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Sample records for hospital system based

  1. Performance Based Supplementary Payment System at University Hospitals in Turkey

    Directory of Open Access Journals (Sweden)

    Vahit YÝÐÝT

    2017-06-01

    Results: The result of the analysis has revealed that PBSP system encourage physicians who would like to receive financial incentives. PBSP system supports the individual performance, reduces waiting times in patients, increases revenues and decreases expenditures and increases in efficiency of department. However, this payment system increases work load, number of examinations and provokes the conflict among personals. Conclusions: University hospitals are academic institutions that perform important missions such as research, medical education and health services provision. Therefore, PBSP system should be revised so as to encourage performing these missions at university hospitals. There is also shortage of financial resources at the university hospitals. This situation leads to less additional payments to physicians. [J Contemp Med 2017; 7(2.000: 126-131

  2. Decision Support System of Nursing Human Resources Allocation in General Wards Based on Hospital Information System.

    Science.gov (United States)

    Chen, Hong; Zhao, Shangping; Feng, Ling

    2016-01-01

    To construct a Decision support system of nursing human resources allocation in general wards based on Hospital information system (HIS). Time series prediction model and Information technical method were used based on data of HIS in West China Hospital, Sichuan University (Chengdu, P.R. China). This study completed the function design and system implementation of the nursing human resources allocation decision support system. The system would help nursing managers choose the optimal scheme and make scientific decisions in combination with "the actual" situation but more empirical studies are needed.

  3. UNIX based client/server hospital information system.

    Science.gov (United States)

    Nakamura, S; Sakurai, K; Uchiyama, M; Yoshii, Y; Tachibana, N

    1995-01-01

    SMILE (St. Luke's Medical Center Information Linkage Environment) is a HIS which is a client/server system using a UNIX workstation under an open network, LAN(FDDI&10BASE-T). It provides a multivendor environment, high performance with low cost and a user-friendly GUI. However, the client/server architecture with a UNIX workstation does not have the same OLTP environment (ex. TP monor) as the mainframe. So, our system problems and the steps used to solve them were reviewed. Several points that are necessary for a client/server system with a UNIX workstation in the future are presented.

  4. Exploring information systems outsourcing in U.S. hospital-based health care delivery systems.

    Science.gov (United States)

    Diana, Mark L

    2009-12-01

    The purpose of this study is to explore the factors associated with outsourcing of information systems (IS) in hospital-based health care delivery systems, and to determine if there is a difference in IS outsourcing activity based on the strategic value of the outsourced functions. IS sourcing behavior is conceptualized as a case of vertical integration. A synthesis of strategic management theory (SMT) and transaction cost economics (TCE) serves as the theoretical framework. The sample consists of 1,365 hospital-based health care delivery systems that own 3,452 hospitals operating in 2004. The findings indicate that neither TCE nor SMT predicted outsourcing better than the other did. The findings also suggest that health care delivery system managers may not be considering significant factors when making sourcing decisions, including the relative strategic value of the functions they are outsourcing. It is consistent with previous literature to suggest that the high cost of IS may be the main factor driving the outsourcing decision.

  5. Design of the Hospital Integrated Information Management System Based on Cloud Platform.

    Science.gov (United States)

    Aijing, L; Jin, Y

    2015-12-01

    At present, the outdated information management style cannot meet the needs of hospital management, and has become the bottleneck of hospital's management and development. In order to improve the integrated management of information, hospitals have increased their investment in integrated information management systems. On account of the lack of reasonable and scientific design, some hospital integrated information management systems have common problems, such as unfriendly interface, poor portability and maintainability, low security and efficiency, lack of interactivity and information sharing. To solve the problem, this paper carries out the research and design of a hospital information management system based on cloud platform, which can realize the optimized integration of hospital information resources and save money.

  6. A UML-based ontology for describing hospital information system architectures.

    Science.gov (United States)

    Winter, A; Brigl, B; Wendt, T

    2001-01-01

    To control the heterogeneity inherent to hospital information systems the information management needs appropriate hospital information systems modeling methods or techniques. This paper shows that, for several reasons, available modeling approaches are not able to answer relevant questions of information management. To overcome this major deficiency we offer an UML-based ontology for describing hospital information systems architectures. This ontology views at three layers: the domain layer, the logical tool layer, and the physical tool layer, and defines the relevant components. The relations between these components, especially between components of different layers make the answering of our information management questions possible.

  7. DRG-based hospital payment systems and technological innovation in 12 European countries.

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    Scheller-Kreinsen, David; Quentin, Wilm; Busse, Reinhard

    2011-12-01

    To assess how diagnosis-related group-based (DRG-based) hospital payment systems in 12 European countries participating in the EuroDRG project pay and incorporate technological innovation. A standardized questionnaire was used to guide comprehensive DRG system descriptions. Researchers from each country reviewed relevant materials to complete the questionnaire and drafted standardized country reports. Two characteristics of DRG-based hospital payment systems were identified as particularly important: the existence of short-term payment instruments encouraging technological innovation in different countries, and the characteristics of long-term updating mechanisms that assure technological innovation is ultimately incorporated into DRG-based hospital payment systems. Short-term payment instruments and long-term updating mechanisms differ greatly among the 12 European countries included in this study. Some countries operate generous short-term payment instruments that provide additional payments to hospitals for making use of technological innovation (e.g., France). Other countries update their DRG-based hospital payment systems very frequently and use more recent data for updates. Generous short-term payment instruments to promote technological innovation should be applied carefully as they may imply rapidly increasing health-care expenditures. In general, they should be granted only if rigorous analyses have demonstrated their benefits. If the evidence remains uncertain, coverage with evidence development frameworks or frequent updates of the DRG-based hospital systems may provide policy alternatives. Once the data and evidence base is substantially improved, future research should empirically investigate how different policy arrangements affect the adoption and use of technological innovation and health-care expenditures. Copyright © 2011 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  8. Criteria for the evaluation of a cloud-based hospital information system outsourcing provider.

    Science.gov (United States)

    Low, Chinyao; Hsueh Chen, Ya

    2012-12-01

    As cloud computing technology has proliferated rapidly worldwide, there has been a trend toward adopting cloud-based hospital information systems (CHISs). This study examines the critical criteria for selecting the CHISs outsourcing provider. The fuzzy Delphi method (FDM) is used to evaluate the primary indicator collected from 188 useable responses at a working hospital in Taiwan. Moreover, the fuzzy analytic hierarchy process (FAHP) is employed to calculate the weights of these criteria and establish a fuzzy multi-criteria model of CHISs outsourcing provider selection from 42 experts. The results indicate that the five most critical criteria related to CHISs outsourcing provider selection are (1) system function, (2) service quality, (3) integration, (4) professionalism, and (5) economics. This study may contribute to understanding how cloud-based hospital systems can reinforce content design and offer a way to compete in the field by developing more appropriate systems.

  9. Hospital's activity-based financing system and manager-physician [corrected] interaction.

    Science.gov (United States)

    Crainich, David; Leleu, Hervé; Mauleon, Ana

    2011-10-01

    This paper examines the consequences of the introduction of an activity-based reimbursement system on the behavior of physicians and hospital's managers. We consider a private for-profit sector where both hospitals and physicians are initially paid on a fee-for-service basis. We show that the benefit of the introduction of an activity-based system depends on the type of interaction between managers and physicians (simultaneous or sequential decision-making games). It is shown that, under the activity-based system, a sequential interaction with physician leader could be beneficial for both agents in the private sector. We further model an endogenous timing game à la Hamilton and Slutsky (Games Econ Behav 2: 29-46, 1990) in which the type of interaction is determined endogenously. We show that, under the activity-based system, the sequential interaction with physician leader is the unique subgame perfect equilibrium.

  10. Improving Healthcare Team Collaboration in Hospital Transfers through Cloud-Based Mobile Systems

    Directory of Open Access Journals (Sweden)

    Andres Neyem

    2016-01-01

    Full Text Available It is a clinical fact that better patient flow management in and between hospitals improves quality of care, resource utilization, and cost efficiency. As the number of patients in hospitals constantly grows, the need for hospital transfers is directly affected. Interhospital transfers can be required for several reasons but they are most commonly made when the diagnostic and therapeutic facilities required for a patient are not available locally. Transferring a critical patient between hospitals is commonly associated with risk of death and complications. This raises the question: How can we improve healthcare team collaboration in hospital transfers through the use of emerging information technology and communication services? This paper presents a cloud-based mobile system for supporting team collaboration and decision-making in the transportation of patients in critical condition. The Rapid Emergency Medicine Score (REMS scale was used as an outcome variable, being a useful scale to assess the risk profile of critical patients requiring transfers between hospitals. This helps medical staff to adopt proper risk-prevention measures when handling a transfer and to react on time if any complications arise in transit.

  11. Barriers for Hospital-Based Nurse Practitioners Utilizing Clinical Decision Support Systems: A Systematic Review.

    Science.gov (United States)

    Borum, Cindy

    2018-01-23

    There is a national focus on the adoption of healthcare technology to improve the delivery of safe, efficient, and high-quality patient care. Nurse practitioners fulfill an emerging strategic role in the hospital setting. A comprehensive literature review focused on the question: What are the barriers for nurse practitioners utilizing clinical decision support in the hospital setting? Nine studies conducted from 2011 to 2017 were the basis for this review, which identified 13 barriers for nurse practitioners utilizing clinical decision support in the hospital. Having the right information, including up-to-date evidence-based practice guidelines, accurate clinical pathways, and current clinical algorithms, was the most common barrier. Providing reliable clinical decision support is crucial as nurse practitioners become more dependent on hospital technology systems in the delivery of safe patient care. Eliminating barriers to the use of clinical decision support is important for informaticists and nurse practitioners because both groups concentrate on acceptance of decision support systems in the hospital to meet the goal of safe and high-quality patient care.

  12. A new costing model in hospital management: time-driven activity-based costing system.

    Science.gov (United States)

    Öker, Figen; Özyapıcı, Hasan

    2013-01-01

    Traditional cost systems cause cost distortions because they cannot meet the requirements of today's businesses. Therefore, a new and more effective cost system is needed. Consequently, time-driven activity-based costing system has emerged. The unit cost of supplying capacity and the time needed to perform an activity are the only 2 factors considered by the system. Furthermore, this system determines unused capacity by considering practical capacity. The purpose of this article is to emphasize the efficiency of the time-driven activity-based costing system and to display how it can be applied in a health care institution. A case study was conducted in a private hospital in Cyprus. Interviews and direct observations were used to collect the data. The case study revealed that the cost of unused capacity is allocated to both open and laparoscopic (closed) surgeries. Thus, by using the time-driven activity-based costing system, managers should eliminate the cost of unused capacity so as to obtain better results. Based on the results of the study, hospital management is better able to understand the costs of different surgeries. In addition, managers can easily notice the cost of unused capacity and decide how many employees to be dismissed or directed to other productive areas.

  13. Evaluating the ability of hospital information systems to establish evidence-based medicine in Iran.

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    Rangraz Jeddi, Fatemeh; Abazari, Fatemeh; Moravveji, Alireza; Nadjafi, Maryam

    2013-04-01

    Evidence-based medicine (EBM) is the correct use of the best evidences in clinical decision making for patient care. Hospital Information Systems (HIS) can act as a bridge between medical data and medical knowledge through context-sensitive merging and filtering of patient data, individual clinical knowledge and external evidence. The aim of this study was to determine the ability of HISs to establish EBM in Iran. This descriptive cross-sectional study was carried out on HISs of 30 hospitals from March 2011 to October 2011. Data were collected using a researcher-constructed checklist including applicant's background information as well as information based on research objectives: clinical decision support system (CDSS), reference databases, contextual and case-specific information, clinical and administrative data repositories and Internet-based health information. Face and content validity of the checklist were assessed by the qualified specialists and then the data were analyzed using descriptive statistics and SPSS 16 software. The results of the study revealed that the HISs lacked the essential components to providing access to CDSS, reference databases and Internet-based health information in 19, 16 and 20 hospitals were 63.3 %, 53.3 % and 66.7, respectively. Twenty-two hospitals (70 %) had more than two-thirds of the essential components to access clinical and administrative data repositories; 23 hospitals (76.7 %) had at least one essential component to access contextual and case-specific information. It can be concluded that the ability of the HISs to establish EBM in providing access to the clinical and administrative data repositories is better than other research objectives. Furthermore, more attention should be paid to other related objectives.

  14. Evaluation of the in-hospital hemovigilance by introduction of the information technology-based system.

    Science.gov (United States)

    Fujihara, Harumi; Yamada, Chiaki; Furumaki, Hiroaki; Nagai, Seiya; Shibata, Hiroki; Ishizuka, Keiko; Watanabe, Hiroko; Kaneko, Makoto; Adachi, Miwa; Takeshita, Akihiro

    2015-12-01

    Hemovigilance is an important aspect of transfusion medicine. However, the frequency of the adverse reactions often varies using different reporters. Recently, we have employed a new information technology (IT)-based in-hospital hemovigilance system. Here, we evaluated changes in practice after implementation of an IT-based reporting system. We compared the rate of frequency and details of blood transfusion-related adverse reactions 3 years before and after introduction of the IT-based reporting system. Contents and severity of the adverse reactions were reported in a paper-based reporting system, but input by selecting items in an IT-based reporting system. The details of adverse reactions are immediately sent to the blood transfusion unit online. After we introduced the IT-based reporting system, the reported rate of transfusion-related adverse reactions increased approximately 10-fold from 0.20% to 2.18% (p introduction of an IT-based reporting system. © 2015 AABB.

  15. 78 FR 10579 - TRICARE Revision to CHAMPUS DRG-Based Payment System, Pricing of Hospital Claims

    Science.gov (United States)

    2013-02-14

    ... the beneficiary's discharge by the hospital, but using the rules, weights, and rates that were in... used to reimburse hospitals at that time. For patients admitted after implementation of the DRG-based... the hospital was an effective operational policy for TRICARE. It is now time, however, to revise this...

  16. Hospital Value-Based Purchasing

    Data.gov (United States)

    U.S. Department of Health & Human Services — Hospital Value-Based Purchasing (VBP) is part of the Centers for Medicare and Medicaid Services (CMS) long-standing effort to link Medicares payment system to a...

  17. eMedication - a smartphone-based e-medication system for hospitalized patients

    OpenAIRE

    Thapa, Sanjit Jung

    2015-01-01

    Purpose: The purpose of this research was to develop a smartphone based e-medication app for hospitalized patients at the University Hospital of North Norway (UNN). The app was expected to provide an overview of medication that the patient is given during hospitalization. Motivation: E-medication has become widely popular in many countries, and has replaced the paper-based prescription. This replacement has enhanced the quality of the medication process and reduced medication err...

  18. Hospital automation system RFID-based: technology embedded in smart devices (cards, tags and bracelets).

    Science.gov (United States)

    Florentino, Gustavo H P; Paz de Araujo, Carlos A; Bezerra, Heitor U; Junior, Helio B A; Xavier, Marcelo Araujo; de Souza, Vinicius S V; de M Valentim, Ricardo A A; Morais, Antonio H F; Guerreiro, Ana M G; Brandao, Glaucio B

    2008-01-01

    RFID is a technology being adopted in many business fields, especially in the medical field. This work has the objective to present a system for automation of a hospital clinical analysis laboratory. This system initially uses contactless smart cards to store patient's data and for authentication of hospital employees in the system. The proposed system also uses RFID tags stuck to containers containing patient's collected samples for the correct identification of the patient who gave away the samples. This work depicts a hospital laboratory workflow, presents the system modeling and deals with security matters related to information stored in the smart cards.

  19. A web-based system for total parenteral nutrition prescription in a pediatric hospital - biomed 2010.

    Science.gov (United States)

    Bava, Michele; Bradashia, Fulvio; Rovere, Francesca; Maestro, Alessandra; Vecchi Brumatti, Liz; Accardo, Agostino; Paparazzo, Rossella; Zanon, Davide

    2010-01-01

    otal Parenteral Nutrition (TPN) is defined as feeding a patient by infusing nutrients intravenously, bypassing the usual process of eating and digestion. There are two kinds of TPN: short-term TPN may be used when a patient's digestive system is temporarily nonfunctional because of an interruption in its continuity; long-term TPN is used to treat patients with an impairment or a lack in nutrient absorption. TPN has extended the life of children born with nonexistent or severely deformed digestive organs and is a vital support for these patients. In Burlos Pediatric Department, pediatricians fill in a pharmacy request form in which nutritional needs are included for each patient. Subsequently, clinical pharmacists evaluate the patients individual data and decide which TPN formula to prepare. To enhance the TPN prescription process, an intranet web-based system has been developed to replicate the original paper-based forms. The software, developed in PHP and based on open source tools and services, has been constructed according to pharmacists requirements. These professionals, together with the Hospital Information System technicians, thanks to the availability of affordable instruments, perceive the advantages that such a system would have in improving clinical practice and quality of care. The system was devised with the goal to avoid common reading errors, to improve the correct text comprehension, to ensure prescription preparation, administration and tracking. According to a process of total quality control, the system reduces clinical risks regarding issues such as the correct and rapid availability of medical prescriptions and the incorrect identification of the patients. In comparison with paper-based TPN prescriptions, electronic-based forms have reduced the incidence of errors, the possible lack of patient data and reading misunderstandings. Regarding future improvements, IT technicians are defining the procedures to implement digital signature and medical

  20. Integration of modeling and simulation into hospital-based decision support systems guiding pediatric pharmacotherapy

    National Research Council Canada - National Science Library

    Barrett, Jeffrey S; Mondick, John T; Narayan, Mahesh; Vijayakumar, Kalpana; Vijayakumar, Sundararajan

    2008-01-01

    Decision analysis in hospital-based settings is becoming more common place. The application of modeling and simulation approaches has likewise become more prevalent in order to support decision analytics...

  1. Efficacy of computer-based endoscope cleaning and disinfection using a hospital management information system.

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    Wang, Caixia; Chen, Yuanyuan; Yang, Feng; Ren, Jie; Yu, Xin; Wang, Jiani; Sun, Siyu

    2016-08-01

    The present study aimed to assess the efficacy of computer-based endoscope cleaning and disinfection using a hospital management information system (HMIS). A total of 2,674 gastroscopes were eligible for inclusion in this study. For the processes of disinfection management, the gastroscopes were randomly divided into 2 groups: gastroscope disinfection HMIS (GD-HMIS) group and manual group. In the GD-HMIS group, an integrated circuit card (IC card) chip was installed to monitor and record endoscope cleaning and disinfection automatically and in real time, whereas the endoscope cleaning and disinfection in the manual group was recorded manually. The overall disinfection progresses for both groups were recorded, and the total operational time was calculated. For the GD-HMIS group, endoscope disinfection HMIS software was successfully developed. The time to complete a single session of cleaning and disinfecting on a gastroscope was 15.6 minutes (range, 14.3-17.2 minutes) for the GD-HMIS group and 21.3 minutes (range, 20.2-23.9 minutes) for the manual group. Failure to record information, such as the identification number of the endoscope, occasionally occurred in the manual group, which affected the accuracy and reliability of manual recording. Computer-based gastroscope cleaning and disinfection using a hospital management information system could monitor the process of gastroscope cleaning and disinfection in real time and improve the accuracy and reliability, thereby ensuring the quality of gastroscope cleaning and disinfection. Copyright © 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  2. Integration of modeling and simulation into hospital-based decision support systems guiding pediatric pharmacotherapy.

    Science.gov (United States)

    Barrett, Jeffrey S; Mondick, John T; Narayan, Mahesh; Vijayakumar, Kalpana; Vijayakumar, Sundararajan

    2008-01-28

    Decision analysis in hospital-based settings is becoming more common place. The application of modeling and simulation approaches has likewise become more prevalent in order to support decision analytics. With respect to clinical decision making at the level of the patient, modeling and simulation approaches have been used to study and forecast treatment options, examine and rate caregiver performance and assign resources (staffing, beds, patient throughput). There us a great need to facilitate pharmacotherapeutic decision making in pediatrics given the often limited data available to guide dosing and manage patient response. We have employed nonlinear mixed effect models and Bayesian forecasting algorithms coupled with data summary and visualization tools to create drug-specific decision support systems that utilize individualized patient data from our electronic medical records systems. Pharmacokinetic and pharmacodynamic nonlinear mixed-effect models of specific drugs are generated based on historical data in relevant pediatric populations or from adults when no pediatric data is available. These models are re-executed with individual patient data allowing for patient-specific guidance via a Bayesian forecasting approach. The models are called and executed in an interactive manner through our web-based dashboard environment which interfaces to the hospital's electronic medical records system. The methotrexate dashboard utilizes a two-compartment, population-based, PK mixed-effect model to project patient response to specific dosing events. Projected plasma concentrations are viewable against protocol-specific nomograms to provide dosing guidance for potential rescue therapy with leucovorin. These data are also viewable against common biomarkers used to assess patient safety (e.g., vital signs and plasma creatinine levels). As additional data become available via therapeutic drug monitoring, the model is re-executed and projections are revised. The management of

  3. Towards high performing hospital enterprise systems: an empirical and literature based design framework

    Science.gov (United States)

    dos Santos Fradinho, Jorge Miguel

    2014-05-01

    Our understanding of enterprise systems (ES) is gradually evolving towards a sense of design which leverages multidisciplinary bodies of knowledge that may bolster hybrid research designs and together further the characterisation of ES operation and performance. This article aims to contribute towards ES design theory with its hospital enterprise systems design (HESD) framework, which reflects a rich multidisciplinary literature and two in-depth hospital empirical cases from the US and UK. In doing so it leverages systems thinking principles and traditionally disparate bodies of knowledge to bolster the theoretical evolution and foundation of ES. A total of seven core ES design elements are identified and characterised with 24 main categories and 53 subcategories. In addition, it builds on recent work which suggests that hospital enterprises are comprised of multiple internal ES configurations which may generate different levels of performance. Multiple sources of evidence were collected including electronic medical records, 54 recorded interviews, observation, and internal documents. Both in-depth cases compare and contrast higher and lower performing ES configurations. Following literal replication across in-depth cases, this article concludes that hospital performance can be improved through an enriched understanding of hospital ES design.

  4. Defining Reported Errors on Web-based Reporting System Using ICPS From Nine Units in a Korean University Hospital

    Directory of Open Access Journals (Sweden)

    Chul-Hoon Kim, DDS, PhD

    2009-12-01

    Conclusion: The web-based error reporting system using ICPS proved to be an easy, feasible system for hospitals in Korea. This system will be helpful for inducing general agreement upon errors within clinical nursing practice and bring more attention to any errors made or near misses. Also, it will be able to ameliorate the punitive culture for errors and transform error reporting into a habit for healthcare providers.

  5. The definition, selection and implementation of a new Clinical Information System to prepare the hospital for the electronic future: an example of project-based education

    NARCIS (Netherlands)

    Spil, Antonius A.M.; van de Meeberg, Henk J.; Sikkel, Nicolaas

    The software supplier of a large hospital has been taken over. The hospital gets notice that the central hospital information system (HIS) will no longer be maintained, starting next year. This problem, not uncommon in business today, is used as a real-life case in a project-based course for first

  6. An interactive voice response system to continue a hospital-based smoking cessation intervention after discharge.

    Science.gov (United States)

    Regan, Susan; Reyen, Michele; Lockhart, Abigail C; Richards, Ann E; Rigotti, Nancy A

    2011-04-01

    Hospitalized smokers benefit from tobacco counseling received in hospital only if it continues after discharge. Interactive voice response (IVR) technology may be useful in delivering this care. We conducted a randomized controlled trial testing two intensities of follow-up contact using an IVR system; 738 cigarette smokers who received inpatient counseling at an academic medical center were enrolled. Participants were randomized to receive four IVR calls during the first month postdischarge that included the offer of a call back (CB) from a smoking counselor (IVR + CB, N = 368) or 1 IVR call at 2 weeks postdischarge that assessed smoking outcomes without offering any counseling support (IVR, N = 370). All were assessed by human telephone call at 12 weeks. Postdischarge counseling and medication utilization rates and self-reported smoking cessation were assessed at 2 and 12 weeks postdischarge. Of those randomized to IVR + CB, 59% received a CB offer and 34% of those receiving offers accepted. Cessation rates did not differ between IVR + CB and IVR at 2 weeks (39% vs. 39%, rate ratio: 1.02, 95% CI: 0.85-1.22) or 12 weeks (29% vs. 26%, rate ratio: 1.11, 95% CI: 0.90-1.41). Medication use did not differ by group but was higher among those accepting versus declining CB offers (69% vs. 52%, p offers, although offers were not associated with increased smoking cessation.

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

    Directory of Open Access Journals (Sweden)

    Nghia Ho Dang Trung

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

  8. Development of a global hospital self-assessment tool and prioritization tier system based on FIP's Basel Statements.

    Science.gov (United States)

    Lyons, Kayley; Blalock, Susan J; Brock, Tina Penick; Manasse, Henri R; Eckel, Stephen F

    2016-04-01

    The objective of this study was to develop and pilot a hospital self-assessment tool and prioritization system for hospitals to evaluate their pharmacy practice performance against the International Pharmaceutical Federation (FIP)'s Basel Statements. To develop the self-assessment tool, we reviewed the Basel statements to identify characteristics that could be measured at the individual hospital level and finalized these based on feedback from five cognitive interviews. The survey instrument was pilot tested in four countries; two high-, one lower middle- and one low-income country. Participants were electronically sent the survey tool and enrolled through the snowball sampling method. Tiers were developed by investigators to assist hospitals in prioritizing the achievement of Basel Statement practices. Tiers were validated by the Hospital Section chairs of FIP through a card sorting exercise. Simple agreement and Cohen's kappa was used to characterize inter-rater reliability. Descriptive statistics were used to characterize the responses. Forty-four survey responses were collected from 36 hospitals in four countries. The survey response rate was 29% and took an average of 26 minutes to complete. The overall average agreement of constructs was 83%. The survey characterized how far a hospital was to achieving the Basel Statement practices with an average achievement rate of 57% (ranging from 30% to 90%). The survey highlighted medication safety challenges facing the pharmacy profession. The results produced a benchmarking report for each respondent. The results support the validity and reliability of the survey tool. This comprehensive survey tool can be used by institutions to track their progress towards achieving the Basel Statement practices. © 2015 Royal Pharmaceutical Society.

  9. Development of an RFID-based Surgery Management System: Lesson Learnt from a Hong Kong Public Hospital

    Directory of Open Access Journals (Sweden)

    S. L. Ting

    2012-01-01

    Full Text Available Medical errors happen during surgery such as leaving medical instruments in patient's body after surgery. In recent years, numerous cases have shown successful applications of Radio Frequency Identification (RFID technology in hospitals. This paper aims to investigate the potential applications of RFID in surgery management in a Hong Kong public hospital where the nurse to patient ratio is much lower than other countries. An RFID-based Surgery Management System is proposed to tackle the problems identified in the current situation. Apart from helping to reduce medical errors and enhance patient safety, it is expected that this system will also reduce the workload of care givers so that they can put more emphasis on providing high quality services to patients.

  10. The architecture of enterprise hospital information system.

    Science.gov (United States)

    Lu, Xudong; Duan, Huilong; Li, Haomin; Zhao, Chenhui; An, Jiye

    2005-01-01

    Because of the complexity of the hospital environment, there exist a lot of medical information systems from different vendors with incompatible structures. In order to establish an enterprise hospital information system, the integration among these heterogeneous systems must be considered. Complete integration should cover three aspects: data integration, function integration and workflow integration. However most of the previous design of architecture did not accomplish such a complete integration. This article offers an architecture design of the enterprise hospital information system based on the concept of digital neural network system in hospital. It covers all three aspects of integration, and eventually achieves the target of one virtual data center with Enterprise Viewer for users of different roles. The initial implementation of the architecture in the 5-year Digital Hospital Project in Huzhou Central hospital of Zhejiang Province is also described.

  11. A web-based incident reporting system and multidisciplinary collaborative projects for patient safety in a Japanese hospital

    Science.gov (United States)

    Nakajima, K; Kurata, Y; Takeda, H

    2005-01-01

    

Problem: When patient safety programs were mandated for Japanese health care institutions, a safety culture, a tool for collecting incident reports, an organizational arrangement for multidisciplinary collaboration, and interventional methods for improvement had to be established. Design: Observational study of effects of new patient safety programs. Setting: Osaka University Hospital, a large government-run teaching hospital. Strategy for change: A voluntary and anonymous web-based incident reporting system was introduced. For the new organizational structure a clinical risk management committee, a department of clinical quality management, and area clinical risk managers were established with their respective roles clearly defined to advance the plan-do-study-act cycle and to integrate efforts. For preventive action, alert procedures, staff education, ward rounds by peers, a system oriented approach for reducing errors, and various feedback channels were introduced. Effects of change: Continuous incident reporting by all hospital staff has been observed since the introduction of the new system. Several error inducing situations have been improved: wrong choice of drug in computer prescribing, maladministration of drugs due to a look-alike appearance or confusion about the manipulation of a medical device, and poor after hours service of the blood transfusion unit. Staff participation in educational seminars has been dramatically improved. Ward rounds have detected problematic procedures which needed to be dealt with. Lessons learnt: Patient safety programs based on a web-based incident reporting system, responsible persons, staff education, and a variety of feedback procedures can help promote a safety culture, multidisciplinary collaboration, and strong managerial leadership resulting in system oriented improvement. PMID:15805458

  12. Optimized biofilm-based systems for removal of pharmaceuticals from hospital waste water

    DEFF Research Database (Denmark)

    Andersen, Henrik R; Chhetri, Ravi; Hansen, Kamilla

    Discharge of hospital wastewater is of increasing concern, as hospitals are identified as chemical pollution source due to pharmaceutical content. This project seeks to develop the most efficient and economically feasible technology to remove pharmaceuticals from wastewater, regardless of the poi...

  13. [Clinical application features of Fufang Kushen injection in treating malignant esophageal tumor: real world study based on hospital information system].

    Science.gov (United States)

    Liu, Ya-Xin; Wang, Zhi-Fei; Xie, Yan-Ming; Zhang, Yin; Chen, Cen; Zhuang, Yan

    2017-08-01

    To analyze the clinical application features of Fufang Kushen injection in treating malignant esophageal tumors in the real world by using hospital information system database, and provide reference for clinical application of Fufang Kushen injection. The electronic medical data from 2 550 patients with malignant esophageal tumors using Fufang Kushen injection from 22 large-scale hospitals nationwide were extracted based on the hospital information system (HIS) established by Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences. Then the descriptive analysis based on frequency and rate was conducted for general characteristics, diagnostic characteristics, characteristics of dosage and medication information, characteristics of drug combination, and discharge outcome characteristics. The results showed that the average age of patients treated with Fufang Kushen injection for malignant esophageal tumors was 62.3 years old; more males than females; admitted to hospital mainly in department of cardiology, oncology and digestology first. The total efficiency was 47.15% based on the discharge outcome characteristics; the most common dosage was 10-20 mL for single use; the course of treatment was mainly 4-7 d; and the common drugs in drug combinations included dexamethasone, tropisetron injection, thymosin injection, compound amino acid injection, pantoprazole sodium injection, fluorouracil, et al. The characteristics of the crowd using Fufang Kushen injection to treat the malignant esophageal tumors were clear and in line with the general rule of malignant esophageal tumors; its clinical dosage and scope of treatment for malignant esophageal tumors in the real world were basically consistent with the specification; and the types of clinical drug use combinations were more extensive. Copyright© by the Chinese Pharmaceutical Association.

  14. Demonstration of Advanced Technologies for Multi-Load Washers in Hospitality and Healthcare -- Ozone Based Laundry Systems

    Energy Technology Data Exchange (ETDEWEB)

    Boyd, Brian K. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Parker, Graham B. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Petersen, Joseph M. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Sullivan, Greg [Efficiency Solutions, LLC (United States); Goetzler, W. [Navigant Consulting, Inc. (United States); Sutherland, T. A. [Navigant Consulting, Inc. (United States); Foley, K. J. [Navigant Consulting, Inc. (United States)

    2014-08-14

    The objective of this demonstration project was to evaluate market-ready retrofit technologies for reducing the energy and water use of multi-load washers in healthcare and hospitality facilities. Specifically, this project evaluated laundry wastewater recycling technology in the hospitality sector and ozone laundry technology in both the healthcare and hospitality sectors. This report documents the demonstration of ozone laundry system installations at the Charleston Place Hotel in Charleston, South Carolina, and the Rogerson House assisted living facility in Boston, Massachusetts.

  15. Aerospace technology and hospital systems

    Science.gov (United States)

    1972-01-01

    The use of aerospace medical techniques to improve the quality of earth health care systems is discussed. Data are focused on physiological measurements and monitoring, medical information management, clean room technology, and reliability and quality assurance for hospital equipment.

  16. Impact of a Local Low-Cost Ward-Based Response System in a Canadian Tertiary Care Hospital

    Directory of Open Access Journals (Sweden)

    Andrea Blotsky

    2016-01-01

    Full Text Available Background. Medical emergency teams (METs or rapid response teams (RRTs facilitate early intervention for clinically deteriorating hospitalized patients. In healthcare systems where financial resources and intensivist availability are limited, the establishment of such teams can prove challenging. Objectives. A low-cost, ward-based response system was implemented on a medical clinical teaching unit in a Montreal tertiary care hospital. A prospective before/after study was undertaken to examine the system’s impact on time to intervention, code blue rates, and ICU transfer rates. Results. Ninety-five calls were placed for 82 patients. Median time from patient decompensation to intervention was 5 min (IQR 1–10, compared to 3.4 hours (IQR 0.6–12.4 before system implementation (p<0.001. Total number of ICU admissions from the CTU was reduced from 4.8/1000 patient days (±2.2 before intervention to 3.3/1000 patient days (±1.4 after intervention (IRR: 0.82, p=0.04 (CI 95%: 0.69–0.99. CTU code blue rates decreased from 2.2/1000 patient days (±1.6 before intervention to 1.2/1000 patient days (±1.3 after intervention (IRR: 0.51, p=0.02 (CI 95%: 0.30–0.89. Conclusion. Our local ward-based response system achieved a significant reduction in the time of patient decompensation to initial intervention, in CTU code blue rates, and in CTU to ICU transfers without necessitating additional usage of financial or human resources.

  17. A simulation-based training system for hip fracture fixation for use within the hospital environment.

    Science.gov (United States)

    Blyth, P; Stott, N S; Anderson, I A

    2007-10-01

    We report development of a PC-based virtual reality training system for hip fracture fixation that comprises a surgical simulator and an assessment component. The simulator allows hip fracture fixation to be performed on a virtual hip model using two-dimensional radiographic images to guide fracture reduction and implant placement. Ten operative scenarios with increasing complexities of fracture type are available. The face validity of the simulator was tested using a 26 item feedback questionnaire, with answers on a 5 cm visual analogue scale from 'disagree strongly' to 'agree strongly'. Ten study participants, aged 20-50, and with variable levels of surgical skills, each performed six operative scenarios on the simulator before completing the questionnaire. The results showed that the simulator had good face validity, with the majority of subjects stating it provided a realistic view of the operating environment (median score 8.2/10) and that the three-dimensional view provided was all that was required (median score 7.8/10). The subjects considered the simulator was able to test problem solving ability (median score 8.0/10). These results confirm that this simulator achieves good face validity without computationally intensive touch feedback (haptics). Overall, this study demonstrates that non-haptic simulators have a larger role to play in virtual simulation than is currently recognised.

  18. Randomized trial of a novel game-based appointment system for a university hospital venereology unit: study protocol.

    Science.gov (United States)

    Gabarron, Elia; Serrano, J Artur; Fernandez-Luque, Luis; Wynn, Rolf; Schopf, Thomas

    2015-04-08

    Chlamydia is the most common reportable sexually transmitted disease (STD) in Norway, and its incidence in the two northernmost counties has been disclosed to be nearly the double of the Norwegian average. The latest publicly available rates showed that 85.6% of the new cases were diagnosed in people under 29 years old. The information and communication technologies are among the most powerful influences in the lives of young people. The Internet can potentially represent a way to educate on sexual health and encourage young people, and especially youth, to be tested for STDs. If hospital websites include an easy and anonymous system for scheduling appointments with the clinic, it is possible that this could lead to an increase in the number of people tested for STDs. The purpose of the study is to assess the impact of a game-based appointment system on the frequency of consultations at a venereology unit and on the use of an educational web app. An A/B testing methodology is used. Users from the city of Tromsø, in North Norway, will be randomized to one of the two versions of the game-style web app on sexual health at www.sjekkdeg.no. Group A will have access to educational content only, while group B will have, in addition, access to a game-based appointment system with automatic prioritization. After one year of the trial, it will be analyzed if the game-based appointment system increases the number of consultations at the venereology unit and if health professionals deem the system useful. This study will explore if facilitating the access to health services for youth through the use of a game-based appointment system integrated in a game-style web app on sexual health education can have an impact on appointment rates. The trial is registered at clinicaltrials.org under the identifier ClinicalTrials.gov NCT:02128620.

  19. Prescription errors and the impact of computerized prescription order entry system in a community-based hospital.

    Science.gov (United States)

    Jayawardena, Suriya; Eisdorfer, Jacob; Indulkar, Shalaka; Pal, Sethi Ajith; Sooriabalan, Danushan; Cucco, Robert

    2007-01-01

    Adverse drug events occur often in hospitals. They can be prevented to a large extent by minimizing the human errors of prescription writing. To evaluate the efficacy of a computerized prescription order entry (CPOE) system with the help of ancillary support in minimizing prescription errors. Retrospective study carried out in a community-based urban teaching hospital in south Brooklyn, NY from January 2004 to January 2005. Errors were categorized into inappropriate dosage adjustment for creatinine clearance, duplication, incorrect orders, allergy verification, and incomplete orders. The pharmacists identified the type of error, the severity of error, the class of drug involved, and the department that made the error. A total of 466,311 prescriptions were entered in the period of 1 year. There were 3513 errors during this period (7.53 errors per 1000 prescriptions). More than half of these errors were made by the internal medicine specialty. In our study, 50% of the errors were severe errors (overdosing medications with narrow therapeutic index or over-riding allergies), 46.28% were moderate errors (overdosing, wrong dosing, duplicate orders, or prescribing multiple antibiotics), and 3.71% were not harmful errors (wrong dosing or incomplete orders). The errors were also categorized according to the class of medication. Errors in antibiotic prescription accounted for 53.9% of all errors. The pharmacist detected all these prescription errors as the prescriptions were reviewed in the CPOE system. Prescription errors are common medical errors seen in hospitals. The CPOE system has prevented and alerted the prescriber and pharmacist to dosage errors and allergies. Involvement of the pharmacist in reviewing the prescription and alerting the physician has minimized prescription errors to a great degree in our hospital setting. The incidence of prescription errors before the CPOE has been reported to range from 3 to 99 per 1000 prescriptions. The disparity could be due to

  20. Evaluation of hospital information systems of the teaching hospitals affiliated to Shiraz University of Medical Sciences, based on the American College of Physicians Criteria

    Directory of Open Access Journals (Sweden)

    E Emami

    2014-01-01

    Full Text Available Introduction: Hospital information system (HIS is a computerized system used for management of hospital information as an electronic device and has an indispensible role in the field of qualified healthcare services. Nevertheless, compared to other industrial and commercial systems, this information system is lagged in using the information technology and applying the controlling standards for satisfying the customers. Therefore, the present study aimed to evaluate HIS, identify its strength and weak points, and improve it in the teaching hospitals affiliated to Shiraz University of Medical Sciences, Shiraz, Iran. Method: The present descriptive, cross-sectional study was conducted in the 8 teaching hospitals of Shiraz University of Medical Sciences which used HIS in 2011. The study data were collected through interview and direct observation using the criteria of American Physician College check-list. Finally, SPSS statistical software was used to analyze the data through descriptive statistics. Results: The study results showed that laboratory and medical records had respectively the most %43.5 and the least %21.03 conformity to the criteria of American College of Physicians. Also, Faghihi and Zeinabiye hospitals respectively had the most %41.8 and the least %25.2 conformity to the American College of Physicians’ criteria. In pharmacy, data entrance mechanism and presentation of reports had complete conformity to the scales of American College of Physicians, while drug interactions showed no conformity. In laboratory, data entrance mechanism had complete conformity to the above-mentioned criteria and keeping the test history had %87.5 conformity. The possibility of receiving information from centers out of laboratory had no conformity to the desired criteria. In the radiology department, data entrance mechanism had complete conformity to the above-mentioned criteria and keeping the test history had %87.5 conformity. Besides, the possibility

  1. Psychiatrist Health Human Resource Planning - An Essential Component of a Hospital-Based Mental Healthcare System Transformation.

    Science.gov (United States)

    Jarmain, Sarah

    2016-01-01

    The World Health Organization (WHO) defines health human resource planning as "the process of estimating the number of persons and the kinds of knowledge, skills, and attitudes they need to achieve predetermined health targets and ultimately health status objectives" (OHA 2015). Health human resource planning is a critical component of successful organizational and system transformation, and yet little has been written on how to do this for physicians at the local level. This paper will outline a framework for developing and managing key aspects of physician human resource planning related to both the quantity and quality of work within a hospital setting. Using the example of a complex multiphase hospital-based mental health transformation that involved both the reduction and divestment of beds and services, we will outline how we managed the physician human resource aspects to establish the number of psychiatrists needed and the desired attributes of those psychiatrists, and how we helped an existing workforce transition to meet the new expectations. The paper will describe a process for strategically aligning the selection and management of physicians to meet organizational vision and mandate.

  2. Smartphone-Based Geofencing to Ascertain Hospitalizations.

    Science.gov (United States)

    Nguyen, Kaylin T; Olgin, Jeffrey E; Pletcher, Mark J; Ng, Madelena; Kaye, Leanne; Moturu, Sai; Gladstone, Rachel A; Malladi, Chaitanya; Fann, Amy H; Maguire, Carol; Bettencourt, Laura; Christensen, Matthew A; Marcus, Gregory M

    2017-03-01

    Ascertainment of hospitalizations is critical to assess quality of care and the effectiveness and adverse effects of various therapies. Smartphones, mobile geolocators that are ubiquitous, have not been leveraged to ascertain hospitalizations. Therefore, we evaluated the use of smartphone-based geofencing to track hospitalizations. Participants aged ≥18 years installed a mobile application programmed to geofence all hospitals using global positioning systems and cell phone tower triangulation and to trigger a smartphone-based questionnaire when located in a hospital for ≥4 hours. An in-person study included consecutive consenting patients scheduled for electrophysiology and cardiac catheterization procedures. A remote arm invited Health eHeart Study participants who consented and engaged with the study via the internet only. The accuracy of application-detected hospitalizations was confirmed by medical record review as the reference standard. Of 22 eligible in-person patients, 17 hospitalizations were detected (sensitivity 77%; 95% confidence interval, 55%-92%). The length of stay according to the application was positively correlated with the length of stay ascertained via the electronic medical record (r=0.53; P=0.03). In the remote arm, the application was downloaded by 3443 participants residing in all 50 US states; 243 hospital visits at 119 different hospitals were detected through the application. The positive predictive value for an application-reported hospitalization was 65% (95% confidence interval, 57%-72%). Mobile application-based ascertainment of hospitalizations can be achieved with modest accuracy. This first proof of concept may ultimately be applicable to geofencing other types of prespecified locations to facilitate healthcare research and patient care. © 2017 American Heart Association, Inc.

  3. Patient visits to a hospital-based alternative medicine clinic from 1997 through 2002: experience from an integrated healthcare system.

    Science.gov (United States)

    Bracha, Yiscah; Svendsen, Kenneth; Culliton, Patricia

    2005-01-01

    Efforts to integrate complementary and alternative medicine (CAM) into conventional healthcare systems raise questions about expected levels of CAM use and its cost in an integrated system. This paper documents actual patient usage of a hospital-based alternative medicine clinic that has been operating on a conventional healthcare campus since 1993. Hennepin Faculty Associates (HFA) is a multispecialty physician organization serving the Hennepin County Medical Center (HCMC), a public teaching hospital in downtown Minneapolis. In 1993, HFA opened an alternative medicine clinic, primarily providing acupuncture. The clinic has since expanded services to offer chiropractic, massage/bodywork, and herbs. Administrative claims data showing visit dates, treatment received, payment source, charges, and patient complaints are available from 1997 through 2002. Of all HFA patients who received conventional care on the HCMC campus every year (1997-2002), 6.5% also received care at the Alternative Medicine Clinic (AMC). Nearly 80% of AMC patients received third-party reimbursement for AMC services. Averaged over 6 years, self-pay patients had 3.2 visits per year and incurred $173 in charges per year; patients with a mixture of third-party payment sources had 8.0 visits per year and incurred $634 in charges per year. Number of visits per patient per year remained relatively constant over the 6 years, except for patients aged 65 or older, who showed an increase in number of visits, particularly for acupuncture. This report contributes a new perspective on use of CAM in the general population. Results from this perspective differ markedly from those provided by published survey data, showing a lower prevalence of use and lower charges incurred. Concern that insurance coverage for CAM would increase healthcare costs dramatically are not substantiated by these data.

  4. Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Policy Changes and Fiscal Year 2018 Rates; Quality Reporting Requirements for Specific Providers; Medicare and Medicaid Electronic Health Record (EHR) Incentive Program Requirements for Eligible Hospitals, Critical Access Hospitals, and Eligible Professionals; Provider-Based Status of Indian Health Service and Tribal Facilities and Organizations; Costs Reporting and Provider Requirements; Agreement Termination Notices. Final rule.

    Science.gov (United States)

    2017-08-14

    We are revising the Medicare hospital inpatient prospective payment systems (IPPS) for operating and capital-related costs of acute care hospitals to implement changes arising from our continuing experience with these systems for FY 2018. Some of these changes implement certain statutory provisions contained in the Pathway for Sustainable Growth Rate (SGR) Reform Act of 2013, the Improving Medicare Post-Acute Care Transformation Act of 2014, the Medicare Access and CHIP Reauthorization Act of 2015, the 21st Century Cures Act, and other legislation. We also are making changes relating to the provider-based status of Indian Health Service (IHS) and Tribal facilities and organizations and to the low-volume hospital payment adjustment for hospitals operated by the IHS or a Tribe. In addition, we are providing the market basket update that will apply to the rate-of-increase limits for certain hospitals excluded from the IPPS that are paid on a reasonable cost basis subject to these limits for FY 2018. We are updating the payment policies and the annual payment rates for the Medicare prospective payment system (PPS) for inpatient hospital services provided by long-term care hospitals (LTCHs) for FY 2018. In addition, we are establishing new requirements or revising existing requirements for quality reporting by specific Medicare providers (acute care hospitals, PPS-exempt cancer hospitals, LTCHs, and inpatient psychiatric facilities). We also are establishing new requirements or revising existing requirements for eligible professionals (EPs), eligible hospitals, and critical access hospitals (CAHs) participating in the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs. We are updating policies relating to the Hospital Value-Based Purchasing (VBP) Program, the Hospital Readmissions Reduction Program, and the Hospital-Acquired Condition (HAC) Reduction Program. We also are making changes relating to transparency of accrediting organization survey

  5. Acceptance model of a Hospital Information System.

    Science.gov (United States)

    Handayani, P W; Hidayanto, A N; Pinem, A A; Hapsari, I C; Sandhyaduhita, P I; Budi, I

    2017-03-01

    The purpose of this study is to develop a model of Hospital Information System (HIS) user acceptance focusing on human, technological, and organizational characteristics for supporting government eHealth programs. This model was then tested to see which hospital type in Indonesia would benefit from the model to resolve problems related to HIS user acceptance. This study used qualitative and quantitative approaches with case studies at four privately owned hospitals and three government-owned hospitals, which are general hospitals in Indonesia. The respondents involved in this study are low-level and mid-level hospital management officers, doctors, nurses, and administrative staff who work at medical record, inpatient, outpatient, emergency, pharmacy, and information technology units. Data was processed using Structural Equation Modeling (SEM) and AMOS 21.0. The study concludes that non-technological factors, such as human characteristics (i.e. compatibility, information security expectancy, and self-efficacy), and organizational characteristics (i.e. management support, facilitating conditions, and user involvement) which have level of significance of pgovernment-owned hospitals. Based on the results of this study, hospital management and IT developers should have more understanding on the non-technological factors to better plan for HIS implementation. Support from management is critical to the sustainability of HIS implementation to ensure HIS is easy to use and provides benefits to the users as well as hospitals. Finally, this study could assist hospital management and IT developers, as well as researchers, to understand the obstacles faced by hospitals in implementing HIS. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  6. [Analysis of clinical medication rules in 48 398 patients with limb fractures based on hospital information system].

    Science.gov (United States)

    Jia, Cheng-Hui; Zhang, Yin; Xie, Yan-Ming; Wei, Xu; Yin, He; Feng, Bo; Zhuang, Yan

    2016-07-01

    To explore the clinical medication rules in the patients with limb fractures, and provide guidance for clinical practice. Data of 48 398 patients with limb fractures from 2001 to 2011 was extracted from the hospital information system(HIS) established by the institute of basic research in clinical medicine, China academy of Chinese medical sciences. The gender and age distribution of patients and clinical medication characteristics were described. Apriori algorithm was adopted to analyze the common drug combinations of Chinese medicine(CM) and western medicine(WM). The study results showed that the ratio of included males and females was 1.83∶1. There was a high peak of incidence for the patients from 18 to 44 years. Apriori algorithm showed that the usage of WM was more frequent than that of CM. The most commonly used CM was Lugua polypeptide and sodium aescinate injection. Blood-activating and stasis-resolving medicines, as well as tendons and bones-strengthening medicines were the commonly used CM types. In addition, WM antibiotics plus blood-activating and stasis-resolving CM, or antibiotics plus tendons and bones-strengthening CM was the most commonly used drug combination. Based on the analysis of available data, the prevalence of limb fracture was higher in men than in women; more in young and middle-aged patients; the common drug combination was antibiotics plus blood-activating and stasis-resolving CM, or antibiotics plus tendons and bones-strengthening CM. More prospective and high-quality clinical trials are necessary to evaluate the effect of CM or integrative medicine treatment for limb fracture in the future research. Copyright© by the Chinese Pharmaceutical Association.

  7. 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.

  8. Electronic referral system for hospitals in Nigeria | Idowu | Ife Journal ...

    African Journals Online (AJOL)

    The advent of Information Technology gave birth to Telemedicine, which has led to electronic-based consultations such as electronic referral system in hospitals. In Nigeria, all the state hospitals are having problems in referring patients from one hospital to another. Most of the time before a patient could be referred from one ...

  9. An OAIS-based Hospital Information System on the Cloud: Analysis of a NoSQL Column-Oriented Approach.

    Science.gov (United States)

    Celesti, Antonio; Maria, Fazio; Romano, Agata; Bramanti, Alessia; Bramanti, Placido; Villari, Massimo

    2017-03-10

    The Open Archive Information System (OAIS) is a reference model for organizing people and resources in a system, and it is already adopted in care centers and medical systems to efficiently manage clinical data, medical personnel and patients. Archival storage systems are typically implemented using traditional relational database systems, but the relation-oriented technology strongly limits the efficiency in the management of huge amount of patients' clinical data, especially in emerging Cloud-based, that are distributed. In this paper, we present an OAIS healthcare architecture usefull to manage a huge amount of HL7 clinical documents in a scalable way. Specifically, it is based on a NoSQL column-oriented Data Base Management System (DBMS) deployed in the Cloud, thus to benefit from a big tables and wide rows available over a virtual distributed infrastructure. We developed a prototype of the proposed architecture at the IRCCS, and we evaluated its efficiency in a real case of study.

  10. Hospital Outpatient Prospective Payment System (OPPS) Lim...

    Data.gov (United States)

    U.S. Department of Health & Human Services — Hospital Outpatient Prospective Payment System (OPPS) Limited Data Set This file contains select claim level data and is derived from 2010 hospital outpatient PPS...

  11. Implementing an evidence-based computerized decision support system to improve patient care in a general hospital: the CODES study protocol for a randomized controlled trial.

    Science.gov (United States)

    Moja, Lorenzo; Polo Friz, Hernan; Capobussi, Matteo; Kwag, Koren; Banzi, Rita; Ruggiero, Francesca; González-Lorenzo, Marien; Liberati, Elisa Giulia; Mangia, Massimo; Nyberg, Peter; Kunnamo, Ilkka; Cimminiello, Claudio; Vighi, Giuseppe; Grimshaw, Jeremy; Bonovas, Stefanos

    2016-07-07

    Computerized decision support systems (CDSSs) are information technology-based software that provide health professionals with actionable, patient-specific recommendations or guidelines for disease diagnosis, treatment, and management at the point-of-care. These messages are intelligently filtered to enhance the health and clinical care of patients. CDSSs may be integrated with patient electronic health records (EHRs) and evidence-based knowledge. We designed a pragmatic randomized controlled trial to evaluate the effectiveness of patient-specific, evidence-based reminders generated at the point-of-care by a multi-specialty decision support system on clinical practice and the quality of care. We will include all the patients admitted to the internal medicine department of one large general hospital. The primary outcome is the rate at which medical problems, which are detected by the decision support software and reported through the reminders, are resolved (i.e., resolution rates). Secondary outcomes are resolution rates for reminders specific to venous thromboembolism (VTE) prevention, in-hospital all causes and VTE-related mortality, and the length of hospital stay during the study period. The adoption of CDSSs is likely to increase across healthcare systems due to growing concerns about the quality of medical care and discrepancy between real and ideal practice, continuous demands for a meaningful use of health information technology, and the increasing use of and familiarity with advanced technology among new generations of physicians. The results of our study will contribute to the current understanding of the effectiveness of CDSSs in primary care and hospital settings, thereby informing future research and healthcare policy questions related to the feasibility and value of CDSS use in healthcare systems. This trial is seconded by a specialty trial randomizing patients in an oncology setting (ONCO-CODES). ClinicalTrials.gov, https://clinicaltrials.gov/ct2

  12. A Computerized Hospital Patient Information Management System

    Science.gov (United States)

    Wig, Eldon D.

    1982-01-01

    The information processing needs of a hospital are many, with varying degrees of complexity. The prime concern in providing an integrated hospital information management system lies in the ability to process the data relating to the single entity for which every hospital functions - the patient. This paper examines the PRIMIS computer system developed to accommodate hospital needs with respect to a central patient registry, inpatients (i.e., Admission/Transfer/Discharge), and out-patients. Finally, the potential for expansion to permit the incorporation of more hospital functions within PRIMIS is examined.

  13. [Hospital-based Health Technology Assessment].

    Science.gov (United States)

    Zavadil, Martin; Rogalewicz, Vladimír; Kubátová, Ivana; Matloňová, Veronika; Salačová, Kristýna

    Hospital-based HTA (HB-HTA) consists in implementation of assessment activities "in" or "for" hospitals; hence, it covers processes and methods supporting organization and execution of health technology assessment (HTA) at the level of individual hospitals. This process is multidisciplinary, systematic and evidence-based.HB-HTA objectives and methods differ from the classic utilization of HTA at the national regulator level. Most experience and information concerning HB-HTA has originated in two large recent projects: activities of the HB-HTA Interest Group of the HTAi international association established in 2006, and the AdHopHTA European research project (20122015).This paper describes four basic organizational models of HB-HTA, their characteristics and utilization in various countries and hospital types. Results of the AdHopHTA project are analyzed, and recommendations for HB-HTA implementation in Czech hospitals are formulated.Key words: hospital-based HTA, medical device, implementation, hospital strategy.

  14. Comparing a Japanese and a German hospital information system.

    Science.gov (United States)

    Jahn, F; Issler, L; Winter, A; Takabayashi, K

    2009-01-01

    To examine the architectural differences and similarities of a Japanese and German hospital information system (HIS) in a case study. This cross-cultural comparison, which focuses on structural quality characteristics, offers the chance to get new insights into different HIS architectures, which possibly cannot be obtained by inner-country comparisons. A reference model for the domain layer of hospital information systems containing the typical enterprise functions of a hospital provides the basis of comparison for the two different hospital information systems. 3LGM(2) models, which describe the two HISs and which are based on that reference model, are used to assess several structural quality criteria. Four of these criteria are introduced in detail. The two examined HISs are different in terms of the four structural quality criteria examined. Whereas the centralized architecture of the hospital information system at Chiba University Hospital causes only few functional redundancies and leads to a low implementation of communication standards, the hospital information system at the University Hospital of Leipzig, having a decentralized architecture, exhibits more functional redundancies and a higher use of communication standards. Using a model-based comparison, it was possible to detect remarkable differences between the observed hospital information systems of completely different cultural areas. However, the usability of 3LGM(2) models for comparisons has to be improved in order to apply key figures and to assess or benchmark the structural quality of health information systems architectures more thoroughly.

  15. Smart information system for gachon university gil hospital.

    Science.gov (United States)

    Park, Dong Kyun; Jung, Eun Young; Jeong, Byung Hui; Moon, Byung Chan; Kang, Hyung Wook; Tchah, Hann; Han, Gi Seong; Cheng, Woo Sung; Lee, Young Ho

    2012-03-01

    In this research, the hospital information system of Gachon University Gil hospital is introduced and a future strategy for hospital information systems is proposed. This research introduces the development conditions of hospital information system at Gachon University Gil hospital, information about the development of the enterprise resource planning (ERP), a medical service process improvement system, and the personal health record (PHR) system. The medical service process and work efficiency were improved through the medical service process improvement system, which is the most common hospital information system at Gachon University Gil hospital and which includes an emergency medical service system, an online evaluation system and a round support system. Gachon University Gil hospital developed medical service improvement systems to increase work efficiency of medical team and optimized the systems to prove the availability of high-quality medical services for patients and their families. The PHR-based personalized health care solution is under development and will provide higher quality medical service for more patients in the future.

  16. A study on building data warehouse of hospital information system.

    Science.gov (United States)

    Li, Ping; Wu, Tao; Chen, Mu; Zhou, Bin; Xu, Wei-guo

    2011-08-01

    Existing hospital information systems with simple statistical functions cannot meet current management needs. It is well known that hospital resources are distributed with private property rights among hospitals, such as in the case of the regional coordination of medical services. In this study, to integrate and make full use of medical data effectively, we propose a data warehouse modeling method for the hospital information system. The method can also be employed for a distributed-hospital medical service system. To ensure that hospital information supports the diverse needs of health care, the framework of the hospital information system has three layers: datacenter layer, system-function layer, and user-interface layer. This paper discusses the role of a data warehouse management system in handling hospital information from the establishment of the data theme to the design of a data model to the establishment of a data warehouse. Online analytical processing tools assist user-friendly multidimensional analysis from a number of different angles to extract the required data and information. Use of the data warehouse improves online analytical processing and mitigates deficiencies in the decision support system. The hospital information system based on a data warehouse effectively employs statistical analysis and data mining technology to handle massive quantities of historical data, and summarizes from clinical and hospital information for decision making. This paper proposes the use of a data warehouse for a hospital information system, specifically a data warehouse for the theme of hospital information to determine latitude, modeling and so on. The processing of patient information is given as an example that demonstrates the usefulness of this method in the case of hospital information management. Data warehouse technology is an evolving technology, and more and more decision support information extracted by data mining and with decision-making technology is

  17. Usability Evaluation of Ulite Web-Based Picture Archiving and communication Systems Software in Shiraz University of Medical Science Hospitals

    Directory of Open Access Journals (Sweden)

    Somayyeh Zakerabasali

    2015-10-01

    Full Text Available Introduction: Health information systems have the potential of improving the quality of healthcare and treatment procedures and supporting the physicians in their clinical diagnoses. Nowadays, evaluating the usability is widely accepted as a crucial factor in the acceptance and success of the interactive healthcare systems. The present study aimed to evaluate the usability of Ulite Software based on the ISO 9241 model. Method: This analytical-empirical study was performed in 2014. The target population consisted of 50 Utile Software users. The data were collected througha valid and reliable questionnaire containing questions from 10 valid and reliable questionnaires on the related field. The content validity of the questionnaire was evaluated and confirmed by the scholars and experts in Picture Archiving and Communication Systems (PACS and the reliability was estimated through statistical procedures using Chronbach’s alpha Test (α=0.958 . Data were analyzed in SPSS 20 using descriptive statistics and Smart-PLS version 3, using Structural Equation Method and Partial Least Square Approach. Results:The obtained results of the simultaneous analysis of all constructs regarding ISO 9241 model indicated a positive effect of “effectiveness” (P-value= 0.05 and “satisfaction” (P-value= 0.00 on the usability of web-based PACS, while the effect of “efficiency” (P-value= 0.68 was not confirmed. Conclusion: Usability evaluation of Ulite software in the demo version was performed based on the ISO 9241 model. Based on the results, it seems that this software has the necessary effectiveness and user satisfaction has been somewhat successful, but since the evaluation in the demo version aimed to purchasethe system and eliminate initial problems,we should focus on the deficiencies that decrease the efficiency of the system

  18. WebBio, a web-based management and analysis system for patient data of biological products in hospital.

    Science.gov (United States)

    Lu, Ying-Hao; Kuo, Chen-Chun; Huang, Yaw-Bin

    2011-08-01

    We selected HTML, PHP and JavaScript as the programming languages to build "WebBio", a web-based system for patient data of biological products and used MySQL as database. WebBio is based on the PHP-MySQL suite and is run by Apache server on Linux machine. WebBio provides the functions of data management, searching function and data analysis for 20 kinds of biological products (plasma expanders, human immunoglobulin and hematological products). There are two particular features in WebBio: (1) pharmacists can rapidly find out whose patients used contaminated products for medication safety, and (2) the statistics charts for a specific product can be automatically generated to reduce pharmacist's work loading. WebBio has successfully turned traditional paper work into web-based data management.

  19. National test of an experimental hospital pharmacy management information system.

    Science.gov (United States)

    Stolar, M H

    1983-11-01

    An experimental hospital pharmacy management information system (HPMIS) was evaluated in a national pilot test. Approximately 250 information and materials packets were distributed to hospitals that had inquired about the project. Monthly data on pharmacy expenses, personnel use, and productivity were collected for a six-month period by participating hospitals. This information was processed quarterly and converted into the HPMIS indicators; results were categorized according to hospital characteristics and locations. A questionnaire soliciting opinions about the system was sent to participants at the end of the data-collection period. One hundred six hospitals agreed to participate; 84 hospitals submitted data for at least one quarterly period. The range of values for most indicators varied 100-fold; this was attributed to misinterpretation of data item definitions. Based on indicator values, drug and personnel expenses and supportive-personnel use were greater in unit dose hospitals than in hospitals without total unit dose drug distribution systems. Both drug and fluid costs and the extent of supportive-personnel use increased with increasing hospital size. Data-collection time was less in hospitals with computerized pharmacy operations. Responses to the questionnaire indicated that the clinical services indicators were favored the least; however, only a few changes in the data-collection format of the system were suggested. HPMIS appears to be a useful work-measurement tool but needs to be simplified if it to serve as the standard for these systems.

  20. Abuse in Hospital-Based Birth Settings?

    OpenAIRE

    Hodges, Susan

    2009-01-01

    Are laboring and birthing women treated abusively in the hospital? Although seldom recognized as abuse or violence against women, bullying and medical treatments under false pretenses, even in a hospital, constitute abuse and a basic human rights issue that needs attention. Naming the problem is a first step. The power of medical authority, the lack of accountability in the hospital hierarchical system, policies and protocols, and expectations of compliancy all make an environment ripe for ab...

  1. Productivity and quality of Dutch hospitals during system reform

    OpenAIRE

    van Ineveld, Martin; van Oostrum, Jeroen; Vermeulen, Roel; Steenhoek, Adri; van de Klundert, Joris

    2015-01-01

    markdownabstractThis study addresses the productivity of Dutch hospitals since the start of the health systems reform in 2005. We consider DEA based measures, which include efficiency and quality for the complete set of Dutch hospitals and present cross-sectional and longitudinal analysis. In particular, we consider how hospital efficiency has developed. As the reform created an environment of regulated competition, we pay special attention to relative efficiency. Our results suggest that the...

  2. Productivity and quality of Dutch hospitals during system reform

    NARCIS (Netherlands)

    B.M. van Ineveld (Martin); J.M. van Oostrum (Jeroen); R. Vermeulen (Roel); A. Steenhoek (Adri); J.J. van de Klundert (Joris)

    2016-01-01

    markdownabstractThis study addresses the productivity of Dutch hospitals since the start of the health systems reform in 2005. We consider DEA based measures, which include efficiency and quality for the complete set of Dutch hospitals and present cross-sectional and longitudinal analysis. In

  3. Assessment of hospital-based adult triage at emergency receiving areas in hospitals in Northern Uganda.

    Science.gov (United States)

    Opiro, Keneth; Wallis, Lee; Ogwang, Martin

    2017-06-01

    Limited health service resources must be used in a manner which does "the most for the most". This is partly achieved through the use of a triage system. Whereas efforts have been made to introduce paediatric triage in Uganda such as Emergency Triage Assessment and Treatment Plus (ETAT+), it is not clear if hospitals have local protocols for adult triage being used in each setting. To determine the presence of existing hospital triage systems, the cadre of staff undertaking triage and barriers to development/improvement of formal triage systems. This was a descriptive cross-sectional study. Acholi sub-region was randomly selected for the study among the three sub-regions in Northern Uganda. The study was conducted in 6 of the 7 hospitals in the region. It was a written self-administered questionnaire. Thirty-three participants from 6 hospitals consented and participated in the study. Only one hospital (16.7%) of the 6 hospitals surveyed had a formal hospital-based adult triage protocol in place. Only 2 (33.3%) hospitals had an allocated emergency department, the rest receive emergency patients/perform triage from OPD and wards. Lack of training, variation of triage protocols from hospital to another, shortage of staff on duty, absence of national guidelines on triage and poor administrative support were the major barriers to improvement/development of formal triage in all these hospitals. Formal adult hospital-based triage is widely lacking in Northern Uganda and staff do perform subjective "eyeball" judgments to make triage decisions.

  4. Is the incidence of esophageal adenocarcinoma increasing in Japan? Trends from the data of a hospital-based registration system in Akita Prefecture, Japan.

    Science.gov (United States)

    Koizumi, Shigeto; Motoyama, Satoru; Iijima, Katsunori

    2017-11-14

    At present, squamous cell carcinoma accounts for most esophageal cancers in Japan; however, there is concern that the incidence of esophageal adenocarcinoma in Japan is increasing in comparison to Western countries. Akita Prefecture, with a population of 1 million, has the highest rate of esophageal cancer-associated mortality in Japan; the vast majority of these cases are squamous cell carcinoma. The aim of the present study was to investigate the latest trends in the incidence of esophageal adenocarcinoma in Akita Prefecture using a registration system. We examined the data from a collaborative hospital-based registration system for cancer patients. Eleven of the main hospitals in Akita Prefecture participate in this system, which covers 90% of the cancer cases in the region and which provides near population-based data. Using this registration system, we examined the sequential trends in the percentage of adenocarcinoma cases in relation to total esophageal cancer cases in Akita Prefecture from 2007 to 2014. In 2007-2014, a total of 2527 esophageal cancer patients were registered in the system. Among these, only 43 (1.8%) had adenocarcinoma. However, the number of adenocarcinoma patients gradually increased from 1 case in 2007 to 14 cases in 2014. Consequently, the percentage of adenocarcinoma cases showed a significant increase from 0.66% in the first 4 years of the study period to 2.5% in the latter 4 years of the study period (P registration data for 2007-2014 suggest that the incidence of esophageal adenocarcinoma may have begun to increase in Akita Prefecture; this may reflect recent trends in other parts of Japan.

  5. Mesiodens: A Hospital Based Study.

    Science.gov (United States)

    Limbu, Senchhema; Dikshit, Parajeeta; Gupta, Sujaya

    2017-09-08

     Background: A mesiodens, is the most frequent supernumerary tooth present in the maxillary central incisor region. This study is conducted to know the radiographic characteristics and management of mesiodens in children visiting hospital. A cross-sectional retrospective data collection was done from hospital dental records of children who visited the institution from December 2015-December 2016. Radiographic characteristic of mesiodens including the number, shape, position, direction of crown and complication caused by mesiodens were recorded. Data were analyzed using IBM SPSS v.20.0. Out of 1871 dental records, it was found that 40 children had 53 mesiodens, with male female ratio of 3:1 and most of them were discovered at 8 years. Majority of mesiodens, 54.7% were erupted, conical, palatally placed with 77.3% vertically directed crown.Complications associated with it were crowding followed by diastema and delayed eruption. Among 40 children, one had three mesiodens, eleven had two mesiodens and rest had one each. Radiographically fully formed tooth was seen in 29 mesiodens. Immature apex was seen in 38 central incisors associated with mesiodens. Management undertaken was simple/surgical extraction and only few cases were kept for periodic observation. Periodic radiographs act as an important tool for clinicians in detecting and managing mesiodens.

  6. Hubble Systems Optimize Hospital Schedules

    Science.gov (United States)

    2009-01-01

    Don Rosenthal, a former Ames Research Center computer scientist who helped design the Hubble Space Telescope's scheduling software, co-founded Allocade Inc. of Menlo Park, California, in 2004. Allocade's OnCue software helps hospitals reclaim unused capacity and optimize constantly changing schedules for imaging procedures. After starting to use the software, one medical center soon reported noticeable improvements in efficiency, including a 12 percent increase in procedure volume, 35 percent reduction in staff overtime, and significant reductions in backlog and technician phone time. Allocade now offers versions for outpatient and inpatient magnetic resonance imaging (MRI), ultrasound, interventional radiology, nuclear medicine, Positron Emission Tomography (PET), radiography, radiography-fluoroscopy, and mammography.

  7. Participatory simulation in hospital work system design

    DEFF Research Database (Denmark)

    Andersen, Simone Nyholm

    When ergonomic considerations are integrated into the design of work systems, both overall system performance and employee well-being improve. A central part of integrating ergonomics in work system design is to benefit from emplo y-ees’ knowledge of existing work systems. Participatory simulation...... (PS) is a method to access employee knowledge; namely employees are involved in the simulation and design of their own future work systems through the exploration of models representing work system designs. However, only a few studies have investigated PS and the elements of the method. Yet...... understanding the elements is essential when analyzing and planning PS in research and practice. This PhD study investigates PS and the method elements in the context of the Danish hospital sector, where PS is applied in the renewal and design of public hospitals and the work systems within the hospitals...

  8. Record of hospitalizations for ambulatory care sensitive conditions: validation of the hospital information system

    Directory of Open Access Journals (Sweden)

    Tania Cristina Morais Santa Barbara Rehem

    2013-09-01

    Full Text Available OBJECTIVE: to estimate the sensitivity, specificity and positive and negative predictive values of the Unified Health System's Hospital Information System for the appropriate recording of hospitalizations for ambulatory care-sensitive conditions. METHOD: the hospital information system records for conditions which are sensitive to ambulatory care, and for those which are not, were considered for analysis, taking the medical records as the gold standard. Through simple random sampling, a sample of 816 medical records was defined and selected by means of a list of random numbers using the Statistical Package for Social Sciences. RESULT: the sensitivity was 81.89%, specificity was 95.19%, the positive predictive value was 77.61% and the negative predictive value was 96.27%. In the study setting, the Hospital Information System (SIH was more specific than sensitive, with nearly 20% of care sensitive conditions not detected. CONCLUSION: there are no validation studies in Brazil of the Hospital Information System records for the hospitalizations which are sensitive to primary health care. These results are relevant when one considers that this system is one of the bases for assessment of the effectiveness of primary health care.

  9. Towards elicitation of users requirements for hospital information system: from a care process modelling technique to a web based collaborative tool.

    Science.gov (United States)

    Staccini, Pascal M; Joubert, Michel; Quaranta, Jean-Francois; Fieschi, Marius

    2002-01-01

    Growing attention is being given to the use of process modeling methodology for user requirements elicitation. In the analysis phase of hospital information systems, the usefulness of care-process models has been investigated to evaluate the conceptual applicability and practical understandability by clinical staff and members of users teams. Nevertheless, there still remains a gap between users and analysts in their mutual ability to share conceptual views and vocabulary, keeping the meaning of clinical context while providing elements for analysis. One of the solutions for filling this gap is to consider the process model itself in the role of a hub as a centralized means of facilitating communication between team members. Starting with a robust and descriptive technique for process modeling called IDEF0/SADT, we refined the basic data model by extracting concepts from ISO 9000 process analysis and from enterprise ontology. We defined a web-based architecture to serve as a collaborative tool and implemented it using an object-oriented database. The prospects of such a tool are discussed notably regarding to its ability to generate data dictionaries and to be used as a navigation tool through the medium of hospital-wide documentation.

  10. Maturity of hospital information systems: Most important influencing factors.

    Science.gov (United States)

    Vidal Carvalho, João; Rocha, Álvaro; Abreu, António

    2017-07-01

    Maturity models facilitate organizational management, including information systems management, with hospital organizations no exception. This article puts forth a study carried out with a group of experts in the field of hospital information systems management with a view to identifying the main influencing factors to be included in an encompassing maturity model for hospital information systems management. This study is based on the results of a literature review, which identified maturity models in the health field and relevant influencing factors. The development of this model is justified to the extent that the available maturity models for the hospital information systems management field reveal multiple limitations, including lack of detail, absence of tools to determine their maturity and lack of characterization for stages of maturity structured by different influencing factors.

  11. Hospital Quality Systems - working mechanisms unraveled.

    NARCIS (Netherlands)

    Schoten, S. van; Groenewegen, P.; Wagner, C.

    2015-01-01

    Context: Quality systems were implemented in healthcare institutions to assure and improve the quality of care. Despite the fact that all Dutch hospitals have implemented a quality system, incidents persist to surface. How could this be explained? The current research was set out to gain thorough

  12. A Comparative Study of Activity-Based Costing vs. Current Pricing System for Pathology Examinations at Okmeydani Training and Research Hospital, Turkey.

    Science.gov (United States)

    Yarikkaya, Enver; Özekinci, Selver; Sargan, Aytül; Durmuş, Şenay Erdoğan; Yildiz, Fetin Rüştü

    2017-01-01

    To provide real cost data for pathology examinations by using activity-based costing method, in order to provide means to departments, health administrators and the social security institution to achieve improvements in financial planning, quality and cost control. The cost of the histopathological examinations, which were accepted by the Department of Pathology at Okmeydanı Training and Research Hospital during August 2014, was calculated using the activity-based costing method. The costs were compared with the amounts specified in the Healthcare Implementation Notification Tariff and the conventional volume-based costing. Most pathology examinations listed within a given band in the Healthcare Implementation Notification Tariff show variations in unit costs. The study found that the costs of 77.4% of the examinations were higher than the prices listed in the Healthcare Implementation Notification Tariff. The pathology examination tariffs specified in the Healthcare Implementation Notification do not reflect the real costs of the examinations. The costs that are calculated using the activity-based costing system may vary according to the service types and levels of health care institutions. However, the main parameters of the method used in the study reflect the necessity of a more accurate banding of pathology examinations. The banding specified by the Healthcare Implementation Notification Tariff needs to be revised to reflect the real costs in Turkey.

  13. The assessment of Picture Archiving and Communication System based on Canadian Infoway PACS Opinion Survey in Teaching Hospitals of Shiraz University of Medical Sciences

    Directory of Open Access Journals (Sweden)

    Fatemeh Bahador

    2017-10-01

    Full Text Available Introduction: Today the use of information technology in accordance with the rapid environmental changes and flexibility acquisition is necessary and unavoidable. Picture Archiving and Communication System (PACS is one of the medical information technology used in health facilities. PACS provides the images archive and transmission possibility electronically in different units of the teaching and treatment centers. This study aimed to assess the PACS system in teaching hospitals of Shiraz University of Medical Sciences based on a survey of Canadian Infoway. Method: This descriptive cross-sectional study was performed on 53 individuals selected through Two-Stage Stratified Random Sampling. The study population consisted of 156 PACS users in Shiraz University of Medical Sciences hospitals which were equipped with the PACS system in 2015. Data were collected by the valid and reliable customized questionnaire of Canadian Infoway. The reliability was measured by a pilot study on 25 PACS users; Cronbach’s Alpha was estimated 0.78. Data were analyzed using SPSS 18. Also, frequency, mean, standard deviation were used. Results: The results are presented in three sections: environment (Background Variables, benefits and challenges of PACS. As to the system availability, 20.8% of the users in the clinic, 75.5% in the diagnostic imaging department, only 3.8% in offices had access to the PACS. As to system accessibility, 49.1% of the users just had access to tests, 5.7% only to the reports, and 45.3% to both reports and tests. With respect to benefits of PACS, the mean was 4.16 (SD: 0.5 (five-point scale 1-5 estimated, and in challenges, the mean was 3.48(SD: 0.5 (five-point scale 1-5. Conclusion: The results showed that although PACS could eliminate many restrictions concerning the use of radiology images and films, there were challenges in this regard. Users are recommended to have access to PACS in all clinics, physicians’ offices, and diagnostic

  14. Evaluation of clinical rules in a standalone pharmacy based clinical decision support system for hospitalized and nursing home patients.

    Science.gov (United States)

    de Wit, Hugo A J M; Mestres Gonzalvo, Carlota; Cardenas, Jenny; Derijks, Hieronymus J; Janknegt, Rob; van der Kuy, Paul-Hugo M; Winkens, Bjorn; Schols, Jos M G A

    2015-06-01

    To improve the current standalone pharmacy clinical decision support system (CDSS) by identifying and quantifying the benefits and limitations of the system. Alerts and handling of the executed clinical rules were extracted from the CDSS from the period September 2011 to December 2011. The number of executed clinical rule alerts, number of actions on alerts, and the reason why alerts were classified as not relevant were analyzed. The alerts where considered clinically relevant when the pharmacist needed to contact the physician. The 4065 alerts have been separated into: 1137 (28.0%) new alerts, 2797 (68.8%) repeat alerts and 131 (3.2%) double alerts. When the alerts were analyzed, only 3.6% were considered clinically relevant. Reasons why alerts were considered as not to be relevant were: (a) the dosage was correct or already adjusted, (b) the drug was (temporarily) stopped and (c) the monitored laboratory value or drug dosage had already reverted to be within the reference limits. The reasons for no action were linked to three categorical limitations of the used system: 'algorithm alert criteria', 'CDSS optimization', and 'data delivery'. This study highlighted a number of ways in which the CDSS could be improved. These different aspects have been identified as important for developing an efficient CDSS. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  15. The American General Hospital as a Complex Social System

    Science.gov (United States)

    Georgopoulos, Basil S.; Matejko, Aleksander

    1967-01-01

    Based on data from and about the medical, nursing, and administrative staffs in a probability sample of general hospitals, involving 41 institutions and some 2,400 respondents, certain aspects of the hospital social system are examined in each of the following basic problem-areas: organizational and member goal attainment; availability and allocation of organizational resources; organizational coordination; social integration; intraorganizational strain; and organizational adaptation. These areas are examined separately and in relation to one another, as a basis for understanding and assessing the overall effectiveness of the hospital as a complex social organization. Hospital effectiveness is viewed in the context of open system theory, as a joint function of the relative success with which the organization handles its problems in these key areas. Findings concerning a number of social-psychological variables in each area are presented and discussed, with emphasis on the interdependence of the areas and on organizational issues and implications. The results show some of the basic strengths and weaknesses of the system. Important differences associated with hospital size and affiliation are also discussed to illustrate the typical profile of the American general hospital and significant variations from it. Similarly, differences among the principal groups in the system are presented, where appropriate. Finally, promising directions for future organizational research in the hospital field are briefly presented.

  16. Acceptability of picture archiving and communication system (PACS) among hospital healthcare personnel based on a unified theory of acceptance and use of technology.

    Science.gov (United States)

    Ahmadi, Maryam; Mehrabi, Nahid; Sheikhtaheri, Abbas; Sadeghi, Mojtaba

    2017-09-01

    The picture archiving and communication system (PACS) is a healthcare system technology which manages medical images and integrates equipment through a network. There are some theories about the use and acceptance of technology by people to describe the behavior and attitudes of end users towards information technologies. We investigated the influential factors on users' acceptance of PACS in the military hospitals of Tehran. In this applied analytical and cross-sectional study, 151 healthcare employees of military hospitals who had experience in using the PACS system were investigated. Participants were selected by census. The following variables were considered: performance expectancy, efforts expectancy, social influence, facilitating conditions and behavioral intention. Data were gathered using a questionnaire. Its validity and reliability were approved by a panel of experts and was piloted with 30 hospital healthcare staff (Cronbach's alpha =0.91). Spearman correlation coefficient and multiple linear regression analysis were used in analyzing the data. Expected performance, efforts expectancy, social impact and facilitating conditions had a significant relationship with behavioral intention. The multiple regression analysis indicated that only performance expectancy can predict the user's behavioral intentions to use PACS technology. Performance and effort expectancies are quite influential in accepting the use of PACS in hospitals. All healthcare personnel should become aware that using such technology is necessary in a hospital. Knowing the influencing factors that affect the acceptance of using new technology can help in improving its use, especially in a healthcare system. This can improve the offered healthcare services' quality.

  17. Mount Sinai Hospital's approach to Ontario's Health System Funding Reform.

    Science.gov (United States)

    Chalk, Tyler; Lau, Davina; Morgan, Matthew; Dietrich, Sandra; Beduz, Mary Agnes; Bell, Chaim M

    2014-01-01

    In April 2012, the Ontario government introduced Health System Funding Reform (HSFR), a transformational shift in how hospitals are funded. Mount Sinai Hospital recognized that moving from global funding to a "patient-based" model would have substantial operational and clinical implications. Adjusting to the new funding environment was set as a top corporate priority, serving as the strategic basis for re-examining and redesigning operations to further improve both quality and efficiency. Two years into HSFR, this article outlines Mount Sinai Hospital's approach and highlights key lessons learned. Copyright © 2014 Longwoods Publishing.

  18. (A Hospital-based Histopathological Study)

    African Journals Online (AJOL)

    ABSTRACT. This is a hospital based retrospective histopathological study of urological tumours in 10 years. Specimens consisted of all surgical excisions, trucut and fine needle biopsies of kidney, prostate, urinary bladder, testis and penis. Urological tumours accounted for 11.45% of all malignant tumours during the period ...

  19. 78 FR 50495 - Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the...

    Science.gov (United States)

    2013-08-19

    ... Episode-of-Care for Acute Myocardial Infarction (AMI) Measure 7. Electronic Clinical Quality Measures 8... for Acute Care Hospitals and the Long Term Care; Hospital Prospective Payment System and Fiscal Year... 0938-AR73 Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and...

  20. Efficiency and hospital effectiveness in improving Hospital Consumer Assessment of Healthcare Providers and Systems ratings.

    Science.gov (United States)

    Al-Amin, Mona; Makarem, Suzanne C; Rosko, Michael

    2016-01-01

    Efficiency has emerged as a central goal to the operations of health care organizations. There are two competing perspectives on the relationship between efficiency and organizational performance. Some argue that organizational slack is a waste and that efficiency contributes to organizational performance, whereas others maintain that slack acts as a buffer, allowing organizations to adapt to environmental demands and contributing to organizational performance. As value-based purchasing becomes more prevalent, health care organizations are incented to become more efficient and, at the same time, improve their patients' experiences and outcomes. Unused slack resources might facilitate the timely implementation of these improvements. Building on previous research on organizational slack and inertia, we test whether efficiency and other organizational factors predict organizational effectiveness in improving Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) ratings. We rely on data from the American Hospital Association and HCAHPS. We estimate hospital cost-efficiency by Stochastic Frontier Analysis and use regression analysis to determine whether efficiency, competition, hospital size, and other organizational factors are significant predictors of hospital effectiveness. Our findings indicate that efficiency and hospital size have a significant negative association with organizational ability to improve HCAHPS ratings. Although achieving organizational efficiency is necessary for health care organizations, given the changes that are currently occurring in the U.S. health care system, it is important for health care managers to maintain a certain level of slack to respond to environmental demands and have the resources needed to improve their performance.

  1. Study of Development for RFID System to Hospital Environment.

    Science.gov (United States)

    Hong, Seung Kwon; Sung, Myung-Whun

    2015-01-01

    RFID/USN develops information systems for anytime, anywhere to anybody access Electronic Medical Records (EMR). The goal of the present study is to develop a RFID/USN-based information system for the hospital environment. First, unable to recognize, second, able to recognize as a pursuit of place and suppose the time of medical examination. A retrospective analysis of 235 RFID monitoring results, from four ENT ambulatory clinics of Seoul National University Hospital were extracted by a reader program and monitoring of RFID tag (2006.11.16~2006.12.16). RFID detection for sensing reader of this study has been put into representing "place" and "spending time" of patients for medical history taking and examination. Through the RFID of detection for specific place and spending time of medical examination, RFID/USN develops information system progressing in the EMR of hospital system.

  2. Information Systems Evaluation: A Study in Hospital Organizations

    Directory of Open Access Journals (Sweden)

    Laís Coelho Ayala

    2012-06-01

    Full Text Available Given increasing demand for timely and accurate information to support decision making, hospitals, a particularly complex type of service organization, have increasingly resorted to a wide range of tools such as the Clinical Information Systems (CIS. However, research has shown that such systems do not always meet hospital managers’ needs, and assessment processes are necessary both before and after CIS implementation. Aiming to identify whether the CIS do meet hospital managers’ information needs and do fit in the specificities of such organizations, this paper reports on the assessment of four CIS based on the perspective of their users in four hospitals in the Metropolitan Region of Belo Horizonte, State of Minas Gerais, Brazil. The data was collected by means of semi-structured interviews and non-obtrusive observation. On the one hand, the result shows that the four organizations have difficulties in using their systems, such as accessibility problems, inadequate training and system underutilization. On the other hand, they also benefit from such systems, as they make processes faster and enable information control. One can say that the results from this research contribute to a better understanding of evaluating information systems in hospitals. Managers of such organizations can benefit from these results when seeking to evaluate and improve their information systens.

  3. Acceptability of picture archiving and communication system (PACS) among hospital healthcare personnel based on a unified theory of acceptance and use of technology

    Science.gov (United States)

    Ahmadi, Maryam; Mehrabi, Nahid; Sheikhtaheri, Abbas; Sadeghi, Mojtaba

    2017-01-01

    Background and aim The picture archiving and communication system (PACS) is a healthcare system technology which manages medical images and integrates equipment through a network. There are some theories about the use and acceptance of technology by people to describe the behavior and attitudes of end users towards information technologies. We investigated the influential factors on users’ acceptance of PACS in the military hospitals of Tehran. Methods In this applied analytical and cross-sectional study, 151 healthcare employees of military hospitals who had experience in using the PACS system were investigated. Participants were selected by census. The following variables were considered: performance expectancy, efforts expectancy, social influence, facilitating conditions and behavioral intention. Data were gathered using a questionnaire. Its validity and reliability were approved by a panel of experts and was piloted with 30 hospital healthcare staff (Cronbach’s alpha =0.91). Spearman correlation coefficient and multiple linear regression analysis were used in analyzing the data. Results Expected performance, efforts expectancy, social impact and facilitating conditions had a significant relationship with behavioral intention. The multiple regression analysis indicated that only performance expectancy can predict the user’s behavioral intentions to use PACS technology. Conclusion Performance and effort expectancies are quite influential in accepting the use of PACS in hospitals. All healthcare personnel should become aware that using such technology is necessary in a hospital. Knowing the influencing factors that affect the acceptance of using new technology can help in improving its use, especially in a healthcare system. This can improve the offered healthcare services’ quality. PMID:29038717

  4. [Hospital organizational analysis based on the Mintzberg model: the case of Sheikh Zayed Hospital, Rabat].

    Science.gov (United States)

    Makhloufi, Imane; Saadi, Janad; El Hiki, Lahcen; El Hassani, Amine

    2012-01-01

    The new system of hospital governance requires health institutions to develop new managerial, financial and social skills beyond their public service duties. As part of this new approach, the organizational modernization of hospitals involves introducing good management practices. However, managing the transition requires taking into account the specificities of existing organizational systems. Organizational systems are generally difficult to model and involve diverse and sometimes competing interests, concerns, habits, languages, cultures, tools and representations. This explains the high failure rate observed in hospital development projects at an organizational level. A number of organizational theories from a range of disciplines (sociology, biology, history, etc.) have examined the question of organization in hospitals. The many theories developed in this area are not incompatible. Rather, they form a set of useful tools for the analysis of organizational management. The purpose of this study was to conduct an organizational analysis of Sheikh Zayed Hospital (Rabat) based on the Mintzberg model as a prerequisite for the development and implementation of a restructuring plan.

  5. [Relationship between cost systems and hospital expenditure].

    Science.gov (United States)

    García-Cornejo, Beatriz; Pérez-Méndez, José A

    2017-08-31

    To analyze the relationship between the degree of development of hospital cost systems (CS) implemented by the regional health services (RHS) and the variation in unit cost of hospitals in Spanish National Health Service (NHS) between 2010 and 2013 and to identify other explanatory factors of this variation. A database of NHS hospitals was constructed from exclusively public sources. Using a multilevel regression model, explaining factors of the variation in unit cost (cost per weighted unit of activity [WAU]) of a sample of 170 hospitals were analyzed. The variables representative of the degree of development of CS are associated in a negative and significant way with the variation of the cost per WAU. It is observed that if a high-level development CS is used the cost variation per WAU would be reduced by close to 3.2%. There is also a negative and significant relationship between the variation in the cost per WAU and the variations in the percentage of high technology and the hospital occupancy rate. On the other hand, the variations in the average cost of personnel and in the number of workers per 100 beds are associated in a positive and significant way with the variation of the cost per WAU. In the period analysed, during which the main health expenditure adjustment was made, the control in hospital unit cost is associated not only with spending cuts but also with aspects related to their management, such as the implementation of more developed CS. Copyright © 2017 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

  6. Prevalence and transmission of antimicrobial resistance among Aeromonas populations from a duckweed aquaculture based hospital sewage water recycling system in Bangladesh.

    Science.gov (United States)

    Rahman, Mokhlasur; Huys, Geert; Kühn, Inger; Rahman, Motiur; Möllby, Roland

    2009-10-01

    In order to investigate the influence of a duckweed aquaculture based hospital sewage water recycling plant on the prevalence and dissemination of antibiotic resistance, we made use of an existing collection of 1,315 Aeromonas isolates that were previously typed by the biochemical fingerprinting PhP-AE system. In these treatment plant, hospital raw sewage water is first collected in a settlement pond (referred to as sewage water in this study) and is then transferred to a lagoon, where the duckweed (Lemnaceae) is grown (referred to as lagoon). The duckweed is harvested and used as feed for the fish in a separate pond (referred to as fish pond). From this collection, representatives of 288 PhP types were subjected to antibiotic susceptibility testing for eight antimicrobials by broth microdilution method. The overall resistance rates among Aeromonas isolates from the treatment plant were highest for ampicillin (87%) and erythromycin (79%) followed by cephalothin (58%), nalidixic acid (52%), streptomycin (51%), tetracycline (31%), chloramphenicol (13%) and gentamicin (8%). A significantly lower prevalence of antibiotic resistance was found in Aeromonas from environmental control water, patient stool samples, duckweed and fish compared to sewage water isolates. The prevalence of resistance in the sewage water was not significantly reduced compared to the lagoon water and fish pond. Throughout the treatment system, the frequencies of resistant strains were found to diminish during the sewage water purification process, i.e. in the lagoon where sewage water is used to grow the duckweed. However, the frequency of resistant strains again increased in the fish pond where sewage grown duckweed is used for aquaculture. Among the selected isolates, two multiresistant clonal groups of Aeromonas caviae HG4 were identified that exhibited indistinguishable PhP and amplified fragment length polymorphism fingerprints and shared a common plasmid of approximately 5 kb

  7. Case-based reimbursement for psychiatric hospital care.

    Science.gov (United States)

    Sederer, L I; Eisen, S V; Dill, D; Grob, M C; Gougeon, M L; Mirin, S M

    1992-11-01

    A fixed-prepayment system (case-based reimbursement) for patients initially requiring hospital-level care was evaluated for one year through an arrangement between a private nonprofit psychiatric hospital and a self-insured company desiring to provide psychiatric services to its employees. This clinical and financial experiment offered a means of containing costs while monitoring quality of care. A two-group, case-control study was undertaken of treatment outcomes at discharge, patient satisfaction with hospital care, and service use and costs during the program's first year. Compared with costs for patients in the control group, costs for those in the program were lower per patient and per admission; cumulative costs for patients requiring rehospitalization were also lower. However, costs for outpatient services for patients in the program were not calculated. Treatment outcomes and patients' satisfaction with hospital care were comparable for the two groups.

  8. STUDY ON WASTEWATER TREATMENT SYSTEMS IN HOSPITALS OF IRAN

    Directory of Open Access Journals (Sweden)

    M. Majlesi Nasr, A. R. Yazdanbakhsh

    2008-07-01

    Full Text Available Nowadays, water resources shortage is one of the most important issues for environmental engineers and managers as well as its conservation due to population growth and ever-increasing water demands. Besides, hospital wastewater has the same quality as municipal wastewater, but may also potentially contain various hazardous components. In this paper, physical and chemical specifications of produced wastewater in hospitals of Iran were investigated experiments. Results were compared with the effluent parameters of wastewater standards of Iranian Department of the Environment. 70 governmental hospitals from different provinces of Iran were selected by purposive (non-random sampling method. For data analysis, SPSS and EXCEL softwares were applied. The findings of the study showed that 52% of the surveyed hospitals were not equipped and 48% were equipped with wastewater treatment systems. The mean of Biochemical Oxygen Demand, Chemical Oxygen Demand and Total Suspended Solids of the effluent of wastewater treatment systems were reported as 113, 188 and 99 mg/L respectively. Comparison of the indicators between effluents of wastewater treatment systems and the standards of Departments of the Environment, showed the inefficiency in these systems and it was concluded that despite the recent improvements in hospital wastewater treatment systems, they should be upgraded based on the remarks in this paper.

  9. Revenue management system for the hospitality

    OpenAIRE

    Kalinka Pavlova

    2017-01-01

    The purpose of this study is to describe the essence of the revenue management system, applicable for entities in the hospitality industry, as a multidisciplinary concept, that draws its features from a variety of established academic areas, by consistently clarifying its intrinsic elements. This paper is intended to examine the revenue-management related theory, in regards with its generation and evolution, essence, as well as characteristics of service industries applying revenue management...

  10. The Hospital System and the Urban Resilience

    Directory of Open Access Journals (Sweden)

    Francesca Pirlone

    2012-07-01

    Full Text Available The concept of resilience is critical when addressing the issue of natural hazards. The role of an urban planner is to analyze the territorial system, consisting of several functional sub-systems (housing, education, health, etc.. and its vulnerability. In order to have a specific knowledge of the territory in question, before the occurrence of a disaster it would be necessary, for each functional system, analyze various aspects and define risk simulations. In a city, in fact, there are strategic elements that should not lose functionality during or following a natural event; the definition of specific scenarios could put structures exposed to risk on safety in order not to compromise the system. In this paper I report a specific experience of research carried out within the hospital system that, in case of occurrence of a natural event, is often simultaneously exposed, and therefore need of rescue, and it is a dispenser of rescue. It’s considered strategic because it has to ensure the functionality of its service regardless of the occurrence of external events, such as natural ones; its functionality must be ensured in the continuum. In today is not very thorough the scientific literature about the analysis of the hospital system in respect of such events. Given the importance of the theme there are several initiatives, also promoted by The Italian Civil Protection, in particular the drafting of hospital emergency plans, which cover issues such as fire, road accidents, floods, ... Interesting was the collaboration between the Italian Civil Protection Department with Applied Technology Council for the planning of a background paper intended for the preparation of earthquake emergency plans, within which there are also aspects of prevention such as the evaluation of seismic vulnerability of hospitals themselves. The described methodology has allowed the definition of risk simulations for the hospital system, starting from the determination of

  11. Relative performance of for-profit psychiatric hospitals in investor-owned systems and nonprofit psychiatric hospitals.

    Science.gov (United States)

    McCue, M J; Clement, J P

    1993-01-01

    The authors analyzed the differences in operational and financial performance between 42 matched pairs of for-profit psychiatric hospitals belonging to multifacility organizations and nonprofit psychiatric hospitals for the fiscal years ending in 1986 through 1990. The pairs of short-term hospitals were matched according to location, standard metropolitan statistical area, or wage index. Analyses were based on data on these hospitals from the Health Care Financing Administration. The groups of variables studied included the hospitals' operational performance and productivity, profitability and payer mix, revenue and expenses, and capital structure. Differences in the mean values of the variables for the for-profit hospitals and the nonprofit hospitals were analyzed by pairwise t tests. The for-profit organization hospitals had significantly higher net revenue, lower salary expenses, and higher profits than the nonprofit hospitals. Patients in the for-profit hospitals had longer stays, and these hospitals had fewer full-time employees per adjusted inpatient day and per adjusted discharge. The higher prices and operating margins of the for-profit hospitals belonging to investor-owned systems reflect the profit-maximizing goal of these facilities. The ability of for-profit organization hospitals to achieve economies of scale in expenses, however, was not evident except in the case of salary expenses.

  12. Timing of surgery for hip fracture and in-hospital mortality: a retrospective population-based cohort study in the Spanish National Health System

    Directory of Open Access Journals (Sweden)

    Librero Julián

    2012-01-01

    Full Text Available Abstract Background While the benefits or otherwise of early hip fracture repair is a long-running controversy with studies showing contradictory results, this practice is being adopted as a quality indicator in several health care organizations. The aim of this study is to analyze the association between early hip fracture repair and in-hospital mortality in elderly people attending public hospitals in the Spanish National Health System and, additionally, to explore factors associated with the decision to perform early hip fracture repair. Methods A cohort of 56,500 patients of 60-years-old and over, hospitalized for hip fracture during the period 2002 to 2005 in all the public hospitals in 8 Spanish regions, were followed up using administrative databases to identify the time to surgical repair and in-hospital mortality. We used a multivariate logistic regression model to analyze the relationship between the timing of surgery ( Results Early surgery was performed on 25% of the patients. In the unadjusted analysis early surgery showed an absolute difference in risk of mortality of 0.57 (from 4.42% to 3.85%. However, patients undergoing delayed surgery were older and had higher comorbidity and severity of illness. Timeliness for surgery was not found to be related to in-hospital mortality once confounding factors such as age, sex, chronic comorbidities as well as the severity of illness were controlled for in the multivariate analysis. Conclusions Older age, male gender, higher chronic comorbidity and higher severity measured by the Risk Mortality Index were associated with higher mortality, but the time to surgery was not.

  13. The impact of health system reform plan on the hospital\\'s performance indicators of Lorestan University of Medical Sciences

    Directory of Open Access Journals (Sweden)

    Reza Dadgar

    2017-10-01

    Conclusion: The health system  reform plan has been positive changes in indicators of hospital performance. Therefore, while considering the current trend of continuous improvement, the continuity of the project was advised based on the results of this study.

  14. Hospital Mortality In Alwahda Hospital, Derna, Libya Based On A ...

    African Journals Online (AJOL)

    care delivery. Methods: This is a retrospective study evaluating the causes of deaths which occurred during the years 1997-2006 in Alwahda hospital, Derna, Libya. The leading causes of deaths were classified according to the nature of the ...

  15. 75 FR 60640 - Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the...

    Science.gov (United States)

    2010-10-01

    ..., 485, and 489 RIN 0938-AP80; RIN 0938-AP33 Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System Changes and FY...: Correction of final rules and interim final rule with comment period. SUMMARY: This document corrects...

  16. [The revised system of hospitalization for medical care and protection].

    Science.gov (United States)

    Fukuo, Yasuhisa

    2014-01-01

    community by persons with mental disorders, efforts will be made to enhance psychiatric care for them, with guidelines to be developed to ensure the provision of medical care to persons with mental disorders. The revised law clarifies that members of psychiatric review boards shall be "persons with expert knowledge and experience pertaining to the health and/or welfare of persons with mental disorders." Provision is made for a review of conditions related to implementation of the revised law approximately three years after it takes effect, with measures to be taken as necessary based on results of the review. The main focus of this presentation will be the revisions to the system of hospitalization for medical care and protection, and the deletion of provisions relating to the system of guardianship.

  17. [Introduction of an accreditation system for hospital informed consent forms].

    Science.gov (United States)

    López-Picazo, J J; Tomás-Garcia, N; Calle-Urra, J E; Parra-Hidalgo, P; Valverde-Iniesta, J J

    2015-01-01

    To describe an accreditation system for informed consent forms (ICF) in a tertiary hospital, as an intervention to improve their quality, and to check the improvements achieved. Following an external evaluation of the ICF quality in a public hospital in Murcia (Spain), an accreditation committee set the ICF requirements and associated procedures. Effectiveness is assessed by comparing two external evaluations carried out by the EMCA Program (2011 and 2013) and based on 19 criteria and a sample of 60 ICF for every public hospital in Murcia Region. To be accredited, every ICF must meet the 19 external criteria plus 5 based on legibility, readability and scientific and technical validity. A form to fill in the contents of every ICF was agreed, which would be reviewed, approved and validated for five years. Before the implementation, 8.2 defects/ICF were detected. The accreditation system obtained an 89% improvement (0.9 defects/ICF) and achieved significant improvements in 18 criteria, 16 of which are benchmarked. The accreditation system achieved a substantial improvement in the ICF (obtaining a better result in external evaluations) and guarantees their contents, legibility and readability. This system needs to be extended to other hospitals, since it is not clear whether common ICFs would be suitable. However, this improvement is structural and does not guarantee that the overall information/consent procedure is done properly, thus complementary strategies for measurement and improvement are required. Copyright © 2014 SECA. Published by Elsevier Espana. All rights reserved.

  18. Revenue risk and price transparency in hospital-based laboratories.

    Science.gov (United States)

    Myers, Jeffrey H

    2015-11-01

    Two developments with important revenue implications for hospital laboratories demand the attention of hospital finance leaders: > Significant differences in pricing between higher-priced hospital-based laboratory services and lower-priced services delivered by commercial laboratories give patients a disincentive to use the hospital-based services. > Hospital operating revenue will be substantially affected beginning in 2017 by deep, statutory cuts in payment for the highest-volume tests on the Part B Clinical Laboratory Fee Schedule.

  19. Creating a balanced scorecard for a hospital system.

    Science.gov (United States)

    Pink, G H; McKillop, I; Schraa, E G; Preyra, C; Montgomery, C; Baker, G R

    2001-01-01

    In 1999, hospitals in Ontario, Canada, collaborated with a university-based research team to develop a report on the relative performance of individual hospitals in Canada's most populated province. The researchers used the balanced-scorecard framework advocated by Kaplan and Norton. Indicators of performance were developed in four areas: clinical utilization and outcomes, patient satisfaction, system integration and change, and financial performance and condition. The process of selecting, calculating, and validating meaningful indicators of financial performance and condition is outlined. Lessons learned along the way are provided. These lessons may prove valuable to other finance researchers and practitioners who are engaged in performance measurement endeavors.

  20. Revenue management system for the hospitality

    Directory of Open Access Journals (Sweden)

    Kalinka Pavlova

    2017-03-01

    Full Text Available The purpose of this study is to describe the essence of the revenue management system, applicable for entities in the hospitality industry, as a multidisciplinary concept, that draws its features from a variety of established academic areas, by consistently clarifying its intrinsic elements. This paper is intended to examine the revenue-management related theory, in regards with its generation and evolution, essence, as well as characteristics of service industries applying revenue management. The revenue management elements, related with economics, marketing, strategic management, information technology and finance, are summarized and described.

  1. Culinary and hospitality teaching as a research-based profession

    African Journals Online (AJOL)

    Culinary and hospitality teaching is henceforth referred to by the inclusive term hospitality. Hospitality is not currently a research-based profession. If it were, I have no doubt that culinary and hospitality teaching would be more effective and much more satisfying for both teachers and students, and be acknowledged by ...

  2. Activity-based computing for medical work in hospitals

    DEFF Research Database (Denmark)

    Bardram, Jakob Eyvind

    2009-01-01

    tasks such as word processing while sitting at a desk. This article presents the concept of Activity-Based Computing (ABC), which seeks to create computational support for human activities. The ABC approach has been designed to address activity-based computing support for clinical work in hospitals......Studies have revealed that people organize and think of their work in terms of activities that are carried out in pursuit of some overall objective, often in collaboration with others. Nevertheless, modern computer systems are typically single-user oriented, that is, designed to support individual....... In a hospital, the challenges arising from the management of parallel activities and interruptions are amplified because multitasking is now combined with a high degree of mobility, collaboration, and urgency. The article presents the empirical and theoretical background for activity-based computing, its...

  3. The design and evaluation of a system for improved surveillance and prevention programmes in resource-limited settings using a hospital-based burn injury questionnaire.

    Science.gov (United States)

    Peck, Michael; Falk, Henry; Meddings, David; Sugerman, David; Mehta, Sumi; Sage, Michael

    2016-04-01

    Limited and fragmented data collection systems exist for burn injury. A global registry may lead to better injury estimates and identify risk factors. A collaborative effort involving the WHO, the Global Alliance for Clean Cookstoves, the CDC and the International Society for Burn Injuries was undertaken to simplify and standardise inpatient burn data collection. An expert panel of epidemiologists and burn care practitioners advised on the development of a new Global Burn Registry (GBR) form and online data entry system that can be expected to be used in resource-abundant or resource-limited settings. International burn organisations, the CDC and the WHO solicited burn centre participation to pilot test the GBR system. The WHO and the CDC led a webinar tutorial for system implementation. During an 8-month period, 52 hospitals in 30 countries enrolled in the pilot and were provided the GBR instrument, guidance and a data visualisation tool. Evaluations were received from 29 hospitals (56%). Median time to upload completed forms was <10 min; physicians most commonly entered data (64%), followed by nurses (25%); layout, clarity, accuracy and relevance were all rated high; and a vast majority (85%) considered the GBR 'highly valuable' for prioritising, developing and monitoring burn prevention programmes. The GBR was shown to be simple, flexible and acceptable to users. Enhanced regional and global understanding of burn epidemiology may help prioritise the selection, development and testing of primary prevention interventions for burns in resource-limited settings. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  4. Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs; Organ Procurement Organization Reporting and Communication; Transplant Outcome Measures and Documentation Requirements; Electronic Health Record (EHR) Incentive Programs; Payment to Nonexcepted Off-Campus Provider-Based Department of a Hospital; Hospital Value-Based Purchasing (VBP) Program; Establishment of Payment Rates Under the Medicare Physician Fee Schedule for Nonexcepted Items and Services Furnished by an Off-Campus Provider-Based Department of a Hospital. Final rule with comment period and interim final rule with comment period.

    Science.gov (United States)

    2016-11-14

    This final rule with comment period revises the Medicare hospital outpatient prospective payment system (OPPS) and the Medicare ambulatory surgical center (ASC) payment system for CY 2017 to implement applicable statutory requirements and changes arising from our continuing experience with these systems. In this final rule with comment period, we describe the changes to the amounts and factors used to determine the payment rates for Medicare services paid under the OPPS and those paid under the ASC payment system. In addition, this final rule with comment period updates and refines the requirements for the Hospital Outpatient Quality Reporting (OQR) Program and the ASC Quality Reporting (ASCQR) Program. Further, in this final rule with comment period, we are making changes to tolerance thresholds for clinical outcomes for solid organ transplant programs; to Organ Procurement Organizations (OPOs) definitions, outcome measures, and organ transport documentation; and to the Medicare and Medicaid Electronic Health Record Incentive Programs. We also are removing the HCAHPS Pain Management dimension from the Hospital Value-Based Purchasing (VBP) Program. In addition, we are implementing section 603 of the Bipartisan Budget Act of 2015 relating to payment for certain items and services furnished by certain off-campus provider-based departments of a provider. In this document, we also are issuing an interim final rule with comment period to establish the Medicare Physician Fee Schedule payment rates for the nonexcepted items and services billed by a nonexcepted off-campus provider-based department of a hospital in accordance with the provisions of section 603.

  5. Non-VA Hospital System (NVH)

    Data.gov (United States)

    Department of Veterans Affairs — The Veterans Health Administration (VHA) pays for care provided to VA beneficiaries in non-VA hospitals through its contract hospitalization program as mandated by...

  6. Improvements in Patient Acceptance by Hospitals Following the Introduction of a Smartphone App for the Emergency Medical Service System: A Population-Based Before-and-After Observational Study in Osaka City, Japan.

    Science.gov (United States)

    Katayama, Yusuke; Kitamura, Tetsuhisa; Kiyohara, Kosuke; Iwami, Taku; Kawamura, Takashi; Izawa, Junichi; Gibo, Koichiro; Komukai, Sho; Hayashida, Sumito; Kiguchi, Takeyuki; Ohnishi, Mitsuo; Ogura, Hiroshi; Shimazu, Takeshi

    2017-09-11

    Recently, the number of ambulance dispatches has been increasing in Japan, and it is therefore difficult for hospitals to accept emergency patients smoothly and appropriately because of the limited hospital capacity. To facilitate the process of requesting patient transport and hospital acceptance, an emergency information system using information technology (IT) has been built and introduced in various communities. However, its effectiveness has not been thoroughly revealed. We introduced a smartphone app system in 2013 that enables emergency medical service (EMS) personnel to share information among themselves regarding on-scene ambulances and the hospital situation. The aim of this study was to assess the effects of introducing this smartphone app on the EMS system in Osaka City, Japan. This retrospective study analyzed the population-based ambulance records of Osaka Municipal Fire Department. The study period was 6 years, from January 1, 2010 to December 31, 2015. We enrolled emergency patients for whom on-scene EMS personnel conducted hospital selection. The main endpoint was the difficulty experienced in gaining hospital acceptance at the scene. The definition of difficulty was making ≥5 phone calls by EMS personnel at the scene to hospitals until a decision to transport was determined. The smartphone app was introduced in January 2013, and we compared the patients treated from 2010 to 2012 (control group) with those treated from 2013 to 2015 (smartphone app group) using an interrupted time-series analysis to assess the effects of introducing this smartphone app. A total of 600,526 emergency patients for whom EMS personnel selected hospitals were eligible for our analysis. There were 300,131 emergency patients in the control group (50.00%, 300,313/600,526) from 2010 to 2012 and 300,395 emergency patients in the smartphone app group (50.00%, 300,395/600,526) from 2013 to 2015. The rate of difficulty in hospital acceptance was 14.19% (42,585/300,131) in the

  7. Activity-based costing and its application in a Turkish university hospital.

    Science.gov (United States)

    Yereli, Ayşe Necef

    2009-03-01

    Resource management in hospitals is of increasing importance in today's global economy. Traditional accounting systems have become inadequate for managing hospital resources and accurately determining service costs. Conversely, the activity-based costing approach to hospital accounting is an effective cost management model that determines costs and evaluates financial performance across departments. Obtaining costs that are more accurate can enable hospitals to analyze and interpret costing decisions and make more accurate budgeting decisions. Traditional and activity-based costing approaches were compared using a cost analysis of gall bladder surgeries in the general surgery department of one university hospital in Manisa, Turkey. Copyright (c) AORN, Inc, 2009.

  8. Managerial innovation in the hospital: an analysis of the diffusion of hospital cost-accounting systems.

    Science.gov (United States)

    Counte, M A; Glandon, G L

    1988-01-01

    Currently much interest is focused on the uses of cost-accounting systems within the hospital industry. Proponents frequently contend that such systems will help hospitals successfully adapt to new methods of financial reimbursement because they are essential to a number of major management functions, including competitive bidding, cost management, pricing, and profitability assessment. This article reports the results of a study conducted to examine the extent to which hospitals in a major market are actually beginning to use standard cost-accounting systems and identify factors that either aid or hinder the diffusion of these methods. Chief financial officers from 94 hospitals (83 percent response rate) participated in the study during the summer of 1986 where less than half of the hospitals (43 percent) had recently purchased a cost-accounting system. Detailed information about the interface of cost-accounting systems with other application systems and their specific management uses is reported.

  9. Hospital and Pre-Hospital Triage Systems in Disaster and Normal Conditions; a Review Article

    Directory of Open Access Journals (Sweden)

    Saeed Safari

    2015-02-01

    Full Text Available Triage is a priority classification system based on the severity of problem to do the best therapeutic proceedings for patients in the less time. A triage system should be performed in a way which can make a decision with high accuracy and in the least time for each patient. Simplicity and reliability of the performance are the most important features of a standard triage system. An appropriate triage causes to increase the quality of health care services and patients’ satisfaction rate, decrease the waiting time as well as mortality rate, and increase the yield and efficiency of emergency wards along with reducing the related expenses. Considering to the above statements, in the present study the history of triage formation was evaluated and categorizing of all triage systems regarding prehospital and hospital as well as triage in normal and critical conditions were assessed, too.

  10. The financial performance of hospitals belonging to health networks and systems.

    Science.gov (United States)

    Bazzoli, G J; Chan, B; Shortell, S M; D'Aunno, T

    2000-01-01

    The U.S. health industry is experiencing substantial restructuring through ownership consolidation and development of new forms of interorganizational relationships. Using an established taxonomy of health networks and systems, this paper develops and tests four hypotheses related to hospital financial performance. Consistent with our predictions, we find that hospitals in health systems that had unified ownership generally had better financial performance than hospitals in contractually based health networks. Among health network hospitals, those belonging to highly centralized networks had better financial performance than those belonging to more decentralized networks. However, health system hospitals in moderately centralized systems performed better than those in highly centralized systems. Finally, hospitals in networks or systems with little differentiation or centralization experienced the poorest financial performance. These results are consistent with resource dependence, transaction cost economics, and institutional theories of organizational behavior, and provide a conceptual and empirical baseline for future research.

  11. Object-oriented modeling of hospital information systems.

    Science.gov (United States)

    Graeber, S

    1995-01-01

    We have chosen an object-oriented approach for the modeling of a hospital information system; this avoids some disadvantages of the classic methods (i.e., a combination of Structured Analysis and Entity-Relationship-Model). The primary goal of this procedure was to find and represent the needs of communication in the computer-based part of the information system and, with that, to configure an information server that handles all the interactions. Furthermore, we wanted to develop communication interfaces for the application programs on an object-oriented level.

  12. Hospital managers' attitude and commitment toward electronic medical records system in Isfahan hospitals 2014.

    Science.gov (United States)

    Jahanbakhsh, Maryam; Karimi, Saeed; Hassanzadeh, Akbar; Beigi, Maliheh

    2017-01-01

    Electronic medical record system (EMRS) is a valuable system for safe access to the patient's data and increases health care quality. Manpower is one of the requirements for EMRS, among which manager is the most important person in any hospital. Taking into account manager's positive attitude and good commitments, EMRS will be implemented successfully. As such, we decided to assess manager's attitude and commitment toward EMRS in Isfahan hospitals in the year of 2014. This article aimed to determine the hospital managers' attitude and commitment toward the implementation of EMRS. The present article is an applied analytic study. Research society consisted of the managers of all the hospitals in Isfahan that include hospitals affiliated to Isfahan University of Medical Sciences, private, and social security hospitals. This study was done in 2014. Data collection tools included a questionnaire for which reliability and validity were determined. Data were analyzed by means of SPSS 20. Average score for the managers' attitude toward EMRS in the city of Isfahan was 77.5 out of 100 and their average score for commitment was 74.7. Manager's attitude in social security hospitals was more positive than the private and governmental ones (83.3%). In addition, the amount of commitment by the managers in social security hospitals was higher than the same in private and governmental hospitals (86.6%). At present, managers' attitude and commitment in Isfahan hospitals toward EMRS are very high and social security hospitals show more readiness in this respect.

  13. Hospital Rating Systems and Implications For Patient Travel to Better-rated Hospitals.

    Science.gov (United States)

    Subramanian, Arun; Adler, Joel T; Shah, Nilay D; Hyder, Joseph A

    2017-03-01

    Publicly reported hospital ratings aim to encourage transparency, spur quality improvement, and empower patient choice. Travel burdens may limit patient choice, particularly for older adults (aged 65 years and more) who receive most medical care. For 3 major hospital ratings systems, we estimated travel burden as the additional 1-way travel distance to receive care at a better-rated hospital.Distances were estimated from publicly available data from the US Census, US News Top Hospitals, Society of Thoracic Surgeons composite rating for coronary artery bypass grafting (STS-CABG), and Centers for Medicare and Medicaid Services Hospital Consumer Assessment of Healthcare Providers and Services (HCAHPS).Hospitals were rated for HCAHPS (n = 4656), STS-CABG (n = 470), and US News Top Hospitals (n = 15). Older adults were commonly located within 25 miles of their closest HCAHPS hospital (89.6%), but less commonly for STS-CABG (62.9%). To receive care at a better-rated hospital, travel distances commonly exceeded 25 miles: HCAHPS (39.2%), STS-CABG (62.7%), and US News Top Hospital (85.2%). Additional 1-way travel distances exceeded 25 miles commonly: HCAHPS (23.7%), STS-CABG (36.7%), US News Top Hospitals (81.8%).Significant travel burden is common for older adults seeking "better" care and is an important limitation of current hospital ratings for empowering patient choice.

  14. [The development of hospital medical supplies information management system].

    Science.gov (United States)

    Cao, Shaoping; Gu, Hongqing; Zhang, Peng; Wang, Qiang

    2010-05-01

    The information management of medical materials by using high-tech computer, in order to improve the efficiency of the consumption of medical supplies, hospital supplies and develop a new technology way to manage the hospital and material support. Using C # NET, JAVA techniques to develop procedures for the establishment of hospital material management information system, set the various management modules, production of various statistical reports, standard operating procedures. The system is convenient, functional and strong, fluent statistical functions. It can always fully grasp and understand the whole hospital supplies run dynamic information, as a modern and effective tool for hospital materials management.

  15. Integrating hospital information systems in healthcare institutions: a mediation architecture.

    Science.gov (United States)

    El Azami, Ikram; Cherkaoui Malki, Mohammed Ouçamah; Tahon, Christian

    2012-10-01

    Many studies have examined the integration of information systems into healthcare institutions, leading to several standards in the healthcare domain (CORBAmed: Common Object Request Broker Architecture in Medicine; HL7: Health Level Seven International; DICOM: Digital Imaging and Communications in Medicine; and IHE: Integrating the Healthcare Enterprise). Due to the existence of a wide diversity of heterogeneous systems, three essential factors are necessary to fully integrate a system: data, functions and workflow. However, most of the previous studies have dealt with only one or two of these factors and this makes the system integration unsatisfactory. In this paper, we propose a flexible, scalable architecture for Hospital Information Systems (HIS). Our main purpose is to provide a practical solution to insure HIS interoperability so that healthcare institutions can communicate without being obliged to change their local information systems and without altering the tasks of the healthcare professionals. Our architecture is a mediation architecture with 3 levels: 1) a database level, 2) a middleware level and 3) a user interface level. The mediation is based on two central components: the Mediator and the Adapter. Using the XML format allows us to establish a structured, secured exchange of healthcare data. The notion of medical ontology is introduced to solve semantic conflicts and to unify the language used for the exchange. Our mediation architecture provides an effective, promising model that promotes the integration of hospital information systems that are autonomous, heterogeneous, semantically interoperable and platform-independent.

  16. Reliability Electrical Power System of Hospital as Cold Standby System

    Directory of Open Access Journals (Sweden)

    Grabski Franciszek

    2016-07-01

    Full Text Available The probabilistic model of a hospital electrical power system consisting of mains, an emergency power system and the automatic transfer switch with the generator starter are discussed in this paper. The reliability model is semi-Markov process describing two different units renewable cold standby system and switch. The embedded Semi-Markov processes concept is applied for description of the system evolution. Time to failure of the system is represented by a random variable denoting the first passage time of the process from the given state to the subset of states. The appropriate theorems of the Semi-Markov processes theory allow us to evaluate the reliability function and some reliability characteristics.

  17. The utilization of activity-based cost accounting in hospitals.

    Science.gov (United States)

    Emmett, Dennis; Forget, Robert

    2005-01-01

    Healthcare costs are being examined on all fronts. Healthcare accounts for 11% of the gross national product and will continue to rise as the "babyboomers" reach retirement age. While ascertaining costs is important, most research shows that costing methods have not been implemented in hospitals. This study is concerned with the use of costing methods; particularly activity-based cost accounting. A mail survey of CFOs was undertaken to determine the type of cost accounting method they use. In addition, they were asked whether they were aware of activity-based cost accounting and whether they had implemented it or were planning to implement it. Only 71.8% were aware of it and only 4.7% had implemented it. In addition, only 52% of all hospitals report using any cost accounting systems. Education needs to ensure that all healthcare executives are cognizant of activity-based accounting and its importance in determining costs. Only by determining costs can hospitals strive to contain them.

  18. Evaluation of Hospital-Based Palliative Care Programs.

    Science.gov (United States)

    Hall, Karen Lynn; Rafalson, Lisa; Mariano, Kathleen; Michalek, Arthur

    2016-02-01

    This study evaluated current hospital-based palliative care programs using recommendations from the Center to Advance Palliative Care (CAPC) as a framework. Seven hospitals located in Buffalo, New York were included based on the existence of a hospital-based palliative care program. Data was collected from August through October of 2013 by means of key informant interviews with nine staff members from these hospitals using a guide comprised of questions based on CAPC's recommendations. A gap analysis was conducted to analyze the current state of each hospital's program based upon CAPC's definition of a quality palliative care program. The findings identify challenges facing both existing/evolving palliative care programs, and establish a foundation for strategies to attain best practices not yet implemented. This study affirms the growing availability of palliative care services among these selected hospitals along with opportunities to improve the scope of services in line with national recommendations. © The Author(s) 2014.

  19. Implementation of Total Hospital Information System (THIS In Malaysian Public Hospitals: Challenges and Future Prospects

    Directory of Open Access Journals (Sweden)

    Roshidi Hassan

    2013-07-01

    Full Text Available Total Hospital Information System (THIS is a project by the Ministry of Health (MOH of Malaysia that provide a complete and comprehensive Hospital Information System (HIS by establishing integrated electronic information handling and processing in a hospital by means of Information and Communications Technology (ICT. Implementation of such rigorous system in a complex organization such as health services involves many challenges, and if they are not tackled appropriately, the system may fail and reject by the user. This paper analyzed and discussed on a few major challenges faced by the MOH on their implementation of THIS at 13 government hospitals nationwide. The challenges include digital gap, knowledge and skills, system quality, redundancy and data abundance. Initiatives taken to address the challenges were explained and some suggestions were also introduced. Furthermore, the article look into the future prospective of the system, on how the system could benefit further which eventually may go beyond its initial objective.

  20. The interRAI Acute Care instrument incorporated in an eHealth system for standardized and web-based geriatric assessment: strengths, weaknesses, opportunities and threats in the acute hospital setting.

    Science.gov (United States)

    Devriendt, Els; Wellens, Nathalie I H; Flamaing, Johan; Declercq, Anja; Moons, Philip; Boonen, Steven; Milisen, Koen

    2013-09-05

    The interRAI Acute Care instrument is a multidimensional geriatric assessment system intended to determine a hospitalized older persons' medical, psychosocial and functional capacity and needs. Its objective is to develop an overall plan for treatment and long-term follow-up based on a common set of standardized items that can be used in various care settings. A Belgian web-based software system (BelRAI-software) was developed to enable clinicians to interpret the output and to communicate the patients' data across wards and care organizations. The purpose of the study is to evaluate the (dis)advantages of the implementation of the interRAI Acute Care instrument as a comprehensive geriatric assessment instrument in an acute hospital context. In a cross-sectional multicenter study on four geriatric wards in three acute hospitals, trained clinical staff (nurses, occupational therapists, social workers, and geriatricians) assessed 410 inpatients in routine clinical practice. The BelRAI-system was evaluated by focus groups, observations, and questionnaires. The Strengths, Weaknesses, Opportunities and Threats were mapped (SWOT-analysis) and validated by the participants. The primary strengths of the BelRAI-system were a structured overview of the patients' condition early after admission and the promotion of multidisciplinary assessment. Our study was a first attempt to transfer standardized data between home care organizations, nursing homes and hospitals and a way to centralize medical, allied health professionals and nursing data. With the BelRAI-software, privacy of data is guaranteed. Weaknesses are the time-consuming character of the process and the overlap with other assessment instruments or (electronic) registration forms. There is room for improving the user-friendliness and the efficiency of the software, which needs hospital-specific adaptations. Opportunities are a timely and systematic problem detection and continuity of care. An actual shortage of

  1. Value-based purchasing, efficiency, and hospital performance.

    Science.gov (United States)

    Zhao, Mei; Haley, D Rob; Spaulding, Aaron; Balogh, Holly A

    2015-01-01

    The Medicare hospital value-based purchasing (HVBP) program that links Medicare payments to quality of care became effective in 2013 in the United States. Hospital efficiency will be added to the HVBP in 2015. It is unclear whether hospital efficiency-specific hospital characteristics are associated with HVBP performance scores and the subsequent incentive payments. Using data from the American Hospital Association Annual Survey the Medicare Hospital Compare, this article examines the association of hospital efficiency hospital characteristics with the HVBP performance scores. The results indicate that less efficient hospitals are more likely to have lower patient satisfaction scores and total performance scores compared with more efficient hospitals. Hospital size, ownership, and payer mix also have significant impact on HVBP performance scores. The findings of this study provide significant policy practice implications. On the one hand, hospitals should consider investing their limited resources into identifying implementing the most cost-effective procedures to improve their patient experience total performance scores. On the other hand, policymakers should consider the unintended negative impact that these new payment incentives will likely have on hospitals that serve a higher proportion of low-income racial ethnic minority populations.

  2. How Should Disaster Base Hospitals Prepare for Dialysis Therapy after Earthquakes? Introduction of Double Water Piping Circuits Provided by Well Water System.

    Science.gov (United States)

    Ikegaya, Naoki; Seki, George; Ohta, Nobutaka

    2016-01-01

    After earthquakes, continuing dialysis for patients with ESRD and patients suffering from crush syndrome is the serious problem. In this paper, we analyzed the failure of the provision of dialysis services observed in recent disasters and discussed how to prepare for disasters to continue dialysis therapy. Japan has frequently experienced devastating earthquakes. A lot of dialysis centers could not continue dialysis treatment owing to damage caused by these earthquakes. The survey by Japanese Society for Dialysis Treatment (JSDT) after the Great East Japan Earthquake in 2011 showed that failure of lifelines such as electric power and water supply was the leading cause of the malfunction of dialysis treatment. Our hospital is located in Shizuoka Prefecture, where one of the biggest earthquakes is predicted to occur in the near future. In addition to reconstructing earthquake-resistant buildings and facilities, we therefore have adopted double electric and water lifelines by introducing emergency generators and well water supply systems. It is very important to inform politicians, bureaucrats, and local water departments that dialysis treatment, a life sustaining therapy for patients with end stage renal diseases, requires a large amount of water. We cannot prevent an earthquake but can curb the extent of a disaster by preparing for earthquakes.

  3. Hospital-based health technology assessment for innovative medical devices in university hospitals and the role of hospital pharmacists: learning from international experience.

    Science.gov (United States)

    Martelli, Nicolas; Lelong, Anne-Sophie; Prognon, Patrice; Pineau, Judith

    2013-04-01

    Several models of hospital-based health technology assessment (HTA) have been developed worldwide, for the introduction of innovative medical devices and support evidence-based decision making in hospitals. Two such models, the HTA unit and mini-HTA models, are widespread in university hospitals and involve various stakeholders. The purpose of this work was to highlight the potential role of hospital pharmacists in hospital-based HTA activities. We searched for articles, reviews, and letters relating to hospital-based HTA, as defined by the Hospital-Based Health Technology Assessment Worldwide Survey published by the Health Technology Assessment International (HTAi) Society, in the Health Technology Assessment database, MEDLINE, EMBASE, and hospital pharmacy journals. The number of university hospitals performing hospital-based HTA has increased since the 2008 Hospital-Based Health Technology Assessment Worldwide Survey. Our own experience and international findings show that hospital pharmacists already contribute to hospital-based HTA activities and have developed study interpretation skills and a knowledge of medical devices. Promoting multidisciplinary approaches is one of the key success factors in hospital-based HTA. Hospital pharmacists occupy a position between hospital managers, clinicians, health economists, biomedical engineers, and patients and can provide a new perspective. In the future, hospital pharmacists are likely to become increasingly involved in hospital-based HTA activities.

  4. A simulation model of hospital management based on cost accounting analysis according to disease.

    Science.gov (United States)

    Tanaka, Koji; Sato, Junzo; Guo, Jinqiu; Takada, Akira; Yoshihara, Hiroyuki

    2004-12-01

    Since a little before 2000, hospital cost accounting has been increasingly performed at Japanese national university hospitals. At Kumamoto University Hospital, for instance, departmental costs have been analyzed since 2000. And, since 2003, the cost balance has been obtained according to certain diseases for the preparation of Diagnosis-Related Groups and Prospective Payment System. On the basis of these experiences, we have constructed a simulation model of hospital management. This program has worked correctly at repeated trials and with satisfactory speed. Although there has been room for improvement of detailed accounts and cost accounting engine, the basic model has proved satisfactory. We have constructed a hospital management model based on the financial data of an existing hospital. We will later improve this program from the viewpoint of construction and using more various data of hospital management. A prospective outlook may be obtained for the practical application of this hospital management model.

  5. Mining of hospital laboratory information systems

    DEFF Research Database (Denmark)

    Søeby, Karen; Jensen, Peter Bjødstrup; Werge, Thomas

    2015-01-01

    in creatinine levels at different time points after birth and around the early teens, which challenges the establishment and usefulness of reference intervals in those age groups. Conclusions: The study documents that hospital laboratory data may inform on the developmental aspects of creatinine, on periods......Abstract Background: The knowledge of physiological fluctuation and variation of even commonly used biochemical quantities in extreme age groups and during development is sparse. This challenges the clinical interpretation and utility of laboratory tests in these age groups. To explore the utility...... of hospital laboratory data as a source of information, we analyzed enzymatic plasma creatinine as a model analyte in two large pediatric hospital samples. Methods: Plasma creatinine measurements from 9700 children aged 0-18 years were obtained from hospital laboratory databases and partitioned into high...

  6. Impacts of Hospitals' Innovativeness on Information System Outsourcing Decisions

    OpenAIRE

    Park, Jae Sung

    2014-01-01

    Objectives The purpose of this study was to identify the effects of hospitals' innovativeness on outsourcing decision-making regarding four information system (IS) functions, namely, software programs, network maintenance, hardware systems, and PC/printer maintenance. Methods Using the 2011 roster of the Korean Hospital Association, this study selected 311 general hospitals as a study population. After identifying the managers who were in charge of outsourcing, this study administered questio...

  7. An automated, broad-based, near real-time public health surveillance system using presentations to hospital Emergency Departments in New South Wales, Australia

    Directory of Open Access Journals (Sweden)

    Chiu Clayton

    2005-12-01

    Full Text Available Abstract Background In a climate of concern over bioterrorism threats and emergent diseases, public health authorities are trialling more timely surveillance systems. The 2003 Rugby World Cup (RWC provided an opportunity to test the viability of a near real-time syndromic surveillance system in metropolitan Sydney, Australia. We describe the development and early results of this largely automated system that used data routinely collected in Emergency Departments (EDs. Methods Twelve of 49 EDs in the Sydney metropolitan area automatically transmitted surveillance data from their existing information systems to a central database in near real-time. Information captured for each ED visit included patient demographic details, presenting problem and nursing assessment entered as free-text at triage time, physician-assigned provisional diagnosis codes, and status at departure from the ED. Both diagnoses from the EDs and triage text were used to assign syndrome categories. The text information was automatically classified into one or more of 26 syndrome categories using automated "naïve Bayes" text categorisation techniques. Automated processes were used to analyse both diagnosis and free text-based syndrome data and to produce web-based statistical summaries for daily review. An adjusted cumulative sum (cusum was used to assess the statistical significance of trends. Results During the RWC the system did not identify any major public health threats associated with the tournament, mass gatherings or the influx of visitors. This was consistent with evidence from other sources, although two known outbreaks were already in progress before the tournament. Limited baseline in early monitoring prevented the system from automatically identifying these ongoing outbreaks. Data capture was invisible to clinical staff in EDs and did not add to their workload. Conclusion We have demonstrated the feasibility and potential utility of syndromic surveillance using

  8. Epidemiology of systemic inflammatory response syndrome and sepsis in cats hospitalized in a veterinary teaching hospital.

    Science.gov (United States)

    Babyak, Jonathan M; Sharp, Claire R

    2016-07-01

    OBJECTIVE To describe the epidemiology of the systemic inflammatory response syndrome (SIRS) and sepsis in cats hospitalized in a veterinary teaching hospital. DESIGN Observational study. ANIMALS 246 client-owned cats. PROCEDURES During a 3-month period, daily treatment records were evaluated for all hospitalized cats. Information extracted included signalment, temperature, heart rate, respiratory rate, diagnostic test results, diagnosis, duration of hospitalization, and outcome (survival or death). Cats were classified into 1 of 4 disease categories (sepsis [confirmed infection and SIRS], infection [confirmed infection without SIRS], noninfectious SIRS [SIRS without a confirmed infection], and no SIRS [no SIRS or infection]). RESULTS Of the 246 cats, 26 and 3 were hospitalized 2 and 3 times, respectively; thus, 275 hospitalizations were evaluated. When SIRS was defined as the presence of ≥ 2 of 4 SIRS criteria, 17 cats had sepsis, 16 had infections, 81 had noninfectious SIRS, and 161 were classified in the no SIRS category at hospital admission. The prevalence of sepsis at hospital admission was 6.2 cases/100 admissions. Four cats developed sepsis while hospitalized, resulting in a sepsis incidence rate of 1.5 cases/100 hospital admissions. Four of 17 cats with sepsis at hospital admission and 3 of 4 cats that developed sepsis while hospitalized died or were euthanized, resulting in a mortality rate of 33.3% for septic cats; 239 hospitalizations resulted in survival, 28 resulted in euthanasia, and 8 resulted in death. CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that many hospitalized cats have evidence of SIRS and some have sepsis. In cats, sepsis is an important clinical entity with a high mortality rate.

  9. Implementation of a program for type 2 diabetes based on the Chronic Care Model in a hospital-centered health care system: "the Belgian experience"

    Directory of Open Access Journals (Sweden)

    Van Royen Paul

    2009-08-01

    Full Text Available Abstract Background Most research publications on Chronic Care Model (CCM implementation originate from organizations or countries with a well-structured primary health care system. Information about efforts made in countries with a less well-organized primary health care system is scarce. In 2003, the Belgian National Institute for Health and Disability Insurance commissioned a pilot study to explore how care for type 2 diabetes patients could be organized in a more efficient way in the Belgian healthcare setting, a setting where the organisational framework for chronic care is mainly hospital-centered. Methods Process evaluation of an action research project (2003–2007 guided by the CCM in a well-defined geographical area with 76,826 inhabitants and an estimated number of 2,300 type 2 diabetes patients. In consultation with the region a program for type 2 diabetes patients was developed. The degree of implementation of the CCM in the region was assessed using the Assessment of Chronic Illness Care survey (ACIC. A multimethod approach was used to evaluate the implementation process. The resulting data were triangulated in order to identify the main facilitators and barriers encountered during the implementation process. Results The overall ACIC score improved from 1.45 (limited support at the start of the study to 5.5 (basic support at the end of the study. The establishment of a local steering group and the appointment of a program manager were crucial steps in strengthening primary care. The willingness of a group of well-trained and motivated care providers to invest in quality improvement was an important facilitator. Important barriers were the complexity of the intervention, the lack of quality data, inadequate information technology support, the lack of commitment procedures and the uncertainty about sustainable funding. Conclusion Guided by the CCM, this study highlights the opportunities and the bottlenecks for adapting chronic care

  10. Health systems: changes in hospital efficiency and profitability.

    Science.gov (United States)

    Büchner, Vera Antonia; Hinz, Vera; Schreyögg, Jonas

    2016-06-01

    This study investigates potential changes in hospital performance after health system entry, while differentiating between hospital technical and cost efficiency and hospital profitability. In the first stage we obtained (bootstrapped) data envelopment analysis (DEA) efficiency scores. Then, genetic matching is used as a novel matching procedure in this context along with a difference-in-difference approach within a panel regression framework. With the genetic matching procedure, independent and health system hospitals are matched along a number of environmental and organizational characteristics. The results show that health system entry increases hospital technical and cost efficiency by between 0.6 and 3.4 % in four alternative post-entry periods, indicating that health system entry has not a transitory but rather a permanent effect on hospital efficiency. Regarding hospital profitability, the results reveal an increase in hospital profitability only 1 year after health system entry, and the estimations suggest that this effect is a transitional phenomenon. Overall, health system entry may serve as an appropriate management instrument for decision makers to increase hospital performance.

  11. 77 FR 27869 - Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the...

    Science.gov (United States)

    2012-05-11

    ... Administration HCO High-cost outlier HCRIS Hospital Cost Report Information System HHA Home health agency HHS... Abdominal Aortic Aneurysm (AAA) Endovascular Graft III. Proposed Changes to the Hospital Wage Index for... Chemotherapy Is Considered or Administered Within 4 Months (120 Days) of Surgery to Patient Under the Age of 80...

  12. Hospital-based patient education programs and the role of the hospital librarian.

    Science.gov (United States)

    Harris, C L

    1978-04-01

    This paper examines current advances in hospital-based patient education, and delineates the role of the hospital librarian in these programs. Recently, programs of planned patient education have been recognized by health care personnel and the public as being an integral part of health care delivery. Various key elements, including legislative action, the advent of audiovisual technology, and rising health care costs have contributed to the development of patient education programs in hospitals. As responsible members of the hospital organization, hospital librarians should contribute their expertise to patient education programs. They are uniquely trained with skills in providing information on other health education programs; in assembling, cataloging, and managing collections of patient education materials; and in providing documentation of their use. In order to demonstrate the full range of their skills and to contribute to patient care, education, and research, hospital librarians should actively participate in programs of planned patient education.

  13. Evaluation of a Cyber Security System for Hospital Network.

    Science.gov (United States)

    Faysel, Mohammad A

    2015-01-01

    Most of the cyber security systems use simulated data in evaluating their detection capabilities. The proposed cyber security system utilizes real hospital network connections. It uses a probabilistic data mining algorithm to detect anomalous events and takes appropriate response in real-time. On an evaluation using real-world hospital network data consisting of incoming network connections collected for a 24-hour period, the proposed system detected 15 unusual connections which were undetected by a commercial intrusion prevention system for the same network connections. Evaluation of the proposed system shows a potential to secure protected patient health information on a hospital network.

  14. Impacts of hospitals' innovativeness on information system outsourcing decisions.

    Science.gov (United States)

    Park, Jae Sung

    2014-04-01

    The purpose of this study was to identify the effects of hospitals' innovativeness on outsourcing decision-making regarding four information system (IS) functions, namely, software programs, network maintenance, hardware systems, and PC/printer maintenance. Using the 2011 roster of the Korean Hospital Association, this study selected 311 general hospitals as a study population. After identifying the managers who were in charge of outsourcing, this study administered questionnaires. A total of 103 hospitals responded. Of the responding hospitals, 55.34% outsourced at least one IS function, whereas 88.35% outsourced at least one managerial function. IS outsourcing was motivated by the need for outside experts, but other managerial functions were outsourced for cost savings. Innovative and early adopter hospitals were 4.52 and 4.91 times more likely to outsource IS functions related with work processes (i.e., software and network maintenance) than early and late majority hospitals, respectively. IT outsourcing effectiveness significantly influenced the outsourcing decisions regarding four IS functions. Hospitals that had perceived more risks of outsourcing significantly preferred non-outsourcing on their hardware systems, but the risks of outsourcing were not significant for outsourcing decisions regarding the other IS functions. Hospitals' innovativeness also significantly explained the quantity of innovation adoptions. Innovative and early adopter hospitals did more outsourcing than early and late majority hospitals. Hospitals' innovativeness influences decision-making regarding outsourcing. Innovative hospitals are more likely to outsource their work-process-related IS functions. Thus, organizational traits, especially hospitals' innovativeness, should be considered as a key success factor for IS management.

  15. Hospital Systems, Convenient Care Strategies, and Healthcare Reform.

    Science.gov (United States)

    Kaissi, Amer; Shay, Patrick; Roscoe, Christina

    2016-01-01

    Retail clinics (RCs) and urgent care centers (UCCs) are convenient care models that emerged on the healthcare scene in the past 10 to 15 years. Characterized as disruptive innovations, these models of healthcare delivery seem to follow a slightly different path from each other. Hospital systems, the very organizations that were originally threatened by convenient care models, are developing them and partnering with existing models. We posit that legislative changes such as the Affordable Care Act created challenges for hospital systems that accelerated their adoption of these models. In this study, we analyze 117 hospital systems in six states and report on their convenient care strategies. Our data suggest that UCCs are more prevalent than RCs among hospital systems, and that large and unexplained state-by-state variations exist in the adoption of these strategies. We also postulate about the future role of hospital systems in leading these innovations.

  16. Is the maturity of hospitals' quality improvement systems associated with measures of quality and patient safety?

    Directory of Open Access Journals (Sweden)

    Groene Oliver

    2011-12-01

    Full Text Available Abstract Background Previous research addressed the development of a classification scheme for quality improvement systems in European hospitals. In this study we explore associations between the 'maturity' of the hospitals' quality improvement system and clinical outcomes. Methods The maturity classification scheme was developed based on survey results from 389 hospitals in eight European countries. We matched the hospitals from the Spanish sample (113 hospitals with those hospitals participating in a nation-wide, voluntary hospital performance initiative. We then compared sample distributions and explored associations between the 'maturity' of the hospitals' quality improvement system and a range of composite outcomes measures, such as adjusted hospital-wide mortality, -readmission, -complication and -length of stay indices. Statistical analysis includes bivariate correlations for parametrically and non-parametrically distributed data, multiple robust regression models and bootstrapping techniques to obtain confidence-intervals for the correlation and regression estimates. Results Overall, 43 hospitals were included. Compared to the original sample of 113, this sample was characterized by a higher representation of university hospitals. Maturity of the quality improvement system was similar, although the matched sample showed less variability. Analysis of associations between the quality improvement system and hospital-wide outcomes suggests significant correlations for the indicator adjusted hospital complications, borderline significance for adjusted hospital readmissions and non-significance for the adjusted hospital mortality and length of stay indicators. These results are confirmed by the bootstrap estimates of the robust regression model after adjusting for hospital characteristics. Conclusions We assessed associations between hospitals' quality improvement systems and clinical outcomes. From this data it seems that having a more

  17. Ocular morbidity on headache ruled out of systemic causes—A prevalence study carried out at a community based hospital in Nepal

    Science.gov (United States)

    Marasini, Sanjay; Khadka, Jyoti; Sthapit, Purnima Raj Karnikar; Sharma, Ranjana; Nepal, Bhagvat Prasad

    2012-01-01

    Purpose The association between ophthalmic anomalies and headache still needs to be investigated largely. We aimed to look for it in the context of a rural community hospital of Nepal. Methods Hundred patients with headache were investigated for ophthalmic anomalies after the probable systemic association was ruled out. All the patients were first examined by general physician, otorhinolaryngologist and psychiatrist. Ocular evaluation consisted of detailed refractive, binocularity assessment and anterior and posterior segment examination. Data were analyzed using t-test, chi-square test, multiple logistic regression, odds ratio as well as frequency and percentages. Results Female above the age of 17 suffered more (p  0.05). In students and housewives frontal headache was more common (OR 3.467, 0.848–14.174; 95% CI and 1.167, 0.303–4.499; 95% CI). Refractive error was associated with frontal headache (OR, 1.429, 1.130–0.806, 95% CI). On presentation, 88% had visual acuity 6/9 or better. Forty-four percent had refractive error among whom astigmatism was more frequent (63.63%) followed by hyperopia (27.27%) and myopia (9.09%). Known eye problems were significantly associated with refractive error and binocular vision anomalies (p < 0.001). Convergence insufficiency (16.25%) and fusional vergence (11.25%) deficiencies were common among unstable binocularity. Conclusion Ocular anomalies co-exist with headache complains very frequently. Refractive and binocular vision anomalies need to be largely investigated in all headache patients. It is important to get a good headache history so that patients can be referred to the appropriate specialist.

  18. Information security risk management for computerized health information systems in hospitals: a case study of Iran.

    Science.gov (United States)

    Zarei, Javad; Sadoughi, Farahnaz

    2016-01-01

    In recent years, hospitals in Iran - similar to those in other countries - have experienced growing use of computerized health information systems (CHISs), which play a significant role in the operations of hospitals. But, the major challenge of CHIS use is information security. This study attempts to evaluate CHIS information security risk management at hospitals of Iran. This applied study is a descriptive and cross-sectional research that has been conducted in 2015. The data were collected from 551 hospitals of Iran. Based on literature review, experts' opinion, and observations at five hospitals, our intensive questionnaire was designed to assess security risk management for CHISs at the concerned hospitals, which was then sent to all hospitals in Iran by the Ministry of Health. Sixty-nine percent of the studied hospitals pursue information security policies and procedures in conformity with Iran Hospitals Accreditation Standards. At some hospitals, risk identification, risk evaluation, and risk estimation, as well as risk treatment, are unstructured without any specified approach or methodology. There is no significant structured approach to risk management at the studied hospitals. Information security risk management is not followed by Iran's hospitals and their information security policies. This problem can cause a large number of challenges for their CHIS security in future. Therefore, Iran's Ministry of Health should develop practical policies to improve information security risk management in the hospitals of Iran.

  19. Hospital-based, acute care after ambulatory surgery center discharge.

    Science.gov (United States)

    Fox, Justin P; Vashi, Anita A; Ross, Joseph S; Gross, Cary P

    2014-05-01

    As a measure of quality, ambulatory surgery centers have begun reporting rates of hospital transfer at discharge. This process, however, may underestimate the acute care needs of patients after care. We conducted this study to determine rates and evaluate variation in hospital transfer and hospital-based, acute care within 7 days among patients discharged from ambulatory surgery centers. Using data from the Healthcare Cost and Utilization Project, we identified adult patients who underwent a medical or operative procedure between July 2008 and September 2009 at ambulatory surgery centers in California, Florida, and Nebraska. The primary outcomes were hospital transfer at the time of discharge and hospital-based, acute care (emergency department visits or hospital admissions) within 7-days expressed as the rate per 1,000 discharges. At the ambulatory surgery center level, rates were adjusted for age, sex, and procedure-mix. We studied 3,821,670 patients treated at 1,295 ambulatory surgery centers. At discharge, the hospital transfer rate was 1.1 per 1,000 discharges (95% confidence interval 1.1-1.1). Among patients discharged home, the hospital-based, acute care rate was 31.8 per 1,000 discharges (95% confidence interval 31.6-32.0). Across ambulatory surgery centers, there was little variation in adjusted hospital transfer rates (median = 1.0/1,000 discharges [25th-75th percentile = 1.0-2.0]), whereas substantial variation existed in adjusted, hospital-based, acute care rates (28.0/1,000 [21.0-39.0]). Among adult patients undergoing ambulatory care at surgery centers, hospital transfer at time of discharge from the ambulatory care center is a rare event. In contrast, the rate of need for hospital-based, acute care in the first week afterwards is nearly 30-fold greater, varies across centers, and may be a more meaningful measure for discriminating quality. Published by Mosby, Inc.

  20. Hospital-based, acute care following ambulatory surgery center discharge

    Science.gov (United States)

    Fox, Justin P.; Vashi, Anita A.; Ross, Joseph S.; Gross, Cary P.

    2014-01-01

    Background As a measure of quality, ambulatory surgery centers have begun reporting rates of hospital transfer at discharge. However, this may underestimate patient’s acute care needs after care. We conducted this study to determine rates and evaluate variation in hospital transfer and hospital-based, acute care within 7 days among patients discharged from ambulatory surgery centers. Methods Using data from the Healthcare Cost and Utilization Project, we identified adult patients who underwent a medical or surgical procedure between July 2008 and September 2009 at ambulatory surgery centers in California, Florida, and Nebraska. The primary outcomes were hospital transfer at the time of discharge and hospital-based, acute care (emergency department visits or hospital admissions) within 7-days expressed as the rate per 1,000 discharges. At the ambulatory surgery center level, rates were adjusted for age, sex, and procedure-mix. Results We studied 3,821,670 patients treated at 1,295 ambulatory surgery centers. At discharge, the hospital transfer rate was 1.1/1,000 discharges (95% CI, 1.1–1.1). Among patients discharged home, the hospital-based, acute care rate was 31.8/1,000 discharges (95% CI, 31.6–32.0). Across ambulatory surgery centers, there was little variation in adjusted hospital transfer rates (median=1.0/1,000 discharges [25th–75th percentile=1.0–2.0]), while substantial variation existed in adjusted hospital-based, acute care rates (28.0/1,000 [21.0–39.0]). Conclusions Among adult patients undergoing ambulatory surgery center care, hospital transfer at discharge is a rare event. In contrast, the hospital-based, acute care rate is nearly 30-fold higher, varies across centers, and may be a more meaningful measure for discriminating quality. PMID:24787100

  1. Exploring patients' experience of hospital meal-ordering systems.

    Science.gov (United States)

    Ottrey, Ella; Porter, Judi

    2017-08-09

    Meal-ordering systems are an important aspect of hospital food services, informing patients of the available menu choices and supporting the collection of meal orders. Although several meal-ordering systems are used in hospitals, there has been limited research into patients' experience of these systems. Aim To explore patients' experience of written, spoken and visual menus in the acute hospital setting. Method Ten patients from a tertiary teaching hospital were asked to evaluate three meal-ordering systems, which were randomly allocated to them. Semi-structured interviews were conducted to gain an understanding of the patients' experience of meal-ordering systems. Findings The type and quality of food provided, the importance of information, the characteristics of the menu monitor, and the meal-ordering process were identified as important factors in enhancing patient satisfaction with hospital food services, regardless of the meal-ordering system used. Conclusion Patients place a high value on the quality of hospital food, and hospital food service departments should engage with patients when reviewing and designing menus. Healthcare organisations should also consider implementing spoken or visual menus to complement existing strategies to enhance patient satisfaction with hospital food services.

  2. Medicare and Medicaid programs: hospital outpatient prospective payment and ambulatory surgical center payment systems and quality reporting programs; Hospital Value-Based Purchasing Program; organ procurement organizations; quality improvement organizations; Electronic Health Records (EHR) Incentive Program; provider reimbursement determinations and appeals. Final rule with comment period and final rules.

    Science.gov (United States)

    2013-12-10

    : This final rule with comment period revises the Medicare hospital outpatient prospective payment system (OPPS) and the Medicare ambulatory surgical center (ASC) payment system for CY 2014 to implement applicable statutory requirements and changes arising from our continuing experience with these systems. In this final rule with comment period, we describe the changes to the amounts and factors used to determine the payment rates for Medicare services paid under the OPPS and those paid under the ASC payment system. In addition, this final rule with comment period updates and refines the requirements for the Hospital Outpatient Quality Reporting (OQR) Program, the ASC Quality Reporting (ASCQR) Program, and the Hospital Value-Based Purchasing (VBP) Program. In the final rules in this document, we are finalizing changes to the conditions for coverage (CfCs) for organ procurement organizations (OPOs); revisions to the Quality Improvement Organization (QIO) regulations; changes to the Medicare fee-for-service Electronic Health Record (EHR) Incentive Program; and changes relating to provider reimbursement determinations and appeals.

  3. Digestive system complications among hospitalized children with ...

    African Journals Online (AJOL)

    USER

    among hospitalized children with sickle cell anaemia in University of ... cell anaemia. History taking, diligent physical examination and relevant laboratory and imaging studies, would readily facilitate the diagnosis, and save lives. Keywords: Acute abdominal crisis, .... respective socio-economic classifications were estimated ...

  4. Hospital information system institutionalization processes in indonesian public, government-owned and privately owned hospitals.

    Science.gov (United States)

    Handayani, P W; Hidayanto, A N; Ayuningtyas, Dumilah; Budi, Indra

    2016-11-01

    The Hospital Information System (HIS) could help hospitals as a public entity to provide optimal health services. One of the main challenges of HIS implementation is an institutional change. Using institutional theory as the analytical lens, this study aims to explain the institutionalization of HIS as an instance of e-health initiatives in Indonesia. Furthermore, this paper aims for hospital management and researchers to improve the understanding of the social forces that influence hospital personnel's HIS acceptance within an organizational context. We use case studies from four public, government-owned hospitals and four privately owned (public and specialty) hospitals to explain the HIS institutionalization process by exploring the three concepts of institutional theory: institutional isomorphism, institutional logic, and institutional entrepreneurship. This study reveals that differences exist between public, government-owned and private hospitals with regard to the institutionalization process: public, government-owned hospitals' management is more motivated to implement HIS to comply with the regulations, while private hospitals' management views HIS as an urgent requirement that must be achieved. The study findings also reveal that various institutional isomorphism mechanisms and forms of institutional logic emerge during the process. Finally, three factors-self-efficacy, social influence, and management support-have a significant influence on the individual acceptance of HIS. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  5. Hospital-based home care for children with cancer

    DEFF Research Database (Denmark)

    Hansson, Eva Helena; Kjaergaard, H; Schmiegelow, K

    2012-01-01

    The study aims to describe the experiences of a hospital-based home care programme in the families of children with cancer. Fourteen parents, representing 10 families, were interviewed about their experiences of a hospital-based home care programme during a 4-month period in 2009 at a university...... hospital in Denmark. Five children participated in all or part of the interview. The interviews were transcribed verbatim and analysed using qualitative content analysis. The findings indicate that hospital-based home care enabled the families to remain intact throughout the course of treatment......, as it decreased the strain on the family and the ill child, maintained normality and an ordinary everyday life and fulfilled the need for safety and security. According to family members of children with cancer, hospital-based home care support enhanced their quality of life during the child's cancer trajectory...

  6. Longitudinal analysis on the development of hospital quality management systems in the Netherlands.

    NARCIS (Netherlands)

    Dückers, M.; Makai, P.; Vos, L.; Groenewegen, P.; Wagner, C.

    2009-01-01

    OBJECTIVE: Many changes have been initiated in the Dutch hospital sector to optimize health-care delivery: national agenda-setting, increased competition and transparency, a new system of hospital reimbursement based on diagnosis-treatment combinations, intensified monitoring of quality and a

  7. Hidden Costs of Hospital Based Delivery from Two Tertiary Hospitals in Western Nepal.

    Directory of Open Access Journals (Sweden)

    Jeevan Acharya

    Full Text Available Hospital based delivery has been an expensive experience for poor households because of hidden costs which are usually unaccounted in hospital costs. The main aim of this study was to estimate the hidden costs of hospital based delivery and determine the factors associated with the hidden costs.A hospital based cross-sectional study was conducted among 384 post-partum mothers with their husbands/house heads during the discharge time in Manipal Teaching Hospital and Western Regional Hospital, Pokhara, Nepal. A face to face interview with each respondent was conducted using a structured questionnaire. Hidden costs were calculated based on the price rate of the market during the time of the study.The total hidden costs for normal delivery and C-section delivery were 243.4 USD (US Dollar and 321.6 USD respectively. Of the total maternity care expenditures; higher mean expenditures were found for food & drinking (53.07%, clothes (9.8% and transport (7.3%. For postpartum women with their husband or house head, the total mean opportunity cost of "days of work loss" were 84.1 USD and 81.9 USD for normal delivery and C-section respectively. Factors such as literate mother (p = 0.007, employed house head (p = 0.011, monthly family income more than 25,000 NRs (Nepalese Rupees (p = 0.014, private hospital as a place of delivery (p = 0.0001, C-section as a mode of delivery (p = 0.0001, longer duration (>5days of stay in hospital (p = 0.0001, longer distance (>15km from house to hospital (p = 0.0001 and longer travel time (>240 minutes from house to hospital (p = 0.007 showed a significant association with the higher hidden costs (>25000 NRs.Experiences of hidden costs on hospital based delivery and opportunity costs of days of work loss were found high. Several socio-demographic factors, delivery related factors (place and mode of delivery, length of stay, distance from hospital and travel time were associated with hidden costs. Hidden costs can be a

  8. Hidden Costs of Hospital Based Delivery from Two Tertiary Hospitals in Western Nepal.

    Science.gov (United States)

    Acharya, Jeevan; Kaehler, Nils; Marahatta, Sujan Babu; Mishra, Shiva Raj; Subedi, Sudarshan; Adhikari, Bipin

    2016-01-01

    Hospital based delivery has been an expensive experience for poor households because of hidden costs which are usually unaccounted in hospital costs. The main aim of this study was to estimate the hidden costs of hospital based delivery and determine the factors associated with the hidden costs. A hospital based cross-sectional study was conducted among 384 post-partum mothers with their husbands/house heads during the discharge time in Manipal Teaching Hospital and Western Regional Hospital, Pokhara, Nepal. A face to face interview with each respondent was conducted using a structured questionnaire. Hidden costs were calculated based on the price rate of the market during the time of the study. The total hidden costs for normal delivery and C-section delivery were 243.4 USD (US Dollar) and 321.6 USD respectively. Of the total maternity care expenditures; higher mean expenditures were found for food & drinking (53.07%), clothes (9.8%) and transport (7.3%). For postpartum women with their husband or house head, the total mean opportunity cost of "days of work loss" were 84.1 USD and 81.9 USD for normal delivery and C-section respectively. Factors such as literate mother (p = 0.007), employed house head (p = 0.011), monthly family income more than 25,000 NRs (Nepalese Rupees) (p = 0.014), private hospital as a place of delivery (p = 0.0001), C-section as a mode of delivery (p = 0.0001), longer duration (>5days) of stay in hospital (p = 0.0001), longer distance (>15km) from house to hospital (p = 0.0001) and longer travel time (>240 minutes) from house to hospital (p = 0.007) showed a significant association with the higher hidden costs (>25000 NRs). Experiences of hidden costs on hospital based delivery and opportunity costs of days of work loss were found high. Several socio-demographic factors, delivery related factors (place and mode of delivery, length of stay, distance from hospital and travel time) were associated with hidden costs. Hidden costs can be a

  9. Sustained Hospital-based Wellness Program

    Science.gov (United States)

    Danielson, Karen; Jeffers, Katharine; Kaiser, Leslie; McKinley, Lee; Kuhn, Thomas; Voorhies, Gigi

    2014-01-01

    Introduction: Beginning as a grassroots initiative, a community hospital employing 2800 celebrates the stress-transforming benefits of HeartMath for its employees and community. Initially introduced to address the deleterious effects of personal stress experienced by the high healthcare claimants of the organization, HeartMath was eventually introduced to every stratification of the organization's population health management. The ensuing depth and breadth of HeartMath's presence in the organization is a consequence of a deliberate effort to integrate the program at every possible and sensible touch point of the organization and, ultimately, patient care. Today, 5 years later, the success of HeartMath at Indiana University (IU) Health Bloomington continues to be a tribute to the grassroots movement of an established worksite wellness program. Methods: HeartMath was initiated as an intervention for transforming the stress of a workforce's highest healthcare claimants: those with the complexities of co-morbidities as well as challenging psychosocial and economic realities. This segment of a workforce is invariably the greatest strain to any organization's health plan. As importantly, on an individual level and subsequent to their health status, the respective employees can experience tremendous personal strain in several dimensions of their lives. Further compounding their marginal and worsening physical health, the inherent challenges of the current medical system to integrate and advocate for their care requires that stress be addressed and skills developed for a positive, long-term, and sustainable outcome. From this small but powerful vantage point, IU Health Bloomington's platinum worksite wellness program (a distinction of the Wellness Council of America) extended HeartMath to every population health management stratification within the organization. This specific program migration happened initially by way of departments and units that expressed, in an

  10. Hospital-based surveillance of congenital rubella syndrome in Indonesia.

    Science.gov (United States)

    Herini, Elisabeth Siti; Gunadi; Triono, Agung; Mulyadi, Asal Wahyuni Erlin; Mardin, Niprida; Rusipah; Soenarto, Yati; Reef, Susan E

    2017-03-01

    Congenital rubella syndrome (CRS) has serious consequences, such as miscarriage, stillbirth, and severe birth defects in infants, resulting from rubella virus infection during pregnancy. However, rubella vaccine has not yet been implemented in Indonesia. This study aimed (1) to estimate the incidence of CRS in Indonesia, (2) describe the clinical features of CRS at our referral hospital, and (3) pilot a CRS surveillance system to be extended to other hospitals. We conducted a 4-month prospective surveillance study of infants aged rubella-specific IgM antibody or rubella IgG antibody levels. Of 47 suspected cases of CRS, 11/47 (23.4%), 9/47 (19.1%), and 27/47 (57.5%) were diagnosed as laboratory-confirmed, clinically compatible, and discarded CRS, respectively. The most common defects among laboratory-confirmed CRS cases were hearing impairment (100%), congenital cataracts (72.7%), microcephaly (72.7%), and congenital heart defects (45.5%). The number of laboratory-confirmed CRS cases among Indonesian infants is high. Furthermore, hearing impairment is the most common clinical feature of CRS in infants. Our findings indicate the importance of implementation of rubella vaccine in Indonesia. Conducting hospital-based surveillance of CRS in other hospitals in Indonesia may be appropriate. What is Known: •Congenital rubella syndrome (CRS) has serious consequences in infants resulting from rubella virus infection during pregnancy. •The incidence of CRS in most developed countries has greatly decreased since implementation of rubella vaccination. •Rubella vaccine has not yet been implemented in many developing countries. What is New: •The number of laboratory-confirmed CRS cases among Indonesian infants was high. •Implementation of rubella vaccine into immunization programs in Indonesia is important because of the high number of CRS cases. •Our study highlights the need for ongoing prospective surveillance of CRS in Indonesia.

  11. [Application of HIS Hospital Management System in Medical Equipment].

    Science.gov (United States)

    Li, Yucheng

    2015-07-01

    To analyze the effect of HIS hospital management system in medical equipment. From April 2012 to 2013 in our hospital 5 100 sets of medical equipment as the control group, another 2013 in our hospital from April 2014 may 100 sets of medical equipment as the study group, comparative analysis of two groups of medical equipment scrap rate, usage, maintenance score and the score of benefit etc. Control group and taken to hospital information system, his research group equipment scrap rate, there was a significant difference, the research group of equipment maintenance score and efficiency scores were higher than those of the control group (P equipment maintenance score and efficiency scores were higher than those of the control group. HIS hospital management system for medical equipment management has positive clinical application value, can effectively improve the use of medical equipment, it is worth to draw and promote.

  12. Hospitals Known for Nursing Excellence Perform Better on Value Based Purchasing Measures.

    Science.gov (United States)

    Lasater, Karen B; Germack, Hayley D; Small, Dylan S; McHugh, Matthew D

    2016-11-01

    It is well-established that hospitals recognized for good nursing care - Magnet hospitals - are associated with better patient outcomes. Less is known about how Magnet hospitals compare to non-Magnets on quality measures linked to Medicare reimbursement. The purpose of this study was to determine how Magnet hospitals perform compared to matched non-Magnet hospitals on Hospital Value Based Purchasing (VBP) measures. A cross-sectional analysis of three linked data sources was performed. The sample included 3,021 non-federal acute care hospitals participating in the VBP program (323 Magnets; 2,698 non-Magnets). Propensity score matching was used to match Magnet and non-Magnet hospitals with similar hospital characteristics. After matching, linear and logistic regression models were used to examine the relationship between Magnet status and VBP performance. After matching and adjusting for hospital characteristics, Magnet recognition predicted higher scores on Total Performance (Regression Coefficient [RC] = 1.66, p hospitals known for nursing excellence perform better on Hospital VBP measures. As healthcare systems adapt to evolving incentives that reward value, attention to nurses at the front lines may be central to ensuring high-value care for patients.

  13. [Hospital clinical engineer orientation and function in the maintenance system of hospital medical equipment].

    Science.gov (United States)

    Li, Bin; Zheng, Yunxin; He, Dehua; Jiang, Ruiyao; Chen, Ying; Jing, Wei

    2012-03-01

    The quantity of medical equipment in hospital rise quickly recent year. It provides the comprehensive support to the clinical service. The maintenance of medical equipment becomes more important than before. It is necessary to study on the orientation and function of clinical engineer in medical equipment maintenance system. Refer to three grade health care system, the community doctors which is called General practitioner, play an important role as the gatekeeper of health care system to triage and cost control. The paper suggests that hospital clinical engineer should play similar role as the gatekeeper of medical equipment maintenance system which composed by hospital clinical engineer, manufacture engineer and third party engineer. The hospital clinical engineer should be responsible of guard a pass of medical equipment maintenance quality and cost control. As the gatekeeper, hospital clinical engineer should take the responsibility of "General engineer" and pay more attention to safety and health of medical equipment. The responsibility description and future transition? development of clinical engineer as "General Engineer" is discussed. More attention should be recommended to the team building of hospital clinical engineer as "General Engineer".

  14. Unified Modeling Language (UML) for hospital-based cancer registration processes.

    Science.gov (United States)

    Shiki, Naomi; Ohno, Yuko; Fujii, Ayumi; Murata, Taizo; Matsumura, Yasushi

    2008-01-01

    Hospital-based cancer registry involves complex processing steps that span across multiple departments. In addition, management techniques and registration procedures differ depending on each medical facility. Establishing processes for hospital-based cancer registry requires clarifying specific functions and labor needed. In recent years, the business modeling technique, in which management evaluation is done by clearly spelling out processes and functions, has been applied to business process analysis. However, there are few analytical reports describing the applications of these concepts to medical-related work. In this study, we initially sought to model hospital-based cancer registration processes using the Unified Modeling Language (UML), to clarify functions. The object of this study was the cancer registry of Osaka University Hospital. We organized the hospital-based cancer registration processes based on interview and observational surveys, and produced an As-Is model using activity, use-case, and class diagrams. After drafting every UML model, it was fed-back to practitioners to check its validity and improved. We were able to define the workflow for each department using activity diagrams. In addition, by using use-case diagrams we were able to classify each department within the hospital as a system, and thereby specify the core processes and staff that were responsible for each department. The class diagrams were effective in systematically organizing the information to be used for hospital-based cancer registries. Using UML modeling, hospital-based cancer registration processes were broadly classified into three separate processes, namely, registration tasks, quality control, and filing data. An additional 14 functions were also extracted. Many tasks take place within the hospital-based cancer registry office, but the process of providing information spans across multiple departments. Moreover, additional tasks were required in comparison to using a

  15. Assessing performance of Botswana's public hospital system: the use of the World Health Organization Health System Performance Assessment Framework.

    Science.gov (United States)

    Seitio-Kgokgwe, Onalenna; Gauld, Robin Dc; Hill, Philip C; Barnett, Pauline

    2014-09-01

    Very few studies have assessed performance of Botswana public hospitals. We draw from a large research study assessing performance of the Botswana Ministry of Health (MoH) to evaluate the performance of public hospital system using the World Health Organization Health Systems Performance Assessment Framework (WHO HSPAF). We aimed to evaluate performance of Botswana public hospital system; relate findings of the assessment to the potential for improvements in hospital performance; and determine the usefulness of the WHO HSPAF in assessing performance of hospital systems in a developing country. This article is based on data collected from document analysis, 54 key informants comprising senior managers and staff of the MoH (N= 40) and senior officers from stakeholder organizations (N= 14), and surveys of 42 hospital managers and 389 health workers. Data from documents and transcripts were analyzed using content and thematic analysis while data analysis for surveys was descriptive determining proportions and percentages. The organizational structure of the Botswana's public hospital system, authority and decision-making are highly centralized. Overall physical access to health services is high. However, challenges in the distribution of facilities and inpatient beds create inequities and inefficiencies. Capacity of the hospitals to deliver services is limited by inadequate resources. There are significant challenges with the quality of care. While Botswana invested considerably in building hospitals around the country resulting in high physical access to services, the organization and governance of the hospital system, and inadequate resources limit service delivery. The ongoing efforts to decentralize management of hospitals to district level entities should be expedited. The WHO HSPAF enabled us to conduct a comprehensive assessment of the public hospital system. Though relatively new, this approach proved useful in this study.

  16. [Evaluation of the Oran university hospital information system].

    Science.gov (United States)

    Chougrani, Saada; Ouhadj, Salah; Agag, Fouzia

    2013-01-01

    Oran university hospital has been operating since 2010. It is a public institution that must assess the resources required to achieve institutional goals integrated into the strategic objectives defined in the hospital development project. Implementation of this project could be supported, among other things, by a strong and efficient hospital information system. Three investigations were conducted: 1- evaluation of the hospital information system, 2- assessment of the quality of the hospital discharge summary reports, 3- assessment of the quality of medical records. The six components of the hospital information system (resources, indicators, sources, management, quality and dissemination and use of data) were clearly present but not satisfactory with a score ranging from 25 to 50% of the total score. The scores by component were as follows: 36% for resources, 37% for indicators, 42% for patient records, 19% for data management and 27% for the dissemination of information. The overall completeness of medical records was 85.2%. Completeness by group of variables gave the following results: 66% for medical information, 54% for the patient's stay and 38% for information relating to the patient's discharge. Hospital discharge summary reports were available in 59.8% of cases, but were blank in 4% of cases. The critical variable, the principal diagnosis was found in 51% of cases. The correct principal diagnosis rate was 33.3%. The deficiencies observed for content and data management raise real questions concerning data management at Oran university hospital as part of a real managerial approach.

  17. Hospital kanban system implementation: Evaluating satisfaction of nursing personnel

    National Research Council Canada - National Science Library

    Aguilar-Escobar, Víctor G; Bourque, Sarah; Godino-Gallego, Nicolás

    2015-01-01

    .... This study aims to measure nurses’ satisfaction with kanban systems in logistics of medical consumables and assesses possible advantages and differences among user groups through an anonymous survey at Hospital Universitario Virgen...

  18. Performance of interventional procedures in a day-hospital system

    Energy Technology Data Exchange (ETDEWEB)

    Bae, Jae Ik; Park, Auh Whan; Cho, Hye Seon; Park, Eun Hee; Choi, Gap Suk; Lee, Seon Ju; Kim, Yong Woo; Juhn, Je Ryang [Busan Paik Hospital, Inje University College of Medicine, Busan (Korea, Republic of)

    2007-01-15

    We wanted to describe the practice and results of applying the day-hospital system in an interventional radiology clinic. From Oct. 2004 to Dec. 2005, the day-hospital system was applied to various interventional procedures with using a part of the recovery room of an angiography suite as a facility for hospital admission. The study included 91 cases in 73 patients. The source of the patient referral, the procedures, hospital courses and complications were analyzed and questionnaire surveys were conducted for the available 55 patients. Among the patients, 70% (n=64) were referred form other departments, 5% (n=5) from other hospitals, 5% (n=4) were new patients and 20% (n=18) were re-admissions. The procedures included gastrointestinal, biliary, urinary, hemodialysis related-and implantable port related interventions. 96% (n=87) of the patients were successfully discharged in a day and admission to the general ward was only 4% (n=4). Minor complications occurred after discharges in 3% (n=3). The questionnaire survey revealed that 96% (n=53) of the patients were satisfied with the service and they were not anxious after discharge. Most of common interventional procedures were safely done under the day-hospital system with the patients being highly satisfied. The day-hospital system can be a good tool for establishing admitting privileges for an interventional radiology clinic.

  19. Hospital based Treatment for Internet Addicts.

    Science.gov (United States)

    Gioka, Sophia; Kefaliakos, Antonis; Ioannou, Andriani; Mechili, Aggelos; Diomidous, Marianna

    2014-01-01

    The importance of recognizing the symptoms of Internet addiction constitutes the first step for treatment. Internet use can be pathological, and the percentage of addicted people is increasing while people become dependent on technology and Internet continues to develop. This study is a systematic litterature review. An electronic literature search was conducted using as keywords internet addiction, psychological implications, internet abuse etc. to the following databases: Medline, PubMed and Google Schoolar. The majority of research was conducted in Europe and in North America. We found 20 surveys. 9 were excluded on the basis of screening due to full text articles were not available. The final number of included surveys was 11. Hospitals and clinics have to emerge with outpatient treatment services for Internet addiction recovery, and in some cases there may be a need for addiction rehabilitation centers as admitted from people with Internet addiction into inpatient care.

  20. Advantages of Re-Establishing Hospital Based Schools of Nursing

    OpenAIRE

    Dahl, Susan

    2006-01-01

    This study examined perceptions of hospital-based nursing schools among nursing professionals to determine whether this type of nursing education model is viable in the modern nursing context. Nursing education is faced with the twin problems of insufficient nurses, which creates a demand for rapid education of nurses, and ensuring adequate clinical quality of nurses, which creates a demand for more extensive undergraduate clinical training. Hospital-based nursing schools are three-year progr...

  1. Design and implementation of materials management system for hospital warehouse of combat readiness based on RFID%基于RFID的医院战备库物资管理系统设计与实现

    Institute of Scientific and Technical Information of China (English)

    姜宏涛; 向卓

    2017-01-01

    目的:开发一种基于射频识别(RFID)技术部队医院战备库物资管理信息系统,用于提高部队医疗队战备物资的管理水平.方法:在战备物资上粘贴相应信息的RFID标签,通过阅读器读取物资信息.采用SQL Server2005作为后台数据库,将VC#结合RFID技术进行软件系统开发.结果:开发出基于RFID部队医院战备库物资管理信息系统,实现了物资的信息管理、出入库管理、预案管理以及预警管理的信息化.经过演练,医疗队物资平均出库时间比之前节省了12 min.结论:医院战备库物资信息管理系统的研发,对研究RFID技术在战备库物资管理中的应用具有一定参考价值.%Objective:To develop a materials management information system for military hospital warehouse of combat readiness based on RFID so as to enhance the management of military medical corps for materials of war preparation.Methods:RFID(Radio Frequency Identification) tags were attached on war materials and the information could been read by bar-code reader. SQL Server 2005 was used as the backend database, and VC# was combined with RFID to develop the software system.Results: This research has developed a materials management information system for military hospital warehouse of combat readiness based on RFID and this system could achieve informatization for information management, management of out and in warehouse, emergency plans management and forewarning management. Through manoeuvre, the average time of war materiel out warehouse has saved 12min.Conclusion: The research and development of information management system for materiel information of hospital warehouse for combat readiness has reference value for the application of researching RBID technique in material management.

  2. Information security risk management for computerized health information systems in hospitals: a case study of Iran

    Directory of Open Access Journals (Sweden)

    Zarei J

    2016-05-01

    Full Text Available Javad Zarei,1 Farahnaz Sadoughi2 1Health Information Management, Health Management and Economics Research Center, School of Health Management and Information Science, Iran University of Medical Sciences, Tehran, Islamic Republic of Iran, 2Health Information Management Department, School of Health Management and Information Science, Iran University of Medical Sciences, Tehran, Islamic Republic of Iran Background: In recent years, hospitals in Iran – similar to those in other countries – have experienced growing use of computerized health information systems (CHISs, which play a significant role in the operations of hospitals. But, the major challenge of CHIS use is information security. This study attempts to evaluate CHIS information security risk management at hospitals of Iran.Materials and methods: This applied study is a descriptive and cross-sectional research that has been conducted in 2015. The data were collected from 551 hospitals of Iran. Based on literature review, experts’ opinion, and observations at five hospitals, our intensive questionnaire was designed to assess security risk management for CHISs at the concerned hospitals, which was then sent to all hospitals in Iran by the Ministry of Health.Results: Sixty-nine percent of the studied hospitals pursue information security policies and procedures in conformity with Iran Hospitals Accreditation Standards. At some hospitals, risk identification, risk evaluation, and risk estimation, as well as risk treatment, are unstructured without any specified approach or methodology. There is no significant structured approach to risk management at the studied hospitals.Conclusion: Information security risk management is not followed by Iran’s hospitals and their information security policies. This problem can cause a large number of challenges for their CHIS security in future. Therefore, Iran’s Ministry of Health should develop practical policies to improve information security

  3. Hospital incident command system (HICS performance in Iran; decision making during disasters

    Directory of Open Access Journals (Sweden)

    Djalali Ahmadreza

    2012-02-01

    Full Text Available Abstract Background Hospitals are cornerstones for health care in a community and must continue to function in the face of a disaster. The Hospital Incident Command System (HICS is a method by which the hospital operates when an emergency is declared. Hospitals are often ill equipped to evaluate the strengths and vulnerabilities of their own management systems before the occurrence of an actual disaster. The main objective of this study was to measure the decision making performance according to HICS job actions sheets using tabletop exercises. Methods This observational study was conducted between May 1st 2008 and August 31st 2009. Twenty three Iranian hospitals were included. A tabletop exercise was developed for each hospital which in turn was based on the highest probable risk. The job action sheets of the HICS were used as measurements of performance. Each indicator was considered as 1, 2 or 3 in accordance with the HICS. Fair performance was determined as Results None of the participating hospitals had a hospital disaster management plan. The performance according to HICS was intermediate for 83% (n = 19 of the participating hospitals. No hospital had a high level of performance. The performance level for the individual sections was intermediate or fair, except for the logistic and finance sections which demonstrated a higher level of performance. The public hospitals had overall higher performances than university hospitals (P = 0.04. Conclusions The decision making performance in the Iranian hospitals, as measured during table top exercises and using the indicators proposed by HICS was intermediate to poor. In addition, this study demonstrates that the HICS job action sheets can be used as a template for measuring the hospital response. Simulations can be used to assess preparedness, but the correlation with outcome remains to be studied.

  4. Introduction of voluntary environmental management systems into the Spanish hospital network: current state (2015

    Directory of Open Access Journals (Sweden)

    Sergio García Vicente

    2016-12-01

    Full Text Available Hospitals produce vast amounts of waste and are large consumers of energy and natural resources. However, do they worry about environmental health? With this question in mind, and in order to approach hospital environmental practices, the introduction into the Spanish hospital network of the most accepted certified environmental management systems (CEMS, such as ISO 14001 and EMAS, was evaluated so as to obtain a point of reference for environmental practices in our National Health System as no up-to-date, specific official register exists. To this end, a list of hospitals by Spanish Autonomous Community having CEMS in force in 2015 was drawn up using official databases, evaluating information and conducting fieldwork. We found that 18.9 % of hospitals had CEMS (ISO 14001 in all cases: 149 out of 787 hospitals, in the National Hospitals Catalogue, especially in Madrid (40 and Andalusia (37. Eighty-one of the certified hospitals are private. Only 23 had EMAS: 12 are public and 11 private. The resulting “map” shows the main references in order for the need to offer citizens a balance between healthcare and environmental friendliness, to be compared and envisaged based on hospital activity, considering hospitals socially responsible, environmentally friendly organisations, that seek leadership in the field of environmental sustainability together with other sectors (environmental, engineering, industrial.

  5. The changing configuration of hospital systems: centralization, federalization, or fragmentation?

    Science.gov (United States)

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

    2012-01-01

    Research on hospital system organization is dated and cross-sectional. We analyze trends in system structure during 2000-2010 to ascertain whether they have become more centralized or decentralized. We test hypotheses drawn from organization theory and estimate empirical models to study the structural transitions that systems make between different "clusters" defined by the American Hospital Association. There is a clear trend toward system fragmentation during most of this period, with a small recent shift to centralization in some systems. Systems decentralize as they increase their members and geographic dispersion. This is particularly true for systems that span multiple states; it is less true for smaller regional systems and local systems that adopt a hub-and-spoke configuration around a teaching hospital. Our time series ends in 2010 just as health care reform was implemented. We also rely on a single measure of system centralization. Systems that appear to be able to centrally coordinate their services are those that operate in local or regional markets. Larger systems that span several states are likely to decentralize or fragment. System fragmentation may thwart policy aims pursued in health care reform. The potential of Accountable Care Organizations rests on their ability to coordinate multiple providers via centralized governance. Hospitals systems are likely to be central players in many ACOs, but may lack the necessary coherence to effectively play this governance role. Not all hospital systems act in a systemic manner. Those systems that are centralized (and presumably capable of acting in concerted fashion) are in the minority and have declined in prevalence over most of the past decade.

  6. Hospital charitable lotteries: taking a gamble on systems thinking.

    Science.gov (United States)

    Reynolds, Jennifer

    2013-12-01

    The presence of lotteries can be witnessed worldwide. Charitable lotteries are often portrayed as 'good works', and recently, hospitals have utilized them as a popular fundraising vehicle to raise necessary funds to help achieve organizational goals and objectives. Research indicates that lotteries contribute to gambling-related harms; however, research into charitable lotteries has been underdeveloped. Both the gambling and the health care industries are complex and evolving, consisting of many interacting stakeholders with often different and competing interests. This article seeks to present systems thinking as a conceptual framework to help fill the gap in understanding the use of gambling within hospitals and its possible benefits and unforeseen negative consequences. Addressing the gap in knowledge is important to help inform decision making aimed at reducing gambling-related harms. This article proposes how the school of systems thinking, specifically framing hospitals as complex adaptive systems and system dynamics modelling, can be utilized to understand the policy implications of the adoption of lotteries as a revenue source for hospitals. Hospitals have a duty to care, inform and protect. Hospital charitable lotteries have become big business; however, its incorporation into critical funding strategies needs to be carefully understood. Systems thinking theory and methodologies provide an integrated approach to examine this dynamic and evolving fundraising initiative. Findings from this article can inform the development of action strategies, including policy development at multiple levels. © 2013 John Wiley & Sons Ltd.

  7. Challenges of using Hospital Information Systems by nurses: comparing academic and non-academic hospitals.

    Science.gov (United States)

    Ahmadian, Leila; Dorosti, Nafise; Khajouei, Reza; Gohari, Sadrieh Hajesmaeel

    2017-06-01

    Hospital Information Systems (HIS) are used for easy access to information, improvement of documentation and reducing errors. Nonetheless, using these systems is faced with some barriers and obstacles. This study identifies the challenges and the obstacles of using these systems in the academic and non-academic hospitals in Kerman. This is a cross-sectional study which was carried out in 2015. The statistical population in this study consisted of the nurses who had been working in the academic and non-academic hospitals in Kerman. A questionnaire consisting of two sections was used. The first section consisted of the demographic information of the participants and the second section comprised 34 questions about the challenges of HIS use. Data were analyzed by the descriptive and statistical analysis (t-test, and ANOVA) using SPSS 19 software. The most common and important challenges in the academic hospitals were about human environment factors, particularly "negative attitude of society toward using HIS". In the non-academic hospitals, the most common and important challenges were related to human factors, and among them, "no incentive to use system" was the main factor. The results of the t-test method revealed that there was a significant relationship between gender and the mean score of challenges related to the organizational environment category in the academic hospitals and between familiarity with HIS and mean score of human environment factors (pinformation systems are the factors related to the human environment and the human factors. The results of this study can bring a good perspective to the policy makers and the managers regarding obstacles of using HISs from the nurses' perspective, so that they can solve their problems and can successfully implement these systems.

  8. Hospital Value-Based Purchasing Performance: Do Organizational and Market Characteristics Matter?

    Science.gov (United States)

    Spaulding, Aaron; Edwardson, Nick; Zhao, Mei

    The hospital value-based purchasing (HVBP) program of the Centers for Medicare & Medicaid Services challenges hospitals to deliver high-quality care or face a reduction in Medicare payments. How do different organizational structures and market characteristics enable or inhibit successful transition to this new model of value-based care? To address that question, this study employs an institutional theory lens to test whether certain organizational structures and market characteristics mediate hospitals' ability to perform across HVBP domains.Data from the 2014 American Hospital Association Annual Survey Database, Area Health Resource File, the Medicare Hospital Compare Database, and the association between external environment and hospital performance are assessed through multiple regression analysis. Results indicate that hospitals that belong to a system are more likely than independent hospitals to score highly on the domains associated with the HVBP incentive arrangement. However, varying and sometimes counterintuitive market influences bring different dimensions to the HVBP program. A hospital's ability to score well in this new value arrangement may be heavily based on the organization's ability to learn from others, implement change, and apply the appropriate amount of control in various markets.

  9. Recommended modifications and applications of the Hospital Emergency Incident Command System for hospital emergency management.

    Science.gov (United States)

    Arnold, Jeffrey L; Dembry, Louise-Marie; Tsai, Ming-Che; Dainiak, Nicholas; Rodoplu, Ulkümen; Schonfeld, David J; Paturas, James; Cannon, Christopher; Selig, Scott

    2005-01-01

    The Hospital Emergency Incident Command System (HEICS), now in its third edition, has emerged as a popular incident command system model for hospital emergency response in the United States and other countries. Since the inception of the HEICS in 1991, several events have transformed the requirements of hospital emergency management, including the 1995 Tokyo Subway sarin attack, the 2001 US anthrax letter attacks, and the 2003 Severe Acute Respiratory Syndrome (SARS) outbreaks in eastern Asia and Toronto, Canada. Several modifications of the HEICS are suggested to match the needs of hospital emergency management today, including: (1) an Incident Consultant in the Administrative Section of the HEICS to provide expert advice directly to the Incident Commander in chemical, biological, radiological, nuclear (CBRN) emergencies as needed, as well as consultation on mental health needs; (2) new unit leaders in the Operations Section to coordinate the management of contaminated or infectious patients in CBRN emergencies; (3) new unit leaders in the Operations Section to coordinate mental health support for patients, guests, healthcare workers, volunteers, and dependents in terrorism-related emergencies or events that produce significant mental health needs; (4) a new Decedent/Expectant Unit Leader in the Operations Section to coordinate the management of both types of patients together; and (5) a new Information Technology Unit Leader in the Logistics Section to coordinate the management of information technology and systems. New uses of the HEICS in hospital emergency management also are recommended, including: (1) the adoption of the HEICS as the conceptual framework for organizing all phases of hospital emergency management, including mitigation, preparedness, response, and recovery; and (2) the application of the HEICS not only to healthcare facilities, but also to healthcare systems. Finally, three levels of healthcare worker competencies in the HEICS are suggested

  10. Nurse Staffing Calculation in the Emergency Department - Performance-Oriented Calculation Based on the Manchester Triage System at the University Hospital Bonn.

    Directory of Open Access Journals (Sweden)

    Ingo Gräff

    Full Text Available To date, there are no valid statistics regarding the number of full time staff necessary for nursing care in emergency departments in Europe.Staff requirement calculations were performed using state-of-the art procedures which take both fluctuating patient volume and individual staff shortfall rates into consideration. In a longitudinal observational study, the average nursing staff engagement time per patient was assessed for 503 patients. For this purpose, a full-time staffing calculation was estimated based on the five priority levels of the Manchester Triage System (MTS, taking into account specific workload fluctuations (50th-95th percentiles.Patients classified to the MTS category red (n = 35 required the most engagement time with an average of 97.93 min per patient. On weighted average, for orange MTS category patients (n = 118, nursing staff were required for 85.07 min, for patients in the yellow MTS category (n = 181, 40.95 min, while the two MTS categories with the least acute patients, green (n = 129 and blue (n = 40 required 23.18 min and 14.99 min engagement time per patient, respectively. Individual staff shortfall due to sick days and vacation time was 20.87% of the total working hours. When extrapolating this to 21,899 (2010 emergency patients, 67-123 emergency patients (50-95% percentile per month can be seen by one nurse. The calculated full time staffing requirement depending on the percentiles was 14.8 to 27.1.Performance-oriented staff planning offers an objective instrument for calculation of the full-time nursing staff required in emergency departments.

  11. A hospital-based cost minimization study of the potential financial impact on the UK health care system of introduction of iron isomaltoside 1000

    Directory of Open Access Journals (Sweden)

    Sunil Bhandari

    2011-03-01

    Full Text Available Sunil BhandariDepartment of Renal Medicine, Hull and East Yorkshire Hospitals National Health Service Trust and Hull York Medical School, Kingston upon Hull, UKBackground: The clinical need to be able to administer high doses of intravenous iron conveniently in a single rapid infusion has been addressed by the recent introduction of ferric carboxymaltose and subsequently iron isomaltoside 1000. Neither requires a test dose. Ferric carboxymaltose can be administered at 15 mg/kg body weight to a maximum dose of 1000 mg, whereas iron isomaltoside 1000 can be administered at 20 mg/kg body weight. The ability to give high doses of iron is important in the context of managing iron deficiency anemia in a number of clinical conditions where demands for iron are high (including chronic blood loss associated with inflammatory bowel disease, menorrhagia, and chronic kidney disease. It is also an important component in the strategy as an alternative to a blood transfusion. Affordability is a key issue for health services.Methods: This study was a comparative analysis of the costs of administering the newly available intravenous iron formulations against standard practice (blood transfusion, intravenous iron sucrose by considering the cost of this treatment option plus nursing costs associated with administration, equipment for administration, and patient transportation in the secondary care (hospital setting across three dosage levels (600 mg, 1000 mg, and 1600 mg.Results and conclusion: The analysis indicates that the use of iron isomaltoside 1000 results in a net saving when compared with iron sucrose, blood, and ferric carboxymaltose. At 600 mg and 1000 mg doses, it is cheaper than low-molecular-weight iron dextran but more expensive at a dose of 1600 mg. However, it takes six hours to administer low-molecular-weight iron dextran at this dose level, which is inconvenient and reduces patient throughput (productivity.Keywords: iron isomaltoside 1000, iron

  12. A Multi-Modal Digital Game-Based Learning Environment for Hospitalized Children with Chronic Illnesses.

    Science.gov (United States)

    Chin, Jui-Chih; Tsuei, Mengping

    2014-01-01

    The aim of this study was to explore the digital game-based learning for children with chronic illnesses in the hospital settings. The design-based research and qualitative methods were applied. Three eight-year-old children with leukemia participated in this study. In the first phase, the multi-user game-based learning system was developed and…

  13. DYSELECTROLYTEMIA IN ELDERLY: A HOSPITAL BASED STUDY

    Directory of Open Access Journals (Sweden)

    Tanushree

    2016-03-01

    Full Text Available INTRODUCTION Dyselectrolytemia is a common problem affecting elderly hospitalised patients. Although hypo/hypernatremia is the most common electrolyte abnormality found in elderly, abnormalities in other electrolytes may also occur in various settings. Information regarding the pattern of electrolyte abnormalities in elderly is lacking in this part of the country. With this background the following case control study was taken up with the following aims and objectives. OBJECTIVES • To study the various patterns of dyselectrolytemia in elderly and compare them with young. • To evaluate and compare the various aetiological factors and comorbid conditions involved in the occurrence of electrolyte abnormalities in these groups of patients. RESULTS The mean age of the study population was 66.174 years (SD- 6.512 years and of the control group was 41.94 years (SD - 10.924 years. Hyponatraemia was the most common electrolyte abnormality encountered in both the groups (57% vs. 60%, p- 0.61. The incidence of hyperkalaemia was significantly higher in the older age group (19.5% vs. 11.5%, p-0.03. Also, in the elderly, the presence of abnormalities in more than one electrolyte level was significantly higher than the young (25.5% vs. 14%, p -0.005. The average length of hospital stay in the elderly was 10.05 days (SD- 4.40 days whereas in the young was 6.35 days (SD- 3.27 days, p <0.0001. The mortality rate was also significantly higher in the elderly group (16% vs. 3.5%, p<0.0001. CONCLUSION Dyselectrolytemia is a common pathological condition encountered in the elderly population which is associated with a very high morbidity and mortality when compared with the young. Hence, elderly patients particularly with associated comorbid conditions should be screened routinely for the presence of associated electrolyte disturbances.

  14. Determinants of quality management systems implementation in hospitals.

    Science.gov (United States)

    Wardhani, Viera; Utarini, Adi; van Dijk, Jitse Pieter; Post, Doeke; Groothoff, Johan Willem

    2009-03-01

    To identify the problems and facilitating factors in the implementation of quality management system (QMS) in hospitals through a systematic review. A search strategy was performed on the Medline database for articles written in English published between 1992 and early 2006. Using the thesaurus terms 'Total Quality Management' and 'Quality Assurance Health Care', combined with the term 'hospital' and 'implement*', we identified 533 publications. The screening process was based on empirical articles describing organization-wide QMS implementation. Fourteen empirical articles fulfilled the inclusion criteria and were reviewed in this paper. An organization culture emphasizing standards and values associated with affiliation, teamwork and innovation, assumption of change and risk taking, play as the key success factor in QMS implementation. This culture needs to be supported by sufficient technical competence to apply a scientific problem-solving approach. A clear distribution of QMS function within the organizational structure is more important than establishing a formal quality structure. In addition to management leadership, physician involvement also plays an important role in implementing QMS. Six supporting and limiting factors determining QMS implementation are identified in this review. These are the organization culture, design, leadership for quality, physician involvement, quality structure and technical competence.

  15. Interdisciplinary Quality Improvement Conference: Using a Revised Morbidity and Mortality Format to Focus on Systems-Based Patient Safety Issues in a VA Hospital: Design and Outcomes.

    Science.gov (United States)

    Gerstein, Wendy H; Ledford, Judith; Cooper, Jacqueline; Lloyd, Melissa G; Moore, Timothy; Harji, Farzana; Twitty, Vivian; Brooks, Annette; Oliver, Rosalinda C; Goff, James M

    2016-01-01

    The Veterans Healthcare Administration (VA) has embraced patient safety and quality improvement in the quest to improve care for veterans. The New Mexico VA Health Care System introduced a new morbidity and mortality conference, called the Interdisciplinary Quality Improvement Conference (IQIC), using patient case presentations to focus on underlying systems in the clinical care environment. The revised conference design also effectively teaches the 6 Accreditation Council for Graduate Medical Education (ACGME) core requirements for resident education. A formal process was established for case selection, presentation, systems issue identification, tracking, and follow-up. The IQIC has enabled the identification of more than 20 system issues at the study institution. Outcome data show lasting improvement in system issues that were addressed by this mechanism. The VA IQIC is an effective method to both identify and correct systems issues that affect patient care and is an effective method for teaching residents the 6 ACGME requirements for residency education. © The Author(s) 2014.

  16. Why hospitals are prime candidates for CHP systems

    Energy Technology Data Exchange (ETDEWEB)

    Katsanis, J.S.; Tsarabaris, P.T.; Bourkas, P.D. [National Technical Univ. of Athens, Athens (Greece). Dept. of Electrical and Computer Engineering; Malahias, G.N. [Hellenic Naval Academy, Athens (Greece)

    2007-07-01

    Combined heat and power systems for hospitals were discussed. Hospitals and clinics have higher energy consumption levels in relation than many other buildings. High power reliability and quality is required. While hospitals typically drive their heat and electrical power separately, the approach can lead to losses from power station generators and local boilers. CHP units eliminate losses by burning fuels to generate electricity while using waste heat to provide warmth and hot water. Studies have demonstrated that considerable decreases in energy use can be achieved if CHP systems are used in hospitals. A new directive from the European Union is designed to promote high efficiency cogeneration in the internal energy market. The use of on-site power generators will allow hospitals to decide when to generate their own power and can offer significant savings and improved energy efficiency. A case study of a Greek hospital in Athens was used to demonstrate that in addition to significantly reducing energy costs for the hospital, carbon dioxide (CO{sub 2}) emissions were reduced by 46 per cent. 25 refs., 4 tabs., 9 figs.

  17. A hospital microwave system for library telecommunication.

    Science.gov (United States)

    Hempel, R M; Ward, B A

    1988-01-01

    The medical library of the Olin E. Teague Veterans' Center needed access to an online integrated library system at a site eighty miles away. The center already operated a tower-to-tower microwave for teleconferencing and the library was able to use this as a temporary means of communication with the distant online system. The microwave link performed satisfactorily, leading to consideration of its use for other library applications. PMID:3224225

  18. Patient Accessibility to Hospitals in Winter Road Conditions: GIS-Based Analysis Using Car Navigation Probe Data.

    Science.gov (United States)

    Tanikawa, Takumi; Ohba, Hisateru; Yagahara, Ayako; Ogasawara, Katsuhiko

    2017-01-01

    The purpose of this study was to estimate geographical patient flow to hospitals during winter seasons using simulation analysis. We used probe data collected from car navigation systems and performed a Geographical Information System (GIS)-based analysis to determine the relationship between travel time to hospitals and winter road conditions. Accessibility to hospitals based on travel time in summer and winter was overlayed on a map to demonstrate the increase in travel time during winter.

  19. Hospital food service: a comparative analysis of two foodservice systems at a Danish Hospital

    DEFF Research Database (Denmark)

    Justesen, Lise; René, Michael; Kristensen, Marianne Boll

    2016-01-01

    % of the protein requirements on CCP compared to 33 % on BTS (p=0,216). Conclusions A new foodservice system (CCP) which increases availability and choice of food 24/7 does not show a significant improvement of energy and protein intake in hospitalized patients and patients at nutritional risk. However, further......Background Insufficient dietary intake is common among hospitalised patients and may affect prognosis negatively. Hence hospital meals are central in the treatment, and their efficacy in ensuring adequate intake is crucial. This study aimed to compare patients’ dietary intake from a cook......-serve buffet-trolley serving system (BTS) to a new cook-chill pre-plated concept (CCP) allowing patients to choose from a static menu 24/7. Methods A quasi-experimental study was conducted at two orthopaedic surgical and a gynaecological surgical ward at a Danish Hospital. 57patients (≥3 days) were served...

  20. SELECTING A MANAGEMENT SYSTEM HOSPITAL BY A METHOD MULTICRITERIA

    Directory of Open Access Journals (Sweden)

    Vitorino, Sidney L.

    2016-12-01

    Full Text Available The objective of this report is to assess how the multi-criteria method Analytic Hierarchy Process [HP] can help a hospital complex to choose a more suitable management system, known as Enterprise Resource Planning (ERP. The choice coated is very complex due to the novelty of the process of choosing and conflicts generated between areas that did not have a single view of organizational needs, generating a lot of pressure in the department responsible for implementing systems. To assist in this process, he was hired an expert consultant in decision-making and AHP, which in its role of facilitator, contributed to the criteria for system selection were defined, and the choice to occur within a consensual process. We used the study of a single case, based on two indepth interviews with the consultant and the project manager, and documents generated by the advisory and the tool that supported the method. The results of this analysis showed that the method could effectively collaborate in the system acquisition process, but knowledge of the problems of employees and senior management support, it was not used in new decisions of the organization. We conclude that this method contributed to the consensus in the procurement process, team commitment and engagement of those involved.

  1. The impact of epidural analgesia compared to systemic opioid-based analgesia with regard to length of hospital stay and recovery of bowel function: retrospective evaluation of 1555 patients undergoing thoracotomy.

    Science.gov (United States)

    Kampe, Sandra; Weinreich, Gerhard; Darr, Christopher; Eicker, Kolja; Stamatis, Georgios; Hachenberg, Thomas

    2014-11-23

    To assess the protocols of epidural analgesia versus systemic opioid-based analgesia retrospectively in 1555 thoracotomies in our thoracic centre during 2011-2013. Pain therapy is aggressive and standardized in our thoracic centre thoughout the complete postoperative stay. Patients receive either standardized epidural analgesia with ropivacaine + sufentanil 4-8 mls/h (500 mls bag) and are bridged when the epidural bag is finished to a standardized controlled-release oxycodone protocol with non opioid every 6 hours (EDA Group), or patients receive immediately postoperative standardized oral analgesic protocol with controlled-released oxycodone and non opioid every 6 h (Opioid Group). All patients are visited daily by a pain specialist throughout the whole stay. Data of 1555 thoracotomies from 2011-2013 were analysed, 838 patients in the EDA Group and 717 patients in the Opioid Group. There was no difference with regard to sex or age between groups. 7.5% of patients in the EDA Group and 13% in the Oxy Group had a preexisting pain therapy (p = 0.001). In the EDA Group epidural analgesia was performed for 4.6 ± 1.5 days. Length of hospital stay was the same in both groups (EDA: 9.9.6 ± 4.9 vs Opioid: 9.6 ± 5.8 days). 84.7% of patients in the EDA Group and 79.1% of patients of the Oxy Group were dismissed with oral opioid (p < 0.004). When patients were dismissed with opioid medication patients in the EDA Group were dismissed with higher oxycodone opioid doses than patients in the Opioid Group (29.5 ± 15.2 mg vs 26.9 ± 15.2 mg, p = 0.01). There was no difference with regard to dejection time between the two groups (EDA: 3.8 ± 2.2 days vs Opioid: 3.7 ± 1.6 days, n.s.). We first present data monitoring postoperative analgesic protocols after thoracotomies throughout the whole stay in hospital until dismission. Our retrospective data indicate that patients with epidural analgesia stay as long in hospital as

  2. Is There a Relationship Between Value-Based Purchasing and Hospital Profitability? An Exploratory Study of Missouri Hospitals.

    Science.gov (United States)

    Turner, Jason S; Broom, Kevin D; Counte, Michael A

    2015-01-01

    Recent US legislation is attempting to transition inpatient Medicare payments to a value-based purchasing (VBP) program. The VBP program is a pay-for-performance (P4P) system that incentivizes hospitals to improve patient satisfaction, health outcomes, and adherence to clinical protocols while simultaneously holding down costs. Our study evaluates (1) the impact of financial performance on the VBP adjustments and (2) whether there is a correlation between the VBP adjustment and the financial performance of Missouri hospitals that opted into the program. While upward and downward adjustments to the inpatient base rate may be related to hospital financial performance, prior financial performance may also be related to the adjustments. Financial health may allow facilities to invest and position the hospital for favorable future P4P adjustments. The results of our analysis indicate the VBP adjustment to the inpatient base rate is very small (±0.18%), clustered around zero, and is not correlated with financial performance. We also find that financial performance and improvement in the years prior to the adjustment are not related to the VBP adjustment or its respective components. This suggests that CMS is avoiding penalizing less profitable facilities, but the adjustment is also so small and tightly clustered around zero that it is failing to provide an adequate incentive to hospitals. The costs of improving patient satisfaction, clinical process adherence, health care outcomes, and efficiency above that of peers coupled with the growing number of metrics being used to calculate the VBP adjustments call into question the financial incentives of the hospital VBP program.

  3. An Evaluation of the Management Information System and Technology in Hospitals (GESITI/Hospitals

    Directory of Open Access Journals (Sweden)

    Antonio José Balloni

    2017-02-01

    Full Text Available The research project "Management of System and Information Technology in Hospitals" (GESITI/Hospitals has the purpose of mapping out the management of Information Systems (IS and Information Technology (IT in hospitals. By applying a multifocal prospective questionnaire in hospitals, the research aims to identify the hospitals need and demand, prospecting for unfolding, and generate a public integrated research report for supporting public and/or private decisions-makings. The ultimate result from this GESITI/Health research project should be a significant improvement on the hospital management and on the decisions-makings, which must reflect on peoples more satisfied regarding a better health care. Therefore, this paper aims to publish the main ideas of the GESITI/Health project i.e., its "Methodology & original Prospective Questionnaire (PQ". The methodology used is the Interpretative (or Introspective. About the PQ, we do not known, up to this date, who have developed a multifocal broad field tool -the PQ-, aiming wide hospitals management-. From 2010-16 the "methodology and PQ" have been implemented by about forty -40- universities -and increasing-, from Brazil and Abroad and, forty local research reports were generated. A book, published by the Brazilian Minister of Health [1], presents the results of a pilot project carried out by nineteen -19- out of these forty -40- universities, to know: sixteen Brazilian, one Mexican, one Argentina, one from Slovakia and one from Portugal. The chapter 25 of this book [1.A] presents an integrated research from all nineteen chapters -an integrated research report-. Finally, in the oral presentation, we will briefly present the "Methodology and the PQ" presented in this paper and, also, we will present an integrated comparative analyzes -main results got with the field application of the PQ- regarding the case studies accomplished by the universities from Brazil and Abroad.

  4. Hospital accounting and information systems: a critical assessment.

    Science.gov (United States)

    Macintosh, N B

    1991-01-01

    Public sector organisations seem to be caught up in the global wave of 'neo-Thatcherism'. As such, they are being held 'accountable' today by their respective government finance departments for the costs and benefits of the services they provide to the general public. As the public purse tightens, hospitals (and related health service units) more and more compete with other public sector organisations (old-age pensions and services, post-secondary education, day-care centres, port authorities, unemployment insurance, parks and recreation, elite sport programs, aboriginal peoples aid and development, and so on) for a diminishing piece of what seems a smaller and smaller pie. In this 'fight-for-funding', hospitals seem particularly vulnerable. Sky-rocketing costs, public resentment of doctors' high income and a deliberate restriction and limiting of medical school places, among other things, contribute to general public antagonism. The message for hospitals is that cost-effective accountability will loom large when hospitals come begging at the public trough. Even left-wing politicians today seem to be heeding the words of free-market economists like Freedman of Chicago. 'Privatisation' is the constant threat for those deemed inefficient. As a consequence, hospital administrators around the world, caught up in this trend, seem to be stampeding to 'boot-up' some kind of new accounting information system. For example, at my own university hospital (Queen's University, Kingston, Canada), the hospital administrators are in the process of introducing a version of the Johns Hopkins Hospital (Baltimore, Maryland) case-mix-loading cost-accumulation system. In other parts of the world they are known by other fancy names such as 'patient-costing', 'diagnosis-related-groups' (or DRGs). Trendy accounting systems seem to be the order of the day, a sort of panacea for the current plague of problems hospitals face. As the new systems become operational, however, traditional

  5. Digestive system complications among hospitalized children with ...

    African Journals Online (AJOL)

    Conclusion: Acute abdominal crisis is the most common digestive system complication in children with sickle cell anaemia in our setting. Efforts should be made to exclude other potential causes of acute abdomen which may require surgical intervention in children with sickle cell anaemia. History taking, diligent physical ...

  6. 78 FR 27485 - Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the...

    Science.gov (United States)

    2013-05-10

    ... I-O Input-Output IOM Institute of Medicine IPF Inpatient psychiatric facility IPFQR Inpatient... Disorders of the Circulatory System) a. Discharge/Transfer to Designated Disaster Alternative Care Site b... Program e. Proposed Disaster/Extraordinary Circumstance Waivers under the Hospital VBP Program 10...

  7. Surveillance during pregnancy: methods and response rates from a hospital based pilot study of the Pregnancy Risk Assessment Monitoring System in Ireland

    National Research Council Canada - National Science Library

    O'Keeffe, Linda M; Kearney, Patricia M; Greene, Richard A

    2013-01-01

    .... PRAMS is a CDC surveillance program which was established in the United States in 1987 to generate high quality, population based data to reduce infant mortality rates and improve maternal and infant health...

  8. Value-Based Purchasing: The Effect of Hospital Ownership and Size.

    Science.gov (United States)

    Chatfield, J Seth

    2016-01-01

    This research tests the effect of hospital ownership and size on value-based purchasing scores. Representative samples were randomly selected of short-term acute-care hospitals from across the nation and grouped into 3 categories of both ownership and size. The ownership categories are as follows: (1) for-profit, (2) nonprofit, and (3) government. The size categories are as follows: (1) small, 99 beds or fewer; (2) medium, 100 to 249 beds; (3) large, 250 beds or more. Value-based purchasing scores for the 12 process-of-care (PC) measures and the 8 patient experience-of-care (Hospital Consumer Assessment of Healthcare Providers and System [HCAHPS]) measures were calculated and combined into their single total performance score (TPS). The results reveal that for-profit controlled hospitals outperform both nonprofit and government-controlled hospitals in PC measures, HCAHPS measures, and value-based purchasing TPSs. The results also reveal that small hospitals (≤99 beds) outperform both medium hospitals (100-249 beds) and large hospitals (≥250 beds) in PC measures, HCAHPS measures, and TPS. Results are discussed.

  9. Value-based purchasing and hospital acquired conditions: are we seeing improvement?

    Science.gov (United States)

    Spaulding, Aaron; Zhao, Mei; Haley, D Rob

    2014-12-01

    To determine if the Value-Based Purchasing Performance Scoring system correlates with hospital acquired condition quality indicators. This study utilizes the following secondary data sources: the American Hospital Association (AHA) annual survey and the Centers for Medicare and Medicaid (CMS) Value-Based Purchasing and Hospital Acquired Conditions databases. Zero-inflated negative binomial regression was used to examine the effect of CMS total performance score on counts of hospital acquired conditions. Hospital structure variables including size, ownership, teaching status, payer mix, case mix, and location were utilized as control variables. The secondary data sources were merged into a single database using Stata 10. Total performance scores, which are used to determine if hospitals should receive incentive money, do not correlate well with quality outcome in the form of hospital acquired conditions. Value-based purchasing does not appear to correlate with improved quality and patient safety as indicated by Hospital Acquired Condition (HAC) scores. This leads us to believe that either the total performance score does not measure what it should, or the quality outcome measurements do not reflect the quality of the total performance scores measure. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  10. Value-based design and management of hospital buildings

    NARCIS (Netherlands)

    Van der Voordt, T.J.M.; Van der Zwart, J.

    2011-01-01

    The purpose of this paper it to explore the concept of adding value by real estate and related performance indicators, and the way it is or could be applied in value-based design and management of buildings. The concept is being illustrated with research findings on hospital buildings, based on a

  11. Medical economic impact of tracheotomy patients on a hospital system.

    Science.gov (United States)

    Altman, Kenneth W; Banoff, Karen Merl; Tong, Charles C L

    2015-04-01

    Tracheotomy patients are a small portion of hospitalizations, but account for disproportionately high risk and costs. There are many complex decisions that go into the care of these patients, and practice variation is expected to be compounded in a health system. This study sought to characterize the medical economic impact of tracheotomy patients on the hospital system. A retrospective review of the health system's hospital billing software was performed for 2013, and pertinent outcomes measures were tabulated. There were 829 tracheotomies performed in the health system of seven hospitals, with total costs of $128,883,865. Average length of stay was 36.74 days for principal procedures, and 43.36 days for tracheotomy as secondary procedures. Mortality was ∼ 18% overall, and re-admissions were 10.93% for primary, and 14.36% for secondary procedures. A fairly wide variation in each category among the different hospitals was observed. There are potentially many factors that impact variations of care and outcomes in patients with tracheotomy. Due to their large economic impact and risks for morbidity and mortality, a formalized care pathway is warranted. Goals of the pathway should include understanding medical decisions surrounding these complex patients, monitoring pertinent outcomes, reducing practice variation, and improving the efficiency of compassionate care.

  12. HOSPITAL INFORMATION SYSTEMS: A STUDY OF ELECTRONIC PATIENT RECORDS

    Directory of Open Access Journals (Sweden)

    Pedro Luiz Cortês

    2011-05-01

    Full Text Available The importance of patient records, also known as medical records, is related to different needs and objectives, as they constitute permanent documents on the health of patients. With the advancement of information technologies and systems, patient records can be stored in databases, resulting in a positive impact on patient care. Based on these considerations, a research question that arises is “what are the benefits and problems that can be seen with the use of electronic versions of medical records?” This question leads to the formulation of the following hypothesis: although problems can be identified during the process of using electronic record systems, the benefits outweigh the difficulties, thereby justifying their use. To respond to the question and test the presented hypothesis, a research study was developed with users of the same electronic record system, consisting of doctors, nurses, and administrative personnel in three hospitals located in the city of São Paulo, Brazil. The results show that, despite some problems in their usage, the benefits of electronic patient records outweigh possible disadvantages.

  13. Functionality of hospital information systems: results from a survey of quality directors at Turkish hospitals.

    Science.gov (United States)

    Saluvan, Mehmet; Ozonoff, Al

    2018-01-12

    We aimed to determine availability of core Hospital Information Systems (HIS) functions implemented in Turkish hospitals and the perceived importance of these functions on quality and patient safety. We surveyed quality directors (QDs) at civilian hospitals in the nation of Turkey. Data were collected via web survey using an instrument with 50 items describing core functionality of HIS. We calculated mean availability of each function, mean and median values of perceived impact on quality, and we investigated the relationship between availability and perceived importance. We received responses from 31% of eligible institutions, representing all major geographic regions of Turkey. Mean availability of 50 HIS functions was 65.6%, ranging from 19.6% to 97.4%. Mean importance score was 7.87 (on a 9-point scale) ranging from 7.13 to 8.41. Functions related to result management (89.3%) and decision support systems (52.2%) had the highest and lowest reported availability respectively. Availability and perceived importance were moderately correlated (r = 0.52). QDs report high importance of the HIS functions surveyed as they relate to quality and patient safety. Availability and perceived importance of HIS functions are generally correlated, with some interesting exceptions. These findings may inform future investments and guide policy changes within the Turkish healthcare system. Financial incentives, regulations around certified HIS, revisions to accreditation manuals, and training interventions are all policies which will help integrate HIS functions to support quality and patient safety in Turkish hospitals.

  14. Hospital Incident Command System (HICS) performance in Iran; decision making during disasters.

    Science.gov (United States)

    Djalali, Ahmadreza; Castren, Maaret; Hosseinijenab, Vahid; Khatib, Mahmoud; Ohlen, Gunnar; Kurland, Lisa

    2012-02-06

    Hospitals are cornerstones for health care in a community and must continue to function in the face of a disaster. The Hospital Incident Command System (HICS) is a method by which the hospital operates when an emergency is declared. Hospitals are often ill equipped to evaluate the strengths and vulnerabilities of their own management systems before the occurrence of an actual disaster. The main objective of this study was to measure the decision making performance according to HICS job actions sheets using tabletop exercises. This observational study was conducted between May 1st 2008 and August 31st 2009. Twenty three Iranian hospitals were included. A tabletop exercise was developed for each hospital which in turn was based on the highest probable risk. The job action sheets of the HICS were used as measurements of performance. Each indicator was considered as 1, 2 or 3 in accordance with the HICS. Fair performance was determined as performance according to HICS was intermediate for 83% (n = 19) of the participating hospitals. No hospital had a high level of performance. The performance level for the individual sections was intermediate or fair, except for the logistic and finance sections which demonstrated a higher level of performance. The public hospitals had overall higher performances than university hospitals (P = 0.04). The decision making performance in the Iranian hospitals, as measured during table top exercises and using the indicators proposed by HICS was intermediate to poor. In addition, this study demonstrates that the HICS job action sheets can be used as a template for measuring the hospital response. Simulations can be used to assess preparedness, but the correlation with outcome remains to be studied.

  15. HOSPITAL-BASED HEALTH TECHNOLOGY ASSESSMENT IN IRAN.

    Science.gov (United States)

    Mohtasham, Farideh; Majdzadeh, Reza; Jamshidi, Ensiyeh

    2017-08-17

    Hospitals with health technology assessment (HTA) programs have reported its positive effects on the management of resources and costs. This study aimed to identify the barriers faced by hospital-based HTA (HBHTA) in Iran by inductive content analysis of stakeholders' and decision-makers' points of view. The key individuals and organizations that could provide rich, relevant, and diverse data in response to the research question were purposively selected for the interviews and focus group discussion. Twelve stakeholders from seven public hospitals participated in the interviews. Another eighteen stakeholders from twelve HBHTA-related organizations took part in the focus group discussion. Most of the hospitals' senior management team did not feel the need for HBHTA and believed that in Iran a systematic process like HTA faces many challenges. The stakeholders participating in this study highlighted the significance of certain points that needed to be addressed before establishing HBHTA in Iran.

  16. 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. © The Author(s) 2015.

  17. Association between value-based purchasing score and hospital characteristics

    Directory of Open Access Journals (Sweden)

    Borah Bijan J

    2012-12-01

    Full Text Available Abstract Background Medicare hospital Value-based purchasing (VBP program that links Medicare payments to quality of care will become effective from 2013. It is unclear whether specific hospital characteristics are associated with a hospital’s VBP score, and consequently incentive payments. The objective of the study was to assess the association of hospital characteristics with (i the mean VBP score, and (ii specific percentiles of the VBP score distribution. The secondary objective was to quantify the associations of hospital characteristics with the VBP score components: clinical process of care (CPC score and patient satisfaction score. Methods Observational analysis that used data from three sources: Medicare Hospital Compare Database, American Hospital Association 2010 Annual Survey and Medicare Impact File. The final study sample included 2,491 U.S. acute care hospitals eligible for the VBP program. The association of hospital characteristics with the mean VBP score and specific VBP score percentiles were assessed by ordinary least square (OLS regression and quantile regression (QR, respectively. Results VBP score had substantial variations, with mean score of 30 and 60 in the first and fourth quartiles of the VBP score distribution. For-profit status (vs. non-profit, smaller bed size (vs. 100–199 beds, East South Central region (vs. New England region and the report of specific CPC measures (discharge instructions, timely provision of antibiotics and beta blockers, and serum glucose controls in cardiac surgery patients were positively associated with mean VBP scores (p Conclusions Although hospitals serving the poor and the elderly are more likely to score lower under the VBP program, the correlation appears small. Profit status, geographic regions, number and type of CPC measures reported explain the most variation among scores.

  18. Hospital information system utilization in Iran: a qualitative study.

    Science.gov (United States)

    Abbasi Moghadam, Mohammad Ali; Fayaz Bakhsh, Ahmad

    2014-01-01

    Hospital information system (HIS) should ideally allow different forms of data to be stored and used for decision making by clinicians and managers alike. This system has been developed since the early 1980's, and many hospitals gradually converted from an unrelated system into an integrated one. In successful implementation of HIS plans, the role of human factors, either individually or as a group, is expected to be very important and decisive. In this phenomenological qualitative research, in-depth personal interviews were conducted with the hospital's senior managers, and discussions were conducted in six to eight member focus groups. To include participants for interviews, purposive sampling was used in an Iranian hospital among doctors, nurses and other healthcare providers who had experience in using HIS. Data collection continued until saturation stage. The meetings took about 90 to 120 minutes, in which the participants were asked about discovering needs as well as facilitating and inhibiting factors regarding HIS application. Two members of the research team independently analyzed the interview transcripts.  As a result, problems in HIS isolation were reported to be related to the following: software, hardware, manpower, management and training. About the last point, it was stated that adequate continuing professional development programs did not exist for proper use of computers in the hospital. To achieve the ultimate goal of HISs (e.g. increasing patient satisfaction and decreasing hospital costs), it is necessary to create basic changes in the training system, and to get feedback from hospital personnel. Other steps include addressing software and hardware shortcomings as well as moving towards reinforcing the facilitating factors and refraining from inhibiting ones discovered in this study.

  19. Hospital information system utilization in Iran: a qualitative study.

    Directory of Open Access Journals (Sweden)

    Mohammad Ali Abbasi Moghadam

    2014-11-01

    Full Text Available Hospital information system (HIS should ideally allow different forms of data to be stored and used for decision making by clinicians and managers alike. This system has been developed since the early 1980's, and many hospitals gradually converted from an unrelated system into an integrated one. In successful implementation of HIS plans, the role of human factors, either individually or as a group, is expected to be very important and decisive. In this phenomenological qualitative research, in-depth personal interviews were conducted with the hospital's senior managers, and discussions were conducted in six to eight member focus groups. To include participants for interviews, purposive sampling was used in an Iranian hospital among doctors, nurses and other healthcare providers who had experience in using HIS. Data collection continued until saturation stage. The meetings took about 90 to 120 minutes, in which the participants were asked about discovering needs as well as facilitating and inhibiting factors regarding HIS application. Two members of the research team independently analyzed the interview transcripts.  As a result, problems in HIS isolation were reported to be related to the following: software, hardware, manpower, management and training. About the last point, it was stated that adequate continuing professional development programs did not exist for proper use of computers in the hospital. To achieve the ultimate goal of HISs (e.g. increasing patient satisfaction and decreasing hospital costs, it is necessary to create basic changes in the training system, and to get feedback from hospital personnel. Other steps include addressing software and hardware shortcomings as well as moving towards reinforcing the facilitating factors and refraining from inhibiting ones discovered in this study.

  20. A Multidisciplinary Hospital-based Antimicrobial Use Program: Impact on Hospital Pharmacy Expenditures and Drug Use

    Directory of Open Access Journals (Sweden)

    Suzette Salama

    1996-01-01

    Full Text Available The authors’ hospital embarked on a three-component, multidisciplinary, hospital-based antimicrobial use program to cut costs and reduce inappropriate antimicrobial use. Initially, antimicrobial use patterns and costs were monitored for 12 months. For the next two years, an antimicrobial use program was implemented consisting of three strategies: automatic therapeutic interchanges; antimicrobial restriction policies; and parenteral to oral conversion. The program resulted in a reduction in the antimicrobial portion of the total pharmacy drug budget from 41.6% to 28.2%. Simultaneously, the average cost per dose per patient day dropped from $11.88 in 1991 to $10.16 in 1994. Overall, mean monthly acquisition cost savings rose from $6,810 in 1992 to $27,590 in 1994. This study demonstrates that a multidisciplinary antimicrobial use program in a Canadian hospital can effect dramatic cost savings and serve as a quality assurance activity of physician antimicrobial prescribing behaviour.

  1. Hospital-based surveillance of Japanese encephalitis at a tertiary hospital in Manila.

    Science.gov (United States)

    Alera, Ma Theresa P; Velasco, John Mark S; Ypil-Cardenas, Charity Ann; Jarman, Richard G; Nisalak, Ananda N; Thaisomboonsuk, Butsaya; Gibbons, Robert V; Dimaano, Efren M; Yoon, In-Kyu

    2013-09-01

    Japanese encephalitis virus (JEV) is endemic in the Philippines but the incidence and burden of disease are not well established. We conducted a prospective hospital-based study at San Lazaro Hospital, a tertiary level hospital in Manila, from September 2005 to December 2006. Cases were determined using an in-house dengue and Japanese encephalitis (JE) enzyme-linked immunosorbent assay in order to detect the proportion of JE cases among the acute encephalitis syndrome (AES) cases admitted to our hospital. Fifteen patients were found to have AES, of whom 6 (40%) had confirmed JE. Of the JE cases, 4 were females and 2 were males with an age range of 3-14 years. Three of the 6 JE cases occurred during July. The most common signs and symptoms on admission among JE cases were: fever, headache, loss of appetite, neck rigidity and altered sensorium. JE likely comprises a significant proportion of hospitalized AES cases among children from Manila and nearby provinces. Further studies on the nation-wide prevalence and distribution of JE in the Philippines are needed to guide health authorities in disease control and prevention strategies.

  2. Hospitals

    Data.gov (United States)

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

  3. Rationale for adopting activity-based costing in hospitals:three longitudinal case studies

    OpenAIRE

    Järvinen, J.

    2005-01-01

    Abstract In the 1990's, a large number of Finnish hospitals began implementing new cost accounting systems, which were aimed at pricing the hospital outputs at full cost. Often the method of choice was activity-based costing, which was in the process of being transferred from the manufacturing industry to health care service production. The aim of this study is to analyse the motivations and rationale of this phenomenon in the light of three longitudinal case studies. The first case ...

  4. Understanding the acceptance factors of an Hospital Information System: evidence from a French University Hospital.

    Science.gov (United States)

    Ologeanu-Taddei, R; Morquin, D; Domingo, H; Bourret, R

    2015-01-01

    The goal of this study was to examine the perceived usefulness, the perceived ease of use and the perceived behavioral control of a Hospital Information System (HIS) for the care staff. We administrated a questionnaire composed of open-end and closed questions, based on the main concepts of Technology Acceptance Model. As results, the perceived usefulness, ease of use and behavioral control (self-efficacy and organizational support) are correlated with medical occupations. As an example, we found that a half of the medical secretaries consider the HIS is ease of use, at the opposite to the anesthesiologists, surgeons and physicians. Medical secretaries reported also the highest rate of PBC and a high rate of PU. Pharmacists reported the highest rate of PU but a low rate of PBC, which is similar to the rate of the surgeons and physicians. Content analysis of open questions highlights factors influencing these constructs: ergonomics, errors in the documenting process, insufficient compatibility with the medical department or the occupational group. Consequently, we suggest that the gap between the perceptions of the different occupational groups may be explained by the use of different modules and by interdependency of the care stare staff.

  5. Cluster based architecture and network maintenance protocol for medical priority aware cognitive radio based hospital.

    Science.gov (United States)

    Al Mamoon, Ishtiak; Muzahidul Islam, A K M; Baharun, Sabariah; Ahmed, Ashir; Komaki, Shozo

    2016-08-01

    Due to the rapid growth of wireless medical devices in near future, wireless healthcare services may face some inescapable issue such as medical spectrum scarcity, electromagnetic interference (EMI), bandwidth constraint, security and finally medical data communication model. To mitigate these issues, cognitive radio (CR) or opportunistic radio network enabled wireless technology is suitable for the upcoming wireless healthcare system. The up-to-date research on CR based healthcare has exposed some developments on EMI and spectrum problems. However, the investigation recommendation on system design and network model for CR enabled hospital is rare. Thus, this research designs a hierarchy based hybrid network architecture and network maintenance protocols for previously proposed CR hospital system, known as CogMed. In the previous study, the detail architecture of CogMed and its maintenance protocols were not present. The proposed architecture includes clustering concepts for cognitive base stations and non-medical devices. Two cluster head (CH selector equations are formulated based on priority of location, device, mobility rate of devices and number of accessible channels. In order to maintain the integrity of the proposed network model, node joining and node leaving protocols are also proposed. Finally, the simulation results show that the proposed network maintenance time is very low for emergency medical devices (average maintenance period 9.5 ms) and the re-clustering effects for different mobility enabled non-medical devices are also balanced.

  6. A web-based audiometry database system

    OpenAIRE

    Yeh, Chung-Hui; Wei, Sung-Tai; Chen, Tsung-Wen; Wang, Ching-Yuang; Tsai, Ming-Hsui; Lin, Chia-Der

    2014-01-01

    To establish a real-time, web-based, customized audiometry database system, we worked in cooperation with the departments of medical records, information technology, and otorhinolaryngology at our hospital. This system includes an audiometry data entry system, retrieval and display system, patient information incorporation system, audiometry data transmission program, and audiometry data integration. Compared with commercial audiometry systems and traditional hand-drawn audiometry data, this ...

  7. The James Connolly Memorial Hospital Electronic Menu Card system

    OpenAIRE

    McLoughlin, Simon

    2017-01-01

    The James Connolly Memorial Hospital (JCM) require an Electronic Menu Card system so that their patients can choose their meals in a more informed and efficient manner. This entails presenting menus to the patients electronically and with an interface that will allow them to choose their meal. The electronic nature of such a system means more options can be incorporated in terms of language and presentation. In addition the system can be accessed anytime so the information will be available i...

  8. wHospital: a web-based application with digital signature for drugs dispensing management.

    Science.gov (United States)

    Rossi, Lorenzo; Margola, Lorenzo; Manzelli, Vacia; Bandera, Alessandra

    2006-01-01

    wHospital is the result of an information technology research project, based on the utilization of a web based application for managing the hospital drugs dispensing. Part of wHospital back bone and its key distinguishing characteristic is the adoption of the digital signature system,initially deployed by the Government of Lombardia, a Northern Italy Region, throughout the distribution of smart cards to all the healthcare and hospital staffs. The developed system is a web-based application with a proposed Health Records Digital Signature (HReDS) handshake to comply with the national law and with the Joint Commission International Standards. The prototype application, for a single hospital Operative Unit (OU), has focused on data and process management, related to drug therapy. Following a multi-faceted selection process, the Infective Disease OU of the Hospital in Busto Arsizio, Lombardia, was chosen for the development and prototype implementation. The project lead time, from user requirement analysis to training and deployment was approximately 8 months. This paper highlights the applied project methodology, the system architecture, and the achieved preliminary results.

  9. Hospital branding in Italy: A pilot study based on the case method.

    Science.gov (United States)

    Esposito, Annamaria

    2017-01-01

    The article investigates if, and in affirmative case how, Italian hospitals are managing corporate brand communication. Thanks to results of qualitative research, this article offers insights on Italian hospital branding. The pilot study based in the case method is to be considered a starting point for wider investigations on this topic, and it is useful for managers and practitioners who want to understand the role of corporate brand in hospital communication management and to connect health care professionals with the audience in a meaningful way in those countries in which the health care system is a mix of both public and private institutions.

  10. A Trial of Nursing Cost Accounting using Nursing Practice Data on a Hospital Information System.

    Science.gov (United States)

    Miyahira, Akiko; Tada, Kazuko; Ishima, Masatoshi; Nagao, Hidenori; Miyamoto, Tadashi; Nakagawa, Yoshiaki; Takemura, Tadamasa

    2015-01-01

    Hospital administration is very important and many hospitals carry out activity-based costing under comprehensive medicine. However, nursing cost is unclear, because nursing practice is expanding both quantitatively and qualitatively and it is difficult to grasp all nursing practices, and nursing cost is calculated in many cases comprehensively. On the other hand, a nursing information system (NIS) is implemented in many hospitals in Japan and we are beginning to get nursing practical data. In this paper, we propose a nursing cost accounting model and we simulate a cost by nursing contribution using NIS data.

  11. Hospital-Based First Responder Mass Prophylaxis Plan

    Science.gov (United States)

    2005-03-01

    Contact Phone • Age • Date of Birth • Weight • Gender Medical information: • Allergies • Current Medications • Medical Conditions • Pregnancy ...Yes No Stomach Problems Yes No Cancer Yes No Hepatitis/Liver Disease Yes No Stroke...Medical Center Brea Fire Department Care Ambulance Fullerton Fire Department Hospital Disaster Support Communications System Los Alamitos Medical

  12. Prevalence and Prognosis of Cerebrovascular Accidents and its Subtypes Among Patients with Systemic Lupus Erythematosus in Isfahan, Iran: A Hospital Clinic-based Study.

    Science.gov (United States)

    Saadatnia, Mohammad; Sayed-Bonakdar, Zahra; Mohammad-Sharifi, Ghasem; Sarrami, Amir Hossein

    2014-01-01

    The aim of the present study was to determine the prevalence and prognosis of cerebrovascular accident (CVA) and its subtypes among Iranian patients with systemic lupus erythematosus (SLE). In a cross-sectional study, medical records of 575 SLE patients were reviewed. The patients developing CVA in their course of disease were extracted. In these patients, data about demographic features, lupus anti bodies, duration of the disease until CVA, CVA manifestation(s) and follow-up duration were gathered. In the next step, patients with any kinds of CVA were summoned to Neurology clinic to identify the grade of disability in each patient with CVA. We identified 38 patients with CVA of which 6 (15.8%) were men and 32 (84.2%) were women. The most common subtype of CVA was small vessels thrombosis (21.05%) among the study patients and hemi paresis was the most prevalent initial presentation (39.47%). In 11 (28.9%) patients, SLE was initiated with CVA and in 3 (7.9%) patients CVA had happened in the 1(st) year of SLE. Anti-phospholipid antibodies (APLA) were positive in 29 (76.3%) patients. Mean modified Rankin Scale in patient with positive and negative serology for APLA was 0.93 ± 1.11 and 0.22 ± 0.66 respectively (P = 0.006). Our study shows that 6.6% of Iranian SLE patients have CVA during their course of the disease. Small vessels thrombosis is the most common CVA subtype and hemi paresis is the most prevalent initial presentation. Moreover, we showed that the prognosis of CVA in Iranian SLE patients is not unfavorable.

  13. A European benchmarking system to evaluate in-hospital mortality rates in acute coronary syndrome: the EURHOBOP project.

    Science.gov (United States)

    Dégano, Irene R; Subirana, Isaac; Torre, Marina; Grau, María; Vila, Joan; Fusco, Danilo; Kirchberger, Inge; Ferrières, Jean; Malmivaara, Antti; Azevedo, Ana; Meisinger, Christa; Bongard, Vanina; Farmakis, Dimitros; Davoli, Marina; Häkkinen, Unto; Araújo, Carla; Lekakis, John; Elosua, Roberto; Marrugat, Jaume

    2015-03-01

    Hospital performance models in acute myocardial infarction (AMI) are useful to assess patient management. While models are available for individual countries, mainly US, cross-European performance models are lacking. Thus, we aimed to develop a system to benchmark European hospitals in AMI and percutaneous coronary intervention (PCI), based on predicted in-hospital mortality. We used the EURopean HOspital Benchmarking by Outcomes in ACS Processes (EURHOBOP) cohort to develop the models, which included 11,631 AMI patients and 8276 acute coronary syndrome (ACS) patients who underwent PCI. Models were validated with a cohort of 55,955 European ACS patients. Multilevel logistic regression was used to predict in-hospital mortality in European hospitals for AMI and PCI. Administrative and clinical models were constructed with patient- and hospital-level covariates, as well as hospital- and country-based random effects. Internal cross-validation and external validation showed good discrimination at the patient level and good calibration at the hospital level, based on the C-index (0.736-0.819) and the concordance correlation coefficient (55.4%-80.3%). Mortality ratios (MRs) showed excellent concordance between administrative and clinical models (97.5% for AMI and 91.6% for PCI). Exclusion of transfers and hospital stays ≤1day did not affect in-hospital mortality prediction in sensitivity analyses, as shown by MR concordance (80.9%-85.4%). Models were used to develop a benchmarking system to compare in-hospital mortality rates of European hospitals with similar characteristics. The developed system, based on the EURHOBOP models, is a simple and reliable tool to compare in-hospital mortality rates between European hospitals in AMI and PCI. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  14. Determinants of quality management systems implementation in hospitals

    NARCIS (Netherlands)

    Wardhani, Viera; Utarini, Adi; van Dijk, Jitse Pieter; Post, Doeke; Groothoff, Johan Willem

    Objective: To identify the problems and facilitating factors in the implementation of quality management system (QMS) in hospitals through a systematic review. Method: A search strategy was pet-formed on the Medline database for articles written in English published between 1992 and early 2006.

  15. Smoking habits in lung cancer patients: a hospital based case ...

    African Journals Online (AJOL)

    This retrospective, hospital based case-control study was designed to investigate the cigarette smoking history, the relationship between cigarette smoking and the risk of lung cancer in KHMC-Jordan. Six hundred cases with lung cancer (576 males, 24 females) and 600 controls were included in the study. The majority of ...

  16. A collegiate model within a hospital-based program.

    Science.gov (United States)

    Ruiz, G; Kimmons, C; Martino, S

    1979-01-01

    In the current age of consumerism, educators in radiologic technology must be accountable to provide high level educational experiences for students. The authors address the issue of standardizing and upgrading education by proposing that a collegiate model be developed and implemented with a hospital-based radiography program.

  17. Hospital-based home care for children with cancer

    DEFF Research Database (Denmark)

    Hansson, Helena; Hallström, Inger; Kjaergaard, Hanne

    2011-01-01

    Hospital-based home care (HBHC) is widely applied in Pediatric Oncology. We reviewed the potential effect of HBHC on children's physical health and risk of adverse events, parental and child satisfaction, quality of life of children and their parents, and costs. A search of PubMed, CINAHL...... for children with cancer....

  18. Genre-based Course Book for Hospitality Departmentn in Surakarta

    OpenAIRE

    Suprihatin, Yeni

    2016-01-01

    This research is aimed at designing ESP Course book at SMK Sahid Surakarta that mainly focus: To investigate the quality of existing learning book used in English teaching and learning at SMK especially in hospitality department and to describe the design of Genre-based ESP course book for hospitality department of SMK.This research and development was carried out in SMK Sahid Surakarta in the academic year of 2015/2016. The number of population was three classes (that consisted of the eighth...

  19. Networking Hospital ePrescribing: A Systemic View of Digitalization of Medicines' Use in England.

    Science.gov (United States)

    Lichtner, Valentina; Hibberd, Ralph; Cornford, Tony

    2016-01-01

    Medicine management is at the core of hospital care and digitalization of prescribing and administration of medicines is often the focus of attention of health IT programs. This may be conveyed to the public in terms of the elimination of paper-based drug charts and increased readability of doctors' prescriptions. Based on analysis of documents about hospital medicines supply and use (including systems' implementation) in the UK, in this conceptual paper electronic prescribing and administration are repositioned as only one aspect of an important wider transformation in medicine management in hospital settings, involving, for example, procurement, dispensing, auditing, waste management, research and safety vigilance. Approaching digitalization from a systemic perspective has the potential to uncover the wider implications of this transformation for patients, the organization and the wider health care system.

  20. The Boston Children's Hospital Academy: Development and Initial Assessment of a Hospital-Based Teaching Academy.

    Science.gov (United States)

    Gooding, Holly C; McCarty, Caitlin; Millson, Rebecca; Jiang, Hungyu; Armstrong, Elizabeth; Leichtner, Alan M

    2016-01-12

    Medical education academies play an important role in the recognition and career advancement of educators. However, hospital-based clinical faculty have unique professional development needs that may not be met by medical-school-based academies. The Boston Children's Hospital Academy was founded in 2008 to serve the needs of its clinician-educators. It was open to junior faculty scholars and to senior faculty scholars and mentors, including interprofessional educators. To maintain membership, individuals must propose and work toward an education project or serve as a project mentor. In 2012, a survey was sent to all members, and annual project reports were reviewed to assess the academy's impact. Sixty-five members completed the survey. The majority agreed that the academy created a community of educators, provided opportunities for networking and scholarship, contributed to their personal identity as an educator, and led to recognition by their chief. Projects addressed curriculum development, faculty development, learner assessment, program assessment, and resource development. They largely focused on graduate medical education and on patient safety and quality. During their tenure in the academy (mean length of membership = 2.4 years), members produced an average of 4.4 education presentations and 1.9 education publications, and 11 members were promoted. A hospital-based academy provides opportunities for interprofessional faculty development. Next steps include increasing interprofessional membership, wider dissemination of members' successes, better integration with the hospital's mission, specifically regarding graduate medical education and patient safety, and additional evaluation of the academy's impact on project completion and members' accomplishments.

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

    Science.gov (United States)

    Ramani, K V

    2004-01-01

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

  2. Influences of hospital information systems, indicator data collection and computation on reported Dutch hospital performance indicator scores.

    Science.gov (United States)

    Anema, Helen A; Kievit, Job; Fischer, Claudia; Steyerberg, Ewout W; Klazinga, Niek S

    2013-06-12

    For health care performance indicators (PIs) to be reliable, data underlying the PIs are required to be complete, accurate, consistent and reproducible. Given the lack of regulation of the data-systems used in the Netherlands, and the self-report based indicator scores, one would expect heterogeneity with respect to the data collection and the ways indicators are computed. This might affect the reliability and plausibility of the nationally reported scores. We aimed to investigate the extent to which local hospital data collection and indicator computation strategies differ and how this affects the plausibility of self-reported indicator scores, using survey results of 42 hospitals and data of the Dutch national quality database. The data collection and indicator computation strategies of the hospitals were substantially heterogenic. Moreover, the Hip and Knee replacement PI scores can be regarded as largely implausible, which was, to a great extent, related to a limited (computerized) data registry. In contrast, Breast Cancer PI scores were more plausible, despite the incomplete data registry and limited data access. This might be explained by the role of the regional cancer centers that collect most of the indicator data for the national cancer registry, in a standardized manner. Hospitals can use cancer registry indicator scores to report to the government, instead of their own locally collected indicator scores. Indicator developers, users and the scientific field need to focus more on the underlying (heterogenic) ways of data collection and conditional data infrastructures. Countries that have a liberal software market and are aiming to implement a self-report based performance indicator system to obtain health care transparency, should secure the accuracy and precision of the heath care data from which the PIs are calculated. Moreover, ongoing research and development of PIs and profound insight in the clinical practice of data registration is warranted.

  3. Hospital information systems: measuring end user computing satisfaction (EUCS).

    Science.gov (United States)

    Aggelidis, Vassilios P; Chatzoglou, Prodromos D

    2012-06-01

    Over the past decade, hospitals in Greece have made significant investments in adopting and implementing new hospital information systems (HISs). Whether these investments will prove beneficial for these organizations depends on the support that will be provided to ensure the effective use of the information systems implemented and also on the satisfaction of its users, which is one of the most important determinants of the success of these systems. Measuring end-user computing satisfaction has a long history within the IS discipline. A number of attempts have been made to evaluate the overall post hoc impact of HIS, focusing on the end-users and more specifically on their satisfaction and the parameters that determine it. The purpose of this paper is to build further upon the existing body of the relevant knowledge by testing past models and suggesting new conceptual perspectives on how end-user computing satisfaction (EUCS) is formed among hospital information system users. All models are empirically tested using data from hospital information system (HIS) users (283). Correlation, explanatory and confirmation factor analysis was performed to test the reliability and validity of the measurement models. The structural equation modeling technique was also used to evaluate the causal models. The empirical results of the study provide support for the EUCS model (incorporating new factors) and enhance the generalizability of the EUCS instrument and its robustness as a valid measure of computing satisfaction and a surrogate for system success in a variety of cultural and linguistic settings. Although the psychometric properties of EUCS appear to be robust across studies and user groups, it should not be considered as the final chapter in the validation and refinement of these scales. Continuing efforts should be made to validate and extend the instrument. Copyright © 2012 Elsevier Inc. All rights reserved.

  4. Analysis of the quality of hospital information systems Audit Trails.

    Science.gov (United States)

    Cruz-Correia, Ricardo; Boldt, Isabel; Lapão, Luís; Santos-Pereira, Cátia; Rodrigues, Pedro Pereira; Ferreira, Ana Margarida; Freitas, Alberto

    2013-08-06

    Audit Trails (AT) are fundamental to information security in order to guarantee access traceability but can also be used to improve Health information System's (HIS) quality namely to assess how they are used or misused. This paper aims at analysing the existence and quality of AT, describing scenarios in hospitals and making some recommendations to improve the quality of information. The responsibles of HIS for eight Portuguese hospitals were contacted in order to arrange an interview about the importance of AT and to collect audit trail data from their HIS. Five institutions agreed to participate in this study; four of them accepted to be interviewed, and four sent AT data. The interviews were performed in 2011 and audit trail data sent in 2011 and 2012. Each AT was evaluated and compared in relation to data quality standards, namely for completeness, comprehensibility, traceability among others. Only one of the AT had enough information for us to apply a consistency evaluation by modelling user behaviour. The interviewees in these hospitals only knew a few AT (average of 1 AT per hospital in an estimate of 21 existing HIS), although they all recognize some advantages of analysing AT. Four hospitals sent a total of 7 AT - 2 from Radiology Information System (RIS), 2 from Picture Archiving and Communication System (PACS), 3 from Patient Records. Three of the AT were understandable and three of the AT were complete. The AT from the patient records are better structured and more complete than the RIS/PACS. Existing AT do not have enough quality to guarantee traceability or be used in HIS improvement. Its quality reflects the importance given to them by the CIO of healthcare institutions. Existing standards (e.g. ASTM:E2147, ISO/TS 18308:2004, ISO/IEC 27001:2006) are still not broadly used in Portugal.

  5. A web-based audiometry database system.

    Science.gov (United States)

    Yeh, Chung-Hui; Wei, Sung-Tai; Chen, Tsung-Wen; Wang, Ching-Yuang; Tsai, Ming-Hsui; Lin, Chia-Der

    2014-07-01

    To establish a real-time, web-based, customized audiometry database system, we worked in cooperation with the departments of medical records, information technology, and otorhinolaryngology at our hospital. This system includes an audiometry data entry system, retrieval and display system, patient information incorporation system, audiometry data transmission program, and audiometry data integration. Compared with commercial audiometry systems and traditional hand-drawn audiometry data, this web-based system saves time and money and is convenient for statistics research. Copyright © 2013. Published by Elsevier B.V.

  6. Hydrogel based occlusion systems

    NARCIS (Netherlands)

    Stam, F.A.; Jackson, N.; Dubruel, P.; Adesanya, K.; Embrechts, A.; Mendes, E.; Neves, H.P.; Herijgers, P.; Verbrugghe, Y.; Shacham, Y.; Engel, L.; Krylov, V.

    2013-01-01

    A hydrogel based occlusion system, a method for occluding vessels, appendages or aneurysms, and a method for hydrogel synthesis are disclosed. The hydrogel based occlusion system includes a hydrogel having a shrunken and a swollen state and a delivery tool configured to deliver the hydrogel to a

  7. Characteristics of Hospital-Based Munchausen Syndrome by Proxy in Japan

    Science.gov (United States)

    Fujiwara, Takeo; Okuyama, Makiko; Kasahara, Mari; Nakamura, Ayako

    2008-01-01

    Objective: This article explores characteristics of Munchausen Syndrome by Proxy (MSBP) in Japan, a country which provides an egalitarian, low cost, and easy-access health care system. Methods: We sent a questionnaire survey to 11 leading doctors in the child abuse field in Japan, each located in different hospital-based sites. Child abuse doctors…

  8. Application of the Activity-Based Costing Method for Unit-Cost Calculation in a Hospital.

    Science.gov (United States)

    Javid, Mahdi; Hadian, Mohammad; Ghaderi, Hossein; Ghaffari, Shahram; Salehi, Masoud

    2015-05-17

    Choosing an appropriate accounting system for hospital has always been a challenge for hospital managers. Traditional cost system (TCS) causes cost distortions in hospital. Activity-based costing (ABC) method is a new and more effective cost system. This study aimed to compare ABC with TCS method in calculating the unit cost of medical services and to assess its applicability in Kashani Hospital, Shahrekord City, Iran.‎ This cross-sectional study was performed on accounting data of Kashani Hospital in 2013. Data on accounting reports of 2012 and other relevant sources at the end of 2012 were included. To apply ABC method, the hospital was divided into several cost centers and five cost categories were defined: wage, equipment, space, material, and overhead costs. Then activity centers were defined. ABC method was performed into two phases. First, the total costs of cost centers were assigned to activities by using related cost factors. Then the costs of activities were divided to cost objects by using cost drivers. After determining the cost of objects, the cost price of medical services was calculated and compared with those obtained from TCS.‎ The Kashani Hospital had 81 physicians, 306 nurses, and 328 beds with the mean occupancy rate of 67.4% during 2012. Unit cost of medical services, cost price of occupancy bed per day, and cost per outpatient service were calculated. The total unit costs by ABC and TCS were respectively 187.95 and 137.70 USD, showing 50.34 USD more unit cost by ABC method. ABC method represented more accurate information on the major cost components. By utilizing ABC, hospital managers have a valuable accounting system that provides a true insight into the organizational costs of their department.

  9. Application of the Activity-Based Costing Method for Unit-Cost Calculation in a Hospital

    Science.gov (United States)

    Javid, Mahdi; Hadian, Mohammad; Ghaderi, Hossein; Ghaffari, Shahram; Salehi, Masoud

    2016-01-01

    Background: Choosing an appropriate accounting system for hospital has always been a challenge for hospital managers. Traditional cost system (TCS) causes cost distortions in hospital. Activity-based costing (ABC) method is a new and more effective cost system. Objective: This study aimed to compare ABC with TCS method in calculating the unit cost of medical services and to assess its applicability in Kashani Hospital, Shahrekord City, Iran. Methods: This cross-sectional study was performed on accounting data of Kashani Hospital in 2013. Data on accounting reports of 2012 and other relevant sources at the end of 2012 were included. To apply ABC method, the hospital was divided into several cost centers and five cost categories were defined: wage, equipment, space, material, and overhead costs. Then activity centers were defined. ABC method was performed into two phases. First, the total costs of cost centers were assigned to activities by using related cost factors. Then the costs of activities were divided to cost objects by using cost drivers. After determining the cost of objects, the cost price of medical services was calculated and compared with those obtained from TCS. Results: The Kashani Hospital had 81 physicians, 306 nurses, and 328 beds with the mean occupancy rate of 67.4% during 2012. Unit cost of medical services, cost price of occupancy bed per day, and cost per outpatient service were calculated. The total unit costs by ABC and TCS were respectively 187.95 and 137.70 USD, showing 50.34 USD more unit cost by ABC method. ABC method represented more accurate information on the major cost components. Conclusion: By utilizing ABC, hospital managers have a valuable accounting system that provides a true insight into the organizational costs of their department. PMID:26234974

  10. Object Based Systems Engineering

    Science.gov (United States)

    2011-10-17

    Based Systems Engineering ( MBSE ) has shifted the emphasis of the Systems Engineering community away from documents towards view-based artifacts. These...Engineering lies primarily in these objects, not the containers that deliver them. FIGURE 1: Evolution of Systems Engineering Practice MBSE ...capture minority viewpoints and discussion threads associated with each object of interest. If the majority view doesn’t lead to success, this data may

  11. [The data processing system in the Herford district hospital (author's transl)].

    Science.gov (United States)

    Freybott, A

    1976-08-06

    A problem analysis, independent of hardware, showed that the use of a multi-computer compound system is the most favorable solution for a general hospital. Together with the Federal Republic and the State of North Rhein-Westphalia, a hospital control system based on small computers by integration of the information flow of autarkic data processing subsystems was developed, and put into service. In this way communication and data management are carried out in one hierarchic high-ranking data processing subsystem, the data processing for medical technology (roentgendiagnosis radiotherapy, nuclear medicine, medical electronics, clinical chemistry laboratory) and administration in autarkic subsystems.

  12. Avatar-based interactive ileostomy education in hospitalized patients.

    Science.gov (United States)

    Bedra, McKenzie; Wick, Elizabeth; Brotman, Daniel; Finkelstein, Joseph

    2013-01-01

    Computer-assisted education can be an effective means for patient engagement and empowerment however the feasibility of postoperative computer-assisted ileostomy education has not been studied systematically. The purpose of this study was to assess feasibility and patient acceptance of tablet-based interactive ileostomy education in patients with new stomas, and to evaluate the impact of this education modality on knowledge and self-efficacy. An interactive multimedia education for ileostomy management guided by adult learning theories was tested in 15 hospitalized patients with new ileostomies. After using the avatar-based education, the ileostomy knowledge score improved from 27.8±3.4 to 31.3±1.5 (pstoma care self-efficacy improved from 78.4±22.7 to 92.7±14.1 (peducation to hospitalized patients.

  13. Hospital Based Health Technology Assessment: an example from Siena

    Directory of Open Access Journals (Sweden)

    Pietro Manzi

    2015-03-01

    Full Text Available The Health Technology Assessment (HTA has emerged in recent years as a useful tool in healthcare decision-making. It is a multidisciplinary process that summarizes information about the medical, social, economic and ethical issues related to the use of a health technology and provides evidence-based information on how to allocate resources. The experience of Siena University Hospital is an example of multidisciplinary hospital-based HTA. In the present paper we summarize the organization of HTA commission and the assessment methodology of the purchase, rental or sale of medical equipment and medical devices. Furthermore we illustrate the data concerning the commission activities in 2013.http://dx.doi.org/10.7175/fe.v16i1.943

  14. On the interdependence of ambulatory and hospital care in the German health system.

    Science.gov (United States)

    Büyükdurmus, Tugba; Kopetsch, Thomas; Schmitz, Hendrik; Tauchmann, Harald

    2017-12-01

    For some considerable time now the interface between ambulatory and hospital care has been mooted as a cause of inefficiencies in the German health system and there have been calls for a softening of the strict separation between the two sectors. This debate emphasizes the need for detailed empirical information on the interdependence between the two sectors. Using extensive administrative data at the level of the 412 German counties for the years 2007 to 2009 and a simultaneous equation model which allows the numbers of ambulatory and hospital cases to be mutually interdependent, we examine the connection between ambulatory and hospital specialist care separately for ten medical specialties. The results show that the interdependence of ambulatory and hospital services is far from homogeneous. The relationship depends, on the one hand, on the specialty and, on the other, on the direction of the effect observed. This heterogeneity needs to be taken into account for cross-sector needs-based planning.

  15. Comprehensive Outpatient Rehabilitation Program: Hospital-Based Stroke Outpatient Rehabilitation.

    Science.gov (United States)

    Rice, Danielle; Janzen, Shannon; McIntyre, Amanda; Vermeer, Julianne; Britt, Eileen; Teasell, Robert

    2016-05-01

    Few studies have considered the effectiveness of outpatient rehabilitation programs for stroke patients. The objective of this study was to assess the effectiveness of a hospital-based interdisciplinary outpatient stroke rehabilitation program with respect to physical functioning, mobility, and balance. The Comprehensive Outpatient Rehabilitation Program provides a hospital-based interdisciplinary approach to stroke rehabilitation in Southwestern Ontario. Outcome measures from physiotherapy and occupational therapy sessions were available at intake and discharge from the program. A series of paired sample t-tests were performed to assess patient changes between time points for each outcome measure. A total of 271 patients met the inclusion criteria for analysis (56.1% male; mean age = 62.9 ± 13.9 years). Significant improvements were found between admission and discharge for the Functional Independence Measure, grip strength, Chedoke-McMaster Stroke Assessment, two-minute walk test, maximum walk test, Timed Up and Go, Berg Balance Scale, and one-legged stance (P stroke. A hospital-based, stroke-specific rehabilitation program should be considered when patients continue to experience deficits after inpatient rehabilitation. Copyright © 2016 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  16. System-Level Shared Governance Structures and Processes in Healthcare Systems With Magnet®-Designated Hospitals: A Descriptive Study.

    Science.gov (United States)

    Underwood, Carlisa M; Hayne, Arlene N

    The purpose was to identify and describe structures and processes of best practices for system-level shared governance in healthcare systems. Currently, more than 64.6% of US community hospitals are part of a system. System chief nurse executives (SCNEs) are challenged to establish leadership structures and processes that effectively and efficiently disseminate best practices for patients and staff across complex organizations, geographically dispersed locations, and populations. Eleven US healthcare SCNEs from the American Nurses Credentialing Center's repository of Magnet®-designated facilities participated in a 35-multiquestion interview based on Kanter's Theory of Organizational Empowerment. Most SCNEs reported the presence of more than 50% of the empowerment structures and processes in system-level shared governance. Despite the difficulties and complexities of growing health systems, SCNEs have replicated empowerment characteristics of hospital shared governance structures and processes at the system level.

  17. HOSPITAL KANBAN SYSTEM IMPLEMENTATION: EVALUATING SATISFACTION OF NURSING PERSONNEL

    Directory of Open Access Journals (Sweden)

    Aguilar-Escobar, Víctor G.

    2015-09-01

    Full Text Available Literature on healthcare supply chain management has shown that the kanban system can provide significant benefits. However, very few benefits have been empirically demonstrated and the extent of each remains unknown. This study aims to measure nurses’ satisfaction with kanban systems in logistics of medical consumables and assesses possible advantages and differences among user groups through an anonymous survey at Hospital Universitario Virgen Macarena of Seville, Spain. Treatment of responses included an exploratory factor analysis, and a CAPTCA analysis. The results showed a high level of satisfaction for each aspect of the kanban system. Moreover, it highlighted the differences of opinion between groups of individuals according to workplace, nursing units, job category, seniority, age and kanban training. The exploratory factor analysis revealed that two factors underlie the collected assessments: the inherent advantages of a kanban system, and the logistics system performance as a whole. Thus, hospital managers should promote the implementation of kanban systems, since it increases nurses’ satisfaction and provides significant benefits.

  18. Thirty-day hospital readmissions in systemic lupus erythematosus: predictors and hospital- and state-level variation.

    Science.gov (United States)

    Yazdany, Jinoos; Marafino, Ben J; Dean, Mitzi L; Bardach, Naomi S; Duseja, Reena; Ward, Michael M; Dudley, R Adams

    2014-10-01

    Systemic lupus erythematosus (SLE) has one of the highest hospital readmission rates among chronic conditions. This study was undertaken to identify patient-level, hospital-level, and geographic predictors of 30-day hospital readmissions associated with SLE. Using hospital discharge databases from 5 geographically dispersed states, we studied all-cause readmission of SLE patients between 2008 and 2009. We evaluated each hospitalization as a possible index event leading up to a readmission, our primary outcome. We accounted for clustering of hospitalizations within patients and within hospitals and adjusted for hospital case mix. Using multilevel mixed-effects logistic regression, we examined factors associated with 30-day readmission and calculated risk-standardized hospital-level and state-level readmission rates. We examined 55,936 hospitalizations among 31,903 patients with SLE. Of these hospitalizations, 9,244 (16.5%) resulted in readmission within 30 days. In adjusted analyses, age was inversely related to risk of readmission. African American and Hispanic patients were more likely to be readmitted than white patients, as were those with Medicare or Medicaid insurance (versus private insurance). Several clinical characteristics of lupus, including nephritis, serositis, and thrombocytopenia, were associated with readmission. Readmission rates varied significantly between hospitals after accounting for patient-level clustering and hospital case mix. We also found geographic variation, with risk-adjusted readmission rates lower in New York and higher in Florida as compared to California. We found that ~1 in 6 hospitalized patients with SLE were readmitted within 30 days of discharge, with higher rates among historically underserved populations. Significant geographic and hospital-level variation in risk-adjusted readmission rates suggests potential for quality improvement. Copyright © 2014 by the American College of Rheumatology.

  19. Thirty-day Hospital Readmissions in Systemic Lupus Erythematosus: Predictors and Hospital and State-level Variation

    Science.gov (United States)

    Yazdany, Jinoos; Marafino, Ben J.; Dean, Mitzi L.; Bardach, Naomi S.; Duseja, Reena; Ward, Michael M.; Dudley, R. Adams

    2014-01-01

    Objective Systemic lupus erythematosus (SLE) has among the highest hospital readmission rates among chronic conditions. We sought to identify patient-level, hospital-level, and geographic predictors of 30-day hospital readmissions in SLE. Methods Using hospital discharge databases from 5 geographically dispersed states, we performed a study of all-cause SLE readmissions between 2008 and 2009. We evaluated each hospitalization as a possible index event leading up to a readmission, our primary outcome. We accounted for clustering of hospitalizations within patients and within hospitals and adjusted for hospital case-mix. Using multi-level mixed-effects logistic regression, we examined factors associated with 30-day readmissions and calculated risk-standardized hospital-level and state-level readmission rates. Results We examined 55,936 hospitalizations among 31,903 patients with SLE. 9,244 (16.5%) hospitalizations resulted in readmission within 30 days. In adjusted analyses, age was inversely related to risk of readmission. Black and Hispanic patients were more likely to be readmitted compared to white patients, as were those with Medicare or Medicaid insurance (versus private insurance). Several lupus clinical characteristics, including lupus nephritis, serositis and thrombocytopenia were associated with readmission. Readmission rates varied significantly between hospitals after accounting for patient-level clustering and hospital case mix. There was also geographic variation, with risk-adjusted readmission rates lower in New York and higher in Florida compared to California. Conclusions We found that about 1 in 6 hospitalized patients with SLE were readmitted within 30 days, with higher rates in historically underserved populations. Significant geographic and hospital-level variation in risk-adjusted readmission rates suggests potential for quality improvement. PMID:25110993

  20. Depiction of Trends in Administrative Healthcare Data from Hospital Information System.

    Science.gov (United States)

    Kalankesh, Leila R; Pourasghar, Faramarz; Jafarabadi, Mohammad Asghari; Khanehdan, Negar

    2015-06-01

    administrative healthcare data are among main components of hospital information system. Such data can be analyzed and deployed for a variety of purposes. The principal aim of this research was to depict trends of administrative healthcare data from HIS in a general hospital from March 2011 to March 2014. data set used for this research was extracted from the SQL database of the hospital information system in Razi general hospital located in Marand. The data were saved as CSV (Comma Separated Values) in order to facilitate data cleaning and analysis. The variables of data set included patient's age, gender, final diagnosis, final diagnosis code based on ICD-10 classification system, date of hospitalization, date of discharge, LOS(Length of Stay), ward, and survival status of the patient. Data were analyzed and visualized after applying appropriate cleansing and preparing techniques. morbidity showed a constant trend over three years. Pregnancy, childbirth and the puerperium were the leading category of final diagnosis (about 32.8 %). The diseases of the circulatory system were the second class accounting for 13 percent of the hospitalization cases. The diseases of the digestive system had the third rank (10%). Patients aged between 14 and 44 constituted a higher proportion of total cases. Diseases of the circulatory system was the most common class of diseases among elderly patients (age≥65). The highest rate of mortality was observed among patients with final diagnosis of the circulatory system diseases followed by those with diseases of the respiratory system, and neoplasms. Mortality rate for the ICU and the CCU patients were 62% and 33% respectively. The longest average of LOS (7.3 days) was observed among patients hospitalized in the ICU while patients in the Obstetrics and Gynecology ward had the shortest average of LOS (2.4 days). Multiple regression analysis revealed that LOS was correlated with variables of surgery, gender, and type of payment, ward, the

  1. Benefits of a hospital-based peer intervention program for violently injured youth.

    Science.gov (United States)

    Shibru, Daniel; Zahnd, Elaine; Becker, Marla; Bekaert, Nic; Calhoun, Deane; Victorino, Gregory P

    2007-11-01

    Exposure to violence predisposes youths to future violent behavior. Breaking the cycle of violence in inner cities is the primary objective of hospital-based violence intervention and prevention programs. An evaluation was undertaken to determine if a hospital-based, peer intervention program, "Caught in the Crossfire," reduces the risk of criminal justice involvement, decreases hospitalizations from traumatic reinjury, diminishes death from intentional violent trauma, and is cost effective. We designed a retrospective cohort study conducted between January 1998 and June 2003 at a university-based urban trauma center. The duration of followup was 18 months. Patients were 12 to 20 years of age and were hospitalized for intentional violent trauma. The "enrolled" group had a minimum of five interactions with an intervention specialist. The control group was selected from the hospital database by matching age, gender, race or ethnicity, type of injury, and year of admission. All patients came from socioeconomically disadvantaged areas. The total sample size was 154 patients. Participation in the hospital-based peer intervention program lowered the risk of criminal justice involvement (relative risk=0.67; 95% CI, 0.45, 0.99; p=0.04). There was no effect on risks of reinjury and death. Subsequent violent criminal behavior was reduced by 7% (p=0.15). Logistic regression analysis showed age had a confounding effect on the association between program participation and criminal justice involvement (relative risk=0.71; p=0.043). When compared with juvenile detention center costs, the total cost reduction derived from the intervention program annually was $750,000 to $1.5 million. This hospital-based peer intervention program reduces the risk of criminal justice system involvement, is more effective with younger patients, and is cost effective. Any effect on reinjury and death will require a larger sample size and longer followup.

  2. Functional propotype of a performance management system for hospitality

    OpenAIRE

    António, Nuno Miguel da Conceição

    2014-01-01

    Dissertação de mestrado, Direcção e Gestão Hoteleira, Escola Superior de Gestão, Hotelaria e Tursimo, Universidade do Algarve, 2014 This project involved the creation and real-life evaluation in four hotels, of a functional prototype of a performance management system specific for the hospitality industry, with the objective of testing the viability to develop a commercial service. This system can be defined as a set of dashboards that enable the systematic monitoring of busine...

  3. Neonatal hearing screening: modelling cost and effectiveness of hospital- and community-based screening

    Directory of Open Access Journals (Sweden)

    Taylor Rod S

    2006-02-01

    Full Text Available Abstract Background Children with congenital hearing impairment benefit from early detection and management of their hearing loss. These and related considerations led to the recommendation of universal newborn hearing screening. In 2001 the first phase of a national Newborn Hearing Screening Programme (NHSP was implemented in England. Objective of this study was to assess costs and effectiveness for hospital and community-based newborn hearing screening systems in England based on data from this first phase with regard to the effects of alterations to parameter values. Methods Design: Clinical effectiveness analysis using a Markov Model. Outcome measure: quality weighted detected child months (QCM. Results Both hospital and community programmes yielded 794 QCM at the age of 6 months with total costs of £3,690,000 per 100,000 screened children in hospital and £3,340,000 in community. Simulated costs would be lower in hospital in 48% of the trials. Any statistically significant difference between hospital and community in prevalence, test sensitivity, test specificity and costs would result in significant differences in cost-effectiveness between hospital and community. Conclusion This modelling exercise informs decision makers by a quantitative projection of available data and the explicit and transparent statements about assumptions and the degree of uncertainty. Further evaluation of the cost-effectiveness should focus on the potential differences in test parameters and prevalence in these two settings.

  4. Hydrogel based occlusion systems

    OpenAIRE

    Stam, F.A.; Jackson, N.; Dubruel, P.; Adesanya, K.; Embrechts, A.; Mendes, E.; Neves, H.P.; Herijgers, P.; Verbrugghe, Y.; Shacham, Y.; Engel, L; Krylov, V.

    2013-01-01

    A hydrogel based occlusion system, a method for occluding vessels, appendages or aneurysms, and a method for hydrogel synthesis are disclosed. The hydrogel based occlusion system includes a hydrogel having a shrunken and a swollen state and a delivery tool configured to deliver the hydrogel to a target occlusion location. The hydrogel is configured to permanently occlude the target occlusion location in the swollen state. The hydrogel may be an electro-activated hydrogel (EAH) which could be ...

  5. Assessment of pharmacy information system performance in selected hospitals in isfahan city during 2011.

    Science.gov (United States)

    Saqaeian Nejad Isfahani, Sakineh; Mirzaeian, Razieh; Habibi, Mahbobe

    2013-01-01

    In supporting a therapeutic approach and medication therapy management, pharmacy information system acts as one of the central pillars of information system. This ensures that medication therapy is being supported and evaluated with an optimal level of safety and quality similar to other treatments and services. This research aims to evaluate the performance of pharmacy information system in three types of teaching, private and social affiliated hospitals. The present study is an applied, descriptive and analytical study which was conducted on the pharmacy information system in use in the selected hospitals. The research population included all the users of pharmacy information systems in the selected hospitals. The research sample is the same as the research population. Researchers collected data using a self-designed checklist developed following the guidelines of the American Society of Health-System Pharmacists, Australia pharmaceutical Society and Therapeutic guidelines of the Drug Commission of the German Medical Association. The checklist validity was assessed by research supervisors and pharmacy information system pharmacists and users. To collect data besides observation, the questionnaires were distributed among pharmacy information system pharmacists and users. Finally, the analysis of the data was performed using the SPSS software. Pharmacy information system was found to be semi-automated in 16 hospitals and automated in 3 ones. Regarding the standards in the guidelines issued by the Society of Pharmacists, the highest rank in observing the input standards belonged to the Social Services associated hospitals with a mean score of 32.75. While teaching hospitals gained the highest score both in processing standards with a mean score of 29.15 and output standards with a mean score of 43.95, and the private hospitals had the lowest mean scores of 23.32, 17.78, 24.25 in input, process and output standards respectively. Based on the findings, the studied

  6. Hospital-based home care for children with cancer

    DEFF Research Database (Denmark)

    Hansson, Eva Helena; Kjaergaard, Hanne; Johansen, Christoffer

    2013-01-01

    BACKGROUND: To assess the feasibility and psychosocial impact of a hospital-based home care (HBHC) program for children with cancer. PROCEDURE: A HBHC program was carried out with 51 children (0-18 years) with cancer to assess its feasibility in terms of satisfaction, care preferences, safety...... children and 43 parents in the home care group, and 47 children and 66 parents receiving standard hospital care. RESULTS: All parents in the HBHC program were satisfied and preferred home care. There were no serious adverse events associated with HBHC, and costs did not increase. When adjusting for age......, gender, diagnosis and time since diagnosis, we found significant higher HRQOL scores in parent-reported physical health (P = 0.04; 95% confidence interval (CI): -0.2-19.5) and worry (P = 0.04; 95% CI: -0.4-20.6) in the home-care group indicating better physical health and less worry for children...

  7. [How to establish the hospital information system security policies].

    Science.gov (United States)

    Gong, Qing-Yue; Shi, Cheng

    2008-03-01

    It is important to establish the hospital information system security policies. While these security policies are being established, a comprehensive consideration should be given to the acceptable levels of users, IT supporters and hospital managers. We should have a formal policy designing process that is consistently followed by all security policies. Reasons for establishing the security policies and their coverage and applicable objects should be stated clearly. Besides, each policy should define user's responsibilities and penalties of violation. Every organization will need some key policies, such as of information sources usage, remote access, information protection, perimeter security, and baseline host/device security. Security managing procedures are the mechanisms to enforce the policies. An incident-handling procedure is the most important security managing procedure for all organizations.

  8. Design of multimedia telemedicine system for inter-hospital consultation.

    Science.gov (United States)

    Yoo, Sun K; Kim, Kwang M; Jung, Suck M; Lee, K J; Kim, Nam H

    2004-01-01

    The telemedicine systems for the decision of patient transfer, and the direction of patient treatment through remote consultation are necessarily required for better patient care in emergency situation. In this paper, the prototype emergency telemedicine system has been designed and implemented. The unified integration of multimedia components, including full-quality video, vital sign signals, radiological images and video conferencing in a single computer, provides an efficient means to investigate the accurate status of emergency patient at the remote location. The software implementation of needed functionality without any externally attached hardware CODEC units enables the compact design with low cost, and ease of operation at the emergency room. Experimental tests at the local networks analyze the technical aspects of implemented systems, and optimize the parameters subjectively to run telemedicine systems with affordable error. Inter-hospital experiments demonstrate the possibility to be effectively used at emergency situation.

  9. CLINICAL SURFACES -- Activity-Based Computing for Distributed Multi-Display Environments in Hospitals

    DEFF Research Database (Denmark)

    Bardram, Jakob Eyvind; Bunde-Pedersen, Jonathan; Doryab, Afsaneh

    2009-01-01

    and browsing of patient data on public displays. We present the design and implementation of CLINICAL SURFACES, and report from an evaluation of the system at a large hospital. The evaluation shows that using distributed public displays to support activity-based computing inside a hospital is very useful...... and activities that the MDE is being used for. This paper presents a novel approach to support activity-based computing in distributed MDEs, where displays are physically distributed across a large building. CLINICAL SURFACES was designed for clinical work in hospitals, and enables context-sensitive retrieval...... for clinical work, and that the apparent contradiction between maintaining privacy of medical data in a public display environment can be mitigated by the use of CLINICAL SURFACES....

  10. Status of costing hospital nursing work within Australian casemix activity-based funding policy.

    Science.gov (United States)

    Heslop, Liza

    2012-02-01

    Australia has a long history of patient level costing initiated when casemix funding was implemented in several states in the early 1990s. Australia includes, to some extent, hospital payment based on nursing intensity adopted within casemix funding policy and the Diagnostic Related Group system. Costing of hospital nursing services in Australia has not changed significantly in the last few decades despite widespread introduction of casemix funding policy at the state level. Recent Commonwealth of Australia National Health Reform presents change to the management of the delivery of health care including health-care costing. There is agreement for all Australian jurisdictions to progress to casemix-based activity funding. Within this context, nurse costing infrastructure presents contemporary issues and challenges. An assessment is made of the progress of costing nursing services within casemix funding models in Australian hospitals. Valid and reliable Australian-refined nursing service weights might overcome present cost deficiencies and limitations. © 2012 Blackwell Publishing Asia Pty Ltd.

  11. Use of a geographic information system to identify differences in automated external defibrillator installation in urban areas with similar incidence of public out-of-hospital cardiac arrest: a retrospective registry-based study.

    Science.gov (United States)

    Fredman, David; Haas, Jan; Ban, Yifang; Jonsson, Martin; Svensson, Leif; Djarv, Therese; Hollenberg, Jacob; Nordberg, Per; Ringh, Mattias; Claesson, Andreas

    2017-06-02

    Early defibrillation in out-of-hospital cardiac arrest (OHCA) is of importance to improve survival. In many countries the number of automated external defibrillators (AEDs) is increasing, but the use is low. Guidelines suggest that AEDs should be installed in densely populated areas and in locations with many visitors. Attempts have been made to identify optimal AED locations based on the incidence of OHCA using geographical information systems (GIS), but often on small datasets and the studies are seldom reproduced. The aim of this paper is to investigate if the distribution of public AEDs follows the incident locations of public OHCAs in urban areas of Stockholm County, Sweden. OHCA data were obtained from the Swedish Register for Cardiopulmonary Resuscitation and AED data were obtained from the Swedish AED Register. Urban areas in Stockholm County were objectively classified according to the pan-European digital mapping tool, Urban Atlas (UA). Furthermore, we reclassified and divided the UA land cover data into three classes (residential, non-residential and other areas). GIS software was used to spatially join and relate public AED and OHCA data and perform computations on relations and distance. Between 1 January 2012 and 31 December 2014 a total of 804 OHCAs occurred in public locations in Stockholm County and by December 2013 there were 1828 AEDs available. The incidence of public OHCAs was similar in residential (47.3%) and non-residential areas (43.4%). Fewer AEDs were present in residential areas than in non-residential areas (29.4% vs 68.8%). In residential areas the median distance between OHCAs and AEDs was significantly greater than in non-residential areas (288 m vs 188 m, pgeographical location into account when suggesting locations for AED installation. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  12. Hospital Consumer Assessment of Healthcare Providers and Systems: An Ethical Leadership Dilemma to Satisfy Patients.

    Science.gov (United States)

    Piper, Llewellyn E; Tallman, Erin

    2016-01-01

    This article examines the parameters and the dynamics of Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) that create an ethical leadership dilemma to satisfy patients in the hospital setting while still ensuring appropriate care for quality clinical outcomes. Under the Affordable Care Act, hospitals and health care systems are in a high-stakes struggle of winners and losers based on HCAHPS scores. This high-stakes struggle creates unintended consequences of an ethical dilemma of doing what is right for the patient versus doing whatever it takes to please the patient in order to achieve high scores of satisfaction that are tied to better reimbursements. This article also reports the results of a national survey of 500 chief executive officers by the authors about the attitudes and frustrations of chief executive officers confronting the wild unrest caused by HCAHPS.

  13. Hospital

    African Journals Online (AJOL)

    treatment modality. Design: It is a retrospective study of all confirmed. Burkitt's lymphoma of the head and neck region seen at the Obafemi Awolowo University Teaching Hospital Ile. Ife (OAUTHC) between 1986 and 2002. Patients and methods: The medical records of all the patients with the histopathologically confirmed ...

  14. Implementation of integrated heterogeneous electronic electrocardiography data into Maharaj Nakorn Chiang Mai Hospital Information System.

    Science.gov (United States)

    Khumrin, Piyapong; Chumpoo, Pitupoom

    2016-03-01

    Electrocardiography is one of the most important non-invasive diagnostic tools for diagnosing coronary heart disease. The electrocardiography information system in Maharaj Nakorn Chiang Mai Hospital required a massive manual labor effort. In this article, we propose an approach toward the integration of heterogeneous electrocardiography data and the implementation of an integrated electrocardiography information system into the existing Hospital Information System. The system integrates different electrocardiography formats into a consistent electrocardiography rendering by using Java software. The interface acts as middleware to seamlessly integrate different electrocardiography formats. Instead of using a common electrocardiography protocol, we applied a central format based on Java classes for mapping different electrocardiography formats which contains a specific parser for each electrocardiography format to acquire the same information. Our observations showed that the new system improved the effectiveness of data management, work flow, and data quality; increased the availability of information; and finally improved quality of care. © The Author(s) 2014.

  15. Key performance indicators in hospital based on balanced scorecard model

    Directory of Open Access Journals (Sweden)

    Hamed Rahimi

    2017-01-01

    Full Text Available Introduction: Performance measurement is receiving increasing verification all over the world. Nowadays in a lot of organizations, irrespective of their type or size, performance evaluation is the main concern and a key issue for top administrators. The purpose of this study is to organize suitable key performance indicators (KPIs for hospitals’ performance evaluation based on the balanced scorecard (BSC. Method: This is a mixed method study. In order to identify the hospital’s performance indicators (HPI, first related literature was reviewed and then the experts’ panel and Delphi method were used. In this study, two rounds were needed for the desired level of consensus. The experts rated the importance of the indicators, on a five-point Likert scale. In the consensus calculation, the consensus percentage was calculated by classifying the values 1-3 as not important (0 and 4-5 to (1 as important. Simple additive weighting technique was used to rank the indicators and select hospital’s KPIs. The data were analyzed by Excel 2010 software. Results: About 218 indicators were obtained from a review of selected literature. Through internal expert panel, 77 indicators were selected. Finally, 22 were selected for KPIs of hospitals. Ten indicators were selected in internal process perspective and 5, 4, and 3 indicators in finance, learning and growth, and customer, respectively. Conclusion: This model can be a useful tool for evaluating and comparing the performance of hospitals. However, this model is flexible and can be adjusted according to differences in the target hospitals. This study can be beneficial for hospital administrators and it can help them to change their perspective about performance evaluation.

  16. Case Mix Management Systems: An Opportunity to Integrate Medical Records and Financial Management System Data Bases

    Science.gov (United States)

    Rusnak, James E.

    1987-01-01

    Due to previous systems selections, many hospitals (health care facilities) are faced with the problem of fragmented data bases containing clinical, demographic and financial information. Projects to select and implement a Case Mix Management System (CMMS) provide an opportunity to reduce the number of separate physical files and to migrate towards systems with an integrated data base. The number of CMMS candidate systems is often restricted due to data base and system interface issues. The hospital must insure the CMMS project provides a means to implement an integrated on-line hospital information data base for use by departments in operating under a DRG-based Prospective Payment System. This paper presents guidelines for use in selecting a Case Mix Mangement System to meet the hospital's financial and operations planning, budgeting, marketing, and other management needs, while considering the data base implications of the implementation.

  17. National hospital ratings systems share few common scores and may generate confusion instead of clarity.

    Science.gov (United States)

    Austin, J Matthew; Jha, Ashish K; Romano, Patrick S; Singer, Sara J; Vogus, Timothy J; Wachter, Robert M; Pronovost, Peter J

    2015-03-01

    Attempts to assess the quality and safety of hospitals have proliferated, including a growing number of consumer-directed hospital rating systems. However, relatively little is known about what these rating systems reveal. To better understand differences in hospital ratings, we compared four national rating systems. We designated "high" and "low" performers for each rating system and examined the overlap among rating systems and how hospital characteristics corresponded with performance on each. No hospital was rated as a high performer by all four national rating systems. Only 10 percent of the 844 hospitals rated as a high performer by one rating system were rated as a high performer by any of the other rating systems. The lack of agreement among the national hospital rating systems is likely explained by the fact that each system uses its own rating methods, has a different focus to its ratings, and stresses different measures of performance. Project HOPE—The People-to-People Health Foundation, Inc.

  18. Validation of hospital register-based diagnosis of Parkinson's disease

    DEFF Research Database (Denmark)

    Wermuth, Lene; Lassen, Christina Funch; Himmerslev, Liselotte

    2012-01-01

    Denmark has a long-standing tradition of maintaining one of the world's largest health science specialized register data bases as the National Hospital Register (NHR). To estimate the prevalence and incidence of diseases, the correctness of the diagnoses recorded is critical. Parkinson's disease...... (PD) is a neurodegenerative disorder and only 75-80% of patients with parkinsonism will have idiopathic PD (iPD). It is necessary to follow patients in order to determine if some of them will develop other neurodegenerative diseases and a one-time-only diagnostic code for iPD reported in the register...

  19. A Knowledge-Constrained Access Control Model for Protecting Patient Privacy in Hospital Information Systems.

    Science.gov (United States)

    Zhang, Runtong; Chen, Donghua; Shang, Xiaopu; Zhu, Xiaomin; Liu, Kecheng

    2017-04-24

    Current access control mechanisms of the hospital information system can hardly identify the real access intention of system users. A relaxed access control increases the risk of compromise of patient privacy. To reduce unnecessary access of patient information by hospital staff, this paper proposes a Knowledge-Constrained Role-Based Access Control (KC-RBAC) model in which a variety of medical domain knowledge is considered in access control. Based on the proposed Purpose Tree and knowledge-involved algorithms, the model can dynamically define the boundary of access to the patient information according to the context, which helps protect patient privacy by controlling access. Compared with the Role-Based Access Control model, KC-RBAC can effectively protect patient information according to the results of the experiments.

  20. SCM: a practical tool to implement hospital-based syndromic surveillance.

    Science.gov (United States)

    Ye, Chuchu; Li, Zhongjie; Fu, Yifei; Lan, Yajia; Zhu, Weiping; Zhou, Dinglun; Zhang, Honglong; Lai, Shengjie; Buckeridge, David L; Sun, Qiao; Yang, Weizhong

    2016-06-18

    Syndromic surveillance has been widely used for the early warning of infectious disease outbreaks, especially in mass gatherings, but the collection of electronic data on symptoms in hospitals is one of the fundamental challenges that must be overcome during operating a syndromic surveillance system. The objective of our study is to describe and evaluate the implementation of a symptom-clicking-module (SCM) as a part of the enhanced hospital-based syndromic surveillance during the 41st World Exposition in Shanghai, China, 2010. The SCM, including 25 targeted symptoms, was embedded in the sentinels' Hospital Information Systems (HIS). The clinicians used SCM to record these information of all the visiting patients, and data were collated and transmitted automatically in daily batches. The symptoms were categorized into seven targeted syndromes using pre-defined criteria, and statistical algorithms were applied to detect temporal aberrations in the data series. SCM was deployed successfully in each sentinel hospital and was operated during the 184-day surveillance period. A total of 1,730,797 patient encounters were recorded by SCM, and 6.1 % (105,352 visits) met the criteria of the seven targeted syndromes. Acute respiratory and gastrointestinal syndromes were reported most frequently, accounted for 92.1 % of reports in all syndromes, and the aggregated time-series presented an obvious day-of-week variation over the study period. In total, 191 aberration signals were triggered, and none of them were identified as outbreaks after verification and field investigation. SCM has acted as a practical tool for recording symptoms in the hospital-based enhanced syndromic surveillance system during the 41st World Exposition in Shanghai, in the context of without a preexisting electronic tool to collect syndromic data in the HIS of the sentinel hospitals.

  1. Clinical course of untreated tonic-clonic seizures in childhood: prospective, hospital based study.

    NARCIS (Netherlands)

    C.A. van Donselaar (Cees); O.F. Brouwer (Oebele); A.T. Geerts (Ada); W.F.M. Arts (Willem Frans); H. Stroink (Hans); A.C.B. Peters (Boudewijn)

    1997-01-01

    textabstractTo assess declaration and acceleration in the disease process in the initial phase of epilepsy in children with new onset tonic-clonic seizures. STUDY DESIGN: Hospital based follow up study. SETTING: Two university hospitals, a general hospital, and a children's hospital in the

  2. Information Technologies in Florida's Rural Hospitals: Does System Affiliation Matter?

    Science.gov (United States)

    Menachemi, Nir; Burke, Darrell; Clawson, Art; Brooks, Robert G.

    2005-01-01

    Context: The recent explosive growth of information technology in hospitals promises to improve hospital and patient outcomes. Financial barriers may cause rural hospitals to lag in adoption of information technology, however, formal studies that examine rural hospital adoption of information technology are lacking. Purpose: To determine the…

  3. Implementing the Hospital Emergency Incident Command System: an integrated delivery system's experience.

    Science.gov (United States)

    Zane, Richard D; Prestipino, Ann L

    2004-01-01

    Hospital disaster manuals and response plans often lack formal command structure; instead, they rely on the presence of key individuals who are familiar with hospital operations, or who are in leadership positions during routine, day-to-day operations. Although this structure occasionally may prove to be successful, it is unreliable, as this leadership may be unavailable at the time of the crisis, and may not be sustainable during a prolonged event. The Hospital Emergency Incident Command System (HEICS) provides a command structure that does not rely on specific individuals, is flexible and expandable, and is ubiquitous in the fire service, emergency medical services, military, and police agencies, thus allowing for ease of communication during event management. A descriptive report of the implementation of the HEICS throughout a large healthcare network is reviewed. Implementation of the HEICS provides a consistent command structure for hospitals that enables consistency and commonality with other hospitals and disaster response entities.

  4. 76 FR 39006 - Medicare Program; Hospital Inpatient Value-Based Purchasing Program; Correction

    Science.gov (United States)

    2011-07-05

    ... Program; Hospital Inpatient Value-Based Purchasing Program; Correction AGENCY: Centers for Medicare...) entitled ``Medicare Program; Hospital Inpatient Value-Based Purchasing Program.'' DATES: Effective Date... properly reflects the performance standards we have finalized for the hospital value-based purchasing...

  5. Hospital at home: home-based end of life care

    Science.gov (United States)

    Shepperd, Sasha; Wee, Bee; Straus, Sharon E

    2014-01-01

    Background The policy in a number of countries is to provide people with a terminal illness the choice of dying at home. This policy is supported by surveys indicating that the general public and patients with a terminal illness would prefer to receive end of life care at home. Objectives To determine if providing home-based end of life care reduces the likelihood of dying in hospital and what effect this has on patients’ symptoms, quality of life, health service costs and care givers compared with inpatient hospital or hospice care. Search methods We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library) to October 2009, Ovid MED-LINE(R) 1950 to March 2011, EMBASE 1980 to October 2009, CINAHL 1982 to October 2009 and EconLit to October 2009. We checked the reference lists of articles identified for potentially relevant articles. Selection criteria Randomised controlled trials, interrupted time series or controlled before and after studies evaluating the effectiveness of home-based end of life care with inpatient hospital or hospice care for people aged 18 years and older. Data collection and analysis Two authors independently extracted data and assessed study quality. We combined the published data for dichotomous outcomes using fixed-effect Mantel-Haenszel meta-analysis. When combining outcome data was not possible we presented the data in narrative summary tables. Main results We included four trials in this review. Those receiving home-based end of life care were statistically significantly more likely to die at home compared with those receiving usual care (RR 1.33, 95% CI 1.14 to 1.55, P = 0.0002; Chi 2 = 1.72, df = 2, P = 0.42, I2 = 0% (three trials; N=652)). We detected no statistically significant differences for functional status (measured by the Barthel Index), psychological well-being or cognitive status, between patients receiving home-based end of life care compared with those receiving standard care (which

  6. Hospital distribution in a metropolitan city: assessment by a geographic information system grid modelling approach.

    Science.gov (United States)

    Lee, Kwang-Soo; Moon, Kyeong-Jun

    2014-05-01

    Grid models were used to assess urban hospital distribution in Seoul, the capital of South Korea. A geographical information system (GIS) based analytical model was developed and applied to assess the situation in a metropolitan area with a population exceeding 10 million. Secondary data for this analysis were obtained from multiple sources: the Korean Statistical Information Service, the Korean Hospital Association and the Statistical Geographical Information System. A grid of cells measuring 1 × 1 km was superimposed on the city map and a set of variables related to population, economy, mobility and housing were identified and measured for each cell. Socio-demographic variables were included to reflect the characteristics of each area. Analytical models were then developed using GIS software with the number of hospitals as the dependent variable. Applying multiple linear regression and geographically weighted regression models, three factors (highway and major arterial road areas; number of subway entrances; and row house areas) were statistically significant in explaining the variance of hospital distribution for each cell. The overall results show that GIS is a useful tool for analysing and understanding location strategies. This approach appears a useful source of information for decision-makers concerned with the distribution of hospitals and other health care centres in a city.

  7. Hospital distribution in a metropolitan city: assessment by a geographical information system grid modelling approach

    Directory of Open Access Journals (Sweden)

    Kwang-Soo Lee

    2014-05-01

    Full Text Available Grid models were used to assess urban hospital distribution in Seoul, the capital of South Korea. A geographical information system (GIS based analytical model was developed and applied to assess the situation in a metropolitan area with a population exceeding 10 million. Secondary data for this analysis were obtained from multiple sources: the Korean Statistical Information Service, the Korean Hospital Association and the Statistical Geographical Information System. A grid of cells measuring 1 × 1 km was superimposed on the city map and a set of variables related to population, economy, mobility and housing were identified and measured for each cell. Socio-demographic variables were included to reflect the characteristics of each area. Analytical models were then developed using GIS software with the number of hospitals as the dependent variable. Applying multiple linear regression and geographically weighted regression models, three factors (highway and major arterial road areas; number of subway entrances; and row house areas were statistically significant in explaining the variance of hospital distribution for each cell. The overall results show that GIS is a useful tool for analysing and understanding location strategies. This approach appears a useful source of information for decision-makers concerned with the distribution of hospitals and other health care centres in a city.

  8. The ability of hospital ventilation systems to filter Aspergillus and other fungi following a building implosion.

    Science.gov (United States)

    Srinivasan, Arjun; Beck, Christopher; Buckley, Timothy; Geyh, Allison; Bova, Greg; Merz, William; Perl, Trish M

    2002-09-01

    To assess the ability of hospital air handling systems to filter Aspergillus, other fungi, and particles following the implosion of an adjacent building; to measure the quantity and persistence of airborne fungi and particles at varying distances during a building implosion; and to determine whether manipulating air systems based on the movement of the dust cloud would be an effective strategy for managing the impact of the implosion. Air sampling study. A 976-bed teaching hospital in Baltimore, Maryland. Single-stage impactors and particle counters were placed at outdoor sites 100, 200, and 400 m from the implosion and in five locations in the hospital: two oncology floors, the human immunodeficiency virus unit, the cardiac surgical intensive care unit, and the ophthalmology unit. Air handling systems would operate normally unless the cloud approached the hospital. Wind carried the bulk of the cloud away from the hospital. Aspergillus counts rose more than tenfold at outdoor locations up to 200 m from the implosion, but did not increase at 400 m. Total fungal counts rose more than sixfold at 100 and 200 m and twofold at 400 m. Similar to Aspergillus, particle counts rose several-fold following the implosion at 100 and 200 m, but did not rise at 400 m. No increases in any fungi or particles were measured at indoor locations. Reacting to the movement of the cloud was effective, because normal operation of the hospital air handling systems was able to accommodate the modest increase in Aspergillus, other fungi, and particles generated by the implosion. Aspergillus measurements were paralleled by particle counts.

  9. Collaboration between physicians and a hospital-based palliative care team in a general acute-care hospital in Japan

    Directory of Open Access Journals (Sweden)

    Nishikitani Mariko

    2010-06-01

    Full Text Available Abstract Background Continual collaboration between physicians and hospital-based palliative care teams represents a very important contributor to focusing on patients' symptoms and maintaining their quality of life during all stages of their illness. However, the traditionally late introduction of palliative care has caused misconceptions about hospital-based palliative care teams (PCTs among patients and general physicians in Japan. The objective of this study is to identify the factors related to physicians' attitudes toward continual collaboration with hospital-based PCTs. Methods This cross-sectional anonymous questionnaire-based survey was conducted to clarify physicians' attitudes toward continual collaboration with PCTs and to describe the factors that contribute to such attitudes. We surveyed 339 full-time physicians, including interns, employed in a general acute-care hospital in an urban area in Japan; the response rate was 53% (N = 155. We assessed the basic characteristics, experience, knowledge, and education of respondents. Multiple logistic regression analysis was used to determine the main factors affecting the physicians' attitudes toward PCTs. Results We found that the physicians who were aware of the World Health Organization (WHO analgesic ladder were 6.7 times (OR = 6.7, 95% CI = 1.98-25.79 more likely to want to treat and care for their patients in collaboration with the hospital-based PCTs than were those physicians without such awareness. Conclusion Basic knowledge of palliative care is important in promoting physicians' positive attitudes toward collaboration with hospital-based PCTs.

  10. Fidelity considerations for simulation-based usability assessments of mobile ICT for hospitals

    DEFF Research Database (Denmark)

    Dahl, Yngve; Alsos, Ole A; Svanæs, Dag

    2010-01-01

    Controlled laboratory-based usability assessments of mobile information and communications technologies (ICT) for hospitals have been conducted. As part of these assessments, clinicians have acted out mobile work scenarios and used the systems to solve related tasks. The evaluations show...... that relevant usability issues go beyond those of graphical user interfaces. Many of these usability issues only show up when the real-world context of use is replicated in the laboratory to a high degree of fidelity. The complexity of the context of use for mobile ICT in hospitals has motivated us to explore...... for hospitals. Our argument is substantiated by using the identified set of fidelity dimensions in a retrospective analysis of two usability assessments. The analysis explains how the configuration of fidelity dimensions, each reflecting various degrees of realism vis-à-vis the actual performance context...

  11. Comparing three methods for participatory simulation of hospital work systems

    DEFF Research Database (Denmark)

    Broberg, Ole; Andersen, Simone Nyholm

    Summative Statement: This study compared three participatory simulation methods using different simulation objects: Low resolution table-top setup using Lego figures, full scale mock-ups, and blueprints using Lego figures. It was concluded the three objects by differences in fidelity and affordance...... and why this influence took place. Research Objective / Question: How does the simulation object influence which elements of a work system are being evaluated in participatory simulation events? Methodology: Observation notes and video recordings of three types of simulation events using different objects...... simulation objects may to a certain degree influence what part of a work system is being addressed in participatory simulation events. For human factors practitioners in hospital design projects it is important to pay attention to this when planning and facilitating simulation events to evaluate different...

  12. Hospitals

    DEFF Research Database (Denmark)

    Mullins, Michael

    2013-01-01

    . Documentation exists in; well-being of patients and staff, sleep disorders, pain distraction, confidentiality and privacy, levels of errors in hospitals. Art and the use of color: Art can be context related so one should be aware whether it is in a private ward or the foyer and related to the experience...... in treating disease can be supported by architecture which is sensitive to the contextual conditions of healing in health facilities. It is not the intention to supplant technology, but a question of supplementing the incredible advances that have been made in medicine in recent decades. The central premise......- sick-leave and work-related injuries....

  13. Hospital-based surveillance of intussusception among infants

    Directory of Open Access Journals (Sweden)

    Eder Gatti Fernandes

    2016-04-01

    Full Text Available Abstract Objective: Intussusception surveillance was initiated after the nationwide introduction of live attenuated monovalent rotavirus vaccine (RV1. The objective is to assess the epidemiology of intussusception and compare the number of cases before and after the introduction of rotavirus vaccine. Methods: Cases of intussusception occurring between March 2006 and January 2008 were identified through a prospective enhanced passive surveillance system established in sentinel state hospitals. Retrospective review of medical records was used to identify cases, which occurred in sentinel hospitals between January 2001 and February 2006. Results: From 2001 to 2008, 331 intussusception cases were identified, 59.5% were male, with peak incidence among those 18–24 weeks of age. Overall <10% of cases were among infants 6–14 weeks of age (when the first dose of RV1 is administered. The most frequently observed signs or symptoms of intussusception included vomiting (89.4%, bloody stool (75.5%, and abdominal distention (71.8%. A majority (92.1% of the case-patients required surgery for treatment; 31.8% of those who underwent surgery required bowel resection, and 13 (3.9% died. Among the 21 hospitals that reported cases throughout the entire surveillance period (2001–2008, the number of intussusception events during 2007 (n = 26 and 2008 (n = 19 was not greater than the average annual number (n = 31, range 24–42 during baseline years 2001–2005. Conclusions: Although this analysis did not identify an increase in intussusception cases during the two years after RV1 introduction, these results support the need for special epidemiologic methods to assess the potential link between rotavirus vaccine and this very rare adverse event.

  14. Biodegradation of pharmaceuticals in hospital wastewater by a hybrid biofilm and activated sludge system (Hybas)

    DEFF Research Database (Denmark)

    Escola Casas, Monica; Chhetri, Ravi Kumar; Ooi, Gordon Tze Hoong

    2015-01-01

    amount, the last reactor (biofilm only) appeared to have the most effective biomass in respect of removing pharmaceuticals. In the batch experiment, out of 26 compounds, 16 were assessed to degrade more than 20% of the respective pharmaceutical within the Hybas train. In the continuous flow experiment......Hospital wastewater contributes a significant input of pharmaceuticals into municipal wastewater. The combination of suspended activated sludge and biofilm processes, as stand-alone or as hybrid process, has been suggested as a possible solution for hospital wastewater treatment. Hybas......TM is a hybrid process, based on the integrated fixed-film activated sludge technology, where plastic carriers for biofilm growth are suspended within activated sludge. To investigate the potential of a hybrid system for the removal of pharmaceuticals in hospital wastewater a pilot plant consisting of a series...

  15. Ensemble-based methods for forecasting census in hospital units

    Science.gov (United States)

    2013-01-01

    Background The ability to accurately forecast census counts in hospital departments has considerable implications for hospital resource allocation. In recent years several different methods have been proposed forecasting census counts, however many of these approaches do not use available patient-specific information. Methods In this paper we present an ensemble-based methodology for forecasting the census under a framework that simultaneously incorporates both (i) arrival trends over time and (ii) patient-specific baseline and time-varying information. The proposed model for predicting census has three components, namely: current census count, number of daily arrivals and number of daily departures. To model the number of daily arrivals, we use a seasonality adjusted Poisson Autoregressive (PAR) model where the parameter estimates are obtained via conditional maximum likelihood. The number of daily departures is predicted by modeling the probability of departure from the census using logistic regression models that are adjusted for the amount of time spent in the census and incorporate both patient-specific baseline and time varying patient-specific covariate information. We illustrate our approach using neonatal intensive care unit (NICU) data collected at Women & Infants Hospital, Providence RI, which consists of 1001 consecutive NICU admissions between April 1st 2008 and March 31st 2009. Results Our results demonstrate statistically significant improved prediction accuracy for 3, 5, and 7 day census forecasts and increased precision of our forecasting model compared to a forecasting approach that ignores patient-specific information. Conclusions Forecasting models that utilize patient-specific baseline and time-varying information make the most of data typically available and have the capacity to substantially improve census forecasts. PMID:23721123

  16. Retrospective hospital based surveillance of intussusception in children in a sentinel paediatric hospital: benefits and pitfalls for use in post-marketing surveillance of rotavirus vaccines.

    Science.gov (United States)

    Lloyd-Johnsen, C; Justice, F; Donath, S; Bines, J E

    2012-04-27

    Evaluation of the safety of rotavirus vaccines, particularly with respect to the risk of intussusception, is recommended for countries planning to introduce rotavirus vaccines into the National Immunisation Program. However, as prospective studies are costly, require time to conduct and may be difficult to perform in some settings, retrospective hospital based surveillance at sentinel sites has been suggested as an option for surveillance for intussusception following introduction of rotavirus vaccines. To assess the value of retrospective hospital based surveillance to describe clinical and epidemiological features of intussusception in children aged Hospital, Melbourne, Australia over an 8-year period including before and after rotavirus vaccine introduction into the National Immunisation Program, was conducted using patients identified by a medical record database (ICD-10-CM 56.1). Patient profile, clinical presentation, treatment and outcome were analysed along with records of immunisation status obtained using the Australian Childhood Immunisation Register. A 9% misclassification rate of discharge diagnosis of intussusception was identified on critical chart review. The incidence rate of intussusception at the Royal Children's Hospital over the study period was 1.91 per 10,000 infants hospital medical records in a sentinel paediatric hospital using standardised methodology. However, there are methodological limitations and the quality of the data is highly dependent on the accuracy and completeness of the patient information recorded, the system of coding and record retrieval. Copyright © 2011 Elsevier Ltd. All rights reserved.

  17. Prevalence and management status of urologic disease in geriatric hospitals in South Korea: A population-based analysis.

    Science.gov (United States)

    Suh, Jungyo; Kim, Khae Hawn; Lee, Sang Heon; Kim, Hyung Suk; Lee, Young Ju; Lee, Sang Rim; Jeong, Chang Wook

    2017-07-01

    This study aimed to investigate the prevalence and management status of urologic disease in geriatric hospitals in Korea. We conducted population-based analyzed using cohort established by the National Health Insurance Service of Korea, which contains the medical insurance data of 1 million people from 2002 to 2013. The prevalence, prescription rate, and complication incidence of urologic disease in geriatric hospitals were compared with similar-sized general hospitals. We analyzed the changes that followed the adoption of the fixed sum medical fee per day for geriatric hospitals, which began in January 2008. Subgroup analysis was conducted in an elderly group and a propensity score matching (PSM) group. During this time, the number of geriatric hospitals exponentially increased over general hospitals (675.5%/y vs. 30.9%/y). The prevalence, prescription rate, and complication incidence of urologic disease was higher in geriatric hospitals than in general hospitals (2.1, 1.8, and 1.4 times higher). In the elderly group, the prevalence of urologic disorders was higher in geriatric hospitals than in general hospitals, but the prescription rate was lower (26.5% vs. 19.9% and 6.8% vs. 10.0%). This tendency also founded in the PSM analysis. After the medical fee system changed, diagnosis and prescription rates decreased in geriatric hospitals but increased in general hospitals. Urologic diseases are more prevalent yet management has some problem in geriatric hospitals. Lack of institutional urologists and changes in the medical payment system should be associated with this problem. Additional study and political support are needed to overcome this issue.

  18. Prevalence and management status of urologic disease in geriatric hospitals in South Korea: A population-based analysis

    Directory of Open Access Journals (Sweden)

    Jungyo Suh

    2017-07-01

    Full Text Available Purpose: This study aimed to investigate the prevalence and management status of urologic disease in geriatric hospitals in Korea. Materials and Methods: We conducted population-based analyzed using cohort established by the National Health Insurance Service of Korea, which contains the medical insurance data of 1 million people from 2002 to 2013. The prevalence, prescription rate, and complication incidence of urologic disease in geriatric hospitals were compared with similar-sized general hospitals. We analyzed the changes that followed the adoption of the fixed sum medical fee per day for geriatric hospitals, which began in January 2008. Subgroup analysis was conducted in an elderly group and a propensity score matching (PSM group. Results: During this time, the number of geriatric hospitals exponentially increased over general hospitals (675.5%/y vs. 30.9%/y. The prevalence, prescription rate, and complication incidence of urologic disease was higher in geriatric hospitals than in general hospitals (2.1, 1.8, and 1.4 times higher. In the elderly group, the prevalence of urologic disorders was higher in geriatric hospitals than in general hospitals, but the prescription rate was lower (26.5% vs. 19.9% and 6.8% vs. 10.0%. This tendency also founded in the PSM analysis. After the medical fee system changed, diagnosis and prescription rates decreased in geriatric hospitals but increased in general hospitals. Conclusions: Urologic diseases are more prevalent yet management has some problem in geriatric hospitals. Lack of institutional urologists and changes in the medical payment system should be associated with this problem. Additional study and political support are needed to overcome this issue.

  19. An approach to hospital operating room HVAC system design

    Energy Technology Data Exchange (ETDEWEB)

    El-Sawah, G. [Higher Technological Inst., Ramadan Tenth City (Egypt); Fouad, M. [Cairo Univ., Cairo (Egypt). Faculty of Engineering]|[ECDG Consulting, Cairo (Egypt); Hendawi, T. [ECDG Consulting, Cairo (Egypt)

    2006-07-01

    A computational fluid dynamics (CFD) program was used to model airflow and contaminant concentrations in a hospital operating room. The study compared different heating ventilation and air conditioning (HVAC) systems. The study then compared a conventional operating room set-up with a new system configuration. A range of different configurations and air inlet velocities were investigated in order to measure the benefits of unidirectional displacement ventilation systems in controlling airborne infections. Results of the study showed that the proposed operating room HVAC system was more efficient than the conventional system in reducing the risk of injection and contamination during surgery. The study also determined a specific configuration that provided minimum contaminant concentrations in a controlled zone by offering a uni-directional flow in the working area that prevented cross-contamination from surrounding areas. The optimum configuration used vertical unidirectional flow diffusers with air curtains that used a room-within-a-room principle that provided a high number of air changes within the operating theatre. 10 refs., 10 figs.

  20. Supporting in- and off-Hospital Patient Management Using a Web-based Integrated Software Platform.

    Science.gov (United States)

    Spyropoulos, Basile; Botsivali, Maria; Tzavaras, Aris; Pierros, Vasileios

    2015-01-01

    In this paper, a Web-based software platform appropriately designed to support the continuity of health care information and management for both in and out of hospital care is presented. The system has some additional features as it is the formation of continuity of care records and the transmission of referral letters with a semantically annotated web service. The platform's Web-orientation provides significant advantages, allowing for easily accomplished remote access.

  1. Pattern of congenital malformations in newborn: a hospital-based study

    Directory of Open Access Journals (Sweden)

    Mohamed El Koumi

    2013-02-01

    Full Text Available Background: Birth defects, encountered frequently by pediatricians, are important causes of childhood morbidity and mortality. Birth defects can be classified based on their severity, pathogenic mechanism or whether they involve a single system or multiple systems. This hospital based prospective descriptive study highlights the prevalence of congenital anomalies (CAs in one year, among liveborn neonates delivered in a university hospital. Design and methods: All women giving birth to babies were included. Demographic details, associated risk factors and the type of CAs in babies were recorded. Diagnosis of CAs was based on clinical evaluation, radiographic examination and chromosomal analysis of newborn whenever recommended. Results: The overall incidence of CAs among liveborn neonates was 2.5%, as most of the cases were referred to Zagazig University Hospital for delivery. The musculoskeletal system (23% was the most commonly involved; followed by central nervous system (20.3%. Involvement of more than one system was observed in (28.6% cases. Out of the maternal and fetal risk factors, parental consanguinity, maternal undernutrition and obesity, positive history of an anomaly in the family, low birth weight(LBW, and prematurity were significantly associated with higher frequency of CAs(p <0.05, with non-significant differences for maternal age and the sex of the neonates. Conclusion : The current study highlighted the point prevalence of congenital anomalies in one year in zagazig university hospital in Egypt. The present study revealed a high prevalence of congenital anomalies in our locality and stressed upon the importance of carrying out a thorough clinical examination of all neonates at birth.

  2. Hospital Value-Based Purchasing (HVBP) – Heart Failure Scores

    Data.gov (United States)

    U.S. Department of Health & Human Services — A list of hospitals participating in the Hospital VBP Program and their performance rates and scores for the Clinical Process of Care Heart Failure measures.

  3. Reorganization of a hospital catering system increases food intake in patients with inadequate intake

    DEFF Research Database (Denmark)

    Freil, M; Nielsen, MA; Blitz, B

    2006-01-01

    Background : Low food intake is a frequent problem in undernourished hospital patients. Objective: To study whether a reorganization of a hospital catering system enabling patients to choose their evening meal individually, in combination with an increase in the energy density of the food....... Conclusions: Reorganization of a hospital catering system can increase energy and protein intake and reduce waste substantially....

  4. Evaluation of a Hospital-Based Pneumonia Nurse Navigator Program.

    Science.gov (United States)

    Seldon, Lisa E; McDonough, Kelly; Turner, Barbara; Simmons, Leigh Ann

    2016-12-01

    The aim of this study is to evaluate the effectiveness of a hospital-based pneumonia nurse navigator program. This study used a retrospective, formative evaluation. Data of patients admitted from January 2012 through December 2014 to a large community hospital with a primary or secondary diagnosis of pneumonia, excluding aspiration pneumonia, were used. Data included patient demographics, diagnoses, insurance coverage, core measures, average length of stay (ALOS), disposition, readmission rate, financial outcomes, and patient barriers to care were collected. Descriptive statistics and parametric testing were used to analyze data. Core measure performance was sustained at the 90th percentile 2 years after the implementation of the navigator program. The ALOS did not decrease to established benchmarks; however, the SD for ALOS decreased by nearly half after implementation of the navigator program, suggesting the program decreased the number and length of extended stays. Charges per case decreased by 21% from 2012 to 2014. Variable costs decreased by 4% over a 2-year period, which increased net profit per case by 5%. Average readmission payments increased by 8% from 2012 to 2014, and the net revenue per case increased by 8.3%. The pneumonia nurse navigator program may improve core measures, reduce ALOS, and increase net revenue. Future evaluations are necessary to substantiate these findings and optimize the cost and quality performance of navigator programs.

  5. Categorizing communication errors in integrated hospital information systems.

    Science.gov (United States)

    Saboor, Samrend; Ammenwerth, Elske

    2009-01-01

    Hospital information systems (HIS) are the hospital's nervous system. The HIS are mostly grown over several years, dedicated to specific needs and comprise individual workarounds. Changes to such complex systems may cause a variety of differ-ent negative side-effects. In order to understand the nature of incorrect communication in integrated HIS, a concise structured categorization of common communication problems and their reasons is essential. The objective of this paper is to present such a categorization, its development and verification. We used a combined approach for the development of the error categorization: We started with a qualitative content analysis on available literature in PubMed. In order to ensure the validity and completeness of the results, we chose the method of problem-centered expert interviews. The resulting categorization of communication problems is represented as a five-level hierarchy. It comprises 81 problems that are related to the electronic communication. Further, it contains in total 229 entries that are either the reasons of these problems or recommendation for avoiding the problems. To our knowledge there is no similar summary that concisely summarizes common communication problems and also refers to their underlying reasons. Equivalent content is mostly published in experience reports that just concentrate on single aspects. We used the details of such references in order to compile our categorization - it thus can be regarded as an intersection of relevant experiences. The categorization can raise a basic awareness on potential problems and supports the understanding of the underlying reasons. An evaluation in a real environment must prove whether the content of the categorization is correct.

  6. Applied patent RFID systems for building reacting HEPA air ventilation system in hospital operation rooms.

    Science.gov (United States)

    Lin, Jesun; Pai, Jar-Yuan; Chen, Chih-Cheng

    2012-12-01

    RFID technology, an automatic identification and data capture technology to provide identification, tracing, security and so on, was widely applied to healthcare industry in these years. Employing HEPA ventilation system in hospital is a way to ensure healthful indoor air quality to protect patients and healthcare workers against hospital-acquired infections. However, the system consumes lots of electricity which cost a lot. This study aims to apply the RFID technology to offer a unique medical staff and patient identification, and reacting HEPA air ventilation system in order to reduce the cost, save energy and prevent the prevalence of hospital-acquired infection. The system, reacting HEPA air ventilation system, contains RFID tags (for medical staffs and patients), sensor, and reacting system which receives the information regarding the number of medical staff and the status of the surgery, and controls the air volume of the HEPA air ventilation system accordingly. A pilot program was carried out in a unit of operation rooms of a medical center with 1,500 beds located in central Taiwan from Jan to Aug 2010. The results found the air ventilation system was able to function much more efficiently with less energy consumed. Furthermore, the indoor air quality could still keep qualified and hospital-acquired infection or other occupational diseases could be prevented.

  7. [Introduction of hospital information system and anesthesia information management system into the perianesthetic practice at Osaka City University Hospital].

    Science.gov (United States)

    Shimizu, Motoko; Tanaka, Katsuaki; Hagiwara, Chie; Ikenaga, Kazutake; Yoshioka, Miwako; Asada, Akira

    2011-06-01

    Recently, the hospital information systems (HIS) and anesthesia information management systems (AIMS) have been rapidly improved and have been introduced into the clinical practice in Japan drastically; however, few reports have detailed their influences on clinical practice. We here report our experience. We introduced HIS (EGMAIN-EX, Fujitsu Co., Ltd.) in our preoperative evaluation clinic and in the postoperative care unit. AIMS (ORSYS, Philips Electronics Japan) was introduced almost only to the intraoperative management. It became easy for us to acquire patient's information and to share it with the medical staffs in the other departments. However, we had to invest large human resources for the introduction and maintenance of the HIS and the AIMS. Though AIMS is more useful in anesthetic management than HIS, it seems to be more suitable for coordination with the medical staffs in the other departments to use HIS for perioperative management than to use AIMS.

  8. A queueing theory based model for business continuity in hospitals.

    Science.gov (United States)

    Miniati, R; Cecconi, G; Dori, F; Frosini, F; Iadanza, E; Biffi Gentili, G; Niccolini, F; Gusinu, R

    2013-01-01

    Clinical activities can be seen as results of precise and defined events' succession where every single phase is characterized by a waiting time which includes working duration and possible delay. Technology makes part of this process. For a proper business continuity management, planning the minimum number of devices according to the working load only is not enough. A risk analysis on the whole process should be carried out in order to define which interventions and extra purchase have to be made. Markov models and reliability engineering approaches can be used for evaluating the possible interventions and to protect the whole system from technology failures. The following paper reports a case study on the application of the proposed integrated model, including risk analysis approach and queuing theory model, for defining the proper number of device which are essential to guarantee medical activity and comply the business continuity management requirements in hospitals.

  9. 78 FR 61197 - Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the...

    Science.gov (United States)

    2013-10-03

    ... that we identified to be subsection (d) hospitals and subsection (d) Puerto Rico hospitals eligible to... SEASONAL INFLUENZA VACCINE , in the table heading, line 2, the phrase ``PERCENTAGE OF RESIDENTS'' is... AND APPROPRIATELY GIVEN THE SEASONAL INFLUENZA VACCINE , in the table heading, line 2, the phrase...

  10. Does marriage protect against hospitalization with pneumonia? A population-based case-control study

    Directory of Open Access Journals (Sweden)

    Mor A

    2013-10-01

    Full Text Available Anil Mor, Sinna P Ulrichsen, Elisabeth Svensson, Klara Berencsi, Reimar W Thomsen Department of Clinical Epidemiology, Institute of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark Background: To reduce the increasing burden of pneumonia hospitalizations, we need to understand their determinants. Being married may decrease the risk of severe infections, due to better social support and healthier lifestyle. Patients and methods: In this population-based case-control study, we identified all adult patients with a first-time pneumonia-related hospitalization between 1994 and 2008 in Northern Denmark. For each case, ten sex- and age-matched population controls were selected from Denmark's Civil Registration System. We performed conditional logistic regression analysis to estimate the odds ratios (ORs for pneumonia hospitalization among persons who were divorced, widowed, or never married, as compared with married persons, adjusting for age, sex, 19 different comorbidities, alcoholism-related conditions, immunosuppressant use, urbanization, and living with small children. Results: The study included 67,162 patients with a pneumonia-related hospitalization and 671,620 matched population controls. Compared with controls, the pneumonia patients were more likely to be divorced (10% versus 7% or never married (13% versus 11%. Divorced and never-married patients were much more likely to have previous diagnoses of alcoholism-related conditions (18% and 11%, respectively compared with married (3% and widowed (6% patients. The adjusted OR for pneumonia-related hospitalization was increased, at 1.29 (95% confidence interval [CI]: 1.25-1.33 among divorced; 1.15 (95% CI: 1.12-1.17 among widowed; and 1.33 (95% CI: 1.29-1.37 among never-married individuals as compared with those who were married. Conclusion: Married individuals have a decreased risk of being hospitalized with pneumonia compared with never-married, divorced, and widowed patients

  11. Costs for in hospital treatment of urinary lithiasis in the Brazilian public health system.

    Science.gov (United States)

    Korkes, Fernando; Silva Ii, Jarques Lúcio da; Heilberg, Ita Pfeferman

    2011-12-01

    To estimate costs associated to hospital treatment of urinary lithiasis in the Brazilian public health system as well as to evaluate demographic and epidemiological data referred to hospital admissions in the Brazilian public health system (or unified health care system). Data from the Informatic Department of Brazilian public health system were obtained as referred to costs in hospital admissions for urinary lithiasis during 2010 and also epidemiological data from 1996 through 2010. There were 69,039 hospital admissions for urinary lithiasis, totaling 0.61% of all hospital admissions in the Brazilian public health system. The mean cost of each of these hospital admissions was US$ 240,23 or R$ 423.42 having as result an overall cost of US$ 16,240,378.00 or R$ 29.232.682,56. Hospital admissions for urinary lithiasis in the Brazilian public health system increased 69% from 1996 to 2010 (43,176 versus 69,309; p lithiasis in Brazil.

  12. Hospital Malnutrition: Prevalence, Identification and Impact on Patients and the Healthcare System

    Science.gov (United States)

    Barker, Lisa A.; Gout, Belinda S.; Crowe, Timothy C.

    2011-01-01

    Malnutrition is a debilitating and highly prevalent condition in the acute hospital setting, with Australian and international studies reporting rates of approximately 40%. Malnutrition is associated with many adverse outcomes including depression of the immune system, impaired wound healing, muscle wasting, longer lengths of hospital stay, higher treatment costs and increased mortality. Referral rates for dietetic assessment and treatment of malnourished patients have proven to be suboptimal, thereby increasing the likelihood of developing such aforementioned complications. Nutrition risk screening using a validated tool is a simple technique to rapidly identify patients at risk of malnutrition, and provides a basis for prompt dietetic referrals. In Australia, nutrition screening upon hospital admission is not mandatory, which is of concern knowing that malnutrition remains under-reported and often poorly documented. Unidentified malnutrition not only heightens the risk of adverse complications for patients, but can potentially result in foregone reimbursements to the hospital through casemix-based funding schemes. It is strongly recommended that mandatory nutrition screening be widely adopted in line with published best-practice guidelines to effectively target and reduce the incidence of hospital malnutrition. PMID:21556200

  13. Reorganization of a hospital catering system increases food intake in patients with inadequate intake

    DEFF Research Database (Denmark)

    Freil, M.; Nielsen, M. A.; Biltz, C.

    2006-01-01

    Background: Low food intake is a frequent problem in undernourished hospital patients. Objective: To study whether a reorganization of a hospital catering system enabling patients to choose their evening meal individually, in combination with an increase in the energy density of the food, increases......: Reorganization of a hospital catering system can increase energy and protein intake and reduce waste substantially. Keywords: hospital food; nutritional risk; undernutrition...

  14. Economic analysis of cloud-based desktop virtualization implementation at a hospital

    Directory of Open Access Journals (Sweden)

    Yoo Sooyoung

    2012-10-01

    Full Text Available Abstract Background Cloud-based desktop virtualization infrastructure (VDI is known as providing simplified management of application and desktop, efficient management of physical resources, and rapid service deployment, as well as connection to the computer environment at anytime, anywhere with anydevice. However, the economic validity of investing in the adoption of the system at a hospital has not been established. Methods This study computed the actual investment cost of the hospital-wide VDI implementation at the 910-bed Seoul National University Bundang Hospital in Korea and the resulting effects (i.e., reductions in PC errors and difficulties, application and operating system update time, and account management time. Return on investment (ROI, net present value (NPV, and internal rate of return (IRR indexes used for corporate investment decision-making were used for the economic analysis of VDI implementation. Results The results of five-year cost-benefit analysis given for 400 Virtual Machines (VMs; i.e., 1,100 users in the case of SNUBH showed that the break-even point was reached in the fourth year of the investment. At that point, the ROI was 122.6%, the NPV was approximately US$192,000, and the IRR showed an investment validity of 10.8%. From our sensitivity analysis to changing the number of VMs (in terms of number of users, the greater the number of adopted VMs was the more investable the system was. Conclusions This study confirms that the emerging VDI can have an economic impact on hospital information system (HIS operation and utilization in a tertiary hospital setting.

  15. Economic analysis of cloud-based desktop virtualization implementation at a hospital.

    Science.gov (United States)

    Yoo, Sooyoung; Kim, Seok; Kim, Taeki; Baek, Rong-Min; Suh, Chang Suk; Chung, Chin Youb; Hwang, Hee

    2012-10-30

    Cloud-based desktop virtualization infrastructure (VDI) is known as providing simplified management of application and desktop, efficient management of physical resources, and rapid service deployment, as well as connection to the computer environment at anytime, anywhere with any device. However, the economic validity of investing in the adoption of the system at a hospital has not been established. This study computed the actual investment cost of the hospital-wide VDI implementation at the 910-bed Seoul National University Bundang Hospital in Korea and the resulting effects (i.e., reductions in PC errors and difficulties, application and operating system update time, and account management time). Return on investment (ROI), net present value (NPV), and internal rate of return (IRR) indexes used for corporate investment decision-making were used for the economic analysis of VDI implementation. The results of five-year cost-benefit analysis given for 400 Virtual Machines (VMs; i.e., 1,100 users in the case of SNUBH) showed that the break-even point was reached in the fourth year of the investment. At that point, the ROI was 122.6%, the NPV was approximately US$192,000, and the IRR showed an investment validity of 10.8%. From our sensitivity analysis to changing the number of VMs (in terms of number of users), the greater the number of adopted VMs was the more investable the system was. This study confirms that the emerging VDI can have an economic impact on hospital information system (HIS) operation and utilization in a tertiary hospital setting.

  16. INTRODUCTION OF INNOVATIVE MEDICAL DEVICES AT FRENCH UNIVERSITY HOSPITALS: AN OVERVIEW OF HOSPITAL-BASED HEALTH TECHNOLOGY ASSESSMENT INITIATIVES.

    Science.gov (United States)

    Martelli, Nicolas; Billaux, Mathilde; Borget, Isabelle; Pineau, Judith; Prognon, Patrice; van den Brink, Helene

    2015-01-01

    Local health technology assessment (HTA) to determine whether new health technologies should be adopted is now a common practice in many healthcare organizations worldwide. However, little is known about hospital-based HTA activities in France. The objective of this study was to explore hospital-based HTA activities in French university hospitals and to provide a picture of organizational approaches to the assessment of new and innovative medical devices. Eighteen semi-structured interviews with hospital pharmacists were conducted from October 2012 to April 2013. Six topics were discussed in depth: (i) the nature of the institution concerned; (ii) activities relating to innovative medical devices; (iii) the technology assessment and decision-making process; (iv) the methodology for technology assessment; (v) factors likely to influence decisions and (vi) suggestions for improving the current process. The interview data were coded, collated and analyzed statistically. Three major types of hospital-based HTA processes were identified: medical device committees, innovation committees, and "pharmacy & management" processes. HTA units had been set up to support medical device and innovation committees for technology assessment. Slow decision making was the main limitation to both these committee-based approaches. As an alternative, "pharmacy & management" processes emerged as a means of rapidly obtaining a formal assessment. This study provides an overview of hospital-based HTA initiatives in France. We hope that it will help to promote hospital-based HTA activities in France and discussions about ways to improve and harmonize practices, through the development of national guidelines and/or a French mini-HTA tool, for example.

  17. Pre-hospital care after a seizure: Evidence base and United Kingdom management guidelines.

    Science.gov (United States)

    Osborne, Andrew; Taylor, Louise; Reuber, Markus; Grünewald, Richard A; Parkinson, Martin; Dickson, Jon M

    2015-01-01

    Seizures are a common presentation to pre-hospital emergency services and they generate significant healthcare costs. This article summarises the United Kingdom (UK) Ambulance Service guidelines for the management of seizures and explores the extent to which these guidelines are evidence-based. Summary of the Clinical Practice Guidelines of the UK Joint Royal Colleges Ambulance Liaison Committee relating to the management of seizures. Review of the literature relating to pre-hospital management of seizure emergencies. Much standard practice relating to the emergency out of hospital management of patients with seizures is drawn from generic Advanced Life Support (ALS) guidelines although many patients do not need ALS during or after a seizure and the benefit of many ALS interventions in seizure patients remains to be established. The majority of studies identified pertain to medical treatment of status epilepticus. These papers show that benzodiazepines are safe and effective but it is not possible to draw definitive conclusions about the best medication or the optimal route of administration. The evidence base for current pre-hospital guidelines for seizure emergencies is incomplete. A large proportion of patients are transported to hospital after a seizure but many of these may be suitable for home management. However, there is very little research into alternative care pathways or criteria that could be used to help paramedics avoid transport to hospital. More research is needed to improve care for people after a seizure and to improve the cost-effectiveness of the healthcare systems within which they are treated. Copyright © 2014 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  18. [Public health impact of a remote diagnosis system implemented in regional and district hospitals in Paraguay].

    Science.gov (United States)

    Galván, Pedro; Velázquez, Miguel; Benítez, Gualberto; Ortellado, José; Rivas, Ronald; Barrios, Antonio; Hilario, Enrique

    2017-06-08

    Determine the viability of a remote diagnosis system implemented to provide health care to remote and scattered populations in Paraguay. The study was conducted in all regional and general hospitals in Paraguay, and in the main district hospitals in the country's 18 health regions. Clinical data, tomographic images, sonography, and electrocardiograms (ECGs) of patients who needed a diagnosis by a specialized physician were entered into the system. This information was sent to specialists in diagnostic imaging and in cardiology for remote diagnosis and the report was then forwarded to the hospitals connected to the system. The cost-benefit and impact of the remote diagnosis tool was analyzed from the perspective of the National Health System. Between January 2014 and May 2015, a total of 34 096 remote diagnoses were made in 25 hospitals in the Ministry of Health's telemedicine system. The average unit cost of remote diagnosis was US$2.6 per ECG, tomography, and sonography, while the unit cost of "face-to-face" diagnosis was US$11.8 per ECG, US$68.6 per tomography, and US$21.5 per sonography. As a result of remote diagnosis, unit costs were 4.5 times lower for ECGs; 26.4 times lower for tomography, and 8.3 times lower for sonography. In monetary terms, implementation of the remote diagnosis system during the 16 months of the study led to average savings of US$2 420 037. Paraguay has a remote diagnosis system for electrocardiography, tomography, and sonography, using low-cost information and communications technologies (ICTs) based on free software that is scalable to other types of remote diagnostic studies of interest for public health. Implementation of remote diagnosis helped to strengthen the integrated network of health services and programs, enabling professionals to optimize their time and productivity, while improving quality, increasing access and equity, and reducing costs.

  19. Development and piloting of the Fiji Injury Surveillance in Hospitals System (TRIP Project-1).

    Science.gov (United States)

    Wainiqolo, I; Kafoa, B; McCaig, E; Kool, B; McIntyre, R; Ameratunga, S

    2013-01-01

    Whilst more than 90% of injury related deaths are estimated to occur in low-and-middle-income countries (LMICs), the epidemiology of fatal and hospitalised injuries in Pacific Island Countries has received scant attention. This study describes the development and piloting of a population-based trauma registry in Fiji to address this gap in knowledge. The Fiji Injury Surveillance in Hospitals (FISH) system was an active surveillance system designed to identify injuries resulting in death or a hospital admission in Viti Levu, Fiji. During the pilot conducted over five months in 2005, Accident and Emergency registers, admission folders and morgue registers from 8 of Viti Levu's 12 hospitals, and an additional 3 hospitals in other parts of the country were reviewed by hospital staff and medical students to identify cases and extract a minimum data set that included demographic factors; the mechanism, nature and context of injury; substance use; and discharge outcomes. The system was audited to identify and redress difficulties with data quality in a manner that also supported local capacity development and training in injury surveillance and data management. This pilot study demonstrated the potential to collect high quality data on injuries that can pose a significant threat to life in Fiji using a mechanism that also increased the capability of health professionals to recognise the significance of injury as a public health issue. The injury surveillance system piloted provides the opportunity to inform national injury control strategies in Fiji and increase the capacity for injury prevention and more focused research addressing risk factors in the local context. Copyright © 2011 Elsevier Ltd. All rights reserved.

  20. Cooperation between Japanese and Cambodian Dietitians in Setting up a Hospital Diet Management System.

    Science.gov (United States)

    Ly, Koung Ry; Saito, Shino; Kusama, Kaoru

    2015-01-01

    Cambodia faces a considerably high percentage of the stunted under 5 (Unicef, 2014). Despite the National Nutrition Strategy Launched by the Ministry of Health in cooperation with development partners, nutrition improvement projects have not always been effective. It is generally said these issues are addressed in many other developing nations, and the literature largely documented that successful nutrition programmes are community-based programmes because of their sustainability and the intensive communications between health workers and beneficiaries. Learning from the past experiences, the Foundation for International Development/Relief organized a project team with a Cambodian dietitian and an experienced Japanese dietitian to implement a hospital diet programme for children from April 2006 to March 2014 in the National Pediatric Hospital (NPH) in Cambodia. The project has two objectives: establishing a hospital diet management system, and developing the capacity of NPH staff. Hospital food menus were created paying particular attention to Cambodian culture, eating habits and accessibility to the ingredients for the purpose of continuous supply. We have also put emphasis on the communication between dietitians and family members of the children to let them understand the importance of a nutritious diet. After 8 y of project implementation, the hospital diet management system was established providing 7 types of menu with nutritious diets. The final evaluation of the project showed that NPH staff have the intention to continue hospital food supply with their acquired knowledge and capacity. In practice, a Cambodian dietitian currently takes the initiative for a continuous nutritional diet in NPH. The key to this success is the collaboration between Japanese dietitians with experience and Cambodian dietitians with knowledge of Cambodian eating habits. Taking our experience into account, it is highly recommended to educate Cambodian dietitians, as they are

  1. Geospatial analysis of hospital consumer assessment of healthcare providers and systems pain management experience scores in U.S. hospitals.

    Science.gov (United States)

    Tighe, Patrick J; Fillingim, Roger B; Hurley, Robert W

    2014-05-01

    Although prior work has investigated the interplay between demographic and intrasurvey correlations of Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores, these prior studies have not included geospatial analyses, or analyses that take into account location effects. Here, we report the results of a geospatial analysis (not equivalent to simple geographical analysis) of patient experience scores pertaining to pain. HCAHPS data collected in 2011 were examined to test the hypothesis that HCAHPS patient experience with pain management (PEPM) scores were geospatially distributed throughout the United States using Moran's Index, which measures the association between PEPM scores and hospital location. After limiting the dataset to hospitals in the continental United States with nonzero HCAHPS response rates, 3645 hospitals were included in the analyses. "Always" responses were geospatially clustered amongst the analyzed hospitals. Clustering was significant in all distances tested from 10 to 5000km (P<0.0001). We identified 6 demarcated groups of hospitals. Taken together, these results strongly suggest a regional geographic effect on PEPM scores. These results may carry policy implications for U.S. hospitals with regard to acute pain outcomes. Further analyses will be necessary to evaluate policy explanations and implications of the regional geographic differences in PEPM results. Copyright © 2014 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

  2. Understanding the context of balanced scorecard implementation: a hospital-based case study in Pakistan.

    Science.gov (United States)

    Rabbani, Fauziah; Lalji, Sabrina Nh; Abbas, Farhat; Jafri, Sm Wasim; Razzak, Junaid A; Nabi, Naheed; Jahan, Firdous; Ajmal, Agha; Petzold, Max; Brommels, Mats; Tomson, Goran

    2011-03-31

    As a response to a changing operating environment, healthcare administrators are implementing modern management tools in their organizations. The balanced scorecard (BSC) is considered a viable tool in high-income countries to improve hospital performance. The BSC has not been applied to hospital settings in low-income countries nor has the context for implementation been examined. This study explored contextual perspectives in relation to BSC implementation in a Pakistani hospital. Four clinical units of this hospital were involved in the BSC implementation based on their willingness to participate. Implementation included sensitization of units towards the BSC, developing specialty specific BSCs and reporting of performance based on the BSC during administrative meetings. Pettigrew and Whipp's context (why), process (how) and content (what) framework of strategic change was used to guide data collection and analysis. Data collection methods included quantitative tools (a validated culture assessment questionnaire) and qualitative approaches including key informant interviews and participant observation. Method triangulation provided common and contrasting results between the four units. A participatory culture, supportive leadership, financial and non-financial incentives, the presentation of clear direction by integrating support for the BSC in policies, resources, and routine activities emerged as desirable attributes for BSC implementation. The two units that lagged behind were more involved in direct inpatient care and carried a considerable clinical workload. Role clarification and consensus about the purpose and benefits of the BSC were noted as key strategies for overcoming implementation challenges in two clinical units that were relatively ahead in BSC implementation. It was noted that, rather than seeking to replace existing information systems, initiatives such as the BSC could be readily adopted if they are built on existing infrastructures and data

  3. Pattern of blindness in a community based hospital of Nepal.

    Science.gov (United States)

    Sharma, R; Marasini, S; Nepal, B P

    2013-01-01

    Because of the availability of modern health facilities and moderately easy access to health services in the last 25 years, the blindness due to cataract and trachoma is expected to decline in Nepal. So it is felt that the causes of blindness need to be revised. To regroup the disease pattern leading to permanent blindness in patients attending a suburban multidisciplinary community-based hospital of Nepal. A cross-sectional, descriptive study was conducted in patients attending Dhulikhel hospital over a period of 12 months, from March 2010. Only the patients with best corrected visual acuity of less than 3/60 were enrolled in the study. A detailed ocular examination was carried out. A total of 76 eyes of 58 patients were analyzed. Of all, 32 were male (55.2 %). The mean age of the patients was 43.03 ± 22.98, with a range of 7 years to 84 years. Retinal diseases had the higher prevalence (23, 39.7 %) followed by amblyopia (10, 17.2 %) and corneal diseases (9, 15.51 %). Anisometropic amblyopia (3.94 %) was the commonest type of amblyopia. Retinitis pigmentosa (9.21 %) and age-related macular degeneration (7.89 %) were common retinal diseases whereas anterior staphyloma (5.26 %) and leucoma (3.94 %) were common corneal diseases. Other important and rare causes of blindness included ethambutol-induced optic neuropathy and vitelliform dystrophy. Periodic collection of statistics on the relative frequency of the causes of blindness is important in socioeconomically developing nations like Nepal. This helps to revise the pattern of blinding diseases so that priorities can be redefined. © NEPjOPH.

  4. Hospital-based surveillance of enteric parasites in Kolkata

    Directory of Open Access Journals (Sweden)

    Ghosh Mrinmoy

    2009-06-01

    Full Text Available Abstract Background Diarrhoea is the second leading cause of illness and death in developing countries and the second commonest cause of death due to infectious diseases among children under five in such countries. Parasites, as well as bacterial and viral pathogens, are important causes of diarrhoea. However, parasitic infections are sometimes overlooked, leading after a period of time to an uncertain aetiology. In this paper we report the prevalence of Giardia lamblia, Entamoeba histolytica and Cryptosporidium sp. in and around Kolkata. Findings A hospital-based laboratory surveillance study was conducted among the patients admitted between November 2007 and October 2008 to the Infectious Diseases (ID Hospital (Population = 1103 with diarrhoeal complaints. Of the 1103 samples collected, 147 were positive for Giardia lamblia, 84 for Cryptosporidium sp. and 51 for Entamoeba histolytica. For all these parasites there was a high rate of mixed infection with common enteric viruses and bacteria such as Rotavirus, Vibrio cholerae and Shigella sp. There were also cases of co-infection with all other diarrheogenic pathogens. The age group ≥ 5 years had the highest prevalence of parasites whereas the age group >5 – 10 years was predominantly infected with Giardia lamblia (p =10 – 20 years could also be considered at risk for G. lamblia (p = 0.009; OR = 2.231; 95% CI = 1.223 – 4.067. Month-wise occurrence data showed an endemic presence of G. lamblia whereas Cryptosporidium sp. and E. histolytica occurred sporadically. The GIS study revealed that parasites were more prevalent in areas such as Tangra, Tiljala and Rajarhat, which are mainly slum areas. Because most of the population surveyed was in the lower income group, consumption of contaminated water and food could be the major underlying cause of parasitic infestations. Conclusion This study provides important information on the occurrence and distribution of three important intestinal

  5. Evaluating hospital information systems from the point of view of the medical records section users in Medical-Educational Hospitals of Kermanshah 2014.

    Science.gov (United States)

    Rostami, S; Sarmad, A; Mohammadi, M; Cheleie, M; Amiri, S; Zardoei Golanbary, S H

    2015-01-01

    Evaluating hospital information systems leads to the improvement and devotion based on the users' needs, especially the medical records section users in hospitals, which are in contact with this system from the moment the patient enters the hospital until his/ her release and after that. The present research aimed to evaluate the hospital information systems from the point of view of the medical record section employees. Materials and method: The current research was applicative-descriptive analytical and the research society included 70 users of the medical history section in the educational-medical centers of Kermanshah city. The data-gathering tool was the 10th part of 9241/ 10 Isometric standard questionnaire of evaluating hospital information systems, with 75 specific questions in 7 bases, with the five spectra Likertt scale, its conceptual admissibility being confirmed in previous researches. 22 SPSS statistical software analyzed its permanency in the present study, which was also confirmed by Cronbach's's alpha test, which equaled to 0.89, and the data. Findings: The highest level of the employees' satisfaction, based on gained scores median, was respectively the incompatibility with the users' expectations, measuring 3.55, self-description measuring 3.54 and controllability - 3.51, which in total presented the average scores of 3.39, the lowest level of satisfaction being related to useful learning , whose value was 3.19. Discussion and conclusion: Hospital information systems' users believe that it is more desirable that the existing systems are based on the measures and consider them proper for making them non-governmental and useful for undesired learning. Considering the long distance of the existing information systems with the desired performance, it is essential that "these systems pay more attention to a more complete and deeper recognition and awareness of users' opinions and requirements in their road. The movement and development is to increase

  6. A techno-economic assessment of grid connected photovoltaic system for hospital building in Malaysia

    Science.gov (United States)

    Mat Isa, Normazlina; Tan, Chee Wei; Yatim, AHM

    2017-07-01

    Conventionally, electricity in hospital building are supplied by the utility grid which uses mix fuel including coal and gas. Due to enhancement in renewable technology, many building shall moving forward to install their own PV panel along with the grid to employ the advantages of the renewable energy. This paper present an analysis of grid connected photovoltaic (GCPV) system for hospital building in Malaysia. A discussion is emphasized on the economic analysis based on Levelized Cost of Energy (LCOE) and total Net Present Post (TNPC) in regards with the annual interest rate. The analysis is performed using Hybrid Optimization Model for Electric Renewables (HOMER) software which give optimization and sensitivity analysis result. An optimization result followed by the sensitivity analysis also being discuss in this article thus the impact of the grid connected PV system has be evaluated. In addition, the benefit from Net Metering (NeM) mechanism also discussed.

  7. Scenario based outdoor simulation in pre-hospital trauma care using a simple mannequin model

    Directory of Open Access Journals (Sweden)

    Grier Gareth

    2010-03-01

    Full Text Available Abstract Introduction We describe a system of scenario-based training using simple mannequins under realistic circumstances for the training of pre-hospital care providers. Methods A simple intubatable mannequin or student volunteers are used together with a training version of the equipment used on a routine basis by the pre-hospital care team (doctor + paramedic. Training is conducted outdoors at the base location all year round. The scenarios are led by scenario facilitators who are predominantly senior physicians. Their role is to brief the training team and guide the scenario, results of patient assessment and the simulated responses to interventions and treatment. Pilots, fire-fighters and medical students are utilised in scenarios to enhance realism by taking up roles as bystanders, additional ambulance staff and police. These scenario participants are briefed and introduced to the scene in a realistic manner. After completion of the scenario, the training team would usually be invited to prepare and deliver a hospital handover as they would in a real mission. A formal structured debrief then takes place. Results This training method technique has been used for the training of all London Helicopter Emergency Medical Service (London HEMS doctors and paramedics over the last 24 months. Informal participant feedback suggests that this is a very useful teaching method, both for improving motor skills, critical decision-making, scene management and team interaction. Although formal assessment of this technique has not yet taken place we describe how this type of training is conducted in a busy operational pre-hospital trauma service. Discussion The teaching and maintenance of pre-hospital care skills is essential to an effective pre-hospital trauma care system. Simple mannequin based scenario training is feasible on a day-to-day basis and has the advantages of low cost, rapid set up and turn around. The scope of scenarios is limited only by

  8. Factors for change in maternal and perinatal audit systems in Dar es Salaam hospitals, Tanzania

    Directory of Open Access Journals (Sweden)

    Kisanga Felix

    2010-06-01

    Full Text Available Abstract Background Effective maternal and perinatal audits are associated with improved quality of care and reduction of severe adverse outcome. Although audits at the level of care were formally introduced in Tanzania around 25 years ago, little information is available about their existence, performance, and practical barriers to their implementation. This study assessed the structure, process and impacts of maternal and perinatal death audit systems in clinical practice and presents a detailed account on how they could be improved. Methods A cross sectional descriptive study was conducted in eight major hospitals in Dar es Salaam in January 2009. An in-depth interview guide was used for 29 health managers and members of the audit committees to investigate the existence, structure, process and outcome of such audits in clinical practice. A semi-structured questionnaire was used to interview 30 health care providers in the maternity wards to assess their awareness, attitude and practice towards audit systems. The 2007 institutional pregnancy outcome records were reviewed. Results Overall hospital based maternal mortality ratio was 218/100,000 live births (range: 0 - 385 and perinatal mortality rate was 44/1000 births (range: 17 - 147. Maternal and perinatal audit systems existed only in 4 and 3 hospitals respectively, and key decision makers did not take part in audit committees. Sixty percent of care providers were not aware of even a single action which had ever been implemented in their hospitals because of audit recommendations. There were neither records of the key decision points, action plan, nor regular analysis of the audit reports in any of the facilities where such audit systems existed. Conclusions Maternal and perinatal audit systems in these institutions are poorly established in structure and process; and are less effective to improve the quality of care. Fundamental changes are urgently needed for successful audit systems in

  9. [Assessment and comparison of hospital operating efficiency under different management systems].

    Science.gov (United States)

    2017-06-18

    descent of SE in the commission hospitals was larger than that in the municipal hospitals. There are significant differences in the operation efficiency between different management systems and the main factors associated with operation efficiency are the technological and management level. Given scale efficiency status and macroeconomic medical policies, the commission hospitals and the municipal hospitals require further adjusting the distribution of medical resources, and it is of great significance for all the commission hospitals and the municipal hospitals to improve the management level and resource integration capability.

  10. Current nursing practice by hospital-based stoma specialist nurses.

    Science.gov (United States)

    Burch, Jennie

    Nurses frequently care for patients who have stomas. A common complication is sore peristomal skin (skin around the stoma). The study aim was to answer the research question: what is the current nursing practice for peristomal skin problems among UK stoma specialist nurses? The question was explored through investigation of descriptions, treatments and opinions of peristomal skin problems. Results were examined to ascertain if practice reflects the literature and if care was evidence-based. A questionnaire was posted in September 2009 to the stoma care nurses in all UK NHS hospitals (n=596). The proportion of completed or partially completed questionnaires was 15% (89 of 596). Most of the responding nurses held a stoma-related qualification (86%), a degree (55%) and had specialised in stoma care for over 5 years (67%). Respondents used erythema to describe sore skin (80%). Stoma powder (98%) and convex appliances (98%) were the most commonly used treatments. The most common cause of sore skin was appliance leakage (61%). The study population was deemed suitably qualified and experienced to answer the research question. Many responses were reflected in the literature (predominantly opinion articles), reflecting a degree of reliability and validity. It could be concluded that stoma specialist nurses can accurately assess and use stoma accessories to treat sore skin, but due to the paucity of research, the care cannot be defined as evidence-based. More research is needed to determine universally accepted definitions and treatments for sore peristomal skin.

  11. A standardised pre-hospital electronic patient care system.

    Science.gov (United States)

    Gaynor, Mark; Myung, Dan; Gupta, Amar; Moulton, Steve

    2009-01-01

    This paper describes the design, development and testing of a pre-hospital documentation and patient monitoring application called iRevive. The application utilises a sensor gateway and data mediator to enable semantic interoperability with a wide variety of medical devices and applications. Initial test results indicate that complete and consistent pre-hospital Electronic Medical Records (EMR) can be semantically exchanged with two heterogeneous, in-hospital IT applications.

  12. Integration Between Aqli And Naqli In Development Of Database For Hospital Information System

    Directory of Open Access Journals (Sweden)

    Muhammad Mursyidan Mah Dahwi

    2015-08-01

    Full Text Available Abstract Database era has been appear during Prophet Muhammad S.A.W. We are using the same concept but only deployed in the medical environment with security features which is related to aqli and naqli. The development of a system not only covered the ability of the system to be functioned and execute very well but a good and efficient system must be able to communicate with the users and become a user friendly system. This research is about developing Hospital Patient Information System developed for Hematology Ward and Hemato-oncology Laboratory at the Hospital UniversitiSains Malaysia HUSM based on the aqli and naqli. It lacks of security in term of data integrity of the system. It will be enhanced in its security features which will be implemented with the data integrity feature and also password encryption to overcome the problems. As a result an automated calculation of blood series and graph production as for data analysis will be implemented in this system.An approach of agile method is the chosen process to be used in realizing this research. This system will come out with the ability of protection in data integrity password encryption and automatic calculation in order to reduce the fraud and human errors.

  13. Op weg naar een accreditatiesysteem van Nederlandse ziekenhuizen [Towards an accreditation system of Dutch hospitals

    NARCIS (Netherlands)

    Gennip, E.M.S.J. van; Linnebank, F.; Sillevis Smitt, P.A.E.; Geldof, C.A.

    1999-01-01

    The development of the Netherlands system for accreditation of hospitals started in 1989 in the Pilotproject Accreditation (PACE). This resulted in the establishment of the Netherlands Institute for Accreditation of Hospitals (NIAH) early 1999, by the Dutch Association of Hospitals, the Dutch

  14. Antipsychotics and risk of first-time hospitalization for myocardial infarction: a population-based case-control study

    DEFF Research Database (Denmark)

    Nakagawa, S; Pedersen, Lene; Olsen, Mette Lena

    2006-01-01

    . Objective. To examine risk of hospitalization for myocardial infarction (MI) amongst users of antipsychotics compared with non-users. Design and subjects. A population-based case-control study using data from hospital discharge registries in the counties of North Jutland, Viborg and Aarhus, Denmark......, and the Danish Civil Registration System. We identified 21 377 cases of first-time hospitalization for MI and 106 885 sex- and age-matched non-MI population controls in the period 1992-2004. All prescriptions for antipsychotics filled prior to the date of admission for MI were retrieved from population...... overall risk of being admitted to hospital for MI when compared with non-users of antipsychotics. These findings were consistent in all examined subgroups. Further, we found no association between the cumulative dose of antipsychotics and the risk of hospitalization for MI. Conclusion. These findings do...

  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. A system dynamics approach for hospital waste management in a city in a developing country: the case of Nablus, Palestine.

    Science.gov (United States)

    Al-Khatib, Issam A; Eleyan, Derar; Garfield, Joy

    2016-09-01

    Hospitals and health centers provide a variety of healthcare services and normally generate hazardous waste as well as general waste. General waste has a similar nature to that of municipal solid waste and therefore could be disposed of in municipal landfills. However, hazardous waste poses risks to public health, unless it is properly managed. The hospital waste management system encompasses many factors, i.e., number of beds, number of employees, level of service, population, birth rate, fertility rate, and not in my back yard (NIMBY) syndrome. Therefore, this management system requires a comprehensive analysis to determine the role of each factor and its influence on the whole system. In this research, a hospital waste management simulation model is presented based on the system dynamics technique to determine the interaction among these factors in the system using a software package, ithink. This model is used to estimate waste segregation as this is important in the hospital waste management system to minimize risk to public health. Real data has been obtained from a case study of the city of Nablus, Palestine to validate the model. The model exhibits wastes generated from three types of hospitals (private, charitable, and government) by considering the number of both inpatients and outpatients depending on the population of the city under study. The model also offers the facility to compare the total waste generated among these different types of hospitals and anticipate and predict the future generated waste both infectious and non-infectious and the treatment cost incurred.

  17. Does autonomy for public hospitals in developing countries increase performance? Evidence-based case studies.

    Science.gov (United States)

    De Geyndt, Willy

    2017-04-01

    Governments in middle and low income countries have sought ways for the past decades to make their public hospitals more performing. The objectives of this assessment are to: (a) synthesize the experience of eleven countries at granting autonomy to their public hospitals and the obstacles encountered; (b) deduce which autonomy policies have or have not been effective documenting successes and failures; and (c) propose evidence-based recommendations to policy makers. Data for five countries are derived from the author's participation in the autonomy process augmented by current updates provided by national colleagues. Data for the other six countries are derived from publications available in the literature. Policies granting autonomy to public hospitals have had limited success. In all cases Boards of Directors have been created. Governance of autonomized hospitals by Boards however is obstructed by the resistance of central level entities to have their authority diminished. The Ministry of Finance tends to maintain control over revenues and expenditures. The Public Service Commission resists abdicating its role to hire, promote, transfer and dismiss government employees. The Ministry of Health attempts to keep its authority to appoint hospital staff, procure medical supplies and equipment; it may do so directly or indirectly by selecting and appointing Board members. Management information systems continue to collect activity measures to be aggregated at the national level for statistical purposes and do not provide financial and clinical data useful for decision making by the Boards and by senior management. Decentralizing decision making to the operational level has had limited success. Stakeholders at the central level devise strategies to maintain their power. Two main obstacles are delegating authority over human resources and finances that are sine qua non conditions for governing and increasing the performance of public hospitals. Copyright © 2017 Elsevier

  18. Effect of hospital volume on processes of breast cancer care: A National Cancer Data Base study.

    Science.gov (United States)

    Yen, Tina W F; Pezzin, Liliana E; Li, Jianing; Sparapani, Rodney; Laud, Purushuttom W; Nattinger, Ann B

    2017-05-15

    The purpose of this study was to examine variations in delivery of several breast cancer processes of care that are correlated with lower mortality and disease recurrence, and to determine the extent to which hospital volume explains this variation. Women who were diagnosed with stage I-III unilateral breast cancer between 2007 and 2011 were identified within the National Cancer Data Base. Multiple logistic regression models were developed to determine whether hospital volume was independently associated with each of 10 individual process of care measures addressing diagnosis and treatment, and 2 composite measures assessing appropriateness of systemic treatment (chemotherapy and hormonal therapy) and locoregional treatment (margin status and radiation therapy). Among 573,571 women treated at 1755 different hospitals, 38%, 51%, and 10% were treated at high-, medium-, and low-volume hospitals, respectively. On multivariate analysis controlling for patient sociodemographic characteristics, treatment year and geographic location, hospital volume was a significant predictor for cancer diagnosis by initial biopsy (medium volume: odds ratio [OR] = 1.15, 95% confidence interval [CI] = 1.05-1.25; high volume: OR = 1.30, 95% CI = 1.14-1.49), negative surgical margins (medium volume: OR = 1.15, 95% CI = 1.06-1.24; high volume: OR = 1.28, 95% CI = 1.13-1.44), and appropriate locoregional treatment (medium volume: OR = 1.12, 95% CI = 1.07-1.17; high volume: OR = 1.16, 95% CI = 1.09-1.24). Diagnosis of breast cancer before initial surgery, negative surgical margins and appropriate use of radiation therapy may partially explain the volume-survival relationship. Dissemination of these processes of care to a broader group of hospitals could potentially improve the overall quality of care and outcomes of breast cancer survivors. Cancer 2017;123:957-66. © 2016 American Cancer Society. © 2016 American Cancer Society.

  19. Does marriage protect against hospitalization with pneumonia? A population-based case-control study.

    Science.gov (United States)

    Mor, Anil; Ulrichsen, Sinna P; Svensson, Elisabeth; Berencsi, Klara; Thomsen, Reimar W

    2013-01-01

    To reduce the increasing burden of pneumonia hospitalizations, we need to understand their determinants. Being married may decrease the risk of severe infections, due to better social support and healthier lifestyle. In this population-based case-control study, we identified all adult patients with a first-time pneumonia-related hospitalization between 1994 and 2008 in Northern Denmark. For each case, ten sex- and age-matched population controls were selected from Denmark's Civil Registration System. We performed conditional logistic regression analysis to estimate the odds ratios (ORs) for pneumonia hospitalization among persons who were divorced, widowed, or never married, as compared with married persons, adjusting for age, sex, 19 different comorbidities, alcoholism-related conditions, immunosuppressant use, urbanization, and living with small children. The study included 67,162 patients with a pneumonia-related hospitalization and 671,620 matched population controls. Compared with controls, the pneumonia patients were more likely to be divorced (10% versus 7%) or never married (13% versus 11%). Divorced and never-married patients were much more likely to have previous diagnoses of alcoholism-related conditions (18% and 11%, respectively) compared with married (3%) and widowed (6%) patients. The adjusted OR for pneumonia-related hospitalization was increased, at 1.29 (95% confidence interval [CI]: 1.25-1.33) among divorced; 1.15 (95% CI: 1.12-1.17) among widowed; and 1.33 (95% CI: 1.29-1.37) among never-married individuals as compared with those who were married. Married individuals have a decreased risk of being hospitalized with pneumonia compared with never-married, divorced, and widowed patients.

  20. Chronic diseases requiring hospitalization and risk of non-melanoma skin cancers-A population based study from Denmark

    DEFF Research Database (Denmark)

    Jensen, Annette Ø; Olesen, Anne B; Dethlefsen, Claus

    2008-01-01

    We examined the associations between chronic diseases requiring hospitalization and the risk of non-melanoma skin cancers (NMSCs) in a population-based case-control study of 4,187 patients diagnosed with a first primary NMSC in 1995 in Denmark. From the National Patient Registry covering all Danish...... hospitals, we obtained data on hospitalizations with chronic diseases, recorded before the date of NMSC diagnosis. Using incidence density sampling, we selected 10 age-, gender-, and residence-matched controls from the Danish Civil Registration System. We used conditional logistic regression to compute...

  1. Short Communication - Hospital-Based Mortality in Federal Capital ...

    African Journals Online (AJOL)

    Background: Cause-specific mortality data are important to monitor trends in mortality over time. Medical records provide reliable documentation of the causes of deaths occurring in hospitals. This study describes all causes of mortality reported at hospitals in the Federal Capital Territory (FCT) of Nigeria. Methods: Deaths ...

  2. Culinary and hospitality teaching as a research-based profession ...

    African Journals Online (AJOL)

    This is not just an academic paper, it is a resource. It addresses the topic of how hospitality and tourism education is likely to change in 5, 10 and 15 years' time. The principal function of a hospitality academy is to design, plan, prepare and deliver a programme of learning in ways that foster and support student learning.

  3. [Strategy for promoting evidence-based nursing practice in hospital].

    Science.gov (United States)

    Chen, Yu-Chih; Tang, Lee-Chun; Chou, Shin-Shang

    2013-10-01

    Evidence-based practice has been demonstrated to improve quality of care, increase patients' satisfaction, and reduce the costs of medical care. Therefore, evidence-based practice is now central to the clinical decision-making process and to achieving better quality of care. Today, it is one of the important indicators of core competences for healthcare providers and accreditation for healthcare and educational systems. Further, evidence-based practice encourages in-school and continuous education programs to integrate evidence-based elements and concepts into curricula. Healthcare facilities and professional organizations proactively host campaigns and encourage healthcare providers to participate in evidence-based related training courses. However, the clinical evidence-based practice progress is slow. The general lack of a model for organizational follow-up may be a key factor associated with the slow adoption phenomenon. The authors provide a brief introduction to the evidence-based practice model, then described how it may be successfully translated through a staged process into the evidence-based practices of organizational cultures. This article may be used as a reference by healthcare facilities to promote evidence-based nursing practice.

  4. Studying Sensing-Based Systems

    DEFF Research Database (Denmark)

    Kjærgaard, Mikkel Baun

    2013-01-01

    Recent sensing-based systems involve a multitude of users, devices, and places. These types of systems challenge existing approaches for conducting valid system evaluations. Here, the author discusses such evaluation challenges and revisits existing system evaluation methodologies....

  5. 75 FR 45699 - Medicare Program: Changes to the Hospital Outpatient Prospective Payment System and CY 2010...

    Science.gov (United States)

    2010-08-03

    ... 410, 416 and 419 Medicare Program: Changes to the Hospital Outpatient Prospective Payment System and CY 2010 Payment Rates; Changes to the Ambulatory Surgical Center Payment System and CY 2010 Payment...: Changes to the Hospital Outpatient Prospective Payment System and CY 2010 Payment Rates; Changes to the...

  6. Clinical leadership and hospital performance: assessing the evidence base.

    Science.gov (United States)

    Sarto, F; Veronesi, G

    2016-05-24

    A widespread assumption across health systems suggests that greater clinicians' involvement in governance and management roles would have wider benefits for the efficiency and effectiveness of healthcare organisations. However, despite growing interest around the topic, it is still poorly understood how managers with a clinical background might specifically affect healthcare performance outcomes. The purpose of this review is, therefore, to map out and critically appraise quantitatively-oriented studies investigating this phenomenon within the acute hospital sector. The review has focused on scientific papers published in English in international journals and conference proceedings. The articles have been extracted through a Boolean search strategy from ISI Web of Science citation and search source. No time constraints were imposed. A manual search by keywords and citation tracking was also conducted concentrating on highly ranked public sector governance and management journals. Nineteen papers were identified as a match for the research criteria and, subsequently, were classified on the basis of six items. Finally, a thematic mapping has been carried out leading to identify three main research sub-streams on the basis of the types of performance outcomes investigated. The analysis of the extant literature has revealed that research focusing on clinicians' involvement in leadership positions has explored its implications for the management of financial resources, the quality of care offered and the social performance of service providers. In general terms, the findings show a positive impact of clinical leadership on different types of outcome measures, with only a handful of studies highlighting a negative impact on financial and social performance. Therefore, this review lends support to the prevalent move across health systems towards increasing the presence of clinicians in leadership positions in healthcare organisations. Furthermore, we present an

  7. Technology based Education System

    DEFF Research Database (Denmark)

    Kant Hiran, Kamal; Doshi, Ruchi; Henten, Anders

    2016-01-01

    Abstract - Education plays a very important role for the development of the country. Education has multiple dimensions from schooling to higher education and research. In all these domains, there is invariably a need for technology based teaching and learning tools are highly demanded...... in the academic institutions. Thus, there is a need of comprehensive technology support system to cater the demands of all educational actors. Cloud Computing is one such comprehensive and user-friendly technology support environment that is the need of an hour. Cloud computing is the emerging technology that has...... and operational data that is used within a university for daily routine work. This paper presents a hybrid cloud computing model for higher education institutions to share intellectual data. Moreover, it proposes, the strategies for the implementation of the cloud computing in the academic institutions. Keywords...

  8. Hospital-based expert model for health technology procurement planning in hospitals.

    Science.gov (United States)

    Miniati, R; Cecconi, G; Frosini, F; Dori, F; Regolini, J; Iadanza, E; Biffi Gentili, G

    2014-01-01

    Although in the last years technology innovation in healthcare brought big improvements in care level and patient quality of life, hospital complexity and management cost became higher. For this reason, necessity of planning for medical equipment procurement within hospitals is getting more and more important in order to sustainable provide appropriate technology for both routine activity and innovative procedures. In order to support hospital decision makers for technology procurement planning, an expert model was designed as reported in the following paper. It combines the most widely used approaches for technology evaluation by taking into consideration Health Technology Assessment (HTA) and Medical Equipment Replacement Model (MERM). The designing phases include a first definition of prioritization algorithms, then the weighting process through experts' interviews and a final step for the model validation that included both statistical testing and comparison with real decisions. In conclusion, the designed model was able to provide a semi-automated tool that through the use of multidisciplinary information is able to prioritize different requests of technology acquisition in hospitals. Validation outcomes improved the model accuracy and created different "user profiles" according to the specific needs of decision makers.

  9. User acceptance factors of hospital information systems and related technologies: Systematic review.

    Science.gov (United States)

    Handayani, Putu Wuri; Hidayanto, Achmad Nizar; Budi, Indra

    2017-08-22

    This study reviews the literature on the most important acceptance factors associated with Hospital Information Systems (HIS) and related technologies based on user groups' perspectives (medical staff, hospital management, administrative personnel, patient, medical student, and IT staff), which can assist researchers and hospital management to develop suitable acceptance models to improve the quality of HIS. We conducted searches in online databases with large repositories of academic studies, written in English and fully accessible by the authors. The articles being reviewed are related to health information technology (HIT), clinical information systems (CIS), HIS, electronic medical records (EMR), telemedicine or telehealth, picture archiving and communication systems (PACS), radio frequency identification (RFID), and computerized physician order entry (CPOE), where the use of most of those applications and technologies is highly integrated. A predefined string was used to extract 1,005 articles, and the results were reviewed and checked. The results of this study found 15 user acceptance factors related to HIS and related technologies that were frequently identified by a minimum of five previous studies. These factors were related to individual, technological, and organizational factors. In addition, HIS and related technologies' user acceptance factors in each user group describe different results.

  10. The Integration of Hospitals: The Transition from a System to a System of Systems

    Science.gov (United States)

    2014-12-01

    2005; Asbury 2013; Wolf 2008). These two factors alone have resulted in loss revenue as the hospitals are not compensated for the care ( indigent care...significant changes in how hospital administrators cope with the uncertainty. 15 Today, hospital administrators face financial uncertainty from indigent care...use to offset the losses from unprofitable procedures and indigent care (uncompensated care). These factors directly reduce operating margins and

  11. The relationship between social capital and quality management systems in European hospitals: a quantitative study.

    Directory of Open Access Journals (Sweden)

    Antje Hammer

    Full Text Available BACKGROUND: Strategic leadership is an important organizational capability and is essential for quality improvement in hospital settings. Furthermore, the quality of leadership depends crucially on a common set of shared values and mutual trust between hospital management board members. According to the concept of social capital, these are essential requirements for successful cooperation and coordination within groups. OBJECTIVES: We assume that social capital within hospital management boards is an important factor in the development of effective organizational systems for overseeing health care quality. We hypothesized that the degree of social capital within the hospital management board is associated with the effectiveness and maturity of the quality management system in European hospitals. METHODS: We used a mixed-method approach to data collection and measurement in 188 hospitals in 7 European countries. For this analysis, we used responses from hospital managers. To test our hypothesis, we conducted a multilevel linear regression analysis of the association between social capital and the quality management system score at the hospital level, controlling for hospital ownership, teaching status, number of beds, number of board members, organizational culture, and country clustering. RESULTS: The average social capital score within a hospital management board was 3.3 (standard deviation: 0.5; range: 1-4 and the average hospital score for the quality management index was 19.2 (standard deviation: 4.5; range: 0-27. Higher social capital was associated with higher quality management system scores (regression coefficient: 1.41; standard error: 0.64, p=0.029. CONCLUSION: The results suggest that a higher degree of social capital exists in hospitals that exhibit higher maturity in their quality management systems. Although uncontrolled confounding and reverse causation cannot be completely ruled out, our new findings, along with the results of

  12. The Relationship between Social Capital and Quality Management Systems in European Hospitals: A Quantitative Study

    Science.gov (United States)

    Hammer, Antje; Arah, Onyebuchi A.; DerSarkissian, Maral; Thompson, Caroline A.; Mannion, Russell; Wagner, Cordula; Ommen, Oliver; Sunol, Rosa; Pfaff, Holger

    2013-01-01

    Background Strategic leadership is an important organizational capability and is essential for quality improvement in hospital settings. Furthermore, the quality of leadership depends crucially on a common set of shared values and mutual trust between hospital management board members. According to the concept of social capital, these are essential requirements for successful cooperation and coordination within groups. Objectives We assume that social capital within hospital management boards is an important factor in the development of effective organizational systems for overseeing health care quality. We hypothesized that the degree of social capital within the hospital management board is associated with the effectiveness and maturity of the quality management system in European hospitals. Methods We used a mixed-method approach to data collection and measurement in 188 hospitals in 7 European countries. For this analysis, we used responses from hospital managers. To test our hypothesis, we conducted a multilevel linear regression analysis of the association between social capital and the quality management system score at the hospital level, controlling for hospital ownership, teaching status, number of beds, number of board members, organizational culture, and country clustering. Results The average social capital score within a hospital management board was 3.3 (standard deviation: 0.5; range: 1-4) and the average hospital score for the quality management index was 19.2 (standard deviation: 4.5; range: 0-27). Higher social capital was associated with higher quality management system scores (regression coefficient: 1.41; standard error: 0.64, p=0.029). Conclusion The results suggest that a higher degree of social capital exists in hospitals that exhibit higher maturity in their quality management systems. Although uncontrolled confounding and reverse causation cannot be completely ruled out, our new findings, along with the results of previous research, could

  13. Performance evaluation of hospitals that provide care in the public health system, Brazil

    Directory of Open Access Journals (Sweden)

    Marcelo Cristiano de Azevedo Ramos

    2015-01-01

    Full Text Available OBJECTIVE To analyze if size, administrative level, legal status, type of unit and educational activity influence the hospital network performance in providing services to the Brazilian Unified Health System.METHODS This cross-sectional study evaluated data from the Hospital Information System and the Cadastro Nacional de Estabelecimentos de Saúde (National Registry of Health Facilities, 2012, in Sao Paulo, Southeastern Brazil. We calculated performance indicators, such as: the ratio of hospital employees per bed; mean amount paid for admission; bed occupancy rate; average length of stay; bed turnover index and hospital mortality rate. Data were expressed as mean and standard deviation. The groups were compared using analysis of variance (ANOVA and Bonferroni correction.RESULTS The hospital occupancy rate in small hospitals was lower than in medium, big and special-sized hospitals. Higher hospital occupancy rate and bed turnover index were observed in hospitals that include education in their activities. The hospital mortality rate was lower in specialized hospitals compared to general ones, despite their higher proportion of highly complex admissions. We found no differences between hospitals in the direct and indirect administration for most of the indicators analyzed.CONCLUSIONS The study indicated the importance of the scale effect on efficiency, and larger hospitals had a higher performance. Hospitals that include education in their activities had a higher operating performance, albeit with associated importance of using human resources and highly complex structures. Specialized hospitals had a significantly lower rate of mortality than general hospitals, indicating the positive effect of the volume of procedures and technology used on clinical outcomes. The analysis related to the administrative level and legal status did not show any significant performance differences between the categories of public hospitals.

  14. A Hospital Is Not Just a Factory, but a Complex Adaptive System-Implications for Perioperative Care.

    Science.gov (United States)

    Mahajan, Aman; Islam, Salim D; Schwartz, Michael J; Cannesson, Maxime

    2017-07-01

    Many methods used to improve hospital and perioperative services productivity and quality of care have assumed that the hospital is essentially a factory, and therefore, that industrial engineering and manufacturing-derived redesign approaches such as Six Sigma and Lean can be applied to hospitals and perioperative services just as they have been applied in factories. However, a hospital is not merely a factory but also a complex adaptive system (CAS). The hospital CAS has many subsystems, with perioperative care being an important one for which concepts of factory redesign are frequently advocated. In this article, we argue that applying only factory approaches such as lean methodologies or process standardization to complex systems such as perioperative care could account for difficulties and/or failures in improving performance in care delivery. Within perioperative services, only noncomplex/low-variance surgical episodes are amenable to manufacturing-based redesign. On the other hand, complex surgery/high-variance cases and preoperative segmentation (the process of distinguishing between normal and complex cases) can be viewed as CAS-like. These systems tend to self-organize, often resist or react unpredictably to attempts at control, and therefore require application of CAS principles to modify system behavior. We describe 2 examples of perioperative redesign to illustrate the concepts outlined above. These examples present complementary and contrasting cases from 2 leading delivery systems. The Mayo Clinic example illustrates the application of manufacturing-based redesign principles to a factory-like (high-volume, low-risk, and mature practice) clinical program, while the Kaiser Permanente example illustrates the application of both manufacturing-based and self-organization-based approaches to programs and processes that are not factory-like but CAS-like. In this article, we describe how factory-like processes and CAS can coexist within a hospital and how

  15. Inertial Sensor-Based Robust Gait Analysis in Non-Hospital Settings for Neurological Disorders

    Directory of Open Access Journals (Sweden)

    Can Tunca

    2017-04-01

    Full Text Available The gold standards for gait analysis are instrumented walkways and marker-based motion capture systems, which require costly infrastructure and are only available in hospitals and specialized gait clinics. Even though the completeness and the accuracy of these systems are unquestionable, a mobile and pervasive gait analysis alternative suitable for non-hospital settings is a clinical necessity. Using inertial sensors for gait analysis has been well explored in the literature with promising results. However, the majority of the existing work does not consider realistic conditions where data collection and sensor placement imperfections are imminent. Moreover, some of the underlying assumptions of the existing work are not compatible with pathological gait, decreasing the accuracy. To overcome these challenges, we propose a foot-mounted inertial sensor-based gait analysis system that extends the well-established zero-velocity update and Kalman filtering methodology. Our system copes with various cases of data collection difficulties and relaxes some of the assumptions invalid for pathological gait (e.g., the assumption of observing a heel strike during a gait cycle. The system is able to extract a rich set of standard gait metrics, including stride length, cadence, cycle time, stance time, swing time, stance ratio, speed, maximum/minimum clearance and turning rate. We validated the spatio-temporal accuracy of the proposed system by comparing the stride length and swing time output with an IR depth-camera-based reference system on a dataset comprised of 22 subjects. Furthermore, to highlight the clinical applicability of the system, we present a clinical discussion of the extracted metrics on a disjoint dataset of 17 subjects with various neurological conditions.

  16. Inertial Sensor-Based Robust Gait Analysis in Non-Hospital Settings for Neurological Disorders

    Science.gov (United States)

    Tunca, Can; Pehlivan, Nezihe; Ak, Nağme; Arnrich, Bert; Salur, Gülüstü; Ersoy, Cem

    2017-01-01

    The gold standards for gait analysis are instrumented walkways and marker-based motion capture systems, which require costly infrastructure and are only available in hospitals and specialized gait clinics. Even though the completeness and the accuracy of these systems are unquestionable, a mobile and pervasive gait analysis alternative suitable for non-hospital settings is a clinical necessity. Using inertial sensors for gait analysis has been well explored in the literature with promising results. However, the majority of the existing work does not consider realistic conditions where data collection and sensor placement imperfections are imminent. Moreover, some of the underlying assumptions of the existing work are not compatible with pathological gait, decreasing the accuracy. To overcome these challenges, we propose a foot-mounted inertial sensor-based gait analysis system that extends the well-established zero-velocity update and Kalman filtering methodology. Our system copes with various cases of data collection difficulties and relaxes some of the assumptions invalid for pathological gait (e.g., the assumption of observing a heel strike during a gait cycle). The system is able to extract a rich set of standard gait metrics, including stride length, cadence, cycle time, stance time, swing time, stance ratio, speed, maximum/minimum clearance and turning rate. We validated the spatio-temporal accuracy of the proposed system by comparing the stride length and swing time output with an IR depth-camera-based reference system on a dataset comprised of 22 subjects. Furthermore, to highlight the clinical applicability of the system, we present a clinical discussion of the extracted metrics on a disjoint dataset of 17 subjects with various neurological conditions. PMID:28398224

  17. 77 FR 60315 - Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the...

    Science.gov (United States)

    2012-10-03

    ... grammatical error in our discussion of the Agency for Healthcare Research and Quality (AHRQ) indicators. On... Hospital Quality Reporting Program (PCHQR), we made a grammatical error. On page 53601, in the table... requirements for the LTCH Quality Reporting Program, we made a grammatical error in our response to a comment...

  18. On the Development of a Hospital-Patient Web-Based Communication Tool: A Case Study From Norway.

    Science.gov (United States)

    Granja, Conceição; Dyb, Kari; Bolle, Stein Roald; Hartvigsen, Gunnar

    2015-01-01

    Surgery cancellations are undesirable in hospital settings as they increase costs, reduce productivity and efficiency, and directly affect the patient. The problem of elective surgery cancellations in a North Norwegian University Hospital is addressed. Based on a three-step methodology conducted at the hospital, the preoperative planning process was modeled taking into consideration the narratives from different health professions. From the analysis of the generated process models, it is concluded that in order to develop a useful patient centered web-based communication tool, it is necessary to fully understand how hospitals plan and organize surgeries today. Moreover, process reengineering is required to generate a standard process that can serve as a tool for health ICT designers to define the requirements for a robust and useful system.

  19. CE: Original research: hospital system barriers to rapid response team activation: a cognitive work analysis.

    Science.gov (United States)

    Braaten, Jane Saucedo

    2015-02-01

    The goal of rapid response team (RRT) activation in acute care facilities is to decrease mortality from preventable complications, but such efforts have been only moderately successful. Although recent research has shown decreased mortality when RRTs are activated more often, many hospitals have low activation rates. This has been linked to various hospital, team, and nursing factors. Yet there is a dearth of research examining how hospital systems shape nurses' behavior with regard to RRT activation. Making systemic constraints visible and modifying them may be the key to improving RRT activation rates and saving more lives. The purpose of this study was to use cognitive work analysis to describe factors within the hospital system that shape medical-surgical nurses' RRT activation behavior. Cognitive work analysis offers a framework for the study of complex sociotechnical systems. This framework was used as the organizing element of the study. Qualitative descriptive design was used to obtain data to fill the framework's five domains: resources, tasks, strategies, social systems, and worker competency. Data were obtained from interviews with 12 medical-surgical nurses and document review. Directed content analysis was used to place the obtained data into the framework's predefined domains. Many system factors affected participants' decisions to activate or not activate an RRT. Systemic constraints, especially in cases of subtle or gradual clinical changes, included a lack of adequate information, the availability of multiple strategies, the need to justify RRT activation, a scarcity of human resources, and informal hierarchical norms in the hospital culture. The most profound constraint was the need to justify the call. Justification was based on the objective or subjective nature of clinical changes, whether the nurse expected to be able to "handle" these changes, the presence or absence of a physician, and whether there was an expectation of support from the RRT

  20. Variations in renal morphometry: A hospital-based Indian study

    Directory of Open Access Journals (Sweden)

    Ranjeet S Rathore

    2016-01-01

    Conclusions: Our study revealed that there exist differences in various morphometric parameters of the kidney and ureter in different subsets of the Indian population attending our hospital as compared with the standard values quoted in the world literature.

  1. Culinary and hospitality teaching as a research-based profession ...

    African Journals Online (AJOL)

    Research in Hospitality Management. Journal Home · ABOUT · Advanced Search · Current Issue · Archives · Journal Home > Vol 5, No 2 (2015) >. Log in or Register to get access to full text downloads.

  2. A "Medical Physics" Course Based Upon Hospital Field Experience

    Science.gov (United States)

    Onn, David G.

    1972-01-01

    Describes a noncalculus, medical physics'' course with a basic element of direct hospital field experience. The course is intended primarily for premedical students but may be taken by nonscience majors. (Author/PR)

  3. Hospital-acquired legionnaires disease in a university hospital: impact of the copper-silver ionization system.

    Science.gov (United States)

    Mòdol, Josep; Sabrià, Miquel; Reynaga, Esteban; Pedro-Botet, Maria L; Sopena, Nieves; Tudela, Pere; Casas, Irma; Rey-Joly, Celestino

    2007-01-15

    We evaluated the impact of the copper-silver ionization system in a hospital where hyperendemic nosocomial legionellosis and was present and all previous disinfection measures had failed. After implementation of the copper-silver ionization system, environmental colonization with Legionella species decreased significantly, and the incidence of nosocomial legionellosis decreased dramatically, from 2.45 to 0.18 cases per 1000 patient discharges.

  4. Association of bond, market, operational, and financial factors with multi-hospital system bond issues.

    Science.gov (United States)

    Carpenter, C E; McCue, M J; Hossack, J B

    2001-01-01

    Despite the growth of multi-hospital systems in the 1990s, their performance in the tax-exempt bond market has not been adequately evaluated. The purpose of this study is to compare bonds issued by multi-hospital systems to those issued by individual hospitals in terms of bond, market, operational, and financial characteristics. The study sample includes 2,078 newly issued, tax-exempt, revenue bonds between 1991 and 1997. The findings indicate that multi-hospital systems issued larger amounts of debt at a lower cost, were more likely to be insured, had higher debt service coverage and higher operating margins.

  5. Design of a robotic automation system for transportation of goods in hospitals

    DEFF Research Database (Denmark)

    Özkil, Ali Gürcan; Sørensen, Torben; Fan, Zhun

    2007-01-01

    Hospitals face with heavy traffic of goods everyday, where transportation tasks are mainly carried by human. Analysis of the current situation of transportation in a typical hospital showed several transportation tasks are suitable for automation. This paper presents a system, consisting of a fleet...... of robot vehicles, automatic stations and smart containers for automation of transportation of goods in hospitals. Design of semi-autonomous robot vehicles, containers and stations are presented and the overall system architecture is described. Implementing such a system in an existing hospital showed...

  6. Tracking the patient journey by combining multiple hospital database systems.

    Science.gov (United States)

    Wong, Andy; Kozan, Erhan; Sinnott, Michael; Spencer, Lyndall; Eley, Robert

    2014-06-01

    With new national targets for patient flow in public hospitals designed to increase efficiencies in patient care and resource use, better knowledge of events affecting length of stay will support improved bed management and scheduling of procedures. This paper presents a case study involving the integration of material from each of three databases in operation at one tertiary hospital and demonstrates it is possible to follow patient journeys from admission to discharge.

  7. [Portable Epileptic Seizure Monitoring Intelligent System Based on Android System].

    Science.gov (United States)

    Liang, Zhenhu; Wu, Shufeng; Yang, Chunlin; Jiang, Zhenzhou; Yu, Tao; Lu, Chengbiao; Li, Xiaoli

    2016-02-01

    The clinical electroencephalogram (EEG) monitoring systems based on personal computer system can not meet the requirements of portability and home usage. The epilepsy patients have to be monitored in hospital for an extended period of time, which imposes a heavy burden on hospitals. In the present study, we designed a portable 16-lead networked monitoring system based on the Android smart phone. The system uses some technologies including the active electrode, the WiFi wireless transmission, the multi-scale permutation entropy (MPE) algorithm, the back-propagation (BP) neural network algorithm, etc. Moreover, the software of Android mobile application can realize the processing and analysis of EEG data, the display of EEG waveform and the alarm of epileptic seizure. The system has been tested on the mobile phones with Android 2. 3 operating system or higher version and the results showed that this software ran accurately and steadily in the detection of epileptic seizure. In conclusion, this paper provides a portable and reliable solution for epileptic seizure monitoring in clinical and home applications.

  8. Evaluation of an adolescent hospital-based injury prevention program.

    Science.gov (United States)

    Stewart, Tanya Charyk; Polgar, Denise; Girotti, Murray J; Vingilis, Evelyn; Caro, Daniel; Corbett, Bradley A; Parry, Neil

    2009-05-01

    IMPACT (Impaired Minds Produce Actions Causing Trauma) is an adolescent, hospital-based program aimed to prevent injuries and their consequences caused by alcohol or drug impairment and other high-risk behaviors. The overall objective of this evaluation was to determine the effect of the program on students' knowledge and behavior regarding drinking and driving, over time. A randomized control trial between students randomly selected to attend IMPACT and those not selected served as a control group. Students completed a questionnaire before the program and at three posttime periods (1 week, 1 month, and 6 months). Panel data models were used to analyze the effects of the experiment on students' knowledge of alcohol and crash issues and negative driving behaviors (no seat belt, driving while using a cell phone, involved in conversation, eating, annoyed with other drivers, and drowsy). Descriptive statistics and logistic regression models were used to analyze the effect of IMPACT on students' influence on friends and family about road safety. This study consisted of 269 students (129 IMPACT; 140 control) with an overall response rate of 84% (range, 99% presurvey to 71% at 6 months). The IMPACT group had a 57%, 38%, and 43% increase in the number of correct answers on alcohol and crash issues during the three time periods, respectively (p driving behaviors. Men and students who drove more frequently had worse driving behavior. Our evaluation demonstrates that the IMPACT program had a statistically significant, positive effect on students' knowledge of alcohol and crash issues that was sustained over time. IMPACT had an initial effect on students' behaviors in terms of peer influence toward improving road safety (i.e., buckling up, not drinking, and driving) 1 week after the program, but this effect diminished after 1 month. Other negative driving behaviors had low prevalence at baseline and were not further influenced by the program.

  9. PROFILE OF OCULAR TRAUMA IN UTTARAKHAND, A HOSPITAL BASED STUDY.

    Directory of Open Access Journals (Sweden)

    Renu Dhasmana

    2013-01-01

    Full Text Available Background: Although ocular trauma is preventable public health problem throughout the world it is still one of the common causes of ophthalmic morbidity and monocular blindness. There are no published studies on pattern and severity of ocular trauma in Uttarakhand. The present study analyzes the pattern and visual outcome of ocular trauma in this region. Methods: Study design: Prospective hospital-based study. Settings: Patients of ocular trauma presenting to Ophthalmology OPD and emergency department of Himalayan Institute of Medical Sciences, Dehradun. Participants: All ocular injury patients seen for the first time during the period January to December 2008. Results: A total of 88 patients, and 103 eyes, were studied. Men had two fold higher rate of ocular injury than women. The mean age of presentation was 31.2 + 13.6 years (range: 6 - 80 years. The predominant age group of patients was 21-40 years, 55.29 % (n = 47. Eye injuries related to road traffic accident were seen in 37.86% of eyes. Industrial workers were more frequently involved in ocular trauma (23.86%. Closed globe injuries were noted in 55 eyes (53.39% and open globe injuries were noted in 40 eyes (38.83%. Eight eyes (7.76% suffered from chemical injuries. The initial presenting visual acuity of patients with blunt ocular trauma was better than penetrating injury. Eye with better visual acuity at presentation had better visual prognosis at 6 months. Conclusion: Ocular injuries were common in young males. Road traffic accidents related eye injuries were noted in significant number of cases. Strict implementation of traffic rules, health education and preventive strategies may help to decrease the occurrence of ocular injuries.

  10. [Hospital-at-home in older patients: a scoping review on opportunities of developing comprehensive geriatric assessment based services].

    Science.gov (United States)

    Mas, Miquel Àngel; Santaeugènia, Sebastià

    2015-01-01

    This scoping review focused on the opportunity of developing new hospital-at-home schemes in our health systems adapted to older patients with complex conditions due to acute illness. A review was conducted on articles including, randomized controlled trials, systematic reviews and meta-analysis in PubMed and Cochrane Library, from January 1990 to July 2013. Search terms were: hospital-at-home, Early Supported Discharge, hospital in the home and home hospitalization. An analysis was performed to include: the intervention model (admission avoidance or early discharge), age, diagnosis, main inclusion criteria and intervention characteristics (disciplines involved, duration of intervention, main outcomes and objectives). It is concluded that there are several models of hospital-at-home care, with favorable clinical outcomes. The majority of teams in our country focused on acute health care in the less elderly with chronic diseases. Other schemes based on comprehensive geriatric assessment and interdisciplinary teams specialized in complex interventions are also highlighted. The development of comprehensive geriatric assessment based hospital-at-home care by teams led by geriatricians is an opportunity to develop alternatives to conventional hospitalization interventions tailored to older patients. Copyright © 2014 SEGG. Published by Elsevier Espana. All rights reserved.

  11. Talking about quality: exploring how 'quality' is conceptualized in European hospitals and healthcare systems.

    Science.gov (United States)

    Wiig, Siri; Aase, Karina; von Plessen, Christian; Burnett, Susan; Nunes, Francisco; Weggelaar, Anne Marie; Anderson-Gare, Boel; Calltorp, Johan; Fulop, Naomi

    2014-10-11

    Conceptualization of quality of care - in terms of what individuals, groups and organizations include in their meaning of quality, is an unexplored research area. It is important to understand how quality is conceptualised as a means to successfully implement improvement efforts and bridge potential disconnect in language about quality between system levels, professions, and clinical services. The aim is therefore to explore and compare conceptualization of quality among national bodies (macro level), senior hospital managers (meso level), and professional groups within clinical micro systems (micro level) in a cross-national study. This cross-national multi-level case study combines analysis of national policy documents and regulations at the macro level with semi-structured interviews (383) and non-participant observation (803 hours) of key meetings and shadowing of staff at the meso and micro levels in ten purposively sampled European hospitals (England, the Netherlands, Portugal, Sweden, and Norway). Fieldwork at the meso and micro levels was undertaken over a 12-month period (2011-2012) and different types of micro systems were included (maternity, oncology, orthopaedics, elderly care, intensive care, and geriatrics). The three quality dimensions clinical effectiveness, patient safety, and patient experience were incorporated in macro level policies in all countries. Senior hospital managers adopted a similar conceptualization, but also included efficiency and costs in their conceptualization of quality. 'Quality' in the forms of measuring indicators and performance management were dominant among senior hospital managers (with clinical and non-clinical background). The differential emphasis on the three quality dimensions was strongly linked to professional roles, personal ideas, and beliefs at the micro level. Clinical effectiveness was dominant among physicians (evidence-based approach), while patient experience was dominant among nurses (patient

  12. [Cost of hospitalization by the Activity Based Costing method in the neonatal department of Principal Hospital of Dakar].

    Science.gov (United States)

    Tchamdja, T; Balaka, A; Tchandana, M; Agbétra, A

    2015-01-01

    To determine the cost of hospitalization per day in the neonatal department of Principal Hospital of Dakar. This prospective study took place during the month of July 2011 in the newborn unit. The activity-based costing method was used to analyze costs. During the study period, 52 newborns were hospitalized for a total of 590 days. The cost of the human resources during that month was 9,907,832 FCFA (US $ 19,815.66), the cost of depreciation of fixed assets was estimated at 571,952 FCFA (US $ 1143.90), and supplies at 112,084 FCFA (US $ 224.17). External services cost 386,753 FCFA (US $ 773.51) and support services 6,917,380.65 FCFA (US $ 13,834.7613). The monthly expenses incurred for the hospitalization of newborns totaled 17,896,002 FCFA (US $ 35,792), for a cost per patient per day of 30,332.20 FCFA (US $ 60.66) and an average cost of hospitalization 334,153.88 FCFA (US $ 668,31). This study is the first of its kind in Senegal and neighboring countries. By applying the ABC approach, we can obtain a more detailed and precise estimate of the cost of activities and services. Process improvements and corrective actions should make it possible to identify cost drivers, such as time.

  13. First-Case Operating Room Delays: Patterns Across Urban Hospitals of a Single Health Care System

    Directory of Open Access Journals (Sweden)

    Callie M. Cox Bauer

    2016-08-01

    Full Text Available Purpose: Operating room delays decrease health care system efficiency and increase costs. To improve operating room efficiency in our system, we retrospectively investigated delay frequencies, causes and costs. Methods: We studied all first-of-the-day nonemergent surgical cases performed at three high-volume urban hospitals of a large health system from July 2012 to November 2013. Times for patient flow from arrival to procedure start and documented reasons for delay were obtained from electronic medical records. Delay was defined as patient placement in the operating room later than scheduled surgery time. Effects of patient characteristics, late patient arrival to the hospital, number of planned procedures, years of surgeon experience, service department and hospital facility on odds of delay were examined using logistic regression. Results: Of 5,598 cases examined, 88% were delayed. Patients arrived late to the hospital (surgery in 65% of first cases. Mean time from arrival to scheduled surgery and in-room placement was 104.6 and 127.4 minutes, respectively. Mean delay time was 28.2 minutes. Nearly 60% of delayed cases had no documented reason for delay. For cases with documentation, causes included the physician (52%, anesthesia (15%, patient (13%, staff (9%, other sources (6% and facility (5%. Regression analysis revealed age, late arrival, department and facility as significant predictors of delay. Estimated delay costs, based on published figures and representing lost revenue, were $519,388. Conclusions: To improve operating room efficiency, multidisciplinary strategies are needed for increasing patient adherence to recommended arrival times, documentation of delay by medical staff and consistency in workflow patterns among facilities and departments.

  14. A geographical information system using the Google Map API for guidance to referral hospitals.

    Science.gov (United States)

    Kobayashi, Shinji; Fujioka, Tetsushi; Tanaka, Yuji; Inoue, Michiyoshi; Niho, Yoshiyuki; Miyoshi, Akira

    2010-12-01

    Our hospital acts as a regional core hospital through inter-hospital collaboration. Geographical information is necessary to guide patients to the other hospitals. Although paper maps, which contain directions, nearest public transportation, etc., are usually provided to guide patients to the hospitals, the geographical information tends to change daily. However, updating the geographical information on the maps is costly. We constructed an electronic geographical information system using the Google Map API ( http://code.google.com/apis/maps/ ) with open source software to improve our ability to collaborate with other clinics.

  15. Medical office automation integrated into the distributed architecture of a hospital information system.

    Science.gov (United States)

    Scherrer, J R; Revillard, C; Borst, F; Berthoud, M; Lovis, C

    1994-05-01

    Patient histories, discharge summaries, and medical consultant reports are made up of written texts. Therefore, the gathering and archiving of these texts in machine-readable form has many characteristics of computer-based medical records. In Geneva, approximately 1,540 PCs are connected to the Hospital Information System DIOGENE 2, with the possibility of accessing all the functions offered by the system without losing any of their MS-DOS word processing capabilities. The UNIDOC system, presented in this paper, takes all these features into account, a real marriage of technologies between the MS-DOS environment and the distributed client-server architecture. The INGRES database management system supports the entire archiving process of the medical patient texts, structured by prelabelled paragraphs and automatically indexed. Both the quality and accessibility of the records are enhanced, while the archiving capacity is neither too limited nor too expensive.

  16. EPR (Electronic Patient Record Laboratory - Simulated Environment to Learn about a Hospital EPR System

    Directory of Open Access Journals (Sweden)

    Kazuko Yamamoto

    2011-03-01

    Full Text Available The “Electronic Patient Record (EPR Laboratory” is a computer based self-learning system developed for students to acquire practical skills and knowledge required to deal with EPRs. The system is designed to supplement conventional lectures on health information systems given as part of our undergraduate curriculum. Using the Laboratory, the students may learn not only operations of EPR systems but also the subjects connected with patient information handling, including privacy, security and health information ethics. The EPR Laboratory is composed of an eLearing system and an EPR system. The learning materials are arranged in units in the eLearning system, and in each unit, the student learns the materials and the EPR operations through practice. Tests are given at each end of unit, and if a student failed a test, the system shows which questions were answered incorrectly and indicates which parts of the unit he/she should review. For this purpose, we introduced a structure to the learning materials based on an information model. In this paper, the overview of the system, the simulated environment to learn patient flow, information flow and hospital workflow, fundamental EPR operations, and structured learning materials for the test and review cycle are described.

  17. Activity-Based Costing in the Hospitality Industry: A Case Study in a Hotel

    OpenAIRE

    Bita Mashayekhi; Mohammad Ara

    2017-01-01

    The purpose of this study is to provide some empirical evidence about implementing Activity-Based Costing (ABC) in the hospitality industry in Iran. For this purpose, we consider the Tabriz International Hotel as our sample hotel and then gather the relevant data from its cost accounting system in 2012. Then, we use ABC as our costing method and compare the cost of each service unit with that cost which had been extracted for the traditional costing method. The results show a different cost p...

  18. Systemic Inflammatory Response and Potential Prognostic Implications After Out-of-Hospital Cardiac Arrest

    DEFF Research Database (Denmark)

    Bro-Jeppesen, John; Kjaergaard, Jesper; Wanscher, Michael

    2015-01-01

    OBJECTIVES: Whole-body ischemia during out-of-hospital cardiac arrest triggers immediate activation of inflammatory systems leading to a sepsis-like syndrome. The aim was to investigate the association between level of systemic inflammation and mortality in survivors after out-of-hospital cardiac...

  19. Implementing a nationwide criteria-based emergency medical dispatch system

    DEFF Research Database (Denmark)

    Andersen, Mikkel S; Johnsen, Søren Paaske; Sørensen, Jan Nørtved

    2013-01-01

    A criteria-based nationwide Emergency Medical Dispatch (EMD) system was recently implemented in Denmark. We described the system and studied its ability to triage patients according to the severity of their condition by analysing hospital admission and case-fatality risks.......A criteria-based nationwide Emergency Medical Dispatch (EMD) system was recently implemented in Denmark. We described the system and studied its ability to triage patients according to the severity of their condition by analysing hospital admission and case-fatality risks....

  20. Design and implementation of GRID-based PACS in a hospital with multiple imaging departments

    Science.gov (United States)

    Yang, Yuanyuan; Jin, Jin; Sun, Jianyong; Zhang, Jianguo

    2008-03-01

    Usually, there were multiple clinical departments providing imaging-enabled healthcare services in enterprise healthcare environment, such as radiology, oncology, pathology, and cardiology, the picture archiving and communication system (PACS) is now required to support not only radiology-based image display, workflow and data flow management, but also to have more specific expertise imaging processing and management tools for other departments providing imaging-guided diagnosis and therapy, and there were urgent demand to integrate the multiple PACSs together to provide patient-oriented imaging services for enterprise collaborative healthcare. In this paper, we give the design method and implementation strategy of developing grid-based PACS (Grid-PACS) for a hospital with multiple imaging departments or centers. The Grid-PACS functions as a middleware between the traditional PACS archiving servers and workstations or image viewing clients and provide DICOM image communication and WADO services to the end users. The images can be stored in distributed multiple archiving servers, but can be managed with central mode. The grid-based PACS has auto image backup and disaster recovery services and can provide best image retrieval path to the image requesters based on the optimal algorithms. The designed grid-based PACS has been implemented in Shanghai Huadong Hospital and been running for two years smoothly.

  1. Equipment for pre-hospital airway management on Helicopter Emergency Medical System helicopters in central Europe.

    Science.gov (United States)

    Schmid, M; Schüttler, J; Ey, K; Reichenbach, M; Trimmel, H; Mang, H

    2011-05-01

    For advanced out-of-hospital airway management, skilled personnel and adequate equipment are key prerequisites. There are little data on the current availability of airway management equipment and standards of medical staff on Helicopter Emergency Medical System (HEMS) helicopters in central Europe. An internet search identified all HEMS helicopters in Austria, Switzerland and Luxembourg. We identified 15 HEMS helicopter bases in Switzerland, 28 in Austria and three in Luxembourg. A questionnaire was sent to all bases, asking both for the details of the clinical background and experience of participating staff, and details of airway management equipment carried routinely on board. Replies were received from 14 helicopter bases in Switzerland (93%), 25 bases in Austria (89%) and all three bases in Luxembourg. Anaesthesiologists were by far the most frequent attending physicians (68-85%). All except one bases reported to have at least one alternative supraglottic airway device. All bases had capnometry and succinylcholine. All bases in the study except two in Austria had commercial pre-packed sets for a surgical airway. All helicopters were equipped with automatic ventilators, although not all were suitable for non-invasive ventilation (NIV; Switzerland: 43%, Austria: 12%, Luxembourg: 100%). Masks for NIV were rarely available in Switzerland (two bases; 14%) and in Austria (three bases; 12%), whereas all three bases in Luxembourg carried those masks. Most HEMS helicopters carry appropriate equipment to meet the demands of modern advanced airway management in the pre-hospital setting. Further work is needed to ensure that appropriate airway equipment is carried on all HEMS helicopters.

  2. Ethico-legal aspects of hospital-based blood transfusion practice ...

    African Journals Online (AJOL)

    Methods: Relevant articles retrieved via PubMed/MEDLINE and Google scholar search engines were used. Results: This review found that, medical practitioners are directly or vicariously liable in professional negligence in hospital-based transfusion injuries. The potential weaknesses in hospital-based blood transfusion ...

  3. Low-birth-weight babies among hospital deliveries in Nepal: a hospital-based study

    Directory of Open Access Journals (Sweden)

    Koirala AK

    2015-06-01

    Full Text Available Arun K Koirala,1 Dharma N Bhatta2,3 1Administrative Department, Helping Hands Community Hospital, Chabahil, Kathmandu, 2Department of Public Health, Nobel College, Pokhara University, Kathmandu, Nepal; 3Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand Background: Birth weight is an important indicator of a population’s health and is associated with numerous interrelated factors in the infant, mother, and physical environment. The objective of this study was to assess the proportion of low birth weight and identify the associated factors for low birth weight in a liveborn infant among the women in Morang, Nepal.Methods: A cross-sectional survey was carried out from December 2010 to March 2011 among 255 mothers who gave birth during the study period at the Koshi Zonal Hospital, Nepal. Data were collected using a structured questionnaire with face-to-face interviews. Data were analyzed through logistic regression and presented with crude and adjusted odds ratios (AORs with 95% confidence intervals (CIs.Results: The study showed that the prevalence of low-birth-weight babies was 23.1% (95% CI: 17.9–28.1. The mean (standard deviation age of mothers was 23.23 (4.18 years. The proportion of low birth weight of previous baby was 3.9% (95% CI: 0.1–7.9, and 15.7% (95% CI: 11.5–20.5 of the respondents had preterm delivery. Nearly one-third (36.1%; 95% CI: 26.4–45.6 of the respondents had >2 years’ gap after the previous delivery. Nonformal employment (AOR: 2.14; 95% CI: 0.523–8.74, vegetarian diet (AOR: 1.47; 95% CI: 0.23–9.36, and no rest during pregnancy (AOR: 1.38; 95% CI: 0.41–4.39 were factors more likely to determine low birth weight. However, none of the variables showed a significant association between low birth weight and other dependent variables.Conclusion: Low birth weight is an important factor for perinatal morbidity and mortality and is a common problem in the developing world. The

  4. Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System Policy Changes and Fiscal Year 2016 Rates; Revisions of Quality Reporting Requirements for Specific Providers, Including Changes Related to the Electronic Health Record Incentive Program; Extensions of the Medicare-Dependent, Small Rural Hospital Program and the Low-Volume Payment Adjustment for Hospitals. Final rule; interim final rule with comment period.

    Science.gov (United States)

    2015-08-17

    We are revising the Medicare hospital inpatient prospective payment systems (IPPS) for operating and capital related costs of acute care hospitals to implement changes arising from our continuing experience with these systems for FY 2016. Some of these changes implement certain statutory provisions contained in the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010 (collectively known as the Affordable Care Act), the Pathway for Sustainable Growth Reform(SGR) Act of 2013, the Protecting Access to Medicare Act of 2014, the Improving Medicare Post-Acute Care Transformation Act of 2014, the Medicare Access and CHIP Reauthorization Act of 2015, and other legislation. We also are addressing the update of the rate-of-increase limits for certain hospitals excluded from the IPPS that are paid on a reasonable cost basis subject to these limits for FY 2016.As an interim final rule with comment period, we are implementing the statutory extensions of the Medicare dependent,small rural hospital (MDH)Program and changes to the payment adjustment for low-volume hospitals under the IPPS.We also are updating the payment policies and the annual payment rates for the Medicare prospective payment system (PPS) for inpatient hospital services provided by long-term care hospitals (LTCHs) for FY 2016 and implementing certain statutory changes to the LTCH PPS under the Affordable Care Act and the Pathway for Sustainable Growth Rate (SGR) Reform Act of 2013 and the Protecting Access to Medicare Act of 2014.In addition, we are establishing new requirements or revising existing requirements for quality reporting by specific providers (acute care hospitals,PPS-exempt cancer hospitals, and LTCHs) that are participating in Medicare, including related provisions for eligible hospitals and critical access hospitals participating in the Medicare Electronic Health Record (EHR)Incentive Program. We also are updating policies relating to the

  5. Capability-based computer systems

    CERN Document Server

    Levy, Henry M

    2014-01-01

    Capability-Based Computer Systems focuses on computer programs and their capabilities. The text first elaborates capability- and object-based system concepts, including capability-based systems, object-based approach, and summary. The book then describes early descriptor architectures and explains the Burroughs B5000, Rice University Computer, and Basic Language Machine. The text also focuses on early capability architectures. Dennis and Van Horn's Supervisor; CAL-TSS System; MIT PDP-1 Timesharing System; and Chicago Magic Number Machine are discussed. The book then describes Plessey System 25

  6. Organizational decision to adopt hospital information system: an empirical investigation in the case of Malaysian public hospitals.

    Science.gov (United States)

    Ahmadi, Hossein; Nilashi, Mehrbakhsh; Ibrahim, Othman

    2015-03-01

    This study mainly integrates the mature Technology-Organization-Environment (TOE) framework and recently developed Human-Organization-Technology (HOT) fit model to identify factors that affect the hospital decision in adopting Hospital Information System (HIS). Accordingly, a hybrid Multi-Criteria-Decision-Making (MCDM) model is used to address the dependence relationships of factors with the aid of Analytic Network Processes (ANP) and Decision Making Trial and Evaluation Laboratory (DEMATEL) approaches. The initial model of the study is designed by considering four main dimensions with 13 variables as organizational innovation adoption factors with respect to HIS. By using DEMATEL, the interdependencies strength among the dimensions and variables are tested. The ANP method is then adopted in order to determine the relative importance of the adoption factors, and is used to identify how these factors are weighted and prioritized by the public hospital professionals, who are wholly familiar with the HIS and have years of experience in decision making in hospitals' Information System (IS) department. The results of this study indicate that from the experts' viewpoint "Perceived Technical Competence" is the most important factor in the Human dimension. In the Technology dimension, the experts agree that the "Relative Advantage" is more important in relation to the other factors. In the Organization dimension, "Hospital Size" is considered more important rather than others. And, in the Environment dimension, according to the experts judgment, "Government Policy" is the most important factor. The results of ANP survey from experts also reveal that the experts in the HIS field believed that these factors should not be overlooked by managers of hospitals and the adoption of HIS is more related to more consideration of these factors. In addition, from the results, it is found that the experts are more concerned about Environment and Technology for the adoption HIS. The

  7. Home-Based versus Hospital-Based Rehabilitation Program after Total Knee Replacement

    Directory of Open Access Journals (Sweden)

    Remedios López-Liria

    2015-01-01

    Full Text Available Objectives. To compare home-based rehabilitation with the standard hospital rehabilitation in terms of improving knee joint mobility and recovery of muscle strength and function in patients after a total knee replacement. Materials and Methods. A non-randomised controlled trial was conducted. Seventy-eight patients with a prosthetic knee were included in the study and allocated to either a home-based or hospital-based rehabilitation programme. Treatment included various exercises to restore strength and joint mobility and to improve patients’ functional capacity. The primary outcome of the trial was the treatment effectiveness measured by the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC. Results. The groups did not significantly differ in the leg side (right/left or clinical characteristics (P>0.05. After the intervention, both groups showed significant improvements (P<0.001 from the baseline values in the level of pain (visual analogue scale, the range of flexion-extension motion and muscle strength, disability (Barthel and WOMAC indices, balance, and walking. Conclusions. This study reveals that the rehabilitation treatments offered either at home or in hospital settings are equally effective.

  8. Hospital-based acute care after outpatient colonoscopy: implications for quality measurement in the ambulatory setting.

    Science.gov (United States)

    Fox, Justin P; Burkardt, Deepika D'Cunha; Ranasinghe, Isuru; Gross, Cary P

    2014-09-01

    Ambulatory surgery centers now report immediate hospital transfer rates as a measure of quality. For patients undergoing colonoscopy, this measure may fail to capture adverse events, which occur after discharge yet still require a hospital-based acute care encounter. We conducted this study to estimate rates of immediate hospital transfer and hospital-based acute care following outpatient colonoscopy performed in ambulatory surgery centers. Using state ambulatory surgery databases from the 2009-2010 Healthcare Cost and Utilization Project, we identified adult patients who underwent colonoscopy. Immediate hospital transfer and overall acute health care utilization in the 14 days following colonoscopy was determined from corresponding inpatient, ambulatory surgery, and emergency department databases. To compare rates across centers while accounting for differences in patient populations, we calculated risk-standardized rates using hierarchical generalized linear modeling. The final sample included 1,137,381 colonoscopy discharges from 1019 centers. At the ambulatory surgery center level, the median risk-standardized hospital transfer rate was 0.0% (interquartile range=0.0%), whereas the hospital-based acute care rate was 2.1% (interquartile range=0.6%), with few centers (N=36) having no observed encounters. No correlation was noted between the risk-standardized hospital transfer and hospital-based acute care rates (volume weighted correlation coefficient=0.04, P=0.16). Patients more frequently experience hospital-based acute care encounters after colonoscopy than the need for immediate hospital transfer. Broadening existing quality measures to include hospital-based acute care in the postdischarge period may provide a more complete measure of quality.

  9. Implementation of an Open Source Library Management System: Experiences with Koha 3.0 at the Royal London Homoeopathic Hospital

    Science.gov (United States)

    Bissels, Gerhard

    2008-01-01

    Purpose: The purpose of this paper is to describe the selection process and criteria that led to the implementation of the Koha 3.0 library management system (LMS) at the Complementary and Alternative Medicine Library and Information Service (CAMLIS), Royal London Homoeopathic Hospital. Design/methodology/approach: The paper is a report based on…

  10. The Economic Standpoint of Referral System at Using Tertiary Hospital Services in Iran

    Directory of Open Access Journals (Sweden)

    Samad Rouhani

    2017-03-01

    Full Text Available Background and purpose: Although, economically, referral systems make utilization of health facilities at different levels sound, in many countries caretakers often bypass primary care facilities that are regularly costlier for caretakers and health care systems. The main objective of the current study was to assess the utilization of hospital services with more emphasis on economic point of view.  Materials and methods: The present study was a facility-based cross-sectional study. A researcher developed questionnaire was used to collect the data. The samples were randomly selected and interviewed on their consent. SPSS Software was also used to analyze the collected data through Chi-2, correlation, and t-test. Results: Just 29.4 percent of the attendees to the hospital were carrying out a referral slip from their family medicine. Five variables including type of care, type of attending, appointment arrangement, satisfaction with family medicine, and vising family medicine were statistically analyzed and found significantly related to carrying referral slip. Conclusion: Because of dysfunction of referral system, Iran’s health care system was found to be far from achieving economic advantages of a referral based DHS. It is actually an inappropriate use of limited health resources in a country like Iran that seriously suffers from shortage of financial and health system resources. This is likely due to deficiencies in the components of its referral system, therefore, a full revision of current reforms and appropriate remedies for deficiencies in the components of referral system was found to be in top priority in Iran.

  11. Intelligence-based systems engineering

    CERN Document Server

    Tolk, Andreas

    2011-01-01

    The International Council on Systems Engineering (INCOSE) defines Systems Engineering as an interdisciplinary approach and means to enable the realization of successful systems. Researchers are using intelligence-based techniques to support the practices of systems engineering in an innovative way. This research volume includes a selection of contributions by subject experts to design better systems.

  12. Hospital practice versus evidence-based obstetrics: categorizing practices for normal birth in an Egyptian teaching hospital.

    Science.gov (United States)

    Khalil, Karima; Elnoury, Amr; Cherine, Mohamed; Sholkamy, Hania; Hassanein, Nevine; Mohsen, Lamia; Breebaart, Miral; Aziz Shoubary, Abdel

    2005-12-01

    Little is known of common normal labor hospital practices in Egypt or of their relationship to evidence-based obstetrics. This study documented facility-based practices for normal labor and delivery in Egypt for the first time by categorizing 44 practices observed in a busy obstetric teaching hospital according to the World Health Organization (WHO) Technical Working Group on Normal Birth classification of normal birth practices. A multidisciplinary approach combined directly observing practices that were applied to individual laboring women and their newborns, observing ward activities, interviews, and focus groups. One hundred seventy-five normal births were observed in their entirety, over 28 days and nights, by medically trained observers using an observation checklist that documented 537 variables for each woman. Mothers were interviewed postpartum, and findings were shared with practitioners for their feedback. Observed practices were categorized according the 1999 WHO classification of 59 practices for normal birth, depending on their usefulness, effectiveness, or harmfulness. There was infrequent use of beneficial practices that should be encouraged and an unexpectedly high level of harmful practices that should be eliminated. Some beneficial practices were applied inappropriately, and practices of unproved benefit were also documented, some of which are potentially harmful to childbearing mothers and their babies. Hospital practices for normal labor were largely not in accordance with the WHO evidence-based classification of practices for normal birth. The findings are worrying, given the increasing proportion of hospital-based births in Egypt and the country's improved but relatively high maternal and neonatal mortality rates. Obstacles to following evidence-based protocols for normal labor require examination.

  13. RESEARCH The effectiveness of a hospital-based intervention for ...

    African Journals Online (AJOL)

    A substance-abuse intervention model was developed by SANCA Western Cape, the Department of. Social Development, the Department of Health and Cape Town Drug. Counselling Centre. Implementation of the model saw the initiation of a substance-abuse services centre at the hospital, staffed by a social worker, an ...

  14. Low vision in children and adolesents: Hospital based study ...

    African Journals Online (AJOL)

    One thousand five hundred clinical recordswere chosen from the Medical Records Department of the eye clinic, Central Hospital, Benin, Edo State between 2000 and 2004 by cluster random sampling method. Data was classified according to the different etiologies of low vision, gender, congenital and acquired causes, ...

  15. Diabetic foot disease in Ethiopian patients: A hospital based study

    African Journals Online (AJOL)

    Bernt Lindtjørn

    stage of their life, and foot diseases are leading cause of hospitalization among such patients (2-4). The presentation of diabetic foot disease is variable, ranging from cellulitis, abscesses, and ulcers to gangrene. Surgical management depends on the presentation, and varies from minor debridement, incision and drainage, ...

  16. Determination of factors required to increase uptake of influenza vaccination among hospital-based healthcare workers

    NARCIS (Netherlands)

    Hopman, C.E.; Riphagen-Dalhuisen, J.; Looijmans-van den Akker, I; Frijstein, G.; Van der Geest-Blankert, A.D.; Danhof-Pont, M.B.; De Jager, H.J.; Bos, A.A.; Smeets, E.; De Vries, M.J.; Gallee, P.M.; Lenderink, A.F.; Hak, E.

    A questionnaire study was performed in all eight University Medical Centers in The Netherlands to determine the predictors of influenza vaccination compliance in hospital-based healthcare workers (HCWs). Demographical, behavioural and organisational determinants were assessed based on behavioural

  17. Determination of factors required to increase uptake of influenza vaccination among hospital-based healthcare workers

    NARCIS (Netherlands)

    Hopman, C. E.; Riphagen-Dalhuisen, J.; Looijmans-van den Akker, I.; Frijstein, G.; van der Geest-Blankert, A. D. J.; Danhof-Pont, M. B.; de Jager, H. J.; Bos, A. A.; Smeets, E.; de Vries, M. J. T.; Gallee, P. M. M.; Lenderink, A. F.; Hak, E.

    2011-01-01

    A questionnaire study was performed in all eight University Medical Centers in The Netherlands to determine the predictors of influenza vaccination compliance in hospital-based healthcare workers (HCWs). Demographical, behavioural and organisational determinants were assessed based on behavioural

  18. Evaluating Usability of Radiology Information Systems in Hospitals of Tabriz University of Medical Sciences.

    Science.gov (United States)

    Rezaei-Hachesu, Peyman; Pesianian, Esmaeil; Mohammadian, Mohsen

    2016-02-01

    Radiology information system (RIS) in order to reduce workload and improve the quality of services must be well-designed. Heuristic evaluation is one of the methods that understand usability problems with the least time, cost and resources. The aim of present study is to evaluate the usability of RISs in hospitals. This is a cross-sectional descriptive study (2015) that uses heuristic evaluation method to evaluate the usability of RIS used in 3 hospitals of Tabriz city. The data are collected using a standard checklist based on 13 principles of Nielsen Heuristic evaluation method. Usability of RISs was investigated based on the number of components observed from Nielsen principles and problems of usability based on the number of non-observed components as well as non-existent or unrecognizable components. by evaluation of RISs in each of the hospitals 1, 2 and 3, total numbers of observed components were obtained as 173, 202 and 196, respectively. It was concluded that the usability of RISs in the studied population, on average and with observing 190 components of the 291 components related to the 13 principles of Nielsen is 65.41 %. Furthermore, problems of usability were obtained as 26.35%. The established and visible nature of some components such as response time of application, visual feedbacks, colors, view and design and arrangement of software objects cause more attention to these components as principal components in designing UI software. Also, incorrect analysis before system design leads to a lack of attention to secondary needs like Help software and security issues.

  19. Leadership facilitation strategies to establish evidence-based practice in an acute care hospital.

    Science.gov (United States)

    Hauck, Sheila; Winsett, Rebecca P; Kuric, Judy

    2013-03-01

    To assess the impact of leadership facilitation strategies on nurses' beliefs of the importance and frequency of using evidence in daily nursing practice and the perception of organizational readiness in an acute care hospital. Integrating evidence in practice is a prominent issue for hospital nursing as knowledge and skills, beliefs, organizational infrastructure and nursing leadership must all be addressed. Prospective, descriptive comparative. Three surveys were used in this prospective descriptive comparative study. Evidence-Based Practice Beliefs Scale, the Implementation Scale and Organizational Culture & Readiness for System-Wide Integration Survey measured change before and after facilitating strategies for evidence-based practice enculturation. Data were collected in December 2008 (N = 427) and in December 2010 (N = 469). Leadership facilitated infrastructure development in three major areas: incorporating evidence-based practice outcomes in the strategic plan; supporting mentors; and advocating for resources for education and outcome dissemination. With the interventions in place, the total group scores for beliefs and organizational readiness improved significantly. Analyses by job role showed that direct care nurses scores improved more than other role types. No differences were found in the implementation scores. Successful key strategies were evidence-based practice education and establishing internal opportunities to disseminate findings. Transformational nursing leadership drives organizational change and provides vision, human and financial resources and time that empowers nurses to include evidence in practice. © 2012 Blackwell Publishing Ltd.

  20. A case study of an EMR system at a large hospital in India: challenges and strategies for successful adoption.

    Science.gov (United States)

    Scholl, Jeremiah; Syed-Abdul, Shabbir; Ahmed, Luai Awad

    2011-12-01

    This paper presents an ethnographically inspired interpretive case study of the Electronic Medical Record (EMR) system at Sankara Nethralaya hospital in India. It presents challenges related to the adoption of the system and methods and strategies that were utilized in order to overcome these challenges and help the system be adopted successfully. One of the more notable challenges at the hospital was a user base that included skeptical users, those lacking computing skills, and that had a history of rejecting designs. Despite these barriers the hospital was able to adopt the EMR system successfully. Notable issues related to the success of the system include the design strategy that was eventually used, and critical technical and social features of the system intended to support skeptical users and those lacking IT skills. The study contributes to overall understanding of the environment at large hospitals in developing countries as it relates to the adoption of EMR systems, and helps inform on methods that can be used to improve the adoption of EMR systems in similar contexts in both developed and developing countries. Copyright © 2011 Elsevier Inc. All rights reserved.

  1. Hospital-wide PACS with a digital image intensifier TV system.

    Science.gov (United States)

    Okaniwa, H; Tsuneyoshi, H; Kabata, S; Satoh, K; Yokouchi, H; Okabe, T

    1994-05-01

    Tokyo Hitachi Hospital, Hitachi Ltd., has used a hospital-wide PACS for over 1 year. The system runs a 100 Mb/s optical fiber network over the whole hospital including wards and outpatient clinic rooms, with 11 image workstations. The network links digital imaging modalities such as X-CT, MRI, computed radiography (CR) and digital radiography (DR) with a 2048 x 2048 (2k x 2k) matrix image intensifier television (I.I.-TV) system. These modalities generate about 200 images/day. The system has managed over 300,000 images of about 8000 patients so far. Although being still under improvement, the system has really been used for routine work. The hospital-wide PACS of a small hospital has been proved to be very useful for both image diagnosis and image management.

  2. Factors Influencing Laboratory Information System Effectiveness Through Strategic Planning in Shiraz Teaching Hospitals.

    Science.gov (United States)

    Bahador, Fateme; Sharifian, Roxana; Farhadi, Payam; Jafari, Abdosaleh; Nematolahi, Mohtram; Shokrpour, Nasrin

    This study aimed to develop and test a research model that examined 7effective factors on the effectiveness of laboratory information system (LIS) through strategic planning. This research was carried out on total laboratory staff, information technology staff, and laboratory managers in Shiraz (a city in the south of Iran) teaching hospitals by structural equation modeling approach in 2015. The results revealed that there was no significant positive relationship between decisions based on cost-benefit analysis and LIS functionality with LIS effectiveness, but there was a significant positive relationship between other factors and LIS effectiveness. As expected, high levels of strategic information system planning result in increasing LIS effectiveness. The results also showed that the relationship between cost-benefit analysis, LIS functionality, end-user involvement, and information technology-business alignment with strategic information system planning was significant and positive.

  3. Evidence based breast-feeding promotion: the Baby-Friendly Hospital Initiative.

    Science.gov (United States)

    Pérez-Escamilla, Rafael

    2007-02-01

    The Baby-Friendly Hospital Initiative (BFHI) is the translational tool developed by WHO and UNICEF to promote breast-feeding (BF) in maternity wards worldwide. BFHI was officially launched in the 1980s based on a "common sense" approach. Since then, research conducted in Latin America has shown that BFHI is highly cost-effective. BF trends over the past 2 decades strongly suggest that BFHI has had a global impact on BF outcomes. The 10th step of BFHI related to community-based BF promotion is one of the most challenging ones to address. Randomized controlled trials conducted in the Americas, Asia, and sub-Saharan Africa indicate that peer counseling is a very efficacious tool for increasing EBF rates. Low-cost rapid-response monitoring systems are needed to monitor the proper implementation and administration of BFHI steps following an evidence-based approach. This approach is essential for reenergizing the BFHI worldwide.

  4. Do Robotic Surgical Systems Improve Profit Margins? A Cross-Sectional Analysis of California Hospitals.

    Science.gov (United States)

    Shih, Ya-Chen Tina; Shen, Chan; Hu, Jim C

    2017-09-01

    The aim of this study was to examine the association between ownership of robotic surgical systems and hospital profit margins. This study used hospital annual utilization data, annual financial data, and discharge data for year 2011 from the California Office of Statewide Health Planning and Development. We first performed bivariate analysis to compare mean profit margin by hospital and market characteristics and to examine whether these characteristics differed between hospitals that had one or more robotic surgical systems in 2011 and those that did not. We applied the t test and the F test to compare mean profit margin between two groups and among three or more groups, respectively. We then conducted multilevel logistic regression to determine the association between ownership of robotic surgical systems and having a positive profit margin after controlling for other hospital and market characteristics and accounting for possible correlation among hospitals located within the same market. The study sample included 167 California hospitals with valid financial information. Hospitals with robotic surgical systems tended to report more favorable profit margins. However, multilevel logistic regression showed that this relationship (an association, not causality) became only marginally significant (odds ratio [OR] = 6.2; P = 0.053) after controlling for other hospital characteristics, such as ownership type, teaching status, bed size, and surgical volumes, and market characteristics, such as total number of robotic surgical systems owned by other hospitals in the same market area. As robotic surgical systems become widely disseminated, hospital decision makers should carefully evaluate the financial and clinical implications before making a capital investment in this technology. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  5. Understanding the context of balanced scorecard implementation: a hospital-based case study in pakistan

    Directory of Open Access Journals (Sweden)

    Ajmal Agha

    2011-03-01

    Full Text Available Abstract Background As a response to a changing operating environment, healthcare administrators are implementing modern management tools in their organizations. The balanced scorecard (BSC is considered a viable tool in high-income countries to improve hospital performance. The BSC has not been applied to hospital settings in low-income countries nor has the context for implementation been examined. This study explored contextual perspectives in relation to BSC implementation in a Pakistani hospital. Methods Four clinical units of this hospital were involved in the BSC implementation based on their willingness to participate. Implementation included sensitization of units towards the BSC, developing specialty specific BSCs and reporting of performance based on the BSC during administrative meetings. Pettigrew and Whipp's context (why, process (how and content (what framework of strategic change was used to guide data collection and analysis. Data collection methods included quantitative tools (a validated culture assessment questionnaire and qualitative approaches including key informant interviews and participant observation. Results Method triangulation provided common and contrasting results between the four units. A participatory culture, supportive leadership, financial and non-financial incentives, the presentation of clear direction by integrating support for the BSC in policies, resources, and routine activities emerged as desirable attributes for BSC implementation. The two units that lagged behind were more involved in direct inpatient care and carried a considerable clinical workload. Role clarification and consensus about the purpose and benefits of the BSC were noted as key strategies for overcoming implementation challenges in two clinical units that were relatively ahead in BSC implementation. It was noted that, rather than seeking to replace existing information systems, initiatives such as the BSC could be readily adopted if

  6. [Characteristics of transfusion recipients in Bordeaux University Hospital. A descriptive study using hospital claims and haemovigilance system databases].

    Science.gov (United States)

    de Pommerol, M; Gilleron, V; Kostrzewa, A; Roger, I; Boiron, J-M; Salmi, L-R

    2010-10-01

    The steady increase of the blood demand since 2001 requires to study the clinical characteristics of blood components recipients. The objective was to describe patients transfused in 2006 in Bordeaux University Hospital, and to identify the diseases which justified the transfusion practice, using French hospital claims database. Data from haemovigilance system were linked to hospital claims databases in order to describe patients transfused in 2006. To target diseases related to transfusion, a list of diagnoses considered as markers for transfusion was drawn up, and validated by physicians prescribing blood components. Among the 100,004 patients admitted to hospital in 2006, 6275 (6.3%) received blood components; 46,727 blood units were transfused to these patients, including 67% of red blood cell, 13% of platelet concentrates and 20% of fresh-frozen plasma; 69% of blood units were prescribed in medical wards, 30% in surgery wards and 1% in gynaecology and obstetrics. The main diagnoses associated with blood transfusion were circulatory complications after cardiac surgery (80% of patients with this diagnosis were transfused), bone marrow aplasia (76% of patients), anaemia (55%), and gastro-intestinal bleeding (48%). The highest numbers of blood units were transfused to patients with hypovolemic, traumatic or postoperative shock, anaemia, hemopathy, or coagulation disorders. This study provided a clinical profile of the transfused patients. Data collected could be used to plan blood collection and to define objectives and resources of healthcare establishments. Copyright © 2010 Elsevier Masson SAS. All rights reserved.

  7. CONSIDERATIONS REGARDING THE IMPLEMENTATION OF A PERFORMANCE MANAGEMENT SYSTEM IN PRIVATE HOSPITALS

    Directory of Open Access Journals (Sweden)

    Marian TAICU

    2013-09-01

    Full Text Available Obtaining performance in private hospitals require a proper management of costs and implementing a situation for performance monitoring. The implementation of a cost calculation method in hospitals is a complex process that must take into account the particularities of the activity in health care system. This paper presents a comparative analysis of four costing methods and a model of performance monitoring situation, adapted to the specific of the hospitals.

  8. Comparative analysis of current payment system for hospital services in Serbia and projected payments under diagnostic related groups system in urology

    Directory of Open Access Journals (Sweden)

    Babić Uroš

    2015-01-01

    Full Text Available Background/Aim. Global budget per calendar year is a traditional method of funding hospitals in Serbia. Diagnose related groups (DGR is a method of hospital payment based on classification of patients into groups with clinically similar problems and similar utilization of hospital resources. The aim of this study was to compare current methods of hospital services payment with the projected costs by DRG payment method in urology. Methods. The data were obtained from the information system used in the Clinical Hospital Center “Dr. Dragiša Mišović” - Dedinje in Belgrade, Serbia. The implemented hospital information system was the main criterion for selection of healthcare institutions. The study included 994 randomly selected patients treated surgically and conservatively in 2012. Results. Average costs under the current payment method were slightly higher than those projected by DRG, however, the variability was twice as high (54,111 ± 69,789 compared to 53,434 ± 32,509, p < 0,001 respectively. The univariate analysis showed that the highest correlation with the current payment method as well as with the projected one by DRG was observed in relation to the number of days of hospitalization (ρ = 0.842, p < 0.001, and ρ = 0.637, p < 0.001, respectively. Multivariate regression models confirmed the influence of the number of hospitalization days to costs under the current payment system (β = 0.843, p < 0.001 as well as under the projected DRG payment system (β = 0.737, p < 0.001. The same predictor was crucial for the difference in the current payment method and the projected DRG payment methods (β = 0.501, p <0.001. Conclusion. Payment under the DRG system is administratively more complex because it requires detailed and standardized coding of diagnoses and procedures, as well as the information on the average consumption of resources (costs per DRG. Given that aggregate costs of treatment under two hospital payment methods compared

  9. Hospital-at-home Integrated Care Program for Older Patients With Orthopedic Processes: An Efficient Alternative to Usual Hospital-Based Care.

    Science.gov (United States)

    Closa, Conxita; Mas, Miquel À; Santaeugènia, Sebastià J; Inzitari, Marco; Ribera, Aida; Gallofré, Miquel

    2017-09-01

    To compare outcomes and costs for patients with orthogeriatric conditions in a home-based integrated care program versus conventional hospital-based care. Quasi-experimental longitudinal study. An acute care hospital, an intermediate care hospital, and the community of an urban area in the North of Barcelona, in Southern Europe. In a 2-year period, we recruited 367 older patients attended at an orthopedic/traumatology unit in an acute hospital for fractures and/or arthroplasty. Patients were referred to a hospital-at-home integrated care unit or to standard hospital-based postacute orthogeriatric unit, based on their social support and availability of the resource. We compared home-based care versus hospital-based care for Relative Functional Gain (gain/loss of function measured by the Barthel Index), mean direct costs, and potential savings in terms of reduction of stay in the acute care hospital. No differences were found in Relative Functional Gain, median (Q25-Q75) = 0.92 (0.64-1.09) in the home-based group versus 0.93 (0.59-1) in the hospital-based group, P =.333. Total health service direct cost [mean (standard deviation)] was significantly lower for patients receiving home-based care: €7120 (3381) versus €12,149 (6322), P home-based care [10.1 (7)] than in patients discharged to the postacute orthogeriatric hospital-based unit [15.3 (12) days, P home integrated care program was suitable for managing older patients with orthopedic conditions who have good social support for home care. It provided clinical care comparable to the hospital-based model, and it seems to enable earlier acute hospital discharge and lower direct costs. Copyright © 2017 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

  10. A novel web-based depth video rewind approach toward fall preventive interventions in hospitals.

    Science.gov (United States)

    Enayati, Moein; Banerjee, Tanvi; Popescu, Mihail; Skubic, Marjorie; Rantz, Marilyn

    2014-01-01

    The purpose of this study was to implement a web based application to provide the ability to rewind and review depth videos captured in hospital rooms to investigate the event chains that led to patient's fall at a specific time. In this research, Kinect depth images are being used to capture shadow-like images of the patient and their room to resolve concerns about patients' privacy. As a result of our previous research, a fall detection system has been developed and installed in hospital rooms, and fall alarms are generated if any falls are detected by the system. Then nurses will go through the stored depth videos to investigate for possible injury as well as the reasons and events that may have caused the patient's fall to prevent future occurrences. This paper proposes a novel web application to ease the process of search and reviewing the videos by means of new visualization techniques to highlight video frames that contain potential risk of fall based on our previous research.

  11. Design of Catamaran Propulsion System with Demihull Distance Variation on Hospital Ship

    Directory of Open Access Journals (Sweden)

    Amiadji Amiadji

    2017-06-01

    Full Text Available Various problems faced by health services in the area of remote islands based on survey data Ministry of Health, that limited human resources in health and treatment facilities, as well as the difficult geographical conditions causing problems transport and communication are the main problem. From the above, the problems faced by means of a mobile hospital in the form of vessels operating from one small island to another small island is the solution of health problems for the people living within the island of MaduraIn this thesis the work will be done planning catamaran ship propulsion system with a variety of distances and determine the power demihull hospital equipmen. From the calculation results in a variation within demihull get with B = 19.51 m, 0,1B = 21.46, 0,2B = 23.41, 25.36 resulting 0,3B = 97.8 kN after the engine power of 812.71 kW obtained. From the selection of the engine 10 criteria obtained type Caterpillar 3508B engines.Power generators are required for a hospital ship is 75kW for 4 gensets.

  12. Hospital based patient coordination for ethnic minority patients - a health technology assessment

    DEFF Research Database (Denmark)

    Sodemann, Morten

    A cross diciplinary, cross specialty, cross sectoral hospital based approach to cultural management of ethnic minority patients is effective in creating more approprite patient flows, better quality of care and increases functional level of patients. Surprisingly the aggregated effect saves...... especially on public medicine expenses and social services. Ethnic minority patients can achieve increased empowerment & Equity in type and quality of hospital care through cross dicplinary cross specialty cultural case management & support between hospital departments and primary sectors...

  13. Qualitative analysis of vendor discussions on the procurement of Computerised Physician Order Entry and Clinical Decision Support systems in hospitals.

    Science.gov (United States)

    Cresswell, Kathrin M; Lee, Lisa; Slee, Ann; Coleman, Jamie; Bates, David W; Sheikh, Aziz

    2015-10-26

    We studied vendor perspectives about potentially transferable lessons for implementing organisations and national strategies surrounding the procurement of Computerised Physician Order Entry (CPOE)/Clinical Decision Support (CDS) systems in English hospitals. Data were collected from digitally audio-recorded discussions from a series of CPOE/CDS vendor round-table discussions held in September 2014 in the UK. Nine participants, representing 6 key vendors operating in the UK, attended. The discussions were transcribed verbatim and thematically analysed. Vendors reported a range of challenges surrounding the procurement and contracting processes of CPOE/CDS systems, including hospitals' inability to adequately assess their own needs and then select a suitable product, rushed procurement and implementation processes that resulted in difficulties in meaningfully engaging with vendors, as well as challenges relating to contracting leading to ambiguities in implementation roles. Consequently, relationships between system vendors and hospitals were often strained, the vendors attributing this to a lack of hospital management's appreciation of the complexities associated with implementation efforts. Future anticipated challenges included issues surrounding the standardisation of data to enable their aggregation across systems for effective secondary uses, and implementation of data exchange with providers outside the hospital. Our results indicate that there are significant issues surrounding capacity to procure and optimise CPOE/CDS systems among UK hospitals. There is an urgent need to encourage more synergistic and collaborative working between providers and vendors and for a more centralised support for National Health Service hospitals, which draws on a wider body of experience, including a formalised procurement framework with value-based product specifications. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a

  14. Management of the picture archiving and communications system archive at Texas Children's Hospital.

    Science.gov (United States)

    Blado, M E

    2001-06-01

    As hospitals convert from conventional film-based imaging to picture archival and communications systems (PACS), methods for managing an enormous library of images must change considerably. While most hospitals are required to retain general, nonmammographic, radiologic images for 7 years beyond the examination date, our pediatric hospital must maintain images until the child's eighteenth birthday, plus the 5-year statute of limitations. Although the physical extent of an electronic archive is tiny compared with a film archive, a long-range strategy is required to ensure that electronic images acquired today can be retrieved and viewed 23 years in the future. Challenges to the long-term stability of the electronic archive include the limited and uncertain shelf life of high-density electronic storage media, the finite maintainability of the electromechanical systems for reading the media, the short product lifetime of software for accessing the images, rapid development of higher density storage products, and the exponential advancement of computer and networking technology that fuels product obsolescence. Since we cannot assure the function of our current archive in two decades, we are committed to a continual process of migration of old electronic image data to newer media and systems. As an early-adopter of PACS technology, Texas Children's Hospital's (TCH) archive management experience is relevant to others. Although not filled to capacity, our first digital archive, based on phase-change write-once-read-many (WORM) technology, was forced into an inactive status by software and hardware changes. Our second set of archives was partially filled with low-density magneto-optical disk (MOD) media, when the drives were upgraded to high density and then filled to capacity. This undesirable situation forced us into shelf management of media. Our third-generation archive is based on a helical tape library with the capacity to contain 7 years of examinations. We will

  15. Development of the Leapfrog methodology for evaluating hospital implemented inpatient computerized physician order entry systems.

    Science.gov (United States)

    Kilbridge, P M; Welebob, E M; Classen, D C

    2006-04-01

    The 1999 Institute of Medicine report raised public awareness of the frequency and cost of adverse drug events in medicine. In response, in November 2000 a coalition of healthcare purchasers announced the formation of the Leapfrog Group, an organization dedicated to making "great leaps forward" in the safety and quality of health care in America. Their first target-computerized physician order entry (CPOE)-was selected specifically for its potential to reduce harm to patients from medications. The Leapfrog inpatient CPOE standard included a requirement that the organization operating CPOE should demonstrate via a test that their inpatient CPOE system can alert physicians to at least 50% of common serious prescribing errors. This paper outlines the development of this test which evaluates the ability of implemented CPOE systems to prevent the occurrence of medication errors that have a high likelihood of leading to adverse drug events. A framework was developed to include 12 different categories of CPOE based decision support that could prevent prescribing errors leading to adverse drug events. A scoring system was developed based on the known frequency and severity of adverse drug events. Simulated test patients and accompanying simulated test medication orders were developed to evaluate the ability of a CPOE system to intercept prescribing errors in all 12 decision support categories. The test was validated at a number of inpatient sites using both commercially available and custom developed CPOE systems. A web based application was developed to allow hospitals to self-administer the evaluation.

  16. Reducing Hospital ICU Noise: A Behavior-Based Approach

    OpenAIRE

    Avinash Konkani; Barbara Oakley; Barbara Penprase

    2014-01-01

    Noise in Intensive Care Units (ICUs) is gaining increasing attention as a significant source of stress and fatigue for nursing staff. Extensive research indicates that hospital noise also has negative impact on patients. The objective of this study was to analyze noise variations as experienced by both nursing staff and patients, to gain a better understanding of noise levels and frequencies observed in ICU settings over extended (week-long) durations, and to implement a low cost behavior mod...

  17. Using DRG to analyze hospital production: a re-classification model based on a linear tree-network topology

    Directory of Open Access Journals (Sweden)

    Achille Lanzarini

    2014-09-01

    Full Text Available Background: Hospital discharge records are widely classified through the Diagnosis Related Group (DRG system; the version currently used in Italy counts 538 different codes, including thousands of diagnosis and procedures. These numbers reflect the considerable effort of simplification, yet the current classification system is of little use to evaluate hospital production and performance.Methods: As the case-mix of a given Hospital Unit (HU is driven by its physicians’ specializations, a grouping of DRGs into a specialization-driven classification system has been conceived through the analysis of HUs discharging and the ICD-9-CM codes. We propose a three-folded classification, based on the analysis of 1,670,755 Hospital Discharge Cards (HDCs produced by Lombardy Hospitals in 2010; it consists of 32 specializations (e.g. Neurosurgery, 124 sub-specialization (e.g. skull surgery and 337 sub-sub-specialization (e.g. craniotomy.Results: We give a practical application of the three-layered approach, based on the production of a Neurosurgical HU; we observe synthetically the profile of production (1,305 hospital discharges for 79 different DRG codes of 16 different MDC are grouped in few groups of homogeneous DRG codes, a more informative production comparison (through process-specific comparisons, rather than crude or case-mix standardized comparisons and a potentially more adequate production planning (considering the Neurosurgical HUs of the same city, those produce a limited quote of the whole neurosurgical production, because the same activity can be realized by non-Neurosugical HUs.Conclusion: Our work may help to evaluate the hospital production for a rational planning of available resources, blunting information asymmetries between physicians and managers. 

  18. Assessment of Pharmacy Information System Performance in Three Hospitals in Eastern Province, Saudi Arabia.

    Science.gov (United States)

    El Mahalli, Azza; El-Khafif, Sahar H; Yamani, Wid

    2016-01-01

    The pharmacy information system is one of the central pillars of a hospital information system. This research evaluated a pharmacy information system according to six aspects of the medication process in three hospitals in Eastern Province, Saudi Arabia. System administrators were interviewed to determine availability of functionalities. Then, system users within the hospital were targeted to evaluate their level of usage of these functionalities. The study was cross-sectional. Two structured surveys were designed. The overall response rate of hospital users was 31.7 percent. In all three hospitals studied, the electronic health record is hybrid, implementation has been completed and the system is running, and the systems have computerized provider order entry and clinical decision support. Also, the pharmacy information systems are integrated with the electronic health record, and computerized provider order entry and almost all prescribing and transcription functionalities are available; however, drug dispensing is a mostly manual process. However, the study hospitals do not use barcode-assisted medication administration systems to verify patient identity and electronically check dose administration, and none of them have computerized adverse drug event monitoring that uses the electronic health record. The numbers of users who used different functionalities most or all of the time was generally low. The highest frequency of utilization was for patient administration records (56.8 percent), and the lowest was for linkage of the pharmacy information system to pharmacy stock (9.1 percent). Encouraging users to use different functionalities was highly recommended.

  19. A HOSPITAL-BASED STUDY ON THE PREVALENCE OF DRY EYES IN A TERTIARY CARE HOSPITAL

    Directory of Open Access Journals (Sweden)

    Prashant V. Solanke

    2017-06-01

    Full Text Available BACKGROUND Dry eye syndrome is a common eye disease. Dry Eye Syndrome (DES, also known as Keratoconjunctivitis Sicca (KCS, is the condition of having dry eyes. Other associated symptoms include irritation, redness, discharge and easily fatigued eyes. Blurred vision may also occur. The symptoms can range from mild and occasional to severe and continuous. Scarring of the cornea may occur in some cases without treatment. Dry eye occurs when either the eye does not produce enough tears or when the tears evaporate too quickly. Tobacco smoke exposure or infection may also lead to the condition. Diagnosis is mostly based on the symptoms, though a number of other tests may be used. Prevalence of dry eyes are commoner in females than males. There is a positive relationship between glaucoma and ocular dryness as well as diabetic retinopathy and ocular dryness. Dry eye is a multifactorial disease of the tears and ocular surface. Ocular symptoms such as pain, irritation and poor vision can result from dry eye. The aim of the study is to study the prevalence, symptomatology and distribution of dry eyes. MATERIALS AND METHODS A cross-sectional study was conducted during July 2016 to March 2017. Study place was Outpatient Department of Ophthalmology at Sree Mookambika Institute of Medical Sciences, Kulasekharam. Sample size was calculated by 4PQ/d², which was 132. Systemic random sampling was used for the study. RESULTS Prevalence of dry eyes - 17.8%. Dry eyes in males - 16.8% and in females - 24.6%. Dry eyes in age 40 yrs. - 21.8%. Prevalence of dry eyes in contact lens wearers - 36.5%. Prevalence of dry eyes in glaucoma cases - 38.2%. Prevalence of dry eyes in farmers - 27.3%, in smokers - 36.7%. Dry eyes in emmetropes - 12.8% in myopes - 17.2% in hypermetropes - 28.6%. CONCLUSION Dry eyes prevalence obtained was 17.8%. Dry eyes were seen more in females. As age increases, prevalence of dry eyes increases. Ocular surface dryness was observed more in contact

  20. 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...

  1. User Acceptance of the Human Resource Information System: A Study of a Private Hospital in Malaysia

    OpenAIRE

    Kamaludin, Kamilah; Kamaludin, Kamil Zaki

    2017-01-01

    Technological acceptance and usage is a critical concern as substantial investments are made implementing new information systems. Ipoh Specialist Hospital (ISH) adopted the Human Resource Information System (HRIS) to better manage its human resource functions. Nonetheless, low usage levels have alerted top management that the system may have failed its intended purpose. Thus, this study aims to understand the underlying factors that influence user acceptance of the HRIS at the hospital. Usin...

  2. Development of New Quality Measures for Hospital-Based Care of Suicidal Youth.

    Science.gov (United States)

    Parast, Layla; Bardach, Naomi S; Burkhart, Q; Richardson, Laura P; Murphy, J Michael; Gidengil, Courtney A; Britto, Maria T; Elliott, Marc N; Mangione-Smith, Rita

    2017-10-31

    To develop, validate, and test the feasibility of implementation of 4 new quality measures assessing emergency department (ED) and inpatient care for suicidal youth. Four quality measures were developed to assess hospital-based care for suicidal youth. These measures, focused on counseling caregivers about restricting access to lethal means of self-harm and benefits and risks of antidepressant medications, were operationalized into 2 caregiver surveys that assessed ED and inpatient quality, respectively. Survey field tests included caregivers of youth who received inpatient and/or ED care for suicidality at 1 of 2 children's hospitals between July 2013 and June 2014. We examined the feasibility of obtaining measure scores and variation in scores. Multivariate models examined associations between quality measure scores and 4 validation metrics: modified Child Hospital Consumer Assessments of Health Care Providers and Systems, communication composites, hospital readmissions, and ED return visits. Response rates were 35% (ED) and 31% (inpatient). Most caregivers reported receiving counseling to restrict their child's access to lethal means of self-harm (90% in the ED and 96% in the inpatient setting). In the inpatient setting, caregivers reported higher rates of counseling on benefits (95%) of newly prescribed antidepressants than risks (physical adverse effects 85%, increased suicidality 72%). Higher scores on the latter measure were associated with higher nurse (P < .001) and doctor (P < .01) communication composite scores. Measure scores were not associated with readmissions or ED return visits. These new quality measures evaluate key aspects of care for suicidal youth, and they may facilitate assessing quality of care for this vulnerable population. Copyright © 2017 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  3. Achieving revenue integrity in hospitals and health systems.

    Science.gov (United States)

    Schoen, Marianne; Najera, Michael

    2012-09-01

    The Bellevue Hospital sought to improve its performance in three areas-days in accounts receivable (A/R), denials, and charge capture-to enhance revenue integrity. Results included the following: A 30-percent reduction in days in A/R. A nearly 200 percent increase in bad debt collections. A more than $1.6 million reduction in denials write-offs. An improvement in net revenue of more than $1 million.

  4. Indian Hospitality Industry: Moving Towards Customer Oriented Information System (COIS)

    OpenAIRE

    Dhillon, Dr. Jaskaran Singh; Joshi, Madhur; Verma, Ramita

    2012-01-01

    Increasing occupancy rates and revenue by improving customer experience is the aim of modern Indian hospitality organizations. To achieve these results, hotel managers need to have a deep knowledge of customers needs, behavior, and preferences and be aware of the ways in which the services delivered create value for the customers and then stimulate their retention and loyalty. In this article a methodological framework to analyze the guesthotel relationship and to profile hotel guests is disc...

  5. Hospital based emergency department visits attributed to child physical abuse in United States: predictors of in-hospital mortality.

    Directory of Open Access Journals (Sweden)

    Veerajalandhar Allareddy

    Full Text Available OBJECTIVES: To describe nationally representative outcomes of physical abuse injuries in children necessitating Emergency Department (ED visits in United States. The impact of various injuries on mortality is examined. We hypothesize that physical abuse resulting in intracranial injuries are associated with worse outcome. MATERIALS AND METHODS: We performed a retrospective analysis of the Nationwide Emergency Department Sample (NEDS, the largest all payer hospital based ED database, for the years 2008-2010. All ED visits and subsequent hospitalizations with a diagnosis of "Child physical abuse" (Battered baby or child syndrome due to various injuries were identified using ICD-9-CM (International Classification of Diseases, 9th Revision, Clinical Modification codes. In addition, we also examined the prevalence of sexual abuse in this cohort. A multivariable logistic regression model was used to examine the association between mortality and types of injuries after adjusting for a multitude of patient and hospital level factors. RESULTS: Of the 16897 ED visits that were attributed to child physical abuse, 5182 (30.7% required hospitalization. Hospitalized children were younger than those released treated and released from the ED (1.9 years vs. 6.4 years. Male or female partner of the child's parent/guardian accounted for >45% of perpetrators. Common injuries in hospitalized children include- any fractures (63.5%, intracranial injuries (32.3% and crushing/internal injuries (9.1%. Death occurred in 246 patients (13 in ED and 233 following hospitalization. Amongst the 16897 ED visits, 1.3% also had sexual abuse. Multivariable analyses revealed each 1 year increase in age was associated with a lower odds of mortality (OR = 0.88, 95% CI = 0.81-0.96, p < 0.0001. Females (OR = 2.39, 1.07-5.34, p = 0.03, those with intracranial injuries (OR = 65.24, 27.57-154.41, p<0.0001, or crushing/internal injury (OR = 4.98, 2.24-11.07, p<0.0001 had higher odds of

  6. Marketing and reputation aspects of neonatal safeguards and hospital-security systems.

    Science.gov (United States)

    Smith, Alan D

    2009-01-01

    Technological advancements have migrated from personal-use electronics into the healthcare setting for security enhancements. Within maternity wards and nurseries, technology was seen as one of best way to protect newborns from abduction. The present study is a focus on what systems and methods are used in neonatal security, the security arrangements, staff training, and impacts outside the control of the hospital, customer satisfaction and customer relations management. Through hypothesis-testing and exploratory analysis, gender biases and extremely high levels of security were found within a web-enabled and professional sample of 200 respondents. The factor-based constructs were found to be, in order of the greatest explained variance: security concerns, personal technology usage, work technology applications, and demographic maturity concerns, resulting in four factor-based scores with significant combined variance of 61.5%. It was found that through a better understanding on the importance and vital need for hospitals to continue to improve on their technology-based security policies significantly enhanced their reputation in the highly competitive local healthcare industry.

  7. A validation of ground ambulance pre-hospital times modeled using geographic information systems

    Directory of Open Access Journals (Sweden)

    Patel Alka B

    2012-10-01

    Full Text Available Abstract Background Evaluating geographic access to health services often requires determining the patient travel time to a specified service. For urgent care, many research studies have modeled patient pre-hospital time by ground emergency medical services (EMS using geographic information systems (GIS. The purpose of this study was to determine if the modeling assumptions proposed through prior United States (US studies are valid in a non-US context, and to use the resulting information to provide revised recommendations for modeling travel time using GIS in the absence of actual EMS trip data. Methods The study sample contained all emergency adult patient trips within the Calgary area for 2006. Each record included four components of pre-hospital time (activation, response, on-scene and transport interval. The actual activation and on-scene intervals were compared with those used in published models. The transport interval was calculated within GIS using the Network Analyst extension of Esri ArcGIS 10.0 and the response interval was derived using previously established methods. These GIS derived transport and response intervals were compared with the actual times using descriptive methods. We used the information acquired through the analysis of the EMS trip data to create an updated model that could be used to estimate travel time in the absence of actual EMS trip records. Results There were 29,765 complete EMS records for scene locations inside the city and 529 outside. The actual median on-scene intervals were longer than the average previously reported by 7–8 minutes. Actual EMS pre-hospital times across our study area were significantly higher than the estimated times modeled using GIS and the original travel time assumptions. Our updated model, although still underestimating the total pre-hospital time, more accurately represents the true pre-hospital time in our study area. Conclusions The widespread use of generalized EMS pre-hospital

  8. Structured physical exercise improves neuropsychiatric symptoms in acute dementia care : a hospital-based RCT

    NARCIS (Netherlands)

    Fleiner, Tim; Dauth, Hannah; Gersie, Marleen; Zijlstra, Wiebren; Haussermann, Peter

    2017-01-01

    BACKGROUND: The primary objective of this trial is to investigate the effects of a short-term exercise program on neuropsychiatric signs and symptoms in acute hospital dementia care. METHODS: Within a hospital-based randomized controlled trial, the intervention group conducted a 2-week exercise

  9. Diversity in the scope and practice of hospital-based midwives in the Netherlands

    NARCIS (Netherlands)

    Cronie, D.; Rijnders, M.E.B.; Buitendijk,S.E.

    2012-01-01

    INTRODUCTION: Not all midwives in the Netherlands are independent practitioners. One in 4 midwives registered to practice is employed in the hospital setting, where 67% of all births occur. There has not yet been an in-depth examination of hospital-based midwives' practice in the Netherlands, in the

  10. The development of hospital-based palliative care services in public ...

    African Journals Online (AJOL)

    With the recent approval of a South African (SA) National Policy Framework and Strategy for Palliative Care by the National Health Council, it is pertinent to reflect on initiatives to develop palliative care services in public hospitals. This article reviews the development of hospital-based palliative care services in the Western ...

  11. Web Based Projects Enhancing English Language and Generic Skills Development for Asian Hospitality Industry Students

    Science.gov (United States)

    Wang, Mei-jung

    2009-01-01

    This study investigated hospitality students' responses toward their learning experiences from undertaking group projects based upon a College web platform, the "Ubiquitous Hospitality English Learning Platform" (U-HELP). Twenty-six students in the Department of Applied Foreign Languages participated in this study. Their attitudes toward…

  12. Hospital, Patient, and Local Health System Characteristics Associated with the Prevalence and Duration of Observation Care

    Science.gov (United States)

    Wright, Brad; Jung, Hye-Young; Feng, Zhanlian; Mor, Vincent

    2014-01-01

    Objective To examine the association between hospital, patient, and local health system characteristics and the likelihood, prevalence, and duration of observation care among fee-for-service Medicare beneficiaries. Data Sources The 100 percent Medicare inpatient and outpatient claims and enrollment files for 2009, supplemented with 2007 American Hospital Association Survey and 2009 Area Resource File data. Study Design Using a lagged cross-sectional design, we model the likelihood of a hospital providing any observation care using logistic regression and the conditional prevalence and duration of observation care using linear regression, among 3,692 general hospitals in the United States. Principle Findings Critical access hospitals (CAHs) have 97 percent lower odds of providing observation care compared to other hospitals, and they conditionally provide three fewer observation stays per 1,000 visits. The provision of observation care is negatively associated with the proportion of racial minority patients, but positively associated with average patient age, proportion of outpatient visits occurring in the emergency room, and diagnostic case mix. Duration is between 1.5 and 2.8 hours shorter at government-owned, for-profit hospitals, and CAHs compared to other nonprofit hospitals. Conclusions Variation in observation care depends primarily on hospital characteristics, patient characteristics, and geographic measures. By contrast, local health system characteristics are not a factor. PMID:24611617

  13. Clinical decision support systems at the Vienna General Hospital using Arden Syntax: Design, implementation, and integration.

    Science.gov (United States)

    Schuh, Christian; de Bruin, Jeroen S; Seeling, Walter

    2015-12-01

    The Allgemeines Krankenhaus Informations Management (AKIM) project was started at the Vienna General Hospital (VGH) several years ago. This led to the introduction of a new hospital information system (HIS), and the installation of the expert system platform (EXP) for the integration of Arden-Syntax-based clinical decision support systems (CDSSs). In this report we take a look at the milestones achieved and the challenges faced in the creation and modification of CDSSs, and their integration into the HIS over the last three years. We introduce a three-stage development method, which is followed in nearly all CDSS projects at the Medical University of Vienna and the VGH. Stage one comprises requirements engineering and system conception. Stage two focuses on the implementation and testing of the system. Finally, stage three describes the deployment and integration of the system in the VGH HIS. The HIS provides a clinical work environment for healthcare specialists using customizable graphical interfaces known as parametric medical documents. Multiple Arden Syntax servers are employed to host and execute the CDSS knowledge bases: two embedded in the EXP for production and development, and a further three in clinical routine for production, development, and quality assurance. Three systems are discussed; the systems serve different purposes in different clinical areas, but are all implemented with Arden Syntax. MONI-ICU is an automated surveillance system for monitoring healthcare-associated infections in the intensive care setting. TSM-CDS is a CDSS used for risk prediction in the formation of cutaneous melanoma metastases. Finally, TacroDS is a CDSS for the manipulation of dosages for tacrolimus, an immunosuppressive agent used after kidney transplantation. Problems in development and integration were related to data quality or availability, although organizational difficulties also caused delays in development and integration. Since the inception of the AKIM

  14. Technology transfer with system analysis, design, decision making, and impact (Survey-2000) in acute care hospitals in the United States.

    Science.gov (United States)

    Hatcher, M

    2001-10-01

    This paper provides the results of the Survey-2000 measuring technology transfer for management information systems in health care. The relationships with systems approaches, user involvement, usersatisfaction, and decision-making were measured and are presented. The survey also measured the levels Internet and Intranet presents in acute care hospitals, which will be discussed in future articles. The depth of the survey includes e-commerce for both business to business and customers. These results are compared, where appropriate, with results from survey 1997 and changes are discussed. This information will provide benchmarks for hospitals to plan their network technology position and to set goals. This is the first of three articles based upon the results of the Srvey-2000. Readers are referred to a prior article by the author that discusses the survey design and provides a tutorial on technology transfer in acute care hospitals.

  15. Sphere based fluid systems

    Science.gov (United States)

    Elleman, Daniel D. (Inventor); Wang, Taylor G. (Inventor)

    1989-01-01

    Systems are described for using multiple closely-packed spheres. In one system for passing fluid, a multiplicity of spheres lie within a container, with all of the spheres having the same outside diameter and with the spheres being closely nested in one another to create multiple interstitial passages of a known size and configuration and smooth walls. The container has an inlet and outlet for passing fluid through the interstitial passages formed between the nested spheres. The small interstitial passages can be used to filter out material, especially biological material such as cells in a fluid, where the cells can be easily destroyed if passed across sharp edges. The outer surface of the spheres can contain a material that absorbs a constitutent in the flowing fluid, such as a particular contamination gas, or can contain a catalyst to chemically react the fluid passing therethrough, the use of multiple small spheres assuring a large area of contact of these surfaces of the spheres with the fluid. In a system for storing and releasing a fluid such as hydrogen as a fuel, the spheres can include a hollow shell containing the fluid to be stored, and located within a compressable container that can be compressed to break the shells and release the stored fluid.

  16. 75 FR 50041 - Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the...

    Science.gov (United States)

    2010-08-16

    ... IOM Institute of Medicine IPF Inpatient psychiatric facility IPPS inpatient prospective payment system... 2012, FY 2013, and FY 2014 Payment Determinations 6. RHQDAPU Program Disaster Extensions and Waivers 7...

  17. Starting and maintaining a hospital-based ostomy support group.

    Science.gov (United States)

    Cross, Heidi Huddleston; Hottenstein, Patricia

    2010-01-01

    Ostomy surgery alters body image; this process can be distressing for patients, who must transition through a type of grieving process. Attending an ostomy support group provides an atmosphere of acceptance, a feeling of being able to cope, and mutual respect. The WOC nurse employed by an acute care facility is well positioned to facilitate such a group. Our clinical experiences strongly suggest that patients move more rapidly through the stages of grief to acceptance of the ostomy when they interact with others who have shared similar experiences. This article describes how one hospital started and maintains an ostomy support group, and gives suggestions for successful implementation of a support group.

  18. The Study of the Optimal Parameter Settings in a Hospital Supply Chain System in Taiwan

    Directory of Open Access Journals (Sweden)

    Hung-Chang Liao

    2014-01-01

    Full Text Available This study proposed the optimal parameter settings for the hospital supply chain system (HSCS when either the total system cost (TSC or patient safety level (PSL (or both simultaneously was considered as the measure of the HSCS’s performance. Four parameters were considered in the HSCS: safety stock, maximum inventory level, transportation capacity, and the reliability of the HSCS. A full-factor experimental design was used to simulate an HSCS for the purpose of collecting data. The response surface method (RSM was used to construct the regression model, and a genetic algorithm (GA was applied to obtain the optimal parameter settings for the HSCS. The results show that the best method of obtaining the optimal parameter settings for the HSCS is the simultaneous consideration of both the TSC and the PSL to measure performance. Also, the results of sensitivity analysis based on the optimal parameter settings were used to derive adjustable strategies for the decision-makers.

  19. A flexible home monitoring platform for patients affected by chronic heart failure directly integrated with the remote Hospital Information System

    Science.gov (United States)

    Donati, Massimiliano; Bacchillone, Tony; Saponara, Sergio; Fanucci, Luca

    2011-05-01

    Today Chronic Heart Failure (CHF) represents one of leading cause of hospitalization among chronic disease, especially for elderly citizens, with a consequent considerable impact on patient quality of life, resources congestion and healthcare costs for the National Sanitary System. The current healthcare model is mostly in-hospital based and consists of periodic visits, but unfortunately it does not allow to promptly detect exacerbations resulting in a large number of rehospitalization. Recently physicians and administrators identify telemonitoring systems as a strategy able to provide effective and cost efficient healthcare services for CHF patients, ensuring early diagnosis and treatments in case of necessity. This work presents a complete and integrated ICT solution to improve the management of chronic heart failure through the remote monitoring of vital signs at patient home, able to connect in-hospital care of acute syndrome with out-of-hospital follow-up. The proposed platform represents the patient's interface, acting as link between biomedical sensors and the data collection point at the Hospital Information System (HIS) in order to handle in transparent way the reception, analysis and forwarding of the main physiological parameters.

  20. Reduced pre-hospital and in-hospital survival rates after out-of-hospital cardiac arrest of patients with type-2 diabetes mellitus : An observational prospective community-based study

    NARCIS (Netherlands)

    Van Hoeijen, Daniel A.; Blom, Marieke T.; Bardai, Abdennasser; Souverein, Patrick C.; De Boer, Anthonius; Tan, Hanno L.

    2015-01-01

    Aims Out-of-hospital cardiac arrest (OHCA) remains a major cause of death. We aimed to determine whether type-2 diabetes mellitus (T2DM) is associated with reduced pre-hospital and in-hospital survival rates after OHCA. Methods and results An observational community-based cohort study was performed

  1. Controlling Legionella in hospital drinking water: an evidence-based review of disinfection methods.

    Science.gov (United States)

    Lin, Yusen E; Stout, Janet E; Yu, Victor L

    2011-02-01

    Hospital-acquired Legionnaires' disease is directly linked to the presence of Legionella in hospital drinking water. Disinfecting the drinking water system is an effective preventive measure. The efficacy of any disinfection measures should be validated in a stepwise fashion from laboratory assessment to a controlled multiple-hospital evaluation over a prolonged period of time. In this review, we evaluate systemic disinfection methods (copper-silver ionization, chlorine dioxide, monochloramine, ultraviolet light, and hyperchlorination), a focal disinfection method (point-of-use filtration), and short-term disinfection methods in outbreak situations (superheat-and-flush with or without hyperchlorination). The infection control practitioner should take the lead in selection of the disinfection system and the vendor. Formal appraisals by other hospitals with experience of the system under consideration is indicated. Routine performance of surveillance cultures of drinking water to detect Legionella and monitoring of disinfectant concentrations are necessary to ensure long-term efficacy.

  2. [Nutritional support in the home-based hospitalization setting].

    Science.gov (United States)

    Chicharro, L; Planas, M; Pérez-Portabella, C; Vélez, C; San José, A

    2009-01-01

    The Hospital at Home (HAD) is a choice of care that enables own care in a hospital at home patient. Moreover, the nutritional support (NS) -enteral or parenteral nutrition- is usually indicated in patients with serious underlying disease, and/or frequently remain severely disabled. To analyze the characteristics of the patients, attended at home for specific questions of the NS that receive. descriptive and retrospective study of the patients attended by the Nutritional Support Unit (NSU), in the area of the HAD, from September 1, 2006 until August 31, 2007. At home, the realized procedure was: refill of gastrostomia or jejunostomia feeding tube in 158 cases; modification of the guideline of enteral nutrition (EN) or parenteral nutrition (PN) in 53 cases; training of the skill of artificial nutrition in 14 cases. 39 visits were realized by complications -by infection or lead throught the estoma and by obstruction of the feeding tube-. Only in 3 patients (7.7%) the domiciliary assistance indicated the movement of the patient to the Emergency Unit. In our center, the infrastructure of the HAD has allowed to give answer to the needs of the patients who receive NS at home in our area of influence.

  3. Epidemiology of psoriasis in malaysia: a hospital based study.

    Science.gov (United States)

    Sinniah, B; Saraswathy Devi, S; Prashant, B S

    2010-06-01

    Psoriasis is a complex chronic inflammatory skin disease with a worldwide distribution. To determine the prevalence of psoriasis according to age, gender and ethnicity among outpatients attending the dermatology clinic in Hospital Tengku Ampuan Rahimah, Klang Malaysia. All outpatients attending the specialist clinic of the dermatology department in Hospital Tengku Ampuan Rahimah, Klang, Malaysia from January 2003 to December 2005. This is a retrospective descriptive study of all outpatients who attended the specialist clinic from January 2003 to December 2005 and diagnosed for psoriasis. The study population consisted of patients of all ages, both gender and different ethnic groups (Malay, Chinese, Indians and foreign workers) living in the Klang Valley and the surrounding areas. A total of 5607 patients were examined during a period of three years and 9.5% were found to be suffering with psoriasis. It was more common in males (11.6%) than in females (7.2%). Patients within the 40-60 year age group had the highest (17.2%) rate and were lower in the younger age group including those aged over 60 years (8.1%). With regards to ethnicity, it was more common in Indians followed by Malays, Chinese and migrant foreign workers respectively. The study indicates that psoriasis is common in Malaysia and its distribution varies with age, ethnicity and gender.

  4. Case Study: Evidence-Based Interventions Enhancing Diabetic Foot Care Behaviors among Hospitalized DM Patients

    Directory of Open Access Journals (Sweden)

    Titis Kurniawan

    2011-01-01

    Full Text Available Background: Improving diabetic patients’ foot care behaviors is one of the most effective strategies in minimizing diabetic foot ulceration and its further negative impacts, either in diabetic hospitalized patients or outpatients.Purpose: To describe foot care knowledge and behaviors among hospitalized diabetic patients, to apply selected foot care knowledge and behaviors improvement evidence, and to evaluate its effectiveness.Method: Four diabetic patients who were under our care for at least three days and could communicate in Thai language were selected from a surgical ward in a university hospital. The authors applied educational program based on patients’ learning needs, provided diabetic foot care leaflet, and assisted patients to set their goal and action plans. In the third day of treatment, we evaluated patients’ foot care knowledge and their goal and action plan statements in improving foot care behaviors.Result: Based on the data collected among four hospitalized diabetic patients, it was shown that all patients needed foot care behaviors improvement and the educational program improved hospitalized patients’ foot care knowledge and their perceived foot care behaviors. The educational program that combined with goal setting and action plans method was easy, safe, and seemed feasibly applicable for diabetic hospitalized patients.Conclusion: The results of this study provide valuable information for improvement of hospitalized diabetic patients’ foot care knowledge and behaviors. The authors recommend nurses to use this evidence-based practice to contribute in improving the quality of diabetic care.Keywords: Intervention, diabetic foot care, hospitalized diabetic patients

  5. Compliance with accreditation and recommended hospital care-a Danish nationwide population-based study.

    Science.gov (United States)

    Falstie-Jensen, Anne Mette; Bogh, Søren Bie; Hollnagel, Erik; Johnsen, Søren Paaske

    2017-10-01

    To examine the association between compliance with accreditation and recommended hospital care. A Danish nationwide population-based follow-up study based on data from six national, clinical quality registries between November 2009 and December 2012. Public, non-psychiatric Danish hospitals. Patients with acute stroke, chronic obstructive pulmonary disease, diabetes, heart failure, hip fracture and bleeding/perforated ulcers. All hospitals were accredited by the first version of The Danish Healthcare Quality Programme. Compliance with accreditation was defined by level of accreditation awarded the hospital after an announced onsite survey; hence, hospitals were either fully (n = 11) or partially accredited (n = 20). Recommended hospital care included 48 process performance measures reflecting recommendations from clinical guidelines. We assessed recommended hospital care as fulfilment of the measures individually and as an all-or-none composite score. In total 449 248 processes of care were included corresponding to 68 780 patient pathways. Patients at fully accredited hospitals had a significantly higher probability of receiving care according to clinical guideline recommendations than patients at partially accredited hospitals across conditions (individual measure: adjusted odds ratio (OR) = 1.20, 95% CI: 1.01-1.43, all-or-none: adjusted OR = 1.27, 95% CI: 1.02-1.58). For five of the six included conditions there were an association; the pattern appeared particular strong among patients with acute stroke and hip fracture (all-or-none; acute stroke: adjusted OR = 1.39, 95% CI: 1.05-1.83, hip fracture: adjusted OR = 1.57, 95% CI: 1.00-2.49). High compliance with accreditation standards was associated with a higher level of evidence-based hospital care in Danish hospitals.

  6. [The Perspectives and Expectations of New Nursing Graduates Regarding the Hospital-Based Nursing Students Scholarship].

    Science.gov (United States)

    Chen, Kuan-Ling; Tsai, Yun-Fang; Shao, Jung-Hua; Shyu, Yea-Ing

    2016-10-01

    The hospital-based scholarship is a relatively recent incentive used by hospitals to recruit new nursing graduates. Few studies have explored the impact of these scholarship programs on hospital recruitment. To explore the perspectives and expectations of new nursing graduates on the application of a hospital-based scholarship for nursing students. This study used a qualitative research approach. Purposive sampling was used to recruit 20 new nursing graduates from one university in northern Taiwan in 2013. Content analysis was applied to analyze the data. Two themes were identified by participants who had applied for a hospital-based scholarship: "aspire to be a nursing-scholarship recipient and work towards this aspiration" and "look forward to receiving a nursing-scholarship and imagine possible features of the future life." One theme was identified by participants who had not applied for a hospital-based scholarship: "agree with the policy of hospital-based scholarship but resist the restrictions on their life." Although both groups agreed that the scholarship program helped relieve financial stresses, participants who had applied for the scholarship tended to hold positive and aggressive attitudes towards the nursing scholarship. Conversely, participants who had not applied for the scholarship did so due to the perceived conflicts between the scholarship and their career plans. It is recommended to consider providing career-planning assistance to new graduates and to arrange that students who sign a scholarship contract have their clinical practice in their working unit in order to improve adaptation.

  7. The information security needs in radiological information systems-an insight on state hospitals of Iran, 2012.

    Science.gov (United States)

    Farhadi, Akram; Ahmadi, Maryam

    2013-12-01

    Picture Archiving and Communications System (PACS) was originally developed for radiology services over 20 years ago to capture medical images electronically. Medical diagnosis methods are based on images such as clinical radiographs, ultrasounds, CT scans, MRIs, or other imaging modalities. Information obtained from these images is correlated with patient information. So with regards to the important role of PACS in hospitals, we aimed to evaluate the PACS and survey the information security needed in the Radiological Information system. First, we surveyed the different aspects of PACS that should be in any health organizations based on Department of Health standards and prepared checklists for assessing the PACS in different hospitals. Second, we surveyed the security controls that should be implemented in PACS. Checklists reliability is affirmed by professors of Tehran Science University. Then, the final data are inputted in SPSS software and analyzed. The results indicate that PACS in hospitals can transfer patient demographic information but they do not show route of information. These systems are not open source. They don't use XML-based standard and HL7 standard for exchanging the data. They do not use DS digital signature. They use passwords and the user can correct or change the medical information. PACS can detect alternation rendered. The survey of results demonstrates that PACS in all hospitals has the same features. These systems have the patient demographic data but they do not have suitable flexibility to interface network or taking reports. For the privacy of PACS in all hospitals, there were passwords for users and the system could show the changes that have been made; but there was no water making or digital signature for the users.

  8. Population-based characteristics of fatal and hospital admissions for poisoning in Fiji: TRIP Project-11

    Science.gov (United States)

    Peiris-John, Roshini; Kafoa, Berlin; Wainiqolo, Iris; Reddy, Ravi Krishnan; McCaig, Eddie; Ameratunga, Shanthi N

    2013-01-01

    This study investigated the incidence and characteristics of poisoning fatalities and hospital admissions among indigenous Fijians and Indians in Viti Levu, Fiji. Individuals with a mechanism of injury classified as poisoning were identified using the Fiji injury surveillance in hospitals system, a population-based registry established for 12 months in Viti Levu, and analysed using population-based denominators. The mean annual rates of fatalities and hospitalisations were 2.3 and 26.0 per 100 000, respectively. Over two-thirds of poisonings occurred among people of Indian ethnicity. Most intentional poisoning admissions occurred among women (58.3%) and in 15–29-year-old individuals (73.8%). Unintentional poisoning admission rates were highest among Indian boys aged 0–14 years. While over 75% of events occurred at home, the substances involved were not systematically identified. The findings indicate the need for a strategy that addresses the differing contexts across age group, gender and ethnicity, and a lead agency responsible for implementing and monitoring its effectiveness. PMID:23353079

  9. An epidemic outbreak of nephrogenic systemic fibrosis in a Danish hospital

    DEFF Research Database (Denmark)

    Marckmann, P.

    2008-01-01

    The nephrological department of Copenhagen University Hospital Herlev experienced an epidemic accumulation of patients developing nephrogenic systemic fibrosis in the period 2002-2006. Systematic studies of these patients revealed that they all had a gadodiamide-enhanced magnetic resonance...

  10. Occurrence of Opportunistic Pathogens Legionella pneumophila and non-tuberculous mycobacteria in hospital plumbing systems

    Science.gov (United States)

    Occurrence of Opportunistic Pathogens Legionella pneumophila and non-tuberculous mycobacteria in hospital plumbing systems Jill Hoelle, Michael Coughlin, Elizabeth Sotkiewicz, Jingrang Lu, Stacy Pfaller, Mark Rodgers, and Hodon Ryu U.S. Environmental Protection Agency, Cincinnati...

  11. Prospective Payment System (PPS)-Exempt Cancer Hospital Quality Reporting (PCHQR)

    Data.gov (United States)

    U.S. Department of Health & Human Services — Prospective Payment System (PPS)-Exempt Cancer Hospital Quality Reporting (PCHQR) Program currently uses one clinical effectiveness measure—External Beam...

  12. Maternal pre-gravid obesity and early childhood respiratory hospitalization: a population-based case-control study.

    Science.gov (United States)

    Parsons, Elizabeth C; Patel, Kevin; Tran, Betty T; Littman, Alyson J

    2013-08-01

    Inflammation in utero is linked to childhood respiratory and infectious complications. Obesity is an increasingly common chronic inflammatory state, yet little is known about its role in childhood respiratory illness. We sought to examine the association between maternal pre-gravid BMI and early childhood respiratory hospitalization. We conducted a population-based case-control study using the Washington State Comprehensive Hospital Abstract Reporting System and linked birth certificate data. Cases were children age 0-5 years, born in Washington state, with a respiratory hospitalization between 2003 and 2008. We identified 15,318 cases, frequency matching each case to two controls by birth year (total 31,060 controls). We used logistic regression to estimate the risk (approximated by odds ratios) of early childhood respiratory hospitalization according to maternal pre-gravid body mass index (BMI) category (underweight, normal, overweight, obese), after adjustment for maternal and infant characteristics. An elevated maternal pre-gravid BMI was associated with increased risk of childhood respiratory hospitalization, with an adjusted odds ratio OR [95 % CI] = 1.08 [1.03-1.14] for overweight mothers (BMI 25-29.9 kg/m(2)), and OR = 1.29 [1.22-1.36] for obese mothers (BMI ≥ 30 kg/m(2)). An elevated maternal pre-gravid BMI was associated with higher risk of early childhood respiratory hospitalization. Childhood respiratory illness may be an important complication of excess maternal weight that should be shared with expectant mothers.

  13. 77 FR 53257 - Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the...

    Science.gov (United States)

    2012-08-31

    ... Medicine IPF Inpatient psychiatric facility IPPS inpatient prospective payment system IRF Inpatient... IQR Program Disaster Extensions or Waivers 11. Electronic Health Records (EHRs) a. Background b... Wage Index 1. Secretary's Report to Congress on Wage Index Reform 2. Institute of Medicine (IOM) Study...

  14. 78 FR 38679 - Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the...

    Science.gov (United States)

    2013-06-27

    ... HUMAN SERVICES Centers for Medicare & Medicaid Services 42 CFR Parts 412, 482, 485, and 489 RIN 0938... Deep Brain Stimulator (DBS) and Vagus Nerve Stimulator (VNS) Systems (the table is titled ``KEY... Prevention's National Healthcare Safety Network (NHSN). On page 27704, in our discussion of the HAI measures...

  15. MTA Computer Based Evaluation System.

    Science.gov (United States)

    Brenner, Lisa P.; And Others

    The MTA PLATO-based evaluation system, which has been implemented by a consortium of schools of medical technology, is designed to be general-purpose, modular, data-driven, and interactive, and to accommodate other national and local item banks. The system provides a comprehensive interactive item-banking system in conjunction with online student…

  16. [Implementation of ECG Monitoring System Based on Internet of Things].

    Science.gov (United States)

    Lu, Liangliang; Chen, Minya

    2015-11-01

    In order to expand the capabilities of hospital's traditional ECG device and enhance medical staff's work efficiency, an ECG monitoring system based on internet of things is introduced. The system can monitor ECG signals in real time and analyze data using ECG sensor, PDA, Web servers, which embeds C language, Android systems, .NET, wireless network and other technologies. After experiments, it can be showed that the system has high reliability and stability and can bring the convenience to medical staffs.

  17. The Design and Simulation of Natural Personalised Ventilation (NPV System for Multi-Bed Hospital Wards

    Directory of Open Access Journals (Sweden)

    Zulfikar A. Adamu

    2015-05-01

    Full Text Available Adequate ventilation is necessary for thermal comfort and reducing risks from infectious bio-aerosols in hospital wards, but achieving this with mechanical ventilation has carbon and energy implications. Natural ventilation is often limited to window-based designs whose dilution/mixing effectiveness are subject to constraints of wind speed, cross ventilation, and in the case of hospital wards, proximity of patients to external walls. A buoyancy-driven natural ventilation system capable of achieving dilution/mixing was shown to be feasible in a preceding study of novel system called natural personalised ventilation (NPV. This system combined both architecture and airflow engineering principles of space design and buoyancy and was tested and validated (salt-bath experiment for a single bed ward. This research extends the previous work and is proof-of-concept on the feasibility of NPV system for multi-bed wards. Two different four-bed ward types were investigated of using computational fluid dynamics (CFD simulations under wind-neutral conditions. Results predict that NPV system could deliver fresh air to multiple patients, including those located 10 m away from external wall, with absolute flow rates of between 32 L·s−1 and 54 L·s−1 for each patient/bed. Compared to same wards simulated using window design, ingress of airborne contaminants into patients’ breathing zone and summer overheating potential were minimised, while overall ward dilution was maximised. Findings suggest the NPV has potentials for enabling architects and building service engineers to decouple airflow delivery from the visualisation and illumination responsibilities placed upon windows.

  18. Manifestaciones Orales en pacientes VIH/SIDA del Hospital Base de Valdivia en Chile

    National Research Council Canada - National Science Library

    Rubén Gallardo-Rosales; Katherine Castillo-Torres; Patricia Alegría-Conejeros; Eileen Blackburn-Tapia

    2016-01-01

    .... Materials and methods: 177 patients living with HIV in control and / or treatment of the Base Hospital of Valdivia in Chile, where he underwent an oral examination and values of the last count of CD4 lymphocytes and viral...

  19. Constructing optimal experience for the hospitalized newborn through neuro-based music therapy

    Directory of Open Access Journals (Sweden)

    Helen eShoemark

    2015-09-01

    Full Text Available Music-based intervention for hospitalized newborn infants has traditionally been based in a biomedical model, with physiological stability as the prime objective. More recent applications are grounded in other theories, including attachment, trauma and neurological models in which infant, parent and the dyadic interaction may be viewed as a dynamic system bound by the common context of the NICU. The immature state of the preterm infant’s neurological system and particularly auditory system means that no assumptions can be made about auditory processing and stimulation should proceed with caution. The infant’s experience of an unpredictable auditory environment is further compromised by a potential lack of meaningful auditory stimulation. Parents often feel disconnected from their own capacities to nurture their infant. The implications for the infant’s neurobehavioral and psychological well-being are life-long. This perspectives paper will outline the likely neurological considerations for auditory processing in the premature infant as well as establishing a premise for music-based interventions. A hypothetical clinical case will illustrate the application of music by a music therapist with an infant and family in NICU.

  20. Reducing Hospital ICU Noise: A Behavior-Based Approach

    Directory of Open Access Journals (Sweden)

    Avinash Konkani

    2014-01-01

    Full Text Available Noise in Intensive Care Units (ICUs is gaining increasing attention as a significant source of stress and fatigue for nursing staff. Extensive research indicates that hospital noise also has negative impact on patients. The objective of this study was to analyze noise variations as experienced by both nursing staff and patients, to gain a better understanding of noise levels and frequencies observed in ICU settings over extended (week-long durations, and to implement a low cost behavior modification program to reduce noise. The results of our study indicate that behavioral modification alone is not adequate to control excessive noise. There is a need for further research involving the supportive involvement by clinicians, ICU staff, along with effective medical device alarm management, and continuous process improvement methods.

  1. A short history of the beginnings of hospital information systems in Argentina.

    Science.gov (United States)

    Yácubsohn, V

    2012-01-01

    To describe the development of early health information systems in Argentina and their impact on the development of professional societies in the discipline The first hospital information systems and health surveillance systems in Argentina are described and related to the rise of professional organizations for health informatics. The early health information systems in Argentina are related to precursor developments in medical informatics. Argentina saw a number of hospital information systems developed starting in 1977, which had an important influence on the practice and experience in medical informatics in the country, and the participation of Argentine professionals in national, regional, and international activities in the field.

  2. Benefits of a Hospital Two-Bin Kanban System

    Science.gov (United States)

    2014-09-01

    system MTF military treatment facility PACU post-anesthesia care unit PAR periodic automatic replenishment RFID radio-frequency identification ...system, the aspects of the radio frequency identification ( RFID ) capabilities of the two-bin kanban system were not addressed in this thesis. The...of a Radio-Frequency Identification ( RFID ) two-bin kanban system. This was recommended due to the relative simplicity of the replenishment process

  3. Marketing skills for hospital-based laboratory managers in a managed care environment.

    Science.gov (United States)

    Marchwinski, J; Coggins, F

    1997-01-01

    Managers of hospital-based laboratories have begun to realize the importance of a successful outreach program in protecting against declining inpatient activity. Succeeding in the highly competitive field of outpatient testing requires some new skills and techniques that may not have been apparent when addressing normal inpatient requirements. This article provides an overview of some very basic marketing concepts and attempts to show how they can assist the hospital-based laboratory manager in developing a successful outreach program.

  4. The Impact of National Cultural Differences on Nurses' Acceptance of Hospital Information Systems.

    Science.gov (United States)

    Lin, Hsien-Cheng

    2015-06-01

    This study aims to explore the influence of national cultural differences on nurses' perceptions of their acceptance of hospital information systems. This study uses the perspective of Technology Acceptance Model; national cultural differences in terms of masculinity/femininity, individualism/collectivism, power distance, and uncertainty avoidance are incorporated into the Technology Acceptance Model as moderators, whereas time orientation is a control variable on hospital information system acceptance. A quantitative research design was used in this study; 261 participants, US and Taiwan RNs, all had hospital information system experience. Data were collected from November 2013 to February 2014 and analyzed using a t test to compare the coefficients for each moderator. The results show that individualism/collectivism, power distance, and uncertainty avoidance all exhibit significant difference on hospital information system acceptance; however, both masculinity/femininity and time orientation factors did not show significance. This study verifies that national cultural differences have significant influence on nurses' behavioral intention to use hospital information systems. Therefore, hospital information system providers should emphasize the way in which to integrate different technological functions to meet the needs of nurses from various cultural backgrounds.

  5. Investigating health system performance: An application of data envelopment analysis to Zambian hospitals

    Directory of Open Access Journals (Sweden)

    Masiye Felix

    2007-04-01

    Full Text Available Abstract Background Zambia has recently articulated an ambitious national health program designed to meeting health-related MDGs. Public expectations are high and Zambia continues to receive significant resources from global and bilateral donors to support its health agenda. Although the lack of adequate resources presents the most important constraint, the efficiency with which available resources are being utilised is another challenge that cannot be overlooked. Inefficiency in producing health care undermines the service coverage potential of the health system. This paper estimates the technical efficiency of a sample of hospitals in Zambia. Methods Efficiency is measured using a DEA model. Vectors of hospital inputs and outputs, representing hospital expended resources and output profiles respectively, were specified and measured. The data were gathered from a sample of 30 hospitals throughout Zambia. The model estimates an efficiency score for each hospital. A decomposition of technical efficiency into scale and congestion is also provided. Results Results show that overall Zambian hospitals are operating at 67% level of efficiency, implying that significant resources are being wasted. Only 40% of hospitals were efficient in relative terms. The study further reveals that the size of hospitals is a major source of inefficiency. Input congestion is also found to be a source of hospital inefficiency. Conclusion This study has demonstrated that inefficiency of resource use in hospitals is significant. Policy attention is drawn to unsuitable hospital scale of operation and low productivity of some inputs as factors that reinforce each other to make Zambian hospitals technically inefficient at producing and delivering services. It is argued that such evidence of substantial inefficiency would undermine Zambia's prospects of achieving its health goals.

  6. Analysis of information security management systems at 5 domestic hospitals with more than 500 beds.

    Science.gov (United States)

    Park, Woo-Sung; Seo, Sun-Won; Son, Seung-Sik; Lee, Mee-Jeong; Kim, Shin-Hyo; Choi, Eun-Mi; Bang, Ji-Eon; Kim, Yea-Eun; Kim, Ok-Nam

    2010-06-01

    The information security management systems (ISMS) of 5 hospitals with more than 500 beds were evaluated with regards to the level of information security, management, and physical and technical aspects so that we might make recommendations on information security and security countermeasures which meet both international standards and the needs of individual hospitals. The ISMS check-list derived from international/domestic standards was distributed to each hospital to complete and the staff of each hospital was interviewed. Information Security Indicator and Information Security Values were used to estimate the present security levels and evaluate the application of each hospital's current system. With regard to the moderate clause of the ISMS, the hospitals were determined to be in compliance. The most vulnerable clause was asset management, in particular, information asset classification guidelines. The clauses of information security incident management and business continuity management were deemed necessary for the establishment of successful ISMS. The level of current ISMS in the hospitals evaluated was determined to be insufficient. Establishment of adequate ISMS is necessary to ensure patient privacy and the safe use of medical records for various purposes. Implementation of ISMS which meet international standards with a long-term and comprehensive perspective is of prime importance. To reflect the requirements of the varied interests of medical staff, consumers, and institutions, the establishment of political support is essential to create suitable hospital ISMS.

  7. Comparative economic evaluation of home-based and hospital-based palliative care for terminal cancer patients.

    Science.gov (United States)

    Kato, Koki; Fukuda, Haruhisa

    2017-11-01

    To quantify the difference between adjusted costs for home-based palliative care and hospital-based palliative care in terminally ill cancer patients. We carried out a case-control study of home-care patients (cases) who had died at home between January 2009 and December 2013, and hospital-care patients (controls) who had died at a hospital between April 2008 and December 2013. Data on patient characteristics were obtained from insurance claims data and medical records. We identified the determinants of home care using a multivariate logistic regression analysis. Cox proportional hazards analysis was used to examine treatment duration in both types of care, and a generalized linear model was used to estimate the reduction in treatment costs associated with home care. The case and control groups comprised 48 and 99 patients, respectively. Home care was associated with one or more person(s) living with the patient (adjusted OR 6.54, 95% CI 1.18-36.05), required assistance for activities of daily living (adjusted OR 3.61, 95% CI 1.12-10.51), non-use of oxygen inhalation therapy (adjusted OR 12.75, 95% CI 3.53-46.02), oral or suppository opioid use (adjusted OR 5.74, 95% CI 1.11-29.54) and transdermal patch opioid use (adjusted OR 8.30, 95% CI 1.97-34.93). The adjusted hazard ratio of home care for treatment duration was not significant (adjusted OR 0.95, 95% CI 0.59-1.53). However, home care was significantly associated with a reduction of $7523 (95% CI $7093-7991, P = 0.015) in treatment costs. Despite similar treatment durations between the groups, treatment costs were substantially lower in the home-care group. These findings might inform the policymaking process for improving the home-care support system. Geriatr Gerontol Int 2017; 17: 2247-2254. © 2017 Japan Geriatrics Society.

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

    Directory of Open Access Journals (Sweden)

    Nancy L. Weaver

    2014-10-01

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

  9. Childrens Hospital Integrated Patient Electronic Record System Continuation (CHIPERS)

    Science.gov (United States)

    2015-12-01

    childhood  deaths2       New  recommenda;ons  suggest  that  sep;c  shock  be  addressed   at  the...culture  of  their  hospital,  namely  the  hierarchy  of  medicine  and  a   stigma  for  nurses  calling   for...hierarchy  of  medicine  and  a   stigma  for  nurses  calling  for  extra  help  with  a

  10. Comparison of computing capability and information system abilities of state hospitals owned by Ministry of Labor and Social Security and Ministry of Health.

    Science.gov (United States)

    Tengilimoğlu, Dilaver; Celik, Yusuf; Ulgü, Mahir

    2006-08-01

    The main purpose of this study is to give an idea to the readers about how big and important the computing and information problems that hospital managers as well as policy makers will face with after collecting the Ministry of Labor and Social Security (MoLSS) and Ministry of Health (MoH) hospitals under single structure in Turkey by comparing the current level of computing capability of hospitals owned by two ministries. The data used in this study were obtained from 729 hospitals that belong to both ministries by using a data collection tool. The results indicate that there have been considerable differences among the hospitals owned by the two ministries in terms of human resources and information systems. The hospital managers and decision makers making their decisions based on the data produced by current hospital information system (HIS) would more likely face very important difficulties after merging MoH and MoLSS hospitals in Turkey. It is also possible to claim that the level and adequacy of computing abilities and devices do not allow the managers of public hospitals to use computer technology effectively in their information management practices. Lack of technical information, undeveloped information culture, inappropriate management styles, and being inexperienced are the main reasons of why HIS does not run properly and effectively in Turkish hospitals.

  11. Estimate of physical sequelae in victims of road traffic accidents hospitalized in the Public Health System.

    Science.gov (United States)

    Andrade, Silvânia Suely Caribé de Araújo; Jorge, Maria Helena Prado de Mello

    2016-03-01

    To describe the profile of the victims of road accidents presenting physical sequelae, according to the criteria established by researchers and analyze the trends in hospitalization for this cause in Brazil, from 2000 to 2013. An ecological time-series study was performed using the data from the Hospital Information System of the National Health System (SUS). Trends in hospitalization were estimated using Prais-Winstein regression. During this period, a total of 1,747,191 hospitalizations for traffic accidents were registered; 410,448 were victims with physical sequelae. About 77.7% of them were male subjects, 26.5% belonged to the age group of 20 - 29 years, 46.4% lived in Southeast Brazil, 44.0% were pedestrians, and 31.1% were motorcyclists. In total, 51,189 cases were "confirmed" sequelae (12.5%), and pedestrians accounted for 43.8% of cases. There were 359,259 hospitalizations for the diagnosis of "possible" sequelae, and motorcyclists accounted for 43.3% of these cases. There was a trend of stability for all the patients with confirmed and possible sequelae, but there was a significant rise in hospitalization rates owing to confirmed sequelae among the men in North and Central-West regions. The hospitalizations associated with physical sequelae were responsible for about one-fourth of the hospitalizations in the Hospital Information System in the studied period. Most events involved men, young adults, residents in Southeast Brazil, and pedestrians. Hospitalization rates for traffic accidents associated with physical sequelae were stable in Brazil and regions, but a significant increase was observed for confirmed sequelae among men in the North and Central-West regions.

  12. Developing a management information system for a hospital: a case study on vendor selection.

    Science.gov (United States)

    Tsay, B Y; Stackhouse, J R

    1991-12-01

    This study examines the decision-making process that a medium-sized hospital took to develop a management information system. Since system developers in this particular hospital were all users without system expertise, a substantial amount of time was devoted to their search for relevant information. Outside consulting, literature review, and a market survey were conducted for the developers to understand the characteristics of systems products on the market. Developers also invited extended user participation in vendor evaluation. The authors analyzed the reasoning process behind the successful selection of a vendor-supported information system. The findings provide hospitals of similar characteristics a decision model to follow in their search for a vendor-supported information system.

  13. Rebuilding and the private cloud of the hospital information system by the virtualization technology.

    Science.gov (United States)

    Yamashita, Yoshinori; Ogaito, Tatoku

    2013-01-01

    In our hospital, we managed an electronic health record system and many section subsystems as a hospital information system. By the expansion of these information systems, a system becomes complicated, and maintenance and operative cost increased. Furthermore, the environment that is available to medical information is demanded anywhere anytime by expansion of the computerization. However, the expansion of the information use becomes necessary for the expansion such as the personal protection of information for security. We became rebuilding and the private cloud of the hospital information system by the virtualization technology to solve such a problem. As a result, we were able to perform a decrease in number of the servers which constituted a system, a decrease in network traffic, reduction of the operative cost.

  14. Opportunities for the improvement of cost accounting systems in public hospitals in Italy and Croatia: A case study

    Directory of Open Access Journals (Sweden)

    Michele Bertoni

    2017-01-01

    Full Text Available The purpose of this paper is to highlight similarities and differences between one Croatian and one Italian public hospital regarding the implementation of cost accounting and full costing method in their accounting systems. Moving from the theoretical background, it is evident that cost accounting methods introduced in healthcare sector bring benefits to the whole society through an increased efficiency of the healthcare services provided. It primarily ensures better governing of hospital’s resources allowing more transparency in spending public funds. The main topic is that with the introduction of cost accounting system for internal purposes in public hospitals, the management would be able to govern them in a more efficient and effective way while reducing costs. The research for this paper was conducted through the interview of accounting officers in one Croatian and one Italian public hospital. The main results show that there are differences in legislation background regarding how they record costs, but also how they allocate costs to the cost objects and in how they use cost information in their decision-making process. In order to successfully manage public hospitals, it is crucial that true, timely and valid information are obtained as a base for the decision-making process. The cost accounting methodology is therefore essential to the management of public hospitals. It must provide information on the type and amount of resources spent, and thus enable the preconditions for control, management and potential reduction of costs.

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

    Directory of Open Access Journals (Sweden)

    Krüger Andreas J

    2011-11-01

    Full Text Available Abstract Background Physician-staffed pre-hospital units are employed in many Western emergency medical services (EMS systems. Although these services usually integrate well within their EMS, little is known about the quality of care delivered, the precision of dispatch, and whether the services deliver a higher quality of care to pre-hospital patients. There is no common data set collected to document the activity of physician pre-hospital activity which makes shared research efforts difficult. The aim of this study was to develop a core data set for routine documentation and reporting in physician-staffed pre-hospital services in Europe. Methods Using predefined criteria, we recruited sixteen European experts in the field of pre-hospital care. These experts were guided through a four-step modified nominal group technique. The process was carried out using both e-mail-based communication and a plenary meeting in Stavanger, Norway. Results The core data set was divided into 5 sections: "fixed system variables", "event operational descriptors", " patient descriptors", "process mapping", and "outcome measures and quality indicators". After the initial round, a total of 361 variables were proposed by the experts. Subsequent rounds reduced the number of core variables to 45. These constituted the final core data set. Emphasis was placed on the standardisation of reporting time variables, chief complaints and diagnostic and therapeutic procedures. Conclusions Using a modified nominal group technique, we have established a core data set for documenting and reporting in physician-staffed pre-hospital services. We believe that this template could facilitate future studies within the field and facilitate standardised reporting and future shared research efforts in advanced pre-hospital care.

  16. Hospital Readmissions Following Physician Call System Change: A Comparison of Concentrated and Distributed Schedules.

    Science.gov (United States)

    Yarnell, Christopher J; Shadowitz, Steven; Redelmeier, Donald A

    2016-07-01

    Physician call schedules are a critical element for medical practice and hospital efficiency. We compared readmission rates prior to and after a change in physician call system at Sunnybrook Health Sciences Centre. We studied patients discharged over a decade (2004 through 2013) and identified whether or not each patient was readmitted within the subsequent 28 days. We excluded patients discharged for a surgical, obstetrical, or psychiatric diagnosis. We used time-to-event analysis and time-series analysis to compare rates of readmission prior to and after the physician call system change (January 1, 2009). A total of 89,697 patients were discharged, of whom 10,001 (11%) were subsequently readmitted and 4280 died. The risk of readmission was increased by about 26% following physician call system change (9.7% vs 12.2%, P system change (95% confidence interval, 22%-31%; P system change persisted across patients with diverse ages, estimated readmission risks, and medical diagnoses. The net effect was equal to 7240 additional patient days in the hospital following call system change. A modest increase was observed at a nearby acute care hospital that did not change physician call system, and no increase in risk of death was observed with increased hospital readmissions. We suggest that changes in physician call systems sometimes increase subsequent hospital readmission rates. Further reductions in readmissions may instead require additional resources or ingenuity. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. A Customized Workflow-Driven Instant Messaging System Support Team Communication in the Hospital.

    Science.gov (United States)

    Lee, Ying-Li; Chien, Tsai-Feng; Chen, Hsiu-Chin

    2016-01-01

    Effective communication among the healthcare team is a very important skill to support team resource management (TRM). However, we take too much effort to connect with other team members by using traditional telephone communication. In this study, we developed an instant messaging system embedded in the original hospital information system and evaluated the preliminary outcome and the usage of the system.

  18. 75 FR 45769 - Medicare Program; Changes to the Hospital Outpatient Prospective Payment System and Ambulatory...

    Science.gov (United States)

    2010-08-03

    ... Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System for CY 2010, and... and addenda for payments made under the Medicare Ambulatory Surgical Center (ASC) payment system for... announces the extension of payment under Medicare Part B to hospitals and ambulatory care clinics operated...

  19. Current Status of Electronic Medical Record Systems in Hospitals and Clinics in Korea.

    Science.gov (United States)

    Park, Young-Taek; Han, Dongwoon

    2017-07-01

    Many healthcare organizations and professionals have had interests in healthcare information and communication technology (ICT). The objective of this study was to investigate the current status of overall healthcare ICT, especially focusing on Electronic Medical Record (EMR) systems in Korea. This study used a part of the nationwide survey collected for the OECD benchmarking ICT study. The Health Insurance Review and Assessment Service conducted the survey from November 19, 2013 to January 10, 2014. This study followed the methodological guidelines of the OECD. A total of 2,093 hospitals and clinics, including long-term care hospitals, participated in the survey. Among them, 554 hospitals and 906 clinics were included in this study for the generalization of the results. The adoption rates of EMR systems were 96.3% in hospitals and 95.7% in clinics. Most of the hospitals and clinics had high rates of healthcare information exchange (HIE) within the organization; however, there were extremely low HIE rates among external organizations. Most of the hospitals and clinics had EMR systems with clinical-decision-supporting functionalities. Ninety-six percent of the EMR systems of the hospitals and 89.2% of the clinic systems had checking functions, such as alerts or reminders, on contraindications of drug-drug and drug-age interaction. Korea has maintained a high healthcare ICT status compared to countries in the European Union. The EMR systems of hospitals and clinics in Korea had sophisticated functionalities; however, their HIE status was extremely low, which indicates the need for healthcare ICT standardization.

  20. Genome-based characterization of hospital-adaptedEnterococcus faecalislineages.

    Science.gov (United States)

    Raven, Kathy E; Reuter, Sandra; Gouliouris, Theodore; Reynolds, Rosy; Russell, Julie E; Brown, Nicholas M; Török, M Estée; Parkhill, Julian; Peacock, Sharon J

    2016-03-01

    Vancomycin-resistant Enterococcus faecalis (VREfs) is an important nosocomial pathogen1,2. We undertook whole genome sequencing of E. faecalis associated with bloodstream infection in the UK and Ireland over more than a decade to determine the population structure and genetic associations with hospital adaptation. Three lineages predominated in the population, two of which (L1 and L2) were nationally distributed, and one (L3) geographically restricted. Genome comparison with a global collection identified that L1 and L3 were also present in the USA, but were genetically distinct. Over 90% of VREfs belonged to L1-L3, with resistance acquired and lost multiple times in L1 and L2, but only once followed by clonal expansion in L3. Putative virulence and antibiotic resistance genes were over-represented in L1, L2 and L3 isolates combined, versus the remainder. Each of the three main lineages contained a mixture of vancomycin-resistant and -susceptible E. faecalis (VSEfs), which has important implications for infection control and antibiotic stewardship.

  1. Patient satisfaction with a hospital-based neuropsychology service.

    Science.gov (United States)

    Foran, Amie; Millar, Elisa; Dorstyn, Diana

    2016-09-01

    Objective The aim of the present study was to develop and pilot a measure of patient satisfaction that encompasses themes, activities, settings and interactions specific to the neuropsychological assessment process. Methods A focus group of out-patients (n=15) was surveyed to identify the factors commonly associated with a satisfactory neuropsychological experience. Responses informed a purposely designed 14-item patient satisfaction scale (α=0.88) that was completed by 66 hospital out-patients with mild to moderate cognitive impairment. Results Satisfaction with the neuropsychological assessment process was generally reported, with the testing phase (85%) rated significantly more favourably than the pre-assessment (79%) and feedback (70%) phases. Commentaries provided by 32 respondents identified interpersonal facilitators to a satisfactory neuropsychological assessment experience, but also dissatisfaction with physical aspects of the testing environment in addition to service availability. Conclusions The patient satisfaction scale can be used as a quality assurance tool to evaluate neuropsychological service delivery. Large-scale research is needed to confirm the scale's psychometric properties. Further research may also include a broader perspective on the consumers' experience of neuropsychological services.

  2. Hospital-Based Palliative Care with Medicare Claims: Evidence From Colorado.

    Science.gov (United States)

    Kassner, Cordt T; Bhavsar, Nrupen A; Harker, Matthew; Bull, Janet; Taylor, Donald H

    2018-01-01

    The prevalence of hospital-based palliative care has been largely anecdotal as an increasing service being provided and there is a need to understand what trends can be analyzed with Medicare data. To compare 2 methods of identifying hospital-based palliative care in the Medicare population in Colorado. Through Medicare claims data and phone surveys, we ascertained the presence of hospital-based palliative care services, number of patients receiving palliative care, and number of care visits provided during the previous year. Data were collected from every Medicare-certified hospital in Colorado during 2008 and 2013. We measured the presence of hospital-based palliative care teams and their average number of consultations through a phone survey and cross-referenced using a v-code modifier of Medicare claims indicating a palliative care consult visit. The number of hospital-based palliative care consultations increased five-fold from 2008-2013, and Medicare claims under-counted the number of these consultations compared to phone surveys. The systematic measurement of palliative care nationally is a key priority. More evidence is needed from other states to better understand the usefulness of Medicare claims in this effort.

  3. [Design and research of hospital medical supplies management information system].

    Science.gov (United States)

    Xu, Hai-lin

    2009-03-01

    This paper introduces an advanced means to confirm management objective, analyze management need, reduce purchase and operating cost, optimize the flow management and establish a medical supplies management information system in purchasing, using, maintaining and disposing step. The system has advantage in realizing efficiency analyze, improving service and quality, guaranteeing safely use of medical supplies.

  4. Understanding ERP system implementation in a hospital by analysing stakeholders

    NARCIS (Netherlands)

    Boonstra, A.; Govers, M.

    Implementing enterprise resource planning (ERP) systems requires significant organisational, as well as technical, changes. These will affect stakeholders with varying perspectives and interests in the system. This is particularly the case in health care, as a feature of this sector is that

  5. Prolonged effect of two combined methods for Legionella disinfection in a hospital water system.

    Science.gov (United States)

    Casari, E; Ferrario, A; Montanelli, A

    2007-01-01

    This study was conducted in our 650 bed general hospital, which is situated on the southern outskirts of Milan (Italy). After a first nosocomial case of pneumonia (caused by Legionella pneumophila serogroup 1), we first used a conventional method (heat shock) without success. To solve the problem we then tried a copper-silver ionization system combined with a chlorine dioxide device. During the four years after the installation of these two systems we recorded a significant (p ionization system, combined with a chlorine dioxide device, is a highly promising method for the control of Legionella pneumophila in a hospital water distribution system.

  6. Extrapulmonary tuberculosis in Kabul, Afghanistan: a hospital-based retrospective review.

    Science.gov (United States)

    Fader, Tim; Parks, John; Khan, Najeeb Ullah; Manning, Richard; Stokes, Sonya; Nasir, Nasir Ahmad

    2010-02-01

    The purpose of this study is to amplify the knowledge base of the epidemiology, symptoms, and signs of extrapulmonary tuberculosis (EPTB) in Afghanistan. This is a retrospective review of EPTB diagnosed at CURE International Hospital and CURE Family Health Center (FHC) in Kabul, Afghanistan during a recent 20-month period. One hundred eighteen cases were identified from patients presenting to the hospital and FHC. This group represents the spectrum of EPTB seen at a single referral center in Kabul. The ratio of females to males was 2.03:1. Lymph node tuberculosis comprised the greatest number of EPTB cases (37.3%, n=44). The central nervous system was the next most frequent site of EPTB involvement (20.3%, n=24), followed in descending order by skeletal, pleural, abdominal, cutaneous, genitourinary, pericardial, miliary, and breast tuberculosis. The 2:1 ratio of female to male EPTB cases coincides with the unusual epidemiologic pattern seen in smear-positive pulmonary TB in Afghanistan. As the first epidemiological report of EPTB from Afghanistan, this study illustrates the varied presentations of EPTB that should be known by healthcare workers throughout the country. Copyright 2009 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  7. Telehealth coordinators in hospital based telehealth services: Who are they and what do they do?

    Science.gov (United States)

    Edirippulige, Sisira; Armfield, Nigel R; Greenup, Phil; Bryett, Andrew

    2016-12-01

    Many studies have identified the importance of 'telehealth coordinators' for successful telehealth implementation and operation. However, little is known about the telehealth coordinators' functions, the skills and competencies required and the reasons for their influence. This study aimed to examine the key functions of telehealth coordinators in the Queensland public health system, their perceptions about their role, and the level of competencies to support this role. All telehealth coordinators within Queensland Health Telehealth Services were invited to complete a questionnaire. We collected: (i) demographic information; (ii) details of their telehealth work; and (iii) information about knowledge and skills relevant to their telehealth coordinator role. Eighteen of 20 (90%) participants completed and submitted the survey. Telehealth coordinators were responsible for a range of tasks relating to telehealth consultations, technical assistance, administration, research, promotion and marketing. Nearly all telehealth coordinators (n = 17, 94%) were confident in carrying out the tasks of their job. The majority of telehealth coordinators (n = 13, 72%) thought education and training relating to telehealth would help improve their job. The top three topics that telehealth coordinators were keen to learn about were: (i) examples of clinical use of telehealth; (ii) types of technologies used; and (iii) telehealth clinical and business models. Our participants were all hospital-based; as the use of telehealth is growing outside of the traditional hospital settings, the role of telehealth coordinators is likely to change. © The Author(s) 2016.

  8. Closing the quality gap: promoting evidence-based breastfeeding care in the hospital.

    Science.gov (United States)

    Bartick, Melissa; Stuebe, Alison; Shealy, Katherine R; Walker, Marsha; Grummer-Strawn, Laurence M

    2009-10-01

    Evidence shows that hospital-based practices affect breastfeeding duration and exclusivity throughout the first year of life. However, a 2007 CDC survey of US maternity facilities documented poor adherence with evidence-based practice. Of a possible score of 100 points, the average hospital scored only 63 with great regional disparities. Inappropriate provision and promotion of infant formula were common, despite evidence that such practices reduce breastfeeding success. Twenty-four percent of facilities reported regularly giving non-breast milk supplements to more than half of all healthy, full-term infants. Metrics available for measuring quality of breastfeeding care, range from comprehensive Baby-Friendly Hospital Certification to compliance with individual steps such as the rate of in-hospital exclusive breastfeeding. Other approaches to improving quality of breastfeeding care include (1) education of hospital decision-makers (eg, through publications, seminars, professional organization statements, benchmark reports to hospitals, and national grassroots campaigns), (2) recognition of excellence, such as through Baby-Friendly hospital designation, (3) oversight by accrediting organizations such as the Joint Commission or state hospital authorities, (4) public reporting of indicators of the quality of breastfeeding care, (5) pay-for-performance incentives, in which Medicaid or other third-party payers provide additional financial compensation to individual hospitals that meet certain quality standards, and (6) regional collaboratives, in which staff from different hospitals work together to learn from each other and meet quality improvement goals at their home institutions. Such efforts, as well as strong central leadership, could affect both initiation and duration of breastfeeding, with substantial, lasting benefits for maternal and child health.

  9. Understanding Technology and People Issues in Hospital Information System (HIS) Adoption: Case study of a tertiary hospital in Malaysia.

    Science.gov (United States)

    Zakaria, Nasriah; Mohd Yusof, Shafiz Affendi

    Hospital Information Systems (HIS) can improve healthcare outcome quality, increase efficiency, and reduce errors. The government of Malaysia implemented HIS across the country to maximize the use of technology to improve healthcare delivery, however, little is known about the benefits and challenges of HIS adoption in each institution. This paper looks at the technology and people issues in adopting such systems. The study used a case study approach, using an in-depth interview with multidisciplinary medical team members who were using the system on a daily basis. A thematic analysis using Atlas.ti was employed to understand the complex relations among themes and sub-themes to discover the patterns in the data. . Users found the new system increased the efficiency of workflows and saved time. They reported less redundancy of work and improved communication among medical team members. Data retrieval and storage were also mentioned as positive results of the new HIS system. Healthcare workers showed positive attitudes during training and throughout the learning process. From a technological perspective, it was found that medical workers using HIS has better access and data management compared to the previously used manual system. The human issues analysis reveals positive attitudes toward using HIS among the users especially from the physicians' side. Copyright © 2016. Published by Elsevier Ltd.

  10. Hospital Surge Capacity: A Web-Based Simulation Tool for Emergency Planners.

    Science.gov (United States)

    Toerper, Matthew F; Kelen, Gabor D; Sauer, Lauren M; Bayram, Jamil D; Catlett, Christina; Levin, Scott

    2017-10-18

    The National Center for the Study of Preparedness and Catastrophic Event Response (PACER) has created a publicly available simulation tool called Surge (accessible at http://www.pacerapps.org) to estimate surge capacity for user-defined hospitals. Based on user input, a Monte Carlo simulation algorithm forecasts available hospital bed capacity over a 7-day period and iteratively assesses the ability to accommodate disaster patients. Currently, the tool can simulate bed capacity for acute mass casualty events (such as explosions) only and does not specifically simulate staff and supply inventory. Strategies to expand hospital capacity, such as (1) opening unlicensed beds, (2) canceling elective admissions, and (3) implementing reverse triage, can be interactively evaluated. In the present application of the tool, various response strategies were systematically investigated for 3 nationally representative hospital settings (large urban, midsize community, small rural). The simulation experiments estimated baseline surge capacity between 7% (large hospitals) and 22% (small hospitals) of staffed beds. Combining all response strategies simulated surge capacity between 30% and 40% of staffed beds. Response strategies were more impactful in the large urban hospital simulation owing to higher baseline occupancy and greater proportion of elective admissions. The publicly available Surge tool enables proactive assessment of hospital surge capacity to support improved decision-making for disaster response. (Disaster Med Public Health Preparedness. 2017;page 1 of 10).

  11. [Do hospital physicians really want to go digital? --Acceptance of a picture archiving and communication system in a university hospital].

    Science.gov (United States)

    Duyck, P; Pynoo, B; Devolder, P; Voet, T; Adang, L; Vercruysse, J

    2008-07-01

    Radiology departments are making the transition from analog film to digital images by means of PACS (Picture Archiving and Communication System). It is critical for the hospital that its physicians adopt and accept the new digital work method regarding radiological information. The aim of this study is to investigate hospital physicians' acceptance of PACS using questionnaires pre- and post-implementation and to identify main influencing factors. The study was conducted in an 1169 bed university hospital. The UTAUT (Unified Theory of Acceptance and Use of Technology) questionnaire was administered at two times: one month pre-implementation (T1) and 1.5 years post-implementation (T2) of PACS, targeting all hospital physicians with the exemption of radiologists. The UTAUT scales (Behavioral Intention BI; Facilitating Conditions FC; Effort Expectancy EE; Performance Expectancy PE; Anxiety ANX; Social Influence SI; System Use USE; Attitude toward technology ATT; Self-Efficacy SE) were used to assess questions regarding: a) PACS' usefulness, b) PACS' ease of learning/using, c) PACS support availability, d) the perceived pressure to use PACS, e) physicians' attitude towards PACS and f) physicians' intention to use and actual use of PACS. At T 1 scale ratings were positive toward the PACS implementation. The ratings on all scales with the exception of self-efficacy improved at T 2. Regression analysis revealed that the key factor for intention to use PACS at T 1 was the usefulness of PACS, while the availability and awareness of support was its most important predictor at T 2. Overall, PE was the best predictor of BI, but all four UTAUT-determinants (PE, FC, EE and SI) were salient for its prediction. Variance explained in BI ranged from 31 to 37 % while variance explained in USE was very low (3 %). The implementation of PACS has succeeded. At T 1 the physicians were welcoming PACS and this was confirmed at T 2. Experience with PACS led to an overall improved attitude

  12. Frequency of legionella contamination in conditional & water distribution systems of Tehran hospitals

    Directory of Open Access Journals (Sweden)

    Davod Esmaieli

    2008-09-01

    Full Text Available Background: Legionella species are ubiquitous in natural aquatic environments, capable of existing in waters with varied temperatures, PH levels, and nutrient and oxygen contents. Of 49 known legionella species, 20 species have been linked to pneumonia in humans. Contamination by legionella has occurred in the distribution systems of many hospitals. Aerosol-generating systems such as faucets, showerheads, cooling towers, and nebulizers are responsible for their transmission from water to air. Methods: A total of 113 water samples were gathered from different wards of 32 hospitals in different geographical regions of Tehran city. These samples were concentrated by filtration, treated with the acid and temperature buffers, and isolated on a BCYE agar culture medium. Results: A total of 22 hospitals out of 33 (26.5% were contaminated by legionella species, and 30 samples (26.5% out of 113 were positive. Chlorine concentration and pH level of the water samples were 0.18-2.2 mg/l and 6.6-7.6, respectively. Conclusion: The high rate of waste water contamination in Tehran hospitals with Legionella indicates the resistance of this microorganism to chlorine and other disinfectants, or inadequate disinfection process, representing the insufficiency of the current decontamination of hospital water distribution system. Thus identifying legionella species and their controlling in water distribution system of hospitals is of great importance.

  13. Histopathological Evaluation of Lymph Node Biopsies: A Hospital Based Study

    Directory of Open Access Journals (Sweden)

    Syeda Tasfia Siddika

    2012-07-01

    Full Text Available Background: Lymphadenopathy is a common manifestation of a large variety of disorders,both benign and malignant. It is essential to define the pattern of disorders presenting primarily as lymph node enlargement in a particular environment. Histopathological examination of the lymph node biopsies is a gold standard test in the distinction between reactive and malignant lymphoid proliferations as well as for detailed subtyping oflymphomas. We designed this study in our population for histopathological evaluation of lymph nodes that might be helpful for clinical management of these lesions. Objective: Histopathological evaluation of lymphadenopathy from excised specimen, in relation to ageand sex of the patients, and distribution of the lymph nodes. Materials and Methods: It was a retrospective cross sectional study conducted in the department of Pathology, Enam Medical College & Hospital, Savar, Dhaka during the period from January 2006 to December 2010. Lymph node biopsies of all patients of both sexes and all age groups were included.Metastatic lymph nodes associated with evidence of primaries elsewhere in the body were excluded from the study. Total 191 lymph node biopsies were selected for histopathological evaluation. Among these 90 (47.12% were from males and 101 (52.88% were from females with male to female ratio being 1:2.1. The age of the patients ranged from 2 to 85 years with a mean age of 35.73 ± 18 years. Results: Cervical lymph nodes were the most common (56% biopsied group. Of the 191 cases 59 cases (30.89% were reactive lymphadenitis, 64 cases (33.5% were tuberculosis, 2 cases (1.05% were non-caseous granuloma, 11 cases (5.76% were Hodgkin lymphoma, 22 cases (11.52% were non-Hodgkin lymphoma, 24 cases (12.57% were metastatic neoplasm and 9 cases (4.7% were other lesions. Conclusion: Tuberculosis was the most common cause of lymphadenopathy, followed by reactive lymphadenitis and the cervical group of lymph nodes was most

  14. An exchange format for use-cases of hospital information systems.

    Science.gov (United States)

    Masuda, G; Sakamoto, N; Sakai, R; Yamamoto, R

    2001-01-01

    Object-oriented software development is a powerful methodology for development of large hospital information systems. We think use-case driven approach is particularly useful for the development. In the use-cases driven approach, use-cases are documented at the first stage in the software development process and they are used through the whole steps in a variety of ways. Therefore, it is important to exchange and share the use-cases and make effective use of them through the overall lifecycle of a development process. In this paper, we propose a method of sharing and exchanging use-case models between applications, developers, and projects. We design an XML based exchange format for use-cases. We then discuss an application of the exchange format to support several software development activities. We preliminarily implemented a support system for object-oriented analysis based on the exchange format. The result shows that using the structural and semantic information in the exchange format enables the support system to assist the object-oriented analysis successfully.

  15. Risk factors and therapy for goat mastitis in a hospital-based case-control study in Bangladesh.

    Science.gov (United States)

    Koop, Gerrit; Islam, Md Nurul; Rahman, Md Mizanur; Khatun, Momena; Ferdous, Jinnat; Sayeed, Md Abu; Islam, Shariful; Ahaduzzaman, Md; Akter, Sazeda; Mannan, Abdul; Hassan, Mohammad Mahmudul; Dissanayake, Ravi; Hoque, Md Ahasanul

    2016-02-01

    Bangladesh has a large population of goats, which contribute to the income, nutrition and welfare of the households of many families. Mastitis in goats has a low incidence, but is often very severe, making veterinary care necessary. The aim of this study was to identify seasonality and risk factors for goat mastitis in a hospital-based matched case-control study in a teaching veterinary hospital in Chittagong, Bangladesh and to describe the range of antimicrobial treatments applied in this situation. Cases of mastitis and controls were drawn from the hospital patient recording system, along with their risk factor status. Multiple imputation was applied to deal with the missing values in the data analysis. Mastitis occurred somewhat more in the rainy season, and comprised about 3% of all goats admitted to the hospital during January 2011-June 2014. Free-ranging farming system, poor body condition score and non-native goat breeds were significantly associated with case status. Treatment of clinical mastitis was variable and unsystematic, but the use of gentamicin was commonly recorded. The need for more prudent and evidence-based antimicrobial therapies is discussed. Copyright © 2015 Elsevier B.V. All rights reserved.

  16. From striving to thriving: systems thinking, strategy, and the performance of safety net hospitals.

    Science.gov (United States)

    Clark, Jonathan; Singer, Sara; Kane, Nancy; Valentine, Melissa

    2013-01-01

    Safety net hospitals (SNH) have, on average, experienced declining financial margins and faced an elevated risk of closure over the past decade. Despite these challenges, not all SNHs are weakening and some are prospering. These higher-performing SNHs provide substantial care to safety net populations and produce sustainable financial returns. Drawing on the alternative structural positioning and resource-based views, we explore strategic management as a source of performance differences across SNHs. We employ a mixed-method design, blending quantitative and qualitative data and analysis. We measure financial performance using hospital operating margin and quantitatively evaluate its relationship with a limited set of well-defined structural positions. We further evaluate these structures and also explore the internal resources of SNHs based on nine in-depth case studies developed from site visits and extensive interviews. Quantitative results suggest that structural positions alone are not related to performance. Comparative case studies suggest that higher-performing SNH differ in four respects: (1) coordinating patient flow across the care continuum, (2) engaging in partnerships with other providers, (3) managing scope of services, and (4) investing in human capital. On the basis of these findings, we propose a model of strategic action related to systems thinking--the ability to see wholes and interrelationships rather than individual parts alone. Our exploratory findings suggest the need to move beyond generic strategies alone and acknowledge the importance of underlying managerial capabilities. Specifically, our findings suggest that effective strategy is a function of both the internal resources (e.g., managers' systems-thinking capability) and structural positions (e.g., partnerships) of organizations. From this perspective, framing resources and positioning as distinct alternatives misses the nuances of how strategic advantage is actually achieved.

  17. Protocol for hospital based-surveillance of cerebral palsy (CP) in Hanoi using the Paediatric Active Enhanced Disease Surveillance mechanism (PAEDS-Vietnam): a study towards developing hospital-based disease surveillance in Vietnam.

    Science.gov (United States)

    Khandaker, Gulam; Van Bang, Nguyen; Dũng, Trịnh Quang; Giang, Nguyen Thi Huong; Chau, Cao Minh; Van Anh, Nguyen Thi; Van Thuong, Nguyen; Badawi, Nadia; Elliott, Elizabeth J

    2017-11-09

    The epidemiology, pathogenesis, management and outcomes of cerebral palsy (CP) in low-income and middle-income countries including Vietnam are unknown because of the lack of mechanisms for standardised collection of data. In this paper, we outline the protocol for developing a hospital-based surveillance system modelled on the Paediatric Active Enhanced Disease Surveillance (PAEDS) system in Australia. Using PAEDS-Vietnam we will define the aetiology, motor function and its severity, associated impairments, and nutritional and rehabilitation status of children with CP in Hanoi, Vietnam. These essential baseline data will inform future health service planning, health professional education and training, and family support. This is a hospital-based prospective surveillance of children with CP presenting to the rehabilitation, neurology and general paediatric services at the National Children's Hospital and St Paul Hospital in Hanoi. We will use active, prospective daily case-finding for all children with CP aged CP, known risk factors for CP, and nutrition, immunisation, education and rehabilitation status. This study was approved by the Hanoi Medical University Institutional Review Board (decision no 1722) and The University of Sydney Human Research Ethics Committee (approval no 2016/456). Establishment of PAEDS-Vietnam will enable hospital-based surveillance of CP for the first time in Vietnam. It will identify preventable causes of CP, patient needs and service gaps, and facilitate early diagnosis and intervention. Study findings will be disseminated through local and international conferences and peer-reviewed publications. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  18. Occupational health and safety in hospitals accreditation system: the case of Lebanon.

    Science.gov (United States)

    Habib, Rima R; Blanche, Ghandour; Souha, Fares; El-Jardali, Fadi; Nuwayhid, Iman

    2016-07-01

    Hospital accreditation can be an incentive to improve occupational health and safety (OHS) performance. This study assesses the relationship between status of accreditation among private Lebanese hospitals and compliance with OHS accreditation standards. A survey was administered to 68 private Lebanese hospitals to assess accreditation status and specific indicators related to each of the 9 OHS codes in the Lebanese accreditation manual. Chi-square, Fisher's exact test, and independent sample t-tests compared the OHS standards between accredited and non-accredited hospitals. Fifty-six percent of participating private hospitals were accredited. Accredited hospitals reported statistically better OHS performance than non-accredited hospitals based on the standards outlined in the accreditation manual. However, there was inconsistent performance on numerous OHS indicators among participating hospitals. The gaps in OHS performance suggest the need for strengthened OHS guidelines in the national accreditation process to safeguard workers' health. Strategies to fortify OHS performance include tying service reimbursement to OHS compliance and linking OHS standards with national labor legislation.

  19. Hungry in hospital, well-fed in prison? A comparative analysis of food service systems.

    Science.gov (United States)

    Johns, Nick; Edwards, John S A; Hartwell, Heather J

    2013-09-01

    Meals served in prisons and hospitals are produced in similar ways and have similar characteristics, yet hospital patients are often at risk of being undernourished, while prisoners typically are not. This article examines field notes collected during nutritional studies of prison and hospital food service, which confirmed the difference in nutrient intake claimed by other authors. A comparison of food service processes and systems showed that the production of meals and the quality leaving the kitchen was similar in both types of institution. However, the delivery and service system was found to be much less coherent in hospital than in prison. Transport and service of hospital food were subject to delays and disruptions from a number of sources, including poor communication and the demands of medical professionals. These meant that meals reached hospital patients in a poorer, less appetising condition than those received by prisoners. The findings are discussed in the light of previous work and in terms of hospital food service practice. Crown Copyright © 2013. Published by Elsevier Ltd. All rights reserved.

  20. An investigation on physicians' acceptance of hospital information systems: a case study.

    Science.gov (United States)

    Chen, Rai-Fu; Hsiao, Ju-Ling

    2012-12-01

    Information technology is used to support a wide range of highly specified healthcare tasks and services. There is, therefore, a need to understand the factors affecting the acceptance of this technology by healthcare professionals. Physicians are key providers of healthcare services and are among the principal users of hospital information systems. Their acceptance of hospital information systems is hence of great significance when evaluating the success of those systems. The survey methodology was employed to targeted physicians in the selected case hospital for investigating factors affecting physicians' acceptance of hospital information systems. A total of 202 questionnaires were sent out, with 124 completed copies returned, indicating a valid response rate of 61.4%. We used structural equation modeling to analyze the data. The results indicated that top management support (γ=0.431, psystem quality (γ=0.369, pinformation systems. Physicians' perceptions of the usefulness (β=0.132, pinformation systems had a significant impact on the acceptance of the systems, accounting for 81.4% of total explained variance. Through the understanding of the identified critical factors affecting physicians' HIS acceptance, the planners and managers should ensure that hospital information systems to be introduced into a hospital are useful and ease to use. Effort should be focuses on providing sufficient top management support, selecting qualified project team members, and delivering higher system quality in addressing physicians' clinical needs. Thus, our research results can help planners and managers understand key considerations affecting HIS development and use, and may be used as a reference for system design, development and implementation. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.