: a case example for nonprofit hospital leaders

    Directory of Open Access Journals (Sweden)

    Oglesby WH

    2014-10-01

    Full Text Available Willie H Oglesby, Ken Slenkovich Department of Health Policy and Management, College of Public Health, Kent State University, Kent, OH, USA Background: The Patient Protection and Affordable Care Act created new requirements for nonprofit hospitals to conduct a Community Health Needs Assessment (CHNA at least once every 3 years, with a significant tax penalty for noncompliance. While some resources exist to help nonprofit hospital leaders conduct various aspects of a CHNA, few reflect the new Internal Revenue Service requirements. Methods: Many different models of CHNAs have emerged over the years. Although each has its unique features, the essential elements of a CHNA include engaging stakeholders, defining the community, gathering sufficient representative data, prioritizing information, and reporting results. In this paper, we expand upon this basic approach by offering a practical step-by-step guide to conducting CHNAs that meets new Internal Revenue Service regulations. Results: We developed and tested this methodology in partnership with several nonprofit hospital systems in Northeast Ohio, USA. In this paper, we discuss our use of the methodology and identify recommendations for other nonprofit hospital leaders. Conclusion: The methodology presented in this paper is a cost-effective approach to satisfying new CHNA requirements and nonprofit hospital leaders should consider using it or modifying it to fit their unique needs. Keywords: Affordable Care Act, CHNA, community benefit, community hospital

  6. "Feed from the Service": Corruption and Coercion in the State--University Relations in Central Eurasia

    Science.gov (United States)

    Osipian, Ararat L.

    2007-01-01

    Education in Central Eurasia has become one of the industries, most affected by corruption. Corruption in academia, including bribery, extortions, embezzlement, nepotism, fraud, cheating, and plagiarism, is reflected in the region's media and addressed in few scholarly works. This paper considers corruption in higher education as a product of…

  7. The Central Information Services Function in County Governments: From Controller to Enabler.

    Science.gov (United States)

    Fletcher, Patricia T.; Bertot, John Carlo

    1994-01-01

    Discussion of the role of county government regarding the management of information technology focuses on a national study of the centralized management of information technology that was conducted to identify practices; assess benefits, costs, and constraints; enumerate critical success factors; and identify future challenges. (Contains 12…

  8. [The Mini Nutritional Assessment of the elderly in the practice of a hospital geriatrics service: inception, validation and operational characteristics].

    Science.gov (United States)

    Cuyac Lantigua, Magdalena; Santana Porbén, Sergio

    2007-09-01

    The results of the administration of the Mini Nutritional Assessment (MNA) of the Elderly to 197 patients (Women: 62.5%; Ages between 60-75 years: 55.4%; Older than 85 years: 9.7%; Whites: 73.7%) consecutively admitted to the Geriatrics Service of the "Hermanos Ameijeiras" Hospital (La Habana, Cuba) are presented. Sixty-nine percent of the patients had between 2 - 7 concurrent health problems. Neoplasms and lymphoproliferative processes (22.8%), heart and blood vessels diseases (15.7%), and infections (12.2%) were prevalent. The state of nutritional anthropometric and biochemical markers was as follows: Body Mass Index < 21 kg x m(-2): 30.9%; Mid-arm Circumference <22 cm: 19.3%; Leg Circumference <31 cm: 42.6%; Serum Albumin <35 g x L(-1): 20.3%. Sixty-eight percent of the patients received scores <24 after administering the MNA. It is to be noticed that 19.3% of the patients was malnourished after receiving scores < 17. MNA scores <24 were concentrated in: Neurological disorders (80.0%), Neoplasms and lymphoproliferative processes (77.8%), heart and blood vessels diseases (74.2%), gastrointestinal disorders (70.6%), infections (69.7%), Diabetes mellitus (66.7%). Patients with the lowest scores also exhibited the lowest values of anthropometric and biochemical markers. MNA score was independent from the patient's sex, skin colour, or number of concurrent health problems. Age had not any influence upon MNA score, although lower scores were observed among the oldest patients. MNA scoring was 80.0% coincident with nutritional diagnosis independently done with anthropometric and biochemical markers used either separately or combined. Aging of the Cuban population, along with increased proportions of elder patients in hospital areas should lead to consider the nutritional status of patients older than 60 years as an important predictor of the success of medical interventions and the quality of medical assistance.

  9. The EASTR Study: indications for transfusion and estimates of transfusion recipient numbers in hospitals supplied by the National Blood Service.

    Science.gov (United States)

    Wells, A W; Llewelyn, C A; Casbard, A; Johnson, A J; Amin, M; Ballard, S; Buck, J; Malfroy, M; Murphy, M F; Williamson, L M

    2009-12-01

    This study provides data on National Blood Service (NBS) red blood cell (RBC, n = 9142), platelet (PLT, n = 4232) and fresh frozen plasma (FFP, n = 3584) recipients independently sampled by monthly quota from 29 representative hospitals over 12 months in 2001-2002. Hospitals were stratified by size according to total yearly RBC issues. Transfusion indications were chosen from diagnostic and procedural codes, and recipients grouped into Epidemiology and Survival of Transfusion Recipients Case-mix Groups (E-CMGs). The main E-CMGs were digestive [19% of RBC recipients; including 5% gastrointestinal (GI) bleeds and 3% colorectal surgery], musculoskeletal (15%; 12% hip and knee replacement), haematology (13%) and obstetrics and gynaecology (10%). Renal failure, fractured neck of femur, cardiac artery by-pass grafting (CABG) and paediatrics, each accounted for 3-4% recipients. FFP recipients: the main E-CMGs were digestive (21% of FFP recipients; including 7% GI bleeds and 3% colorectal surgery), hepatobiliary (15%; 7% liver disease and 2% liver transplant), cardiac (12%) and paediatrics (9%) The renal, paediatrics, vascular and haematology E-CMGs each had 6-7% of recipients. PLT recipients: the main E-CMGs were haematology (27% of PLT recipients; including 9% lymphoma and 8% acute leukaemia), cardiac (17%), paediatrics (13%), hepatobiliary (10%) and digestive (9%). Back-weighting gave national estimates of 433 000 RBC, 57 500 FFP and 41 500 PLT recipients/year in England and North Wales, median age 69, 64 and 59 years, respectively. Digestive and hepatobiliary indications emerged as the top reason for transfusion in RBC and FFP recipients, and was also a frequent indication in PLT recipients.

  10. The association between effectiveness of the management processes and quality of health services from the perspective of the managers in the university hospitals of Ahvaz, Iran.

    Science.gov (United States)

    Faraji-Khiavi, F; Ghobadian, S; Moradi-Joo, E

    2015-01-01

    Background and Objective: Knowledge management is introduced as a key element of quality improvement in organizations. There was no such research in university hospitals of Ahvaz. This study aimed to determine the association between the effectiveness of the processes of knowledge management and the health services quality from the managers' view in the educational hospitals of Ahvaz city. Materials and Methods: in this correlational and research, the research population consisted of 120 managers from hospitals in University of Medical Sciences Ahvaz. Due to the limited population, the census was run. Three questionnaires were used for data collection: Demographic characteristics, the effectiveness of knowledge management processes and the quality of medical services. To analyze the data, the Spearman association analysis, The Kruskal-Wallis, the Mann-Whitney U test, were used in SPSS. Results: estimation of average scoring of the effectiveness of knowledge management processes and its components were relatively appropriate. Quality of medical services was estimated as relatively appropriate. Relationship of quality of health services with the effectiveness of knowledge management processes showed a medium and positive correlation (p quality. To improve the health care quality in university hospitals, managers should pay more attention to develop the cultures of innovation, encourage teamwork, and improve communication and creative thinking in the knowledge management context.

  11. The Effects of Temporary Services and Contracting Out on Low-Skilled Workers: Evidence from Auto Suppliers, Hospitals, and Public Schools. Staff Working Paper.

    Science.gov (United States)

    Erickcek, George; Houseman, Susan; Kalleberg, Arne

    A study examined why employers use temporary agency and contract company workers and implications of these practices for wages, benefits, and working conditions of workers in low-skilled labor markets. Case studies in manufacturing (automotive supply), services (hospitals), and public sector (primary and secondary schools) industries defined the…

  12. Nuclear relations with administrations of industry services; Relaciones de las centrales nucleares con las administraciones de los Servicios de Industria

    Energy Technology Data Exchange (ETDEWEB)

    Bernardez Garcia, A.

    2011-07-01

    The object of the article is to try to answer to the following question that can arise to the holder of a nuclear power station: What Administration of Industry must I myself direct to be able to support my complementary facilities of Industrial Security inside the in force legality?. The raised discussion arise between if the competent administration for the legal steps, is the Central Administration across his delegates and sub delegates of government, or is of the Territorial Services of Industry of Autonomous communities. (Author)

  13. Challenges to Providing a Successful Central Configuration Service to Support CERN’s New Controls Diagnostics and Monitoring System

    CERN Document Server

    Makonnen, Z; Zaharieva, Z

    2014-01-01

    The Controls Diagnostic and Monitoring service (DIAMON) provides monitoring and diagnostics tools to the operators in the CERN Control Centre. A recent reengineering presented the opportunity to restructure its data management and to integrate it with the central Controls Configuration Service (CCS). The CCS provides the Configuration Management for the Controls System for all accelerators at CERN. The new facility had to cater for the configuration management of all agents monitored by DIAMON, (>3000 computers of different types), provide deployment information, relations between metrics, and historical information. In addition, it had to be integrated into the operational CCS, while ensuring stability and data coherency. An important design decision was to largely reuse the existing infrastructure in the CCS and adapt the DIAMON data management to it e.g. by using the device/property model through a Virtual Devices framework to model the DIAMON agents. This article will show how these challenging requiremen...

  14. The long-term hospitalization experience following military service in the 1991 Gulf War among veterans remaining on active duty, 1994–2004

    Directory of Open Access Journals (Sweden)

    Smith Besa

    2008-02-01

    Full Text Available Abstract Background Despite more than a decade of extensive, international efforts to characterize and understand the increased symptom and illness-reporting among veterans of the 1991 Gulf War, concern over possible long-term health effects related to this deployment continue. The purpose of this study was to describe the long-term hospitalization experience of the subset of U.S. Gulf War veterans still on active duty between 1994 and 2004. Methods Gulf War veterans on active duty rosters as of October 1, 1994, were identified (n = 211 642 and compared with veterans who had separated from military service and then assessed for attrition at three-year intervals during a 10-year follow-up period, examining demographic and military service characteristics, Gulf War exposure variables, and hospitalization data. Cox proportional hazard modeling was used to evaluate independent predictors of all-cause hospitalization among those still on active duty and to estimate cumulative probability of hospitalization, 1994–2004, by service branch. Results Members of our 1994 active duty cohort were more likely to be officers, somewhat older, and married compared with those who had separated from the military after serving in the 1991 Gulf War. Selected war-related exposures or experiences did not appear to influence separation with the exception of in-theater presence during the brief ground combat phase. Overall the top three diagnostic categories for hospitalizations were musculo-skeletal, injury and poisoning, and digestive disorders. Diseases of the circulatory system and symptoms, signs, and ill-defined conditions increased proportionately over time. In-theater hospitalization was the only significant independent predictor of long-term hospitalization risk among selected war-related exposures or experiences examined. The cumulative probability of hospitalization was highest for Army and lowest for Marines. Conclusion Our results were generally consistent

  15. Assessing the efficacy of LGBT cultural competency training for aging services providers in California's central valley.

    Science.gov (United States)

    Leyva, Valerie L; Breshears, Elizabeth M; Ringstad, Robin

    2014-01-01

    This study reviews the outcomes of a cultural competency training for aging services providers regarding lesbian, gay, bisexual, and transgender (LGBT) older adults. Results indicate that participants significantly increased their knowledge, skills, and positive attitudes about working with LGBT older adults, with men and non-LGBT individuals reporting the most gain. Recommendations for future research include determining which factors influence the enduring effects of this type of training and developing a standardized instrument for measuring such success. Legislative and policy changes targeted at requiring this type of cultural competency training for all direct service providers are considered.

  16. Community hospitals – the place of local service provision in a modernising NHS: an integrative thematic literature review

    Directory of Open Access Journals (Sweden)

    Heaney David

    2006-12-01

    Full Text Available Abstract Background Recent developments within the United Kingdom's (UK health care system have re-awakened interest in community hospitals (CHs and their role in the provision of health care. This integrative literature review sought to identify and assess the current evidence base for CHs. Methods A range of electronic reference databases were searched from January 1984 to either December 2004 or February 2005: Medline, Embase, Web of Knowledge, BNI, CINAHL, HMIC, ASSIA, PsychInfo, SIGLE, Dissertation Abstracts, Cochrane Library, Kings Fund website, using both keywords and text words. Thematic analysis identified recurrent themes across the literature; narrative analyses were written for each theme, identifying unifying concepts and discrepant issues. Results The search strategy identified over 16,000 international references. We included papers of any study design focussing on hospitals in which care was led principally by general practitioners or nurses. Papers from developing countries were excluded. A review of titles revealed 641 potentially relevant references; abstract appraisal identified 161 references for review. During data extraction, a further 48 papers were excluded, leaving 113 papers in the final review. The most common methodological approaches were cross-sectional/descriptive studies, commentaries and expert opinion. There were few experimental studies, systematic reviews, economic studies or studies that reported on longer-term outcomes. The key themes identified were origin and location of CHs; their place in the continuum of care; services provided; effectiveness, efficiency and equity of CHs; and views of patients and staff. In general, there was a lack of robust evidence for the role of CHs, which is partly due to the ad hoc nature of their development and lack of clear strategic vision for their future. Evidence for the effectiveness and efficiency of the services provided was limited. Most people admitted to CHs

  17. Hospital Outpatient PPS Partial Hospitalization Program LDS

    Data.gov (United States)

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

  18. Mapping Ecosystem Services for Land Use Planning, the Case of Central Kalimantan

    NARCIS (Netherlands)

    Sumarga, E.; Hein, L.G.

    2014-01-01

    Indonesia is subject to rapid land use change. One of the main causes for the conversion of land is the rapid expansion of the oil palm sector. Land use change involves a progressive loss of forest cover, with major impacts on biodiversity and global CO2 emissions. Ecosystem services have been propo

  19. Recidivism at the Kumasi Central Prison: A Look into Guidance and Counselling Services

    Science.gov (United States)

    Afari, Sarah Aba; Osei, Mavis; Adu-Agyem, Joe

    2015-01-01

    Recidivism is on the increase as ex-convicts who are expected by the society to be reformed in prison and reintegrated to lead meaningful lives, only return to crime shortly after their release and find themselves back into prison in spite of the harsh punishment and counselling services received while incarcerated. The study aimed to identify the…

  20. Marketing Informal Education Institutions in Israel: The Centrality of Customers' Active Involvement in Service Development

    Science.gov (United States)

    Oplatka, Izhar

    2004-01-01

    The current paper outlines a unique marketing perspective that prevails in some informal education institutions in Israel parallel with "traditional modes of marketing", such as promotion, public relations and the like. Based on a case study research in five community centres, a service development based on active participation of the…

  1. "Medical tourism" and the global marketplace in health services: U.S. patients, international hospitals, and the search for affordable health care.

    Science.gov (United States)

    Turner, Leigh

    2010-01-01

    Health services are now advertised in a global marketplace. Hip and knee replacements, ophthalmologic procedures, cosmetic surgery, cardiac care, organ transplants, and stem cell injections are all available for purchase in the global health services marketplace. "Medical tourism" companies market "sun and surgery" packages and arrange care at international hospitals in Costa Rica, India, Mexico, Singapore, Thailand, and other destination nations. Just as automobile manufacturing and textile production moved outside the United States, American patients are "offshoring" themselves to facilities that use low labor costs to gain competitive advantage in the marketplace. Proponents of medical tourism argue that a global market in health services will promote consumer choice, foster competition among hospitals, and enable customers to purchase high-quality care at medical facilities around the world. Skeptics raise concerns about quality of care and patient safety, information disclosure to patients, legal redress when patients are harmed while receiving care at international hospitals, and harms to public health care systems in destination nations. The emergence of a global market in health services will have profound consequences for health insurance, delivery of health services, patient-physician relationships, publicly funded health care, and the spread of medical consumerism.

  2. Central nervous system tuberculosis in children: review of 35 cases at the Hospital Universitario San Vicente de Paúl in Medellín, Colombia.1997-2004. Meningoencefalitis tuberculosa en niños: Revisión de 35 casos en el Hospital Universitario San Vicente de Paúl en Medellín, Colombia. 1997-2004

    OpenAIRE

    José William Cornejo Ochoa; Dagoberto Nicanor Cabrera Hémer; Rodrigo Andrés Solarte Mila

    2005-01-01

    Objetive. To document the clinical and diagnostic features and to explore factors associated with central nervous system tuberculosis at the “Hospital San Vicente de Paúl (HUSVP)” in Medellín-Colombia. Patients and methods. Review of the patient’s records to obtain information on demographic data, medical history, clinical manifestations, laboratory results, treatment and complications of 35 children with central nervous system tuberculosis admitted to the hospital between July 1997 and July ...

  3. Bacteriological assessment of the hospital environment in two referral hospitals in Yaoundé-Cameroon

    OpenAIRE

    Gonsu, Kamga Hortense; Guenou, Etienne; Toukam, Michel; Ndze, Valantine Ngum; Mbakop, Calixte Didier; Tankeu, Dongmo Norbert; Mbopi-Keou, Francois Xavier; Takongmo, Samuel

    2015-01-01

    Introduction Many studies still show significant numbers of surgical patients contracting nosocomial infections each year globally with high morbidity and mortality. The aim of this study was to identify potential bacteria reservoirs that may be responsible for nosocomial infection in surgical services in the Yaoundé University Teaching Hospital (YUTH) and the Central Hospital Yaoundé (CHY). Methods A cross sectional descriptive study was conducted from June to August 2012. Air, water, and su...

  4. Integration of Services for Victims of Child Sexual Abuse at the University Teaching Hospital One-Stop Centre

    Directory of Open Access Journals (Sweden)

    Elwyn Chomba

    2010-01-01

    Full Text Available Objective. To improve care of sexually abused children by establishment of a “One Stop Centre” at the University Teaching Hospital. Methodology. Prior to opening of the One Stop Centre, a management team comprising of clinical departmental heads and a technical group of professionals (health workers, police, psychosocial counselors lawyers and media were put in place. The team evaluated and identified gaps and weaknesses on the management of sexually abused children prevailing in Zambia. A manual was produced which would be used to train all professionals manning a One Stop Centre. A team of consultants from abroad were identified to offer need based training activities and a database was developed. Results. A multidisciplinary team comprising of health workers, police and psychosocial counselors now man the centre. The centre is assisted by lawyers as and when required. UTH is offering training to other areas of the country to establish similar services by using a Trainer of Trainers model. A comprehensive database has been established for Lusaka province. Conclusion. For establishment of a One Stop Centre, there needs to be a core group comprising of managers as well as a technical team committed to the management and protection of sexually abused children.

  5. Treatment received, satisfaction with health care services, and psychiatric symptoms 3 months after hospitalization for self-poisoning

    Directory of Open Access Journals (Sweden)

    Grimholt Tine K

    2012-04-01

    Full Text Available Abstract Background Patients who self-poison have high repetition and high mortality rates. Therefore, appropriate follow-up is important. The aims of the present work were to study treatment received, satisfaction with health care services, and psychiatric symptoms after hospitalization for self-poisoning. Methods A cohort of patients who self-poisoned (n = 867 over a period of 1 year received a questionnaire 3 months after discharge. The Beck Depression Inventory (BDI, Beck Hopelessness Scale (BHS, and Generalized Self-Efficacy Scale (GSE were used. The participation rate was 28% (n = 242; mean age, 41 years; 66% females. Results Although only 14% of patients were registered without follow-up referrals at discharge, 41% reported no such measures. Overall, satisfaction with treatment was fairly good, although 29% of patients waited more than 3 weeks for their first appointment. A total of 22% reported repeated self-poisoning and 17% cutting. The mean BDI and BHS scores were 23.3 and 10.1, respectively (both moderate to severe. The GSE score was 25.2. BDI score was 25.6 among patients with suicide attempts, 24.9 for appeals, and 20.1 for substance-use-related poisonings. Conclusions Despite plans for follow-up, many patients reported that they did not receive any. The reported frequency of psychiatric symptoms and self-harm behavior indicate that a more active follow-up is needed.

  6. The evaluation of the patients who admitted to a regional hospital emergency service with suspect of rabies

    Directory of Open Access Journals (Sweden)

    Nurettin Tunç

    2012-09-01

    Full Text Available Objectives: Rabies is one of the highest mortality ratesinfectious disease. The aim was the evaluation of the patientswho admitted to The Batman Regional State HospitalEmergency Service with suspect of rabies in the datesbetween June 2011 and November 2011.Materials and methods: Totally, 166 cases who admittedto our center was recorded according to the followingdata: place of residence (rural/urban, contact type andwound information, time after the contact, whether vaccineor immunoglobulin is applied or not and also the species,breed and being owned of suspected animal.Results: Our study population consisted of a total of 166cases including 38 women (23%, 128 men (77% withthe mean age of 22.01 ± 17.90 years. Of all subjects, 105(63% lived in urban and 61 (37% lived in rural areas.Eighty-five percent of suspicious animals (51% had anowner, while 81 animals were unattended.Conclusions: Our results showed that all admitted patientswere vaccinated and the ones contacted with petsor had a surface wound were vaccinated with 3 doses.Moreover, since the 49% of our cases were contactedwith animals which cannot be follow-up, our study obviouslyreveals that in our country deficiencies in the controlof waifs still is a public health problem and increases thecost of vaccination. J Clin Exp Invest 2012; 3 (3: 383-386Key words: Rabies, suspected bite, rabies prophylaxis

  7. 医院等级评审对图书馆管理的作用%The Effect of Hospital Grade Assessment on Library Service Management

    Institute of Scientific and Technical Information of China (English)

    刘会婷; 姚西侠

    2014-01-01

    医院等级评审是全面评价医院综合实力的客观手段,并且对医院图书馆管理提出明确的评审要求。为了适应医院的快速发展并顺利通过等级评审,我院运用PDCA法对图书馆的物理环境、服务内容、服务模式、规章制度方面进行全面质量管理,获得较好效果。同时,医院评审对图书馆的建设与发展起到积极的推动作用。%The hospital grade assessment, an objective way to comprehensively assess the overall capacity of hospitals, sets specific evaluation requirements for library management in hospital. In order to adapt to the fast development of hospital and pass the assessment successfully, The First Affiliated Hospital of Xi'an Jiaotong University used the PDCA to conduct comprehensive quality management in the physical environment, the library service content, service mode, rules and regulations. In addition to the achievement in the quality management, the assessment also played a positive role in the construction and development of the library.

  8. Do Medicare Advantage enrollees tend to be admitted to hospitals with better or worse outcomes compared with fee-for-service enrollees?

    Science.gov (United States)

    Friedman, Bernard; Jiang, H Joanna

    2010-06-01

    The hospitals selected by or for Medicare beneficiaries might depend on whether the patient is enrolled in a Medicare Advantage (MA) plan. A theoretical model of profit maximization by MA plans takes into account the tradeoffs of consumer preferences for annual premium versus outcomes of care in the hospital and other attributes of the plan. Hospital discharge databases for 13 states in 2006, maintained by the Agency for Healthcare Research and Quality, are the main source of data. Risk-adjusted mortality rates are available for all non-maternity adult patients in each of 15 clinical categories in about 1,500 hospitals. All-adult postoperative safety event rates covering 9 categories of events are calculated for surgical cases in about 900 hospitals. Instrumental variables are used to address potential endogeneity of the choice of a MA plan. The key findings are these: enrollees in MA plans tend to be treated in hospitals with lower resource cost and higher risk-adjusted mortality compared to Fee-for-Service (FFS) enrollees. The risk-adjusted mortality measure is about 1.5 percentage points higher for MA plan enrollees than the overall mean of 4%. However, the rate of safety events in surgical patients favors MA plan enrollees--the rate is 1 percentage point below the average of 3.5%. These discrepant results are noteworthy and are plausibly due to greater discretion by the health plan in approving patients for elective surgery and as well as selecting hospitals for surgical patients. Emergency patients are generally excluded for the safety outcome measures. In addition, the current mortality measures may not adequately represent all surgical patients. Such caveats should be prominently highlighted when presenting comparative data. With that proviso, the study justifies informing Medicare beneficiaries about the mortality and safety outcome measures for hospitals being used by a MA plan compared to hospitals used by FFS enrollees.

  9. 驻海岛中心医院体系部队健康促进工作做法%Health Promotion Measures of Army Served by Central Hospital Located in Island

    Institute of Scientific and Technical Information of China (English)

    蔡宏伟; 谭小云; 朱长发

    2015-01-01

    建院以来,医院始终立足院区医疗拓展院外服务,方式从巡诊、邮路、电话服务向网络、培训、代职服务转变,有力推动体系部队健康促进工作开展。通过巡诊服务送健康、院内服务给健康、网络互动教健康、院队合作强健康四方面分析,总结医院在体系部队健康促进工作中的做法,提出加强组织领导、开展院队协同、强化人才培训的建议,为进一步做好部队健康促进提供有益的经验方法。%Since hospital establishing, our hospital has always been based on medical school in hospital ar-ea to expand services outside the hospital.Our service mode converts from rounds, postman, telephone service to the network, training and vocational help services.Hospital practiced effectively promotes system health promotion work carried troops.The article summarized the hospital practice in health promotion from itinerant service delivery health, hospital services for health, health education network interaction, teamwork and strong health hospital.We proposed to strengthen the organization and leadership, carried out the hospital team collaboration, strengthened personnel training advice, and provided useful empirical method for further improving health promotion.

  10. Medicare program; hospital inpatient prospective payment systems for acute care hospitals and the long-term care hospital prospective payment system and fiscal year 2015 rates; quality reporting requirements for specific providers; reasonable compensation equivalents for physician services in excluded hospitals and certain teaching hospitals; provider administrative appeals and judicial review; enforcement provisions for organ transplant centers; and electronic health record (EHR) incentive program. Final rule.

    Science.gov (United States)

    2014-08-22

    We are revising the Medicare hospital inpatient prospective payment systems (IPPS) for operating and capital-related costs of acute care hospitals to implement changes arising from our continuing experience with these systems. Some of these changes implement certain statutory provisions contained in the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010 (collectively known as the Affordable Care Act), the Protecting Access to Medicare Act of 2014, and other legislation. These changes are applicable to discharges occurring on or after October 1, 2014, unless otherwise specified in this final rule. We also are updating the rate-of-increase limits for certain hospitals excluded from the IPPS that are paid on a reasonable cost basis subject to these limits. The updated rate-of-increase limits are effective for cost reporting periods beginning on or after October 1, 2014. We also are updating the payment policies and the annual payment rates for the Medicare prospective payment system (PPS) for inpatient hospital services provided by long-term care hospitals (LTCHs) and implementing certain statutory changes to the LTCH PPS under the Affordable Care Act and the Pathway for Sustainable Growth Rate (SGR) Reform Act of 2013 and the Protecting Access to Medicare Act of 2014. In addition, we discuss our proposals on the interruption of stay policy for LTCHs and on retiring the "5 percent" payment adjustment for collocated LTCHs. While many of the statutory mandates of the Pathway for SGR Reform Act apply to discharges occurring on or after October 1, 2014, others will not begin to apply until 2016 and beyond. In addition, we are making a number of changes relating to direct graduate medical education (GME) and indirect medical education (IME) payments. We are establishing new requirements or revising requirements for quality reporting by specific providers (acute care hospitals, PPS-exempt cancer hospitals, and LTCHs) that

  11. [Organization of scientific-methodological work in Central Military Clinical Hospital named after A.A. Vishnevskiĭ].

    Science.gov (United States)

    Beliakin, S A; Fokin, Iu N; Kokhan, E P; Frolkin, M N

    2009-09-01

    There was congested a wide experience of organization and management of scientific work in the 3rd CMCH by Vishnevsky A.A. for a term of more than 40 years. This experience is subjected to generalization, analyze for the purpose of determination of it's priority orientations of improvement. Scientific-methods work in hospital is rated as a complex of measures, organisationaly-planed and coordinated by purpose and reinforcement of scientific schools of the 3rd CMCH by Vishnevsky A.A., as a basis of effective delivery of specialized medical aid. The vector of scientific researches is directed, generally, to solving questions of military and field medicine.

  12. Applying an ecosystem service approach to unravel links between ecosystems and society in the coast of central Chile.

    Science.gov (United States)

    de Juan, Silvia; Gelcich, Stefan; Ospina-Alvarez, Andres; Perez-Matus, Alejandro; Fernandez, Miriam

    2015-11-15

    Ecosystem-based management implies understanding feedbacks between ecosystems and society. Such understanding can be approached with the Drivers-Pressures-State change-Impacts-Response framework (DPSIR), incorporating stakeholders' preferences for ecosystem services to assess impacts on society. This framework was adapted to six locations in the central coast of Chile, where artisanal fisheries coexist with an increasing influx of tourists, and a set of fisheries management areas alternate with open access areas and a no-take Marine Protected Area (MPA). The ecosystem services in the study area were quantified using biomass and species richness in intertidal and subtidal areas as biological indicators. The demand for ecosystem services was elicited by interviews to the principal groups of users. Our results evidenced decreasing landings and a negative perception of fishermen on temporal trends of catches. The occurrence of recreational fishing was negligible, although the consumption of seafood by tourists was relatively high. Nevertheless, the consumption of organisms associated to the study system was low, which could be linked, amongst other factors, to decreasing catches. The comparison of biological indicators between management regimens provided variable results, but a positive effect of management areas and the MPA on some of the metrics was observed. The prioritising of ecosystem attributes by tourists was highly homogenous across the six locations, with "scenic beauty" consistently selected as the preferred attribute, followed by "diversity". The DPSIR framework illustrated the complex interactions existing in these locations, with weak linkages between society's priorities, existing management objectives and the state of biological communities. Overall, this work improved our knowledge on relations between components of coastal areas in central Chile, of paramount importance to advance towards an ecosystem-based management in the area.

  13. Buying time II: an economic evaluation of a joint NHS/Social Services residential rehabilitation unit for older people on discharge from hospital.

    Science.gov (United States)

    Ellis, Annie; Trappes-Lomax, Tessa; Fox, Mary; Taylor, Rod; Power, Michael; Stead, Jonathan; Bainbridge, Ian

    2006-03-01

    The study's aim was to investigate the cost-effectiveness of an NHS/Social Services short-term residential rehabilitation unit (a form of intermediate care) for older people on discharge from community hospital compared with 'usual' community services. An economic evaluation was conducted alongside a prospective controlled trial, which explored the effectiveness of a rehabilitation unit in a practice setting. The aim of the unit was to help individuals regain independence. A matched control group went home from hospital with the health/social care services they would ordinarily receive. The research was conducted in two matched geographical areas in Devon: one with a rehabilitation unit, one without. Participants were recruited from January 1999 to October 2000 in 10 community hospitals and their eligibility determined using the unit's strict inclusion/exclusion criteria, including 55 years or older and likely to benefit from a short-term rehabilitation programme: potential to improve, realistic, achievable goals, motivation to participate. Ninety-four people were recruited to the intervention and 112 to the control group. Details were collated of the NHS and Social Services resources participants used over a 12-month follow-up. The cost of the resource use was compared between those who went to the unit and those who went straight home. Overall, costs were very similar between the two groups. Aggregated mean NHS/Social Services costs for the 12 months of follow-up were pound 8542.28 for the intervention group and pound 8510.68 for the control. However, there was a clear 'seesaw' effect between the NHS and Social Services: the cost of the unit option fell more heavily on Social Services (pound 5011.56, whereas pound 3530.72 to the NHS), the community option more so on the NHS (pound 5146.74, whereas pound 3363.94 to Social Services). This suggests that residential rehabilitation for older people is no more cost-effective over a year after discharge from community

  14. A Rare case of bear attack on the face and the treatment in a tertiary hospital in Central Nepal

    Directory of Open Access Journals (Sweden)

    Ashutosh Kumar Singh

    2015-11-01

    Full Text Available This case report presents a case of wild bear attack in the central region of Nepal causing extensive maxillofacial injuries and its management. The patient suffered bilateral comminuted midface fractures with extensive soft tissue lacerations. Management included multidisciplinary approach including maxillofacial surgeons, ENT surgeons and cosmetic surgeon to realign the injured soft tissue and bone to pre injury state. Outcome was satisfactory given the initial presentation of patient.JCMS Nepal. 2015; 11(2:31-33

  15. All for one, one for all: collaboration between NHS and Higher Education in establishing provision of a multi-disciplinary, hospital-based library and information services.

    Science.gov (United States)

    Black, Coral; Bury, Rachel

    2004-06-01

    Developing multi-disciplinary library and information services is high on the agenda for many NHS trusts and this brings with it a climate of change for both those who manage and work in services today. The development of such new services needs to be carefully managed and developed, and this presents a challenge for librarians and service managers. In the UK during 1999 and 2000, Aintree Hospital Trust, in conjunction with Edge Hill College of Higher Education, established a truly multi-disciplinary service based at its hospital site and managed by Edge Hill. This paper outlines the key stages in the development of the Library and Information Service with the focus on the management of change, collaboration and the development of a unique partnership between Higher Education and an NHS trust. The case study example will provide an outline of strategic and project planning, with insights into staff management and development, delivering user expectations and developing stakeholder relationships in the health library setting.

  16. Adoption of land uses compatible with the water ecosystem service in agricultural farms in Central America

    Directory of Open Access Journals (Sweden)

    Víctor Meza

    2013-12-01

    Full Text Available The presence of trees in the farms is typically considered a good practice in water shed management. Therefore, it was examined the voluntary adoption of land uses considered more compatible with the water ecosystem service (shade coffee and woodland in the region of Trifinio (located in Honduras and Guatemala, where there is not given any incentives or payment for this environmental service. It was observed low adoption of these land uses on small farms. In practice, participation of small farms in conservation programs are subject to certain factors beyond the control of the producers such as minimum area of the farm. But, other factors such as perceived importance of land use has on food security and future motivation for adopting a production system can be more easily manipulated, although, in practical terms it is not always possible. Thus, for a spontaneous adoption of the trees and the forest should also influence cultural factors, even if the changes in this dimension generally take longer to be observed than the lifetime of the conservation projects.

  17. Spontaneous intracerebral hemorrhage: Clinical and computed tomography findings in predicting in-hospital mortality in Central Africans

    Directory of Open Access Journals (Sweden)

    Michel Lelo Tshikwela

    2012-01-01

    Full Text Available Background and Purpose: Intracerebral hemorrhage (ICH constitutes now 52% of all strokes. Despite of its deadly pattern, locally there is no clinical grading scale for ICH-related mortality prediction. The first objective of this study was to develop a risk stratification scale (Kinshasa ICH score by assessing the strength of independent predictors and their association with in-hospital 30-day mortality. The second objective of the study was to create a specific local and African model for ICH prognosis. Materials and Methods: Age, sex, hypertension, type 2 diabetes mellitus (T2DM, smoking, alcohol intake, and neuroimaging data from CT scan (ICH volume, Midline shift of patients admitted with primary ICH and follow-upped in 33 hospitals of Kinshasa, DR Congo, from 2005 to 2008, were analyzed using logistic regression models. Results: A total of 185 adults and known hypertensive patients (140 men and 45 women were examined. 30-day mortality rate was 35% (n=65. ICH volume>25 mL (OR=8 95% CI: 3.1-20.2; P 7 mm, a consequence of ICH volume, was also a significant predictor of mortality. The Kinshasa ICH score was the sum of individual points assigned as follows: Presence of coma coded 2 (2 × 2 = 4, absence of coma coded 1 (1 × 2 = 2, ICH volume>25 mL coded 2 (2 × 2=4, ICH volume of ≤25 mL coded 1(1 × 2=2, left hemispheric site of ICH coded 2 (2 × 1=2, and right hemispheric site of hemorrhage coded 1(1 × 1 = 1. All patients with Kinshasa ICH score ≤7 survived and the patients with a score >7 died. In considering sex influence (Model 3, points were allowed as follows: Presence of coma (2 × 3 = 6, absence of coma (1 × 3 = 3, men (2 × 2 = 4, women (1 × 2 = 2, midline shift ≤7 mm (1 × 3 = 3, and midline shift >7 mm (2 × 3 = 6. Patients who died had the Kinshasa ICH score ≥16. Conclusion: In this study, the Kinshasa ICH score seems to be an accurate method for distinguishing those ICH patients who need continuous and special management

  18. Comparative analysis of current payment system for hospital services in Serbia and projected payments under diagnostic related groups system in urology

    Directory of Open Access Journals (Sweden)

    Babić Uroš

    2015-01-01

    Full Text Available Background/Aim. Global budget per calendar year is a traditional method of funding hospitals in Serbia. Diagnose related groups (DGR is a method of hospital payment based on classification of patients into groups with clinically similar problems and similar utilization of hospital resources. The aim of this study was to compare current methods of hospital services payment with the projected costs by DRG payment method in urology. Methods. The data were obtained from the information system used in the Clinical Hospital Center “Dr. Dragiša Mišović” - Dedinje in Belgrade, Serbia. The implemented hospital information system was the main criterion for selection of healthcare institutions. The study included 994 randomly selected patients treated surgically and conservatively in 2012. Results. Average costs under the current payment method were slightly higher than those projected by DRG, however, the variability was twice as high (54,111 ± 69,789 compared to 53,434 ± 32,509, p < 0,001 respectively. The univariate analysis showed that the highest correlation with the current payment method as well as with the projected one by DRG was observed in relation to the number of days of hospitalization (ρ = 0.842, p < 0.001, and ρ = 0.637, p < 0.001, respectively. Multivariate regression models confirmed the influence of the number of hospitalization days to costs under the current payment system (β = 0.843, p < 0.001 as well as under the projected DRG payment system (β = 0.737, p < 0.001. The same predictor was crucial for the difference in the current payment method and the projected DRG payment methods (β = 0.501, p <0.001. Conclusion. Payment under the DRG system is administratively more complex because it requires detailed and standardized coding of diagnoses and procedures, as well as the information on the average consumption of resources (costs per DRG. Given that aggregate costs of treatment under two hospital payment methods compared

  19. A retrospective clinical audit of 696 central venous catheterizations at a tertiary care teaching hospital in India

    Directory of Open Access Journals (Sweden)

    Sanjay Agrawal

    2012-01-01

    Full Text Available Background: Malpositions after central venous cannulation are frequently encountered and may need a change in catheter. The incidence of malpositions are varied according to various studies and depend on the experience of the operator performing the cannulation. Aim: To access the incidence of malpositions and related complications associated with landmark-guided central venous cannulation in a 15-bedded medical surgical ICU over a period of three years. Settings and Design: Retrospective analysis of records of all the central venous cannulation done in a 15- bedded medical- surgical ICU over the period of three years (April 2008 to June 2011 were evaluated for the site and side of insertion, number of attempts of puncture, arterial puncture as well as the malpositions on post procedural chest X-ray. The records were also evaluated for the experience of the operator performing cannulation and relationship between experience of operator to malpositions of catheter. Statistical Analysis: Analysis was done using SPSS v 17.0 for Windows. Chi-square test was applied to evaluate the statistical significance. P > 0.05 was significant. Results: Records of 696 cannulations were evaluated. Malpositions occurred in 40 patients. Subclavian vein cannulation resulted in increased malpositions in relation to internal jugular vein cannulation. More common with left sided cannulation. Experience of operator had positive correlation with malpositions and arterial puncture. Arterial puncture was common in 6%, while more than one attempt for cannulation was taken in 100 patients. Conclusion: Incidence of malpositions was low. We conclude that experience of operator improves successful catheterization with lesser number of complications.

  20. BACTERIAL CAUSES OF LOWER RESPIRATORY TRACT INFECTIONS IN PATIENTS ATTENDING CENTRAL REFERRAL HOSPITAL, GANGTOK WITH REFERENCE TO ANTIBIOTIC RESISTANCE PATTERN

    Directory of Open Access Journals (Sweden)

    Priyanka Paul

    2013-10-01

    Full Text Available ABSTRACT: BACKGROUND: There is inadequate information from India on various lower respiratory tract pathogens and their resistance pattern in hospital settings. The present study was undertaken to see the bacteriological profile an d the antibiotic resistance pattern of the isolates causing LRTI from this geographic region. OBJECTIVE: To identify and characterize bacterial pathogens causing community acquired and hospital acquired infections with reference to antibiogram pattern. MET HODS: A total of 137 samples from patients suffering from lower respiratory tract infections were studied. All the sputum samples were subjected to gram staining, culture. Various organisms were identified by standard methods. The Kirby – Bauer method was e mployed to perform the antibiotic sensitivity on Mueller Hinton agar [MHA]. For Streptococcus pneumoniae blood agar was used. MHA with 4% NaCl was used to detect methicillin resistant Staphylococcus aureus [MRSA]. RESULTS: Growth of pathogens was obtained in 66.4% of sputum samples in case of inpatients and in 33.5% outpatients. Klebsiella pneumonia [15.3%] was the predominant isolate among the inpatients whereas Streptococcus pneumonia [8.5%] was the most common pathogen isolated from outpatients. Haemophi lus influenzae was not isolated. Quinolone was found to be most effective antibiotic against gram negative organi sms. A single isolate of Morax ella catarrhalis was isolated from a case of MDR - TB. CONCLUSION : Culture and susceptibility reports should be enc ouraged before therapy to combat the problem of emergence of MDR, ESBL and MRSA strains and to subside the economic burden due to increase in cost according to the consequence of development of antibiotic resistant microbial strains