Jaklevic, M C
Christus Health has bucked the trend by looking to Mexico for expansion. The Roman Catholic system based in Irving, Texas, bought 51% of Hospital Muquerza in the prosperous northern Mexico state of Nuevo Leon. Christus believes the move makes sense on many levels.
Aramayo, Roberto R.
Full Text Available The aim of this text is to highlight the Kantian influence upon the thought of Javier Muguerza, an influence which is evident in Muguerza's three «Critiques»: The Critique of Analytic Reason, The Critique of Dialogic Reason and The Critique of Oniric Reason. But Kant's influence can also be detected in the so-called «imperative of dissidence» with which Muguerza wants to render contemporary the three versions of the Kantian categorical imperative, and which also leads him to propose, in a Blochian manner, a primacy of utopia. In short, Muguerza invites us to pose again aH the famous Kantian questions, even if he is more interested in those that Kant left open, than in those which he himself replied too We have to be thankful to Muguerza for the translation of these questions into contemporary philosophical queries.
Se pretende resaltar aquí la veta kantiana que atraviesa el pensamiento de Javier Muguerza. Este hilo conductor se pondría de manifiesto sin ir más lejos en las tres «Críticas» muguerzianas, a saber: Crítica de la razón analítica, Crítica de la razón dialógica y Crítica de la razón onírica . Pero también cabe detectarlo en el denominado «imperativo de la disidencia», con que Muguerza quiere actualizar las tres versiones del imperativo categórico kantiano y que le hace apostar, finalmente, por un blochiano primado de la utopía. En definitiva, todo ello acaba por invitarnos a replantear las célebres preguntas kantianas. Desde luego, a Javier Muguerza le interesan mucho más las cuestiones dejadas abiertas por Kant que sus respuestas, y hay que agradecerle que sepa traducirlas a las inquietudes filosóficas del presente.
Jaap L. Helberg
Full Text Available Die geweldsoptrede in Openbaring herinner baie aan die tyd van Dawid en dit laat die vraag ontstaan of die ‘regering in liefde’ soos dit in die res van die Nuwe Testament verkondig word, nou plek maak vir ‘geweldsregering’. In hierdie artikel word die antwoord gesoek in die apokaliptiese taal en styl (oortreffende vergelykingstrappe en skerp teenstellings en in die omraming deur God as die Alfa en die Omega, op wie die hele fokus gerig is en wat alles integreer. Daar word ondersoek hoe dit God se regverdigheid en genade raak en watter rol Dawid in God se koningsheerskappy speel, in die lig van sy verbinding met Christus as die Leeu en die Lam. Aandag word geskenk aan Dawid as koning, as voorbeeldige gelowige en tog sondige mens en aan die betekenis van berou en bekering en ’n persoonlike verhouding met God. Die bevinding is dat die verbandlegging met Dawid ’n verlange vertolk na ’n integrasie van geregtigheid en liefde wat in Dawid skaduagtig was en ten volle tot vervulling kom in die wonder van God in Jesus Christus se lewe, sterwe, opstanding en wederkoms. Openbaring is ’n teken van God se genade deur die ernstige en onophoudelike waarskuwing en oproep tot geloofsvolharding en bekering. Tegelykertyd is dit ’n uitnodiging om na Hom te kom omdat daar net deur en by Hom, die lewende en persoonlike God, lewe is. Buite Hom is daar net disintegrasie. The violence in Revelation resembles much of the violence in the time of David, and this raises the question whether the ‘loving rule’ as proclaimed in the rest of the New Testament gives way to ‘violent rule’. In this article the answer is sought in the apocalyptic language and style of the book (superlatives, sharp contrasts, and in the framing of God as the Alpha and the Omega on Whom everything is focused and Who integrates all. The research investigates how this affects God’s justice and his mercy, and what role David plays in God’s kingly rule, in view of him being
Jaap L. Helberg
Full Text Available Die geweldsoptrede in Openbaring herinner baie aan die tyd van Dawid en dit laat die vraag ontstaan of die ‘regering in liefde’ soos dit in die res van die Nuwe Testament verkondig word, nou plek maak vir ‘geweldsregering’. In hierdie artikel word die antwoord gesoek in die apokaliptiese taal en styl (oortreffende vergelykingstrappe en skerp teenstellings en in die omraming deur God as die Alfa en die Omega, op wie die hele fokus gerig is en wat alles integreer. Daar word ondersoek hoe dit God se regverdigheid en genade raak en watter rol Dawid in God se koningsheerskappy speel, in die lig van sy verbinding met Christus as die Leeu en die Lam. Aandag word geskenk aan Dawid as koning, as voorbeeldige gelowige en tog sondige mens en aan die betekenis van berou en bekering en ’n persoonlike verhouding met God. Die bevinding is dat die verbandlegging met Dawid ’n verlange vertolk na ’n integrasie van geregtigheid en liefde wat in Dawid skaduagtig was en ten volle tot vervulling kom in die wonder van God in Jesus Christus se lewe, sterwe, opstanding en wederkoms. Openbaring is ’n teken van God se genade deur die ernstige en onophoudelike waarskuwing en oproep tot geloofsvolharding en bekering. Tegelykertyd is dit ’n uitnodiging om na Hom te kom omdat daar net deur en by Hom, die lewende en persoonlike God, lewe is. Buite Hom is daar net disintegrasie.The violence in Revelation resembles much of the violence in the time of David, and this raises the question whether the ‘loving rule’ as proclaimed in the rest of the New Testament gives way to ‘violent rule’. In this article the answer is sought in the apocalyptic language and style of the book (superlatives, sharp contrasts, and in the framing of God as the Alpha and the Omega on Whom everything is focused and Who integrates all. The research investigates how this affects God’s justice and his mercy, and what role David plays in God’s kingly rule, in view of him being
Full Text Available I reconstruct several deeply rooted deceptions by taking Villoro’s reflections as a starting point: i.e., the alternative consensus/ dissent; the nationalist enthusiasm or the understanding of habits and costumes as «the last word»; a non-reasonable concept of reason. With respect to the latter I make use of some observations owed to Muguerza to further develop the discussion.
Partiendo de algunas reflexiones de L. Villoro se reconstruyen varios engaños-fetiches muy arraigados: la alternativa consensos/disensos, el entusiasmo nacionalista o los usos y costumbres como la última palabra, un concepto no razonable de razón. Respecto de este último engaño se enriquece la discusión con algunas observaciones de J. Muguerza.
Pérez-Topete, S E; Miranda-Aquino, T; Hernández-Portales, J A
Clostridium difficile (C. difficile) is a Gram-positive bacillus that is a common cause of diarrhea in the hospital environment, with a documented incidence of up to 10%. There are different methods to detect it, but a widely used test in our environment is the immunoassay for toxins A and B. The aim of our study was to 1) estimate the positive predictive value of the immunoassay for the detection of the C. difficile toxins A and B, 2) to establish the incidence of C. difficile-associated diarrhea in the hospital, and 3) to know the most common associated factors. A diagnostic test accuracy study was conducted within the time frame of January 2010 to August 2013 at the Hospital Christus Muguerza® Alta Especialidad on patients with symptoms suggestive of C. difficile-associated diarrhea that had a positive immunoassay test and confirmation of C. difficile through colon biopsy and stool culture. The immunoassay for toxins A and B was performed in 360 patients. Fifty-five of the cases had positive results, 35 of which showed the presence of C. difficile. Incidence was 10.2% and the positive predictive value of the test for C. difficile toxins A and B was 0.64 (95% CI, 0.51-0.76). Previous antibiotic therapy (n=29) and proton pump inhibitor use (n=19) were the most common associated factors. C. difficile incidence in our environment is similar to that found in the literature reviewed, but the positive predictive value of the test for toxin A and B detection was low. Copyright © 2016 Asociación Mexicana de Gastroenterología. Publicado por Masson Doyma México S.A. All rights reserved.
Verkondig Christus totdat hy kom! Die huidige denke binne die Evangeliese Beweging. J J Kritzinger. Universiteit van Pretoria. Abstract. World evangelisation within the Lausanne movement. This article considers a number of key themes regarding world evangelisation. The point of departure is the second general ...
Pogings in die verlede om die geboortedatum van Christus vas te stel, het daartoe gelei dat datums so vroeg as 20 v.C. maar ook so laat as 2 n.C. voorgestel is. In hierdie artikel word die beperkte primêre historiese bronne noukeurig ontleed en kontemporêre interpretasies daarvan krities in oënskou geneem.
Hospital deals are heating up as summer settles in, fueled in part by Medicare reform and the "Tenet effect." One recent move by Christus Health made Alice, Texas, a one-hospital town again. Christus' Peter Maddox, left, denies that the consolidation means prices will rise. "It's not a retail world anymore," he says.
en die kerugmatiese Christus by Walter Schmithals. PBBoshoff. Universiteit van Pretoria. Abstract. Christology; The historical Jesus and the kerygmatic. Christ according to Walter Schmithals. This article shows how and why Walter Schmithals undertook to regard the kerygmatic Christ rather than the historical Jesus as the ...
J. E. U itman , Christus het Hoofd (De brief aan de Colossenzen). (Uitgewers: G. F. Callenbach-Nijkerk, 1955.) J. E. Uitman gee ons in hierdie werkie 'n voortreflike kommentaar van die besonderlike brief van die apostel Paulus. Die ryk inhoud is by verreweg na nog nie teologies verwerk nie. Tog het die skrywer daarin.
Meyer, Donna; Wei, Raymond
In a time of public scrutiny, it is paramount that Catholic health care organizations examine their commitments to their communities and effectively communicate community benefit activities to stakeholders-employees, physicians, patients, and the public. CHRISTUS Academy, a leadership development program at CHRISTUS Health, Irving, TX, conducted two studies regarding community benefit. The first researched community benefit practices at more than 20 highly respected, tax-exempt CHA- and VHA-member organizations, comparing them with the practices of about 40 publicly traded, for-profit organizations. The primary conclusion was that community benefit is not just about measuring the numbers-it is also about "telling the story." Unlike the for-profit organizations, tax-exempt health care organizations tend to struggle with adequately measuring and reporting their community contributions. In a second study, the academy surveyed CHRISTUS Health's employees and physicians regarding their knowledge of the system's commitment vis-à-vis identifying and meeting community needs. The vast majority said the system is important to the community and is actively involved in understanding and meeting the needs of the community. However, they also ranked the system lower in terms of working with other community organizations, being a leader in community health, and being known for sponsoring volunteer activities. These lower rankings indicate that the community benefit activities are not well publicized or known within the organization. Catholic health organizations must take an active approach in communicating their work to the public, the media, and each other. In doing so, they fulfill an integral part their mission.
Texas hospitals share creative uses of non-clinical staff to reduce ER costs. In central Texas, Christus Spohn Hospital and Seton Health Care are independently exploring the use of non-clinical staff to improve utilization of clinical and emergency services, but their existing programs employ different structures and outcomes measurements.
Angiomax allows for easier post-percutaneous coronary intervention care and enhanced throughput and has become the gold standard of care in our institution. This article describes how Angiomax was brought into our hospital; the rationale and science to support its use; and the resulting patient and staff satisfaction, improved throughput, and cost savings.
Full Text Available The atomic play Atom vor Christus (1952 by the Viennese playwright Kurt Becsi (1920-1988 is one of the very numerous works on the subject of the nuclear threat that appeared in German-speaking countries in the 1950s and ’60s. This article investigates the complex Christian religious discourse that embeds the dramatization of atomic issues and apocalyptic ideas of the End in Becsi’s play. Special focus is given to such aspects as the struggle between generations and, in particular, the conflict between the unscrupulous scientist (and his hubris and the figure of the repentant bomber pilot that becomes a monk (Science versus love, logic versus Christian grace.
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...
treatment modality. Design: It is a retrospective study of all conﬁrmed. Burkitt's lymphoma of the head and neck region seen at the Obafemi Awolowo University Teaching Hospital Ile. Ife (OAUTHC) between 1986 and 2002. Patients and methods: The medical records of all the patients with the histopathologically conﬁrmed ...
. Documentation exists in; well-being of patients and staff, sleep disorders, pain distraction, confidentiality and privacy, levels of errors in hospitals. Art and the use of color: Art can be context related so one should be aware whether it is in a private ward or the foyer and related to the experience...... in treating disease can be supported by architecture which is sensitive to the contextual conditions of healing in health facilities. It is not the intention to supplant technology, but a question of supplementing the incredible advances that have been made in medicine in recent decades. The central premise......- sick-leave and work-related injuries....
Juárez-Parra, M A; Carmona-Cantú, J; González-Cano, J R; Arana-Garza, S; Trevino-Frutos, R J
There is a coordinated inhibition of motility of the colon after its surgical manipulation that contributes to the accumulation of fluids and gas, in turn characterized by nausea,vomiting, pain, abdominal distension, and constipation. Motility is recovered in the majority of patients within the first 72 hours. A delay in its resolution is known as prolonged postoperative ileus. To study the preoperative, intraoperative, and postoperative risk factors for developing prolonged ileus in patients that underwent elective colon resection.Materials and methods: The association between 25 perioperative variables and the presentation of prolonged ileus was analyzed in 85 patients that underwent colon resection at Hospital Christus Muguerza Alta Especialidad within the time frame of 2011 and 2014. Postoperative ileus occurred in 22.3% of the patients. The statistically significant predictors of ileus were obesity (OR 1.119, P=.048) and admission to the intensive care unit (OR3.571, P=.050). The use of peridural anesthesia during the surgical act was found to be a protective factor (OR 0.363, P=.050). The presence of these risk factors can alert the physician to the need for a closer follow-up in patients at high risk for postoperative ileus, and the use of peridural anesthesiacan possibly lower the incidence of ileus.
U.S. Department of Health & Human Services — Unplanned Hospital Visits â provider data. This data set includes provider data for the hospital return days (or excess days in acute care) measures, the unplanned...
University of Rhode Island Geospatial Extension Program — Hospital Facilities information was compiled from several various sources. Main source was the RI Department of Health Facilities Regulation database, License 2000....
U.S. Department of Health & Human Services — A list of hospital ratings for the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS). HCAHPS is a national, standardized survey of hospital...
U.S. Department of Health & Human Services — Hospital Compare has information about the quality of care at over 4,000 Medicare-certified hospitals across the country. You can use Hospital Compare to find...
Not long after the word hospitality emerged as a collective noun to describe the commercial provision of services associated with accommodation, drinking and eating, some academics began to investigate the meanings of hospitality and hospitableness. Whilst most academic programme provision related to developing ...
1) Johns Hopkins Medical Services Co., (2) Brighton Marine Health Center, (3) Martin’s Point Health Care, (4) CHRISTUS Health, (5) Pacific...over the years, some hospitals that were formerly separate designated providers were consolidated under CHRISTUS Health. 16One former designated...Point Health Care 41% South Humana Military Healthcare Services CHRISTUS Health 57% West UnitedHealth Pacific Medical Centers 88% Source: GAO
World evangelisation within the Lausanne movement. This article considers a number of key themes regarding world evangelisation. The point of departure is the second general conference of the Lausanne movement, which was held in Manila during July 1989. The first section gives some background to the Lausanne ...
W. J. Snyman
Full Text Available 1. Met die eerste uitbreiding van die Christendom na Afrika in die begin van onse jaartelling, was die kerk nog ’n eenheid. Oorblyfsels van die Apostoliese Kerk na die teëslag van die Mohammedanisme vind ons slegs nog in die Koptiese Ortodokse Kerk en die Armenies Evangeliese Kerk in Egipte en in die Etiopiese Kerk in Etiopië en Eritrea, in soverre dit nog daarin herkenbaar is. Met sy tweede aanslag op Afrika sinds die 17e eeu was die Christelike kerk ’n verdeelde kerk. Afrika laat die Christelike kerk homself soos in ’n spieël sien in sy opgebrokenheid.
Full Text Available Does Christ sustain the Netherdutch Reformed Church of Africa? The Netherdutch Reformed Church of Africa (NRCA that is situated in South-Africa is currently experiencing a serious decline in numbers. The question arises whether Christ will sustain the NRCA in the words of the Afrikaans Hymn 477 in the ‘Liedboek van die Kerk’ (Hymnbook of the Church: ‘Christ will maintain his church …’ Is it a matter of faith, or even more – a matter of obedience? The membership of the NRCA mainly consists of white Afrikaans-speaking people. Apart from the situation in the NRCA there is also a serious decline in the number of white people in South Africa. It raises the question about the sustainability of the NRCA if it continues to maintain a membership of predominately white Afrikaans-speaking people. The NRCA is very much institutionalised with a history that lacks missional intention and involvement in the community. This study investigates the possibility for a more applicable missional curriculum in the training of theology students to counter the lack of missional involvement. It also investigates new ways to reach the unchurched society with a missional approach. The Fresh Expression Movement that originated in the UK provides a new paradigm for the NRCA that will hopefully lead to a new way of thinking and doing. Will Christ sustain the NRCA? The answer lies in the willingness of the NRCA to show a missional heart for all the people of Africa, especially those in Southern Africa.Keywords: Missional; missional curriculum; missional ecclesiology; institutionalism; toxic organization; spiritual; church planting; fringes; Fresh Expressions
15 Jul 2016 ... smart phone or mobile device to read online. Author: André Ungerer1. Affiliation: 1Reformed Theological. College, University of. Pretoria, South Africa. Project leader: A. Ungerer. Project number: ...... Roossenekal-gemeente het in daardie stadium ook versuur en is later verbreek. Sy skryf soos volg:.
van Mars, Jupiter, Venus en Merkurius in die sterrebeeld van die Leeu. Jupiter en die ster Regulus het in Desember 3 v.C., in Februarie 2. v.C. en weer in Mei 2 v.C. in konjunksie gegaan (Carroll 2000:1-16;. Hughes 1979:132-133). 5. DIE KINDERMOORD. Die kindermoord in Betlehem en omgewing, soos dit in Matteus.
Crucifi xion is a concept that is far removed from the experience and understanding of the 21stcentury post-modern man. To understand the power of the message of the cross, one fi rst has to determine what the meaning of crucifi xion was to the person in antiquity. The relevant facts about the cross and crucifi xion were ...
The virginal conception of Jesus Christ: Remarks on an important debate Although not completely neglected, the current day discussion elsewhere in the world about the virginal conception of Jesus Christ seemingly does not receive much attention in the Afrikaans churches in South Africa. With special reference to ...
Journal for the Study of Religion. Journal Home · ABOUT · Advanced Search · Current Issue · Archives · Journal Home > Vol 15, No 1 (2002) >. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register. DOWNLOAD FULL TEXT Open Access DOWNLOAD FULL TEXT ...
The metaphor 'being crucifi ed with Christ' in sociohistorical context. Crucifi xion is a concept that is far removed from the experience and understanding of the 21stcentury post-modern man. To understand the power of the message of the cross, one fi rst has to determine what the meaning of crucifi xion was to the person in ...
A. le R. du Plooy
Full Text Available Reformed church polity acknowledges a very close relation between Christology and ecclesiology, and intends to be a polity of the kingdom of God. This means the acceptance of Christ as the only Head of His church. He governs the church through the Holy Spirit and the Word of God, and by means of the ministry of the offices. History reveals that although many systems of church government confess the Headship of Christ, analysis of these systems indicates distortions or even elimination of Christ as the one and only Head of the church. A critical review of the systems of the Roman Catholic Church, of Lutheranism, Erastianism, Collegialism and Congregationalism shows that views concerning the authority in the church differ widely. Various forms of authority can be distinguished, i.e. the authority of the pope, office and/or church authority, state government authority in church affairs, etc. In contrast to these viewpoints, the Reformation states that Christ has the only authority in His church. He exercises His government through the offices in the church. These offices are servants and minister His authority in the church. The only authority of the church or the offices is therefore a ministerial authority.
HTS Teologiese Studies / Theological Studies. Journal Home ... Is it a matter of faith, or even more – a matter of obedience? ... Apart from the situation in the NRCA there is also a serious decline in the number of white people in South Africa.
Research in Hospitality Management. Journal Home · ABOUT · Advanced Search · Current Issue · Archives · Journal Home > Vol 5, No 1 (2015) >. Log in or Register to get access to full text downloads.
years and below, who presented at the University of Port Harcourt Teaching' Hospital during a. 12-year period. ... However, the role of malignancies as a cause of death- .University of Port-Harcourt Teaching Hospital,. 'Port-Harcourt . " Department of Anatomical Pathology _ ' '. '''Lecturer ' ' - .... decreasing numerical order.
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...
College of the Canyons, Valencia, CA.
A project was conducted at College of the Canyons (Valencia, California) to initiate a new 2-year hospitality program with career options in hotel or restaurant management. A mail and telephone survey of area employers in the restaurant and hotel field demonstrated a need for, interest in, and willingness to provide internships for such a program.…
Phipps, Alison; Barnett, Ronald
Academic hospitality is a feature of academic life. It takes many forms. It takes material form in the hosting of academics giving papers. It takes epistemological form in the welcome of new ideas. It takes linguistic form in the translation of academic work into other languages, and it takes touristic form through the welcome and generosity with…
Jensen, Tina Blegind; Aanestad, Margunn
propose to use the concepts of hospitality and hostility to turn our attention to the interaction between the host (the surgeons) and the guest (the information system) and consider how the boundaries between them evolved in the everyday work practices. As an alternative to previous studies on technology......The purpose of this paper is to discuss the adoption of healthcare information systems (HIS) from a user perspective. Our case study concerns how a group of orthopaedic surgeons experienced and reacted to the adoption and mandatory use of an Electronic Patient Record system in a Danish hospital. We...... adoption, these concepts help us appreciate and put special emphasis on particular aspects of the adoption process: the mutual and co-constitutive relationship between the users and the technology and the continued coexistence of both positive and negative attitudes among the users. The findings suggest...
Hospitality and the hospitality industry need to be reevaluated in the era of the new prosumer and smart prosuming machines. Traditional notions of hospitality hearken back to an earlier era and ongoing changes are forcing us to reconsider them. Among those changes are the decline of settings that offer hospitality; the ...
U.S. Department of Health & Human Services — Hospital Outpatient Prospective Payment System (OPPS) Partial Hospitalization Program LDS This file contains select claim level data and is derived from 2010 claims...
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....
U.S. Department of Health & Human Services — A list of hospital ratings for the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS). HCAHPS is a national, standardized survey of hospital...
Costello, M M
With more hospitals embracing the marketing function in their organizational management over the past decade, hospital marketing can no longer be considered a fad. However, a review of hospital marketing efforts as reported in the professional literature indicates that hospitals must pay greater attention to the marketing mix elements of service, price and distribution channels as their programs mature.
This literature review examines the effects of hospitalization on the young child and suggests ways in which parents and hospital personnel can protect children from the potentially harmful emotional and intellectual effects of hospitalization. The history of attitudes toward the hospitalization of children is discussed. Children's emotional…
... 16 for a list of other organizations that work to improve hospital quality. 12 Section 2: A Closer Look At Hospital Quality How can I find information about hospital quality? Medicare publishes information about hospital quality on the Hospital Compare ...
Anderson, David W.
This paper contributes to a Christian hermeneutic of special education by suggesting the biblical concept of hospitality as a necessary characteristic of classroom and school environments in which students with disabilities and other marginalized students can be effectively incorporated into the body of the classroom. Christian hospitality, seen…
Wu, Ziqi; Robson, Stephani; Hollis, Brooke
In the last decade, many hospital designs have taken inspiration from hotels, spurred by factors such as increased patient and family expectations and regulatory or financial incentives. Increasingly, research evidence suggests the value of enhancing the physical environment to foster healing and drive consumer decisions and perceptions of service quality. Although interest is increasing in the broader applicability of numerous hospitality concepts to the healthcare field, the focus of this article is design innovations, and the services that such innovations support, from the hospitality industry. To identify physical hotel design elements and associated operational features that have been used in the healthcare arena, a series of interviews with hospital and hotel design experts were conducted. Current examples and suggestions for future hospitality elements were also sought from the experts, academic journals, and news articles. Hospitality elements applied in existing hospitals that are addressed in this article include hotel-like rooms and decor; actual hotels incorporated into medical centers; hotel-quality food, room service, and dining facilities for families; welcoming lobbies and common spaces; hospitality-oriented customer service training; enhanced service offerings, including concierges; spas or therapy centers; hotel-style signage and way-finding tools; and entertainment features. Selected elements that have potential for future incorporation include executive lounges and/or communal lobbies with complimentary wireless Internet and refreshments, centralized controls for patients, and flexible furniture. Although the findings from this study underscore the need for more hospitality-like environments in hospitals, the investment decisions made by healthcare executives must be balanced with cost-effectiveness and the assurance that clinical excellence remains the top priority.
U.S. Department of Health & Human Services — Hospital Compare is a consumer-oriented website that provides information on how well hospitals provide recommended care to their patients. This information can help...
... this page: //medlineplus.gov/ency/patientinstructions/000449.htm Staph infections - hospital To use the sharing features on ... can also spread from one person to another. Staph Infections in the Hospital Staph germs are mostly ...
... Updates Practice Hospital Bed Safety Share Tweet Linkedin Pin it More sharing options Linkedin Pin it Email Print Hospital Bed Entrapment Zones An ... the side edge of the head or foot board 7. between the head or foot board and ...
... Distance Requirements and Critical Access Hospital (CAH) Recertification Checklist for Evaluation of Compliance with the Location and ... purchase new equipment such as hospital beds and office machines. Visit the funding section of this guide ...
Justesen, Lise; Overgaard, Svend Skafte
This article presents an analytical model that aims to conceptualize how meal experiences are framed when taking into account a dynamic understanding of hospitality: the meal model is named The Hospitable Meal Model. The idea behind The Hospitable Meal Model is to present a conceptual model...... that can serve as a frame for developing hospitable meal competencies among professionals working within the area of institutional foodservices as well as a conceptual model for analysing meal experiences. The Hospitable Meal Model transcends and transforms existing meal models by presenting a more open......-ended approach towards meal experiences. The underlying purpose of The Hospitable Meal Model is to provide the basis for creating value for the individuals involved in institutional meal services. The Hospitable Meal Model was developed on the basis of an empirical study on hospital meal experiences explored...
U.S. Department of Health & Human Services — Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) Hospital Survey The intent of the HCAHPS initiative is to provide a standardized survey...
environment. A. Objectives: The objective of this paper is to determine the mode of transmission, clinical presentations and outcome of hospital admissions in children with Paediatric HIV/AIDS at the National Hospital Abuja Nigeria. Methods: Aretrospective study of children with Paediatric HIV/AIDS admitted into the hospital ...
U.S. Department of Health & Human Services — The "Medicare hospital spending per patient (Medicare Spending per Beneficiary)" measure shows whether Medicare spends more, less or about the same per Medicare...
Research in Hospitality Management. Journal Home · ABOUT · Advanced Search · Current Issue · Archives · Journal Home > Vol 5, No 1 (2015) >. Log in or Register to get access to full text downloads.
Mark W. Westmoreland
Full Text Available Come in. Welcome. Be my guest and I will be yours. Shall we ask, in accordance with the Derridean question, "Is not hospitality an interruption of the self?" What is the relationship between the interruption and the moment one enters the host's home? Derrida calls us toward a new understanding of hospitality - as an interruption. This paper will illuminate the history of hospitality in the West as well as trace Derrida's discussions of hospitality throughout many of works. The overall goal of this project is to provide readers of Derrida with a sort of reference guide for his discussions on and deconstructive approach to hospitality.
Maximiliano Emanuel Korstanje
Full Text Available Modern studies emphasized on the needs of researching the hospitality as relevant aspects of tourism and hospitality fields. Anyway, these approaches are inextricably intertwined to the industry of tourism and do not take seriously the anthropological and sociological roots of hospitality. In fact, the hotel seems to be a partial sphere of hospitality at all. Under this context, the present paper explores the issue of hospitality enrooted in the political and economic indo-European principle of free-transit which is associated to a much broader origin. Starting from the premise etymologically hostel and hospital share similar origins, we follow the contributions of J Derrida to determine the elements that formed the hospitality up to date.
Justesen, Lise; Strøjer, Anna-Lise
Abstract: There is a growing interest in articulating institutional meal serving practices as a hospitality activity involving host and guest interactions. This study aims to qualify institutional hospitality and meal activities by exploring private hospitality events. The study is based......-structured interview, students reflected on their hospitality experiences. The interviews were transcribed and analyzed using a thematic analysis method. The emerging themes on hospitality activities were identified. It was found that hospitality activities could be characterized as a process where the individual...... was transformed into a guest. Information on purpose of the event and other information given in the invitation were part of this process. Furthermore, hospitality activities could be characterized by blurred host-guest relations and by being able to embrace unexpected events as well. The activities were...
Fox, Lindy P
Inpatient dermatology is emerging as a distinct dermatology subspecialty where dermatologists specialize in caring for patients hospitalized with skin disease. While the main focus of inpatient dermatology is the delivery of top-quality and timely dermatologic care to patients in the hospital setting, the practice of hospital-based dermatology has many additional components that are critical to its success. ©2017 Frontline Medical Communications.
Jun 28, 2017 ... following aspects must be present: • the function exposes individuals visiting from overseas to examples of Canadian or regional art and culture; and. • the function is less expensive than meal-type hospitality. Hospitality activities usually have no formal agenda and program. The emphasis is on networking.
... Thoracopaedia - An Imaging Encyclopedia of Pediatric Thoracic Disease Virtual Pediatric Hospital is the Apprentice's Assistant Last revised ... pediatric resources: GeneralPediatrics.com | PediatricEducation.org | SearchingPediatrics.com Virtual Pediatric Hospital is curated by Donna M. D' ...
Prætorius, Thim; Hasle, Peter; Edwards, Kasper
Hospitals are increasingly faced with conflicting demands as they have to respond to increasing patient demands as well as financial, clinical and quality challenges. To handle these demands the hospital need to reconfigure its organization, and we propose to build on a concept for the collaborat......Hospitals are increasingly faced with conflicting demands as they have to respond to increasing patient demands as well as financial, clinical and quality challenges. To handle these demands the hospital need to reconfigure its organization, and we propose to build on a concept...... for the collaborative hospital as new organizational form which is better equipped to respond to the challenges facing modern hospitals. The collaborative hospital is an ambidextrous organization that opens for pursuing both exploration and exploitation within the same organizational structure. The basic principles...... of the collaborative hospital concern the creation of an appropriate balance between standardization and local autonomy, shared purpose centred around providing the best possible care, and use of enabling structures that sustain the new ways of collaborative work. The chapter builds on the theoretical framework...
California State Dept. of Education, Sacramento. Bureau of Homemaking Education.
This curriculum guide on the hospitality occupations was developed to help secondary and postsecondary home economics teachers prepare individuals for entry-level jobs in the hospitality industry. The content is in seven sections. The first section presents organizational charts of a medium-size hotel, food and beverage division, housekeeping and…
Many hospital libraries suffer from being poorly housed. This article describes a successful effort to find better space for a hospital library. Issues of planning, staff participation, and implementation are discussed, including constraints, what worked well, and what could have worked better.
Occasional events, regular workshops, concerts, shows, artists in residence, cultural outings...Hospital does not necessarily have to be a place of silence and sadness. But this situation has not always been so straightforward as on the face of it, nothing is more incompatible with a hospital environment than music, which, by definition, is festive and noisy.
Texas Tech Univ., Lubbock. Home Economics Curriculum Center.
This guide, which was developed as part of Texas' home economics education program, is intended to assist teachers of a hospitality services course focusing on the food and lodging segments of the hospitality and tourism industry. The first 40% of the approximately 600-page guide consists of strategies for teaching each of 29 essential…
The Northern Arizona Hospitality Education Program is an exemplary three-year project designed to help students, mainly Indian, obtain job skills and attitudes necessary for successful employment in the hospitality industry. Nine high schools from Apache, Coconino, and Navajo Counties participated in the project. Objectives included providing an…
U.S. Department of Health & Human Services — Hospital returns â national data. This data set includes national-level data for the hospital return days (or excess days in acute care) measures and the 30-day...
U.S. Department of Health & Human Services — Hospital returns â state data. This data set includes state-level data for the hospital return days (or excess days in acute care) measures and the 30-day...
drew an interpretative picture of the dynamic of hospitality,. I prepared a descriptive scheme, with times .... the development of which may result in a pacifying effect, sentiments that range from friendship, love and ..... momentarily, the guest reassumes his position of superiority. All this takes place as if the hospitality scene ...
Kawada, T; Wolf, W; Mochizuki, D
Training of radiopharmacists, including self-study and a hospital short-term course, is discussed. A systematic approach for self-study is suggested. The 30-day hospital training program described includes both didactic material and on-the-job experience.
Laarse, van der R.; Egberts, L.
Heritage, Tourism and HospitalityInternational Conference 2015 (HTHIC2015)Preservation, Presentation, Promotion and ProfitResearch Agendas, Best Practices and Hospitable Partnerships in TourismFollowing the success of the first conference in the series in Istanbul, Rotterdam School of
Full Text Available The idea of hospitality is evident in several types of human behavior including obligatory duties, commercial activity, and prosocial action. These are intertwined and revolve around the commitment to caring for others whether they are relatives, guests, or strangers. This article explores the ethic of hospitality in its various forms.
Frandsen, F; Nielsen, J R; Gram, L
During the period 1.10.1986-30.9.1987, all patients with cardiac arrest outside hospital brought to the casualty department in Odense Hospital were registered. Out of 160 patients, 133 (83%) could be primarily resuscitated, 19 (12%) were resuscitated but died later in hospital and eight patients (5......%) were resuscitated and could be discharged alive from hospital. Out of the eight patients who were discharged alive, only two (1%) had retained reasonable cerebral function as assessed by dementia testing. Treatment of the cardiac arrest prior to the arrival of the ambulance, duration of the cardiac...... arrest for less than six minutes and staffing of the ambulance with three first-aid men were factors of decisive importance for survival of the patients. The results of this investigation demonstrate that treatment of cardiac arrest outside hospital is unsatisfactory. Proposals for improvement...
Although specialists in hospitality have worked extensively on hospitality with respect to relations between different nations or between nations and individuals of a different nationality, for instance when they seek asylum, Jacques Derrida preferred to focus instead upon the relationship between...... the guest and the host. This has provided a much-needed rethinking of how to understand hospitality as a way of relating, as an ethics and as a politics. Within this work, there have often appeared discussions of ‘spaces of hospitality’, but these spaces have remained largely abstract. This is where...... this paper comes in: It will re open discussions of spaces of hospitality with an introduction into an on-going research project that studies the performative, structural and social dynamics of cultural encounters focusing on forms of hospitality that are related to particular sites in the city, namely...
The study was conducted at the University of llorin. Teaching Hospital (U1TH) llorin between May and June 2002. The Hospital is a second generation Teaching Hospital es- tablished on 2nd May, 1980. Currently, the hospital has a total bed space of 515 distributed as follows: i. General Hospital Wing, llorin with 304 beds;.
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...
Full Text Available The preached Jesus - The preaching of Jesus between theology and historism This article deals with the tension between the preaching of the gospel of Jesus (the preached Jesus as a source of joy on the one hand and the critical questions of the theologian (the historical Jesus on the other. In this field of tension the question arises: who Jesus is to us at this point in time. The author deals briefly with these two approaches. He pleads for caution against a rigorous confessional or doctrinal approach on the one hand and on the other an approach in terms of which only the historically founded may be stated. The author searches for a way where justice is done to the view that in Jesus we are confronted with the world of God, but where historical criticism is also taken seriously. In this quest Barth and Marquardt are used as partners in dialogue. The admission that the Spirit creates a bridge between God and man, guards preaching against petrification and opens the way to meaningful creativity. The author accepts that preaching in itself provides no answer, but creates a space in which Christ himself may enter to speak. This presupposition prevents an arrogant theology. The preacher and congregation pray that the Spirit of God enters this space to speak. It does not result in vague content, but leads the preacher to speak in a careful and humble way on Christ. The space is guarded by the diligent scanning of the witnesses regarding Jesus and by anchoring them in the books of Moses, the prophets and David. Through this testimony God enters into our midst.
Vicente Jara Vera
Full Text Available The Flemish painters Quentin Massys and his son Jan Massys appear to be the authors of four works with a very similar motif, the bust of Jesus Christ. These canvasses can be found in different locations today: the Prado Museum in Madrid (Spain, the RKD Netherlands Institute for Art History of The Hague (Netherlands, the Kunstmuseum Winterthur (Switzerland, and another one in a private collection. Written on the edge of the robe around the neck, these canvasses display a series of Hebrew or pseudo-Hebrew letters. We offer the complete solution deciphered, until today incomplete, for three of them, with a very similar letter sequence. Finally, we resolve completely one of the canvasses, which, until today, had no known solution.
J H van Wyk
Full Text Available �Is Christ divided?� Reflections on the theological justification of church disunity and church schismIn this article the author investigates the question whether a church schism could ever be justified. He considers on the one hand the Biblical message on church unity and on the other hand the many justifications of church disunity (schism. He concludes that most of these justifications are unacceptable rasionalisations and that Post-Reformation theology distanced itself far away from Biblical ecclesiology in this regard.
Full Text Available Images of Christ’s cross in the 4th and 5th centuriesThe Church Fathers did not have a common theory or system of atonement. Therefore, if one wants to appreciate what they had to say about atonement, one needs to study the rich images that pervade their literature. Their beliefs concerning atonement were not expressed in words, but in symbols, especially of the cross. This article discusses the various symbols of the cross of Christ which are to be found in the writings of theologians of the 4th and 5th centuries. Reijners (1965 has undertaken an exhaustive study of the images of the cross in the first three centuries, but the writings of the fourth and fifth centuries have never been scrutinized for these images.
Japie P. Malan
Full Text Available The metaphor ‘being crucified with Christ’ in sociohistorical contextCrucifixion is a concept that is far removed from the experience and understanding of the 21stcentury post-modern man. To understand the power of the message of the cross, one first has to determine what the meaning of crucifixion was to the person in antiquity. The relevant facts about the cross and crucifixion were intertwined with social and political realities of the time. This article endeavours to construct a valid and probable sociohistorical context for the metaphor [foreign font omitted] (‘I am being crucified with Christ’. The relevant terminology as well as the practice of crucifixion in ancient nations also receive attention. Possible differences in the shape of the cross and crucifixion procedures are being debated. The article also tries to conceive of the shame and rejection the condemned had to endure. The sociohistorical implications of the preposition ‘with’ will be discussed to indicate its meaning to the person from ancient times. What would such a person have understood and experienced when told that he had to be crucified with Christ? To any individual from that social and historical context such a statement would have immediately conjured up a clear picture of the price that was to be paid. It would have meant the renunciation of everything that was dear and essential in the life of that person; rejection of family and friends; inhuman pain, both physically and emotionally, as well as the knowledge that the decision was irrevocable.
Full Text Available Tacitus’ information about the beginnings of Christianity contains details, which may be historically precise. He learnt them, perhaps, from Christian followers of some other than the received tradition, whom he could have tried during his proconsulship of Asia. Dio’s account of the trial of Flavius Clemens and others is probably taken from Tacitus, who in his capacity of quindecemvir sacris faciundis could have participated or been interested in the trial. Dio’s actual formulation of this account omitting Christianity should thus be believed. The implication is that, when treating this affair in his Histories, prior to his sojourn to Asia, Tacitus need not have known anything yet about Christianity, and its beginnings in particular. His information would thus come exclusively from Asia and could be treated as such by modern scholarship.
U.S. Department of Health & Human Services — In October 2012, CMS began reducing Medicare payments for Inpatient Prospective Payment System hospitals with excess readmissions. Excess readmissions are measured...
U.S. Department of Health & Human Services — In October 2012, CMS began reducing Medicare payments for Inpatient Prospective Payment System hospitals with excess readmissions. Excess readmissions are measured...
U.S. Department of Health & Human Services — These are the official datasets used on the Medicare.gov Hospital Compare Website provided by the Centers for Medicare and Medicaid Services. These data allow you to...
U.S. Department of Health & Human Services — Use of medical imaging - provider data. These measures give you information about hospitals' use of medical imaging tests for outpatients. Examples of medical...
...), the hotel eventually felt the need to hire a director of social hospitality. Hotels -- big and small, luxury and economy, independent and chain -- are coming to grips with a new breed of consumer...
Allegheny County / City of Pittsburgh / Western PA Regional Data Center — The data on health care facilities includes the name and location of all the hospitals and primary care facilities in Allegheny County. The current listing of...
... get pneumonia while in the hospital if they: Abuse alcohol Have had chest surgery or other major ... Treatments may include: Antibiotics through your veins (IV) to treat the lung infection. The antibiotic you are given will fight the germs that ...
We report the results of a qualitative study that evaluated the effect of an educational intervention aimed at rural ... performance spiral in academically isolated rural hospitals. .... Heavy after-hrs workload, alcohol ... Continued academic stimula-.
Allegheny County / City of Pittsburgh / Western PA Regional Data Center — This data includes the number of people hospitalized with diabetes between 2013-2015, by age group, for Allegheny County Zip Codes.
U.S. Department of Health & Human Services — To provide a historical overview of the participating hospitals, before the first project report, Premier Healthcare Informatics has used data already available for...
U.S. Department of Health & Human Services — Section 4523 of the Balanced Budget Act of 1997 (BBA) provides authority for CMS to implement a prospective payment system (PPS) under Medicare for hospital...
... human resources management, financial management, marketing, strategic management, economics, business forecasting, information technology and development, national and international legislation will be considered for publication. Articles covering social theory and the history and politics of the hospitality industry ...
Özkil, Ali Gürcan
believe that these transportation tasks, to a great extent, can be and will be automated using mobile robots. This thesis consequently addresses the key technical issues of implementing service robots in hospitals. In simple terms, a robotic system for automating hospital logistics has to be reliable......, adaptable and scalable. Robots have to be semi-autonomous, and should reliably navigate in large and dynamic environments in the hospital. The complexity of the problem has to be manageable, and the solutions have to be flexible, so that the system can be applicable in real world settings. This thesis...... summarizes the efforts to address these issues. Upon the analysis of the transportation tasks and how they are currently handled in hospitals, a navigation system is envisaged. Visual tags are a part of this system, and a survey was conducted to find out the most prominent ones to be used in mobile robot...
Research in Hospitality Management. Journal Home · ABOUT · Advanced Search · Current Issue · Archives · Journal Home > Vol 5, No 1 (2015) >. Log in or Register to get access to full text downloads.
U.S. Department of Health & Human Services — Section 6001 of the Affordable Care Act of 2010 amended section 1877 of the Social Security Act to impose additional requirements for physician-owned hospitals to...
Holst, Malene Kirstine
This PhD project presents a design model that generates and evaluates hospital designs with respect to long-term performances and functionalities. By visualizing and quantifying costs and performances in the early design phases, it is possible to make design choices based on a qualified, profound...... foundation. The basis of the present study lies in solving the architectural design problem in order to respond to functionalities and performances. The emphasis is the practical applicability for architects, engineers and hospital planners for assuring usability and a holistic approach of functionalities...... and performances. By formal descriptions, a design model can weigh and compare the impact of different perspectives and, even in the early design phase, it can visualize and quantify consequences for design choices. By qualitative study of hospital design and hospital functionality, formal descriptions develop...
Klimov, A S; Gromov, M F
In December 2011 marked 80 years of the founding of the Ryazan garrison hospital, originally housed in two buildings: "Redut housed"--a monument of architecture of the XVIII century and the former almshouses room "for the maimed in the war", was built in 1884 now Ryazan garrison hospital (from 2010--Branch No 6 FSI "in 1586 the district military hospital in the Western Military District", the Defense Ministry of Russia)--a multi-field medical preventive institution on the basis of which soldiers, military retirees, family members and military retirees from Ryazan, Moscow, Tambov regions are treated. Every year more than 7 thousand patients get treatment here. During the counterterrorism operations in Chechnya over 800 wounded were brought to the hospital from the battle area.
... Equity of Care Hiring Veterans Hospitals Against Violence Organ Donation The Patient Care Partnership Put It In Writing ... Gout drug may increase risk of heart-related death AHA guide offers strategies for improving transportation for ...
... for kids, you'll probably also see medical students (who are learning to be doctors) and residents ( ... be glad to make you more comfortable. After spending time at the hospital, you should be on ...
Vermont Center for Geographic Information — (Link to Metadata) This data layer contains point locations of all major community, regional, comprehensive health, and healthcare provider hospitals in the state of...
Nutrition support in hospitals is becoming an area of focus because of the evidence showing improved clinical outcome with nutrition support, its status as a human rights issue and its integration into quality assurance.......Nutrition support in hospitals is becoming an area of focus because of the evidence showing improved clinical outcome with nutrition support, its status as a human rights issue and its integration into quality assurance....
Lugosi, Peter; Lynch, Paul; Morrison, Alison
This paper discusses the development of critical hospitality management research (CHMR) and explores key issues that such approaches raise. The paper is split into two parts. The first reviews contemporary writings that reflect the changing nature of hospitality management research and accounts for the emergence of a critical tradition. The second part identifies eight areas which are central concerns for the future development of CHMR: criticality, ethics and advocacy, scale, claims of legit...
Hospitals that hire contract service firms to manage one or all aspects of their hospitality service departments increasingly expect those firms to help meet total quality management goals as well as offer the more traditional cost reduction, quality improvement and specialized expertise, finds the 1992 Hospital Contract Services Survey conducted by Hospitals.
Full Text Available Byrne’s paper consists of two parallel texts. The first explores the limits of cosmopolitanism in practice, taking as its subject the Life in the UK Citizenship Test, inaugurated under the Labour Government in 2005. It argues that the test exemplifies the predicament of all attempts at cosmopolitan hospitality as unconditional welcoming, through a discussion of the relation between questioning and welcoming the stranger. Establishing the relationship between cosmopolitanism and hospitality as envisaged in Derrida’s reading of Kant it asks what kind of cosmopolitan hospitality is either possible or desirable by exploring what Derrida calls the ‘perversions’ inherent in the structures of hospitality. It focuses on the concept of the ‘trick questions’ that the state asks the foreigner observed by Derrida in his reading of The Apology of Socrates; questions that seem to invite answers but foreclose the possibilities of a free response. The second text asks how this logic that Derrida identifies can be pushed or coaxed into new ways of addressing the perceived threats of ‘unconditional’ hospitality through a reading of ‘unconditional hospitality’ as queer in the work of Tove Jansson.
El-Eid, Ghada R.; Kaddoum, Roland; Tamim, Hani; Hitti, Eveline A.
Abstract Delays in discharging patients can impact hospital and emergency department (ED) throughput. The discharge process is complex and involves setting specific challenges that limit generalizability of solutions. The aim of this study was to assess the effectiveness of using Six Sigma methods to improve the patient discharge process. This is a quantitative pre and post-intervention study. Three hundred and eighty-six bed tertiary care hospital. A series of Six Sigma driven interventions over a 10-month period. The primary outcome was discharge time (time from discharge order to patient leaving the room). Secondary outcome measures included percent of patients whose discharge order was written before noon, percent of patients leaving the room by noon, hospital length of stay (LOS), and LOS of admitted ED patients. Discharge time decreased by 22.7% from 2.2 hours during the preintervention period to 1.7 hours post-intervention (P discharge. Hospital LOS dropped from 3.4 to 3.1 days postintervention (P hospital was significantly lower in the postintervention period (6.9 ± 7.8 vs 5.9 ± 7.7 hours; P discharge time. The focus of institutions aspiring to tackle delays in the discharge process should be on adopting the core principles of Six Sigma rather than specific interventions that may be institution-specific. PMID:25816029
Boisen, Kirsten A; Boisen, Anne Bank; Thomsen, Stine Legarth
BACKGROUND: There is a need for youth-friendly hospital environments as the ward environment may affect both patient satisfaction and health outcomes. OBJECTIVE: To involve young people in designing youth-friendly ward environment. METHODS: We arranged a design competition lasting 42 h (Hackathon...... in two-bed wardrooms and social contact with other hospitalized AYA. The winning project included an integrated concept for both wardrooms and the AYA day room, including logos and names for the rooms and an 'energy wall' in the day room. CONCLUSION: A hackathon event was an effective mode of youth...... participation. The design concepts and ideas were in line with current evidence regarding pleasing hospital environment and youth-friendly inpatient facilities and may be applicable to other young patients....
Ludvigsen, Mette Spliid
Patient life in hospital.A qualitative study of informal relationships between hospitalised patients Introduction Within a patientology framework, this PhD dissertation is about an empirical study on patient life that provides insight into the nature of informal relationships between patients...... in the various hospital wards gives a varied potential for mutuality and the development of relationships. When patients build these informal and often short-lived relationships, they may make possible the intensifying of their wellbeing and possibly improve healing processes within themselves when they engage...
Tobias Nygren is Professor and Head of Department at the School of Hospitality, Culinary Arts, and Meal Science in Grythyttan, Sweden. He has been working for several years on meals, restaurants and hospitality. We meet at Grythyttan, and we need a few more lines to describe the place, which is quite unique in the Nordic food landscape. The School of Culinary Arts is a branch of the Örebro University and since 1993 it has offered multidisciplinary studies, combining science with practical sk...
Caracuel García, Ángel Manuel
Normalization can be understood as the establishing measures against repetitive situations through the development, dissemination, and application of technical design documents called standards. In Andalusia there are 45 public hospitals with 14,606 beds, and in which 11,700 full pensions / day are served. The Working Group on Hospital Food Standardization of the Andalusian Society for Clinical Nutrition and Dietetics, started in 2010, working on the certification of suppliers, product specifications, and meals technical card. - Develop a specific tool to help improving food safety through the certification of their suppliers. - Develop a standardized technical specifications of foodstuffs necessary for the development of menus established codes diets Andalusian hospitals document. - Develop a catalog of data sheets plates of hospital meals, to homogenize menus, respecting local and unifying criteria for qualitative and quantitative ingredients. - Providing documentation and studying of several public hospitals in Andalusia: • Product specifications and certification of suppliers. • International standards certification and distribution companies. • Legislation. • Data sheets for the menu items. • Specifications of different product procurement procedures. - Development of the draft standard HOSPIFOOD®, and approval of the version “0.0”. - Training course for auditors to this standard. - Development of a raw materials catalog as technical cards. - Meals Technical cards review and election of the ones which will be part of the document. After nearly three years of work, we have achieved the following products: - Standardized database of technical specifications for the production of food dietary codes for: fish, seafood, meat and meat products, meats and pates, ready meals, bread and pastries, preserves, milk and dairy products, oils, cereals, legumes , vegetables, fruits, fresh and frozen vegetables, condiments and spices. - Standardized database of
Hendricks, Ann M.
Average fiscal year 1982 wages from 2,302 rural American hospitals were used to test for a gradient descending from hospitals in counties adjacent to metropolitan areas to those not adjacent. Considerable variation in the ratios of adjacent to nonadjacent averages existed. No statistically significant difference was found, however. Of greater importance in explaining relative wages within States were occupational mix, mix of part-time and full-time workers, case mix, presence of medical residencies, and location in a high-rent county within the State. Medicare already adjusts payments for only two of these variables. PMID:10313454
This article builds around a framework of cure, care, control, and community, with collaboration at the center, to consider 12 issues common to many hospitals. These include, among others, the fragmentation of efforts, confusion in mission (and in mission statements), the problems of bundling research with clinical work, selectivity in informing board members, the dangers of professional management, and the difficulties of combining external advocacy with internal reconciliation in the senior manager's job. The article concludes that hospitals could better learn how to solve systemic problems systemically, and that to do so will require not the wish lists of strategic planning and structural reorganizing, but tangible changes in their collective behavior.
Stephen W. Litvin
Full Text Available Government policy has a significant impact on the hospitality and tourism industry, but it is unclear if political leaders fully understand this economic sector when crafting policies. This article offers new research about the direct involvement of industry practitioners in the political process, by analyzing the backgrounds of legislators in the six New England states. The data indicate that only 3% of these legislators have current or former careers related to hospitality and tourism. The author suggests that practitioners should seek election to political office, to better influence government policy.
Hospital mergers in Europe and North America have been launched to scale down expenditure, enhance the delivery of health care and elevate quality. However, the outcome of mergers suggest that they neither generated cost savings nor improved the quality of care. Almost all consolidations fall short, since those in leadership positions lack the necessary understanding and appreciation of the differences in culture, values and goals of the existing facilities. In spite of these shortcomings, hospital mergers will continue to be pursued in order to improve market share, eliminate excess capacity, gain access to capital and enhance the personal egos of the organizations' leaders.
Godiwalla, Y H; Batra, H C; Johnson, J A; Godiwalla, S Y
Hospital environments have changed dramatically over the past two decades. Hospitals now have to contend with the dynamics of regulation, market forces, and quality and cost-conscious environments. The strategies proposed here emulate the changes pursued by much of US industry. Provides a framework for analysing hospital environments. Applies Deming's total quality management concepts to hospitals. Also suggests strategies to deal effectively with different types of hospital environments.
Glenn A. Melnick PhD
Full Text Available A surge in hospital consolidation is fueling formation of ever larger multi-hospital systems throughout the United States. This article examines hospital prices in California over time with a focus on hospitals in the largest multi-hospital systems. Our data show that hospital prices in California grew substantially (+76% per hospital admission across all hospitals and all services between 2004 and 2013 and that prices at hospitals that are members of the largest, multi-hospital systems grew substantially more (113% than prices paid to all other California hospitals (70%. Prices were similar in both groups at the start of the period (approximately $9200 per admission. By the end of the period, prices at hospitals in the largest systems exceeded prices at other California hospitals by almost $4000 per patient admission. Our study findings are potentially useful to policy makers across the country for several reasons. Our data measure actual prices for a large sample of hospitals over a long period of time in California. California experienced its wave of consolidation much earlier than the rest of the country and as such our findings may provide some insights into what may happen across the United States from hospital consolidation including growth of large, multi-hospital systems now forming in the rest of the rest of the country.
that mixes ideals of goodness and beauty. What is the ritual of hospitality? It is a scene, in the theatrical sense of the word, with two central actors, whether individual or collective, one considered to be the host and the other the guest, with precise marking points in both time and space. Whether in the home, in the street, ...
Dzhandzhugazova, Elena A.; Blinova, Ekaterina A.; Orlova, Liubov N.; Romanova, Marianna M.
The article focuses on the study of the role and importance of innovation, its classification, the problems of its application in the hotel industry with emphasis on the application of sensory marketing tools in the development of the innovative marketing mix within the hospitality industry. The article provides an analysis of the "seven…
Department of Surgery, University of Maiduguri Teaching Hospital, Maiduguri, Borno State, Nigeria. ABSTRACT . Background: Incisional hernias (IH) represent a breakdown or loss of continuity of a fascial closure. They are thus unique as the only external wall hernias that are iatrogenic in aetiology. Incisional hernias are ...
It has a strong focus on issues which have an immediate practical application – giving the journal relevance to academics as well as industry practitioners. The journal includes articles from ... hospitality industry are welcome. As of 2016, this journal is open access under a Creative Commons Attribution Licence (CC BY 4.0).
for by volunteer workers who included; the Red Cross, med- ical and nursing students and their lecturers. The two-week strike at QECH has left an almost indelible mark in as far as tertiary level health care delivery in Malawi is concerned. We report on the conduct of the hospital workers strike and discuss ethical issues in ...
playing slot machines (and other automated gambling games), where the gamblers (consumers) produce their own games, as well as the payouts from those games. In all of these examples, the prosumer produces outcomes, does work, which was formerly done for them. That work was often performed in a hospitable ...
May 1, 2016 ... Application. The Hospitality may be extended under one or more of the following general circumstances to non- employees who are not in receipt of travel allowances from IDRC: • when discussions on official matters or business development take place;. • on the occasion of visits by persons who are ...
Management accounting for hospitals. Hennan leyenaar. The worldwide trend today is for the health sector to be under siege with increasing patient loads, more complex procedures and ever-rising medical costs. The cost of hospitalisation is the most dominant cost factor. absorbing most of the resources. Managing the ...
Review of the Aetiology and Complications of Primary Postpartum Haemorrhage following vaginal delivery at University of Calabar Teaching Hospital (UCTH), Calabar, Nigeria: A 5-year Review. EMAIL FULL TEXT EMAIL FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. CI Emechebe, CO Njoku, AN Njoku, ...
Poulsen, Signe; Jørgensen, Michael Søgaard
also identified. Research limitations: The assessment of the dietary changes based on the canteen take-away food was only based on indirect assessments based on interviews with users and non-users and furthermore based on a questionnaire at one of the hospitals. Value/originality: Canteen take...
cations were more pronounced in infants yo¡jnger than six months of age, in infants affected by RSV and in infants who had never been breast fed. Acknowledgment. We thank the medical students, the hou: e officers, the residents and the nurses at the pediatric emergency room and the pediatric ward at Assir Central Hospit ...
Current concepts in leadership and governance on the level of supervisory board, management and departments are often considered as insufficient to cope with the profound structural change which actually takes place in the German health care system. While vertical and horizontal disconnecting is typical of the professional bureaucracy of hospitals, transition from functional to divisional structure further increases this risk. Accordingly, medical experts are oriented towards their professional peers and patient care on the one side; on the other side the management gets isolated and looses operative and strategic control. Several studies provide evidence for the relevance of role models to serve as agents of change, which are now developed into the concept of "Clinical Governance": evidence-based medicine, guidelines, continuous quality improvement, safety culture, resource accountability and organisational learning. The present situation makes it necessary to extend this conception, which focuses on the departmental level in an organisation with divisional features, to one of "Clinical Corporate Governance". This term, which also includes supervisory structures and the management board and is relevant for the total hospital and company, respectively, is based on the corporate governance concept. Inside the hospital, the management and the heads of the departments have to agree that (1) experts really need to be integrated into the decision process, and that (2) the outcomes of the entire hospital have to be regarded as equal or superior to the aims of a single department. The public image of the hospital should be one of a strong and reliable partner in health care and health care business on a local, regional and national level. Members of the supervisory board should clearly put corporate aspects above political and other implications and pay attention to personal independence from the leaders of the medical departments.
Milanović, Jasmina; Milenković, Sanja; Pavlović, Momcilo; Stojanović, Dragos
This year Zemun Hospital--Clinical Hospital Center Zemun celebrates 230th anniversary of continuous work, thus becoming the oldest medical facility in Serbia.The exact date of the hospital founding has been often questioned in history. Various dates appeared in the literature, but the most frequent one was 25th of February 1784. Until now, the document which confirms this has never been published. This article represents the first official publication of the document which confirms that Zemun Hospital was indeed founded on this date. The first hospitals started emerging in Zemun when the town became a part of the Habsburg Monarchy. The first sanitary facility ever formed was the"Kontumac"--a quarantine established in 1730. Soon after, two more confessional hospitals were opened.The Serbian (Orthodox) Hospital was founded before 1769, whereas the German (Catholic) Hospital started working in 1758. Both hospitals were financed, amongst others, by the Town Hall--the Magistrate. In order to improve efficiency of these hospitals, a decision was made to merge them into a single City Hospital. It was founded on 25th February 1784, when the General Command ordered the Magistrate of Zemun to merge the financess of all existing hospitals and initiate the construction of a new building. Although financially united, the hospitals continued working in separate buildings over a certain period of time.The final, physical merging of these hospitals was completed in 1795.
Justesen, Lise; Gyimóthy, Szilvia; Mikkelsen, Bent E.
Hospital meals and their role in nutritional care have been studied primarily from a life and natural science perspective. This article takes a different approach and explores the idea of hospitality inspired by Jacques Derrida’s work on the ontology of hospitality. By drawing on ethnographic...... 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...... 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...
Justesen, Lise; Gyimóthy, Szilvia; Mikkelsen, Bent Egberg
reveal how the daily atmosphere could be changed by social activities such as a dancing nurse, or through artefacts such as meatballs or napkins in disruptive micro-events, creating a possibility for different hospitalityscapes manifested in cultural, humorous or social performances. The article suggests...... that a focus on disruptive micro-events might create opportunities for hospitalityscapes and add value to future hospital meal experiences....
Toode, Kristi; Routasalo, Pirkko; Helminen, Mika; Suominen, Tarja
The knowledge surrounding nurses' work motivation is currently insufficient, and previous studies have rarely taken into account the role of many influential background factors. This study investigates the motivation of Estonian nurses in hospitals, and how individual and organisational background factors influence their motivation to work. The study is quantitative and cross-sectional. An electronically self-reported questionnaire was used for data collection. The sample comprised of 201 Registered Nurses working in various hospital settings in Estonia. Data were analysed using descriptive statistics, two-sample Wilcoxon rank-sum (Mann-Whitney) test, Kruskal-Wallis equality-of-populations rank test and Spearman's correlation. Both extrinsic and intrinsic motivations were noted among hospital nurses. Nurses were moderately externally motivated (M = 3.63, SD = 0.89) and intrinsically strongly motivated (M = 4.98, SD = 1.03). A nurses' age and the duration of service were positively correlated with one particular area of extrinsic work motivation, namely introjected regulation (p extrinsic motivation (p = 0.016) and intrinsic work motivation (p = 0.004). The findings expand current knowledge of nurses' work motivation by describing the amount and orientation of work motivation among hospital nurses and highlighting background factors which should be taken into account in order to sustain and increase their intrinsic work motivation. The instrument used in the study can be an effective tool for nurse managers to determine a nurse's reasons to work and to choose a proper motivational strategy. Further research and testing of the instrument in different countries and in different contexts of nursing is however required. © 2014 Nordic College of Caring Science.
Full Text Available This hospital is built on the circular system. This arrangement has economic and functional advantages. The nurses walk 40 % less distance than in a hospital of similar size, of conventional layout. The rooms are situated along the external perimeter and the beds are orientated towards the corridor, rather than towards the window. However, the patients can see out of doors by turning on their side. The hospital is most carefully fitted out, and is very comfortable. There is air conditioning, and patients can control their own TV sets. There are also curtains separating each bed form the rest, thus providing maximum independence. Warm colours have been adopted in the decoration of rooms facing north, whilst those facing south are painted in cooler tones. The circular design arrangement makes the distribution far more flexible, and it will be easier to include further units later on; by adding small adjustments to the central building. To reduce external noise, and to improve the surrounding landscape, small sand hills have been provided in the garden, and the parking site also serves to partially absorb the noise.Presenta esta solución de unidades circulares numerosas ventajas de tipo económico, ahorra espacio y da eficiencia a la circulación— las enfermeras recorren un 40 por 100 menos de camino que en otro hospital de dimensiones similares—. Las habitaciones están distribuidas a lo largo del perímetro exterior y tienen las camas orientadas hacia los corredores, en lugar de hacia las ventanas, pero de tal modo que los pacientes puedan contemplar el exterior al volverse sobre uno de sus costados. Están cuidadosamente diseñadas y dotadas de las máximas comodidades: aire acondicionado y aparatos de televisión controlados por el paciente; así como cortinas divisorias que le proporcionan el grado de aislamiento deseado.
Hidalgo, Julio Villalobos; Orrit, Joan; Villalobos, Juan Pablo
This article describes the history, current status, advantages of and opposition to the implementation of e-procurement in hospitals and examines the results of its implementation in a psychiatric hospital.
Earth Data Analysis Center, University of New Mexico — Hospitals in New Mexico The term "hospital" ... means an institution which- (1) is primarily engaged in providing, by or under the supervision of physicians, to...
Throughout the past 30 years, there has been a lot of controversy surrounding the proliferation of new forms of health care delivery organizations that challenge and compete with general NFP community hospitals. Traditionally, the health care system in the United States has been dominated by general NFP (NFP) voluntary hospitals. With the number of for-profit general hospitals, physician-owned specialty hospitals, and ambulatory surgical centers increasing, a question arises: “Why is the general NFP community hospital the dominant model?” In order to address this question, this paper reexamines the history of the hospital industry. By understanding how the “general NFP hospital” model emerged and dominated, we attempt to explain the current dominance of general NFP hospitals in the ever changing hospital industry in the United States.
Novikov, V Ia; Alborov, Z Ts
History of the Volgograd military hospital dates back to July 24, 1941, when on the basis of the regional children's bone tuberculosis sanatorium in Krasnodar was transformed into 2150th military hospital consisted of 240 beds. Since May 1944 relocated in the city of Stalingrad became a garrison hospital. Today the hospital is a multidisciplinary health centre of the Russian Defense Ministry. Annually, the hospital performed at least 3000 surgical procedures, including more than 37%--are complex. In surgery, improved endovideosurgical direction, over 31% of emergency operations performed using this method. Since December 2009 the hospital became a structural division of the District Hospital in 1602 in Rostov on Don. The close connection between the branch and district hospital allows for complex diagnostic situations to consult leading experts, including consultation, thus ensuring the most effective treatment results.
Holst, Malene Kirstine; Kirkegaard, Poul Henning; Christoffersen, L.D.
Present paper presents a parametric performancebased design model for optimizing hospital design. The design model operates with geometric input parameters defining the functional requirements of the hospital and input parameters in terms of performance objectives defining the design requirements...
Zwanziger, Jack; Mooney, Cathleen
On Jan. 1, 1997, New York ended its regulation of hospital prices with the intent of using competitive markets to control prices and increase efficiency. This paper uses data that come from annual reports filed by all health maintenance organizations (HMOs) operating in New York and include payments to and usage in the major hospitals in an HMO's network. We estimate the relationship between implied prices and hospital, plan, and market characteristics. The models show that after 1997, hospitals in more competitive markets paid less. Partially offsetting these price reductions were price increases associated with hospital mergers that reduced the competitiveness of the local market. Hospital deregulation was successful, at least in the short run, in using price competition to reduce hospital payments; it is unclear whether this success will be undermined by the structural changes taking place in the hospital industry.
Egeberg, Alexander; Thyssen, Jacob P; Gislason, Gunnar H
Erythrodermic psoriasis (EP) and erythroderma exfoliativa (EE) are acute and potentially life-threatening inflammatory reactions. We estimated hazard ratios (HRs) of 3-year mortality following hospitalization for EP or EE compared with general population controls, patients hospitalized for psoria...
Houk, Scott; Cleverley, James O
A survey of finance leaders found that hospitals with lower charges were more likely than other hospitals to emphasize making prices defensible rather than simply transparent. Finance leaders of hospitals with higher charges were more likely to express concern that price transparency would cause a reduction in hospital revenue by forcing them to lower charges. Those respondents said commercial payers likely will have to agree to renegotiate contracts for price transparency to be a financially viable proposition.
ABSTRACT This paper reflects the application of visual methodologies adapted in an explorative study on hospitality and hospital meals. It takes point of departure in a multi-sited ethnographic fieldwork placed at a general hospital in 2012. Visual methodologies were applied in multiple ways....... This includes visual methodologies as part of observation and interview strategies. The paper presents and discusses how the application of different visual methodologies can contribute to the construction of ethnographical knowledge on hospitality and hospital meals. Finally ethical considerations as well...
Holst, Malene Kirstine; Kirkegaard, Poul Henning; Christoffersen, Lars D.
The present paper surveys the input parameters in hospital design and describes them formally as building attributes in preparation for facilitating planning and designing of hospitals with the aim of a more optimal design process. The overview of the hospital functionalities, bonds, logistics...... and needs is based on an approach of understanding the complexity of the hospital functionalities based on capacities, qualities and times beforehand specific department or units are described. This approach attempts to create an overview of the hospital functionalities respecting capacities, qualities...
Texas Tech Univ., Lubbock. Home Economics Curriculum Center.
This student activity book contains pencil-and-paper activities for use in a hospitality services course focusing on the food and lodging segments of the hospitality and tourism industry. The activities are organized into 29 chapters on the following topics: hospitality services industry; professional ethics; organization/management structures in…
Research indicates that hospitals manage their earnings. However, these findings might be influenced by methodological issues. In this study, I exploit specific features of Dutch hospitals to study income smoothing while limiting these methodological issues. The managers of Dutch hospitals have the
Sheridan, Mary S.
The Talk Time program, which focuses on discussion and encourages children to share their fears and fantasies of the hospital experience, was started at the University of Illinois hospital. It has proved effective as well in teaching hospital personnel about pediatric patients. (Author)
Haswell, Janis; Haswell, Richard; Blalock, Glenn
There has been little discussion of hospitality as a practice in college writing courses. Possible misuses of hospitality as an educational and ethical practice are explored, and three traditional and still tenable modes of hospitality are described and historicized: Homeric, Judeo-Christian, and nomadic. Application of these modes to…
Johnson, Eric D. M.; Kazmer, Michelle M.
Library scholars and practitioners have frequently reflected on the various factors that in combination make up a hospitable library, but there has been little theoretical synthesis of the notion of the library as a place of hospitality. The hospitality industry provides a rich vein of theoretical material from which to draw definitions of…
Purpose: The purpose of this paper is to explore current strands in hospitality management education and research, and suggest that future programs should reflect a more social science informed content. Design/methodology/approach: The paper reviews current research in hospitality management education and in the study of hospitality and…
Full Text Available Background: There has been conflicting data on whether Nursing Magnet Hospitals (NMH provide better care. Methods: NMH in the Southwest USA (Arizona, California, Colorado, Hawaii, Nevada, and New Mexico were compared to hospitals not designated as NMH using the Centers for Medicare and Medicaid (CMS hospital compare star designation. Results: NMH had higher star ratings than non-NMH hospitals (3.34 + 0.78 vs. 2.86 + 0.83, p<0.001. The hospitals were mostly large, urban non-critical access hospitals. Academic medical centers made up a disproportionately large portion of the NMH. Conclusions: Although NMH had higher hospital ratings, the data may favor non-critical access academic medical centers which are known to have better outcomes.
Kemper, Alex R; Kennedy, Emily J; Dechert, Ronald E; Saint, Sanjay
The objectives of this study were to determine the rate and risk factors for hospital readmission after inpatient treatment for bronchiolitis. We conducted a retrospective cohort study from 2000 to 2002. The readmission rate within 30 days was 3.7% (95% Confidence Interval: 2.1%-6.0%). Readmission was not associated with age, prematurity, respiratory syncytial virus status, receipt of intensive care, or the observation period off supplemental oxygen. Those who required supplemental oxygen had a lower risk of readmission. Identifying children at risk for readmission is challenging. Children who did not require supplemental oxygen may be at greater risk because they are progressing in their illness.
WESTERT, GP; NIEBOER, AP; GROENEWEGEN, PP
Whether one examines the average length of hospital stay at the level of geographic areas, at the level of hospitals, or at the level of doctors, length-of-stay figures are known to vary widely. Even for hospital admissions for comparable surgical procedures among comparable groups of patients,
Westert, Gert P.; Nieboer, Anna P.; Westert, G.P.; Groenewegen, Peter P.
Whether one examines the average length of hospital stay at the level of geographic areas, at the level of hospitals, or at the level of doctors, length-of-stay figures are known to vary widely. Even for hospital admissions for comparable surgical procedures among comparable groups of patients,
Westert, G.P.; Nieboer, A.P.; Groenewegen, P.P.
Whether one examines the average length of hospital stay at the level of geographic areas, at the level of hospitals, or at the level of doctors, length-of-stay figures are known to vary widely. Even for hospital admissions for comparable surgical procedures among comparable groups of patients,
The hospital environment of most Western countries is currently undergoing dramatic changes. Competition among hospitals is increasing, and economic issues have become decisive factors for the allocation of medical care. Hospitals therefore require management tools to respond to these changes adequately. The balanced scorecard is a method of enabling development and implementation of a business strategy that equally respects the financial requirements, the needs of the customers, process development, and organizational learning. This method was used to derive generally valid success factors for hospital management based on an analysis of an academic hospital in Switzerland. Strategic management, the focus of medical services, customer orientation, and integration of professional groups across the hospital value chain were identified as success factors for hospital management.
Busch, R W; Kay, S D; Voss, A
Objective To determine the incidence, duration and cause of hospitalization in a cohort of Danish patients with systemic lupus erythematosus (SLE). In addition, we investigated risk factors for admission and prolonged hospital stay. Methods A total of 155 SLE patients from a population-based cohort...... of 101 of the 155 SLE patients (65%) had one or more hospitalization during the study period. The incidence rate of all hospitalizations was 0.50 per year. Leading causes of admission were complications to SLE or its treatment, but infections were also common. Mean duration of hospital stay was 6.4 ± 10.......5 days, and SLE Disease Activity Index 2000 (SLEDAI-2K) on admission emerged as a risk factor for prolonged hospital stay. Conclusion Danish SLE patients experience frequent admissions to hospital. Complications to SLE or its treatment, as well as infections, are leading causes of admission. High SLEDAI...
NSGIC State | GIS Inventory — HOSPITALS_HAZUS_IN is a point shapefile that shows locations of hospitals and clinics in Indiana. HOSPITALS_HAZUS_IN was derived from the shapefile named "HOSPITAL."...
Gill, K.E. (HDR, Inc., Dallas, TX (United States)); Wozniak, A.L. (Pure Air Control Services, Inc., Clearwater, FL (United States))
Findings and remediation efforts performed over the past year in a large hospital are presented. Recommended practice in new design and retrofit to reduce the potential for microbial growth in HVAC systems in discussed. The request for a building health check at a large, central Florida hospital was prompted by concern for the welfare of employees and patients. This facility consists of approximately 830,000 sq ft of building with 985 patient beds and was constructed over the past 40 years with a diversity of mechanical systems ranging from fan-coils to multizone air handlers to dual-duct built up air handlers serving over 100,000 sq ft. All air distribution systems are served by a chilled-water and hot-water four-pipe system from a central chiller/boiler plant. Air filtration systems range from 20 percent throwaway panel filters to 40 percent prefilters and 95 percent final air handler filters. Outside air quantities range from 25 cfm per person to 100 percent outside air once-through systems.
Sihuin-Tapia, Elsa Yudy; Gómez-Quispe, Oscar Elisban; Ibáñez-Quispe, Vladimiro
In order to determine the satisfaction of hospitalized patients in the Sub-regional Hospital of Andahuaylas, 175 patients were surveyed using the Servqual multidimensional model. The estimate of variables associated with the satisfaction of the hospitalized patients was performed by using bivariate and multivariate logistic regression analysis. We found 25.0% satisfaction. Lower levels of satisfaction were associated with having a secondary level education (aOR: 0.05; 95% CI: 0.01 to 0.64) and with having been hospitalized in the surgery department (aOR 0.14, CI: 95%: 0.04 to 0.53). It was concluded that there was a low level of satisfaction with the quality of care received by hospitalized patients and this was associated with the level of education and type of hospital department.
Meernik, Clare; Baker, Hannah M; Paci, Karina; Fischer-Brown, Isaiah; Dunlap, Daniel; Goldstein, Adam O
Smoke and tobacco-free policies on hospital campuses have become more prevalent across the U.S. and Europe, de-normalizing smoking and reducing secondhand smoke exposure on hospital grounds. Concerns about the increasing use of electronic cigarettes (e-cigarettes) and the impact of such use on smoke and tobacco-free policies have arisen, but to date, no systematic data describes e-cigarette policies on hospital campuses. The study surveyed all hospitals in North Carolina (n = 121) to assess what proportion of hospitals have developed e-cigarette policies, how policies have been implemented and communicated, and what motivators and barriers have influenced the development of e-cigarette regulations. Seventy-five hospitals (62%) completed the survey. Over 80% of hospitals reported the existence of a policy regulating the use of e-cigarettes on campus and roughly half of the hospitals without a current e-cigarette policy are likely to develop one within the next year. Most e-cigarette policies have been incorporated into existing tobacco-free policies with few reported barriers, though effective communication of e-cigarette policies is lacking. The majority of hospitals strongly agree that e-cigarette use on campus should be prohibited for staff, patients, and visitors. Widespread incorporation of e-cigarette policies into existing hospital smoke and tobacco-free campus policies is feasible but needs communication to staff, patients, and visitors.
Full Text Available Smoke and tobacco-free policies on hospital campuses have become more prevalent across the U.S. and Europe, de-normalizing smoking and reducing secondhand smoke exposure on hospital grounds. Concerns about the increasing use of electronic cigarettes (e-cigarettes and the impact of such use on smoke and tobacco-free policies have arisen, but to date, no systematic data describes e-cigarette policies on hospital campuses. The study surveyed all hospitals in North Carolina (n = 121 to assess what proportion of hospitals have developed e-cigarette policies, how policies have been implemented and communicated, and what motivators and barriers have influenced the development of e-cigarette regulations. Seventy-five hospitals (62% completed the survey. Over 80% of hospitals reported the existence of a policy regulating the use of e-cigarettes on campus and roughly half of the hospitals without a current e-cigarette policy are likely to develop one within the next year. Most e-cigarette policies have been incorporated into existing tobacco-free policies with few reported barriers, though effective communication of e-cigarette policies is lacking. The majority of hospitals strongly agree that e-cigarette use on campus should be prohibited for staff, patients, and visitors. Widespread incorporation of e-cigarette policies into existing hospital smoke and tobacco-free campus policies is feasible but needs communication to staff, patients, and visitors.
Baceviciute, Sarune; Bruni, Luis Emilio; Burelli, Paolo
The idea of this pilot experiment within the context of the “Art in Hospitals” project was to explore the fruitfulness and future perspectives for integrating psychophysiological methods to the ethnographic approach so far implemented in the project. As a pilot study it serves to open the doors...... to experimental avenues that can support the ethnographic investigation. Therefore in order to form a basis for applications of these methodologies in future studies in the field, this pilot was concentrated in one of the initial premises of the project, which intended to challenge current recommendations for art...... in hospitals. Most of these guidelines favor figurative over abstract art, based on ideas leaning to the emotional congruence theory, which would claim that abstract art leads to ambiguity and therefore it could augment the current emotional base-line of an already stressed patient. The early ethnographic...
In this paper we outline the possibilities of an ethic of care based on our self-affection and subjectivity in the ethical spaces between-two. In this we first refer to three Irigarayan concepts - breath, silence and listening from the third phase of her philosophy, and discuss them within the methodological framework of an ethics of intersubjectivity and interiority. Together with attentiveness, we analyse them as four categories of our ethical becoming. Furthermore, we argue that self-affection is based on our inchoate receptivity for the needs of the other(s) and is thus dialectical in its character. In this we critically confront some epistemological views of our ethical becoming. We wind up this paper with a proposal for an ethics towards two autonomous subjects, based on care and our shared ethical becoming - both as signs of our deepest hospitality towards the other.
Prætorius, Thim; Hasle, Peter; Nielsen, Anders Paarup
To meet demands for high quality and efficient care, hospitals increasingly organize horizontally around standardized processes (like lean and care pathways) and/or set-up formal structural arrangements such as using performance boards, having daily huddles or assigning specific roles. This trend...... highlights a management paradox that calls for balancing a both/and approach to bureaucratization and collaboration in hospitals. Through a qualitative multiple, embedded case study of four hospitals, the paper investigates how standardized processes and structural arrangements—instances of organizational...... design—facilitate collaboration in hospitals. This is important as the literature on formal organization is disconnected from the informal aspects of the organization, thereby limiting the understanding of how hospitals function. Findings suggest that hospitals use many different types of organizational...
Schneider, John E; Miller, Thomas R; Ohsfeldt, Robert L; Morrisey, Michael A; Zelner, Bennet A; Pengxiang Li
Specialty hospitals, particularly those specializing in surgery and owned by physicians, have generated a relatively high degree of policy attention over the past several years. The main focus of policy debates has been in two areas: the extent to which specialty hospitals might compete unfairly with incumbent general hospitals and the extent to which physician ownership might be associated with higher usage. Largely absent from the debates, however, has been a discussion of the basic economic model of specialty hospitals. This article reviews existing literature, reports, and findings from site visits to explore the economic rationale for specialty hospitals. The discussion focuses on six factors associated with specialization: consumer demand, procedural operating margins, clinical efficiencies, procedural economies of scale, economies (and diseconomies) of scope, and competencies and learning. A better understanding of the economics of specialization will help policy makers evaluate the full spectrum of advantages and disadvantages of specialty hospitals.
Danvers, Kreag; Nikolov, Pavel
Organizations outsource non-core service functions to achieve cost reductions and strategic benefits, both of which can impact profitability performance. This article examines relations between managerial outsourcing decisions and profitability for a multi-state sample of non-profit hospitals, across 16 states and four regions of the United States. Overall regression results indicate that outsourcing does not necessarily improve hospital profitability. In addition, we identify no profitability impact from outsourcing for urban hospitals, but somewhat positive effects for teaching hospitals. Our regional analysis suggests that hospitals located in the Midwest maintain positive profitability effects with outsourcing, but those located in the South realize negative effects. These findings have implications for cost reduction efforts and the financial viability of non-profit hospitals.
Koys, Daniel J; Martin, Wm Marty; LaVan, Helen; Katz, Marsha
The authors address the hospital outcomes of patient satisfaction, healthcare quality, and net income per bed. They define union density as the percentage of a hospital's employees who are in unions, healthcare quality as its 30-day acute myocardial infraction (AMI; heart attack) mortality rate, and patient satisfaction as its overall Hospital Consumer Assessment of Healthcare Providers and Systems score. Using a random sample of 84 union and 84 nonunion hospitals from across the United States, multiple regression analyses show that union density is negatively related to patient satisfaction. Union density is not related to healthcare quality as measured by the AMI mortality rate or to net income per bed. This implies that unions per se are not good or bad for hospitals. The authors suggest that it is better for hospital administrators to take a Balanced Scorecard approach and be concerned about employee satisfaction, patient satisfaction, healthcare quality, and net income.
Freeland, Mark S.; Schendler, Carol Ellen; Anderson, Gerard
This paper describes the development of regional hospital input price indexes that is consistent with the general methodology used for the National Hospital Input Price Index. The feasibility of developing regional indexes was investigated because individuals inquired whether different regions experienced different rates of increase in hospital input prices. The regional indexes incorporate variations in cost-share weights (the amount an expense category contributes to total spending) associa...
Gluck, Jeannine Cyr; Hassig, Robin Ackley; Balogh, Leeni; Bandy, Margaret; Doyle, Jacqueline Donaldson; Kronenfeld, Michael R.; Lindner, Katherine Lois; Murray, Kathleen; Petersen, Joan; Rand, Debra C.
The Medical Library Association's “Standards for Hospital Libraries 2002” have been developed as a guide for hospital administrators, librarians, and accrediting bodies to ensure that hospitals have the resources and services to effectively meet their needs for knowledge-based information. Specific requirements for knowledge-based information include that the library be a separate department with its own budget. Knowledge-based information in the library should be directed by a qualified libr...
Lee, Keon-Hyung; Park, Jungwon; Lim, Seunghoo; Park, Sang-Chul
Hospital competition and managed care have affected the hospital industry in various ways including technical efficiency. Hospital efficiency has become an important topic, and it is important to properly measure hospital efficiency in order to evaluate the impact of policies on the hospital industry. The primary independent variable is hospital competition. By using the 2001-2004 inpatient discharge data from Florida, we calculate the degree of hospital competition in Florida for 4 years. Hospital efficiency scores are developed using the Data Envelopment Analysis and by using the selected input and output variables from the American Hospital Association's Annual Survey of Hospitals for those acute care general hospitals in Florida. By using the hospital efficiency score as a dependent variable, we analyze the effects of hospital competition on hospital efficiency from 2001 to 2004 and find that when a hospital was located in a less competitive market in 2003, its technical efficiency score was lower than those in a more competitive market.
Clare Meernik; Baker, Hannah M.; Karina Paci; Isaiah Fischer-Brown; Daniel Dunlap; Goldstein, Adam O.
Smoke and tobacco-free policies on hospital campuses have become more prevalent across the U.S. and Europe, de-normalizing smoking and reducing secondhand smoke exposure on hospital grounds. Concerns about the increasing use of electronic cigarettes (e-cigarettes) and the impact of such use on smoke and tobacco-free policies have arisen, but to date, no systematic data describes e-cigarette policies on hospital campuses. The study surveyed all hospitals in North Carolina (n = 121) to assess w...
Qualitative interviews and univariate logistic regression were conducted to determine predictors of out-of-hospital deaths. Results: Of 1,242 children discharged, 61 died during the six month post-discharge period, with most (n=40, 66%) dying outside of a hospital. Incremental increases in maternal education were ...
de Korne, Dirk F.; van Wijngaarden, Jeroen D. H.; Sol, Kees J. C. A.; Betz, Robert; Thomas, Richard C.; Schein, Oliver D.; Klazinga, Niek S.
Benchmarking is increasingly considered a useful management instrument to improve quality in health care, but little is known about its applicability in hospital settings. The aims of this study were to assess the applicability of a benchmarking project in U.S. eye hospitals and compare the results
Scanlon, Dennis P; Lindrooth, Richard C; Christianson, Jon B
To determine if a tiered hospital benefit and safety incentive shifted the distribution of admissions toward safer hospitals. A large manufacturing company instituted the hospital safety incentive (HSI) for union employees. The HSI gave union patients a financial incentive to choose hospitals that met the Leapfrog Group's three patient safety "leaps." The analysis merges data from four sources: claims and enrollment data from the company, the American Hospital Association, the AHRQ HCUP-SID, and a state Office of the Insurance Commissioner. Changes in hospital admissions' patterns for union and nonunion employees using a difference-in-difference design. We estimate the probability of choosing a specific hospital from a set of available alternatives using conditional logistic regression. Patients affiliated with the engineers' union and admitted for a medical diagnosis were 2.92 times more likely to select a hospital designated as safer in the postperiod than in the preperiod, while salaried nonunion (SNU) patients (not subject to the financial incentive) were 0.64 times as likely to choose a compliant hospital in the post- versus preperiod. The difference-in-difference estimate, which is based on the predictions of the conditional logit model, is 0.20. However, the machinists' union was also exposed to the incentive and they were no more likely to choose a safer hospital than the SNU patients. The incentive did not have an effect on patients admitted for a surgical diagnosis, regardless of union status. All patients were averse to travel time, but those union patients selecting an incentive hospital were less averse to travel time. Patient price incentives and quality/safety information may influence hospital selection decisions, particularly for medical admissions, though the optimal incentive level for financial return to the plan sponsor is not clear.
Infection control committee as the central decision-making and infection control team (ICT) for carrying out all aspects of infection control are important for hospital infection control. Standard precautions are used for all patients and apply to all body fluids except for sweat, whether or not they contain visible blood. Transmission-based precautions involve airborne, droplet, contact vector-borne and common vehicle precautions. Airborne precautions are for tuberculosis, varicella and measles. Small particles (precautions are for influenza, rubella, pertussis, and so on. Transmission via large droplet (transmissions are for blood-borne pathogens, such as hepatitis B and C virus and HIV, bacterial infections via percutaneous and mucocutaneous exposure, and so on. Vaccinations for measles, rubella, varicella, mumps, influenza and hepatitis B virus to health-care workers are important. Influenza virus is mainly transmitted via droplet and contact, but also via airborne transmission in the aerosol-generating procedures such as intubation and suctioning. WHO declared a public health emergency in April 2009. A novel influenza has spread rapidly across the globe, and it will be necessary to prepare for the outbreak in this autumn and winter.
Full Text Available Background. Bevacizumab (BEV, a humanized immunoglobulin G1 monoclonal antibody that inhibits VEGF has demonstrated activity against recurrent high-grade gliomas (HGG in phase II clinical trials. Patients and Methods. Data were collected from patients with recurrent HGG who initiated treatment with BEV outside a clinical trial protocol at two Belgian university hospitals. Results. 19 patients (11 M/8 F were administered a total of 138 cycles of BEV (median 4, range 1–31. Tumor response assessment by MRI was available for 15 patients; 2 complete responses and 3 partial responses for an objective response rate of 26% for the intent to treat population were observed on gadolinium-enhanced T1-weighted images; significant regressions on T2/FLAIR were documented in 10 out of 15 patients (67%. A reduced uptake on PET was documented in 3 out of 4 evaluable patients. The six-month progression-free survival was 21% (95% CI 2.7–39.5. Two patients had an ongoing tumor response and remained free from progression after 12 months of BEV treatment. Conclusions. The activity and tolerability of BEV were comparable to results from previous prospective phase II trials. Reduced uptake on PET suggests a metabolic response in addition to an antiangiogenic effect in some cases with favorable clinical outcome.
Larson, Paul C.
Explores integration of counseling psychology and neuropsychology in hospital setting. Sees example of such interchange occurring in rehabilitation unit or hospital where psychologist has responsibilities for helping patients, families, and staff to understand implications of central nervous system dysfunction and to adapt to changes. Discusses…
The population of Milton Keynes continues to grow and with it the need for more facilities in its recently opened community hospital. But how can the hospital cope now that Buckinghamshire AHA has put staff replacements under an embargo? Alison Hyde finds out how the staff are facing up to disappointed hopes, delayed plans and an establishment level which is one third under target.
Bradford Hudson, Ph.D.
Full Text Available An astonishing array of firsts and near firsts in the history of the modern hospitality sector have occurred in and around Boston, and some of the oldest surviving hospitality businesses in the United States may be found in the area today. This article explores the evolution of hotels and restaurants in Boston from 1633 to the present.
Brotherton, Bob, Ed.; And Others
Seven articles on hospitality management training discuss the following: computerized management games for restaurant manager training, work placement, real-life exercises, management information systems in hospitality degree programs, modular programming, service quality concepts in the curriculum, and General National Vocational Qualifications…
Proponents of hospital consolidation claim that mergers lead to significant cost savings, but there is little systematic evidence backing these claims. For a large sample of hospital mergers between 2000 and 2010, I estimate difference-in-differences models that compare cost trends at acquired hospitals to cost trends at hospitals whose ownership did not change. I find evidence of economically and statistically significant cost reductions at acquired hospitals. On average, acquired hospitals realize cost savings between 4 and 7 percent in the years following the acquisition. These results are robust to a variety of different control strategies, and do not appear to be easily explained by post-merger changes in service and/or patient mix. I then explore several extensions of the results to examine (a) whether the acquiring hospital/system realizes cost savings post-merger and (b) if cost savings depend on the size of the acquirer and/or the geographic overlap of the merging hospitals. Copyright © 2017 Elsevier B.V. All rights reserved.
Burwell, Rebecca; Huyser, Mackenzi
This article explores pedagogical approaches to teaching students how to practice hospitality toward the other. Using case examples from the college classroom, the authors discuss the roots of Christian hospitality and educational theory on transformative learning to explore how students experience engaging with others after they have…
Lynn, Christine; Hales, Jonathan A; Wiener, Paul
Internships can help hospitality faculty build industry relationships while also ensuring the best and most current training for their students. Many hospitality organizations have structured faculty internships available or are willing to work with faculty to provide individualized internship opportunities. Career and technical educators in…
Author Guidelines. Original research papers, substantive topic reviews, viewpoints and short communications that make an original contribution to the understanding of hospitality and hospitality management in a global context will be considered for publication in the Journal. Submissions should be e-mailed to the ...
Bradford Hudson, Ph.D.
An astonishing array of firsts and near firsts in the history of the modern hospitality sector have occurred in and around Boston, and some of the oldest surviving hospitality businesses in the United States may be found in the area today. This article explores the evolution of hotels and restaurants in Boston from 1633 to the present.
Kay, B G; Boyar, R L; Raspante, P S
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.
De Cauwer, Harald; Somville, Francis; Sabbe, Marc; Mortelmans, Luc J
In recent years, the world has been rocked repeatedly by terrorist attacks. Arguably, the most remarkable were: the series of four coordinated suicide plane attacks on September 11, 2001 on buildings in New York, Virginia, and Pennsylvania, USA; and the recent series of two coordinated attacks in Brussels (Belgium), on March 22, 2016, involving two bombings at the departure hall of Brussels International Airport and a bombing at Maalbeek Metro Station located near the European Commission headquarters in the center of Brussels. This statement paper deals with different aspects of hospital policy and disaster response planning that interface with terrorism. Research shows that the availability of necessary equipment and facilities (eg, personal protective clothing, decontamination rooms, antidotes, and anti-viral drugs) in hospitals clearly is insufficient. Emergency teams are insufficiently prepared: adequate and repetitive training remain necessary. Unfortunately, there are many examples of health care workers and physicians or hospitals being targeted in both political or religious conflicts and wars. Many health workers were kidnapped and/or killed by insurgents of various ideology. Attacks on hospitals also could cause long-term effects: hospital units could be unavailable for a long time and replacing staff could take several months, further compounding hospital operations. Both physical and psychological (eg, posttraumatic stress disorder [PTSD]) after-effects of a terrorist attack can be detrimental to health care services. On the other hand, physicians and other hospital employees have shown to be involved in terrorism. As data show that some offenders had a previous history with the location of the terror incident, the possibility of hospitals or other health care services being targeted by insiders is discussed. The purpose of this report was to consider how past terrorist incidents can inform current hospital preparedness and disaster response planning
Gentry, Melanie B
ANNUAL PERFORMANCE evaluations can be difficult to prepare and may rely, in part, on anecdotal information. PERIOPERATIVE RNs at CHRISTUS St Patrick Hospital, Lake Charles, La, developed and implemented a peer evaluation as part of nurses' annual performance evaluations. THE EVALUATION FORMS created were considered to be useful and fair by both staff members and managers.
The crisis in auction-rate securities is coming down hard on tax-exempt providers. Buyers are disappearing, sending interest rates soaring. Some hospitals and other healthcare borrowers are being forced to pay maximum interest. "Basically, the investor pool has all but vanished," says Melissa Williams, left, of Christus Health.
Kerwat, Klaus; Wulf, Hinnerk
Hospital clothing worn by medical personnel in German hospitals can be divided into two groups, work clothing and protective clothing. Work clothing is not changed between patient visits and hence is no measure of infection control. Its function is to protect private clothing and to identify medical personnel. Protective clothing on the other hand should protect staff and patients from nosocomial infections. It has to be changed between patient visits and is especially recommended with invasive procedures and immunocompromised patients.
Full Text Available Objectives: This paper evaluates the drivers of profitability for a large sample of U.S. hospitals. Following a methodology frequently used by financial analysts, we use a DuPont analysis as a framework to evaluate the quality of earnings. By decomposing returns on equity (ROE into profit margin, total asset turnover, and capital structure, the DuPont analysis reveals what drives overall profitability. Methods: Profit margin, the efficiency with which services are rendered (total asset turnover, and capital structure is calculated for 3,255 U.S. hospitals between 2007 and 2012 using data from the Centers for Medicare & Medicaid Services’ Healthcare Cost Report Information System (CMS Form 2552. The sample is then stratified by ownership, size, system affiliation, teaching status, critical access designation, and urban or non-urban location. Those hospital characteristics and interaction terms are then regressed (OLS against the ROE and the respective DuPont components. Sensitivity to regression methodology is also investigated using a seemingly unrelated regression. Results: When the sample is stratified by hospital characteristics, the results indicate investor-owned hospitals have higher profit margins, higher efficiency, and are substantially more leveraged. Hospitals in systems are found to have higher ROE, margins, and efficiency but are associated with less leverage. In addition, a number of important and significant interactions between teaching status, ownership, location, critical access designation, and inclusion in a system are documented. Many of the significant relationships, most notably not-for-profit ownership, lose significance or are predominately associated with one interaction effect when interaction terms are introduced as explanatory variables. Results are not sensitive to the alternative methodology. Conclusion: The results of the DuPont analysis suggest that although there appears to be convergence in the behavior of
Broom, Kevin; Elliott, Michael; Lee, Jen-Fu
Objectives: This paper evaluates the drivers of profitability for a large sample of U.S. hospitals. Following a methodology frequently used by financial analysts, we use a DuPont analysis as a framework to evaluate the quality of earnings. By decomposing returns on equity (ROE) into profit margin, total asset turnover, and capital structure, the DuPont analysis reveals what drives overall profitability. Methods: Profit margin, the efficiency with which services are rendered (total asset turnover), and capital structure is calculated for 3,255 U.S. hospitals between 2007 and 2012 using data from the Centers for Medicare & Medicaid Services’ Healthcare Cost Report Information System (CMS Form 2552). The sample is then stratified by ownership, size, system affiliation, teaching status, critical access designation, and urban or non-urban location. Those hospital characteristics and interaction terms are then regressed (OLS) against the ROE and the respective DuPont components. Sensitivity to regression methodology is also investigated using a seemingly unrelated regression. Results: When the sample is stratified by hospital characteristics, the results indicate investor-owned hospitals have higher profit margins, higher efficiency, and are substantially more leveraged. Hospitals in systems are found to have higher ROE, margins, and efficiency but are associated with less leverage. In addition, a number of important and significant interactions between teaching status, ownership, location, critical access designation, and inclusion in a system are documented. Many of the significant relationships, most notably not-for-profit ownership, lose significance or are predominately associated with one interaction effect when interaction terms are introduced as explanatory variables. Results are not sensitive to the alternative methodology. Conclusion: The results of the DuPont analysis suggest that although there appears to be convergence in the behavior of NFP and IO
This PhD thesis is a contribution to an ongoing debate in Denmark about improving the building design processes of complex buildings, especially in relation to the current hospital developments. It provides knowledge about capturing user needs and defines the process model for usability briefing...... for hospital architecture from a user perspective. The thesis is based on comprehensive literature studies, three main case studies at hospitals,numerous expert interviews and workshops. The research results generate a better understanding of how knowledge about user needs, acquired from workshops...
is overall related to the construction of new Danish hospitals, where the design concept healing architecture is introduced in a national context, representing the vision of a promoted healing process of hospitalised patients, supported by design related influence. Past research studies provides evidence...... that the physical environments affect the patients’ level of stress and influence their process of recovery and healing. However, although research in this field of hospital design has increased substantially in recent years, knowledge on the use of new materials and textiles in hospital interiors is still rather...
Coye, Molly Joel; Kell, Jason
Hospital technology decision makers now confront a growing pipeline of information technology (IT) and major medical equipment that challenges traditional capital allocation processes. In a highly fragmented industry that is driven by coverage and reimbursement policies set by the Centers for Medicare and Medicaid Services (CMS) and private insurers, the cumulative impact of hospitals' technology investment decisions shapes health care for decades.We propose a framework for the development of a national collaboration for the planning and assessment of emerging technologies, designed to improve the quality and efficiency of hospital decisions. Broader application of technology assessment would restrain inappropriate technology adoption and use.
Strømgaard, Sofie; Rasmussen, Søren Wistisen; Schmidt, Thomas Andersen
BACKGROUND: Crowded departments are a common problem in Danish hospitals, especially in departments of internal medicine, where a large proportion of the patients are elderly. We therefore chose to investigate the number and character of hospitalizations of elderly patients with a duration of less......, swollen or painful leg conditions, dyspnea, suspected parenchyma surgical disease and problems with the urinary system or catheters. The most common diagnoses given at hospital were chronic cardiovascular disease, bacterial infection, symptoms deriving from bone, muscle or connective tissue, liquid...
Norotte, C; Omnès, C; Crozier, C; Verlyck, C; Romanos, M
The availability of short-stay beds for brief admission (less than 72hours) of crisis patients presenting to the emergency room is a model that has gained a growing interest because it allows time for developing alternatives to psychiatric hospitalization and favors a maintained functioning in the community. Still, the determinants influencing the disposition decision at discharge after crisis intervention remain largely unexplored. The primary objective of this study was to determine the factors predicting aftercare dispositions at crisis unit discharge: transfer for further hospitalization or return to the community. Secondary objectives included the description of clinical and socio-demographic characteristics of patients admitted to the crisis unit upon presentation to the emergency room. All patients (n=255) admitted to the short-stay unit of the emergency department of Rambouillet General Hospital during a one-year period were included in the study. Patient characteristics were collected in a retrospective manner from medical records: patterns of referral, acute stressors, presenting symptoms, initial patient demand, Diagnostic and Statistical Manual, 5th edition (DSM-5) disorders, psychiatric history, and socio-demographic characteristics were inferred. Logistic regression analysis was used to determine the factors associated with hospitalization decision upon crisis intervention at discharge. Following crisis intervention at the short-stay unit, 100 patients (39.2%) required further hospitalization and were transferred. Statistically significant factors associated with a higher probability of hospitalization (P<0.05) included the patient's initial wish to be hospitalized (OR=4.28), the presence of a comorbid disorder (OR=3.43), a referral by family or friends (OR=2.89), a history of psychiatric hospitalization (OR=2.71) and suicidal ideation on arrival in the emergency room (OR=2.26). Conversely, significant factors associated with a lower probability of
U.S. Department of Health & Human Services — In the interest of promoting high-quality, patient-centered care and accountability, the Centers for Medicare and Medicaid Services (CMS) and Hospital Quality...
Focus and Scope. The Nigerian Hospital Practice Journal serves in enhancing advancement of medicine globally, a medium for disseminating information about current clinical and drug practices in Nigeria and medical science world, and a medium for continued medical education.
U.S. Department of Health & Human Services — Hospital Value-Based Purchasing (VBP) is part of the Centers for Medicare and Medicaid Services (CMS) long-standing effort to link Medicares payment system to a...
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...
Full Text Available How do European governments conceptualize what they call "hospitality" when they draft immigration laws and when they allow the concepts of asylum, of illegal immigrants, to change according to a constantly evolving political context? What consequences…
Bergenholtz, Heidi; Jarlbæk, Lene; Hølge-Hazelton, Bibi
Background: It can be challenging to provide generalist palliative care in hospitals, owing to difficulties in integrating disease-orientedtreatment with palliative care and the influences of cultural and organisational conditions. However, knowledge on the interactionsthat occur is sparse. Aim......: To investigate the interactions between organisation and culture as conditions for integrated palliative care in hospital and, ifpossible, to suggest workable solutions for the provision of generalist palliative care. Design: A convergent parallel mixed-methods design was chosen using two independent studies...... hospital with 29 department managements and one hospital management. Results: Two overall themes emerged: (1) ‘generalist palliative care as a priority at the hospital’, suggesting contrasting issues regardingprioritisation of palliative care at different organisational levels, and (2) ‘knowledge and use...
Walther-Larsen, S; Pedersen, M T; Friis, S M
BACKGROUND: Pain management in hospitalized children is often inadequate. The prevalence and main sources of pain in Danish university hospitals is unknown. METHODS: This prospective mixed-method cross-sectional survey took place at four university hospitals in Denmark. We enrolled 570 pediatric...... patients who we asked to report their pain experience and its management during the previous 24 hours. For patients identified as having moderate to severe pain, patient characteristics and analgesia regimes were reviewed. RESULTS: Two hundred and thirteen children (37%) responded that they had experienced...... pain in the previous 24 hours. One hundred and thirty four (24%) indicated moderate to severe pain and 43% would have preferred an intervention to alleviate the pain. In children hospitalized for more than 24 hours, the prevalence of moderate/severe pain was significantly higher compared to children...
mother allegedly mistreated for preeclampsia at Tripler Army Medical Center could maintain an action for medical malpractice nothwithstanding Feres.1 2...perinatologists at most military hospitals perform genetic counseling. Due to their primary responsibilities fo management of high risk pregnancies
Full Text Available The importance of waste management in hospitals is indisputable in preserving the environment and protecting public health, but management models are rarely discussed. This study presents the legal and conceptual frameworks of good waste management practices applicable to hospitals and associated indicators. As a case study, the overall performance of Hospital Centre of São João, in Porto, was analysed based on published reports. Data on the production of waste in their different typologies were collected from 2010 to 2016, enabling a correlation of the waste production with the kg/bed/day indicator. The aim of this study was to gather data and discuss trends in a real scenario of evolution over a six-year period in order to contribute to a future research proposal on indicators that can be used as reference for benchmarking the construction of methodological guides for hospital waste management.
Ana Cláudia Afonso Valladares
Full Text Available ABSTRACT: Hospitalization may have negative effects on child development. It takes the child off her routine and prevents her from contacts with stimulating environments. The aim of this work was to evaluate the development and quality on drew productions, before and after art therapy intervention, during the hospitalization of 7 to 10 years old children, with infectious diseases. It was proposed a quasi experimental design with a control group (n=9 and a group that was submitted to art therapy intervention (n=10. Results show that these interventions were effective in improving the development and the quality of the drawings. Hospitals can also be stimulating environments for children offering them caring practices that go beyond the disease. KEY WORDS: Art therapy; Pediatric Nursing; Hospitalization.
The use of aerospace medical techniques to improve the quality of earth health care systems is discussed. Data are focused on physiological measurements and monitoring, medical information management, clean room technology, and reliability and quality assurance for hospital equipment.
Presents statistics on the utilization of non-Federal short-stay hospitals based on data collected through the National Hospital Discharge Survey from a national sample of the hospital records of discharged inpatients...
Kathleen Carey; James F. Burgess; Gary J. Young
...: changes in service provision by general hospitals in local markets. Results suggest that general hospitals are stepping up their own offerings of services that are in direct competition with those of specialty hospitals...
DEVELOPMENT OF IMPROVED SOLID HOSPITAL WASTE MANAGEMENT PRACTICES IN A NIGERIAN TERTIARY HOSPITAL. ... Nigerian Journal of Technology ... A pre-intervention situation analysis was conducted to assess Hospital Waste Management (HWM) practices, solutions were proffered for the observed ...
Amoroso, V; Gjestvang, R
Air handling units should provide proper quality and conditioned air to various hospital areas. Unit capacity should be able to meet limited space functionality or load changes as well as any smoke control requirements. System components should be readily accessible and appropriate for spaces served. In summary, engineers should consider the following: Environmental design criteria for area being served Components desired Unit type required Economic issues affecting design. Using this approach, design engineers can design hospital air handling units methodically and logically.
Ruth Rios-Morales; Ian Jenkins
In the era of globalization, the economic contribution of the tourism, hospitality and leisure industry to the world’s GDP is significant. Tourism represents one of the main sources of income for many countries; tourism creates jobs, enhances exports and contributes to the economic welfare of a host country. Although the contribution of tourism, hospitality and the leisure industry in the era of globalization has been broadly recognized, there are also numerous challenges that this industry f...
Katoue, Maram Gamal; Al-Taweel, Dalal; Matar, Kamal Mohamed; Kombian, Samuel B
Purpose - The purpose of this paper is to explore parenteral nutrition (PN) practices in hospital pharmacies of Kuwait and identify potential avenues for quality improvement in this service. Design/methodology/approach - A descriptive, qualitative study about PN practices was conducted from June 2012 to February 2013 in Kuwait. Data were collected via in-depth semi-structured interviews with the head total parenteral nutrition (TPN) pharmacists at seven hospitals using a developed questionnaire. The questionnaire obtained information about the PN service at each hospital including the existence of nutritional support teams (NSTs), PN preparation practices, quality controls and guidelines/protocols. The interviews were audio-recorded, transcribed verbatim and analyzed for content. Findings - Seven hospitals in Kuwait provided PN preparation service through TPN units within hospital pharmacies. Functional NSTs did not exist in any of these hospitals. All TPN units used paper-based standard PN order forms for requesting PN. The content of PN order forms and PN formulas labeling information were inconsistent across hospitals. Most of the prepared PN formulas were tailor-made and packed in single compartment bags. Quality controls used included gravimetric analysis and visual inspection of PN formulations, and less consistently reported periodic evaluation of the aseptic techniques. Six TPN units independently developed PN guidelines/protocols. Originality/value - This study revealed variations in many aspects of PN practices among the hospitals in Kuwait and provided recommendations to improve this service. Standardization of PN practices would enhance the quality of care provided to patients receiving PN and facilitate national monitoring. This can be accomplished through the involvement of healthcare professionals with expertise in nutrition support working within proactive NSTs.
The term hospitality is associated with the industry of tourism. In fact, it is very well considered as a form of relationship between hosts and guest in that modern activity. Nevertheless, its historical root remains occulted in the bottom of darkness. Under that circumstance, ancient history contributes with hard evidence that proves hospitality was present and used as a mechanism to create legitimacy in the conquest of America. That way, Hominem viatores assured that Crown’s boundaries wer...
Martínez-Ramos, M; Flores-Pardo, E; Uris-Sellés, J
The aim of this article is to show that the redesign and planning process of hospital discharge advances the departure time of the patient from a hospital environment. Quasi-experimental study conducted from January 2011 to April 2013, in a local hospital. The cases analysed were from medical and surgical nursing units. The process was redesigned to coordinate all the professionals involved in the process. The hospital discharge improvement process improvement was carried out by forming a working group, the analysis of retrospective data, identifying areas for improvement, and its redesign. The dependent variable was the time of patient administrative discharge. The sample was classified as pre-intervention, inter-intervention, and post-intervention, depending on the time point of the study. The final sample included 14,788 patients after applying the inclusion and exclusion criteria. The mean discharge release time decreased significantly by 50 min between pre-intervention and post-intervention periods. The release time in patients with planned discharge was one hour and 25 min less than in patients with unplanned discharge. Process redesign is a useful strategy to improve the process of hospital discharge. Besides planning the discharge, it is shown that the patient leaving the hospital before 12 midday is a key factor. Copyright © 2015 SECA. Published by Elsevier Espana. All rights reserved.
Mansbach, Jonathan M; Clark, Sunday; Piedra, Pedro A; Macias, Charles G; Schroeder, Alan R; Pate, Brian M; Sullivan, Ashley F; Espinola, Janice A; Camargo, Carlos A
For children hospitalized with bronchiolitis, there is uncertainty about the expected inpatient clinical course and when children are safe for discharge. Examine the time to clinical improvement, risk of clinical worsening after improvement, and develop discharge criteria. Prospective multiyear cohort study. Sixteen US hospitals. Consecutive hospitalized children age <2 years with bronchiolitis. We defined clinical improvement using: (1) retraction severity, (2) respiratory rate, (3) room air oxygen saturation, and (4) hydration status. After meeting improvement criteria, children were considered clinically worse based on the inverse of ≥1 of these criteria or need for intensive care. Among 1916 children, the median number of days from onset of difficulty breathing until clinical improvement was 4 (interquartile range, 3-7.5 days). Of the total, 1702 (88%) met clinical improvement criteria, with 4% worsening (3% required intensive care). Children who worsened were age <2 months (adjusted odds ratio [AOR]: 3.51; 95% confidence interval [CI]: 2.07-5.94), gestational age <37 weeks (AOR: 1.94; 95% CI: 1.13-3.32), and presented with severe retractions (AOR: 5.55; 95% CI: 2.12-14.50), inadequate oral intake (AOR: 2.54; 95% CI: 1.39-4.62), or apnea (AOR: 2.87; 95% CI: 1.45-5.68). Readmissions were similar for children who did and did not worsen. Although children hospitalized with bronchiolitis had wide-ranging recovery times, only 4% worsened after initial improvement. Children who worsened were more likely to be younger, premature infants presenting in more severe distress. For children hospitalized with bronchiolitis, these data may help establish more evidence-based discharge criteria, reduce practice variability, and safely shorten hospital length-of-stay. © 2015 Society of Hospital Medicine.
Research in Hospitality Management: Journal Sponsorship. Journal Home > About the Journal > Research in Hospitality Management: Journal Sponsorship. Log in or Register to get access to full text downloads.
Van Gestel, Raf; De Graeve, Diana; Vrints, Christiaan; Rodrigus, Inez; Bosmans, Johan
Considering the sizeable cost of transcatheter aortic valve implantation (TAVI) and conflicting cost-effectiveness studies, it is useful to gain more insight into the cost structure of the TAVI hospitalization. This study provides such a cost analysis and starts to evaluate options to soften the hospitalization cost burden in order to make TAVI economically more feasible. Costs forTAVI hospitalization in the University Hospital of Antwerp were analysed uni- and bivariately. Graphical and numerical displays of the data are supplemented with the non-parametric Wilcoxon rank sum statistic and Spearman rank rho correlation. Overall, 47 percent of the cost could be attributed to the implanted valve and 21 percent was accounted for by the room costs. Further, costs seemed highly insensitive to pre-existing patient characteristics. Only patients with pulmonary hypertension were characterized with systematically higher costs (Wilcoxon rank sum P-value of 0.049). Complications related to TAVI had a significant upward impact on the costs and there was also evidence for a learning effect on total costs. In general the analyses showed that only limited options remain for cost reduction of the TAVI hospitalization cost. The most promising option is the reduction of the valve price. Avoidance of complications is hard to achieve given the current state of the art although this would significantly reduce overall costs.
There are so many obvious delays and inefficiencies in our traditional system of acute hospital care; it is clear that if outcomes are to be improved prompt accurate assessment immediately followed by competent and efficient treatment is essential. Early warning scores (EWS) help detect acutely ill patients who are seriously ill and likely to deteriorate. However, it is not known if any EWS has universal applicability to all patient populations. The benefit of Rapid Response Systems (RRS) such as Medical Emergency Teams has yet to be proven, possibly because doctors and nurses are reluctant to call the RRS for help. Reconfiguration of care delivery in an Acute Medical Assessment Unit has been suggested as a "proactive" alternative to the "reactive" approach of RRS. This method ensures every patient is in an appropriate and safe environment from the moment of first contact with the hospital. Further research is needed into what interventions are most effective in preventing the deterioration and\\/or resuscitating seriously ill patients. Although physicians expert in hospital care decrease the cost and length of hospitalization without compromising outcomes hospital care will continue to be both expensive and potentially dangerous.
Christus leeft in mij, en daartoe prediken wij de heden ten dage levende persoonlijkheid van Christus, niet alleen den historischen. Christus, die 1900 jaar geleden op aarde gewandeld heeft, maar Jezus. Christus, die nu nog elken dag naast ons staat.... Deze persoonlijke verhouding tot omgang met Jezus Christus komt tot ...
C. J. Bekker
Full Text Available The use of the 'sacrifice' of Isaac as a motif for the proclamation of Jesus as the suffering Christ. In this article the authors try to trace the possible influence of the sacrifice' of Isaac, as narrated in Genesis 22, on the proclanwtion of Jesus as the suffering Messiah. The New Testament authors made use of this tradition to explain the death and resurrection of Jesus within the context of Jewish belief As Abraham and Isaac were examples of suffering righteous figures, Jesus became the prime example of the suffering, Messiah for the Christian community and the believer under oppression.
J. L. Helberg (emeritus
Full Text Available The extraordinary birth of Jesus Christ and the reign of his church, especially regarding women The issue whether there is room for women in the special ser- vices of the church, especially as elder, is currently corespons- ible for tension within the Reformed Churches in South Africa (RCSA. The ruling task of the church is closely linked with the way God rules his people and with what the relation between Him and his people is. The book of Matthew shows that there is an essential unity but also a drastic difference between the Old Testament and the New Testament dispensations in this regard. This article investigates at what dominates both dispen- sations and how they differ concerning this. Sin disrupted humanness and harmony fundamentally and in the most intimate relations. In the old dispensation power was inter alia exercised by force, for example in slavery and disregard of women’s full humanness. The birth of Jesus Christ through the Holy Spirit from a woman without a man is the fulfilment of the Old Testament promises. All believers without difference in class or gender are recreated by Jesus Christ as the image of God and are reinstated in a personal relation with Him. Exercise of power over others, like in male domination of women and in earthly kingship and slavery makes room for being serviceable. Jesus Christ exercises his authority in a serving way. Especially his church must rule in a serving way by acknowledging Him as Head and testifying about his life, death and resurrection as contained in his Word. A believing woman is just as well equiped for this as a man.
Berry, Jay G; Ziniel, Sonja I; Freeman, Linda; Kaplan, William; Antonelli, Richard; Gay, James; Coleman, Eric A; Porter, Stephanie; Goldmann, Don
To describe parent perceptions of their child's hospital discharge and assess the relationship between these perceptions and hospital readmission. A prospective study of parents surveyed with questions adapted from the care transitions measure, an adult survey that assesses components of discharge care. Participant answers, scored on a 5-point Likert scale, were compared between children who did and did not experience a readmission using a Fisher's exact test and logistic regression that accounted for patient characteristics associated with increased readmission risk, including complex chronic condition and assistance with medical technology. A tertiary-care children's hospital. A total of 348 parents surveyed following their child's hospital discharge between March and October 2010. None. Unplanned readmission within 30 days of discharge. There were 28 children (8.1%) who experienced a readmission. Children had a lower readmission rate (4.4 vs. 11.3%, P = 0.004) and lower adjusted readmission likelihood [odds ratio 0.2 (95% confidence interval 0.1, 0.6)] when their parents strongly agreed (n = 206) with the statement, 'I felt that my child was healthy enough to leave the hospital' from the index admission. Parent perceptions relating to care management responsibilities, medications, written discharge plan, warning signs and symptoms to watch for and primary care follow-up were not associated with readmission risk in multivariate analysis. Parent perception of their child's health at discharge was associated with the risk of a subsequent, unplanned readmission. Addressing concerns with this perception prior to hospital discharge may help mitigate readmission risk in children.
de Korne, Dirk F; van Wijngaarden, Jeroen D H; Sol, Kees J C A; Betz, Robert; Thomas, Richard C; Schein, Oliver D; Klazinga, Niek S
Benchmarking is increasingly considered a useful management instrument to improve quality in health care, but little is known about its applicability in hospital settings. The aims of this study were to assess the applicability of a benchmarking project in U.S. eye hospitals and compare the results with an international initiative. We evaluated multiple cases by applying an evaluation frame abstracted from the literature to five U.S. eye hospitals that used a set of 10 indicators for efficiency benchmarking. Qualitative analysis entailed 46 semistructured face-to-face interviews with stakeholders, document analyses, and questionnaires. The case studies only partially met the conditions of the evaluation frame. Although learning and quality improvement were stated as overall purposes, the benchmarking initiative was at first focused on efficiency only. No ophthalmic outcomes were included, and clinicians were skeptical about their reporting relevance and disclosure. However, in contrast with earlier findings in international eye hospitals, all U.S. hospitals worked with internal indicators that were integrated in their performance management systems and supported benchmarking. Benchmarking can support performance management in individual hospitals. Having a certain number of comparable institutes provide similar services in a noncompetitive milieu seems to lay fertile ground for benchmarking. International benchmarking is useful only when these conditions are not met nationally. Although the literature focuses on static conditions for effective benchmarking, our case studies show that it is a highly iterative and learning process. The journey of benchmarking seems to be more important than the destination. Improving patient value (health outcomes per unit of cost) requires, however, an integrative perspective where clinicians and administrators closely cooperate on both quality and efficiency issues. If these worlds do not share such a relationship, the added
Full Text Available Introduction: Severe Psychiatricillness is accompanied by gross disturbances in patient's occupational role. This study presents a comparative picture of work performance before and after psychiatric hospitalization. Method: Subjects comprised 440 psychiatric admitters from Noor Medical center - Isfahan - Iran, who were followed from November 1999 to November 2000. Their work adjustment was measured by means of Weiss man's index. Data were computer analyzed using SPSS by running paired t- student and ANOVA. Results: Majority of the patients (53 % were without permanent sources of income before psychiatric hospitalization, about 12 percent of those who were working prior to hospitalization lost their job after being discharged from hospital. Better work adjustment before hospitalization was positively correlated with better work adjustment after discharge for working patients (r =0/66. Working ability of the patients after discharge was lesser than before the attack f9r patients with regular and irregular job (P < 001. Discussion: Job loss or poor working ability after psychiatric admission reported by several researchers and has bean confirmed in this study as well. These observatoins have been discussed in view of the current socio economic problems in the society and nature of psychiatric disturbances.
van Merode, Godefridus G; Groothuis, Siebren; Hasman, Arie
Integrated hospitals need a central planning and control system to plan patients' processes and the required capacity. Given the changes in healthcare one can ask the question what type of information systems can best support these healthcare delivery organizations. We focus in this review on the potential of enterprise resource planning (ERP) systems for healthcare delivery organizations. First ERP systems are explained. An overview is then presented of the characteristics of the planning process in hospital environments. Problems with ERP that are due to the special characteristics of healthcare are presented. The situations in which ERP can or cannot be used are discussed. It is suggested to divide hospitals in a part that is concerned only with deterministic processes and a part that is concerned with non-deterministic processes. ERP can be very useful for planning and controlling the deterministic processes.
Attias, D; Tal, Y; Winter, S T; Jaffe, M
This study comprises 260 children aged less than or equal to 13 yr hospitalized following accidents during a 9-mo period for a total of 923 hospital days. The ratio of boys to girls was 1.8:1. There were 21 road accidents and 104 accidents in the home; 75.4% of the accidents took place after school hours. Half of the admissions were for head trauma; 96 injuries were serious; and 78 patients required general anesthesia. In 67 families, there had been at least one previous childhood accident requiring hospitalization of the cohort child or sibling; factors in this group may have been the child's temperament or tension in the home.
Özkil, Ali Gürcan
be and will be automated using mobile robots. This talk consequently addresses the key technical issues of implementing service robots in hospitals. In simple terms, a robotic system for automating hospital logistics has to be reliable, adaptable and scalable. Robots have to be semi-autonomous, and should reliably...... for localization. The system features automatic annotation, which significantly reduces manual work and offer many advantages beyond robotics. A case study on logistics solutions is finally presented. A robotic solution is tested in a hospital to handle the transportation of blood samples between the clinic...... and the lab. Without any environmental modification; it is shown that lab turnover time can be reduced from hours to minutes; by simply replacing the human porter with a mobile robot....
Traverso, G; Lu, C -C; Maa, R; Langer, R; Bourouiba, L
Hospital-acquired infections represent significant health and financial burdens to society. Clostridium difficile (C. difficile) is a particularly challenging bacteria with the potential to cause severe diarrhea and death. One mode of transmission for C. difficile, as well as other pathogens, which has received little attention is the potential air contamination by pathogen-bearing droplets emanating from toilets. In the fluid dynamics video submitted to the APS DFD Gallery of Fluid Motion 2013, we present flow visualizations via high-speed recordings showing the capture of the product of the fluid fragmentation generated by hospital toilet high-pressure flushes. Important quantities of both large and small droplets are observed. We illustrate how high-pressure flushes and cleaning products currently used in hospital toilets result in aggravating, rather than alleviating, the suspension and recirculation of tenacious airborne pathogen-bearing droplets.
Hospitality is often understood as an ethical openness towards the other. Hospitality, in this way, is a gift. But is this really the situation of hospitality in the world today? Europeans have created another, bespoke hospitality and they insist on being given a generous welcome all over the world
Flynn, Maureen; McCarthy, Geraldine
The aim of this research was to investigate characteristics of the nursing practice environment and the impact of organizational structures and processes on nursing in 11 major acute general hospitals in Ireland from the perspective of staff-nurses (n = 368) and Directors of Nursing (n = 10). The study was descriptive, cross-sectional and quantitative. The Nursing Work Index-Revised (NWI-R) and an instrument developed by Havens were used and Directors of Nursing supplied hospital documentary evidence of organizational structures and processes. A convenience sample of 368 staff-nurses and 10 Directors of Nursing, participated. Staff-nurses had a moderately positive perception of relationships with doctors (2.77); autonomy in practice (2.56); organizational support (2.51) and control over practice settings (2.35). A significant statistical difference was found between the practice environments in the 11 hospitals, particularly in relation to organizational support (P = 0.001); control over practice setting (P = 0.003); nurse autonomy (P = 0.004) and nurse-doctor relationships (P = 0.024). When comparisons were made with US Magnet hospital research findings, lower scores on all dimensions of professional practice environment were achieved by Irish nurses.
and long-term development. In broader terms the objectives were to formulate practical short- and long-term plans for the development of information systems, and to create management policies intended to guarantee the success of the hospital's data processing function. A synopsis of the methodology of the HIPS and its ...
care delivery. Methods: This is a retrospective study evaluating the causes of deaths which occurred during the years 1997-2006 in Alwahda hospital, Derna, Libya. The leading causes of deaths were classified according to the nature of the ...
Taunton, R L; Perkins, S; Oetker-Black, S; Heaton, R
Lack of standardization in formulas for calculating absenteeism impeded comparison among institutions and comparison to rates reported for the health care industry. Even though illness related benefits, replacement costs for absent employees and attendance incentives absorbed scarce financial resources, more than 40% of hospitals had no standard for excessive absence. Directors of nursing were concerned about staffing and the possibility that employees were tiring to the point of becoming ill. Among directors, concern about absenteeism was greatest in urban hospitals of 100-200 beds.
Henríquez Martínez, T; Armero Fuster, M
A review of the following points was performed: Factors favouring the development and presence of malnutrition among hospitalized patients. Useful parameters in nutritional evaluation. Types of malnutrition. The Chang nutritional evaluation protocol is used in our Hospital, which is simple, inexpensive, reliable, specific and easily reproduced. This is based on five variables (three anthropometric and two biochemical), randomized and based on reference tables and values. A study was made on data corresponding to 70 patients, in whom a prevalence of malnutrition was observed in critical patients. The patients were classified based on three different definitive possibilities (Marasmo, Kwashiorkor and combined), and three grades of malnutrition (slight, moderate and severe).
Gargallo, Ana; Gómez-Varela, Ana I.; González-Nuñez, Hector; Delgado, Tamara; Almaguer, Citlalli; Cambronero, Ferran; Garcia-Sanchez, Angel; Flores-Arias, Maria T.
USC-OSA is a student chapter whose objective is to bring Optics knowledge closer to the non-optics community. The activity developed at the Hospital school was one of the most important last year. It was consisted in a few Optics experiments and workshops with hospitalized children of different ages and pathologies. The experiments had to be adapted to their physical conditions with the aim of everyone could participate. We think this activity has several benefits including spreading Optics through children meanwhile they have fun and forget their illness for a while.
Haindl, Friedrich F.
Full Text Available It consists of: the actual hospital, one house for the staff, one service yard and underground garage. The hospital comprises four storeys and two basements, whilst the other building only has three floors. On the ground floor of the hospital are we located: the entrance; the nucleus of vertical communication; work rooms for the doctors and nurses; the administration section; X-ray and cobalt installations; and a small chapel. The three remaining upper floors contain 160 beds distributed over 6 wards and in single, double or triple rooms. Each floor is equipped with a service section. The first basement includes the ambulance entrance, the medical wards of the hospital, the staff dining-room, a kitchen and the heating installation. The second basement is reserved for kitchen storage rooms and the remaining installations of the building. Structure of reinforced concrete and outer walls of brick covered with panels of washed concrete.Está formado por: el hospital propiamente dicho, un edificio destinado a viviendas para el personal, patio de servicio y garaje subterráneo. El hospital consta de cuatro plantas y dos sótanos, mientras que el otro edificio sólo tiene tres plantas. En la planta baja del hospital se encuentran: la entrada; el núcleo de comunicación vertical; las salas de trabajo de médicos y enfermeras; la zona de administración; las instalaciones de rayos X y bomba de cobalto; y una pequeña capilla. En las tres plantas superiores se distribuyen 160 camas repartidas en seis unidades de hospitalización, con habitaciones de 1, 2 ó 3 camas. Cada planta cuenta, además, con una zona de servicio. En el primer sótano se hallan, además de la entrada de ambulancias, los servicios médicos del hospital, los comedores del personal, una cocina, y la instalación de calefacción. El segundo sótano se dedica, en su totalidad, a almacenes de la cocina y del resto de las instalaciones del edificio. Estructura de
Smith, R P
We have all faced the problem of whether or not to venture into that gastronomic wasteland known as the hospital cafeteria. Hospital cafeterias have developed a reputation, deserved or otherwise, as less than ideal places to eat. Many people overlook the fact that this is a direct result of trying to provide patient meals that are salt-free, sugar-free, fiber-free, and taste-free. (Some faint traces of color may, occasionally, be found.) How then does one go about choosing whether to venture in, and how does one survive the encounter once there? The following guide has been assembled to help the reader through this difficult process.
Full Text Available Responsible management of global hospitality companies increasingly recognizes how important are concerns about the society, the environment as well as all stakeholders in maintaining a good market position. In Serbia, the concept of corporate social responsibility is relatively unknown and insufficiently researched in all business areas, especially in the hospitality industry where small businesses are dominated. The papers task is to present particular activities that demonstrate social responsibility to employees, customers-guests, local communities as well as the environment. The paper aims to highlight the benefits of adopting the principles of corporate social responsibility and innovation applied in catering enterprises as an example of good corporate social responsibility practices.
Berry, Jay G.; Ziniel, Sonja I.; Freeman, Linda; Kaplan, William; Antonelli, Richard; Gay, James; Coleman, Eric A.; Porter, Stephanie; Goldmann, Don
Objective To describe parent perceptions of their child's hospital discharge and assess the relationship between these perceptions and hospital readmission. Design A prospective study of parents surveyed with questions adapted from the care transitions measure, an adult survey that assesses components of discharge care. Participant answers, scored on a 5-point Likert scale, were compared between children who did and did not experience a readmission using a Fisher's exact test and logistic regression that accounted for patient characteristics associated with increased readmission risk, including complex chronic condition and assistance with medical technology. Setting A tertiary-care children's hospital. Participants: A total of 348 parents surveyed following their child's hospital discharge between March and October 2010. Intervention None. Main Outcome Measure Unplanned readmission within 30 days of discharge. Results There were 28 children (8.1%) who experienced a readmission. Children had a lower readmission rate (4.4 vs. 11.3%, P = 0.004) and lower adjusted readmission likelihood [odds ratio 0.2 (95% confidence interval 0.1, 0.6)] when their parents strongly agreed (n = 206) with the statement, ‘I felt that my child was healthy enough to leave the hospital’ from the index admission. Parent perceptions relating to care management responsibilities, medications, written discharge plan, warning signs and symptoms to watch for and primary care follow-up were not associated with readmission risk in multivariate analysis. Conclusions Parent perception of their child's health at discharge was associated with the risk of a subsequent, unplanned readmission. Addressing concerns with this perception prior to hospital discharge may help mitigate readmission risk in children. PMID:23962990
Reddy, Madhu C; Purao, Sandeep; Kelly, Mary
This article presents a study identifying benefits and challenges of a novel hospital-to-hospital information technology (IT) outsourcing partnership (HHP). The partnership is an innovative response to the problem that many smaller, rural hospitals face: to modernize their IT infrastructure in spite of a severe shortage of resources. The investigators studied three rural hospitals that outsourced their IT infrastructure, through an HHP, to a larger, more technologically advanced hospital in the region. The study design was based on purposive sampling and interviews of senior managers from the four hospitals. The results highlight the HHP's benefits and challenges from both the rural hospitals' and vendor hospital's perspectives. The HHP was considered a success: a key outcome was that it has improved the rural hospitals' IT infrastructure at an affordable cost. The investigators discuss key elements for creating a successful HHP and offer preliminary answers to the question of what it takes for an HHP to be successful.
Is there something distinct about the traditional Hospitality Management curriculum? First offered in 1893 at the Ecole Hoteliere Lausanne in Switzerland and launched in the United States at The School of Hotel Administration at Cornell University in 1922, has this course of study evolved over time to focus on both of Meyer's skills - originally based on technical skills but now transforming to emotional skills?
Wagner, C.; Cuperus-Bosma, J.; Wal, G. van der
In various studies outside the Netherlands, it has been shown that a substantial number of patients suffer from some kind of harm during their treatment in hospital. The incidence of these so-called adverse events varies between 2.9% and 16.6%; it is estimated that between over a quarter and a half
Li, Yuguo; Nielsen, Peter V.; Sandberg, Mats
Hospital differ from conventional buildings in terms of ventilation needs. Exhaled infectious droplets or droplet nuclei of an infected patient need to be removed in general wards, waiting areas and isolation rooms to minimize transmission to health-care workers, other patients and visitors...
van Merode, Godefridus G.; Groothuis, Siebren; Hasman, Arie
Integrated hospitals need a central planning and control system to plan patients' processes and the required capacity. Given the changes in healthcare one can ask the question what type of information systems can best support these healthcare delivery organizations. We focus in this review on the
cardiology and the development of cardiac magnetic resonance imaging. • Nephrology and renal transplantation: The ... The hospital, when fully functional, will have 24 neonatal and 24 paediatric ICU and ... Imaging: State-of-the-art magnetic resonance imaging, computed tomography and positron emission tomography- ...
Nelson, Elizabeth A.
This annotated bibliography is a sample collection of reference materials in the hospitality industry suitable for a small academic library. It is assumed that the library has a general reference collection. Publication dates range from 1992-96, with two publication dates in the 1980s. No periodicals are included. The 41 reference materials are…
Conciu.-riorr.'This study concluded that the initial clinical and radiological evaluation of patients with suspected CSI in iiilulago Hospital was inadequate with sorne injuries being missed alto-getlrer. INTRO DUCTIDN. Cervical Spine injury ECSI} occur in 2-5% oi' all trauma casesii] and in 5-10% of all major trauma cases 12}.
Blanken, Anneloes; Dewulf, Geert P.M.R.; Bult-Spiering, Mirjam; Abel, J.; Barlow, J.; Carthey, J.; Codinhoto, R.; Dewulf, G.; Dilani, A.
Over the last decade hospitals concessions have been increasingly implemented around the world. Nonetheless, concession arrangements are subject to many criticisms, which are to a large extent related to the issue of flexibility. Several authors have expressed concerns as to whether concession
In addition to the behind-the-scenes work involved with planning and implementing continuing nursing education activities, there are additional ways we can enhance the learner's experience. This article presents ideas on how to improve your hospitality quotient. Copyright 2015, SLACK Incorporated.
Rognås, Leif Kåre; Christensen, Erika Frischknecht; Sloth, Erik
Danish anaesthesiologists use ultrasound (US) to examine and treat acutely ill or traumatized patients in the emergency room, operating theatre and intensive care unit. They are also involved in pre-hospital care where US may theoretically be beneficial for both diagnostic and therapeutic purpose...
Stidsen, Lone Mandrup
by the patients in the ward. The project is based on the Danish Regulation for light in hospitals (DS703), which is a supplement to the regulation of artificial lighting in workplaces (DS700). The kick-off to the project was reading the DS703, second paragraph, chapter 2 about general requirements for lighting...
110 million with a blindness prevalence rate of 1%. Cataract is responsible ... contribution of teaching hospitals to the prevention of blind- ness. Several factors ... All the adult patients before the age of 40 had extracapsular cataract extraction; those above had intracapsular cataract extraction. The children all had congenital ...
Weil, T P; Hollingsworth, A T
Reduced inpatient census has created an overstaffing problem in many hospitals. Managers, unfamiliar with the layoff process, are now faced with reducing staffing levels. Detailed here are the options available for and the policies, procedures, and implementation of a reduction in force.
completed week of gestational age as attributed for nearly 40% of all maternal calculated from the last menstrual period deaths (6). ..... HIV-1 infection, gonorrhea and syphilis at Five Hospital in the city of Addis Ababa: was not found to be significantly different WHO, Multi-center Survey by abortionists, in patients with ...
Grimes, Tamasine C
Movement into or out of hospital is a vulnerable period for medication safety. Reconciling the medication a patient is using before admission with the medication prescribed on discharge, and documenting any changes (medication reconciliation) is recommended to improve safety. The aims of the study were to investigate the factors contributing to medication reconciliation on discharge, and identify the prevalence of non-reconciliation.
Kunkel, Martin; Morbach, Thomas; Kleis, Wilfried; Wagner, Wilfried
The aim of this study was to describe demographic and clinical patterns of subjects hospitalized with complications associated with third molars (M3). The investigation was designed as a prospective cohort study composed of subjects admitted to hospital for management of M3-associated complications. The predictor variable was "clinical status of the M3" defined as (A) prophylactic M3 removal, (B) nonelective M3 removal, or (C) M3 present at the time of admission. Outcome variables were infection parameters, treatment costs, length of hospital stay, and days of disability. Postoperative complications (A and B) were compared to complications based on pericoronitis (C). Complications due to prophylactic removal (A) were compared to those arising from pericoronitis or from the removal of symptomatic teeth (B and C). From January 2003 to December 2004, 45 deep space infections, 6 mandibular fractures, 2 lingual nerve injuries, 1 parapharyngeal tooth luxation, and 1 osteomyelitis were noticed. Fifteen complications resulted from prophylactic surgery (A), 25 from nonelective removal (B), and 15 from pericoronitis (C). Direct treatment costs were 147,000 euro (A: 42,000 euro; B: 74,000 euro; C: 31,000 euro). In 10 of the 15 patients of group C, deep space involvement resulted immediately from the first episode of pericoronitis. Neither clinical markers of infection nor economic parameters showed significant differences between the groups. Within the catchment area of our institution, the majority of third molar-related hospitalizations resulted from diseased third molars or their removal.
Tudela, Pere; Mòdol, Josep Maria
Recent years have seen a range of measures deployed to curb crowding in hospital emergency departments, but as episodes of overcrowding continue to occur the discussion of causes and possible solutions remains open. The problem is universal, and efforts to revamp health care systems as a result of current socioeconomic circumstances have put emergency services in the spotlight. Consensus was recently achieved on criteria that define emergency department overcrowding. The causes are diverse and include both external factors and internal ones, in the form of attributes specific to a department. The factors that have the most impact, however, involve hospital organization, mainly the availability of beds and the difficulty of assigning them to emergency patients requiring admission. Crowding is associated with decreases in most health care quality indicators, as departments see increases in the number of patients waiting, the time until initial processing, and the time until a physician or nurse intervenes. Crowding is also associated with risk for more unsatisfactory clinical outcomes. This situation leads to dissatisfaction all around-of patients, families, and staff-as aspects such as dignity, comfort, and privacy deteriorate. Proposals to remedy the problem include assuring that the staff and structural resources of a facility meet minimum standards and are all working properly, facilitating access to complementary tests, and providing observation areas and short-stay units. The response of hospitals to the situation in emergency departments should include alternatives to conventional admission, through means for rapid diagnosis, day hospitals, and home hospitalization as well as by offering a clear response in cases where admission is needed, granting easier access to beds that are in fact available. For its part, the health system overall, should improve the care of patients with chronic diseases, so that fewer admissions are required. It is also essential to
Hospital capital investment is important for acquiring and maintaining technology and equipment needed to provide health care. Reduction in capital investment by a hospital has negative implications for patient outcomes. Most hospitals rely on debt and internal cash flow to fund capital investment. The great recession may have made it difficult for hospitals to borrow, thus reducing their capital investment. I investigated the impact of the great recession on capital investment made by California hospitals. Modeling how hospital capital investment may have been liquidity constrained during the recession is a novel contribution to the literature. I estimated the model with California Office of Statewide Health Planning and Development data and system generalized method of moments. Findings suggest that not-for-profit and public hospitals were liquidity constrained during the recession. Comparing the changes in hospital capital investment between 2006 and 2009 showed that hospitals used cash flow to increase capital investment by $2.45 million, other things equal.
Guzmán Laura, K P; Periañez Vasco, A; Falcón Neyra, M D; Croche Santander, B
Varicella (chickenpox) can cause serious complications and admission to hospital. Several countries included the varicella vaccine in their immunization schedules. A descriptive and retrospective study of hospitalizations due to varicella and its complications was conducted in a referral center from 2005 to 2011. A total of 1192 children with varicella were seen in the emergency room, of which 99 (8.5%) required admission. The annual incidence of admissions due to varicella and varicella complications was, 19.4 and 15.3 cases per 100,000 children under 14 years, respectively. Complications were more common in children under 5 years (79.5%), and with no underlying disease (78.2%). Infection of skin and soft tissue was the most common complication (62%). The mean hospital stay was 4.5 days (SD 4). Varicella causes high morbidity, and is more frequent in absolute terms in healthy children under 5 years of age. Therefore, routine vaccination recommended by the Immunization Advisory Committee should be mandatory. Copyright © 2013 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.
Zijlker-Jansen, Pauline Y.; Janssen, M. P.|info:eu-repo/dai/nl/304818208; van Tilborgh-de Jong, A. J W; Schipperus, M. R.; Wiersum-Osselton, J. C.
Background: The 2011 Dutch Blood Transfusion Guideline for hospitals incorporates seven internal quality indicators for evaluation of the hospital transfusion chain. The indicators aim to measure guideline compliance as shown by the instatement of a hospital transfusion committee and transfusion
Lee, Tang G
As occupants in a hospital, patients are susceptible to air contaminants that can include biological agents dispersed throughout the premise. An exposed patient can become ill and require medical intervention. A consideration for patients is that they may have become environmentally sensitive and require placement in an environment that does not compromise their health. Unfortunately, the hospital environment often contains more biological substances than can be expected in an office or home environment. When a hospital also experiences water intrusion such as flooding or water leaks, resulting mold growth can seriously compromise the health of patients and others such as nursing staff and physicians (Burge, Indoor Air and Infectious Disease. Occupational Medicine: State of the Art Reviews, 1980; Lutz et al., Clinical Infectious Diseases 37: 786-793, 2003). Micro-organism growth can propagate if the water is not addressed quickly and effectively. Immunocompromised patients are particularly at risk when subjected to fungal infection such that the US Center for Disease Control issued guideline for building mold in health care facilities (Centers for Disease and Control [CDC], Centers for Disease and Control: Questions and Answers on Stachybotrys chartarum and Other Molds, 2000). This paper is based on mold remediation of one portion of a hospital unit due to water from construction activity and inadequate maintenance, resulting in mold growth. A large proportion of the hospital staff, primarily nurses in the dialysis unit, exhibited health symptoms consistent with mold exposure. Unfortunately, the hospital administrators did not consider the mold risk to be serious and refused an independent consultant retained by the nurse's union to examine the premise (Canadian Broadcasting Corporation [CBC], Nurses file complaints over mold at Foothills. Canadian Broadcasting Corporation, 2003). The nurse's union managed to have the premise examined by submitting a court order of
Fajardo-Ortiz, Guillermo; Salcedo-Alvarez, Rey Arturo
This study attempts to recount the history of the main hospitals of the port of Acapulco from colonial times until the end of the 20th century. The Augustine friars began hospital care at the end of the first part of the 16th century. Later, Bernardino Alvarez (1514?-1584), with the support of the Spanish crown, founded the first formal hospital in Acapulco called Hospital de Nuestra Señora de la Consolación (Our Lady of Consolation Hospital). During the 16th and 17th centuries, the sick were attended by friars, and by the end of the 19th century there were physicians and surgeons. From the end of the Independence War until the end of the 19th century, the port did not have any true hospital. The first degreed physicians and surgeons arrived and resided in Acapulco in 1920. In 1938, the Hospital Civil Morelos (Morelos Civil Hospital) began providing services. It was replaced by the Hospital General de Acapulco (General Hospital of Acapulco). At the fourth decade of the past century the Cruz Roja (Red Cross) was created. In 1957 the hospital services of the Instituto Mexicano del Seguro Social (IMSS, Mexican Institute of Social Security), which was founded in 1963, was inaugurated with the Unidad Medico/Social (Medical and Social Unit) of the IMSS in Acapulco. This began the journey of modernity in Acapulco. In 1992, Hospital Regional Vicente Guerrero (Regional Hospital Vicente Guerrero) of the IMSS, initiated its services. In 1960, medical services for civil workers and their families were housed in the Hospital Civil Morelos (Morelos Civil Hospital). Shortly afterwards, the Instituto de Seguridad y Servicios Sociales para los Trabajadores del Estado (ISSSTE, Security and Social Services Institute for State Employees) had their own hospital. During the 20th century, Acapulco has added other hospital services to care for members of the navy and armed forces, as well as for those persons with financial resources for private care.
Silva, Soraia Aparecida da; Valácio, Reginaldo Aparecido; Botelho, Flávia Carvalho; Amaral, Carlos Faria Santos
To analyze the causes of delay in hospital discharge of patients admitted to internal medicine wards. We reviewed 395 medical records of consecutive patients admitted to internal medicine wards of two public teaching hospitals: Hospital das Clínicas of the Universidade Federal de Minas Gerais and Hospital Odilon Behrens. The Appropriateness Evaluation Protocol was used to define the moment at which notes in the medical records indicated hospital stay was no longer appropriate and patients could be discharged. The interval between this estimated time and actual discharge was defined as the total number of days of delay in hospital discharge. An instrument was used to systematically categorize reasons for delay in hospital discharge and frequencies were analyzed. Delays in discharge occurred in 60.0% of 207 hospital admissions in the Hospital das Clínicas and in 58.0% of 188 hospital admissions in the Hospital Odilon Behrens. Mean delay per patient was 4.5 days in the former and 4.1 days in the latter, corresponding to 23.0% and 28.0% of occupancy rates in each hospital, respectively. The main reasons for delay in the two hospitals were, respectively, waiting for complementary tests (30.6% versus 34.7%) or for results of performed tests to be released (22.4% versus 11.9%) and medical-related accountability (36.2% versus 26.1%) which comprised delays in discussing the clinical case and in clinical decision making and difficulties in providing specialized consultation (20.4% versus 9.1%). Both hospitals showed a high percentage of delay in hospital discharge. The delays were mainly related to processes that could be improved by interventions by care teams and managers. The impact on mean length of stay and hospital occupancy rates was significant and troubling in a scenario of relative shortage of beds and long waiting lists for hospital admission.
Millsap, P; Brown, E; Kiser, L; Pruitt, D
Health-care professionals are currently operating in the context of a rapidly changing health-care delivery system, including the move away from inpatient services to outpatient services in order to control costs. Those who practice in partial-hospital settings are in a position to offer effective, cost-efficient services; however, there continue to be obstacles which hinder appropriate utilization of the modality. The development and use of a well-designed marketing plan is one strategy for removing these obstacles. This paper presents a brief overview of the marketing process, ideas for developing a marketing plan, and several examples of specific marketing strategies as well as ways to monitor their effectiveness. Partial-hospital providers must take an active role in answering the calls for alternative sources of psychiatric care. A comprehensive, education-oriented marketing approach will increase the public's awareness of such alternatives and enable programs to survive in a competitive environment.
Full Text Available Hospitality industry is a complex product-service economic activity which besides accommodation, food and beverages offers a variety of complementary and ancillary services in order to meet modern needs, demands and desires of tourists consumers. Contemporary needs, demands and desires of tourists consumers (increased need for security and preservation of health; emphasis on ecology and healthy food; pure nature stay; growing demand for adventure activities and excitement; convention facilities and incentive offerings; visits to towns, big sports, cultural, religious, business events; new travel motivation have led to the emergence of new trends in hospitality offering design. Wellness and spa hotels, boutique hotels, all inclusive hotels, slow-food restaurants, and wine and lounge bars are just some of the main trends, and successful hoteliers and caterers will examine each of the trends and devise development politics in accordance with the new requirements and global market needs.
Hospitality industry is a complex product-service economic activity which besides accommodation, food and beverages offers a variety of complementary and ancillary services in order to meet modern needs, demands and desires of tourists consumers. Contemporary needs, demands and desires of tourists consumers (increased need for security and preservation of health; emphasis on ecology and healthy food; pure nature stay; growing demand for adventure activities and e...
Full Text Available Is there something distinct about the traditional Hospitality Management curriculum? First offered in 1893 at the Ecole Hoteliere Lausanne in Switzerland and launched in the United States at The School of Hotel Administration at Cornell University in 1922, has this course of study evolved over time to focus on both of Meyer's skills - originally based on technical skills but now transforming to emotional skills?
Woo, Gon Kima, 1,; Hyunjung, Limb,; Robert, A. Brymerc, 2,
This paper investigates how managing online reviews affects hotel performance. An international hotel chain provided the hotel performance data and the online review data. A leading social media firm for the hospitality industry collected the online review data, which the hotel company purchased. The results indicate that overall ratings are the most salient predictor of hotel performance, followed by response to negative comments. The better the overall ratings and the higher the response ra...
Kumar, Sameer; Steinebach, Marc
Healthcare costs in the USA have continued to rise steadily since the 1980s. Medical errors are one of the major causes of deaths and injuries of thousands of patients every year, contributing to soaring healthcare costs. The purpose of this study is to examine what has been done to deal with the medical-error problem in the last two decades and present a closed-loop mistake-proof operation system for surgery processes that would likely eliminate preventable medical errors. The design method used is a combination of creating a service blueprint, implementing the six sigma DMAIC cycle, developing cause-and-effect diagrams as well as devising poka-yokes in order to develop a robust surgery operation process for a typical US hospital. In the improve phase of the six sigma DMAIC cycle, a number of poka-yoke techniques are introduced to prevent typical medical errors (identified through cause-and-effect diagrams) that may occur in surgery operation processes in US hospitals. It is the authors' assertion that implementing the new service blueprint along with the poka-yokes, will likely result in the current medical error rate to significantly improve to the six-sigma level. Additionally, designing as many redundancies as possible in the delivery of care will help reduce medical errors. Primary healthcare providers should strongly consider investing in adequate doctor and nurse staffing, and improving their education related to the quality of service delivery to minimize clinical errors. This will lead to an increase in higher fixed costs, especially in the shorter time frame. This paper focuses additional attention needed to make a sound technical and business case for implementing six sigma tools to eliminate medical errors that will enable hospital managers to increase their hospital's profitability in the long run and also ensure patient safety.
Escher, Achim; Hainc, Nicolin; Boll, Daniel
Business intelligence (BI) is a worthwhile investment, and will play a significant role in hospital management in the near future. Implementation of BI is challenging and requires resources, skills, and a strategy, but enables management to have easy access to relevant analysis of data and visualization of important key performance indicators (KPI). Modern BI applications will help to overcome shortages of common "hand-made" analysis, save time and money, and will enable even managers to do "self-service" analysis and reporting.
Ola, Samuel Olawale
Treatment of patients with HIV/AIDS in Nigeria has progressed from the stage of inactivity, unconcern, abandonment and neglect to the present stage of holistic care involving treatment of the infection with Highly Active Anti Retroviral Agents, complications of the disease and side effects of antiretroviral therapy as well as that of human behavioural responses towards the disease with hope and promising outcome. The goal of the treatment is to prolong the patient's life while maintaining the best possible quality of health and life. It is now a continuum of care between the hospital and the different sectors of the community. Hospital treatment of patients with HIV-AIDS is complex and yet a simple task if there is healthy interaction of the patients and health care providers in a milieu of well equipped hospital setting with available treatment facilities for proper management of diseases. Similarly, for the care to achieve its goal, it requires a joint participation of the community and the commitment of the government not only on curtailment of the reservoir of HIV infection by antiretroviral therapy but total eradication of diseases, poverty and ignorance in all its entirety.
Katona, Katalin; Canoy, Marcel
There is a broad literature on the consequences of applying different welfare standards in merger control. Total welfare is usually defined as the sum of consumer and provider surplus, i.e., potential external effects are not considered. The general result is then that consumer welfare is a more restrictive standard than total welfare, which is advantageous in certain situations. This relationship between the two standards is not necessarily true when the merger has significant external effects. We model mergers on hospital markets and allow for not-profit-maximizing behavior of providers and mandatory health insurance. Mandatory health insurance detaches the financial and consumption side of health care markets, and the concept consumer in merger control becomes non-evident. Patients not visiting the merging hospitals still are affected by price changes through their insurance premiums. External financial effects emerge on not directly affected consumers. We show that applying a restricted interpretation of consumer (neglecting externality) in health care merger control can reverse the relation between the two standards; consumer welfare standard can be weaker than total welfare. Consequently, applying the wrong standard can lead to both clearing socially undesirable and to blocking socially desirable mergers. The possible negative consequences of applying a simple consumer welfare standard in merger control can be even stronger when hospitals maximize quality and put less weight on financial considerations. We also investigate the implications of these results for the practice of merger control.
Ahmed, Mohamed; Jones, Eleri; Redmond, Elizabeth; Hewedi, Mahmoud; Wingert, Andreas; Gad El Rab, Mohamed
The purpose of this paper is to apply value stream mapping holistically to hospital food production/service systems focused on high-quality food. Multiple embedded case study of three (two private-sector and one public-sector) hospitals in the UK. The results indicated various issues affecting hospital food production including: the menu and nutritional considerations; food procurement; food production; foodservice; patient perceptions/expectations. Value stream mapping is a new approach for food production systems in UK hospitals whether private or public hospitals. The paper identifies opportunities for enhancing hospital food production systems. The paper provides a theoretical basis for process enhancement of hospital food production and the provision of high-quality hospital food.
U.S. Department of Health & Human Services — Hospital Outpatient Prospective Payment System (OPPS) Limited Data Set This file contains select claim level data and is derived from 2010 hospital outpatient PPS...
U.S. Department of Health & Human Services — The National Hospital Ambulatory Medical Care Survey (NHAMCS) is designed to collect data on the utilization and provision of ambulatory care services in hospital...
The National Hospital Discharge Survey (NHDS) is an annual probability survey that collects information on the characteristics of inpatients discharged from non-federal short-stay hospitals in the United States.
especially have been reformed due to the high proportion of resources they absorb and the apparent difficulty of prioritizing and coordinating health care within hospitals. There is abundant research literature on the topic of reforming hospital management models. Lacking from the literature, however......, is insight into how we can understand and explain how medical professionals adapt hospital management over time in relation to changing hospital management models that are global in their influence in hospital organizations. The aim of this dissertation is to understand and explain how medical professionals...... adapt, interpret and negotiate hospital management over time in relation to changing hospital management models in hospital organizations in the Nordic health system context, illustrated by the Danish health system....
... news/fullstory_166896.html Fewer Americans Hospitalized for Heart Failure But blacks still face far greater odds than ... HealthDay News) -- The number of Americans hospitalized for heart failure has dropped substantially since 2002, but blacks still ...
... fullstory_165869.html At Major Teaching Hospitals, Lower Death Rates Researchers assess 30-day survival for older ... dies," said lead author Dr. Laura Burke. If death rates at non-teaching hospitals were similar to ...
U.S. Department of Health & Human Services — The current Medicare policy of non-payment to hospitals for Hospital Acquired Conditions (HAC) seeks to avoid payment for preventable complications identified within...
... page: https://medlineplus.gov/news/fullstory_166427.html Depression Can Slow Hospital Patients' Recovery: Study Screening for ... 9, 2017 FRIDAY, June 9, 2017 (HealthDay News) -- Depression affects about one-third of hospital patients and ...
U.S. Department of Health & Human Services — There are two methods for a hospital to qualify for the Medicare DSH adjustment. The primary method is for a hospital to qualify based on a statutory formula that...
Department of Veterans Affairs — The Veterans Health Administration (VHA) pays for care provided to VA beneficiaries in non-VA hospitals through its contract hospitalization program as mandated by...
Rural hospitals serve as major sources of health care and employment for their communities, but recently they have been under increased financial stress. What are the causes of this stress, and how have hospitals and their communities responded?
... Topics Action Center Current & Emerging Payment Models Leveraging Technology Quality and Patient Safety Access & Health Coverage Strategic Workforce Compliance Issues for You Small or Rural Hospitals Critical Access Hospitals Long Term Care & Rehabilitation Health ...
Jessee, Peggy O.
Discusses the importance of child life specialists and programs in helping children cope with the stress and anxiety of hospital experiences. These specialists and programs promote children's growth and development both in the hospital and after returning home. (BB)
Maslow, Katie; Mezey, Mathy
Many hospital patients with dementia have no documented dementia diagnosis. In some cases, this is because they have never been diagnosed. Recognition of Dementia in Hospitalized Older Adults proposes several approaches that hospital nurses can use to increase recognition of dementia. This article describes the Try This approaches, how to implement them, and how to incorporate them into a hospital's current admission procedures. For a free online video demonstrating the use of these approaches, go to http://links.lww.com/A216.
M Adib Hajbaghery; Akbari, H.; GA Mousavi
Background: During recent years, cardiopulmonary resuscitation (CPR) in hospital has received much attention. However, the survival rate of CPR in Iran’s hospitals is unknown. This study was designed to evaluate outcome of in-hospital CPR in Kashan. Methods: A longitudinal case registry study was conducted on all cases of in-hospital CPR during 6 months at 2002. Necessary data including; age, sex, underlying disease, working shift, time from cardiac arrest until initiating of CPR and unt...
Pijls-Hoekstra, Ruth; Groen, Brenda H.; Galetzka, Mirjam; Pruyn, Adriaan T.H.
Hospitality is a much-researched topic, but its definition is still debated. This paper is part of a larger research project into the perception of hospitality. Previous research using the Delphi-method (hospitality providers and experts) and the Critical Incident Technique (guests and consumers) yielded a concept of hospitality containing nine experiential dimensions. However, verbal methods require respondents to recognize and phrase their experiences, even though part of this experience is...
Brown, Thomas C; Werling, Krist A; Walker, Barton C; Burgdorfer, Rex J; Shields, J Jordan
Healthcare reform will impact hospital consolidation in three key areas: Payment rates will decrease, indirectly encouraging consolidation by forcing hospitals to find new ways to reduce costs and increase negotiating clout with suppliers and payers. The cost of doing business will increase as hospitals spend more on compliance, technology, and physician employment. The ACO model will encourage hospital network formation by rewarding integrated healthcare systems that can reduce costs and improve quality.
Fink, Daniel J.
University teaching hospitals face increasing competition from community hospitals, expanding regulation of health care, consumerism, and a declining urban population base. New marketing strategies are seen as ways in which teaching hospitals can achieve better relationships with institutions, practitioners, and surrounding communities and…
Sep 5, 2005 ... 1999). Hospital wastewater samples are very often different in nature eliciting different effects on biological systems. The aim of the paper was to investigate the potential toxicity and genotoxicity of an untreated hospital wastewaters obtained from a University. Teaching Hospital in the Niger Delta Region of.
Full Text Available This is a retrospective study of the factors which contributed to accidental injuries sustained by those patients who fell in a White provincial hospital in die period 1 January to 30 June 1982. The research study was undertaken by Diploma in Nursing Administration students during their 3-week hospital practice at a White provincial hospital.
2. Analysis ...............................................................................................43 E. COMMANDER’S RISK ASSESMENT EFFECTS...continental United States CSH combat support hospital CT computed tomography FASH forward Army surgical hospital FH field hospital FSH forward... computed tomography (CT) scanner versus a FST having a simple and portable X-ray machine. Figure 4. A forward surgical team has appropriate mobility
Pijls-Hoekstra, Ruth; Groen, Brenda H.; Galetzka, Mirjam; Pruyn, Ad T.H.
Hospitality is a much-researched topic, but its definition is still debated. This paper is part of a larger research project into the perception of hospitality. Previous research using the Delphi-method (hospitality providers and experts) and the Critical Incident Technique (guests and consumers)
Since 1989 there has been a burgeoning of the visual arts in Northern Ireland hospitals. This paper compares the three organisational models for hospital arts currently operating within the Province and in an overview discusses ways to coordinate working practice for future development of the visual arts in local hospitals. Images Fig 1 Fig 2 Fig 3 PMID:8533183
Inappropriate involuntary admissions to psychiatric hospitals. P L van der Merwe, A Allan, M M Allan. Abstract. Background. In order to preserve scarce resources, treabnent in tertiary psychiatric hospitals should be restricted to those whose treatment needs make admission to such hospitals essential. However, anecdotal ...
Pijls-Hoekstra, Ruth; Pijls-Hoekstra, Ruth; Groen, Brenda H.; Galetzka, Mirjam; Pruyn, Adriaan T.H.
Hospitality is a much-researched topic, but its definition is still debated. This paper is part of a larger research project into the perception of hospitality. Previous research using the Delphi-method (hospitality providers and experts) and the Critical Incident Technique (guests and consumers)
Adler-Milstein, Julia; DesRoches, Catherine M; Jha, Ashish K
To determine the proportion of US hospitals engaged in health information exchange (HIE) with unaffiliated providers and to identify key hospital-level and market-level factors associated with participating in exchange. Using the 2009 American Hospital Association Information Technology survey, supplemented by Dartmouth Atlas, Area Resource File, and other national data, we examined which hospitals participated in regional efforts to electronically exchange clinical data. We used logistic regression models to determine hospital-level characteristics and market-level characteristics associated with hospitals' likelihood of participating in HIE. We found that 10.7% of US hospitals engaged in HIE with unaffiliated providers. In communities where exchange occurred, for-profit hospitals and those with a small market share were far less likely to engage in HIE than nonprofit hospitals or those with a larger market share. Hospitals in more concentrated markets were more likely to exchange and hospitals in markets with higher Medicare spending were less likely to exchange. At the start of implementation of the Health Information Technology for Economic and Clinical Health (HITECH) Act, only a small minority of US hospitals electronically exchange clinical data with unaffiliated providers. Health information exchange is a key part of reforming the healthcare system, and factors related to competitiveness may be holding some providers back.
Vaughan-Sarrazin Mary S
Full Text Available Abstract Background The emergence of physician owned specialty hospitals focusing on high margin procedures has generated significant controversy. Yet, it is unclear whether physician owned specialty hospitals differ significantly from non physician owned specialty hospitals and thus merit the additional scrutiny that has been proposed. Our objective was to assess whether physician owned specialty orthopedic hospitals and non physician owned specialty orthopedic hospitals differ with respect to hospital characteristics and patient populations served. Methods We conducted a descriptive study using Medicare data of beneficiaries who underwent total hip replacement (THR (N = 10,478 and total knee replacement (TKR (N = 15,312 in 29 physician owned and 8 non physician owned specialty orthopedic hospitals during 1999–2003. We compared hospital characteristics of physician owned and non physician owned specialty hospitals including procedural volumes of major joint replacements (THR and TKR, hospital teaching status, and for profit status. We then compared demographics and prevalence of common comorbid conditions for patients treated in physician owned and non physician owned specialty hospitals. Finally, we examined whether the socio-demographic characteristics of the neighborhoods where physician owned and non physician owned specialty hospitals differed, as measured by zip code level data. Results Physician owned specialty hospitals performed fewer major joint replacements on Medicare beneficiaries in 2003 than non physician owed specialty hospitals (64 vs. 678, P Conclusion Physician owned specialty orthopedic hospitals differ significantly from non physician owned specialty orthopedic hospitals and may warrant the additional scrutiny policy makers have proposed.
... Episode-of-Care for Acute Myocardial Infarction (AMI) Measure 7. Electronic Clinical Quality Measures 8... for Acute Care Hospitals and the Long Term Care; Hospital Prospective Payment System and Fiscal Year... 0938-AR73 Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and...
McCarthy, Aidan; Maor, Dorit; McConney, Andrew
The aim of this study was to identify hospital teachers' professional learning needs to enable effective use of mobile technology in hospital schools. Hospitalized students cannot attend their regular schools and as a result their educational progress and development can suffer. In an attempt to address this, hospital schools provide learning…
Folmann, Nana Bro; Bossen, Kristine Skovgaard; Willaing, Ingrid
.5-24.9 kg/m2 were defined as normal weight. Individuals with BMI DESIGN: We undertook a 3-year retrospective study of the relationship between obesity and use of hospital resources. Data on hospital contacts and costs were obtained from The National Patient...... Registry and DRG. Analyses were performed using two-part models and Poisson regression. Outcome variables were costs and hospital contacts. RESULTS: This study has demonstrated that obese individuals have a greater use of hospital services and greater hospital costs compared with normal weight individuals...
Hao, Aimin; Yi, Tao; Li, Xia; Wei, Lei; Huang, Pei; Xu, Xinzhou; Yi, Lihua
Purpose: The quality of medical services provided by competing public hospitals is the primary consideration of the public in determining the selection of a specific hospital for treatment. The main objective of strategic planning is to improve the quality of public hospital medical services. This paper provides an introduction to the history, significance, principles and practices of public hospital medical service strategy, as well as advancing the opinion that public hospital service strategy must not merely aim to produce but actually result in the highest possible level of quality, convenience, efficiency and patient satisfaction.
Full Text Available Hospital infections are the most frequent and important complications occurring in hospitalized patients. The concern is greater when the affected hospital infection are neonates admitted to intensive care units where the risk increases due to factors such as prematurity, low birth weight, types of procedures adopted and susceptibility due to their immature immune system. The prevention and control measures involve detection of hospital infection, development of norms of standardization, collaboration with the training of all health professionals, achieving control of antibiotic prescription and technical support for hospital administration.
Alkibay, Sanem; Ozdogan, F Bahar; Ermec, Aysegul
This paper aims to present a perspective to better understand corporate identity through examining the perceptions of Turkish patients and develop a corporate visual identity scale. While there is no study related to corporate identity research on hospitals in Turkey as a developing country, understanding consumer's perceptions about corporate identity efforts of hospitals could provide different perspectives for recruiters. When the hospitals are considered in two different groups as university and state hospitals, the priority of the characteristics of corporate visual identity may change, whereas the top five characteristics remain the same for all the hospitals.
Wig, Eldon D.
The information processing needs of a hospital are many, with varying degrees of complexity. The prime concern in providing an integrated hospital information management system lies in the ability to process the data relating to the single entity for which every hospital functions - the patient. This paper examines the PRIMIS computer system developed to accommodate hospital needs with respect to a central patient registry, inpatients (i.e., Admission/Transfer/Discharge), and out-patients. Finally, the potential for expansion to permit the incorporation of more hospital functions within PRIMIS is examined.
Beck, Anne Marie; Balknäs, Ulla N.; Camilo, Maria E.
Disease-related undernutrition is significant in European hospitals but is seldom treated or prevented. In 1999, the Council of Europe decided to collect information regarding nutrition programs in hospitals, and for this purpose, a network consisting of national experts from 12 of the Partial...... Agreement member states was established. The aim was to review the current practices in Europe regarding hospital food provision, to highlight deficiencies, and to issue recommendations to improve the nutritional care and support of hospitalized patients. Five major common problems were identified: 1) lack...... is required from national authorities and hospital staff, including managers, to ensure appropriate nutritional care and support....
Cordula Wagner; Jacqueline Cuperus-Bosma; Gerrit van der Wal
In various studies outside the Netherlands, it has been shown that a substantial number of patients suffer from some kind of harm during their treatment in hospital. The incidence of these so-called adverse events varies between 2.9% and 16.6%; it is estimated that between over a quarter and a half of these are considered to be avoidable.
Preventable adverse events can be considered to be a starting point for interventions to increase patient safety. In response to ...
Zarb, P; Amadeo, B; Muller, A
Anatomical Therapeutic Chemical (ATC) classification for 'antimycotics for systemic use' (J02) 2009 version was used. Demographic data and information about indications and diagnoses were collected in 2008 and 2009. From 99,053 patients, 29,324 (29.6%) received antimicrobials. Antifungals represented 1529...... of 40,878 (3.7%) antimicrobials. Antifungals were mainly (54.2%) administered orally. Hospital-acquired infections represented 44.5% of indications for antifungals followed by medical prophylaxis at 31.2%. The site of infection was not defined in 36.0% of cases but the most commonly targeted sites were...
Casana, Noemí L.; Simonetti, Estela; Sisu, María Guadalupe; Marini, María Alicia
La Cátedra de Pediatria “B” con sede en el Hospital Zonal Especializado “Dr. Noel H. Sbarra” desarrolla un programa que abarca la enseñanza de la pediatría, fortaleciendo el compromiso con la prevención y promoción de la salud del niñ@ en su “Desarrollo Integral” que incluye desarrollo, crecimiento y ambiente, la interacción del ser humano con ese ambiente, y dentro del ambiente la relación con otros y con la cultura circundante. El desarrollo integral, ofrece una mirada holística involucr...
Don Rosenthal, a former Ames Research Center computer scientist who helped design the Hubble Space Telescope's scheduling software, co-founded Allocade Inc. of Menlo Park, California, in 2004. Allocade's OnCue software helps hospitals reclaim unused capacity and optimize constantly changing schedules for imaging procedures. After starting to use the software, one medical center soon reported noticeable improvements in efficiency, including a 12 percent increase in procedure volume, 35 percent reduction in staff overtime, and significant reductions in backlog and technician phone time. Allocade now offers versions for outpatient and inpatient magnetic resonance imaging (MRI), ultrasound, interventional radiology, nuclear medicine, Positron Emission Tomography (PET), radiography, radiography-fluoroscopy, and mammography.
Amestoy, Simone Coelho; Trindade, Letícia de Lima; Waterkemper, Roberta; Heidman, Ivonete Teresinha Schülter; Boehs, Astrid Egged; Backes, Vânia Marli Schubert
The aim of this study is make a theorical-reflection about the importance of using dialogical leadership in hospital institutions through Freirean referencial. The dialogical leadership pattern differs from the coercive and autocratic methods, for being reasoned on the establishment of an efficient communicational process, able to stimulate autonomy, co-responsibility and appreciation of each member from nurse team. The dialogical leadership, unlike the directive one, is a management instrument, that pursuits to minimize the conflicts and stimulate the formation of healthy interpersonal relationships, which can contribute to the improvement of organizational atmosphere and quality care provided to health services users.
Golshani, Alireza; Bosmia, Anand N; Ahmadi, Aida; Adloo, Sara; Tubbs, R Shane; Bayazidi, Ali; Golshani, Amir-Hossin; Shoja, Mohammadali M
This article discusses three significant hospitals that were constructed in medieval Persia, specifically in the city of Shiraz, which is located in central present-day Iran. The first of these three hospitals is the Azodi Hospital, which was constructed during the Buyid dynasty. The second hospital was constructed during the Salghurid dynasty and is referred to as the Mozzafari Hospital by a primary source written by Qutb al-Din Shirazi, a physician who worked there. The third hospital is also referred to as the Mozzafari Hospital and was constructed during the Mozzafarid dynasty. Recent efforts have yielded archaeological evidence that marks the location in present-day Shiraz of this third hospital or an area south of its location. The evidence consists of the gravesite for Seyed Sharaf al-Din Jorjani, a prominent theologian who was employed by Shah Shoja of the Mozzafarid dynasty in the fourteenth century CE. at the compound containing the third hospital. The gravesite for Sharaf al-Din Jorjani in present-day Shiraz marks the site of the remains of the Mozzafari Hospital built during the reign of Shah Shoja of the Mozzafarid dynasty or an area south of Shah Shoja's Mozzafari Hospital.
Full Text Available A prospective study was undertaken to compare the patterns of psychiatric referrals in two general hospitals in Bombay viz. the King Edward Memorial Hospital (64 cases and the Jaslok Hospital and Research Centre (62 cases. It was observed that depressive symptoms were the most common presenting symptoms in these patients attending either of the hospitals. Similarly, the commonest diagnoses were depression and organic mental disorder. Attempted suicide with organophosphorous compounds was the commonest reason for hospitalization at K.E.M. Hospital (p less than 0.001. A significant number of these patients were females (p less than 0.05. The psychiatric referrals at Jaslok had been hospitalized mainly for suspected medical or neurological illness (p less than 0.001. These patients belonged to higher economic strata and hence had a better paying capacity compared to patients at KEM hospital, a significant number of whom were unemployed (p less than 0.001. The duration of pre-referred illness of patients and their stay at Jaslok hospital were longer as compared to those at KEM Hospital (p less than 0.01. The number of non-relevant special investigations carried out on patients in Jaslok was more (p less than 0.01. Further analysis of diagnoses revealed that a significant number of patients at KEM Hospital were admitted as primary psychiatric illness (p less than 0.05.
Moss, Hilary; Donnellan, Claire; O'Neill, Desmond
To assess the impact of hospitalization on arts engagement among older people; and to assess perceptions of whether hospitals are aesthetically deprived environments. A Survey of Aesthetic and Cultural Health was developed to explore the role of aesthetics before, during and after hospital. Study participants were n = 150 hospital in-patients aged >65. Descriptive and inferential statistics were used to analyze the data. Attendance at arts events was an important part of life for this sample and a large drop off was noted in continuation of these activities in the year post-hospital stay. Physical health issues were the main causes but also loss of confidence and transport issues. Film, dance, and music were the most popular arts for this sample prior to hospital stay. Noise pollution caused by other patients, lack of control over TV/radio, and access to receptive arts in hospital (reading and listening to music) were important issues for patients in hospital. This study identifies a trend for decreasing exposure to arts beginning with a hospital stay and concludes that older people may need encouragement to resume engagement in arts following a hospital stay. There is relatively limited evidence regarding the nature of, and potential benefit from, aesthetics in healthcare and limited studies with rigorous methodology, and further research is needed to understand the aesthetic preferences of older people in hospital. Copyright © 2015 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.
Zavadil, Martin; Rogalewicz, Vladimír; Kubátová, Ivana; Matloňová, Veronika; Salačová, Kristýna
Hospital-based HTA (HB-HTA) consists in implementation of assessment activities "in" or "for" hospitals; hence, it covers processes and methods supporting organization and execution of health technology assessment (HTA) at the level of individual hospitals. This process is multidisciplinary, systematic and evidence-based.HB-HTA objectives and methods differ from the classic utilization of HTA at the national regulator level. Most experience and information concerning HB-HTA has originated in two large recent projects: activities of the HB-HTA Interest Group of the HTAi international association established in 2006, and the AdHopHTA European research project (20122015).This paper describes four basic organizational models of HB-HTA, their characteristics and utilization in various countries and hospital types. Results of the AdHopHTA project are analyzed, and recommendations for HB-HTA implementation in Czech hospitals are formulated.Key words: hospital-based HTA, medical device, implementation, hospital strategy.
Full Text Available The continuous growth of competition in the hospitality sector has created the need to retain guests and prevent them from switching company due to better offer or saturation. Loyal customers are a valuable asset for catering companies, not only because of the awareness of the effects of customer loyalty. They tend to spread word-of-mouth advertising, more tolerant to price changes, as well as they casually create a linkage to their friends, relatives, colleagues, and other probable consumers and thus enable businesses to uphold a guest's base. By recognizing loyalty guests' importance, the global hospitality industry created monetary and non-monetary rewards for loyal visitors, delayed gratification (points collection and immediate rewards, as well as numerous other reward systems that try to keep them. To win customer loyalty, together with all benefits arising from it, caterers need to become familiar with factors, which determine guests' loyalty. The paper will show the results of research regarding the impact of the service quality and guests' satisfaction to their loyalty. Many authors have confirmed that employees' satisfaction affected customers' satisfaction, so this paper will give an answer does it influence on customers' loyalty as well.
Limbu, Senchhema; Dikshit, Parajeeta; Gupta, Sujaya
Background: A mesiodens, is the most frequent supernumerary tooth present in the maxillary central incisor region. This study is conducted to know the radiographic characteristics and management of mesiodens in children visiting hospital. A cross-sectional retrospective data collection was done from hospital dental records of children who visited the institution from December 2015-December 2016. Radiographic characteristic of mesiodens including the number, shape, position, direction of crown and complication caused by mesiodens were recorded. Data were analyzed using IBM SPSS v.20.0. Out of 1871 dental records, it was found that 40 children had 53 mesiodens, with male female ratio of 3:1 and most of them were discovered at 8 years. Majority of mesiodens, 54.7% were erupted, conical, palatally placed with 77.3% vertically directed crown.Complications associated with it were crowding followed by diastema and delayed eruption. Among 40 children, one had three mesiodens, eleven had two mesiodens and rest had one each. Radiographically fully formed tooth was seen in 29 mesiodens. Immature apex was seen in 38 central incisors associated with mesiodens. Management undertaken was simple/surgical extraction and only few cases were kept for periodic observation. Periodic radiographs act as an important tool for clinicians in detecting and managing mesiodens.
Ternák, G; Almási, I
The authors publish the results of a survey conducted among hospital records of patients discharged from eight inpatient's institutes between 1-31st of January 1995 to gather information on the indications and usage of antibiotics. The institutes were selected from different part of the country to represent the hospital structure as much as possible. Data from the 13,719 documents were recorded and analysed by computer program. It was found that 27.6% of the patients (3749 cases) received antibiotic treatment. 407 different diagnosis and 365 different surgical procedures (as profilaxis) were considered as indications of antibiotic treatment (total: 4450 indications for 5849 antibiotic treatment). The largest group of patients receiving antibiotics was of antibiotic profilaxis (24.56%, 1093 cases), followed by lower respiratory tract infections (19.89%, 849 cases), uroinfections (10.53%, 469 cases) and upper respiratory tract infections. Relatively large group of patients belonged to those who had fever or subfebrility without known reason (7.35%, 327 cases) and to those who did not have any proof in their document indicating the reasons of antibiotic treatment (6.4%, 285 cases). We can not consider the antibiotic indications well founded in those groups of patients (every sixth or every fifth cases). The most frequently used antibiotics were of [2-nd] generation cefalosporins. The rate of nosocomial infections were found as 6.78% average. The results are demonstrated on diagrams and table.
It is known that there is a large extent of working dissatisfaction within some professional groups of the health service system. Especially in the hospital sector, many "struggles for power" take place. Unfortunately, these struggles are often only examined with regard to individual points of view without considering the system-oriented background. The following text will reflect the discussion in social sciences as to the distribution of power within the health service system. The double meaning of the distribution of power will be explained and, by means of decisive phenomenons, the development of cost and efficiency structures on the one hand as well as the development of health political processes in decision-making on the other hand will be described. In the section "The Hospital in the 20th Century", the structures that still can be widely found nowadays will be specified and examined as to aspects in behavioural sciences. Finally, as a logical consequence, an urgently needed reorientation from administration towards management will be pointed out.
Vincent, Jennifer Orr; Lo, Huay-Ying; Wu, Susan
Viral bronchiolitis is a common cause of hospitalization in young children, but despite a variety of therapeutic options, the mainstay of treatment remains supportive care. To examine the most recent evidence for supportive care measures and pharmacologic options in the treatment of bronchiolitis in the hospital setting Methods: MEDLINE search with expert medical librarian for publications on management and therapies for bronchiolitis Results: Evidence does not support the use of bronchodilators, racemic epinephrine, deep suctioning, systemic corticosteroids, or antibiotics in the absence of a concomitant bacterial infection, as these treatments do not change the course of illness or shorten length of stay (LOS). Nebulized hypertonic saline is not routinely recommended, though it may provide some benefit for patients with anticipated prolonged LOS. Continuous pulse oximetry should not be routinely used in stable patients as it may be associated with longer LOS. Supplemental oxygen should be used to maintain oxyhemoglobin concentrations >90%, a level lower than what many clinicians may have used previously. Current evidence suggests high-flow nasal cannula may reduce intubation rate, but its effect on LOS is unclear. Intravenous or nasogastric tube hydration should be used when oral hydration is not sufficient. Overall, bronchiolitis remains a self-limited disease whose mainstay of therapy is supportive care. Copyright© Bentham Science Publishers; For any queries, please email at firstname.lastname@example.org.
Jiménez-Buñuales, M T; Martínez-Sáenz, M S; González-Diego, P; Vallejo-García, M; Gallardo-Anciano, J; Cestafe-Martínez, A
The purpose of this study is to know the incidence rate of medication reconciliation at admission and discharge in patients of La Rioja and to improve the patient safety on medication reconciliation. An observational prospective study, part of the Joint Action PaSQ, Work Package 5, European Union Network for Patient Safety and Quality of Care. The study has taken into account the definitions of the Institute for Safe Medication Practices. Any unintended discrepancy in medication between chronic treatment and the treatment prescribed in the hospital was considered as a reconciliation error. A total of 750 patients were included, 9 (1.2%) of whom showed at least one discrepancy. The patients had a total of 3,156 mediations registered: 2,313 prescriptions (73.4%) showed no differences, while 821 prescriptions (26%) were intended discrepancies and 21 prescriptions (0.6%) unintended discrepancies were considered by the physician as reconciliation errors. A percentage of 1.2 of the patients, which represents 0.6% of the medicines (one in 166 medications registered) had reconciliation errors during their hospital stay. A proceeding has been implemented by means of the physician doing the medication reconciliation and reviewing it with the help of a medication reconciliation form. The medication reconciliation is a priority strategic objective to improve the safety of patients. Copyright © 2016 SECA. Published by Elsevier Espana. All rights reserved.
Maurice E Pouw
Full Text Available BACKGROUND: The hospital standardized mortality ratio (HSMR is developed to evaluate and improve hospital quality. Different methods can be used to standardize the hospital mortality ratio. Our aim was to assess the validity and applicability of directly and indirectly standardized hospital mortality ratios. METHODS: Retrospective scenario analysis using routinely collected hospital data to compare deaths predicted by the indirectly standardized case-mix adjustment method with observed deaths. Discharges from Dutch hospitals in the period 2003-2009 were used to estimate the underlying prediction models. We analysed variation in indirectly standardized hospital mortality ratios (HSMRs when changing the case-mix distributions using different scenarios. Sixty-one Dutch hospitals were included in our scenario analysis. RESULTS: A numerical example showed that when interaction between hospital and case-mix is present and case-mix differs between hospitals, indirectly standardized HSMRs vary between hospitals providing the same quality of care. In empirical data analysis, the differences between directly and indirectly standardized HSMRs for individual hospitals were limited. CONCLUSION: Direct standardization is not affected by the presence of interaction between hospital and case-mix and is therefore theoretically preferable over indirect standardization. Since direct standardization is practically impossible when multiple predictors are included in the case-mix adjustment model, indirect standardization is the only available method to compute the HSMR. Before interpreting such indirectly standardized HSMRs the case-mix distributions of individual hospitals and the presence of interactions between hospital and case-mix should be assessed.
Lee, S Y; Alexander, J A
To examine (1) the degree to which organizational changes affected hospital survival; (2) whether core and peripheral organizational changes affected hospital survival differently; and (3) how simultaneous organizational changes affected hospital survival. AHA Hospital Surveys, the Area Resource File, and the AHA Hospital Guides, Part B: Multihospital Systems. The study employed a longitudinal panel design. We followed changes in all community hospitals in the continental United States from 1981 through 1994. The dependent variable, hospital closure, was examined as a function of multiple changes in a hospital's core and peripheral structures as well as the hospital's organizational and environmental characteristics. Cox regression models were used to test the expectations that core changes increased closure risk while peripheral changes decreased such risk, and that simultaneous core and peripheral changes would lead to higher risk of closure. Results indicated more peripheral than core changes in community hospitals. Overall, findings contradicted our expectations. Change in specialty, a core change, was beneficial for hospitals, because it reduced closure risk. The two most frequent peripheral changes, downsizing and leadership change, were positively associated with closure. Simultaneous organizational changes displayed a similar pattern: multiple core changes reduced closure risk, while multiple peripheral changes increased the risk. These patterns held regardless of the level of uncertainty in hospital environments. Organizational changes are not all beneficial for hospitals, suggesting that hospital leaders should be both cautious and selective in their efforts to turn their hospitals around.
Dong, Gang Nathan
This paper examines the hospital management practices of manipulating financial earnings within the bounds of generally accepted accounting principles (GAAP). We conduct regression analyses that relate earnings management to hospital characteristics to assess the economic determinants of hospital earnings management behavior. From the CMS Cost Reports we collected hospital financial data of all U.S. hospitals that request reimbursement from the federal government for treating Medicare patients, and regress discretionary accruals on hospital size, profitability, asset liquidity, operating efficiency, labor cost, and ownership. Hospitals with higher profit margin, current ratio, working capital, days of patient receivables outstanding and total wage are associated with more earnings management, whereas those with larger size and higher debt level, asset turnover, days cash on hand, fixed asset age are associated with lower level of earnings manipulation. Additionally, managers of non-profit hospitals are more likely to undertake some form of window-dressing by manipulating accounting accruals without changing business models or pricing strategies than their public hospital counterparts. We provide direct evidence of the use of discretionary accruals to manage financial earnings among U.S. hospitals and the finding has profound policy implications in terms of assessing the pervasiveness of accounting manipulation and the overall integrity of financial reporting in this very special public and quasi-public service sector.
Audebert, Heinrich; Fassbender, Klaus; Hussain, M Shazam; Ebinger, Martin; Turc, Guillaume; Uchino, Ken; Davis, Stephen; Alexandrov, Anne; Grotta, James
Background The PRE-hospital Stroke Treatment Organization was formed in 2016 as an international consortium of medical practitioners involved in pre-hospital treatment of patients with acute stroke. Aims PRE-hospital Stroke Treatment Organization's mission is to improve stroke outcomes by supporting research and advocacy for pre-hospital stroke treatment in Mobile Stroke Units. PRE-hospital Stroke Treatment Organization will provide a platform to enhance collaborative research across the spectrum of acute stroke management in the pre-hospital setting. PRE-hospital Stroke Treatment Organization will also facilitate the appropriate proliferation and distribution of Mobile Stroke Units by providing a forum for professional communication, resource for public education, and stimulus for government, industry, and philanthropic support. Summary of review In this "white paper", we describe the evidence supporting pre-hospital stroke treatment, progress to date, practical issues such as application in various environments and staffing, planned research initiatives, and organizational structure. Conclusions PRE-hospital Stroke Treatment Organization is not-for-profit, with membership open to anyone involved (or hoping to become involved) in pre-hospital stroke care. PRE-hospital Stroke Treatment Organization has a Steering Committee comprised of members from Europe, U.S., Canada, Australia, and other regions having a Mobile Stroke Unit in operation. PRE-hospital Stroke Treatment Organization convenes satellite meetings for membership at the International Stroke Conference and European Stroke Congress each year to address the PRE-hospital Stroke Treatment Organization mission. The first research collaborations agreed upon are to: (1) develop a list of common data elements to be collected by all Mobile Stroke Unit programs and entered into a common research database, and (2) develop a protocol for investigating the natural history of hyper-acute Intracerebral Hemorrhage.
Background The Norwegian hospital reform of 2002 was an attempt to make restructuring of hospitals easier by removing politicians from the decision-making processes. To facilitate changes seen as necessary but politically difficult, the central state took over ownership of the hospitals and stripped the county politicians of what had been their main responsibility for decades. This meant that decisions regarding hospital structure and organization were now being taken by professional administrators and not by politically elected representatives. The question raised here is whether this has had any effect on the speed of restructuring of the hospital sector. Method The empirical part is a case study of the restructuring process in Innlandet Hospital Trust (IHT), which was one of the largest enterprise established after the hospital reform and where the vision for restructuring was clearly set. Different sources of qualitative data are used in the analysis. These include interviews with key actors, observational data and document studies. Results The analysis demonstrates how the new professional leaders at first acted in accordance with the intentions of the hospital reform, but soon chose to avoid the more ambitious plans for restructuring the hospital structure and in fact reintroduced local politics into the decision-making process. The analysis further illustrates how local networks and engagement of political representatives from all levels of government complicated the decision-making process surrounding local structural reforms. Local political representatives teamed up with other actors and created powerful networks. At the same time, national politicians had incentives to involve themselves in the processes as supporters of the status quo. Conclusion Because of the incentives that faced political actors and the controversial nature of major hospital reforms, the removal of local politicians and the centralization of ownership did not necessarily facilitate
Plet, H. T.; Hallas, J.; Kjeldsen, L. J.
PURPOSE: To investigate adherence rates to hospital drug formularies (HDFs) and cost of drugs in hospitals. METHODS: Data on drugs used during 2010 were analyzed for ten hospitals (two hospitals from each of the five regions), constituting 30 % of hospitals and 45 % of hospital beds in Denmark......, we also identified the drugs constituting 90 % of the volume (= DU90%) and the adherence to the HDF in this segment (Index of Adherence). RESULTS: Substances used by hospitals varied between 598 and 1,093. The proportion of used substances that were on the HDF varied between 14 % and 44 %. University....... Drug use data from individual hospitals were retrieved from the hospital pharmacies. Adherence to the HDFs was analyzed for selected substances characterised by extensive use both in primary and secondary sectors (ATC codes A10, B03, C03, C07, C08, C09, C10, J01, N02, N05 and R03). Within each group...
Full Text Available Abstract Objective In-hospital mortality is an important performance measure for quality improvement, although it requires proper risk adjustment. We set out to develop in-hospital mortality prediction models for acute hospitalization using a nation-wide electronic administrative record system in Japan. Methods Administrative records of 224,207 patients (patients discharged from 82 hospitals in Japan between July 1, 2002 and October 31, 2002 were randomly split into preliminary (179,156 records and test (45,051 records groups. Study variables included Major Diagnostic Category, age, gender, ambulance use, admission status, length of hospital stay, comorbidity, and in-hospital mortality. ICD-10 codes were converted to calculate comorbidity scores based on Quan's methodology. Multivariate logistic regression analysis was then performed using in-hospital mortality as a dependent variable. C-indexes were calculated across risk groups in order to evaluate model performances. Results In-hospital mortality rates were 2.68% and 2.76% for the preliminary and test datasets, respectively. C-index values were 0.869 for the model that excluded length of stay and 0.841 for the model that included length of stay. Conclusion Risk models developed in this study included a set of variables easily accessible from administrative data, and still successfully exhibited a high degree of prediction accuracy. These models can be used to estimate in-hospital mortality rates of various diagnoses and procedures.
Cho, Na-Eun; Chang, Jongwha; Atems, Bebonchu
To determine the impact of health information technology (HIT) adoption and hospital-physician integration on hospital efficiency. Using 2010 data from the American Hospital Association's (AHA) annual survey, the AHA IT survey, supplemented by the CMS Case Mix Index, and the US Census Bureau's small area income and poverty estimates, we examined how the adoption of HIT and employment of physicians affected hospital efficiency and whether they were substitutes or complements. The sample included 2173 hospitals. We employed a 2-stage approach. In the first stage, data envelopment analysis was used to estimate technical efficiency of hospitals. In the second stage, we used instrumental variable approaches, notably 2-stage least squares and the generalized method of moments, to examine the effects of IT adoption and integration on hospital efficiency. We found that HIT adoption and hospital-physician integration, when considered separately, each have statistically significant positive impacts on hospital efficiency. Also, we found that hospitals that adopted HIT with employed physicians will achieve less efficiency compared with hospitals that adopted HIT without employed physicians. Although HIT adoption and hospital-physician integration both seem to be key parts of improving hospital efficiency when one or the other is utilized individually, they can hurt hospital efficiency when utilized together.
Forchhammer, Hysse B; Løvholt, Annelise P.; Mathiesen, Lone Lundbak
Aims It is a challenge for health professionals to involve patients with aphasia (PWAs) in their own treatment, care and rehabilitation. Disrupted communication may also influence patient safety and lead to social isolation. In order to increase health care professionals’ ability to engage PWAs i...... hospital staff’s confidence and self-assessed ability to communicate with PWAs....... month period. Each course had 10-12 participants and lasted 6 hours, including instruction in the SCA principles, video analysis, interdisciplinary group work, and practice sessions with PWAs. Self-assessed learning outcomes were evaluated with a brief questionnaire filled out by staff members...... immediately before course attendance and 3-6 months afterwards. Results Self-rated knowledge of aphasia had significantly improved when assessed 3-6 months after the course and improvement was seen for all groups of health professionals. Comfort and ease in communicating with PWA and ability to solve problems...
Lucélia Ferreira Lima
Full Text Available Objective: To identify the risks reported at a public institution andto know the main patient risks from the nursing staff point of view.Methods: A retrospective, descriptive and exploratory study. Thesurvey was developed at a hospital in the city of Taboão da Serra, SãoPaulo, Brazil. The study included all nurses working in care areas whoagreed to participate in the study. At the same time, sentinel eventsoccurring in the period from July 2006 to July 2007 were identified.Results: There were 440 sentinel events reported, and the main risksincluded patient falls, medication errors and pressure ulcers. Sixty-fivenurses were interviewed. They also reported patient falls, medicationerrors and pressure ulcers as the main risks. Conclusions: Riskassessment and implementation of effective preventive actions arenecessary to ensure patient’s safety. Involvement of a multidisciplinaryteam is one of the steps for a successful process.
Villalbí, Joan R; Rodríguez-Campos, Mònica; Orcau, Àngels; Espachs, M Àngels; Salamero, Marta; Maldonado, José; Caylà, Joan A
This article describes the actions of public health services of the city of Barcelona to prevent tuberculosis transmission by noncompliant smear-positive patients by using the possibilities of Spanish Law 3/1986. The actions were based on a resolution of the health authorities on the need to locate such patients and to detain them in hospitals to provide treatment. This involved police cooperation, informing noncompliant patients, and requesting ratification from the Administrative Court. The article describes the process and the characteristics of the cases involved. Over nine years, from July 2006 to June 2015, the law was used in only twelve cases. The authors conclude that the criteria of prudence and proportionality were used in the application of the law, which resulted in the treatment of patients who posed a risk to their environment, reducing the transmission of infection. Copyright © 2016 SESPAS. Published by Elsevier Espana. All rights reserved.
Wilson, A; Parker, H; Wynn, A; Jagger, C; Spiers, N; Jones, J; Parker, G
To compare effectiveness of patient care in hospital at home scheme with hospital care. Pragmatic randomised controlled trial. Leicester hospital at home scheme and the city's three acute hospitals. 199 consecutive patients referred to hospital at home by their general practitioner and assessed as being suitable for admission. Six of 102 patients randomised to hospital at home refused admission, as did 23 of 97 allocated to hospital. Hospital at home or hospital inpatient care. Mortality and change in health status (Barthel index, sickness impact profile 68, EuroQol, Philadelphia geriatric morale scale) assessed at 2 weeks and 3 months after randomisation. The main process measures were service inputs, discharge destination, readmission rates, length of initial stay, and total days of care. Hospital at home group and hospital group showed no significant differences in health status (median scores on sickness impact profile 68 were 29 and 30 respectively at 2 weeks, and 24 and 26 at 3 months) or in dependency (Barthel scores 15 and 14 at 2 weeks and 16 for both groups at 3 months). At 3 months' follow up, 26 (25%) of hospital at home group had died compared with 30 (31%) of hospital group (relative risk 0. 82 (95% confidence interval 0.52 to 1.28)). Hospital at home group required fewer days of treatment than hospital group, both in terms of initial stay (median 8 days v 14.5 days, P=0.026) and total days of care at 3 months (median 9 days v 16 days, P=0.031). Hospital at home scheme delivered care as effectively as hospital, with no clinically important differences in health status. Hospital at home resulted in significantly shorter lengths of stay, which did not lead to a higher rate of subsequent admission.
Full Text Available
In various studies outside the Netherlands, it has been shown that a substantial number of patients suffer from some kind of harm during their treatment in hospital. The incidence of these so-called adverse events varies between 2.9% and 16.6%; it is estimated that between over a quarter and a half of these are considered to be avoidable.
Preventable adverse events can be considered to be a starting point for interventions to increase patient safety. In response to this, a study was initiated in Dutch hospitals investigating the nature and extent of adverse events and their causes. Lessons learnt will be discussed within the European Research Network on Quality in Health Care (ENQual, where researchers and policy makers come together to exchange knowledge and experiences. Two important goals of the Dutch study are to reach a consensus on basic concepts and to improve research methodology. An unintended event resulting in harm caused by healthcare is called an adverse event in international literature. Preventable adverse events are especially important for prevention, in these cases the harm can be attributed to unintended events in the care process, caused by insufficient action according to professional standards and failures within the care system. Most adverse events, caused as they may seem by human action or failing to act at first sight, are often partly caused by a care process that has not been properly organized. Uniform concepts are needed in order to facilitate European comparisons, which would allow, for example, the comparison of Dutch research results with those from other countries, and the identification of specific concepts. One of the six action areas of the WHO’s World Alliance for Patient Safety is the development of a ‘patient safety taxonomy’.
Cutler, David M; Scott Morton, Fiona
A large reduction in use of inpatient care combined with the incentives in the Affordable Care Act is leading to significant consolidation in the hospital industry. What was once a set of independent hospitals having arms-length relationships with physicians and clinicians who provide ambulatory care is becoming a small number of locally integrated health systems, generally built around large, prestigious academic medical centers. The typical region in the United States has 3 to 5 consolidated health systems, spanning a wide range of care settings, and a smaller fringe of health care centers outside those systems. Consolidated health systems have advantages and drawbacks. The advantages include the ability to coordinate care across different practitioners and sites of care. Offsetting this is the potential for higher prices resulting from greater market power. Market power increases because it is difficult for insurers to bargain successfully with one of only a few health systems. Antitrust authorities are examining these consolidated systems as they form, but broad conclusions are difficult to draw because typically the creation of a system will generate both benefit and harm and each set of facts will be different. Moreover, the remedies traditionally used (eg, blocking the transaction or requiring that the parties divest assets) by antitrust authorities in cases of net harm are limited. For this reason, local governments may want to introduce new policies that help ensure consumers gain protection in the event of consolidation, such as insurance products that charge consumers more for high-priced clinicians and health care centers, bundling payments to clinicians and health care organizations to eliminate the incentives of big institutions to simply provide more care, and establishing area-specific price or spending targets.
Lu, Xudong; Duan, Huilong; Li, Haomin; Zhao, Chenhui; An, Jiye
Because of the complexity of the hospital environment, there exist a lot of medical information systems from different vendors with incompatible structures. In order to establish an enterprise hospital information system, the integration among these heterogeneous systems must be considered. Complete integration should cover three aspects: data integration, function integration and workflow integration. However most of the previous design of architecture did not accomplish such a complete integration. This article offers an architecture design of the enterprise hospital information system based on the concept of digital neural network system in hospital. It covers all three aspects of integration, and eventually achieves the target of one virtual data center with Enterprise Viewer for users of different roles. The initial implementation of the architecture in the 5-year Digital Hospital Project in Huzhou Central hospital of Zhejiang Province is also described.
Full Text Available After the liberation of Nis from the Turks which took place on January 11th, 1878, there were two military hospitals: one was next to The Skull Tower and the other on the road to Leskovac and there was Islahana the civil institution which was not the forerunner of the district hospital in Nis. At first, they founded the military hospital in Nis in 1878 and then they founded The District Hospital on July 17th in 1881. The first director of the District hospital was Anton Zajicek. He is also the first graduated medical doctor in Nis. The District Hospital was situated on the left bank of the Nisava river in a private house.
Xuzhou Center Hospital is in a competing medical market in Xuzhou city. This hospital has been dedicating to improve the medical skills and provide professional and individualized service to the patients in order to improve the patient's experience and increase the patient's satisfaction. On the other side, this hospital has provided an all-round marketing campaign to build up the social influence and public reputation through public-praise marketing, web marketing, media marketing, and scholar marketing. Besides, this hospital has been cooperating with foreign medical institutions and inviting foreign medical specialists to academic communication. With the combined effects of improving medical service and all-round marketing, the hospital's economic performance has been enhanced significantly and laid a solid foundation for its ambition to become the first-class hospital in Huaihai Economic Zone.
Ayodeji, Sesan P.; Adeyeri, Michael K.; Omoniyi, Olaoluwa
Hospital meal carts are used to deliver meals, drugs and some other materials to patients in the hospital environment. These carts which are moved manually by operators, the health workers, mostly do not comply with ergonomics guidelines and physical requirements of the equipment users in terms of anthropometry data of the region thus increasing the risk of musculoskeletal disorder among the meal cart users. This study carried out ergonomic evaluation of the available meal carts in some western Nigeria hospitals. A well-structured questionnaire has two major segments: Operational survey and biomechanical survey, which were administered to the health workers using hospital meal carts in some hospitals in southwestern Nigeria, and physical assessment, which was undertaken to collect data for the ergonomic evaluation. The responses from the questionnaires show that some areas on the existing hospital meal carts are of concern to the users which need to be improved upon.
Beck, Anne M; Balknäs, Ulla N; Camilo, Maria E; Fürst, Peter; Gentile, Maria G; Hasunen, Kaija; Jones, Liz; Jonkers-Schuitema, Cora; Keller, Ulrich; Melchior, Jean-Claude; Mikkelsen, Bent E; Pavcic, Marusa; Schauder, Peter; Sivonen, Lauri; Zinck, Orla; Øien, Henriette; Ovesen, Lars
Disease-related undernutrition is significant in European hospitals but is seldom treated or prevented. In 1999, the Council of Europe decided to collect information regarding nutrition programs in hospitals, and for this purpose, a network consisting of national experts from 12 of the Partial Agreement member states was established. The aim was to review the current practices in Europe regarding hospital food provision, to highlight deficiencies, and to issue recommendations to improve the nutritional care and support of hospitalized patients. Five major common problems were identified: 1) lack of clearly defined responsibilities, 2) lack of sufficient education, 3) lack of influence and knowledge of the patients, 4) lack of cooperation between different staff groups, and 5) lack of involvement from the hospital management. To solve the problems highlighted, a combined timely and concerted effort is required from national authorities and hospital staff, including managers, to ensure appropriate nutritional care and support.
Brotman, Billie Ann
This article examines demand factors for sophisticated medical treatments offered by private hospitals operating in India. Three types of medical tourism exist: Outbound, Inbound, and Intrabound. Increased profitability and positive growth trends by private hospital chains can be attributed to rising domestic income levels within India. Not all of the chains examined were financially solvent. Some of the hospital groups in this sample that advertised directly to potential Inbound medical tourists appear to be experiencing negative cash flows.
Bhuian, S N; Abdul-Gader, A
Using the more recent methodological developments in the assessment of the unidemensionality, reliability, and validity, the authors developed and examined a scale of market orientation for the hospital industry. The scale is based on a clear definition of the content of the construct of market orientation in the hospital industry. To this end, a national random sample of 237 hospital administrators was used. In addition to the support for the reliability and validity, the scale promises parsimony, pragmatism, and wide-ranging applicability.
CHEN, Po-Han; Kan, Meng-Shen; Chang, Luh-Maan
—This Hospitals consume large amounts of energy due to its operation characteristic. The HVAC system designed in hospital buildings runs 24 hours and has special air supply requirements. This study aims to evaluate the energy-saving efficiency of HVAC system by studying two Taiwan’s green hospital buildings. Results show 39.3% energy saving efficiency based on integrating VFD (Variable Frequency Drive) chiller, VAV (Variable Air Volume) system and VWV (Variable Water Volume) system for an exi...
Are laboring and birthing women treated abusively in the hospital? Although seldom recognized as abuse or violence against women, bullying and medical treatments under false pretenses, even in a hospital, constitute abuse and a basic human rights issue that needs attention. Naming the problem is a first step. The power of medical authority, the lack of accountability in the hospital hierarchical system, policies and protocols, and expectations of compliancy all make an environment ripe for ab...
Jennifer G Duckworth
Full Text Available The first matron of Grey’s Hospital, Mrs Isabella O ’Hara, was appointed in October 1855 and she presided over a temporary hospital which was established in a house until such time as the hospital building should be ready. The patients were mainly lunatics and destitute people who had until then been accommodated in a room at the goal. The sick were usually cared for in their homes.
This bachelor thesis deals with the issue of Comprehensive care for seniors in hospital. The conception of this thesis is theoretically-empirical. The theoretical part is focused on the characteristics of old-age and changes that accompany it, on the concept of comprehensive care, workers who participate in complex care and comprehensive care in hospital reception and hospitalization. Subsequently, it is oriented towards peculiarities concerning communication with seniors, the nurse´s role in...
Rosenthal, JL; Hilton, JF; Teufel, RJ; Romano, PS; Kaiser, SV; Okumura, MJ
Copyright © 2016 by the American Academy of Pediatrics. BACKGROUND AND OBJECTIVE: The hospital-to-hospital transfer of pediatric patients is a common practice that is poorly understood. To better understand this practice, we examined a national database to profile pediatric interfacility transfers. METHODS: We used the 2012 Kids' Inpatient Database to examine characteristics of hospitalized pediatric patients ( < 21 years; excluding pregnancy diagnoses) with a transfer admission source. We pe...
Galvin, Eileen Catherine; Wills, Teresa; Coffey, Alice
To report on an analysis on the concept of 'readiness for hospital discharge'. No uniform operational definition of 'readiness for hospital discharge' exists in the literature; therefore, a concept analysis is required to clarify the concept and identify an up-to-date understanding of readiness for hospital discharge. Clarity of the concept will identify all uses of the concept; provide conceptual clarity, an operational definition and direction for further research. Literature review and concept analysis. A review of literature was conducted in 2016. Databases searched were: Academic Search Complete, CINAHL Plus with Full Text, PsycARTICLES, Psychology and Behavioural Sciences Collection, PsycINFO, Social Sciences Full Text (H.W. Wilson) and SocINDEX with Full Text. No date limits were applied. Identification of the attributes, antecedents and consequences of readiness for hospital discharge led to an operational definition of the concept. The following attributes belonging to 'readiness for hospital discharge' were extracted from the literature: physical stability, adequate support, psychological ability, and adequate information and knowledge. This analysis contributes to the advancement of knowledge in the area of hospital discharge, by proposing an operational definition of readiness for hospital discharge, derived from the literature. A better understanding of the phenomenon will assist healthcare professionals to recognize, measure and implement interventions where necessary, to ensure patients are ready for hospital discharge and assist in the advancement of knowledge for all professionals involved in patient discharge from hospital. © 2017 John Wiley & Sons Ltd.
Adwell, James P
The purpose of this study was to develop a baseline measurement tool by assessing individual attitudes regarding hospital preparedness, departmental preparedness, and preparedness through education and training...
Dychtwald, K; Zitter, M
The initial stages of developing a strategic marketing plan for hospitals are explored in this excerpt from the book, The Role of the Hospital in an Aging Society: A Blueprint for Action. The elderly have unique perceptual, cognitive, social, and psychological needs and preferences, and a marketing strategy for eldercare services must reflect these factors, as well as the financial role of third-party payers and the decision-making influence of families and physicians. Among the elements the hospital must address when developing a marketing strategy are market selection and segmentation, targeting markets with specific services, pricing, and positioning the hospital for a maximum share of the eldercare market.
Sifuentes, Laura Y; Gerba, Charles P; Weart, Ilona; Engelbrecht, Kathleen; Koenig, David W
Hospital cleaning practices are critical to the prevention of nosocomial infection transmission. To this end, cloth towels soaked in disinfectants are commonly used to clean and disinfect hospital surfaces. Cloth cleaning towels have been linked to an outbreak of Bacillus cereus and have been shown to reduce the effectiveness of commonly used quaternary ammonium disinfectants. Thus, it is important to determine whether the reuse of cloth towels increases the risk of pathogen transmission in hospitals. The goal of this project was to determine the effects of laundry and cleaning practices commonly used in hospitals for washing, storage, and disinfection of cloth cleaning towels on their microbial loads. Our results indicate that cloth towels used for cleaning hospital rooms contained high numbers of microbial contaminants. In this case, hospital laundering practices appear insufficient to remove microbial contaminants and may even add contaminants to the towels. Furthermore, it has been previously reported that towels can interfere with the action of common hospital disinfectants. Either independently or in combination, these 2 factors may increase the risk for transmission of pathogens in hospitals. These observations indicate the need to critically reevaluate current hospital cleaning practices associated with reuse of cloth towels. Copyright © 2013 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.
Rayburn, J M; Rayburn, L G
This research traces the origins, development, and reasons for change in the power equation in the U.S. hospitals between physicians, administrators and accountants. The paper contains three major sections: a review of the literature concerning authority, power, influence, and institutional theory; a review of the development of the power of professions, especially physicians, accounting and healthcare administrators, and the power equilibrium of a hospital; and, a discussion of the social policy implications of the power struggle. The basis for physicians' power derives from their legal ability to act on which others are dependent, such as choosing which hospital to admit patients, order tests and procedures for their patients. The Federal Government's prospective payment system and the hospitals' related case-mix accounting systems appear to influence the power structure in hospitals by redistributing that power. The basis of the accountants' power base is control of financial information. Accountants have a definite potential for influencing which departments receive financial resources and for what purpose. This moves hospital accountants into the power equation. The basis of the hospital administrators' power is their formal authority in the organization. Regardless of what actions federal government agencies, hospital accountants, or hospital administrators take, physicians are expected to remain the dominant factor in the power equation. Without major environmental changes to gain control of physician services, only insignificant results in cost containment will occur.
This paper analyzes the architectural characteristics and trends and suggests some tasks for better hospitals. Hospital design has been improved qualitatively in architectural form and interior. Although overall forms of most buildings have a vertical concept, horizontal concept hospitals have been attempted. In ward plan, various shapes have appeared and interior space has been more dynamic. Special clinics and centres have been established and operated to meet the high level of patients' demand. Suggestions for better hospital could be the increase of private rooms, decreasing the size of the nursing unit, the use of the horizontal concept, supplement of safety-privacy-hygiene, and some sensory factors.
Bertoli, Paola; Grembi, Veronica
We assess the lifesaving effect of hospital proximity using data on fatality rates of road-traffic accidents. While most of the literature on this topic is based on changes in distance to the nearest hospital triggered by hospital closures and use OLS estimates, our identification comes from......) increases the fatality rate by 13.84% on the sample average. This is equal to a 0.92 additional death per every 100 accidents. We show that OLS estimates provide a downward biased measure of the real effect of hospital proximity because they do not fully solve spatial sorting problems. Proximity matters...
Kristensen, Troels; Bogetoft, Peter; Pedersen, Kjeld Moeller
The Danish hospital sector faces a major rebuilding program to centralize activity in fewer and larger hospitals. We aim to conduct an efficiency analysis of hospitals and to estimate the potential cost savings from the planned hospital mergers. We use Data Envelopment Analysis (DEA) to estimate a cost frontier. Based on this analysis, we calculate an efficiency score for each hospital and estimate the potential gains from the proposed mergers by comparing individual efficiencies with the efficiency of the combined hospitals. Furthermore, we apply a decomposition algorithm to split merger gains into technical efficiency, size (scale) and harmony (mix) gains. The motivation for this decomposition is that some of the apparent merger gains may actually be available with less than a full-scale merger, e.g., by sharing best practices and reallocating certain resources and tasks. Our results suggest that many hospitals are technically inefficient, and the expected "best practice" hospitals are quite efficient. Also, some mergers do not seem to lower costs. This finding indicates that some merged hospitals become too large and therefore experience diseconomies of scale. Other mergers lead to considerable cost reductions; we find potential gains resulting from learning better practices and the exploitation of economies of scope. To ensure robustness, we conduct a sensitivity analysis using two alternative returns-to-scale assumptions and two alternative estimation approaches. We consistently find potential gains from improving the technical efficiency and the exploitation of economies of scope from mergers.
Etxeberria-Lekuona, D; Casas Fernández de Tejerina, J M; Méndez López, I; Oteiza Olaso, J; Arteaga Mazuelas, M; Jarne Betran, V
Patient who require multiple hospitalizations result in a considerable consumption of healthcare resources. In this study, we analyzed the factors associated with the multiple hospitalizations of a cohort of patients treated at a department of internal medicine. A total of 613 consecutive hospitalizations were analyzed. A multiple-hospitalization patient was defined as one who at the time of admission had been hospitalized 3 or more times in the past year. We analyzed the relationship between demographic, clinical and societal factors on one hand and having been hospitalized on multiple occasions on the other. We also analyzed readmissions in the 6 months after discharge, as well as mortality during the hospitalization and in the 6 and 12 months after discharge. When compared with patients who have not been hospitalized on multiple occasions, multiple-hospitalization patients are more likely to be male, younger and to have greater comorbidity, greater consumption of medicines and higher Katz Index scores. The main cause for admission for multiple-hospitalizations patients was chronic disease decompensation (87.3%). The diseases that were most obviously associated with multiple hospitalizations were heart failure, diabetes mellitus and chronic obstructive pulmonary disease. In the first 6 months after discharge, multiple-hospitalization patients had a greater number of readmissions. During the study period, 40.4% of the multiple-hospitalization patients died, and 28.8% of the nonmultiple-hospitalization patients died. Multiple-hospitalization patients have a greater clinical complexity than nonmultiple-hospitalization patients, and multiple hospitalizations are associated with chronic diseases, polypharmacy, functional impairment and high mortality rates. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.
Harris, Donna L; Lloyd, James W; Marrinan, Mike
The Skills, Knowledge, Aptitude, and Attitude (SKA) Subcommittee of the National Commission on Veterinary Economic Issues (NCVEI) has identified the need for veterinary teaching hospitals (VTH) to be at the forefront of progressive business management to serve as a model for both students and practitioners to emulate. To provide a foundation for developing a model, this study reviewed pertinent literature applicable to the management of a VTH. Much of the literature relevant to VTH management relates to work completed for the human side of medicine (academic health centers, or AHCs) or to the private sector. This review explores management practices in strategic planning, financial management, human resource management, marketing, pricing, operations, and legal issues. It is concluded that strategic management is important to provide the foundation for success in the VTH. In addition, periodic financial reports are recommended, as are the development and use of benchmarks for financial management. Establishing positive, motivating human resource practices is also suggested, along with development of a marketing plan based on a clear understanding of VTH core competencies and the market's specific needs.
Moriya, Asako S; Vogt, William B; Gaynor, Martin
There has been substantial consolidation among health insurers and hospitals, recently, raising questions about the effects of this consolidation on the exercise of market power. We analyze the relationship between insurer and hospital market concentration and the prices of hospital services. We use a national US dataset containing transaction prices for health care services for over 11 million privately insured Americans. Using three years of panel data, we estimate how insurer and hospital market concentration are related to hospital prices, while controlling for unobserved market effects. We find that increases in insurance market concentration are significantly associated with decreases in hospital prices, whereas increases in hospital concentration are non-significantly associated with increases in prices. A hypothetical merger between two of five equally sized insurers is estimated to decrease hospital prices by 6.7%.
Torun, Nazan; Celik, Yusuf; Younis, Mustafa Z
The level of competition among hospitals in Turkey was analyzed for the years 1990 through 2006 using the Herfindahl-Hirschman Index (HHI). Multiple and simple regression analyses were run to observe the development of competition among hospitals over this period of time, to examine likely determinants of competition, and to calculate the effects of competition on efficiency and quality in individual hospitals. This study found that the level of competition among hospitals in Turkey has increased throughout the years. Also, competition has had a positive effect on the efficiency of hospitals; however, it did not have a significant positive effect on their quality. Moreover, there are important differences in the level of competition among hospitals that vary according to the geographical region, the type of ownership, and the type of hospital. This study is one of the first to evaluate the effects of health policies on competition as well as the effects of increasing competition on hospital quality and efficiency in Turkey.
Kai, T; Ukai, T; Ohta, M; Pretto, E
To investigate the adequacy of hospital disaster preparedness in the Osaka, Japan area. Questionnaires were constructed to elicit information from hospital administrators, pharmacists, and safety personnel about self-sufficiency in electrical, gas, water, food, and medical supplies in the event of a disaster. Questionnaires were mailed to 553 hospitals. A total of 265 were completed and returned (Recovery rate; 48%). Of the respondents, 16% of hospitals that returned the completed surveys had an external disaster plan, 93% did not have back-up plans to accept casualties during a disaster if all beds were occupied, 8% had drugs and 6% had medical supplies stockpiled for disasters. In 78% of hospitals, independent electric power generating plants had been installed. However, despite a high proportion of power-plant equipment available, 57% of hospitals responding estimated that emergency power generation would not exceed six hours due to a shortage of reserve fuel. Of the hospitals responding, 71% had reserve water supply, 15% of hospitals responding had stockpiles of food for emergency use, and 83% reported that it would be impossible to provide meals for patients and staff with no main gas supply. No hospitals fulfilled the criteria for adequate disaster preparedness based on the categories queried. Areas of greatest concern requiring improvement were: 1) lack of an external disaster plan; and 2) self-sufficiency in back-up energy, water, and food supply. It is recommended that hospitals in Japan be required to develop plans for emergency operations in case of an external disaster. This should be linked with hospital accreditation as is done for internal disaster plans.
Nguyen, Kaylin T; Olgin, Jeffrey E; Pletcher, Mark J; Ng, Madelena; Kaye, Leanne; Moturu, Sai; Gladstone, Rachel A; Malladi, Chaitanya; Fann, Amy H; Maguire, Carol; Bettencourt, Laura; Christensen, Matthew A; Marcus, Gregory M
Ascertainment of hospitalizations is critical to assess quality of care and the effectiveness and adverse effects of various therapies. Smartphones, mobile geolocators that are ubiquitous, have not been leveraged to ascertain hospitalizations. Therefore, we evaluated the use of smartphone-based geofencing to track hospitalizations. Participants aged ≥18 years installed a mobile application programmed to geofence all hospitals using global positioning systems and cell phone tower triangulation and to trigger a smartphone-based questionnaire when located in a hospital for ≥4 hours. An in-person study included consecutive consenting patients scheduled for electrophysiology and cardiac catheterization procedures. A remote arm invited Health eHeart Study participants who consented and engaged with the study via the internet only. The accuracy of application-detected hospitalizations was confirmed by medical record review as the reference standard. Of 22 eligible in-person patients, 17 hospitalizations were detected (sensitivity 77%; 95% confidence interval, 55%-92%). The length of stay according to the application was positively correlated with the length of stay ascertained via the electronic medical record (r=0.53; P=0.03). In the remote arm, the application was downloaded by 3443 participants residing in all 50 US states; 243 hospital visits at 119 different hospitals were detected through the application. The positive predictive value for an application-reported hospitalization was 65% (95% confidence interval, 57%-72%). Mobile application-based ascertainment of hospitalizations can be achieved with modest accuracy. This first proof of concept may ultimately be applicable to geofencing other types of prespecified locations to facilitate healthcare research and patient care. © 2017 American Heart Association, Inc.
Nguyen, Hoa L; Ha, Duc Anh; Phan, Dat Tuan; Nguyen, Quang Ngoc; Nguyen, Viet Lan; Nguyen, Nguyen Hanh; Nguyen, Ha; Goldberg, Robert J
Cardiovascular disease is one of the leading causes of morbidity and mortality in Vietnam. We conducted a pilot study of Hanoi residents hospitalized with acute myocardial infarction (AMI) at the Vietnam National Heart Institute in Hanoi. The objectives of this observational study were to examine sex differences in clinical characteristics, hospital management, in-hospital clinical complications, and mortality in patients hospitalized with an initial AMI. The study population consisted of 302 Hanoi residents hospitalized with a first AMI at the largest tertiary care medical center in Hanoi in 2010. The average age of study patients was 66 years and one third were women. Women were older (70 vs. 64 years) and were more likely than men to have had hyperlipidemia previously diagnosed (10% vs. 2%). During hospitalization, women were less likely to have undergone percutaneous coronary intervention (PCI) compared with men (57% vs. 74%), and women were more likely to have developed heart failure compared with men (19% vs. 10%). Women experienced higher in-hospital case-fatality rates (CFRs) than men (13% vs. 4%) and these differences were attenuated after adjustment for age and history of hyperlipidemia (OR: 2.64; 95% CI: 1.01, 6.89), and receipt of PCI during hospitalization (OR: 2.09; 95% CI: 0.77, 5.09). Our pilot data suggest that among patients hospitalized with a first AMI in Hanoi, women experienced higher in-hospital CFRs than men. Full-scale surveillance of all Hanoi residents hospitalized with AMI at all Hanoi medical centers is needed to confirm these findings. More targeted and timely educational and treatment approaches for women appear warranted.
Hoa L Nguyen
Full Text Available BACKGROUND: Cardiovascular disease is one of the leading causes of morbidity and mortality in Vietnam. We conducted a pilot study of Hanoi residents hospitalized with acute myocardial infarction (AMI at the Vietnam National Heart Institute in Hanoi. The objectives of this observational study were to examine sex differences in clinical characteristics, hospital management, in-hospital clinical complications, and mortality in patients hospitalized with an initial AMI. METHODS: The study population consisted of 302 Hanoi residents hospitalized with a first AMI at the largest tertiary care medical center in Hanoi in 2010. RESULTS: The average age of study patients was 66 years and one third were women. Women were older (70 vs. 64 years and were more likely than men to have had hyperlipidemia previously diagnosed (10% vs. 2%. During hospitalization, women were less likely to have undergone percutaneous coronary intervention (PCI compared with men (57% vs. 74%, and women were more likely to have developed heart failure compared with men (19% vs. 10%. Women experienced higher in-hospital case-fatality rates (CFRs than men (13% vs. 4% and these differences were attenuated after adjustment for age and history of hyperlipidemia (OR: 2.64; 95% CI: 1.01, 6.89, and receipt of PCI during hospitalization (OR: 2.09; 95% CI: 0.77, 5.09. CONCLUSIONS: Our pilot data suggest that among patients hospitalized with a first AMI in Hanoi, women experienced higher in-hospital CFRs than men. Full-scale surveillance of all Hanoi residents hospitalized with AMI at all Hanoi medical centers is needed to confirm these findings. More targeted and timely educational and treatment approaches for women appear warranted.
Rosenthal, Jennifer L; Hilton, Joan F; Teufel, Ronald J; Romano, Patrick S; Kaiser, Sunitha V; Okumura, Megumi J
The hospital-to-hospital transfer of pediatric patients is a common practice that is poorly understood. To better understand this practice, we examined a national database to profile pediatric interfacility transfers. We used the 2012 Kids' Inpatient Database to examine characteristics of hospitalized pediatric patients (patient characteristics, utilization, and hospital characteristics between those admitted by transfer versus routine admission. We constructed a multivariable logistic regression model to identify patient characteristics associated with being admitted by transfer versus routine admission. Of the 5.95 million nonpregnancy hospitalizations in the United States in 2012, 4.4% were admitted by transfer from another hospital. Excluding neonatal hospitalizations, this rate increased to 9.4% of the 2.10 million nonneonatal, nonpregnancy hospitalizations. Eighty-six percent of transfers were to urban teaching hospitals. The most common transfer diagnoses to all hospitals nationally were mood disorder (8.9%), other perinatal conditions (8.7%), prematurity (4.8%), asthma (4.2%), and bronchiolitis (3.8%). In adjusted analysis, factors associated with higher odds of being admitted by transfer included having a neonatal principal diagnosis, male gender, white race, nonprivate insurance, rural residence, higher illness severity, and weekend admission. Interfacility transfers are relatively common among hospitalized pediatric patients. Higher odds of admission by transfer are associated not only with higher illness severity but also with principal diagnosis, insurance status, and race. Further studies are needed to identify the etiologies and clinical impacts of identified transfer differences. Copyright © 2016 by the American Academy of Pediatrics.
Handayani, P W; Hidayanto, A N; Pinem, A A; Hapsari, I C; Sandhyaduhita, P I; Budi, I
The purpose of this study is to develop a model of Hospital Information System (HIS) user acceptance focusing on human, technological, and organizational characteristics for supporting government eHealth programs. This model was then tested to see which hospital type in Indonesia would benefit from the model to resolve problems related to HIS user acceptance. This study used qualitative and quantitative approaches with case studies at four privately owned hospitals and three government-owned hospitals, which are general hospitals in Indonesia. The respondents involved in this study are low-level and mid-level hospital management officers, doctors, nurses, and administrative staff who work at medical record, inpatient, outpatient, emergency, pharmacy, and information technology units. Data was processed using Structural Equation Modeling (SEM) and AMOS 21.0. The study concludes that non-technological factors, such as human characteristics (i.e. compatibility, information security expectancy, and self-efficacy), and organizational characteristics (i.e. management support, facilitating conditions, and user involvement) which have level of significance of pgovernment-owned hospitals. Based on the results of this study, hospital management and IT developers should have more understanding on the non-technological factors to better plan for HIS implementation. Support from management is critical to the sustainability of HIS implementation to ensure HIS is easy to use and provides benefits to the users as well as hospitals. Finally, this study could assist hospital management and IT developers, as well as researchers, to understand the obstacles faced by hospitals in implementing HIS. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
Lambert, V; Coad, J; Hicks, P; Glacken, M
In the last number of years heightened interest has been attributed to the impact of hospital environments on children's psychosocial well-being. With policy largely built around adult assumptions, knowledge about what constitutes a child-friendly hospital environment from young children's perspectives has been lacking. If hospital environments are to aspire to being child friendly then the views of younger aged children must be taken into account. The current study investigated young children's perspectives of hospital social spaces to inform the design of the built environment of a new children's hospital. An exploratory qualitative participatory design was employed. Data were collected through semi-structured interviews (one-to-one and group workshops) which incorporated art-based activities to actively engage young children. Fifty-five young children aged 5 to 8 years with various acute and chronic illnesses were recruited from inpatient, outpatient and emergency departments of three children's hospitals. Young children want a diversity of readily available, independently accessible, age, gender and developmentally appropriate leisure and entertainment facilities seamlessly integrated throughout the hospital environment. Such activities were invaluable for creating a positive hospital experience for children by combating boredom, enriching choice and control and reducing a sense of isolation through enhanced socialization. When in hospital, young children want to feel socially connected to the internal hospital community as well as to the outside world. Technology can assist to broaden the spectrum of children's social connectivity when in hospital - to home, school and the wider outside world. While technology offers many opportunities to support children's psychosocial well-being when in confined healthcare spaces, the implementation and operation of such services and systems require much further research in the areas of ethics, facilitation, organizational
Tyagi, Rajesh K; Cook, Lori; Olson, John; Belohlav, James
Background Healthcare technology and quality improvement programs have been identified as a means to influence healthcare costs and healthcare quality in Canada. This study seeks to identify whether the ability to implement healthcare technology by a hospital was related to usage of quality improvement programs within the hospital and whether the culture within a hospital plays a role in the adoption of quality improvement programs. Methods A cross-sectional study of Canadian hospitals was co...
Tarrant, R C
The WHO (2001) recommends exclusive breast-feeding and delaying the introduction of solid foods to an infant\\'s diet until 6 months postpartum. However, in many countries, this recommendation is followed by few mothers, and earlier weaning onto solids is a commonly reported global practice. Therefore, this prospective, observational study aimed to assess compliance with the WHO recommendation and examine weaning practices, including the timing of weaning of infants, and to investigate the factors that predict weaning at ≤ 12 weeks. From an initial sample of 539 pregnant women recruited from the Coombe Women and Infants University Hospital, Dublin, 401 eligible mothers were followed up at 6 weeks and 6 months postpartum. Quantitative data were obtained on mothers\\' weaning practices using semi-structured questionnaires and a short dietary history of the infant\\'s usual diet at 6 months. Only one mother (0.2%) complied with the WHO recommendation to exclusively breastfeed up to 6 months. Ninety-one (22.6%) infants were prematurely weaned onto solids at ≤ 12 weeks with predictive factors after adjustment, including mothers\\' antenatal reporting that infants should be weaned onto solids at ≤ 12 weeks, formula feeding at 12 weeks and mothers\\' reporting of the maternal grandmother as the principal source of advice on infant feeding. Mothers who weaned their infants at ≤ 12 weeks were more likely to engage in other sub-optimal weaning practices, including the addition of non-recommended condiments to their infants\\' foods. Provision of professional advice and exploring antenatal maternal misperceptions are potential areas for targeted interventions to improve compliance with the recommended weaning practices.
Thomairy, Noora Al; Mummaneni, Mounica; Alsalamah, Sami; Moussa, Nicole; Coustasse, Alberto
Mobile technology has begun to change the landscape of the medical profession, with more than two-thirds of physicians regularly using smartphones. Smartphones have allowed health care professionals and the general public to communicate more efficiently, collect data, and facilitate clinical decision making. The methodology for this study was a qualitative literature review following a systematic approach of smartphone use among physicians in hospitals. Fifty-one articles were selected for this study based on inclusion criteria. The findings were classified and described into 7 categories: use of smartphone in obstetrics, pediatrics, surgery, internal medicine, radiology, and dermatology, which were chosen based on the documented use of smartphone application in different health care practices. A last section of patient safety and issues with confidentiality is also described. This study suggests that smartphones have been playing an increasingly important role in health care. Medical professionals have become more dependent upon medical smartphone applications. However, concerns of patient safety and confidentiality will likely lead to increased oversight of mobile device use by regulatory agencies and accrediting bodies.
Smith, Y R; Quint, E H; Hertzberg, R B
This study was undertaken to assess the causes and treatments of menorrhagia in adolescents hospitalized for this menstrual disorder. A retrospective chart review was performed of all adolescents adolescents with 46 admissions for menorrhagia were identified. The average age of menarche was 12.9 years and the average age at admission was 15.9 years. Nineteen adolescents had significant medical diseases. For the 46 admissions, causes of menorrhagia were anovulation (21), hematologic disease (15), chemotherapy-related (5), and infections (5). Transfusions of blood products were performed in 28 of the admissions. Treatments included oral contraceptive pills or progestins (30), intravenous conjugated estrogens (8), antibiotics (4), immune gammaglobulin (3), DDAVP (3), and prednisone (1). Twelve surgical procedures were performed, including eight dilatation and curettages (D&Cs), three laparoscopies, and one hysterectomy. Sixty-one percent of admissions for adolescent menorrhagia were in adolescents with significant medical problems. The patients with menorrhagia who required admission had severe anemia and were transfused in 63% of cases. The predominant causes for these admissions included anovulation in 46%, hematologic disease in 33%, chemotherapy in 11%, and infection in 11%. Hormonal regulation or suppression of menses should be considered in adolescents with significant medical disease.
Tüchsen, Finn; Bach, Elsa
The Occupational Hospitalization Register (OHR) is an ongoing register for research and surveillance established by the National Research Centre for the Working Environment in the 1980s. This review puts in perspective the contributions from the OHR to the understanding of relation between work and the burden of diseases in general and circulatory disease in particular. This review covers selected topics in which studies based on OHR has contributed to the scientific knowledge during more than two decades. One PhD thesis and so far 49 OHR studies have contributed to the estimation of the excess fraction of several diseases attributable to work and to the identification of relative risks for occupational diseases like circulatory diseases, diseases of the nervous system, musculoskeletal disorders, pulmonary disease, infertility, and recently also mental disorders. OHR is a cost-effective instrument for surveillance of health consequences of the working environment and social conditions as well as a valuable register for ad-hoc studies of the aetiology of occupational diseases.
..., 485, and 489 RIN 0938-AP80; RIN 0938-AP33 Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System Changes and FY...: Correction of final rules and interim final rule with comment period. SUMMARY: This document corrects...
Bruijne, M.C. de; Zegers, M.; Hoonhout, L.H.F.; Spreeuwenberg, P.M.M.; Groenewegen, P.P.; Wagner, C.
Objective: To assess the variation in adverse event (AE) rates at the hospital and hospital department level, in order to gain insight in room for improvement of patient safety at each level. Methods: Randomly selected records of 7926 hospital admissions of 2004 from 4 university and 17 general
... economic growth, innovation, job-creation, and competitiveness. To achieve a more robust and effective... hospitals, if hospitals so choose. Nursing care plan: We have allowed hospitals the options of having a stand-alone nursing care plan or a single interdisciplinary care plan that addresses nursing and other...
...) Performance of basic hospital functions. The hospital meets one of the following criteria: (A) The hospital performs the basic functions specified in §§ 482.21 through 482.27, 482.30, 482.42, 482.43, and 482.45 of.... (F) For cost reporting and apportionment purposes, it uses an accounting system that properly...
Pijls-Hoekstra, Ruth; Pijls-Hoekstra, Ruth; Groen, Brenda H.; Galetzka, Mirjam; Pruyn, Adriaan T.H.
What is hospitality? Only few academic articles tap into the meaning of the concept of hospitality. Especially academic investigation of hospitality from a guest perspective is scarce; the combination of ‘hospitality’ and ‘experience’ has received hardly any attention. The present paper describes a
Herklots, T.; Acht, L. van; Meguid, T.; Franx, A.; Jacod, B.C.
OBJECTIVE: to analyse the impact of in-hospital care on severe maternal morbidity using WHO's near-miss approach in the low-resource, high mortality setting of Zanzibar's referral hospital. SETTING: Mnazi Mmoja Hospital, a tertiary care facility, in Zanzibar, Tanzania. METHODS: We identified all
Georges, Patrick M; Samson, Julien
Leadership methods can be understood and applied by hospital managers in the same way teachers and the seminar's participants respect certain conventions. Each method should be discussed and adapted, recognizing its limitations for use within hospitals. This article first presents what is taught in a traditional leadership course and then, discusses ways the course can be adapted for use by hospital managers.
Pijls-Hoekstra, Ruth; Groen, Brenda H.; Galetzka, Mirjam; Pruyn, Ad T.H.
What is hospitality? Only few academic articles tap into the meaning of the concept of hospitality. Especially academic investigation of hospitality from a guest perspective is scarce; the combination of ‘hospitality’ and ‘experience’ has received hardly any attention. The present paper describes a
Subramanian, Arun; Adler, Joel T; Shah, Nilay D; Hyder, Joseph A
Publicly reported hospital ratings aim to encourage transparency, spur quality improvement, and empower patient choice. Travel burdens may limit patient choice, particularly for older adults (aged 65 years and more) who receive most medical care. For 3 major hospital ratings systems, we estimated travel burden as the additional 1-way travel distance to receive care at a better-rated hospital.Distances were estimated from publicly available data from the US Census, US News Top Hospitals, Society of Thoracic Surgeons composite rating for coronary artery bypass grafting (STS-CABG), and Centers for Medicare and Medicaid Services Hospital Consumer Assessment of Healthcare Providers and Services (HCAHPS).Hospitals were rated for HCAHPS (n = 4656), STS-CABG (n = 470), and US News Top Hospitals (n = 15). Older adults were commonly located within 25 miles of their closest HCAHPS hospital (89.6%), but less commonly for STS-CABG (62.9%). To receive care at a better-rated hospital, travel distances commonly exceeded 25 miles: HCAHPS (39.2%), STS-CABG (62.7%), and US News Top Hospital (85.2%). Additional 1-way travel distances exceeded 25 miles commonly: HCAHPS (23.7%), STS-CABG (36.7%), US News Top Hospitals (81.8%).Significant travel burden is common for older adults seeking "better" care and is an important limitation of current hospital ratings for empowering patient choice.
Sixty-two patients (57.4 %) did not get any First Aid prior to admission. All Patients received supportive therapy. None of the patients received snake antivenom since it was unavailable at the hospital. All the 108 patients (100 %) improved and were discharged. The duration of hospital stay was 2 to 17 days with a mean of ...
Kumar, Sameer; Livermont, Gregory; McKewan, Gregory
The use of radio frequency identification device (RFID) technology within the healthcare industry was researched and specific instances of implementation of this technology in the hospital environment were examined. The study primarily makes use of ideas from operations and supply chain management, such as work flow diagrams, value stream mapping, and poka-yokes (mistake proofing measures) for investigations of processes, failures, and solutions. This study presents a step-by-step approach of how to implement the use of RFID tracking systems within the entire hospital. A number of poka-yokes were also devised for improving the safety of the patient and cost effectiveness of the hospital to insure the success of the hospital health care delivery system. Many players in the hospital environment may be impacted. This includes patients, doctors, nurses, technicians, administrators, and other hospital personnel. Insurance and government agencies may be impacted as well. Different levels of training of hospital personnel will be required based on the degree of interaction with the RFID system. References to costs, Return On Investment, change management, ethical and legal considerations are also made to help the reader understand the benefits and implications of the technology in the hospital environment.
Pham, Thuy Linh
The purpose of this paper is to examine the relative efficiency and productivity of hospitals during the health reform process. Data envelopment analyses method (DEA) with the input-oriented variable-returns-to-scale model was used to calculate efficiency scores. Malmquist total factor productivity index approach was then employed to calculate productivity of hospitals. Data of 101 hospitals was extracted from databases of the Ministry of Health, Vietnam from the years 1998 to 2006. There was evidence of improvement in overall technical efficiency from 65 per cent in 1998 to 76 per cent in 2006. Hospitals' productivity progressed around 1.4 per cent per year, which was mainly due to the technical efficiency improvement. Furthermore, provincial hospitals were more technically efficient than their central counterparts and hospitals located in different regions performed differently. The paper provides an insight in the performance of Vietnamese public hospitals that has been rarely examined before and contributes to the existing literature of hospital performance in developing countries
Folmann, Nana Bro; Bossen, Kristine Skovgaard; Willaing, Ingrid
To quantify the association between obesity and somatic hospital costs and number of overall somatic hospital contacts--number of inpatient admissions, number of outpatient visits, and number of emergency department visits--based on anthropometric measurements of waist circumference (WC) and info...
Although hospitals are increasingly recognizing the importance of marketing, many have difficulty assimilating what has been primarily an industrial concern into a health care environment. The author explains the function of marketing in health care, the outlook and expectations of a good marketing executive, and why hospital management and the medical staff may have difficulty accepting marketing and the expectations of the marketing executive.
Bodilsen, Ann Christine; Pedersen, Mette Merete; Petersen, Janne
OBJECTIVE: Acute hospitalization of older patients may be associated with loss of muscle strength and functional performance. The aim of this study was to investigate the effect of acute hospitalization as a result of medical disease on muscle strength and functional performance in older medical ...
... medlineplus.gov/ency/patientinstructions/000867.htm Leaving the hospital - your discharge plan To use the sharing features on this ... need any special equipment or supplies, such as: Hospital bed Wheelchair Walker or cane Shower ... Checklist Your discharge planner will give you a ...
Full Text Available In prior quarterly reports, Pinnacle Advisory Group presented timely updates about the New England lodging industry, which included focused profiles on particular cities. In this issue, the firm offers more general insight about the hospitality industry. Several Pinnacle executives recently participated in a panel discussion about investment, management, and careers in the hospitality industry.
[CC BY 4.0] (http://creativecommons.org/licenses/by/4.0). Introduction. Within the hospitality industry, as in other industries, attention is given to environmental sustainability. Unfortunately, however, most hospitality companies are lagging behind in the process of becoming more sustainable (van Rheede & Blomme, 2012a).
The Obstetrics Gynecology and Children's Hospital Emergency. Room waiting time before hospitalization. *Ocak T1, Bekdas M2, Duran A1, Göksügür SB2, Küçükbayrak B3. 1. Abant Izzet Baysal University Faculty of Medicine, Department of Emergency Medicine, Bolu, Turkey. 2. Abant Izzet Baysal University Faculty of ...
Brennen, Paul George
The research study recognized that, although the knowledge obtained from academic textbooks and traditional classes are important to post-secondary hospitality management curriculum as they provide numerous insights and perspectives of different methods to manage a particular avenue within the hospitality industry; it is not the only aspect of the…
Walker, Susan S.
This teacher's guide is the core publication of a series of instructional materials developed for the hospitality and tourism industry. It includes the entry-level competencies students will need to enter any of the occupational areas identified in the four cluster areas of the hospitality and tourism industry: lodging, food service, travel and…
Nigerian Quarterly Journal of Hospital Medicine is published quarterly and the contents include articles in Medicine, Dentistry, Pharmaceutical and Basic Medical Sciences with emphasis on health problems and solutions relating to developing countries. The readership are in - Libraries, Teaching Hospitals, Universities, ...
Zahedpisheh, Nahid; Abu Bakar, Zulqarnain B.; Saffari, Narges
The quick development of the tourism and hospitality industry can straightly influence the English language which is the most widely used and spoken language in international tourism in the twenty-first century. English for tourism has a major role in the delivery of quality service. Employees who work in the tourism and hospitality industry are…
Dobson, Michael B.
This practical manual is designed to help medical officers in small hospitals provide safe and effective anesthesia for patients. Intended for doctors with at least one year of postgraduate clinical experience, it describes anesthetic techniques suitable for use in hospitals with limited resources. Chapter 2 describes fundamental principles and…
The study was conducted at Eben Donges Hospital, a regional hospital in the Boland/Overberg area of the Western Cape, where pesticide-intensive fruit farming remains the largest revenue generator. Subjects. The study included all children aged 12 years or less (as per health services classification) with confirmed OPP.
Whitman, Marilyn V.; Harbison, Phillip Adam
Purpose: This paper aims to examine the level of smoke-free policies in general hospitals and the barriers faced in implementing restrictive policies banning smoking inside buildings and on surrounding grounds. Design/methodology/approach; A survey was developed to gather data on hospitals' current smoke-free policies, including the challenges…
How does the current paradigm of the host-guest relationship cause the hospitality industry to lag behind in sustainable development? Hospitality is often defined as “a feeling of being welcome”. It is about “welcoming the stranger: a person who comes today and stays tomorrow”, or “a stranger who is treated like a god”.
Learning the C-A-Bs: Resuscitation Training at Rwanda Military Hospital. Kathryn Norgang1, Auni Idi Muhire1, Sarah Howrath1. 1Rwanda Military Hospital, Rwanda. Background. There is a lack of trained staff to respond to critically ill patients and cardiac and respiratory arrests in a health facility in Rwanda. This lack of ...
Full Text Available Few industries rely on self-confidence to the extent that the hospitality industry does because guests must feel welcome and that they are in capable hands. This article examines the results of hundreds of student interviews with industry professionals at all levels to determine where the majority of the hospitality industry gets their self-confidence.
Thus, further justifying the use of birth weight of 4000g and above as cut-off point for HBW in the present study. Teaching hospitals by their nature are referral centres. Therefore, data from such institutions are inevitably referral-biased. From this standpoint, a private hospital, which does not select patients and has a high ...
Facilities for proper hand washing are suboptimal. We recommend the introduction of hand washing policy for the hospital and the provision of an environment conducive for its implementation by the hospital management as well as adequate support for the infection control committee in the discharge of her duties.
Weld, Tim; Klein, Gina
Proposed rules in accounting for defined benefit plans may affect hospitals' statement of operations and affect the time, effort, and cost to comply with periodic financial reporting requirements. The new standard would require immediate recognition of the full amount of plan amendments in determining operating income. Hospitals should consider the role of pension plans in their compensation programs.
Neurocysticercosis - experience at the teaching hospitals ofthe University ofCape Town . A. J. G~ THOMSON. Abstract In the 15 years 1975-1989, 239 patients attending the associated teaching hospitals ofthe University of Cape Town have been identified retrospectively as having neurocysticercosis. One hundred and.
Klingner, Jill; Moscovice, Ira; Tupper, Judith; Coburn, Andrew; Wakefield, Mary
Implementation of patient safety initiatives can be costly in time and energy. Because of small volumes and limited resources, rural hospitals often are not included in nationally driven patient safety initiatives. This article describes the Tennessee Rural Hospital Patient Safety Demonstration project, whose goal was to strengthen capacity for…
Full Text Available Background: Instead of waiting for challenges to confront hospital management, doctors and managers should act in advance to optimize and sustain value-based health. This work highlights the importance of scenario planning in hospitals, proposes an elaborated definition of the stakeholders of a hospital and defines the influence factors to which hospitals are exposed to. Methodology: Based on literature analysis as well as on personal interviews with stakeholders we propose an elaborated definition of stakeholders and designed a questionnaire that integrated the following influence factors, which have relevant impact on hospital management: political/legal, economic, social, technological and environmental forces. These influence factors are examined to develop the so-called critical uncertainties. Thorough identification of uncertainties was based on a “Stakeholder Feedback”. Results: Two key uncertainties were identified and considered in this study: According to the developed scenarios, complementary education of the medical staff as well as of non-medical top executives and managers of hospitals was the recommended core strategy. Complementary scenario-specific strategic options should be considered whenever needed to optimize dealing with a specific future development of the health care environment. Conclusion: Strategic planning in hospitals is essential to ensure sustainable success. It considers multiple situations and integrates internal and external insights and perspectives in addition to identifying weak signals and “blind spots”. This flows into a sound planning for multiple strategic options. It is a state of the art tool that allows dealing with the increasing challenges facing hospital management.
staff training. For example, two of the fee-for-service hospital groups run nurse's training colleges at present, and some ofthe contractor hospitals participate in train- ... pan, to the fundamental changes in areas of state policy in recent years, e.g. the switch .... this case, a strong incentive to reduce the length of stay. One of the ...
Dunne, T; Davis, S
Very little has been published about the effects of hospital closure in terms of the service, financial or management issues of the process. Attempts through a case-study format to redress the balance and as such represents the reflections of practitioners who have recently undergone the experience of hospital closure and the often neglected issues arising both during and after the process.
Full Text Available Pharmaceutical expenditure growth has outpaced GDP and healthcare expenditure growth rates in Denmark as in most OECD countries for the last decade. A major part of this increase was due to high growth rates in specialist areas that are typically located in hospital settings. Yet the market for hospital medicines and their procurement are still poorly understood. The present paper characterises the market for hospital medicines in Denmark in terms of its organisation and developments between 2005 and 2009. In Denmark hospital medicines are publicly financed and procurement is centrally organised. 98% of all medicines administered at Danish public hospitals are purchased through a public procurement agency by means of public tenders. Using data on actual contract prices we decompose pharmaceutical expenditure growth into the contributions from newly introduced medicines, price and volume increases and use summary statistics to compare market performance in both sectors. The market for hospital medicine is more concentrated than the pharmaceutical retail sector and the share of generics and parallel imported products is significantly lower. Between 2005 and 2009 expenditures for hospital medicines more than doubled -accounting for almost 40% of the total Danish pharmaceutical market in 2009. Price increases however - although positive and higher than in the pharmaceutical retail sector - were only moderate. The majority of the expenditure growth was due to an increase in utilisation and the introduction of new medicines in the hospital sector. Centralised tendering may therefore have important implications for competition and industry structure in the long run.
P.M.G. Filius (Margreet)
textabstractThe general aim of the studies in this thesis was to explore the current emergence of antibiotic resistance in hospitals. This aim is addressed in two research projects. The first project concerns the optimization of surveillance of quantitative antibiotic use in hospitals. Studies are
A hospital based cross-sectional qualitative study was conducted at Kintampo Municipal Hospital in Northern Ghana, to identify obstetric emergencies and barriers to emergency care seeking; examine the perspective of midwives regarding their role in maternity care and management of obstetric emergencies, and explore ...
The time interval between the trauma and the patient arrival at the hospital and management varied between 30 minutes and 24 hours with the medium of 12.7 hours. The majority (71.6%) of the patients were received in hospital within the first 6 hours after the trauma. Abdominal paracentesis or diagnostic peritoneal lavage ...
Norwegian hospitals have been characterised by increasing activity, expansion of services and increasing costs for a long time. Differences in quality and accessibility have been documented between hospitals in various geographic locations. Transferral of hospital ownership to the state (from 2002) aimed at increasing capacities and improving quality of services, but also at restricting the increase of costs. These goals have only been partly met. The structure of hospital trusts and organisation of services are therefore continuously debated. This literature review aims at examining whether hospital mergers can reduce costs and at the same time increase the quality of services offered. Literature was identified through a Medline search using the terms "hospital", "merger" and "cost saving". The results are summarized and discussed. Seven original studies of totally 476 hospital mergers (in the USA, Great Britain and Norway) were identified in the period 1982 - 2000. The literature indicates that hospital mergers have a potential to reduce costs by about 10 % if the process achieves complete fusion of previously independent organisations, with a more optimal dimensioning of services and development of a common organizational culture. Collaboration between top management and the professional bureaucracy are prerequisites for success. Mergers are associated with a significant risk of unexpected problems and temporary reduced quality of the services.
Full Text Available Children with Down syndrome present with multiple medical problems in a higher prevalence compared with the general population, which may lead to hospitalizations. Methods: Analysis of 560 hospitalizations of 162 children aged 0-16 years with Down syndrome at Hadassah Medical Center during the years 1988-2007 compared with data on children in the general population, hospitalized at the same period. Data was collected from patient files and statistical data from the Ministry of Health. Results: Respiratory infections were the leading cause for hospitalization of children with Down syndrome. The number of hospitalizations of children with Down syndrome compared to the number of all children, who were hospitalized was surprisingly similar to their proportion in the general population. Eleven children died during their hospitalization (five heart failure, three sepsis, one respiratory tract infection and one due to complication after surgery. Nine of the eleven had a congenital heart anomaly. Conclusions: Children with Down syndrome can present with complex medical issues and we support the concept of a multidisciplinary team that has experience and knowledge to serve as a one stop shop for these individuals and their families, with timely visits in which a comprehensive evaluation is performed, problems attended to and prevention plans applied. In this way we may prevent morbidity, hospitalizations and mortality.
Tenenbaum, Ariel; Hanna, Rana N; Averbuch, Diana; Wexler, Isaiah D; Chavkin, Maor; Merrick, Joav
Children with Down syndrome present with multiple medical problems in a higher prevalence compared with the general population, which may lead to hospitalizations. Analysis of 560 hospitalizations of 162 children aged 0-16 years with Down syndrome at Hadassah Medical Center during the years 1988-2007 compared with data on children in the general population, hospitalized at the same period. Data was collected from patient files and statistical data from the Ministry of Health. Respiratory infections were the leading cause for hospitalization of children with Down syndrome. The number of hospitalizations of children with Down syndrome compared to the number of all children, who were hospitalized was surprisingly similar to their proportion in the general population. Eleven children died during their hospitalization (five heart failure, three sepsis, one respiratory tract infection, and one due to complication after surgery). Nine of the 11 had a congenital heart anomaly. Children with Down syndrome can present with complex medical issues and we support the concept of a multidisciplinary team that has experience and knowledge to serve as a "one stop shop" for these individuals and their families, with timely visits in which a comprehensive evaluation is performed, problems attended to and prevention plans applied. In this way, we may prevent morbidity, hospitalizations, and mortality.
This address traces the emergence of the hospital in the 18th century as a facility for combating disease and tending to the sick. Reference is made to the reports of Tenon and Howard on hospitals in several European countries, which instead of considering the hospital as a mere architectural object make recommendations based on the numbers of beds of an institution, its usable space, the dimensions of wards, mortaility rates, etc.; the result is a new functional concept of the medical and physical organization of the hospital. The author delves into the characteristics of the hospital and medical practice in the Middle Ages, the 17th and 18th centuries, and since the middle of the 18th. He brings out the direct relationship of hospital organization to the economic regulations that emerged with mercantilism. He stresses the importance of man for social and military development on the one hand, and, on the other hand, to the application of a technology that could be described as political: the discipline. He is of the view that the introduction of disciplinary mechanisms in the confused environment of the hospital permitted its "medicalization" and the development of the medical-therapeutic hospital.
Howard Feiertag, of Blacksburg, an instructor in hospitality and tourism management at Virginia Tech's Pamplin College of Business, received the inaugural Excellence in Sales and Marketing Strategy Award at the Hospitality Sales and Marketing Association/New York University Strategy Conference in New York recently.
Smith, Robert B
A hospital that provides cardiovascular services and embraces a heart-hospital brand and strategy can achieve competitive advantage. Providers that want to compete aggressively for cardiovascular services are developing a specialty-based carve-out strategy. A heart-hospital initiative can cannibalize revenues from a hospital's other programs and services. A successful heart-hospital strategy requires physician buy-in. A heart hospital needs a brand that customers will value.
Full Text Available Background: Hospital waste contains a large quantity of dangerous pathogenic agents, which are hazardous to the health of man, animal, plant and the environment. In Iran, like many other developing countries, not enough attention is paid to this matter and available information regarding the generation and disposal of medical wastes are low. The existing information about production and disposal of wastes in our hospitals is little and incomplete. In this study, a survey on hospital waste management system in Bushehr province hospitals was conducted. Methods: In this cross-sectional study, 8 hospitals in Bushehr province were investigated during a period of 6 months using a questionnaire, interviews and direct observations. The questionnaire had 93 questions (open and closed about general information on the hospitals and about various systems of managing hospital waste according to the World Health Organization suggested survey questionnaire for hospital waste management in developing countries. Results: In hospitals of bushehr province, waste generation rate was 2615 kg/day, including domestic waste (51.7%, infectious waste (20.8%, sharps (15.2% and chemical and drugs wastes (12.3%. In almost all hospitals, segregation of infectious waste from domestic waste at the place of origin and putting them in special containers had been done but this segregation wasn’t complete and sometimes some hazardous waste were disposed of in domestic waste containers. All hospitals used a color coding system for waste containers, 75 % of hospitals had incinerators. In others, waste was carried out by municipal service daily. In all hospitals, all workers were trained about hospital waste management. In none of the surveyed hospitals, there was an obvious policy and plan for purchasing equipment and necessary facilities in order to dispose hospital waste correctly and also no clear budget was allocated for hospital waste management. In none of these hospitals
Taking a failing hospital from the brink of financial ruin and turning it into a thriving, profitable entity takes more than a dose of good luck. It takes a strong leader who has the vision, determination and skill to execute a successful turnaround and put that hospital back on track. In addition to addressing financial factors, an effective leader will promote a good working relationship between the hospital management, board, staff, patients, caregivers and community members. Following are seven California hospitals that have all faced financial crises in recent years. These hospitals have made the transition out of the red and into the black with the kind of leadership that relies on trust, teamwork, common sense and ingenuity.
Pharmaceutical expenditure growth has outpaced GDP and healthcare expenditure growth rates in Denmark as in most OECD countries for the last decade. A major part of this increase was due to high growth rates in specialist areas that are typically located in hospital settings. Yet the market for h...... and the introduction of new medicines in the hospital sector. Centralised tendering may therefore have important implications for competition and industry structure in the long run....... for hospital medicines and their procurement are still poorly understood. The present paper characterises the market for hospital medicines in Denmark in terms of its organisation and developments between 2005 and 2009. In Denmark hospital medicines are publicly financed and procurement is centrally organised...
Tayyari Dehbarez, Nasrin; Lou, Stina; Uldbjerg, Niels
OBJECTIVE: To investigate pregnant women's decision making in relation to their choice of birthing hospital and, in particular, their priorities regarding hospital characteristics. METHODS: The focus of this study was the choice of birthing hospital among pregnant women. A qualitative interview...... design was used and women were recruited during their first pregnancy-related visit to a general practitioner. The interviews were conducted using a semi-structured interview guide, and a thematic analysis of the data was carried out. RESULTS: Women made their hospital choice decision independently...... and they relied extensively on their own or peers' experiences. Travel distance played a role, but some women were willing to incur longer travel times to give birth at a specialized hospital in order to try to reduce the risks (in case of unexpected events). The women associated the presence of specialized...
Roelsgaard Obling, Anne
different fields: a cancer department (located at a major teaching hospital); a rehabilitation castle (located on the countryside) and a cancer and health centre (located across the road of the teaching hospital). In the paper’s analyses a repeated truism coined in the case study is followed. The truism...... tells: ‘This is definitely not a hospital’ and points to the fact that cancer staff and clientele use the presence/non-presence of the hospital institution to either align or differentiate from it. It is suggested in the paper that the more the hospital is manifest, i.e., discursively, physically......, imaginatively and so on and so forth, the more delimited and well-defined are the professional roles, organizational coordination mechanisms, and the active contribution of practices on the managed areas of the patients. This also means that in those cases where the hospital is profoundly absent, it has some...
Aim To investigate participants' experiences of visiting hospitalised friends and family members in adult acute medical or surgical wards in NHS hospitals in England, to improve knowledge of hospital visiting practices and to inform future policy-making and professional practice. Method A review of the contextual influences and the literature identified that hospital visitors might experience many of the characteristics of liminality, which is a state of being between two social structures or ways of being. In 2013, a total of 17 semi-structured, recorded and transcribed interviews were conducted with participants who had been hospital visitors in the period 2011-2013. The transcribed interviews underwent a thematic analysis. Liminality was then used as an analytic lens, and was central to the theoretical framework that was constructed to further consider the experiences of hospital visitors. Findings Participants experienced the hospitalisation of their friend or family member and their subsequent role as hospital visitors as a suspension of their everyday lives. Liminality was a predominant and consistent theme of the interviews. Five main themes of liminality were identified in relation to hospital visitors' experiences: total obedience; loss of status; ambiguity and being betwixt and between; uncertainty; and structure and communitas. The findings suggested that nurses consider the area behind the nurses' station as 'back stage'; a place they can use for downtime, socialising and computer work. In contrast, hospital visitors perceive the nurses' station to be a continuation of the ward, where they expect professional 'front stage behaviour' from staff. Conclusion When hospital visitors, already discomfited in their liminal status, encounter nurses' 'back-stage behaviour' at the nurses' station, their feelings of marginalisation, exclusion and mistrust increase. This may lead them to judge that the nurses lack professionalism and care, which can lead them to
Martelli, Nicolas; Lelong, Anne-Sophie; Prognon, Patrice; Pineau, Judith
Several models of hospital-based health technology assessment (HTA) have been developed worldwide, for the introduction of innovative medical devices and support evidence-based decision making in hospitals. Two such models, the HTA unit and mini-HTA models, are widespread in university hospitals and involve various stakeholders. The purpose of this work was to highlight the potential role of hospital pharmacists in hospital-based HTA activities. We searched for articles, reviews, and letters relating to hospital-based HTA, as defined by the Hospital-Based Health Technology Assessment Worldwide Survey published by the Health Technology Assessment International (HTAi) Society, in the Health Technology Assessment database, MEDLINE, EMBASE, and hospital pharmacy journals. The number of university hospitals performing hospital-based HTA has increased since the 2008 Hospital-Based Health Technology Assessment Worldwide Survey. Our own experience and international findings show that hospital pharmacists already contribute to hospital-based HTA activities and have developed study interpretation skills and a knowledge of medical devices. Promoting multidisciplinary approaches is one of the key success factors in hospital-based HTA. Hospital pharmacists occupy a position between hospital managers, clinicians, health economists, biomedical engineers, and patients and can provide a new perspective. In the future, hospital pharmacists are likely to become increasingly involved in hospital-based HTA activities.
Alexandrescu, Roxana; Bottle, Alex; Hua Jen, Min; Jarman, Brian
Summary Objectives To present a case-mix adjustment model that can be used to calculate Massachusetts hospital standardised mortality ratios and can be further adapted for other state-wide data-sets. Design We used binary logistic regression models to predict the probability of death and to calculate the hospital standardised mortality ratios. Independent variables were patient sociodemographic characteristics (such as age, gender) and healthcare details (such as admission source). Statistical performance was evaluated using c statistics, Brier score and the Hosmer–Lemeshow test. Setting Massachusetts hospitals providing care to patients over financial years 2005/6 to 2007/8. Patients 1,073,122 patients admitted to Massachusetts hospitals corresponding to 36 hospital standardised mortality ratio diagnosis groups that account for 80% of in-hospital deaths nationally. Main outcome measures Adjusted in-hospital mortality rates and hospital standardised mortality ratios. Results The significant factors determining in-hospital mortality included age, admission type, primary diagnosis, the Charlson index and do-not-resuscitate status. The Massachusetts hospital standardised mortality ratios for acute (non-specialist) hospitals ranged from 60.3 (95% confidence limits 52.7–68.6) to 130.3 (116.1–145.8). The reference standard hospital standardised mortality ratio is 100 with the values below and above 100 suggesting either random or special cause variation. The model was characterised by excellent discrimination (c statistic 0.87), high accuracy (Brier statistics 0.03) and close agreement between predicted and observed mortality rates. Conclusions We have developed a case-mix model to give insight into mortality rates for patients served by hospitals in Massachusetts. Our analysis indicates that this technique would be applicable and relevant to Massachusetts hospital care as well as to other US hospitals. PMID:25852951
Ford-Eickhoff, Karen; Plowman, Donde Ashmos; McDaniel, Reuben R
Despite pressures to change the role of hospital boards, hospitals have made few changes in board composition or director selection criteria. Hospital boards have often continued to operate in their traditional roles as either "monitors" or "advisors." More attention to the direct involvement of hospital boards in the strategic decision-making process of the organizations they serve, the timing and circumstances under which board involvement occurs, and the board composition that enhances their abilities to participate fully is needed. We investigated the relationship between broader expertise among hospital board members, board involvement in the stages of strategic decision making, and the hospital's strategic focus. We surveyed top management team members of 72 nonacademic hospitals to explore the participation of critical stakeholder groups such as the board of directors in the strategic decision-making process. We used hierarchical regression analysis to explore our hypotheses that there is a relationship between both the nature and involvement of the board and the hospital's strategic orientation. Hospitals with broader expertise on their boards reported an external focus. For some of their externally-oriented goals, hospitals also reported that their boards were involved earlier in the stages of decision making. In light of the complex and dynamic environment of hospitals today, those charged with developing hospital boards should match the variety in the external issues that the hospital faces with more variety in board makeup. By developing a board with greater breadth of expertise, the hospital responds to its complex environment by absorbing that complexity, enabling a greater potential for sensemaking and learning. Rather than acting only as monitors and advisors, boards impact their hospitals' strategic focus through their participation in the strategic decision-making process.
Full Text Available Hospital-acquired infections (HAI are often seen as preventable incidents that result from unsafe practices or poor hospital hygiene. This however ignores the fact that transmissibility is not only a property of the causative organisms but also of the hosts who can translocate bacteria when moving between hospitals. In an epidemiological sense, hospitals become connected through the patients they share. We here postulate that the degree of hospital connectedness crucially influences the rates of infections caused by hospital-acquired bacteria. To test this hypothesis, we mapped the movement of patients based on the UK-NHS Hospital Episode Statistics and observed that the proportion of patients admitted to a hospital after a recent episode in another hospital correlates with the hospital-specific incidence rate of MRSA bacteraemia as recorded by mandatory reporting. We observed a positive correlation between hospital connectedness and MRSA bacteraemia incidence rate that is significant for all financial years since 2001 except for 2008-09. All years combined, this correlation is positive and significantly different from zero (partial correlation coefficient r = 0.33 (0.28 to 0.38. When comparing the referral pattern for English hospitals with referral patterns observed in the Netherlands, we predict that English hospitals more likely see a swifter and more sustained spread of HAIs. Our results indicate that hospitals cannot be viewed as individual units but rather should be viewed as connected elements of larger modular networks. Our findings stress the importance of cooperative effects that will have a bearing on the planning of health care systems, patient management and hospital infection control.
Abstract Background Problem alcohol use is associated with adverse health outcomes among current or former heroin users and primary care is providing methadone treatment for increasing numbers of this population. This study aimed todetermine the prevalence of problem alcohol use among current or former heroin users attending primary care for methadone treatment and to describe the socio-demographic characteristics and health service utilisation characteristics associated with problem alcohol uses. Methods We conducted a cross sectional survey of patients sampled from a national database of patients attending general practice for methadone treatment. Participants were recruited by their general practitioner and data was collected using an interviewer-administered questionnaire, which included the Alcohol Use Disorders Identification Test (\\'AUDIT\\'), with a score of >7 considered abnormal (ie \\'AUDIT positive cases\\') and socio-demographic, medical and substance use characteristics. Results We interviewed 196 patients (71% of those invited, 31% of those sampled, 11% of the national database). The median age was 32 years, 55% were hepatitis C positive, 79% had used illicit drugs in the previous month and 68% were male. Sixty-eight \\'AUDIT positive\\' cases were identified (prevalence of 35%, 95% CI = 28–41%) and these were more likely to have attended a local Emergency Department in the previous year (p < 0.05) and less likely to have attended a hospital clinic in the previous year (p < 0.05). Twenty-seven (14%) scored 20 or higher indicating possible alcohol dependence. Conclusion Problem alcohol use has a high prevalence among current or former heroin users attending primary care for methadone treatment and interventions that address this issue should be explored as a priority. Interventions that address problem alcohol use in this population should be considered as a priority, although the complex medical and psychological needs of this population may make
Bao, Xiaoyuan; Yang, Chao; Fang, Kai; Shi, Moye; Yu, Guopei; Hu, Yonghua
The aim of the present study was to investigate hospitalization costs, diabetes complications, and their relationships using a large dataset in Beijing, China. Data for 2006-10 from the 38 top-ranked (Grade 3 A) hospitals in Beijing, obtained from electronic Hospitalization Summary Reports (HSRs), were analyzed for hospitalization costs and diabetic complications. Patient demographics, types of costs, and length of hospital stay (LOS) were also evaluated. During the period evaluated, 62 523 patients with diabetes were hospitalized, of which 41 875 (67.0 %) had diabetes-associated complications. The median cost of hospitalization for diabetic patients was 7996.11 RMB. Prescribed drugs and laboratory tests were two major contributors to hospitalization costs, accounting for 36.2 % and 22.4 %, respectively. Hospitalization costs were significantly associated with LOS, number of complications, age, year of admission, admission status, sex, and medical insurance (P costs and LOS increased substantially with an increase in the number of complications (P costs were seen in those diabetic patients with foot complications. Diabetic complications have a significant effect on increases in hospitalization costs and LOS in patients with type 2 diabetes mellitus. © 2016 Ruijin Hospital, Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd.
Jahanbakhsh, Maryam; Karimi, Saeed; Hassanzadeh, Akbar; Beigi, Maliheh
Electronic medical record system (EMRS) is a valuable system for safe access to the patient's data and increases health care quality. Manpower is one of the requirements for EMRS, among which manager is the most important person in any hospital. Taking into account manager's positive attitude and good commitments, EMRS will be implemented successfully. As such, we decided to assess manager's attitude and commitment toward EMRS in Isfahan hospitals in the year of 2014. This article aimed to determine the hospital managers' attitude and commitment toward the implementation of EMRS. The present article is an applied analytic study. Research society consisted of the managers of all the hospitals in Isfahan that include hospitals affiliated to Isfahan University of Medical Sciences, private, and social security hospitals. This study was done in 2014. Data collection tools included a questionnaire for which reliability and validity were determined. Data were analyzed by means of SPSS 20. Average score for the managers' attitude toward EMRS in the city of Isfahan was 77.5 out of 100 and their average score for commitment was 74.7. Manager's attitude in social security hospitals was more positive than the private and governmental ones (83.3%). In addition, the amount of commitment by the managers in social security hospitals was higher than the same in private and governmental hospitals (86.6%). At present, managers' attitude and commitment in Isfahan hospitals toward EMRS are very high and social security hospitals show more readiness in this respect.
Full Text Available Abstract Objectives To investigate whether the long term lease of public hospital owned land could be an additional financing mechanism for Greek public (mental health hospitals. Methods We performed a financial analysis of the official 2008 data of a case - study hospital (Mental Health Hospital of Chania. We used a capital budgeting approach to investigate whether value is created for the public hospital by engaging its assets in a project for the development of a private renal dialysis Unit. Results The development of the private unit in hospital owned land is a good investment decision, as it generates high project Net Present Value and Internal Rate of Return. When the project commences generating operating cash flows, nearly €400.000 will be paid annually to the Mental Health Hospital of Chania as rent, thereby gradually decreasing the annual deficit of the hospital. Conclusions Revenue generated from the long term lease of public hospital land is crucial to gradually eliminate hospital deficit. The Ministry of Health should encourage similar forms of Public Private Partnerships in order to ensure the sustainability of public (mental hospitals.
Messeder, Ana Márcia; Osorio-de-Castro, Claudia Garcia Serpa; Camacho, Luiz Antonio Bastos
This paper discusses the development of a methodological approach to classify hospital pharmacies according to their performance, measured by structure and process indicators. The method considers the influence exerted on performance by the level of care in the hospital and the interdependence among pharmaceutical activities. Algorithms for assessing performance of hospital pharmacies were constructed for each level of care. Different weights were used for core activities in the pharmacy and other specific activities, according to the level of care in the hospital where the respective service was provided. This methodology allowed classifying hospital pharmacies from best to worst, based on performance. Independently of level of care in the hospital, no hospital pharmacies were classified as high-performance, and more than 50% were classified as low-performance.
Mackay, J M; Lamb, C W
Marketing has become widely recognized as an important component of hospital management (Kotler and Clarke 1987; Ludke, Curry, and Saywell 1983). Physicians are becoming recognized as an important target market that warrants more marketing attention than it has received in the past (Super 1987; Wotruba, Haas, and Hartman 1982). Some experts predict that hospitals will begin focusing more marketing attention on physicians and less on consumers (Super 1986). Much of this attention is likely to take the form of practice management assistance, such as computer-based information system support or consulting services. The survey results reported here are illustrative only of how one hospital addressed the problem of physician need assessment. Other potential target markets include physicians who admit patients only to competitor hospitals and physicians who admit to multiple hospitals. The market might be segmented by individual versus group practice, area of specialization, or possibly even physician practice life cycle stage (Wotruba, Haas, and Hartman 1982). The questions included on the survey and the survey format are likely to be situation-specific. The key is the process, not the procedure. It is important for hospital marketers to recognize that practice management assistance needs will vary among markets (Jensen 1987). Therefore, hospitals must carefully identify their target physician market(s) and survey them about their specific needs before developing and implementing new physician marketing programs. Only then can they be reasonably confident that their marketing programs match their customers' needs.
Kirkland, Lisa L; Parham, William M; Pastores, Stephen M
The purpose of this article is to provide intensivists with information and examples regarding cooling technology selection, cost assessment, adaptation, barriers, and presentation to hospital administrators. A review of medical and business literature was conducted using the following search terms: technology assessment, organizational innovation, intensive care, critical care, hospital administration, and presentation to administrators. General recommendations for intensivists are made for assessing cooling technology with descriptions of common new technology implementation stages. A study of 16 hospitals implementing a new cardiac surgery technology is described. A description of successful implementation of an induced hypothermia protocol by one of the authors is presented. Although knowledgeable about the applications of new technologies, including cooling technology, intensivists have little guidance or training on tactics to obtain a hospital administration's funding and support. Intensive care unit budgets are usually controlled by nonintensivists whose interests are neutral, at best, to the needs of intensivists. To rise to the top of the large pile of requisition requests, an intensivist's proposal must be well conceived and aligned with hospital administration's strategic goals. Intensivists must understand the hospital acquisition process and administrative structure and participate on high-level hospital committees. Using design thinking and strong leadership skills, the intensivist can marshal support from staff and administrators to successfully implement cooling technology.
Full Text Available Our paper empirically examines how the decision to purchase private insurance and hospitalization are made based on household income, socio-demographic factors, and private health insurance factors in both Japan and the USA. Using these two data-sets, we found some similarities and dissimilarities between Japan and the United States. As income of households rises, households have a positive effect on purchasing health insurance as a normal good. Another similarity between the two countries is seen in the income effect on risk of hospitalization, which is negative for both Japanese and US cases. For dissimilarity, the insurance premium effect on risk of hospitalization is positive for the Japanese case, while negative for the US case. Since the Japanese insurance data had variables such as payments per day of hospitalization if household gets hospitalized, insurance payments upon death of an insured person, and annuity payments at maturity, we tested to see if these characteristics affect the risk of hospitalization for households; we do not eliminate a possibility of adverse selection. For the US pure health issuance characteristics, an increase in premium of health insurance policies cause individuals to substitute more health capital investment which causes lower risk of hospitalization.
Daurat, G; Py, J-Y
In France, most blood products are delivered by the établissement francais du sang, directly to the recipients, and hospital blood banks deliver a minor part, but are independent from it. However that may be, hospital blood banks are hazardous activities regarding to recipients, blood products, blood supply of the hospital and regional blood supply. Because of the high risk level, a computerized information system is compulsory for all hospital blood banks, except for those only devoted to vital emergency transfusion. On the field, the integration of computerization in the different processes is very heterogeneous. So, it has been decided to publish guidelines for computerizing hospital blood banks information systems and production management. They have been built according to risk assessment and are intended to minimize those risks. The principle is that all acquisition and processing of data about recipients or blood products and tracking, must be fully computerized and that the result of all manual processes must be checked by computer before proceeding to the next step. The guidelines list the different processes and, for each of them, the functions the software must play. All together, they form the basic level all hospital blood banks should reach. Optional functions are listed. Moreover, the guidelines are also aimed to be a common tool for regional health authorities who supervise hospital blood banks. Copyright © 2012 Elsevier Masson SAS. All rights reserved.
Chen, Yuqi; Guo, Wensheng; Kotanko, Peter; Usvyat, Len; Wang, Yuedong
Modeling hospitalization is complicated because the follow-up time can be censored due to death. In this paper, we propose a shared frailty joint model for survival time and hospitalization. A random effect semi-parametric proportional hazard model is assumed for the survival time and conditional on the follow-up time, hospital admissions or total length of stay is modeled by a generalized linear model with a nonparametric offset function of the follow-up time. We assume that the hospitalization and the survival time are correlated through a latent subject-specific random frailty. The proposed model can be implemented using existing software such as SAS Proc NLMIXED. We demonstrate the feasibility through simulations. We apply our methods to study hospital admissions and total length of stay in a cohort of patients on hemodialysis. We identify age, albumin, neutrophil to lymphocyte ratio (NLR) and vintage as significant risk factors for mortality, and age, gender, race, albumin, NLR, pre-dialysis systolic blood pressure (preSBP), interdialytic weight gain (IDWG) and equilibrated Kt/V (eKt/V) as significant risk factors for both hospital admissions and total length of stay. In addition, hospitalization admissions is positively associated with vintage.
M. Abdi Talarposht
Full Text Available Background: Agility is an effective response to the changing and unpredictable environment and using these changes as opportunities for organizational improvement. Objective: The aim of the present study was to rank the factors affecting agile supply chain of hospitals of Iran. Methods: This applied study was conducted by cross sectional-descriptive method at some point of 2015 for one year. The research population included managers, administrators, faculty members and experts were selected hospitals. A total of 260 people were selected as sample from the health centers. The construct validity of the questionnaire was approved by confirmatory factor analysis test and its reliability was approved by Cronbach's alpha (α=0.97. All data were analyzed by Kolmogorov-Smirnov, Chi-square and Friedman tests. Findings: The development of staff skills, the use of information technology, the integration of processes, appropriate planning, and customer satisfaction and product quality had a significant impact on the agility of public hospitals of Iran (P<0.001. New product introductions had earned the highest ranking and the development of staff skills earned the lowest ranking. Conclusion: The new product introduction, market responsiveness and sensitivity, reduce costs, and the integration of organizational processes, ratings better to have acquired agility hospitals in Iran. Therefore, planners and officials of hospitals have to, through the promotion quality and variety of services customer-oriented, providing a basis for investing in the hospital and etc to apply for agility supply chain public hospitals of Iran.
Introduction: A devastating earthquake is inevitable in the long term and likely in the near future in Iran. The objective of the study was to assess the knowledge of hospital staff to disaster management system in hospital and to determine nonstructural safety assessment in Shahid Mohammadi hospital in Bandar Abbas city of Iran. This hospital is the main referral hospital in Hormozgan province with a capacity of about 450 beds and the highest patient admissions. Methods: The cross-sectional study was conducted in 2013 on 200 healthcare workers at Shahid Mohammadi hospital, in the city of Bandar Abbas, Iran. This hospital is the main referral hospital in Hormozgan province and has a capacity of about 450 beds with highest numbers of patient admissions. Questionnaire and checklist used for assessing health workers knowledge and awareness towards disaster management and nonstructural safety this hospital. Results: This study found that knowledge, awareness, and disaster preparedness of hospital staff need continual reinforcement to improve self efficacy for disaster management. Equipping health care facilities at the time of natural disasters, especially earthquakes are of great importance all over the world, especially in Iran. This requires the national strategies and planning for all health facilities. Conclusion: It seems due to limitations of hospital beds, insufficient of personnel, and medical equipment, health care providers paid greater attention to this issue. Since this hospital is the only educational public hospital in the province, it is essential to pay much attention to the risk management not only to this hospital but at the national level to health facilities. PMID:26573039
Babyak, Jonathan M; Sharp, Claire R
OBJECTIVE To describe the epidemiology of the systemic inflammatory response syndrome (SIRS) and sepsis in cats hospitalized in a veterinary teaching hospital. DESIGN Observational study. ANIMALS 246 client-owned cats. PROCEDURES During a 3-month period, daily treatment records were evaluated for all hospitalized cats. Information extracted included signalment, temperature, heart rate, respiratory rate, diagnostic test results, diagnosis, duration of hospitalization, and outcome (survival or death). Cats were classified into 1 of 4 disease categories (sepsis [confirmed infection and SIRS], infection [confirmed infection without SIRS], noninfectious SIRS [SIRS without a confirmed infection], and no SIRS [no SIRS or infection]). RESULTS Of the 246 cats, 26 and 3 were hospitalized 2 and 3 times, respectively; thus, 275 hospitalizations were evaluated. When SIRS was defined as the presence of ≥ 2 of 4 SIRS criteria, 17 cats had sepsis, 16 had infections, 81 had noninfectious SIRS, and 161 were classified in the no SIRS category at hospital admission. The prevalence of sepsis at hospital admission was 6.2 cases/100 admissions. Four cats developed sepsis while hospitalized, resulting in a sepsis incidence rate of 1.5 cases/100 hospital admissions. Four of 17 cats with sepsis at hospital admission and 3 of 4 cats that developed sepsis while hospitalized died or were euthanized, resulting in a mortality rate of 33.3% for septic cats; 239 hospitalizations resulted in survival, 28 resulted in euthanasia, and 8 resulted in death. CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that many hospitalized cats have evidence of SIRS and some have sepsis. In cats, sepsis is an important clinical entity with a high mortality rate.
Japanese health care is characterized by a pluralistic system with a high degree of private producers. Central government regulates the prices and the financing system. All citizens are covered by a mandatory employment-based health insurance operating on a non-profit basis. The consumer has a free choice of physician and hospital. A comparison between Japan, Sweden and some other countries shows significant dissimilarities in the length of stay, number of treatments per hospital bed and year and the staffing of hospitals. About 80 per cent of the hospitals and 94 per cent of the clinics are privately owned. The typical private hospital owned by a physician has less than 100 beds. In this paper, data collected (1992/93) in an empirical study of Japanese hospitals and their leadership is presented. Also discussed are the hospitals' style of management, tools and strategies for competition and competences--personal and formal skills required of the leadership in the hospital. There follows a study of ten hospitals, among which hospital directors and chief physicians were interviewed. Interviews are also made with key persons in the Ministry of Health and Welfare and other organizations in the health care field. The result is also analysed from a cultural perspective--'what kind of impact does the Japanese culture have on the health care organization?' and/or 'what kind of sub-culture is developed in the Japanese hospitals'. Some comparisons are made with Sweden, USA, Canada and Germany. The different roles of the professions in the hospital are included in the study as well as the incentives for different kinds of strategies--specialization, growing in size, investments in new equipment, different kind of ownership and hospitals. Another issue discussed is the attempt to uncover whether there is an implicit distribution of specialties--silent agreements between hospitals, etc.
existing hospitals, making use of temporary hospitals and converting other buildings into hospitals. Eventually more ... as demands for hospital beds increased. Suitable sites, i.e. with adequate water supplies, ease .... healing of mind and body'.12 Dr ArclUbald Young, one of the civilian surgeons attached to this hospital in ...
Full Text Available Context Over the past decade the number of accidents and disasters has been growing around the world. In addition to damaging communities and infrastructures, unexpected disasters also affect service providers. This study aimed to evaluate the readiness of hospitals when confronted with unexpected disasters. Evidence Acquisition The present study was a simple review article, which was conducted via searching different sites, such as: Web of Science, Scopus, Science Direct and PubMed, using different key words such as: Disasters, Crisis, Hospital and preparedness. The relationship between the articles found in relation to our subject was investigated through the title and abstract of articles. The relationship between the articles, which were found in relation to our subject, was investigated through the title and abstract of the articles. Our search included papers published during the period between 2007 and 2015 and we only considered studies that measured the preparedness of hospitals in critical conditions. Among the 30 articles, which were found, 17 were excluded from the study due to lack of relevant data. Hence, 15 papers, which were of proper design and robust data analysis, were included in the current study. Results Hospital preparedness in disaster was evaluated in three dimensions: structural, non-structural factors and vulnerability management performance. A total of readiness of hospitals in three dimensions was mediocre. Conclusions Overall, the results derived from these studies indicated that hospital safety levels in most of the surveyed hospitals were moderate. Although the situation in hospitals is not critical, there is a need to plan and take appropriate measures to improve the safety level of the hospitals.
Kaufman, Brystana G; Thomas, Sharita R; Randolph, Randy K; Perry, Julie R; Thompson, Kristie W; Holmes, George M; Pink, George H
Since 2010, the rate of rural hospital closures has increased significantly. This study is a preliminary look at recent closures and a formative step in research to understand the causes and the impact on rural communities. The 2009 financial performance and market characteristics of rural hospitals that closed from 2010 through 2014 were compared to rural hospitals that remained open during the same period, stratified by critical access hospitals (CAHs) and other rural hospitals (ORHs). Differences were tested using Pearson's chi-square (categorical variables) and Wilcoxon rank test of medians. The relationships between negative operating margin and (1) market factors and (2) utilization/staffing factors were explored using logistic regression. In 2009, CAHs that subsequently closed from 2010 through 2014 had, in general, lower levels of profitability, liquidity, equity, patient volume, and staffing. In addition, ORHs that closed had smaller market shares and operated in markets with smaller populations compared to ORHs that remained open. Odds of unprofitability were associated with both market and utilization factors. Although half of the closed hospitals ceased providing health services altogether, the remainder have since converted to an alternative health care delivery model. Financial and market characteristics appear to be associated with closure of rural hospitals from 2010 through 2014, suggesting that it is possible to identify hospitals at risk of closure. As closure rates show no sign of abating, it is important to study the drivers of distress in rural hospitals, as well as the potential for alternative health care delivery models. © 2015 National Rural Health Association.
Mohammad-Reza ESMAEELI; ERFANI SAYAR, Reza; SAGHEBI, Ali; Elmi, Saghi; Shagheyegh RAHMANI; ELMI, Sam; RABBANI JAVADI, Akram
How to Cite This Article: Esmaeeli M, Erfani Sayar R, Saghebi A, Elmi Saghi, Rahmani Sh, Elmi S, Rabbani Javadi A. Screening for Depression in Hospitalized Pediatric Patients. Iran J Child Neurol. 2014 Winter; 8(1):47-51. ObjectiveIn chronically ill children who are hospitalized, many mood changes occur. For example, in children with cancer or renal failure, prolonged hospitalization and chemotherapy can lead to depression. With the improved survival of childhoodmalignancies, the effect of tr...
Mogensen, Jeppe; Fisker, Anna Marie; Poulsen, Søren Bolvig
Hospitalised patients’ healing process, supported by stimulating architecture. In this regard, we address focus on the potential influence of the design principle, discussing how healing architecture may contribute in making the future hospital institutions more responsive to human needs. The main...... of some of the stakeholders involved in the design process? Relating to the Danish scene of hospital design, we introduce the research project “Smart Textiles in Future Hospitals”, stating the overall hypothesis that textiles in hospital interiors possess an unexploited architectural potential in relation...
Air quality is a topic of prime importance in hospitals. A badly designed or maintained installation can lead the development of nosocomial pathologies. This dossier comprises four papers dealing with: the technical rules of air quality mastery in hospitals (air treatment, fight against contamination, general recommendations, topology of installations), the design, diagnosis, cleaning and decontamination of aeraulic networks, the new regulatory constraints of air treatment in hospitals and surgery rooms, and the risks of infectious disease transmission through air conditioning and ventilation systems. (J.S.)
Despite the prestige and reputation of teaching hospitals, as a group they are in financial distress. If this trend continues, one would expect to see a higher incidence of mergers and acquisitions or divestitures of assets and services, and other strategies designed to combat failing businesses. Nearly one out of every six teaching hospitals sampled was predicted to be near immediate bankruptcy, and the overwhelming majority was not far behind. It will take a significant effort for these hospitals to continue to treat their operations as a clinical and research "business," but they must do just that if they are to survive the continually turbulent market.
Norton, Christine; Flood, David; Brittin, Andy; Miles, Jane
Sleep is important to health and recovery from illness, but is known to be difficult in hospital. This article describes a quality improvement project conducted on 18 wards in acute hospitals. Patients reported sleeping an average of five hours per night, and 47% (352/749) rated their sleep quality as good or excellent in hospital. Individualised ward action plans were implemented. At follow up, disturbance by noise and light had fallen significantly and 69% (540/783) of patients rated their sleep as good or excellent, 22% more than before the intervention (Psleep.
The first-ever Ecological Footprint of a hospital was carried out in the summer of 2001 in North Vancouver, British Columbia. Although there has been growing concern that the healthcare system in Canada might be adversely affecting the environment, there have been few analyses of its environmental impact. Lions Gate Hospital bravely agreed to participate in this study and have its footprint calculated. This displays real leadership, reflecting very positively on the hospital's commitment to becoming more environmentally responsible and its willingness to open up to scrutiny.
Fabiana Rossi Varallo
Full Text Available OBJECTIVES: Drug safety problems can lead to hospital admission. In Brazil, the prevalence of hospitalization due to adverse drug events is unknown. This study aims to estimate the prevalence of hospitalization due to adverse drug events and to identify the drugs, the adverse drug events, and the risk factors associated with hospital admissions. METHOD: A cross-sectional study was performed in the internal medicine ward of a teaching hospital in São Paulo State, Brazil, from August to December 2008. All patients aged ≥18 years with a length of stay ≥24 hours were interviewed about the drugs used prior to hospital admission and their symptoms/complaints/causes of hospitalization. RESULTS: In total, 248 patients were considered eligible. The prevalence of hospitalization due to potential adverse drug events in the ward was 46.4%. Overprescribed drugs and those indicated for prophylactic treatments were frequently associated with possible adverse drug events. Frequently reported symptoms were breathlessness (15.2%, fatigue (12.3%, and chest pain (9.0%. Polypharmacy was a risk factor for the occurrence of possible adverse drug events. CONCLUSION: Possible adverse drug events led to hospitalization in a high-complexity hospital, mainly in polymedicated patients. The clinical outcomes of adverse drug events are nonspecific, which delays treatment, hinders causality analysis, and contributes to the underreporting of cases.
Zhou, Ping; Bundorf, Kate; Le Chang, Ji; Huang, Jin Xin; Xue, Di
To measure perceptions of organizational culture among employees of public hospitals in China and to determine whether perceptions are associated with hospital performance. Hospital, employee, and patient surveys from 87 Chinese public hospitals conducted during 2009. Developed and administered a tool to assess organizational culture in Chinese public hospitals. Used factor analysis to create measures of organizational culture. Analyzed the relationships between employee type and perceptions of culture and between perceptions of culture and hospital performance using multivariate models. Employees perceived the culture of Chinese public hospitals as stronger in internal rules and regulations, and weaker in empowerment. Hospitals in which employees perceived that the culture emphasized cost control were more profitable and had higher rates of outpatient visits and bed days per physician per day but also had lower levels of patient satisfaction. Hospitals with cultures perceived as customer-focused had longer length of stay but lower patient satisfaction. Managers in Chinese public hospitals should consider whether the culture of their organization will enable them to respond effectively to their changing environment. © Health Research and Educational Trust.
Derrick, Jennifer Willahan; Bellini, Sarah Gunnell; Spelman, Julie
Health-promoting environments advance health and prevent chronic disease. Hospitals have been charged to promote health and wellness to patients, communities, and 5.3 million adults employed in United States health care environments. In this cross-sectional observational study, the Hospital Nutrition Environment Scan (HNES) was used to measure the nutrition environment of hospital cafeterias and evaluate the influence of the LiVe Well Plate health initiative. Twenty-one hospitals in the Intermountain West region were surveyed between October 2013 and May 2014. Six hospitals participated in the LiVe Well Plate health initiative and were compared with 15 hospitals not participating. The LiVe Well Plate health initiative identified and promoted a healthy meal defined as cafeterias were scored on four subcategories: facilitators and barriers, grab-and-go items, menu offerings, and selection options at point of purchase. Overall, hospitals scored 35.3±13.7 (range=7 to 63) points of 86 total possible points. Cafeterias in health initiative hospitals had significantly higher mean nutrition composite scores compared with non-health initiative hospitals (49.2 vs 29.7; Pcafeterias. Additional research is needed to quantify and strategize ways to improve nutrition environments within hospital cafeterias and assess the influence on healthy lifestyle behaviors. Copyright © 2015 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.
Annetta, M G; Pittiruti, M; De Rosa, S; Franchi, P; Pintaudi, G; Caricato, A; Antonelli, M
A proper strategy for fighting hospital malnutrition should include nutritional screening of all hospitalized patients, adequate utilization of the Hospital facilities - such as Clinical Nutrition Services or Nutrition Teams - and an adequate algorithm for the adoption of proper nutrition support (oral, enteral or parenteral) with proper timing. The main aim of the present study was to investigate the current policies of different non-intensive wards of our institution (a 1100 beds University Hospital) in terms of prevention of hospital malnutrition. We conducted a one-day survey to verify the current policies of nutritional screening and the indication to nutritional support in adult patients, interviewing nurses and physicians of our non-intensive hospital wards. A total of 29 wards were considered, which sum up to 755 hospitalized patients. We found that nutritional screening at admission is routinely assessed only in 41% of wards and that oral nutrient intake is controlled regularly only in 72%. Indication to clinical nutrition support and specifically to artificial nutrition is not consistent with the current international guidelines. Only 14% of patients were receiving artificial nutrition at the moment of the survey and the majority of them were given parenteral nutrition rather than enteral feeding. Our survey confirmed that in large hospitals the main barriers to the fight against hospital malnutrition are the lack of knowledge and/or commitment by nurses and physicians as well as the lack of well-defined hospital policies on early nutritional screening, surveillance of nutritional status and indication to nutrition support.
Thibodeau, Patricia L; Funk, Carla J
The research studied the status of hospital librarians and library services to better inform the Medical Library Association's advocacy activities. The Vital Pathways Survey Subcommittee of the Task Force on Vital Pathways for Hospital Librarians distributed a web-based survey to hospital librarians and academic health sciences library directors. The survey results were compared to data collected in a 1989 survey of hospital libraries by the American Hospital Association in order to identify any trends in hospital libraries, roles of librarians, and library services. A web-based hospital library report form based on the survey questions was also developed to more quickly identify changes in the status of hospital libraries on an ongoing basis. The greatest change in library services between 1989 and 2005/06 was in the area of access to information, with 40% more of the respondents providing access to commercial online services, 100% more providing access to Internet resources, and 28% more providing training in database searching and use of information resources. Twenty-nine percent (n = 587) of the 2005/06 respondents reported a decrease in staff over the last 5 years. Survey data support reported trends of consolidation of hospitals and hospital libraries and additions of new services. These services have likely required librarians to acquire new skills. It is hoped that future surveys will be undertaken to continue to study these trends.
Al-Ahmadi, Talal A
The issue of patient safety has received an increasing attention worldwide. In Saudi Arabia, policy makers and health organizations continually strive to substantially reduce medical errors and improve quality of health care. The aim of this research was to explore the perceptions of Riyadh hospitals' staff on patient safety and error reporting and to identify factors that influence the levels of frequency of events reported. A cross-sectional survey, using Hospital Survey on Patient Safety Culture (HSPSC), was carried out in 2008. The questionnaire was distributed to all hospitals' staff in Riyadh, which included nine public hospitals and two private hospitals. A total of 1224 questionnaires were returned over a six-month period, giving a response rate of 47.4%. Organizational learning was the safety culture dimension with the highest positive response (75.9%), while the non-punitive response to error received the lowest positive response (21.1%). The key areas that need improvement in public hospitals include handoffs and transitions, communication openness, staffing, and non-punitive response to error. The private hospitals need an improvement in two aspects; staffing and non-punitive response to error. The results show that all types of mistakes were reported more frequency in private hospitals than in public hospitals. Most respondents reported "no events" in the twelve months preceding the survey, with the percentage of not reporting being higher in private sector compared to public hospitals. The high percent of "no event" reports may represent under-reporting in all hospitals. Regression analysis indicated that event reporting was influenced by feedback and communication about error, staff position, teamwork across units, non- punitive response to error, supervisor/managers expectations and actions promoting patients safety, and type of hospital. Areas needs improvement in Riyadh hospitals includes handoffs and transitions, communication openness, staffing
Vendemiatti, Mariana; Siqueira, Elisabete Straditto; Filardi, Fernando; Binotto, Erlaine; Simioni, Flávio José
This study analyzes the context of the hospital management professionalization process showing as the main challenges the leadership role to solve the conflict between the doctor, the nurse and the administrative sub-culture. This is a descriptive research and a field investigation based on the survey tools with interview and observation of thirty professionals from the hospital. The results show that the conflict between the various kinds of activities is derivate from the control rules within the hospital, the difference of social assistance and individual values. The conclusion points the need to change the leadership focus from total control to a more flexible kind of management, with emphasis in the dialog and negotiation between these activities in a hospital.
Søeby, Karen; Jensen, Peter Bjødstrup; Werge, Thomas
in creatinine levels at different time points after birth and around the early teens, which challenges the establishment and usefulness of reference intervals in those age groups. Conclusions: The study documents that hospital laboratory data may inform on the developmental aspects of creatinine, on periods......Abstract Background: The knowledge of physiological fluctuation and variation of even commonly used biochemical quantities in extreme age groups and during development is sparse. This challenges the clinical interpretation and utility of laboratory tests in these age groups. To explore the utility...... of hospital laboratory data as a source of information, we analyzed enzymatic plasma creatinine as a model analyte in two large pediatric hospital samples. Methods: Plasma creatinine measurements from 9700 children aged 0-18 years were obtained from hospital laboratory databases and partitioned into high...
U.S. Department of Health & Human Services — About 25 percent of the hospitalizations for dual eligible beneficiaries in 2005 were potentially avoidable. Medicare and Medicaid spending for those potentially...
Skov Benthien, Kirstine; Nordly, Mie; von Heymann-Horan, Annika
CONTEXT: Avoidable hospital admissions are important negative indicators of quality of end-of-life care. Specialized palliative care (SPC) may support patients remaining at home. OBJECTIVES: Therefore, the purpose of this study was to investigate if SPC at home could prevent hospital admissions...... in patients with incurable cancer. METHODS: These are secondary results of Domus: a randomized controlled trial of accelerated transition to SPC with psychological intervention at home (Clinicaltrials.gov: NCT01885637). Participants were patients with incurable cancer and limited antineoplastic treatment...... options and their caregivers. They were included from the Department of Oncology, Rigshospitalet, Denmark, between 2013 and 2016. The control group received usual care. Outcomes were hospital admissions, causes thereof, and patient and caregiver perceptions of place of care (home, hospital, etc...
Gómez de Lara, José Luis
The city of Zamora de Hidalgo is home to one of the most important hospitals in the region, built in 1841 and named the Civil Hospital of Zamora. Built following demand for municipal health needs and with the support of the City Council of Zamora and private donations, it functioned as a hostel for pilgrims, the destitute and the sick. It was administered and maintained by residents, subsequently by the mothers of the Sacred Heart of Jesus, and finally by the federal Government. It currently gives the Zamorano community services, and admits sick people from other locations such as Jacona, Jiquilpan, Patamban Ocumicho, Chavinda, Tangancicuaro, Chilchota, and Tangamandapio, among others. It was called the Civil hospital because as the only hospital that operated in Zamora, it ceased to be administered by the Ecclesiastic Chapter, and passed into the hands of the State.
Burau, Viola; Bro, Flemming
Background Timely discharge is a key component of contemporary hospital governance and raises questions about how to move to more explicit discharge arrangements. Although associated organisational changes closely intersect with professional interests, there are relatively few studies...... in the literature on hospital discharge that explicitly examine the role of professional groups. Recent contributions to the literature on organisational studies of the professions help to specify how professional groups in hospitals contribute to the introduction and routinisation of discharge arrangements...... and involvement in the process of organisational change: whereas in the ‘add on’ model the professional groups remain at a distance, in the ‘embedded model’ they are closely engaged. Conclusions In terms of understanding the making of hospital discharge arrangements, the study contributes two sets of insights...
U.S. Department of Health & Human Services — The "Medicare hospital spending per patient (Medicare Spending per Beneficiary)" measure shows whether Medicare spends more, less or about the same per Medicare...
Svetla Slavova; Terry L. Bunn; Jeffery Talbert
Objectives. We compared three methods for identifying drug overdose cases in inpatient hospital discharge data on their ability to classify drug overdoses by intent and drug type(s) involved. Methods...
U.S. Department of Health & Human Services — In FY 2016, 758 out of 3,308 hospitals subject to the HAC Reduction Program are in the worst performing quartile and will have a one percent payment reduction...
Schmid, K J; Tewari, R; Nordin, A J
Prolonged hospital admissions frequently overshadow the experience of gynaecological cancer patients. In East Kent, we identified obstacles in the inpatient journey through the hospital by performing a patient pathway mapping audit of admissions in May/June 2006 and 2007. We achieved substantial reductions in the length of stay for major gynaecological oncology surgery. The number of the lead consultant's patients with a total duration of admission of no more than 5 days increased from one of 28 in Q1 2006 (3.6%), to 17 of 28 (60.7%) in Q4 2007. Identified problems prolonging the length of stay included admission the day before surgery, prolonged use of i.v. antibiotics and late referrals to social services. Early discharge planning involving staff and patients as active participants has the greatest impact on reduction of duration of hospital admission. A reduction in duration of hospital admissions is associated with an increase in the rate of readmissions.
Full Text Available The physical design and infrastructure of a hospital or institution is an essential component of its infection control measure. Thus is must be a prerequisite to take these into consideration from the initial conception and planning stages of the building. The balance between designing a hospital to be an open, accessible and public place and the control to reduce the spread of infections diseases is a necessity. At Singapore General Hospital, many lessons were learnt during the SARS outbreak pertaining to this. During and subsequent to the SARS outbreak, many changes evolved in the hospital to enable us to handle and face any emerging infectious situation with calm, confidence and the knowledge that staff and patients will be in good stead. This paper will share some of our experiences as well as challenges
Pedersen, Mona Kyndi
services is the point where patients’ needs meet the professional system. There is a need to enhance our understanding of the complex pattern of risk factors associated with hospital readmission and to investigate the role of current practices and organisational determinants to improve the health outcomes......Hospital readmission is common and considered an adverse health outcome in older persons. Acute readmission of recently discharged patients puts additional pressure on clinical resources within health care services and support. Despite the frequency of readmissions, affecting health and wellbeing...... of older persons, there is still a relatively incomplete understanding of the broader array of factors pertaining to hospital readmission. The current evidence on risk factors for hospital readmission is not adequate to identify person at risk of readmission in a heterogeneous population of older persons...
Full Text Available Hospitalization and medical experiences can be confusing and stressful for children, teens and their families. It is very common for young people and their families to have many questions when they are scheduled for surgery or hospitalization. When children are given opportunities to cope successfully with medical experiences, they may see themselves as more capable, more in control, and more reassured. This success often leads to a more positive sense of self, as well as a healthier regard for medical procedures in general. Also, previous medical experiences can affect how the child will react to hospitalization. It is important to maintain a normal routine and activities, such as playing and schooling. Family and friend’s child should be encouraged to visit the child patient. The best way to prepare the child for hospitalization is to prepare ourselves by understanding what will occur.
Agarwal, Divya; Garg, Poonam
In a competitive healthcare sector, hospitals have to focus on their processes in order to deliver high-quality care while at the same time reducing costs. Many hospitals have decided to adopt one or another Enterprise Resource Planning (ERP) system to improve their businesses, but implementing an ERP system can be a demanding endeavour. The systems are so difficult to implement that some are successful; many have failed, causing multimillion dollar losses. The challenge of ERP solutions lie in implementation because they are complex, time consuming and expensive too. This paper describes the various process workflows and phases of ERP implementation at Fortis Hospital Cunningham Road, Bangalore, India. This knowledge will provide valuable insights for the researchers and practitioners to understand the different process workflows and to make informed decisions when implementing ERP in any hospital.
... https://medlineplus.gov/news/fullstory_167720.html Rotavirus Vaccine Cut Kids' Hospitalization, Medical Costs Virus a common ... the sustained impact and effectiveness of the rotavirus vaccine program," study author Dr. Eyal Leshem said in ...
antemortem diagnosis) with autopsies (post-mortem diagnosis) on patients managed at Lagos University Teaching Hospital (LUTH) between October 1999 and November, 2000. In the study period, a total of 1843 deaths were registered out of which ...
Hospital and Kibungo School of Nursing and Midwifery. Purpose. To design ... maternity, surgery, internal medicine, mental health, biomedicine, pharmacy, laboratory, and admissions. The ... At the course end, participants had a foundation of ...
Mokhtar, Ariffin Marzuki
The future hospital is a resilient, physical learning facility featuring digital enhancement and leveraging an ecosystem of platforms for the Internet of Things (IoT) and analytics, achieving patient-centric care delivery via multidisciplinary healthcare provider teams coordinated to meet patients' medical, psychological, social and economic needs. It exists in a just ecosystem that assimilates the care spectrum from healthy living, the prevention of disease to acute care and the rehabilitation of patients recuperating from illnesses. It will take some time for these future hospitals to be built or for current hospitals to evolve and/or transform, but efforts to spread wisdom among the stakeholders, healthcare providers and patients must start now. The development of the digital components can also begin today, as can competency building for the healthcare providers who will be staffing these future hospitals, ensuring that they are equipped with competent staff employing patient-centric care processes that cater to patients' current and future needs.
Raúl Esteban Sastre Cifuentes; Juan Carlos García Ubaque; Carlos Alberto Díaz Correa
... de instituciones.Se destaca que el hospital debe ser el aula más importantedurante el entrenamiento en salud, para lo cual debe coincidirel uso planificado y programado de los recursoshospitalarios...
Smith, R K
The Catholic health care provider's self-definition must be "servant." Individuals and institutions are called upon to avoid selfism and to accept exhilarating tensions between "going-out" (mission) and "welcoming-in" (hospitality).
Presentation descibes results from two studies of water quality and pathogen occurrence in water and biofilm samples from two area hospitals. Includes data on the effectiveness of copper/silver ionization as a disinfectant.
Teare, Richard, Ed.; And Others
A theme issue devoted to management development in hospitality and tourism includes nine articles on assessing human resource needs and priorities, management development and training, preparing managers, curriculum design, supervised work experience, manager role, and the current business environment. (JOW)
U.S. Department of Health & Human Services — The "Medicare hospital spending per patient (Medicare Spending per Beneficiary)" measure shows whether Medicare spends more, less or about the same per Medicare...
Barra, Daniela Couto Carvalho; Waterkemper, Roberta; Kempfer, Silvana Silveira; Carraro, Telma Elisa; Radünz, Vera
Qualitative research whose purpose was to reflect and argue about the relationship between hospitality, care and nursing according to experiences of PhD students. The research was developed from theoretic and practical meeting carried through by disciplines "the care in Nursing and Health" of PhD nursing Program at Santa Catarina Federal University. Its chosen theoretical frame of Hospitality perspective while nursing care. Data were collected applying a semi-structured questionnaire at ten doctoral students. The analysis of the data was carried through under the perspective of the content analysis according to Bardin. Hospitality it is imperative for the individuals adaptation in the hospital context or any area where it is looking for health care.
Research in Hospitality Management. Journal Home · ABOUT · Advanced Search · Current Issue · Archives · Journal Home > Vol 6, No 2 (2016) >. Log in or Register to get access to full text downloads.
Five-rights - medication; Medication administration - hospital; Medical errors - medication; Patient safety - medication safety ... means there is less chance of a medicine error with electronic prescriptions. Your doctor can tell your nurse to write ...
Jäger, Matthias; Ospelt, Isabelle; Kawohl, Wolfram; Theodoridou, Anastasia; Rössler, Wulf; Hoff, Paul
This study aims at investigating the formal and content-related quality of medical certificates directing compulsory hospital admissions before the scheduled alteration of the Swiss civil legislation in January 2013. A comparison between physicians with different professional backgrounds concerning certificates and patients was conducted. Retrospective investigation of medical records of involuntary inpatients at the University Hospital of Psychiatry in Zurich during a period of six months (N=489). Considerable deficits concerning formal and particularly content-related aspects of the certificates were found. Psychiatrists issued certificates of the highest quality followed by emergency physicians, hospital doctors and general practitioners. Patients differed with respect to several sociodemographic and clinical variables. The quality of certificates directing involuntary hospital admission has to be improved considering the impact on the individual concerned. The consequences of the new legislation on the quality of the admission practices should be inquired in order to improve professional training on the issue.
Katz, David E; Friedman, N Deborah; Ostrovski, Evgenia; Ravid, Dor; Amrami, Nadav; Avivi, Dori; Mengesha, Bethlehem; Zaidenstein, Ronit; Lazarovitch, Tsilia; Dadon, Mor; Marchaim, Dror
Acute infections of the diabetic foot (DFI) are a common and complex condition. Patients are generally managed in the ambulatory setting and epidemiological data pertaining to hospitalized patients is lacking...
Research in Hospitality Management. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 7, No 1 (2017) >. Log in or Register to get access to full text downloads.
Research in Hospitality Management. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 7, No 1 (2017) >. Log in or Register to get access to full text downloads.
there are limits to its financial resources. What is more, the focus on claim-making and extended rights of the migrant produces a tendency for the language and practice of hospitality to ‘turn’ against the guest today, and notably the construction of the figure of guests who not only fail to fulfil their duties...... (welfare ‘parasites’) but even betray the host. Next, an enquiry of the concept of hospitality as possible lens for migration studies; it implies a twofold analyses with two levels, a macro level, to focus our attention to the modalities of hospitality given by the juridical status of the stranger and its...... influence on civil inclusion (Sassen 2007; Brenner 2011); and a meso level, to focus instead upon hospitality as an inter-subjective relationship between the host and the guest as a way to relate, as an experience and as an ethics (Derrida 2001). Finally the paper gives a short introduction into an on...