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Sample records for hospital foodservice operations

  1. What can foodservice operators do to remedy undernutrition in hospitals?

    DEFF Research Database (Denmark)

    Mikkelsen, Bent Egberg; Beck, Anne Marie; Balknäs, Ulla Nilsson

    2003-01-01

    of clearly defined responsibilities, and a lack of educational possibilities, as well as a lack of cooperation between those groups. Foodservice and nutritional care does not pay sufficient attention to the rights of the patients and their needs for information, and, finally, hospital management seems...

  2. Implementing healthier foodservice guidelines in hospital and federal worksite cafeterias: barriers, facilitators and keys to success.

    Science.gov (United States)

    Jilcott Pitts, S B; Graham, J; Mojica, A; Stewart, L; Walter, M; Schille, C; McGinty, J; Pearsall, M; Whitt, O; Mihas, P; Bradley, A; Simon, C

    2016-12-01

    Healthy foodservice guidelines are being implemented in worksites and healthcare facilities to increase access to healthy foods by employees and public populations. However, little is known about the barriers to and facilitators of implementation. The present study aimed to examine barriers to and facilitators of implementation of healthy foodservice guidelines in federal worksite and hospital cafeterias. Using a mixed-methods approach, including a quantitative survey followed by a qualitative, in-depth interview, we examined: (i) barriers to and facilitators of implementation; (ii) behavioural design strategies used to promote healthier foods and beverages; and (iii) how implementation of healthy foodservice guidelines influenced costs and profitability. We used a purposive sample of five hospital and four federal worksite foodservice operators who recently implemented one of two foodservice guidelines: the United States Department of Health and Human Services/General Services Administration Health and Sustainability Guidelines ('Guidelines') in federal worksites or the Partnership for a Healthier America Hospital Healthier Food Initiative ('Initiative') in hospitals. Descriptive statistics were used to analyse quantitative survey data. Qualitative data were analysed using a deductive approach. Implementation facilitators included leadership support, adequate vendor selections and having dietitians assist with implementation. Implementation barriers included inadequate selections from vendors, customer complaints and additional expertise required for menu labelling. Behavioural design strategies used most frequently included icons denoting healthier options, marketing using social media and placement of healthier options in prime locations. Lessons learned can guide subsequent steps for future healthy foodservice guideline implementation in similar settings. © 2016 The British Dietetic Association Ltd.

  3. Energy management within Canadian foodservice and hospitality education programs

    Energy Technology Data Exchange (ETDEWEB)

    1984-06-01

    This study identified 38 Canadian community colleges and universities that offer programs in the foodservice and hospitality technology. A combined mail and telephone survey was conducted to determine the extent that topics in the energy management field have penetrated the curricula at these institutions. The results of the study indicate that none of the institutions presently has a course within their curricula that concentrates specifically on energy management in the foodservice/hospitality industry. However, several administrators/instructors indicated that such topics as electrical demand cost control as well as energy conserving food processes and equipment were discussed within present programs. Overall, there was an indication that the emphasis on the energy management technology within the course material was increasing and that the need for related teaching aids, resource material and external technical support as stimuli was required. 2 refs., 1 fig.

  4. Factors Effect Direct Cost of Hospital Foodservices and Approximate Cost Analyze

    Directory of Open Access Journals (Sweden)

    Fatma Çelik

    2006-01-01

    Full Text Available The aim of this study was to investigate the cost of foodservice for the university hospital by taking into account of the criteria’s of well diet balanced using information technology. The data explain cost of food were obtained from input, output of hospital food barn that processed by hospital information system for 1995, 2000-2004 years. All details for calculating the net expenditure of food and direct cost of nutrition services were obtained from hospital information system that records all data on line. The energy and nutrient values of daily food served were calculated using the output of hospital food barn by the computer software that was developed. It was found that, our hospital catering system supplied a daily food ration of 2728 kcal and 98,1 gr protein/person in 2004.It has found that the cost of food was increased 10 times from 1995 to 2004. The expenditure of food groups that used in the hospital was 58.96% percent in the total cost of all nutrition services. The big part (28.92% of food expenditure was red meat and pulses. It has been thought that the daily approximate food cost for per person was 3,15 YTL. The total approximate cost could be estimated by adding the cost of staffs and the various managing expenditures to the approximate food cost. These data would be used to make the hospital foodservices private.In conclusion, to be successful in managing hospital food services depends on regular inspection and to take all costs under control daily. To present the results of cost analysis for hospitals will increase the quality of foodservices and will be possible to compare with the others.

  5. Getting a taste for food waste: a mixed methods ethnographic study into hospital food waste before patient consumption conducted at three New Zealand foodservice facilities.

    Science.gov (United States)

    Goonan, Sarah; Mirosa, Miranda; Spence, Heather

    2014-01-01

    Foodservice organizations, particularly those in hospitals, are large producers of food waste. To date, research on waste in hospitals has focused primarily on plate waste and the affect of food waste on patient nutrition outcomes. Less focus has been placed on waste generation at the kitchen end of the hospital food system. We used a novel approach to understand reasons for hospital food waste before consumption and offer recommendations on waste minimization within foodservices. A mixed methods ethnographic research approach was adopted. Three New Zealand hospital foodservices were selected as research sites, all of which were contracted to an external foodservice provider. Data collection techniques included document analyses, observations, focus groups with kitchen staff, and one-on-one interviews with managers. Thematic analysis was conducted to generate common themes. Most food waste occurred during service and as a result of overproduction. Attitudes and habits of foodservice personnel were considered influential factors of waste generation. Implications of food waste were perceived differently by different levels of staff. Whereas managers raised discussion from a financial perspective, kitchen staff drew upon social implications. Organizational plans, controls, and use of pre-prepared ingredients assisted in waste minimization. An array of factors influenced waste generation in hospital foodservices. Exploring attitudes and practices of foodservice personnel allowed an understanding of reasons behind hospital food waste and ways in which it could be minimized. This study provides a foundation for further research on sustainable behavior within the wider foodservice sector and dietetics practice. Copyright © 2014 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

  6. HACCP models for quality control of entrée production in hospital foodservice systems. I. Development of hazard analysis critical control point models.

    Science.gov (United States)

    Bobeng, B J; David, B D

    1978-11-01

    HACCP models were developed as part of a research project for quality control of entrée production in three types of hospital foodservice systems: Conventional, cook/chill, and cook/freeze. Critical control points at process stages were identified. Time-temperature was a critical control point throughout entrée production in each model; time-temperature parameters were established for critical control points. Equipment sanitation and personnel sanitation are critical control points for which standards must be established by each foodservice system. Determination of the effectiveness of control measures included continuous monitoring of critical control points for time-temperature. Sanitation of equipment and personnel should be monitored using standards established by the foodservice system.

  7. A Biosecurity Checklist for School Foodservice Programs: Developing a Biosecurity Management Plan

    Science.gov (United States)

    US Department of Agriculture, 2004

    2004-01-01

    The purpose of this document is to introduce the need for securing foodservice operations from bioterrorism, provide a checklist of suggestions for improving the security of foodservice operations, and assist individuals responsible for school food service programs in strengthening the safety of the foodservice operation. While not mandatory, the…

  8. Hazard Analysis and Critical Control Point Program for Foodservice Establishments.

    Science.gov (United States)

    Control Point ( HACCP ) inspections in foodservice operations throughout the state. The HACCP system , which first emerged in the late 1960s, is a rational...has been adopted for use in the foodservice industry. The HACCP system consists of three main components which are the: (1) Assessment of the hazards...to monitor critical control points. This system has shown promise as a tool to reduce the frequency of foodborne disease outbreaks in foodservice

  9. Significant Trends Are Now Reshaping the Industry Training for Foodservice and Hospitality.

    Science.gov (United States)

    Reiman, Tyrus

    1984-01-01

    The hospitality industry is one that is not adversely affected by the information revolution. As tourism is stimulated by government economic development efforts, opportunities in the food service and hospitality occupations are increasing, both for the young and for the unemployed who need retraining. (SK)

  10. Practices of Selected Foodservice Establishments in Iloilo City, Philippines

    Directory of Open Access Journals (Sweden)

    Raymund B. Moreno

    2015-02-01

    Full Text Available This study aimed to determine the practices of foodservice establishments in Iloilo City. The subjects of this study were selected foodservice establishments in Iloilo City which were selected purposively. The findings of the study showed that the number of foodservice establishments as respondents was equally divided into fast foods and specialty foodservice establishments in Iloilo City. Majority of the foodservice establishment was located uptown or outside of the City of Iloilo and has operated for more than five years. All specialty establishments have undergone accreditation by the Department of Tourism. Since the foodservice establishments practiced all times the different foodservice practices in purchasing, receiving, storage, inventory and safety it is recommended that the owners and managers should continue to perform the different practices to ensure quality service and satisfaction to the customers. It is recommended that the hotel and restaurant management teachers should disseminate the result of the study through their lecture and discussion so that the students could be aware of the good practices employed in the foodservice establishments and enable them to apply this in their future career as effective and productive foodservice worker. Similar study can be conducted to validate the results of this study using other variables and respondents.

  11. Benchmarking in Foodservice Operations.

    Science.gov (United States)

    2007-11-02

    51. Lingle JH, Schiemann WA. From balanced scorecard to strategic gauges: Is measurement worth it? Mgt Rev. 1996; 85(3):56-61. 52. Struebing L...studies lasted from nine to twelve months, and could extend beyond that time for numerous reasons (49). Benchmarking was not industrial tourism , a...not simply data comparison, a fad, a means for reducing resources, a quick-fix program, or industrial tourism . Benchmarking was a complete process

  12. How do the work environment and work safety differ between the dry and wet kitchen foodservice facilities?

    OpenAIRE

    2012-01-01

    In order to create a worker-friendly environment for institutional foodservice, facilities operating with a dry kitchen system have been recommended. This study was designed to compare the work safety and work environment of foodservice between wet and dry kitchen systems. Data were obtained using questionnaires with a target group of 303 staff at 57 foodservice operations. Dry kitchen facilities were constructed after 2006, which had a higher construction cost and more finishing floors with ...

  13. Foodservice yield and fabrication times for beef as influenced by purchasing options and merchandising styles.

    Science.gov (United States)

    Weatherly, B H; Griffin, D B; Johnson, H K; Walter, J P; De La Zerda, M J; Tipton, N C; Savell, J W

    2001-12-01

    steaks in terms of yield and labor cost, foodservice operators will be better equipped to decide what option is more viable for their operation.

  14. Consumer perceptions on sustainable practices implemented in foodservice organizations in Korea.

    Science.gov (United States)

    Ju, Seyoung; Chang, Hyeja

    2016-02-01

    Sustainable practices in foodservice organizations including commercial and noncommercial ones are critical to ensure the protection of the environment for the future. With the rapid growth of the foodservice industry, wiser usage of input sources such as food, utilities, and single use packaging should be reconsidered for future generations. Therefore, this study aims to investigate the customer's perceptions on sustainable practices and to identify the relationship among sustainable practices, social contribution and purchase intention. The study was conducted using content analyses by reviewing articles on sustainable food service practices published domestically and abroad. Thereafter, data were collected with a face-to-face survey using a questionnaire and analyzed with factor analyses and multiple regressions. Sustainable practices classified with factor analysis consisted of 6 dimensions of green food material procurement, sustainable food preparation, green packaging, preservation of energy, waste management, and public relations on green activity, with a total of 25 green activities in foodservice operations. Consumers were not very familiar with the green activities implemented in the foodservice unit, with the lowest awareness of "green food material procurement (2.46 out of 5 points)", and the highest awareness of "green packaging (3.74)" and "waste management (3.28). The factors influencing the perception of social contribution by foodservice organizations among 6 sustainable practice dimensions were found to be public relations on green activity (β = 0.154), waste management (β = 0.204) and sustainable food preparation (β = 0.183). Green packaging (β = 0.107) and the social contribution of the foodservice organization (β = 0.761) had strong relationships with the image of the organization. The purchase intentions of customers was affected only by the foodservice image (β = 0.775). The results of this study suggest that sustainable practices by

  15. Workplace foodservice; perception of quality and trust.

    Science.gov (United States)

    Price, Sarah; Hartwell, Heather; Hemingway, Ann; Chapleo, Chris

    2016-02-01

    In settings such as workplaces there is a growing acceptance that the food provided has a significant impact on health and wellbeing. This is a captive environment where the overall contribution of the meal served could be an important element of the overall diet and represents an under researched area. Despite growing demand, little information is available; time pressure when making food choice alongside the challenge of understanding information provided can act as barriers for healthy selection and can also decrease confidence in the food system. We would also argue that the fundamental human right of informing consumers what they are eating is not currently being addressed and is underscored. This study used focus groups to explore criteria that motivate peoples' food choice in a workplace foodservice setting. Thematic analysis was applied to categorise data according to frequently occurring responses. Data were collected from four focus groups in Germany and the UK with a total of 23 participants. Although there is little expectation in the quality of food served in the workplace, respondents valued any transparency of information and the opportunity to socialise with other work colleagues. Criteria of importance were identified as: Value for money, Variety, Naturalness, Nutrition, Portion Size, Taste, Visual Appearance, Origin, Animal welfare, Environmental impact, Fair Trade and Organic. Gaining insight into these criteria can enable operators to meet the needs and expectations of their customers in order to increase confidence in the food provided and in addition signpost a healthier selection.

  16. Controle de perdas de carotenóides em hortaliças preparadas em unidade de alimentação e nutrição hospitalar Control of carotenoid loss in vegetables prepared in a hospital foodservice

    Directory of Open Access Journals (Sweden)

    Ceres Mattos Della Lucia

    2008-10-01

    Full Text Available Objetivou-se avaliar procedimentos de manipulação visando o controle de perdas de β-caroteno e licopeno em couve e tomate preparados em uma Unidade de Alimentação e Nutrição (UAN hospitalar. Os critérios adotados não utilizados previamente pela UAN foram: armazenamento por 24 h sob refrigeração (10°C, sanitização por 15 min e distribuição logo após o preparo. As hortaliças foram coletadas após a recepção e depois de cada etapa de manipulação. A análise foi realizada por cromatografia líquida de alta eficiência (CLAE, usando como fase móvel metanol, acetato de etila e acetonitrila (50:40:10. A ANOVA (α = 0,05 foi utilizada para detecção de diferenças significativas. Não foram encontradas diferenças significativas quanto ao conteúdo dos componentes entre as etapas de manipulação, mas houve redução importante das taxas de retenção. Para β-caroteno em couve, verificou-se retenção de 68,2% após 60 minutos de exposição para consumo, enquanto em tomate, 91,96% do conteúdo desse composto foi preservado após 120 minutos de espera até a distribuição. Não foi observada redução importante na taxa de retenção de licopeno. Os procedimentos avaliados na UAN hospitalar contribuíram para controlar as perdas de carotenóides nas hortaliças, pois sua retenção foi elevada, sendo sugerida sua adoção em outras UAN.The aim of this study was to assess the handling procedures of kale and tomatoes in a hospital foodservice (HFS in order to control loss of β-carotene and licopene. The adopted measures, up to then not used by the HFS, were: 24-h storage under refrigeration (10°C, hygienizing for 15 min and distribution immediately after preparation. Vegetable samples were collected after reception and after each stage of manipulation in the HFS. The samples were analyzed using high performance liquid chromatography (HPLC with a mobile phase of methanol, ethyl acetate and acetonitrile (50:40:10. ANOVA (α = 0

  17. Development of Career Progression Systems for Employees in the Foodservice Industry. Final Report.

    Science.gov (United States)

    National Restaurant Association, Chicago, IL.

    Firms representing four segments of the foodservice industry (institutional foodservice (9 jobs), commercial restaurants (19 jobs), hotel foodservice (100 jobs), and airline foodservice (10 jobs), participated in a career and training study to test the feasibility of designing and implementing career progression (c.p.) systems within these…

  18. Foodservice Systems for Navy Forces in the 1990’s

    Science.gov (United States)

    1991-04-01

    Next, a cross-section evaluation of ships throughout the fleet was conducted with emphasis on foodservice system operations and deficiencies to...individual or group preferences. 82 In regard to individual food preferences, increased popularity was predicted for fresh foods, such as vegetarian ...Simplesse, made from protein , can be used in salad dressings, whipped toppings, cakes, icings, and other noncooked applications. The protein in

  19. Integrating hospital and physician revenue cycle operations.

    Science.gov (United States)

    Lockett, Kevin M

    2014-03-01

    Standardized revenue cycle processes should be a key component of the coordinated care delivery strategy organizations will require to complete the transition to population health management. Integrating hospital and physician revenue cycle operations can help organizations better navigate new payment models, reduce costs, and improve value. The most comprehensive approach involves integrating patient access and registration, coding operations, and receivables management across different settings.

  20. Innovation Processes in Large-Scale Public Foodservice-Case Findings from the Implementation of Organic Foods in a Danish County

    DEFF Research Database (Denmark)

    Mikkelsen, Bent Egberg; Nielsen, Thorkild; Kristensen, Niels Heine

    2005-01-01

    foods into large-scale foodservice such as that taking place in hospitals and larger homes for the elderly, has proven to be quite difficult. The very complex planning, procurement and processing procedures used in such facilities are among reasons for this. Against this background an evaluation...... was carried out of the change process related implementation of organic foods in large-scale foodservice facilities in Greater Copenhagen county in order to study the effects of such a change. Based on the findings, a set of guidelines has been developed for the successful implementation of organic foods...... into the large-scale foodservice. The findings and guidelines are however applicable to other types of innovation processes in food service....

  1. Key operating and financial ratios for Alberta hospitals.

    Science.gov (United States)

    Jacobs, P; Hall, E M

    1994-01-01

    Comparative financial and operating ratios in Canadian hospitals are examined to reveal sources of increased efficiency. The study involved 70 Alberta hospitals, which were divided into three groups: teaching hospitals, regional hospitals and smaller rural hospitals. Data were obtained from HS-1 and HS-2 reports. Hospitals across Canada can calculate their own ratios to give them a general idea of how they compare with the hospitals in this report.

  2. Time and Temperature Conditions during Product Flow and Sensory Quality of Potato Salad Prepared in a Conventional Foodservice System.

    Science.gov (United States)

    1983-01-01

    prevent recontami- nation during refrigerated storage, and thorough reheating of meat loaves for assembly. Development of the HACCP Concept Bauman...implementation of the hazard analysis critical control point ( HACCP ) concept for foodservice operations as a control device managers could use to...eliminate a microbiological hazard and control quality. The work of Bobeng and David (1977) and Matthews (1982b) on implementation of the HACCP concept shows

  3. Food-service establishment wastewater characterization.

    Science.gov (United States)

    Lesikar, B J; Garza, O A; Persyn, R A; Kenimer, A L; Anderson, M T

    2006-08-01

    Food-service establishments that use on-site wastewater treatment systems are experiencing pretreatment system and/or drain field hydraulic and/or organic overloading. This study included characterization of four wastewater parameters (five-day biochemical oxygen demand [BOD5]; total suspended solids [TSS]; food, oil, and grease [FOG]; and flow) from 28 restaurants located in Texas during June, July, and August 2002. The field sampling methodology included taking a grab sample from each restaurant for 6 consecutive days at approximately the same time each day, followed by a 2-week break, and then sampling again for another 6 consecutive days, for a total of 12 samples per restaurant and 336 total observations. The analysis indicates higher organic (BOD5) and hydraulic values for restaurants than those typically found in the literature. The design values for this study for BOD5, TSS, FOG, and flow were 1523, 664, and 197 mg/L, and 96 L/day-seat respectively, which captured over 80% of the data collected.

  4. Measuring School Foodservice Workers’ Perceptions of Organizational Culture

    Science.gov (United States)

    School foodservice workers (SFW) are a direct link to children eating school meals. SFW who perceive positive and supportive organizational culture at their school nutrition departments also may perceive that such environments foster their own promotion of healthful food choices by students. To date...

  5. Hospital markup and operation outcomes in the United States.

    Science.gov (United States)

    Gani, Faiz; Ejaz, Aslam; Makary, Martin A; Pawlik, Timothy M

    2016-07-01

    Although the price hospitals charge for operations has broad financial implications, hospital pricing is not subject to regulation. We sought to characterize national variation in hospital price markup for major cardiothoracic and gastrointestinal operations and to evaluate perioperative outcomes of hospitals relative to hospital price markup. All hospitals in which a patient underwent a cardiothoracic or gastrointestinal procedure were identified using the Nationwide Inpatient Sample for 2012. Markup ratios (ratio of charges to costs) for the total cost of hospitalization were compared across hospitals. Risk-adjusted morbidity, failure-to-rescue, and mortality were calculated using multivariable, hierarchical logistic regression. Among the 3,498 hospitals identified, markup ratios ranged from 0.5-12.2, with a median markup ratio of 2.8 (interquartile range 2.7-3.9). For the 888 hospitals with extreme markup (greatest markup ratio quartile: markup ratio >3.9), the median markup ratio was 4.9 (interquartile range 4.3-6.0), with 10% of these hospitals billing more than 7 times the Medicare-allowable costs (markup ratio ≥7.25). Extreme markup hospitals were more often large (46.3% vs 33.8%, P markup ratio compared with 19.3% (n = 452) and 6.8% (n = 35) of nonprofit and government hospitals, respectively. Perioperative morbidity (32.7% vs 26.4%, P markup hospitals. There is wide variation in hospital markup for cardiothoracic and gastrointestinal procedures, with approximately a quarter of hospital charges being 4 times greater than the actual cost of hospitalization. Hospitals with an extreme markup had greater perioperative morbidity. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Quality, efficiency, and sustainability in the foodservice supply chain

    DEFF Research Database (Denmark)

    Wang, Yang; Grunow, Martin

    Consumers have become more and more demanding with regards to food quality, food safety, sustainability, and associated product attributes. Looking at food supply chains from an integrated point of view has therefore become an industry paradigm. The overall aim of this thesis is to contribute...... to the literature with regards to the development of efficient, high-quality, and sustainable food supply chains; especially focusing on integrated methodologies. In this thesis, research is presented on the inclusion of the specifics of the food industry, food engineering related knowledge, and sustainability...... assessment methodology into food supply chain management. This thesis builds on a case from the foodservice industry, which is used throughout the thesis to illustrate the proposed methodologies. As an important part of the food industry, the foodservice industry connects agricultural producers, food...

  7. Hospitalization in Small-Scale Contingency Operations

    Science.gov (United States)

    2006-05-31

    That Don’t): Creating Conditions for Effective Teamwork . San Francisco: Jossey-Bass Publishers. Hellriegel, Don, John W. Slocum, Jr., and Richard W...General Accounting Office. 1995. GAO. 1996. See United States General Accounting Office. 1996. Hackman , J. Richard, ed. 1990 . Groups That Work (and Those...on the characteristics and capabilities that echelon-III hospital units need in order to deploy and support SSCs under present and emerging conditions

  8. HB 1347 and Its Relationship to Foodservice Outsourcing in Illinois Public Schools

    Science.gov (United States)

    Brashear, Gary L.

    2012-01-01

    This study examined foodservice outsourcing in the State of Illinois. School administrators currently outsourcing foodservice were surveyed about their perceptions of HB1347 and its components. This study looked at HB1347 in Illinois, and its effects on outsourcing in school districts. Data for this study was collected from a survey sent to 100%…

  9. HB 1347 and Its Relationship to Foodservice Outsourcing in Illinois Public Schools

    Science.gov (United States)

    Brashear, Gary L.

    2012-01-01

    This study examined foodservice outsourcing in the State of Illinois. School administrators currently outsourcing foodservice were surveyed about their perceptions of HB1347 and its components. This study looked at HB1347 in Illinois, and its effects on outsourcing in school districts. Data for this study was collected from a survey sent to 100%…

  10. [The army nurse, from hospital to overseas operations].

    Science.gov (United States)

    Guérot, Françoise; Saliou, Henri; Lefort, Hugues; De Rudnickl, Stéphane

    2014-09-01

    Assigned to French army teaching hospitals, the army nurse can be deployed on overseas operations in support of the armed forces. Experience in the treatment of casualties in life-threatening emergencies is essential, as is the ability to adapt and react. Designated on a voluntary basis, after some two years of working in an army teaching hospital, the hospital nurse receives training in the specificities of the theatre of deployment.

  11. Reducing cancelled surgery operations in a hospital: brief report

    Directory of Open Access Journals (Sweden)

    Ali Mohammad Mosadeghrad

    2016-08-01

    Full Text Available Background: Operation theatre in a hospital requires considerable human and physical resources to deliver surgery services on an agreed schedule. However, operation theatres are sometimes underutilized due to avoidable last minute cancellations of operations. Cancellation of operations on the day of intended surgery results in operation theatre planning difficulties, hospital inefficiency and resource wastage. In addition, it causes stress for patients and their relatives and results in unnecessary hospital staying. Cancellation of planned operations could be avoided by applying appropriate management strategies and techniques. Quality management as an organizational strategy helps enhance hospital departments’ productivity. Methods: This study aimed to reduce cancelled surgeries in Shahid Rajaei Hospital in Tehran using a quality management model. A participatory action research was used for the intervention between April 2013 and March 2014. Information on operations cancelled on the day of surgery obtained each day from the operating theatre list. Using a checklist, the reasons for operations cancellation were identified, investigated and an action plan was developed for its reduction. The plan was implemented using the action research cycle. Results: The number of surgeries increased by 4.06 percent and operations cancellation was reduced by 32.4 percent using the quality management strategy. Surgeon and anesthetist related factors, over-running of previous surgery, changes in patient clinical status and lack of intensive care unit beds were the main reasons for cancelling surgeries. Standardization of processes, proper planning and using anesthetics clinic helped reduce the operations cancellation. Conclusion: Last minute surgeries cancellation is potentially avoidable. Implementing an appropriate quality management model helps enhance hospital departments’ productivity and reduce surgical cancellation.

  12. Modern approach to the operation of a hospital

    Directory of Open Access Journals (Sweden)

    Christos Karasoulos

    2014-01-01

    Full Text Available The health sector is characterized by diversity due to its singularity but also the many professions associated with it (e.g. doctors, nurses, nursing attendants, managers, suppliers etc.. This kind of diversity has resulted in a dramatic increase of health costs leading hospitals into using business techniques to reduce costs. Purpose: The purpose of the present review was to explore the possibility of operating a hospital standards of operational policy. Material and Method: The methodology followed is based on searching and reviewing research studies and scientific articles abstracted from an international database (Scopus and from the Greek and international literature between the years 1996 to 2012, using keywords such as: hospital, business, health expenditure, supplies, total quality management. Results: The review of literature shows that hospitals suffered from mismanagement, excessive expenses and insufficient health care services. The application of Lean Six Sigma methodologies and TQM helped to reduce costs, the continuous control problems encountered in raising the level of benefits. Conclusions: The hospital cannot be associated with a business, because the hospital is meant to care for the public in general as opposed to businesses that aim at increasing their profits. However, adopting techniques of the business field, the hospitals have the ability to control operating costs and curb costs, therefore, the modern hospital can function as an ‘idiosyncratic’ form of business.

  13. How do the work environment and work safety differ between the dry and wet kitchen foodservice facilities?

    Science.gov (United States)

    Chang, Hye-Ja; Kim, Jeong-Won; Ju, Se-Young; Go, Eun-Sun

    2012-08-01

    In order to create a worker-friendly environment for institutional foodservice, facilities operating with a dry kitchen system have been recommended. This study was designed to compare the work safety and work environment of foodservice between wet and dry kitchen systems. Data were obtained using questionnaires with a target group of 303 staff at 57 foodservice operations. Dry kitchen facilities were constructed after 2006, which had a higher construction cost and more finishing floors with anti-slip tiles, and in which employees more wore non-slip footwear than wet kitchen (76.7%). The kitchen temperature and muscular pain were the most frequently reported employees' discomfort factors in the two systems, and, in the wet kitchen, "noise of kitchen" was also frequently reported as a discomfort. Dietitian and employees rated the less slippery and slip related incidents in dry kitchens than those of wet kitchen. Fryer area, ware-washing area, and plate waste table were the slippery areas and the causes were different between the functional areas. The risk for current leakage was rated significantly higher in wet kitchens by dietitians. In addition, the ware-washing area was found to be where employees felt the highest risk of electrical shock. Muscular pain (72.2%), arthritis (39.1%), hard-of-hearing (46.6%) and psychological stress (47.0%) were experienced by employees more than once a month, particularly in the wet kitchen. In conclusion, the dry kitchen system was found to be more efficient for food and work safety because of its superior design and well managed practices.

  14. A Scheduling Problem for Hospital Operating Theatre

    CERN Document Server

    Sufahani, Suliadi F; Ismail, Zuhaimy

    2012-01-01

    This paper provides a classification of real scheduling problems. Various ways have been examined and described on the problem. Scheduling problem faces a tremendous challenges and difficulties in order to meet the preferences of the consumer. Dealing with scheduling problem is complicated, inefficient and time-consuming. This study aims to develop a mathematical model for scheduling the operating theatre during peak and off peak time. Scheduling problem is a well known optimization problem and the goal is to find the best possible optimal solution. In this paper, we used integer linear programming technique for scheduling problem in a high level of synthesis. In addition, time and resource constrained scheduling was used. An optimal result was fully obtained by using the software GLPK/AMPL. This model can be adopted to solve other scheduling problems, such as the Lecture Theatre, Cinemas and Work Shift.

  15. Achieving hospital operating objectives in the light of patient preferences.

    Science.gov (United States)

    Ramirez Valdivia, M T; Crowe, T J

    1997-01-01

    Patient satisfaction is becoming increasingly important for the successful operation of private and public hospitals. The quality of the service provided can be improved if internal and external customers' opinions are taken into account during the definition of hospital operating objectives. This research presents a new methodology, called the simulation service quality system (SSQS), developed to improve operating performance measures in the light of customer preferences. The motivation for the development of the SSQS methodology arose from the need to achieve timeliness standards at United States Veterans' Hospitals. The Harry S. Truman Memorial Veterans' Hospital in Columbia Missouri served as the validation and initial application site for the SSQS methodology. Details one such project: the objective of reducing customer waiting times to 30 minutes or less at an outpatient treatment clinic. Through the identification of relationships and interactions, discrete-event simulation techniques are applied to model and experiment with the system to ultimately arrive at recommended changes in hospital operating policies which achieve the objective.

  16. 76 FR 62341 - Agency Information Collection Activities: Proposed Collection; Comment Request-School Foodservice...

    Science.gov (United States)

    2011-10-07

    ..., contact John Endahl, Senior Program Analyst, Office of Research and Analysis, Food and Nutrition Service... Food and Nutrition Service Agency Information Collection Activities: Proposed Collection; Comment Request--School Foodservice Indirect Cost Study AGENCY: Food and Nutrition Service (FNS), United...

  17. Moderating effects of leader-member exchange (LMX) on job burnout in dietitians and chefs of institutional foodservice.

    Science.gov (United States)

    Lee, Kyung-Eun

    2011-02-01

    The objectives of the study were to investigate job burnout and leader-member exchange (LMX) levels as well as to evaluate buffering effects of LMX on burnout among dietitians and chefs at institutional foodservices. Hypotheses were proposed based on the Job Demands-Resources model and LMX theory. The study population consisted of dietitians and chefs who were in charge of managing unit operations in a nationwide contract management company. Positive/negative affectivity, workload, job burnout, and LMX scales that had been validated in previous research were adopted. A total of 552 questionnaires were distributed and 154 responses were returned. Results indicated that respondents' burnout levels were moderate and emotional exhaustion was greater than cynicism. In terms of LMX, the surveyed dietitians and chefs showed higher respect toward their supervisors than loyalty. When positive affectivity and negative affectivity were controlled, workload influenced emotional exhaustion and professional efficacy significantly. With affectivity and workload controlled, however, LMX did not influence any dimensions of burnout. The moderating effect of LMX on the relationship between workload and cynicism was significant. That is, the effect of workload on cynicism was weak if the dietitians and chefs perceived the relationship with their supervisor positively. Based on the findings and literature reviewed, how to mitigate job burnout among foodservice managers is discussed.

  18. A norm utilisation for scarce hospital resources: Evidence from operating rooms in a Dutch university hospital

    NARCIS (Netherlands)

    van Houdenhoven, Mark; Hans, Elias W.; Klein, Jan; Wullink, Gerhard; Kazemier, Geert

    2007-01-01

    Background: Utilisation of operating rooms is high on the agenda of hospital managers and researchers. Many efforts in the area of maximising the utilisation have been focussed on finding the holy grail of 100% utilisation. The utilisation that can be realised, however, depends on the patient mix an

  19. The Use of Operational Excellence Principles in a University Hospital

    Directory of Open Access Journals (Sweden)

    Eric R. Edelman

    2017-07-01

    Full Text Available The introduction of Operational Excellence in the Maastricht University Medical Center (MUMC+ has been the first of its kind and scale for a university hospital. The policy makers of the MUMC+ have combined different elements from various other business, management, and healthcare philosophies and frameworks into a unique mix. This paper summarizes the journey of developing this system and its most important aspects. Special attention is paid to the role of the operating rooms and the improvements that have taken place there, because of their central role in the working of the hospital. The MUMC+ is the leading tertiary healthcare center for the South-East region of The Netherlands and beyond. Regional, national, and international developments encouraged the MUMC+ to start significantly reorganizing its care processes from 2009 onward. First experiments with Lean Six Sigma and Business Modeling were combined with lessons learned from other centers around the world to form the MUMC+’s own type of Operational Excellence. At the time of writing, many improvement projects of different types have been successfully completed. Every single department in the hospital now uses Operational Excellence and design thinking in general as a method to develop new models of care. An evaluation in 2014 revealed several opportunities for improvement. A large number of projects were in progress, but 75% of all projects had not been completed, despite the first projects being initiated back in 2012. This led to a number of policy changes, mainly focusing on more intensive monitoring of projects and trying to do more improvement projects directly under the responsibility of the line manager. Focusing on patient value, continuous improvement, and the reduction of waste have proven to be very fitting principles for healthcare in general and specifically for application in a university hospital. Approaching improvement at a systems level while directly involving the

  20. The Use of Operational Excellence Principles in a University Hospital.

    Science.gov (United States)

    Edelman, Eric R; Hamaekers, Ankie E W; Buhre, Wolfgang F; van Merode, Godefridus G

    2017-01-01

    The introduction of Operational Excellence in the Maastricht University Medical Center (MUMC+) has been the first of its kind and scale for a university hospital. The policy makers of the MUMC+ have combined different elements from various other business, management, and healthcare philosophies and frameworks into a unique mix. This paper summarizes the journey of developing this system and its most important aspects. Special attention is paid to the role of the operating rooms and the improvements that have taken place there, because of their central role in the working of the hospital. The MUMC+ is the leading tertiary healthcare center for the South-East region of The Netherlands and beyond. Regional, national, and international developments encouraged the MUMC+ to start significantly reorganizing its care processes from 2009 onward. First experiments with Lean Six Sigma and Business Modeling were combined with lessons learned from other centers around the world to form the MUMC+'s own type of Operational Excellence. At the time of writing, many improvement projects of different types have been successfully completed. Every single department in the hospital now uses Operational Excellence and design thinking in general as a method to develop new models of care. An evaluation in 2014 revealed several opportunities for improvement. A large number of projects were in progress, but 75% of all projects had not been completed, despite the first projects being initiated back in 2012. This led to a number of policy changes, mainly focusing on more intensive monitoring of projects and trying to do more improvement projects directly under the responsibility of the line manager. Focusing on patient value, continuous improvement, and the reduction of waste have proven to be very fitting principles for healthcare in general and specifically for application in a university hospital. Approaching improvement at a systems level while directly involving the people on the work

  1. Skinner boxes for psychotics: Operant conditioning at Metropolitan state hospital

    OpenAIRE

    Rutherford, Alexandra

    2003-01-01

    Between 1953 and 1965, Ogden Lindsley and his associates conducted free-operant research with psychiatric inpatients and normal volunteers at Metropolitan State Hospital in Waltham, Massachusetts. Their project, originally named “Studies in Behavior Therapy,” was renamed “Harvard Medical School Behavior Research Laboratory” in 1955. This name change and its implications were significant. The role of the laboratory in the history of the relationship between the experimental analysis of behavio...

  2. The Use of Operational Excellence Principles in a University Hospital

    Science.gov (United States)

    Edelman, Eric R.; Hamaekers, Ankie E. W.; Buhre, Wolfgang F.; van Merode, Godefridus G.

    2017-01-01

    The introduction of Operational Excellence in the Maastricht University Medical Center (MUMC+) has been the first of its kind and scale for a university hospital. The policy makers of the MUMC+ have combined different elements from various other business, management, and healthcare philosophies and frameworks into a unique mix. This paper summarizes the journey of developing this system and its most important aspects. Special attention is paid to the role of the operating rooms and the improvements that have taken place there, because of their central role in the working of the hospital. The MUMC+ is the leading tertiary healthcare center for the South-East region of The Netherlands and beyond. Regional, national, and international developments encouraged the MUMC+ to start significantly reorganizing its care processes from 2009 onward. First experiments with Lean Six Sigma and Business Modeling were combined with lessons learned from other centers around the world to form the MUMC+’s own type of Operational Excellence. At the time of writing, many improvement projects of different types have been successfully completed. Every single department in the hospital now uses Operational Excellence and design thinking in general as a method to develop new models of care. An evaluation in 2014 revealed several opportunities for improvement. A large number of projects were in progress, but 75% of all projects had not been completed, despite the first projects being initiated back in 2012. This led to a number of policy changes, mainly focusing on more intensive monitoring of projects and trying to do more improvement projects directly under the responsibility of the line manager. Focusing on patient value, continuous improvement, and the reduction of waste have proven to be very fitting principles for healthcare in general and specifically for application in a university hospital. Approaching improvement at a systems level while directly involving the people on the work

  3. Indoor environmental quality in Hellenic hospital operating rooms

    Energy Technology Data Exchange (ETDEWEB)

    Dascalaki, Elena G.; Gaglia, Athina G.; Balaras, Constantinos A. [Group Energy Conservation, Institute for Environmental Research and Sustainable Development, National Observatory of Athens, I. Metaxa and Vas. Pavlou, GR 152 36 P. Penteli (Greece); Lagoudi, Argyro [Terra Nova Ltd., Environmental Engineering Consultancy, Athens, Kaisareias 39, GR 115 27 Athens (Greece)

    2009-05-15

    Indoor environmental quality (IEQ) in hospital operating rooms (ORs) constitutes a major challenge for the proper design and operation of an energy efficient hospital. A subjective assessment of the indoor environment along with a short monitoring campaign was performed during the audits of 18 ORs at nine major Hellenic hospitals. A total of 557 medical personnel participated in an occupational survey, providing data for a subjective assessment of IEQ in the audited ORs. The OR personnel reported work related health symptoms and an assessment of indoor conditions (thermal, visual and acoustical comfort, and air quality). Overall, personnel reported an average of 2.24 work-related symptoms each, and 67.2% of respondents reported at least one. Women suffer more health symptoms than men. Special dispositions, such as smoking and allergies, increase the number of reported symptoms for male and female personnel. Personnel that perceive satisfactory indoor comfort conditions (temperature, humidity, ventilation, light, and noise) average 1.18 symptoms per person, while for satisfactory indoor air quality the average complaints are 0.99. The perception of satisfactory IEQ (satisfactory comfort conditions and air quality) reduces the average number of health complaints to 0.64 symptoms per person and improves working conditions, even in a demanding OR environment. (author)

  4. Post-operative hospitalization in retinal detachment correlation to recurrences

    Directory of Open Access Journals (Sweden)

    Enzo Maria Vingolo

    2013-12-01

    Full Text Available PURPOSE: To evaluate relationships between the incidence of re-detachment and postoperative days of hospitalization in patients with diagnosis of retinal detachment (RD who underwent surgery either through ab-externo approach (scleral buckling and encircling or ab-interno approach (vitrectomy and oil-gas tamponade. METHODS: This retrospective study included 268 patients (268 eyes with diagnosis of primary RD: 127 males (47% and 141 (53% females, mean age of 64.1 ± 17.3 years. 46 patients (17% underwent a surgical ab-externo approach (group A, while 222 patients (83% underwent an ab-interno surgical approach. Each RD was graded according to the "Retinal detachment grading system of Royal College of Ophthalmologists" and treated within 5 days after diagnosis. The redetachment (RT related to a surgical failure was considered within 30 days after first operation. RESULTS: In the group 1 without night hospitalization (day surgery global RT rate was 3.5% (4.17% for ab-interno technique and 0% for ab-externo techniques. In the group 2 with one day of hospitalization global RT rate was 1.33% (1.49% for ab-interno technique and 0% for ab-externo techniques. In the group 3 with 2 days of hospitalization global RT rate was 3.80% (4.62% for ab-interno techniques and 0% for ab-externo techniques. In the group 4 with 3 or more days of hospitalization global RT rate was 12.28% (14.29% for ab-interno techniques for 6.67% ab-externo techniques. The incidence of RT in group 1, day surgery, is comparable to the other groups and it is less compared to group 4 (3 or more days of hospitalization. CONCLUSIONS: The incidence of retinal redetachment (RRD is not increased in day surgery mode. These data support outpatient management of RD patients to reduce medical cost and problems related to the hospitalization. Further studies are needed for patients' security.

  5. Utilization of operating room time in a cancer hospital

    Directory of Open Access Journals (Sweden)

    P Ranganathan

    2013-01-01

    Full Text Available Background: Appropriate usage of operating room (OR time can improve efficiency of utilization of resources and help to decrease surgical waiting lists. Aims: This study was conducted to evaluate the pattern of usage of OR time in a tertiary referral cancer hospital. Setting and Design: This was a prospective audit carried out over 2 months in 11 major ORs in a cancer hospital. Materials and Methods: OR anesthesiologists filled a standard form for all patients undergoing elective surgery and documented the following times: entry into OR, start of anesthesia, handover to surgeon, incision, start of reversal, end of anesthesia, and shifting out of patient. Statistical Analysis: Median time utilized for various OR processes was calculated. Results: An average of two surgeries were performed per OR session (828 surgeries in 407 OR sessions. Anesthesia and surgery-related processes contributed to 17% and 79%, respectively, of total OR time, with turnover time between cases accounting for the remaining 4%. Fifteen percent (60 out of 407 OR sessions started more than 10 min later than the planned start time, and 17% (70 of 407 of OR sessions ended more than 2 h after the scheduled finish time. An anesthesia procedure room was utilized in only 15% of cases where it could potentially have been used. Conclusion: This audit identified patterns of OR usage in a cancer hospital and helped to detect areas of inefficient utilization. Anesthesia-related processes contributed to 17% of the total OR time.

  6. Teamwork in the operating room: frontline perspectives among hospitals and operating room personnel.

    Science.gov (United States)

    Sexton, J Bryan; Makary, Martin A; Tersigni, Anthony R; Pryor, David; Hendrich, Ann; Thomas, Eric J; Holzmueller, Christine G; Knight, Andrew P; Wu, Yun; Pronovost, Peter J

    2006-11-01

    The Joint Commission on Accreditation of Healthcare Organizations is proposing that hospitals measure culture beginning in 2007. However, a reliable and widely used measurement tool for the operating room (OR) setting does not currently exist. OR personnel in 60 US hospitals were surveyed using the Safety Attitudes Questionnaire. The teamwork climate domain of the survey uses six items about difficulty speaking up, conflict resolution, physician-nurse collaboration, feeling supported by others, asking questions, and heeding nurse input. To justify grouping individual-level responses to a single score at each hospital OR level, the authors used a multilevel confirmatory factor analysis, intraclass correlations, within-group interrater reliability, and Cronbach's alpha. To detect differences at the hospital OR level and by caregiver type, the authors used multivariate analysis of variance (items) and analysis of variance (scale). The response rate was 77.1%. There was robust evidence for grouping individual-level respondents to the hospital OR level using the diverse set of statistical tests, e.g., Comparative Fit Index = 0.99, root mean squared error of approximation = 0.05, and acceptable intraclasss correlations, within-group interrater reliability values, and Cronbach's alpha = 0.79. Teamwork climate differed significantly by hospital (F59, 1,911 = 4.06, P teamwork climate is possible using this psychometrically sound teamwork climate scale. This tool and initial benchmarks allow others to compare their teamwork climate to national means, in an effort to focus more on what excellent surgical teams do well.

  7. Flow analysis of airborne particles in a hospital operating room

    Science.gov (United States)

    Faeghi, Shiva; Lennerts, Kunibert

    2016-06-01

    Preventing airborne infections during a surgery has been always an important issue to deliver effective and high quality medical care to the patient. One of the important sources of infection is particles that are distributed through airborne routes. Factors influencing infection rates caused by airborne particles, among others, are efficient ventilation and the arrangement of surgical facilities inside the operating room. The paper studies the ventilation airflow pattern in an operating room in a hospital located in Tehran, Iran, and seeks to find the efficient configurations with respect to the ventilation system and layout of facilities. This study uses computational fluid dynamics (CFD) and investigates the effects of different inflow velocities for inlets, two pressurization scenarios (equal and excess pressure) and two arrangements of surgical facilities in room while the door is completely open. The results show that system does not perform adequately when the door is open in the operating room under the current conditions, and excess pressure adjustments should be employed to achieve efficient results. The findings of this research can be discussed in the context of design and controlling of the ventilation facilities of operating rooms.

  8. Foodservice employees benefit from interventions targeting barriers to food safety.

    Science.gov (United States)

    York, Valerie K; Brannon, Laura A; Shanklin, Carol W; Roberts, Kevin R; Howells, Amber D; Barrett, Elizabeth B

    2009-09-01

    The number of foodborne illnesses traced to improper food handling in restaurants indicates a need for research to improve food safety in these establishments. Therefore, this 2-year longitudinal study investigated the effectiveness of traditional ServSafe (National Restaurant Association Educational Foundation, Chicago, IL) food-safety training and a Theory of Planned Behavior intervention program targeting employees' perceived barriers and attitudes toward important food-safety behaviors. The effectiveness of the training and intervention was measured by knowledge scores and observed behavioral compliance rates related to food-safety practices. Employees were observed for handwashing, thermometer usage, and proper handling of work surfaces at baseline, after receiving ServSafe training, and again after exposure to the intervention targeting barriers and negative attitudes about food-safety practices. Repeated-measures analyses of variance indicated training improved handwashing knowledge, but the intervention was necessary to improve overall behavioral compliance and handwashing compliance. Results suggest that registered dietitians; dietetic technicians, registered; and foodservice managers should implement a combination of training and intervention to improve knowledge and compliance with food-safety behaviors, rather than relying on training alone. Challenges encountered while conducting this research are discussed, and recommendations are provided for researchers interested in conducting this type of research in the future.

  9. Skinner boxes for psychotics: operant conditioning at Metropolitan State Hospital.

    Science.gov (United States)

    Rutherford, Alexandra

    2003-01-01

    Between 1953 and 1965, Ogden Lindsley and his associates conducted free-operant research with psychiatric inpatients and normal volunteers at Metropolitan State Hospital in Waltham, Massachusetts. Their project, originally named "Studies in Behavior Therapy," was renamed "Harvard Medical School Behavior Research Laboratory" in 1955. This name change and its implications were significant. The role of the laboratory in the history of the relationship between the experimental analysis of behavior and applied behavior analysis is discussed. A case is made for viewing Lindsley's early work as foundational for the subfield of the experimental analysis of human behavior that formally coalesced in the early 1980s. The laboratory's work is also contextualized with reference to the psychopharmacological revolution of the 1950s. Finally, a four-stage framework for studying the historical and conceptual development of behavior analysis is proposed.

  10. Educating Immigrant Hispanic Foodservice Workers about Food Safety Using Visual-Based Training

    Science.gov (United States)

    Rajagopal, Lakshman

    2013-01-01

    Providing food safety training to a diverse workforce brings with it opportunities and challenges that must be addressed. The study reported here provides evidence for benefits of using visual-based tools for food safety training when educating immigrant, Hispanic foodservice workers with no or minimal English language skills. Using visual tools…

  11. Diabetes Preparedness in Schools: What Do Foodservice Personnel Need to Know to Respond?

    Science.gov (United States)

    Grenci, Alexandra

    2009-01-01

    Diabetes is increasing in youth, presenting a serious public health threat. Although type 1 diabetes has historically been more common in children, type 2 diabetes is on the rise, linked to increases in overweight and obesity among American youth, particularly those of high risk racial and ethnic groups. Foodservice personnel, along with other…

  12. School Foodservice Personnel's Struggle with Using Labels to Identify Whole-Grain Foods

    Science.gov (United States)

    Chu, Yen Li; Orsted, Mary; Marquart, Len; Reicks, Marla

    2012-01-01

    Objective: To describe how school foodservice personnel use current labeling methods to identify whole-grain products and the influence on purchasing for school meals. Methods: Focus groups explored labeling methods to identify whole-grain products and barriers to incorporating whole-grain foods in school meals. Qualitative analysis procedures and…

  13. Barriers and Opportunities Related to Whole Grain Foods in Minnesota School Foodservice

    Science.gov (United States)

    Hesse, David; Braun, Curtis; Dostal, Allison; Jeffery, Robert; Marquart, Len

    2009-01-01

    Purpose/Objectives: The purpose of this research was to identify barriers and opportunities associated with the introduction of whole grain foods into school cafeterias. The primary objective was to elicit input from school foodservice personnel (SFP) regarding their experiences in ordering, purchasing, preparing, and serving whole grain foods in…

  14. Whole-Grain Continuing Education for School Foodservice Personnel: Keeping Kids from Falling Short

    Science.gov (United States)

    Roth-Yousey, Lori; Barno, Trina; Caskey, Mary; Asche, Kimberly; Reicks, Marla

    2009-01-01

    Objective: The purpose of this project was to develop and test whole-grain continuing education for school foodservice personnel. Methods: A continuing education program was developed to address planning, purchasing, preparing, and serving whole-grain food in schools. Participants completed a pre-post questionnaire to assess changes in knowledge,…

  15. Diabetes Preparedness in Schools: What Do Foodservice Personnel Need to Know to Respond?

    Science.gov (United States)

    Grenci, Alexandra

    2009-01-01

    Diabetes is increasing in youth, presenting a serious public health threat. Although type 1 diabetes has historically been more common in children, type 2 diabetes is on the rise, linked to increases in overweight and obesity among American youth, particularly those of high risk racial and ethnic groups. Foodservice personnel, along with other…

  16. Work/Life Practices and the Recruitment and Retention of Large School Districts' Foodservice Professionals

    Science.gov (United States)

    Harrison, Mary Kate

    2010-01-01

    With the forthcoming retirement of school foodservice directors, the increasing pressures faced by employees at home and work, and the financial constraints of school districts, recruiting and retaining skilled and diverse employees will be challenging. Marketing work/life benefits to potential employees and supporting these policies to current…

  17. Educating Immigrant Hispanic Foodservice Workers about Food Safety Using Visual-Based Training

    Science.gov (United States)

    Rajagopal, Lakshman

    2013-01-01

    Providing food safety training to a diverse workforce brings with it opportunities and challenges that must be addressed. The study reported here provides evidence for benefits of using visual-based tools for food safety training when educating immigrant, Hispanic foodservice workers with no or minimal English language skills. Using visual tools…

  18. School Foodservice Personnel's Struggle with Using Labels to Identify Whole-Grain Foods

    Science.gov (United States)

    Chu, Yen Li; Orsted, Mary; Marquart, Len; Reicks, Marla

    2012-01-01

    Objective: To describe how school foodservice personnel use current labeling methods to identify whole-grain products and the influence on purchasing for school meals. Methods: Focus groups explored labeling methods to identify whole-grain products and barriers to incorporating whole-grain foods in school meals. Qualitative analysis procedures and…

  19. Whole-Grain Continuing Education for School Foodservice Personnel: Keeping Kids from Falling Short

    Science.gov (United States)

    Roth-Yousey, Lori; Barno, Trina; Caskey, Mary; Asche, Kimberly; Reicks, Marla

    2009-01-01

    Objective: The purpose of this project was to develop and test whole-grain continuing education for school foodservice personnel. Methods: A continuing education program was developed to address planning, purchasing, preparing, and serving whole-grain food in schools. Participants completed a pre-post questionnaire to assess changes in knowledge,…

  20. Barriers and Opportunities Related to Whole Grain Foods in Minnesota School Foodservice

    Science.gov (United States)

    Hesse, David; Braun, Curtis; Dostal, Allison; Jeffery, Robert; Marquart, Len

    2009-01-01

    Purpose/Objectives: The purpose of this research was to identify barriers and opportunities associated with the introduction of whole grain foods into school cafeterias. The primary objective was to elicit input from school foodservice personnel (SFP) regarding their experiences in ordering, purchasing, preparing, and serving whole grain foods in…

  1. Hospital bed ventilation: impact of operation mode on exposure

    DEFF Research Database (Denmark)

    Bolashikov, Zhecho Dimitrov; Melikov, Arsen Krikor; Barova, Mariya

    2014-01-01

    Full-scale measurements were performed in a climate chamber set as a two-bed hospital room with overhead ventilation. Air temperature was kept constant at 22 °C. Two breathing thermal manikins were used to mimic a sick patient lying sideways in one of the beds and a doctor. A thermal dummy mimicked...... a second patient lying in the other bed. The doctor stood up 0.55 m from the bed facing the sick patient. Two pairs of localized ventilation units were attached near the heads of both patients alongside the beds to capture, clean and release the captured exhaled air from the lying patients. When the bed...... and droplet nuclei of less than 3 μm aerodynamic diameter. Two modes of operation of the bed incorporated ventilation unit were tested: releasing the cleaned air upwards (pull mode) or supplying it sideways over the lying patient (“push and pull” mode). The strategy to exhaust pollutants close o release...

  2. An empirical investigation of the effectiveness of contemporary managerial philosophies in a hospital operational setting.

    Science.gov (United States)

    Yasin, Mahmoud M; Zimmerer, Linda W; Miller, Phillip; Zimmerer, Thomas W

    2002-01-01

    The new realities of the healthcare marketplace are forcing healthcare decision makers to implement innovative operational philosophies, techniques, and tools that were proven in other industries to enhance the effectiveness of their organization. This study examines the acceptance and effectiveness of these philosophies, techniques, and tools in a hospital operational setting. The impact of implementation on operational and strategic outcomes is examined for 108 hospitals. Overall, the results of this study appear to indicate that certain quality improvement philosophies, techniques, and tools have been successful when applied in a hospital operational setting.

  3. The Hospitable Meal Model

    DEFF Research Database (Denmark)

    Justesen, Lise; Overgaard, Svend Skafte

    2017-01-01

    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...

  4. Post-operative Nausea and Vomiting at Mulago Hospital

    African Journals Online (AJOL)

    jen

    1Department of Surgery, 2Dept of Anaesthesia Mulago Hospital, Kampala – Uganda ... problem because it is transient and does not carry mortality implications. .... Breast. Others. 45 (50.0). 4 (10.8). 19 (59.4). 3 (25.0). 3 (27.3). 45 (50.0).

  5. Does physician leadership affect hospital quality, operational efficiency, and financial performance?

    Science.gov (United States)

    Tasi, Michael C; Keswani, Aakash; Bozic, Kevin J

    2017-07-11

    With payers and policymakers' focus on improving the value (health outcomes achieved per health care dollar spent) of health care delivery, physicians are increasingly taking on senior leadership/management positions in health care organizations (Carsen & Xia, 2006). Little research has been done to understand the impact of physician leadership on the delivery of care. The aim of this study was to examine whether hospital systems led by physicians were associated with better U.S. News and World Report (USNWR) quality ratings, financial performance, and operating efficiency as compared with those led by nonphysician managers. Cross-sectional analysis of nationally representative data from Medicare Cost Reports and the USNWR on the 115 largest U.S. hospitals was performed. Bivariate analysis of physician-led and non-physician-led hospital networks included three categories: USNWR quality ratings, hospital volume, and financial performance. Multivariate analysis of hospital leadership, percent operating margin, inpatient days per hospital bed, and average quality rating was subsequently performed. Hospitals in physician-led hospital systems had higher quality ratings across all specialties and more inpatient days per hospital bed than did non-physician-led hospitals; however, there were no differences in the total revenue or profit margins between the groups. Physician leadership was independently associated with higher average quality ratings and inpatient days per bed. Large hospital systems led by physicians in 2015 received higher USNWR ratings and bed usage rates than did hospitals led by nonphysicians, with no differences in financial performance. This study suggests that physician leaders may possess skills, qualities, or management approaches that positively affect hospital quality and the value of care delivered. Hospital quality and efficiency ratings vary significantly and can impact consumer decisions. Hospital systems may benefit from the presence of

  6. Exploring perceptions of hospital operations by a modified SERVQUAL approach.

    Science.gov (United States)

    Reidenbach, R E; Sandifer-Smallwood, B

    1990-12-01

    The authors employ a modified SERVQUAL approach to understanding the relationships among patients' perceptions of inpatient, outpatient, and emergency room services and their overall perceptions of service quality, satisfaction with their care, and willingness to recommend the hospital's services to others. Three models of these perceptions and related behavioral variables are developed. Dominating these models is a dimension labeled "patient confidence," which has a significant impact on nearly all measures of patient satisfaction.

  7. Hospital volume and post-operative mortality after resection for gastric cancer

    NARCIS (Netherlands)

    Damhuis, RAM; Meurs, CJC; Dijkhuis, CM; Stassen, LPS; Wiggers, T

    2002-01-01

    Aims: In low-volume hospitals, expertise in gastric surgery is difficult to maintain because of the decreasing incidence of gastric cancer and the fall of surgery for ulcer disease. We evaluated the prognostic impact of hospital volume on post-operative mortality (POM) in a consecutive series of 197

  8. Hospital volume and post-operative mortality after resection for gastric cancer

    NARCIS (Netherlands)

    Damhuis, RAM; Meurs, CJC; Dijkhuis, CM; Stassen, LPS; Wiggers, T

    Aims: In low-volume hospitals, expertise in gastric surgery is difficult to maintain because of the decreasing incidence of gastric cancer and the fall of surgery for ulcer disease. We evaluated the prognostic impact of hospital volume on post-operative mortality (POM) in a consecutive series of

  9. Operational Auditing in, Hospitality Businesses via Data Envelopment Analysis

    Directory of Open Access Journals (Sweden)

    Süleyman Uyar

    2014-12-01

    Full Text Available In today's world, as in almost all sectors, there is intense competition in the tourism sector. Activity levels of accommodation establishments in the tourism sector have a very important place because of competitive market conditions. When it comes to efficiency measurem ent, control activities come to mind. Data Envelopment Analysis (DEA can be used in operational auditing as a tool for performance measurement The purpose of this study is to make the operational auditing activities of accommodation establishments in Alanya with the DEA. In this study, data for the year 2013 of 37 accommodation establishments were evaluated. As input variables, number of rooms, number of beds, the annual average number of employees, annual energy costs and annual food and beverage expenses were used. As output variables; customer satisfaction, the annual number of overnight stays, occupancy rates and room revenues are used. The obtained results show that the accommodation establishments of five are active.

  10. [Comparative study of the operation of two day's Hospitals in Athens].

    Science.gov (United States)

    Mantonakis, J; Karakatsanis, N; Spilioti, E; Karanikoli, I; Stentoumis, C; Stefanis, C

    2014-01-01

    The present paper describes the preparation for the commencement of services by the University Mental Health Research Institute (UMHRI) Day Hospital and Eginition Day Hospital whose operation (in 1977) signifies the beginning of the Psychiatric Reform in our country. The two units' functional characteristics and the type of offered services are mentioned. Psychotherapeutic, biological and sociotherapeutic approaches are practiced on a daily basis within a framework of Therapeutic Community services. Moreover, relations, similarities and differences among the two day hospitals are pointed out. Special mention is given to the problems and difficulties that these two units faced upon their commencement, which took place at different time periods, set 32 years apart. The lack of legislative framework with regards to the operation of Day Hospitals, the bureaucratic obstacles and the skepticism towards the new treatment approach of patients, were the basic obstacles that had to be overcome in order for the first Day Hospital to become operational in 1977. Licensing and funding were the main obstacles that the creation of UMHRI's Day Hospital faced, although these two units had already been established. Emphasis was placed on the staff's training, which mainly consisted of young professionals and at the social environment's and all those services' (health-care, community etc) attitude, in the specific catchment area (6th Mental Health Sector). The study of patients' characteristics hospitalized in Eginition's Day Hospital throughout its first year of operation (1977-1978) and of patients hospitalized at UMHRI's Day Hospital, also at its first year of operation (2009-2010), showed, among other things, that in both cases, the number of hospitalized male patients is larger than the number of female patients. This constitutes an exception compared to other countries, whereby female patients outnumber male patients in Day Hospitals. Especially at UMHRI's Day Hospital, the

  11. The Possibilities of Reducing Food Choice to Improve the Performance of College Foodservices.

    Science.gov (United States)

    Mirosa, Miranda; Loh, Joanne; Spence, Heather

    2016-07-01

    College administrative and management leaders, foodservice personnel, and student residents value social, nutritional, financial, and environmental sustainability in their dining expectations. Menu choice reduction looks promising as a strategy to achieve these goals. However, foodservice research about dominant attitudes across these stakeholders is limited. To identify qualitative views from all stakeholders about choice reduction to ensure that any changes to the meal service are not to the detriment of consumer satisfaction. A comprehensive list of 74 statements representing the spectrum of attitudes surrounding choice was generated by searching a variety of resources, including academic literature and Internet sites, and by conducting semistructured interviews with stakeholders. A final set of 42 statements resulted from researcher scrutiny for optimum balance, clarity, appropriateness, simplicity, and applicability. A new sample of participants was then asked to sort these 42 statements into a normal distribution grid from "strongly disagree" to "strongly agree." A purposive convenience sample of stakeholders (staff n=5 and residents n=4) was used to identify statements about choice reduction. A second sample of stakeholders (staff n=6 and residents n=29) were recruited to sort the final 42 statements. Q methodology analysis techniques were used. This involved conducting a by-person factor analysis, using the centroid factor extraction method because of the permissiveness it allows for data exploration. A varimax factor rotation to enhance interpretability of the results identified shared viewpoints. Three dominant viewpoints toward the possibility of choice reduction in the meal service were identified. Factor 1 was "health driven" (in which healthiness was paramount). Factor 2 was "variety seekers" (in which choice had instrumental value). Factor 3 was "choice lovers" (in which choice had intrinsic value). Although participants could see a number of

  12. COMPARISON OF TWO METHODS OF OPERATING THEATRE PLANNING: APPLICATION IN BELGIAN HOSPITAL

    Institute of Scientific and Technical Information of China (English)

    Sondes CHAABANE; Nadine MESKENS; Alain GUINET; Marius LAURENT

    2008-01-01

    Operating Theatre is the centre of the hospital management's efforts. It constitutes the most expensive sector with more than 10% of the intended operating budget of the hospital. To reduce the costs while maintaining a good quality of care, one of the solutions is to improve the existent planning and scheduling methods by improving the services and surgical specialty coordination or finding the best estimation of surgical case durations. The other solution is to construct an effective surgical case plan and schedule. The operating theatre planning and scheduling is the two important steps, which aim to make a surgical case programming with an objective of obtaining a realizable and efficient surgical case schedule. This paper focuses on the first step, the operating theatre planning problem. Two planning methods are introduced and compared. Real data of a Belgian university hospital "Tivoli" are used for the experiments.

  13. Implementation of a risk management plan in a hospital operating room

    Directory of Open Access Journals (Sweden)

    Li Guo

    2015-12-01

    Full Text Available A risk management program based on AS–NZS4360 risk management standards was developed and implemented in the operating room of Peking University Third Hospital. To accomplish this task, we developed a risk quantification matrix and a risk register form to identify potential risks in the operating room, and then implemented operating room policies designed to reduce or eliminate those risks. We also established a consultation mechanism and risk monitoring system designed to minimize risks to operation room nurses. Finally, we continuously seek to improve our operating room risk management capabilities, so we can continue to improve the quality of service provided and guarantee the safety of surgical patients.

  14. Intervenção nas situações de trabalho em um serviço de nutrição hospitalar e repercussões nos sintomas osteomusculares Intervention in a hospital foodservice and its effects on musculoskeletal symptoms

    Directory of Open Access Journals (Sweden)

    Mitsue Isosaki

    2011-06-01

    Full Text Available OBJETIVO: Analisar as situações de trabalho em serviço de nutrição hospitalar, antes e depois da implantação de ações de intervenções ergonômicas, e seu impacto na prevalência de sintomas osteomusculares relacionados ao trabalho. MÉTODOS: Trata-se de estudo de caso desenvolvido em hospital público especializado em cardiologia, localizado em São Paulo, com a participação de 115 trabalhadores. A abordagem metodológica foi a da Análise Ergonômica do Trabalho e da ergonomia participativa. A coleta de dados foi realizada por meio da aplicação de questionários e da análise ergonômica do trabalho, antes e depois da intervenção. A análise dos dados incluiu testes estatísticos para verificar se houve mudança da prevalência de sintomas antes e depois das intervenções, com nível de significância de 5%, por meio dos Programas Statistical Package for Social Sciences 13.0 e Excel 2003. RESULTADOS: A população constitui-se, em sua maioria, de mulheres, na faixa etária de 25 a 34 anos, com grau médio de escolaridade, casadas, com filhos, e que ocupavam o cargo de atendente de nutrição. Os principais problemas observados foram espaço físico reduzido, equipamentos e materiais de trabalho inadequados, deficit de pessoal, volume excessivo de trabalho com elevado esforço mental e alta prevalência de sintomas osteomusculares, principalmente nos membros inferiores e ombros. Após as intervenções realizadas, houve melhora na situação de trabalho, com redução dos sintomas osteomusculares, bem como os profissionais perceberam mudanças em termos de ambiente físico, equipamentos e organização do trabalho. CONCLUSÃO: As intervenções repercutiram em melhorias, principalmente quanto ao ambiente e equipamentos, e na redução dos sintomas osteomusculares nos membros inferiores, ombros, pescoço/região cervical, antebraço e região lombar, apesar de a redução não ter sido estatisticamente significativa

  15. Application of Boston matrix combined with SWOT analysis on operational development and evaluations of hospital development.

    Science.gov (United States)

    Tao, Z-Q; Shi, A-M

    2016-05-01

    The aim of this study is to explore the application of Boston matrix combined with SWOT analysis on operational development and evaluations of hospital departments. We selected 73 clinical and medical technology departments of our hospital from 2011 to 2013, and evaluated our hospital by Boston matrix combined with SWOT analysis according to the volume of services, medical quality, work efficiency, patients' evaluations, development capacity, operational capability, economic benefits, comprehensive evaluation of hospital achievement, innovation ability of hospital, influence of hospital, human resources of hospital, health insurance costs, etc. It was found that among clinical departments, there were 11 in Stars (22.4%), 17 in cash cow (34.7%), 15 in question marks (31.2%), 6 Dogs (12.2%), 16 in the youth stage of life cycle assessment (27.6%), 14 in the prime stage (24.1%), 12 in the stationary stage (20.7%), 9 in the aristocracy stage (15.5%) and 7 in the recession stage (12.1%). Among medical technology departments, there were 5 in Stars (20.8%), 1 in Cash cow (4.2%), 10 in question marks (41.6%), 8 Dogs (29.1%), 9 in the youth stage of life cycle assessment (37.5%), 4 in the prime stage (16.7%), 4 in the stable stage (16.7%), 1 in the aristocracy stage (4.2%) and 6 in the recession stage (25%). In conclusion, Boston matrix combined with SWOT analysis is suitable for operational development and comprehensive evaluations of hospital development, and it plays an important role in providing hospitals with development strategies.

  16. Use of Visuals for Food Safety Education of Spanish-Speaking Foodservice Workers: A Case Study in Iowa

    Science.gov (United States)

    Rajagopal, Lakshman

    2012-01-01

    Providing food safety training to an audience whose native language is not English is always a challenge. In the study reported here, minimal-text visuals in Spanish were used to train Hispanic foodservice workers about proper handwashing technique and glove use based on the 2005 Food Code requirements. Overall, results indicated that visuals…

  17. Use of Visuals for Food Safety Education of Spanish-Speaking Foodservice Workers: A Case Study in Iowa

    Science.gov (United States)

    Rajagopal, Lakshman

    2012-01-01

    Providing food safety training to an audience whose native language is not English is always a challenge. In the study reported here, minimal-text visuals in Spanish were used to train Hispanic foodservice workers about proper handwashing technique and glove use based on the 2005 Food Code requirements. Overall, results indicated that visuals…

  18. Importance of relationship quality and communication on foodservice for the elderly

    Science.gov (United States)

    Back, Ki Joon; Shanklin, Carol W.

    2011-01-01

    In order to promote foodservice for the elderly, foodservice managers in Continuing Care Retirement Communities (CCRCs) must identify the main factors to enhance the satisfaction and behavioral intentions with food service. The purpose of this study was to investigate the relationships between relationship quality (consisting of trust, commitment, and satisfaction) and communication in the formation of elderly's behavioral intentions with food services at CCRCs. A survey was administered to residents in two CCRCs and a total of 327 residents participated. A tested structural equation model exhibited good model fit and explanatory power of the study construct. Satisfaction directly influenced word-of-mouth and service quality has an influence on commitment. Commitment was a significant determinant of behavioral intentions to eat more often in the dining room. Also, communication showed positive association with trust. The results provided strong evidence for the importance of satisfaction and communication as a consequence of relationship marketing efforts. Suggestions for future research to better understand the elderly' behavioral intention judgments were given. PMID:21487500

  19. Using student opinion and design inputs to develop an informed university foodservice menu.

    Science.gov (United States)

    Feldman, Charles; Harwell, Heather; Brusca, Joseph

    2013-10-01

    The potential for Universities and Colleges to be settings that promote health and wellbeing has become the subject for debate where the role of foodservice has been acknowledged as influential. The aim of this research was to evaluate an effective design to promote healthy selections from university foodservice menus. The research was designed around a grounded theory approach utilizing semiological prompts based on different existing nutrition labeling schemes. A total of 39 students (17 male, 22 female) participated in seven focus groups at Montclair State University, US. The participants of this study clearly called for nutrition labeling on college menus and a prototype design had been agreed. The students also itemized five nutrients they wanted listed in a Traffic Light system of colors and then quantified on the menu: calories, sodium, sugar, fat and carbohydrates, plus beneficial ingredients or nutrients for display in menu icons. The nutrients and display order varies somewhat from industry and government standards, though the student recommendations are suggestive of common understandings of published nutrient guidelines. Students have a stake in how menu information is presented on campus and their opinions could positively impact the general selection of healthy foods. Copyright © 2013 Elsevier Ltd. All rights reserved.

  20. Inventory control system achievement test for dietetics and foodservice management students.

    Science.gov (United States)

    Yang, I S; Fanslow, A M; Finley, D A

    1991-06-01

    The purpose of this study was to develop an inventory control system achievement test that measures cognitive achievement of students in a foodservice management information systems course. We developed a table of specifications for inventory control systems that included the following content areas: receiving, storing, issuing, inventory control, inventory valuation, and inventory control computer systems. We composed 114 test items in a multiple-choice format on the basis of the table of specifications. A sample of 105 students responded to the test; each had previously received 3 hours of instruction on inventory control systems in a foodservice management information systems course. The 50 best items, judged on the basis of item-analysis data and adherence to the table of specification, were selected for the final form of the inventory control system achievement test. The 50-item test was reliable as indicated by a Kuder-Richardson 20 value of .84. The test may be used to evaluate individual student's achievement, to evaluate the effectiveness of instruction, and to compare achievement of different groups.

  1. Menu label accuracy at a university's foodservices. An exploratory recipe nutrition analysis.

    Science.gov (United States)

    Feldman, Charles; Murray, Douglas; Chavarria, Stephanie; Zhao, Hang

    2015-09-01

    The increase in the weight of American adults and children has been positively associated with the prevalence of the consumption of food-away-from-home. The objective was to assess the accuracy of claimed nutritional information of foods purchased in contracted foodservices located on the campus of an institution of higher education. Fifty popular food items were randomly collected from five main dining outlets located on a selected campus in the northeastern United States. The sampling was repeated three times on separate occasions for an aggregate total of 150 food samples. The samples were then weighed and assessed for nutrient composition (protein, cholesterol, fiber, carbohydrates, total fat, calories, sugar, and sodium) using nutrient analysis software. Results were compared with foodservices' published nutrition information. Two group comparisons, claimed and measured, were performed using the paired-sample t-test. Descriptive statistics were used as well. Among the nine nutritional values, six nutrients (total fat, sodium, protein, fiber, cholesterol, and weight) had more than 10% positive average discrepancies between measured and claimed values. Statistical significance of the variance was obtained in four of the eight categories of nutrient content: total fat, sodium, protein, and cholesterol (P nutritional information does not accurately reflect the declared values on menus, conclusions, decisions and actions based on posted information may not be valid.

  2. Association of market, operational, and financial factors with nonprofit hospitals' capital investment.

    Science.gov (United States)

    Kim, Tae Hyun; McCue, Michael J

    2008-01-01

    Capital investments in the latest medical equipment and the replacement of aging facilities are critical decisions for sustaining hospitals' financial viability. A recent survey over the period 1997 to 2001 found that hospitals increased their capital expenditures by only 1%. The aim of this study is to gain insight into the changes in market, operational, and financial factors that may have influenced hospital capital investment during this period. The sample consisted of a panel of nonprofit hospitals operating between 1998 and 2001. Capital investment was measured on the basis of capital purchases for buildings, fixtures, and movable equipment during a fiscal year. The results suggest that liquidity-the availability of internal funds-is a critical determinant of capital investment in both urban and rural facilities. From a market perspective, findings indicate that growth in the over-65 population led to increases in the capital investment of rural hospitals. Financially, an increase in cash flow also was strongly related to a change in capital investment among urban facilities. Surprisingly, rural hospitals with aging plants and equipment had declining capital investment.

  3. Is the system really the solution? Operating costs in hospital systems.

    Science.gov (United States)

    Burns, Lawton Robert; McCullough, Jeffrey S; Wholey, Douglas R; Kruse, Gregory; Kralovec, Peter; Muller, Ralph

    2015-06-01

    Hospital system formation has recently accelerated. Executives emphasize scale economies that lower operating costs, a claim unsupported in academic research. Do systems achieve lower costs than freestanding facilities, and, if so, which system types? We test hypotheses about the relationship of cost with membership in systems, larger systems, and centralized and local hub-and-spoke systems. We also test whether these relationships have changed over time. Examining 4,000 U.S. hospitals during 1998 to 2010, we find no evidence that system members exhibit lower costs. However, members of smaller systems are lower cost than larger systems, and hospitals in centralized systems are lower cost than everyone else. There is no evidence that the system's spatial configuration is associated with cost, although national system hospitals exhibit higher costs. Finally, these results hold over time. We conclude that while systems in general may not be the solution to lower costs, some types of systems are.

  4. The role of non-operating income in community benefit provision by not-for-profit hospitals.

    Science.gov (United States)

    Song, Paula H; McCullough, Jeffrey S; Reiter, Kristin L

    2013-01-01

    Not-for-profit hospitals are under increased public scrutiny for providing what some view as insufficient levels of community benefit compared to their tax-exempt benefits. One potential driver of community benefit is financial surplus, which arises from both patient care (operating) activities and non-patient care (non-operating) activities. This study addresses the effect of hospitals' non-operating income on not-for-profit hospitals' provision of community benefit. The study sample includes 217 unique not-for-profit, non-governmental, general, acute care hospitals in California between 1997 and 2010 that filed annual reports with the California Office of Statewide Health Planning and Development (OSHPD). We model the effect of hospitals' operating and non-operating incomes on hospitals' community benefit, controlling for observable hospital characteristics such as scale and system membership, local competition, time trends, and hospital fixed effects. Our results indicate that non-operating income has no effect on levels of community benefit provided by not-for-profit hospitals. This finding suggests that not-for-profit hospitals budget for uncompensated care at levels that are prioritized over other potential investments if non-operating income falls, but remain fixed if non-operating income rises.

  5. Activity-based costing in the operating room at Valley View Hospital.

    Science.gov (United States)

    Baker, J J; Boyd, G F

    1997-01-01

    This article presents an example of how one hospital reports the results of activity-based costing (ABC). It examines the composition and supporting assumptions of an ABC report for a particular procedure in the operating room (OR). It describes management uses of the information generated. It comments upon how the continuous quality improvement (CQI) is synchronized with the ABC reporting.

  6. Reporting surgical site infections following total hip and knee arthroplasty: impact of limiting surveillance to the operative hospital.

    Science.gov (United States)

    Yokoe, Deborah S; Avery, Taliser R; Platt, Richard; Huang, Susan S

    2013-11-01

    Public reporting of surgical site infections (SSIs) by hospitals is largely limited to infections detected during surgical hospitalizations or readmissions to the same facility. SSI rates may be underestimated if patients with SSIs are readmitted to other hospitals. We assessed the impact of readmissions to other facilities on hospitals' SSI rates following primary total hip arthroplasty (THA) or total knee arthroplasty (TKA). This was a retrospective cohort study of all patients who underwent primary THA or TKA at California hospitals between 1 January 2006 and 31 December 2009. SSIs were identified using ICD-9-CM diagnosis codes predictive of SSI assigned at any California hospital within 365 days of surgery using a statewide repository of hospital data that allowed tracking of patients between facilities. We used statewide data to estimate the fraction of each hospital's THA and TKA SSIs identified at the operative hospital versus other hospitals. A total of 91 121 THA and 121 640 TKA procedures were identified. Based on diagnosis codes, SSIs developed following 2214 (2.3%) THAs and 2465 (2.0%) TKAs. Seventeen percent of SSIs would have been missed by operative hospital surveillance alone. The proportion of hospitals' SSIs detected at nonoperative hospitals ranged from 0% to 100%. Including SSIs detected at nonoperative hospitals resulted in better relative ranking for 61% of THA hospitals and 61% of TKA hospitals. Limiting SSI surveillance to the operative hospital caused varying degrees of SSI underestimation and substantially impacted hospitals' relative rankings, suggesting that alternative methods for comprehensive postdischarge surveillance are needed for accurate benchmarking.

  7. Integration of hospital information systems, operative and peri-operative information systems, and operative equipment into a single information display.

    Science.gov (United States)

    Meyer, Mark; Levine, Wilton C; Brzezinski, Philip; Robbins, Jeffrey; Lai, Fuji; Spitz, Gabriel; Sandberg, Warren S

    2005-01-01

    The integration of disparate information systems in the operative environment allows access to information that is typically unseen or unused. Through a collaborative effort, a variety of information systems and surgical equipment are being integrated. This provides improved context-sensitive information display and decision support and improved access to information to improve workflow, safety and visualization of information that was previously unattainable.

  8. Improving operating room efficiency in academic children's hospital using Lean Six Sigma methodology.

    Science.gov (United States)

    Tagge, Edward P; Thirumoorthi, Arul S; Lenart, John; Garberoglio, Carlos; Mitchell, Kenneth W

    2017-06-01

    Lean Six Sigma (LSS) is a process improvement methodology that utilizes a collaborative team effort to improve performance by systematically identifying root causes of problems. Our objective was to determine whether application of LSS could improve efficiency when applied simultaneously to all services of an academic children's hospital. In our tertiary academic medical center, a multidisciplinary committee was formed, and the entire perioperative process was mapped, using fishbone diagrams, Pareto analysis, and other process improvement tools. Results for Children's Hospital scheduled main operating room (OR) cases were analyzed, where the surgical attending followed themselves. Six hundred twelve cases were included in the seven Children's Hospital operating rooms (OR) over a 6-month period. Turnover Time (interval between patient OR departure and arrival of the subsequent patient) decreased from a median 41min in the baseline period to 32min in the intervention period (p<0.0001). Turnaround Time (interval between surgical dressing application and subsequent surgical incision) decreased from a median 81.5min in the baseline period to 71min in the intervention period (p<0.0001). These results demonstrate that a coordinated multidisciplinary process improvement redesign can significantly improve efficiency in an academic Children's Hospital without preselecting specific services, removing surgical residents, or incorporating new personnel or technology. Prospective comparative study, Level II. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. Nitrous Oxide Levels In Operating and Recovery Rooms of Iranian Hospitals

    Directory of Open Access Journals (Sweden)

    Sh Sadigh Maroufi

    2011-06-01

    Full Text Available "nBackground: Nitrous oxide (N2O is the oldest anesthetic in routine clinical use and its occupational exposure is under regulation by many countries. As studies are lacking to demonstrate the status of nitrous oxide levels in operating and recovery rooms of Iranian hospitals, we aimed to study its level in teaching hospitals of Tehran University of Medical Sciences."nMethods: During a 6-month period, we have measured the shift-long time weighted average concentration of N2O in 43 op­erating and 12 recovery rooms of teaching hospitals of Tehran University of Medical Sciences."nResults: The results show that the level of nitrous oxide in all hospitals is higher than the limits set by different countries and anesthetists are at higher risk of exposure. In addition, it was shown that installation of air ventilation could reduce not only the overall exposure level, but also the level of exposure of anesthetists in comparison with other personnel."nConclusion: The high nitrous oxide level in Iranian hospitals necessitates improvement of waste gas evacuation systems and regular monitoring to bring the concentration of this gas into the safe level.

  10. Air-conditioning vs. presence of pathogenic fungi in hospital operating theatre environment.

    Science.gov (United States)

    Gniadek, Agnieszka; Macura, Anna B

    2011-01-01

    Infections related to modern surgical procedures present a difficult problem for contemporary medicine. Infections acquired during surgery represent a risk factor related to therapeutical interventions. Eradication of microorganisms from hospital operating theatre environment may contribute to reduction of infections as the laminar flow air-conditioning considerably reduces the number of microorganisms in the hospital environment. The objective of the study was to evaluate the occurrence of fungi in air-conditioned operating theatre rooms. The study was carried out in one of the hospitals in Krak6w during December 2009. Indoor air samples and imprints from the walls were collected from five operating theatre rooms. A total of fifty indoor air samples were collected with a MAS-100 device, and twenty five imprints from the walls were collected using a Count Tact method. Fungal growth was observed in 48 air samples; the average numbers of fungi were within the range of 5-100 c.f.u. in one cubic metre of the air. Fungi were detected only in four samples of the wall imprints; the number of fungi was 0.01 c.f.u. per one square centimetre of the surface. The mould genus Aspergillus was most frequently isolated, and the species A. fumigatus and A. versicolor were the dominating ones. To ensure microbiological cleanness of hospital operating theatre, the air-conditioning system should be properly maintained. Domination of the Aspergillus fungi in indoor air as well as increase in the number of moulds in the samples taken in evenings (p < 0.05) may suggest that the room decontamination procedures were neglected.

  11. Hospitals

    Data.gov (United States)

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

  12. Epidemiology of 411 140 cataract operations performed in public hospitals and private hospitals/clinics in Denmark between 2004 and 2012

    DEFF Research Database (Denmark)

    Solborg Bjerrum, Søren; Mikkelsen, Kim Lyngby; la Cour, Morten

    2015-01-01

    PURPOSE: To study the epidemiology and mortality in patients who had cataract surgery in public hospitals and private hospitals/clinics in Denmark between 2004 and 2012 and to assess the validity of the Danish cataract registries. METHODS: Register- and chart-based study. RESULTS: A total of 411...... 140 cataract operations were performed in 243 856 patients. Patients who had cataract surgery in public hospitals had an overall statistically significantly 62% higher mortality compared to patients who had cataract surgery in private hospitals/clinics. The decrease in mean age at first eye cataract...... surgery in private hospitals/clinics was statistically significantly greater compared to the decrease in mean age at first eye cataract surgery in public hospitals (p cataract surgery decreased statistically significantly during the study...

  13. Reliability of the hospital nutrition environment scan for cafeterias, vending machines, and gift shops.

    Science.gov (United States)

    Winston, Courtney P; Sallis, James F; Swartz, Michael D; Hoelscher, Deanna M; Peskin, Melissa F

    2013-08-01

    According to ecological models, the physical environment plays a major role in determining individual health behaviors. As such, researchers have started targeting the consumer nutrition environment of large-scale foodservice operations when implementing obesity-prevention programs. In 2010, the American Hospital Association released a call-to-action encouraging health care facilities to join in this movement and improve their facilities' consumer nutrition environments. The Hospital Nutrition Environment Scan (HNES) for Cafeterias, Vending Machines, and Gift Shops was developed in 2011, and the present study evaluated the inter-rater reliability of this instrument. Two trained raters visited 39 hospitals in southern California and completed the HNES. Percent agreement, kappa statistics, and intraclass correlation coefficients were calculated. Percent agreement between raters ranged from 74.4% to 100% and kappa statistics ranged from 0.458 to 1.0. The intraclass correlation coefficient for the overall nutrition composite scores was 0.961. Given these results, the HNES demonstrated acceptable reliability metrics and can now be disseminated to assess the current state of hospital consumer nutrition environments.

  14. A market, operation, and mission assessment of large rural for-profit hospitals with positive cash flow.

    Science.gov (United States)

    McCue, Michael J

    2007-01-01

    National benchmark data for 2002 indicate that large rural for-profit hospitals have a median cash flow margin of 19.5% compared to 9.2% for their nonprofit counterparts. This study aims to gain insight regarding the driving factors behind the high cash flow performance of large rural for-profit hospitals. Using 3 annual periods of Centers for Medicare and Medicaid cost report data with the last fiscal year ending between September 30, 2002, and August 30, 2003, the study found a cash flow margin of 21.5% for the large rural for-profit hospitals. All these facilities were owned by hospital management companies. To assess their underlying market, operational, and mission factors, these hospitals were compared to a similar comparison group of large rural nonprofit hospitals that are system owned and have positive cash flows. Using logistic regression analysis, the study found lower operating expense per adjusted discharge and salary expense as a percentage of total operating expense among large rural for-profit, system-owned hospitals with positive cash flows relative to nonprofits with similar traits. Overall, the findings of this study reflect how these for-profit hospitals, which are owned by hospital management companies, focus on controlling their labor costs as well as operating costs per discharge in order to achieve a greater positive cash flow position.

  15. [Microbial air purity in hospitals. Operating theatres with air conditioning system].

    Science.gov (United States)

    Krogulski, Adam; Szczotko, Maciej

    2010-01-01

    The aim of this study was to show the influence of air conditioning control for microbial contamination of air inside the operating theatres equipped with correctly working air-conditioning system. This work was based on the results of bacteria and fungi concentration in hospital air obtained since 2001. Assays of microbial air purity conducted on atmospheric air in parallel with indoor air demonstrated that air filters applied in air-conditioning systems worked correctly in every case. To show the problem of fluctuation of bacteria concentration more precisely, every sequences of single results from successive measure series were examined independently.

  16. Prognostic comparison of operative and non-operative therapies for intracerebral hemorrhage in a local hospital: Case retrospection

    Institute of Scientific and Technical Information of China (English)

    Deming Zhao; Zenghong Jiang; Bin Wang

    2006-01-01

    BACKGROUND: At present, it is satisfactory for micro-trauma craniopuncture therapy for cerebral hemor rhage to treat spontaneous intracerebral hemorrhage (ICH). Surgical treatment can decrease fatality rate of ICH patients; however, some reports suggest that there are no obvious differences of therapeutic effects between surgical treatment and medical therapy because of various states, operative indications, contraindi cations and operative styles.OBJECTIVE: To observe the effect of surgical treatment on ICH prognosis, especially on fatality rate. DESIGN: Retrospective-case study.SETTING: Huaibei People's Hospital. PARTICIPANTS: ① A total of 241 ICH patients selected from Huaibei People's Hospital from January 1988 to May 1989 were regarded as group A. They were all coincidence with Diagnostic Criteria of Intracerebral Hemorrhage in the National Cerebrovascular Disease Academic Meeting. There were 154 males and 87 females aged 34-94 years, and among them, 230 patients were older than 50 years (95.4%). Hemorrhage sites: Among 142 patients, 85 cases had internal capsule hemorrhage, 18 external capsule hemorrhage, 15 thalamic hemorrhage, 9 cerebellar hemorrhage, 7 brain stem hemorrhage, 7 cerebral lobe hemorrhage, and 1 corpus callosum hemorrhage. Hemorrhage volume: Among 89 clear records, 44 cases had of 1-10 mL, 35 of 11-30 mL, 5 of 31-40 mL, and 5 of 41-80 mL. Except 2 patients, other ones were treated with medical operation. ② A total of 203 ICH patients selected from the same hospital from January 2003 to December 2005 were regarded as group B. Among them, 72 cases were treated with operation, but other 131 ones were treated with non-operation. They were all diagnosed with CT. There were 113 males and 90 females aged 30-88 years, and among them, 183 patients were older than 50 years (90.1%). Hemorrhage sites: Among 203 patients, 104 cases had internal capsule hemorrhage, 17 external capsule hemorrhage, 19 thalamic hemorrhage, 9 cerebellar hemorrhage, 12 brain

  17. A comparison of food policy and practice reporting between credentialed and noncredentialed Ohio school foodservice directors.

    Science.gov (United States)

    Mincher, Jeanine L; Symons, Cynthia W; Thompson, Amy

    2012-12-01

    With rising childhood obesity rates and the increasing complexity of the school food environment, practitioners working in school nutrition need adequate preparation for their responsibilities. School foodservice directors (SFSDs) vary widely in their academic preparation, and there are no established standards for individuals in this occupation. Credentialing provides a way in which baseline knowledge of SFSDs can be established; however, little is known about the influence of such credentials on food-related policies and practices in public schools. Our cross-sectional study compared the reported food policies and practices between credentialed and noncredentialed SFSDs within all districts (N=364) of the Ohio public school system during the 2009-2010 school year. Using a Likert-type format, policy and practice scores were measured by asking participants to respond to statements adapted from the School Health Index assessment tool. Differences in the policy and practice scores reported by SFSDs holding a food-related credential and those not holding a credential were determined by t test. Results indicated that respondents with a food-related credential were more likely to report both comprehensive food-related policies (14.51 vs 13.39; range=0 to 21) and practices (33.86 vs 32.50; range=0 to 39). These findings support the value of credentialing SFSDs. However, further research is required to establish which credential provides the optimal match in the provision of high quality nutrition care to schoolchildren.

  18. A computer-based decision support system aids distribution in planning and control of foodservices.

    Science.gov (United States)

    Hicks, Z R; Matthews, M E; Norback, J P

    1986-09-01

    Three scenarios, developed from typical situations in the foodservice, were stimulated on the Sperry 1100/80 computer to illustrate how the decision support system assisted dietitians. The scenarios included an analysis of price changes and discounts from a potential vendor; menu planning and pricing for a holiday dinner for 800 to 900 employees; and a comparison of costs between 1 day of meals for a patient on a general and a diabetic diet. In the analysis of price discounts, 1.5 hours were required for finding an acceptable solution using the decision support system. Prices were changed on 349 ingredients; then matrix multiplication within the decision support system resulted in recosting all menu items with those ingredients and provided new prices for cost per meals. Eight new ingredients, 13 menu items, and 2 menu plans for two different holiday meals were entered into the computer; precise amounts and prices for menu items and meals were obtained in 1 hour. Twelve hours was the minimum time estimated for finding a solution by hand calculations. Time to calculate costs of 27 different menu items for one patient day was estimated to be 9 hours manually. With the decision support system, cost comparisons were available in 1 hour. Both the usefulness and the potential of the decision support system were demonstrated.

  19. Co-operation and conflict in a hospital: interprofessional differences in perception and management of conflicts.

    Science.gov (United States)

    Skjørshammer, M

    2001-02-01

    This article presents a case study of a Norwegian hospital, analysing how health professionals manage conflicts related to work co-operation. Altogether, 29 health professionals working in the hospital were interviewed, and data was analysed according to a grounded theory approach. When in conflict, health professionals seem to use three major approaches to handling the situation: avoidance, forcing and negotiation, and usually in that order. Avoidance behaviour or suppression is the most common reaction to an emerging conflict. If the use of power does not re-establish a balance between the participants, one negotiates. These conflict styles seem to be determined by two major factors: the perceived interdependence between parties and the perceived urgency of doing something about the situation. Nurses and physicians in particular seem to differ considerably in their perception of what is a conflict and when to do something about it. Such differences in perceptions and the extensive use of avoidance represent important challenges to managers and clinical leaders when it comes to advancing interprofessional co-operation.

  20. Operative Exposure of a Surgical Trainee at a Tertiary Hospital in Kenya

    Directory of Open Access Journals (Sweden)

    Daniel Kinyuru Ojuka

    2015-01-01

    Full Text Available Background. Psychomotor domain training requires repetitive exposure in order to develop proficiency in skills. This depends on many training factors in any training institution. Objective. This study sought to look at the operative exposure of surgical trainees in a tertiary hospital in a developing country. Design and Setting. This was a six-month retrospective study performed in one surgical firm at Kenyatta National Hospital. Patients and Methods. The files of all patients admitted to the unit at that time were retrieved. The demographics, diagnosis at admission, need for surgery, and cadre of operating surgeon among others were recorded. Scientific Package for Social Sciences (SPSS version 17.0 was used for data entry and analysis. Results. The study cohort was 402 patients of the 757 patients admitted in the study period. The average age was 36.7 years, a female to male ratio of 1 : 2.5. The majority (69.7% of patients required surgery. Trauma was the most common reason for admission (44.5%. Year 2 residents received the most clinical exposure. Consultant was available in only 34.5% of the cases. Conclusion. The junior residents performed the vast majority of procedures with an unsatisfactory amount of supervision from the senior residents and faculty.

  1. hospital

    African Journals Online (AJOL)

    Pattern of congenital orthopaedic malformations in an African teaching hospital ... malformation in this environment while congenital hip dislocation (CDH) is rare when .... malformations of radial dysplasia and other congenital malformations.

  2. St John's Hospital (Morton House), Launceston, Australia: A history of the hospital and Dr William Russ Pugh's first operations under ether.

    Science.gov (United States)

    Haridas, R P; Paull, J D

    2017-03-01

    On 7 June 1847, William Russ Pugh, MD, performed two operations at the St John's Hospital and Self-Supporting Dispensary, Launceston, Tasmania, while his patients were rendered insensible by the inhalation of sulphuric ether. These operations are the earliest documented surgical operations under ether in Australia. St John's Hospital officially opened on 1 September 1845. The hospital may have closed in late 1853 because of financial difficulties. The two-storey Georgian-style building which served as the hospital was completed c1831-1832. It has served as a residence, school, boarding school, hospital, medical consulting rooms and commercial offices. The building is now known as Morton House. We could not identify the date when the name Morton House was adopted, or explain the origin of the name. The earliest identified use of this name is in May 1873 in a newspaper advertisement for boarders. No person with the surname Morton is known to have been associated with the building as an owner or as a tenant. The name Morton House may honour William T.G. Morton, MD, the Boston dentist who performed the first public demonstration of surgical etherisation on 16 October 1846.

  3. Institutional Effectiveness Assessment Process, 1992-93. Executive Summary. Hospitality and Service Occupations Division, Food Sciences Department, Food Production Program, Food Production Management Program, Pastry and Specialty Baking Program.

    Science.gov (United States)

    South Seattle Community Coll., Washington.

    In the 1992-93 academic year, the Hospitality and Food Sciences Department at South Seattle Community College conducted surveys of current and former students and local foodservice employers to determine the level of satisfaction with Department programs. Specifically, the surveys focused on four key outcomes: determining the extent to which…

  4. Associated Roles of Perioperative Medical Directors and Anesthesia: Hospital Agreements for Operating Room Management.

    Science.gov (United States)

    Dexter, Franklin; Epstein, Richard H

    2015-12-01

    As reviewed previously, decision making can be made systematically shortly before the day of surgery based on reducing the hours of overutilized operating room (OR) time and tardiness of case starts (i.e., patient waiting). We subsequently considered in 2008 that such decision making depends on rational anesthesia-hospital agreements specifying anesthesia staffing. Since that prior study, there has been a substantial increase in understanding of the timing of decision making to reduce overutilized OR time. Most decisions substantively influencing overutilized OR time are those made within 1 workday before the day of surgery and on the day of surgery, because only then are ORs sufficiently full that case scheduling and staff assignment decisions affect overutilized OR time. Consequently, anesthesiologists can easily be engaged in such decisions, because generally they must be involved to ensure that the corresponding anesthesia staff assignments are appropriate. Despite this, at hospitals with >8 hours of OR time used daily in each OR, computerized recommendations are superior to intuition because of cognitive biases. Decisions need to be made by a Perioperative Medical Director who has knowledge of the principles of perioperative managerial decision making published in the scientific literature rather than by a committee lacking this competency. Education in the scientific literature, and when different analytical methods should be used, is important. The addition that we make in this article is to show that an agreement between an anesthesia group and a hospital can both reduce overutilized OR time and patient waiting: The anesthesia group and hospital will ensure, hourly, that, when there are case(s) waiting to start, the number of ORs in use for each service will be at least the number that maximizes the efficiency of use of OR time. Neither the anesthesia group nor the hospital will be expected to run more than that number of ORs without mutual agreement

  5. Nivel de formalización de restaurantes de compra media en el mercado de foodservice en Colombia

    OpenAIRE

    2014-01-01

    Los cambios en el estilo de vida del colombiano y el auge del consumo por fuera del hogar, han revestido de gran importancia el mercado de foodservice que se encuentra en desarrollo en Colombia -- Estos cambios han generado una mayor la oferta de restaurantes y por ende exigen cada vez un mejor desempeño y servicio por parte de los mismos -- Siendo los restaurantes de menú fijo de estratos 3 y 4 aquellos que constituyen el mayor número de establecimientos del sector, se hace relevante su anál...

  6. Nivel de formalización de restaurantes de compra media en el mercado de foodservice en Colombia

    OpenAIRE

    Heredia González, María Antonia; Quintero Zuluaga, Natalie

    2014-01-01

    Los cambios en el estilo de vida del colombiano y el auge del consumo por fuera del hogar, han revestido de gran importancia el mercado de foodservice que se encuentra en desarrollo en Colombia -- Estos cambios han generado una mayor la oferta de restaurantes y por ende exigen cada vez un mejor desempeño y servicio por parte de los mismos -- Siendo los restaurantes de menú fijo de estratos 3 y 4 aquellos que constituyen el mayor número de establecimientos del sector, se hace relevante su anál...

  7. 42 CFR 412.75 - Determination of the hospital-specific rate for inpatient operating costs based on a Federal...

    Science.gov (United States)

    2010-10-01

    ... inpatient operating costs based on a Federal fiscal year 1987 base period. 412.75 Section 412.75 Public... hospital-specific rate for inpatient operating costs based on a Federal fiscal year 1987 base period. (a) Base-period costs—(1) General rule. Except as provided in paragraph (a)(2) of this section, for...

  8. Lobotomy at a state mental hospital in Sweden. A survey of patients operated on during the period 1947-1958.

    Science.gov (United States)

    Ogren, Kenneth; Sandlund, Mikael

    2007-01-01

    This retrospective survey aims at describing patients subjected to prefrontal lobotomies and the general treatment conditions at Umedalen State Mental Hospital during the period 1947-1958. Data collected from psychiatric and surgical medical records was analysed using quantitative and qualitative content analysis. A total of 771 patients subjected to lobotomy during the years 1947-1958 were identified. From these, a sample of 105 patients was selected for the purpose of obtaining detailed data on socio-economic status, diagnosis, symptomatology, other psychiatric treatments applied before the pre-frontal lobotomy operation, time spent in hospital before operation, praxis of consent and mortality. The diagnosis of schizophrenia was found in 84% of the 771 lobotomized patients. The post-operative mortality was 7.4% (57 deaths), with the highest rate in 1949 (17%). The mean age of the patient at the time of operation was 44.8 years for females and 39.5 years for male patients. The average length of pre-operative time in hospital for females was 10.7 years and for males 3.5 years. It remains unclear why this mental hospital conducted the lobotomy operation to such a comparatively great extent. Factors such as overcrowding of wards and its status as a modern mental hospital may have contributed.

  9. The effect of introducing a Trauma Network on patient flow, hospital finances and trainee operating.

    Science.gov (United States)

    Hipps, Daniel; Jameson, Simon; Murty, An; Gregory, Rob; Large, David; Gregson, Jackie; Refaie, Ramsay; Reed, Mike

    2015-02-01

    In April 2012 the National Health Service in England introduced the Trauma Network system with the aim of improving the quality of trauma care. In this study we wished to determine how the introduction of the Trauma network has affected patient flow, hospital finances and orthopaedic trauma training across our region. The overall pattern of trauma distribution was not greatly affected, reflecting the relative rarity of major trauma in the UK. A small decrease in the total number of operations performed by trainees was noted in our region. Trainees at units designated as Major Trauma Centres gained slightly more operative experience in trauma procedures overall, and specifically in those associated with high energy, such as long bone nail insertion and external fixation procedures. However, there have been no significant changes in this pattern since the introduction of the Trauma Networks. Falling operative numbers presents a challenge for delivering high quality training within a surgical training programme, and each case should be seen as a vital educational opportunity. Best practice tariff targets for trauma were delivered for 99% of cases at our MTCs. Future audit and review to analyse the evolving role of the MTCs is desirable.

  10. Assessment of operative times of multiple surgical specialties in a public university hospital.

    Science.gov (United States)

    Costa, Altair da Silva

    2017-01-01

    To evaluate the indicators duration of anesthesia, operative time and time patients stay in the operating rooms of different surgical specialties at a public university hospital. It was done by a descriptive cross-sectional study based on the operating room database. The following stages were measured: duration of anesthesia, procedure time and patient length of stay in the room of the various specialties. We included surgeries carried out in sequence in the same room, between 7:00 a.m. and 5 p.m., either elective or emergency. We calculated the 80th percentile of the stages, where 80% of procedures were below this value. The study measured 8,337 operations of 12 surgical specialties performed within one year. The overall mean duration of anesthesia of all specialties was 178.12±110.46 minutes, and the 80th percentile was 252 minutes. The mean operative time was 130.45±97.23 minutes, and the 80th percentile was 195 minutes. The mean total time of the patient in the operating room was 197.30±113.71 minutes, and the 80th percentile was 285 minutes. Thus, the variation of the overall mean compared to the 80th percentile was 41% for anesthesia, 49% for surgeries and 44% for operating room time. In average, anesthesia took up 88% of the operating room period, and surgery, 61%. This study identified patterns in the duration of surgery stages. The mean values of the specialties can assist with operating room planning and reduce delays. Avaliar os indicadores de tempo da anestesia, da operação e da permanência do paciente em sala de diversas especialidades do centro cirúrgico de um hospital universitário. Foi realizado em estudo descritivo transversal a partir da base de dados do centro cirúrgico e mensuradas as seguintes etapas: duração de anestesia, tempo do procedimento e tempo de permanência do paciente em sala das diversas especialidades. Foram incluídas as operações realizadas em sequência na mesma sala, das 7h às 17h, eletivas ou de urg

  11. Advertised sustainability practices among suppliers to a university hospital operating room.

    Science.gov (United States)

    Schieble, Thomas M

    2008-01-01

    The present study aimed to identify firms supplying products to our university operating room (OR) that promote sustainable manufacturing methods. Results show that 72% of our suppliers, or 152 of 211 companies, do not promote sustainability practices in a salient manner. Multi-national firms document sustainability methods significantly more than U.S. divisions of multi-nationals or U.S. firms with chi-square = 157.93 (p sustainability promotion is an important marketing tool through which purchasers may begin the process of due diligence for product selection. Lack of sustainability information among suppliers in this study suggests that hospital procurement departments likely focus solely on issues like price or quality when making purchase decisions. These results also suggest an opportunity for healthcare administrators to evaluate more fully the products involved in the healthcare supply chain; the intrinsic, intangible value added to hospital products through sustainable manufacturing is consistent with responsible patient care and has the potential to create marketing and public relations value.

  12. Improving sustainability during hospital design and operation a multidisciplinary evaluation tool

    CERN Document Server

    Bottero, Marta; Buffoli, Maddalena; Lettieri, Emanuele

    2015-01-01

    This book describes the Sustainable High Quality Healthcare (SustHealth) project, which had the goal of developing an original multidisciplinary evaluation tool that can be applied to assess and improve hospitals’ overall sustainability. The comprehensive nature of the appraisal offered by this tool exceeds the scope of most current rating systems, which typically permit a thorough evaluation of relevant environmental factors when designing a new building but fail to consider social and economic impacts of the design phase or the performance of the hospital’s operational structure in these fields. The multidisciplinary evaluation system was developed, from its very inception through to its testing, by following a scientific experimental method in which a global perspective was constantly maintained, as opposed to a focus only on specific technical issues. Application of the SustHealth rating tool to a currently functioning hospital, or one under design, will identify weaknesses and guide users to potentia...

  13. A statewide consortium of surgical care: a longitudinal investigation of vascular operative procedures at 16 hospitals.

    Science.gov (United States)

    Henke, Peter K; Kubus, Jim; Englesbe, Michael J; Harbaugh, Calista; Campbell, Darrell A

    2010-10-01

    Regional surgical quality improvement consortiums are becoming more common. Herein we have reported the effectiveness of a statewide consortium focusing on open vascular operative procedures. The statewide Michigan Surgical Quality Consortium was established in 2005 with 16 hospitals that report cases of vascular open operative intervention, in a sampling manner consistent with the private sector National Surgical Quality Improvement Program. Data are abstracted by onsite trained nurses using defined and validated pre-, peri-, and postoperative variables with 30-day follow-up. Outpatient and emergent cases were excluded. We compared outcomes over the course of the consortium (era I, April 2005-March 2007; era II, April 2007-March 2008) via univariate and multivariate techniques. Era I (n = 2,453) and era II (n = 3,409) cases were similar in age (mean, 68 years), gender (61% male), relative value units (mean, 21), and distribution of Current Procedural Terminology codes. Duration of stay and operative time decreased by 15% and 11%, respectively, when comparing era I with era II (P cardiac or renal, complications. When evaluating both eras, modifiable variables (able to be altered by the surgeon) for morbidity included increased length of operation (odds ratio [OR], 1.004; 95% confidence interval [CI], 1.003-1.005; P < .0001), hypertension (OR, 1.46; 95% CI, 1.03-2.1; P = .03), and blood transfusion (OR, 2.8; 95% CI, 2.04-3.88; P < .0001). However, anemic patients (11%; hematocrit <30) who were transfused were less likely to suffer morbidity (OR, 56; 95% CI, 0.47-0.67; P < .0001) than those transfused who were not anemic. The absolute 2% reduction in complications led to a $172 cost savings for the payers per patient in era II compared with era I. A statewide quality-of-care consortium with timely feedback of data was associated with decreased morbidity over a relatively short follow-up period in vascular patients. Focusing on best processes in real-world practice

  14. Performance of European system for cardiac operative risk evaluation in Veterans General Hospital Kaohsiung cardiac surgery.

    Science.gov (United States)

    Shih, Hsin-Hung; Kang, Pei-Luen; Pan, Jun-Yen; Wu, Tung-Ho; Wu, Chieh-Ten; Lin, Chun-Yao; Lin, Yu-Hsin; Chou, Wan-Ting

    2011-03-01

    The European System for Cardiac Operative Risk Evaluation (EuroSCORE) model is a widely-used risk prediction algorithm for in-hospital or 30-day mortality in adult cardiac surgery patients. Recent studies indicated that EuroSCORE tends to overpredict mortality. The aim of our study is to evaluate the validity of EuroSCORE in Veterans General Hospital Kaohsiung (VGHKS) cardiac surgery including a number of different surgical and risk subgroups. From January 2006 to December 2009, 1,240 adult patients who underwent cardiac surgery in VGHKS were included in this study. The study was followed the guidelines of the Ethics Committee of Kaohsiung Veterans General Hospital, Taiwan. Both additive and logistic score of all patients were calculated depending on the formula in the official EuroSCORE website. The entire cohort, different surgical type and risk stratification subgroups were analyzed. Model discrimination was tested by determining the area under receiver operating characteristic (ROC) curve. Model calibration was tested by the Hosmer-Lemeshow chi-square test. Clinical performance of model was assessed by comparing the observed and predicted mortality rates. There were significant differences between the VGHKS and European cardiac surgical populations. The additive score and logistic score for the overall group were 7.16% and 12.88%, respectively. Observed mortality was 10.72% overall, 5.68% for isolated coronary artery bypass grafting (CABG), 4.67% for the mitral valve only and 4.25% for the aortic valve only group. The discriminative ability EuroSCORE was very good in all and various surgical subgroups, with area under the ROC curve from 0.75 to 0.87. The addictive and logistic models of EuroSCORE showed excellent accuracy, 0.839 and 0.845, respectively. Good calibration power was recognized by p value higher than 0.05 for the entire cohort and all subgroups of patients except for isolated CABG. The logistic EuroSCORE model overestimated mortality to different

  15. The 1966 enactment of Medicare: its effect on discharges from Los Angeles County-operated hospitals.

    Science.gov (United States)

    Glassman, P A; Bell, R M; Tranquada, R E

    1994-08-01

    The effect of Medicare on two public hospitals in Los Angeles County was analyzed by examining the percentage of patients 65 years of age and older among all discharges from 1958 through 1971. At Harbor General Hospital, discharges of elderly patients had dropped from 21.7% to 7.9% by late 1966; at Los Angeles County General Hospital, discharges decreased from 15.3% to 10.7% between 1966 and 1967. Monitoring public hospitals' demographic changes after enacting a national health plan may provide information on patients' and providers' acceptance of insurance and on resources needed by public hospitals to care for those left without coverage.

  16. Economic analysis of linking operating room scheduling and hospital material management information systems for just-in-time inventory control.

    Science.gov (United States)

    Epstein, R H; Dexter, F

    2000-08-01

    Operating room (OR) scheduling information systems can decrease perioperative labor costs. Material management information systems can decrease perioperative inventory costs. We used computer simulation to investigate whether using the OR schedule to trigger purchasing of perioperative supplies is likely to further decrease perioperative inventory costs, as compared with using sophisticated, stand-alone material management inventory control. Although we designed the simulations to favor financially linking the information systems, we found that this strategy would be expected to decrease inventory costs substantively only for items of high price ($1000 each) and volume (>1000 used each year). Because expensive items typically have different models and sizes, each of which is used by a hospital less often than this, for almost all items there will be no benefit to making daily adjustments to the order volume based on booked cases. We conclude that, in a hospital with a sophisticated material management information system, OR managers will probably achieve greater cost reductions from focusing on negotiating less expensive purchase prices for items than on trying to link the OR information system with the hospital's material management information system to achieve just-in-time inventory control. In a hospital with a sophisticated material management information system, operating room managers will probably achieve greater cost reductions from focusing on negotiating less expensive purchase prices for items than on trying to link the operating room information system with the hospital's material management information system to achieve just-in-time inventory control.

  17. Simulation of operational processes in hospital emergency units as lean healthcare tool

    Directory of Open Access Journals (Sweden)

    Andreia Macedo Gomes

    2017-07-01

    Full Text Available Recently, the Lean philosophy is gaining importance due to a competitive environment, which increases the need to reduce costs. Lean practices and tools have been applied to manufacturing, services, supply chain, startups and, the next frontier is healthcare. Most lean techniques can be easily adapted to health organizations. Therefore, this paper intends to summarize Lean practices and tools that are already being applied in health organizations. Among the numerous techniques and lean tools used, this research highlights the Simulation. Therefore, in order to understand the use of Simulation as a Lean Healthcare tool, this research aims to analyze, through the simulation technique, the operational dynamics of the service process of a fictitious hospital emergency unit. Initially a systematic review of the literature on the practices and tools of Lean Healthcare was carried out, in order to identify the main techniques practiced. The research highlighted Simulation as the sixth most cited tool in the literature. Subsequently, a simulation of a service model of an emergency unit was performed through the Arena software. As a main result, it can be highlighted that the attendants of the built model presented a degree of idleness, thus, they are able to atend a greater demand. As a last conclusion, it was verified that the emergency room is the process with longer service time and greater overload.

  18. Re-admissions, re-operations and length of stay in hospital after aseptic revision knee replacement in Denmark

    DEFF Research Database (Denmark)

    Lindberg-Larsen, M.; Jørgensen, C. C.; Hansen, Torben Bæk

    2014-01-01

    of hospital stay was four days (interquartile range: 3 to 5), with a 90 days re-admission rate of 9.9%, re-operation rate of 3.5% and mortality rate of 0.2%. The age ranges of 51 to 55 years (p = 0.018), 76 to 80 years (p ...-admission. The age ranges of 76 to 80 years (p = 0.018) and the large partial revision subgroup (p = 0.073) were related to an increased risk of re-operation. The ages from 76 to 80 years (p 120 min (p hospital stay...... that a length of hospital stay ≤ four days and discharge home at that time is safe following aseptic knee revision surgery in Denmark....

  19. Virtual subject innovation platform: a new operational pattern for comprehensive hospital.

    Science.gov (United States)

    Xu, Huan; Liu, Yuxiu; Su, Yi; Zhou, Linming; Yang, Guobin; Yi, Xueming

    2012-08-01

    This is a study that describes the prevalence and patterns of constructing virtual subject in hospital in China. It is a high risk for hospital to invest greatly for innovation of hospital disciplines, so we want to establish some new comprehensive platforms which based on some informational systems that involve diseases treatment, medical research, diseases recoveries, prevent diseases and medicine developments. But the virtual subject platform could afford a superior chance for cooperation between interior and exterior medical organizations. This article discusses the subject's structure, the construction's principles, cooperation advantages and clarifies that the platform could boost the efficiency of hospital to do some medical research.

  20. Reasons for cancellation of operation on the day of intended surgery in a multidisciplinary 500 bedded hospital

    Directory of Open Access Journals (Sweden)

    Rajender Kumar

    2012-01-01

    Full Text Available Background: Cancellation of operations in hospitals is a significant problem with far reaching consequences. This study was planned to evaluate reasons for cancellation of elective surgical operation on the day of surgery in a 500 bedded Government hospital. Materials and Methods: The medical records of all the patients, from December 2009 to November 2010, who had their operations cancelled on the day of surgery in all surgical units of the hospital, were audited prospectively. The number of operation cancelled and reasons for cancellation were documented. Results: 7272 patients were scheduled for elective surgical procedures during study period; 1286 (17.6 % of these were cancelled on the day of surgery. The highest number of cancellation occurred in the discipline of general surgery (7.1% and the least (0.35% occurred in Ear-Nose-Throat surgery. The most common cause of cancellation was the lack of availability of theater time 809 (63% and patients not turning up 244 (19% patients. 149 cancellations (11.6% were because of medical reasons; 16 (1.2% were cancelled by the surgeon due to a change in the surgical plan; 28 (2.1% were cancelled as patients were not ready for surgery; and 40 (3.1% were cancelled due to equipment failure.]. Conclusion: Most causes of cancellations of operations are preventable.

  1. Assessment of Operational Maintenance in Public Hospitals Buildings in the Gaza Strip

    Directory of Open Access Journals (Sweden)

    Adnan Enshassi

    2015-01-01

    Full Text Available The issue of public hospitals buildings’ maintenance in Palestine is regarded as a challenging issue. The lack of attention to maintenance management in hospitals has led to deterioration of buildings and reduced the health care services. The aim of this paper is to assess the current practice of maintenance process and management in public hospitals buildings in the Gaza Strip. A questionnaire survey that distributed to 13 public hospitals, which are administered by the Ministry of Health (MoH in the Gaza Strip, was used to collect the primary data for this study. The results of this study present an overview of the current situation of the maintenance process in public hospitals buildings in the Gaza Strip. The findings indicated that while the corrective maintenance is implemented in all the 13 public hospitals, preventive maintenance is employed along with corrective maintenance, only in three hospitals. In addition, the findings indicated variances in responding to maintenance requests, while 50% of the maintenance departments took few hours to respond to maintenance requests, the rest took a few days to respond, this can be explained due to lack of spare parts and qualified staff. The study showed also that there is a shortage in training the hospital facility’s users on how to report maintenance problems. The results of this study indicated that most hospitals in the Gaza Strip have no maintenance plan for medical equipment; they do not have quality control system for repair and preventive maintenance. It is recommended to employ experience maintenance staff in order to prepare adequate maintenance plan and detailed check list, which is required for preventive maintenance. The MoH should organize specialized training courses in maintenance management for their staff in order to improve their effectiveness and efficiency. Hospitals in Gaza should make sure that all spare parts available in their storages for immediate action when

  2. Measuring potential access to food stores and food-service places in rural areas in the U.S.

    Science.gov (United States)

    Sharkey, Joseph R

    2009-04-01

    Geographic access to healthy food resources remains a major focus of research that examines the contribution of the built environment to healthful eating. Methods used to define and measure spatial accessibility can significantly affect the results. Considering the implications for marketing, policy, and programs, adequate measurement of the food environment is important. Little of the published work on food access has focused on rural areas, where the burden of nutrition-related disease is greater. This article seeks to expand our understanding of the challenges to measurement of potential spatial access to food resources in rural areas in the U.S. Key challenges to the accurate measurement of the food environment in rural areas include: (1) defining the rural food environment while recognizing that market factors may be changing; (2) describing characteristics that may differentiate similar types of food stores and food-service places; and (3) determining location coordinates for food stores and food-service places. In order to enhance measurements in rural areas, "ground-truthed" methodology, which includes on-site observation and collection of GPS data, should become the standard for rural areas. Measurement must also recognize the emergence of new and changing store formats. Efforts should be made to determine accessibility, in terms of both proximity to a single location and variety of multiple locations within a specified buffer, from origins other than the home, and consider multipurpose trips and trip chaining. The measurement of food access will be critical for community-based approaches to meet dietary needs. Researchers must be willing to take the steps necessary for rigorous measurement of a dynamic food environment.

  3. Inter-agency communication and operations capabilities during a hospital functional exercise: reliability and validity of a measurement tool.

    Science.gov (United States)

    Savoia, Elena; Biddinger, Paul D; Burstein, Jon; Stoto, Michael A

    2010-01-01

    As proxies for actual emergencies, drills and exercises can raise awareness, stimulate improvements in planning and training, and provide an opportunity to examine how different components of the public health system would combine to respond to a challenge. Despite these benefits, there remains a substantial need for widely accepted and prospectively validated tools to evaluate agencies' and hospitals' performance during such events. Unfortunately, to date, few studies have focused on addressing this need. The purpose of this study was to assess the validity and reliability of a qualitative performance assessment tool designed to measure hospitals' communication and operational capabilities during a functional exercise. The study population included 154 hospital personnel representing nine hospitals that participated in a functional exercise in Massachusetts in June 2008. A 25-item questionnaire was developed to assess the following three hospital functional capabilities: (1) inter-agency communication; (2) communication with the public; and (3) disaster operations. Analyses were conducted to examine internal consistency, associations among scales, the empirical structure of the items, and inter-rater agreement. Twenty-two questions were retained in the final instrument, which demonstrated reliability with alpha coefficients of 0.83 or higher for all scales. A three-factor solution from the principal components analysis accounted for 57% of the total variance, and the factor structure was consistent with the original hypothesized domains. Inter-rater agreement between participants' self reported scores and external evaluators' scores ranged from moderate to good. The resulting 22-item performance measurement tool reliably measured hospital capabilities in a functional exercise setting, with preliminary evidence of concurrent and criterion-related validity.

  4. Plastic surgeons’ self-reported operative infection rates at a Canadian academic hospital

    OpenAIRE

    Ng, Wendy KY; Kaur, Manraj Nirmal; Thoma, Achilleas

    2014-01-01

    The significant morbidity associated with surgical site infections, in addition to increased hospital stays and health care resource utilization, has garnered much attention, especially in the era of cost-conscious health care systems and third-party payers. Although previous studies have investigated hospital-acquired infection rates across all surgical subspecialities, none have focused specifically on plastic surgery procedures. This retrospective study examined surgical site infection dat...

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

    Science.gov (United States)

    2009-09-01

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

  6. The application of DEA (Data Envelopment Analysis) window analysis in the assessment of influence on operational efficiencies after the establishment of branched hospitals.

    Science.gov (United States)

    Jia, Tongying; Yuan, Huiyun

    2017-04-12

    Many large-scaled public hospitals have established branched hospitals in China. This study is to provide evidence for strategy making on the management and development of multi-branched hospitals by evaluating and comparing the operational efficiencies of different hospitals before and after their establishment of branched hospitals. DEA (Data Envelopment Analysis) window analysis was performed on a 7-year data pool from five public hospitals provided by health authorities and institutional surveys. The operational efficiencies of sample hospitals measured in this study (including technical efficiency, pure technical efficiency and scale efficiency) had overall trends towards increase during this 7-year period of time, however, a temporary downturn occurred shortly after the establishment of branched hospitals; pure technical efficiency contributed more to the improvement of technical efficiency compared to scale efficiency. The establishment of branched-hospitals did not lead to a long-term negative effect on hospital operational efficiencies. Our data indicated the importance of improving scale efficiency via the optimization of organizational management, as well as the advantage of a different form of branch-establishment, merging and reorganization. This study brought an insight into the practical application of DEA window analysis on the assessment of hospital operational efficiencies.

  7. The association of debt financing with not-for-profit hospitals' operational and capital-investment efficiency.

    Science.gov (United States)

    Magnus, Stephen A; Wheeler, John R C; Smith, Dean G

    2004-01-01

    Increased debt in companies can motivate both operational and capital-investment efficiency. This positive influence of debt is attributed to creditors' oversight of corporate behavior and the need to generate cash flows to service debt. Our study investigates whether debt has a similar relationship with efficiency in not-for-profit hospitals. Using statistical analysis of a database of audited financial statements of not-for-profit hospitals, we test whether debt is associated with six distinct measures of operational and capital-investment efficiency. We find that debt either has no association with efficiency or predicts decreased efficiency. Possible explanations are that creditors' oversight is less tight in the not-for-profit setting and that debt may at times motivate excessive capital investment because of a legal requirement to tie tax-exempt debt with a capital-investment project.

  8. THE IMPACT OF EFFECTIVE STOCK MANAGEMENT ON THE PROFITABILITY OF THE HOSPITALITY OPERATIONS (A CASE OF CHELSEA HOTEL ABUJA)

    OpenAIRE

    Olawale - Olakunle Olajumoke Elizabeth

    2017-01-01

    This paper examines effective slack management and its impact on the profitability of the hospitality operations. A sound and dynamic stock management strategy is indispensable in contemporary time where aggressive competition for survival is the common business trend coupled with rapid increase in technological acceleration. Secondary sources of data collection were employed to get relevant information. The result reveals that effective stock management is inevitably the bedrock upon which e...

  9. Mobilizing to Re-value and Re-skill Foodservice Labor in U.S. School Lunchrooms: A Pathway to Community-level Food Sovereignty?

    Directory of Open Access Journals (Sweden)

    Jennifer E. Gaddis

    2014-02-01

    Full Text Available School foodservice is a form of reproductive labor, which is a term meant to encompass various kinds of work—mental, manual, and emotional—aimed at providing the historically and socially, as well as biologically, defined care necessary to maintain existing life and to reproduce the next generation. The increasing reliance on part-time work, convenience foods, and privatization that began in the early 1970s prevents many lunchroom workers’ from performing critical acts of reproductive labor. The unintended consequences of this transformation are now becoming clear in terms of the quality of food served in the nation’s lunchrooms, the nature of school foodservice labor, and the ecological consequences of the industrial food system. For a radical food politics, reversing the devaluing and deskilling of school foodservice provides a tremendous opportunity to engage both workers and students in pursuit of a just and sustainable food system. Much is at stake – over thirty million children participate in the National School Lunch Program each day. Thus the critical question becomes one of how such a radical revaluing and reskilling can be initiated. One possible avenue is through organized labor. In this article, I analyze early efforts to drive such a transformation, drawn from twelve months of participatory research with UNITE HERE! during their “Real Food, Real Jobs” campaigns in three U.S. cities.

  10. An application of the MEMbrain training module: Pre-hospital rescue operation

    DEFF Research Database (Denmark)

    Andersen, V.

    1998-01-01

    A system for training in pre-hospital emergency management is being developed and the first version of a prototype has been completed. The training system fulfils the demands from the domain of hospital emergency planning centres and medical attendants concerning increased efficiency of rescue...... efforts. This includes enhanced first aid on site and improved overall co-ordination amongst the organisations involved in coping with emergency situations. The training system is based on the Multi-User System for Training Emergency Response (MUSTER) concept which is used for the training module...... in the decision support system MEMbrain. (C) 1998 Elsevier Science Ltd. All rights reserved....

  11. 42 CFR 413.124 - Reduction to hospital outpatient operating costs.

    Science.gov (United States)

    2010-10-01

    ... surgical center approved surgical procedures performed in the hospital outpatient setting under § 413.118.... 413.124 Section 413.124 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH... RENAL DISEASE SERVICES; OPTIONAL PROSPECTIVELY DETERMINED PAYMENT RATES FOR SKILLED NURSING...

  12. Post operative complications in a dedicated elective orthopaedic hospital: transfers requiring specialist critical care support.

    Science.gov (United States)

    Dawson, P; Daly, A; Lui, D; Butler, J S; Cashman, J

    2015-05-01

    We aim to report our experience with out of hospital transfers for postoperative complications in a stand-alone elective orthopaedic hospital. We aim to describe the cohort of patients transferred, the rate of transfer and assess the risk factors for transfer. Patients were identified who were transferred out of the hospital to another acute hospital for management of non-routine medical problems. Patient data was collected relating to age, BMI, ASA, type of surgery, nature of the complication, timing and the outcome of transfer. In 2012, 2,853 inpatient surgical procedures were carried out, 51 patients (1.8%) developed a postoperative complication that required out of hospital transfer. Mean age of patients transferred was 67 (12-86) years, mean age of the overall case mix 58 years (0-96) (p = 0.01). 37.7% of the overall case mix of surgeries was made up of primary hip and knee arthroplasty procedures, these patients made up 63.7% of patients transferred out (p = 0.001). Mean BMI recorded was 31.7 (22-48) compared to the mean BMI of the total arthroplasty case mix of 28.8 (20-44) (p = 0.02). 59% of all patients at our institution were ASA category II or III. 76% of patients transferred were ASA category II or III (p = 0.005). We can conclude that patients requiring transfer are typically older. Arthroplasty patients are more likely to require transfer than patients undergoing other orthopaedic procedures. Among the arthroplasty cohort transferred patients will typically have a higher BMI than average. Patients with ASA category II or III make up nearly three quarters of those patients transferred. The mean age of patients transferred is typically older by 9 years.

  13. Outcome of 337 intracranial aneurysms patients operated in a public hospital Resultados da cirurgia de 337 pacientes portadores de aneurisma intracraniano operados em um hospital público

    Directory of Open Access Journals (Sweden)

    JOSÉ CARLOS LYNCH

    1998-09-01

    Full Text Available Many recent series of surgery for intracranial aneurysms have been based on experience of developed countries with great resources and a state of art health care. The purpose of the current study is to correlate the outcome of patients operated for intracranial aneurysms. reported from intensive high technology neurosurgical centers with the results of low technology, environment, where we practice. Between January 1986 and December 1996, 337 patients with intracranial aneurysms were operated on at the Servidores do Estado Hospital. We retrospectively reviewed the medical and radiologic records and compared the outcome of this group with other series derived from developed countries. The overall mortality of this series was 6.9%. Of the 313 good grades surgical patients, the mortality was 4.7% and the sucessfull results were obtained in 88.8% individuals. We conclude that patients harboring intracranial aneurysms can be satisfactory handled in less developed nations, if a meticulous intraoperative technique is employed, even though sophisticated technology and equipments are not available.Séries recentes que analisam os resultados da cirurgia de aneurismas intracranianianos são originadas de países com grande desenvolvimento médico e tecnológico. O objetivo do presente estudo é comparar os resultados dessas series com os resultados obtidos por um serviço de neurocirurgia de um hospital público (HSE no Brasil. A mortalidade geral neste estudo foi de 6,9%. Dos 313 bons candidatos cirurgicos, a mortalidade encontrada foi de 4,7%. Neste grupo, 88,8% dos pacientes retornaram a sua vida prévia. Concluímos que pacientes com aneurismas intracranianos podem ser satisfatoriamente tratados em países menos desenvolvidos, se uma técnica cirurgica meticulosa for empregada, mesmo sem dispormos de tecnologia cara e sofisticada.

  14. Post-operative analgesia for major abdominal surgery and its effectiveness in a tertiary care hospital

    Directory of Open Access Journals (Sweden)

    Aliya Ahmed

    2013-01-01

    Conclusion: Epidural, PCIA and opioid infusions are used for pain relief after major abdominal surgeries at our hospital. Although there is limited drug availability, regular assessments and appropriate dose adjustments by acute pain management service (APMS and use of multimodal analgesia led to a high level of patient satisfaction. We recommend that feedback to the primary anesthesiologists by APMS is of utmost importance to enable improvement in practice.

  15. Optimizing Ship-to-Shore Movement for Hospital Ship Humanitarian Assistance Operations

    Science.gov (United States)

    2008-03-01

    Programming – The Global Search.” (2007). ———. Xpress -MP Release 2007 www.dashoptimization.com (accessed March 21, 2008). Department of the Navy...of personnel between T-AH and watercraft. The T-AH HAT model is implemented in Xpress -MP, with a supporting MS- Access database. Our optimized...Governmental Organization (NGO) partners. It has been noted hospital ships may be viewed as offensive participants in the so-called Global War on

  16. Nursing care system development for patients with cleft lip-palate and craniofacial deformities in operating room Srinagarind Hospital.

    Science.gov (United States)

    Riratanapong, Saowaluck; Sroihin, Waranya; Kotepat, Kingkan; Volrathongchai, Kanittha

    2013-09-01

    For a successful surgical outcome for patients with cleft lip/palate (CLP), the attending nurses must continuously develop their potential, knowledge, capacity and skills. The goal is to meet international standards of patient safety and efficiency. To assess and improve the nursing care system for patients with CLP and craniofacial deformities at the operating room (OR), Srinagarind Hospital, Khon Kaen University. Data were collected for two months (between March 1, 2011 and April 30, 2011). Part I was an enquiry regarding the attitude of OR staff on serving patients with CLP; and, Part 2.1) patient and caregiver satisfaction with service from the OR staff and 2.2) patient and caregiver satisfaction with the OR transfer service. The authors interviewed 28 staff in OR unit 2 of the OR nursing division and 30 patients with CLP and his/her caregiver. The respective validity according to the Cronbach's alpha coefficient was 0.87 and 0.93. The OR staff attitude visa-vis service provision for patients with CLP service was middling. Patient and caregiver satisfaction with both OR staff and the transfer service was very satisfactory. Active development of the nursing care system for patients with CLP and craniofacial deformities in the operating room, Srinagarind Hospital improved staff motivation with respect to serving patients with CLP. The operating theater staff was able to co-ordinate the multidisciplinary team through the provision of surgical service for patients with CLP.

  17. Integrating Strategic and Operational Decision Making Using Data-Driven Dashboards: The Case of St. Joseph Mercy Oakland Hospital.

    Science.gov (United States)

    Jack Weiner; Balijepally, Venugopal; Tanniru, Mohan

    2015-01-01

    Hospitals have invested and continue to invest heavily in building information systems to support operations at various levels of administration. These systems generate a lot of data but fail to effectively convert these data into actionable information for decision makers. Such ineffectiveness often is attributed to a lack of alignment between strategic planning and information technology (IT) initiatives supporting operational goals. We present a case study that illustrates how the use of digital dashboards at St. Joseph Mercy Oakland (SJMO) Hospital in Pontiac, Michigan, was instrumental in supporting such an alignment. Driven by a focus on key performance indicators (KPIs), dashboard applications also led to other tangible and intangible benefits. An ability to track KPIs over time and against established targets, with drill-down capabilities, allowed leadership to hold staff members accountable for achieving their performance targets. By displaying the dashboards in prominent locations (such as operational unit floors, the physicians' cafeteria, and nursing stations), SJMO ushered in transparency in the planning and monitoring processes. The need to develop KPI metrics and drive data collection efforts became ingrained in the work ethos of people at every level of the organization. Although IT-enabled dashboards have been instrumental in supporting this cultural transformation, the focus of investment was the ability of technology to make collective vision and action the responsibility of all stakeholders.

  18. Molecular diagnostics for lassa fever at Irrua specialist teaching hospital, Nigeria: lessons learnt from two years of laboratory operation.

    Directory of Open Access Journals (Sweden)

    Danny A Asogun

    Full Text Available BACKGROUND: Lassa fever is a viral hemorrhagic fever endemic in West Africa. However, none of the hospitals in the endemic areas of Nigeria has the capacity to perform Lassa virus diagnostics. Case identification and management solely relies on non-specific clinical criteria. The Irrua Specialist Teaching Hospital (ISTH in the central senatorial district of Edo State struggled with this challenge for many years. METHODOLOGY/PRINCIPAL FINDINGS: A laboratory for molecular diagnosis of Lassa fever, complying with basic standards of diagnostic PCR facilities, was established at ISTH in 2008. During 2009 through 2010, samples of 1,650 suspected cases were processed, of which 198 (12% tested positive by Lassa virus RT-PCR. No remarkable demographic differences were observed between PCR-positive and negative patients. The case fatality rate for Lassa fever was 31%. Nearly two thirds of confirmed cases attended the emergency departments of ISTH. The time window for therapeutic intervention was extremely short, as 50% of the fatal cases died within 2 days of hospitalization--often before ribavirin treatment could be commenced. Fatal Lassa fever cases were older (p = 0.005, had lower body temperature (p<0.0001, and had higher creatinine (p<0.0001 and blood urea levels (p<0.0001 than survivors. Lassa fever incidence in the hospital followed a seasonal pattern with a peak between November and March. Lassa virus sequences obtained from the patients originating from Edo State formed--within lineage II--a separate clade that could be further subdivided into three clusters. CONCLUSIONS/SIGNIFICANCE: Lassa fever case management was improved at a tertiary health institution in Nigeria through establishment of a laboratory for routine diagnostics of Lassa virus. Data collected in two years of operation demonstrate that Lassa fever is a serious public health problem in Edo State and reveal new insights into the disease in hospitalized patients.

  19. Prevalence of Allergy to Natural Rubber Latex and Potential Cross Reacting Food in Operation Room Staff in Shiraz Hospitals -2006

    Directory of Open Access Journals (Sweden)

    H Nabavizade

    2007-07-01

    Full Text Available Introduction & Objective: Allergic reactions to natural rubber latex have increased during past 10 years especially among health care workers and patients with high exposure to latex allergens. Allergic reaction to latex is related to many diseases like occupational asthma. This study was performed to determine the prevalence of allergy to natural rubber latex and potential cross reacting food in operation room staff in Shiraz hospitals. Materials & Methods: In this cross-sectional descriptive study five hundred eighty operation room staff of ten private and state hospitals in Shiraz completed latex allergy questionnaire. They were questioned about personal history and previous history of latex sensitivity, symptoms of latex reactivity and about other allergies particularly to foods that may cross react with latex. Informed consent was obtained and skin prick testing was performed with natural rubber latex. Skin prick tests were done with three potentially cross reacting food (banana, Kiwi, and potato. The obtained data were analyzed with SPSS software and Chi-square test. Results: Among the 580 operation room workers 104 (17.9 % of participants were positive to latex skin test. We found a significant association between positive skin test to latex in operation room staff and atopy, urticaria and food allergy. Positive skin test to latex related to positive kiwi skin test (p<0.05. The prevalence did not vary by sex, age, education, surgical and non surgical glove users, history of contact dermatitis or smoking status. Conclusion: Latex allergy has a high prevalence in personnel of operation room. Evaluation of present symptom and prediction of future disease necessitate screening test in individuals at risk.

  20. Mean sound level in operation rooms in a referral hospital: a brief report

    Directory of Open Access Journals (Sweden)

    Ahmad Joneidi Jafari

    2014-02-01

    Conclusion: Overall total noise dose during all types of surgeries was measured as twice of permitted dose and also orthopedic and general operation rooms experience brief periods of noise exposure in excess.

  1. Operating experiences with rotary air-to-air heat exchangers: hospitals, schools, nursing homes, swimming pools

    Energy Technology Data Exchange (ETDEWEB)

    Pearson, R.J.

    1976-01-01

    Systems utilizing rotary air-to-air heat exchangers are discussed. Basic considerations of use (fresh air requirements, system configurations, cost considerations), typical system layout/design considerations, and operating observations by engineers, staff and maintenance personnel are described.

  2. In-hospital mortality analysis in patients with proximal femoral fracture operatively treated by hip arthroplasty procedure

    Directory of Open Access Journals (Sweden)

    Starčević Srdjan

    2016-01-01

    Full Text Available Background/Aim. Hip fracture remains the leading cause of death in trauma among elderly population and is a great burden to national health services. In-patient death analysis is important to evaluate risk factors, make appropriate selection and perform adequate treatment of infections for patients to be operated. The aim of this study was to analyze in-hospital mortality in proximal femoral fracture patients operatively treated with hip arthroplasty procedure. Methods. We followed 622 consecutive patients, and collected data about age, gender, the presence of infection preoperatively and postoperatively, American Society of Anesthesiologists (ASA score, diabetes mellitus and the type of surgical procedure. Postoperative infections included pneumonia, urinary tract infections, surgical site infections and sepsis. Results. We found a statistically significant influence of preoperative and postoperative infection presence for in-patient mortality with relative risk for lethal outcome of 4.53 (95% CI: 1.44-14.22 for patients with preoperative infection and 7.5 (95% CI: 1.90-29.48 for patients with postoperative infection. We did not confirm a statistically significant influence of age, gender, ASA score, diabetes mellitus or the type of surgical procedure for increased mortality rate. Conclusion. Adequate preoperative selection, risk evaluation and adequate treatment of infections are of the key importance for lowering the risk of death in patients operated due to proximal femoral fracture and treated by hip arthroplasty procedures. Special attention is to be paid for the presence of preoperative and postoperative infections in patients operatively treated due to the risk for increased in-hospital mortality.

  3. [Malaria and post operative fever in the University Hospital Center of Yaounde (Cameroon)].

    Science.gov (United States)

    Takongmo, S; Gaggini, J; Malonga, E; Leundji, H; Same Ekobo, A

    1993-01-01

    This study from a series of 80 patients showed that the prevalence rate of malaria increased from 8% before to 15% after surgery in the tropics. The difference was not significant (p post-operative fever, antimalarial drugs should be prescribed only to patients with a positive thick film.

  4. An Investigation on the Current Status of the Operation Recovery Rooms in Yazd Hospitals in 2010-2011

    Directory of Open Access Journals (Sweden)

    MR Khajeh Aminian

    2012-08-01

    Full Text Available Introduction: The recovery ward is a vital unit to care patients awaking from anesthesia and is a standard requirement for the operating room. Recovery ward is located adjacent to the operation room and is easily accessible to trained and skilled individuals. The unit must have adequate equipment for surveillance and monitoring of patients and required medication should also be provided. Methods: This study is a cross-sectional conducted in one phase through referring to hospital facilities and equipment. Physical space, personnel and their skill levels and other factors that are involved in the care of patients in the recovery have been investigated. The instruments used in this study were a check list and observe sheet which were completed by the researchers. Data analysis was conducted by SPSS software. Results: The results showed that the standards of buildings and physical space in the researched areas were mostly nonstandard. Equipment standards were to some extent in line with the criteria set by American Association of Anesthesia. Besides, some equipment was blow standard levels. Personnel standards regarding the number of nurses toward the number of recovery beds did not meet the standard criteria in most of the cases. Conclusion: The research shows that building standards in most cases are not in line with mentioned references. Undertaking equipment standards in the hospital recovery wards needs reviewing and providing controlling equipment for preventing the complications of recovery phase of anesthesia in recovery wards.

  5. Fresh-Frozen Plasma: Ordering Patterns and Utilization in the Operating Rooms of a Tertiary Referral Hospital.

    Science.gov (United States)

    Meyer, Matthew J; Dzik, Walter H; Levine, Wilton C

    2017-02-01

    Blood product transfusion is the most commonly performed hospital procedure. Intraoperative blood product utilization varies between institutions and anesthesiologists. In the United States in 2011, nearly 4 million plasma units were transfused. A retrospective analysis of intraoperative plasma ordering patterns and utilization (thawing and transfusing) was performed at a tertiary, academic hospital between January 2015 and March 2016. Over 15 months, 46,002 operative procedures were performed. In 1540 of them, plasma was thawed or transfused: 8297 plasma units were thawed and 3306 of those units were transfused. These 3306 plasma units were transfused in 749 cases with a median of 2 plasma units (interquartile range, 2-4) transfused. The percentage of average monthly procedures with plasma thawed and none transfused was 51.3% (confidence interval, 49.0%-53.6%). The cardiac surgery service requested the greatest number of plasma units to be thawed (2143) but only transfused 712 (33.2%) of them. Of all plasma units not transfused, 45% were generated by procedures with 1 to 4 units of plasma thawed; 95.7% of these units were thawed as even integers (ie, 2, 4). For operative procedures, far more plasma was thawed than was transfused and this practice occurred across surgical specialties and anesthesiologists. Considering the plasma that was not transfused, 45% occurred in procedures with 4 or fewer units of plasma requested suggesting these low-volume requests were a primary source of potential waste. Further studies are needed to examine associations between plasma utilization and clinical outcomes.

  6. Depression, C-reactive protein and length of post-operative hospital stay in coronary artery bypass graft surgery patients.

    Science.gov (United States)

    Poole, Lydia; Kidd, Tara; Leigh, Elizabeth; Ronaldson, Amy; Jahangiri, Marjan; Steptoe, Andrew

    2014-03-01

    This study aimed to explore the role of C-reactive protein (CRP) in mediating the association between greater pre-operative depression symptoms and longer post-operative length of stay in patients undergoing coronary artery bypass graft (CABG) surgery. We used a sample of 145 elective CABG patients and measured depression symptoms using the Beck Depression Inventory (BDI) prior to surgery and collected baseline measures of CRP. Participants were followed up during their in-hospital stay to measure early (1-3 days post-surgery) and persistent (4-8 days post-surgery) CRP responses to surgery. We found that compared with participants with low depression symptoms, those with elevated depression symptoms (BDI>10) prior to CABG were at increased odds of a hospital stay of greater than one week (OR 3.51, 95% CI 1.415-8.693, p=0.007) and that greater persistent CRP responses mediated this association. Further work is needed to explore the exact physiological pathways through which depression and CRP interact to affect recovery in CABG patients.

  7. An Analysis of Operating Room Performance Metrics at Reynolds Army Community Hospital

    Science.gov (United States)

    2009-06-28

    the MTF does not receive any performance earnings from workload generated under the Dental inpatient and outpatient codes (CAA5 and ABFA). Also OR...increasing nursing staffing to permit completion of more cases: A case study. Anesthesia & Analgesia , 94(1), 138 - 142. Dexter, F., & Macario, A. (2002...as possible. Anesthesia & Analgesia , 94(5), 1272 - 1279. OR Metrics 54 Dexter, F., Macario, A., Traub, R.D., & Lubarsky, D.A. (2003). Operating room

  8. Frequency of thyroid cancer in patients operated at Cantonal Hospital Zenica, Bosnia and Herzegovina, in the period 2007- 2014

    Directory of Open Access Journals (Sweden)

    Nermin Hrnčić

    2016-08-01

    Full Text Available Aim To determine frequency and type of thyroid cancer (TC as well as gender and age distribution of patients operated at the Department of Ear, Nose and Throat (ENT, Cantonal Hospital Zenica, Bosnia and Herzegovina. Methods A retrospective analysis of data obtained from an operating protocol and disease history of patients operated in the eightyear period (2007- 2014 was made according to the frequency and type of thyroid cancer, as well as age and gender of the patients. χ2 test was used for statistical with p˂0.05. Results A total of 818 surgeries of the thyroid gland were conducted, in 714 (87.29% female and 104 (12.71% male patients. Malignancies were diagnosed in 74 (9.05% patients, of whom 64 (86.49% were females and 10 (13.51% were males, resulting in the gender prevalence of 8.96% and 9.62%, respectively. The most often presented type was papillary carcinoma, in 48 (out of 74, 64.86% patients, followed by follicular carcinoma in 10 (13.51%, medullary carcinoma in four (5.41%, Hurthle cell carcinoma in four (5.41% patients, while anaplastic carcinoma was found in one (1.35% patient. The number of diagnosed malignancy varied from 0% (in 2007 to 13.91% (in 2014 (p=0.05. Conclusion The prevalence of thyroid cancer is low, but has an increasing trend. A large number of unnecessary surgeries on thyroid gland was performed. Preoperative diagnostic procedures for diseases of the thyroid gland in Cantonal Hospital Zenica should be improved in order to avoid unessential surgeries.

  9. The recurrence rate of breast cancer conserving operation in Yokohama Citizen's Hospital

    Energy Technology Data Exchange (ETDEWEB)

    Ishiyama, Akira; Chishima, Takashi; Hayashi, Kazushige; Kito, Fumihiko; Fukushima, Tumeo [Yokohama Municipal Citizen' s Hospital (Japan)

    2000-05-01

    During the last nine year period from Jan. 1991 to Dec. 1999, a total of 615 patients with primary breast cancer were experienced at our hospital. Eighty-eight patients underwent breast conserving therapy, 9 out of 88 patients received radiation therapy after surgical procedures. Recurrence were observed in five patients (5.7%). One of them had skin metastasis which looked like inflammatory breast cancer. This case was treated by postoperative 50 Gy radiation therapy to the remnant breast tissue but was unsuccessful in this case. We believe that postoperative radiation therapy is indicated for breast cancer patients with cancer-positive surgical margin or massive lymph node metastases. The other recurrent cases included one patient with supraclavicular lymph node metastases and three patients with local recurrence of remnant breast tissue cancer as a result of multicentricity. Our five recurrent patients are now alive after the various salvage therapies. Breast conserving therapy without radiation is thought to be useful in certain indicated cases. (author)

  10. PCDD/Fs in soil around a hospital waste incinerator: comparison after three years of operation

    Institute of Scientific and Technical Information of China (English)

    Xiaodong Li; Mi Yan; Jie Yang; Tong Chen; Shengyong Lu; Jianhua Yan

    2012-01-01

    Polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/Fs) can be formed during the cooling of flue gases in waste incinerator.These pollutants are either in the gas phase or attached to the fine particles,escaping dust collection.After stack emission,they are slowly oxidized photochemically (gas phase),or eventually are deposited (dry and wet deposition of particulate) in earth surface.In 2007 and 2010,11 soil samples were collected in the vicinity of a hospital waste incinerator (HWI),prior and after its startup.In order to find out any variation of PCDD/Fs in soil,in brief dioxins,their concentrations were analyzed by high-resolution gas chromatography with high-resolution mass spectrometry (HRGC/HRMS).Compared to the baseline survey (2007),PCDD/Fs in soil significantly increased,by average,+81.6% in total PCDD/Fs and +132.7% in international toxic equivalency (Ⅰ-TEQ) unit.By principal component analysis (PCA),both the PCDD/Fs homologue and the HxCDF isomer profile in soil were found to become more similar with fly ash.Generally,this incinerator influences the soil only in a limited area.More comprehensive supervision,stricter management and more advanced technology should be implemented m this plant to reduce pollutants emission,even though the level of PCDD/Fs in soil is quite low at present.

  11. Resident training in a teaching hospital: How do attendings teach in the real operative environment?

    Science.gov (United States)

    Glarner, Carly E; Law, Katherine E; Zelenski, Amy B; McDonald, Robert J; Greenberg, Jacob A; Foley, Eugene F; Wiegmann, Douglas A; Greenberg, Caprice C

    2017-07-01

    The study aim was to explore the nature of intraoperative education and its interaction with the environment where surgical education occurs. Video and audio recording captured teaching interactions between colorectal surgeons and general surgery residents during laparoscopic segmental colectomies. Cases and collected data were analyzed for teaching behaviors and workflow disruptions. Flow disruptions (FDs) are considered deviations from natural case progression. Across 10 cases (20.4 operative hours), attendings spent 11.2 hours (54.7%) teaching, using directing (M = 250.1), and confirming (M = 236.1) most. FDs occurred 410 times, accounting for 4.4 hours of case time (21.57%). Teaching occurred with FD events for 2.4 hours (22.2%), whereas 77.8% of teaching happened outside FD occurrence. Teaching methods shifted from active to passive during FD events to compensate for patient safety. Understanding how FDs impact operative learning will inform faculty development in managing interruptions and improve its integration into resident education. Copyright © 2016. Published by Elsevier Inc.

  12. An audit of operating room time utilization in a teaching hospital: is there a place for improvement?

    Science.gov (United States)

    Stavrou, George; Panidis, Stavros; Tsouskas, John; Tsaousi, Georgia; Kotzampassi, Katerina

    2014-01-01

    Aim. To perform a thorough and step-by-step assessment of operating room (OR) time utilization, with a view to assess the efficacy of our practice and to identify areas of further improvement. Materials and Methods. We retrospectively analyzed the most ordinary general surgery procedures, in terms of five intervals of OR time utilization: anaesthesia induction, surgery preparation, duration of operation, recovery from anaesthesia, and transfer to postanaesthesia care unit (PACU) or intensive care unit (ICU). According to their surgical impact, the procedures were defined as minor, moderate, and major. Results. A total of 548 operations were analyzed. The mean (SD) time in minutes for anaesthesia induction was 19 (9), for surgery preparation 13 (8), for surgery 115 (64), for recovery from anaesthesia 12 (8), and for transfer to PACU/ICU 12 (9). The time spent in each step presented an ascending escalation pattern proportional to the surgical impact (P = 0.000), which was less pronounced in the transfer to PACU/ICU (P = 0.006). Conclusions. Albeit, our study was conducted in a teaching hospital, the recorded time estimates ranged within acceptable limits. Efficient OR time usage and outliers elimination could be accomplished by a better organized transfer personnel service, greater availability of anaesthesia providers, and interdisciplinary collaboration.

  13. Process frame instances for integrating strategic, tactical and operational information management in hospitals.

    Science.gov (United States)

    Issler, Lutz; Funkat, Gert; Smers, Stefan; Winter, Alfred

    2006-01-01

    An approach to reduce the complexity of information management is to distinguish it into strategic, tactical and operational management with each of the levels using its own software tools. In practice, the management levels are tightly connected and interact closely. The most evident information that has to be interchanged between the management levels is the information about finished, cancelled, running and planned activities or projects, respectively. We claim that the levels of information management should share information about the work done, and propose their integration by means of a network of so-called process frame instances. Process frame instances hold information about the activities of different information management levels in a structured and reusable way.

  14. Microbial contamination of operating Theatre at Ayder Referral Hospital, Northern Ethiopia

    Directory of Open Access Journals (Sweden)

    Tewelde Tesfaye

    2015-10-01

    Full Text Available Background: Microbial contamination of the Operating Theatre (OT had continued to increase the prevalence of nosocomial infections. Aim: This study was conducted to assess the level of microbial contamination and to determine the antimicrobial resistance of the bacterial isolates. Settle plate’s method was used for air sample collection while swab method was used to collect samples from surfaces and other articles in the major OT. Collected samples were transported and microbiologically processed using standard procedures. Findings: One hundred twenty air, 36 article and 12 surface samples were taken for microbiological evaluation. The highest level of microbial contamination was detected in the OT air before proper cleaning-fumigation as compared to after the intervention. Moreover, microbial growth was found on surfaces and semi-critical articles. On the other hand articles which were sterilized by autoclave showed no microbial growth. There were five types of bacteria isolated with the highest prevalence of coagulase negative Staphylococci (68; 53.5% followed by Staphylococcus aureus (42; 33.1%. Methicillin resistance S. aureus (MRSA account for 7.7% of the S. aureus isolates. The highest resistance was found against penicillin G and ampicillin with a resistance rate of 52.7%, and 44.5% respectively. Multidrug resistance was observed among 23(36.5% of the bacterial isolates. Conclusion: In general, the results indicate proper cleaning-fumigation of operating theatre significantly reduced the microbial contamination, and bacterial strains such as CoNS, and S. aureus have a greater propensity to cause contamination in OT. Therefore, efforts should be made to ensure strict infection control practices in the OT.

  15. [Who is suited as operation room manager? Evaluation process for hospitals and candidates].

    Science.gov (United States)

    Schüpfer, G; Bauer, M

    2011-03-01

    Operation room (OR) management is not an end in itself. The challenge is more to organize the complex, inhomogeneous and interference-prone machinery of intraoperative service provision according to business objectives. Although business objectives may differ in some details the ultimate consequence is always to assure the quality of medical care along with adhering to the general economic conditions. The narrower the economic framework the smaller the company's tolerance to unprofessional OR management. Consequently, it can be noticed that OR management has become of age. An internal socialization as frontline leader is no longer sufficient for taking over a job profile which, regarding the risks of revenues and costs belongs to the top management of a company. Prior to looking for a future OR manager it is mandatory to develop a profile of qualifications tailored to the company. In the following selection process the important thing is to identify the candidate who fits best to the developed profile. This paper sees itself as an assistance in the development of such a company-specific qualification profile for an OR manager. On the basis of knowledge, skills and characteristics, different manager typologies are developed, facilitating the successful evaluation in a selection process for both the company and the candidate.

  16. PEST Analysis on Hospital Operation by Society under New Medical Reform%新医改背景下成都市社会办医的PEST分析

    Institute of Scientific and Technical Information of China (English)

    何思长; 高琦; 孙渤星; 陈瑜; 李娇月

    2015-01-01

    With the deepening of new medical reform,our nation encourages hospital operation by social capital, which accelerates various forms of hospital operation. With the encouragement of hospital operation by social capital,the authors make PEST analysis on the factors of politics,economy,society and technology in Chengdu City,put forward coun-termeasures and suggestions in order to promote healthy,orderly and fast development of hospital operation by social cap-ital,establish better structures of hospital operation by social capital and alleviate“difficulty in seeing a doctor and costli-ness in seeking medical treatment”.%随着新医改的深入,国家鼓励和引导社会资本办医,加快了形成多元化办医格局的步伐。笔者在鼓励社会资本办医的大背景下,运用PEST分析方法,对成都市社会办医的政治、经济、社会、技术因素进行分析,并提出对策建议,以期促进成都市社会办医健康、有序、快速发展,更好地形成多元化的办医格局,缓解“看病难、看病贵”。

  17. The impact of audit in a district general hospital on post-operative nausea and vomiting after major gynaecological surgery.

    Science.gov (United States)

    Hadji, F; Eastwood, D; Fear, S; Corfield, H J

    1998-09-01

    An audit of post-operative nausea and vomiting (PONV) was undertaken in 935 female patients who used morphine patient-controlled analgesia (PCA) for pain relief after major gynaecological operations in a district general hospital. We investigated retrospectively five different antiemetic policies and a reference group without policy from January 1993 to July 1995. The department's computerized audit system was used to analyse the observations. At the beginning of the audit, the incidence of nausea and vomiting was as high as 71.5%. But as a consequence of this audit, a departmental policy was adopted 3 years later, which had an incidence of PONV of only 51.7%. During this time the compliance with antiemetic protocols increased from 41% to 76%. There was significantly less PONV if an antiemetic protocol was followed (P = 0.002). This emphasizes the importance of corporate involvement in the development, formulation and evaluation of departmental protocols if compliance is to be high. We conclude that audit as a corporate effort improves the acceptance of departmental protocols. This reduces PONV significantly irrespective of the type of antiemetic drug used.

  18. The relationship between in-hospital mortality, readmission into the intensive care nursing unit and/or operating theatre and nurse staffing levels.

    Science.gov (United States)

    Diya, Luwis; Van den Heede, Koen; Sermeus, Walter; Lesaffre, Emmanuel

    2012-05-01

      The aim of this article was to assess the relationship between (1) in-hospital mortality and/or (2) unplanned readmission to intensive care units or operating theatre and nurse staffing variables.   Adverse events are used as surrogates for patient safety in nurse staffing and patient safety research. A single adverse event cannot adequately capture the multi-dimensional attributes of patient safety; hence, there is a need to consider composite measures. Unplanned readmission into the postoperative Intensive Care nursing unit and/or operating Theatre and in-hospital mortality can be viewed as measures that incorporate the effects of several adverse events.   We conducted a Bayesian multilevel analysis on a subset of the 2003 Belgian Hospital Discharge and Nursing Minimum Data sets. The sample included 9054 patients who underwent coronary artery bypass surgery or heart valve procedures from 28 Belgian acute hospitals. Two proxies of patient safety were considered, namely postoperative in-hospital mortality in the first postoperative intensive care unit and unplanned readmission into the intensive care and/or operating theatre (including mortality beyond the first postoperative intensive care unit) after the first-operative intensive care nursing unit.   There is an association between in-hospital mortality and/or unplanned readmissions and nurse staffing levels, but the relationship is moderated by volume and severity of illness respectively. In addition, the relationship differs between the two endpoints.   Higher nurse staffing levels on postoperative general nursing cardiac surgery units protected patients from unplanned readmission to intensive care units or operating theatre and in-hospital mortality. © 2011 Blackwell Publishing Ltd.

  19. Splenectomy in a Nigerian Teaching Hospital: A comparison of sonographic correlation with intra-operative findings in trauma

    Directory of Open Access Journals (Sweden)

    Oludolapo Afuwape

    2013-01-01

    Full Text Available Background: Missed or inappropriately-treated splenic injury is a significant cause of preventable trauma-related death. Physical examination and abdominal ultrasonography are essential tools for early diagnosis of splenic injury. However, some injuries may not be accurately diagnosed by ultrasonography at initial evaluation. Aim: The aim of this study was to audit indications for splenectomy at the University College Hospital, Ibadan and to compare the intra-operative findings in trauma-related cases with the sonographic findings. Materials and Methods: We retrospectively reviewed all adult (12 years and older patients′ records who had splenectomy between July 2003 and June 2010. The data extracted included patient demographics and indications for splenectomy. In trauma cases, the mode of injury and vital signs at presentation, sonographic findings, and operation findings were recorded. The intervals between injury and sonography and duration to surgery were also noted respectively. Results: Eighty-four patients were reviewed in the 7-year review period. The male to female ratio was approximately 2:1. The ages ranged from 14 to 76 years with a peak incidence in the third decade. Elective indications for splenectomy were 14 (16.6%, while 70 (83.3% were emergency cases. Forty-four of the trauma-related patients had pre-operative abdominal ultrasound, of which 31 (70% was reported as sonographically normal prior to surgery, while the rest of the trauma-related cases were considered too ill for ultrasonography. Conclusion: Potentially significant injuries may be missed with screening sonography. For this reason, a physician must maintain a high index of suspicion and consider the patient′s clinical status or an alternative imaging modality in excluding a diagnosis of splenic injury.

  20. Operating Profitability of For-Profit and Not-for-Profit Florida Community Hospitals During Medicare Policy Changes, 2000 to 2010

    Directory of Open Access Journals (Sweden)

    Barbara Langland-Orban PhD

    2015-08-01

    Full Text Available Medicare Advantage was implemented in 2004 and the Recovery Audit Contractor (RAC program was implemented in Florida during 2005. Both increase surveillance of medical necessity and deny payments for improper admissions. The purpose of the present study was to determine their potential impact on for-profit (FP and not-for-profit (NFP hospital operating margins in Florida. FP hospitals were expected to be more adversely affected as admissions growth has been one strategy to improve stock performance, which is not a consideration at NFPs. This study analyzed Florida community hospitals from 2000 through 2010, assessing changes in pre-tax operating margin (PTOM. Florida Agency for Health Care Administration data were analyzed for 104 community hospitals (62 FPs and 42 NFPs. Academic, public, and small hospitals were excluded. A mixed-effects model was used to assess the association of RAC implementation, organizational and payer type variables, and ownership interaction effects on PTOM. FP hospitals began the period with a higher average PTOM, but converged with NFPs during the study period. The average Medicare Advantage effect was not significant for either ownership type. The magnitude of the RAC variable was significantly negative for average PTOM at FPs (−4.68 and positive at NFPs (0.08, meaning RAC was associated with decreasing PTOM at FP hospitals only. RAC complements other Medicare surveillance systems that detect medically unnecessary admissions, coding errors, fraud, and abuse. Since its implementation in Florida, average FP and NFP operating margins have been similar, such that the higher margins reported for FP hospitals in the 1990s are no longer evident.

  1. Unplanned return to operating room after endovascular repair of abdominal aortic aneurysm (EVAR) is associated with increased risk of hospital readmission.

    Science.gov (United States)

    Aziz, Faisal; Ferranti, Katelynn; Lehman, Erik B

    2017-01-01

    Objectives Hospital readmissions after surgical operations are considered serious events. Centers for Medicare and Medicaid (CMS) consider surgical readmissions as preventable and hold hospitals responsible for them. Endovascular abdominal aortic aneurysm (EVAR) has become the first line modality of treatment for suitable patients with abdominal aortic aneurysm (AAA). The purpose of this study is to retrospectively review the factors associated with hospital readmission after EVAR. Methods The 2013 EVAR targeted American College of Surgeons (ACS-NSQIP) database and generalized 2013 general and vascular surgery ACS-NSQIP participant use files were used for this study. Patient, diagnosis, and procedure characteristics of patients undergoing EVAR surgery were assessed. Multivariate logistic regression analysis was used to determine independent risk factors for hospital readmission within 30 days after surgery. Results A total of 2277 patients (81% males, 19% females) underwent EVAR operations in the year 2013. Indications for operations included: asymptomatic large diameter (79%), symptomatic (5.7%), rupture without hypotension (4.3%), and rupture with hypotension (2.8%). Among these patients, 178 (7.8%) were readmitted to the hospital within 30 days after surgery. About 53% of all readmissions were within two weeks after the discharge. Risk factors, associated with readmission included: body mass index (per 5-units, OR 1.23, CI 1.06-1.42, p return to the operating room (OR 11.29, CI 6.29-20.28, p Risk of readmission for patients with presence of all these seven factors was 99.9%. Conclusions Readmission after EVAR is a serious occurrence. Various factors predispose a patient at a high risk for readmission. Unplanned return to operating room after EVAR is associated with a 11-fold increase in hospital readmission.

  2. Development and implementation of a human accuracy program in patient foodservice.

    Science.gov (United States)

    Eden, S H; Wood, S M; Ptak, K M

    1987-04-01

    For many years, industry has utilized the concept of human error rates to monitor and minimize human errors in the production process. A consistent quality-controlled product increases consumer satisfaction and repeat purchase of product. Administrative dietitians have applied the concepts of using human error rates (the number of errors divided by the number of opportunities for error) at four hospitals, with a total bed capacity of 788, within a tertiary-care medical center. Human error rate was used to monitor and evaluate trayline employee performance and to evaluate layout and tasks of trayline stations, in addition to evaluating employees in patient service areas. Long-term employees initially opposed the error rate system with some hostility and resentment, while newer employees accepted the system. All employees now believe that the constant feedback given by supervisors enhances their self-esteem and productivity. Employee error rates are monitored daily and are used to counsel employees when necessary; they are also utilized during annual performance evaluation. Average daily error rates for a facility staffed by new employees decreased from 7% to an acceptable 3%. In a facility staffed by long-term employees, the error rate increased, reflecting improper error documentation. Patient satisfaction surveys reveal satisfaction, for tray accuracy increased from 88% to 92% in the facility staffed by long-term employees and has remained above the 90% standard in the facility staffed by new employees.

  3. A prospective survey of intra-operative critical incidents in a teaching hospital in a developing country.

    Science.gov (United States)

    Khan, F A; Hoda, M Q

    2001-02-01

    Critical incident monitoring has the advantage of identifying a potential risk to the patient without it necessarily resulting in morbidity. An added advantage in developing countries is the low cost involved in introducing the programme. This paper analyses the incidents reported from the operating room suite in a teaching hospital in a developing country from August 1997 to 31 December 1999. During the period, 20 819 anaesthetics were administered and 329 incidents were reported (1.58% of the cases). Seventy-three per cent of the incidents were reported in patients of ASA grade 1 or 2. Thirty-nine per cent occurred during induction, 51% during maintenance and 10% during emergence. Human error was the cause in 41%, equipment error in 50% and system error in 8.5%. Twenty-two per cent of the incidents resulted in minor, and 13% in major physiological disturbance. The technique has been found useful in identifying trends and selecting issues to be discussed in departmental quality assurance meetings, but requires persistent motivation of the reporting staff.

  4. 军队医院网络安全风险与控制%Security Risk Analysis of Military Hospital Network Security and Practice on Security Operation

    Institute of Scientific and Technical Information of China (English)

    杨俊; 刘敏超

    2015-01-01

    Hospital network is a carrier of hospital information system. Building network security has the proper meaning of military hospital informatization. By analyzing the complexity and security risk of military hospital network, we summarized the network security operation scheme including physical isolation, physical security, access security, internet security, authorization and terminal security in practice.%医院网络是医院信息系统的载体,构建安全网络是军队医院信息化的题中之义。通过分析军队医院网络复杂性及其安全风险,总结我院构建网络隔离、物理安全、接入安全、互联安全、权限管理和终端安全的网络安全运维实践方案。

  5. In-hospital operative mortality of ruptured abdominal aortic aneurysm: a population-based analysis of 5593 patients in The Netherlands over a 10-year period.

    NARCIS (Netherlands)

    Visser, P.; Akkersdijk, G.J.; Blankensteijn, J.D.

    2005-01-01

    OBJECTIVE: To determine the operative mortality of ruptured abdominal aortic aneurysm (RAAA) in The Netherlands. DESIGN: Retrospective population-based study of nation-wide in-hospital mortality of RAAA repair. METHODS: Data were obtained from a national registry for medical diagnosis and

  6. The effect of music on post operative delirium in elder women undergoing hip surgery hospitalized in orthopaedic ward

    Directory of Open Access Journals (Sweden)

    afsaneh Beiranvand

    2007-09-01

    Full Text Available Beiranvand A1, Fallahi M2, Ashayeri H3, Rahgozar M4 1. Instructor, Department of nursing, Faculty of nursing, Lorestan University of medical sciences 2. Assistant professor, Department of nursing, Faculty of nursing, Iran University of medical sciences 3. Associate professor, Department of psychology medicine, Faculty of medicine, Iran University of medical sciences 4. Assistant professor, Department of statistic, Faculty of medicine, Iran University of medical sciences Abstract Background: Usually the incidence rate of delirium after hip surgery in elders is high. It causes several complication,bad prognosis and even mortality. Due to several side effects of drugs, music can be a nonpharmacological unrisk method for prevention of delirium. The purpose of the present study was to determin the effect of music on post operative delirium in elder women who underwent hip surgery hospitalized in orthopaedic ward. Materials and methods: The present study is a semi experimental research. The samples were including 100 old women over 65 years of age with hip fracture in khorramabad Shohada hospital during 4 month. They were allocated according to inclusion criteria and sampling method to 2 equal groups of intervention and control, each with 50 persons. The tools of gathering data were demographic questionnaire, screening questionnaire and mini-mental state examination(MMSE. First, patient`s cognitive state were assessed by MMSE. Music was played for persons in intervention group for 20 minute, three times daily from 1 day before surgery until 4 days after surgery,while participants in the control group received standard care. During the intervention ,patient`s cognitive state was assessed by MMSE two times daily. Then patient`s were divided in 2 groups before and after scores in intervention group were compared. Results: Findings showed that there is significant difference between before and after scores in intervention group(p=0/018. This difference

  7. Forward Surgical Teams provide comparable outcomes to combat support hospitals during support and stabilization operations on the battlefield.

    Science.gov (United States)

    Eastridge, Brian J; Stansbury, Lynn G; Stinger, Harry; Blackbourne, Lorne; Holcomb, John B

    2009-04-01

    Forward Surgical Teams (FST) provide forward deployed surgical care within the battle space. The next level of care in theater, the Combat Support Hospitals (CSH), are distinguished from the FST by advanced resource capabilities including more complex diagnostic imaging, laboratory support with blood banking, and intensive care units. This study was intended to assess the effect of FST capability on the outcome of seriously injured casualties in comparison to the CSH. We reviewed all casualty records in the Joint Theater Trauma Registry database from April 2004 to April 2006. The study cohort included all US military battle casualties who were admitted to either a FST or a CSH and were not returned to duty within 72 hours. Data were tabulated and assessed for basic demographics, mechanism of injury, injury severity score, ventilator and critical care days, and mortality. Statistical inferences were made using Chi square and Student's t tests. As of April 2006, the above information was available in the Joint Theater Trauma Registry on 2,617 US military battle casualties who survived to reach care at a FST and/or CSH. Of this population, 77 subsequently died of wounds and 2,540 survived. We found no significant difference in died of wounds rates between the sample populations or rates of ventilator or critical care days between the two groups, nor did controlling for injury severity score alter this picture. The most significant predictor of mortality in both these groups was head injury. The disparity between the availability of the highest level of injury care and the ability to care for injury as soon as possible is an issue of central importance to both the civilian and military trauma care communities. Our analysis demonstrates that despite the operational and logistic challenges that burden the FST, this level of surgical care confers equivalent battlefield injury outcome results compared with the CSH.

  8. Comparative efficacy assessment of Tramadol versus Morphine for post operative pain relief following abdominal surgery, Shariati Hospital (1999

    Directory of Open Access Journals (Sweden)

    Soroosh AR

    2002-11-01

    Full Text Available Introduction: The objective of the present study is to compare the respiratory function and pain relief of two parenteral analgesics tramadol and morphine under clinical conditions. Materials and Methods: The trial was conducted as an open label-randomized, single center study. The study was performed during 3 months in 1999. In total, 64 patients were enrolled in Shariatie University Hospital, while the other 32 patients were treated with morphine. Results: There were 12 male and 20 female in either groups. The mean age was 48±15 in tramadol versus 43±16 morphine group. Concerning the amount of the medication given to the patients. It would be observed that tramadol patients received 194±72 mg and morphine patients 17±7 mg out of drugs. At study admission vital signs were recorded. The pulse rate, blood pressure and respiratory rate are presented revealing no obvious differences between the treatment groups. There was a broad range regarding the underlying type of operation, however, a laparatomy or a cholecystectomy was performed in 24 (75.0% Vs. 26 (81.3% patients, respectively. All 64 patients were receiving anaesthetics as stipulated in the protocol. Of them being diazepam, sufentanil, succinylcholine chloride and thiopental as the most frequent reported, 4 Vs. 3 patient were given additional fentanylin a mean dosage of 220 mg Vs. 83 mcg. The oxygen saturation was the main safety parameter of the present study. No obvious differences between the two treatment groups can be detected (P<0.472. Primary efficacy end point was the pain assessment. The pain intensity at each scheduled time point was recorded. At study inclusion no differences between the treatment groups uncured, but during the 24 hour observation period the tramadol patients were in advantage (P<0.001. Conclusion: This study shows that long-term efficacy of tramadol is better than morphine.

  9. Study on Performance of Infectious Waste Sterilizing Set in Kashan Shahid Beheshti Hospital and Determination of its Optimum Operating Condition

    Directory of Open Access Journals (Sweden)

    M Heidari

    2012-03-01

    Full Text Available Background and Objectives; Autoclaving is one of  the methods which sterilizes infectious solid wastes. Since variety of parameters such as temperature, time, and pressure influence autoclave performance, this study was carried out to evaluate the parameters and set optimum condition for the autoclave apparatus  applied in Shahid Beheshti Hospital in Kashan.Materials and Methods: In this descriptive-analytical study, the performance of subjected autoclave was surveyed based on biological index and through setting 144 tests. Variables were packaging type in two groups (open and wrapped, loading type in three groups (light, medium and heavy, and four temperature-time features in fixed pressure equal to 101 kpa. Biological index was ATCC 7953 which contained Stearotermophilus Geobacillus spores. Finally obtained results were analyzed by Chi-Square test.Results: The results of statistical test showed that there isnt any meaningful relation between packaging type of waste, system loading, and efficiency of sterilization(P>0.05,while meaningful relation was found between system performance and variety states of temperature-time feature(P<0.05, illustrating temperature and time effects in fixed pressure on sterilization of solid waste.Conclusion: Based on the results, the best autoclave operational condition for sterilizing infectious solid wastes are: temperature-time equal to 10 min-140°C and 15 min-134°C in fixed pressure of 101 kpa, respectively. It was also revealed that temperature-time condition suggested by manufactory, i.e. 20min-121°C, is not sufficient for complete sterilization of solid waste.

  10. A Market, Operation, and Mission Assessment of Large Rural For-Profit Hospitals with Positive Cash Flow

    Science.gov (United States)

    McCue, Michael J.

    2007-01-01

    Context: National benchmark data for 2002 indicate that large rural for-profit hospitals have a median cash flow margin of 19.5% compared to 9.2% for their nonprofit counterparts. Purpose: This study aims to gain insight regarding the driving factors behind the high cash flow performance of large rural for-profit hospitals. Methods: Using 3 annual…

  11. Using Goal Setting, Task Clarification, and Feedback to Increase the Use of the Hands-Free Technique by Hospital Operating Room Staff

    Science.gov (United States)

    Cunningham, Thomas R; Austin, John

    2007-01-01

    We evaluated the effects of a behavioral treatment on the safe passing of sharp instruments using the hands-free technique among hospital operating room personnel during surgical procedures. Treatment consisted of participative goal setting, task clarification, and feedback. The average percentage of sharp instruments passed safely increased from 32% to 64% and 31% to 70% between baseline and treatment phases in the inpatient and outpatient surgery units, respectively. Five-month follow-up data suggested maintenance of treatment effects. These findings suggest the utility of organizational behavior management strategies in reducing risky behavior in hospital settings. PMID:18189098

  12. Evaluation of the five-year operation period of a rapid response team led by an intensive care physician at a university hospital

    Science.gov (United States)

    Mezzaroba, Ana Luiza; Tanita, Marcos Toshiyuki; Festti, Josiane; Carrilho, Claudia Maria Dantas de Maio; Cardoso, Lucienne Tibery Queiroz; Grion, Cintia Magalhães Carvalho

    2016-01-01

    Objective To evaluate the implementation of a multidisciplinary rapid response team led by an intensive care physician at a university hospital. Methods This retrospective cohort study analyzed assessment forms that were completed during the assessments made by the rapid response team of a university hospital between March 2009 and February 2014. Results Data were collected from 1,628 assessments performed by the rapid response team for 1,024 patients and included 1,423 code yellow events and 205 code blue events. The number of assessments was higher in the first year of operation of the rapid response team. The multivariate analysis indicated that age (OR 1.02; 95%CI 1.02 - 1.03; p < 0.001), being male (OR 1.48; 95%CI 1.09 - 2.01; p = 0.01), having more than one assessment (OR 3.31; 95%CI, 2.32 - 4.71; p < 0.001), hospitalization for clinical care (OR 1.77; 95%CI 1.29 - 2.42; p < 0.001), the request of admission to the intensive care unit after the code event (OR 4.75; 95%CI 3.43 - 6.59; p < 0.001), and admission to the intensive care unit before the code event (OR 2.13; 95%CI 1.41 - 3.21; p = 0.001) were risk factors for hospital mortality in patients who were seen for code yellow events. Conclusion The hospital mortality rates were higher than those found in previous studies. The number of assessments was higher in the first year of operation of the rapid response team. Moreover, hospital mortality was higher among patients admitted for clinical care. PMID:27626952

  13. [Conditions for the survival of combat casualties in overseas operations: procedure and experience from the Afghan out-of-hospital theater].

    Science.gov (United States)

    Palmier, Bruno

    2012-01-01

    Recent conflicts have led the French Army Health Service to specify the setting condition for the survival of combat casualties in overseas operations. The majority of them are victims of explosion injuries, and an early and effective control of bleeding is the primary means of improving survival. A procedure called "Combat Rescue" is taught. This chronological procedure favours external haemostasis and led to specific equipment, in particular a tourniquet and a haemostatic bandage of high efficiency. It is applied in recent years on the Afghan out-of-hospital theatre. A very front medical presence, which is systematic during evacuations, is a feature of the French Army Health Service operations support.

  14. Continuous treatment of non-sterile hospital wastewater by Trametes versicolor: How to increase fungal viability by means of operational strategies and pretreatments.

    Science.gov (United States)

    Mir-Tutusaus, J A; Sarrà, M; Caminal, G

    2016-11-15

    Hospital wastewaters have a high load of pharmaceutical active compounds (PhACs). Fungal treatments could be appropriate for source treatment of such effluents but the transition to non-sterile conditions proved to be difficult due to competition with indigenous microorganisms, resulting in very short-duration operations. In this article, coagulation-flocculation and UV-radiation processes were studied as pretreatments to a fungal reactor treating non-sterile hospital wastewater in sequential batch operation and continuous operation modes. The influent was spiked with ibuprofen and ketoprofen, and both compounds were successfully degraded by over 80%. UV pretreatment did not extent the fungal activity after coagulation-flocculation measured as laccase production and pellet integrity. Sequential batch operation did not reduce bacteria competition during fungal treatment. The best strategy was the addition of a coagulation-flocculation pretreatment to a continuous reactor, which led to an operation of 28days without biomass renovation. Copyright © 2016 Elsevier B.V. All rights reserved.

  15. Factors influencing the departure of South African advanced life support paramedics from pre-hospital operational practice

    Directory of Open Access Journals (Sweden)

    Stuart Hackland

    2011-06-01

    Conclusion: Whilst the job of an ALS paramedic is difficult and demanding, it was not operational factors that appeared to cause the majority of ALS paramedics to leave operational practice, but rather organisational and career-based factors. These factors should be addressed in order to improve job satisfaction, with the objective of retaining more operational paramedics for longer.

  16. Difficult points and countermeasures for hospital infection control in operating room%手术室医院感染控制的难点及对策

    Institute of Scientific and Technical Information of China (English)

    冯迎辉

    2011-01-01

    Objective:To solve the difficulties of controlling hospital infection in operating room and give some solutions to this problem in order to improve the quality of nursing. Methods: The problems which found in our hospital in daily work were analyzed, improved and summaried, such as the operating room environment, the management of sterile goods, hand hygiene, movement in the surgery. Results: Cut the way caused the operating room infection, make the indicators of the operating room in the normal range, could avoid the occurrence of various surgical infections and improve the quality of health care. Conclusion: The effective implementations of the operating room disinfection and isolation measures were an important way to control hospital infection.%目的:解决手术室医院感染控制的难点并探讨手术室医院感染控制对策,以提高医疗护理质量.方法:通过我院感染管理科在日常工作中发现的问题,如手术室环境、无菌物品的管理、手卫生、手术中人员流动、各项感染措施及各项制度的落实等找出原因进行分析、整改和总结.结果:切断了引起手术室医院感染的途径,使手术室的各项指标在正常范围,避免了各项手术感染的发生,提高了医院的医疗护理质量.结论:有效地落实手术室消毒隔离措施是控制医院感染的重要途径.

  17. Type and Concentration of Bioaerosols in the Operating Room of Educational Hospitals of Hamadan University of Medical Sciences and Effectiveness of Ventilation Systems, in Year 2004

    Directory of Open Access Journals (Sweden)

    F. Ghorbani Shahna

    2006-07-01

    Full Text Available Introduction & Objective: The bioaerosol is one of the operating room(OR hazards that can be threaten of personel health and capable to creating of postoperetive infection in the patients. Because of the hospital infection rate has correleted to bioaerosol concentration, therefore, it is important to determine of type and concentration of these microorganisms as the main goal of this study. Materials and Methods: In this research, 23 operation rooms in the 4 educational hospitals of the Hamadan City were studied. 115 air samples were collected in the various locations and conditions according to filtration method suggested by bioaerosol committee of ACGIH. The samples were transported to blood agar and cultivated immediatedly. The type and number of colonies were determined in the laberatory then, the bioaerosol concentration were calculated in terms of cfu/m3. The data of physical conditions of ORs , ventilation specifications and other environmental parameters have been recorded in the work sheet.Results: The results have demonstrated that the mean of total bioaerosol and pathogen bioaerosol concentration were 136 cfu/m3 and 4.01 cfu/m3 respectively. The concentration of 25.3% of the total pathogen samples be exceeded of recommended limit. It is apeared that have been correlation between concentration of bioaerosols and duration of surgry (P<0.05, also the concentration of morninig shift were higher than the other shifts(P<0.05.Conclusion: According to the detected bioaerosols pathogens in the samples, high cleaning class in the operating rooms is necessary. It is necessary to design and administrate the ventilation systems according to standards because of the absence of appropriate ventilation system in the three hospitals of four investigated hospitals.

  18. Risk Control of Public Hospital's Operating Deficit%公立医院负债经营的风险规制

    Institute of Scientific and Technical Information of China (English)

    敖检根; 万贻平

    2012-01-01

    Public hospital is in the rapid growth of new period, faring lo meet the pressing fund demand, bank loans and other funding breakthrough in the development of hospital capital "bottleneck". But the excessive debt management will also bring risks. First of all the article learned about public hospital liabilities of ihe business situation. Then, it analyzes the liabilities of the operating system. Behavior Anomie performance. Ami unalysis of public hospitals needs to guard against the- financial liability management, market risk. Finally, from the angle of construction of the public hospital liability risk analysis index system and early warning mechanism, and strict control of infrastructure construction and configuration of large medical equipment, am! So on to search for the indebted management risk regulation strategy, in order to promote the harmonious, healthy and sustainable development of hospital.%公立医院处于快速发展的新时期,面对迫切的资金需求,银行贷款等资金的注入突破了医院发展中的资金“瓶颈”,但过度负债经营也将带来风险.本文通过了解公立医院负债经营的现状,分析了负债经营的制度、行为等失范的表现,探析了公立医院负债经营需要防范的财务、市场等风险,从构建公立医院负债风险分析指标体系及预警机制、严格控制基础设施建设和大型医用设备配置等视角,探寻其负债经营的风险规制策路,以促进医院协调、健康和可持续发展.

  19. Operative Time, Airway Management, Need for Blood Transfusions, and In-Hospital Stay for Bimaxillary, Intranasal, and Osseous Genioplasty Surgery: Current Clinical Practices.

    Science.gov (United States)

    Posnick, Jeffrey C; Choi, Elbert; Chavda, Anish

    2016-03-01

    The purpose of this study was to assess operative time, perioperative airway management, early postoperative cardiopulmonary health, need for blood transfusion, and in-hospital stay associated with simultaneous bimaxillary, intranasal, and osseous genioplasty surgery. The authors executed a retrospective cohort study derived from patients treated by 1 surgeon at a single institution from 2009 through 2014. The sample consisted of a consecutive series of patients with symptomatic chronic obstructed nasal breathing and a dentofacial deformity (DFD). All underwent at least a Le Fort I osteotomy, sagittal ramus osteotomies, septoplasty, inferior turbinate reduction, and osseous genioplasty. For each patient, the design of the osteotomies and the fixation techniques were consistent. The outcome variables included need for blood transfusion, operating time, success of nasotracheal intubation, time and place of extubation, early postoperative cardiopulmonary health, length of in-hospital stay, and need for readmission after surgery. For the 166 patients studied, the average age was 25 years (range, 13 to 65 yr; 87 female patients [52%]). The primary patterns of presenting DFD included long face (43 of 166, 26%), maxillary deficiency (41 of 166, 25%), asymmetric mandibular excess (37 of 166, 22%), short face (28 of 166, 17%), and mandibular deficiency (15 of 166, 9%). Forty-two patients (25%) were confirmed to have symptomatic obstructive sleep apnea. The open wound operating time averaged 2 hours 59 minutes (standard deviation, 32 minutes). Only 3 of the 166 patients (1.8%) received blood transfusions. All patients underwent successful nasotracheal intubation. Ninety-six percent of patients were extubated in the operating room and the remaining 4% were extubated in the recovery room. No patients required reintubation or tracheostomy. One hundred thirty-seven patients (83%) were discharged after a 1- or 2-night in-hospital stay. Twenty-five (15%) required a 3-night stay

  20. Evaluation Of Factors Influencing On Causes Of Prosthetic Valve Re-operation And Early Postoperative Survival Tehran Emam hospital (1991-2001

    Directory of Open Access Journals (Sweden)

    Rahmani Reaza

    2003-06-01

    Full Text Available Prosthetic valve re-operation has greater mortality and morbidity than primary valve replacement. By recognition of factors influencing on causes of redo operation and preoperative survival, one can select appropriate prosthesis at primary valve replacement and when operation performed at appropriate time, surgical risk can be reduced."nMethods and Materials: Two hundred patients that underwent prosthetic valve re-operation from October 1991 through November 2001 were included in this study. There were 68 men and 132 women with the mean age of 42:tl 1.8 years. Structural failure was the commonest cause of bio-prosthesis replacement (93%. Valve thrombosis was the common cause of mechanical valve replacement (32%. Age younger Than 50 (P= 0.01 and interval after the first implantation more than 10 years (P= 0.01 affected bio-prosthesis degeneration."nResults: Atrial fibrillation (P<0.01, Older age especially more than 40 (P<0.05 and mitral position (P<0.01 affected mechanical valve thrombosis. Cross clamp time (P= 0.005, Tricuspid insufficiency (P = 0.001, NYHA IV (P = 0.005 and emergent operation (P= 0.001 were independent determinants of hospital mortality."nConclusion: In conclusion, in patients with more than 10-years life expectancy and age younger than 50, mechanical valve can be selected for primary valve replacement. If operation performed before patients reach deteriorated condition, preoperative survival would be excellent.

  1. Food security practice in Kansas schools and health care facilities.

    Science.gov (United States)

    Yoon, Eunju; Shanklin, Carol W

    2007-02-01

    This pilot study investigated perceived importance and frequency of specific preventive measures, and food and nutrition professionals' and foodservice directors' willingness to develop a food defense management plan. A mail questionnaire was developed based on the US Department of Agriculture document, Biosecurity Checklist for School Foodservice Programs--Developing a Biosecurity Management Plan. The survey was sent to food and nutrition professionals and foodservice operators in 151 acute care hospitals, 181 long-term-care facilities, and 450 school foodservice operations. Chemical use and storage was perceived as the most important practice to protect an operation and was the practice implemented most frequently. Results of the study indicate training programs on food security are needed to increase food and nutrition professionals' motivation to implement preventive measures.

  2. Performance of the Operating Room Personnel in following of the standards of Infection Control in the Educational Hospitals of Yasuj University of Medical Sciences in 2009

    Directory of Open Access Journals (Sweden)

    A Rostaminejad

    2011-04-01

    Full Text Available Introduction & Objective: Surgical wound infection is one of the common nosocomial infections. During operation, members of the surgical team which are in contact with the tissue incision should observe the standards of infection control in the operating room since it has a great role in prevention and control of these infections. The present study aimed to determine the performance of the operating room personnel in observing the standards of infection control in educational hospitals of Yasuj University of Medical Sciences in 2009. Materials & Methods: Forty two operating room personnel participated in this cross-sectional analytic-descriptive study. A check list was used for unnoticeably collecting the data about the performance of personnel in respect of infection control standards at three different times. Their performances were classified into four levels (very weak, weak, moderate and good and the results were shown as absolute and relative frequency distribution. Data were analyzed using Chi-square and Fischer exact test by the SPSS software. Results: Performance of personnel in following the standards of infection control in this study was moderate. Conclusion: The results indicate that the participants of the study do not follow some of the standards of infection control in the operating rooms. Therefore, further activities of the committees of infection control and using of new antiseptic for surgical scrub are recommended.

  3. Analysis of Bacterial Contamination in Anesthetic Equipments in Operation Room of Vali-E-Asr Hospital of Fasa; Efficiency of Disinfection Methods

    Directory of Open Access Journals (Sweden)

    Abbas Abdollahi

    2011-09-01

    Full Text Available Background & Objectives: Anesthetic equipments could be one of the factors transmitting infection in a surgical operation. We could be prevent infection transmission to a great extend, by providing efficient methods of disinfection of anesthetic equipments. The purpose of the present research is to analyze the bacterial contamination in anesthetic equipment in operation rooms of Vali-e-Asr hospital in Fasa city, Fars province, and evaluate the efficiency of the applied disinfection methods. Materials & Methods: In this cross-sectional & analytical study, sampling from anesthetic equipment was done by sterile swap and culture on nutrient media, irregularly and randomly, before and after using and washing tools. Used anesthetic equipment in such operation rooms have been washed with Betadine 7.5% by experts and technicians of anesthetic section and were prepared for the next operation. Results: Total contamination was 2.3% in 210 samples taken. 5 culture items indicated the existence of bacterial contamination, among which 2 contamination cases were observed in nasal airway (coagulase negative Staphylococcus, non pathogen Neisseria, 2 contamination cases in red rubber endotracheal tube (nonpathogen Neisseria and Klebsiella pneumonia and 1 contamination case in oxygen mask (Escherichia coli. Conclusion: The very low level of contamination (20-85% contamination in anesthetic equipments in our research is probably due to application of a appropriate disinfection method used by educated personnel in operation rooms. This could have a significant role in decreasing the infection rate in one hand and decreasing expenses and time on the other hand.

  4. A Study on the Frequency and the Reasons for Cancellation of Surgical Operations in Khatam Hospital (Mashhad, Iran in 2013

    Directory of Open Access Journals (Sweden)

    Hossein Ebrahimipour

    2014-10-01

    Conclusion: In a high percentage of canceled cases, the reasons of operation cancellations had not been mentioned in the patient’s file. A significant portion of theses cancellations can be attributed to the patients' incomplete cooperation.  Cancellations can be significantly reduced through providing the patient with enough instructions and explanations.

  5. Paper-Based Medical Records: the Challenges and Lessons Learned from Studying Obstetrics and Gynaecological Post-Operation Records in a Nigerian Hospital

    Directory of Open Access Journals (Sweden)

    Adekunle Yisau Abdulkadir

    2010-10-01

    Full Text Available AIM: With the background knowledge that auditing of Medical Records (MR for adequacy and completeness is necessary if it is to be useful and reliable in continuing patient care; protection of the legal interest of the patient, physicians, and the Hospital; and meeting requirements for researches, we scrutinized theatre records of our hospital to identify routine omissions or deficiencies, and correctable errors in our MR system. METHOD: Obstetrics and Gynaecological post operation theatre records between January 2006 and December 2008 were quantitatively and qualitatively analyzed for details that included: hospital number; Patients age; diagnosis; surgery performed; types and modes of anesthesia; date of surgery; patients’ ward; Anesthetists names; surgeons and attending nurses names, and abbreviations used with SPSS 15.0 for Windows. RESULTS: Hardly were any of the 1270 surgeries during the study period documented without an omission or an abbreviation. Hospital numbers and patients’ age were not documented in 21.8% (n=277 and 59.1% (n=750 respectively. Diagnoses and surgeries were recorded with varying abbreviations in about 96% of instances. Surgical team names were mostly abbreviated or initials only given. CONCLUSION: To improve the quality of Paper-based Medical Record, regular auditing, training and good orientation of medical personnel for good record practices, and discouraging large volume record book to reduce paper damages and sheet loss from handling are necessary else what we record toady may neither be useful nor available tomorrow. [TAF Prev Med Bull 2010; 9(5.000: 427-432

  6. [Localization Establishment of an Interdisciplinary Intervention Model to Prevent Post-Operative Delirium in Older Patients Based on 'Hospital Elder Life Program'].

    Science.gov (United States)

    Wang, Yan-Yan; Liao, Yu-Lin; Gao, Lang-Li; Hu, Xiu-Ying; Yue, Ji-Rong

    2017-06-01

    Postoperative delirium is a significant complication in elderly patients. The occurrence of delirium may increase the related physical and psychological risks, delay the length of hospital stays, and even lead to death. According to the current evidence-based model, the application of interdisciplinary intervention may effectively prevent delirium, shorten the length of hospital stays, and save costs. To establish a culturally appropriate interdisciplinary intervention model for preventing postoperative delirium in older Chinese patients. The authors adapted the original version of the Hospital Elder Life Program (HELP©) from the Hebrew Senior Life Institute for Aging Research of Harvard University by localizing the content using additional medical resources and translating the modified instrument into Chinese. Furthermore, the final version of this interdisciplinary intervention model for postoperative delirium was developed in accordance with the "guideline of delirium: diagnosis, prevention and management produced by the National Institute for Health and Clinical Excellence in 2010" and the "clinical practice guideline for postoperative delirium in older adults" produced by American geriatrics society in 2014. Finally, the translated instrument was revised and improved using discussions, consultations, and pilot study. The abovementioned procedure generated an interdisciplinary intervention model for preventing postoperative delirium that is applicable to the Chinese medical environment. The content addresses personnel structure and assignment of responsibility; details of interdisciplinary intervention protocols and implementation procedures; and required personnel training. The revised model is expected to decrease the occurrence of post-operative delirium and other complications in elderly patients, to help them maintain and improve their function, to shorten the length of their hospital stays, and to facilitate recovery.

  7. [The Mini Nutritional Assessment of the elderly in the practice of a hospital geriatrics service: inception, validation and operational characteristics].

    Science.gov (United States)

    Cuyac Lantigua, Magdalena; Santana Porbén, Sergio

    2007-09-01

    The results of the administration of the Mini Nutritional Assessment (MNA) of the Elderly to 197 patients (Women: 62.5%; Ages between 60-75 years: 55.4%; Older than 85 years: 9.7%; Whites: 73.7%) consecutively admitted to the Geriatrics Service of the "Hermanos Ameijeiras" Hospital (La Habana, Cuba) are presented. Sixty-nine percent of the patients had between 2 - 7 concurrent health problems. Neoplasms and lymphoproliferative processes (22.8%), heart and blood vessels diseases (15.7%), and infections (12.2%) were prevalent. The state of nutritional anthropometric and biochemical markers was as follows: Body Mass Index < 21 kg x m(-2): 30.9%; Mid-arm Circumference <22 cm: 19.3%; Leg Circumference <31 cm: 42.6%; Serum Albumin <35 g x L(-1): 20.3%. Sixty-eight percent of the patients received scores <24 after administering the MNA. It is to be noticed that 19.3% of the patients was malnourished after receiving scores < 17. MNA scores <24 were concentrated in: Neurological disorders (80.0%), Neoplasms and lymphoproliferative processes (77.8%), heart and blood vessels diseases (74.2%), gastrointestinal disorders (70.6%), infections (69.7%), Diabetes mellitus (66.7%). Patients with the lowest scores also exhibited the lowest values of anthropometric and biochemical markers. MNA score was independent from the patient's sex, skin colour, or number of concurrent health problems. Age had not any influence upon MNA score, although lower scores were observed among the oldest patients. MNA scoring was 80.0% coincident with nutritional diagnosis independently done with anthropometric and biochemical markers used either separately or combined. Aging of the Cuban population, along with increased proportions of elder patients in hospital areas should lead to consider the nutritional status of patients older than 60 years as an important predictor of the success of medical interventions and the quality of medical assistance.

  8. 基于SERVQUAL的医院IT运维服务质量评价%Quality Evaluation of Hospital IT Operation and Maintain Service Based on SERVQUAL

    Institute of Scientific and Technical Information of China (English)

    孟晓阳; 朱卫国

    2015-01-01

    As hospital information system is getting bigger and bigger, many IT departments in hospital have established ITIL-based IT operational processes. The establishment of ITIL process effectively improves the quality of IT service, but how to evaluate the quality of IT operation and maintain service is the basis of Continual Service Improvement.In respect of IT operational service quality evaluation, our approach is based on SERVQUAL theory, analyzing real problems in routine work from 5 dimensions of service quality evaluation, and finding out the method to improve customer satisfaction through Gaps Model of Service Quality, which turns out to be successful.It indicates that SERVQUAL theory, which is widely used in the service industry, applies to IT operational service in hospital, too. Applying theory to practice can yield twice the result with half the effort.%随着医院信息系统的规模越来越大,很多医院的IT部门都建立了基于ITIL的运维流程。ITIL流程的建立有效的提高了IT运维服务质量,而如何对IT运维服务质量进行评价是进行持续改进的基础。在IT运维服务质量评价方面,北京协和医院以SERVQUAL理论为基础,从服务质量评价的5个维度分析工作中遇到的具体问题,通过服务差距模型找出提高用户满意度的方法,取得较好的工作效果。通过实践证明,在服务行业广泛适用的SERVQUAL理论同样适用于医院的IT运维服务,将理论应用于实践工作,可以得到事半功倍的效果。

  9. Private Hospital La Clinique de La Qiataigneraie Deployed Wi-Fi Network to Optimize the Management of its Operating Rooms

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    Symbol Technologies, Inc. (NYSE:SBL), The Enterprise Mobility Company, and Ekahau, one of the leading suppliers of Wi-Fi positioning solutions, today announced that the La Chataigneraie private clinic implemented the Ekahau Real Time Location System (RTLS) solution. The wireless solution incorporates two Symbol WS5100 wireless switches and 30 AP300 access ports, and is used to improve communications in and between its 16 operating rooms.

  10. Do recommendations for institutional food service result in better food service? A study of compliance in Danish hospitals and nursing homes from 1995 to 2002-2003

    DEFF Research Database (Denmark)

    Mikkelsen, Bent Egberg; Beck, Anne Marie; Lassen, Anne Dahl

    2007-01-01

    and nursing home residents has resulted in measurable progress. Design: A questionnaire-based study was carried out among foodservice managers in Danish hospitals (n = 96) and nursing homes (n = 898) in 1995 and 2002/3 (n = 90) and (n = 682), respectively. The study used compliance with selected issues....../3, hospitals had a higher compliance, except in the case of established feedback routines. Differences were statistically significant. The results indicate that nutritional care is higher on the agenda in hospital, than in nursing homes. However, very little progress can be seen in compliance when results......Background: Since 1995, significant efforts by authorities and researchers have been directed towards addressing the nutritional problems in Danish hospitals and nursing homes. Aim: The purpose of this study was to investigate whether the increased focus on nutritional problems in patients...

  11. Field Evaluations and Definition of the Proposed Air Force Forward Base Foodservice System - The New Harvest Eagle

    Science.gov (United States)

    1982-07-01

    which there is opprtunity for sccommdation. As discussod in your telecon with Dr. Ut1s of I December 1980, copies of this letter and inclosures should be...of the hospital. f. Capt Smitherman wrote an article on off-base public health threats that appeared in the Tent City Newsletter. 153 .... _ -5- "S

  12. Managing risk and expected financial return from selective expansion of operating room capacity: mean-variance analysis of a hospital's portfolio of surgeons.

    Science.gov (United States)

    Dexter, Franklin; Ledolter, Johannes

    2003-07-01

    Surgeons using the same amount of operating room (OR) time differ in their achieved hospital contribution margins (revenue minus variable costs) by >1000%. Thus, to improve the financial return from perioperative facilities, OR strategic decisions should selectively focus additional OR capacity and capital purchasing on a few surgeons or subspecialties. These decisions use estimates of each surgeon's and/or subspecialty's contribution margin per OR hour. The estimates are subject to uncertainty (e.g., from outliers). We account for the uncertainties by using mean-variance portfolio analysis (i.e., quadratic programming). This method characterizes the problem of selectively expanding OR capacity based on the expected financial return and risk of different portfolios of surgeons. The assessment reveals whether the choices, of which surgeons have their OR capacity expanded, are sensitive to the uncertainties in the surgeons' contribution margins per OR hour. Thus, mean-variance analysis reduces the chance of making strategic decisions based on spurious information. We also assess the financial benefit of using mean-variance portfolio analysis when the planned expansion of OR capacity is well diversified over at least several surgeons or subspecialties. Our results show that, in such circumstances, there may be little benefit from further changing the portfolio to reduce its financial risk. Surgeon and subspecialty specific hospital financial data are uncertain, a fact that should be taken into account when making decisions about expanding operating room capacity. We show that mean-variance portfolio analysis can incorporate this uncertainty, thereby guiding operating room management decision-making and reducing the chance of a strategic decision being made based on spurious information.

  13. A STUDY OF PRE OPERATION NURSING VISIT ABOUT THE NURSES’ VIEW FROM THE SURGERY ROOM OF A UNIVERSITY HOSPITAL.

    Directory of Open Access Journals (Sweden)

    Izilda Esmenia Muglia Araújo

    2004-08-01

    Full Text Available This study to do an analysis of the PONV`s importance, by nurses from the Daily’s SurgeryRoom of an University Hospital, through forms distributed to them and to apply the written communicationinstrument on the PONV,proposed by NORONHA & ARAÚJO (1995. The results this research were: 92,9% ofthe nurses from the Daily’s Surgery Room think that it is important the performance of the PONV to the patientand Nursing aid, and 85,7% think the PONV is important for the nurse who works in a Surgery Room. Thewritten communication instrument on the PONV was applied with success, being really easy to fill it in with clearquestions , showing so to be a lot of viable but some items of the instrument like blood group and FATOR RHcouldn’t be filled even after the records check. In this way, I think it is worth the suggestion o9f sitting the writtencommunication instrument proposed by ARAÚJO AND NORONHA (1995 at this State University, proposinghowever, inclusion on the patients’ records data about blood group and FATOR RH.

  14. Scheduling Operative Surgical Services to Recover CHAMPUS Surgical Procedures at Blanchfield Army Community Hospital, Fort Campbell, Kentucky

    Science.gov (United States)

    1993-08-01

    any given date range, the report sub-totals the number of each type of anesthesia used ( general , local , etc.). 68 Ippendiz D Operating Roon Report by...46 5359 UMBILICAL HERNIA REPAIR 33 59:20 1:48 5300 LEFT INGUINAL HERNIA REPAIR 164 294:38 1:48 470 APPENDECTOMY 64 121:03 1:53 3859 LIG/STRIPPING OF...VARCOSE VEINS 21 45:50 2:10 9999 OTHER 277 617:42 2:13 5310 BILAT INGUINAL HERNIA REP 13 29:30 2:16 5421 DIAGNOSTIC LAPAROSCOPY 6 14:40 2:27 5351

  15. Choice of Operative Technique for Emergency Cases of Sigmoid Volvulus in a Tertiary Care Hospital of Gujarat

    Directory of Open Access Journals (Sweden)

    Patel Upendra

    2012-04-01

    Full Text Available Introduction: Sigmoid volulus is by far the most common type of volvulus, accounting for 75 to 90 % of all volvulus. Most common presenting symptom is abdominal pain and constipation. . It may be initially managed by sigmoidoscopy or rectal tube insertion but where fear of compromised vascular supply of the sigmoid colon is associated, immediate laparotomy after resuscitation must be undertaken to avoid gangrene and septic shock. The primary objective of the study is to demonstrate the most suitable procedure for management of patients with sigmoid volvulus needing emergency surgery. Methodology: All patients presenting with volvulus and needing emergency operative intervention during 1 years duration from January 2010 to December 2011 were included in this study. Total 41 patients were included in the study of which 25 presented with gangrenous sigmoid colon on laparotomy and viable sigmoid colon was present in the remaining 16 cases. Comparison is done with respect to mortality and early morbidity associated with different operative procedures. Results: Highest mortality i.e. 33.3% observed among patients who underwent primary resection and anastomosis without proximal colostomy. Wound infection was more common following all forms of stoma procedure. Conclusion: Hartmann’s procedure goes a long way in decreasing mortality due to sigmoid volvulus in the emergency setting. [National J of Med Res 2012; 2(2.000: 226-228

  16. Fast track surgery, a strategy to improve operational efficiency in a high-complexity hospital in Latin America.

    Science.gov (United States)

    Betancur, Juan David Angel; Montaño, Liliana Marcela Betancur; Jaramillo, André Felipe Espinosa; Delgado, Carlos Enrique Yepes

    2015-01-01

    Fast Track surgery is designed to optimize time in low-complexity procedures, thus improving efficiency in care provision, and preserving patient safety. Before and after intervention study in a surgical setting, with failure mode and effects analysis, identification and prioritization of improvement opportunities, process measurement before the intervention, improvement implementation, practical application, process measurement after the intervention, and surgical time comparisons. With the Fast Track program, 19% of the operating room capacity available was freed per day; before surgical FastTrack implementation, 50% of the procedures started 23 minutes behind schedule. After the Fast Track program was implemented, procedures start 5 minutes ahead of schedule. Anesthesia induction time was reduced by 50%, and skin-to-skin surgical time dropped by 28%. The number of surgical procedures performed in the day increased by 33-50%. There were noincidents or adverse events. Fast Track surgery is a useful strategy for improving operating room efficiency and reducing surgical time. Procedures start on time, with increased timely care, patient and practitioner satisfaction, and lower service costs.

  17. How do we actually put smarter snacks in schools? NOURISH (Nutrition Opportunities to Understand Reforms Involving Student Health) conversations with food-service directors.

    Science.gov (United States)

    Rosenfeld, Lindsay E; Cohen, Juliana Fw; Gorski, Mary T; Lessing, Andrés J; Smith, Lauren; Rimm, Eric B; Hoffman, Jessica A

    2017-02-01

    In autumn 2012, Massachusetts schools implemented comprehensive competitive food and beverage standards similar to the US Department of Agriculture's Smart Snacks in School standards. We explored major themes raised by food-service directors (FSD) regarding their school-district-wide implementation of the standards. For this qualitative study, part of a larger mixed-methods study, compliance was measured via direct observation of foods and beverages during school site visits in spring 2013 and 2014, calculated to ascertain the percentage of compliant products available to students. Semi-structured interviews with school FSD conducted in each year were analysed for major implementation themes; those raised by more than two-thirds of participating school districts were explored in relationship to compliance. Massachusetts school districts (2013: n 26; 2014: n 21). Data collected from FSD. Seven major themes were raised by more than two-thirds of participating school districts (range 69-100 %): taking measures for successful transition; communicating with vendors/manufacturers; using tools to identify compliant foods and beverages; receiving support from leadership; grappling with issues not covered by the law; anticipating changes in sales of competitive foods and beverages; and anticipating changes in sales of school meals. Each theme was mentioned by the majority of more-compliant school districts (65-81 %), with themes being raised more frequently after the second year of implementation (range increase 4-14 %). FSD in more-compliant districts were more likely to talk about themes than those in less-compliant districts. Identified themes suggest best-practice recommendations likely useful for school districts implementing the final Smart Snacks in School standards, effective July 2016.

  18. Success of commonly used operating room management tools in reducing tardiness of first case of the day starts: evidence from German hospitals.

    Science.gov (United States)

    Ernst, Christian; Szczesny, Andrea; Soderstrom, Naomi; Siegmund, Frank; Schleppers, Alexander

    2012-09-01

    One of the declared objectives of surgical suite management in Germany is to increase operating room (OR) efficiency by reducing tardiness of first case of the day starts. We analyzed whether the introduction of OR management tools by German hospitals in response to increasing economic pressure was successful in achieving this objective. The OR management tools we considered were the appointment of an OR manager and the development and adoption of a surgical suite governance document (OR charter). We hypothesized that tardiness of first case starts was less in ORs that have adopted one or both of these tools. Using representative 2005 survey data from 107 German anesthesiology departments, we used a Tobit model to estimate the effect of the introduction of an OR manager or OR charter on tardiness of first case starts, while controlling for hospital size and surgical suite complexity. Adoption reduced tardiness of first case starts by at least 7 minutes (mean reduction 15 minutes, 95% confidence interval (CI): 7-22 minutes, P tardiness of first case starts figure prominently the objectives of surgical suite management in Germany. Our results suggest that the appointment of an OR manager or the adoption of an OR charter support this objective. For short-term decision making on the day of surgery, this reduction in tardiness may have economic implications, because it reduced overutilized OR time.

  19. [Comparison of waste anesthetic gases in operating rooms with or without an scavenging system in a Brazilian University Hospital].

    Science.gov (United States)

    Braz, Leandro Gobbo; Braz, José Reinaldo Cerqueira; Cavalcante, Guilherme Aparecido Silva; Souza, Kátina Meneghetti; Lucio, Lorena Mendes de Carvalho; Braz, Mariana Gobbo

    Occupational exposure to waste anesthetic gases in operating room (OR) without active scavenging system has been associated with adverse health effects. Thus, this study aimed to compare the trace concentrations of the inhaled anesthetics isoflurane and sevoflurane in OR with and without central scavenging system. Waste concentrations of isoflurane and sevoflurane were measured by infrared analyzer at different locations (near the respiratory area of the assistant nurse and anesthesiologist and near the anesthesia station) and at two times (30 and 120minutes after the start of surgery) in both OR types. All isoflurane and sevoflurane concentrations in unscavenged OR were higher than the US recommended limit (2 parts per million), regardless of the location and time evaluated. In scavenged OR, the average concentrations of isoflurane were within the limit of exposure, except for the measurements near the anesthesia station, regardless of the measurement times. For sevoflurane, concentrations exceeded the limit value at all measurement locations and at both times. The exposure to both anesthetics exceeded the international limit in unscavenged OR. In scavenged OR, the concentrations of sevoflurane, and to a lesser extent those of isoflurane, exceeded the recommended limit value. Thus, the OR scavenging system analyzed in the present study decreased the anesthetic concentrations, although not to the internationally recommended values. Copyright © 2017 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

  20. Evaluating the prevalence of canceling surgical operations,including its influencing factors at Imam Khomeini hospital in Sari during 2006-2007

    Directory of Open Access Journals (Sweden)

    A. Zamani kiasari

    2008-01-01

    Full Text Available AbstractBackground and Purpose: Hospital admission for surgery is an important event for patients. Canceling surgical procedures produce several unpleasant results for patients such as waste of time, including payment. The aim of this study is to identify the prevalence and causes of canceling surgical procedures, in order to achieve problem solving methods.Materials and Methods: This is a descriptive cross-sectional study. Statistical data regarding all surgical procedures (without sampling performed during 2006 to 2007, were recorded in a checklist. Study variables were identified based on surgical procedures that were canceled during this study. Data was analyzed using SPSS software and statistical analysis tests.Results: Of 4,711 scheduled patients, 510 (10/9% surgical operations were canceled. The highest number of patient candidates for surgical operation was related to gynecology, orthopedic, urology, while the least were related to reconstructive and vascular surgery groups respectively. The most canceled surgical procedures were related to neurosurgical operation 32/4% (68 from 207 cases while the least canceled cases belonged to gynecology 4/4% (48 from 1094 cases.Conclusion: The results of our study showed that 54/2% of canceled cases were preventable. The results of this study and similar studies demonstrate that traditional pre-operative preparation for surgical scheduling, day before surgery is in need of serious consideration. We recommend a fundamental change by discarding traditional methods and creating a new committee including specialized bed or resource groups, monthly management meetings to discuss causes of canceling surgical procedures, in order to reduce its occurrence. Thus, decreasing the rate of canceling surgical wasted, while reducing anxiety in patients and their family. J Mazand Univ Med Sci 2008; 18(65:52-62 (Persian

  1. RFID-based Operative Instrument Management in Certain Hospital%某院基于RFID技术的手术器械管理

    Institute of Scientific and Technical Information of China (English)

    丁燕; 黄云; 陈多姿; 王蓓; 陆美芳

    2015-01-01

    Objective To build up a whole-process, real-time and backward management system for operative instrument.Methods The technique of radio frequency identification ( RFID) was adopted to perform record and whole-process monitoring of recycling, cleaning, packing, sterilizing and post-operation check.Re-sults Application of RFID information technology in operative instrument management could backward the use-link at any time and promote its work more effectively, correctly and safety.Conclusion The application of RFID-based information technology could promote the safe of operation patient, enhance work efficiency, patients'sat-isfaction and informationization degree of hospital.%目的:对手术器械处理与使用进行全程、实时、可追溯的管理。方法采用无线射频识别( RFID)技术对手术器械的回收、清洗、打包、灭菌及术后的清点实施记录与全程监控。结果将RFID技术应用于手术器械包管理中,随时可追溯手术器械使用环节中的信息,使手术器械的管理工作更加高效、准确、安全。结论该系统的使用提升手术患者的安全;提高工作效率、患者满意度和医院的信息化程度。

  2. Avaliação da preceptoria na residência médica em cirurgia geral, no centro cirúrgico, comparação entre um hospital universitário e um hospital não universitário Assessment of preceptorship in general surgery residency in the operating room, comparison between a teaching hospital and a non teaching hospital

    Directory of Open Access Journals (Sweden)

    Elizabeth Gomes Santos

    2012-12-01

    Full Text Available OBJETIVO: Avaliar e comparar a preceptoria no programa de residência médica em Cirurgia Geral, no centro cirúrgico, em um hospital universitário e em um hospital não universitário, a partir da ótica dos residentes que ingressaram em 2010 e 2011. MÉTODOS: Questionário aplicado aos residentes, modificado de Sarker SK, Vincent C, e Darzi AW e usando-se a escala de Likert para qualificar o ítem pesquisado sobre as atitudes dos preceptores. A comparação da distribuição das respostas entre os dois hospitais foi analisada pelo teste de c² para tendências. RESULTADOS: No hospital universitário foram avaliados 12 preceptores por sete residentes. No hospital não universitário foram 11 preceptores avaliados por 13 residentes. O hospital não universitário apresentou a tendência de resposta discordante e indiferente (DC, D e I maior que o hospital universitário. Só o resultado de uma pergunta apresentou significância estatística. Não houve diferença significativa na comparação das respostas nas demais perguntas entre os dois hospitais. CONCLUSÃO: Os hospitais apresentaram preceptoria semelhante.BACKGROUND: Medical residency is well known as the best training method after graduation. It is a moment when, in addition to receiving technical guidance, residents should also develop attitudes, ethics, and professionalism. In order for that to occur, preceptors should be prepared for their task. OBJECTIVE: To evaluate and compare the preceptorship in the Medical Residency in General Surgery program, in the operating room of a Teaching Hospital (TH and a Non-teaching Hospital (NTH, from the viewpoint of the residents who entered in 2010 and 2011. METHODS: A questionnaire was applied to the residents, adapted from Sarker, Vincent and Darzi, and the Likert scale was used to qualify the survey items on the preceptors' attitudes. RESULTS: At the TH, 12 preceptors were evaluated by 7 residents. One of the residents did not answer the

  3. Multidrug resistant Psudomonas aeruginosa infections complicating surgical wounds and the potential challenges in managing post-operative wound infections:University of Calabar Teaching Hospital experience

    Institute of Scientific and Technical Information of China (English)

    Jombo GT; Akpan S; Epoke J; Denen Akaa P; Odey F

    2010-01-01

    Objective:To ascertain the antimicrobial susceptibility profile of Pseudomonas aeruginosa (P. aeruginosa) recovered from surgical site infections (SSIs). Methods:The study was retrospective in nature and was compiled for a period of five years (1st February, 2004-31st January, 2009). Data were generated from the culture of post-operative wound swab specimens by the microbiology laboratory of University of Calabar Teaching Hospital. Relevant information from the patients’ records was compiled, such as age, gender, type of surgical procedure, microorganisms recovered and their antibiotic sensitivity patterns. Obtained data was analysed by using Epi Info 6 statistical software. Results:Of the 4 533 wound swab specimens processed, 673 were culture positive and P. aeruginosa was recovered from 13.1%of the culture positive specimens with its rate of recovery decreasing with age progression (P0.05). Most of the P. aeruginosa isolates were from general surgery wards and least from orthopaedic wards. Ofloxacin, ceftriaxone and augmentin were the most active antibiotics while ampicillin, tetracycline and co-trimoxazole were the least active antibiotics, with no antibiotic having a 100%activity against the organism. Conclusions:In view of the high resistance displayed by P. aeruginosa recovered from SSIs, adequate antiseptic procedures should be entrenched to avoid colonization of surgical wounds by this microorganism as well as others with similar sensitivity profile. Ofloxacin, ceftriaxone and augmentin may be considered for prevention of P.aeruginosa infection.

  4. [Designing and Operating a Comprehensive Mental Health Management System to Support Faculty at a University That Contains a Medical School and University Hospital].

    Science.gov (United States)

    Kawanishi, Chiaki

    2016-01-01

    In Japan, healthcare professionals and healthcare workers typically practice a culture of self-assessment when it comes to managing their own health. Even where this background leads to instances of mental health disorders or other serious problems within a given organization, such cases are customarily addressed by the psychiatrists or psychiatric departments of the facilities affected. Organized occupational mental health initiatives for professionals and workers within the healthcare system are extremely rare across Japan, and there is little recognition of the need for such initiatives even among those most directly affected. The author has some experience designing and operating a comprehensive health management system to support students and faculty at a university in the Tokyo Metropolitan Area that contains a medical school and university hospital. At this university, various mental health-related problems were routinely being allowed to develop into serious cases, while the fundamental reforms required by the health management center and the mental health management scheme organized through the center had come to represent a challenge for the entire university. From this initial situation, we undertook several successive initiatives, including raising the number of staff in the health management center and its affiliated organizations, revising and drafting new health management rules and regulations, launching an employment support and management system, implementing screenings to identify people with mental ill-health, revamping and expanding a counselling response system, instituting regular collaboration meetings with academic affairs staff, and launching educational and awareness-raising activities. This resulted in the possibility of intervention in all cases of mental health crisis, such as suicidal ideation. We counted more than 2,400 consultations (cumulative total number; more than half of consultations was from the medical school, postgraduate

  5. Post-operative delirium is an independent predictor of 30-day hospital readmission after spine surgery in the elderly (≥65years old): A study of 453 consecutive elderly spine surgery patients.

    Science.gov (United States)

    Elsamadicy, Aladine A; Wang, Timothy Y; Back, Adam G; Lydon, Emily; Reddy, Gireesh B; Karikari, Isaac O; Gottfried, Oren N

    2017-03-02

    In the last decade, costs of U.S. healthcare expenditures have been soaring, with billions of dollars spent on hospital readmissions. Identifying causes and risk factors can reduce soaring readmission rates and help lower healthcare costs. The aim of this is to determine if post-operative delirium in the elderly is an independent risk factor for 30-day hospital readmission after spine surgery. The medical records of 453 consecutive elderly (≥65years old) patients undergoing spine surgery at Duke University Medical Center from 2008 to 2010 were reviewed. We identified 17 (3.75%) patients who experienced post-operative delirium according to DSM-V criteria. Patient demographics, comorbidities, and post-operative complication rates were collected for each patient. Elderly patients experiencing post-operative delirium had an increased length of hospital stay (10.47days vs. 5.70days, p=0.009). Complication rates were similar between the cohorts with the post-operative delirium patients having increased UTI and superficial surgical site infections. In total, 12.14% of patients were re-admitted within 30-days of discharge, with post-operative delirium patients experiencing approximately a 4-fold increase in 30-day readmission rates (Delirium: 41.18% vs. No Delirium: 11.01%, p=0.002). In a multivariate logistic regression analysis, post-operative delirium is an independent predictor of 30-day readmission after spine surgery in the elderly (p=0.03). Elderly patients experiencing post-operative delirium after spine surgery is an independent risk factor for unplanned readmission within 30-days of discharge. Preventable measures and early awareness of post-operative delirium in the elderly may help reduce readmission rates.

  6. Hospitais filantrópicos e a operação de planos de saúde próprios no Brasil Philanthropic hospitals and the operation of provider-owned health plans in Brazil

    Directory of Open Access Journals (Sweden)

    Sheyla Maria Lemos Lima

    2007-02-01

    Full Text Available OBJETIVO: Descrever o desempenho gerencial de hospitais filantrópicos com operadoras de planos de saúde em comparação com o conjunto de hospitais filantrópicos no Brasil. MÉTODOS: Foram comparadas as estruturas gerenciais presentes nos hospitais filantrópicos com operadoras próprias de planos de saúde com aquelas observadas num conjunto representativo do setor hospitalar filantrópico, em seis dimensões: direção e planejamento, econômico-financeira, recursos humanos, serviços técnicos, serviços logísticos e tecnologia de informações. Consideraram-se os dados de uma amostra aleatória de 69 hospitais, extraída do setor hospitalar filantrópico, e 94 hospitais filantrópicos com operadoras próprias de planos de saúde. Nos dois casos incluíram-se apenas os hospitais com menos de 599 leitos. RESULTADOS: Foram identificados resultados mais positivos para o conjunto de hospitais com operadoras próprias de planos de saúde em todas as dimensões gerenciais comparadas. Em particular, destacaram-se as dimensões econômico-financeira e de tecnologia de informações, nas quais mais de 50% dos hospitais com operadoras apresentaram quase todas as condições consideradas. CONCLUSÕES: O setor hospitalar filantrópico é importante na prestação de serviços ao Sistema Único de Saúde. Os desafios para a sua manutenção e desenvolvimento impõem encontrar alternativas. O fomento de uma parceria público-privado neste segmento, por meio da operação de planos próprios ou prestação de serviços a outros planos de saúde convivendo com o SUS, constitui um campo que merece uma análise mais aprofundada.OBJECTIVE: To describe the management performance of philanthropic hospitals that operate their own health plans, in comparison with philanthropic hospitals as a whole in Brazil. METHODS: The managerial structures of philanthropic hospitals that operated their own health plans were compared with those seen in a representative group

  7. The Practical Exploration of Reducing the Operational Cost of Hospitals by Lean Management%运用精益管理降低医院运营成本的实践探索

    Institute of Scientific and Technical Information of China (English)

    吴磊

    2015-01-01

    现代医院管理必须要与先进的企业管理模式接轨,在确保不断提升医疗服务质量的同时,实施全面的成本控制,以消除医院的运营风险。精益管理源于“丰田生产方式”的管理哲学。在精益管理模式下,医院需从内部控制与经济活动控制两个层面来加强医院管理,从而为降低医院的运营成本扎下良好的基础。%Modern hospital management must be in line with advanced enterprise management mode. While improving the quality of medical services, the implementation of comprehensive cost control need to practice in order to eliminate the operational risk of the hospital.Lean management comes from "TOYOTA production mode". Under the lean management mode, the hospital wil be from the internal control and economic activities control to enhance the effectiveness of hospital management, so as to reduce the operation cost of the hospital and prick a good foundation.

  8. MBR工艺处理医院污水的运行效果分析%Analysis on Operation Efficiency of Membrane Bioreactor in Hospital Wastewater Treatment

    Institute of Scientific and Technical Information of China (English)

    王秀丽; 顾平; 陶亚静; 代玲玲; 朱丹

    2012-01-01

    An immersed membrane bioreactor ( MBR) was used to treat hospital wastewater. High removal rates of COD, ammonia nitrogen, microorganisms and turbidity were achieved in the MBR. The average effluent concentrations of COD and ammonia nitrogen were 17.3 mg/L and 0. 93 mg/L; the corresponding removal rates were 85. 1% and 97. 9% , respectively. The average logarithmic removal rates of the total bacteria, total coliform and fecal coliform were 2. 2, 3.7 and 4.5, respectively. After the effluent was disinfected by chlorine dioxide, the average logarithmic removal rate of total bacteria reached 3.5. Total coliform and fecal coliform were not detected in the effluent. During normal operation, the average effluent turbidity was 0.67 NTU. The effluent of MBR was colorless and odorless. The main indexes could meet the requirements of Discharge Standard of Water Pollutants for Medical Organization (GB 18466 -2005). The MBR is characterized by simple and stable operation, a small footprint, low sludge discharge and high removal rate of microorganisms. Therefore, the immersed MBR is suitable for hospital wastewater treatment.%采用浸没式膜生物反应器(MBR)处理医院污水,实际运行效果表明,MBR工艺对COD、氨氮、微生物及浊度均具有较高的去除率.膜出水COD和氨氮的平均浓度分别为17.3、0.93mg/L,平均去除率分别为85.1%和97.9%;MBR对菌落总数、总大肠菌群和粪大肠菌群的平均对数去除率分别为2.2、3.7、4.5,膜出水再经二氧化氯消毒后,对菌落总数的平均对数去除率为3.5,总大肠菌群和粪大肠菌群未检出;正常运行期间,MBR出水浊度平均为0.67 NTU.MBR工艺出水无色、无味,主要水质指标均能满足《医疗机构水污染物排放标准》( GB 18466-2005)的要求.该工艺操作简单、运行稳定、占地面积小、排泥少并且对微生物的去除率高,适用于医院类污水的处理.

  9. 整形美容科门诊手术室医院感染隐患与防控对策%Security risks and prevention and control measures of the plastic surgery outpatient operating room of hospital infection

    Institute of Scientific and Technical Information of China (English)

    王靖; 杨爱芝; 赵应兰

    2012-01-01

    目的:探讨整形美容门诊手术室医院感染的安全隐患与控制措施.方法:分析发生感染的危险因素,采取相应的感染预防与控制措施,严格遵守感染预防原则,做好布局、流程、监测等环节的管理.结果:通过预防措施,规范了整形美容患者进入门诊手术室手术的流程,降低了医院感染率,提高了医疗护理质量,避免了医疗纠纷.结论:通过分析整形美容门诊手术室医院感染的安全隐患,加强整形美容门诊手术室医院感染的管理,增加了医院的社会及经济效益.%Objective:To explore the security risks and control measures of cosmetic surgery outpatient operating room and hospital infection. Methods:Ana-lyzed of the occurrence of risk factors for infection, and took the appropriate infection prevention and control measures, strict compliance with infection pre-vention principles,good layout,processes, monitoring and other aspects of management. Results:Through preventive measures,standardized the process of cosmetic surgery patients entered the outpatient operating room surgery, reduced hospital infection rates, improved the quality of medical nursing, avoided medical disputes. Conclusion;Through the analyze the security risks of cosmetic surgery clinic operating room hospital infections,to strengthen the manage-ment of cosmetic surgery to the outpatient operating room of hospital infection,and increase the hospital's social and economic benefits.

  10. Hospital diversification strategy.

    Science.gov (United States)

    Eastaugh, Steven R

    2014-01-01

    To determine the impact of health system restructuring on the levels of hospital diversification and operating ratio this article analyzed 94 teaching hospitals and 94 community hospitals during the period 2008-2013. The 47 teaching hospitals are matched with 47 other teaching hospitals experiencing the same financial market position in 2008, but with different levels of preference for risk and diversification in their strategic plan. Covariates in the analysis included levels of hospital competition and the degree of local government planning (for example, highly regulated in New York, in contrast to Texas). Moreover, 47 nonteaching community hospitals are matched with 47 other community hospitals in 2008, having varying manager preferences for service-line diversification and risk. Diversification and operating ratio are modeled in a two-stage least squares (TSLS) framework as jointly dependent. Institutional diversification is found to yield better financial position, and the better operating profits provide the firm the wherewithal to diversify. Some services are in a growth phase, like bariatric weight-loss surgery and sleep disorder clinics. Hospital managers' preferences for risk/return potential were considered. An institution life cycle hypothesis is advanced to explain hospital behavior: boom and bust, diversification, and divestiture, occasionally leading to closure or merger.

  11. FacilitiesHospitals_HOSPITAL

    Data.gov (United States)

    Vermont Center for Geographic Information — This data layer contains point locations of all major community, regional, comprehensive health, and healthcare provider hospitals in the state of Vermont. The...

  12. Hospitals; hospitals13

    Data.gov (United States)

    University of Rhode Island Geospatial Extension Program — Hospital Facilities information was compiled from several various sources. Main source was the RI Department of Health Facilities Regulation database, License 2000....

  13. A comparative study of a private non-profit hospital and a public hospital on financial operation and sustainable developmen t%不同举办主体的两家非营利性医疗机构财务经营和持续发展比较研究

    Institute of Scientific and Technical Information of China (English)

    刘嫣; 齐璐璐; 朱骞; 朱同玉

    2014-01-01

    Objective:To indicate the difficulties of operating private non-profit hospitals by a comparative study of a private non-profit hospital and a public hospital in the economic performance and the social benefits. Methods:In-depth interviews and a questionnaire survey were conducted to analyze the economic performance and the social benefits of a private non-profit hospital and a public hospital. Results:Between the private non-profit hospital and the public hospital,there were differences in the economic performance and the sustainable development ability. Conclusion:Public hospitals surpass private non-profit hospitals in the economic performance and sustainable development ability.%目的:比较两家不同举办主体的医疗机构在经济运行情况和社会效益方面的差异,揭示社会资本办医之困境。方法:通过深度访谈和问卷调查,对两家医院经济运行和社会效益等指标和数据进行描述性分析。结果:两家不同举办主体的医疗机构,在经济运行状况和持续发展能力方面存在差异。结论:公立医院的经济运行状况和持续发展能力好于民营医院。

  14. Your Lung Operation: After Your Operation

    Medline Plus

    Full Text Available ... in Trauma Surgery Advanced Trauma Life Support Verification, Review, and Consultation Program for Hospitals Trauma Systems Consultation ... Your Operation Guidance for after the operation including review of attached equipment and ways for you to ...

  15. 南京军区南京总医院院前救治情况分析%Exploration of the operational mode of prehospital rescue in grade-3 army hospitals

    Institute of Scientific and Technical Information of China (English)

    唐文杰; 孙海晨; 聂时南; 刘红梅; 邵旦兵; 李百强; 许宝华; 王慧娟

    2012-01-01

    This article presents a retrospective analysis of the prehospital rescue cases in our hospital in the past few years. It points out the characteristic differences of prehospital rescue in a grade-3 army hospital from that in a civilian hospital and the deficiencies of the traditional operational mode. Based on the exploration of a peacetime operational mode of prehospital rescue in the army hospital , it holds that full use should be made of the existing medical resources in the local civilian hospitals, and particular emphasis should be placed on the regularized training of the key members in the basic units, so as to promote prehospital rescue and thus enhance the overall medical support capacity of the army hospital.%回顾性分析近几年对患者进行的院前救护,探讨军队三级医院院前救护不同于地方医院的特殊之处,指出旧运作模式的缺陷,并对军队医院在和平时期院前救治的模式进行分析,认为要充分利用地方已有的医疗卫生资源,加强基层单位、基层人员和重点人员的培训工作,将基础培训工作制度化、常规化,以提高院前救护水平,从而进一步提高军队医院的整体保障力和战斗力.

  16. THE MANAGEMENT MEASURES FOR THE OPERATION QUALITY OF LAMINAR FLOW OPERATING ROOM SYSTEMS SECURITY IN OPERATING ROOM OF THE HOSPITAL%医院手术部层流洁净系统运行质量安全管理措施

    Institute of Scientific and Technical Information of China (English)

    林彬; 李文霞; 李晓花

    2012-01-01

    Objective To observe the operation quality of laminar flow clean system in operating room so as to enhance safety management measures. Methods Through the instrumental analysis and detection methods on the field, the running quality of laminar flow clean system in operating room of this hospital was monitored. Results After the laminar flow system of each level of the operating room and ancillary rooms running for 30 min, the average pass rate of micro - climate of all parts of the indoor environment was more than 98% ; that of precipitating bacterial indicators in the surgical area and the surrounding area of one thousand purification surgery air was more than 97% and that of the subsidence bacteria indicators in the 100 000 - 300 000 clean regional area was 100%. Conclusion The operation quality of laminar flow clean system in operating room of this hospital is reliable and the management is normative. The operating manual should be stricdy executed.%目的 观察医院手术部层流洁净系统运行质量,加强安全管理措施.方法 通过现场仪器分析检测方法,对某医院手术部层流洁净系统运行质量进行了监测.结果 各级别手术室和辅助用房在层流洁净系统运行30min后,所有部位室内环境微小气候平均合格率达到98%以上.1000级手术区和周边区空气中沉降菌指标有97%以上达标;10万至30万级洁净区域沉降菌指标合格率均达到100%.结论 该医院手术部层流洁净系统运行质量可靠,管理规范,主要靠严格执行操作规程.

  17. 50 years experience with Dupuytren's contracture in the Erlangen University Hospital – A retrospective analysis of 2919 operated hands from 1956 to 2006

    Directory of Open Access Journals (Sweden)

    Puschkin Valerij

    2007-07-01

    Full Text Available Abstract Background Dupuytren's disease (DD is a hand disorder mainly among the northern population. In contrast it is rare in the mediterranean population. Therefore typical habits and dietetic influences have been discussed as well as genetic predisposition. Still, since the first description by Dupuytren in 1834 only little is known about the etiology and pathogenesis of this disease. Some hints were found for a higher prevalence among people with diabetes, alcohol abuse or smoking. Also, intensive manual work or hand injuries have been discussed to have an influence on DD. To our knowledge this is the largest retrospectively evaluated series of symptomatic patients published to date. The study includes patients from the last 50 years. It was performed to show possible correlations between DD and typical risk factors such as diabetes, alcohol consumption, and smoking. Methods We retrospectively analysed all patient records with DD documented between 1956 and 2006 in the Surgical University Hospital in Erlangen. Data acquisition was conducted by reviewing the medical records from 1956 to 2006 including data from all patients who were surgically treated because of DD. Results We reviewed 2579 male and 340 female surgically treated patients with DD. More than 80% of the patients were between 40 and 70 years old. In 28.9% only the right hand was effected by DD, in 25.3% only the left hand and in 45.8% both hands. In 10.3% of all Patients suffered from Diabetes mellitus. Statistical analysis revealed no significant correlation between diabetes, alcoholism or smoking on the degree of DD in our patients. Conclusion Most data are consistent with previously published results from smaller, comparable retrospective studies with regard to right- or left handedness. We could not confirm a statistically significant correlation of DD with diabetes mellitus, severe alcohol consumption, heavy smoking or epilepsy and the stage of the disease as described in

  18. CARDIAC SURGERY FOR VALVULAR HEART DISEASE AT A REFERRAL HOSPITAL IN ETHIOPIA: A REVIEW OF CASES OPERATED IN THE LAST 30 YEARS.

    Science.gov (United States)

    Guteta, Senbeta; Yadeta, Dejuma; Azazh, Aklilu; Mekonnen, Dufera

    2016-04-01

    Valvular heart disease has been a significant cause of heart disease worldwide. In Ethiopia, it particularly affects young individuals and constitutes the major cause of cardiovascular disease. Factors associated with choice of treatment for advanced valvular heart disease are variable. The objective of this study is to review surgery done for Ethiopian patients with valvular heart disease. We analyzed data on patients who had valve surgery and follow-up at the Tikur Anbessa Specialized Hospital cardiology unit. We collected data on sociodemographic characteristics, the pre-operative status of effected valves and co-morbidities, and assessed their associations with patient management options. A total of 157 valve surgeries were done from 1983 to 2013. Mean age at time of surgery was 26.7 years and females constituted 66% of the cases. Patients with rheumatic heart disease were younger, more likely to be female and have atrial fibrillation, but less likely to have impaired left ventricular systolic function when compared to patients with non-rheumatic heart disease. More than 75% of the surgical procedures done were mechanical valve replacement. Mechanical valves, compared with bioprosthetic valves, were more likely to be used in patients with rheumatic heart disease. The median age of those receiving mechanical valves, 24 (IQR 22-28) years, was lower than those receiving bioprosthetic valves, 31.5 (IQR 29.9-37.9) years. Mechanical valve replacement was significantly higher in those under the age of 20 years (Adjusted Odds Ratio 41.0, 95% CI: 3.0-557.2) and in those between 20 and 29 years of age (Adjusted Odds Ratio 14.3, 95% CI: 2.3-88.6). Valve surgery for valvular heart diseases has been more common performed for young and female patients. A great majority of the replacements done have been with mechanical valves. As many of the patients have been younger and female, the choice of valve surgery and the need for anticoagulation impacts subsequent management of

  19. Hygiene guideline for the planning, installation, and operation of ventilation and air-conditioning systems in health-care settings - Guideline of the German Society for Hospital Hygiene (DGKH).

    Science.gov (United States)

    Külpmann, Rüdiger; Christiansen, Bärbel; Kramer, Axel; Lüderitz, Peter; Pitten, Frank-Albert; Wille, Frank; Zastrow, Klaus-Dieter; Lemm, Friederike; Sommer, Regina; Halabi, Milo

    2016-01-01

    Since the publication of the first "Hospital Hygiene Guideline for the implementation and operation of air conditioning systems (HVAC systems) in hospitals" (http://www.krankenhaushygiene.de/informationen/fachinformationen/leitlinien/12) in 2002, it was necessary due to the increase in knowledge, new regulations, improved air-conditioning systems and advanced test methods to revise the guideline. Based on the description of the basic features of ventilation concepts, its hygienic test and the usage-based requirements for ventilation, the DGKH section "Ventilation and air conditioning technology" attempts to provide answers for the major air quality issues in the planning, design and the hygienically safe operation of HVAC systems in rooms of health care.

  20. Hygiene guideline for the planning, installation, and operation of ventilation and air-conditioning systems in health-care settings – Guideline of the German Society for Hospital Hygiene (DGKH

    Directory of Open Access Journals (Sweden)

    Külpmann, Rüdiger

    2016-02-01

    Full Text Available Since the publication of the first “Hospital Hygiene Guideline for the implementation and operation of air conditioning systems (HVAC systems in hospitals” ( in 2002, it was necessary due to the increase in knowledge, new regulations, improved air-conditioning systems and advanced test methods to revise the guideline. Based on the description of the basic features of ventilation concepts, its hygienic test and the usage-based requirements for ventilation, the DGKH section “Ventilation and air conditioning technology” attempts to provide answers for the major air quality issues in the planning, design and the hygienically safe operation of HVAC systems in rooms of health care.

  1. Disinfection and sterilization monitoring and hospital infection control in operating room%手术室消毒灭菌监测与医院感染控制

    Institute of Scientific and Technical Information of China (English)

    唐香祝; 阮杏菲; 江翠波

    2016-01-01

    目的:探讨加强手术室消毒灭菌监测,对医院感染控制的作用。方法根据《消毒技术规范》中所规定的操作要求对手术室消毒灭菌效果进行监测。研究采用回顾性及现场临床观察方法,观察患者术后伤口情况。结果实施手术室消毒灭菌监测前,空气灭菌合格率、消毒物品灭菌合格率、医护人员手灭菌合格率分别为92.63%、93.75%、88.57%,实施手术室消毒灭菌监测后,空气灭菌合格率、消毒物品灭菌合格率、医护人员手灭菌合格率分别为98.96%、100.00%、100.00%,差异有统计学意义(P<0.05);实施手术室消毒灭菌监测前,手术患者切口感染率为6.41%,Ⅰ类切口感染率、Ⅱ类切口感染率、Ⅲ类切口感染率分别为2.54%、6.22%、11.34%,实施手术室消毒灭菌监测后,手术患者切口感染率为2.57%,Ⅰ类切口感染率、Ⅱ类切口感染率、Ⅲ类切口感染率分别为0.39%、2.21%、5.77%,差异有统计学意义(P<0.05)。结论通过手术室消毒灭菌监测,能够有效提高手术室内空气、设备、器械等灭菌率。此外,还能够有效降低手术患者术后切口感染率,值得推广。%Objective To study the effect of disinfection and sterilization monitoring and hospital infection control in operating room.MethodsTo monitor the effect of disinfection and sterilization in operating room according to the operation requirements stipulate by disinfection technical guidelines.To observe the patients' postoperative wound condition according to the methods of retrospectively study and spot clinical observation.Results The differences of the eligible sterilization rate of air, disinfection materials, hands of medical staff after implementation of disinfection and sterilization monitoring(98.96%,100.00%,100.00%)were statically significant compared with which before implementation of disinfection and sterilization monitoring(92

  2. Hospital Compare

    Data.gov (United States)

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

  3. HCAHPS - Hospital

    Data.gov (United States)

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

  4. Norovirus - hospital

    Science.gov (United States)

    Gastroenteritis - norovirus; Colitis - norovirus; Hospital acquired infection - norovirus ... fluids ( dehydration ). Anyone can become infected with norovirus. Hospital patients who are very old, very young, or ...

  5. Analysis of Hospital Economic Operation Status through the Capital Structure of the Financial Statements%从财务报表的资金结构中分析某医院经济运营状况

    Institute of Scientific and Technical Information of China (English)

    段建丽

    2014-01-01

    目的:为医院管理者及时提供经营管理中的财务风险警示信息,以便更好地规避风险。方法:借鉴企业资产负债表的分析方法,对医院资产负债表、医疗收入费用明细表两年同期财务数据项目的结构变动程度及结构比例,进行深入对比分析。结果:揭示了医院经济运营中存在的财务风险和经营风险。结论:资产负债表可运用于资金结构的宏观调控,正确制定经营管理决策;医疗收入费用明细表则可从微观上发现管理中存在的问题,及时改进医院的质量管理。%Objective: To provide hospital managers the financial risk warning information, in order to avoid risk better. Methods:Use the analysis of corporate balance sheets as reference to compare and analyze 2 years ’ structural changing degree and structural rate of financial data project in hospital balance sheets and medical income schedule. Results: There are financial risks and operation risks existed in hospital economic operation. Conclusion: Balance sheet could be applied in the macro-control of capital structure to make correct decision for operation management; existing problem of management could be discovered from the micro-side of the medical income fees sheet, so as to improve the qualified management of the hospital.

  6. 浅谈优质护理在基层医院手术患者服务中应用的体会%Experience of High Quality Nursing Service in the Grass-roots Hospital Patients with Operation

    Institute of Scientific and Technical Information of China (English)

    胡春红; 秦辉

    2014-01-01

    The high quality nursing service in the hospital development increasingly highlights the advantages, nurses of operation room, operation interview work reflects the quality of nursing care for patients in the service operation in more human side, set up the philosophy of nursing to the patient as the center. 2011 in our hospital by operation patients in the preoperative, intraoperative, postoperative visit guidance work, has received the good effect, operation room preoperative and postoperative visits, intraoperative guidance reflects the high quality of nursing service, enhance the relationship between doctors and patients, to improve the satisfaction of patients and surgical success rate, reduce the the complications of operation, to ensure maximum safety and benefits operation patient.%优质护理服务在医院发展中日益突显出优点,对手术室的护理工作者而言,手术访视工作体现了优质护理在为手术患者服务中更加人性化的一面,树立了以患者为中心的护理理念。2011年我院通过手术患者开展术前访视、术中指导、术后访视工作,收到了良好效果,手术室开展术前术后访视,术中指导工作是优质护理服务的体现,增进了医患关系,提高了患者满意度和手术成功率,降低了手术并发症,最大限度地保证了手术病员的安全与利益。

  7. Is it safe to perform operation for colorectal malignancy in Chinese patients without DVT prophylaxis? An 8-year experience from a regional hospital in Hong Kong

    Institute of Scientific and Technical Information of China (English)

    Day Weida; Lau Ying Yu Patrick; Yip Wai Chun Andrew

    2010-01-01

    Background Colorectal surgery was regarded as one of the high risk surgery for post-operative deep vein thrombosis (DVT) and pulmonary embolism. This study aimed at investigating the incidence of venous thromboembolism (VTE) after colorectal surgery for malignancy.Methods Data were collected from the prospective database of colorectal malignancy from 2000 to 2008. A total of 1421 colorectal (open and laparoscopic) operations were performed for the colorectal malignancy without DVT prophylaxis.Results Only seven patients (0.5%) developed symptomatic DVT and one of them had complication of pulmonary embolism without mortality. Open operation for colorectal malignancy was identified as possible risk factor of DVT,however, risk factors like operative time, low anterior resection, sex, age etc. were not identified.Conclusion Risk of venous thromboembolism after colorectal operation is low in Chinese of our locality and it might be safe to perform colorectal operation for malignancy without DVT prophylaxis.

  8. On Establishing Method of Internal Operating Performance Evaluation System in Hospital%浅谈医院建立内部经营业绩评价系统的方法

    Institute of Scientific and Technical Information of China (English)

    郑慧

    2012-01-01

    Combined with the thinking and working experience of scientific management, the method of establishing internal operating performance evaluation system in hospital was summarized from eight aspects: management department of establishing hospital internal operating performance evaluation, setting up and breaking up the strategic goal of hospital, identify evaluation objects, establishing evaluation system and standard, system of bonus and payment based on performance, analyzing the differences of performance and forming analysis report.%结合科学管理的思想及工作经验,将医院建立内部经营业绩评价系统的方法概括为成立医院内部经营业绩评价的主管部门、建立并分解医院的战略目标、确定评价客体、建立评价指标体系及评价标准、建立业绩奖金报酬制度、分析业绩执行差异并形成分析报告等8个方面.

  9. 医院实验动物管理与使用委员会的筹建与运作%The IACUC' s Built and Operation in Hospital

    Institute of Scientific and Technical Information of China (English)

    许虎峰; 刘云波; 李学勇; 张仲民; 谢苗荣; 尤红; 葛如军; 张冰

    2013-01-01

    Laboratory animal welfare and ethics has got more and more attention in China. The paper is based on the feature of laboratory animal in hospital and the five "M" concept( Manager/Men/Market/Mechanism/Money) , to discuss how to built and operate the Institutional Animal Care and Use Committee in hospital.%实验动物福利与伦理在国内日益受到重视,结合医院实验动物工作的特色,借鉴管理学五个“M”的理念,探讨了医院实验动物管理与使用委员会(IACUC)的筹建和运作.

  10. Saving Lives on the Battlefield: A Joint Trauma System Review of Pre-Hospital Trauma Care in Combined Joint Operating Area - Afghanistan (CJOA-A)

    Science.gov (United States)

    2013-01-30

    It was a point of emphasis by FORSCOM and TRADOC in the recent past. 14. Not one study has shown any survival benefit from pre-hospital resuscitation...initial entry general medical officer ( GMO ) flight surgeons with minimal clinical and practical experience. The PJ Medical Oversight and Advisory Board...companies vary on how skills are taught (e.g. “high and tight” tourniquets, improper location for needle decompression). Consider cost and benefit of

  11. The application of hospitality elements in hospitals.

    Science.gov (United States)

    Wu, Ziqi; Robson, Stephani; Hollis, Brooke

    2013-01-01

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

  12. Adequação das boas práticas de fabricação em serviços de alimentação Adequacy of good manufacturing procedures in foodservice establishments

    Directory of Open Access Journals (Sweden)

    Rita de Cássia Akutsu

    2005-06-01

    resultado quando comparados às demais unidades analisadas.OBJECTIVE: Classify a sample of 50 food producing establishments located in the Federal District (Brasília, Brazil, according to their fulfillment of essential requisites contained in the sanitary regulation form published by the Agência Nacional de Vigilância Sanitária, Brazil's National Agency for Sanitary Regulation. METHODS: A metanalysis of two monographic studies on food production establishments (hotels and commercial restaurants was performed, and associated to results of these authors' research evaluating ten Foodservice and Nutrition Units led by nutritionists, and five commercial restaurants. The procedures for good manufacturing were evaluated according to the norms of the mentioned Agency; to this effect, the Agency's specific forms were utilized to analyze the adequacy of requisites such as: construction, equipments, handling, production flow, and availability of the manual for good manufacturing procedures. Still according to the Agency's norms, the establishments were further classified into three groups, respective to their fulfillment of the essential requisite items and procedures as defined in the form: in group I, were those establishments fulfilling more than 70% of the requisites; group II, fulfilling 30 to 69.9% of them; and group III, fulfilling less than 30% of the essential items and procedures. RESULTS: According to the analyses, all the hotel foodservices were classified in group II, while the commercial restaurants were classified either in group II (33.3% or in group III (66.7%. As for the Foodservice and Nutrition Units with a nutritionist, 80% were classified as group II, and 20%, as group I. CONCLUSION: The results indicate that the Nutrition and Foodservice Units, which had nutritionists available, were better classified in requisites such as equipments and availability of a manual of good manufacturing procedures. The hotels revealed better conditions on items such as

  13. 对国有医院资产授权运营模式的思考%Thoughts on the authorized operation with state-owned assets in public hospitals

    Institute of Scientific and Technical Information of China (English)

    应争先; 沈琚; 李成

    2008-01-01

    针对我国现有医疗卫生改革的现状及其原因,从医院运营机制角度出发,阐明了医院国有资产授权运营模式的可行性及授权运营具体操作模式,为如何有效解决有限的国有卫生资源投入与人民日益增长的卫生健康需求之间的矛盾提出了一种新的思路.%In view of the current conditions and reasons about the reform of medical and health system in China,the paper expounds the feasibility of authorized operation with state-owned assets of public hospital and the concrete operational pattern from the angle of hospital operational mechanism, which proposes a new idea about how to effectively solve the contradiction between the limited investment on state-owned health resources and the growing demands on medical health.

  14. Parametric Optimization of Hospital Design

    DEFF Research Database (Denmark)

    Holst, Malene Kirstine; Kirkegaard, Poul Henning; Christoffersen, L.D.

    2013-01-01

    Present paper presents a parametric performancebased design model for optimizing hospital design. The design model operates with geometric input parameters defining the functional requirements of the hospital and input parameters in terms of performance objectives defining the design requirements...... and preferences of the hospital with respect to performances. The design model takes point of departure in the hospital functionalities as a set of defined parameters and rules describing the design requirements and preferences....

  15. Parametric Optimization of Hospital Design

    DEFF Research Database (Denmark)

    Holst, Malene Kirstine; Kirkegaard, Poul Henning; Christoffersen, L.D.

    2013-01-01

    Present paper presents a parametric performancebased design model for optimizing hospital design. The design model operates with geometric input parameters defining the functional requirements of the hospital and input parameters in terms of performance objectives defining the design requirements...... and preferences of the hospital with respect to performances. The design model takes point of departure in the hospital functionalities as a set of defined parameters and rules describing the design requirements and preferences....

  16. Operating room manager game

    NARCIS (Netherlands)

    Hans, Erwin W.; Nieberg, Tim

    2007-01-01

    The operating room (OR) department of a hospital forms the heart of the organization, where the single largest cost is incurred. This document presents and reports on the “Operating Room Manager Game,” developed to give insight into managing a large hospital's OR department at various levels of cont

  17. 药剂管理在医院中的作用及运行分析%The Role of the Management in Hospital and Operation Analysis

    Institute of Scientific and Technical Information of China (English)

    高来顺

    2015-01-01

    药剂管理工作承担着药品制剂的质量检测、供应和调剂等一系列非常关键的职能,因此其属于保证患者实现用药安全准确的重要保障. 科学合理的药剂管理工作可以对医院的药品资源进行有效的优化和整合,并且可以使医护人员能够对药品进行正确的使用,最终能够对医院日常工作效率的提升起到有效的促进作用,因此在医院的正常运作中药剂管理属于非常重要的一个环节. 有鉴于此,本文对药剂管理在医院中的主要内容和重要作用进行了分析和介绍.%Pharmaceutical management work to undertake the quality testing, supply and adjustment, and a series of very important functions, so it belongs to ensure that patients can achieve safe and accurate medicine. Scientific and rational drug management can effectively optimize and integrate the drug resources in the hospital, and can make the medical staff can use the medicine correctly, and can promote the efficiency of the hospital daily work. In view of this, this paper ana-lyzes and introduces the main contents and important functions of pharmaceutical management in hospital.

  18. A study to assess the influence of interprofessional point of care simulation training on safety culture in the operating theatre environment of a university teaching hospital.

    Science.gov (United States)

    Hinde, Theresa; Gale, Thomas; Anderson, Ian; Roberts, Martin; Sice, Paul

    2016-01-01

    Interprofessional point of care or in situ simulation is used as a training tool in our operating theatre directorate with the aim of improving crisis behaviours. This study aimed to assess the impact of interprofessional point of care simulation on the safety culture of operating theatres. A validated Safety Attitude Questionnaire was administered to staff members before each simulation scenario and then re-administered to the same staff members after 6-12 months. Pre- and post-training Safety Attitude Questionnaire-Operating Room (SAQ-OR) scores were compared using paired sample t-tests. Analysis revealed a statistically significant perceived improvement in both safety (p culture) 6-12 months after interprofessional simulation training. A growing body of literature suggests that a positive safety culture is associated with improved patient outcomes. Our study supports the implementation of point of care simulation as a useful intervention to improve safety culture in theatres.

  19. Hygiene guideline for the planning, installation, and operation of ventilation and air-conditioning systems in health-care settings – Guideline of the German Society for Hospital Hygiene (DGKH)

    Science.gov (United States)

    Külpmann, Rüdiger; Christiansen, Bärbel; Kramer, Axel; Lüderitz, Peter; Pitten, Frank-Albert; Wille, Frank; Zastrow, Klaus-Dieter; Lemm, Friederike; Sommer, Regina; Halabi, Milo

    2016-01-01

    Since the publication of the first “Hospital Hygiene Guideline for the implementation and operation of air conditioning systems (HVAC systems) in hospitals” (http://www.krankenhaushygiene.de/informationen/fachinformationen/leitlinien/12) in 2002, it was necessary due to the increase in knowledge, new regulations, improved air-conditioning systems and advanced test methods to revise the guideline. Based on the description of the basic features of ventilation concepts, its hygienic test and the usage-based requirements for ventilation, the DGKH section “Ventilation and air conditioning technology” attempts to provide answers for the major air quality issues in the planning, design and the hygienically safe operation of HVAC systems in rooms of health care. PMID:26958457

  20. Trabalho, saúde e subjetividade sob o olhar dos trabalhadores administrativo-operacionais de um hospital geral, público e universitário Work, health and subjectivity in the viewpoint of administrative and operational workers in a public general university hospital

    Directory of Open Access Journals (Sweden)

    Desiree Luzardo Cardozo Bianchessi

    2009-01-01

    investigation was to analyze the suffering of administrative and operational workers and the strategies of health production, due to the frequent occurrence of illnesses and absences from work. The conceptual field articulates the concepts of work, health and subjectivity, seeking the extension of the analysis of the focus in clinical diagnosis. The methodological strategies are based on the assumptions of intervention research, using the group device to operate in the field, combined with individual interviews, observations in the workplace and photographic intervention. The analyses show the configuration of the suffering of administrative and operational worker as related to the experience of invisibility, generated by collisions in labor relations in the organization of work at the hospital, where his place is associated with unworthiness and disqualification. Games of truth in the hospital show that the work recognized as having value is linked to medicine and to the prominent place medical knowledge historically occupies in the hospital. The workers studied suggest experiences of powerlessness in the face of demands of patients and families, considering the limitations imposed by public health policies. In view of the tensions generated in these experiences, they produce strategies linked to the production of health and coping with daily work in the hospital. The intervention research has provided multiple assemblages in the group, making it feasible to carry out the necessary changes in working relationships, bringing new meaning and seeking other modes of subjectivation.

  1. hospital's perspective

    African Journals Online (AJOL)

    Cost effectiveness of autologous blood transfusion - A developing country hospital's ... 4Military Hospital, Lagos. Summary. An autologous blood donation program was set up at. National .... risk of infection for autologous patients was 5.06.

  2. 我院药品运营的信息化管理与用药安全%Information Management of Drug Operations and Medication Safety in Our Hospital

    Institute of Scientific and Technical Information of China (English)

    沈怡雯; 王永庆; 孟玲; 王忠民; 顾民

    2016-01-01

    为实现医院药品运营的全程信息化管理,加强药品可溯源化管理,保障临床用药安全,引入RFID (Radio Frequency Identification,即射频识别)技术,通过医院内部 SCM (Supply Chain Management,即供应链管理)、WMS (Warehouse Management System,即仓储管理系统)、PASS (Prescription Automatic Screening System,即合理用药监测系统)、MCDEX (Clinical Drug Reference,即药物临床信息参考)合理用药信息支持系统等药品信息化平台的构建和运行,连接外部药品监管网络,建立了我院药品运营使用的全方位信息化管理模式。通过医院药品运营的多个管理软件系统的建设,达到了简化工作流程,提高工作效率,降低药品损耗,保障临床用药安全等优质管理目标。全方位的医院药品信息化安全建设,有利于加强药品可溯源化管理和患者用药安全。%In order to develop a whole process information system for drug operations and to ensure the safe clinical medication in our hospital, RFID (Radio Frequency Identification) technology was applied into the information management of drug operations. SCM (Supply Chain Management), WMS (Warehouse Management System), PASS (Prescription Automatic Screening System), MCDEX (Clinical Drug Reference) and other information systems were established and used for drug management in the hospital. The inner information systems were connected to exterior drug regulatory information systems, which formed a compre-hensive information system for drug management in the hospital. The drug management process was simpli-fied, work efficiency was improved, and drug wastage was dropped with the establishment of comprehensive information system in the hospital. In the meanwhile, drug safety for patients was also improved. The de-velopment of full range information system for drug security in hospitals is beneficial to strengthen drug tracing management and drug

  3. Effect of the implementation of the Hazard Analysis Critical Control Point (HACCP prerequisite program in an institutional foodservice unit in Southern Brazil Efeito da implementação do programa pré requisitos para Análise de Perigos e Pontos Críticos de Controle (APPCC em um serviço de alimentação institucional do sul do Brasil

    Directory of Open Access Journals (Sweden)

    Kelly Lameiro Rodrigues

    2012-03-01

    Full Text Available The aims of this study were to investigate the hygienic practices in the food production of an institutional foodservice unit in Southern Brazil and to evaluate the effect of implementing good food handling practices and standard operational procedures using microbiological hygiene indicators. An initial survey of the general operating conditions classified the unit as regular in terms of compliance with State safety guidelines for food service establishments. An action plan that incorporated the correction of noncompliance issues and the training of food handlers in good food handling practices and standard operational procedures were then implemented. The results of the microbiological analysis of utensils, preparation surfaces, food handlers' hands, water, and ambient air were recorded before and after the implementation of the action plan. The results showed that the implementation of this type of practice leads to the production of safer foods.O objetivo deste estudo foi investigar as práticas de higiene na produção de alimentos em um serviço de alimentação do Sul do Brasil, e avaliar o efeito da aplicação das Boas Práticas de Manipulação e Procedimentos Operacionais Padronizados utilizando indicadores microbiológicos de qualidade de higiene. Um levantamento inicial sobre as condições de funcionamento geral classificou a unidade como regular em relação ao cumprimento das diretrizes de segurança do Estado para os estabelecimentos de produção de alimentos. Foi implementado um plano de ação que incorporou a correção das questões de não-conformidade e a formação dos manipuladores de alimentos sobre boas práticas alimentares manipulação e Procedimentos Operacionais Padronizados. Os resultados das análises microbiológicas realizadas em utensílios, superfícies de manipulação de alimentos, mãos de manipuladores de alimentos, água e ar foram registrados antes e depois da implementação do plano de ação. Os

  4. La intervención quirúrgica: Rito de paso en ambiente hospitalario The surgical operation: Rite of passage in a hospital context

    Directory of Open Access Journals (Sweden)

    Javier González Requejo

    2008-09-01

    Full Text Available El ritual que se procede a analizar pertenece al ámbito de la salud/enfermedad. Se trata de una intervención quirúrgica, un acto cotidiano sin ninguna significación aparente más allá de la puramente técnica. La historia de la cirugía es tan antigua como el hombre. En civilizaciones como la egipcia o las precolombinas encontramos pruebas de intervenciones incluso craneales. Para Laín Entralgo "la trepanación craneal ejecutada desde el Paleolítico en los más distintos lugares del planeta fue emprendida con dos finalidades diferentes, a veces combinadas entre sí: la quirúrgica y la mágica." Este ritual se desarrolla hoy en día en el medio hospitalario, el cual se ajusta al modelo de Institución total definido por Goffman. El proceso tiene lugar en el Hospital del Oriente de Asturias, en cuyo bloque quirúrgico trabajo como enfermero desde hace seis años, lo cual facilita una observación participante del mismo. La principal aportación de este artículo es su capacidad para desvelar los significa-dos del proceso quirúrgico desde una posición antropológica. Ello puede servir de base para aplicar el sentido crítico y cuestionarnos sobre nuestras acciones profesionales ya que las cosas significan más de lo que parecen.The ritual is to analyze belongs to the field of health / disease. This is a surgical intervention, an act everyday without any apparent significance beyond the purely technique. The history of surgery is as old as man. In civilizations like Egyptian or pre-Columbian find evidence of interventions including skull. For Lain Entralgo "Cranial trepanation executed from the Palaeolithic in the most diverse places on the planet was undertaken with two different purposes, sometimes combined with each other: the surgical and magic." This ritual takes place today in a hospital setting, which is in line with the model defined total Institution Goffman. The process takes place at the Hospital del Oriente de Asturias, whose

  5. Hospitality within hospital meals –

    DEFF Research Database (Denmark)

    Justesen, Lise; Gyimóthy, Szilvia; Mikkelsen, Bent Egberg

    2016-01-01

    Hospital meals and their role in nutritional care have been studied primarily from a life and natural science perspective. This article takes a different approach and explores the idea of hospitality inspired by Jacques Derrida’s work on the ontology of hospitality. By drawing on ethnographic...... fieldwork in a Danish hospital, hospitality practices were studied using a socio-material assemblage approach. The study showed that rethinking the meal event could change the wards into temporary “pop-up-restaurants,” transcending the hospital context and providing a scene for shifting host...... and management involved in hospital food service and in nutritional care to work more systematically with the environment for improved hospital meal experiences in the future...

  6. Distribution of methicillin-resistant coagulase-positive staphylococci (MRCoPS) in a surgical unit and cystotomy operation sites in a veterinary teaching hospital.

    Science.gov (United States)

    Fungwithaya, Punpichaya; Brikshavana, Pasakorn; Chanchaithong, Pattrarat; Prapasarakul, Nuvee

    2017-02-28

    This study aimed to investigate the spread of methicillin-resistant coagulase-positive staphylococci (MRCoPS) among veterinary staff, hand-touch sites and surgical tissue during cystotomy operations on cats and dogs that were patients, and to analyze the genetic relatedness and antimicrobial resistance profiles of the isolates. Human and environmental samples were obtained from the nasal passageways of 12 surgeons and veterinary assistants and from 29 hand-touch sites of instruments in operative units and subjected to bacterial isolation and enumeration. Swab samples were collected in triplicate from 29 dogs and three cats at the site of incision, from the incision area, from the peritoneum during surgery and from the peritoneum before suture. MRCoPS were identified by mecA gene detection and characterized by their antibiogram profile, SCCmec type and pulsed-field gel electrophoresis. Twenty-four staphylococci were isolated, derived from one veterinary assistant, 12 operating room floor areas and hand-touch sites, three dogs and one cat. Methicillin-resistant S. pseudintermedius (MRSP) was found on an electric clipper and rebreathing circuits in the operating room. Three dogs were positive for MRSP during surgery, and one methicillin-resistant S. aureus (MRSA) was detected in a cat. All MRCoPS were resistant to doxycycline, erythromycin, clindamycin and enrofloxacin, but no patients developed surgical site infections. According to their genotypic patterns, the clones obtained from the environment and human sources differed from the animal clones. Despite intensive hygienic management, a variety of MRCoPS clones were present within the surgical unit and during surgery.

  7. Decreasing delays in urgent and expedited surgery in a university teaching hospital through audit and communication between peri-operative and surgical directorates.

    Science.gov (United States)

    Cosgrove, J F; Gaughan, M; Snowden, C P; Lees, T

    2008-06-01

    National Confidential Enquiry into Patient Outcome and Death guidelines for urgent surgery recommend a fully staffed emergency operating theatre and restriction of 'after-midnight' operating to immediate life-, limb- or organ-threatening conditions. Audit performed in our institution demonstrated significant decreases in waiting times for urgent surgery and an increased seniority of medical care associated with overnight pre-operative assessment of patients by anaesthetic trainees. Nevertheless, urgent cases continued to be delayed unnecessarily. A classification of delays was developed from existing guidelines and their incidence was audited. The results were disseminated to involved directorates. A repeat of the audit demonstrated a significant decrease in delays (p = 0.001), a significant increase in the availability of surgeons (p = 0.001) and a significant decrease in the median waiting time for urgent surgery compared to the first audit cycle and a previous standard (p auditing delays and disseminating the results of the audit significantly decreases delays and median waiting times for urgent surgery because of improved surgical availability.

  8. Analysis of the Effect of Disinfection Management in Operating Room on Hospital Infection Control%手术室消毒对感染控制的效果分析

    Institute of Scientific and Technical Information of China (English)

    程锐; 陈伟丽; 叶旭霞

    2016-01-01

    Objective To explore the effect of disinfection management in operating room on hospital infection control.Methods Disinfection and sterilization monitoring data from January 2013 to December 2014 when traditional operating room management was implemented in our hospital was randomly selected as the control group. Disinfection and sterilization monitoring data from January 2015 to December 2015 when disinfection management in operating room was implemented in our hospital was randomly selected as the treatment group. Comparison of the disinfection effect in operating room and incision infection rate between two groups was made.Results The qualified rate of the air, disinfection articles and hand disinfection of medical staffs in operating room after disinfection management was significantly higher than that in control group with statistically significant difference (P<0.05). The infection rate of surgical patients after the implementation of disinfection management in operating room was lower than that in the control group with statistically significant difference (P<0.05).Conclusion Strengthening the disinfection management in operation room can promote the formation of a good habit for medical personnel in operation room and reduce the incision infection rate.%目的探讨手术室消毒管理对医院感染控制的效果。方法随机抽取2013年1月至2014年12月我院实施传统手术室管理模式期间的消毒灭菌监测资料作为对照组,随机抽取2015年1月至2015年12月我院实施手术室消毒管理模式期间的消毒灭菌监测资料作为观察组,对比两组手术室消毒效果及研究期间手术室收治患者切口感染率。结果实施手术室消毒管理后手术室空气、消毒物品及医护人员手消毒合格率均较传统手术室管理提高,差异有统计学意义(P<0.05);实施手术室消毒管理后各科室手术患者手术部位感染率均较传统手术室管理降低,

  9. Practice of Investment-Operation-Transfer (IOT) Mode Tried in Public Hospitals%公立医院试行IOT模式的实践

    Institute of Scientific and Technical Information of China (English)

    贾文清; 张威

    2013-01-01

    中国的医疗体制改革是关系民生的大问题,改革以什么模式进行引发了众多争议.我们不妨借鉴西方先进国家的经验,从中找到一条适合中国国情的医改之路.门头沟区医院率先在公立医院试行IOT(Investment-Operation-Transfer)模式进行改革,取得了较好的效果.

  10. Study on Operation Strategies of Hospital Official Micro -blog in the All Media Environment%全媒体环境下医院官微的运营策略探析

    Institute of Scientific and Technical Information of China (English)

    徐琨

    2016-01-01

    全媒体时代的到来革新了传媒生态环境,也给医院宣传工作带来改变。微博作为伴随互联网发展而出现的医院宣传管理新平台,同样面临着全媒体时代大环境的冲击和影响。该文主要围绕全媒体时代医院宣传环境以及微博的发展变化进行分析,提出了全媒体环境下医院官微的运营策略。当前,医院官微需要在五个方面作出转变,实现思维方式由“自说自话”走向“对话互动”,角色形象由单纯宣传者走向综合服务者,发布内容由碎片化走向系统化,管理方式由自由化走向集约化,宣传策略由“单打独斗”走向“协同作战”。%The coming of all media era revolutionizes the environment of mass media and also brings change to the hospital propaganda work. Micro-blog, as a new platform of propaganda and management of hospitals with the development of the in-ternet, is also faced with the impact and effect of the all media era. The paper mainly analyzes the hospital propaganda en-vironment and development and change of micro-blog in all media era and puts forwards the operation strategies of hospital official micro-blog in the all media environment. At present, the hospital micro-blog needs to change in five aspects and makes the mode of thinking from “saying to oneself” to “conversational interaction”, the role image from “simple advo-cates” to “comprehensive servers”, publishing content from “fragmentation” to “systematization”, management mode from“liberalization” to “intensification”, and the propaganda strategy from “fighting alone” to “cooperative combat”.

  11. Hospitality Industry

    Directory of Open Access Journals (Sweden)

    Marian Ionel

    2017-03-01

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

  12. Hospital food waste and environmental and economic indicators--A Portuguese case study.

    Science.gov (United States)

    Dias-Ferreira, C; Santos, T; Oliveira, V

    2015-12-01

    This study presents a comprehensive characterization of plate waste (food served but not eaten) at an acute care hospital in Portugal and elaborates on possible waste reduction measures. Even though waste prevention is a priority in Europe, large amounts of food are still being wasted every day, with hospitals giving rise to two to three times more food waste than other foodservice sectors. For this work the plate waste arising at the ward level was audited during 8 weeks, covering almost 8000 meals, using a general hospital as case study. Weighing the food served to patients and that returned after the meal allowed calculating plate waste for the average meal, as well as for individual meal items. Comparison of food waste arising showed that differences exist among wards, with some generating more waste than others. On average each patient throws away 953 g of food each day, representing 35% of the food served. This equates to 8.7 thousand tonnes of food waste being thrown away each year at hospitals across Portugal. These tonnes of food transformed into waste represent economic losses and environmental impacts, being estimated that 16.4 thousand tonnes of CO2 (equivalent) and 35.3 million euros are the annual national indicators in Portugal. This means that 0.5% of the Portuguese National Health budget gets thrown away as food waste. Given the magnitude of the food problem five measures were suggested to reduce food waste, and their potential impact and ease of implementation were discussed. Even though food waste is unavoidable the results obtained in this work highlight the potential financial and environmental savings for Portuguese hospitals, providing a basis to establish future strategies to tackle food waste.

  13. Incidence and Pattern of Cranio-Maxillofacial Injuries: A 22 year Retrospective Analysis of Cases Operated at Major Trauma Hospitals/Centres in Pune, India.

    Science.gov (United States)

    Gadre, Kiran S; Halli, Rajshekhar; Joshi, Samir; Ramanojam, Shandilya; Gadre, Pushkar K; Kunchur, Ranjit; Bhosale, Gururaj; Kaul, Deepak

    2013-12-01

    This study aims to retrospectively analyze the incidence and pattern of cranio-maxillofacial injuries in the developing world in a hope to emphasize on authorities the need of improvising infrastructural facilities, medical and other. Hospital medical records with available radiographs of 6,872 patients treated for cranio-maxillofacial injuries at major trauma centres in Pune, India over a 22 year period (from July 1989 to June 2010) were reviewed. Relevant data pertaining to patients' age, sex, cause of injury, sites of injury, associated injuries, anaesthesia, various treatment modalities and complications were recorded and analyzed statistically. A total of 6,872 patients sustained maxillofacial injuries of which 5,936 (86.4 %) were caused by road traffic accidents (RTA), followed by fall in 608 cases. Distribution pattern of sex revealed male predominance (M:F-2.5:1) and the third decade age group (2,416) sustained maximum cranio-maxillofacial injuries. Of 12,503 cranio-maxillofacial sites involved, mandible (6,456) predominated, while there was middle third involvement in 5,024 cases. Most of the patients (4,856) were treated with open reduction and internal fixation without maxillo-mandibular fixation and complications were noted in 320 patients. In comparison to similar recent studies reported in the literature, our findings show that RTA remains the most common cause of cranio-maxillofacial injuries with male preponderance. Also RTA remains the major preventable etiological factor of cranio-maxillofacial injuries, which should prompt authorities to take "Herculean effort" to implement rules and educate people.

  14. Internal auditing in hospitals.

    Science.gov (United States)

    Edwards, Don; Kusel, Jim; Oxner, Tom

    2003-01-01

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

  15. Delivery times for caesarean section at Queen Elizabeth Central Hospital, Blantyre, Malawi: is a 30-minute 'informed to start of operative delivery time' achievable?

    Science.gov (United States)

    O'Regan, M

    2003-08-01

    A timesheet questionnaire was used to assess the time it took from informing the anaesthetist about a case to the start of operative delivery in 78 consecutive patients undergoing caesarean section. Median (IQR [range]) times for grade-1 cases (immediate threat to the life of the mother or fetus) and grade-2 cases (fetal or maternal compromise without immediate threat to life) were 20 (17-35 [6-75]) min and 41 (27-60 [17-136]) min, respectively. Delays occurred in all the component time intervals examined. The primary avoidable delay was the patient's late arrival in theatre. Many significant delays were apparently not perceived by the anaesthetist. In nine (69%) grade-1 cases, the 30-min target decreed by the Association of Anaesthetists of Great Britain & Ireland and the Obstetric Anaesthetists' Association was achieved.

  16. Prescribing pattern and WHO core prescribing indicators in post-operative patients of Gynaecology department of a tertiary care teaching hospital

    Directory of Open Access Journals (Sweden)

    Bhanu P. Kolasani

    2016-12-01

    Full Text Available Background: Prescription pattern analysis is an essential tool to provide an insight regarding the existing drug usage and to ensure rational drug therapy. Even though drugs used for gynecological disorders are one of the commonly used, they are least studied in terms of prescribing patterns. Hence the present study was planned to analyze the prescribing pattern and WHO core prescribing indicators among post-operative patients of Gynaecology department in our institute. Methods: A prospective observational study was conducted in 76 post-operative patients of Gynaecology department for a period of six months. Each prescription was analyzed for demographic data, total number and various categories of drugs prescribed, the percentage of individual drugs prescribed in each category, the dosage forms and the percentage of drugs prescribed by generic name, and from essential drug list were also analyzed. Results: A total of 990 medications were prescribed among which anti-microbial agents (32.52% were the most commonly prescribed category followed by analgesics (19.60% and Intravenous fluids (13.53%. Metronidazole (27.02% was the most commonly prescribed antimicrobial, Diclofenac (68.04% was the commonly prescribed analgesics and Ringer lactate (38.81% was the commonly prescribed Intravenous fluid. Most commonly prescribed antiulcer drug was ranitidine (75.0%, antiemetic was Ondansetron (76.39%. Majority of drugs (72.54% were prescribed by generic name. Average number of drugs per prescription was 13.03. Percentages of encounters with antibiotics were 32.52%. The percentage of drugs prescribed from the National List of Essential Medicines (NLEM was 82.16%. Injection (57.78% was the most common drug formulation. Conclusions: Antimicrobial agents and analgesics were the most commonly prescribed drugs. Prescription by generic name was high, usage of antibiotics and injections were also high and Poly-pharmacy was common, especially among antimicrobial

  17. Use and Analysis of Field Shelter Hospital Outpatient and Emergency Module in Non-war Operation%非战争军事行动野战方舱医院门急诊模块使用与分析

    Institute of Scientific and Technical Information of China (English)

    赵海鹰; 左广友; 王军; 张磊

    2012-01-01

    Objective To explore the layout of outpatient and emergency department and staff configuration of field shelter hospital. Methods The outpatient and emergency department was separated, and green channel for emergency department was established, The registered triage area for outpatient department was set up, and the specialists from the medical team did the normal treatment, the number of which was adjusted according to the casualty flow. Centre dressing room and special clinic tent were established. Results The layout of outpatient and emergency department and staff configuration studied were taken to the earthquake relief mission in 2008 Mianzhu and 2010 Yushu, and there were no lacks of treatment quality in the pre-control, triage, treatment, technical operations and rescue work. Conclusion The layout of outpatient and emergency department and staff configuration studied adapts to outpatient and emergency department management for field shelter hospital in non-war operation, and greutly improves the treatment force for field shelter hospital.[Chinese Medical Equipment Journal,2012,33(5):82-63]%目的:探讨方舱医院门急诊布局及人员配置.方法:门急诊分开,建主急诊绿色通道;设立门诊挂号分诊区,由医疗组各专科医生出正常门诊,随伤员流动情况调整出诊医生人数;成立中心换药室及特诊帐篷.结果:某部野战方舱医院在2008年赴四川绵竹,2010年赴青海玉树抗震救灾执行任务中,采取此门急诊布局及人员配置,对患者的预控、分诊、治疗、技术操作和抢救等做到了救活质量零缺陷.结论:此种门急诊布局及人员配置,适应非战争军事行动方舱医院的门急诊管理,极大地提高了方舱医院的救活能力.

  18. 8S管理在手术室医院感染控制中的应用%The application of 8S management in the control of operating room hospital infection

    Institute of Scientific and Technical Information of China (English)

    姚锦尚; 肖平平; 张梅

    2015-01-01

    目的::探讨通过实施8S精益管理提高手术室医院感染控制水平的有效管理方法。方法:选择2012年1月~2013年12月我院手术室环境卫生学及消毒灭菌监测资料,将2012年1~12月医院感染控制主要实施规范化管理措施分为对照组;2013年1~12月在规范化管理的基础上引入8S管理理念(即整理、整顿、清扫、清洁、素养、安全、学习、节约)分为观察组。查阅同期产科、普外科、骨科手术出院病人病历,分析比较两组手术室环境卫生学和消毒灭菌监测资料数据,以及不同科室手术患者的手术部位感染数据。结果:两组手术室环境卫生学及消毒灭菌合格率比较手术间空气与医务人员手监测数据差异有统计学意义(P<0.05);不同科室手术患者的手术部位感染数据有统计学意义(P<0.05)。结论:手术室实施8S精益管理,可以促进医务人员形成良好的行为习惯,提高专业文化素养,提高手卫生依从性,有效降低手术患者手术部位感染率。%Objective:To investigate the effctive method of improving the control level of operating room hospital infection through the application of 8S man-agement. Methods:In 2012,standardized management measures were mainy applied in the control of operating room management,whose monioring data were classified as the control group. In the year of 2013,on the base of standardized management,8S management ( sort,straighten,sweep,sanitary,sentiment, safety,study and save) were introduced,whose data were classified as the observation group. Applying method of retrospective survey,by inspecting the re-cords of obstetric,general surgery and orthopedic patients who had been discharged in 2012 and 2013,analyzed and compared the data of sterilization and environmental hygiene and the data of surgical site infection of patients of various departments. Results:Comparing the passing rate of sterilization and envi

  19. The impact of service-specific staffing, case scheduling, turnovers, and first-case starts on anesthesia group and operating room productivity: a tutorial using data from an Australian hospital.

    Science.gov (United States)

    McIntosh, Catherine; Dexter, Franklin; Epstein, Richard H

    2006-12-01

    In this tutorial, we consider the impact of operating room (OR) management on anesthesia group and OR labor productivity and costs. Most of the tutorial focuses on the steps required for each facility to refine its OR allocations using its own data collected during patient care. Data from a hospital in Australia are used throughout to illustrate the methods. OR allocation is a two-stage process. During the initial tactical stage of allocating OR time, OR capacity ("block time") is adjusted. For operational decision-making on a shorter-term basis, the existing workload can be considered fixed. Staffing is matched to that workload based on maximizing the efficiency of use of OR time. Scheduling cases and making decisions on the day of surgery to increase OR efficiency are worthwhile interventions to increase anesthesia group productivity. However, by far, the most important step is the appropriate refinement of OR allocations (i.e., planning service-specific staffing) 2-3 mo before the day of surgery. Reducing surgical and/or turnover times and delays in first-case-of-the-day starts generally provides small reductions in OR labor costs. Results vary widely because they are highly sensitive both to the OR allocations (i.e., staffing) and to the appropriateness of those OR allocations.

  20. A医院心脏介入手术室管理流程再造研究%Study on process reengineering of cardiac interventional operation in hospital A

    Institute of Scientific and Technical Information of China (English)

    刁晓兰; 张伟

    2015-01-01

    目的::心脏介入手术流程的优劣关系到内、外部顾客(医务人员、患者)的满意度和医:的工作效率。本课题对心脏介入手术室工作流程进行分析与改进,旨在提高工作效率与质量。方法:选取流程再造后接受心脏介入的手术患者246例作为观察组,流程再造前接受心脏介入的患者210例作为对照组,比较流程再造前后心脏介入室首台手术等待时间、连台手术间隔时间及每日每手术间台次、患者的遵医行为、不良事件发生率等客观指标及满意度,观察流程再造的效果。结果:流程再造提高了心脏介入手术室的服务质量和工作效率(P<0.05),不良事件发生率减少(P<0.05),患者和手术室工作人员满意度提高(P<0.05)。结论:流程再造是适应学科发展和医:管理的必要内容,是提升医:竞争力的客观要求。%Objective: Quality of intervention operation process is directly related to the satisfaction of the internal and external customers ( patients and doctors ) and efficiency of the hospital. The aim of this investigation is how to increase work efficiency and quality through optimizing cardiac intervention operation processes. Methods: Patients were divided into two groups. The control group was received the primary process, and the observation group was received the reengineering process. The efficiency of work, percentage of satisfaction and incident rate of adverse event were detected by questionnaire. Results: Management of cardiac intervention operation processes could increase the quality and efficiency of medical service in hospital A. Conclusion: The theory of business process optimization and management could be applied into the practical work.

  1. 长沙市综合医院手术室男护士工作现状调查%Investigation of Working Present Situation of Male Nurses at Operating Room in General Hospital of Changsha City

    Institute of Scientific and Technical Information of China (English)

    余尚昆; 董小文

    2016-01-01

    目的:调查湖南省长沙市二级甲等以上综合医院手术室男护士的工作现状,以帮助他们正确看待自己的专业,解决一些疑惑,以便为改善医院手术室男护士身心健康状况提供依据,从而使他们以良好的状态工作。方法采取双向调查的方法,随机选择长沙市8所二级甲等以上综合手术室男护士和女护士各60人,以及男护士参与过手术的患者、手术医生、女护士各50名,采用自行设计的调查问卷进行调查。结果男护士在手术室中承担着大量有益的工作,与女护士比较男护士在应急、体力、学习、互补等方面具有优势,手术患者、手术室医生、手术室护士对男护士满意度较高,差异有统计学意义(P<0.05)。结论手术室应该根据自身情况,不断加强男护士队伍建设,充分发挥其优势,更好地服务患者。%Objective To investigate the working situation of male nurses at operating room in secondary A or higher general hospitals in Changsha and give them assistance to correctly view their major and solve their problems in order to provide evidence for improving the physical and mental health of operating room male nurses. Thus enable them to work in good condition. Methods Adopted to investigate two-way, 8 secondary hospitals above comprehensive operation room male nurses and nurse of 60 people were randomly selected in Changsha, as well as male nurses in surgery patients, doctors and women nurses 50 cases, using self-designed questionnaire survey. Results Male nurse takes a lot of useful work in the operating room, compared with female nurses male nurses in emergency, physical strength, gender, learning, complementary, have obvious advantages, surgery patients, operating room doctors and nurses on male nurse satisfaction is high, the difference has statistical significance (P<0.05).ConclusionAccording to self-condition, operating rooms should continue to

  2. Hospital Inspections

    Data.gov (United States)

    U.S. Department of Health & Human Services — Welcome to hospitalinspections.org, a website run by the Association of Health Care Journalists (AHCJ) that aims to make federal hospital inspection reports easier...

  3. Hospital Inspections

    Data.gov (United States)

    U.S. Department of Health & Human Services — Welcome to hospitalinspections.org, a website run by the Association of Health Care Journalists (AHCJ) that aims to make federal hospital inspection reports easier...

  4. Hospital marketing.

    Science.gov (United States)

    Carter, Tony

    2003-01-01

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

  5. AIR DISINFECTION EFFECT IN THE OPERATING ROOM OF HOSPITAL BY USING THE LOCAL AIR PURIFICATION DEVICE%局部空气净化装置对手术室空气的消毒效果

    Institute of Scientific and Technical Information of China (English)

    陈英

    2012-01-01

    目的 观察空气消毒机对医院手术室空气消毒效果,以评价其实际应用效果.方法 采用平板沉降采样和细菌培养方法,评价该多因子组合空气净化装置对手术室空气中自然菌净化效果,并与紫外线灯照射消毒作平行比较.结果 启动YKX/Y型空气消毒机和紫外线灯作用30 min,5 min后采样,手术室空气中细菌总数<200cfu/m3,随着时间的延长,空气中菌数逐渐增加,15 min后细菌总数逐渐增加到200 cfu/m3以上.在手术室有6人工作的情况下,空气消毒机持续运行,可使空气细菌继续保持在<200 cfu/m3.结论 试验用空气消毒机可以在手术期间持续消毒,可以维持手术室内空气中细菌总数< 200 cfu/m3.%Objective To observe the air disinfection effect in the operating room of hospital by using the local air purification device and evaluate the practical application effect of the device. Methods By using the methods of tablet settlement sampling and bacterial culture, to evaluate and compare the effect of air purification in the operating room by the air purification device and ultraviolet light irradiation. Results 5 mins later after using the air disinfection device of YKX / Y - type and the ultraviolet ray lamp for 30 mins, the total number of bacteria in the air of operating room was less than 200 cfu/m3. As the time prolonged to 15 min, the bacteria number increased to more than 200 cfu/m3. Under the condition of six persons working and the air disinfection device running continuously in the operating room, the bacteria in the air maintained less than 200 cfu/m3. Conclusion The air purification device can continue disinfection during surgical operation and the number of bacteria can maintain less than 200 cfu/m3.

  6. Diversification in the hospital industry.

    Science.gov (United States)

    Eastaugh, Steven R

    2008-01-01

    An institution life cycle hypothesis is advanced to explain hospital behavior: boom and bust, diversification and divestiture, occasionally leading to closure or merger. Hospital diversification and its impact on the operating ratio are studied for 172 hospitals during the period 2002-2007. Diversification and operating ratio are modeled in a two-stage least squares (TSLS) framework as being jointly dependant. Institutional diversification is found to yield better financial position, and the better operating profits allow the institution the wherewithal to diversify. The impact of external government planning and hospital competition is also measured. Some services are in a growth phase, like bariatric weight loss surgery and sleep disorder clinics. Management's attitude concerning risk and reward is considered.

  7. [Laparoscopic operation for colovesical fistula].

    Science.gov (United States)

    Tvedskov, Tove H Filtenborg; Ovesen, Henrik; Seiersen, Michael

    2008-01-14

    Since 2005 the surgical department of Roskilde County Hospital has treated selected patients with colovesical fistulas laparoscopically. We describe two patients with symptoms of pneumaturia and urinary tract infections. CT scanning, cystoscopy and sigmoideoscopy showed colovesical fistula and laparoscopic operation was performed. The operating times were 280 and 285 minutes and the length of their hospital stays was four and three days without complications. We suggest that laparoscopic operation for colovesical fistula can be a good alternative to open operation on selected patients.

  8. Prevention of occupational exposure to nurses in operating room of grass-roots hospitals%基层医院手术室护士职业暴露的预防

    Institute of Scientific and Technical Information of China (English)

    徐秀琴; 谢多希; 谢灵智; 王淑珠; 贾仕林; 胡乐湖; 倪金莲

    2011-01-01

    OBJECTIVE To investigate the factors for occupational exposure to the nurses in hospital operating room,and to adopt intervention measures to reduce the incidence of occupational exposure. METHODS The incidence of occupational exposure to nurses in operating room was analyzed by using questionnaire survey; Efforts was made to develop the training, lectures, establish the management regulations and institute the intervention measures, including the operation guide, to reduce the incidence of occupational exposure. RESULTS After the intervention measures adopted by the target population, the awareness rate of the knowledge about occupational exposure were that before: 36. 8% ~ 89. 5%, after: 88. 2% ~ 100. 0%. The annual rate of occupational exposure were before: 47. 4%, after: 5. 3%. The difference before and after the intervention was statistically significant (P <0. 05 ). CONCLUSION The prevalence of occupational exposure widely occurs to nurses in operating room, the intervention activities related to occupational exposure can be effective in reducing the incidence of occupational exposure.%目的 探讨基层医院手术室护士职业暴露因素之间的关联性,采取干预措施以减少职业暴露发生率.方法 采用问卷调查的方式,统计基层医院手术室护士职业暴露发生情况;开展职业暴露防护培训、讲座、建立管理规章、制定操作防护指南等干预措施,减少职业暴露发生率.结果 职业暴露相关知识知晓率干预前36.8%~89.5%,干预后88.2%~100.0%;年职业暴露率干预前:47.4%,干预后:5.3%;干预前后比较差异有统计学意义(P<0.05).结论 手术室护士发生职业暴露普遍存在,开展职业暴露相关干预活动,可有效减少职业暴露发生率.

  9. Analysis of hospital logistics and costs of the Clinical Engineering Sector in a Philanthropic Hospital

    OpenAIRE

    Antônio Artur de Souza; André Sousa Braga; Ciro Gustavo Bragança; Luiz Augusto de Carvalho Francisco Soares; Ewerton Alex Avelar

    2014-01-01

    Hospitals are considered complex organizations mainly due to the high cost of the health care structure employed for care. Reducing operating costs is a challenge for hospital managers. Particularly in the clinical engineering sector, adequate hospital logistics can reduce costs. In this context, the aim of the research was to analyze the activities of hospital logistics of the Clinical Engineering department at a charity hospital, focusing on cost reduction. The paper presents a ...

  10. Ventilation in the Hospital Operating Room.

    Science.gov (United States)

    1984-10-01

    protocol. a. Give sodium pentothal to make the patient lose consciousness. b. With the patient unconscious, inject a skeletal muscle relaxant . c. In...seconds of flow at 0.1 L/min). (2) The actual time that passes from the intravenous injection of the skeletal muscle relaxant to connection of the...intravenous injection of the skeletal muscle relaxant to connection of the delivery tube is again assumed to be two minutes. Therefore, the one liter

  11. Ensuring cleanliness in operating theatres.

    Science.gov (United States)

    Charkowska, Anna

    2008-01-01

    High cleanliness of a hospital environment is necessary to ensure safe working conditions for the medical staff, a correct process of hospitalization and to protect hospital visitors, an aspect rarely mentioned. A supply of air cleaned in highly-effective air filters to hospital wards with air conditioning systems and exhaust of infected air will help in maintaining the required standards of cleanliness. This article presents information on recommended classes of air and surface cleanliness, with special focus on operating theatres and suites.

  12. Demonstration of Design and Operation of Hospital Performance Inspection under Health Care Reform%新医改政策下医院绩效考核的设计及运行实证研究

    Institute of Scientific and Technical Information of China (English)

    张霞; 李彤娟; 朱玉彦; 赵兰萍

    2011-01-01

    结合国家颁布的医改政策中关于医疗卫生机构要加强和完善内部管理,建立以服务质量为核心、以岗位责任与绩效为基础的考核和激励制度的要求,以及医院自身发展的需要,采用同行调研、问卷调查、专家咨询等方法,使用平衡计分卡、关键业绩指标法等手段,在绩效考核及分配方案设计中充分考虑财务、顾客、服务效率和员工成长4个维度及犯项关键业绩指标,制定了石家庄市第四医院的绩效考核体系.l年多的运行表明:新建立的绩效考核体系操作简单易行,评价指标明确,注重患者和市场.既提高了医院的质量管理目标,又激发了员工的学习和创新能力;既提高了医院的财务收益,又降低了患者负担;既重视了医务人员的服务质量、服务效率,又重视了员工的成长,实现了效率与公平平衡发展的目的.%According to the government's new health reform, the new performance inspection of the fourth hospital of Shijiazhuang is established by introducing the investigation of similar hospital, the comparison experiment of different schemes, the questionnaire of different group and the consulting of specialist as research methods, the balance scorecard (BSC), the key performance index method (KPI) and the behaviorally anchored rating scale (BARS) as research means. Meanwhile, four dimensions such as finance, custom, service efficiency and staff development and 32 key performance indicators are also taken into account. The established performance inspection is executed nearly one year and the results showed that this scheme is operated easily, the appraisal indexes are clearly, and the relation of efficiency and fairness is balanced. The hospital's objective of quality management is improved by the perfect inner running and the study and creative abilities of staff are spirited. Furthermore, the management level of hospital is improved greatly and the health care costs are

  13. Future pension accounting changes: implications for hospitals.

    Science.gov (United States)

    Weld, Tim; Klein, Gina

    2011-05-01

    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.

  14. Academic Hospitality

    Science.gov (United States)

    Phipps, Alison; Barnett, Ronald

    2007-01-01

    Academic hospitality is a feature of academic life. It takes many forms. It takes material form in the hosting of academics giving papers. It takes epistemological form in the welcome of new ideas. It takes linguistic form in the translation of academic work into other languages, and it takes touristic form through the welcome and generosity with…

  15. Hospitality Management.

    Science.gov (United States)

    College of the Canyons, Valencia, CA.

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

  16. Hospital management contracts: institutional and community perspectives.

    OpenAIRE

    Wheeler, J. R.; Zuckerman, H S

    1984-01-01

    Previous studies have shown that external management by contract can improve the performance of managed hospitals. This article presents a conceptual framework which develops specific hypotheses concerning improved hospital operating efficiency, increased ability to meet hospital objectives, and increased ability to meet community objectives. Next, changes in the process and structure of management under contractual arrangements, based on observations from two not-for-profit hospital systems,...

  17. Current status of premature infants′ pain operation experienced during hospitalization%早产儿住院期间经历致痛性操作的现状调查

    Institute of Scientific and Technical Information of China (English)

    陈丽莲; 熊小云; 余霞娟; 袁瑞琴; 黄颖穗; 曹爱芬

    2015-01-01

    目的:调查早产儿住院期间经历致痛性操作的现状,为早产儿的疼痛管理提供理论依据。方法采用方便抽样的方法,选取2014年8—10月深圳市某三级医院新生儿重症监护室收治的111例早产儿为研究对象,调查早产儿住院期间经历致痛性操作的项目、数量及疼痛水平。疼痛评分采用早产儿疼痛评分量表( PIPP)进行评分。结果111例早产儿住院期间共经8258次致痛性操作,平均每例早产儿经历(74.4±18.22)次,每人每天经历(3.72±1.53)次。出生体质量<1500 g的早产儿平均每人经历153次,出生体质量≥1500 g的早产儿平均每人经历46次;早产儿经历最多的疼痛刺激是揭除3M透明敷贴,疼痛评分排在前3位的为外周动脉穿刺、采足底血、皮下注射。结论早产儿,特别是<1500 g的极/超低出生体质量儿在住院期间常需接受大量侵入性、致痛性操作。有必要加强医护人员疼痛管理能力的培训,从而减少疼痛刺激对早产儿造成的不良影响。%Objective To investigate the premature infants′ pain operation during their hospitalization and thus provide evidence for the necessity of premature infants pain management. Methods Using the method of convenient sampling, we prospectively collected data of all painful procedures performed on 111 premature infants who recruited from admission to discharge in a Neonatal Intensive Care Unit in Shenzhen. The pain of premature infant was evaluated by premature infant pain profile ( PIPP ) . Results During hospitalization, 111 premature infants were exposed to 8 258 painful operations, with each preterm having (74. 4 ± 18. 22) times and averagely (3. 72 ± 1. 53) times each day. Below 1 500 g birth weight infants and equal and beyond 1 500 g birth weight infants were exposed to a median of 153 and 46 painful procedures, respectively. Among those painful procedures, 3M Transparent Dressing removal was the most

  18. 某三甲医院手术科室麻醉自费项目现状调查%Survey of Anesthetic Items at Patients' Own Expense in Operation Departments of a Top Grade-three Hospital

    Institute of Scientific and Technical Information of China (English)

    曾俊群; 安玉蓉; 高彤

    2012-01-01

    Objective To study on the proportion of the anesthetic costs at their own expense to total costs and anesthetic items at their own expense in operation departments of a certain top grade-three hospital in Beijing. Methods The status survey on anesthetic items at patients' own expense was done in 15 operation departments of a certain top grade-three hospital in Beijing from March 1st, 2011 to March 7th, 2011. Results The ratio of anesthetic costs to total costs at their own expense in the operation departments was 12.04%. The top 5 proportions of costs of anesthetic items at their own expense was Flurbiprofen Axetil Injection (43.2%), Remifentanil Injection (17.43%), Analgesic Pump (10.04%), Cisatracurium Besylate Injection (8.2%), Ulinastatin Injection (8.14%), respectively. Ratio at one' sown expense has positive correlation with anesthetic costs at one's own expense and negative correlation with proportion of costs of anesthetic items at one's own expense. Conclusion Only resolving reimbursement issues of Flurbiprofen Axetil Injection, Analgesic Pump and Remifentanil Injection, etc can basically control anesthetic fees at their own expense.%目的 探讨现阶段北京某三甲医院手术科室住院医疗保险项目付费自费费用中麻醉自费费用所占比例以及麻醉自费项目发生情况.方法 对北京某三甲医院2011年3月1-7日一周的15个手术科室医保出院病人麻醉自费项目进行现状调查.结果 北京某三甲医院手术科室麻醉自费费用占总自费费用比例为12.04%,麻醉自费项目费用构成排名居前5位的是凯纷注射液(占43.20%)、瑞芬太尼注射液(占17.43%)、镇痛泵(占10.04%)、赛机宁注射液(占8.20%)、天普洛安粉针(占8.14%),自费比例与麻醉自费费用正相关,与麻醉自费项目费用构成负相关.结论 只有解决凯纷注射液、瑞芬太尼注射液和镇痛泵等的报销问题,才能从根本上控制麻醉自费费用.

  19. Gestão de pessoas em unidades produtoras de refeições comerciais e a segurança alimentar People management in foodservice establishments and food safety

    Directory of Open Access Journals (Sweden)

    Suzi Barletto Cavalli

    2007-12-01

    of Campinas (State of São Paulo and Porto Alegre (State of Rio Grande do Sul, divided into segments: self service by weight, barbecue restaurants and fast food restaurants. The total sample consisted of 108 establishments, 62 in Porto Alegre and 46 in Campinas. The managers of the restaurants were interviewed using a previously tested questionnaire comprised of open and closed questions. RESULTS: We observed that only 21.7% of the employees attended courses and specific training in their field of work. Elementary school level prevailed among the human resources, with both genders being present in the same proportion. Most establishments adopt hiring criteria, and personal presentation is the most important. Personal hygiene of the employees was considered of "vital importance" by the managers. Insufficient experience, responsibility in conducting the activities and formal education for the position are among the main difficulties found by the foodservice companies when hiring personnel. CONCLUSION: People management in the field of commercial restaurants must be qualified, so that adequate food safety conditions can be offered for the consumers.

  20. Hospitals, providers collaborate on transitions.

    Science.gov (United States)

    2012-01-01

    Baystate Health, a three-hospital system with headquarters in Springfield, MA, is partnering with post-acute providers to improve transitions as patients move through the continuum of care. A multidisciplinary post-acute performance team partnered with post-acute providers to determine why patients are readmitted to the hospital and to work on ways to avoid readmissions. Facilities share information with the hospitals how they operate and what they need to ensure patients receive the care they need. The health system's director of post-acute services holds regular meetings with providers to brainstorm on improving patient care.

  1. Hospital diversification and financial management.

    Science.gov (United States)

    Eastaugh, S R

    1984-08-01

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

  2. How can a change in the operating system of the mental health review board promote the discharge of long-term hospitalized psychiatric patients? A case study of Seoul city.

    Science.gov (United States)

    Lee, Myung-Soo; Lim, Hee-Young; Kim, Youngki; Lee, Yong-Suk

    2014-01-01

    One of the most typical and chronic problem in Korean mental health system is the prolonged length of hospital stay. In contrast to there are many components which leads to long length of stay of psychiatric patients in Korean situation such as low and fixed medical fee for psychiatric inpatient treatment, shortage of community resources, lack of care-givers' awareness and so on, there are just few mechanisms to handle this issue such as Mental Health Review Board (MHRB) which is based on Mental Health Act since 1995. However, the discharge order rate was very low and there community care system after discharge order is still very weak. The Korean government has revised the Mental Health Act in 2008 and changed the operating principals of the MHRB from a regional level to a local level to strengthen the function of MHRB. However, the discharge order rate versus the whole evaluation requests still remains at a very low level or less than 5%. And it is still very difficult to execute a discharge order against a patient whose symptoms and conditions become psychiatrically stabilized enough for discharge, due to a shortage of community care facilities and a lack of social support system. These results are exactly same with former studies. Any policies to promote psychiatric discharge including MHRB are needed to take the comprehensive factors into consideration, such as payment program, community infrastructure, increasing care-givers' acceptance and so on. Despite of the political trial of Korean government to reduce length of stay of chronic psychiatric patients, it was not successful. Still it had failed to propose a detailed policy measure in terms of the above-mentioned prerequisites. Therefore, new system and program developments including reform of payment system which reflect prior studies' recommendations are essential.

  3. Communication Skill in the Operating Room of Merged Hospital%"收编"医院手术室冲突沟通技巧的探讨舆体会

    Institute of Scientific and Technical Information of China (English)

    鲍菲; 曾英玉; 杨秀霞; 黄惠琼; 刘蔚晴

    2002-01-01

    Zhongshan Medical University merged Huangpu Hospital last year. The staff from different hospital can conflict owning tothe divergence in interests, managernent and concept. As far as the nursing system is concerned, the conflict between the chief nurse andthe nurses, the task and the nursing conduct are the major expression.

  4. Measuring efficiency among US federal hospitals.

    Science.gov (United States)

    Harrison, Jeffrey P; Meyer, Sean

    2014-01-01

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

  5. Pre-hospital emergency medicine.

    Science.gov (United States)

    Wilson, Mark H; Habig, Karel; Wright, Christopher; Hughes, Amy; Davies, Gareth; Imray, Chirstopher H E

    2015-12-19

    Pre-hospital care is emergency medical care given to patients before arrival in hospital after activation of emergency medical services. It traditionally incorporated a breadth of care from bystander resuscitation to statutory emergency medical services treatment and transfer. New concepts of care including community paramedicine, novel roles such as emergency care practitioners, and physician delivered pre-hospital emergency medicine are re-defining the scope of pre-hospital care. For severely ill or injured patients, acting quickly in the pre-hospital period is crucial with decisions and interventions greatly affecting outcomes. The transfer of skills and procedures from hospital care to pre-hospital medicine enables early advanced care across a range of disciplines. The variety of possible pathologies, challenges of environmental factors, and hazardous situations requires management that is tailored to the patient's clinical need and setting. Pre-hospital clinicians should be generalists with a broad understanding of medical, surgical, and trauma pathologies, who will often work from locally developed standard operating procedures, but who are able to revert to core principles. Pre-hospital emergency medicine consists of not only clinical care, but also logistics, rescue competencies, and scene management skills (especially in major incidents, which have their own set of management principles). Traditionally, research into the hyper-acute phase (the first hour) of disease has been difficult, largely because physicians are rarely present and issues of consent, transport expediency, and resourcing of research. However, the pre-hospital phase is acknowledged as a crucial period, when irreversible pathology and secondary injury to neuronal and cardiac tissue can be prevented. The development of pre-hospital emergency medicine into a sub-specialty in its own right should bring focus to this period of care.

  6. Effect of targeted monitoring on control of hospital-acquired pneumonia after neurosurgical operation%目标性监测对控制神经外科手术后 医院获得性肺炎的效果分析

    Institute of Scientific and Technical Information of China (English)

    许缤; 陈红岩; 孙嫣; 仝宇红; 朱丽丽; 陈岩; 陈大华

    2011-01-01

    摘要:目的 研究目标性监测对预防控制神经外科手术后患者医院获得性肺炎的意义.方法开展神经外科手术后医院获得性肺炎的目标性监测,通过教育培训、严格呼吸机管道的消毒、减少外源性污染、患者床头抬高30~45度、氯己定口腔护理、严格的手卫生及每天评估是否可以撤机等综合措施,监测神经外科手术后医院获得性肺炎发病率.结果开展目标性监测后,神经外科手术后医院获得性肺炎发病率由监测前24.57%下降至监测后的8.24%,差异有统计学意义(P<0.05).结论开展目标性监测对控制神经外科手术后医院获得性肺炎发病率具有显著效果,对预防控制医院外科手术后肺炎具有积极意义.%OBJECTIVE To explore the significance of targeted monitoring on the prevention and control hospital acquired pneumonia after neurosurgical operation. METHODS The method of targeted monitoring was applied to the hospital acquired pneumonia after neurosurgical operation. By taking such comprehensive measures as education training, strictly disinfecting the respirator duct, reducing exogenous contamination, raising the patients' bedside 35-40°up, conducting oral cavity nursing with chlorhexidine, strict hand hygiene, and making assessment everyday to determine the withdrawal of the respirator, morbidity rates of hospital acquired pneumonia after neurosurgical operation were monitored. RESULTS By using targeted monitoring, the morbidity rates of hospital acquired pneumonia after neurosurgical operation decreased from 24. 57% to 8. 24%, and there were significant differences(P<0. 05). CONCLUSION Targeted monitoring can effectively control the morbidity rates of hospital acquired pneumonia after neurosurgical operation, and it is of positive significance for the prevention and control of the hospital acquired pneumonia after surgical operation.

  7. Do hospital factors impact readmissions and mortality after colorectal resections at minority-serving hospitals?

    Science.gov (United States)

    Hechenbleikner, Elizabeth M; Zheng, Chaoyi; Lawrence, Samuel; Hong, Young; Shara, Nawar M; Johnson, Lynt B; Al-Refaie, Waddah B

    2017-03-01

    Minority-serving hospitals have greater readmission rates after operative procedures including colectomy; however, little is known about the contribution of hospital factors to readmission risk and mortality in this setting. This study evaluated the impact of hospital factors on readmissions and inpatient mortality after colorectal resections at minority-serving hospitals in the context of patient- and procedure-related factors. More than 168,000 patients who underwent colorectal resections in 374 California hospitals (2004-2011) were analyzed using the State Inpatient Database and American Hospital Association Hospital Survey data. Sequential logistic regression analyses were performed to determine the associations between minority-serving hospital status and 30-day, 90-day, and repeated readmissions. Thirty-day, 90-day, and repeated readmission rates were 11.2%, 16.9%, and 2.9%, respectively. Odds for 30-day, 90-day, and repeated readmissions after colorectal resections were 19%, 20%, and 38% more likely at minority-serving hospitals versus non-minority-serving hospitals, respectively (P hospitals while hospital-level factors contributed roughly 40%. Inpatient mortality was significantly greater at minority-serving hospitals versus non-minority-serving hospitals (4.9% vs 3.8%; P hospitals while hospital factors were less contributory. These findings need to be further validated to shape quality improvement interventions to decrease readmissions. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. [Leadership in the hospital].

    Science.gov (United States)

    Schrappe, Matthias

    2009-01-01

    Current concepts in leadership and governance on the level of supervisory board, management and departments are often considered as insufficient to cope with the profound structural change which actually takes place in the German health care system. While vertical and horizontal disconnecting is typical of the professional bureaucracy of hospitals, transition from functional to divisional structure further increases this risk. Accordingly, medical experts are oriented towards their professional peers and patient care on the one side; on the other side the management gets isolated and looses operative and strategic control. Several studies provide evidence for the relevance of role models to serve as agents of change, which are now developed into the concept of "Clinical Governance": evidence-based medicine, guidelines, continuous quality improvement, safety culture, resource accountability and organisational learning. The present situation makes it necessary to extend this conception, which focuses on the departmental level in an organisation with divisional features, to one of "Clinical Corporate Governance". This term, which also includes supervisory structures and the management board and is relevant for the total hospital and company, respectively, is based on the corporate governance concept. Inside the hospital, the management and the heads of the departments have to agree that (1) experts really need to be integrated into the decision process, and that (2) the outcomes of the entire hospital have to be regarded as equal or superior to the aims of a single department. The public image of the hospital should be one of a strong and reliable partner in health care and health care business on a local, regional and national level. Members of the supervisory board should clearly put corporate aspects above political and other implications and pay attention to personal independence from the leaders of the medical departments.

  9. An Evaluation System for Foodservice Equipment

    Science.gov (United States)

    1985-10-01

    of crumbs must be done daily on all toasters. Wiping of spills and kitchen grime must also be performed daily. Maintenance tasks such as...positive stop. Gear teeth should be deep enough to ensure pan cannot slip and ratchet to full tilt. Cover handle should be non-heat- conductive , and be...selected, they should be hard rubber , and have a sufficient load bearing capacity for the anticipated product load. 55 äSfc&fc^^ äüjtftfitf: iMgi

  10. Healthy Foodservice Benchmarking and Leading Practices

    Science.gov (United States)

    2012-07-01

    Dunkin’ Donuts, Wendy’s, Taco Bell, Kentucky Fried Chicken (KFC), Domino’s Pizza, and Chick-Fil-A (i.e., these are the 10 largest chains when ranked by...pizza, burgers, salads, nachos, fries , chicken wings, soft drinks, and beer (U.S. Army MWR, n.d.-a, n.d.-b). We identified four strategies used by...and Tendergrill® Chicken Sandwiches (Figure 8) differ in their preparation method; one is grilled and the other is fried . The grilled sandwich

  11. Hospitals: Soft Target for Terrorism?

    Science.gov (United States)

    De Cauwer, Harald; Somville, Francis; Sabbe, Marc; Mortelmans, Luc J

    2017-02-01

    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

  12. What hospitals should do to prepare for an influenza pandemic.

    Science.gov (United States)

    Toner, Eric; Waldhorn, Richard

    2006-01-01

    This article offers recommendations on what hospitals should do to prepare for an influenza pandemic and proposes specific actions and priorities for the purpose of making the discussion of hospital pandemic preparedness issues more operationally useful.

  13. A laundry's reincarnation. Hospital Cooperative Laundry, Denver, CO.

    Science.gov (United States)

    1993-12-15

    It started out as an off-site hospital laundry, then was leased to a commercial operator, now it is a cooperative plant that serves several accounts in the Denver area. See what makes Hospital Cooperative Laundry tick.

  14. Financial issues for hospital auxiliaries.

    Science.gov (United States)

    Fogel, L A

    1986-01-01

    Auxiliaries can serve a more important financial role in today's environment than ever before. Hospitals are searching for positive avenues to promote themselves to the community and to generate more financial support to help offset the losses created by decreasing inpatient utilization and payments from third-party payers. Auxiliaries should recognize that their financial role has never been more important to the financial viability of their hospitals. Auxiliaries should communicate closely with hospital administration so that both organizations work to achieve compatible goals. Auxiliaries should be operated more like businesses, which means establishing goals and objectives, preparing effective budgets and interim financial statements, thinking and planning innovatively, and establishing adequate inventory controls, investment policies, and pricing structures. If auxiliaries follow these steps, they will not only succeed in providing more financial support to hospitals than ever before but will also receive the recognition and support they deserve for their effort.

  15. Analysis of parents’ compliance in non-hospital settings during operation of expressed breast milk bank%自体母乳库运行中非医院环节中家属的依从性分析

    Institute of Scientific and Technical Information of China (English)

    杨晓燕; 马越; 胡艳玲; 唐军; 石晶; 母得志

    2016-01-01

    ObjectiveTo investigate the parents’ compliance in non-hospital settings during the operation of expressed breast milk bank.MethodsIn September 2014, a questionnaire survey was carried out to investigate the parents’ willingness about feeding the inpatient neonates with maternal expressed breast milk, to evaluate the effectiveness of the breast milk feeding supporting system, and to monitor the compliance in non-hospital settings during the delivery of maternal expressed breast milk. Improvements in education were made according to the results. A second survey was done in September 2015.ResultsA total of 340 questionnaires were sent out, and 338 usable questionnaires were returned. According to the time when the questionnaires were sent out, they were divided into two groups: 2014 group (n=229) and 2015 group (n=109). The age of most mothers was 20-30 years in the 2014 group and 30-40 years in the 2015 group. Most mothers delivered at the West China Second Hospital of Sichuan University in both groups, but the 2015 group had a signiifcantly higher proportion than the 2014 group (74.3% vs 61.6%;P<0.05). Guidance was given to mothers in the presence of insufifcient breast milk production in both groups, but the 2015 group had a signiifcantly higher proportion than the 2014 group (91.7% vs 79.9%;P<0.05). Both groups had good family compliance in the collection, storage, and transport of breast milk. There were no signiifcant differences in their compliance with washing hands, sterilizing instruments, and using a clean special refrigerator between the two groups.The expressed breast milk was transported strictly according to the procedure in both groups, but the 2015 group had a signiifcantly higher proportion than the 2014 group (100% vs 87.1%;P<0.05).ConclusionsBefore and after improvements in the health education, most parents have good compliance in the collection, storage, and transport of breast milk.%目的:调查分析家属在自体母乳库运行的非

  16. 手术室护理管理对手术患者医院感染的干预意义研究%Study on the Significance of Nursing Management in Operation Room to the Hospital Infection of Surgical Patients

    Institute of Scientific and Technical Information of China (English)

    王雪梅

    2016-01-01

    Objective To investigate the significance of nursing management in the operation room for hospital infection.MethodsSelected from May 2014 to February 2016,75 cases of surgical patients admitted to our hospital were randomly divided into group A,group was given routine operation room management,B group line of comprehensive nursing management. Comparison of intervention results of two groups.Results Patients in group B were significantly higher than group A in nursing management,disinfection and isolation, standard hand washing,sterile operation quality was significantly better than that of A group,the incidence of hospital infection was significantly lower than that of A group,P<0.05.Conclusion The effect of operation room nursing management on hospital infection in patients with surgery.%目的:探讨手术室护理管理对手术患者医院感染的干预意义。方法选取2014年5月~2016年2月我院所收治的75例手术患者随机分组,A组给予手术室常规管理;B组行手术室全面护理管理。比较干预结果。结果 B组患者护理管理满意度比A组高,消毒隔离、规范洗手、无菌操作质量显著比A组好,医院感染发生率显著比A组低,P<0.05。结论手术室护理管理对手术患者医院感染的干预效果确切。

  17. Full-body-cold therapy plants of the Immanual hospital in Berlin-Wannsee. Pt. 3; Aspects of constructional and functional equipment and the operation of the coldest cooling chamber so far. Ganzkoerper-Kaeltetherapie im Immanuel-Krankenhaus Berlin-Wannsee. T. 3; Aspekte der baulichen und funktionellen Ausruestung und des Betriebes der bisher kaeltesten Kaeltekammer

    Energy Technology Data Exchange (ETDEWEB)

    Feurich, H.

    1994-04-01

    In the scope of this continued contribution, a report is given on the technical design of the full-body-cold therapy plants of the Immanuel hospital in Berlin-Wannsee. This part presents the following subjects: medical rooms, cooling chamber, process technology, cooling demand in different phases of treatment as well as operating costs. As a conclusion, comparative evaluations with other plants are presented. (BWI)

  18. Præhospital ultralyd

    DEFF Research Database (Denmark)

    Rognås, Leif Kåre; Christensen, Erika Frischknecht; Sloth, Erik

    2009-01-01

    Danish anaesthesiologists use ultrasound (US) to examine and treat acutely ill or traumatized patients in the emergency room, operating theatre and intensive care unit. They are also involved in pre-hospital care where US may theoretically be beneficial for both diagnostic and therapeutic purposes...

  19. [Perioperative mortality and morbidity for the year of 1999 in 466 Japanese Certified Anesthesia-training Hospitals: with special reference to ASA-physical status--report of Committee on Operating Room Safety of Japan Society of Anesthesiologists].

    Science.gov (United States)

    Irita, K; Kawashima, Y; Kobayashi, T; Goto, Y; Morita, K; Iwao, Y; Seo, N; Tsuzaki, K; Dohi, S

    2001-06-01

    Perioperative mortality and morbidity in Japan for the year 1999 were studied retrospectively. Committee on Operating Room Safety of the Japan Society of Anesthesiologists (JSA) sent confidential questionnaires to 774 Certified Training Hospitals of JSA and received answers from 60.2% of the hospitals. We analyzed their answers with special reference to ASA physical status (ASA-PS). The total number of anesthetics analyzed was 655, 644. Mortality and morbidity due to all kinds of causes including anesthetic management, intraoperative events, co-existing diseases, and operation were as follows. The incidence of cardiac arrest (per 10,000 anesthetics) was 0.68, 3.76, 14.37, 67.03, 0.36, 4.68, 27.96, 206.30 in patients with ASA-PS of I, II, III, IV, I E, II E, III E, and IV E, respectively. The incidences of critical events including cardiac arrest, severe hypotension, and severe hypoxemia were 8.93, 26.99, 71.30, 188.52, 8.68, 31.27, 136.16, and 790.92 in patients with ASA-PS of I, II, III, IV, I E, II E, III E, and IV E, respectively. The mortality rates (death during anesthesia and within 7th postoperative day) after cardiac arrest were 0.16, 0.94, 5.71, 33.51, 0.00, 1.46, 16.41 and 167.76 per 10,000 anesthetics in patients with ASA-PS of I, II, III, IV, I E, II E, III E, and IV E, respectively. The overall mortality rates were 0.24, 1.66, 12.16, 67.03, 0.00, 3.51, 34.65 and 417.14 in patients with ASA-PS of I, II, III, IV, I E, II E, III E, and IV E, respectively. Overall mortality and morbidity were higher in emergency anesthetics than in elective anesthetics. ASA-PS correlated well with overall mortality and with morbidity, regardless of etiology. The incidences of cardiac arrest totally attributable to anesthesia were 0.24, 0.45, 1.47, 8.38, 0.36, 1.75, 2.43 and 11.34 in patients with ASA-PS of I, II, III, IV, I E, II E, III E, and IV E, respectively. The incidences of all critical events totally attributable to anesthesia were 4.92, 8.81, 14.74, 20.95, 4

  20. Medical tourism private hospitals: focus India.

    Science.gov (United States)

    Brotman, Billie Ann

    2010-01-01

    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.

  1. Perfil dos pacientes portadores de câncer colorretal operados em um hospital geral: necessitamos de um programa de rastreamento acessível e efetivo Profile of patients with colorectal cancer operated in a general hospital: we need an accessible and effective screening program

    Directory of Open Access Journals (Sweden)

    Marcus Valadão

    2010-06-01

    study is to demonstrate the current panorama of colorectal cancer in a general hospital in Rio de Janeiro, focusing on aspects related to the clinical presentation and delayed diagnosis. This is a retrospective study that included patients followed at the outpatient section of colorectal cancer follow-up of the Segunda Clínica Cirúrgica do Hospital Federal Bonsucesso in the past five years (2004-2009. The most common symptoms were abdominal pain (60.1%, intestinal obstruction (41.1%, weight loss (36.7%, bleeding (33.5%, anemia (14.5%, perforation (6.3 % and fistula (1.2%. Patients with right colon tumors presented with weight loss (54.5%, pain (45.4%, obstruction (45.4% and anemia (27.2%. In patients with tumors of the left colon and sigmoid, the most common symptoms were pain (60.5%, obstruction (42.9%, weight loss (38.5%, bleeding (32.4% and anemia (16.6%. Patients with rectal tumors presented with bleeding (70%, obstruction (60%, pain (60%, weight loss (20% and perforation (10%. At surgery, 53 patients had distant metastases (33.5%, the liver being the organ most affected in 36 patients (67.9%, followed by the peritoneum in 11 cases (20.7% and ovaries with 4 cases (7.5%. Eighty-eight patients (55.6% had nodal metastasis. Regarding TNM staging, we found that the emergency group distribution was as follows: Stage I 0%, 28.2% Stage II, Stage III 30.4% and 41 3% Stage IV, whereas the elective group staging distribution was: 2.7% Stage I, Stage II 27.7%, 25% Stage III and Stage IV 44%. Conclusion: The profile of patients operated in our institution (which reflects the national reality is composed mainly with patients with advanced cancer stages. Based on the data presented, it is necessary to implement a national screening program for colorectal cancer.

  2. 'Patient satisfaction' in hospitalized cancer patients.

    Science.gov (United States)

    Skarstein, Jon; Dahl, Alv A; Laading, Jacob; Fosså, Sophie D

    2002-01-01

    Predictors of 'patient satisfaction' with hospitalization at a specialized cancer hospital in Norway are examined in this study. Two weeks after their last hospitalization, 2021 consecutive cancer patients were invited to rate their satisfaction with hospitalization, quality of life, anxiety and depression. Compliance rate was 72% (n = 1453). Cut-off levels separating dissatisfied from satisfied patients were defined. It was found that 92% of the patients were satisfied with their stay in hospital, independent of cancer type and number of previous admissions. Performance of nurses and physicians, level of information perceived, outcome of health status, reception at the hospital and anxiety independently predicted 'patient satisfaction'. The model explained 35% of the variance with an area under the curve of 0.76 of the Receiver Operator Curve. Cancer patients' satisfaction with their hospital stay was high, and predicted by four independently predictive variables related to the performance of caregivers. These suggest areas for further improvement in the healthcare service.

  3. Do changes in surgical procedures for breast cancer have consequences for hospital mean length of stay? A study of women operated on for breast cancer in Sweden, 1980-95

    DEFF Research Database (Denmark)

    Lindqvist, Rikard; Möller, Torgil R; Stenbeck, Magnus;

    2002-01-01

    BACKGROUND: Between 1986 and 1996, the overall mean overnight length of stay for all diagnoses in Sweden decreased from 20.8 to 7.1 days. OBJECTIVES: The study describes changes in surgical technique, from mastectomy to breast-conserving surgery, in treatment of female breast cancer and the paral......BACKGROUND: Between 1986 and 1996, the overall mean overnight length of stay for all diagnoses in Sweden decreased from 20.8 to 7.1 days. OBJECTIVES: The study describes changes in surgical technique, from mastectomy to breast-conserving surgery, in treatment of female breast cancer...... and the parallel change in average length of hospital stay, and discusses the possible link between the trends. RESEARCH DESIGN: The study was performed as a descriptive register study on hospital admission data from the Swedish Hospital Discharge Register over a 16-year period (1980-95). RESULTS: During the study...

  4. Ultrasonic cleaning in the hospital.

    Science.gov (United States)

    Detwiler, M S

    1989-04-01

    Ultrasonic cleaning can prolong the life of expensive instruments. In the past, many fine instruments were discarded due to stiffening hinges and box locks, or sticking plungers. Hand scrubbing and spray washing could not thoroughly clean these areas. Ultrasonic cleaners effectively remove dried and baked blood, serums and medications from these instruments. Also, hinged instruments and syringes operate more smoothly during use in surgery when cleaned using ultrasonics. In addition, the use of ultrasonics alleviates the necessity for hand scrubbing of contaminated surgical instruments and laboratory apparatus, a procedure which could lead to injury or infection. The superb cleaning powers of ultrasonic cleaners, their speed and simplicity of operation, and their ability to remove blood, tissue, bacteria and microorganisms within minutes, makes them a valuable addition to any operating room suite, central service department, or emergency room. Their cost-effectiveness is considerable for the small hospital, and compelling for the large hospital.

  5. [Perioperative mortality and morbidity in the year 2000 in 502 Japanese certified anesthesia-training hospitals: with a special reference to ASA-physical status--report of the Japan Society of Anesthesiologists Committee on Operating Room Safety].

    Science.gov (United States)

    Irita, Kazuo; Kawashima, Yasuo; Tsuzaki, Koichi; Iwao, Yasuhide; Kobayashi, Tsutomu; Seo, Norimasa; Goto, Yasuyuki; Morita, Kiyoshi; Shiraishi, Yoshito; Nakao, Yasuo; Tanaka, Yoshifumi; Tosaki, Youko; Dohi, Shuji; Obara, Hidefumi

    2002-01-01

    Perioperative mortality and morbidity in Japan from Jan. 1 to Dec. 31, 2000 were studied retrospectively. Committee on Operating Room Safety in Japanese Society of Anesthesiologists (JSA) sent confidential questionnaires to 794 certified training hospitals of JSA and received answers from 67.6% of the hospitals. We analyzed their answers with a special reference to ASA physical status (ASA-PS). The total number of anesthesia available for this analysis was 897,733. The percentages of patients with ASA-PS of I, II, III, IV, I E, II E, III E, and IV E are 38.0, 40.3, 8.5, 0.4, 4.3, 5.3, 2.5, and 0.7%, respectively. Mortality and morbidity from all kinds of causes including anesthetic management, intraoperative events, co-existing diseases, and surgical problems were as follows. The incidences of cardiac arrest (per 10,000 cases of anesthesia) were 1.11, 3.26, 12.25, 54.60, 0.77, 4.46, 21.08 and 217.75 in patients with ASA-PS of I, II, III, IV, I E, II E, III E, and IV E, respectively. The incidences of critical events including cardiac arrest, severe hypotension, and severe hypoxemia were 6.89, 20.22, 62.18, 148.21, 6.71, 20.38, 106.72 and 592.21 in patients with ASA-PS of I, II, III, IV, I E, II E, III E, and IV E, respectively. The mortality rates (death during anesthesia and within 7 postoperative days) after cardiac arrest were 0.26, 0.77, 3.69, 41.60, 0.00, 1.06, 9.42 and 163.31 per 10,000 cases of anesthesia in patients with ASA-PS of I, II, III, IV, I E, II E, III E, and IV E, respectively. The overall mortality rates were 0.32, 1.38, 9.75, 70.20, 0.26, 2.12, 29.15 and 353.02 in patients with ASA-PS of I, II, III, IV, I E, II E, III E, and IV E, respectively. Overall mortality and morbidity were higher in emergency anesthesia than in elective anesthesia. ASA-PS correlated well with overall mortality and morbidity, regardless of etiology. The incidences of cardiac arrest totally attributable to anesthesia were 0.23, 0.50, 1.32, 0.00, 0.00, 0.85, 2.69 and 4

  6. Hospital Outpatient PPS Partial Hospitalization Program LDS

    Data.gov (United States)

    U.S. Department of Health & Human Services — Hospital Outpatient Prospective Payment System (OPPS) Partial Hospitalization Program LDS This file contains select claim level data and is derived from 2010 claims...

  7. Hospital Outpatient PPS Partial Hospitalization Program LDS

    Data.gov (United States)

    U.S. Department of Health & Human Services — Hospital Outpatient Prospective Payment System (OPPS) Partial Hospitalization Program LDS This file contains select claim level data and is derived from 2010 claims...

  8. [Short- and long-term results in operable pancreatic ductal adenocarcinomas from a cooperation between two departments gastroenterology-visceral surgery at non-university hospitals benchmarked to results of expert-centers].

    Science.gov (United States)

    Dippold, Wolfgang; Sivanathan, Visvakanth; Statt, Katharina; Roitman, Marc; Link, Karl Heinrich

    2017-02-01

    The only curative approach in pancreatic ductal adenocarcinoma (PDAC) is resection, which is possible only in 15 - 30 % of patients. Local tumor spread or distant metastases are contraindications for resection in the majority of patients. Surgical-oncological quality with short- and long-term results are varying tremendously, so that "expertise/quality" are associated to hospital- or surgeon's volume and/or center formation. The treatment results also depend, to a great extent, on the medical diagnostic quality. With our retrospective study, we aim to compare the results-quality of cooperative pancreatic cancer treatment based on an extensive preoperative diagnostic procedure for staging and risk estimation in a specialized GI-medical department and visceral surgical-oncological expertise in pancreatic cancer surgery at a general hospital with the results-quality of expert centers. Fifty-three patients with PDAC had diagnosis and resection of their cancer between 1/2002 and 12/2009. The 30 day hospital-mortality was 3.8 % and the median survival time after demission from the hospital was 23.1 months. The 5-year-survival rate of R0-resected patients, all of whom had received adjuvant chemotherapy, was high with 31 %. The survival data and the extraordinarily high resection rate of 98.1 % in the patient group, whose primary tumor stage was pT3 in 81 %, reflects the excellent cooperation of high standards in medical diagnostic processes, visceral pancreatic surgery, and adjuvant medical chemotherapy. The results are well comparable to those of "high volume centers". The responsible heads of the two departments have been trained at university expert centers. Expertise in the treatment of pancreatic cancer patients may be successfully transferred from an expert center to a general hospital, if the team has high expertise. © Georg Thieme Verlag KG Stuttgart · New York.

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

    Directory of Open Access Journals (Sweden)

    Susmita Chatterjee

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

  10. Hospital-acquired pneumonia

    Science.gov (United States)

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

  11. Structural Measures - Hospital

    Data.gov (United States)

    U.S. Department of Health & Human Services — A list of hospitals and the availability of structural measures at that hospital. A structural measure reflects the environment in which hospitals care for patients....

  12. Going to the Hospital

    Science.gov (United States)

    ... Too Short All About Puberty Going to the Hospital KidsHealth > For Kids > Going to the Hospital Print ... you flowers, balloons, or other treats! previous continue Hospital People You'll meet lots of people in ...

  13. Understanding your hospital bill

    Science.gov (United States)

    ... medlineplus.gov/ency/patientinstructions/000881.htm Understanding your hospital bill To use the sharing features on this ... help you save money. Charges Listed on Your Hospital Bill A hospital bill will list the major ...

  14. Research in Hospitality Management

    African Journals Online (AJOL)

    Research in Hospitality Management is a peer-reviewed journal publishing papers ... to the understanding of hospitality and hospitality management in a global context. ... financial management, marketing, strategic management, economics, ...

  15. Patient survey (HCAHPS) - Hospital

    Data.gov (United States)

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

  16. Using the Systems-Practice Framework to Understand Food Allergen Management Practices at College Catering Operations: A Qualitative Study.

    Science.gov (United States)

    Verstappen, Jennie; Mirosa, Miranda; Thomson, Carla

    2017-07-06

    The number of individuals with food allergies or intolerances attending catered university residential colleges is increasing, and safe dining options are required to minimize the risk of allergic reactions and food-induced death. This qualitative research study sought to advance professional knowledge of the factors affecting allergen management practices, particularly pertaining to college foodservices. Three catered residential colleges affiliated with a major university in New Zealand were selected as research sites. The study used an ethnographic approach and systems-practice theory as a framework for data collection and organizing results. Data collection techniques included document analyses (3 hours per site), observations (6 to 8 hours per site), focus groups with foodservice workers (30 to 45 minutes per site, n=16), and interviews with foodservice managers (45 to 90 minutes per interview, n=5). Notes and transcripts were coded through the process of thematic analysis using NVivo for Mac software, version 11.1.1, to identify factors affecting allergen management practices. The main factors affecting allergen management practices at college foodservices included information provided by residents about dietary requirements; communication between residents and foodservice staff; systems for allergen management; attitude of foodservice staff; and college size. Detailed dietary information, effective communication with residents, sufficient resources, clarification of responsibilities, and thorough systems are required for staff to perform safe allergen management practices. Ultimately, successful implementation was predominantly determined by staff attitude. Foodservice managers are advised to identify motivators and address barriers of staff attitudes toward allergen management practices to promote successful implementation. Copyright © 2017 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

  17. An ideal hospital.

    Science.gov (United States)

    Chandrasiri, Singithi Sidney

    2017-07-03

    Purpose The purpose of this paper is to explore a novel overarching strategy in tackling the key issues raised by the recent inquiry into bullying, harassment and discrimination in surgical practice and surgical training in Australian and New Zealand hospitals. Design/methodology/approach The approach taken is an analysis of the available evidence-based literature to inform the proposed viewpoint. The theoretical subject scope presented is a discussion of how and why the various strategies put forward in this paper should be integrated into and led from an overarching workforce engagement platform. Findings The key themes isolated from the Inquiry into Australian and New Zealand surgical practice ranged from abuse of power by those in leadership positions, gender inequity in the surgical workforce, opaque and corrupt complaints handling processes, excessive surgical trainee working hours to bystander silence secondary to a fear of reprisal. A workforce engagement perspective has elicited the potential to counter various impacts, that of clinical ineffectiveness, substandard quality and safety, inefficient medical workforce management outcomes, adverse economic implications and the operational profitability of a hospital. Generic strategies grounded in evidence-based literature were able to then be aligned with specific action areas to provide a new leadership framework for addressing these impacts. Originality/value To the author's knowledge, this is one of the first responses providing a framework on how medical managers and hospital executives can begin to lead a comprehensive and practical strategy for changing the existing culture of bullying, harassment and discrimination in surgical practice by using a staff engagement framework.

  18. 湖北省咸宁市医务人员生存质量与医疗机构运行效率关系分析%Research on the Relationship between Medical Staffs'Quality of Life and Hospitals'Operating Efficiency in Xianning City

    Institute of Scientific and Technical Information of China (English)

    陈子敏; 熊昌娥; 余志娟; 阮芳; 何国忠

    2011-01-01

    Objective: To study relationship between the hospitalsl operating efficiency and medical staffs' quality of life, then to promote the operating efficiency of hospitals.Methods: with WHOQOL-BREF to survey medical staff quality of life; Meanwhile, to collect the operating efficiency data of hospitats.Then to analysis the relationship between quality of life and hospitals' operating efficiency with one way correlation, multivariate regression.Results : there is a correlative relationship between quality of life of medical staff and operating efficiency of hospitals, such as: out-patient costs and physiology field (P=0.044), psychological domain (P=0.011) were positively related to the fleld of social relations (P=0.021), per capita hospital costs and total score (P=0.044) and environment (P=0.021) scores showed a significant negative correiation.Conclusion: physical health status of the field mainfy affects the patient's disease burden and the growth of hospital; mental health field mainly affects the sustainability ofthe hospital; social relationships influence health status ofpatients' financial satisfaction; environmental field mainly affects the "major" service status ; general health status of affects the hospital' business conditions.%目的:分析医疗机构运行效率与医务人员生存质量间的关系,探讨通过提高医务人员生存质最促进医疗机构运行效率的方法.方法:运用WHOQOL-BREF调查湖北省咸宁市医务人员牛存质量,收集成宁市医疗机构运行效率资料.资料分析主要采用单因素相关、逐步回归等方法.结果:医务人员生存质量与医疗机构运行效率具有相关关系,如次均门诊费用与生理领域(P=0.044)、心理领域(P=0.011)呈正相关,与社会关系领域呈负相关(P=0.021),人均住院费用与总分(P=0.044)和环境领域(P=0.021)得分负相关等.结论:医务人员生理领域健康状况主要影响病人的疾病经济负担和医院的成长情

  19. The effect of ward rounds making by the operation president of the hospital to improve hand hygiene compliance of the medical staff%业务院长查房对提高医务人员手卫生依从性的效果

    Institute of Scientific and Technical Information of China (English)

    刘晖; 罗龙金; 周裕梅

    2015-01-01

    目的:探讨业务院长查房对基层医院医务人员手卫生依从性、医院感染发生率影响,统计快速手消毒剂、洗手液每床每日消耗量。方法医院感染管理科和其他职能部门负责人在业务院长的带领下每天上午参加一个住院病区的业务查房,医院感染管理科将医务人员手卫生依从性作为查房监管的重点,对医务人员手卫生依从性进行观察并记录,在总结会上现场反馈;将业务院长查房前的2012年1-6月设为对照组,业务院长查房后的2013年1-6月设为试验组,比较对照组与试验组手卫生用品消耗量、医院感染例次率、医务人员的洗手依从率。结果医院感染管理科参与业务院长查房后,医务人员手卫生依从性较查房前明显提高,医师由33.10%提高至61.04%,护士由51.86%提高至79.20%,差异有统计学意义( P<0.01);临床科室快速手消毒剂、洗手液每床每日消耗量从查房前的1.88、7.03ml分别提高至5.38、11.51ml,消耗量明显提高;医院感染率由2.01%降低至1.50%,差异有统计学意义( P<0.05);护士手卫生依从性高于医师,各科室手卫生依从性由高到低依次为儿科、妇产科、外科、内科。结论将手卫生纳入业务院长查房内容,取得院领导的重视,可明显提高医务人员手卫生依从性,降低医院感染发生率。%OBJECTIVE To investigate the influence of the ward rounds making by the hospital operation president on hand hygiene compliance and the incidence rate of hospital infection of the medical staff in grass‐roots hospitals , the consumption of the daily use of rapid hand disinfectant and liquid soap for each bed was counted .METHODS The management department of hospital infections and other functional departments participated in a hospital ward rounds with the hospital operation president .The compliance of hand

  20. Hospital marketing revisited.

    Science.gov (United States)

    Costello, M M

    1987-05-01

    With more hospitals embracing the marketing function in their organizational management over the past decade, hospital marketing can no longer be considered a fad. However, a review of hospital marketing efforts as reported in the professional literature indicates that hospitals must pay greater attention to the marketing mix elements of service, price and distribution channels as their programs mature.

  1. Tourism and Hospitality Training: Hallmark of the Culinary and Hospitality Management Institute

    Directory of Open Access Journals (Sweden)

    Donna M. Williams

    2015-02-01

    Full Text Available This paper traces the evolution of tourism and hospitality training in The Bahamas over the last 40 years, focusing on stakeholders, pioneers, partnerships, organizational structures, programs, and other key factors that have contributed to the establishment and operation of the Culinary and Hospitality Management Institute at the College of The Bahamas

  2. 75 FR 4963 - Federal Housing Administration (FHA): Hospital Mortgage Insurance Program-Refinancing Hospital Loans

    Science.gov (United States)

    2010-01-29

    ... comprehensive health care, including outpatient and preventive care, as well as hospitalization. In the case of... following seven criteria: (i) The proposed refinancing would reduce the hospital's total operating expenses... indebtedness; (2) reasonable and customary legal, organization, title, and recording expenses, including...

  3. 大数据技术的应用对医院经营管理的影响%The Application of the Big Data Technology's Impact on Hospital Operation and Management

    Institute of Scientific and Technical Information of China (English)

    贲慧; 熊珂; 姚晶晶; 陈东; 宋元; 殷红; 刘向群

    2016-01-01

    大数据技术将深刻改变医院医疗和经营管理环境:大数据带来以病患信息为起点的全新价值观;成为从海量信息中获取有效信息的技术保障;助力人性化服务和智能医疗;助力管理决策。为了更好地适应大数据时代,医院应该加大信息投入,在患者就诊体验和医疗业务方面,改进人性化服务措施和深化智能医疗,在经营管理方面,医院应该形成数据竞争优势,完善管理流程,合理配置资源。%The big data technology will profoundly change the environment of hospital medical treatment and management:it brings to the new values that the patient information is a starting point for hospital; it isthe technology security to access to effective information from the vast amounts of information;it promotes humanized service and intelligent medical; it pro-motes management decisions.In order to better adapt to the era of big data, the hospital should increase investment in infor-mationsystem, in terms of patient’s medical experience and medical business, it should improve the humanized service measures and deepen the intelligent medical, in terms of government and management, it should develop a data competition advantage, perfect the management process, rationalize the allocation of resources.

  4. A Study to Determine if Ethics Committees Should be a Decision-Making and Review Mechanism for Matters Relating to No-Code Orders in the Continental United States Army Medical Department Hospitals with over One Hundred Total Operating Beds

    Science.gov (United States)

    1984-08-01

    Mexico Air Force hospitals on DNR procedures with inclosures of the Air Force’s general policy and Wilford Hall USAF Medical Center’s DNR guidelines are at...with a request for "assisted suicide" or voluntary euthanasia . "Do Not .:Lsuscitate" does not mean that the medical staff will take any affirmative steps...practice in responding to issues raised in the management of terminally ill patients. 4. The New Mexico Right to Die Act (the "Act", 24-7-1 to 24-7-11

  5. Preços e níveis de complexidade dos serviços praticados por hospitais privados junto à operadoras de planos de saúde = Prices and levels of complexity of the services performed by private hospitals by the health plan operators

    Directory of Open Access Journals (Sweden)

    Romildo de Oliveira Moraes

    2011-09-01

    Full Text Available Este estudo parte da premissa de que hospitais com alto nível de complexidade incorrem em maiores custos quando comparados com hospitais com médio e baixo nível de complexidade. A lógica econômica que sustenta esse raciocínio é que a resolução de diagnósticos mais complexos exige mais investimentos tanto em ativos quanto na capacitação do seu corpo clínico e administrativo. Diante disso, este estudo teve como objetivo verificar se os preços dos serviços hospitalares praticados por hospitais privados junto à operadoras de planos de saúde seriam capazes de discriminar os hospitais de acordo com seu nível de complexidade (alto, médio e baixo. Foram coletados dados relativos a oito serviços em cinqüenta e quatro hospitais privados localizados na cidade de São Paulo. A amostra não é aleatória e foi obtida mediante a análise das faturas de 648 pacientes internados nesses hospitais no período de 2006 e 2007. A Análise Discriminante foi realizada e os resultados indicam que, para a amostra objeto deste estudo, os preços praticados pelos hospitais privados pelos serviços prestados junto a operadoras de planos de saúde não discriminam os hospitais de acordo com seu nível de complexidade, ou seja, há indícios de que, para a amostra selecionada, os planos de saúde não estejam atribuindo importância para o nível de complexidade dos hospitais privados no momento de pactuar os preços dos serviços.This study assumes that hospitals with a high level of complexity resulting in higher costs when compared with hospitals with low and medium level of complexity. The economic logic that underlies this reasoning is that the resolution of more complex diagnoses requires more investment on both the active and the training of clinical staff and administrative staff. Thus, this study aimed to determine whether prices charged for hospital services by private hospitals by the health plan operators would be able to discriminate among

  6. Operative management of appendicitis.

    Science.gov (United States)

    St Peter, Shawn D; Snyder, Charles L

    2016-08-01

    Appendectomy has been the standard of care for appendicitis since the late 1800s, and remains one of the most common operations performed in children. The advent of data-driven medicine has led to questions about every aspect of the operation-whether appendectomy is even necessary, when it should be performed (timing), how the procedure is done (laparoscopic variants versus open and irrigation versus no irrigation), length of hospital stay, and antibiotic duration. The goal of this analysis is to review the current status of, and available data regarding, the surgical management of appendicitis in children. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. Operational amplifiers

    CERN Document Server

    Dostal, Jiri

    1993-01-01

    This book provides the reader with the practical knowledge necessary to select and use operational amplifier devices. It presents an extensive treatment of applications and a practically oriented, unified theory of operational circuits.Provides the reader with practical knowledge necessary to select and use operational amplifier devices. Presents an extensive treatment of applications and a practically oriented, unified theory of operational circuits

  8. Hospitable Classrooms: Biblical Hospitality and Inclusive Education

    Science.gov (United States)

    Anderson, David W.

    2011-01-01

    This paper contributes to a Christian hermeneutic of special education by suggesting the biblical concept of hospitality as a necessary characteristic of classroom and school environments in which students with disabilities and other marginalized students can be effectively incorporated into the body of the classroom. Christian hospitality, seen…

  9. Additional funding mechanisms for Public Hospitals in Greece: the case of Chania Mental Health Hospital

    Science.gov (United States)

    2010-01-01

    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. PMID:21067580

  10. Additional funding mechanisms for Public Hospitals in Greece: the case of Chania Mental Health Hospital

    Directory of Open Access Journals (Sweden)

    Golna Christina

    2010-11-01

    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.

  11. Avaliação de desempenho econômico-financeiro dos serviços de saúde: os reflexos das políticas operacionais no setor hospitalar Evaluation of financial performance of health services: reflections of operational policies in the hospital sector

    Directory of Open Access Journals (Sweden)

    Carlos Alberto Grespan Bonacim

    2011-01-01

    Full Text Available Discussões acerca de condutas e procedimentos de gestão têm merecido destaque entre dirigentes de organizações da área da saúde. A avaliação econômica da saúde aborda esse tema e vêm assumindo um papel de destaque mundial, exigindo dos gestores novos desafios na busca contínua da eficiência e eficácia das atividades. O objetivo é descrever as consequências de mudanças operacionais nos indicadores econômico-financeiros de um hospital universitário público. Como metodologia, foi feito, além da pesquisa bibliográfica, um estudo de caso no Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (FMRP-USP. Os valores encontrados corroboram com o contexto vivido pelo hospital. Conclui-se que os custos médios apresentam comportamentos semelhantes, com tendência à estabilização, confirmando assim ganhos em eficiência. Ressalta-se, por fim, a importância da prestação de contas para a sociedade quanto ao uso do recurso público.Discussions about management manners and procedures has been relevant among organization managers in the health services. The health services economic evaluation approaches this theme and is taking an important role around the world, demanding the manager new challenges concerning the continuous search of activities efficiency and efficacy. The objective is to describe the consequences of operational changes in the economic-financial indicators of a Public Hospital. The methodology applied included besides the literature research, a case study in the "Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto USP". The values found confirm the context of the hospital. One concludes that the average costs present similar behaviors with trend to stabilization, thus confirming improvements in efficiency. The importance of the rendering of accounts for the society related to the use of public resources and how this study can help in this way.

  12. Hospital-integrated PACS at the University Hospital of Geneva

    Science.gov (United States)

    Ratib, Osman M.; Ligier, Yves; Hochstrasser, Denis; Scherrer, Jean-Raoul

    1991-07-01

    The PACS under development at the University Hospital of Geneva is a hospital-wide image management system for radiological as well as non-radiological medical images which is part of one of the widest hospital information systems (HIS) in Switzerland (Diogene system). It is based on a multi-vendor open architecture and a set of widely available industry standards, namely: Unix as the operating system, TCP-IP as network protocol and an SQL-based distributed database (INGRES) that handles both the PACS and the HIS. The PACS is based on a distributed architecture of servers of two types: the archive servers connected to the sources of images and equipped with large optical disk libraries (jukeboxes) and display servers distributed over the hospital. A standard image storage format was developed based on the ACR-NEMA standard. This file format (the PAPYRUS format) allows storage of sets of images as a sequence of ACR-NEMA messages in an 'encapsulated' file structure. In order to provide a more uniform user interface on a variety of different workstations, a common platform for image display and manipulation called OSIRIS is developed based on X-11 windowing system and OSF/Motif extension. Such a platform is designed to be portable to any computer running Unix and equipped with a graphic display system running X-11. Because this software is written in the object-oriented language C++, it is easily expandable and easily adaptable to different needs and requirements.

  13. Profitability: comparing hospital results with other industries.

    Science.gov (United States)

    Cleverley, W O; Harvey, R K

    1990-03-01

    Changes in healthcare economics now permit more meaningful financial comparisons between hospitals and other industries. A study focusing on return on equity and other financial ratios highlighted critical changes needed to improve the fiscal health of hospitals. These suggestions include increasing net prices on existing product lines, entering new markets, using short-term debt to relieve long-term debt burdens, and expanding uses of operating leases.

  14. Organizational diversification in the American hospital.

    Science.gov (United States)

    Snail, T S; Robinson, J C

    1998-01-01

    This paper outlines a conceptual framework of organizational diversification and assesses the state of empirical research on hospital organizational change. The literature on economic organization of hospitals, one of the most developed branches of health services research, still has only weak ties to economic theory. Evolving physician-hospital organizations do not fit into existing frameworks based on horizontal integration, vertical integration, or diversification. Empirical research has primarily focused on horizontal integration, and cause-effect relationships are often obscured by models that depart from economic theory and lack controls for self-selection bias. Recent empirical studies indicate that hospital mergers had moderate, rather than dramatic, effects on the rate of change in operating costs, staffing, and scale. Mergers rarely resulted in hospital closure, but were as likely to result in acute care consolidation and restructuring as in conversion to non-acute inpatient uses. While administrative costs were higher in for-profit than non-profit system hospitals, total costs were similar. System hospitals had lower marginal and average costs per stay than independent hospitals. Hospital vertical integration into subacute care was largely an artifact of the governmental uniform pricing system, which encouraged vertical integration. Hospitals that shared governance or financial risks with physicians outperformed those with high levels of physician governance and financial integration (e.g. stock ownership). Formal physician-hospital organizational arrangements often served to coordinate managed care contracting or to forge links with primary care group practices. Hospital diversification into related services improved short-term financial performance over unrelated diversification, although long-term performance was similar.

  15. Hortaliças in natura ou minimamente processadas em unidades de alimentação e nutrição: quais aspectos devem ser considerados na sua aquisição? Fresh or minimally processed vegetables in foodservices: what aspects should be considered when purchasing them?

    Directory of Open Access Journals (Sweden)

    Gabriel Carvalho Degiovanni

    2010-10-01

    costs of gross weight considering the correction for net yield were compared with the costs of minimally processed vegetables supplied by the manufacturer during two different periods. Results The costs of minimally processed zucchini, carrot, chayote and arracacha were 8.6%, 14.1%, 4.6% and 13.5% lower than their respective fresh counterparts at time 1, a fact that did not repeat itself at time 2, when these vegetables were less expensive when bought fresh. Conclusion In conclusion, numerous factors associated or not with the food directly influence the magnitude of the losses that occur during processing. The working methods and final objectives of each foodservice should define which product is more advantageous since costs vary and production can be affected by seasonality and the supply and demand of the food item, with repercussions on the quality management of the foodservice.

  16. Descrição sócio-demográfica, laboral e de saúde dos trabalhadores do setor de serviços de alimentação dos restaurantes populares do estado do Rio de Janeiro Sociodemographic, labor, and health characteristics of workers from popular foodservices in the state of Rio de Janeiro, Brazil

    Directory of Open Access Journals (Sweden)

    Odaleia Barbosa de Aguiar

    2010-12-01

    Full Text Available OBJETIVO: Este artigo tem o objetivo de descrever uma população de trabalhadores de alimentação coletiva com foco nos perfis sócio-demográfico, laboral e de saúde. MÉTODOS: O estudo, do tipo seccional, foi realizado com 426 trabalhadores dos restaurantes populares do Estado do Rio de Janeiro, com um questionário aplicado por entrevistadores treinados. Os testes para fins de verificação de associação foram o quiquadrado de Pearson, e, alternativamente, o teste exato de Fisher para amostras pequenas. RESULTADOS: Os homens representaram 62,7% do total de trabalhadores. A idade média dos funcionários foi de 35,1 anos, (DP=10,3. Quanto à escolaridade, somente 11,3% possuíam escolaridade menor que quatro anos e 42,2% entre cinco e oito anos de escolaridade. Os incômodos ambientais apresentaram a seguinte ordem decrescente de importância na percepção dos trabalhadores: temperatura (90,1%, ruído (51,2%, esforço físico (36,2% e luminosidade (10,5%. Os relatos de doenças com diagnóstico médico apresentaram prevalência de: 15,0% "doença osteomusculares relacionadas ao trabalho (DORT"; 14,3% hipertensão arterial sistêmica; 12,7%, gastrite e 2,1%, diabete Mellitus tipo II. Em relação aos acidentes de trabalho 20,2% relataram ter sofrido corte, seguido de contusão com 16,0%, nos últimos doze meses. CONCLUSÃO: A análise dos dados permitiu concluir que, embora os diferentes cargos sofram a ação do ambiente de trabalho, da remuneração e da qualificação, estas questões estiveram mais associadas aos auxiliares de serviços gerais.OBJECTIVE: This study described a population of foodservice workers, focusing on their sociodemographic, labor and health characteristics. METHODS: This sectional study included 426 (98% workers of popular foodservices of the state of Rio de Janeiro who answered a questionnaire administered by trained interviewers. Associations were investigated with the Pearson's chi-square test or the Fisher

  17. Staph infections - hospital

    Science.gov (United States)

    ... medlineplus.gov/ency/patientinstructions/000449.htm Staph infections - hospital To use the sharing features on this page, ... one person to another. Staph Infections in the Hospital Staph germs are mostly spread by skin-to- ...

  18. Hospital Compare - Archived Data

    Data.gov (United States)

    U.S. Department of Health & Human Services — Hospital Compare is a consumer-oriented website that provides information on how well hospitals provide recommended care to their patients. This information can help...

  19. HCAHPS Hospital Survey

    Data.gov (United States)

    U.S. Department of Health & Human Services — Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) Hospital Survey The intent of the HCAHPS initiative is to provide a standardized survey...

  20. Mecanismos de microrregulação aplicados por operadoras de planos de saúde sobre hospitais privados Mecanismos de microregulación aplicados por operadoras de seguros de salud en hospitales privados Mechanisms of microregulation of private hospitals by health plan operators

    Directory of Open Access Journals (Sweden)

    Maria Alicia Domínguez Ugá

    2009-10-01

    la calidad de la asistencia contratada, limitándose, en general, a aspectos como definición de valores, de plazos y procedimientos para pagamento.OBJECTIVE: To analyze the mechanisms employed by health plan operators for microregulation of clinical management and health care qualification within care-providing hospitals. METHODS: A nation-wide cross-sectional study was carried out. The universe consisted of hospitals which provided care to health plan operators in 2006. A sample of 83 units was selected, stratified by Brazilian macroregion and type of hospital. Data were obtained by means of a questionnaire administered to hospital managers. RESULTS: Microregulation of hospitals by health plan operators was minimal or almost absent in terms of health care qualification. Operator activity focused predominantly on intense control of the amount of services used by patients. Hospitals providing services to health plan operators did not constitute health micro-systems parallel or supplementary to the Sistema Único de Saúde (SUS - Brazilian National Health System. The private care-providing hospitals were predominantly associated with SUS. However, these did not belong to a private care-provider network, even though their service usage was subject to strong regulation by health plan operators. Operator intervention in the form of system management was incipient or virtually absent. Roughly one-half of investigated hospitals reported adopting clinical directives, whereas only 25.4% reported managing pathology and 30.5% reported managing cases. CONCLUSIONS: Contractual relationships between hospitals and health plan operators are merely commercial contracts with little if any incorporation of aspects related to the quality of care, being generally limited to aspects such as establishment of prices, timeframes, and payment procedures.

  1. Predicting financial distress in teaching hospitals.

    Science.gov (United States)

    Langabeer, Jim

    2006-01-01

    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.

  2. Preliminary Review on the Operation and Management Mechanism of Provincial Key Laboratories Based in Hospitals%以医院为依托单位的省级重点实验室运行与管理机制初探

    Institute of Scientific and Technical Information of China (English)

    张海燕; 李晓晴; 张晶

    2015-01-01

    目的:探讨以医院为依托单位的省级重点实验室运行和管理中存在的问题,借鉴国外重点实验室运行和管理的经验,提出改进重点实验室运行和管理的举措。方法:对国内重点实验室运行管理的规范和研究文章,借鉴国外重点实验室的运行和管理经验。结果与结论:通过强化依托单位与重点实验室间的良性互动,拓宽经费投入保障机制,建立资源共享平台三个方面举措,加强以医院为依托单位的省级重点实验室运行和管理,增加区域卫生科研实力。%Objective: This paper aims to discuss the problems in operation and management of provincial key laboratories in hospital, to draw on practices of key laboratories abroad, and put forward actions for improvement.Methods: To study relevant polices and literatures about operation and management of key laboratories in China, to learn from the experience of foreign key laboratories. Results and Conclusion:The operation and management of provincial key laboratories based in the hospital could be strengthened by reinforcing the positive interaction between the units and key laboratories, expanding the funding to protect mechanism and establishing a resource sharing platform for the three initiatives, thus to upgrade the strength of regional health research.

  3. Japanese hospitals--culture and competition: a study of ten hospitals.

    Science.gov (United States)

    Anbäcken, O

    1994-01-01

    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.

  4. Existe diferença no estadiamento entre doentes operados de câncer colorretal no sistema previdenciário e na clinica privada? There is any difference in staging between patients operated on for colorectal cancer in public or private hospital?

    Directory of Open Access Journals (Sweden)

    Rodrigo Cuiabano Paes Leme

    2007-06-01

    Full Text Available OBJETIVO: Avaliar se existe diferença no estadiamento de doentes submetidos à ressecção intestinal por câncer colorretal no sistema previdenciário e na clínica privada. MÉTODO: Foram estudados de forma retrospectiva 41 doentes (16 homens e 25 mulheres com idade média de 59,4 anos operados no sistema previdenciário (SP e 33 doentes (18 homens e 15 mulheres com idade média de 60,8 anos operados na clínica privada (CP. Foram avaliados o estadiamento TNM, a frequência de operações de urgência, de operações paliativas e do uso de colostomia. RESULTADOS: Não se observou diferença entre o estadiamento dos dois grupos. A frequência de operações de urgência foi 26,8% no SP e 12,1% na CP (p=0,100. As operações paliativas ( 19,5% SP x 6,1% CP e o uso de colostomia ( 26,8 SP X 15,2 CP foram maiores no sistema previdenciário porém os valores não foram estatisticamente significantes, valores de p=0,087 e p=0,352 respectivamente. CONCLUSÃO: Não há diferença significante entre o estadiamento TNM de doentes operados no sistema previdenciário e privado.BACKGROUND: To examine whether there is any difference in staging between patients operated on for colorectal cancer in public or private hospital. METHODS: This study included 41 patients (16 men and 25 women, mean age of 59.4 years old who underwent colorectal resection for adenocarcinoma in public hospital (PU and 33 patients (18 men and 15 women, mean age 60.8 years old operated in private hospital (PR. They were evaluated regarding the TNM stage, mode of presentation (elective or emergency, type of resection (curative or palliative and the use of colostomy. RESULTS: There was no significant difference in the staging among the two groups. Emergency presentation were 26.8% in the PU group and 12.1% in the PR group (p=0.100. Palliative resection (19.5% PU x 6.1% PR and the use of colostomy (26.8% PU X 15.2% PR were more frequently in the patients operated in public hospital but

  5. Medicare Hospital Spending Per Patient - Hospital

    Data.gov (United States)

    U.S. Department of Health & Human Services — The "Medicare hospital spending per patient (Medicare Spending per Beneficiary)" measure shows whether Medicare spends more, less or about the same per Medicare...

  6. Towards the collaborative hospital

    DEFF Research Database (Denmark)

    Prætorius, Thim; Hasle, Peter; Edwards, Kasper;

    2015-01-01

    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...... 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 organization which is used for a discussion of theoretical and empirical aspects of the collaborative hospital....

  7. Interruptions: Derrida and Hospitality

    Directory of Open Access Journals (Sweden)

    Mark W. Westmoreland

    2008-06-01

    Full Text Available Come in. Welcome. Be my guest and I will be yours. Shall we ask, in accordance with the Derridean question, "Is not hospitality an interruption of the self?" What is the relationship between the interruption and the moment one enters the host's home? Derrida calls us toward a new understanding of hospitality - as an interruption. This paper will illuminate the history of hospitality in the West as well as trace Derrida's discussions of hospitality throughout many of works. The overall goal of this project is to provide readers of Derrida with a sort of reference guide for his discussions on and deconstructive approach to hospitality.

  8. A State Cyber Hub Operations Framework

    Science.gov (United States)

    2016-06-01

    level cyber operations from state information technology (IT) and network infrastructure to hospitals , commercial banking, and manufacturing the...tools - TTPs necessary to operate and maintain Authoritative Data Repository for operational related artifacts . - Monitor and report on operations...development of Data Repository structures to enable storage of Cyber Hub related artifacts . - Provides Technical input to Business Case Analyses (BCAs

  9. Mahmood Khan honored with first Brahim's Chair at Universiti Putra Malaysia in Kuala Lumpur

    OpenAIRE

    Micale, Barbara L.

    2010-01-01

    Mahmood Khan, professor, Department of Hospitality and Tourism Management, Pamplin College of Business, National Capital Region, received the first Brahim's Chair in Foodservice and Hospitality Management from the Universiti Putra Malaysia, Kuala Lumpur, during a recent banquet and ceremony.

  10. Operational calculus

    CERN Document Server

    Boehme, Thomas K

    1987-01-01

    Operational Calculus, Volume II is a methodical presentation of operational calculus. An outline of the general theory of linear differential equations with constant coefficients is presented. Integral operational calculus and advanced topics in operational calculus, including locally integrable functions and convergence in the space of operators, are also discussed. Formulas and tables are included.Comprised of four sections, this volume begins with a discussion on the general theory of linear differential equations with constant coefficients, focusing on such topics as homogeneous and non-ho

  11. Operating systems

    CERN Document Server

    Tsichritzis, Dionysios C; Rheinboldt, Werner

    1974-01-01

    Operating Systems deals with the fundamental concepts and principles that govern the behavior of operating systems. Many issues regarding the structure of operating systems, including the problems of managing processes, processors, and memory, are examined. Various aspects of operating systems are also discussed, from input-output and files to security, protection, reliability, design methods, performance evaluation, and implementation methods.Comprised of 10 chapters, this volume begins with an overview of what constitutes an operating system, followed by a discussion on the definition and pr

  12. Optimizing sterilization logistics in hospitals.

    Science.gov (United States)

    van de Klundert, Joris; Muls, Philippe; Schadd, Maarten

    2008-03-01

    This paper deals with the optimization of the flow of sterile instruments in hospitals which takes place between the sterilization department and the operating theatre. This topic is especially of interest in view of the current attempts of hospitals to cut cost by outsourcing sterilization tasks. Oftentimes, outsourcing implies placing the sterilization unit at a larger distance, hence introducing a longer logistic loop, which may result in lower instrument availability, and higher cost. This paper discusses the optimization problems that have to be solved when redesigning processes so as to improve material availability and reduce cost. We consider changing the logistic management principles, use of visibility information, and optimizing the composition of the nets of sterile materials.

  13. Operating room management and operating room productivity: the case of Germany.

    Science.gov (United States)

    Berry, Maresi; Berry-Stölzle, Thomas; Schleppers, Alexander

    2008-09-01

    We examine operating room productivity on the example of hospitals in Germany with independent anesthesiology departments. Linked to anesthesiology group literature, we use the ln(Total Surgical Time/Total Anesthesiologists Salary) as a proxy for operating room productivity. We test the association between operating room productivity and different structural, organizational and management characteristics based on survey data from 87 hospitals. Our empirical analysis links improved operating room productivity to greater operating room capacity, appropriate scheduling behavior and management methods to realign interests. From this analysis, the enforcing jurisdiction and avoiding advance over-scheduling appear to be the implementable tools for improving operating room productivity.

  14. Stage implementation of RFID in hospitals.

    Science.gov (United States)

    Kumar, Sameer; Livermont, Gregory; McKewan, Gregory

    2010-01-01

    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.

  15. ELEMENTAL FORMS OF HOSPITALITY

    Directory of Open Access Journals (Sweden)

    Maximiliano Emanuel Korstanje

    2010-11-01

    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.

  16. Schwartz operators

    Science.gov (United States)

    Keyl, M.; Kiukas, J.; Werner, R. F.

    2016-05-01

    In this paper, we introduce Schwartz operators as a non-commutative analog of Schwartz functions and provide a detailed discussion of their properties. We equip them, in particular, with a number of different (but equivalent) families of seminorms which turns the space of Schwartz operators into a Fréchet space. The study of the topological dual leads to non-commutative tempered distributions which are discussed in detail as well. We show, in particular, that the latter can be identified with a certain class of quadratic forms, therefore making operations like products with bounded (and also some unbounded) operators and quantum harmonic analysis available to objects which are otherwise too singular for being a Hilbert space operator. Finally, we show how the new methods can be applied by studying operator moment problems and convergence properties of fluctuation operators.

  17. Transition Operators

    CERN Document Server

    Alcock-Zeilinger, Judith

    2016-01-01

    In this paper, we give a generic algorithm of the transition operators between Hermitian Young projection operators corresponding to equivalent irreducible representations of SU(N), using the compact expressions of Hermitian Young projection operators derived in a companion paper. We show that the Hermitian Young projection operators together with their transition operators constitute a fully orthogonal basis for the algebra of invariants of $V^{\\otimes m}$ that exhibits a systematically simplified multiplication table. We discuss the full algebra of invariants over $V^{\\otimes 3}$ and $V^{\\otimes 4}$ as explicit examples. In our presentation we make use of various standard concepts such as Young projection operators, Clebsch-Gordan operators, and invariants (in birdtrack notation). We tie these perspectives together and use them to shed light on each other.

  18. Application of special instruments and apparatus of using video in the hospital operating room training%特殊仪器和器械使用视频在专科医院手术室培训中的应用

    Institute of Scientific and Technical Information of China (English)

    唐亚萍; 尤卫红; 何妙东

    2015-01-01

    Objective:To explore the effect of special instruments and apparatus training video used in the hospital operating room. Methods:To surveyed of hospital operating room instruments and equipment usage,according to specialized features identified 15 projects and made into a video,theatre nurses and nursing students for training and learning,To compare the test questions,operation exam and doctor's satisfaction before and after training for nurses and nursing students. Results:After training,the question test,examination results and doctor's satisfaction was higher than before,the difference was statistically significant (P<0. 05). Conclusion:Using special devices and equipment used to record videos for training for new employees and interns and nurses in the operations review and learning can improve nurses perception of special devices and equipment,better with surgery,operational capacity and to improve their own qualities.%目的:探讨在专科医院中对特殊仪器和器械使用视频进行手术室培训的应用效果. 方法:2013年1~12月调查我院手术室的仪器和器械使用情况,根据专科特点确定15项操作项目,并制作成视频,对手术室护士和实习护生进行培训和学习. 比较培训前后护士和实习护生的提问测试及操作考核成绩和医师的满意度. 结果:手术室护士和实习护生使用视频培训学习后,提问测试和操作考核成绩、医师满意度均高于培训前,差异有统计学意义(P<0. 05). 结论:将特殊仪器和器械使用录制成视频用于对新员工和实习生的培训教学及手术室护士的操作复习和学习,能提高护士对特殊仪器和器械的认知程度,更好地配合手术,提高业务能力和自身综合素质.

  19. 陕南3所三级甲等医院清洁手术预防使用抗菌药物的调查分析%Investigation on the preventive use of antibiotics in aseptic operation in three grade A class 3 hospitals in the south Shaanxi province

    Institute of Scientific and Technical Information of China (English)

    程建峰; 杨鹏

    2012-01-01

    目的 调查3所三级甲等医院清洁手术预防使用抗菌药物的情况,评价其应用的合理性.方法 抽取3所医院2011年9月清洁手术(甲状腺、乳腺、腹股沟疝、肾脏、颅脑手术)病例各50份,冠状动脉造影病例各20份,对病例是否使用抗菌药物、抗菌药物的品种、给药时机、给药时限及抗菌药物联合使用情况等进行统计分析.结果 清洁手术及冠状动脉造影诊断预防使用抗菌药物3所医院合计总体使用比例分别为67.3%和57.25%,品种选择合格率为60.8%,用药时机合格率为83.3%,使用疗程合格率为37.5%.结论 3所医院清洁手术预防使用抗菌药物,仅给药时机情况较好,抗菌药物的使用率、品种的选择及使用疗程都存在一定的不合理性.%Objective To investigate on the preventive use of antibiotics of three grade A class 3 hospitals,and to evaluate the rationality of the usage. Methods 50 cases of aseptic operations (thyroid,breast,inguinal hernia,kidney and brain operations) in September of 2011 of the three hospitals and 20 cases of coronary angiography were analyzed in the aspect of utilization,kinds,administration time, time of therapy and the combined use frequency of antibiotics. Results The frequency of preventive using antibiotics was 67. 3 % and 57. 25 % , respectively in the aseptic operation and coronary angiography. The reasonable chosen rate of kinds was 60. 8%, the reasonable chosen rate of administration time was 83. 3% ,and the reasonable chosen rate of time of therapy was 37. 5%. Conclusions The utilization frequency, chosen of kinds and time of therapy of antibiotics are not as reasonable as requested except the administration time of antibiotics in these three grade A class 3 hospitals.

  20. 防范商业贿赂工作机制在我院药库的建立及运作%Establishment and Operation of Working Mechanisms of Commercial Bribery Prevention in Drugstore of Our Hospital

    Institute of Scientific and Technical Information of China (English)

    彭海莹; 吴新荣; 胡丽辉

    2011-01-01

    OBJECTIVE: To prevent commercial bribery through formulating and consummating all kinds of working systems in hospital drugstores. METHODS: Working systems of commercial bribery precaution were established using strategies of purchasing medicine from the main channel, online examination and verification of new drugs data, online drug purchase and quantified evaluation for suppliers, etc. RESULTS & CONCLUSIONS: The working mechanism improves reasonable and fair approval procedure of new drugs, online transparent drug purchase procedure and objective evaluation and selection of distribution companies. Being the key point in drugstore management, the prevention of commercial bribery and the reinforcement of building a clean and honest department should be implemented thoroughly for a long time.%目的:通过在医院药库制定及完善各项工作制度防范商业贿赂.方法:实施主渠道进药、基于网络实现新药资料审核、药品网上采购、对供货公司进行量化考评等方法,建立防范商业贿赂的工作机制.结果与结论:通过建立该工作机制,促进了新药审批环节公平公正化,药品采购流程网络化、透明化以及配送公司的客观评估和遴选.防治商业贿赂、加强廉政建设是药库管理工作的重点,必须长期贯彻执行.

  1. Operational morbidity analysis of soft tissue injuries during Operation TELIC.

    Science.gov (United States)

    Ollerton, J; Hodgetts, T; Russell, R

    2007-12-01

    Soft tissue injury accounted for one in five of all presentations to the Emergency Department (ED) during Operation TELIC (UK forces in Iraq) from March 2003 to November 2006. This ranks soft tissue complaints as the most frequent cause of attendance to a deployed field hospital ED. This paper analyses the injury patterns, together with implications for future clinical practice and operational planning to prevent injury, optimise patient care and maximize force regeneration.

  2. Financial Support of Military Hospitals in Military Operations other than War%非战争军事行动中军队医院财务保障措施

    Institute of Scientific and Technical Information of China (English)

    熊训英

    2012-01-01

    本文依据非战争军事行动对医院财务保障提出的要求,针对当前非战争军事行动中财务保障存在的不足,提出了统筹资源、完善预案、建立机制、保障效益,加大基础建设五个方面的改进措施.%According to the characteristics and defects of financial support in military operation other than war, the author put forward the improving measures, which included planning the resources as a whole, perfecting preplan, establishing mechanism, ensuring effectiveness, increasing the infrastructure construction.

  3. 非战争军事行动中军队医院机动卫勤分队模块化抽组的建设思考%Think about constructing modular pumping grouping of military hospital's mobile medical units in the military operations other than war

    Institute of Scientific and Technical Information of China (English)

    赵从林; 李思睿

    2015-01-01

    In the military operations other than war(MOOTW),the ability and efficiency of mobile medical units of military hospitals in performing medical tasks depend on the convenience and accuracy of modular pumping grouping. The modularity approach is an effective method in dealing with complicated tasks. In an attempt to illustrate the complex problem of pumping grouping in the modular approach through combining the modularization principle and mobile medical unit pumping grouping ,this research has been an useful endeavor to improve the medical capacity of mobile medical units in military hospitals.%在非战争军事行动背景下,军队综合性医院机动卫勤分队遂行卫勤保障任务的效率和能力,取决于模块化抽组的便捷性和准确性。模块化是处理复杂问题的有效方法之一,本文将模块化原理和机动卫勤分队抽组有机结合起来,试图把复杂的抽组问题通过模块化方式得以阐述,为提高军队医院机动卫勤分队卫勤保障能力进行尝试。

  4. Spacecraft operations

    CERN Document Server

    Sellmaier, Florian; Schmidhuber, Michael

    2015-01-01

    The book describes the basic concepts of spaceflight operations, for both, human and unmanned missions. The basic subsystems of a space vehicle are explained in dedicated chapters, the relationship of spacecraft design and the very unique space environment are laid out. Flight dynamics are taught as well as ground segment requirements. Mission operations are divided into preparation including management aspects, execution and planning. Deep space missions and space robotic operations are included as special cases. The book is based on a course held at the German Space Operation Center (GSOC).

  5. The impact of joint ventures on U.S. hospitals.

    Science.gov (United States)

    Harrison, Jeffrey P

    2006-01-01

    This quantitative research study assesses the organizational characteristics, market factors, and profitability of US hospitals that operate joint ventures with other health care organizations. Data was obtained from the 2001 American Hospital Association annual survey, the Area Resource File, and the Center for Medicare and Medicaid Services Minimum Data Set. These data files provide essential information on individual acute care hospitals, the communities they serve, and the level of financial performance. Descriptive statistics were evaluated and a logistic regression model was utilized to examine hospitals operating joint ventures. The study found hospitals that operate joint ventures are located in communities with more elderly patients, lower unemployment, and lower HMO penetration. From an operating performance perspective, hospitals that operate joint ventures have a higher occupancy rate, a higher average length of stay, more clinical services, lower long-term debt, and a greater number of managed care contracts. The results also appear to indicate that joint ventures have a positive financial impact on US hospitals. The study has managerial implications supporting the use of joint ventures to improve hospital performance and policy implications on resource allocation.

  6. Application of PDCA in Management of Perioperative Prophylactic Use of Antibacterial Drugs in Type 1 Incision Operation in Our Hospital%PDCA 法用于Ⅰ类切口手术抗菌药物预防性使用管理实践

    Institute of Scientific and Technical Information of China (English)

    周溯; 魏华莲

    2015-01-01

    目的:探索控制医院围手术期Ⅰ类切口手术抗菌药物预防性使用的管理办法。方法将 PDCA 法应用于医院围手术期Ⅰ类切口手术抗菌药物预防使用管理,通过现状调查、原因分析、确定目标以及制订相应的管理措施,最后对效果进行评价。结果经过 PDCA 循环管理干预后,预防性抗菌药物使用率逐年降低,2011年3月至2012年3月、2012年4月至2013年3月、2013年4月至2014年3月分别为48.56%,39.67%和28.91%。结论 PDCA 循环管理方法用于医院围手术期Ⅰ类切口手术抗菌药物预防性使用管理,效果显著。%Objective To explore the management method for controlling the perioperative prophylactic use of antibacterial drugs in type 1 incision operation in our hospital. Methods The plan, do, check, action (PDCA) method was applied in the management of the peri-operative prophylactic use of antibacterial drugs in type 1 incision operation. The efficacy was finally evaluated through the status quo investigation, causes analysis, setting goals and formulating the corresponding management measures. Results After the PDCA cycle man-agement intervention, the prophylactic use rate of antibacterial drugs was decreased year by year, which from March 2011 to March 2013 were 48. 56% , 39. 67% and 28. 91% respectively. Conclusion The PDCA cycle management method has significant effect in the management of the prophylactic use of perioperative antibacterial drugs in type 1 incision operation in our hospital.

  7. Rural Hospital Mergers and Acquisitions: Which Hospitals Are Being Acquired and How Are They Performing Afterward?.

    Science.gov (United States)

    Noles, Marissa J; Reiter, Kristin L; Boortz-Marx, Jonathan; Pink, George

    2015-01-01

    The number of stand-alone rural hospitals has been shrinking as larger health systems target these hospitals for mergers and acquisitions (M and As). However, little research has focused specifically on rural hospital M and A transactions. Using data from Irving Levin Associates' Healthcare M and A Report and Medicare Cost Reports from 2005 to 2012, we examined two research questions: (1) What were the characteristics of rural hospitals that merged or were acquired, and (2) were there changes in rural hospital financial performance, staffing, or services after an M and A transaction? We used logistic regression to identify factors predictive of merger, and we used multiple regression to examine various hospital measures after an M or A. Study results showed that hospitals with weaker financial performance but lower staffing levels and staffing costs were more likely to merge or be acquired. Statistically weak evidence suggested that operating margins declined after the merger; stronger evidence suggested reductions in salary expense. There was no statistically significant evidence of changes to the number of full-time equivalent (FTE) employees, the service lines that were included in the study, capital expenditures, or the amount of debt financing among the hospitals that merged or were acquired. M and A may not result in a rapid influx of capital, a relief of debt burden, or an improvement in bottom-line profitability. However, M and A may be a viable option for maintaining the hospital and the access to care it provides.

  8. [Water hygiene in hospitals].

    Science.gov (United States)

    Kerwat, Klaus; Wulf, Hinnerk

    2013-10-01

    As a general rule drinking water in hospitals does not represent a risk for the normal patient. However, for high-risk patients with compromised immune defense systems drinking water in hospitals may become a source of nosocomial infections. It may be contaminated with microorganisms that may have the potential to be infectious agents in the hospital environment. Of particular significance in such circumstances are the Gram-negative rods such as Pseudomonas aeruginosa, Acinetobacter spp. and Legionella bacteria. Accordingly, specific behavior patterns and measures in the handling of drinking water in hospitals are meaningful in order to reduce the risks of water-associated nosocomial infections.

  9. Moments of hospitality

    DEFF Research Database (Denmark)

    Justesen, Lise; Gyimóthy, Szilvia; Mikkelsen, Bent Egberg

    2014-01-01

    Hospital meals have increasingly become part of the political and scientific agenda of the welfare discussions in Denmark and other European countries. This article employs non-representational theory to analyse hospitalityscapes in order to explore opportunities for adding value to the hospital...... meal experience. By drawing on research carried out in two Danish hospital wards, this article explores how hospitalityscapes are socio-materially constructed. The research strategy was based on performative participant observations, visual ethnography and semi-structured interviews. The empirical data...... that a focus on disruptive micro-events might create opportunities for hospitalityscapes and add value to future hospital meal experiences....

  10. Central line infections - hospitals

    Science.gov (United States)

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

  11. Operation REDWING

    Science.gov (United States)

    1956-07-31

    only 16mm cinemascope films would be available after 1 August 1956t Act- tion was taken to modify the screens of the Terrace and Starlite theaters...approximately 900, was in operation throughout the interim and operational period. The Starlite Theater, which seats approximately 600, opened in

  12. OPERATION ASKARI

    African Journals Online (AJOL)

    operation using conventional arms against Swapo Plan, while they were still massed in their .... stationed there was no real threat to our planned operation. the idea was to sow confusion in the minds ...... A four by four transport vehi- cle, based ...

  13. Operational Sequencing

    DEFF Research Database (Denmark)

    Nielsen, Thomas Rosendal; Hustvedt, Kjersti

    2016-01-01

    by Bakhtinian theory, Brian Edmiston developed a solution to this in the 1990s: the principle of ‘dialogic sequencing’. Aiming to escape the conflict between relativism and absolutism, we present an alternative to Edmiston’s approach, based on Niklas Luhmann’s theory of ‘operational closure’: operational...

  14. Business & Operations

    Science.gov (United States)

    Agron, Joe

    2007-01-01

    This article presents an interview with John D. Musso, executive director of the Association of School Business Officials (ASBO) International. Musso talks about trends and issues that will most affect school business and operations in 2007 and beyond. Despite the challenges facing school operations, he believes that the key to being successful at…

  15. Operation crosscheck

    Energy Technology Data Exchange (ETDEWEB)

    Gilbert, F. C.

    1964-11-06

    This report consists of three sections covering the three major areas of Lawrence Livermore Laboratory`s participation in Operation Crosscheck. These areas are: Diagnostic Aircraft; Radiochemical Sampling; and Device Assembly and Handling, Barbers Point. The information contained in these sections has been extracted from Crosscheck post-operation reports.

  16. Operational Amplifiers.

    Science.gov (United States)

    Foxcroft, G. E.

    1986-01-01

    Addresses the introduction of low cost equipment into high school and college physical science classes. Examines the properties of an "ideal" operational amplifier and discusses how it might be used under saturated and non-saturated conditions. Notes the action of a "real" operational amplifier. (TW)

  17. Alternative indicators for measuring hospital productivity.

    Science.gov (United States)

    Serway, G D; Strum, D W; Haug, W F

    1987-08-01

    This article explores the premise that the appropriateness and usefulness of typical hospital productivity measures have been affected by three changes in delivery: Organizational restructuring and other definition and data source changes that make full-time equivalent employee (FTE) measurements ambiguous. Transition to prospective payment (diagnosis-related groups). Increase in capitation (prepaid, at risk) programs. The effects of these changes on productivity management indicate the need for alternative productivity indicators. Several productivity measures that complement these changes in internal operations and the external hospital business environment are presented. These are based on an analysis of four hospitals within a multihospital system, and an illustration and interpretation of an array of measures, based on ten months of actual data, is provided. In conclusion, the recommendation is made for hospital management to collect an expanded set of productivity measures and review them in light of changing expense and revenue management schemes inherent in new payment modes.

  18. A new "P" for hospital marketing?

    Science.gov (United States)

    Hill, R C

    1988-01-01

    The rather abrupt introduction of payors to hospitals and vice versa that started a few years ago has now settled down into a learning situation. To be price competitive in the health insurance marketplace, the payor must obtain full contractual performance in price, administrative and utilization review areas. Hospitals need the patients that payors can refer, but there is only a minimal understanding of how the health insurance industry operates both internally and in the marketplace. By selecting payors and soliciting those selected, hospitals have an excellent chance to accomplish their patient and revenue goals while payors have the opportunity to determine the effectiveness of their various programs to help meet their goals. By making a little effort, hospitals can accomplish a lot by adding this new "P" to their marketing mix.

  19. Smart Textiles in Humanistic Hospital Design

    DEFF Research Database (Denmark)

    Mogensen, Jeppe Emil; Fisker, Anna Marie; Poulsen, Søren Bolvig

    2013-01-01

    in Future Hospitals”, stating the overall hypothesis that textiles in hospital interiors possess an unexploited architectural potential in relation to the humanistic visions of healing architecture. Concerned with the operational challenge of unfolding the visionary design principle, we suggest to re......With the construction of new hospitals, the design principle healing architecture is introduced, representing the humanistic vision of improving 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 purpose of this paper is thus to present a review of healing architecture, by considering some of the challenges in the operational use of the design principle...

  20. Hospital economics of primary total knee arthroplasty at a teaching hospital.

    Science.gov (United States)

    Healy, William L; Rana, Adam J; Iorio, Richard

    2011-01-01

    The hospital cost of total knee arthroplasty (TKA) in the United States is a major growing expense for the Centers for Medicare & Medicaid Services (CMS). Many hospitals are unable to deliver TKA with profitable or breakeven economics under the current Diagnosis-Related Group (DRG) hospital reimbursement system. The purposes of the current study were to (1) determine revenue, expenses, and profitability (loss) for TKA for all patients and for different payors; (2) define changes in utilization and unit costs associated with this operation; and (3) describe TKA cost control strategies to provide insight for hospitals to improve their economic results for TKA. From 1991 to 2009, Lahey Clinic converted a $2172 loss per case on primary TKA in 1991 to a $2986 profit per case in 2008. The improved economics was associated with decreasing revenue in inflation-adjusted dollars and implementation of hospital cost control programs that reduced hospital expenses for TKA. Reduction of hospital length of stay and reduction of knee implant costs were the major drivers of hospital expense reduction. During the last 25 years, our economic experience with TKA is concerning. Hospital revenues have lagged behind inflation, hospital expenses have been reduced, and our institution is earning a profit. However, the margin for TKA is decreasing and Managed Medicare patients do not generate a profit. The erosion of hospital revenue for TKA will become a critical issue if it leads to economic losses for hospitals or reduced access to TKA. Level III, Economic and Decision Analyses. See Guidelines for Authors for a complete description of levels of evidence.

  1. Rovers Pave the Way for Hospital Robots

    Science.gov (United States)

    2013-01-01

    The Jet Propulsion Laboratory provided funding for the Massachusetts Institute of Technology to develop capabilities for robotics like Rocky 7. After developing the operating system, Daniel Theobald started working at Cambridge, Massachusetts-based Vecna Technologies. Today, Vecna's QC Bot incorporates systems based on the NASA work and is being used to ease logistics at hospitals. The technology has contributed to 20 new jobs.

  2. HBCUs Gear Up to Produce Hospitality Managers.

    Science.gov (United States)

    Murray, Chris

    1994-01-01

    Increasingly, historically black colleges and universities (HBCUs) are developing professional programs in hotel and restaurant management and travel and tourism. One objective is to train African Americans to become owners and operators of their own enterprises. An obstacle is the perception that hospitality careers involve menial labor. (MSE)

  3. Demands of Training: Australian Tourism and Hospitality.

    Science.gov (United States)

    Freeland, Brett

    Qualitative research was conducted as part of a four-industry project studying operation of training markets, one of which was Australian tourism and hospitality (T&H). Semi-structured interviews were conducted with 23 individuals representing stakeholder groups. Interviews were conducted across Queensland, Victoria, and South Australia and…

  4. Sustainable practices in hospitality : A research framework

    NARCIS (Netherlands)

    Rheede, van A.; Blomme, R.J.

    2012-01-01

    The hospitality industry is starting to take responsibility for environmental sustainability. A strong focus on energy, waste, and water usage is directly linked with financial benefits in the operation of the hoteliers. Practices connected to the social aspect of sustainability are less developed.

  5. Sustainable practices in hospitality : A research framework

    NARCIS (Netherlands)

    Rheede, van A.; Blomme, R.J.

    2012-01-01

    The hospitality industry is starting to take responsibility for environmental sustainability. A strong focus on energy, waste, and water usage is directly linked with financial benefits in the operation of the hoteliers. Practices connected to the social aspect of sustainability are less developed.

  6. Impact of surgical volume on nationwide hospital mortality after pancreaticoduodenectomy

    Institute of Scientific and Technical Information of China (English)

    Chul-Gyu Kim; Sungho Jo; Jae Sun Kim

    2012-01-01

    AIM:To evaluate the impact of surgical volume on nationwide hospital mortality after pancreaticoduodenectomy (PD) for periampullary tumors in South Korea.METHODS:Periampullary cancer patients who underwent PD between 2005 and 2008 were analyzed from the database of the Health Insurance Review and Assessment Service of South Korea.A total of 126 hospitals were divided into 5 categories,each similar in terms of surgical volume for each category.We used hospital mortality as a quality indicator,which was defined as death during the hospital stay for PD,and calculated adjusted mortality through multivariate logistic models using several confounder variables.RESULTS:A total of eligible 4975 patients were enrolled in this study.Average annual surgical volume of hospitals was markedly varied,ranging from 215 PDs in the very-high-volume hospital to < 10 PDs in the verylow-volume hospitals.Admission route,type of medical security,and type of operation were significantly different by surgical volume.The overall hospital mortality was 2.1% and the observed hospital mortality by surgical volume showed statistical difference.Surgical volume,age,and type of operation were independent risk factors for hospital death,and adjusted hospital mortality showed a similar difference between hospitals with observed mortality.The result of the HosmerLemeshow test was 5.76 (P =0.674),indicating an acceptable appropriateness of our regression model.CONCLUSION:The higher-volume hospitals showed lower hospital mortality than the lower-volume hospitals after PD in South Korea,which were clarified through the nationwide database.

  7. Factors associated with lease financing in the hospital industry.

    Science.gov (United States)

    McCue, Michael J

    2007-01-01

    In contrast to capital leases, which are reported on the balance sheet as debt, operating leases are a form of off-balance sheet financing only reported in the notes to the financial statement and have limited disclosure requirements. Following the perpetuity method of corporate finance, this study developed a capitalized operating lease value for hospitals. Evaluating the substitutability between lease and debt financing, the findings show a marginal displacement of debt by lease financing. Assessing the relationship of market, mission, operating, and financial factors on lease financing for all short-term, acute-care hospitals across the United States, the results indicate that investor-owned hospital management companies and hospitals located in CON markets are less likely to lease and that smaller hospitals with fewer unoccupied beds, higher proportion of government payers, low liquidity, and lower capital expenditures are more likely to lease.

  8. Comparative analysis of hospital energy use: pacific northwest and scandinavia.

    Science.gov (United States)

    Burpee, Heather; McDade, Erin

    2014-01-01

    This study aimed to establish the potential for significant energy reduction in hospitals in the United States by providing evidence of Scandinavian operational precedents with high Interior Environmental Quality (IEQ) and substantially lower energy profiles than comparable U.S. facilities. These facilities set important precedents for design teams seeking operational examples for achieving aggressive energy and interior environmental quality goals. This examination of operational hospitals is intended to offer hospital owners, designers, and building managers a strong case and concrete framework for strategies to achieve exceptionally high performing buildings. Energy efficient hospitals have the potential to significantly impact the U.S.'s overall energy profile, and key stakeholders in the hospital industry need specific, operationally grounded precedents in order to successfully implement informed energy reduction strategies. This study is an outgrowth of previous research evaluating high quality, low energy hospitals that serve as examples for new high performance hospital design, construction, and operation. Through extensive interviews, numerous site visits, the development of case studies, and data collection, this team has established thorough qualitative and quantitative analyses of several contemporary hospitals in Scandinavia and the Pacific Northwest. Many Scandinavian hospitals demonstrate a low energy profile, and when analyzed in comparison with U.S. hospitals, such Scandinavian precedents help define the framework required to make significant changes in the U.S. hospital building industry. Eight hospitals, four Scandinavian and four Pacific Northwest, were quantitatively compared using the Environmental Protection Agency's Portfolio Manager, allowing researchers to answer specific questions about the impact of energy source and architectural and mechanical strategies on energy efficiency in operational hospitals. Specific architectural, mechanical

  9. Pastoral care in hospitals: a literature review.

    Science.gov (United States)

    Proserpio, Tullio; Piccinelli, Claudia; Clerici, Carlo Alfredo

    2011-01-01

    This literature review investigates the potential contribution of the pastoral care provided in hospitals by hospital chaplains, as part of an integrated view of patient care, particularly in institutions dealing with severe disease. A search was conducted in the Medline database covering the last 10 years. Ninety-eight articles were considered concerning the modern hospital chaplains' relationships and the principal procedures and practices associated with their roles, i.e., their relations with the scientific world, with other religious figures in the community, with other faiths and religious confessions, with other public health professionals and operators, with colleagues in professional associations and training activities, and with the hospital organization as a whole, as well as their patient assessment activities and the spiritual-religious support they provide, also for the patients' families. Improvements are needed on several fronts to professionalize the pastoral care provided in hospitals and modernize the figure of the hospital chaplain. These improvements include better relations between modern chaplains and the hospital organization and scientific world; more focus on a scientific approach to their activities and on evaluating the efficacy of pastoral care activities; greater clarity in the definition of the goals, methods and procedures; the design of protocols and a stance on important ethical issues; respect for the various faiths, different cultures and both religious and nonreligious or secularized customs; greater involvement in the multidisciplinary patient care teams, of which the hospital chaplains are an integral part; stronger integration with public health operators and cooperation with the psychosocial professions; specific training on pastoral care and professional certification of chaplains; and the development of shared ethical codes for the profession.

  10. Employee organizational commitment and hospital performance.

    Science.gov (United States)

    Baird, Kevin M; Tung, Amy; Yu, Yanjie

    2017-09-15

    There is widespread evidence of the purported benefits of employee organizational commitment (EOC) and its impact on both individual and organizational performance. This study contributes to this literature by providing a unique insight into this relationship, focusing on the interrelationship between EOC with hospital performance and the role of the provision of adequate facilities in eliciting EOC. The aim of this study was to introduce and empirically examine a new theoretical model in which it is argued that the performance of hospitals with regard to the provision of adequate facilities (medical facilities, support facilities, and staff resources) influences the level of EOC, which in turn influences hospital performance with regard to patient care and operational effectiveness. To examine the interrelationships between the provision of adequate facilities, EOC, and hospital performance, the study utilizes a survey of hospital managers. The findings support the theoretical model, with the provision of support facilities and staff resources positively indirectly associated with both patient care and operational effectiveness through their impact on EOC. The findings highlight the importance of providing adequate facilities and EOC within hospitals and suggest that CEOs and general managers should try to enhance the provision of such resources in an attempt to elicit EOC within their hospitals. The findings suggest that managers should try to enhance their provision of adequate facilities in order to elicit EOC and enhance hospital performance. With regard to medical facilities, they should consider and incorporate the latest technology and up-to-date equipment. They should also provide adequate staff resources, including appropriate numbers of beds, nurses, and doctors, to prevent "fatigue" (West, 2001, p. 41) and provide adequate support facilities.

  11. 高效模式下医院手术室一次性无菌物品的管理%Under Highly Effective Revolution Pattern Hospital Operating Room Disposable Asepsis Goods Management

    Institute of Scientific and Technical Information of China (English)

    吴巧琴; 沈惠青

    2014-01-01

    Objective Discusses this courtyard operating room to the disposable asepsis goods management ef ect and the experience.Methods 2012January January through the application of consumables management team re integration, environment layout improvement, goods supply process restructuring and management tools to regulate the new, improved management of disposable sterile items. Results Low seniority nurses can take the object time; leak charge can find the cor ect; reduce the cost of waste; reduce the nurse not on duty time; improve the staf on the disposable use satisfaction; improve the surgeon on nurses' job satisfaction. Conclusion The standardized management ef ectively ensure the safe use of disposable sterile items, make work more orderly, more ef icient, the medical relations more harmonious, but also ful y embodies the patient centered service tenet.%目的:探讨本院手术室对一次性无菌物品管理的效果及体会。方法2012年1月起通过对耗材管理团队的再整合、环境布局的改进、物品供应流程的重组及新的管理工具的应用来进行规范、改进一次性无菌物品的管理。结果缩短了低年资护士拿取物品的时间;漏收费能及时发现更正;减少了科室成本浪费;降低了巡回护士不在岗时间;提高了科室人员对一次性物品使用的满意度;提高了外科医生对护士工作的满意度(P<0.01)。结论规范化管理有效地保证了一次性无菌物品的安全使用,使工作更有序,效率更高,医护关系更融洽,也充分体现了以患者为中心的服务宗旨。

  12. How a hospital must face a massive emergency: the case of Martini Hospital, Turin

    Directory of Open Access Journals (Sweden)

    Antonio Morra

    2008-09-01

    Full Text Available The terms “disaster” or “surge capability”, referred to hospitals, are often used to define a massive casualty admission. This may be a misleading concept, because emergency may as well arise from inside hospitals, and the last years high figures related to fires in the about 2,000 italian hospitals should suggest a different point of view. In this article the authors describe their experience in hospital preparedness at Ospedale Martini in Turin. Hospital operators regularly attend basic (GOM and advanced (HDM© courses about disaster response and organization, and a specific course is dedicated to operators involved in internal safety (fire emergency. In this courses, computer simulations are widely used, associated with conventional didactic. If education is one of the two cornerstones of disaster preparedness at Ospedale Martini, well designed emergency plans and an effective disaster management are the other one. The Internal Emergency Plan (Fire and Evacuation is aimed to give a proper response to fires and other events arising from inside the hospital and potentially requiring its partial or total evacuation. The Massive Casualties Admission Emergency Plan increases the surge capability of the hospital allowing to take care of a great number of injured people, and at the same time avoiding a dramatic fall in the treatment quality. The “Hospital Disaster Management©” system, created by the authors, is an organizational scheme based on team work. Its aim is to “put order in chaos” when hospitals are facing a disaster. Properly trained physicians and nurses, assigned to key positions, act in this system as Hospital Disaster Managers: their tasks are to coordinate the teams, to manage critical resources and to use the emergency plans as powerful instruments.

  13. An analytical review of hospital financial performance measures.

    Science.gov (United States)

    Glandon, G L; Counte, M; Holloman, K; Kowalczyk, J

    1987-11-01

    Hospital administrators must have timely, valid, and interpretable financial information that allows them to make operational decisions in response to the threats of the changing health care environment. Aggregate indexes that reflect dimensions of hospital financial performance and simplify the information in financial ratios are needed to aid in decision making. This article reviews the development and use of hospital financial performance measures and lays the groundwork for research into deriving a multidimensional measure.

  14. Chaotic changes in distribution channels : implications for hospitality companies

    OpenAIRE

    Gursoy, Dogan

    2010-01-01

    Distribution channels of hospitality products are going through chaotic changes and slowly making the traditional tourism and travel marketing obsolete. These changes are already having significant impact on hospitality companies’ operational strategies. As a result, required skills and talents of hospitality employees are evolving from reservation taking and confirming to inventory controlling and forecasting to selling to managing revenue. In addition, the need for synchroniz...

  15. Reactor operation

    CERN Document Server

    Shaw, J

    2013-01-01

    Reactor Operation covers the theoretical aspects and design information of nuclear reactors. This book is composed of nine chapters that also consider their control, calibration, and experimentation.The opening chapters present the general problems of reactor operation and the principles of reactor control and operation. The succeeding chapters deal with the instrumentation, start-up, pre-commissioning, and physical experiments of nuclear reactors. The remaining chapters are devoted to the control rod calibrations and temperature coefficient measurements in the reactor. These chapters also exp

  16. Operator programs and operator processes

    NARCIS (Netherlands)

    Bergstra, J.A.; Walters, P.

    2003-01-01

    We define a notion of program which is not a computer program but an operator program: a detailed description of actions performed and decisions taken by a human operator (computer user) performing a task to achieve a goal in a simple setting consisting of that user, one or more computers and a

  17. Operator programs and operator processes

    NARCIS (Netherlands)

    Bergstra, J.A.; Walters, P.

    2003-01-01

    We define a notion of program which is not a computer program but an operator program: a detailed description of actions performed and decisions taken by a human operator (computer user) performing a task to achieve a goal in a simple setting consisting of that user, one or more computers and a work

  18. Hospitality Occupations. Curriculum Guide.

    Science.gov (United States)

    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…

  19. Heritage, Tourism and Hospitality

    NARCIS (Netherlands)

    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

  20. Hospitality, Tourism, and Recreation.

    Science.gov (United States)

    Novachek, James

    The Northern Arizona Hospitality Education Program is an exemplary three-year project designed to help students, mainly Indian, obtain job skills and attitudes necessary for successful employment in the hospitality industry. Nine high schools from Apache, Coconino, and Navajo Counties participated in the project. Objectives included providing an…

  1. The Ethic of Hospitality

    OpenAIRE

    Christopher Muller

    2013-01-01

    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.

  2. The Ethic of Hospitality

    Directory of Open Access Journals (Sweden)

    Christopher Muller

    2013-04-01

    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.

  3. Hospital benefit segmentation.

    Science.gov (United States)

    Finn, D W; Lamb, C W

    1986-12-01

    Market segmentation is an important topic to both health care practitioners and researchers. The authors explore the relative importance that health care consumers attach to various benefits available in a major metropolitan area hospital. The purposes of the study are to test, and provide data to illustrate, the efficacy of one approach to hospital benefit segmentation analysis.

  4. Hospitality Services. Curriculum Guide.

    Science.gov (United States)

    Texas Tech Univ., Lubbock. Home Economics Curriculum Center.

    This guide, which was developed as part of Texas' home economics education program, is intended to assist teachers of a hospitality services course focusing on the food and lodging segments of the hospitality and tourism industry. The first 40% of the approximately 600-page guide consists of strategies for teaching each of 29 essential…

  5. Medication safety in hospitals.

    Science.gov (United States)

    Kirke, C

    2009-01-01

    Medication error and adverse drug reactions occur frequently, leading to a high burden of patient harm in the hospital setting. Many Irish hospitals have established medication safety initiatives, designed to encourage reporting and learning to improve medication use processes and therefore patient safety. Eight Irish hospitals or hospital networks provided data from voluntary medication safety incident and near miss reporting programmes for pooled analysis of events occurring between 1st January 2006 and 30th June 2007. 6179 reports were received in total (mean 772 per hospital; range 96-1855). 95% of reports did not involve patient harm. Forty seven percent of reports related to the prescribing stage of the medication use process, 40% to the administration stage and 9% to the pharmacy dispensing stage. This data is published to increase awareness of this key patient safety issue, to share learning from these incidents and near misses and to encourage a more open patient safety culture.

  6. Patient life in hospital

    DEFF Research Database (Denmark)

    Ludvigsen, Mette Spliid

    Patient life in hospital.A qualitative study of informal relationships between hospitalised patients Introduction Within a patientology framework, this PhD dissertation is about an empirical study on patient life that provides insight into the nature of informal relationships between patients...... in hospitals today. Purpose The purpose was to explore how informal relationships between patients affect their hospital experiences in the hospital. The assumption is that, on the one hand, the impacts on patients' suffering affect the way they act and experience encounters with fellow patients for good....... Methods The study is designed within a phenomenological-hermeneutical philosophic frame of reference and is based on ethnographic fieldwork among hospitalised patients in a Danish university hospital. Data for the study were collected through participant observations over a period of 18 months. Nine males...

  7. Hjertestop uden for hospital

    DEFF Research Database (Denmark)

    Frandsen, F; Nielsen, J R; Gram, L

    1989-01-01

    %) 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......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...... 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...

  8. Net Operations

    Institute of Scientific and Technical Information of China (English)

    蒋昌俊; 吴哲辉

    1992-01-01

    Two kinds of net operations.addition and Cartesian production of P/T nets,are introduced.They are defined on the set of underlying net of P/T systems.The conditions for preserving structural properties of Petri net after these operations are discussed.It is shown that the set of P/T nets forms and Abelian group for net addition operation and the inverse net of a P/T net in usual meaning of net theory is exactly the inverse of this P/T net as an element of the P/T net group;and that the set of P/T nets forms an Abelian ring for net addition and Caresian product operations.

  9. Operable Units

    Data.gov (United States)

    U.S. Environmental Protection Agency — This dataset consists of operable unit data from multiple Superfund sites in U.S. EPA Region 8. These data were acquired from multiple sources at different times and...

  10. Operator theory

    CERN Document Server

    2015-01-01

    A one-sentence definition of operator theory could be: The study of (linear) continuous operations between topological vector spaces, these being in general (but not exclusively) Fréchet, Banach, or Hilbert spaces (or their duals). Operator theory is thus a very wide field, with numerous facets, both applied and theoretical. There are deep connections with complex analysis, functional analysis, mathematical physics, and electrical engineering, to name a few. Fascinating new applications and directions regularly appear, such as operator spaces, free probability, and applications to Clifford analysis. In our choice of the sections, we tried to reflect this diversity. This is a dynamic ongoing project, and more sections are planned, to complete the picture. We hope you enjoy the reading, and profit from this endeavor.

  11. Adult Day Care and Medical and Hospital Claims.

    Science.gov (United States)

    Chappell, Neena L.; Blandford, Audrey A.

    1987-01-01

    Examined effect of adult day care (ADC) on utilization of health care practitioner and inpatient hospital services. Data from three separate ADC studies revealed that, when operative for some time, ADC may result in dramatic decreases in hospital inpatient stays. Findings warrant further research. (Author/NB)

  12. Hospital-physician joint ventures: maximizing the potential.

    Science.gov (United States)

    Pizzo, James J; Redd, Lewis

    2006-11-01

    Four primary hospital-physician models are per-click service agreements, management services agreements, gainsharing, and equity joint ventures. Four key attributes needed for successful joint ventures are clinical quality, customer satisfaction, operational effectiveness, and financial soundness. Hospitals and physicians need to approach joint ventures with expectations of high performance.

  13. Evaluation of Bioaerosol in a Hospital in Tehran

    Directory of Open Access Journals (Sweden)

    Negar Darvishzadeh

    2013-05-01

    Conclusion: Comparison of bacteria density in different parts of the hospital with the recommended limits of ACGIH (500 CFU/m3 showed that density exceeded the limits in all units except in operating room whereas, density of fungi was less than the recommended limits of ACGIH (100 CFU/m3 in all units of hospital.

  14. Labor and Management Build Skills in the Hospitality Industry.

    Science.gov (United States)

    Moy, Debbie

    1998-01-01

    The San Francisco Hotels Partnership is a consortium of hotel operators and unions that addresses skill-development needs in the hospitality industry. Participating workers were very satisfied with the opportunity to learn communication, problem solving, and teamwork skills. (SK)

  15. Cesarean Myomectomy Outcome in a Nigerian District Hospital

    African Journals Online (AJOL)

    Mubeen

    myomectomy done under the supervision of a Sabbatical obstetrician and gynaecologist at a district hospital in Nigeria. ... the fear of the operation itself may have prevented their ... Room Nurse from the suction bottle, weight differentials.

  16. Corporate and philanthropic models of hospital governance: a taxonomic evaluation.

    Science.gov (United States)

    Weiner, B J; Alexander, J A

    1993-08-01

    We assess the theoretical integrity and practical utility of the corporate-philanthropic governance typology frequently invoked in debates about the appropriate form of governance for nonprofit hospitals operating in increasingly competitive health care environments. Data were obtained from a 1985 national mailed survey of nonprofit hospitals conducted by the American Hospital Association (AHA) and the Hospital Research and Educational Trust (HRET). A sample 1,577 nonprofit community hospitals were selected for study. Representativeness was assessed by comparing the sample with the population of non-profit community hospitals on the dimensions of bed size, ownership type, urban-rural location, multihospital system membership, and census region. Measurement of governance types was based on hospital governance attributes conforming to those cited in the literature as distinguishing corporate from philanthropic models and classified into six central dimensions of governance: (1) size, (2) committee structure and activity, (3) board member selection, (4) board composition, (5) CEO power and influence, and (6) bylaws and activities. Cluster analysis and ANCOVA indicated that hospital board forms adhered only partially to corporate and philanthropic governance models. Further, board forms varied systematically by specific organizational and environmental conditions. Boards exhibiting more corporate governance forms were more likely to be large, privately owned, urban, and operating in competitive markets than were hospitals showing more philanthropic governance forms. Findings suggest that the corporate-philanthropic governance distinction must be seen as an ideal rather than an actual depiction of hospital governance forms. Implications for health care governance are discussed.

  17. Analysis of hospital logistics and costs of the Clinical Engineering Sector in a Philanthropic Hospital

    Directory of Open Access Journals (Sweden)

    Antônio Artur de Souza

    2014-12-01

    Full Text Available Hospitals are considered complex organizations mainly due to the high cost of the health care structure employed for care. Reducing operating costs is a challenge for hospital managers. Particularly in the clinical engineering sector, adequate hospital logistics can reduce costs. In this context, the aim of the research was to analyze the activities of hospital logistics of the Clinical Engineering department at a charity hospital, focusing on cost reduction. The paper presents a case study in a large charity hospital located in the metropolitan region of Belo Horizonte, MG. The analysis focuses on the activities of hospital logistics at this hospital clinical engineering sector. The work in this sector is concentrated in the realization and implementation of equipment maintenance, to the detriment of efforts to reduce costs and increase safety for all streams managed by the sector. It was also found that there are risks of increased costs with inadequate routines: (i acquisition of new and large equipment; (ii maintenance and release schedule for use; and (iii the theft of equipment.

  18. Hospital diversification: evaluating alternatives.

    Science.gov (United States)

    Hammer, L

    1987-05-01

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

  19. Applied Operations Research: Operator's Assistant

    Science.gov (United States)

    Cole, Stuart K.

    2015-01-01

    NASA operates high value critical equipment (HVCE) that requires trouble shooting, periodic maintenance and continued monitoring by Operations staff. The complexity HVCE and information required to maintain and trouble shoot HVCE to assure continued mission success as paper is voluminous. Training on new HVCE is commensurate with the need for equipment maintenance. LaRC Research Directorate has undertaken a proactive research to support Operations staff by initiation of the development and prototyping an electronic computer based portable maintenance aid (Operator's Assistant). This research established a goal with multiple objectives and a working prototype was developed. The research identified affordable solutions; constraints; demonstrated use of commercial off the shelf software; use of the US Coast Guard maintenance solution; NASA Procedure Representation Language; and the identification of computer system strategies; where these demonstrations and capabilities support the Operator, and maintenance. The results revealed validation against measures of effectiveness and overall proved a substantial training and capability sustainment tool. The research indicated that the OA could be deployed operationally at the LaRC Compressor Station with an expectation of satisfactorily results and to obtain additional lessons learned prior to deployment at other LaRC Research Directorate Facilities. The research revealed projected cost and time savings.

  20. On spaces of hospitality

    DEFF Research Database (Denmark)

    Greve, Anni

    Although specialists in hospitality have worked extensively on hospitality with respect to relations between different nations or between nations and individuals of a different nationality, for instance when they seek asylum, Jacques Derrida preferred to focus instead upon the relationship between...... the market place, the religious sanctuary and places for the performing arts and cultural heritage. For the modern city they are the tightly woven fabric of social reality, and their configuration can make certain cities more hospitable than others, is the leading idea....

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

    Science.gov (United States)

    Horwitz, Jill R; Nichols, Austin

    2009-09-01

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

  2. Controlling Legal Risk for Effective Hospital Management.

    Science.gov (United States)

    Park, Hyun Jun; Cho, Duk Young; Park, Yong Sug; Kim, Sun Wook; Park, Jae-Hong; Park, Nam Cheol

    2016-04-01

    To analyze the types of medical malpractice, medical errors, and medical disputes in a university hospital for the proposal of countermeasures that maximize the efficiency of hospital management, medical departments, and healthcare providers. This study retrospectively reviewed and analyzed 55 closed civil lawsuits among 64 medical lawsuit cases carried out in Pusan National University Hospital from January 2000 to April 2013 using medical records, petitions, briefs, and data from the Medical Dispute Mediation Committee. Of 55 civil lawsuits, men were the main plaintiffs in 31 cases (56.4%). The average period from medical malpractice to malpractice proceeding was 16.5 months (range, 1 month to 6.4 years), and the average period from malpractice proceeding to the disposition of a lawsuit was 21.7 months (range, 1 month to 4 years and 11 months). Hospitals can effectively manage their legal risks by implementing a systematic medical system, eliminating risk factors in administrative service, educating all hospital employees on preventative strategies, and improving customer service. Furthermore, efforts should be made to establish standard coping strategies to manage medical disputes and malpractice lawsuits, operate alternative dispute resolution methods including the Medical Dispute Mediation Committee, create a compliance support center, deploy a specialized workforce including improved legal services for employees, and specialize the management-level tasks of the hospital.

  3. New heuristics for planning operating rooms.

    NARCIS (Netherlands)

    Molina-Pariente, J.M.; Hans, E.W.; Framinan, J.M.; Gomez-Cia, T.

    2015-01-01

    We tackle the operating room planning problem of the Plastic Surgery and Major Burns Specialty of the University Hospital “Virgen del Rocio” in Seville (Spain). The decision problem is to assign an intervention date and an operating room to a set of surgeries on the waiting list, minimizing access t

  4. Outpatient Imaging Efficiency - Hospital

    Data.gov (United States)

    U.S. Department of Health & Human Services — Use of medical imaging - provider data. These measures give you information about hospitals' use of medical imaging tests for outpatients. Examples of medical...

  5. Hospitals as health educators

    Science.gov (United States)

    ... Babysitting courses for teens Exercise classes like yoga, tai chi, qigong, Zumba, Pilates, dance, or strength training Weight- ... blood pressure and other health screenings Giveaways like stress balls Health risk surveys Your hospital may sponsor ...

  6. Service Robots for Hospitals

    DEFF Research Database (Denmark)

    Özkil, Ali Gürcan

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

  7. Mathari psychiatric hospital

    African Journals Online (AJOL)

    2007-11-26

    Nov 26, 2007 ... burnout among the staff at the Mathari Psychiatric Hospital. Method: This was .... poor relationship with the management staff were quoted as some of the .... Emotional exhaustion and depersonalization as indicators of burnout ...

  8. Hospital Outpatient PPS

    Data.gov (United States)

    U.S. Department of Health & Human Services — Section 4523 of the Balanced Budget Act of 1997 (BBA) provides authority for CMS to implement a prospective payment system (PPS) under Medicare for hospital...

  9. HOSPITAL IN NIGERIA.

    African Journals Online (AJOL)

    reduce the incidence of prematurity and low birth weight babies must be instituted. Key words: Neonatal mortality. risk factors. tertiary hospital. INTRODUCTION .... Classification of Diseases WHO Geneva 1975: 700. 52 Nigerian Journal v_f(.

  10. Allegheny County Diabetes Hospitalization

    Data.gov (United States)

    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.

  11. Optimal Hospital Layout Design

    DEFF Research Database (Denmark)

    Holst, Malene Kirstine

    This PhD project presents a design model that generates and evaluates hospital designs with respect to long-term performances and functionalities. By visualizing and quantifying costs and performances in the early design phases, it is possible to make design choices based on a qualified, profound...... foundation. The basis of the present study lies in solving the architectural design problem in order to respond to functionalities and performances. The emphasis is the practical applicability for architects, engineers and hospital planners for assuring usability and a holistic approach of functionalities...... and performances. By formal descriptions, a design model can weigh and compare the impact of different perspectives and, even in the early design phase, it can visualize and quantify consequences for design choices. By qualitative study of hospital design and hospital functionality, formal descriptions develop...

  12. Hospital Readmissions Reduction Program

    Data.gov (United States)

    U.S. Department of Health & Human Services — In October 2012, CMS began reducing Medicare payments for Inpatient Prospective Payment System hospitals with excess readmissions. Excess readmissions are measured...

  13. Critical Access Hospitals (CAH)

    Science.gov (United States)

    ... CAH designation is designed to reduce the financial vulnerability of rural hospitals and improve access to healthcare ... MDH) Rural Referral Center (RRC) What types of facilities are eligible for CAH status? Facilities applying to ...

  14. Management accounting for hospitals

    African Journals Online (AJOL)

    Current state. Traditionally hospital systems. especially in the government ... orientated with a system that provides cost-effective, efficient and ... ENT ward activity report. Managers ... categories; {v} consumption based in the same timeframe;.

  15. VT Hospital Site Locations

    Data.gov (United States)

    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...

  16. Physician-Owned Hospitals

    Data.gov (United States)

    U.S. Department of Health & Human Services — Section 6001 of the Affordable Care Act of 2010 amended section 1877 of the Social Security Act to impose additional requirements for physician-owned hospitals to...

  17. Premier Hospital Historical Data

    Data.gov (United States)

    U.S. Department of Health & Human Services — To provide a historical overview of the participating hospitals, before the first project report, Premier Healthcare Informatics has used data already available for...

  18. Teaching Hospital, Sagamu

    African Journals Online (AJOL)

    birth asphyxia. It is recommended that greater effort be made through health education to encourage ... subjects, eight (34.8 percent) were born in private. Kehinde hospitals, six ..... plexus injiuries in Malaysian neonates. ] Trap Pedkztr. 1991 ...

  19. Allegheny County Hospitals

    Data.gov (United States)

    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...

  20. University College Hospital, Ibadan

    African Journals Online (AJOL)

    Pattern of semen analysis of male partners of infertile couples at the. University College ... Hospital, Ibadan, Nigeria, between 1st January 1990 and 31st. December, 1999. .... reproduction, pregnancy can now be accomplished in area where it.

  1. Hospital Readmission Reduction

    Data.gov (United States)

    U.S. Department of Health & Human Services — In October 2012, CMS began reducing Medicare payments for Inpatient Prospective Payment System hospitals with excess readmissions. Excess readmissions are measured...

  2. ~ . Teaching Hospital, Sagamu

    African Journals Online (AJOL)

    Neonatal Mortality at Olabisi Onabanjo University Teaching Hospital, _. -' Sagamu. ..... Africa,3 Bangladesh, 1° and Pakistan.11 Preterrnbirth and septicaemia were almost .... Ibe O. Child Survival in Nigeria: Situation, Response and Prospects.

  3. Hospitality and prosumption

    African Journals Online (AJOL)

    jane.b

    a hospitable environment. The consumers .... 'essential marketing functions for the producers of consumers' goods' (Smythe ... However, in the age of the internet the media have much less ...... Advertising: The Uneasy Persuasion. New York:.

  4. Speech intelligibility in hospitals.

    Science.gov (United States)

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

    2013-07-01

    Effective communication between staff members is key to patient safety in hospitals. A variety of patient care activities including admittance, evaluation, and treatment rely on oral communication. Surprisingly, published information on speech intelligibility in hospitals is extremely limited. In this study, speech intelligibility measurements and occupant evaluations were conducted in 20 units of five different U.S. hospitals. A variety of unit types and locations were studied. Results show that overall, no unit had "good" intelligibility based on the speech intelligibility index (SII > 0.75) and several locations found to have "poor" intelligibility (SII speech intelligibility across a variety of hospitals and unit types, offers some evidence of the positive impact of absorption on intelligibility, and identifies areas for future research.

  5. Hospital Compare Data

    Data.gov (United States)

    U.S. Department of Health & Human Services — These are the official datasets used on the Medicare.gov Hospital Compare Website provided by the Centers for Medicare and Medicaid Services. These data allow you to...

  6. Hospitals of The Future

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

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

  7. American Hospital Association

    Science.gov (United States)

    ... replay of the AHA’s breakdown of the 2016 election results and what they mean for hospitals. Click ... Forum Trustee and Community Leadership Volunteers and Auxiliary Leaders Workforce Center News Center Press Releases AHA Awards ...

  8. Choosing to convert to critical access hospital status.

    Science.gov (United States)

    Dalton, Kathleen; Slifkin, Rebecca; Poley, Stephanie; Fruhbeis, Melissa

    2003-01-01

    The authors profile facilities converting to critical access hospitals (CAHs) from 1998-2000, comparing characteristics of their communities, operations, and finances to those of other small rural providers. Counties where CAHs are located are more sparsely populated, but do not have substantially different sociodemographic profiles than other rural counties. Converting hospitals' acute daily census averaged well below the statutory limit of 15, but over one-half reduced unused bed capacity to meet CAH size limitations. The average case-mix adjusted Medicare cost per case was 16-percent higher for CAH converters than for other small hospitals and their financial ratios were substantially worse, although many other operating characteristics were similar.

  9. Hospitality, Tourism, and Politics

    OpenAIRE

    Stephen W. Litvin

    2012-01-01

    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 ...

  10. Nutrition support in hospitals

    DEFF Research Database (Denmark)

    Kondrup, Jens

    2005-01-01

    Nutrition support in hospitals is becoming an area of focus because of the evidence showing improved clinical outcome with nutrition support, its status as a human rights issue and its integration into quality assurance.......Nutrition support in hospitals is becoming an area of focus because of the evidence showing improved clinical outcome with nutrition support, its status as a human rights issue and its integration into quality assurance....

  11. Operational Circulars

    CERN Multimedia

    2003-01-01

    Operational Circular N° 4 - April 2003 Conditions for use by members of the CERN personnel of vehicles belonging to or rented by CERN - This circular has been drawn up. Operational Circular N° 5 - October 2000 Use of CERN computing facilities - Further details on the personal use of CERN computing facilities Operational Circular N° 5 and its Subsidiary Rules http://cern.ch/ComputingRules defines the rules for the use of CERN computing facilities. One of the basic principles governing such use is that it must come within the professional duties of the user concerned, as defined by the user's divisional hierarchy. However, personal use of the computing facilities is tolerated or allowed provided : a) It is in compliance with Operational Circular N° 5 and not detrimental to official duties, including those of other users; b) the frequency and duration is limited and there is a negligible use of CERN resources; c) it does not constitute a political, commercial and/or profit-making activity; d) it is not...

  12. Operative links

    DEFF Research Database (Denmark)

    Wistoft, Karen

    2010-01-01

    as networks: second, a semantic perspective on discourses and concepts of health, and, third, a health pedagogical perspective on participation, intervention, and roles. This paper argues for the importance of 'operative links' between different levels in health strategies. It is proposed that such links...

  13. Operation Context

    DEFF Research Database (Denmark)

    Stüben, Henning; Tietjen, Anne

    2006-01-01

    Abstract: This paper seeks to challenge the notion of context from an operational perspective. Can we grasp the forces that shape the complex conditions for an architectural or urban design within the notion of context? By shifting the gaze towards the agency of architecture, contextual analysis...

  14. [Hospitals in Europe and Yugoslavia through the centuries].

    Science.gov (United States)

    Topalović, R

    1998-01-01

    The primary object of this paper is to give a retrospective of hospital development in Europe and Yugoslavia for the past twenty-five centuries. The earliest records of hospitals called the "iatreia" date back to the V century B.C., ancient Greece. The sick in those hospitals were treated with drugs as well operated on. The Romans, during the reign of the emperor Augustus, built valetudinaries within military camps. The name "hospital" was introduced in the IV century A.D. and has been used ever since. The first hospital was founded in Cesarea, i.e. in the East Roman Empire in Asia Minor. The chronology of the hospital development in the Middle Ages is given in table 1--"Chronology of Hospital Development in the Middle Ages." St. Sava (Nemanjić) founded the first Serbian hospital in the Monastery of Hilandar about 1199 and in 1208/1209 a hospital in the Monastery of Studenica. In the hospital of the Monastery of St. Arhangel in Prizren, according to the regulations prescribed by tzar Dusan, only curable patients were to be treated. The first hospital in Vojvodina in Bac near Novi Sad dates back to 1234. More data about hospitals in former Yugoslavia are given in table 2--"The Oldest Hospitals in former Yugoslavia" and about the Frontier Hospitals in Vojvodina in table 3--"Frontier Hospitals for the Wounded and Sick in Vojvodina". The first medical high school was established in Salerno in the IX century and the first European University in Bologna in 1088, where the School of Medicine was founded in 1156. The University in Paris was founded in 1107 and in Oxford in 1145.

  15. Facing the recession: how did safety-net hospitals fare financially compared with their peers?

    Science.gov (United States)

    Reiter, Kristin L; Jiang, H Joanna; Wang, Jia

    2014-12-01

    To examine the effect of the recession on the financial performance of safety-net versus non-safety-net hospitals. Agency for Healthcare Research and Quality Hospital Cost and Utilization Project State Inpatient Databases, Medicare Cost Reports, American Hospital Association Annual Survey, InterStudy, and Area Health Resource File. Retrospective, longitudinal panel of hospitals, 2007-2011. Safety-net hospitals were identified using percentage of patients who were Medicaid or uninsured. Generalized estimating equations were used to estimate average effects of the recession on hospital operating and total margins, revenues and expenses in each year, 2008-2011, comparing safety-net with non-safety-net hospitals. 1,453 urban, nonfederal, general acute hospitals in 32 states with complete data. Safety-net hospitals, as identified in 2007, had lower operating and total margins. The gap in operating margin between safety-net and non-safety-net hospitals was sustained throughout the recession; however, total margin was more negatively affected for non-safety-net hospitals in 2008. Higher percentages of Medicaid and uninsured patients were associated with lower revenue in private hospitals in all years, and lower revenue and expenses in public hospitals in 2011. Safety-net hospitals may not be disproportionately vulnerable to macro-economic fluctuations, but their significantly lower margins leave less financial cushion to weather sustained financial pressure. © Health Research and Educational Trust.

  16. Sisters in Dutch hospitals.

    Science.gov (United States)

    van den Bergh-Braam, A H

    1985-11-01

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

  17. Chasm grows between rich and poor. Top hospital performers get stronger as weaker competitors stumble, new research indicates.

    Science.gov (United States)

    Moore, J D

    1999-06-01

    Although recent studies show hospital operating margins dropped 45% in the fourth quarter of 1998, compared with the year-ago period, a new analysis of industrywide financial ratios reveals that the "average" hospital may be less representative of the whole. Instead, a chasm is widening around the median, with strong hospitals getting stronger and weak hospitals showing further decline.

  18. Your Lung Operation: After Your Operation

    Medline Plus

    Full Text Available ... Surgeons Education Patients and Family Skills Programs Your Lung Operation Your Lung Operation DVD After Your Operation Back to Your Lung Operation Your Lung Operation DVD Welcome Your Lung ...

  19. Pricing hospital care: Global budgets and marginal pricing strategies.

    Science.gov (United States)

    Sutherland, Jason M

    2015-08-01

    The Canadian province of British Columbia (BC) is adding financial incentives to increase the volume of surgeries provided by hospitals using a marginal pricing approach. The objective of this study is to calculate marginal costs of surgeries based on assumptions regarding hospitals' availability of labor and equipment. This study is based on observational clinical, administrative and financial data generated by hospitals. Hospital inpatient and outpatient discharge summaries from the province are linked with detailed activity-based costing information, stratified by assigned case mix categorizations. To reflect a range of operating constraints governing hospitals' ability to increase their volume of surgeries, a number of scenarios are proposed. Under these scenarios, estimated marginal costs are calculated and compared to prices being offered as incentives to hospitals. Existing data can be used to support alternative strategies for pricing hospital care. Prices for inpatient surgeries do not generate positive margins under a range of operating scenarios. Hip and knee surgeries generate surpluses for hospitals even under the most costly labor conditions and are expected to generate additional volume. In health systems that wish to fine-tune financial incentives, setting prices that create incentives for additional volume should reflect knowledge of hospitals' underlying cost structures. Possible implications of mis-pricing include no response to the incentives or uneven increases in supply. Copyright © 2015 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

  20. Effect of Hospital Ownership on Outcomes of Heart Failure Hospitalization.

    Science.gov (United States)

    Akintoye, Emmanuel; Briasoulis, Alexandros; Egbe, Alexander; Orhurhu, Vwaire; Ibrahim, Walid; Kumar, Kartik; Alliu, Samson; Nas, Hala; Levine, Diane; Weinberger, Jarrett

    2017-09-01

    This study aimed to evaluate the impact of hospital ownership on heart failure (HF) hospitalization outcomes in the United States using data from the National Inpatient Sample of the Agency for Healthcare Research and Quality. Hospital ownership was classified into three, namely, nonfederal government, not-for-profit, and for-profit hospitals. Participants were adults hospitalized with a primary diagnosis of HF (2013 to 2014). End points included inpatient mortality, length-of-stay, cost and charge of hospitalization, and disposition at discharge. Of the estimated 1.9 million HF hospitalizations in the United States between 2013 and 2014, 73% were in not-for-profit hospitals, 15% were in for-profit hospitals, and 12% were in nonfederal government hospitals. Overall, mortality rate was 3%, mean length of stay was 5.3 days, median cost of hospitalization was USD 7,248, and median charge was USD 25,229, and among those who survived to hospital discharge, 51% had routine home discharge. There was no significant difference in inpatient mortality between hospital ownership among male patients, but there was a significant difference for female patients. Compared with government hospitals, mortality in female patients was lower in not-for-profit (odds ratio: 0.85 [95% confidence interval: 0.77 to 0.94]) and for-profit hospitals (odds ratio: 0.77 [0.68 to 0.87]). In addition, mean length of stay was highest in not-for-profit hospitals (5.4 days) and lowest in for-profit hospitals (5 days). Although cost of hospitalization was highest in not-for-profit hospitals (USD 7462) and lowest in for-profit hospitals (USD 6,290), total charge billed was highest in for-profit hospitals (USD 35,576) and lowest in government hospitals (USD 19,652). The average charge-to-cost ratio was 3:1 for government hospitals, 3.5:1 for not-for-profit hospitals, and 5.9:1 for for-profit hospitals. In conclusion, there exist significant disparities in HF hospitalization outcomes between hospital

  1. Your Lung Operation: After Your Operation

    Medline Plus

    Full Text Available ... Downloads NSQIP in the Literature Newsroom Contact Us Hospital Compare Quality and Safety Conference Registry Login SCR ... Life Support Verification, Review, and Consultation Program for Hospitals Trauma Systems Consultation Program Trauma Education Achieving Zero ...

  2. Short Hospital Stay after Laparoscopic Colorectal Surgery without Fast Track

    DEFF Research Database (Denmark)

    Burgdorf, Stefan K; Rosenberg, Jacob

    2012-01-01

    in our department resulted in shorter hospital stay without using fast track principles for peri- and postoperative care in patients not receiving a stoma during the operation. Consequently, we aimed to reduce hospitalisation without increasing cost in nursing staff per hospital bed. Length of stay......Purpose. Short hospital stay and equal or reduced complication rates have been demonstrated after fast track open colonic surgery. However, fast track principles of perioperative care can be difficult to implement and often require increased nursing staff because of more concentrated nursing tasks...... during the shorter hospital stay. Specific data on nursing requirements after laparoscopic surgery are lacking. The purpose of the study was to evaluate the effect of operative technique (open versus laparoscopic operation), but without changing nurse staffing or principles for peri- or postoperative...

  3. Hospitals look to hospitality service firms to meet TQM goals.

    Science.gov (United States)

    Hard, R

    1992-05-20

    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.

  4. Operation Poorman

    Energy Technology Data Exchange (ETDEWEB)

    Pruvost, N.; Tsitouras, J.

    1981-03-18

    The objectives of Operation Poorman were to design and build a portable seismic system and to set up and use this system in a cold-weather environment. The equipment design uses current technology to achieve a low-power, lightweight system that is configured into three modules. The system was deployed in Alaska during wintertime, and the results provide a basis for specifying a mission-ready seismic verification system.

  5. Joint Operations

    Science.gov (United States)

    2006-09-17

    Unified Task Force (UNITAF) Somalia was formed with forces from France, Italy, Canada, Belgium, Egypt , Turkey, Saudi Arabia, and the United States...military presence, open-source intelligence ( OSINT ) may be the best immediately available information to prepare US forces to operate in a foreign...country. OSINT from radio broadcasts, newspapers, and periodicals often provide tip-offs for HUMINT and other intelligence and information collection

  6. Transition from hospital to daily life

    DEFF Research Database (Denmark)

    Missel, Malene; Schønau, Mai Nanna; Pedersen, Jesper Holst

    2014-01-01

    PURPOSE: To assess the effect of nurse-led systematic rehabilitation counseling performed before discharge to prevent concerns in the hospital-to-home gap in rehabilitation of lung cancer patients after surgery. DESIGN AND METHOD: A quasi-experimental intervention study. One hundred twenty patients...... with operable non-small cell lung cancer admitted for surgery participated. Outcome was assessed by a validated self-rating questionnaire. The intervention was performed at the Department of Thoracic Surgery, University Hospital of Copenhagen, Denmark. RESULTS: Following nurse-led rehabilitation counseling...... in the transition from hospital to daily life. CLINICAL RELEVANCE: Despite promising results, there is still a need to improve support for patients with lung cancer requiring rehabilitation....

  7. The art of governance of Dutch hospitals.

    Science.gov (United States)

    Hoek, H

    1999-01-01

    Hospitals in The Netherlands are governed by two boards: The Board of Directors, the legal representative of the hospital, responsible for strategic and operational business activities; and the Supervisory Board, made up of co-opted volunteers and responsible for checking and approving of the major decisions of the Board of Directors. The question which arises is whether the system of governance is able to function appropriately and guarantee enough concern about general health problems, moral and ethical questions and the interest of the patients. This paper investigate the successes and shortfalls of such a system of governance in Dutch hospitals. The results and conclusions determine that although copied from the corporate governance model, it does not function well in an environment where the influence of patients and the inhabitants of the region are of great importance and shareholders do not exist.

  8. Smart Textiles in Humanistic Hospital Design

    DEFF Research Database (Denmark)

    Mogensen, Jeppe; Fisker, Anna Marie; Poulsen, Søren Bolvig

    2014-01-01

    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......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...... purpose of this paper is thus to present a review of healing architecture, by considering some of the challenges in the operational use of the design principle. Associated with the methodology of evidence-based design (EBD), we in this regard question, if these challenges derive from conflicting paradigms...

  9. Controlling for quality in the hospital cost function.

    Science.gov (United States)

    Carey, Kathleen; Stefos, Theodore

    2011-06-01

    This paper explores the relationship between the cost and quality of hospital care from the perspective of applied microeconomics. It addresses both theoretical and practical complexities entailed in incorporating hospital quality into the estimation of hospital cost functions. That literature is extended with an empirical analysis that examines the use of 15 Patient Safety Indicators (PSIs) as measures of hospital quality. A total operating cost function is estimated on 2,848 observations from five states drawn from the period 2001 to 2007. In general, findings indicate that the PSIs are successful in capturing variation in hospital cost due to adverse patient safety events. Measures that rely on the aggregate number of adverse events summed over PSIs are found to be superior to risk-adjusted rates for individual PSIs. The marginal cost of an adverse event is estimated to be $22,413. The results contribute to a growing business case for inpatient safety in hospital services.

  10. Vertical integration strategies: revenue effects in hospital and Medicare markets.

    Science.gov (United States)

    Cody, M

    1996-01-01

    The purpose of this study was to evaluate the revenue effects of seven vertically integrated strategies on California hospitals. The strategies investigated were managed care contracts, physician affiliations, ambulatory care, ambulatory surgery, home health services, inpatient rehabilitation, and skilled nursing care. The study population included 242 not-for-profit hospitals in continuous operation from 1983 to 1990. Many hospitals developed vertically integrated programs in the 1980s as inpatient utilization fell in response to the Medicare Prospective Payment program. Net revenue rose on average by $2,080 from 1983 to 1990, but fell by $2,421 from the Medicare program. On the whole, the more physicians affiliated with a hospital, the higher the net revenue. However, in the Medicare population, the number of managed care contracts was significant. The pre-hospital strategies generated significant revenue, while the post-hospital strategies did not. In the Medicare program, inpatient rehabilitation significantly reduced revenue.

  11. Transforming hospital board meetings: guidelines for comprehensive change.

    Science.gov (United States)

    Gautam, Kanak

    2005-01-01

    Does the following remind you of a hospital board meeting you attended recently? The meeting starts late, the PowerPoint presentation on hospital operations is too detailed to understand, 20 minutes are spent discussing parking, one or two trustees do all the talking, others check their PDAs or scribble on the agenda, and you try to keep your mouth shut while yawning. Hospital board meetings are often described as ritualized, unfocused, rambling, mindless, and inconclusive. Experts agree that board meetings in many hospitals are dysfunctional and need restructuring (Knecht 2001; Perrine 2003; Orlikoff and Totten 2002). Recently, St. Joseph Hospital in Orange, California, employed consultants and invested much effort in making its board meetings productive (Perrine). More such endeavors are needed for better hospital governance. In the last 5 years, several books and articles have focused on reforming board meetings. In this article I draw on them to discuss key problems of board meetings and how to make the meetings more effective.

  12. Corporate social responsibility and hospitals: US theory, Japanese experiences, and lessons for other countries.

    Science.gov (United States)

    Takahashi, Toshiro; Ellen, Moriah; Brown, Adalsteinn

    2013-01-01

    This paper examines the role that corporate social responsibility can play in advancing hospital management. Corporate social responsibility is the integration of social and environmental concerns within business operations. The authors discuss how corporate social responsibility can help hospitals and provide suggestions to hospitals in deciding which corporate social responsibility initiatives to pursue.

  13. 14 CFR 135.271 - Helicopter hospital emergency medical evacuation service (HEMES).

    Science.gov (United States)

    2010-01-01

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

  14. International benchmarking of specialty hospitals. A series of case studies on comprehensive cancer centres

    NARCIS (Netherlands)

    van Lent, W.A.M.; de Beer, Relinde; van Harten, Willem H.

    2010-01-01

    Background Benchmarking is one of the methods used in business that is applied to hospitals to improve the management of their operations. International comparison between hospitals can explain performance differences. As there is a trend towards specialization of hospitals, this study examines the

  15. International benchmarking of specialty hospitals. A series of case studies on comprehensive cancer centres

    NARCIS (Netherlands)

    Lent, van Wineke A.M.; Beer, de Relinde; Harten, van Wim H.

    2010-01-01

    Background Benchmarking is one of the methods used in business that is applied to hospitals to improve the management of their operations. International comparison between hospitals can explain performance differences. As there is a trend towards specialization of hospitals, this study examines the

  16. Trick questions: cosmopolitan hospitality

    Directory of Open Access Journals (Sweden)

    Eleanor Byrne

    2013-08-01

    Full Text Available Byrne’s paper consists of two parallel texts. The first explores the limits of cosmopolitanism in practice, taking as its subject the Life in the UK Citizenship Test, inaugurated under the Labour Government in 2005. It argues that the test exemplifies the predicament of all attempts at cosmopolitan hospitality as unconditional welcoming, through a discussion of the relation between questioning and welcoming the stranger. Establishing the relationship between cosmopolitanism and hospitality as envisaged in Derrida’s reading of Kant it asks what kind of cosmopolitan hospitality is either possible or desirable by exploring what Derrida calls the ‘perversions’ inherent in the structures of hospitality. It focuses on the concept of the ‘trick questions’ that the state asks the foreigner observed by Derrida in his reading of The Apology of Socrates; questions that seem to invite answers but foreclose the possibilities of a free response. The second text asks how this logic that Derrida identifies can be pushed or coaxed into new ways of addressing the perceived threats of ‘unconditional’ hospitality through a reading of ‘unconditional hospitality’ as queer in the work of Tove Jansson.

  17. Operating Room Telephone Microbial Flora

    Science.gov (United States)

    2007-11-02

    beta-lactamase expressing multi-resistant Acinetobacter baumannii transmitted in the operation area. J Hosp Infect, 2004. 57(4): p. 308-15. 63...Goodman, J. E., Volk, H. M., and Sood, R., Direct costs of multidrug-resistant Acinetobacter baumannii in the burn unit of a public teaching hospital...Scerpella, E.G., Wanger, A. R., Armitige, L., Anderlini, P., & Ericsson, C. D., Nosocomial outbreak caused by a multiresistant clone of Acinetobacter

  18. How do strategic decisions and operative practices affect operating room productivity?

    Science.gov (United States)

    Peltokorpi, Antti

    2011-12-01

    Surgical operating rooms are cost-intensive parts of health service production. Managing operating units efficiently is essential when hospitals and healthcare systems aim to maximize health outcomes with limited resources. Previous research about operating room management has focused on studying the effect of management practices and decisions on efficiency by utilizing mainly modeling approach or before-after analysis in single hospital case. The purpose of this research is to analyze the synergic effect of strategic decisions and operative management practices on operating room productivity and to use a multiple case study method enabling statistical hypothesis testing with empirical data. 11 hypotheses that propose connections between the use of strategic and operative practices and productivity were tested in a multi-hospital study that included 26 units. The results indicate that operative practices, such as personnel management, case scheduling and performance measurement, affect productivity more remarkably than do strategic decisions that relate to, e.g., units' size, scope or academic status. Units with different strategic positions should apply different operative practices: Focused hospital units benefit most from sophisticated case scheduling and parallel processing whereas central and ambulatory units should apply flexible working hours, incentives and multi-skilled personnel. Operating units should be more active in applying management practices which are adequate for their strategic orientation.

  19. Health information as an aid to effective hospital management.

    Science.gov (United States)

    Mogli, G D

    2003-03-01

    No institution can be efficiently organized and managed unless one makes a critical analysis of organizational needs and takes appropriate action to develop the way one wishes it to be. It is, in fact, more true with hospital organization, usually the new hospital starts as a simple and small organization and with-in the space of few years, however, it evolves into a complex body governed by precise laws and regulations, especially as regards finances, facilities and organizations. In order to maintain any organization especially the hospital administration efficiently it is necessary to develop management tools that would reflect the true operation of the hospital and enable resources (personnel, equipment and buildings) to be fully utilized and adapted to the needs of the population serviced. These indicators of true hospital operation would then serve as a basis for determining hospital activity at any given time, in relation to the number and characteristics of the patients, as well as for evaluation hospital activity in terms of progress made towards good utilization of resources. A record of activities, related to the individual patient, would provide a valid basis for establishing a relationship with the morbidity observed in the hospital and would be a first step towards an evaluation of the services "rendered" by the hospital, or its impact on the demand for care in its own particular area. Thus, in its aims of establishing a hospital to adjusting supply to demand in the field of health care. The author had stressed too much emphasis on health information collection and interpretation because of valid reasons. Correct and timely administrative and clinical information which is a barometer of hospital efficiency could indicate whether the quality is balanced with expenditure or whether leading into financial crisis. So, whatever may be the motive behind establishing a hospital whether for profit making, or public-service, it is necessary the investors

  20. HOSPITAL VENTILATION STANDARDS AND ENERGY CONSERVATION: A REVIEW OF GOVERNMENTAL AND PRIVATE AGENCY ENERGY CONSERVATION INITIATIVES

    Energy Technology Data Exchange (ETDEWEB)

    Banks, Robert S.; Rainer, David

    1980-03-01

    This report presents the results of a recent research project originally concerned with review of governmental initiatives for changes to hospital design and operation standards at both the federal and state levels. However. it quickly became apparent that concern with energy conservation was not impacting hospital environmental standards, especially at the state level, irrespective of the energy implications. Consequently, the study was redirected to consider all energy conservation initiatives directed toward design and operating practices unique to the hospital environment. The scope was limited to agency programs (i.e., not undertaken at the initiative of individual hospitals), applicable to non-federal public and private hospitals.

  1. Perioperative nursing in public university hospitals

    DEFF Research Database (Denmark)

    Sørensen, Erik Elgaard; Olsen, Ida Østrup; Tewes, Marianne

    2014-01-01

    BACKGROUND: In recent years, perioperative nursing has received ongoing attention as part of an interprofessional collaboration. Perioperative nursing is constantly faced with new challenges and opportunities that necessitate continual updates of nursing knowledge and technical skills. In light...... of the longstanding relationship between nursing and technology, it is interesting that few studies with this focus have been performed. Therefore, our research question was: What is the content of perioperative nursing and how do nurses facilitate the interaction between nursing care and technology in highly...... specialized operating rooms in public university hospitals? METHODS: An ethnography involving participant observations and interviews was conducted during a 9-month study period. The participants comprised 24 nurses from 9 different operating wards at 2 university hospitals in different regions of Denmark...

  2. [Marianne in hospital].

    Science.gov (United States)

    Weium, Frode

    2003-12-23

    In 1948 Norwegian architect and author Odd Brochmann (1909-92) published his popular children's book Marianne in hospital (Marianne på sykehus). Two years later the book was filmed on the initiative of the Ministry of Social Affairs. This article considers the question of what were the purposes of the film. Officially, it was presented as an attempt to teach children not to be afraid of hospitals. However, in internal notes and letters the health authorities stressed that the film should be an educational film about the social benefits and health services of the welfare state. Furthermore, I will argue that the film was the result of a wish to present the nation's modern hospital care and, by way of conclusion, discuss the characterisation of the film as educational.

  3. [Stress management in hospitals].

    Science.gov (United States)

    Miki, Akiko

    2002-11-01

    Job stress in employees in hospitals has been recognized as a key issue in the workplace. In this paper, characteristics of job stress in the medical profession, especially in doctors and nurses, and the effectiveness of stress management are overviewed. The important points in stress management in hospitals are summarized as follows: 1) improvement of work environment, 2) assurance of participation and autonomy, 3) education or training to reduce job stress (ex. coping behavior, self-care, relaxation), 4) career development, 5) total support among medical professions. Some reports have demonstrated that the establishment of constant meetings is an effective method of reducing job stress and improving mental health in the medical profession, but few prospective intervention studies have been carried out. Further research is necessary to evaluate the effectiveness of stress reduction and to develop effective intervention programs for medical professions in hospitals.

  4. COMPETITIVENESS IN HOSPITALITY INDUSTRY: ROMANIAN STYLE

    Directory of Open Access Journals (Sweden)

    Claudia-Elena TUCLEA

    2008-01-01

    Full Text Available In this paper is presented one of the important sectors of the nationaleconomy, at least from its potential for development perspective: thehospitality industry. The research interest is related to finding out the mainfactors of competitiveness in this field. This research attempts to identify theessential aspects of competitiveness in the hospitality industry. Theobjectives pursued refer to: discovering the degree to which the concept ofcompetitiveness is understood and capitalized on by the managers in theRomanian hospitality industry; identifying a set of factors considered decisivein raising the competitiveness of Romanian firms in the hospitality industry;identifying the strategic concerns of firms operating in the Romanianhospitality industry, in order to establish the connection between strategy andthe competitiveness of the firms belonging to this sector.As a result, the hypotheses are: in the hospitality industry there areparticularities which influence the firms’ competitiveness and strategicorientation; preoccupation towards raising competitiveness and strategicorientation is influenced by the type of exploitation and the number of stars(level of comfort; in the hospitality industry, managers focus on cost controland service quality as decisive factors of competitiveness.

  5. Structural problems in the German hospital system.

    Science.gov (United States)

    Krukemeyer, M G

    2004-09-01

    The German health care system has been based on the Hospital Financing Act, which the German government introduced in 1972. According to that, the federal states plan hospitals and make investments. The health insurance funds finance the operating costs. But now the Hospital Financing Act is obsolete, because both the health insurance funds and the federal states are in financial trouble and try to avoid the costs, which are nevertheless rising. In order to freeze costs, the legislators have introduced a new remuneration system, called DRGs (Diagnosis Related Groups), which will be mandatory from 2007 onwards. In this system, the treatment provided will be coded and remunerated on the basis of the primary diagnosis. Periods of hospitalisation and different remuneration systems will no longer be relevant. Transparency and quality will thus be promoted, and the upshot will be more competition among the hospitals. Hospitals that cannot meet quality standards will lose patients and will ultimately have to close. Other participants in the health care system, such as, for example, nursing staff, physicians, pharmacies, rehabilitaion centres and patients, will also be concerned in many ways. The consequences of the DRGs for the health care system, its future development and possible alternatives are discussed in this article.

  6. Toward healthier hospitals.

    Science.gov (United States)

    Mintzberg, H

    1997-01-01

    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.

  7. Drawing Hospital Foodscapes

    DEFF Research Database (Denmark)

    Tvedebrink, Tenna Doktor Olsen; Fisker, Anna Marie; Kirkegaard, Poul Henning

    This poster presents a series of drawings depicting the initial considerations made with the Ph.D. project for an improved ‘Interior Design for Food’ in a Danish hospital ward. The project concerns a study on the ontological and symbolic interrelationship possibly existing between food and archit......This poster presents a series of drawings depicting the initial considerations made with the Ph.D. project for an improved ‘Interior Design for Food’ in a Danish hospital ward. The project concerns a study on the ontological and symbolic interrelationship possibly existing between food...

  8. Hospitality, Tourism, and Politics

    Directory of Open Access Journals (Sweden)

    Stephen W. Litvin

    2012-09-01

    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.

  9. Marketing the hospital library.

    Science.gov (United States)

    Bridges, Jane

    2005-01-01

    Many librarians do not see themselves as marketers, but marketing is an essential role for hospital librarians. Library work involves education, and there are parallels between marketing and education as described in this article. It is incumbent upon hospital librarians actively to pursue ways of reminding their customers about library services. This article reinforces the idea that marketing is an element in many of the things that librarians already do, and includes a list of suggested marketing strategies intended to remind administrators, physicians, and other customers that they have libraries in their organizations.

  10. An automated cleaning system for hospitals

    OpenAIRE

    Griffin, Colin

    2009-01-01

    Insufficient hygienic practices in Irish hospitals coupled with one of the highest number of reported cases of MRSA in Europe have highlighted the need for solutions to aid in the task of cleaning. This automated cleaning system consisted of two robots: a core robot developed separately with navigational and task scheduling capabilities integrated. The cleaning task was carried out by making use of a commercially available Roomba vacuum cleaner which had been adapted to operate in conju...

  11. [Red Cross hospital in Krapina, during the First world war from 1914 to 1918].

    Science.gov (United States)

    Fures, Rajko; Habek, Dubravko; Kozina, Drago

    2016-08-01

    Red Cross Hospital in Krapina, during the First World War, was active from 1914 to 1918. Hospital led by Dr. Mirko Crkvenac, oriented humanist. The hospital is operated thanks to the help of municipalities and citizens. The hospital staff concern is for civilian and military victims of the First World War. Dr. Crkvenac, with the support of the City of Krapina and Mayor Vilibald Sluga, he succeeds to the organization and operation of the hospital to an enviable level. Across the Austro-Hungarian Empire and Croatian, Hospitals Red Cross, had a significant role in caring for the wounded, injured and sick soldiers and civilians. Red Cross Hospital in Krapina, is an example of a well-organized hospital in the toughest conditions. Such an organization was not simple in its implementation, and left the valuable lessons and experience.

  12. The effect of pre-operative optimization on post-operative outcome in Crohn's disease resections

    DEFF Research Database (Denmark)

    El-Hussuna, Alaa; Iesalnieks, Igors; Horesh, Nir

    2017-01-01

    on the post-operative outcome in CD. METHOD: This is a multicentre retrospective cohort study. The primary outcome was 30-day post-operative complications. Secondary outcomes were intra-abdominal septic complications, surgical site infection (SSI), re-operation, length of post-operative stay in a hospital......BACKGROUND: The timing of surgical intervention in Crohn's disease (CD) may depend on pre-operative optimization (PO) which includes different interventions to decrease the risk for unfavourable post-operative outcome. The objective of this study was to investigate the effect of multi-model PO...

  13. German hospital database-allocation of patients to appropriate hospitals.

    Science.gov (United States)

    Schneider, Rita; Reiners, Christoph

    2010-06-01

    Effective response to radiological emergencies requires information about available qualified hospitals and defined methods to timely allocate patients to appropriate hospitals. In Germany, updated information about hospitals concerning their qualification and willingness to treat radiological emergency patients is not summarized. The objectives were to identify qualified hospitals, assess hospital capacities and treatment capabilities, to examine willingness to respond to various radiological emergencies and to develop a concept for matching patients to hospitals. A Germany-wide combined postal/Web survey of 99 selected hospitals conducted in 2007 covered relevant organizational characteristics, hospital resources, treatment expertise, and the willingness to accept radiological emergency patients by a self-reported written questionnaire with 57 items. Survey results were documented in a Microsoft Access database. A database-driven Web application was developed to allocate patients to hospitals. Of 99 hospitals, 69 responded and 54 indicated their willingness to accept radiological emergency patients. 17,512 total hospital beds, 2,084 intensive care, and 170 reverse isolation beds were reported. Availability of laboratory and in-patient departments ranged from 14 radiobiology to 47 laboratory medicine departments and from 13 burn care to 52 trauma surgery departments. 48 and 40 hospitals stated treatment competence for local and whole body external exposure, respectively. 34 and 29 hospitals reported treatment expertise for contamination and incorporation, respectively. In this publication baseline data of qualified hospitals concerning capacities and competence to manage radiological emergency patients are presented, and an allocation concept for radiological emergency patients is provided.

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

    Directory of Open Access Journals (Sweden)

    Glenn A. Melnick PhD

    2016-06-01

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

  15. Pre-operative anaemia.

    Science.gov (United States)

    Clevenger, B; Richards, T

    2015-01-01

    Pre-operative anaemia is a relatively common finding, affecting a third of patients undergoing elective surgery. Traditionally associated with chronic disease, management has historically focused on the use of blood transfusion as a solution for anaemia in the peri-operative period. Data from large series now suggest that anaemia is an independent risk associated with poor outcome in both cardiac and non-cardiac surgery. Furthermore, blood transfusion does not appear to ameliorate this risk, and in fact may increase the risk of postoperative complications and hospital length of stay. Consequently, there is a need to identify, diagnose and manage pre-operative anaemia to reduce surgical risk. Discoveries in the pathways of iron metabolism have found that chronic disease can cause a state of functional iron deficiency leading to anaemia. The key iron regulatory protein hepcidin, activated in response to inflammation, inhibits absorption of iron from the gastrointestinal tract and further reduces bioavailability of iron stores for red cell production. Consequently, although iron stores (predominantly ferritin) may be normal, the transport of iron either from the gastrointestinal tract or iron stores to the bone marrow is inhibited, leading to a state of 'functional' iron deficiency and subsequent anaemia. Since absorption from the gastrointestinal tract is blocked, increasing oral iron intake is ineffective, and studies are now looking at the role of intravenous iron to treat anaemia in the surgical setting. In this article, we review the incidence and impact of anaemia on the pre-operative patient. We explain how anaemia may be caused by functional iron deficiency, and how iron deficiency anaemia may be diagnosed and treated.

  16. The Mobile Modular Surgical Hospital: the Army Medical Department’s Future Unit of Action

    Science.gov (United States)

    2005-06-17

    4 Operational Terms and Definitions ...constrained by professional personnel shortages and the professional filler system will continue to be necessary. Operational Terms and Definitions ...or renal hemodialysis teams.10 Level (Echelon) IV: This level of care has traditionally been provided by large general hospitals and field hospitals

  17. The improving efficiency frontier of religious not-for-profit hospitals.

    Science.gov (United States)

    Harrison, Jeffrey P; Sexton, Christopher

    2006-01-01

    By using data-envelopment analysis (DEA), this study evaluates the efficiency of religious not-for-profit hospitals. Hospital executives, healthcare policy makers, taxpayers, and other stakeholders benefit from studies that improve hospital efficiency. Results indicate that overall efficiency in religious hospitals improved from 72% in 1998 to 74% in 2001. What is more important is that the number of religious hospitals operating on the efficiency frontier increased from 40 in 1998 to 47 in 2001. This clearly documents that religious hospitals are becoming more efficient in the management of resources. From a policy perspective, this study highlights the economic importance of encouraging increased efficiency throughout the healthcare industry.

  18. The interstices of hospitality

    African Journals Online (AJOL)

    jane.b

    Printed in The Netherlands — All rights reserved. Introduction ... event, the rule of the city is anonymity disguised in the rules of urbanity ... understanding the theoretical meaning of hospitality (in part ... obligation that both behave appropriately in the meeting. ... which the concepts of consumption, commerce, utilitarianism,.

  19. Hospitals as food arenas

    DEFF Research Database (Denmark)

    Poulsen, Signe; Jørgensen, Michael Søgaard

    2010-01-01

    also identified. Research limitations: The assessment of the dietary changes based on the canteen take-away food was only based on indirect assessments based on interviews with users and non-users and furthermore based on a questionnaire at one of the hospitals. Value/originality: Canteen take...

  20. Innovations in Hospitality Industry

    Science.gov (United States)

    Dzhandzhugazova, Elena A.; Blinova, Ekaterina A.; Orlova, Liubov N.; Romanova, Marianna M.

    2016-01-01

    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…