WorldWideScience

Sample records for hospital water system

  1. [Newly Designed Water Treatment Systems for Hospital Effluent].

    Science.gov (United States)

    Azuma, Takashi

    2018-01-01

     Pharmaceuticals are indispensable to contemporary life. Recently, the emerging problem of pharmaceutical-based pollution of river environments, including drinking water sources and lakes, has begun to receive significant attention worldwide. Because pharmaceuticals are designed to perform specific physiological functions in targeted regions of the human body, there is increasing concern regarding their toxic effects, even at low concentrations, on aquatic ecosystems and human health, via residues in drinking water. Pharmaceuticals are consistently employed in hospitals to treat disease; and Japan, one of the most advanced countries in medical treatment, ranks second worldwide in the quantity of pharmaceuticals employed. Therefore, the development of technologies that minimize or lessen the related environmental risks for clinical effluent is an important task as well as that for sewage treatment plants (STPs). However, there has been limited research on clinical effluent, and much remains to be elucidated. In light of this, we are investigating the occurrence of pharmaceuticals, and the development of water treatment systems for clinical effluent. This review discusses the current research on clinical effluent and the development of advanced water treatment systems targeted at hospital effluent, and explores strategies for future environmental risk assessment and risk management.

  2. Prevalence of Legionella spp. in water systems of hospitals and hotels in South Western Greece.

    Science.gov (United States)

    Fragou, K; Kokkinos, P; Gogos, C; Alamanos, Y; Vantarakis, A

    2012-01-01

    The aim of the present study was to determine the prevalence of Legionella spp. in water systems of hospitals and hotels located in South Western Greece, to study the molecular epidemiology of the isolated strains and their possible association with bacterial contamination (total count and Pseudomonas aeruginosa), the water pH, and temperature. A prevalence survey for Legionella spp. by culturing techniques in water distribution systems of eight hospitals and nine hotels occurred in South Western Greece. Water sampling and microbiological analysis were carried out following the ISO methods. Legionella pneumophila was detected in 33% and 36% of the distribution systems of hospitals and hotels, respectively. Our survey results suggest a frequent prevalence of elevated concentrations of Legionella spp. in water systems of hospitals and hotels. Our investigation has confirmed the need to regularly monitor the microbiological condition of water systems in hospitals and hotels.

  3. Accomplishing Water Strategy Policies in Hospitals: The Role of Management Information Systems and Managerial Styles

    Directory of Open Access Journals (Sweden)

    David Naranjo-Gil

    2017-02-01

    Full Text Available Hospitals are using more sophisticated and comprehensive management information systems to implement multiple strategic policies towards water cost saving and water quality enhancement. However, they do not always achieve the intended strategic goals. This paper analyzes how managerial styles interact with sophisticated management information systems to achieve different water strategic priorities. How proactive vs. reactive managerial styles moderate the effects of management information systems on water cost saving and water quality enhancement is analyzed. Relationships are explored using data collected from 122 general services directors in Spanish public hospitals. The findings show a positive effect of sophisticated management information systems on the achievement of water policies focused on cost saving and quality enhancement. Results also show a different moderated effect of managerial styles; thus, sophisticated management information systems with a proactive managerial style facilitate managers to achieve better water quality policies rather than water cost saving policies.

  4. 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.

  5. Drinking water quality assessment and corrosion mitigation in the hospital water supply system of Chacas Village (Peru

    Directory of Open Access Journals (Sweden)

    Riccardo Bigoni

    2014-07-01

    Full Text Available Rural hospitals in developing countries often lack appropriate water treatments to assure their water needs. In these facilities, due to water different uses and its use with medical equipment, water quality problems can cause very hazardous situations. In particular, corrosion of water distribution systems is a common issue that can cause unwanted changes in water quality and failures of the distribution system’s pipes. These considerations suggest that a complete monitoring program and water treatments to control and guarantee the water quality would be required in each health-care facility. This study assessed the quality of the water at the rural hospital of Chacas (Peru as measured via specific physical-chemical and microbiological parameters. The results show that the chemical and microbiological qualities of the water generally worsen from catchment to the hospital’s taps. Moreover, this work investigated the effects of a dolomite limestone filter installed to adjust the quality of the water distributed at the hospital and thereby mitigate the water’s corrosiveness. Corrosion indices were calculated to provide useful information on the water’s corrosiveness and positive results were obtained in reducing corrosiveness after the installation of the dolomite filter.

  6. Peracetic acid in the disinfection of a hospital water system contaminated with Legionella species.

    Science.gov (United States)

    Ditommaso, Savina; Biasin, Cinzia; Giacomuzzi, Monica; Zotti, Carla Maria; Cavanna, Alberto; Ruggenini Moiraghi, Angela

    2005-05-01

    To assess the efficacy of an alternative disinfection method for hospital water distribution systems contaminated with Legionella. Disinfection with peracetic acid was performed in a small hospital contaminated with L. pneumophila serotype 1. The disinfectant was used at concentrations of 50 ppm (first three surveillance phases) and 1,000 ppm (fourth surveillance phase) for 30 minutes. Environmental monitoring revealed that disinfection was maintained 1 week after treatment; however, levels of recontamination surpassing baseline values were detected after approximately 1 month. Comparison of water temperatures measured at the distal outlets showed a statistically significant association between temperature and bacterial load. The circulating water temperature was found to be lower in the two wards farthest away from the hot water production plant than in other wards. It was thought that the lower water temperature in the two wards promoted the bacterial growth even after disinfection. Peracetic acid may be useful in emergency situations, but does not provide definitive protection even if used monthly.

  7. Hot water systems as sources of Legionella pneumophila in hospital and nonhospital plumbing fixtures.

    Science.gov (United States)

    Wadowsky, R M; Yee, R B; Mezmar, L; Wing, E J; Dowling, J N

    1982-05-01

    Samples obtained from plumbing systems of hospitals, nonhospital institutions and homes were cultured for Legionella spp. by plating the samples directly on a selective medium. Swab samples were taken from the inner surfaces of faucet assemblies (aerators, spouts, and valve seats), showerheads, and shower pipes. Water and sediment were collected from the bottom of hot-water tanks. Legionella pneumophila serogroups 1, 5, and 6 were recovered from plumbing fixtures of the hospitals and nonhospital institutions and one of five homes. The legionellae (7 to 13,850 colony-forming units per ml) were also present in water and sediment from hot-water tanks maintained at 30 to 54 degrees C, but not in those maintained at 71 and 77 degrees C. Legionella micdadei was isolated from one tank. Thus legionellae are present in hot-water tanks which are maintained at warm temperatures or whose design results in warm temperatures at the bottom of the tanks. We hypothesize that hot-water tanks are a breeding site and a major source of L. pneumophila for the contamination of plumbing systems. The existence of these bacteria in the plumbing systems and tanks was not necessarily associated with disease. The extent of the hazard of this contamination needs to be delineated.

  8. Hot water systems as sources of Legionella pneumophila in hospital and nonhospital plumbing fixtures

    Energy Technology Data Exchange (ETDEWEB)

    Wadowsky, R.M.; Yee, R.B.; Mezmar, L.; Wing, E.J.; Dowling, J.N.

    1982-05-01

    Samples obtained from plumbing systems of hospitals, nonhospital institutions, and homes were cultured for Legionella spp. by plating the samples directly on a selective medium. Swab samples were taken from the inner surfaces of faucet assemblies (aerators, spouts, and valve seats), showerheads, and shower pipes. Water and sediment were collected from the bottom of hot-water tanks. Legionella pnenumophila serogroups 1.5, and 6 were recovered from plubming fixtures of the hospitals and nonhospital institutions and one of five homes. The legionellae (7 to 13,850 colony-forming units per ml) were also present in water and sediment from hot-water tanks maintained at 30 to 54/sup 0/C, but not in those maintained at 71 and 77/sup 0/C. Legionella micdadei was isolated from one tank. Thus legionellae are present in hot-water tanks which are maintained at warm temperatures or whose design results in warm temperatures at the bottom of the tanks. We hypothesize that hot-water tanks are a breeding site and a major source of L. pneumophila for the contamination of plumbing systems. The existence of these bacteria in the plumbing systems and tanks was not necessarily associated with disease. The extent of the hazard of this contamination needs to be delineated.

  9. Prevalence of Legionella pneumophila in water distribution systems in hospitals and public buildings of the Lublin region of eastern Poland

    Directory of Open Access Journals (Sweden)

    Agnieszka Sikora

    2015-05-01

    The water samples collected form the hot water supply system of hospitals and public buildings showed exceeded counts of L. pneumophila, indicating the risk of infection. The constant monitoring of water distribution systems is an important element of the control of infections caused by these organisms.

  10. Predictive parameters of Legionella pneumophila occurrence in hospital water: HPCs and plumbing system installation age.

    Science.gov (United States)

    Ghanizadeh, Ghader; Mirmohamadlou, Ali; Esmaeli, Davoud

    2016-09-01

    Occurrence of Legionella pneumophila can be relevant to the installation age and the presence of heterotrophic plate counts (HPCs). This research illustrates L. pneumophila contamination of hospital water in accordance with the installation age and the presence of HPCs. One hundred and fifty samples were collected from hot and cold water systems and cultured on R2A and BCYE agar. L. pneumophila identification was done via specific biochemical tests. HPCs and L. pneumophila were detected in 96 and 37.3 % of the samples, respectively. The mean of HPCs density was 947 ± 998 CFU/ml; therefore, 52 % of the samples had higher densities than 500 CFU/ml. High densities of HPCs (>500 CFU/ml) led to colonization of L. pneumophila (≥1000 CFU/ml), mainly observed in cooling systems, gynecological, sonography, and NICU wards. Chi(2) test demonstrated that higher densities (>500 CFU/ml) of HPCs and L. pneumophila contamination in cold water were more frequent than warm water (OR: 2.3 and 1.49, respectively). Univariate regressions implied a significant difference between HPCs density and installation age in positive and negative tests of L. pneumophila (OR = 1.1, p installation age on L. pneumophila occurrences (p installation age (r s  = 0.33, p installation age are relevant; so, plumbing system renovation with appropriate materials and promotion of the effective efforts for hospital's water quality assurance is highly recommended.

  11. Geostatistics – a tool applied to the distribution of Legionella pneumophila in a hospital water system

    Directory of Open Access Journals (Sweden)

    Pasqualina Laganà

    2015-12-01

    Full Text Available [b]Introduction.[/b] Legionnaires’ disease is normally acquired by inhalation of legionellae from a contaminated environmental source. Water systems of large buildings, such as hospitals, are often contaminated with legionellae and therefore represent a potential risk for the hospital population. The aim of this study was to evaluate the potential contamination of [i]Legionella pneumophila[/i] (LP in a large hospital in Italy through georeferential statistical analysis to assess the possible sources of dispersion and, consequently, the risk of exposure for both health care staff and patients. [b]Materials and Method. [/b]LP serogroups 1 and 2–14 distribution was considered in the wards housed on two consecutive floors of the hospital building. On the basis of information provided by 53 bacteriological analysis, a ‘random’ grid of points was chosen and spatial geostatistics or [i]FAIk Kriging[/i] was applied and compared with the results of classical statistical analysis. [b]Results[/b]. Over 50% of the examined samples were positive for [i]Legionella pneumophila[/i]. LP 1 was isolated in 69% of samples from the ground floor and in 60% of sample from the first floor; LP 2–14 in 36% of sample from the ground floor and 24% from the first. The iso-estimation maps show clearly the most contaminated pipe and the difference in the diffusion of the different [i]L. pneumophila[/i] serogroups. [b]Conclusion.[/b] Experimental work has demonstrated that geostatistical methods applied to the microbiological analysis of water matrices allows a better modeling of the phenomenon under study, a greater potential for risk management and a greater choice of methods of prevention and environmental recovery to be put in place with respect to the classical statistical analysis.

  12. Adaptation of Fusarium oxysporum and Fusarium dimerum to the specific aquatic environment provided by the water systems of hospitals.

    Science.gov (United States)

    Steinberg, Christian; Laurent, Julie; Edel-Hermann, Véronique; Barbezant, Marie; Sixt, Nathalie; Dalle, Frédéric; Aho, Serge; Bonnin, Alain; Hartemann, Philippe; Sautour, Marc

    2015-06-01

    Members of the Fusarium group were recently detected in water distribution systems of several hospitals in the world. An epidemiological investigation was conducted over 2 years in hospital buildings in Dijon and Nancy (France) and in non-hospital buildings in Dijon. The fungi were detected only within the water distribution systems of the hospital buildings and also, but at very low concentrations, in the urban water network of Nancy. All fungi were identified as Fusarium oxysporum species complex (FOSC) and Fusarium dimerum species complex (FDSC) by sequencing part of the translation elongation factor 1-alpha (TEF-1α) gene. Very low diversity was found in each complex, suggesting the existence of a clonal population for each. Density and heterogeneous distributions according to buildings and variability over time were explained by episodic detachments of parts of the colony from biofilms in the pipes. Isolates of these waterborne populations as well as soilborne isolates were tested for their ability to grow in liquid medium in the presence of increasing concentrations of sodium hypochlorite, copper sulfate, anti-corrosion pipe coating, at various temperatures (4°-42 °C) and on agar medium with amphotericin B and voriconazole. The waterborne isolates tolerated higher sodium hypochlorite and copper sulfate concentrations and temperatures than did soilborne isolates but did not show any specific resistance to fungicides. In addition, unlike waterborne isolates, soilborne isolates did not survive in water even supplemented with glucose, while the former developed in the soil as well as soilborne isolates. We concluded the existence of homogeneous populations of FOSC and FDSC common to all contaminated hospital sites. These populations are present at very low densities in natural waters, making them difficult to detect, but they are adapted to the specific conditions offered by the complex water systems of public hospitals in Dijon and Nancy and probably other

  13. High pressure, low pressure and hot water heating systems in hospitals. Hochdruck-, Niederdruck- und Warmwasserheizungsanlagen im Krankenhaus

    Energy Technology Data Exchange (ETDEWEB)

    Riedle, K [H. Riedle GmbH, Wiesbaden (Germany)

    1994-07-01

    In hospital nowadays the limitation of the use of steam boilers and their direct supply network to the possible minimum is aimed at when the heating system is exchanged or retrofitted. Independent of the fact whether high pressure or low pressure steam or hot water is used the optimum water treatment should be carried out with a minimum of chemical substances. Here hydroquinone, neutralizing amines, carbohydrazide, sodium sulphite and tannins can be used. The dimensioning of hot water heating circuits is shown with examples. (BWI)

  14. Solar heating and hot water system installed at Charlotte Memorial Hospital, Charlotte, North Carolina

    Science.gov (United States)

    1981-01-01

    Detailed information regarding the design and installation of a heating and hot water system in a commercial application is given. This information includes descriptions of system and building, design philosophy, control logic operation modes, design and installation drawing and a brief description of problems encountered and their solutions.

  15. Occurrence and parameters of frequency of Legionella in warm water systems of hospitals and hotels in Lower Saxony.

    Science.gov (United States)

    Habicht, W; Müller, H E

    1988-03-01

    A total of 1241 water samples was investigated from 103 hospitals and 62 hotels in Lower Saxony 1985-87. 331 of 949 samples from hospitals and 26 of 292 samples from hotels were Legionella positive. All together 70% of the hospitals and 18% of the hotels investigated were Legionella positive, and 836 strains of Legionella were isolated (Table 1). As they could be diagnosed they belong to L. pneumophila SG1 306 strains, SG2 36 strains, SG3 127 strains, SG4 45 strain, SG5 29 strain, SG6 106 strains, SG9 13 strains and SG10 13 strains. Further 134 strains belonging to L. pneumophila but not to SG1-SG12 show cross reactions with serogroups 5, 8, and 10. Finally, 16 strains belong to L. dumoffii and 1 strain to L. anisa (Table 2). The following parameters of water samples were studied, too: temperature, pH value, conductivity, concentration of iron, of organic matter, of other bacteria, occurrence of amoebas, and the materials of water plumbing systems. Most samples contained concentrations of Legionella in the range of 10(1)-10(3) CFU/ml, highest concentrations were 10(5) CFU/ml (Fig. 1). Most frequently, Legionella were isolated within the range of temperature of 35-45 degrees C. However, a few of the water samples were positive for Legionella even up to 66 degrees C (Fig. 3). The conductivity has no and the pH value (Fig. 2) has only little influence on the occurrence of Legionella. There is a positive correlation between concentration of iron and frequency of Legionella (Fig. 4). Also organic matter (Fig. 6) and amoebas (Table 3) seem to enhance the occurrence of Legionella. Plumbing systems consisting of copper showed an inhibitory effect on Legionella during the first five years, whereas no effect could be detected in older systems (Fig. 5).

  16. Legionella contamination in hot water systems of hospitals, nursing homes, hotels, factories and spas in Tuscany-Italy

    Directory of Open Access Journals (Sweden)

    Antonella Lo Nostro

    2011-03-01

    Full Text Available

    Abstract Following the report of many cases of Legionnaires’ disease associated with accommodation facilities such as hotels, spas, workplaces, hospitals and nursing homes, we verified if Legionella pneumophila and Legionella spp. were present in some of those structures in Tuscany, in order to estimate the species and serogroups in circulation. Legionella pneumophila serogroup 1 (30.9% was the most frequently isolated species along with serogroups 3 (16.1% and 6 (13.3%; these three serogroups are identified, in literature, as those most responsible for Legionnaires’ disease (LD. Studying all analyzed structures, we found some parts of the water system where Legionella concentration was higher than 103CFU/L, indicated, in Italy, as the maximum admitted concentration value above which a decontamination treatment is necessary when one or more cases of healthcare-acquired Legionnaires’ disease are observed. Moreover disinfection is recommended in any case when counts exceed 104CFU/L.
    Consequently, in order to prevent cases of Legionnaires’ disease, a continuous surveillance of the water
    systems of all accommodation facilities is necessary, with particular attention to hospitals and nursing
    homes where immunocompromised patients lodge, so as to promptly estimate the presence of the pathogen and consequently plan the most suitable intervention activities. We concluded that, in any structure, a continuous surveillance and disinfecting treatment of water systems is necessary. Moreover, after any disinfection treatment the temperature of the hot water flowing in the system must be necessarily maintained near 51°C in order to minimize the probability of recontamination from Legionella and limit the
    risk of LD in consumers.

  17. 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...

  18. Shift in the microbial ecology of a hospital hot water system following the introduction of an on-site monochloramine disinfection system.

    Science.gov (United States)

    Baron, Julianne L; Vikram, Amit; Duda, Scott; Stout, Janet E; Bibby, Kyle

    2014-01-01

    Drinking water distribution systems, including premise plumbing, contain a diverse microbiological community that may include opportunistic pathogens. On-site supplemental disinfection systems have been proposed as a control method for opportunistic pathogens in premise plumbing. The majority of on-site disinfection systems to date have been installed in hospitals due to the high concentration of opportunistic pathogen susceptible occupants. The installation of on-site supplemental disinfection systems in hospitals allows for evaluation of the impact of on-site disinfection systems on drinking water system microbial ecology prior to widespread application. This study evaluated the impact of supplemental monochloramine on the microbial ecology of a hospital's hot water system. Samples were taken three months and immediately prior to monochloramine treatment and monthly for the first six months of treatment, and all samples were subjected to high throughput Illumina 16S rRNA region sequencing. The microbial community composition of monochloramine treated samples was dramatically different than the baseline months. There was an immediate shift towards decreased relative abundance of Betaproteobacteria, and increased relative abundance of Firmicutes, Alphaproteobacteria, Gammaproteobacteria, Cyanobacteria and Actinobacteria. Following treatment, microbial populations grouped by sampling location rather than sampling time. Over the course of treatment the relative abundance of certain genera containing opportunistic pathogens and genera containing denitrifying bacteria increased. The results demonstrate the driving influence of supplemental disinfection on premise plumbing microbial ecology and suggest the value of further investigation into the overall effects of premise plumbing disinfection strategies on microbial ecology and not solely specific target microorganisms.

  19. Thermal disinfection of hotels, hospitals, and athletic venues hot water distribution systems contaminated by Legionella species.

    Science.gov (United States)

    Mouchtouri, Varvara; Velonakis, Emmanuel; Hadjichristodoulou, Christos

    2007-11-01

    Legionella spp. (> or = 500 cfu liter(-1)) were detected in 92 of 497 water distribution systems (WDS) examined. Thermal disinfection was applied at 33 WDS. After the first and second application of the disinfection procedure, 15 (45.4%) and 3 (9%) positive for remedial actions WDS were found, respectively. Legionella pneumophila was more resistant to thermal disinfection than Legionella non-pneumophila spp. (relative risk [RR]=5.4, 95% confidence intervals [CI]=1-35). WDS of hotels with oil heater were more easily disinfected than those with electrical or solar heater (RR=0.4 95% CI=0.2-0.8). Thermal disinfection seems not to be efficient enough to eliminate legionellae, unless repeatedly applied and in combination with extended heat flushing, and faucets chlorine disinfection.

  20. Shift in the microbial ecology of a hospital hot water system following the introduction of an on-site monochloramine disinfection system.

    Directory of Open Access Journals (Sweden)

    Julianne L Baron

    Full Text Available Drinking water distribution systems, including premise plumbing, contain a diverse microbiological community that may include opportunistic pathogens. On-site supplemental disinfection systems have been proposed as a control method for opportunistic pathogens in premise plumbing. The majority of on-site disinfection systems to date have been installed in hospitals due to the high concentration of opportunistic pathogen susceptible occupants. The installation of on-site supplemental disinfection systems in hospitals allows for evaluation of the impact of on-site disinfection systems on drinking water system microbial ecology prior to widespread application. This study evaluated the impact of supplemental monochloramine on the microbial ecology of a hospital's hot water system. Samples were taken three months and immediately prior to monochloramine treatment and monthly for the first six months of treatment, and all samples were subjected to high throughput Illumina 16S rRNA region sequencing. The microbial community composition of monochloramine treated samples was dramatically different than the baseline months. There was an immediate shift towards decreased relative abundance of Betaproteobacteria, and increased relative abundance of Firmicutes, Alphaproteobacteria, Gammaproteobacteria, Cyanobacteria and Actinobacteria. Following treatment, microbial populations grouped by sampling location rather than sampling time. Over the course of treatment the relative abundance of certain genera containing opportunistic pathogens and genera containing denitrifying bacteria increased. The results demonstrate the driving influence of supplemental disinfection on premise plumbing microbial ecology and suggest the value of further investigation into the overall effects of premise plumbing disinfection strategies on microbial ecology and not solely specific target microorganisms.

  1. 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.

  2. Water systems

    International Nuclear Information System (INIS)

    Riess, R.

    1980-01-01

    The present paper describes the coolant chemistry and its consequences for 1300 MWsub(e) KWU PWR plants. Some selected systems, i.e. primary heat transport system, steam water cycle and cooling water arrangements, are chosen for this description. Various aspects of coolant chemistry regarding general corrosion, selective types of corrosion and deposits on heat transfer surfaces have been discussed. The water supply systems necessary to fulfill the requirements of the coolant chemistry are discussed as well. It has been concluded that a good operating performance can only be achieved when - beside other factors - the water chemistry has been given sufficient consideration. (orig./RW)

  3. Water systems

    International Nuclear Information System (INIS)

    Riess, R.

    1981-01-01

    The present paper describes the coolant chemistry and its consequences for 1300 MWsub(e) KWU PWR plants. Some selected systems, i.e. primary heat transport system, steam water cycle and cooling water arrangements, are chosen for this description. Various aspects of coolant chemistry regarding general corrosion, selective types of corrosion and deposits on heat transfer surface have been discussed. The water supply systems necessary to fulfill the requirements of the coolant chemistry are discussed as well. It has been concluded that a good operating performance can only be achieved when - beside other factors - the water chemistry has been given sufficient consideration. (orig./RW)

  4. Efficacy of thermal treatment and copper-silver ionization for controlling Legionella pneumophila in high-volume hot water plumbing systems in hospitals.

    Science.gov (United States)

    Mietzner, S; Schwille, R C; Farley, A; Wald, E R; Ge, J H; States, S J; Libert, T; Wadowsky, R M; Miuetzner, S

    1997-12-01

    Thermal treatment and copper-silver ionization are often used for controlling Legionella pneumophila in high-volume hospital plumbing systems, although the comparative efficacies of these measures in high-volume systems are unknown. Thermal treatment of a hot water circuit was accomplished by flushing hot water (> 60 degrees C) through distal fixtures for 10 minutes. Copper-silver ionization was conducted in three circuits by installing units into return lines immediately upstream from hot water tanks. Recovery rates of L. pneumophila were monitored by culturing swab samples from faucets. Concentrations of copper and silver in water samples were determined by atomic absorption spectrophotometry. Four heat-flush treatments failed to provide long-term control of L. pneumophila. In contrast, ionization treatment reduced the rate of recovery of L. pneumophila from 108 faucets from 72% to 2% within 1 month and maintained effective control for at least 22 months. Only three samples (1.9%) of hot water from faucets exceeded Environmental Protection Agency standards for silver, and none exceeded the standards for copper. Of 24 samples obtained from hot water tanks, 42% and 50% exceeded the silver and copper standards, respectively. Copper-silver ionization effectively controls L. pneumophila in high-volume plumbing systems and is superior to thermal treatment; however, high concentrations of copper and silver can accumulate at the bottom of hot water tanks.

  5. [i]Legionella spp[/i]., amoebae and not-fermenting Gram negative bacteria in an Italian university hospital water system

    Directory of Open Access Journals (Sweden)

    Pasqualina Laganà

    2014-09-01

    Full Text Available [b]Introduction. [/b]In hospital and other health care facilities, contamination of water systems by potentially infectious microorganisms, such as bacteria, viruses and protozoa, is a source of nosocomial infections, which may originate fromcolonization of water pipes, cooling towers, spa pools, taps, showers and water supplies. [b]Objective. [/b]The study focuses on the occurrence of [i]Legionella spp.[/i], free-living amoebae and non-fermenting Gram-negative microorganisms in a University hospital water system located in the town of Messina (Sicily, Italy, which had never been examined previously. Materials and Methods. From January 2008 – March 2009, hot tap water samples were collected from 10 wards.[i] Legionella spp[/i]. recovered on selective culture medium were identified by microagglutination latex test; free-living amoebae were cultured using [i]Escherichia coli [/i]as a food source. Non-fermenting Gram negative microorganisms were identified by API 20 NE strips. [b]Results.[/b] [i]Legionella spp.[/i] were found in 33.33% of the samples. [i]L. pneumophila[/i] serogroup 1 was recovered from the Laboratory Diagnostic and Anaesthesia-Neurology Wards, with a peak of 3.5 × 10[sup]4[/sup] cfu/L in May 2008. [i]L. pneumophila[/i] serogroups 2–14 were found in the Othorhinolaryngology, Pathologic Anatomy, Paediatrics and Surgery Wards, and peaked (4 × 10[sup]4[/sup] cfu/L in April 2008. Pseudomonadaceae and Hyphomycetes were also detected. Legionella spp. were recovered from samples positive for non-pathogenic amoebae [i]Hartmannella spp[/i]. [b]Conclusion.[/b] This first study of a Messina hospital water system suggested potential health risks related to the detection of [i]Hartmannella spp[/i]., as reservoirs for[i] Legionella spp.[/i], and Pseudomonas aeruginosa, a Gram negative non-fermenting bacterium frequently causing nosocomial pneumonia. The urgent need for monitoring programmes and prevention measures to ensure hospital water

  6. Hospitalization records as a tool for evaluating performance of food- and water-borne disease surveillance systems: a Massachusetts case study.

    Science.gov (United States)

    Mor, Siobhan M; DeMaria, Alfred; Naumova, Elena N

    2014-01-01

    We outline a framework for evaluating food- and water-borne surveillance systems using hospitalization records, and demonstrate the approach using data on salmonellosis, campylobacteriosis and giardiasis in persons aged ≥65 years in Massachusetts. For each infection, and for each reporting jurisdiction, we generated smoothed standardized morbidity ratios (SMR) and surveillance to hospitalization ratios (SHR) by comparing observed surveillance counts with expected values or the number of hospitalized cases, respectively. We examined the spatial distribution of SHR and related this to the mean for the entire state. Through this approach municipalities that deviated from the typical experience were identified and suspected of under-reporting. Regression analysis revealed that SHR was a significant predictor of SMR, after adjusting for population age-structure. This confirms that the spatial "signal" depicted by surveillance is in part influenced by inconsistent testing and reporting practices since municipalities that reported fewer cases relative to the number of hospitalizations had a lower relative risk (as estimated by SMR). Periodic assessment of SHR has potential in assessing the performance of surveillance systems.

  7. Hospitalization records as a tool for evaluating performance of food- and water-borne disease surveillance systems: a Massachusetts case study.

    Directory of Open Access Journals (Sweden)

    Siobhan M Mor

    Full Text Available We outline a framework for evaluating food- and water-borne surveillance systems using hospitalization records, and demonstrate the approach using data on salmonellosis, campylobacteriosis and giardiasis in persons aged ≥65 years in Massachusetts. For each infection, and for each reporting jurisdiction, we generated smoothed standardized morbidity ratios (SMR and surveillance to hospitalization ratios (SHR by comparing observed surveillance counts with expected values or the number of hospitalized cases, respectively. We examined the spatial distribution of SHR and related this to the mean for the entire state. Through this approach municipalities that deviated from the typical experience were identified and suspected of under-reporting. Regression analysis revealed that SHR was a significant predictor of SMR, after adjusting for population age-structure. This confirms that the spatial "signal" depicted by surveillance is in part influenced by inconsistent testing and reporting practices since municipalities that reported fewer cases relative to the number of hospitalizations had a lower relative risk (as estimated by SMR. Periodic assessment of SHR has potential in assessing the performance of surveillance systems.

  8. An energy saving system for hospital laundries

    Energy Technology Data Exchange (ETDEWEB)

    Katsanis, J.S.; Tsarabaris, P.T.; Polykrati, A.D.; Proios, A.N. [National Technical Univ. of Athens, Athens (Greece). School of Electrical and Computer Engineering; Koufakis, E.I. [Public Power Corp. S.A., Crete (Greece)

    2009-07-01

    Hospital laundries are one of the largest consumers of water and electrical and thermal energy. This paper examined the energy savings achieved by a system using the hot wastewater from the washing process. Hospital laundries consume thermal energy using steam, which is produced in boilers by burning diesel oil or natural gas. Electrical energy for the mechanical drives, ventilation and also the lighting required in the laundry area are big consumers of energy. The paper presented the proposed system and discussed the parameters of the system and system dimensioning. The paper also provided and discussed an interpretation of steam and energy savings. The proposed system was considered to be economically viable, simple in its construction, installation and operation. From the application of the suggested system, the cost savings resulted in a satisfactory payback period for the capital invested of approximately three to five years. 14 refs., 4 tabs., 2 figs.

  9. Drinking Water Quality in Hospitals and Other Buildings ...

    Science.gov (United States)

    Drinking water quality entering large buildings is generally adequately controlled by the water utility, but localized problems may occur within building or “premise” plumbing. Particular concerns are loss of disinfectant residual and temperature variability, which may enhance pathogen activity and metallic corrosion. Disinfection systems are available to building managers and are being installed in a variety of commercial buildings (hospitals, hotels, office buildings.) Yet our understanding of such additional treatment and of how to monitor end water quality at these buildings is limited. This class lecture will discuss challenges in maintaining acceptable water quality in hospitals, schools and other buildings. To give a lecture to a class of graduate students (ENVE 6054: Physical/Chemical Processes for Water Quality Control) at the University of Cincinnati, by presenting past research projects.

  10. Something in the Water: Hospital Responds to Water Crisis.

    Science.gov (United States)

    Redfern, Roberta; Micham, Jennifer; Daniels, Rebecca; Childers, Sue

    2018-02-05

    Early on August 2, 2014, in the city of Toledo, Ohio, a media alert informed the public that traces of microcystin, a hazardous toxin, had been detected in the drinking water. The warning stated that residents should not drink, boil, or even touch the contaminated water. A water crisis of this magnitude was recognized to pose a potentially serious and significant impact on patient care and safety in health care environments. ProMedica Toledo Hospital's Emergency Operation Plan addressed 3 critical issues: safe water availability, alternate cleaning solutions, and preparations for a prolonged crisis. This report details some of the lessons learned throughout the response to the crisis: particularly, because the impact was county-wide which affected other hospitals who used the same vendors, alternate water sources should have been secured in advance; the courier service was vital to delivery of supplies and moving equipment to alternate areas for sterilization processes; and finally, communication with staff and patients was jeopardized by external media outlets. Changes to the emergency plan considering these unanticipated aspects proved useful in a later incident and should be considered by all health care facilities as water emergency policies and procedures are created and reviewed. (Disaster Med Public Health Preparedness. 2018;page 1 of 3).

  11. 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.

  12. Trend of Legionella colonization in hospital water supply.

    Science.gov (United States)

    D'Alessandro, D; Fabiani, M; Cerquetani, F; Orsi, G B

    2015-01-01

    In many nosocomial Legionella outbreaks water distribution systems are the most frequent source of infection. Considering the hospital waterline old age, an investigation on colonization by Legionella spp was carried out in order to evaluate the pipeline system weaknesses and to implement environmental preventive measures. From 2004 to 2010, overall 97 samples from the water line were collected. The samples were analyzed according to the italian Legionella spp standard methods; water temperature, pH and residual free chlorine were determined at the time of collection. X2 test, exact-test and t-test were used to compare proportions and means. Overall 28 samples (23.7%) were positive for Legionella spp, and five of them (17.9%) exceeded the threshold level >104 cfu/L. The number of positive samples varied along the years, showing a significant increasing trend (X2 for trend = 11.5; pLegionella spp by comparison to negative ones showed a lower free chlorine concentration (0.08 mg/L vs 0.15 mg/L) and a higher water temperature (46.1° vs 42.7°). Actually the percentage of positive samples decreased significantly with the increasing in free chlorine in the water (X2 for trend = 8.53; pLegionella. All hospital buildings were colonized by Legionella spp, although 80% of samples >104 cfu/L occurred in the C-building. No cases of nosocomial legionellosis were reported during the study period. Hospital water system showed a diffuse colonization by Legionella spp, although the degree of contamination reached the threshold level (>104 cfu/L) only in a small percentage of samples, showing a substantial effectiveness of the control measures applied.

  13. Hospital System Performance within Veterans Affairs

    Data.gov (United States)

    Department of Veterans Affairs — Strategic Analytics for Improvement and Learning Value Model or SAIL, is a system for summarizing hospital system performance within Veterans Health Administration...

  14. Hospital and urban effluent waters as a source of accumulation of toxic metals in the sediment receiving system of the Cauvery River, Tiruchirappalli, Tamil Nadu, India.

    Science.gov (United States)

    Devarajan, Naresh; Laffite, Amandine; Ngelikoto, Patience; Elongo, Vicky; Prabakar, Kandasamy; Mubedi, Josué I; Piana, Pius T M; Wildi, Walter; Poté, John

    2015-09-01

    Hospital and urban effluents contain a variety of toxic and/or persistent substances in a wide range of concentrations, and most of these compounds belong to the group of emerging contaminants. The release of these substances into the aquatic ecosystem can lead to the pollution of water resources and may place aquatic organisms and human health at risk. Sediments receiving untreated and urban effluent waters from the city of Tiruchirappalli in the state of Tamil Nadu, India, are analyzed for potential environmental and human health risks. The sediment samples were collected from five hospital outlet pipes (HOP) and from the Cauvery River Basin (CRB) both of which receive untreated municipal effluent waters (Tiruchirappalli, Tamil Nadu, India). The samples were characterized for grain size, organic matter, toxic metals, and ecotoxicity. The results highlight the high concentration of toxic metals in HOP, reaching values (mg kg(-1)) of 1851 (Cr), 210 (Cu), 986 (Zn), 82 (Pb), and 17 (Hg). In contrast, the metal concentrations in sediments from CRB were lower than the values found in the HOP (except for Cu, Pb), with maximum values (mg kg(-1)) of 75 (Cr), 906 (Cu), 649 (Zn), 111 (Pb), and 0.99 (Hg). The metal concentrations in all sampling sites largely exceed the Sediment Quality Guidelines (SQGs) and the Probable Effect Concentration (PEC) for the Protection of Aquatic Life recommendation. The ecotoxicity test with ostracods exposed to the sediment samples presents a mortality rate ranging from 22 to 100 % (in sediments from HOP) and 18-87 % (in sediments from CRB). The results of this study show the variation of toxic metal levels as well as toxicity in sediment composition related to both the type of hospital and the sampling period. The method of elimination of hospital and urban effluents leads to the pollution of water resources and may place aquatic organisms and human health at risk.

  15. 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...

  16. Drinking Water Distribution Systems

    Science.gov (United States)

    Learn about an overview of drinking water distribution systems, the factors that degrade water quality in the distribution system, assessments of risk, future research about these risks, and how to reduce cross-connection control risk.

  17. Water Fluoridation Reporting System (Public Water Systems)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Water Fluoridation Reporting System (WFRS) has been developed to provide tools to assist states in managing fluoridation programs. WFRS is designed to track all...

  18. 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.

  19. 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.

  20. 78 FR 15882 - Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the...

    Science.gov (United States)

    2013-03-13

    ... Payment Systems for Acute Care Hospitals and the Long Term Care Hospital Prospective Payment System and... Register entitled ``Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long Term Care Hospital Prospective Payment System and Fiscal Year 2013 Rates; Hospitals...

  1. A Clonal Lineage of Fusarium oxysporum Circulates in the Tap Water of Different French Hospitals.

    Science.gov (United States)

    Edel-Hermann, Véronique; Sautour, Marc; Gautheron, Nadine; Laurent, Julie; Aho, Serge; Bonnin, Alain; Sixt, Nathalie; Hartemann, Philippe; Dalle, Frédéric; Steinberg, Christian

    2016-11-01

    Fusarium oxysporum is typically a soilborne fungus but can also be found in aquatic environments. In hospitals, water distribution systems may be reservoirs for the fungi responsible for nosocomial infections. F. oxysporum was previously detected in the water distribution systems of five French hospitals. Sixty-eight isolates from water representative of all hospital units that were previously sampled and characterized by translation elongation factor 1α sequence typing were subjected to microsatellite analysis and full-length ribosomal intergenic spacer (IGS) sequence typing. All but three isolates shared common microsatellite loci and a common two-locus sequence type (ST). This ST has an international geographical distribution in both the water networks of hospitals and among clinical isolates. The ST dominant in water was not detected among 300 isolates of F. oxysporum that originated from surrounding soils. Further characterization of 15 isolates by vegetative compatibility testing allowed us to conclude that a clonal lineage of F. oxysporum circulates in the tap water of the different hospitals. We demonstrated that a clonal lineage of Fusarium oxysporum inhabits the water distribution systems of several French hospitals. This clonal lineage, which appears to be particularly adapted to water networks, represents a potential risk for human infection and raises questions about its worldwide distribution. Copyright © 2016, American Society for Microbiology. All Rights Reserved.

  2. Cooled Water Production System,

    Science.gov (United States)

    The invention refers to the field of air conditioning and regards an apparatus for obtaining cooled water . The purpose of the invention is to develop...such a system for obtaining cooled water which would permit the maximum use of the cooling effect of the water -cooling tower.

  3. 77 FR 4908 - Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the...

    Science.gov (United States)

    2012-02-01

    ... Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Fiscal... the final rule entitled ``Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Fiscal Year 2012 Rates...

  4. 77 FR 65495 - Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the...

    Science.gov (United States)

    2012-10-29

    ... Payment Systems for Acute Care Hospitals and the Long Term Care Hospital Prospective Payment System and... Federal Register entitled ``Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long Term Care Hospital Prospective Payment System and Fiscal Year 2013 Rates...

  5. 75 FR 60640 - Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the...

    Science.gov (United States)

    2010-10-01

    ...; RIN 0938-AP33 Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System Changes and FY 2011 Rates; Provider... Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective...

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

    African Journals Online (AJOL)

    USER

    least common complication, occurring in one (3.3%) of the cases studied. Conclusion: Acute ... Keywords: Acute abdominal crisis, children, haemoglobin, hospitalization, multi-systemic ... improvement of the management of such children.

  7. Cooling water distribution system

    Science.gov (United States)

    Orr, Richard

    1994-01-01

    A passive containment cooling system for a nuclear reactor containment vessel. Disclosed is a cooling water distribution system for introducing cooling water by gravity uniformly over the outer surface of a steel containment vessel using an interconnected series of radial guide elements, a plurality of circumferential collector elements and collector boxes to collect and feed the cooling water into distribution channels extending along the curved surface of the steel containment vessel. The cooling water is uniformly distributed over the curved surface by a plurality of weirs in the distribution channels.

  8. A hybrid solar/diesel water heating system: in medicine area in a hospital in Mexico city; Sistema hibrido de energia solar y diesel para calentamiento de agua: caso en el area de medicina fisica en un hospital en la ciudad de Mexico

    Energy Technology Data Exchange (ETDEWEB)

    Nolasco Mejia, Miguel; Wolpert Kuri, Jorge [UNAM, Mexico, D.F. (Mexico)

    2000-07-01

    A hybrid solar/diesel water heating system for therapy in a hospital in Mexico is described in this paper. The use of solar energy in hospitals and clinics, represent an environmentally friendly alternative to the burning of fossil fuels. Analysis is made regarding the feasibility of integrating both solar energy and conventional energy (fuel oil) as back up, to satisfy the hot water demand for hydrotherapy in a hospital. Results from simulation show that solar energy is a cheap means to provide up to 60% of the hot water demand. The solar assisted system proposed uses flat plate solar collectors integrated with an existing hot water tank, where water is heated with vapor from a diesel ran boiler. This represents significant savings on the solar system cost. [Spanish] La utilizacion de la energia solar en hospitales y clinicas, representa una posibilidad para obtener ahorros importantes de energia para satisfacer la demanda de agua caliente. En el presente estudio se analiza la demanda de agua caliente para uso en medicina fisica (hidroterapia), en un hospital ubicado en la Cd. De Mexico y la factibilidad de usar la energia solar, empleando como apoyo el sistema tradicional de combustible fosil (diesel). Mediante un analisis termico se determina el calor necesario para satisfacer la demanda de agua caliente. El analisis economico muestra los costos del sistema solar, los ahorros que se tendran y el periodo de recuperacion de la inversion. Los resultados muestran que la utilizacion de la energia solar es factible debido a la disminucion tanto del consumo de combustible, como de las emisiones atmosfericas. Se propone la instalacion de un sistema solar con colectores planos y el aprovechamiento de uno de los dos tanques de agua caliente existentes, donde se efectua la trasferencia de calor al agua por medio de vapor, lo cual disminuye el costo del sistema solar. La aportacion solar puede ser mayor del 60%, el complemento sera aportado por el sistema tradicional con

  9. 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 p<0.05, significantly influenced users' opinions of both the ease of use and the benefits of the HIS. This study found that different factors may affect the acceptance of each user in each type of hospital regarding the use of HIS. Finally, this model is best suited for government-owned hospitals. Based on the results of this study, hospital management and IT developers should have more understanding on the non-technological factors to better plan for HIS implementation. Support from management is critical to the sustainability of HIS implementation to ensure HIS is easy to use and provides benefits to the users as well as hospitals. Finally, this study could assist hospital management and IT developers, as well as researchers, to understand the obstacles faced by hospitals in implementing HIS. Copyright © 2016

  10. 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...

  11. 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.

  12. Cooling water injection system

    International Nuclear Information System (INIS)

    Inai, Nobuhiko.

    1989-01-01

    In a BWR type reactor, ECCS system is constituted as a so-called stand-by system which is not used during usual operation and there is a significant discontinuity in relation with the usual system. It is extremely important that ECCS operates upon occurrence of accidents just as specified. In view of the above in the present invention, the stand-by system is disposed along the same line with the usual system. That is, a driving water supply pump for supplying driving water to a jet pump is driven by a driving mechanism. The driving mechanism drives continuously the driving water supply pump in a case if an expected accident such as loss of the function of the water supply pump, as well as during normal operation. That is, all of the water supply pump, jet pump, driving water supply pump and driving mechanism therefor are caused to operate also during normal operation. The operation of them are not initiated upon accident. Thus, the cooling water injection system can perform at high reliability to remarkably improve the plant safety. (K.M.)

  13. Estudio sobre la efectividad para la prevención de la legionelosis del sistema de calentamiento instantáneo, instalado en la red de agua sanitaria de un hospital Effectiveness study of a pasteurization system in controlling contamination with Legionella installed in a hospital's hot water system

    Directory of Open Access Journals (Sweden)

    Laura Gavaldà Mestre

    2006-12-01

    Full Text Available Se ha estudiado la efectividad de un sistema de pasteurización en el control de la contaminación por Legionella en la red de agua caliente de un hospital.El hospital había optado por este sistema debido a que los acumuladores convencionales originales presentaban importantes problemas en la capacidad de producción y en el mantenimiento de las temperaturas de distribución.El estudio fue iniciado después de haberse instalado los pasteurizadores y ha consistido en la realización de controles mensuales de Legionella y temperatura durante un período de 11 meses. De los resultados, se puede valorar que el sistema de pasteurización se considera efectivo, siempre y cuando las condiciones de la red (circulación, material, diseño, etc sean las adecuadas. El sistema no se considera efectivo en redes antiguas y con ramales sin circulación como se ha podido constatar en este estudio en el edificio de servicios, donde las conducciones presentaban un estado de conservación deficiente. En esta zona de servicios los controles de Legionella han mostrado una mejora únicamente después de que se iniciara un programa de purgas junto con la paulatina sustitución de los tramos en mal estado.The effectiveness of a pasteurization system in controlling contamination with Legionella has been evaluated in a hospital’s hot water system.The hospital acquired these equipments because the original system -conventional hot water tanks– had problems in producing and maintaining the distribution temperatures in the hot water circuit.The study started 11 months after the pasteurizers had been installed. The study consisted on Legionella and temperature controls which were conducted monthly during an 11-month period. Results have proved that a pasteurization system method to be an effective system of instantaneous warming provided that there are adequate conditions (circulation, materials, design, etc.. This system has no effectiveness in old nets or nets with

  14. 78 FR 38679 - Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the...

    Science.gov (United States)

    2013-06-27

    ... Systems for Acute Care Hospitals and the Long Term Care Hospital Prospective Payment System and Proposed... Payment Systems for Acute Care Hospitals and the Long Term Care Hospital Prospective Payment System and... regarding MS-DRG classifications and new technology add-on payments. Eva Fung (410) 786-7539, for...

  15. 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

  16. Water quality diagnosis system

    International Nuclear Information System (INIS)

    Nagase, Makoto; Asakura, Yamato; Sakagami, Masaharu

    1989-01-01

    By using a model representing a relationship between the water quality parameter and the dose rate in primary coolant circuits of a water cooled reactor, forecasting for the feature dose rate and abnormality diagnosis for the water quality are conducted. The analysis model for forecasting the reactor water activity or the dose rate receives, as the input, estimated curves for the forecast Fe, Ni, Co concentration in feedwater or reactor water pH, etc. from the water quality data in the post and forecasts the future radioactivity or dose rate in the reactor water. By comparing the result of the forecast and the setting value such as an aimed value, it can be seen whether the water quality at present or estimated to be changed is satisfactory or not. If the quality is not satisfactory, it is possible to take an early countermeasure. Accordingly, the reactor water activity and the dose rate can be kept low. Further, the basic system constitution, diagnosis algorithm, indication, etc. are identical between BWR and PWR reactors, except for only the difference in the mass balance. (K.M.)

  17. Prototype water reuse system

    Science.gov (United States)

    Lucchetti, G.; Gray, G.A.

    1988-01-01

    A small-scale water reuse system (150 L/min) was developed to create an environment for observing fish under a variety of temperature regimes. Key concerns of disease control, water quality, temperature control, and efficiency and case of operation were addressed. Northern squawfish (Ptychocheilus oregonensis) were held at loading densities ranging from 0.11 to 0.97 kg/L per minute and at temperatures from 10 to 20°C for 6 months with no disease problems or degradation ofwater quality in the system. The system required little maintenance during 2 years of operation.

  18. 75 FR 34614 - Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and...

    Science.gov (United States)

    2010-06-17

    ... Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and Fiscal Year 2010 Rates and to the Long- Term Care Hospital Prospective Payment System and Rate Year 2010 Rates... Prospective Payment Systems for Acute Care Hospitals and Fiscal Year 2010 Rates and to the Long-Term Care...

  19. 77 FR 63751 - Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the...

    Science.gov (United States)

    2012-10-17

    ... [CMS-1588-F2] RIN 0938-AR12 Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Fiscal Year 2013 Rates..., 2012 Federal Register entitled ``Medicare Program; Hospital Inpatient Prospective Payment Systems for...

  20. Water Purification Systems

    Science.gov (United States)

    1994-01-01

    Clearwater Pool Technologies employs NASA-developed silver/copper ionization to purify turtle and dolphin tanks, cooling towers, spas, water recycling systems, etc. The pool purifier consists of a microcomputer to monitor water conditions, a pair of metallic electrodes, and a rheostat controller. Ions are generated by passing a low voltage current through the electrodes; the silver ions kill the bacteria, and the copper ions kill algae. This technology has found broad application because it offers an alternative to chemical disinfectants. It was originally developed to purify water on Apollo spacecraft. Caribbean Clear has been using NASA's silver ionization technology for water purification for more than a decade. Two new products incorporate advancements of the basic technology. One is the AquaKing, a system designed for areas with no source of acceptable drinking water. Another is the Caribbean Clear Controller, designed for commercial pool and water park applications where sanitizing is combined with feedback control of pH and an oxidizer, chlorine or bromine. The technology was originally developed to purify water on Apollo spacecraft.

  1. [Development of Hospital Equipment Maintenance Information System].

    Science.gov (United States)

    Zhou, Zhixin

    2015-11-01

    Hospital equipment maintenance information system plays an important role in improving medical treatment quality and efficiency. By requirement analysis of hospital equipment maintenance, the system function diagram is drawed. According to analysis of input and output data, tables and reports in connection with equipment maintenance process, relationships between entity and attribute is found out, and E-R diagram is drawed and relational database table is established. Software development should meet actual process requirement of maintenance and have a friendly user interface and flexible operation. The software can analyze failure cause by statistical analysis.

  2. Water electrolysis system

    International Nuclear Information System (INIS)

    Mizoguchi, Tadao; Ikehara, Masahisa; Kataoka, Noboru; Ueno, Syuichi; Ishikawa, Nobuhide.

    1996-01-01

    Nissho Iwai Co. and Ebara Co. received an order for hydrogen and oxygen generating system (water electrolysis system) to be installed at Tokai-2 power station of The Japan Atomic Power Company, following the previous order at Tsuruga-1 where the gas injection from FY1996 is planned. Hydrogen gas generated by the system will be injected to coolant of boiling water reactors to improve corrosive environment. The system is being offered by a tripartite party, Nissho Iwai, Ebara, and Norsk Hydro Electrolysers of Norway (NHEL). NHEL provides a electrolyser unit, as a core of the system. Ebara provides procurement, installation, and inspection as well as total engineering work, under the basic design by NHEL which has over 60 years-experience in this field. (author)

  3. Disposal of liquid radioactive waste - discharge of radioactive waste waters from hospitals

    International Nuclear Information System (INIS)

    Ludwieg, F.

    1976-01-01

    A survey is given about legal prescriptions in the FRG concerning composition and amount of the liquid waste substances and waste water disposal by emitting into the sewerage, waste water decay systems and collecting and storage of patients excretions. The radiation exposure of the population due to drainage of radioactive waste water from hospitals lower by more than two orders than the mean exposure due to nuclear-medical use. (HP) [de

  4. Hospital managers need management information systems.

    Science.gov (United States)

    Davis, S; Freeman, J R

    1976-01-01

    A new hospital director seeking to bring his institution to the brink of solvency found himself with ten pounds of data but no "information"--at least, not the kind of information he could use as a basis for management decisions. What he needed was a system that would not only present data, but the meaning of the data. Such a system is the integrated MIS.

  5. Hospital System Readmissions: A Care Cycle Approach

    Directory of Open Access Journals (Sweden)

    Cody Mullen

    2012-01-01

    Full Text Available Hospital readmission rates can be used as an indicator of the quality of health care services and can highlight high-priority research areas to ensure better health. A readmission is defined as when a patient is discharged from an acute care hospital and is admitted back to an acute care hospital in a set amount of days, with 30 days being the current national standard. On average, 19.6% of Medicare patients are readmitted to the hospital within 30 days of discharge and 56.1% within a year (Jencks, Williams, & Coleman, 2009. The hypothesis of this study was that the discharge location, or where a patient went immediately after discharge, would not have a significant effect on readmissions. A data set with all admission records was obtained from a major health provider. These data contain all hospital patients’ demographic and diagnosis information. General, women’s, and children’s hospitals were looked at from a system perspective to study the discharge location of patients as well as the effects of patient demographics on discharge location. By using a z-significance test in Microsoft Excel and SAS 9.2, it was discovered that patients discharged to home have a significantly lower likelihood of readmission. Generally, patients who are discharged to an extended care or intermediate care facility or patients with home health carerelated services had a significantly higher likelihood of being readmitted. The findings may indicate a possible need for an institution-to-institution intervention as well as institution-to-patient intervention. Future work will develop potential interventions in partnership with hospital staff.

  6. Sociotechnical factors influencing unsafe use of hospital information systems: A qualitative study in Malaysian government hospitals.

    Science.gov (United States)

    Salahuddin, Lizawati; Ismail, Zuraini; Hashim, Ummi Rabaah; Raja Ikram, Raja Rina; Ismail, Nor Haslinda; Naim Mohayat, Mohd Hariz

    2018-03-01

    The objective of this study is to identify factors influencing unsafe use of hospital information systems in Malaysian government hospitals. Semi-structured interviews with 31 medical doctors in three Malaysian government hospitals implementing total hospital information systems were conducted between March and May 2015. A thematic qualitative analysis was performed on the resultant data to deduce the relevant themes. A total of five themes emerged as the factors influencing unsafe use of a hospital information system: (1) knowledge, (2) system quality, (3) task stressor, (4) organization resources, and (5) teamwork. These qualitative findings highlight that factors influencing unsafe use of a hospital information system originate from multidimensional sociotechnical aspects. Unsafe use of a hospital information system could possibly lead to the incidence of errors and thus raises safety risks to the patients. Hence, multiple interventions (e.g. technology systems and teamwork) are required in shaping high-quality hospital information system use.

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

    Science.gov (United States)

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

    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.

  8. A hospital outbreak of Legionella from a contaminated water supply.

    Science.gov (United States)

    Tercelj-Zorman, Marjeta; Seljak, Marija; Stare, Janez; Mencinger, Joze; Rakovec, Joze; Rylander, Ragnar; Strle, Franc

    2004-03-01

    The authors performed a cross-sectional epidemiological survey to investigate the source of a hospital Legionella outbreak originating in contaminated water. Water temperature and air humidity were measured around possible contamination sources. A dead-end pipe was found to contain Legionella pneumophila serogroup 1. All individuals who acquired legionellosis had spent at least 30 min within 2 m of the contamination source. Among staff, 41 of 71 were exposed, and 31 of these fell ill. All 7 patients exposed to the contaminated water acquired legionellosis. None of the 94 bed-ridden patients from the same units developed the disease. An aerosol with 60% relative air humidity was formed near the suspect water faucets, but the humidity fell rapidly farther from the water source, suggesting that desiccation decreased the risk of infection. The healthy personnel and patients closest to the source acquired legionellosis, suggesting that risk was related less to compromised patients than to exposure.

  9. 42 CFR 419.20 - Hospitals subject to the hospital outpatient prospective payment system.

    Science.gov (United States)

    2010-10-01

    ... prospective payment system. 419.20 Section 419.20 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM PROSPECTIVE PAYMENT SYSTEM FOR HOSPITAL... Outpatient Prospective Payment System § 419.20 Hospitals subject to the hospital outpatient prospective...

  10. Public Water Supply Systems (PWS)

    Data.gov (United States)

    Kansas Data Access and Support Center — This dataset includes boundaries for most public water supply systems (PWS) in Kansas (525 municipalities, 289 rural water districts and 13 public wholesale water...

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

    Science.gov (United States)

    2014-01-01

    hospital needed to provide scrubable surfaces in high-risk sterile areas like the surgery room to facilitate disinfection . To correct these...of a well house, and establishment of a process to ensure that hospital water lines were disinfected . However, we found that the water well was not...Special Inspector General for Afghanistan Reconstruction SIGAR 14-31 Inspection Report SALANG HOSPITAL : LACK OF

  12. Development of a Hospital Information System

    Science.gov (United States)

    1984-01-01

    4~4and overused statement but true nonrAýheless. Arid, if some- "thing is information fur one and not Cor another, what is it for the latter? It is...scheduling your projects, fantastic! Keep doing itl If you schedule your projects according to a combination of your horoscope , the stock market, and...hospital functions. It is true that knowledge of the tools used in the Systems Development Life Cycle can allow one to go into 4.. any setting and

  13. Solar Space and Water Heating for Hospital --Charlottesville, Virginia

    Science.gov (United States)

    1982-01-01

    Solar heating system described in an 86-page report consists of 88 single-glazed selectively-coated baseplate collector modules, hot-water coils in air ducts, domestic-hot-water preheat tank, 3,000 Gallon (11,350-1) concrete urethane-insulated storage tank and other components.

  14. 78 FR 27485 - Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the...

    Science.gov (United States)

    2013-05-10

    ... Readmission 5. MDC 8 (Diseases and Disorders of the Musculoskeletal System and Connective Tissue) a. Reverse... hospitals, PPS-exempt cancer hospitals, LTCHs, and inpatient psychiatric facilities (IPFs)) that are..., (410) 786-2261, PPS-Exempt Cancer Hospital Quality Reporting Issues. Allison Lee, (410) 786-8691 and...

  15. 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...

  16. Automated Water-Purification System

    Science.gov (United States)

    Ahlstrom, Harlow G.; Hames, Peter S.; Menninger, Fredrick J.

    1988-01-01

    Reverse-osmosis system operates and maintains itself with minimal human attention, using programmable controller. In purifier, membranes surround hollow cores through which clean product water flows out of reverse-osmosis unit. No chemical reactions or phase changes involved. Reject water, in which dissolved solids concentrated, emerges from outer membrane material on same side water entered. Flow controls maintain ratio of 50 percent product water and 50 percent reject water. Membranes expected to last from 3 to 15 years.

  17. Systems Measures of Water Distribution System Resilience

    Energy Technology Data Exchange (ETDEWEB)

    Klise, Katherine A. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Murray, Regan [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Walker, La Tonya Nicole [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2015-01-01

    Resilience is a concept that is being used increasingly to refer to the capacity of infrastructure systems to be prepared for and able to respond effectively and rapidly to hazardous events. In Section 2 of this report, drinking water hazards, resilience literature, and available resilience tools are presented. Broader definitions, attributes and methods for measuring resilience are presented in Section 3. In Section 4, quantitative systems performance measures for water distribution systems are presented. Finally, in Section 5, the performance measures and their relevance to measuring the resilience of water systems to hazards is discussed along with needed improvements to water distribution system modeling tools.

  18. 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.

  19. Quality management system in hospital radiopharmacy laboratory

    International Nuclear Information System (INIS)

    Poch, Carolina; Rabiller, Graciela; Basualdo, Daniel A.; El Tamer, Elias A.

    2009-01-01

    Objective: 1) To determine the necessary conditions for increasing the complexity of the Radiopharmacy Laboratory and reach an operational level defined by the IAEA as 3a (Operational Guidance on Hospital Radiopharmacy). Our aim is that, within a framework of quality, last generation radiopharmaceuticals can be used, by sophisticated techniques such as labeling with bifunctional chelating agents, like HYNIC; 2) Consequently, we decided to implement a Quality Management System (QMS) in the field of Hospital Radiopharmacy in order to guarantee the safe and effective preparation and handling of radiopharmaceuticals for the diagnosis of patients, based on recommendations of the IAEA. Procedure For the implementation of the QMS, the sector of Radiopharmacy was capacitated in the application of ISO 9001. In a first stage it had begun with the formulation of the main documents and their enumeration. According to the recommendations of the IAEA Operational Guide, this year we proceeded to the optimization of the documents produced in the first stage and formulation of new documents essential to the improvement of work in the Radiopharmacy Laboratory. Results: Corrections were made to the performed procedures, and new ones were composed such as: Reception of raw materials, Control dose calibrator (Activity meter), General procedure of dosage, Procedure for decontamination, for Using the bio safety cabinet, for Cleaning the hot laboratory, etc. The Quality Controls were added to each of the Work Instructions of radiopharmaceuticals to be undertaken and how and when to carry out, with their respective references. Records were modified and new ones incorporated, in order to ensure traceability of the results before and after injection. Finally, the require documentation has been completed with the addition of the Staff Training Plan, and other records such as Nonconformance and Corrective and Preventive Actions. Conclusion: With the application of a QMS correctly implemented

  20. Water Hydraulic Systems

    DEFF Research Database (Denmark)

    Conrad, Finn

    2005-01-01

    The paper presents research results using IT-Tools for CAD and dynamic modelling, simulation, analysis, and design of water hydraulic actuators for motion control of machines, lifts, cranes and robots. Matlab/Simulink and CATIA are used as IT-Tools. The contributions include results from on......-going research projects on fluid power and mechatronics based on tap water hydraulic servovalves and linear servo actuators and rotary vane actuators for motion control and power transmission. Development and design a novel water hydraulic rotary vane actuator for robot manipulators. Proposed mathematical...... modelling, control and simulation of a water hydraulic rotary vane actuator applied to power and control a two-links manipulator and evaluate performance. The results include engineering design and test of the proposed simulation models compared with IHA Tampere University’s presentation of research...

  1. [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.

  2. First report of isolation of Nocardia otitidiscaviarum from hospital water

    Directory of Open Access Journals (Sweden)

    Shojaei Hasan

    2016-07-01

    Full Text Available Nocardia otitidiscaviarum DSM43242 was first isolated as a novel species in 1924 from infected middle ear of guinea pig. Since then, there have only been a lot number additional reports for example from Spain, the USA, French and Japan, on the isolation of this species from clinical specimens such as pulmonary infection, disseminated infection, cutaneous infection and primary brain abscess. Nocardia infection is mainly associated with immunocompromised patients, but sometimes may appear in healthy humans. We herein present the first report on isolation of this organism from hospital water, which represents the environmental resources as a source of risk for people especially the hospital environment. The isolate NR4 was subjected to identification by conventional phenotypic tests such as resistance to lysozyme and molecular tests including genusspecific PCR for Nocardia based on partial 16S rDNA gene and sequencing analysis of 16S rDNA. Our finding of 16S rDNA gene sequence of the studied strain were identical and showed 100% similarties with those of Nocardia otitidiscaviarum.

  3. Water Treatment Technology - Distribution Systems.

    Science.gov (United States)

    Ross-Harrington, Melinda; Kincaid, G. David

    One of twelve water treatment technology units, this student manual on distribution systems provides instructional materials for six competencies. (The twelve units are designed for a continuing education training course for public water supply operators.) The competencies focus on the following areas: types of pipe for distribution systems, types…

  4. Water-Cut Sensor System

    KAUST Repository

    Karimi, Muhammad Akram; Shamim, Atif; Arsalan, Muhammad

    2018-01-01

    Provided in some embodiments is a method of manufacturing a pipe conformable water-cut sensors system. Provided in some embodiments is method for manufacturing a water-cut sensor system that includes providing a helical T-resonator, a helical ground

  5. 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

  6. Picture archiving and communication systems (PACS) for hospitals, a survey

    International Nuclear Information System (INIS)

    Haar Romeny, B.M. ter; Graaf, C.N. de; Waes, P.F.G.M. van; Rijk, P.P. van; Helder, J.C.; Valk, J.P.J. de

    1985-01-01

    In this article a survey is given for Picture Archiving and Communication Systems (PACS). Several aspects of PACS are treated, as image management, the introduction of the system, expenses etc. Special reference is made to the component parts of PACS: image stations, memory, network, software and coupling to the hospital information system. The introduction of PACS in Dutch hospitals is described. (Auth.)

  7. 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.

  8. Computerized system for hospital engineering service management

    International Nuclear Information System (INIS)

    Centeno, C A; Gonzalez, E A; Cagnolo, F J; Olmos, C E

    2007-01-01

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

  9. Operational Management System for Regulated Water Systems

    Science.gov (United States)

    van Loenen, A.; van Dijk, M.; van Verseveld, W.; Berger, H.

    2012-04-01

    Most of the Dutch large rivers, canals and lakes are controlled by the Dutch water authorities. The main reasons concern safety, navigation and fresh water supply. Historically the separate water bodies have been controlled locally. For optimizating management of these water systems an integrated approach was required. Presented is a platform which integrates data from all control objects for monitoring and control purposes. The Operational Management System for Regulated Water Systems (IWP) is an implementation of Delft-FEWS which supports operational control of water systems and actively gives advice. One of the main characteristics of IWP is that is real-time collects, transforms and presents different types of data, which all add to the operational water management. Next to that, hydrodynamic models and intelligent decision support tools are added to support the water managers during their daily control activities. An important advantage of IWP is that it uses the Delft-FEWS framework, therefore processes like central data collection, transformations, data processing and presentation are simply configured. At all control locations the same information is readily available. The operational water management itself gains from this information, but it can also contribute to cost efficiency (no unnecessary pumping), better use of available storage and advise during (water polution) calamities.

  10. 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.

  11. Pressurized water reactor systems

    International Nuclear Information System (INIS)

    Meyer, P.J.

    1975-01-01

    Design and mode of operation of the main PWR components are described: reactor core, pressure vessel and internals, cooling systems with pumps and steam generators, ancillary systems, and waste processing. (TK) [de

  12. Mining of hospital laboratory information systems

    DEFF Research Database (Denmark)

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

    2015-01-01

    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...... 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...... with pronounced heterogeneity and valid reference intervals. Furthermore, part of the heterogeneity in creatinine distribution is likely due to differences in biological and chronological age of children and should be considered when using age-specific reference intervals....

  13. 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...

  14. State and National Water Fluoridation System (Public Water Systems)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Water Fluoridation Reporting System (WFRS) has been developed to provide tools to assist states in managing fluoridation programs. WFRS is designed to track all...

  15. An unusual outbreak of nontuberculous mycobacteria in hospital respiratory wards: Association with nontuberculous mycobacterial colonization of hospital water supply network

    Directory of Open Access Journals (Sweden)

    Salvatore D′Antonio

    2016-01-01

    Full Text Available The incidence and prevalence of pulmonary nontuberculous mycobacterial (NTM infection is increasing worldwide arousing concerns that NTM infection may become a serious health challenge. We recently observed a significant increase of NTM-positive sputa samples from patients referred to respiratory disease wards of a large tertiary hospital in Rome. A survey to identify possible NTM contamination revealed a massive presence of NTM in the hospital water supply network. After decontamination procedures, NTM presence dropped both in water pipelines and sputa samples. We believe that this observation should encourage water network surveys for NTM contamination and prompt decontamination procedures should be considered to reduce this potential source of infection.

  16. Capital Investment by Independent and System-Affiliated Hospitals.

    Science.gov (United States)

    Carroll, Nathan W; Smith, Dean G; Wheeler, John R C

    2015-01-01

    Capital expenditures are a critical part of hospitals' efforts to maintain quality of patient care and financial stability. Over the past 20 years, finding capital to fund these expenditures has become increasingly challenging for hospitals, particularly independent hospitals. Independent hospitals struggling to find ways to fund necessary capital investment are often advised that their best strategy is to join a multi-hospital system. There is scant empirical evidence to support the idea that system membership improves independent hospitals' ability to make capital expenditures. Using data from the American Hospital Association and Medicare Cost Reports, we use difference-in-difference methods to examine changes in capital expenditures for independent hospitals that joined multi-hospital systems between 1997 and 2008. We find that in the first 5 years after acquisition, capital expenditures increase by an average of almost $16,000 per bed annually, as compared with non-acquired hospitals. In later years, the difference in capital expenditure is smaller and not statistically significant. Our results do not suggest that increases in capital expenditures vary by asset age or the size of the acquiring system. © The Author(s) 2015.

  17. 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.

  18. Development of waste water reuse water system for power plants

    Energy Technology Data Exchange (ETDEWEB)

    Park, K K; Kim, D H; Weon, D Y; Yoon, S W; Song, H R [Korea Electric Power Research Institute, Taejeon (Korea, Republic of)

    1998-12-31

    1. Status of waste water discharge at power plants 2. Present status of waste water reuse at power plants 3. Scheme of waste water reuse at power plants 4. Standardization of optimum system for waste water reuse at power plants 5. Establishment of low cost zero discharge system for waste water 6. Waste water treatment technology of chemical cleaning. (author). 132 figs., 72 tabs.

  19. Development of waste water reuse water system for power plants

    Energy Technology Data Exchange (ETDEWEB)

    Park, K.K.; Kim, D.H.; Weon, D.Y.; Yoon, S.W.; Song, H.R. [Korea Electric Power Research Institute, Taejeon (Korea, Republic of)

    1997-12-31

    1. Status of waste water discharge at power plants 2. Present status of waste water reuse at power plants 3. Scheme of waste water reuse at power plants 4. Standardization of optimum system for waste water reuse at power plants 5. Establishment of low cost zero discharge system for waste water 6. Waste water treatment technology of chemical cleaning. (author). 132 figs., 72 tabs.

  20. Integrated processing of ECG's in a hospital information system

    NARCIS (Netherlands)

    Helder, J.C.; Schram, P.H.; Verwey, H.; Meijler, F.L.; Robles de Medina, E.O.

    The ECG handling in the University Hospital of Utrecht is composed by a system consisting of acquisition and storage of ECG signals, computer analysis, data management, and storage of readings in a patient data base. The last two modules are part of a Hospital Information System (HIS). The modular

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

    Science.gov (United States)

    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 questionnaires. A total of 103 hospitals responded. Results 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. Conclusions 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. PMID:24872912

  2. 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.

  3. 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.

  4. Reverse osmosis water purification system

    Science.gov (United States)

    Ahlstrom, H. G.; Hames, P. S.; Menninger, F. J.

    1986-01-01

    A reverse osmosis water purification system, which uses a programmable controller (PC) as the control system, was designed and built to maintain the cleanliness and level of water for various systems of a 64-m antenna. The installation operates with other equipment of the antenna at the Goldstone Deep Space Communication Complex. The reverse osmosis system was designed to be fully automatic; with the PC, many complex sequential and timed logic networks were easily implemented and are modified. The PC monitors water levels, pressures, flows, control panel requests, and set points on analog meters; with this information various processes are initiated, monitored, modified, halted, or eliminated as required by the equipment being supplied pure water.

  5. 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.

  6. Quality Management Systems Implementation Compared With Organizational Maturity in Hospital.

    Science.gov (United States)

    Moradi, Tayebeh; Jafari, Mehdi; Maleki, Mohammad Reza; Naghdi, Seyran; Ghiasvand, Hesam

    2015-07-27

    A quality management system can provide a framework for continuous improvement in order to increase the probability of customers and other stakeholders' satisfaction. The test maturity model helps organizations to assess the degree of maturity in implementing effective and sustained quality management systems; plan based on the current realities of the organization and prioritize their improvement programs. We aim to investigate and compare the level of organizational maturity in hospitals with the status of quality management systems implementation. This analytical cross sectional study was conducted among hospital administrators and quality experts working in hospitals with over 200 beds located in Tehran. In the first step, 32 hospitals were selected and then 96 employees working in the selected hospitals were studied. The data were gathered using the implementation checklist of quality management systems and the organization maturity questionnaire derived from ISO 10014. The content validity was calculated using Lawshe method and the reliability was estimated using test - retest method and calculation of Cronbach's alpha coefficient. The descriptive and inferential statistics were used to analyze the data using SPSS 18 software. According to the table, the mean score of organizational maturity among hospitals in the first stage of quality management systems implementation was equal to those in the third stage and hypothesis was rejected (p-value = 0.093). In general, there is no significant difference in the organizational maturity between the first and third level hospitals (in terms of implementation of quality management systems). Overall, the findings of the study show that there is no significant difference in the organizational maturity between the hospitals in different levels of the quality management systems implementation and in fact, the maturity of the organizations cannot be attributed to the implementation of such systems. As a result, hospitals

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

    Science.gov (United States)

    Rehem, Tania Cristina Morais Santa Barbara; de Oliveira, Maria Regina Fernandes; Ciosak, Suely Itsuko; Egry, Emiko Yoshikawa

    2013-01-01

    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. 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. 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. 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.

  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. Rate of Legionella pneumophila colonization in hospital hot water network after time flow taps installation.

    Science.gov (United States)

    Totaro, M; Valentini, P; Costa, A L; Giorgi, S; Casini, B; Baggiani, A

    2018-01-01

    In hospital water systems legionellae may be resistant to disinfectants in pipework, which is a problem particularly in areas where there is low flow or stagnation of water. We evaluated legionella colonization of a water network of an Italian hospital after time flow taps (TFTs) installation in proximity to dead legs. The water volume flushed was 64 L/day from May 2016, and 192 L/day from December 2016. Before TFTs installation, Legionella pneumophila sg2-14 was detected in all points (4 × 10 4  ± 3.1 × 10 4  cfu/L). All sites remained positive (2.9 × 10 4  ± 1.9 × 10 4  cfu/L) through November 2016. From December 2016 legionella persisted in one point only (2 × 10 2 to 6.8 × 10 3  cfu/L). TFTs with chemical disinfection may reduce legionella colonization associated with dead legs. Copyright © 2017 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  10. Implementation of a radiology information system in an University Hospital

    International Nuclear Information System (INIS)

    Marques, Paulo Mazzoncini de Azevedo; Santos, Antonio Carlos; Elias Junior, Jorge; Trad, Clovis Simao; Goes, Wilson Moraes; Castro, Carlos Roberto de

    2000-01-01

    This paper describes a radiology information system (RIS) developed and in the process of implementation in an University Hospital (Hospital das Clinicas da Faculdade de Medicina de Ribeirao Preto - Universidade de Sao Paulo) which integrates a plan for a 'filmless' radiology facility. (author)

  11. Capital Investment by Independent and System-Affiliated Hospitals

    Science.gov (United States)

    Carroll, Nathan W.; Smith, Dean G.; Wheeler, John R. C.

    2015-01-01

    Capital expenditures are a critical part of hospitals’ efforts to maintain quality of patient care and financial stability. Over the past 20 years, finding capital to fund these expenditures has become increasingly challenging for hospitals, particularly independent hospitals. Independent hospitals struggling to find ways to fund necessary capital investment are often advised that their best strategy is to join a multi-hospital system. There is scant empirical evidence to support the idea that system membership improves independent hospitals’ ability to make capital expenditures. Using data from the American Hospital Association and Medicare Cost Reports, we use difference-in-difference methods to examine changes in capital expenditures for independent hospitals that joined multi-hospital systems between 1997 and 2008. We find that in the first 5 years after acquisition, capital expenditures increase by an average of almost $16 000 per bed annually, as compared with non-acquired hospitals. In later years, the difference in capital expenditure is smaller and not statistically significant. Our results do not suggest that increases in capital expenditures vary by asset age or the size of the acquiring system. PMID:26105571

  12. [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".

  13. Drinking-water monitoring systems

    International Nuclear Information System (INIS)

    1994-01-01

    A new measuring system was developed by the Austrian Research Centre Seibersdorf for monitoring the quality of drinking-water. It is based on the experience made with the installation of UWEDAT (registered trademark) environmental monitoring networks in several Austrian provinces and regions. The standard version of the drinking-water monitoring system comprises sensors for measuring chemical parameters in water, radioactivity in water and air, and meteorological values of the environment. Further measuring gauges, e.g. for air pollutants, can be connected at any time, according to customers' requirements. For integration into regional and supraregional networks, station computers take over the following tasks: Collection of data and status signals transmitted by the subsystem, object protection, intermediate storage and communication of data to the host or several subcentres via Datex-P postal service, permanent lines or radiotransmission

  14. Portable water quality monitoring system

    Science.gov (United States)

    Nizar, N. B.; Ong, N. R.; Aziz, M. H. A.; Alcain, J. B.; Haimi, W. M. W. N.; Sauli, Z.

    2017-09-01

    Portable water quality monitoring system was a developed system that tested varied samples of water by using different sensors and provided the specific readings to the user via short message service (SMS) based on the conditions of the water itself. In this water quality monitoring system, the processing part was based on a microcontroller instead of Lead and Copper Rule (LCR) machines to receive the results. By using four main sensors, this system obtained the readings based on the detection of the sensors, respectively. Therefore, users can receive the readings through SMS because there was a connection between Arduino Uno and GSM Module. This system was designed to be portable so that it would be convenient for users to carry it anywhere and everywhere they wanted to since the processor used is smaller in size compared to the LCR machines. It was also developed to ease the user to monitor and control the water quality. However, the ranges of the sensors' detection still a limitation in this study.

  15. [Hospital information system performance for road traffic accidents analysis in a hospital recruitment based area].

    Science.gov (United States)

    Jannot, A-S; Fauconnier, J

    2013-06-01

    Road traffic accidents in France are mainly analyzed through reports completed by the security forces (police and gendarmerie). But the hospital information systems can also identify road traffic accidents via specific documentary codes of the International Classification of Diseases (ICD-10). The aim of this study was therefore to determine whether hospital stays consecutive to road traffic accident were truly identified by these documentary codes in a facility that collects data routinely and to study the consistency of results from hospital information systems and from security forces during the 2002-2008 period. We retrieved all patients for whom a documentary code for road traffic accident was entered in 2002-2008. We manually checked the concordance of documentary code for road traffic accident and trauma origin in 350 patient files. The number of accidents in the Grenoble area was then inferred by combining with hospitalization regional data and compared to the number of persons injured by traffic accidents declared by the security force. These hospital information systems successfully report road traffic accidents with 96% sensitivity (95%CI: [92%, 100%]) and 97% specificity (95%CI: [95%, 99%]). The decrease in road traffic accidents observed was significantly less than that observed was significantly lower than that observed in the data from the security force (45% for security force data against 27% for hospital data). Overall, this study shows that hospital information systems are a powerful tool for studying road traffic accidents morbidity in hospital and are complementary to security force data. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  16. Solar space and water heating system installed at Charlottesville, Virginia

    Science.gov (United States)

    1980-01-01

    The solar energy system located at David C. Wilson Neuropsychiatric Hospital, Charlottesville, Virginia, is described. The solar energy system consists of 88 single glazed, Sunworks 'Solector' copper base plate collector modules, hot water coils in the hot air ducts, a Domestic Hot Water (DHW) preheat tank, a 3,000 gallon concrete urethane insulated storage tank and other miscellaneous components. Extracts from the site files, specifications, drawings, installation, operation and maintenance instructions are included.

  17. Factors Affecting Successful Implementation of Hospital Information Systems.

    Science.gov (United States)

    Farzandipur, Mehrdad; Jeddi, Fatemeh Rangraz; Azimi, Esmaeil

    2016-02-01

    Today, the use of information systems in health environments, like any other fields, is necessary and organizational managers are convinced to use these systems. However, managers' satisfaction is not the only factor in successfully implementing these systems and failed information technology projects (IT) are reported despite the consent of the directors. Therefore, this study aims to determine the factors affecting the successful implementation of a hospital information system. The study was carried out as a descriptive method in 20 clinical hospitals that the hospital information system (HIS) was conducted in them. The clinical and paraclinical users of mentioned hospitals are the study group. 400 people were chosen as samples in scientific method and the data was collected using a questionnaire consisted of three main human, managerial and organizational, and technological factors, by questionnaire and interview. Then the data was scored in Likert scale (score of 1 to 5) and were analyzed using the SPSS software. About 75 percent of the population were female, with average work experience of 10 years and the mean age was 30 years. The human factors affecting the success of hospital information system implementation achieved the mean score of 3.5, both organizational and managerial factors 2.9 and technological factors the mean of 3. Human factors including computer skills, perceiving usefulness and perceiving the ease of a hospital information system use are more effective on the acceptance and successful implementation of hospital information systems; then the technological factors play a greater role. It is recommended that for the successful implementation of hospital information systems, most of these factors to be considered.

  18. 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.

  19. Hospital Impact After a Chemical Spill That Compromised the Potable Water Supply: West Virginia, January 2014.

    Science.gov (United States)

    Hsu, Joy; Del Rosario, Maria C; Thomasson, Erica; Bixler, Danae; Haddy, Loretta; Duncan, Mary Anne

    2017-10-01

    In January 2014, a chemical spill of 4-methylcyclohexanemethanol and propylene glycol phenyl ethers contaminated the potable water supply of approximately 300,000 West Virginia residents. To understand the spill's impact on hospital operations, we surveyed representatives from 10 hospitals in the affected area during January 2014. We found that the spill-related loss of potable water affected many aspects of hospital patient care (eg, surgery, endoscopy, hemodialysis, and infection control of Clostridium difficile). Hospital emergency preparedness planning could be enhanced by specifying alternative sources of potable water sufficient for hemodialysis, C. difficile infection control, and hospital processing and cleaning needs (in addition to drinking water). (Disaster Med Public Health Preparedness. 2017;11:621-624).

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

    International Nuclear Information System (INIS)

    Bae, Jae Ik; Park, Auh Whan; Cho, Hye Seon; Park, Eun Hee; Choi, Gap Suk; Lee, Seon Ju; Kim, Yong Woo; Juhn, Je Ryang

    2007-01-01

    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

  1. Hospital Based Customization of a Medical Information System

    Science.gov (United States)

    Rath, Marilyn A.; Ferguson, Julie C.

    1983-01-01

    A Medical Information System must be current if it is to be a viable adjunct to patient care within a hospital setting. Hospital-based customization provides a means of achieving this timeliness with maximum user satisfaction. It, however, requires a major commitment in personnel time as well as additional software and training expenses. The enhanced control of system modifications and overall flexibility in planning the change process result in enthusiastic support of this approach by many hospitals. The key factors for success include careful selection of local personnel with adequate vendor support, extensive QA control, thorough auditing/validation and direct user involvement.

  2. Automatic Water Sensor Window Opening System

    KAUST Repository

    Percher, Michael

    2013-01-01

    A system can automatically open at least one window of a vehicle when the vehicle is being submerged in water. The system can include a water collector and a water sensor, and when the water sensor detects water in the water collector, at least one window of the vehicle opens.

  3. Automatic Water Sensor Window Opening System

    KAUST Repository

    Percher, Michael

    2013-12-05

    A system can automatically open at least one window of a vehicle when the vehicle is being submerged in water. The system can include a water collector and a water sensor, and when the water sensor detects water in the water collector, at least one window of the vehicle opens.

  4. Comammox in drinking water systems.

    Science.gov (United States)

    Wang, Yulin; Ma, Liping; Mao, Yanping; Jiang, Xiaotao; Xia, Yu; Yu, Ke; Li, Bing; Zhang, Tong

    2017-06-01

    The discovery of complete ammonia oxidizer (comammox) has fundamentally upended our perception of the global nitrogen cycle. Here, we reported four metagenome assembled genomes (MAGs) of comammox Nitrospira that were retrieved from metagenome datasets of tap water in Singapore (SG-bin1 and SG-bin2), Hainan province, China (HN-bin3) and Stanford, CA, USA (ST-bin4). Genes of phylogenetically distinct ammonia monooxygenase subunit A (amoA) and hydroxylamine dehydrogenase (hao) were identified in these four MAGs. Phylogenetic analysis based on ribosomal proteins, AmoA, hao and nitrite oxidoreductase (subunits nxrA and nxrB) sequences indicated their close relationships with published comammox Nitrospira. Canonical ammonia-oxidizing microbes (AOM) were also identified in the three tap water samples, ammonia-oxidizing bacteria (AOB) in Singapore's and Stanford's samples and ammonia-oxidizing archaea (AOA) in Hainan's sample. The comammox amoA-like sequences were also detected from some other drinking water systems, and even outnumbered the AOA and AOB amoA-like sequences. The findings of MAGs and the occurrences of AOM in different drinking water systems provided a significant clue that comammox are widely distributed in drinking water systems. Copyright © 2017 Elsevier Ltd. All rights reserved.

  5. 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.

  6. Hospital information systems: experience at the fully digitized Seoul National University Bundang Hospital.

    Science.gov (United States)

    Yoo, Sooyoung; Hwang, Hee; Jheon, Sanghoon

    2016-08-01

    The different levels of health information technology (IT) adoption and its integration into hospital workflow can affect the maximization of the benefits of using of health IT. We aimed at sharing our experiences and the journey to the successful adoption of health IT over 13 years at a tertiary university hospital in South Korea. The integrated system of comprehensive applications for direct care, support care, and smart care has been implemented with the latest IT and a rich user information platform, achieving the fully digitized hospital. The users experience design methodology, barcode and radio-frequency identification (RFID) technologies, smartphone and mobile technologies, and data analytics were integrated into hospital workflow. Applications for user-centered electronic medical record (EMR) and clinical decision support (CDS), closed loop medication administration (CLMA), mobile EMR and dashboard system for care coordination, clinical data warehouse (CDW) system, and patient engagement solutions were designed and developed to improve quality of care, work efficiency, and patient safety. We believe that comprehensive electronic health record systems and patient-centered smart hospital applications will go a long way in ensuring seamless patient care and experience.

  7. Changing patient classification system for hospital reimbursement in Romania.

    Science.gov (United States)

    Radu, Ciprian-Paul; Chiriac, Delia Nona; Vladescu, Cristian

    2010-06-01

    To evaluate the effects of the change in the diagnosis-related group (DRG) system on patient morbidity and hospital financial performance in the Romanian public health care system. Three variables were assessed before and after the classification switch in July 2007: clinical outcomes, the case mix index, and hospital budgets, using the database of the National School of Public Health and Health Services Management, which contains data regularly received from hospitals reimbursed through the Romanian DRG scheme (291 in 2009). The lack of a Romanian system for the calculation of cost-weights imposed the necessity to use an imported system, which was criticized by some clinicians for not accurately reflecting resource consumption in Romanian hospitals. The new DRG classification system allowed a more accurate clinical classification. However, it also exposed a lack of physicians' knowledge on diagnosing and coding procedures, which led to incorrect coding. Consequently, the reported hospital morbidity changed after the DRG switch, reflecting an increase in the national case-mix index of 25% in 2009 (compared with 2007). Since hospitals received the same reimbursement over the first two years after the classification switch, the new DRG system led them sometimes to change patients' diagnoses in order to receive more funding. Lack of oversight of hospital coding and reporting to the national reimbursement scheme allowed the increase in the case-mix index. The complexity of the new classification system requires more resources (human and financial), better monitoring and evaluation, and improved legislation in order to achieve better hospital resource allocation and more efficient patient care.

  8. Understanding end water quality in hospitals and other large buildings

    Science.gov (United States)

    Local hospitals are depending on the use of copper silver ionization treatment to control Legionella in premise plumbing. Discussion will show some results that speak to the effectiveness of this treatment to control opportunistic pathogens.

  9. 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.

  10. 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.

  11. 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.

  12. Drinking Water Quality in Hospitals and Other Buildings

    Science.gov (United States)

    Drinking water quality entering large buildings is generally adequately controlled by the water utility, but localized problems may occur within building or “premise” plumbing. Particular concerns are loss of disinfectant residual and temperature variability, which may enhance pa...

  13. Fungal contaminants in man-made water systems connected to municipal water.

    Science.gov (United States)

    Kadaifciler, Duygu Göksay; Demirel, Rasime

    2018-04-01

    Water-related fungi are known to cause taste and odor problems, as well as negative health effects, and can lead to water-pipeline clogging. There is no legal regulation on the occurrence of fungi in water environments. However, much research has been performed, but further studies are needed. The main objectives of this study were to evaluate the fungal load and the presence of mycotoxigenic fungi in man-made water systems (for homes, hospitals, and shopping centers) connected to municipal water in Istanbul, Turkey. The mean fungal concentrations found in the different water samples were 98 colony-forming units (CFU)/100 mL in shopping centers, 51 CFU/100 mL in hospitals, and 23 CFU/100 mL in homes. The dominant fungal species were identified as Aureobasidium pullulans and Fusarium oxysporum. Aflatoxigenic Aspergillus flavus and ochratoxigenic Aspergillus westerdijkiae were only detected in the hospital water samples. Alternaria alternata, Aspergillus clavatus, Aspergillus fumigatus, and Cladosporium cladosporioides were also detected in the samples. The study reveals that the municipal water supplies, available for different purposes, could thus contain mycotoxigenic fungi. It was concluded that current disinfection procedures may be insufficient, and the presence of the above-mentioned fungi is important for people with suppressed immune systems.

  14. What happens in hospitals does not stay in hospitals: antibiotic-resistant bacteria in hospital wastewater systems.

    Science.gov (United States)

    Hocquet, D; Muller, A; Bertrand, X

    2016-08-01

    Hospitals are hotspots for antimicrobial-resistant bacteria (ARB) and play a major role in both their emergence and spread. Large numbers of these ARB will be ejected from hospitals via wastewater systems. In this review, we present quantitative and qualitative data of extended-spectrum β-lactamase (ESBL)-producing Escherichia coli, vancomycin-resistant enterococci and Pseudomonas aeruginosa in hospital wastewaters compared to community wastewaters. We also discuss the fate of these ARB in wastewater treatment plants and in the downstream environment. Published studies have shown that hospital effluents contain ARB, the burden of these bacteria being dependent on their local prevalence. The large amounts of antimicrobials rejected in wastewater exert a continuous selective pressure. Only a few countries recommend the primary treatment of hospital effluents before their discharge into the main wastewater flow for treatment in municipal wastewater treatment plants. Despite the lack of conclusive data, some studies suggest that treatment could favour the ARB, notably ESBL-producing E. coli. Moreover, treatment plants are described as hotspots for the transfer of antibiotic resistance genes between bacterial species. Consequently, large amounts of ARB are released in the environment, but it is unclear whether this release contributes to the global epidemiology of these pathogens. It is reasonable, nevertheless, to postulate that it plays a role in the worldwide progression of antibiotic resistance. Antimicrobial resistance should now be seen as an 'environmental pollutant', and new wastewater treatment processes must be assessed for their capability in eliminating ARB, especially from hospital effluents. Copyright © 2016. Published by Elsevier Ltd.

  15. 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.

  16. 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.

  17. 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.

  18. FLASH Technology: Full-Scale Hospital Waste Water Treatments Adopted in Aceh

    Science.gov (United States)

    Rame; Tridecima, Adeodata; Pranoto, Hadi; Moesliem; Miftahuddin

    2018-02-01

    A Hospital waste water contains a complex mixture of hazardous chemicals and harmful microbes, which can pose a threat to the environment and public health. Some efforts have been carried out in Nangroe Aceh Darussalam (Aceh), Indonesia with the objective of treating hospital waste water effluents on-site before its discharge. Flash technology uses physical and biological pre-treatment, followed by advanced oxidation process based on catalytic ozonation and followed by GAC and PAC filtration. Flash Full-Scale Hospital waste water Treatments in Aceh from different district have been adopted and investigated. Referring to the removal efficiency of macro-pollutants, the collected data demonstrate good removal efficiency of macro-pollutants using Flash technologies. In general, Flash technologies could be considered a solution to the problem of managing hospital waste water.

  19. 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

  20. 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...

  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. 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

  3. 76 FR 41178 - Medicare Program; Proposed Changes to the Hospital Inpatient Prospective Payment Systems for...

    Science.gov (United States)

    2011-07-13

    ... Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment...; Proposed Changes to the Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Fiscal Year 2012 Rates'' which appeared in the...

  4. Study on the simulation of heat pump heating and cooling systems to hospital building

    International Nuclear Information System (INIS)

    Choi, Young Don; Han, Seong Ho; Cho, Sung Hwan; Kim, Du Sung; Um, Chul Jun

    2008-01-01

    In Korea, air source heat pump system is less efficient than conventional heat source facilities, because the air temperature in winter season is so low that COP of air source heat pump system drops below 3.0. Therefore, the study on the application of heat pump heating and cooling systems is crucial for the efficient popularization of heat pump. In this work, we present the dynamic analysis of energy consumption for the large hospital building by heat resistance-capacitance method. The system simulation of water storage air source heat pump is additionally performed by changing sizes and locations of the hospital building. The computed results show that energy cost of water storage air source heat pump is low, so it is more economical than absorption chiller and heater

  5. Water-Cut Sensor System

    KAUST Repository

    Karimi, Muhammad Akram

    2018-01-11

    Provided in some embodiments is a method of manufacturing a pipe conformable water-cut sensors system. Provided in some embodiments is method for manufacturing a water-cut sensor system that includes providing a helical T-resonator, a helical ground conductor, and a separator at an exterior of a cylindrical pipe. The helical T-resonator including a feed line, and a helical open shunt stub conductively coupled to the feed line. The helical ground conductor including a helical ground plane opposite the helical open shunt stub and a ground ring conductively coupled to the helical ground plane. The feed line overlapping at least a portion of the ground ring, and the separator disposed between the feed line and the portion of the ground ring overlapped by the feed line to electrically isolate the helical T-resonator from the helical ground conductor.

  6. Propulsion Systems in Water Tunnel

    Directory of Open Access Journals (Sweden)

    Nobuyuki Fujisawa

    1995-01-01

    agreement with the field experiment with prototype craft. Measurements are also made for the losses in the intake and the nozzle. The optimization study of the water jet systems is conducted by simulating the change of the nozzle outlet diameter with the variable nozzle arrangement. It is suggested that the nozzle outlet diameter should be decreased as the craft velocity increases to obtain an optimum propulsive efficiency in a wide range of craft velocity.

  7. Hospital employs TQM principles to rework its evaluation system.

    Science.gov (United States)

    Burda, D

    1992-02-24

    One Kansas hospital has taken the traditional employee evaluation process--with all its performance criteria, point systems and rankings--and turned it on its head. The new system employs total quality management principles and promotes personal development, education and teamwork. And everyone gets the same raise.

  8. Integrating knowledge based functionality in commercial hospital information systems.

    Science.gov (United States)

    Müller, M L; Ganslandt, T; Eich, H P; Lang, K; Ohmann, C; Prokosch, H U

    2000-01-01

    Successful integration of knowledge-based functions in the electronic patient record depends on direct and context-sensitive accessibility and availability to clinicians and must suit their workflow. In this paper we describe an exemplary integration of an existing standalone scoring system for acute abdominal pain into two different commercial hospital information systems using Java/Corba technolgy.

  9. Is the Australian hospital system adequately prepared for terrorism?

    Science.gov (United States)

    Rosenfeld, Jeffrey V; Fitzgerald, Mark; Kossmann, Thomas; Pearce, Andrew; Joseph, Anthony; Joseph, Andrew; Tan, Gim; Gardner, Michele; Shapira, Shmuel

    Australian hospitals need to be prepared to deal with mass casualties from terrorist strikes, including bomb blasts and chemical, biological and radiation injury. Injuries from bomb explosions are more severe than those commonly seen in Australian hospitals. In disasters involving mass casualties in urban areas, many of the injured make their own way to hospital, often arriving before the more seriously injured casualties. Major hospitals in Australia should plan for large numbers of undifferentiated and potentially contaminated casualties arriving with minimal warning. It is critical that experienced and trained senior medical officers perform the triage of casualties in emergency departments, with frequent reassessment to detect missed injuries (especially pulmonary blast injury). Hospitals require well developed standard operating procedures for mass casualty events, reinforced by regular drills. Preparing for a major event includes training staff in major incident management, setting up an operational/control unit, nominating key personnel, ensuring there is an efficient intra-hospital communication system, and enhancing links with other emergency services and hospitals.

  10. Water sample-collection and distribution system

    Science.gov (United States)

    Brooks, R. R.

    1978-01-01

    Collection and distribution system samples water from six designated stations, filtered if desired, and delivers it to various analytical sensors. System may be controlled by Water Monitoring Data Acquisition System or operated manually.

  11. Intranet technology in hospital information systems.

    Science.gov (United States)

    Cimino, J J

    1997-01-01

    The clinical information system architecture at the Columbia-Presbyterian Medical Center in New York is being incorporated into an intranet using Internet and World Wide Web protocols. The result is an Enterprise-Wide Web which provides more flexibility for access to specific patient information and general medical knowledge. Critical aspects of the architecture include a central data repository and a vocabulary server. The new architecture provides ways of displaying patient information in summary, graphical, and multimedia forms. Using customized links called Infobuttons, we provide access to on-line information resources available on the World Wide Web. Our experience to date has raised a number of interesting issues about the use of this technology for health care systems.

  12. Total Water Management, the New Paradigm for Urban Water Systems

    Science.gov (United States)

    There is a growing need for urban water managers to take a more holistic view of their water resource systems as population growth, urbanization, and current resource management practices put different stresses on local water resources and urban infrastructure. Total Water Manag...

  13. Availability of software services for a hospital information system.

    Science.gov (United States)

    Sakamoto, N

    1998-03-01

    Hospital information systems (HISs) are becoming more important and covering more parts in daily hospital operations as order-entry systems become popular and electronic charts are introduced. Thus, HISs today need to be able to provide necessary services for hospital operations for a 24-h day, 365 days a year. The provision of services discussed here does not simply mean the availability of computers, in which all that matters is that the computer is functioning. It means the provision of necessary information for hospital operations by the computer software, and we will call it the availability of software services. HISs these days are mostly client-server systems. To increase availability of software services in these systems, it is not enough to just use system structures that are highly reliable in existing host-centred systems. Four main components which support availability of software services are network systems, client computers, server computers, and application software. In this paper, we suggest how to structure these four components to provide the minimum requested software services even if a part of the system stops to function. The network system should be double-protected in stratus using Asynchronous Transfer Mode (ATM) as its base network. Client computers should be fat clients with as much application logic as possible, and reference information which do not require frequent updates (master files, for example) should be replicated in clients. It would be best if all server computers could be double-protected. However, if that is physically impossible, one database file should be made accessible by several server computers. Still, at least the basic patients' information and the latest clinical records should be double-protected physically. Application software should be tested carefully before introduction. Different versions of the application software should always be kept and managed in case the new version has problems. If a hospital

  14. 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.

  15. 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.

  16. Cooling water systems design using process integration

    CSIR Research Space (South Africa)

    Gololo, KV

    2010-09-01

    Full Text Available Cooling water systems are generally designed with a set of heat exchangers arranged in parallel. This arrangement results in higher cooling water flowrate and low cooling water return temperature thus reducing cooling tower efficiency. Previous...

  17. California community water systems inventory dataset, 2010

    Data.gov (United States)

    California Environmental Health Tracking Program — This data set contains information about all Community Water Systems in California. Data are derived from California Office of Drinking Water (ODW) Water Quality...

  18. Water management - management actions applied to water resources system

    International Nuclear Information System (INIS)

    Petkovski, Ljupcho; Tanchev, Ljubomir

    2001-01-01

    In this paper are presented a general description of water resource systems, a systematisation of the management tasks and the approaches for solution, including a review of methods used for solution of water management tasks and the fundamental postulates in the management. The management of water resources is a synonym for the management actions applied to water resource systems. It is a general term that unites planning and exploitation of the systems. The modern planning assumes separating the water racecourse part from the hydro technical part of the project. The water resource study is concerned with the solution for the resource problem. This means the parameters of the system are determined in parallel with the definition of the water utilisation regime. The hydro-technical part of the project is the design of structures necessary for the water resource solution. (Original)

  19. Combined PACS and intranet information system in a University Hospital

    International Nuclear Information System (INIS)

    Heiss, D.; Pfluger, T.; Pfeifer, K.J.; Hahn, K.; Koenig, A.; Endres, S.

    2000-01-01

    Purpose: The Department of Radiology at the University Hospital Innenstadt Munich provides all clinical departments of a large university hospital with several radiology units at different locations. During the last four years all units have been fully digitalized with a stepwise installation of a PACS. The PACS also processes images from the Nuclear Medicine Department. Methods: As image modalities, archive systems and review workstations, we use devices from multiple vendors, which are integrated into a consistent system using the DICOM standard. The hospital has developed its own RIS and an intranet information system, which provides access to all reports and images from radiology for all clinical departments inside the hospital. Additionally, other clinical information such as laboratory results or ECG examinations are available through the system. Results: After one year of operation, the system succeeded in the clinical routine work as the primary source for radiological reports and images as well as for laboratory values. Conclusion: The advantages of digitalization were, besides reduction of film cost, especially optimizations of work flow with access to digital images from every where at any time. (orig.) [de

  20. Small Drinking Water Systems Communication and Outreach ...

    Science.gov (United States)

    As part of our small drinking water systems efforts, this poster highlights several communications and outreach highlights that EPA's Office of Research and Development and Office of Water have been undertaking in collaboration with states and the Association of State Drinking Water Administrators. To share information at EPA's annual small drinking water systems workshop

  1. Heavy water upgrading system in the Fugen heavy water reactor

    International Nuclear Information System (INIS)

    Matsushita, T.; Susaki, S.

    1980-01-01

    The heavy water upgrading system, which is installed in the Fugen heavy water reactor (HWR) was designed to reuse degraded heavy water generated from the deuteration-dedeuteration of resin in the ion exchange column of the moderator purification system. The electrolysis method has been applied in this system on the basis of the predicted generation rate and concentration of degraded heavy water. The structural feature of the electrolytic cell is that it consists of dual cylindrical electrodes, instead of a diaphragm as in the case of conventional water electrolysis. 2 refs

  2. Implementation of an advanced clinical and administrative hospital information system.

    Science.gov (United States)

    Vegoda, P R; Dyro, J F

    1986-01-01

    Over the last six years since University Hospital opened, the University Hospital Information System (UHIS) has continued to evolve to what is today an advanced administrative and clinical information system. At University Hospital UHIS is the way of conducting business. A wide range of patient care applications are operational including Patient Registration, ADT for Inpatient/Outpatient/Emergency Room visits, Advanced Order Entry/Result Reporting, Medical Records, Lab Automated Data Acquisition/Quality Control, Pharmacy, Radiology, Dietary, Respiratory Therapy, ECG, EEG, Cardiology, Physical/Occupational Therapy and Nursing. These systems and numerous financial systems have been installed in a highly tuned, efficient computer system. All applications are real-time, on-line, and data base oriented. Each system is provided with multiple data security levels, forward file recovery, and dynamic transaction backout of in-flight tasks. Sensitive medical information is safeguarded by job function passwords, identification codes, need-to-know master screens and terminal keylocks. University Hospital has an IBM 3083 CPU with five 3380 disk drives, four dual density tape drives, and a 3705 network controller. The network of 300 terminals and 100 printers is connected to the computer center by an RF broadband cable. The software is configured around the IBM/MVS operating system using CICS as the telecommunication monitor, IMS as the data base management system and PCS/ADS as the application enabling tool. The most extensive clinical system added to UHIS is the Physiological Monitoring/Patient Data Management System with serves 92 critical care beds. In keeping with the Hospital's philosophy of integrated computing, the PMS/PDMS with its network of minicomputers was linked to the UHIS system. In a pilot program, remote access to UHIS through the IBM personal computer has been implemented in several physician offices in the local community, further extending the communications

  3. Information system maturity and the hospitality enterprise performance

    Directory of Open Access Journals (Sweden)

    Daniela Garbin Pranicevic

    2015-01-01

    Full Text Available The purpose of this paper is to empirically evaluate the relationship between the maturity of hotels’ information systems and their performance. This study uses customized models of information system (IS maturity and hotel performance measurement. Since we wanted to include the intangible aspects of performance, we opted for an adapted application of the Balanced Scorecard model. In the empirical part of the paper, fundamental constructs of the model are verified, while the individual items are further evaluated by employing discriminant analysis to distinguish hotels with relatively low and high performance levels. The findings demonstrate the existence of a significant and positive relationship between IS maturity and two dimensions of performance in the hospitality industry – process quality and guest relationships. The level of employee development and financial performance do not seem to be related to IS maturity. Although representative, the sample is relatively small, and the primary data were collected in a single country. The paper provides a framework of IS maturity items in the hospitality industry which seem to contribute to hotels’ business performances. As such, it can serve as a practical framework relevant for IT management in tourism and hospitality. The paper addresses a topic already discussed in a range of industries, although it does not seem to have been empirically evaluated by many studies of the tourism and hospitality industry. In addition, a new theoretical model of IT maturity in tourism and hospitality is proposed.

  4. New compliance management system of the University Hospital Frankfurt, Germany

    OpenAIRE

    Irmscher, Bettina

    2016-01-01

    The meaning of Corporate Governance is all values and principles guiding or regulating good and responsible business management. Clearly defined roles and responsibilities for managing compliance, risks and checks is the prerequisite for the latter. For that reason, a compliance management system was set up at the University Hospital Frankfurt in 2015.

  5. 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.

  6. Water reactive hydrogen fuel cell power system

    Science.gov (United States)

    Wallace, Andrew P; Melack, John M; Lefenfeld, Michael

    2014-01-21

    A water reactive hydrogen fueled power system includes devices and methods to combine reactant fuel materials and aqueous solutions to generate hydrogen. The generated hydrogen is converted in a fuel cell to provide electricity. The water reactive hydrogen fueled power system includes a fuel cell, a water feed tray, and a fuel cartridge to generate power for portable power electronics. The removable fuel cartridge is encompassed by the water feed tray and fuel cell. The water feed tray is refillable with water by a user. The water is then transferred from the water feed tray into a fuel cartridge to generate hydrogen for the fuel cell which then produces power for the user.

  7. An Expert System-Based Approach to Hospitality Company Diagnosis

    OpenAIRE

    Balfe, Andrew; O'Connor, Peter; McDonnell, Ciaran

    1994-01-01

    This paper describes the development of a prototype Expert System-based Analysis and Diagnostic (ESAD) package for the Hotel and Catering Industry. This computerised tool aids the hospitality manager in methodically scrutinising the hotel unit and environment, combining key information with systematic reasoning. The system searches through its extensive knowledge base, investigating complicated relationships. The number of possibilities considered is increased which will broaden the depth and...

  8. Hospital medication errors in a pharmacovigilance system in Colombia

    Directory of Open Access Journals (Sweden)

    Jorge Enrique Machado-Alba

    2015-11-01

    Full Text Available Objective: this study analyzes the medication errors reported to a pharmacovigilance system by 26 hospitals for patients in the healthcare system of Colombia. Methods: this retrospective study analyzed the medication errors reported to a systematized database between 1 January 2008 and 12 September 2013. The medication is dispensed by the company Audifarma S.A. to hospitals and clinics around Colombia. Data were classified according to the taxonomy of the National Coordinating Council for Medication Error Reporting and Prevention (NCC MERP. The data analysis was performed using SPSS 22.0 for Windows, considering p-values < 0.05 significant. Results: there were 9 062 medication errors in 45 hospital pharmacies. Real errors accounted for 51.9% (n = 4 707, of which 12.0% (n = 567 reached the patient (Categories C to I and caused harm (Categories E to I to 17 subjects (0.36%. The main process involved in errors that occurred (categories B to I was prescription (n = 1 758, 37.3%, followed by dispensation (n = 1 737, 36.9%, transcription (n = 970, 20.6% and administration (n = 242, 5.1%. The errors in the administration process were 45.2 times more likely to reach the patient (CI 95%: 20.2–100.9. Conclusions: medication error reporting systems and prevention strategies should be widespread in hospital settings, prioritizing efforts to address the administration process.

  9. Water supply facility damage and water resource operation at disaster base hospitals in miyagi prefecture in the wake of the Great East Japan Earthquake.

    Science.gov (United States)

    Matsumura, Takashi; Osaki, Shizuka; Kudo, Daisuke; Furukawa, Hajime; Nakagawa, Atsuhiro; Abe, Yoshiko; Yamanouchi, Satoshi; Egawa, Shinichi; Tominaga, Teiji; Kushimoto, Shigeki

    2015-04-01

    The aim of this study was to shed light on damage to water supply facilities and the state of water resource operation at disaster base hospitals in Miyagi Prefecture (Japan) in the wake of the Great East Japan Earthquake (2011), in order to identify issues concerning the operational continuity of hospitals in the event of a disaster. In addition to interview and written questionnaire surveys to 14 disaster base hospitals in Miyagi Prefecture, a number of key elements relating to the damage done to water supply facilities and the operation of water resources were identified from the chronological record of events following the Great East Japan Earthquake. Nine of the 14 hospitals experienced cuts to their water supplies, with a median value of three days (range=one to 20 days) for service recovery time. The hospitals that could utilize well water during the time that water supply was interrupted were able to obtain water in quantities similar to their normal volumes. Hospitals that could not use well water during the period of interruption, and hospitals whose water supply facilities were damaged, experienced significant disruption to dialysis, sterilization equipment, meal services, sanitation, and outpatient care services, though the extent of disruption varied considerably among hospitals. None of the hospitals had determined the amount of water used for different purposes during normal service or formulated a plan for allocation of limited water in the event of a disaster. The present survey showed that it is possible to minimize the disruption and reduction of hospital functions in the event of a disaster by proper maintenance of water supply facilities and by ensuring alternative water resources, such as well water. It is also clear that it is desirable to conclude water supply agreements and formulate strategic water allocation plans in preparation for the eventuality of a long-term interruption to water services.

  10. An outbreak of Legionnaires disease associated with a decorative water wall fountain in a hospital.

    Science.gov (United States)

    Haupt, Thomas E; Heffernan, Richard T; Kazmierczak, James J; Nehls-Lowe, Henry; Rheineck, Bruce; Powell, Christine; Leonhardt, Kathryn K; Chitnis, Amit S; Davis, Jeffrey P

    2012-02-01

    To detect an outbreak-related source of Legionella, control the outbreak, and prevent additional Legionella infections from occurring. Epidemiologic investigation of an acute outbreak of hospital-associated Legionnaires disease among outpatients and visitors to a Wisconsin hospital. Patients with laboratory-confirmed Legionnaires disease who resided in southeastern Wisconsin and had illness onsets during February and March 2010. Patients with Legionnaires disease were interviewed using a hypothesis-generating questionnaire. On-site investigation included sampling of water and other potential environmental sources for Legionella testing. Case-finding measures included extensive notification of individuals potentially exposed at the hospital and alerts to area healthcare and laboratory personnel. Laboratory-confirmed Legionnaires disease was diagnosed in 8 patients, all of whom were present at the same hospital during the 10 days prior to their illness onsets. Six patients had known exposure to a water wall-type decorative fountain near the main hospital entrance. Although the decorative fountain underwent routine cleaning and maintenance, high counts of Legionella pneumophila serogroup 1 were isolated from cultures of a foam material found above the fountain trough. This outbreak of Legionnaires disease was associated with exposure to a decorative fountain located in a hospital public area. Routine cleaning and maintenance of fountains does not eliminate the risk of bacterial contamination. Our findings highlight the need to evaluate the safety of water fountains installed in any area of a healthcare facility.

  11. Front-Line Physicians' Satisfaction with Information Systems in Hospitals.

    Science.gov (United States)

    Peltonen, Laura-Maria; Junttila, Kristiina; Salanterä, Sanna

    2018-01-01

    Day-to-day operations management in hospital units is difficult due to continuously varying situations, several actors involved and a vast number of information systems in use. The aim of this study was to describe front-line physicians' satisfaction with existing information systems needed to support the day-to-day operations management in hospitals. A cross-sectional survey was used and data chosen with stratified random sampling were collected in nine hospitals. Data were analyzed with descriptive and inferential statistical methods. The response rate was 65 % (n = 111). The physicians reported that information systems support their decision making to some extent, but they do not improve access to information nor are they tailored for physicians. The respondents also reported that they need to use several information systems to support decision making and that they would prefer one information system to access important information. Improved information access would better support physicians' decision making and has the potential to improve the quality of decisions and speed up the decision making process.

  12. A novel system to tackle hospital acquired pressure ulcers.

    Science.gov (United States)

    Renganathan, B S; Preejith, S P; Nagaiyan, Sridhar; Joseph, Jayaraj; Sivaprakasam, Mohanasankar

    2016-08-01

    Hospital acquired pressure ulcers (HAPUs) is a major problem that affects around one in twenty patients who are admitted in hospital with sudden illness. These ulcers often occur when patients have limited mobility and cannot change positions in bed on their own. Traditionally, the occurrence of HAPUs has been minimized by turning the patient every 2 hours to alternating lateral and supine positions, and by using pressure redistributing mattresses. In many healthcare facilities, such a patient repositioning schedule is not always maintained owing to low caregiver compliance to turning protocols. Difficulty in monitoring patient position continuously, lack of turn reminders/alerts and suboptimal caregiver staffing ratio increases the occurrence of HAPUs. A novel method to address the need for improved pressure ulcer prevention is presented. The proposed method consists of a wearable device which continuously monitors the patient's position and communicates wirelessly with a tablet which enables alerts to be sent to the caregiver when a patient turn is due in accordance with the protocol adopted by the hospital. The patient's position is continuously monitored and the turning procedure carried out is logged and updated on the hospital's cloud system, thereby enabling centralized monitoring. Under a controlled setting, system was able to continuously monitor patient's position and can accurately detect standard patient positions.

  13. 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.

  14. 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.

  15. Sustainable Water Use System of Artesian Water in Alluvial Fan

    Science.gov (United States)

    Kishi, K.; Tsujimura, M.; Tase, N.

    2013-12-01

    The traditional water use system, developed with the intelligence of the local residents, usually takes advantage of local natural resources and is considered as a sustainable system, because of its energy saving(only forces of nature). For this reason, such kind of water use system is also recommended in some strategic policies for the purpose of a symbiosis between nature and human society. Therefore, it is important to clarify the relationship between human activities and water use systems. This study aims to clarify the mechanism of traditional water use processes in alluvial fan, and in addition, to investigate the important factors which help forming a sustainable water use system from the aspects of natural conditions and human activities. The study area, an alluvial fan region named Adogawa, is located in Shiga Prefecture, Japan and is in the west of Biwa Lake which is the largest lake in Japan. In this alluvial region where the land use is mainly occupied by settlements and paddy fields, a groundwater flowing well system is called "kabata" according to local tradition. During field survey, we took samples of groundwater, river water and lake water as well as measured the potential head of groundwater. The results showed that the upper boundary of flowing water was approximately 88m amsl, which is basically the same as the results reported by Kishi and Kanno (1966). In study area, a rapid increase of water pumping for domestic water use and melting snow during last 50 years, even if the irrigation area has decreased about 30% since 1970, and this fact may cause a decrease in recharge rate to groundwater. However, the groundwater level didn't decline based on the observed results, which is probably contributed by some water conservancy projects on Biwa Lake which maintained the water level of the lake. All the water samples are characterized by Ca-HCO3 type and similar stable isotopic value of δD and δ18O. Groundwater level in irrigation season is higher

  16. Silver disinfection in water distribution systems

    Science.gov (United States)

    Silvestry Rodriguez, Nadia

    Silver was evaluated as disinfectant to maintain water quality in water distribution system. It was used to inhibit growth of two opportunistic bacteria in planktonik form and in biofilm formation in Robbins devices with stainless steel and PVC surfaces. The results of this work show that silver is a potential secondary disinfectant to be used in water distribution systems.

  17. Workarounds to hospital electronic prescribing systems: a qualitative study in English hospitals.

    Science.gov (United States)

    Cresswell, Kathrin M; Mozaffar, Hajar; Lee, Lisa; Williams, Robin; Sheikh, Aziz

    2017-07-01

    Concerns with the usability of electronic prescribing (ePrescribing) systems can lead to the development of workarounds by users. To investigate the types of workarounds users employed, the underlying reasons offered and implications for care provision and patient safety. We collected a large qualitative data set, comprising interviews, observations and project documents, as part of an evaluation of ePrescribing systems in five English hospitals, which we conceptualised as case studies. Data were collected at up to three different time points throughout implementation and adoption. Thematic analysis involving deductive and inductive approaches was facilitated by NVivo 10. Our data set consisted of 173 interviews, 24 rounds of observation and 17 documents. Participating hospitals were at various stages of implementing a range of systems with differing functionalities. We identified two types of workarounds: informal and formal. The former were informal practices employed by users not approved by management, which were introduced because of perceived changes to professional roles, issues with system usability and performance and challenges relating to the inaccessibility of hardware. The latter were formalised practices that were promoted by management and occurred when systems posed threats to patient safety and organisational functioning. Both types of workarounds involved using paper and other software systems as intermediaries, which often created new risks relating to a lack of efficient transfer of real-time information between different users. Assessing formal and informal workarounds employed by users should be part of routine organisational implementation strategies of major health information technology initiatives. Workarounds can create new risks and present new opportunities for improvement in system design and integration. 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/.

  18. Combined air and water pollution control system

    Science.gov (United States)

    Wolverton, Billy C. (Inventor); Jarrell, Lamont (Inventor)

    1990-01-01

    A bioaquatic air pollution control system for controlling both water and atmospheric pollution is disclosed. The pollution control system includes an exhaust for directing polluted gases out of a furnace and a fluid circulating system which circulates fluid, such as waste water, from a source, past the furnace where the fluid flow entrains the pollutants from the furnace. The combined fluid and pollutants are then directed through a rock/plant/microbial filtering system. A suction pump pumps the treated waste water from the filter system past the exhaust to again entrain more pollutants from the furnace where they are combined with the fluid (waste water) and directed to the filter system.

  19. Greening the global water system

    Science.gov (United States)

    Hoff, H.; Falkenmark, M.; Gerten, D.; Gordon, L.; Karlberg, L.; Rockström, J.

    2010-04-01

    SummaryRecent developments of global models and data sets enable a new, spatially explicit and process-based assessment of green and blue water in food production and trade. An initial intercomparison of a range of different (hydrological, vegetation, crop, water resources and economic) models, confirms that green water use in global crop production is about 4-5 times greater than consumptive blue water use. Hence, the full green-to-blue spectrum of agricultural water management options needs to be used when tackling the increasing water gap in food production. The different models calculate considerable potentials for complementing the conventional approach of adding irrigation, with measures to increase water productivity, such as rainwater harvesting, supplementary irrigation, vapour shift and soil and nutrient management. Several models highlight Africa, in particular sub-Saharan Africa, as a key region for improving water productivity in agriculture, by implementing these measures. Virtual water trade, mostly based on green water, helps to close the water gap in a number of countries. It is likely to become even more important in the future, when inequities in water availability are projected to grow, due to climate, population and other drivers of change. Further model developments and a rigorous green-blue water model intercomparison are proposed, to improve simulations at global and regional scale and to enable tradeoff analyses for the different adaptation options.

  20. Power System Operations With Water Constraints

    Science.gov (United States)

    Qiu, F.; Wang, J.

    2015-12-01

    The interdependency between water and energy, although known for many decades, has not received enough attention until recent events under extreme weather conditions (especially droughts). On one hand, water and several types of energy supplies have become increasingly scarce; the demand on water and energy continues to grow. On the other hand, the climate change has become more and more disruptive (i.e., intensity and frequency of extreme events), causing severe challenges to both systems simultaneously. Water and energy systems have become deeply coupled and challenges from extreme weather events must be addressed in a coordinated way across the two systems.In this work, we will build quantitative models to capture the interactions between water and energy systems. We will incorporate water constraints in power system operations and study the impact of water scarcity on power system resilience.

  1. [Monitoring evaluation system for high-specialty hospitals].

    Science.gov (United States)

    Fajardo Dolci, Germán; Aguirre Gas, Héctor G; Robledo Galván, Héctor

    2011-01-01

    Hospital evaluation is a fundamental process to identify medical units' objective compliance, to analyze efficiency of resource use and allocation, institutional values and mission alignment, patient safety and quality standards, contributions to research and medical education, and the degree of coordination among medical units and the health system as a whole. We propose an evaluation system for highly specialized regional hospitals through the monitoring of performance indicators. The following are established as base thematic elements in the construction of indicators: safe facilities and equipment, financial situation, human resources management, policy management, organizational climate, clinical activity, quality and patient safety, continuity of care, patients' and providers' rights and obligations, teaching, research, social responsibility, coordination mechanisms. Monitoring refers to the planned and systematic evaluation of valid and reliable indicators, aimed at identifying problems and opportunity areas. Moreover, evaluation is a powerful tool to strengthen decision-making and accountability in medical units.

  2. 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

    meals from BTS and the dietary intake was measured. After implementation of CCP on the wards, dietary intake was measured on 56 patients. Intake at mealtimes was assessed through a visual portion size assessment method and intake in-between meals was measured using a self-reported dietary record......% 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...

  3. Models of governance in multihospital systems. Implications for hospital and system-level decision-making.

    Science.gov (United States)

    Morlock, L L; Alexander, J A

    1986-12-01

    This study utilizes data from a national survey of 159 multihospital systems in order to describe the types of governance structures currently being utilized, and to compare the policy making process for various types of decisions in systems with different approaches to governance. Survey results indicate that multihospital systems most often use one of three governance models. Forty-one percent of the systems (including 33% of system hospitals) use a parent holding company model in which there is a system-wide corporate governing board and separate governing boards for each member hospital. Twenty-two percent of systems in the sample (but 47% of all system hospitals) utilize what we have termed a modified parent holding company model in which there is one system-wide governing board, but advisory boards are substituted for governing boards at the local hospital level. Twenty-three percent of the sampled systems (including 11% of system hospitals) use a corporate model in which there is one system-wide governing board but no other governing or advisory boards at either the divisional, regional or local hospital levels. A comparison of systems using these three governance approaches found significant variation in terms of system size, ownership and the geographic proximity of member hospitals. In order to examine the relationship between alternative approaches to governance and patterns of decision-making, the three model types were compared with respect to the percentages of systems reporting that local boards, corporate management and/or system-wide corporate boards have responsibility for decision-making in a number of specific issue areas. Study results indicate that, regardless of model type, corporate boards are most likely to have responsibility for decisions regarding the transfer, pledging and sale of assets; the formation of new companies; purchase of assets greater than $100,000; changes in hospital bylaws; and the appointment of local board members. In

  4. Sustainable Soil Water Management Systems

    OpenAIRE

    Basch, G.; Kassam, A.; Friedrich, T.; Santos, F.L.; Gubiani, P.I.; Calegari, A.; Reichert, J.M.; dos Santos, D.R.

    2012-01-01

    Soil quality and its management must be considered as key elements for an effective management of water resources, given that the hydrological cycle and land management are intimately linked (Bossio et al. 2007). Soil degradation has been described by Bossio et al. (2010) as the starting point of a negative cycle of soil-water relationships, creating a positive, self-accelerating feedback loop with important negative impacts on water cycling and water productivity. Therefore, sustainable soil...

  5. Hospitals

    DEFF Research Database (Denmark)

    Mullins, Michael

    2013-01-01

    The challenge could be briefly seen in these terms: hospitals as places for treatment where there’s a technology focus and hospitals for healing where there’s a human focus. In the 60s - 70s wave of new hospital building, an emphasis on technology can be seen. It’s time to move from the technology...... focus. It is not enough to consider only the factors of function within architecture, hygiene, economy and logistics. We also need to look at aspects of aesthetics, bringing nature into the building, art, color, acoustics, volume and space as we perceive them. Contemporary methods and advances...... placed, accessible, provided with plenty of greenery, and maximize sensory impressions, providing sounds, smells, sight and the possibility to be touched. This is a very well documented area I can say. Hygiene, in terms of architecture can give attention to hand wash facilities and their positioning...

  6. 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.

  7. Advanced Mars Water Acquisition System, Phase I

    Data.gov (United States)

    National Aeronautics and Space Administration — The Advanced Mars Water Acquisition System (AMWAS) recovers and purifies water from Mars soils for oxygen and fuel production, life support, food production, and...

  8. Design data brochure: Solar hot water system

    Science.gov (United States)

    1978-01-01

    A design calculation is detailed for a single-family residence housing a family of four in a nonspecific geographical area. The solar water heater system is designed to provide 80 gallons of 140 F hot water per day.

  9. Performance Analysis of Hospital Information System of the National Health Insurance Corporation Ilsan Hospital

    Science.gov (United States)

    Han, Jung Mi; Boo, Eun Hee; Kim, Jung A; Yoon, Soo Jin; Kim, Seong Woo

    2012-01-01

    Objectives This study evaluated the qualitative and quantitative performances of the newly developed information system which was implemented on November 4, 2011 at the National Health Insurance Corporation Ilsan Hospital. Methods Registration waiting time and changes in the satisfaction scores for the key performance indicators (KPI) before and after the introduction of the system were compared; and the economic effects of the system were analyzed by using the information economics approach. Results After the introduction of the system, the waiting time for registration was reduced by 20%, and the waiting time at the internal medicine department was reduced by 15%. The benefit-to-cost ratio was increased to 1.34 when all intangible benefits were included in the economic analysis. Conclusions The economic impact and target satisfaction rates increased due to the introduction of the new system. The results were proven by the quantitative and qualitative analyses carried out in this study. This study was conducted only seven months after the introduction of the system. As such, a follow-up study should be carried out in the future when the system stabilizes. PMID:23115744

  10. Application of Kanban System on a hospital pharmacy.

    Science.gov (United States)

    Mitka, Eleftheria

    2015-01-01

    This is a brief overview of principles, views and methods, of the Kanban System for the pharmacy of a general hospital. The main goal is the reduction of stores managed by the pharmacy, as well as improvement of the mode of operation. Solutions to problems, such as inadequate storage space, the delay in serving patients or clinics and the expiration of various pharmaceutical formulations, stored for so long time, are provided. The philosophy behind the Kanban procurement System and specifically its applicability to a pharmacy underperforming in terms of efficiency, in Greece, are described. Based on the analysis of stock requirement, item stock prices and demand, it is concluded that a significant percentage of the stocked drugs can be procured using the Kanban System. Significant cost savings and operational advantages following the Kanban System will take place. The challenging endeavor is the analysis, design and application of a system that supports the proposed procurement method. Hospital pharmacies in Greece and in other countries that face an economic crisis may largely benefit after using the Kanban System.

  11. 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.

  12. Biofilm formation in a hot water system

    DEFF Research Database (Denmark)

    Bagh, L.K.; Albrechtsen, Hans-Jørgen; Arvin, Erik

    2002-01-01

    The biofilm formation rate was measured in situ in a hot water system in an apartment building by specially designed sampling equipment, and the net growth of the suspended bacteria was measured by incubation of water samples with the indigeneous bacteria. The biofilm formation rate reached......, in the sludge, or in the water from the distribution system was negligible. This indicated that bacterial growth took place on the inner surfaces in the hot water system and biofilm formation and detachment of bacteria could account for most of the suspended bacteria actually measured in hot water. Therefore...

  13. Recognition of medical errors' reporting system dimensions in educational hospitals.

    Science.gov (United States)

    Yarmohammadian, Mohammad H; Mohammadinia, Leila; Tavakoli, Nahid; Ghalriz, Parvin; Haghshenas, Abbas

    2014-01-01

    Nowadays medical errors are one of the serious issues in the health-care system and carry to account of the patient's safety threat. The most important step for achieving safety promotion is identifying errors and their causes in order to recognize, correct and omit them. Concerning about repeating medical errors and harms, which were received via theses errors concluded to designing and establishing medical error reporting systems for hospitals and centers that are presenting therapeutic services. The aim of this study is the recognition of medical errors' reporting system dimensions in educational hospitals. This research is a descriptive-analytical and qualities' study, which has been carried out in Shahid Beheshti educational therapeutic center in Isfahan during 2012. In this study, relevant information was collected through 15 face to face interviews. That each of interviews take place in about 1hr and creation of five focused discussion groups through 45 min for each section, they were composed of Metron, educational supervisor, health officer, health education, and all of the head nurses. Concluded data interviews and discussion sessions were coded, then achieved results were extracted in the presence of clear-sighted persons and after their feedback perception, they were categorized. In order to make sure of information correctness, tables were presented to the research's interviewers and final the corrections were confirmed based on their view. The extracted information from interviews and discussion groups have been divided into nine main categories after content analyzing and subject coding and their subsets have been completely expressed. Achieved dimensions are composed of nine domains of medical error concept, error cases according to nurses' prospection, medical error reporting barriers, employees' motivational factors for error reporting, purposes of medical error reporting system, error reporting's challenges and opportunities, a desired system

  14. Hospital information system: reusability, designing, modelling, recommendations for implementing.

    Science.gov (United States)

    Huet, B

    1998-01-01

    The aims of this paper are to precise some essential conditions for building reuse models for hospital information systems (HIS) and to present an application for hospital clinical laboratories. Reusability is a general trend in software, however reuse can involve a more or less part of design, classes, programs; consequently, a project involving reusability must be precisely defined. In the introduction it is seen trends in software, the stakes of reuse models for HIS and the special use case constituted with a HIS. The main three parts of this paper are: 1) Designing a reuse model (which objects are common to several information systems?) 2) A reuse model for hospital clinical laboratories (a genspec object model is presented for all laboratories: biochemistry, bacteriology, parasitology, pharmacology, ...) 3) Recommendations for generating plug-compatible software components (a reuse model can be implemented as a framework, concrete factors that increase reusability are presented). In conclusion reusability is a subtle exercise of which project must be previously and carefully defined.

  15. Regional ground-water system

    International Nuclear Information System (INIS)

    Long, J.

    1985-01-01

    The Containment and Isolation Working Group considered issues related to the postclosure behavior of repositories in crystalline rock. This working group was further divided into subgroups to consider the progress since the 1978 GAIN Symposium and identify research needs in the individual areas of regional ground-water flow, ground-water travel time, fractional release, and cumulative release. The analysis and findings of the Ground-Water Regime Subgroup are presented

  16. Napa Earthquake impact on water systems

    Science.gov (United States)

    Wang, J.

    2014-12-01

    South Napa earthquake occurred in Napa, California on August 24 at 3am, local time, and the magnitude is 6.0. The earthquake was the largest in SF Bay Area since the 1989 Loma Prieta earthquake. Economic loss topped $ 1 billion. Wine makers cleaning up and estimated the damage on tourism. Around 15,000 cases of lovely cabernet were pouring into the garden at the Hess Collection. Earthquake potentially raise water pollution risks, could cause water crisis. CA suffered water shortage recent years, and it could be helpful on how to prevent underground/surface water pollution from earthquake. This research gives a clear view on drinking water system in CA, pollution on river systems, as well as estimation on earthquake impact on water supply. The Sacramento-San Joaquin River delta (close to Napa), is the center of the state's water distribution system, delivering fresh water to more than 25 million residents and 3 million acres of farmland. Delta water conveyed through a network of levees is crucial to Southern California. The drought has significantly curtailed water export, and salt water intrusion reduced fresh water outflows. Strong shaking from a nearby earthquake can cause saturated, loose, sandy soils liquefaction, and could potentially damage major delta levee systems near Napa. Napa earthquake is a wake-up call for Southern California. It could potentially damage freshwater supply system.

  17. Intra-hospital use of a telepathology system.

    Science.gov (United States)

    Ongürü, O; Celasun, B

    2000-01-01

    Utilization of telepathology systems to cover distant geographical areas has increased recently. However, the potential usefulness of similar systems for closer distances does not seem to be widely appreciated. In this study, we present data on the use of a simple telepathology system connecting the pathology department and the intra-operative consultation room within the operating theaters of the hospital. Ninety-eight frozen section cases from a past period have been re-evaluated using a real-time setup. Forty-eight of the cases have been re-evaluated in the customary fashion; allowing both ends to communicate and cooperate freely. Fifty of the cases, however, were evaluated by the consultant while the operating room end behaved like a robot; moving the stage of the microscope, changing and focusing the objectives. The deferral rate was lower than the original frozen section evaluations. Overall, the sensitivity was 100%, specificity 98%, negative predictive value 96, 5% and positive predictive value 100%. No significant difference was found for the diagnostic performances between the cooperative and robotic simulation methods.Our results strengthen the belief that telepathology is a valuable tool in offering pathology services to remote areas. The far side of a hospital building can also be a remote area and a low cost system can be helpful for intraoperative consultations. Educational value of such a system is also commendable.

  18. Use of closed systems in the Hospital Pharmacy

    Directory of Open Access Journals (Sweden)

    María Forte Pérez-Minayo

    2016-03-01

    Full Text Available Objective: In the setting of the increasing use of closed systems for reconstitution and preparation of these drugs, we intend to analyze the correct use of these systems in the Hospital Pharmacy, with the objective to minimize the risks of exposure not only for those professionals directly involved, but also for all the staff in the unit, taking also into account efficiency criteria. Method: Since some systems protect against aerosol formation but not from vapours, we decided to review which cytostatics should be prepared using an awl with an air inlet valve, in order to implement a new working procedure. We reviewed the formulations available in our hospital, with the following criteria: method of administration, excipients, and potential hazard for the staff handling them. We measured the diameters of the vials. We selected drugs with Level 1 Risk and also those including alcohol-based excipients, which could generate vapours. Outcomes: Out of the 66 reviewed formulations, we concluded that 11 drugs should be reconstituted with this type of awl: busulfan, cabazitaxel, carmustine, cyclophosphamide, eribulin, etoposide, fotemustine, melphalan, paclitaxel, temsirolimus and thiotepa; these represented an 18% of the total volume of formulations. Conclusions: The selection of healthcare products must be done at the Hospital Pharmacy, because the use of a system with an air valve inlet only for those drugs selected led to an outcome of savings and a more efficient use of materials. In our experience, we confirmed that the use of the needle could only be avoided when the awl could adapt to the different formulations of cytostatics, and this is only possible when different types of awls are available. Besides, connections were only really closed when a single awl was used for each vial. The change in working methodology when handling these drugs, as a result of this study, will allow us to start different studies about environmental contamination as a

  19. Implementation of quality management systems: the role of hospital (management) boards.

    NARCIS (Netherlands)

    Botje, D.; Klazinga, N.S.; Suñol, R.; Wagner, C.

    2013-01-01

    Objectives: Hospitals are putting tremendous efforts in implementing evidence-based management systems and organisational innovations for patient-centred care. Having a hospital quality management system is a prerequisite to successfully implement these innovations. Previous studies showed that the

  20. Grey water treatment systems: A review

    NARCIS (Netherlands)

    Abu-Ghunmi, L.N.A.H.; Zeeman, G.; Fayyad, M.; Lier, van J.B.

    2011-01-01

    This review aims to discern a treatment for grey water by examining grey water characteristics, reuse standards, technology performance and costs. The review reveals that the systems for treating grey water, whatever its quality, should consist of processes that are able to trap pollutants with a

  1. Role of water quality assessments in hospital infection control: Experience from a new oncology center in eastern India

    Directory of Open Access Journals (Sweden)

    Ramkrishna Bhalchandra

    2014-01-01

    Full Text Available Water quality assessment and timely intervention are essential for health. Microbiology, total dissolved solids (TDS and free residual chlorine were measured for water quality maintenance in an oncology center in India. Impact of these interventions over a period of 22 months has been demonstrated with four cardinal events. Pseudomonas in hospital water was controlled by adequate chlorination, whereas high TDS in the central sterile supply department water was corrected by the installation of electro-deionization plant. Contaminated bottled water was replaced using quality controlled hospital supply. Timely detection and correction of water-related issues, including reverse osmosis plant was possible through multi-faceted approach to water quality.

  2. 78 FR 50495 - Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the...

    Science.gov (United States)

    2013-08-19

    ... Connective Tissue) a. Reverse Shoulder Procedures b. Total Ankle Replacement Procedures 6. MDC 15 (Newborns... specific providers (acute care hospitals, PPS-exempt cancer hospitals, LTCHs, and inpatient psychiatric... Issues. James Poyer, (410) 786-2261, PPS-Exempt Cancer Hospital Quality Reporting Issues. Allison Lee...

  3. Smart Water Conservation System for Irrigated Landscape

    Science.gov (United States)

    2016-05-01

    controllers, centralized and site-specific sensor inputs, leak detection sensors, and the use of harvested water (i.e., rainwater and air condition water ...include ET functionality with soil moisture sensor, and leak detection via flow meter. ESTCP Final Report Smart Water Conservation System 58... leakage . The minimum static pressure was not achieved because tank water levels were less than 10 feet in the selected low profile tank.) Adjust break

  4. Functional systems of a pressurized water reactor

    International Nuclear Information System (INIS)

    Heinzel, V.

    1982-01-01

    The main topics, discussed in the present paper, are: - Principle design of the reactor coolant system - reactor pressure vessel with internals - containment design - residual heat removal and emergency cooling systems - nuclear component cooling systems - emergency feed water systems - plant electric power supply system. (orig./RW)

  5. Kansas Water Quality Action Targeting System (KATS)

    Data.gov (United States)

    Kansas Data Access and Support Center — This system is a revision of the original KATS system developed in 1990 as a tool to aid resource managers target Kansas valuable and vulnerable water resources for...

  6. 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.

  7. Defect and Innovation of Water Rights System

    Institute of Scientific and Technical Information of China (English)

    Zhou Bin

    2008-01-01

    The rare deposition of water resources conflicts with its limitless demand. This determined the existence of the water rights transaction system. The implementation of the water rights transaction system requires clarifying the definition of water re-source fight above all distinctly. At present, it is a kind of common right system arrangement which needs the Chinese government to dispose of water resources. Though a series of management sys-tems guaranteed the government's supply of water resource, it hindered the development of the water market seriously and caused the utilization of water resources to stay in the inefficient or low efficient state for a long time. Thus, we should change the government's leading role in the resource distribution and really rely on the market to carry on the water rights trade and transac-tion. In this way, the water rights could become a kind of private property right relatively, and circulate freely in the market. As a result of this, we should overcome the defects of common right, make its external performance internalized maximally and achieve the optimized water resource disposition and use it more effec-tively.

  8. A Classification System for Hospital-Based Infection Outbreaks

    Directory of Open Access Journals (Sweden)

    Paul S. Ganney

    2010-01-01

    Full Text Available Outbreaks of infection within semi-closed environments such as hospitals, whether inherent in the environment (such as Clostridium difficile (C.Diff or Methicillinresistant Staphylococcus aureus (MRSA or imported from the wider community (such as Norwalk-like viruses (NLVs, are difficult to manage. As part of our work on modelling such outbreaks, we have developed a classification system to describe the impact of a particular outbreak upon an organization. This classification system may then be used in comparing appropriate computer models to real outbreaks, as well as in comparing different real outbreaks in, for example, the comparison of differing management and containment techniques and strategies. Data from NLV outbreaks in the Hull and East Yorkshire Hospitals NHS Trust (the Trust over several previous years are analysed and classified, both for infection within staff (where the end of infection date may not be known and within patients (where it generally is known. A classification system consisting of seven elements is described, along with a goodness-of-fit method for comparing a new classification to previously known ones, for use in evaluating a simulation against history and thereby determining how ‘realistic’ (or otherwise it is.

  9. A classification system for hospital-based infection outbreaks.

    Science.gov (United States)

    Ganney, Paul S; Madeo, Maurice; Phillips, Roger

    2010-12-01

    Outbreaks of infection within semi-closed environments such as hospitals, whether inherent in the environment (such as Clostridium difficile (C.Diff) or Methicillin-resistant Staphylococcus aureus (MRSA) or imported from the wider community (such as Norwalk-like viruses (NLVs)), are difficult to manage. As part of our work on modelling such outbreaks, we have developed a classification system to describe the impact of a particular outbreak upon an organization. This classification system may then be used in comparing appropriate computer models to real outbreaks, as well as in comparing different real outbreaks in, for example, the comparison of differing management and containment techniques and strategies. Data from NLV outbreaks in the Hull and East Yorkshire Hospitals NHS Trust (the Trust) over several previous years are analysed and classified, both for infection within staff (where the end of infection date may not be known) and within patients (where it generally is known). A classification system consisting of seven elements is described, along with a goodness-of-fit method for comparing a new classification to previously known ones, for use in evaluating a simulation against history and thereby determining how 'realistic' (or otherwise) it is.

  10. Solar PV energy for water pumping system

    International Nuclear Information System (INIS)

    Mahar, F.

    1997-01-01

    The paper provides an introduction into understanding the relative merits, characteristics, including economics, of photovoltically powered water pumping systems. Although more than 10,000 photovoltaic pumping systems are known to be operating through out the world, many potential users do not know how to decide weather feasibility assessment, and system procurement so that the reader can made an informed decision about water pumping systems, especially those powered with photovoltaics. (author)

  11. Basics of Solar Heating & Hot Water Systems.

    Science.gov (United States)

    American Inst. of Architects, Washington, DC.

    In presenting the basics of solar heating and hot water systems, this publication is organized from the general to the specific. It begins by presenting functional and operational descriptions of solar heating and domestic hot water systems, outlining the basic concepts and terminology. This is followed by a description of solar energy utilization…

  12. Water immersion during labor and birth: is there an extra cost for hospitals?

    Science.gov (United States)

    Poder, Thomas G

    2017-06-01

    Water immersion during labor and birth is growing in popularity, and many hospitals are now considering offering this service to laboring women. Some advantages of water immersion are demonstrated, but others remain uncertain, and particularly, few studies have examined the financial impact of such a device on hospitals. This study simulated what could be the extra cost of water immersion for hospitals. Clinical outcomes were drawn from the results of systematic reviews already published, and cost units were those used in the Quebec health network. A decision tree was used with microsimulations of representative laboring women. Sensitivity analyses were performed as regards analgesic use and labor duration. Microsimulations indicated an extra cost between $166.41 and $274.76 (2014 Canadian dollars) for each laboring woman as regards the scenario considered. The average extra cost was $221.12 (95% confidence interval, 219.97-222.28). While water immersion allows better clinical outcomes, implementation and other costs are higher than the savings generated, which leads to a small extra cost to allow women to potentially have more relaxation and less pain. © 2016 John Wiley & Sons, Ltd.

  13. Rotating Ceramic Water Filter Discs System for Water Filtration

    Directory of Open Access Journals (Sweden)

    Riyadh Z. Al Zubaidy

    2017-04-01

    Full Text Available This work aimed to design, construct and operate a new laboratory scale water filtration system. This system was used to examine the efficiency of two ceramic filter discs as a medium for water filtration. These filters were made from two different ceramic mixtures of local red clay, sawdust, and water. The filtration system was designed with two rotating interfered modules of these filters. Rotating these modules generates shear force between water and the surfaces of filter discs of the filtration modules that works to reduce thickness of layer of rejected materials on the filters surfaces. Each module consists of seven filtration units and each unit consists of two ceramic filter discs. The average measured hydraulic conductivity of the first module was 13.7mm/day and that for the second module was 50mm/day. Results showed that the water filtration system can be operated continuously with a constant flow rate and the filtration process was controlled by a skin thin layer of rejected materials. The ceramic water filters of both filtration modules have high removal efficiency of total suspended solids up to 100% and of turbidity up to 99.94%.

  14. Wash water waste pretreatment system

    Science.gov (United States)

    1977-01-01

    Investigations were completed on wash waters based on each candidate personal cleansing agent. Evaluations of coagulants, antifoam agents, and the effect of promising antifoams on the chemical precipitation were included. Based on these evaluations two candidate soaps as well as their companion antifoam agents were selected for further work. Operating parameters included the effect of soap concentration, ferric chloride concentration, duration of mixing, and pore size of depth filters on the degree of soap removal. The effect of pressure on water flow through filter cartridges and on the rate of decline of water flow was also investigated. The culmination of the program was the recommendation of a pretreatment concept based on chemical precipitation followed by pressure filtration.

  15. Submersible purification system for radioactive water

    Science.gov (United States)

    Abbott, Michael L.; Lewis, Donald R.

    1989-01-01

    A portable, submersible water purification system for use in a pool of water containing radioactive contamination includes a prefilter for filtering particulates from the water. A resin bed is then provided for removal of remaining dissolved, particulate, organic, and colloidal impurities from the prefiltered water. A sterilizer then sterilizes the water. The prefilter and resin bed are suitably contained and are submerged in the pool. The sterilizer is water tight and located at the surface of the pool. The water is circulated from the pool through the prefilter, resin bed, and sterilizer by suitable pump or the like. In the preferred embodiment, the resin bed is contained within a tank which stands on the bottom of the pool and to which a base mounting the prefilter and pump is attached. An inlet for the pump is provided adjacent the bottom of the pool, while the sterilizer and outlet for the system is located adjacent the top of the pool.

  16. Water system integration of a chemical plant

    International Nuclear Information System (INIS)

    Zheng Pingyou; Feng Xiao; Qian Feng; Cao Dianliang

    2006-01-01

    Water system integration can minimize both the freshwater consumption and the wastewater discharge of a plant. In industrial applications, it is the key to determine reasonably the contaminants and the limiting concentrations, which will decide the freshwater consumption and wastewater discharge of the system. In this paper, some rules to determine the contaminants and the limiting concentrations are proposed. As a case study, the water system in a chemical plant that produces sodium hydroxide and PVC (polyvinyl chloride) is integrated. The plant consumes a large amount of freshwater and discharges a large amount of wastewater, so minimization of both the freshwater consumption and the wastewater discharge is very important to it. According to the requirements of each water using process on the water used in it, the contaminants and the limiting concentrations are determined. Then, the optimal water reuse scheme is firstly studied based on the water network with internal water mains. To reduce the freshwater consumption and the wastewater discharge further, decentralized regeneration recycling is considered. The water using network is simplified by mixing some of the used water. After the water system integration, the freshwater consumption is reduced 25.5%, and the wastewater discharge is reduced 48%

  17. Preoperational test report, raw water system

    Energy Technology Data Exchange (ETDEWEB)

    Clifton, F.T.

    1997-10-29

    This represents the preoperational test report for the Raw Water System, Project W-030. Project W-030 provides a ventilation upgrade for the four Aging Waste Facility tanks. The system supplies makeup water to the W-030 recirculation evaporative cooling towers for tanks AY1O1, AY102, AZ1O1, AZ102. The Raw Water pipe riser and associated strainer and valving is located in the W-030 diesel generator building. The tests verify correct system operation and correct indications displayed by the central Monitor and Control System.

  18. Preoperational test report, raw water system

    International Nuclear Information System (INIS)

    Clifton, F.T.

    1997-01-01

    This represents the preoperational test report for the Raw Water System, Project W-030. Project W-030 provides a ventilation upgrade for the four Aging Waste Facility tanks. The system supplies makeup water to the W-030 recirculation evaporative cooling towers for tanks AY1O1, AY102, AZ1O1, AZ102. The Raw Water pipe riser and associated strainer and valving is located in the W-030 diesel generator building. The tests verify correct system operation and correct indications displayed by the central Monitor and Control System

  19. PWR secondary water chemistry diagnostic system

    International Nuclear Information System (INIS)

    Miyazaki, S.; Hattori, T.; Yamauchi, S.; Kato, A.; Suganuma, S.; Yoshikawa, T.

    1989-01-01

    Water chemistry control is one of the most important tasks in order to maintain the reliability of plant equipments and extend operating life of the plant. We developed an advanced water chemistry management system which is able to monitor and diagnose secondary water chemistry. A prototype system had been installed at one plant in Japan since Nov. 1986 in order to evaluate system performance and man-machine interface. The diagnosis system has been successfully tested off line using synthesized plant data for various cases. We are continuing to improve the applicability and develop new technology which make it evaluate steam generator crevice chemistry. (author)

  20. Water turbine system and method of operation

    Science.gov (United States)

    Costin, Daniel P.

    2010-06-15

    A system for providing electrical power from a current turbine is provided. The system includes a floatation device and a mooring. A water turbine structure is provided having an upper and lower portion wherein the lower portion includes a water fillable chamber. A plurality of cables are used to couple the system where a first cable couples the water turbine to the mooring and a second cable couples the floatation device to the first cable. The system is arranged to allow the turbine structure to be deployed and retrieved for service, repair, maintenance and redeployment.

  1. Water hammer analysis in a water distribution system

    Directory of Open Access Journals (Sweden)

    John Twyman

    2017-04-01

    Full Text Available The solution to water hammer in a water distribution system (WDS is shown by applying three hybrid methods (HM based on the Box’s scheme, McCormack's method and Diffusive Scheme. Each HM formulation in conjunction with their relative advantages and disadvantages are reviewed. The analyzed WDS has pipes with different lengths, diameters and wave speeds, being the Courant number different in each pipe according to the adopted discretization. The HM results are compared with the results obtained by the Method of Characteristics (MOC. In reviewing the numerical attenuation, second order schemes based on Box and McCormack are more conservative from a numerical point of view, being recommendable their application in the analysis of water hammer in water distribution systems.

  2. Electronic health systems: challenges faced by hospital-based providers.

    Science.gov (United States)

    Agno, Christina Farala; Guo, Kristina L

    2013-01-01

    The purpose of this article is to discuss specific challenges faced by hospitals adopting the use of electronic medical records and implementing electronic health record (EHR) systems. Challenges include user and information technology support; ease of technical use and software interface capabilities; compliance; and financial, legal, workforce training, and development issues. Electronic health records are essential to preventing medical errors, increasing consumer trust and use of the health system, and improving quality and overall efficiency. Government efforts are focused on ways to accelerate the adoption and use of EHRs as a means of facilitating data sharing, protecting health information privacy and security, quickly identifying emerging public health threats, and reducing medical errors and health care costs and increasing quality of care. This article will discuss physician and nonphysician staff training before, during, and after implementation; the effective use of EHR systems' technical features; the selection of a capable and secure EHR system; and the development of collaborative system implementation. Strategies that are necessary to help health care providers achieve successful implementation of EHR systems will be addressed.

  3. Energy costs and Portland water supply system

    Energy Technology Data Exchange (ETDEWEB)

    Elliott, W.M.; Hawley, R.P.

    1981-10-01

    The changing role of electrical energy on the Portland, Oregon, municipal-water-supply system is presented. Portland's actions in energy conservation include improved operating procedures, pump modifications, and modifications to the water system to eliminate pumping. Portland is implementing a small hydroelectric project at existing water-supply dams to produce an additional source of power for the area. Special precautions in construction and operation are necessary to protect the high quality of the water supply. 2 references, 7 figures.

  4. Screening reactor steam/water piping systems for water hammer

    International Nuclear Information System (INIS)

    Griffith, P.

    1997-09-01

    A steam/water system possessing a certain combination of thermal, hydraulic and operational states, can, in certain geometries, lead to a steam bubble collapse induced water hammer. These states, operations, and geometries are identified. A procedure that can be used for identifying whether an unbuilt reactor system is prone to water hammer is proposed. For the most common water hammer, steam bubble collapse induced water hammer, six conditions must be met in order for one to occur. These are: (1) the pipe must be almost horizontal; (2) the subcooling must be greater than 20 C; (3) the L/D must be greater than 24; (4) the velocity must be low enough so that the pipe does not run full, i.e., the Froude number must be less than one; (5) there should be void nearby; (6) the pressure must be high enough so that significant damage occurs, that is the pressure should be above 10 atmospheres. Recommendations on how to avoid this kind of water hammer in both the design and the operation of the reactor system are made

  5. Comparative analytics of infusion pump data across multiple hospital systems.

    Science.gov (United States)

    Catlin, Ann Christine; Malloy, William X; Arthur, Karen J; Gaston, Cindy; Young, James; Fernando, Sudheera; Fernando, Ruchith

    2015-02-15

    A Web-based analytics system for conducting inhouse evaluations and cross-facility comparisons of alert data generated by smart infusion pumps is described. The Infusion Pump Informatics (IPI) project, a collaborative effort led by research scientists at Purdue University, was launched in 2009 to provide advanced analytics and tools for workflow analyses to assist hospitals in determining the significance of smart-pump alerts and reducing nuisance alerts. The IPI system allows facility-specific analyses of alert patterns and trends, as well as cross-facility comparisons of alert data uploaded by more than 55 participating institutions using different types of smart pumps. Tools accessible through the IPI portal include (1) charts displaying aggregated or breakout data on the top drugs associated with alerts, numbers of alerts per device or care area, and override-to-alert ratios, (2) investigative reports that can be used to characterize and analyze pump-programming errors in a variety of ways (e.g., by drug, by infusion type, by time of day), and (3) "drill-down" workflow analytics enabling users to evaluate alert patterns—both internally and in relation to patterns at other hospitals—in a quick and efficient stepwise fashion. The formation of the IPI analytics system to support a community of hospitals has been successful in providing sophisticated tools for member facilities to review, investigate, and efficiently analyze smart-pump alert data, not only within a member facility but also across other member facilities, to further enhance smart pump drug library design. Copyright © 2015 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  6. The effects of for-profit multihospital system ownership on hospital financial and operating performance.

    Science.gov (United States)

    Lynch, J R; McCue, M J

    1990-11-01

    The financial and operating performance of independent not-for-profit hospitals acquired by US for-profit multi-hospital systems in 10 Southern states between the years 1978 and 1982 was explored. The impact of system ownership on acquired hospitals was investigated by comparing the average financial performance of hospitals in the two years immediately prior to acquisition to the average for 1984 and 1985 and by comparing changes in the performance of acquired hospitals with changes in matched independent facilities. Findings suggest that for-profit multi-hospital systems were able to improve many of the financial and operating problems of acquired facilities. In comparison to independent not-for-profit hospitals, acquired hospitals were found to increase access to long-term debt, make improvements to plant and equipment, improve profitability, and increase efficiency to a greater extent. Prices in acquired hospitals rose more than those in independents and liquidity decreased to a greater extent.

  7. 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....

  8. Impact of Hybrid Water Supply on the Centralised Water System

    Directory of Open Access Journals (Sweden)

    Robert Sitzenfrei

    2017-11-01

    Full Text Available Traditional (technical concepts to ensure a reliable water supply, a safe handling of wastewater and flood protection are increasingly criticised as outdated and unsustainable. These so-called centralised urban water systems are further maladapted to upcoming challenges because of their long lifespan in combination with their short-sighted planning and design. A combination of (existing centralised and decentralised infrastructure is expected to be more reliable and sustainable. However, the impact of increasing implementation of decentralised technologies on the local technical performance in sewer or water supply networks and the interaction with the urban form has rarely been addressed in the literature. In this work, an approach which couples the UrbanBEATS model for the planning of decentralised strategies together with a water supply modelling approach is developed and applied to a demonstration case. With this novel approach, critical but also favourable areas for such implementations can be identified. For example, low density areas, which have high potential for rainwater harvesting, can result in local water quality problems in the supply network when further reducing usually low pipe velocities in these areas. On the contrary, in high demand areas (e.g., high density urban forms there is less effect of rainwater harvesting due to the limited available space. In these high density areas, water efficiency measures result in the highest savings in water volume, but do not cause significant problems in the technical performance of the potable water supply network. For a more generalised and case-independent conclusion, further analyses are performed for semi-virtual benchmark networks to answer the question of an appropriate representation of the water distribution system in a computational model for such an analysis. Inappropriate hydraulic model assumptions and characteristics were identified for the stated problem, which have more

  9. Integrated waste and water management system

    Science.gov (United States)

    Murray, R. W.; Sauer, R. L.

    1986-01-01

    The performance requirements of the NASA Space Station have prompted a reexamination of a previously developed integrated waste and water management system that used distillation and catalytic oxydation to purify waste water, and microbial digestion and incineration for waste solids disposal. This system successfully operated continuously for 206 days, for a 4-man equivalent load of urine, feces, wash water, condensate, and trash. Attention is given to synergisms that could be established with other life support systems, in the cases of thermal integration, design commonality, and novel technologies.

  10. 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.

  11. Are hospitals ready to response to disasters? Challenges, opportunities and strategies of Hospital Emergency Incident Command System (HEICS).

    Science.gov (United States)

    Yarmohammadian, Mohammad Hossein; Atighechian, Golrokh; Shams, Lida; Haghshenas, Abbas

    2011-08-01

    Applying an effective management system in emergency incidents provides maximum efficiency with using minimum facilities and human resources. Hospital Emergency Incident Command System (HEICS) is one of the most reliable emergency incident command systems to make hospitals more efficient and to increase patient safety. This research was to study requirements, barriers, and strategies of HEICS in hospitals affiliated to Isfahan University of Medical Sciences (IUMS). This was a qualitative research carried out in Isfahan Province, Iran during 2008-09. The study population included senior hospital managers of IUMS and key informants in emergency incident management across Isfahan Province. Sampling method was in non-random purposeful form and snowball technique was used. The research instrument for data collection was semi-structured interview; collected data was analyzed by Colaizzi Technique. Findings of study were categorized into three general categories including requirements (organizational and sub-organizational), barriers (internal and external) of HEICS establishment, and providing short, mid and long term strategies. These categories are explained in details in the main text. Regarding the existing barriers in establishment of HEICS, it is recommended that responsible authorities in different levels of health care system prepare necessary conditions for implementing such system as soon as possible via encouraging and supporting systems. This paper may help health policy makers to get reasonable framework and have comprehensive view for establishing HEICS in hospitals. It is necessary to consider requirements and viewpoints of stakeholders before any health policy making or planning.

  12. Models of the Water Systems in Mauritius

    OpenAIRE

    Toth, F.L.

    1992-01-01

    Criteria for sustainable development in terms of managing a nation's water resources include the availability of water in required quantity and appropriate quality. This paper presents a set of water models developed for the IIASA/UNFPA Mauritius Project for use as an integral part of a system of models including demographic, economic, and land use models. The paper identifies the most important factors determining the available freshwater resources in Mauritius (climate, geology, hydrology),...

  13. Corrosion evaluation of service water system materials

    International Nuclear Information System (INIS)

    Stein, A.A.; Felder, C.M.; Martin, R.L.

    1994-01-01

    The availability and reliability of the service water system is critical for safe operation of a nuclear power plant. Degradation of the system piping and components has forced utilities to re-evaluate the corrosion behavior of current and alternative system materials, to support assessments of the remaining service life of the service water system, selection of replacement materials, implementation of corrosion protection methods and corrosion monitoring programs, and identification of maintenance and operational constraints consistent with the materials used. TU Electric and Stone and Webster developed a service water materials evaluation program for the Comanche Peak Steam Electric Station. Because of the length of exposure and the generic interest in this program by the nuclear power industry, EPRI joined TU to co-sponsor the test program. The program was designed to evaluate the corrosion behavior of current system materials and candidate replacement materials and to determine the operational and design changes which could improve the corrosion performance of the system. Although the test program was designed to be representative of service water system materials and environments targeted to conditions at Comanche Peak, these conditions are typical of and relevant to other fresh water cooled nuclear service water systems. Testing was performed in raw water and water treated with biocide under typical service water operating conditions including continuous flow, intermittent flow, and stagnant conditions. The test program evaluated the 300 Series and 6% molybdenum stainless steels, copper-nickel, titanium, carbon steel, and a formed-in-place nonmetallic pipe lining to determine susceptibility to general, crevice, and microbiologically influenced corrosion and pitting attack. This report presents the results of the test program after 4 years of exposure

  14. Performance Analysis of Photovoltaic Water Heating System

    Directory of Open Access Journals (Sweden)

    Tomas Matuska

    2017-01-01

    Full Text Available Performance of solar photovoltaic water heating systems with direct coupling of PV array to DC resistive heating elements has been studied and compared with solar photothermal systems. An analysis of optimum fixed load resistance for different climate conditions has been performed for simple PV heating systems. The optimum value of the fixed load resistance depends on the climate, especially on annual solar irradiation level. Use of maximum power point tracking compared to fixed optimized load resistance increases the annual yield by 20 to 35%. While total annual efficiency of the PV water heating systems in Europe ranges from 10% for PV systems without MPP tracking up to 15% for system with advanced MPP trackers, the efficiency of solar photothermal system for identical hot water load and climate conditions is more than 3 times higher.

  15. [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.

  16. 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.

  17. 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...

  18. Water masers in the Kronian system

    NARCIS (Netherlands)

    Pogrebenko, Sergei V.; Gurvits, Leonid I.; Elitzur, Moshe; Cosmovici, Cristiano B.; Avruch, Ian M.; Pluchino, Salvatore; Montebugnoli, Stelio; Salerno, Emma; Maccaferri, Giuseppe; Mujunen, Ari; Ritakari, Jouko; Molera, Guifre; Wagner, Jan; Uunila, Minttu; Cimo, Giuseppe; Schilliro, Francesco; Bartolini, Marco; Fernández, J. A.; Lazzaro, D.; Prialnik, D.; Schulz, R.

    2010-01-01

    The presence of water has been considered for a long time as a key condition for life in planetary environments. The Cassini mission discovered water vapour in the Kronian system by detecting absorption of UV emission from a background star (Hansen et al. 2006). Prompted by this discovery, we

  19. Residential hot water distribution systems: Roundtablesession

    Energy Technology Data Exchange (ETDEWEB)

    Lutz, James D.; Klein, Gary; Springer, David; Howard, Bion D.

    2002-08-01

    Residential building practice currently ignores the lossesof energy and water caused by the poor design of hot water systems. Theselosses include: combustion and standby losses from water heaters, thewaste of water (and energy) while waiting for hot water to get to thepoint of use; the wasted heat as water cools down in the distributionsystem after a draw; heat losses from recirculation systems and thediscarded warmth of waste water as it runs down the drain. Severaltechnologies are available that save energy (and water) by reducing theselosses or by passively recovering heat from wastewater streams and othersources. Energy savings from some individual technologies are reported tobe as much as 30 percent. Savings calculations of prototype systemsincluding bundles of technologies have been reported above 50 percent.This roundtable session will describe the current practices, summarizethe results of past and ongoing studies, discuss ways to think about hotwater system efficiency, and point to areas of future study. We will alsorecommend further steps to reduce unnecessary losses from hot waterdistribution systems.

  20. APPLICATION OF A PHOTOVOLTAIC SYSTEM IN WATER ...

    African Journals Online (AJOL)

    use of the Photovoltaic system for water pumping is explored. .... employed to advantage for rural Ethiopia are solar energy, wind ... Kwh/sq.m/day and with a yearly average of about .... equator. Well Data : Total head 62m ... Investment return in photovoltaic potable water ... without any considerable change in performance.

  1. 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.

  2. Performance Analysis of an Integrated Heat Pump with Air-Conditioning System for the Existing Hospital Building Application

    Directory of Open Access Journals (Sweden)

    Chen-Yu Chiang

    2017-03-01

    Full Text Available In this study, a complete evaluation procedure of energy-saving and efficiency improvement for a large-scale hospital retrofit project has been established and successfully validated in Taiwan. The retrofit scheme, in integrating the alternative hot water system, namely, a water source heat pump (WSHP, with the existing HVAC (Heating, Ventilating, and Air-Conditioning system, enables the capability to meet the cooling and hot water demand simultaneously with a larger safety margin as well as saving energy. In addition, it has been found that the integrated system provides a new source for cooling which can be utilized as a system redundancy in avoiding system shutdown. This is very useful when considering in specific areas in the hospital, such as intensive care unit, or operation rooms, where cooling should not be interrupted on any occasion. In this study, it is validated that the coefficient of performance (COP of the newly added WSHP system, under heating and cooling mode, is 3.62 and 2.62, respectively. The recorded annual cost reduction by this integrated system is $102,564, with a payback of 1.2 years. The hospital after retrofit has been operating safer, with more redundancy, and more energy-efficient which warrants tremendous potential for implementation in the industry.

  3. Light water reactor safeguards system evaluation

    International Nuclear Information System (INIS)

    Varnado, G.B.; Ericson, D.M. Jr.; Bennett, H.A.; Hulme, B.L.; Daniel, S.L.

    1978-01-01

    A methodology for assessing the effectiveness of safeguards systems was developed in this study and was applied to a typical light water reactor plant. The relative importance of detection systems, barriers, response forces and other safeguards system components was examined in extensive parameter variation studies. (author)

  4. Cold Vacuum Drying facility potable water system design description

    International Nuclear Information System (INIS)

    PITKOFF, C.C.

    1999-01-01

    This document describes the Cold Vacuum Drying Facility (CVDF) potable water (PW) system. The PW system provides potable water to the CVDF for supply to sinks, water closets, urinals, showers, custodial service sinks, drinking fountains, the decontamination shower, supply water to the non-PW systems, and makeup water for the de-ionized water system

  5. Life Support Systems: Wastewater Processing and Water Management

    Data.gov (United States)

    National Aeronautics and Space Administration — Advanced Exploration Systems (AES) Life Support Systems project Wastewater Processing and Water Management task: Within an integrated life support system, water...

  6. Surface Waters Information Management System (SWIMS)

    Data.gov (United States)

    Kansas Data Access and Support Center — The Surface Waters Information Management System (SWIMS) has been designed to meet multi-agency hydrologic database needs for Kansas. The SWIMS project was supported...

  7. An evaluation of gas engines as prime movers in cogeneration systems for the power safety in hospitals

    Energy Technology Data Exchange (ETDEWEB)

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

    2008-07-01

    Modern hospitals are completely dependent on energy. According to Environmental Protection Agency, healthcare organizations spend over $6 billion on energy each year in USA alone to meet patient needs. The increase in the use of technology in healthcare has increased energy demand within hospitals. At the same time energy costs have been on the rise due to the increased energy demand, aging energy infrastructure, and deregulation of energy markets. Heating, cooling, domestic hot water use and lighting systems are responsible for about 80 per cent of the energy consumed in hospitals. Support functions, such as food service and equipment, account for the remaining 20 per cent. From the fuel utilization viewpoint, the permanent demand for electricity, steam, hot water, heating and cooling makes hospitals an ideal candidates for cogeneration. In addition to reducing energy costs, cogeneration with internal combustion engines can provide emergency power capability, improve power quality, and reduce the burden on utility transmission and distribution systems during periods of peak demand. On-site natural gas power generators can be used for primary power, base load power, peak shaving or emergency power. The security of electrical supply is highly important in hospitals. Reciprocating engines are a proven technology with a range of size and the lowest first capital costs of all combined cooling, heating and power systems. Modern gas engines are designed to provide high output with fuel flexibility, low emission rates, high efficiency and high reliability. 20 refs., 2 figs.

  8. Smart Water Conservation System for Irrigated Landscape

    Science.gov (United States)

    2016-05-01

    ht ly M or e W or kl oa d; 5 -M or e W or kl oa d; 6 -S ig ni fic an lty M or...install the water harvesting and pump system was captured from the contractor cost proposal. 7.1.3 Water Cost Water purchased from the Port Hueneme Water...818) 737-2734 KDuke@valleycrest.com Contractor Tom Santoianni 1205 Mill Rd. Bldg. 1430 Public Works, Ventura (805) 982-4075 Tom.Santoianni@navy.mil Energy Manager

  9. 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.

  10. A Comparison of Different Disinfectants on the Microbiological Quality of Water from the Dental Unit Waterlines of a Military Hospital

    International Nuclear Information System (INIS)

    Ma, M.S.; Zalini Yunus; Ahmad Razi Mohamed Yunus; Zukri Ahmad; Farizah Abdul Fatah

    2015-01-01

    Water from the dental unit waterlines (DUWLs) is known to contaminate with microbial from the biofilm that formed in the tubing system. The water quality from DUWLs is important to patients and dental health care professionals as they could be infected either directly from the contaminated water or aerosol that is generated during dental procedures. Suppliers claimed that dental units supplied to the hospital can only use a specific disinfectant which is uneconomic compared with the others. The aims of this study were to evaluate and compare the efficacy of different disinfectant on the water quality of DUWLs. Four disinfectants (Calbenium, A-dec ICX tablet, Dentel 5, Metassys) and distil water were evaluated. 350 mL water sample was collected separately, from the outlet of high-speed hand piece, scaler, 3-ways syringe and cup filler into a sterile thiosulfate bag on the 1st, 2nd, 4th, 8th, 12th and 24th weeks of the study. The samples were tested on the following day for total viable count (TVC). There is significant difference in the efficacies of the different disinfectants. Only one disinfectant consistently produces water quality within the recommended level of American Dental Association (ADA). Within the limitation of this study, it was found that there is alternative disinfectant that can reduce the TVC to the level recommended by ADA. However, the water qualities produced with these disinfectants were not consistent although they did not cause any technical problem to the dental units during the period of study. (author)

  11. The fluoridation of drinking water and hip fracture hospitalization rates in two Canadian communities.

    Science.gov (United States)

    Suarez-Almazor, M E; Flowerdew, G; Saunders, L D; Soskolne, C L; Russell, A S

    1993-05-01

    The purpose of this study was to compare hip fracture hospitalization rates between a fluoridated and a non-fluoridated community in Alberta, Canada: Edmonton, which has had fluoridated drinking water since 1967, and Calgary, which considered fluoridation in 1991 but is currently revising this decision. Case subjects were all individuals aged 45 years or older residing in Edmonton or Calgary who were admitted to hospitals in Alberta between January 1, 1981, and December 31, 1987, and who had a discharge diagnosis of hip fracture. Edmonton rates were compared with Calgary rates, with adjustment for age and sex using the Edmonton population as a standard. The hip fracture hospitalization rate for Edmonton from 1981 through 1987 was 2.77 per 1000 person-years. The age-sex standardized rate for Calgary was 2.78 per 1000 person-years. No statistically significant difference was observed in the overall rate, and only minor differences were observed within age and sex subgroups, with the Edmonton rates being higher in males. These findings suggest that fluoridation of drinking water has no impact, neither beneficial nor deleterious, on the risk of hip fracture.

  12. 76 FR 13292 - Medicare Program: Changes to the Hospital Outpatient Prospective Payment System and CY 2011...

    Science.gov (United States)

    2011-03-11

    ... Prospective Payment System and CY 2011 Payment Rates; Changes to the Ambulatory Surgical Center Payment System..., 2010, entitled ``Medicare Program: Hospital Outpatient Prospective Payment System and CY 2011 Payment Rates; Ambulatory Surgical Center Payment System and CY 2011 Payment Rates; Payments to Hospitals for...

  13. [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.

  14. Adjustable speed drives improve circulating water system

    International Nuclear Information System (INIS)

    Dent, R.A.; Dicic, Z.

    1994-01-01

    This paper illustrates the integration of electrical and mechanical engineering requirements to produce a solution to past problems and future operating demands. The application of adjustable speed drives in the modifications of the circulating water system at Indian Point No. 3 Nuclear Power Plant provided increased operating flexibility, efficiency and avoided otherwise costly renovations to the plant electrical systems. Rectification of the original inadequate design of the circulating water system, in addition to maximizing plant efficiency consistent with environmental considerations, formed the basis for this modification. This entailed replacement of all six circulating water pumps and motors and physical modifications to the intake system. This paper details the methodology used in this engineering task. The new system was installed successfully and has been operating reliably and economically for the past eight years

  15. Hanford 200 area (sanitary) waste water system

    International Nuclear Information System (INIS)

    Danch, D.A.; Gay, A.E.

    1994-09-01

    The US Department of Energy (DOE) Hanford Site is located in southeastern Washington State. The Hanford Site is approximately 1,450 sq. km (560 sq. mi) of semiarid land set aside for activities of the DOE. The reactor fuel processing and waste management facilities are located in the 200 Areas. Over the last 50 years at Hanford dicard of hazardous and sanitary waste water has resulted in billions of liters of waste water discharged to the ground. As part of the TPA, discharges of hazardous waste water to the ground and waters of Washington State are to be eliminated in 1995. Currently sanitary waste water from the 200 Area Plateau is handled with on-site septic tank and subsurface disposal systems, many of which were constructed in the 1940s and most do not meet current standards. Features unique to the proposed new sanitary waste water handling systems include: (1) cost effective operation of the treatment system as evaporative lagoons with state-of-the-art liner systems, and (2) routing collection lines to avoid historic contamination zones. The paper focuses on the challenges met in planning and designing the collection system

  16. Evaluation of the Hospital Wastewater Activated Sludge Extended Aeration System in the Removal of Estrogenic Compounds (Case Study: Khuzestan Hospitals

    Directory of Open Access Journals (Sweden)

    A. Takdastan

    2016-02-01

    Full Text Available Background and Objective: Estrogen is a steroid hormone that is in the water and cause risks for aquatic organisms, especially fish is. Estrogenic hormones naturally (caused by endocrine or artificial (due to hormonal contraceptives such as birth control pills to sewage and hospital to find. This study aimed to determine the amount of estrogen in the sewage and Golestan and Abuzar hospital in Ahvaz were studied. Material and Methods: Sampling was done by tracking estrogen in the aquatic environment. 56 samples 4 months in different parts of the Golestan and Abuzar hospital wastewater treatment plant in Ahvaz were taken. Sample a little electro luminescence (ECL were analyzed by laboratory Iranian city of Ahvaz. In this study, different forms of estrogen (estrone, 17-beta-estradiol, estriol, 17-alpha-ethinyl estradiol has been studied as estrogen. Results: Mean hormone found in raw wastewater to the Golestan hospital wastewater treatment plant effluent from the treatment plant hormone 69.08 ng/l and 7.28 ng/l mean. Mean testosterone in Ahvaz Abuzar hospital treatment input 70.61 ng/l and 18.94 ng/l is refinery output. According to the results of high impact biological treatment is the removal of estrogenic compounds. Conclusion: Secondary treatment of sewage is effective in reducing hormones that can do this at this stage of the biological treatment effect.

  17. Amoxicillin in a biological water recovery system

    International Nuclear Information System (INIS)

    Morse, A.; Jackson, A.; Rainwater, K.; Pickering, K.

    2002-01-01

    Pharmaceuticals are new contaminants of concern in the aquatic environment, having been identified in groundwater, surface water, and residential tap water. Possible sources of pharmaceuticals include household wastewaters, runoff from feedlots, or waste discharges from pharmaceutical manufacturing plants. When surface water or groundwater supplies impacted by pharmaceuticals are used in drinking water production, the contaminants may reduce drinking water quality. Many pharmaceuticals, such as amoxicillin, pass through the body largely unmetabolized and directly enter wastewater collection systems. Pharmaceuticals are designed to persist in the body long enough to have the desired therapeutic effect. Therefore, they may also have the ability to persist in the environment (Seiler et al, 1999). The purpose of this work is to determine the overall transformation potential of a candidate pharmaceutical in wastewater treatment with specific emphasis on recycle systems. Amoxicillin is the selected pharmaceutical agent, an orally absorbed broad-spectrum antibiotic with a variety of clinical uses including ear, nose, and throat infections and lower respiratory tract infections. Experiments were conducted using an anaerobic reactor (with NO 3 - and NO 2 - as the e - acceptors) followed by a two-phase nitrifying tubular reactor. Influent composed of water, urine and surfactant was spiked with amoxicillin and fed into the wastewater recycle system. The concentration of amoxicillin in the feed and effluent was quantified using an HPLC. Results from this study include potential for long-term buildup in recycled systems, accumulation of breakdown products and possible transfer of antibiotic resistance to microorganisms in the system effluent. In addition, the results of this study may provide information on contamination potential for communities that are considering supplementing drinking water supplies with recovered wastewater or for entities considering a closed loop

  18. The impact of hospital and urban wastewaters on the bacteriological contamination of the water resources in Kinshasa, Democratic Republic of Congo.

    Science.gov (United States)

    Kilunga, Pitchouna I; Kayembe, John M; Laffite, Amandine; Thevenon, Florian; Devarajan, Naresh; Mulaji, Crispin K; Mubedi, Josué I; Yav, Zéphirin G; Otamonga, Jean-Paul; Mpiana, Pius T; Poté, John

    2016-10-14

    Although the United Nations General Assembly recognized in 2010 the right to safe and clean drinking water and sanitation as a human right that is essential to the full enjoyment of life and all other human rights, the contamination of water supplies with faecal pathogens is still a major and unsolved problem in many parts of the world. In this study, faecal indicator bacteria (FIB), including Escherichia coli (E. coli) and Enterococcus (ENT), were quantified over the period of June/July 2014 and June/July 2015 to assess the quality of hospital effluents (n = 3: H1, H2 and H3) and of rivers receiving wastewaters from the city of Kinshasa, Democratic Republic of Congo. The water and sediment samples from the river-receiving systems were collected in, upstream and downstream of the hospital outlet pipe (HOP) discharge. The analysis of E. coli and ENT in water and sediment suspension was performed using the cultural membrane filter method. The FIB characterization was performed for general E. coli, Enterococcus faecalis(E. faecalis) and human-specific Bacteroides by PCR using specific primers. The results revealed very high FIB concentration in the hospital effluent waters, with E. coli reaching the values of 4.2 × 10(5), 16.1 × 10(5) and 5.9 × 10(5) CFU 100 mL(-1), for the hospital effluents from H1, H2, and H3, respectively; and Enterococcus reaching the values of 2.3 × 10(4), 10.9 × 10(4) and 4.1 × 10(4) CFU 100 mL(-1), respectively. Interestingly, the FIB levels in the water and sediment samples from river-receiving systems are spatially and temporally highly variable and present in some samples with higher values than the hospital effluents. The PCR assays for human-specific Bacteroides HF183/HF134 further indicate that more than 98% of bacteria were from human origin. The results of this research therefore confirm the hypothesis of our previous studies, indicating that in developing countries (e.g., Democratic Republic of Congo and South India), the

  19. 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

  20. A cluster of cases of nosocomial legionnaires disease linked to a contaminated hospital decorative water fountain.

    Science.gov (United States)

    Palmore, Tara N; Stock, Frida; White, Margaret; Bordner, MaryAnn; Michelin, Angela; Bennett, John E; Murray, Patrick R; Henderson, David K

    2009-08-01

    Nosocomial outbreaks of Legionnaires disease have been linked to contaminated water in hospitals. Immunocompromised patients are particularly vulnerable and, when infected, have a high mortality rate. We report the investigation of a cluster of cases of nosocomial pneumonia attributable to Legionella pneumophila serogroup 1 that occurred among patients on our stem cell transplantation unit. We conducted a record review to identify common points of potential exposure, followed by environmental and water sampling for Legionella species from those sources. We used an air sampler to in an attempt to detect aerosolized Legionella and pulsed-field gel electrophoresis to compare clinical and environmental isolates. The most likely sources identified were the water supply in the patients' rooms and a decorative fountain in the radiation oncology suite. Samples from the patients' rooms did not grow Legionella species. Cultures of the fountain, which had been restarted 4 months earlier after being shut off for 5 months, yielded L. pneumophila serogroup 1. The isolates from both patients and the fountain were identical by pulsed-field gel electrophoresis. Both patients developed pneumonia within 10 days of completing radiation therapy, and each reported having observed the fountain at close range. Both patients' infections were identified early and treated promptly, and both recovered. This cluster was caused by contamination of a decorative fountain despite its being equipped with a filter and ozone generator. Fountains are a potential source of nosocomial Legionnaires disease despite standard maintenance and sanitizing measures. In our opinion, fountains present unacceptable risk in hospitals serving immunocompromised patients.

  1. Space Station Freedom regenerative water recovery system configuration selection

    Science.gov (United States)

    Reysa, R.; Edwards, J.

    1991-01-01

    The Space Station Freedom (SSF) must recover water from various waste water sources to reduce 90 day water resupply demands for a four/eight person crew. The water recovery system options considered are summarized together with system configuration merits and demerits, resource advantages and disadvantages, and water quality considerations used to select the SSF water recovery system.

  2. Installed water resource modelling systems for catchment ...

    African Journals Online (AJOL)

    Following international trends there are a growing number of modelling systems being installed for integrated water resource management, in Southern Africa. Such systems are likely to be installed for operational use in ongoing learning, research, strategic planning and consensus-building amongst stakeholders in the ...

  3. Distilled Water Distribution Systems. Laboratory Design Notes.

    Science.gov (United States)

    Sell, J.C.

    Factors concerning water distribution systems, including an evaluation of materials and a recommendation of materials best suited for service in typical facilities are discussed. Several installations are discussed in an effort to bring out typical features in selected applications. The following system types are included--(1) industrial…

  4. BIOFILMS IN DRINKING WATER DISTRIBUTION SYSTEMS

    Science.gov (United States)

    Virtually anywhere a surface comes into contact with the water in a distribution system, one can find biofilms. Biofilms are formed in distribution system pipelines when microbial cells attach to pipe surfaces and multiply to form a film or slime layer on the pipe. Probably withi...

  5. Water quality control system and water quality control method

    International Nuclear Information System (INIS)

    Itsumi, Sachio; Ichikawa, Nagayoshi; Uruma, Hiroshi; Yamada, Kazuya; Seki, Shuji

    1998-01-01

    In the water quality control system of the present invention, portions in contact with water comprise a metal material having a controlled content of iron or chromium, and the chromium content on the surface is increased than that of mother material in a state where compression stresses remain on the surface by mechanical polishing to form an uniform corrosion resistant coating film. In addition, equipments and/or pipelines to which a material controlling corrosion potential stably is applied on the surface are used. There are disposed a cleaning device made of a material less forming impurities, and detecting intrusion of impurities and removing them selectively depending on chemical species and/or a cleaning device for recovering drain from various kinds of equipment to feedwater, connecting a feedwater pipeline and a condensate pipeline and removing impurities and corrosion products. Then, water can be kept to neutral purified water, and the concentrations of oxygen and hydrogen in water are controlled within an optimum range to suppress occurrence of corrosion products. (N.H.)

  6. TORR system polishes oily water clean

    International Nuclear Information System (INIS)

    Mowers, J.

    2002-01-01

    The TORR (total oil recovery and remediation) system utilizes a specially patented polymer material, similar to styrofoam, which is used to get rid of non-soluble hydrocarbons from water. An application in Fort Smith, Northwest Territories, is described where it was used to recover diesel oil, which had been seeping into the groundwater over a period of 20 years. About 100,000 gallons of heating oil had leached into the water; TORR removed the non-soluble hydrocarbons, while another piece of equipment removed the soluble portions. After treatment the water tested consistently at non-detectable levels and was clean enough to be discharged into the town's sewer system. The system is considered ideal for oil spills clean-up underground, onshore, or the open sea, but it also has many potentially useful applications in industrial and oilfield applications. Water used in steam injection and water floods to produce heavy oil and SAGD applications are some of the obvious ones that come to mind. Cleaning up the huge tailings ponds at the mining and processing of oil sands, and removing diluent from water that is used to thin out bitumen in pipelines so that it can be transported to processing plants, are other promising areas of application. Several field trials to test the effectiveness of the system in these type of applications are scheduled for the summer and fall of 2002

  7. The Role of Hospital Information Systems in Universal Health Coverage Monitoring in Rwanda.

    Science.gov (United States)

    Karara, Gustave; Verbeke, Frank; Nyssen, Marc

    2015-01-01

    In this retrospective study, the authors monitored the patient health coverage in 6 Rwandan hospitals in the period between 2011 and 2014. Among the 6 hospitals, 2 are third level hospitals, 2 district hospitals and 2 private hospitals. Patient insurance and financial data were extracted and analyzed from OpenClinic GA, an open source hospital information system (HIS) used in those 6 hospitals. The percentage of patients who had no health insurer globally decreased from 35% in 2011 to 15% in 2014. The rate of health insurance coverage in hospitals varied between 75% in private hospitals and 84% in public hospitals. The amounts paid by the patients for health services decreased in private hospitals to 25% of the total costs in 2014 (-7.4%) and vary between 14% and 19% in public hospitals. Although the number of insured patients has increased and the patient share decreased over the four years of study, the patients' out-of-pocket payments increased especially for in-patients. This study emphasizes the value of integrated hospital information systems for this kind of health economics research in developing countries.

  8. The deployment of information systems and information technology in field hospitals.

    Science.gov (United States)

    Crowe, Ian R J; Naguib, Raouf N G

    2010-01-01

    Information systems and related technologies continue to develop and have become an integral part of healthcare provision and hospital care in particular. Field hospitals typically operate in the most austere and difficult of conditions and have yet to fully exploit related technologies. This paper addresses those aspects of healthcare informatics, healthcare knowledge management and lean healthcare that can be applied to field hospitals, with a view to improving patient care. The aim is to provide a vision for the deployment of information systems and information technology in field hospitals, using the British Army's field hospital as a representative model.

  9. Comparing systems for costing hospital treatments. The case of stable angina pectoris.

    Science.gov (United States)

    Larsen, Jytte; Skjoldborg, Ulla Slothuus

    2004-03-01

    This paper demonstrates the basic properties in the systems most commonly considered for costing treatments in the Danish hospitals. The differences between the traditional charge system, the DRG system and the ABC system are analysed, and difficulties encountered in comparing these systems are discussed. A sample of patients diagnosed with stable angina pectoris (SAP) at Odense University Hospital was used to compare the three systems when costing an entire treatment path, costing single hospitalisations and studying the effects of length of stay. Furthermore, it is illustrated that the main idea behind each system is reflected in how the systems over- or underestimate costs. Implications when managing the hospitals, particularly reimbursement, are discussed.

  10. Service water system aging assessment - Phase I

    International Nuclear Information System (INIS)

    Jarrell, D.B.; Zimmerman, P.W.; Gore, M.L.

    1988-01-01

    The Service Water System (SWS) represents the final heat transfer loop between decay heat generated in the nuclear core and the safe dispersal of that heat energy in the environment. It is the objective of this investigation to demonstrate that aging phenomena can be identified and quantified such that aging degradation of system components can be detected and mitigated prior to the reduction of system availability to below an acceptable threshold. The approach used during the Phase I task was to (1) perform a literature search of government and private sector reports which relate to service water, aging related degradation, and potential methodologies for analysis; (2) assemble a data base which contains all the commercial power plants in the US, their Service Water System configuration, characteristics, and water source; (3) obtain and examine the available service water data from large generic data bases, i.e. NPRDS, LER, NPE, inspection reports, and other relevant plant reference data; (4) perform a fault tree analysis of a typical plant service water systems to examine failure propagation and understand specific input requirements of probabilistic risk analyses; (5) develop an in-depth questionnaire protocol for examining the information resource at a power plant which is not available through data base query and visit a central station power plant and solicit the required information; (6) analyze the information obtained from the in-depth plant interrogation and draw contrasts and conclusions with the data base information; (7) utilize the plant information to perform an interim assessment of service water system degradation mechanisms and focus future investigations. This paper addresses the elements of this task plan numbered 1, 3, 6, and 7. The remaining items are detailed in the phase-I report

  11. Radon in water aeration system operational performance

    International Nuclear Information System (INIS)

    Lamarre, B.L.

    1990-01-01

    North East Environmental Products, Inc. is a manufacturer of residential scale aeration systems for removal of radon and volatile organic chemicals from private water supplies. This paper is a review of the operational history of residential scale point of entry (POE) radon aeration systems. Emphasis is placed on the difficulties and solutions encountered in actual installations caused by both mechanical difficulties and water quality parameters. A summary of radon reduction efficiency is presented for wells with radon concentrations from 21,000 to 2,600,000 pCi/L. A discussion of customer concerns and attitudes is presented along with other areas for further technical improvement. Training techniques for dealers and installers are also discussed. An update of the current status of the radon in water industry includes current sales volumes as compared to the potential market and an update on the radon in water MCL standard setting process from an industry perspective

  12. Assessment of water supply system and water quality of Lighvan village using water safety plan

    Directory of Open Access Journals (Sweden)

    Mojtaba Pourakbar

    2015-12-01

    Full Text Available Background: Continuous expansion of potable water pollution sources is one of the main concerns of water suppliers, therefore measures such as water safety plan (WSP, have been taken into account to control these sources of pollution. The aim of this study was to identify probable risks and threatening hazards to drinking water quality in Lighvan village along with assessment of bank filtration of the village. Methods: In the present study all risks and probable hazards were identified and ranked. For each of these cases, practical suggestions for removing or controlling them were given. To assess potable water quality in Lighvan village, sampling was done from different parts of the village and physicochemical parameters were measured. To assess the efficiency of bank filtration system of the village, independent t test was used to compare average values of parameters in river and treated water. Results: One of the probable sources of pollution in this study was domestic wastewater which threatens water quality. The results of this study show that bank filtration efficiency in water supply of the village is acceptable. Conclusion: Although Bank filtration imposes fewer expenses on governments, it provides suitable water for drinking and other uses. However, it should be noted that application of these systems should be done after a thorough study of water pollution level, types of water pollutants, soil properties of the area, soil percolation and system distance from pollutant sources.

  13. A Comprehensive Program to Reduce Rates of Hospital-Acquired Pressure Ulcers in a System of Community Hospitals.

    Science.gov (United States)

    Englebright, Jane; Westcott, Ruth; McManus, Kathryn; Kleja, Kacie; Helm, Colleen; Korwek, Kimberly M; Perlin, Jonathan B

    2018-03-01

    The prevention of hospital-acquired pressure ulcers (PrUs) has significant consequences for patient outcomes and the cost of care. Providers are challenged with evaluating available evidence and best practices, then implementing programs and motivating change in various facility environments. In a large system of community hospitals, the Reducing Hospital Acquired-PrUs Program was developed to provide a toolkit of best practices, timely and appropriate data for focusing efforts, and continuous implementation support. Baseline data on PrU rates helped focus efforts on the most vulnerable patients and care situations. Facilities were empowered to use and adapt available resources to meet local needs and to share best practices for implementation across the system. Outcomes were measured by the rate of hospital-acquired PrUs, as gathered from patient discharge records. The rate of hospital-acquired stage III and IV PrUs decreased 66.3% between 2011 and 2013. Of the 149 participating facilities, 40 (27%) had zero hospital-acquired stage III and IV PrUs and 77 (52%) had a reduction in their PrU rate. Rates of all PrUs documented as present on admission did not change during this period. A comparison of different strategies used by the most successful facilities illustrated the necessity of facility-level flexibility and recognition of local workflows and patient demographics. Driven by the combination of a repository of evidence-based tools and best practices, readily available data on PrU rates, and local flexibility with processes, the Reducing Hospital Acquired-PrUs Program represents the successful operationalization of improvement in a wide variety of facilities.

  14. 42 CFR 412.20 - Hospital services subject to the prospective payment systems.

    Science.gov (United States)

    2010-10-01

    ... payment systems. 412.20 Section 412.20 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT HOSPITAL SERVICES Hospital Services Subject to and Excluded From the Prospective Payment Systems for Inpatient...

  15. 42 CFR 419.21 - Hospital outpatient services subject to the outpatient prospective payment system.

    Science.gov (United States)

    2010-10-01

    ... outpatient prospective payment system. 419.21 Section 419.21 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM PROSPECTIVE PAYMENT SYSTEM... Excluded From the Hospital Outpatient Prospective Payment System § 419.21 Hospital outpatient services...

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

    Science.gov (United States)

    Ramos, Marcelo Cristiano de Azevedo; da Cruz, Lucila Pedroso; Kishima, Vanessa Chaer; Pollara, Wilson Modesto; de Lira, Antônio Carlos Onofre; Couttolenc, Bernard François

    2015-01-01

    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.

  17. 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.

  18. 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

    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. 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. 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. 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). 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 have important implications for the work of

  19. 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

  20. Are hospitals ready to response to disasters? Challenges, opportunities and strategies of Hospital Emergency Incident Command System (HEICS

    Directory of Open Access Journals (Sweden)

    Mohammad Hossein Yarmohammadian

    2011-01-01

    Full Text Available Background: Applying an effective management system in emergency incidents provides maximum efficiency with using minimum facilities and human resources. Hospital Emergency Incident Command System (HEICS is one of the most reliable emergency incident command systems to make hospitals more efficient and to increase patient safety. This research was to study requirements, barriers, and strategies of HEICS in hospitals affiliated to Isfahan University of Medical Sciences (IUMS. Methods: This was a qualitative research carried out in Isfahan Province, Iran during 2008-09. The study population included senior hospital managers of IUMS and key informants in emergency incident management across Isfahan Province. Sampling method was in non-random purposeful form and snowball technique was used. The research in-strument for data collection was semi-structured interview; collected data was analyzed by Colaizzi Technique. Results: Findings of study were categorized into three general categories including requirements (organizational and sub-organizational, barriers (internal and external of HEICS establishment, and providing short, mid and long term strategies. These categories are explained in details in the main text. Conclusions: Regarding the existing barriers in establishment of HEICS, it is recommended that responsible authori-ties in different levels of health care system prepare necessary conditions for implementing such system as soon as possible via encouraging and supporting systems. This paper may help health policy makers to get reasonable frame-work and have comprehensive view for establishing HEICS in hospitals. It is necessary to consider requirements and viewpoints of stakeholders before any health policy making or planning.

  1. 77 FR 27869 - Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the...

    Science.gov (United States)

    2012-05-11

    ... Considered HAC Candidate: Iatrogenic Pneumothorax With Venous Catheterization 3. Present on Admission (POA.... History of Measures Adopted for the Hospital IQR Program b. Maintenance of Technical Specifications for...-Associated Infection (HAI) Measures (A) Proposed Central Line Associated Blood Stream Infections ((CLABSI...

  2. 77 FR 34326 - Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the...

    Science.gov (United States)

    2012-06-11

    ... identify outlier cases for both inpatient operating and inpatient capital related payments, which is... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services 42 CFR Parts 412... Fiscal Year 2013 Rates; Hospitals' Resident Caps for Graduate Medical Education Payment Purposes; Quality...

  3. 77 FR 53257 - Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the...

    Science.gov (United States)

    2012-08-31

    ... Estimated Net Savings for Current HACs g. Previously Considered Candidate HACs--RTI Analysis of Frequency of... Program 1. Background 2. Budget Neutrality Offset Amount for FY 2013 L. Hospital Routine Services... Program a. Administrative Requirements (1) Requirements Regarding QualityNet Account and Administrator for...

  4. Noise Pollution Control System in the Hospital Environment

    Science.gov (United States)

    Figueroa Gallo, LM; Olivera, JM

    2016-04-01

    Problems related to environmental noise are not a new subject, but they became a major issue to solve because of the increasing, in complexity and intensity, of human activities due technological advances. Numerous international studies had dealt with the exposure of critical patients to noisy environment such as the Neonatal Intensive Care Units; their results show that there are difficulties in the organization in the developing brain, it can damage the delicate auditory structures and can cause biorhythm disorders, specially in preterm infants. The objective of this paper is to present the development and implementation of a control system that includes technical-management-training aspects to regulate the levels of specific noise sources in the neonatal hospitalization environment. For this purpose, there were applied different tools like: observations, surveys, procedures, an electronic control device and a training program for a Neonatal Service Unit. As a result, all noise sources were identified -some of them are eliminable-; all the service stable staff categories participated voluntarily; environmental noise measurements yielded values between 62.5 and 64.6 dBA and maximum were between 86.1 and 89.7 dBA; it was designed and installed a noise control device and the staff is being trained in noise reduction best practices.

  5. Noise Pollution Control System in the Hospital Environment

    International Nuclear Information System (INIS)

    Figueroa Gallo, LM; Olivera, JM

    2016-01-01

    Problems related to environmental noise are not a new subject, but they became a major issue to solve because of the increasing, in complexity and intensity, of human activities due technological advances. Numerous international studies had dealt with the exposure of critical patients to noisy environment such as the Neonatal Intensive Care Units; their results show that there are difficulties in the organization in the developing brain, it can damage the delicate auditory structures and can cause biorhythm disorders, specially in preterm infants. The objective of this paper is to present the development and implementation of a control system that includes technical-management-training aspects to regulate the levels of specific noise sources in the neonatal hospitalization environment. For this purpose, there were applied different tools like: observations, surveys, procedures, an electronic control device and a training program for a Neonatal Service Unit. As a result, all noise sources were identified -some of them are eliminable-; all the service stable staff categories participated voluntarily; environmental noise measurements yielded values between 62.5 and 64.6 dBA and maximum were between 86.1 and 89.7 dBA; it was designed and installed a noise control device and the staff is being trained in noise reduction best practices. (paper)

  6. Water maser emission from exoplanetary systems

    Science.gov (United States)

    Cosmovici, C. B.; Pogrebenko, S.

    2018-01-01

    Since the first discovery of a Jupiter-mass planet in 1995 more than 2000 exo-planets have been found to exist around main sequence stars. The detection techniques are based on the radial velocity method (which involves the measurement of the star's wobbling induced by the gravitational field of the orbiting giant planets) or on transit photometry by using space telescopes (Kepler, Corot, Hubble and Spitzer) outside the absorbing Earth atmosphere. From the ground, as infrared observations are strongly limited by atmospheric absorption, radioastronomy offers almost the only possible way to search for water presence and abundance in the planetary atmospheres of terrestrial-type planets where life may evolve. Following the discovery in 1994 of the first water maser emission in the atmosphere of Jupiter induced by a cometary impact, our measurements have shown that the water maser line at 22 GHz (1.35 cm) can be used as a powerful diagnostic tool for water search outside the solar system, as comets are able to deliver considerable amounts of water to planets raising the fascinating possibility of extraterrestrial life evolution. Thus in 1999 we started the systematic search for water on 35 different targets up to 50 light years away from the Sun. Here we report the first detection of the water maser emission from the exoplanetary systems Epsilon Eridani, Lalande 21185 and Gliese 581. We have shown the peculiar feasibility of water detection and its importance in the search for exoplanetary systems especially for the Astrobiology programs, given the possibility of long period observations using powerful radiotelescopes equipped with adequate spectrometers.

  7. Chemistry management of generator stator water system

    International Nuclear Information System (INIS)

    Sankar, N.; Santhanam, V.S.; Ayyar, S.R.; Umapathi, P.; Jeena, P.; Hari Krishna, K.; Rajendran, D.

    2015-01-01

    Chemistry management of water cooled turbine generators with hollow copper conductors is very essential to avoid possible re-deposition of released copper oxides on stator windings, which otherwise may cause flow restrictions by partial plugging of copper hollow conductors and impair cooling. The phenomenon which is of more concern is not strictly of corrosion failure, but the consequences caused by the re-deposition of copper oxides that were formed by reaction of copper with oxygen. There were also some Operating experiences (OE) related to Copper oxide fouling in the system resulting shut down/off-line of plants. In Madras Atomic Power Station (MAPS), the turbine generator stator windings are of Copper material and cooled by demineralized water passing through the hollow conductors. The heated water from the stator is cooled by process water. A part of the stator water is continuously passed through a mixed bed polisher to remove any soluble ionic contaminants to maintain the purity of system water and also maintain copper content as low as possible to avoid possible re-deposition of released copper oxides on stator windings. The chemistry regime employed is neutral water with dissolved oxygen content between 1000-2000 ppb. Chemistry management of Stator water system was reviewed to know its effectiveness. Detailed chemical analyses of the spent resins from the polishing unit were carried out in various campaigns which indicated only part exhaustion of the polishing unit resins and reasonably low levels of copper entrapment in the resins, thus highlighting the effectiveness of the in-practice chemistry regime. (author)

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

    Science.gov (United States)

    2014-12-01

    insolvency from uncompensated care, bad debt and charity care which continue to rise at an alarming rate. Public and nonprofit hospitals typically use...poor. Rooted in this tradition of charity , the public hospital traces its ancestry to the development of cities and community efforts to shelter and...effects. An astounding number of hospitals saw an increase in bad debt, charity care combined with an increase number of patients using government

  9. 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.

  10. 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

    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 risk management in the hospitals of Iran. PMID:27313481

  11. A Hospital Nursing Adverse Events Reporting System Project: An Approach Based on the Systems Development Life Cycle.

    Science.gov (United States)

    Cao, Yingjuan; Ball, Marion

    2017-01-01

    Based on the System Development Life Cycle, a hospital based nursing adverse event reporting system was developed and implemented which integrated with the current Hospital Information System (HIS). Besides the potitive outcomes in terms of timeliness and efficiency, this approach has brought an enormous change in how the nurses report, analyze and respond to the adverse events.

  12. Copper-silver ionization at a US hospital: interaction of treated drinking water with plumbing materials, aesthetics and other considerations

    Science.gov (United States)

    Tap water sampling and surface analysis of copper pipe/bathroom porcelain were performed to explore the fate of copper and silver during the first nine months of copper-silver ionization (CSI) applied to cold and hot water at a hospital in Cincinnati, Ohio. Ions dosed by CSI into...

  13. 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.

  14. 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...

  15. Solar Water Heating System for Biodiesel Production

    Directory of Open Access Journals (Sweden)

    Syaifurrahman

    2018-01-01

    Full Text Available Nowadays, electricity become very expensive thing in some remote areas. Energy from solar panels give the solution as renewable energy that is environment friendly. West Borneo is located on the equator where the sun shines for almost 10-15 hours/day. Solar water heating system which is includes storage tank and solar collections becomes a cost-effective way to generate the energy. Solar panel heat water is delivered to water in storage tank. Hot water is used as hot fluid in biodiesel jacked reactor. The purposes of this research are to design Solar Water Heating System for Biodiesel Production and measure the rate of heat-transfer water in storage tank. This test has done for 6 days, every day from 8.30 am until 2.30 pm. Storage tank and collection are made from stainless steel and polystyrene a well-insulated. The results show that the heater can be reach at 50ºC for ±2.5 hours and the maximum temperature is 62ºC where the average of light intensity is 1280 lux.

  16. Solar Water Heating System for Biodiesel Production

    Science.gov (United States)

    Syaifurrahman; Usman, A. Gani; Rinjani, Rakasiwi

    2018-02-01

    Nowadays, electricity become very expensive thing in some remote areas. Energy from solar panels give the solution as renewable energy that is environment friendly. West Borneo is located on the equator where the sun shines for almost 10-15 hours/day. Solar water heating system which is includes storage tank and solar collections becomes a cost-effective way to generate the energy. Solar panel heat water is delivered to water in storage tank. Hot water is used as hot fluid in biodiesel jacked reactor. The purposes of this research are to design Solar Water Heating System for Biodiesel Production and measure the rate of heat-transfer water in storage tank. This test has done for 6 days, every day from 8.30 am until 2.30 pm. Storage tank and collection are made from stainless steel and polystyrene a well-insulated. The results show that the heater can be reach at 50ºC for ±2.5 hours and the maximum temperature is 62ºC where the average of light intensity is 1280 lux.

  17. Wash water waste pretreatment system study

    Science.gov (United States)

    1976-01-01

    The use of real wash water had no adverse effect on soap removal when an Olive Leaf soap based system was used; 96 percent of the soap was removed using ferric chloride. Numerous chemical agents were evaluated as antifoams for synthetic wash water. Wash water surfactants used included Olive Leaf Soap, Ivory Soap, Neutrogena and Neutrogena Rain Bath Gel, Alipal CO-436, Aerosol 18, Miranol JEM, Palmeto, and Aerosol MA-80. For each type of soapy wash water evaluated, at least one antifoam capable of causing nonpersistent foam was identified. In general, the silicones and the heavy metal ions (i.e., ferric, aluminum, etc.) were the most effective antifoams. Required dosage was in the range of 50 to 200 ppm.

  18. Modelling water uptake efficiency of root systems

    Science.gov (United States)

    Leitner, Daniel; Tron, Stefania; Schröder, Natalie; Bodner, Gernot; Javaux, Mathieu; Vanderborght, Jan; Vereecken, Harry; Schnepf, Andrea

    2016-04-01

    Water uptake is crucial for plant productivity. Trait based breeding for more water efficient crops will enable a sustainable agricultural management under specific pedoclimatic conditions, and can increase drought resistance of plants. Mathematical modelling can be used to find suitable root system traits for better water uptake efficiency defined as amount of water taken up per unit of root biomass. This approach requires large simulation times and large number of simulation runs, since we test different root systems under different pedoclimatic conditions. In this work, we model water movement by the 1-dimensional Richards equation with the soil hydraulic properties described according to the van Genuchten model. Climatic conditions serve as the upper boundary condition. The root system grows during the simulation period and water uptake is calculated via a sink term (after Tron et al. 2015). The goal of this work is to compare different free software tools based on different numerical schemes to solve the model. We compare implementations using DUMUX (based on finite volumes), Hydrus 1D (based on finite elements), and a Matlab implementation of Van Dam, J. C., & Feddes 2000 (based on finite differences). We analyse the methods for accuracy, speed and flexibility. Using this model case study, we can clearly show the impact of various root system traits on water uptake efficiency. Furthermore, we can quantify frequent simplifications that are introduced in the modelling step like considering a static root system instead of a growing one, or considering a sink term based on root density instead of considering the full root hydraulic model (Javaux et al. 2008). References Tron, S., Bodner, G., Laio, F., Ridolfi, L., & Leitner, D. (2015). Can diversity in root architecture explain plant water use efficiency? A modeling study. Ecological modelling, 312, 200-210. Van Dam, J. C., & Feddes, R. A. (2000). Numerical simulation of infiltration, evaporation and shallow

  19. Water Treatment Systems for Long Spaceflights

    Science.gov (United States)

    FLynn, Michael T.

    2012-01-01

    Space exploration will require new life support systems to support the crew on journeys lasting from a few days to several weeks, or longer. These systems should also be designed to reduce the mass required to keep humans alive in space. Water accounts for about 80 percent of the daily mass intake required to keep a person alive. As a result, recycling water offers a high return on investment for space life support. Water recycling can also increase mission safety by providing an emergency supply of drinking water, where another supply is exhausted or contaminated. These technologies also increase safety by providing a lightweight backup to stored supplies, and they allow astronauts to meet daily drinking water requirements by recycling the water contained in their own urine. They also convert urine into concentrated brine that is biologically stable and nonthreatening, and can be safely stored onboard. This approach eliminates the need to have a dedicated vent to dump urine overboard. These needs are met by a system that provides a contaminant treatment pouch, referred to as a urine cell or contaminant cell, that converts urine or another liquid containing contaminants into a fortified drink, engineered to meet human hydration, electrolyte, and caloric requirements, using a variant of forward osmosis (FO) to draw water from a urine container into the concentrated fortified drink as part of a recycling stage. An activated carbon pretreatment removes most organic molecules. Salinity of the initial liquid mix (urine plus other) is synergistically used to enhance the precipitation of organic molecules so that activated carbon can remove most of the organics. A functional osmotic bag is then used to remove inorganic contaminants. If a contaminant is processed for which the saline content is different than optimal for precipitating organic molecules, the saline content of the liquid should be adjusted toward the optimal value for that contaminant. A first urine

  20. Water electrolysis system refurbishment and testing

    Science.gov (United States)

    Greenough, B. M.

    1972-01-01

    The electrolytic oxygen generator for the back-up water electrolysis system in a 90-day manned test was refurbished, improved and subjected to a 182-day bench test. The performance of the system during the test demonstrated the soundness of the basic electrolysis concept, the high development status of the automatic controls which allowed completely hands-off operation, and the capability for orbital operation. Some design improvements are indicated.

  1. CLASSIFICATION OF THE MGR SITE WATER SYSTEM

    International Nuclear Information System (INIS)

    J.A. Ziegler

    1999-01-01

    The purpose of this analysis is to document the Quality Assurance (QA) classification of the Monitored Geologic Repository (MGR) site water system structures, systems and components (SSCs) performed by the MGR Safety Assurance Department. This analysis also provides the basis for revision of YMP/90-55Q, Q-List (YMP 1998). The Q-List identifies those MGR SSCs subject to the requirements of DOE/RW-0333P, ''Quality Assurance Requirements and Description'' (QARD) (DOE 1998)

  2. [Maintenance and monitoring of water treatment system].

    Science.gov (United States)

    Pontoriero, G; Pozzoni, P; Tentori, F; Scaravilli, P; Locatelli, F

    2005-01-01

    Water treatment systems must be submitted to maintenance, disinfections and monitoring periodically. The aim of this review is to analyze how these processes must complement each other in order to preserve the efficiency of the system and optimize the dialysis fluid quality. The correct working of the preparatory process (pre-treatment) and the final phase of depuration (reverse osmosis) of the system need a periodic preventive maintenance and the regular substitution of worn or exhausted components (i.e. the salt of softeners' brine tank, cartridge filters, activated carbon of carbon tanks) by a competent and trained staff. The membranes of reverse osmosis and the water distribution system, including dialysis machine connections, should be submitted to dis-infections at least monthly. For this purpose it is possible to use chemical and physical agents according to manufacturer' recommendations. Each dialysis unit should predispose a monitoring program designed to check the effectiveness of technical working, maintenance and disinfections and the achievement of chemical and microbiological standards taken as a reference. Generally, the correct composition of purified water is monitored by continuous measuring of conductivity, controlling bacteriological cultures and endotoxin levels (monthly) and checking water contaminants (every 6-12 months). During pre-treatment, water hardness (after softeners) and total chlorine (after chlorine tank) should be checked periodically. Recently the Italian Society of Nephrology has developed clinical guidelines for water and dialysis solutions aimed at suggesting rational procedures for production and monitoring of dialysis fluids. It is hopeful that the application of these guidelines will lead to a positive cultural change and to an improvement in dialysis fluid quality.

  3. Sustainable Energy, Water and Environmental Systems

    DEFF Research Database (Denmark)

    Østergaard, Poul Alberg; Duic, Neven

    2014-01-01

    This issue presents research results from the 8th Conference on Sustainable Development of Energy, Water and Environment Systems – SDEWES - held in Dubrovnik, Croatia in 2013. Topics covered here include the energy situation in the Middle East with a focus in Cyprus and Israel, energy planning me...

  4. Prototype solar heating and hot water system

    Science.gov (United States)

    1977-01-01

    Progress is reported in the development of a solar heating and hot water system which uses a pyramidal optics solar concentrator for heating, and consists of the following subsystems: collector, control, transport, and site data acquisition. Improvements made in the components and subsystems are discussed.

  5. Water distribution systems design optimisation using metaheuristics ...

    African Journals Online (AJOL)

    The topic of multi-objective water distribution systems (WDS) design optimisation using metaheuristics is investigated, comparing numerous modern metaheuristics, including several multi-objective evolutionary algorithms, an estimation of distribution algorithm and a recent hyperheuristic named AMALGAM (an evolutionary ...

  6. 42 CFR 489.34 - Allowable charges: Hospitals participating in State reimbursement control systems or...

    Science.gov (United States)

    2010-10-01

    ... reimbursement control systems or demonstration projects. 489.34 Section 489.34 Public Health CENTERS FOR... CERTIFICATION PROVIDER AGREEMENTS AND SUPPLIER APPROVAL Allowable Charges § 489.34 Allowable charges: Hospitals participating in State reimbursement control systems or demonstration projects. A hospital receiving payment for...

  7. 78 FR 10579 - TRICARE Revision to CHAMPUS DRG-Based Payment System, Pricing of Hospital Claims

    Science.gov (United States)

    2013-02-14

    ... 0720-AB58 TRICARE Revision to CHAMPUS DRG-Based Payment System, Pricing of Hospital Claims AGENCY... change TRICARE's current regulatory provision for hospital claims priced under the DRG-based payment... under the DRG- based payment system from the beneficiary's date of admission, to pricing such claims...

  8. Employee reactions to the use of management control systems in hospitals: motivation vs. threat

    Directory of Open Access Journals (Sweden)

    Ernesto Lopez-Valeiras

    2018-03-01

    Conclusions: The results obtained contribute to creating specific knowledge on the reactions of employees to the use of management control systems in hospitals. This information may be important in adapting management control systems to the characteristics of the hospital and its employees, which may in turn contribute to reducing dysfunctional worker behavior.

  9. Water column separation in power plant circulating water systems

    International Nuclear Information System (INIS)

    Papadakis, C.N.

    1977-01-01

    Power plant circulating water system condensers operate with a siphon. Column separation is a common occurence in such condensers during low pressure transients. The assumptions that no gas evolves from solution leads to very conservative values of maximum pressures upon rejoining of separated column. A less conservative method led to the development of a macroscopic mathematical model including the presence of air and vapor in a cavity which forms at the top of the condenser. The method of characteristics is used to solve the equations. A case study is analyzed to illustrate the applicability of the developed mathematical model and to provide comparisons of the results obtained

  10. 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.

  11. 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.

  12. Nitrification in Chloraminated Drinking Water Distribution Systems: Factors Affecting Occurrence

    Science.gov (United States)

    Drinking water distribution systems with ammonia present from either naturally occurring ammonia or ammonia addition during chloramination are at risk for nitrification. Nitrification in drinking water distribution systems is undesirable and may result in water quality degradatio...

  13. Drinking Water Microbiome as a Screening Tool for Nitrification in Chloraminated Drinking Water Distribution Systems

    Science.gov (United States)

    Many water utilities in the US using chloramine as disinfectant treatment in their distribution systems have experienced nitrification episodes, which detrimentally impact the water quality. A chloraminated drinking water distribution system (DWDS) simulator was operated throug...

  14. Airflow and Contaminant Distribution in Hospital Wards with a Displacement Ventililation System

    DEFF Research Database (Denmark)

    Qian, H.; Nielsen, Peter Vilhelm; Li, Y.

    2004-01-01

    Airflow and Contaminant Distribution in Hospital Wards with a Displacement Ventilalation System. The 2nd International Conference on Build Environment and Public Health, BEPH 2004, Shenzhen , China . ABSTRACT Displacement ventilation has not been considered to be an applicable system for hospital...... to accurately predict three-dimensional distribution of air velocity, temperature, and contaminant concentration in the ward. Indoor airflow in a displacement ventilation system involves a combination of different flow streams such as the gravity currents and thermal plumes. It is important to choose...... ventilation system in hospital wards. It is for this purpose that we study the performance of displacement ventilation in hospital wards as one of the steps to optimize the ventilation design. When the prospect of applying displacement ventilation system in a hospital ward is examined, it should be necessary...

  15. Energy-Water System Solutions | Energy Analysis | NREL

    Science.gov (United States)

    System Solutions Energy-Water System Solutions NREL has been a pioneer in the development of energy -water system solutions that explicitly address and optimize energy-water tradeoffs. NREL has evaluated energy-water system solutions for Department of Defense bases, islands, communities recovering from

  16. Developing Sustainable Spacecraft Water Management Systems

    Science.gov (United States)

    Thomas, Evan A.; Klaus, David M.

    2009-01-01

    It is well recognized that water handling systems used in a spacecraft are prone to failure caused by biofouling and mineral scaling, which can clog mechanical systems and degrade the performance of capillary-based technologies. Long duration spaceflight applications, such as extended stays at a Lunar Outpost or during a Mars transit mission, will increasingly benefit from hardware that is generally more robust and operationally sustainable overtime. This paper presents potential design and testing considerations for improving the reliability of water handling technologies for exploration spacecraft. Our application of interest is to devise a spacecraft wastewater management system wherein fouling can be accommodated by design attributes of the management hardware, rather than implementing some means of preventing its occurrence.

  17. Acid mine water aeration and treatment system

    Science.gov (United States)

    Ackman, Terry E.; Place, John M.

    1987-01-01

    An in-line system is provided for treating acid mine drainage which basically comprises the combination of a jet pump (or pumps) and a static mixer. The jet pump entrains air into the acid waste water using a Venturi effect so as to provide aeration of the waste water while further aeration is provided by the helical vanes of the static mixer. A neutralizing agent is injected into the suction chamber of the jet pump and the static mixer is formed by plural sections offset by 90 degrees.

  18. Radiology integration in a multi-hospital system.

    Science.gov (United States)

    Welch, D

    1999-01-01

    In 1989, Salt Lake City's Intermountain Health Care (IHC) began a process to reduce costs and streamline processes. Divided into four geographic regions, IHC consists of 24 hospitals and 100 clinics, a 400-member practitioner-physician group, and a staff of 23,000. IHC determined that three Salt Lake Valley hospitals, part of its Urban Central Region, must become one entity with shared management and a reduced staff to cover operations at all three hospitals. Management of the three radiology departments were charged with creating an integration process for the three hospitals. Two directors were selected to manage radiology and meet the outlined goals. Difficulty arose when one director needed to make changes in a facility managed by the other. The directors found that structuring by modality allowed them to plan for all three facilities, standardize equipment purchases and create integrated rather than departmental programs. As consolidation was taking place in top management, employees worried what the resulting changes meant for their jobs. Many were unfamiliar with the concepts of team structure and continuous quality improvement. Various courses and meetings were held to educate staff members and bring them up to new standards. Most successful were the meetings that allowed staff from different facilities to come together and share ideas. Although travel was an issue, these meetings quickly helped move the integration processes forward as peer relationships were developed. Employees were recruited for cross-training and new staff worked wherever needed. As they began to share data, the three hospitals identified best-practice and internal benchmarks. IHC is now ready to hire a single director to manage the radiology departments at the three Salt Lake Valley hospitals.

  19. A Benchmarking System for Domestic Water Use

    Directory of Open Access Journals (Sweden)

    Dexter V. L. Hunt

    2014-05-01

    Full Text Available The national demand for water in the UK is predicted to increase, exacerbated by a growing UK population, and home-grown demands for energy and food. When set against the context of overstretched existing supply sources vulnerable to droughts, particularly in increasingly dense city centres, the delicate balance of matching minimal demands with resource secure supplies becomes critical. When making changes to "internal" demands the role of technological efficiency and user behaviour cannot be ignored, yet existing benchmarking systems traditionally do not consider the latter. This paper investigates the practicalities of adopting a domestic benchmarking system (using a band rating that allows individual users to assess their current water use performance against what is possible. The benchmarking system allows users to achieve higher benchmarks through any approach that reduces water consumption. The sensitivity of water use benchmarks are investigated by making changes to user behaviour and technology. The impact of adopting localised supplies (i.e., Rainwater harvesting—RWH and Grey water—GW and including "external" gardening demands are investigated. This includes the impacts (in isolation and combination of the following: occupancy rates (1 to 4; roof size (12.5 m2 to 100 m2; garden size (25 m2 to 100 m2 and geographical location (North West, Midlands and South East, UK with yearly temporal effects (i.e., rainfall and temperature. Lessons learnt from analysis of the proposed benchmarking system are made throughout this paper, in particular its compatibility with the existing Code for Sustainable Homes (CSH accreditation system. Conclusions are subsequently drawn for the robustness of the proposed system.

  20. The origin of inner Solar System water.

    Science.gov (United States)

    Alexander, Conel M O'D

    2017-05-28

    Of the potential volatile sources for the terrestrial planets, the CI and CM carbonaceous chondrites are closest to the planets' bulk H and N isotopic compositions. For the Earth, the addition of approximately 2-4 wt% of CI/CM material to a volatile-depleted proto-Earth can explain the abundances of many of the most volatile elements, although some solar-like material is also required. Two dynamical models of terrestrial planet formation predict that the carbonaceous chondrites formed either in the asteroid belt ('classical' model) or in the outer Solar System (5-15 AU in the Grand Tack model). To test these models, at present the H isotopes of water are the most promising indicators of formation location because they should have become increasingly D-rich with distance from the Sun. The estimated initial H isotopic compositions of water accreted by the CI, CM, CR and Tagish Lake carbonaceous chondrites were much more D-poor than measured outer Solar System objects. A similar pattern is seen for N isotopes. The D-poor compositions reflect incomplete re-equilibration with H 2 in the inner Solar System, which is also consistent with the O isotopes of chondritic water. On balance, it seems that the carbonaceous chondrites and their water did not form very far out in the disc, almost certainly not beyond the orbit of Saturn when its moons formed (approx. 3-7 AU in the Grand Tack model) and possibly close to where they are found today.This article is part of the themed issue 'The origin, history and role of water in the evolution of the inner Solar System'. © 2017 The Author(s).

  1. 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.

  2. Three-tiered integration of PACS and HIS toward next generation total hospital information system.

    Science.gov (United States)

    Kim, J H; Lee, D H; Choi, J W; Cho, H I; Kang, H S; Yeon, K M; Han, M C

    1998-01-01

    The Seoul National University Hospital (SNUH) started a project to innovate the hospital information facilities. This project includes installation of high speed hospital network, development of new HIS, OCS (order communication system), RIS and PACS. This project aims at the implementation of the first total hospital information system by seamlessly integrating these systems together. To achieve this goal, we took three-tiered systems integration approach: network level, database level, and workstation level integration. There are 3 loops of networks in SNUH: proprietary star network for host computer based HIS, Ethernet based hospital LAN for OCS and RIS, and ATM based network for PACS. They are linked together at the backbone level to allow high speed communication between these systems. We have developed special communication modules for each system that allow data interchange between different databases and computer platforms. We have also developed an integrated workstation in which both the OCS and PACS application programs run on a single computer in an integrated manner allowing the clinical users to access and display radiological images as well as textual clinical information within a single user environment. A study is in progress toward a total hospital information system in SNUH by seamlessly integrating the main hospital information resources such as HIS, OCS, and PACS. With the three-tiered systems integration approach, we could successfully integrate the systems from the network level to the user application level.

  3. HCAHPS - Hospital

    Data.gov (United States)

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

  4. Army Energy and Water Reporting System Assessment

    Energy Technology Data Exchange (ETDEWEB)

    Deprez, Peggy C.; Giardinelli, Michael J.; Burke, John S.; Connell, Linda M.

    2011-09-01

    There are many areas of desired improvement for the Army Energy and Water Reporting System. The purpose of system is to serve as a data repository for collecting information from energy managers, which is then compiled into an annual energy report. This document summarizes reported shortcomings of the system and provides several alternative approaches for improving application usability and adding functionality. The U.S. Army has been using Army Energy and Water Reporting System (AEWRS) for many years to collect and compile energy data from installations for facilitating compliance with Federal and Department of Defense energy management program reporting requirements. In this analysis, staff from Pacific Northwest National Laboratory found that substantial opportunities exist to expand AEWRS functions to better assist the Army to effectively manage energy programs. Army leadership must decide if it wants to invest in expanding AEWRS capabilities as a web-based, enterprise-wide tool for improving the Army Energy and Water Management Program or simply maintaining a bottom-up reporting tool. This report looks at both improving system functionality from an operational perspective and increasing user-friendliness, but also as a tool for potential improvements to increase program effectiveness. The authors of this report recommend focusing on making the system easier for energy managers to input accurate data as the top priority for improving AEWRS. The next major focus of improvement would be improved reporting. The AEWRS user interface is dated and not user friendly, and a new system is recommended. While there are relatively minor improvements that could be made to the existing system to make it easier to use, significant improvements will be achieved with a user-friendly interface, new architecture, and a design that permits scalability and reliability. An expanded data set would naturally have need of additional requirements gathering and a focus on integrating

  5. The effects of ownership and system affiliation on the economic performance of hospitals.

    Science.gov (United States)

    Renn, S C; Schramm, C J; Watt, J M; Derzon, R A

    1985-01-01

    We investigated differences among five types of hospitals, defined by ownership (investor-owned or not-for-profit), system affiliation (system-affiliated or freestanding), and government sponsorship on 24 measures of economic performance. Using multivariate analysis of 1980 Medicare cost report and other data from a national sample of 561 hospitals, we found that investor-owned chain hospitals charged significantly more, and were more profitable, than all other types of hospitals except freestanding for-profits; there were no differences in productive efficiency that could be attributed to ownership or affiliation; the investor-owned hospitals had higher debt-to-asset ratios, less-capital-intensive plants, and greater capital costs as a percentage of operating costs than the not-for-profits; and there were no consistent case-mix differences among the hospitals.

  6. Process and system for treating waste water

    Science.gov (United States)

    Olesen, Douglas E.; Shuckrow, Alan J.

    1978-01-01

    A process of treating raw or primary waste water using a powdered, activated carbon/aerated biological treatment system is disclosed. Effluent turbidities less than 2 JTU (Jackson turbidity units), zero TOC (total organic carbon) and in the range of 10 mg/l COD (chemical oxygen demand) can be obtained. An influent stream of raw or primary waste water is contacted with an acidified, powdered, activated carbon/alum mixture. Lime is then added to the slurry to raise the pH to about 7.0. A polyelectrolyte flocculant is added to the slurry followed by a flocculation period -- then sedimentation and filtration. The separated solids (sludge) are aerated in a stabilization sludge basin and a portion thereof recycled to an aerated contact basin for mixing with the influent waste water stream prior to or after contact of the influent stream with the powdered, activated carbon/alum mixture.

  7. Contamination of hospital tap water: the survival and persistence of Pseudomonas aeruginosa on conventional and 'antimicrobial' outlet fittings.

    Science.gov (United States)

    Hutchins, C F; Moore, G; Thompson, K-A; Webb, J; Walker, J T

    2017-10-01

    Pseudomonas aeruginosa infections have been linked to contaminated hospital taps, highlighting the potential for tap outlet fittings (OF) to harbour biofilm. P. aeruginosa may be transferred to OFs via contaminated cleaning cloths. Suggested interventions include flushing regimens and alternative OF designs. To investigate the transfer of P. aeruginosa from a contaminated cleaning cloth to conventional and 'antimicrobial/antibiofilm' OFs and to determine whether this contamination persists and/or leads to contamination of tap water. Microfibre cloths contaminated with P. aeruginosa (10 8  cfu/mL) were used to wipe four different types of OF [one of conventional design (OF-A) and three marketed as 'antimicrobial' and/or 'antibiofilm' (OF- B, -C and -D)]. OFs were inserted into an experimental water distribution system for up to 24 h. Survival was assessed by culture. Single and multiple water samples were collected and cultured for P. aeruginosa. The median number of P. aeruginosa transferred from cloth to OF was 5.7 × 10 5  cfu (OF-A), 1.9 × 10 6  cfu (OF-B), 1.4 × 10 5  cfu (OF-C) and 2.9 × 10 6  cfu (OF-D). Numbers declined on all OFs during the 24 h period with log reductions ranging from 3.5 (OF-C) to 5.2 (OF-B; P > 0.05). All water samples delivered immediately after OF contamination contained P. aeruginosa at ≥10 cfu per 100 mL. Contamination of water delivered from OF-A persisted despite continued flushing. Water delivered from OF-B did not contain P. aeruginosa beyond the first flush. Contaminated cleaning cloths may transfer P. aeruginosa to OFs, leading to contamination of tap water. Although not removing the potential for contamination, 'antimicrobial/antibiofilm' OFs may prevent P. aeruginosa from continually contaminating water delivered from the outlet. Copyright © 2017 The Healthcare Infection Society. All rights reserved.

  8. Operational water management of Rijnland water system and pilot of ensemble forecasting system for flood control

    Science.gov (United States)

    van der Zwan, Rene

    2013-04-01

    The Rijnland water system is situated in the western part of the Netherlands, and is a low-lying area of which 90% is below sea-level. The area covers 1,100 square kilometres, where 1.3 million people live, work, travel and enjoy leisure. The District Water Control Board of Rijnland is responsible for flood defence, water quantity and quality management. This includes design and maintenance of flood defence structures, control of regulating structures for an adequate water level management, and waste water treatment. For water quantity management Rijnland uses, besides an online monitoring network for collecting water level and precipitation data, a real time control decision support system. This decision support system consists of deterministic hydro-meteorological forecasts with a 24-hr forecast horizon, coupled with a control module that provides optimal operation schedules for the storage basin pumping stations. The uncertainty of the rainfall forecast is not forwarded in the hydrological prediction. At this moment 65% of the pumping capacity of the storage basin pumping stations can be automatically controlled by the decision control system. Within 5 years, after renovation of two other pumping stations, the total capacity of 200 m3/s will be automatically controlled. In critical conditions there is a need of both a longer forecast horizon and a probabilistic forecast. Therefore ensemble precipitation forecasts of the ECMWF are already consulted off-line during dry-spells, and Rijnland is running a pilot operational system providing 10-day water level ensemble forecasts. The use of EPS during dry-spells and the findings of the pilot will be presented. Challenges and next steps towards on-line implementation of ensemble forecasts for risk-based operational management of the Rijnland water system will be discussed. An important element in that discussion is the question: will policy and decision makers, operator and citizens adapt this Anticipatory Water

  9. [Document management systems to support quality management systems at university hospitals - an interview-based study].

    Science.gov (United States)

    Holderried, Martin; Bökel, Ann-Catrin; Ochsmann, Elke

    2018-05-01

    In order to save and control the processes and quality of medical services, a suitable steering system of all relevant documents is essential from the point of view of clinical quality management. Systems supporting an automated steering system of documents are called document management systems (DMS), and they also enter the healthcare sector. The use of DMS in the German healthcare sector has hardly been investigated so far. To close this knowledge gap, interviews were carried out with German university hospitals over a six-month period and subjected to a qualitative content analysis according to Mayring. In total, 25 university hospitals agreed to participate in this study, 19 of which have been working with a digital DMS for about six years on average. There was a great variety among the IT systems used. Document management and usability of the DMS as well as its integration into existing IT structures were key decision-making criteria for the selection of a digital DMS. In general, the long-term usability of the DMS is supported by regular evaluation of one's own requirements for the system, administration and training programs. In addition, DMS have a positive effect on patient safety and the quality of medical care. Copyright © 2018. Published by Elsevier GmbH.

  10. 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.

  11. 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.

  12. The impact of an integrated hospital-community medical information system on quality and service utilization in hospital departments.

    Science.gov (United States)

    Nirel, Nurit; Rosen, Bruce; Sharon, Assaf; Blondheim, Orna; Sherf, Michael; Samuel, Hadar; Cohen, Arnon D

    2010-09-01

    In 2005, an innovative system of hospital-community on-line medical records (OFEK) was implemented at Clalit Health Services (CHS). The goals of the study were to examine the extent of OFEK's use and its impact on quality indicators and medical-service utilization in Internal Medicine and General Surgery wards of CHS hospitals. Examining the frequency of OFEK's use with its own track-log data; comparing, "before" and "after", quality indicators and service utilization data in experimental (CHS patients) versus control groups (other patients). OFEK's use increased by tens of percentages each year, Internal Medicine wards showed a significant decrease in the number of laboratory tests and 3 CT tests performed compared with the control group. Wards using OFEK extensively showed a greater decrease in CT tests, in one imaging test, and in the average number of ambulatory hospitalizations. No similar changes were found in General Surgery wards. The study helps evaluate the extent to which OFEK's targets were achieved and contributes to the development of measures to examine the impact of such systems, which can be used to assess a broad range of Health Information Technology (HIT) systems. Copyright 2010 Elsevier Ireland Ltd. All rights reserved.

  13. Biofouling and biocorrosion in industrial water systems.

    Science.gov (United States)

    Coetser, S E; Cloete, T E

    2005-01-01

    Corrosion associated with microorganisms has been recognized for over 50 years and yet the study of microbiologically influenced corrosion (MIC) is relatively new. MIC can occur in diverse environments and is not limited to aqueous corrosion under submerged conditions, but also takes place in humid atmospheres. Biofouling of industrial water systems is the phenomenon whereby surfaces in contact with water are colonized by microorganisms, which are ubiquitous in our environment. However, the economic implications of biofouling in industrial water systems are much greater than many people realize. In a survey conducted by the National Association of Corrosion Engineers of the United States ten years ago, it was found that many corrosion engineer did not accept the role of bacteria in corrosion, and many of then that did, could not recognize and mitigate the problem. Biofouling can be described in terms of its effects on processes and products such as material degradation (bio-corossion), product contamination, mechanical blockages, and impedance of heat transfer. Microorganisms distinguish themselves from other industrial water contaminants by their ability to utilize available nutrient sources, reproduce, and generate intra- and extracellular organic and inorganic substances in water. A sound understanding of the molecular and physiological activities of the microorganisms involved is necessary before strategies for the long term control of biofouling can be format. Traditional water treatment strategies however, have largely failed to address those factors that promote biofouling activities and lead to biocorrosion. Some of the major developments in recent years have been a redefinition of biofilm architecture and the realization that MIC of metals can be best understood as biomineralization.

  14. Guidelines for transient analysis in water transmission and distribution systems

    NARCIS (Netherlands)

    Pothof, I.W.M.; Karney, B.W.

    2012-01-01

    All water systems leak, and many supply systems do so considerably, with water losses typically of approximately 20% of the water production. The IWA Water Loss Task Force aims for a significant reduction of annual water losses by drafting documents to assist practitioners and others to prevent,

  15. A questionnaire about radiation safety management of the draining-water system at nuclear medicine facilities

    International Nuclear Information System (INIS)

    Shizukuishi, Kazuya; Narita, Hiroto

    2004-01-01

    We conducted a questionnaire survey about radiation-safety management condition in Japanese nuclear medicine facilities to make materials of proposition for more reasonable management of medical radioactive waste. We distributed a questionnaire to institutions equipped with Nuclear Medicine facilities. Of 1,125 institutions, 642 institutes (52.8%) returned effective answers. The questionnaire covered the following areas: scale of an institution, presence of enforcement of radiotherapy, system of a tank, size and number of each tank, a form of draining-water system, a displacement in a radioactive rays management area, a measurement method of the concentration of medical radioactive waste in draining water system, planned and used quantity of radioisotopes for medical examination and treatment, an average displacement of hospital for one month. In most institutions, a ratio of dose limitation of radioisotope in draining-water system was less than 1.0, defined as an upper limitation in ordinance. In 499 hospitals without facilities of hospitalization for unsealed radioisotope therapy, 473 hospitals reported that sum of ratios of dose limits in a draining-water system was less than 1.0. It was calculated by used dose of radioisotope and monthly displacement from hospital, on the premise that all used radioisotope entered in the general draining-water system. When a drainage including radioactivity from a controlled area join with that from other area before it flows out of a institution, it may be diluted and its radioactive concentration should be less than its upper limitation defined in the rule. Especially, in all institutions with a monthly displacement of more than 25,000 m 3 , the sum of ratio of the concentration of each radionuclide to the concentration limit dose calculated by used dose of radioisotope, indicated less than 1.0. (author)

  16. Analysis of Information Security Management Systems at 5 Domestic Hospitals with More than 500 Beds

    OpenAIRE

    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

    2010-01-01

    Objectives 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. Methods The ISMS check-list derived from international/domestic standards was distributed to each hospital to com...

  17. 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.

  18. Medicare's prospective payment system for hospitals: new evidence on transitions among health care settings

    OpenAIRE

    Qian, Xufeng; Russell, Louise B.; Valiyeva, Elmira; Miller, Jane E.

    2007-01-01

    Previous studies of Medicare’s prospective payment system for hospitals (PPS), introduced in 1983, evaluated only its first few years, using data collected during the hospital stay to control for patients’ health. We examine transitions among health care settings over a full decade following implementation of PPS, using survival models and a national longitudinal survey with independent information on health. We find that the rate of discharge from hospitals to nursing homes continued to rise...

  19. Adoption of medication alert systems in hospital outpatient departments in Taiwan.

    Science.gov (United States)

    Kuo, Yu-Chun; Cheng, Shou-Hsia

    2017-06-01

    The adoption of medication alert systems in the health care sector varies among regions. In Taiwan, the health authority introduced policies in 2005 to encourage the adoption of medication alert systems in hospitals. This study aimed to understand the adoption of medication alert systems in the outpatient departments of hospitals in Taiwan using a nationwide survey. A questionnaire was developed and mailed to 380 accredited general hospitals in Taiwan in 2013. The information collected from the questionnaire concerning the outpatient department included (1) the time of adoption of a medication alert system; (2) the operation of individual alert functions: availability, management, and stability; and (3) hospital characteristics: accreditation level, teaching status, ownership, and number of beds. A total of 216 hospitals completed and returned the questionnaire, corresponding to a response rate of 56.8%. The adoption rate of medication alert systems in hospital outpatient departments increased from less than 10% in 1997-95.83% in 2012. Approximately two-thirds of the hospitals developed and maintained the alert systems independently or collaboratively with vendors. Teaching and large hospitals tended to develop more advanced alert functions such as drug-drug interaction functions. Improving the safety and quality of pharmaceutical services and meeting the policy requirements are reasons for hospitals to establish medication alert systems. The adoption rate of medication alert systems reached 95% in accredited general hospitals in Taiwan. Government policy and available health information professionals and vendors may somewhat contribute to the high adoption rate. Copyright © 2017 Elsevier B.V. All rights reserved.

  20. 21 CFR 884.6170 - Assisted reproduction water and water purification systems.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Assisted reproduction water and water purification... Devices § 884.6170 Assisted reproduction water and water purification systems. (a) Identification. Assisted reproduction water purification systems are devices specifically intended to generate high quality...

  1. Water in micro- and nanofluidics systems described using the water potential

    NARCIS (Netherlands)

    Eijkel, Jan C.T.; van den Berg, Albert

    2005-01-01

    This Tutorial Review shows the behaviour of water in micro- and nanofluidic systems. The chemical potential of water (‘water potential’) conveniently describes the energy level of the water at different locations in and around the system, both in the liquid and gaseous state. Since water moves from

  2. Ketamine and the metabolite norketamine: persistence and phototransformation toxicity in hospital wastewater and surface water.

    Science.gov (United States)

    Lin, Angela Yu-Chen; Lee, Wan-Ning; Wang, Xiao-Huan

    2014-04-15

    Ketamine has been increasingly used both recreationally and medicinally around the world. Although the metabolic pathways to form its metabolite norketamine have been carefully investigated in humans and animals, knowledge of their environmental occurrence and fate is limited. In this study, we investigated the occurrence of ketamine and norketamine in 20 natural bodies of water, effluents from 13 hospitals, two wastewater treatment plants and one water supply plant. Ketamine was found at concentrations as high as 10 μg/L. Ketamine and norketamine were consistently found in similar concentrations (ketamine/norketamine ratio: 0.3-4.6) in the collected water samples, and this ratio similar to that found in urine samples. Dark incubation experiments have shown that ketamine is not susceptible to microbial degradation or hydrolysis. Phototransformation was demonstrated to significantly reduce the concentration of ketamine and norketamine in river waters (t(1/2) = 12.6 ± 0.4 and 10.1 ± 0.4 h, respectively) and resulted in byproducts that are similar to human metabolites. Both direct and indirect photolysis led to the N-demethylation of ketamine to form norketamine and other byproducts, including hydroxy-norketamine (HNK), dehydronorketamine (DNK), hydroxy-ketamine (HK) and isomer forms of ketamine and norketamine. Irradiated solutions exhibited higher toxicity (via the Microtox test). Although a final risk assessment could not be made due to a lack of studies on the chronic effects on aquatic organisms, the high and persistent environmental occurrences of ketamine and norketamine as well as the increasingly acute toxicity of the photo byproducts demonstrate the importance of including metabolites in evaluation of the overall risk of ketamine. Copyright © 2014 Elsevier Ltd. All rights reserved.

  3. Condensate and feedwater systems, pumps, and water chemistry. Volume seven

    International Nuclear Information System (INIS)

    Anon.

    1986-01-01

    Subject matter includes condensate and feedwater systems (general features of condensate and feedwater systems, condenser hotwell level control, condensate flow, feedwater flow), pumps (principles of fluid flow, types of pumps, centrifugal pumps, positive displacement pumps, jet pumps, pump operating characteristics) and water chemistry (water chemistry fundamentals, corrosion, scaling, radiochemistry, water chemistry control processes, water pretreatment, PWR water chemistry, BWR water chemistry, condenser circulating water chemistry

  4. Operational cost minimization in cooling water systems

    Directory of Open Access Journals (Sweden)

    Castro M.M.

    2000-01-01

    Full Text Available In this work, an optimization model that considers thermal and hydraulic interactions is developed for a cooling water system. It is a closed loop consisting of a cooling tower unit, circulation pump, blower and heat exchanger-pipe network. Aside from process disturbances, climatic fluctuations are considered. Model constraints include relations concerning tower performance, air flowrate requirement, make-up flowrate, circulating pump performance, heat load in each cooler, pressure drop constraints and climatic conditions. The objective function is operating cost minimization. Optimization variables are air flowrate, forced water withdrawal upstream the tower, and valve adjustment in each branch. It is found that the most significant operating cost is related to electricity. However, for cooled water temperatures lower than a specific target, there must be a forced withdrawal of circulating water and further makeup to enhance the cooling tower capacity. Additionally, the system is optimized along the months. The results corroborate the fact that the most important variable on cooling tower performance is not the air temperature itself, but its humidity.

  5. Characterization of hospitalizations due to external causes in the public health system, Brazil, 2011.

    Science.gov (United States)

    Mascarenhas, Márcio Dênis Medeiros; Barros, Marilisa Berti de Azevedo

    2015-01-01

    The aim of this work is to describe the characteristics of hospital admissions owing to external causes in the public health system in Brazil in 2011. Data from the Hospital Information System of the Unified Health System (SIH/SUS) were analyzed to obtain the frequency, coefficient of hospitalization, and hospital morbidity indicators. Of the 973,015 admissions, falls (38.4%) predominated, followed by traffic accidents (15.8%). The estimated coefficient of hospitalization owing to external causes increased with the age, and it was higher in male patients and in the midwest region of the country. The average stay was higher in hospitalizations for traffic accidents (6.1 days) and assaults (6.0 days), while the hospital mortality rate reached higher values in hospitalizations for assaults (4.7%) and self-harms (4.0%). It is evident from the knowledge of the characteristics described the usefulness of hospital morbidity data for planning care actions and prevention of the external causes.

  6. Cold Vacuum Drying facility deionized water system design description

    International Nuclear Information System (INIS)

    PITKOFF, C.C.

    1999-01-01

    This document describes the Cold Vacuum Drying Facility (CVDF) de-ionized water system. The de-ionized water system is used to provide clean, conditioned water, free from contaminants, chlorides and iron for the CVD Facility. Potable water is supplied to the deionized water system, isolated by a backflow prevention device. After the de-ionization process is complete, via a packaged de-ionization unit, de-ionized water is supplied to the process deionization unit

  7. The Use of Hospital Information Systems Data Base with Word Processing and Other Medical Records System Applications

    OpenAIRE

    Rusnak, James E.

    1982-01-01

    The approach frequently used to introduce computer technology into a hospital Medical Records Department is to implement a Word Processing System. Word processing is a form of computer system application that is intended to improve the department's productivity by improving the medical information transcription process. The effectiveness of the Word Processing System may be further enhanced by installing system facilities to provide access to data processing file information in the Hospital's...

  8. Diverless pipeline repair system for deep water

    Energy Technology Data Exchange (ETDEWEB)

    Spinelli, Carlo M. [Eni Gas and Power, Milan (Italy); Fabbri, Sergio; Bachetta, Giuseppe [Saipem/SES, Venice (Italy)

    2009-07-01

    SiRCoS (Sistema Riparazione Condotte Sottomarine) is a diverless pipeline repair system composed of a suite of tools to perform a reliable subsea pipeline repair intervention in deep and ultra deep water which has been on the ground of the long lasting experience of Eni and Saipem in designing, laying and operating deep water pipelines. The key element of SiRCoS is a Connection System comprising two end connectors and a repair spool piece to replace a damaged pipeline section. A Repair Clamp with elastomeric seals is also available for pipe local damages. The Connection System is based on pipe cold forging process, consisting in swaging the pipe inside connectors with suitable profile, by using high pressure seawater. Three swaging operations have to be performed to replace the damaged pipe length. This technology has been developed through extensive theoretical work and laboratory testing, ending in a Type Approval by DNV over pipe sizes ranging from 20 inches to 48 inches OD. A complete SiRCoS system has been realised for the Green Stream pipeline, thoroughly tested in workshop as well as in shallow water and is now ready, in the event of an emergency situation.The key functional requirements for the system are: diverless repair intervention and fully piggability after repair. Eni owns this technology and is now available to other operators under Repair Club arrangement providing stand-by repair services carried out by Saipem Energy Services. The paper gives a description of the main features of the Repair System as well as an insight into the technological developments on pipe cold forging reliability and long term duration evaluation. (author)

  9. 21 CFR 1250.82 - Potable water systems.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Potable water systems. 1250.82 Section 1250.82... SANITATION Sanitation Facilities and Conditions on Vessels § 1250.82 Potable water systems. The following conditions must be met by vessel water systems used for the storage and distribution of water which has met...

  10. 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.

  11. Radioecological models for inland water systems

    International Nuclear Information System (INIS)

    Raskob, W.; Popov, A.; Zheleznyak, M.J.

    1998-04-01

    Following a nuclear accident, radioactivity may either be directly discharged into rivers, lakes and reservoirs or - after the re-mobilisation of dry and wet deposited material by rain events - may result in the contamination of surface water bodies. These so-called aquatic exposure pathways are still missing in the decision support system IMIS/PARK. Therefore, a study was launched to analyse aquatic and radioecological models with respect to their applicability for assessing the radiation exposure of the population. The computer codes should fulfil the following requirements: 1. to quantify the impact of radionuclides in water systems from direct deposition and via runoff, both dependent on time and space, 2. to forecast the activity concentration in water systems (rivers and lakes) and sediment, both dependent on time and space, and 3. to assess the time dependent activity concentration in fish. To that purpose, a literature survey was conducted to collect a list of all relevant computer models potentially suitable for these tasks. In addition, a detailed overview of the key physical process was provided, which should be considered in the models. Based on the three main processes, 9 codes were selected for the runoff from large watersheds, 19 codes for the river transport and 14 for lakes. (orig.) [de

  12. 42 CFR 412.404 - Conditions for payment under the prospective payment system for inpatient hospital services of...

    Science.gov (United States)

    2010-10-01

    ... payment system for inpatient hospital services of psychiatric facilities. 412.404 Section 412.404 Public... PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT HOSPITAL SERVICES Prospective Payment System for Inpatient Hospital... must meet the conditions of this section to receive payment under the prospective payment system...

  13. A water flow calorimeter calibration system

    International Nuclear Information System (INIS)

    Ullrich, F.T.

    1983-01-01

    Neutral beam systems are instrumented by several water flow calorimeter systems, and some means is needed to verify the accuracy of such systems and diagnose their failures. This report describes a calibration system for these calorimeters. The calibrator consists of two 24 kilowatt circulation water heaters, with associated controls and instrumentation. The unit can supply power from 0 to 48 kW in five coarse steps and one fine range. Energy is controlled by varying the power and the time of operation of the heaters. The power is measured by means of precision power transducers, and the energy is measured by integrating the power with respect to time. The accuracy of the energy measurement is better than 0.5% when the power supplied is near full scale, and the energy resolution is better than 1 kilojoule. The maximum energy delivered is approximately 50 megajoules. The calorimetry loop to be calibrated is opened, and the calibrator is put in series with the calorimeter heat source. The calorimeter is then operated in its normal fashion, with the calibrator used as the heat source. The calibrator can also be used in a stand alone mode to calibrate calorimeter sensors removed from systems

  14. Characterisation, dissemination and persistence of gentamicin resistant Escherichia coli from a Danish university hospital to the waste water environment

    DEFF Research Database (Denmark)

    Jakobsen, Lotte; Sandvang, Dorthe; Hansen, Lars H

    2008-01-01

    The aim of the study was to investigate the potential spread of gentamicin resistant (GEN(R)) Escherichia coli isolates or GEN(R) determinants from a Danish university hospital to the waste water environment. Waste water samples were collected monthly from the outlets of the hospital bed wards...... (aac(3)-II, aac(3)-IV, ant(2'')-I, armA), phenotypic resistance pattern, and virulence genes (hlyA, chuA, sfaS, fogG, malX, traT, iutA, fyuA, iroN, cnf1) to investigate if the hospital and waste water could be reservoirs of antimicrobial resistance and virulence. The ability for GEN(R) determinants......, indicating a potential spread of the gene from patient isolates to waste water isolates. Regardless of origin, most isolates exhibited multi-resistance and contained several virulence genes. In conclusion, our study showed a possible spread of aac(3)-II from the hospital to the waste water. Most of the GEN...

  15. 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

  16. An evaluation of systemic reforms of public hospitals: the Sanming model in China.

    Science.gov (United States)

    Fu, Hongqiao; Li, Ling; Li, Mingqiang; Yang, Chunyu; Hsiao, William

    2017-10-01

    Low- and middle-income countries (LMICs) have been searching for effective strategies to reform their inefficient and wasteful public hospitals. Recently, China developed a model of systemic reforms called the Sanming model to address the inefficiency and waste at public hospitals. In this article, we explain and evaluate how the Sanming model reformed its 22 public hospitals in 2013 by simultaneously restructuring the hospital governance structure, altering the payment system to hospitals, and realigning physicians' incentives. By employing the difference-in-difference (DID) method and using the hospital-level data from 187 public hospitals in Fujian province, we find that the Sanming model has reduced medical costs significantly without measurably sacrificing clinical quality and productive efficiency. The systemic reform, on average, has reduced the medical care cost per outpatient visit and per inpatient admission by 6.1% (P-value = 0.0445) and 15.4% (P-value transformation of public hospitals, where the governance structure, payment system and physician compensation methods are aligned, are crucial to improving their performance; it holds critical lessons for China and other LMICs. © The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  17. Investigating the health care delivery system in Japan and reviewing the local public hospital reform

    Directory of Open Access Journals (Sweden)

    Zhang X

    2016-03-01

    Full Text Available Xing Zhang, Tatsuo Oyama National Graduate Institute for Policy Studies, Tokyo, Japan Abstract: Japan's health care system is considered one of the best health care systems in the world. Hospitals are one of the most important health care resources in Japan. As such, we investigate Japanese hospitals from various viewpoints, including their roles, ownership, regional distribution, and characteristics with respect to the number of beds, staff, doctors, and financial performance. Applying a multivariate analysis and regression model techniques, we show the functional differences between urban populated prefectures and remote ones; the equality gap among all prefectures with respect to the distribution of the number of beds, staff, and doctors; and managerial differences between private and public hospitals. We also review and evaluate the local public hospital reform executed in 2007 from various financial aspects related to the expenditure and revenue structure by comparing public and private hospitals. We show that the 2007 reform contributed to improving the financial situation of local public hospitals. Strategic differences between public and private hospitals with respect to their management and strategy to improve their financial situation are also quantitatively analyzed in detail. Finally, the remaining problems and the future strategy to further improve the Japanese health care system are described. Keywords: health care system, health care resource, public hospital, multivariate regression model, financial performance

  18. The new strategic orientation in innovating hospitality logistics system

    OpenAIRE

    Christian Stipanović; Elena Rudan

    2014-01-01

    Purpose – This paper investigates ways how to innovate logistics processes in the hospitality industry aimed at achieving spatio - temporal transformation of resource base into competitive advantages based on innovation and quality. Economic goal of modern logistics based on knowledge is to provide a unique experience for tourists at minimum cost in order to multiply operational profit. Operational profit has to be largely reinvested in the new strategic orientations as well as in new inta...

  19. Operator Support System for Pressurized Water Reactor

    International Nuclear Information System (INIS)

    Wei Renjie; Shen Shifei

    1996-01-01

    Operator Support System for Pressurized Water Reactor (OSSPWR) has been developed under the sponsorship of IAEA from August 1994. The project is being carried out by the Department of Engineering Physics, Tsinghua University, Beijing, China. The Design concepts of the operator support functions have been established. The prototype systems of OSSPWR has been developed as well. The primary goal of the project is to create an advanced operator support system by applying new technologies such as artificial intelligence (AI) techniques, advanced communication technologies, etc. Recently, the advanced man-machine interface for nuclear power plant operators has been developed. It is connected to the modern computer systems and utilizes new high performance graphic displays. (author). 6 refs, 4 figs

  20. Performance evaluation of public hospital information systems by the information system success model.

    Science.gov (United States)

    Cho, Kyoung Won; Bae, Sung-Kwon; Ryu, Ji-Hye; Kim, Kyeong Na; An, Chang-Ho; Chae, Young Moon

    2015-01-01

    This study was to evaluate the performance of the newly developed information system (IS) implemented on July 1, 2014 at three public hospitals in Korea. User satisfaction scores of twelve key performance indicators of six IS success factors based on the DeLone and McLean IS Success Model were utilized to evaluate IS performance before and after the newly developed system was introduced. All scores increased after system introduction except for the completeness of medical records and impact on the clinical environment. The relationships among six IS factors were also analyzed to identify the important factors influencing three IS success factors (Intention to Use, User Satisfaction, and Net Benefits). All relationships were significant except for the relationships among Service Quality, Intention to Use, and Net Benefits. The results suggest that hospitals should not only focus on systems and information quality; rather, they should also continuously improve service quality to improve user satisfaction and eventually reach full the potential of IS performance.

  1. Do hospital physicians really want to go digital? Acceptance of a picture archiving and communication system in a university hospital

    International Nuclear Information System (INIS)

    Duyck, P.; Pynoo, B.; Devolder, P.; Voet, T.; Adang, L.; Vercruysse, J.

    2008-01-01

    Purpose: 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. Materials and methods: 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. Results: at T1 scale ratings were positive toward the PACS implementation. The ratings on all scales with the exception of self-efficacy improved at T2. Regression analysis revealed that the key factor for intention to use PACS at T1 was the usefulness of PACS, while the availability and awareness of support was its most important predictor at T2. 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%). (orig.)

  2. An analysis of the adoption of managerial innovation: cost accounting systems in hospitals.

    Science.gov (United States)

    Glandon, G L; Counte, M A

    1995-11-01

    The adoption of new medical technologies has received significant attention in the hospital industry, in part, because of its observed relation to hospital cost increases. However, few comprehensive studies exist regarding the adoption of non-medical technologies in the hospital setting. This paper develops and tests a model of the adoption of a managerial innovation, new to the hospital industry, that of cost accounting systems based upon standard costs. The conceptual model hypothesizes that four organizational context factors (size, complexity, ownership and slack resources) and two environmental factors (payor mix and interorganizational dependency) influence hospital adoption of cost accounting systems. Based on responses to a mail survey of hospitals in the Chicago area and AHA annual survey information for 1986, a sample of 92 hospitals was analyzed. Greater hospital size, complexity, slack resources, and interorganizational dependency all were associated with adoption. Payor mix had no significant influence and the hospital ownership variables had a mixed influence. The logistic regression model was significant overall and explained over 15% of the variance in the adoption decision.

  3. 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.

  4. Evaluation of the medical records system in an upcoming teaching hospital-a project for improvisation.

    Science.gov (United States)

    Kumar, B Deepak; Kumari, C M Vinaya; Sharada, M S; Mangala, M S

    2012-08-01

    The medical records system of an upcoming teaching hospital in a developing nation was evaluated for its accessibility, completeness, physician satisfaction, presence of any lacunae, suggestion of necessary steps for improvisation and to emphasize the importance of Medical records system in education and research work. The salient aspects of the medical records department were evaluated based on a questionnaire which was evaluated by a team of 40 participants-30 doctors, 5 personnel from Medical Records Department and 5 from staff of Hospital administration. Most of the physicians (65%) were partly satisfied with the existing medical record system. 92.5% were of the opinion that upgradation of the present system is necessary. The need of the hour in the present teaching hospital is the implementation of a hospital-wide patient registration and medical records re-engineering process in the form of electronic medical records system and regular review by the audit commission.

  5. 75 FR 50041 - Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the...

    Science.gov (United States)

    2010-08-16

    ... site to view public comments. Comments received timely will also be available for public inspection... Stimulation System b. IntraOperative Electron RadioTherapy (IOERT) c. Brachytherapy d. Excisional Debridement...

  6. Apparatus, System, and Method for Forward Osmosis in Water Reuse

    KAUST Repository

    Yangali-Quintanilla, Victor; Li, Zhenyu; Valladares Linares, Rodrigo; Amy, Gary

    2013-01-01

    An apparatus, system, and method for desalinating water is presented. The invention relates to recovery of water from impaired water sources by using FO and seawater as draw solution (DS). The seawater becomes diluted over time and can be easily

  7. The growth of corporate private hospitals in Malaysia: policy contradictions in health system pluralism.

    Science.gov (United States)

    Barraclough, S

    1997-01-01

    The rapid growth of corporate investment in the Malaysian private hospital sector has had a considerable impact on the health care system. Sustained economic growth, the development of new urban areas, an enlarged middle class, and the inclusion of hospital insurance in salary packages have all contributed to a financially lucrative investment environment for hospital entrepreneurs. Many of Malaysia's most technologically advanced hospitals employing leading specialists are owned and operated as corporate business ventures. Corporate hospital investment has been actively encouraged by the government, which regards an expanded private sector as a vital complement to the public hospital system. Yet this rapid growth of corporately owned private hospitals has posed serious contradictions for health care policy in terms of issues such as equity, cost and quality, the effect on the wider health system, and the very role of the state in health care provision. This article describes the growth of corporate investment in Malaysia's private hospital sector and explores some of the attendant policy contradictions.

  8. Passive systems for light water reactors

    International Nuclear Information System (INIS)

    Adinolfi, R.; Noviello, L.

    1990-01-01

    The paper reviews the most original concepts that have been considered in Italy for the back-fitting of the nuclear power plants in order to reduce the probability and the importance of the release to the environment in case of a core melt. With reference either to BWR or PWR, passive concepts have been considered for back-fitting in the following areas: pump seals damage prevention and ECCS passive operation; reactor passive depressurization; molten reactor core passive cooling; metal containment passive water cooling through a water tank located at high level; containment isolation improvement through a sealing system; containment leaks control and limitation of environmental release. In addition some considerations will be made on the protection against external events introduced from the beginning on the PUN design either on building and equipment lay-out either on structure design. (author). 5 figs

  9. 75 FR 45699 - Medicare Program: Changes to the Hospital Outpatient Prospective Payment System and CY 2010...

    Science.gov (United States)

    2010-08-03

    ... Prospective Payment System and CY 2010 Payment Rates; Changes to the Ambulatory Surgical Center Payment System...-1414-CN2] RIN 0938-AP41 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...

  10. Childrens Hospital Integrated Patient Electronic Record System Continuation (CHIPERS)

    Science.gov (United States)

    2015-12-01

    child might...lytes  and  glucose.     **  Time  zero  is  the  first  point  at  which  anyone  considers  that  a   child ...culture  of  their  hospital,  namely  the  hierarchy  of  medicine  and  a   stigma  for  nurses  calling  

  11. [Problems encountered by hospital pharmacists with information systems: Analysis of exchanges within social networks].

    Science.gov (United States)

    Charpiat, B; Mille, F; Fombeur, P; Machon, J; Zawadzki, E; Bobay-Madic, A

    2018-05-21

    The development of information systems in French hospitals is mandatory. The aim of this work was to analyze the content of exchanges carried out within social networks, dealing with problems encountered with hospital pharmacies information systems. Messages exchanged via the mailing list of the Association pour le Digital et l'Information en Pharmacie and abstracts of communications presented at hospital pharmacists trade union congresses were analyzed. Those referring to information systems used in hospital pharmacies were selected. From March 2015 to June 2016, 122 e-mails sent by 80 pharmacists concerned information systems. From 2002 to 2016, 45 abstracts dealt with this topic. Problems most often addressed in these 167 documents were "parameterization and/or functionalities" (n=116), interfaces and complexity of the hospital information systems (n=52), relationship with health information technologies vendors and poor reactivity (n=32), additional workload (n=32), ergonomics (n=30), insufficient user training (n=22). These problems are interdependent, lead to errors and in order to mitigate their consequences, they compel pharmacy professionals to divert a significant amount of working hours to the detriment of pharmaceutical care and dispensing and preparing drugs. Hospital pharmacists are faced with many problems of insecurity and inefficiency generated by information systems. Researches are warranted to determine their cost, specify their deleterious effects on care and identify the safest information systems. Copyright © 2018 Académie Nationale de Pharmacie. Published by Elsevier Masson SAS. All rights reserved.

  12. 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...

  13. Challenges of information systems strategy implementation in public hospitals: a South African experience

    CSIR Research Space (South Africa)

    Hwabamungu, B

    2015-05-01

    Full Text Available on this phenomenon in the healthcare sector. Building on previous IS strategizing research we explored the challenges of Information Systems strategy implementation. We then explored the challenges of IS strategy implementation in public hospitals in developing...

  14. 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...

  15. Evaluation of real-time location systems in their hospital contexts.

    Science.gov (United States)

    Fisher, Jill A; Monahan, Torin

    2012-10-01

    The purpose of the research was to assess real-time location systems (RTLS) that have been implemented in U.S. hospitals. We examined the type of uses to which RTLS have been put, the degree of functionality of the various technologies and software, and the organizational effects of implementing RTLS. The project was a 3-year qualitative study of 23 U.S. hospitals that had implemented RTLS for the purpose of tracking assets, personnel, and/or patients. We observed the systems in use and conducted 80 semi-structured interviews with hospital personnel and vendors. In order to protect the confidentiality of the hospitals and vendors in our sample, we conducted an aggregate analysis of our findings rather than providing evaluations of specific technologies or hospital case studies. The most important findings from our research were (1) substandard functionality of most real-time location systems in use and (2) serious obstacles to effective deployment of the systems due to the material and organizational constraints of the hospitals themselves. We found that the current best use of RTLS is for asset tracking, but importantly it requires whole-hospital deployment as well as centralized control of the system, preferably by materials management or biomedical engineering departments. There are serious technological, material, and organizational barriers to the implementation of RTLS, and these barriers need to be overcome if hospitals are to maximize the potential benefits of these systems. In addition to considering the available technological options, hospitals must assess their unique environments, including the myriad material and organizational constraints that will affect the success of RTLS implementation. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  16. Study on the standardization of hospital information system for medical image information sharing

    International Nuclear Information System (INIS)

    Kim, Seon Chil; Kwon, Su Ja

    2001-01-01

    As the adoption of PACS and hospital information system among university hospitals and hospital level institutions grows bigger, the need of sharing and transferring medical information among medical institutions is rising. For the medical information, which is saved in the hospital medical system, to be transferred within the same hospital, domestic, or foreign medical institutions, a standard protocol is necessary. But realistically, most of the domestic hospitals do not abide by H7L which is the HIS standard and so, information transferring is not possible as of present. As such, the purpose of this research is to implement the information between HIS and PACS to an international standard by constructing HL7 messages through HL7 Interface, which will eventually make possible information transferring between different hospitals. Our research team has developed a method which will make the PACS equip hospitals that do not follow HL7 standard which will make possible to transfer information between HIS and PACS through HL7 Message. By constructing message files, which follow the form of HL7 Message in the HL7 Interface, they can be transferred to PACS through the ftp protocol. The realization of the HIS/OCS Interface through HL7 enables data transferring between domestic and foreign medical institutions possible by implementing the international standard in the PACS and HIS data transferring process. The HL7 that our research team has developed made patient data transfer between medical institutions possible. The Interface is for a specific system model and in order for the data transfer between different systems to be realized, interfaces that are fit for each system must be needed. If the Interface is improvised and implemented to each hospital's information system, the data sharing among medical institutions can be broadened

  17. 42 CFR 412.505 - Conditions for payment under the prospective payment system for long-term care hospitals.

    Science.gov (United States)

    2010-10-01

    ... payment system for long-term care hospitals. 412.505 Section 412.505 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT HOSPITAL SERVICES Prospective Payment System for Long-Term Care Hospitals § 412.505 Conditions for...

  18. Implications of an emerging EHR monoculture for hospitals and healthcare systems.

    Science.gov (United States)

    Koppel, Ross; Lehmann, Christoph U

    2015-03-01

    In many hospitals and health systems, a 'new' electronic health record means a shift to one vendor: Epic, a vendor that dominates in large and medium hospital markets and continues its success with smaller institutions and ambulatory practices. Our paper examines the implications of this emerging monoculture: its advantages and disadvantages for physicians and hospitals and its role in innovation, professional autonomy, implementation difficulties, workflow, flexibility, cost, data standards, interoperability, and interactions with other information technology (IT) systems. © The Author 2014. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  19. Sodium-water reaction product flow system

    Energy Technology Data Exchange (ETDEWEB)

    Shirataki, K; Wada, H

    1978-11-18

    Purpose: To provide the subject equipments wherein thermal insulating layers which neither exfoliate nor react by the impact due to high temperature sodium and hydrogen gas and are used for mitigating the thermal impact are provided on the inner surfaces of the emission system equipments, thereby preventing the destruction of the emission system equipments. Constitution: Thermal insulating layers are formed on the inner surfaces of sodium-water reaction product emission system equipments, that is, the inner surface of the emission system pipeline, that of the accommodation vessel and the surface of the cyclone separator, by film treatment, coating or heat resisting coating, and these surfaces are covered with the layers. Each of the layers is made of a material which does not cause a rapid reaction with high temperature sodium or hydrogen gas nor exfoliates and is withstandable for several seconds in which the thermal impact of at least the emission system comes into question, and its thickness is more than one capable of securing the necessary thermal resistance computed by the thermal impact analysis of the emission system.

  20. Sodium-water reaction product flow system

    International Nuclear Information System (INIS)

    Shirataki, Koji; Wada, Hozumi.

    1978-01-01

    Purpose: To provide the subject equipments wherein thermal insulating layers which neither exfoliate nor react by the impact due to high temperature sodium and hydrogen gas and are used for mitigating the thermal impact are provided on the inner surfaces of the emission system equipments, thereby preventing the destruction of the emission system equipments. Constitution: Thermal insulating layers are formed on the inner surfaces of sodium-water reaction product emission system equipments, that is, the inner surface of the emission system pipeline, that of the accommodation vessel and the surface of the cyclone separator, by film treatment, coating or heat resisting coating, and these surfaces are covered with the layers. Each of the layers is made of a material which does not cause a rapid reaction with high temperature sodium or hydrogen gas nor exfoliates and is withstandable for several seconds in which the thermal impact of at least the emission system comes into question, and its thickness is more than one capable of securing the necessary thermal resistance computed by the thermal impact analysis of the emission system. (Yoshihara, H.)

  1. Antimicrobial resistant Escherichia coli in the municipal wastewater system: effect of hospital effluent and environmental fate.

    Science.gov (United States)

    Harris, Suvi; Morris, Carol; Morris, Dearbhaile; Cormican, Martin; Cummins, Enda

    2014-01-15

    The prevalence of antimicrobial resistant (AMR) bacteria is increasing worldwide and remains a significant medical challenge which may lead to antimicrobial redundancy. The contribution of hospital effluent to the prevalence of resistance in wastewater treatment plant (WWTP) effluents is not fully understood. AMR bacteria contained in hospital effluent may be released into the aquatic and soil environments after WWTP processing. Hence, the objective of this study is to identify the extent hospital effluent contributes to contamination of these environments by comparing two WWTPs, one which receives hospital effluent and one which does not. AMR Escherichia coli were monitored in the two WWTPs. A model was developed using these monitored values to predict the effect of hospital effluent within a WWTP. The model predicted levels of AMR E. coli in the aquatic environment and potential bather exposure to AMR E. coli. The model results were highly variable. WWTP influent containing hospital effluent had a higher mean percentage of AMR E. coli; although, there appeared to be no within treatment plant effect on the prevalence of AMR E. coli. Examination of WWTP sludge showed a similar variation. There appeared to be no consistent effect from the presence of hospital effluent. The human exposure assessment model predicted swimmer intake of AMR E. coli between 6 and 193CFU/100ml sea water. It appears that hospital effluent is not the main contributing factor behind the development and persistence of AMR E. coli within WWTPs, although resistance may be too well-developed to identify an influence from hospital effluent. Mitigation needs to focus on the removal of already present resistant bacteria but for new or hospital specific antimicrobials focus needs to be on their limited release within effluents or separate treatment. © 2013.

  2. 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.

  3. Implementing hospital quality assurance policies in Iran: balancing licensing, annual evaluation, inspections and quality management systems.

    Science.gov (United States)

    Aghaei Hashjin, Asgar; Delgoshaei, Bahram; Kringos, Dionne S; Tabibi, Seyed Jamaladin; Manouchehri, Jila; Klazinga, Niek S

    2015-01-01

    The purpose of this paper is to provide an overview of applied hospital quality assurance (QA) policies in Iran. A mixed method (quantitative data and qualitative document analysis) study was carried out between 1996 and 2010. The QA policy cycle forms a tight monitoring system to assure hospital quality by combining mandatory and voluntary methods in Iran. The licensing, annual evaluation and grading, and regulatory inspections statutorily implemented by the government as a national package to assure and improve hospital care quality, while implementing quality management systems (QMS) was voluntary for hospitals. The government's strong QA policy legislation role and support has been an important factor for successful QA implementation in Iran, though it may affected QA assessment independency and validity. Increased hospital evaluation independency and repositioning, updating standards, professional involvement and effectiveness studies could increase QA policy impact and maturity. The study highlights the current QA policy implementation cycle in Iranian hospitals. It provides a basis for further quality strategy development in Iranian hospitals and elsewhere. It also raises attention about finding the optimal balance between different QA policies, which is topical for many countries. This paper describes experiences when implementing a unique approach, combining mandatory and voluntary QA policies simultaneously in a developing country, which has invested considerably over time to improve hospital quality. The experiences with a mixed obligatory/voluntary approach and comprehensive policies in Iran may contain lessons for policy makers in developing and developed countries.

  4. Contamination Control and Monitoring of Tap Water as Fluid in Industrial Tap Water Hydraulic Systems

    DEFF Research Database (Denmark)

    Conrad, Finn; Adelstorp, Anders

    1998-01-01

    Presentation of results and methods addressed to contamination control and monitoring of tap water as fluid in tap water hydraulic systems.......Presentation of results and methods addressed to contamination control and monitoring of tap water as fluid in tap water hydraulic systems....

  5. Biological stability in drinking water distribution systems : A novel approach for systematic microbial water quality monitoring

    NARCIS (Netherlands)

    Prest, E.I.E.D.

    2015-01-01

    Challenges to achieve biological stability in drinking water distribution systems Drinking water is distributed from the treatment facility to consumers through extended man-made piping systems. The World Health Organization drinking water guidelines (2006) stated that “Water entering the

  6. 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.

  7. Water quality diagnosis system for power plant

    International Nuclear Information System (INIS)

    Igarashi, Hiroo; Fukumoto, Toshihiko

    1991-01-01

    An AI diagnose system for the water quality control of a BWR type reactor is divided into a general diagnosing section for generally classifying the water quality conditions of the plant depending on a causal relation between the symptom of the water quality abnormality and its causes, generally diagnosing the position and the cause of the abnormality and ranking the items considered to be the cause, and a detail diagnosing section for a further diagnosis based on the result of the diagnosis in the former section. The general diagnosing section provides a plurality of threshold values showing the extent of the abnormality depending on the cause to the causal relation between the causes and the forecast events previously formed depending on the data of process sensors in the plant. Since the diagnosis for the abnormality and normality is given not only as an ON or OFF mode but also as the extent thereof, it can enter the detailed diagnosis in the most plausible order, based on a plurality of estimated causes, to enable to find the case and take a counter-measure in an early stage. (N.H.)

  8. INVESTIGATION OF LEGIONELLA SPECIES IN TEHRAN’S HOSPITAL WATER SUPPLIES

    Directory of Open Access Journals (Sweden)

    MOHAMMAD RAFIEE

    2015-03-01

    Full Text Available The present work was performed to investigate the presence of Legionella spp. and its common species in hospital water supplies. Considering the drawback of culture method, polymerase chain reaction (PCR assays were developed to detect the gene 16S rRNA regardless of the bacterial serotype. Four well-established DNA extraction protocols (freeze & thaw and phenol-chloroform as two manual protocols and two commercial kits were examined and critiqued to release DNA from bacterial cells. A total of 45 samples were collected from seven distinct hospitals’ sites during a period of 10 months. The PCR assay was exploited to amplify a 654-bp fragment of the 16S rRNA gene. Legionella were detected in 13 samples (28.9% by all of the methods applied for DNA extraction. Considerable differences were noted in the yield of extracted nucleic acids. Legionella were not detected in any of the samples when DNA extraction by freeze & thaw was used. Omitting this method and comparing manual protocol with commercial kits, Kappa coefficient was calculated as 0.619 with p < 0.05. Although no meaningful differences were found between the kits, DNA extraction with Bioneer kit displayed a higher sensitivity than classical Qiagen. Showerheads and cold-water taps were the most and least contaminated sources with 55.5 and 9 percent positive samples, respectively. Moreover two positive samples were identified for species by DNA sequencing and submitted to the Gene Bank database with accession Nos. FJ480932 and FJ480933.

  9. Chapter 13. Industrial Application of Tap Water Hydraulic Systems

    DEFF Research Database (Denmark)

    Conrad, Finn; Adelstorp, Anders

    1997-01-01

    Design and application of modern pure tap water components and systems in industries, in particular food processing industry.......Design and application of modern pure tap water components and systems in industries, in particular food processing industry....

  10. Chapter 12. Pure Tap Water Hydraulic Systems and Applications

    DEFF Research Database (Denmark)

    Conrad, Finn; Adelstorp, Anders

    1997-01-01

    Presentation of developed a modern pure tap water hydraulic components (Nessie), systems and industrial applications.......Presentation of developed a modern pure tap water hydraulic components (Nessie), systems and industrial applications....

  11. Nitrification in Chloraminated Drinking Water Distribution Systems - Occurrence

    Science.gov (United States)

    This chapter discusses available information on nitrification occurrence in drinking water chloraminated distribution systems. Chapter 4 provides an introduction to causes and controls for nitrification in chloraminated drinking water systems. Both chapters are intended to serve ...

  12. Point-of-care controls for nosocomial legionellosis combined with chlorine dioxide potable water decontamination: a two-year survey at a Welsh teaching hospital.

    Science.gov (United States)

    Hosein, I K; Hill, D W; Tan, T Y; Butchart, E G; Wilson, K; Finlay, G; Burge, S; Ribeiro, C D

    2005-10-01

    This study reports a two-year programme of attempted eradication of Legionella colonization in the potable water supply of a 1000-bed tertiary care teaching hospital in Wales. There was a simultaneous, point-of-care, sterile-water-only policy for all intensive care units (ICU) and bone marrow and renal transplant units in order to prevent acquisition of nosocomial Legionnaires' disease. The programme was initiated following a case of nosocomial pneumonia caused by Legionella pneumophila serogroup 1-Bellingham-like genotype A on the cardiac ICU. The case occurred 14 days after mitral and aortic valve replacement surgery. Clinical and epidemiological investigations implicated aspiration of hospital potable water as the mechanism of infection. Despite interventions with chlorine dioxide costing over 25000 UK pounds per annum, Legionella has remained persistently present in significant numbers (up to 20000 colony forming units/L) and with little reduction in the number of positive sites. Two further cases of nosocomial disease occurred over the following two-year period; in one case, aspiration of tap water was implicated again, and in the other case, instillation of contaminated water into the right main bronchus via a misplaced nasogastric tube was implicated. These cases arose because of inadvertent non-compliance with the sterile-water-only policy in high-risk locations. Enhanced clinical surveillance over the same two-year period detected no other cases of nosocomial disease. This study suggests that attempts at eradication of Legionella spp. from complex water systems may not be a cost-effective measure for prevention of nosocomial infections, and to the best of our knowledge is the first study from the UK to suggest that the introduction of a sterile-water-only policy for ICUs and other high-risk units may be a more cost-effective approach.

  13. Solar system design for water pumping

    Science.gov (United States)

    Abdelkader, Hadidi; Mohammed, Yaichi

    2018-05-01

    In our days, it seems to us that nobody can suspect it on the importance of water and energy for the human needs. With technological advances, the energy need does not cease increasing. This problem of energy is even more sensitive in the isolated sites where the use of the traditional resources proves often very expensive. Indeed, several constraints, like the transport of fuel and the routine maintenances of the diesel engines, return the search for an essential alternative energy source for this type of sites. It summer necessary to seek other resources of energy of replacement. Renewable energies, like photovoltaic energy, wind or hydraulic, represent a replacement solution par excellence and they are used more and more in our days more especially as the national territory has one of the solar layers highest with the world. The duration of insolation can reach the 3900 hours/year on the Sahara. The energy acquired daily on a horizontal surface of 1m2 is about 5kWh, that is to say meadows of 2263kWh/m2/year in the south of the country. The photovoltaic energy utilization for pumping of water is well adapted for more the share of the arid and semi-arid areas because of the existence in these areas of an underground hydraulic potential not very major. Another very important coincidence supports the use of this type of energy for the water pumping is that the demand for water, especially in agriculture, reached its maximum in hot weather and dryness where it is precisely the moment when one has access to the maximum of solar energy. The goal to see an outline on the general composition of a photovoltaic system of pumping, as well as the theoretical elements making it possible to dimension the current pumping stations.

  14. Solar system design for water pumping

    Directory of Open Access Journals (Sweden)

    Abdelkader Hadidi

    2018-01-01

    Full Text Available In our days, it seems to us that nobody can suspect it on the importance of water and energy for the human needs. With technological advances, the energy need does not cease increasing. This problem of energy is even more sensitive in the isolated sites where the use of the traditional resources proves often very expensive. Indeed, several constraints, like the transport of fuel and the routine maintenances of the diesel engines, return the search for an essential alternative energy source for this type of sites. It summer necessary to seek other resources of energy of replacement. Renewable energies, like photovoltaic energy, wind or hydraulic, represent a replacement solution par excellence and they are used more and more in our days more especially as the national territory has one of the solar layers highest with the world. The duration of insolation can reach the 3900 hours/year on the Sahara. The energy acquired daily on a horizontal surface of 1m2 is about 5kWh, that is to say meadows of 2263kWh/m2/year in the south of the country. The photovoltaic energy utilization for pumping of water is well adapted for more the share of the arid and semi-arid areas because of the existence in these areas of an underground hydraulic potential not very major. Another very important coincidence supports the use of this type of energy for the water pumping is that the demand for water, especially in agriculture, reached its maximum in hot weather and dryness where it is precisely the moment when one has access to the maximum of solar energy. The goal to see an outline on the general composition of a photovoltaic system of pumping, as well as the theoretical elements making it possible to dimension the current pumping stations.

  15. Hydrogeology and water quality of the shallow ground-water system in eastern York County, Virginia. Water resources investigation

    International Nuclear Information System (INIS)

    1993-01-01

    The report describes the hydrogeology and water quality of the shallow ground-water system in the eastern part of York County, Va. The report includes a discussion of (1) the aquifers and confining units, (2) the flow of ground water, and (3) the quality of ground water. The report is an evaluation of the shallow ground-water system and focuses on the first 200 ft of sediments below land surface. Historical water-level and water-quality data were not available for the study area; therefore, a network of observation wells was constructed for the study. Water levels were measured to provide an understanding of the flow of ground water through the multiaquifer system. Water samples were collected and analyzed for major inorganic constituents, nutrients, and metals. The report presents maps that show the regional distribution of chloride and iron concentrations. Summary statistics and graphical summaries of selected chemical constituents provide a general assessment of the ground-water quality

  16. Deposit control in process cooling water systems

    International Nuclear Information System (INIS)

    Venkataramani, B.

    1981-01-01

    In order to achieve efficient heat transfer in cooling water systems, it is essential to control the fouling of heat exchanger surfaces. Solubilities of scale forming salts, their growth into crystals, and the nature of the surfaces play important roles in the deposition phenomenon. Condensed phosphates, organic polymers and compounds like phosphates are effective in controlling deposition of scale forming salts. The surface active agents inhibit crystal growth and modify the crystals of the scale forming salts, and thus prevent deposition of dense, uniformly structured crystalline mass on the heat transfer surface. Understanding the mechanism of biofouling is essential to control it by surface active agents. Certain measures taken in the plant, such as back flushing, to control scaling, sometimes may not be effective and can be detrimental to the system itself. (author)

  17. In-Water Hull Cleaning & Filtration System

    Science.gov (United States)

    George, Dan

    2015-04-01

    Dan George R & D Mining Technology LinkedIn GRD Franmarine have received the following prestigious awards in 2014 for their research & development of an in-water hull cleaning and filtration system "The Envirocart: Golden Gecko Award for Environmental Excellence; WA Innovator of the Year - Growth Sector; Department of Fisheries - Excellence in Marine Biosecurity Award - Innovation Category; Lloyd's List Asia Awards - Environmental Award; The Australian Innovation Challenge - Environment, Agriculture and Food Category; and Australian Shipping and Maritime Industry Award - Environmental Transport Award. The Envirocart developed and patented by GRD Franmarine is a revolutionary new fully enclosed capture and containment in-water hull cleaning technology. The Envirocart enables soft Silicon based antifouling paints and coatings containing pesticides such as Copper Oxide to be cleaned in situ using a contactless cleaning method. This fully containerised system is now capable of being deployed to remote locations or directly onto a Dive Support Vessel and is rated to offshore specifications. This is the only known method of in-water hull cleaning that complies with the Department of Agriculture Fisheries and Forestry (DAFF) and Department of Fisheries WA (DoF) Guidelines. The primary underwater cleaning tool is a hydraulically powered hull cleaning unit fitted with rotating discs. The discs can be fitted with conventional brushes for glass or epoxy based coatings or a revolutionary new patented blade system which can remove marine biofouling without damaging the antifouling paint (silicone and copper oxide). Additionally there are a patented range of fully enclosed hand cleaning tools for difficult to access niche areas such as anodes and sea chests, providing an innovative total solution that enables in-water cleaning to be conducted in a manner that causes no biological risk to the environment. In full containment mode or when AIS are present, material is pumped

  18. The optimality of hospital financing system: the role of physician-manager interactions.

    Science.gov (United States)

    Crainich, David; Leleu, Hervé; Mauleon, Ana

    2008-12-01

    The ability of a prospective payment system to ensure an optimal level of both quality and cost reducing activities in the hospital industry has been stressed by Ma (Ma, J Econ Manage Strategy 8(2):93-112, 1994) whose analysis assumes that decisions about quality and costs are made by a single agent. This paper examines whether this result holds when the main decisions made within the hospital are shared between physicians (quality of treatment) and hospital managers (cost reduction). Ma's conclusions appear to be relevant in the US context (where the hospital managers pay the whole cost of treatment). Nonetheless, when physicians partly reimburse hospitals for the treatment cost as it is the case in many European countries, we show that the ability of a prospective payment system to achieve both objectives is sensitive to the type of interaction (simultaneous, sequential or joint decision-making) between the agents. Our analysis suggests that regulation policies in the hospital sector should not be exclusively focused on the financing system but should also take the interaction between physicians and hospital managers into account.

  19. Data that drive: Closing the loop in the learning hospital system.

    Science.gov (United States)

    Liu, Vincent X; Morehouse, John W; Baker, Jennifer M; Greene, John D; Kipnis, Patricia; Escobar, Gabriel J

    2016-11-01

    The learning healthcare system describes a vision of US healthcare that capitalizes on science, information technology, incentives, and care culture to drive improvements in the quality of health care. The inpatient setting, one of the most costly and impactful domains of healthcare, is an ideal setting in which to use data and information technology to foster continuous learning and quality improvement. The rapid digitization of inpatient medicine offers incredible new opportunities to use data from routine care to generate new discovery and thus close the virtuous cycle of learning. We use an object lesson-sepsis care within the 21 hospitals of the Kaiser Permanente Northern California integrated healthcare delivery system-to offer insight into the critical elements necessary for developing a learning hospital system. We then describe how a hospital-wide data-driven approach to inpatient care can facilitate improvements in the quality of hospital care. Journal of Hospital Medicine 2016;11:S11-S17. © 2016 Society of Hospital Medicine. © 2016 Society of Hospital Medicine.

  20. Radiological consequences of radionuclide releases to sewage systems from hospitals in Sweden

    Energy Technology Data Exchange (ETDEWEB)

    Avila, Rodolfo; Cruz, Idalmis de la [Facilia AB (Sweden); Bergman, Synnoeve [Vattenfall Power Consultants AB (Sweden); Hasselblad, Serena [Callido AB (Sweden)

    2007-08-15

    The report addresses radioactive discharges to sewers originating from hospitals, mainly in the form of the excretion of patients treated with radioisotopes for diagnostic or therapeutic purposes. Assessments of doses to the public, including sewage workers, arising from such discharges are performed. Doses are compared against the exemption level of 10 {mu}Sv/a and the dose constraint of 100 {mu}Sv/a. As a basis for the dose assessments, information on the use of radionuclides in Swedish hospitals during the period 1999-2004 is presented and estimates of discharges to the sewage systems are derived. Current sewage treatment practices in Sweden are summarised focusing particularly on the fate of sewage sludge, both in the sewage plant and outside. Radiological impact assessments are performed in two steps. The assessments in the first stage are performed using a simple screening model, not intending to predict exposures realistically but only to identify exposure pathways and radionuclides that are potentially relevant and require further consideration in the more detailed assessments. Results show that only a few of those radionuclides used in the period 1999-2004 in Swedish hospitals for radiotherapy and radiodiagnostics could lead to potentially significant doses (P-32, Y-90, Tc-99m, In-111, I-123, I-131 and Tl-201). Relevant exposure pathways are the external exposure of sewage workers (for Tc- 99m, I-123, I-131, In-111 and Tl-201) and the exposure of the public via ingestion of water (I-131) and fish (P-32, Y-90 and In-111 and I-131). The objective of the second stage is to perform realistic assessments of the doses to sewage workers and to the public through the use of contaminated agricultural sludge and through the contamination of drinking water. For this purpose, the LUCIA model was developed. This model dynamically addresses the behaviour of radionuclides in the different process steps of a sewage plant. The model can address continuous releases as well

  1. Patient, hospital, and local health system characteristics associated with the use of observation stays in veterans health administration hospitals, 2005 to 2012

    OpenAIRE

    Wright, Brad; O'Shea, Amy M.J.; Glasgow, Justin M.; Ayyagari, Padmaja; Vaughan-Sarrazin, Mary

    2016-01-01

    Abstract Recent studies have documented that a significant increase in the use of observation stays along with extensive variation in patterns of use across hospitals. The objective of this longitudinal observational study was to examine the extent to which patient, hospital, and local health system characteristics explain variation in observation stay rates across Veterans Health Administration (VHA) hospitals. Our data came from years 2005 to 2012 of the nationwide VHA Medical SAS inpatient...

  2. 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.

  3. Manganese deposition in drinking water distribution systems.

    Science.gov (United States)

    Gerke, Tammie L; Little, Brenda J; Barry Maynard, J

    2016-01-15

    This study provides a physicochemical assessment of manganese deposits on brass and lead components from two fully operational drinking water distributions systems. One of the systems was maintained with chlorine; the other, with secondary chloramine disinfection. Synchrotron-based in-situ micro X-ray adsorption near edge structure was used to assess the mineralogy. In-situ micro X-ray fluorescence mapping was used to demonstrate the spatial relationships between manganese and potentially toxic adsorbed metal ions. The Mn deposits ranged in thickness from 0.01 to 400 μm. They were composed primarily of Mn oxides/oxhydroxides, birnessite (Mn(3+) and Mn(4+)) and hollandite (Mn(2+) and Mn(4+)), and a Mn silicate, braunite (Mn(2+) and Mn(4+)), in varying proportions. Iron, chromium, and strontium, in addition to the alloying elements lead and copper, were co-located within manganese deposits. With the exception of iron, all are related to specific health issues and are of concern to the U.S. Environmental Protection Agency (U.S. EPA). The specific properties of Mn deposits, i.e., adsorption of metals ions, oxidation of metal ions and resuspension are discussed with respect to their influence on drinking water quality. Copyright © 2015 Elsevier B.V. All rights reserved.

  4. Cost reduction in deep water production systems

    International Nuclear Information System (INIS)

    Beltrao, R.L.C.

    1995-01-01

    This paper describes a cost reduction program that Petrobras has conceived for its deep water field. Beginning with the Floating Production Unit, a new concept of FPSO was established where a simple system, designed to long term testing, can be upgraded, on the location, to be the definitive production unit. Regarding to the subsea system, the following projects will be considered. (1) Subsea Manifold: There are two 8-well-diverless manifolds designed for 1,000 meters presently under construction and after a value analysis, a new design was achieved for the next generation. Both projects will be discussed and a cost evaluation will also be provided. (2) Subsea Pipelines: Petrobras has just started a large program aiming to reduce cost on this important item. There are several projects such as hybrid (flexible and rigid) pipes for large diameter in deep water, alternatives laying methods, rigid riser on FPS, new material...etc. The authors intend to provide an overview of each project

  5. Life cycle management of service water systems

    International Nuclear Information System (INIS)

    Egan, Geoffrey R.; Besuner, Philip M.; Mahajan, Sat P.

    2004-01-01

    As nuclear plants age, more attention must focus on age and time dependent degradation mechanisms such as corrosion, erosion, fatigue, etc. These degradation mechanisms can best be managed by developing a life cycle management plan which integrates past historical data, current conditions and future performance needs. In this paper we present two examples of life cycle management. In the first example, the 20-year maintenance history of a sea water cooling system (cement-lined, cast iron) is reviewed to develop attributes like maintenance cost, spare part inventory, corrosion, and repair data. Based on this information, the future expected damage rate was forecast. The cost of managing the future damage was compared with the cost to replace (in kind and with upgraded materials. A decision optimization scheme was developed to choose the least cost option from: a) Run as-is and repair; b) replace in kind; or c) replace with upgraded material and better design. In the second example, life cycle management techniques were developed for a ceilcote lined steel pipe cooling water system. Screens (fixed and traveling), filters, pumps, motors, valves, and piping were evaluated. (author)

  6. Sensitivity of the Dengue Surveillance System in Brazil for Detecting Hospitalized Cases

    Science.gov (United States)

    2016-01-01

    We evaluated the sensitivity of the dengue surveillance system in detecting hospitalized cases in ten capital cities in Brazil from 2008 to 2013 using a probabilistic record linkage of two independent information systems hospitalization (SIH-SUS) adopted as the gold standard and surveillance (SINAN). Sensitivity was defined as the proportion of cases reported to the surveillance system amid the suspected hospitalized cases registered in SIH-SUS. Of the 48,174 hospitalizations registered in SIH-SUS, 24,469 (50.7%) were reported and registered in SINAN, indicating an overall sensitivity of 50.8% (95%CI 50.3–51.2). The observed sensitivity for each of the municipalities included in the study ranged from 22.0% to 99.1%. The combination of the two data sources identified 71,161 hospitalizations, an increase of 97.0% over SINAN itself. Our results allowed establishing the proportion of underreported dengue hospitalizations in the public health system in Brazil, highlighting the use of probabilistic record linkage as a valuable tool for evaluating surveillance systems. PMID:27192405

  7. 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.

  8. Conversations with the community: the Methodist Hospital System's experience with social media.

    Science.gov (United States)

    Angelle, Denny; Rose, Clare L

    2011-01-01

    The Methodist Hospital System has maintained a social media presence on Facebook, Twitter, and YouTube since 2009. After initial unofficial excursions into the world of social media, we discovered that social media can be a useful tool to extend a conversation with our patients and the community at large and share our hospital's culture with a larger base of like-minded people. But with this new power comes a heightened responsibility--platforms that can potentially reach millions of viewers and readers also provide a potential for misuse that can jeopardize patient privacy and place hospitals at risk. Because of their unique restrictions, even hospitals that use the tools regularly have much left to learn about social media. With constant monitoring and stewardship and a commitment to educating staff, hospitals can effectively use social media tools for marketing and education.

  9. Is it good to be too light? Birth weight thresholds in hospital reimbursement systems.

    Science.gov (United States)

    Reif, Simon; Wichert, Sebastian; Wuppermann, Amelie

    2018-02-02

    Birth weight manipulation has been documented in per-case hospital reimbursement systems, in which hospitals receive more money for otherwise equal newborns with birth weight just below compared to just above specific birth weight thresholds. As hospitals receive more money for cases with weight below the thresholds, having a (reported) weight below a threshold could benefit the newborn. Also, these reimbursement thresholds overlap with diagnostic thresholds that have been shown to affect the quantity and quality of care that newborns receive. Based on the universe of hospital births in Germany from the years 2005-2011, we investigate whether weight below reimbursement relevant thresholds triggers different quantity and quality of care. We find that this is not the case, suggesting that hospitals' financial incentives with respect to birth weight do not directly impact the care that newborns receive. Copyright © 2018 Elsevier B.V. All rights reserved.

  10. STANDARDIZED COSTS FOR WATER SUPPLY DISTRIBUTION SYSTEMS

    Science.gov (United States)

    Presented within the report are cost data for construction and operation/maintenance of domestic water distribution and transmission pipelines, domestic water pumping stations, and domestic water storage reservoirs. To allow comparison of new construction with rehabilitation of e...

  11. A simple high efficiency solar water purification system

    Energy Technology Data Exchange (ETDEWEB)

    Duff, W.S.; Hodgson, D.A. [Colorado State University, Fort Collins, CO (United States). Dept. of Mechanical Engineering

    2005-07-01

    A new passive solar water pasteurization system based on density difference flow principles has been designed, built and tested. The system contains no valves and regulates flow based on the density difference between two columns of water. The new system eliminates boiling problems encountered in previous designs. Boiling is undesirable because it may contaminate treated water. The system with a total absorber area of 0.45 m2 has achieved a peak flow rate of 19.3 kg/h of treated water. Experiments with the prototype systems presented in this paper show that density driven systems are an attractive option to existing solar water pasteurization approaches. (author)

  12. 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.

  13. 21 CFR 876.5665 - Water purification system for hemodialysis.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Water purification system for hemodialysis. 876... SERVICES (CONTINUED) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Therapeutic Devices § 876.5665 Water purification system for hemodialysis. (a) Identification. A water purification system for hemodialysis is a...

  14. Advanced feed water distributing system for WWER 440 steam generators

    Energy Technology Data Exchange (ETDEWEB)

    Matal, O.; Klinga, J. [Energovyzkum Ltd, Brno (Switzerland); Grazl, K. [Vitkovice s.c., Ostrava (Switzerland); Tischler, J.; Mihalik, M. [SEP Atomove Elektrarne Bohunice (Slovakia)

    1995-12-31

    The original designed feed water distributing system was replaced by an advanced one. The characteristics of both feed water distributing systems have been measured and evaluated. The paper deals with the problems of measurement and evaluation of both feed water distributing system characteristics and comparison of statistical data obtained. (orig.). 3 refs.

  15. Maximising water supply system yield subject to multiple reliability ...

    African Journals Online (AJOL)

    Maximising water supply system yield subject to multiple reliability constraints via simulation-optimisation. ... Water supply systems have to satisfy different demands that each require various levels of reliability ... and monthly operating rules that maximise the yield of a water supply system subject to ... HOW TO USE AJOL.

  16. Advanced feed water distributing system for WWER 440 steam generators

    Energy Technology Data Exchange (ETDEWEB)

    Matal, O; Klinga, J [Energovyzkum Ltd, Brno (Switzerland); Grazl, K [Vitkovice s.c., Ostrava (Switzerland); Tischler, J; Mihalik, M [SEP Atomove Elektrarne Bohunice (Slovakia)

    1996-12-31

    The original designed feed water distributing system was replaced by an advanced one. The characteristics of both feed water distributing systems have been measured and evaluated. The paper deals with the problems of measurement and evaluation of both feed water distributing system characteristics and comparison of statistical data obtained. (orig.). 3 refs.

  17. Installation package for a sunspot cascade solar water heating system

    Science.gov (United States)

    1980-01-01

    Solar water heating systems installed at Tempe, Arizona and San Diego, California are described. The systems consist of the following: collector, collector-tank water loop, solar tank, conventional tank, and controls. General guidelines which may be utilized in development of detailed installation plans and specifications are provided along with instruction on operation, maintenance, and installation of solar hot water systems.

  18. Installation package for a solar heating and hot water system

    Science.gov (United States)

    1978-01-01

    Development and installation of two commercial solar heating and hot water systems are reported. The systems consist of the following subsystems: collector, storage, transport, hot water, auxiliary energy and controls. General guidelines are provided which may be utilized in development of detailed installation plans and specifications. In addition, operation, maintenance and repair of a solar heating and hot water system instructions are included.

  19. Advanced feed water distributing system for WWER 440 steam generators

    International Nuclear Information System (INIS)

    Matal, O.; Klinga, J.; Grazl, K.; Tischler, J.; Mihalik, M.

    1995-01-01

    The original designed feed water distributing system was replaced by an advanced one. The characteristics of both feed water distributing systems have been measured and evaluated. The paper deals with the problems of measurement and evaluation of both feed water distributing system characteristics and comparison of statistical data obtained. (orig.)

  20. Drinking water quality and hospital admissions of elderly people for gastrointestinal illness in Eastern Massachusetts, 1998-2008.

    Science.gov (United States)

    Beaudeau, Pascal; Schwartz, Joel; Levin, Ronnie

    2014-04-01

    We used a Poisson regression to compare daily hospital admissions of elderly people for acute gastrointestinal illness in Boston against daily variations in drinking water quality over an 11-year period, controlling for weather, seasonality and time trends. The Massachusetts Water Resources Authority (MWRA), which provides non-filtered water to 1.5 million people in the greater Boston area, changed its disinfection method from chlorination to ozonation during the study period so we were also able to evaluate changes in risk associated with the change in disinfection method. Other available water quality data from the MWRA included turbidity, fecal coliforms, UV-absorbance, and planktonic algae and cyanobacteriae concentrations. Daily weather, rainfall data and water temperature were also available. Low water temperature, increases in turbidity and, to a lesser extent, in fecal coliform and cyanobacteriae were associated with a higher risk of hospital admissions, while the shift from chlorination to ozonation has possibly reduced the health risk. The MWRA complied with US drinking water regulations throughout the study period. Copyright © 2014 Elsevier Ltd. All rights reserved.

  1. Neutral sodium/bicarbonate/sulfate hot waters in geothermal systems

    Energy Technology Data Exchange (ETDEWEB)

    Mahon, W.A.J. (Dept. of Industrial and Scientific Research, Wairakei, New Zealand); Klyen, L.E.; Rhode, M.

    1980-03-01

    The least understood thermal water is a near neutral water which contains varying amounts of bicarbonate and sulfate as the major anions, low concentrations of chloride (< 30 ppM) and sodium as the major cation. In the past this water has been referred to as a sodium bicarbonate water but present studies suggest that the quantities of bicarbonate and sulfate in this water type are frequently of the same order. Of particular interest is the distribution and position of the sodium/bicarbonate/sulfate water in the same and different systems. Many hot springs in Indonesia, for example, discharge water of this composition. Present studies indicate that this water type can originate from high temperature reservoirs which form the secondary steam heated part of a normal high temperature geothermal system. The hydrological conditions producing these waters in geothermal systems are investigated and the relationship between the water type and vapor dominated systems is discussed. It is suggested that the major water type occurring in the so called vapor dominated parts of geothermal systems is this water. The water does not simply represent steam condensate, rather it consists essentially of meteoric water which has been steam heated. The water composition results from the interaction of carbon dioxide and hydrogen sulfide with meteoric water and the rocks confining this water in the aquifer.

  2. A cross-national comparison of incident reporting systems implemented in German and Swiss hospitals.

    Science.gov (United States)

    Manser, Tanja; Imhof, Michael; Lessing, Constanze; Briner, Matthias

    2017-06-01

    This study aimed to empirically compare incident reporting systems (IRS) in two European countries and to explore the relationship of IRS characteristics with context factors such as hospital characteristics and characteristics of clinical risk management (CRM). We performed exploratory, secondary analyses of data on characteristics of IRS from nationwide surveys of CRM practices. The survey was originally sent to 2136 hospitals in Germany and Switzerland. Persons responsible for CRM in 622 hospitals completed the survey (response rate 29%). None. Differences between IRS in German and Swiss hospitals were assessed using Chi2, Fisher's Exact and Freeman-Halton-Tests, as appropriate. To explore interrelations between IRS characteristics and context factors (i.e. hospital and CRM characteristics) we computed Cramer's V. Comparing participating hospitals across countries, Swiss hospitals had implemented IRS earlier, more frequently and more often provided introductory IRS training systematically. German hospitals had more frequently systematically implemented standardized procedures for event analyses. IRS characteristics were significantly associated with hospital characteristics such as hospital type as well as with CRM characteristics such as existence of strategic CRM objectives and of a dedicated position for central CRM coordination. This study contributes to an improved understanding of differences in the way IRS are set up in two European countries and explores related context factors. This opens up new possibilities for empirically informed, strategic interventions to further improve dissemination of IRS and thus support hospitals in their efforts to move patient safety forward. © The Author 2017. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  3. Is the Colombian health system reform improving the performance of public hospitals in Bogotá?

    Science.gov (United States)

    McPake, Barbara; Yepes, Francisco Jose; Lake, Sally; Sanchez, Luz Helena

    2003-06-01

    Many countries are experimenting with public hospital reform - both increasing the managerial autonomy with which hospitals conduct their affairs, and separating 'purchaser' and 'provider' sides of the health system, thus increasing the degree of market pressure brought to bear on hospitals. Evidence suggesting that such reform will improve hospital performance is weak. From a theoretical perspective, it is not clear why public hospitals should be expected to behave like firms and seek to maximize profits as this model requires. Empirically, there is very slight evidence that such reforms may improve efficiency, and reason to be concerned about their equity implications. In Colombia, an ambitious reform programme includes among its measures the attempt to universalize a segmented health system, the creation of a purchaser-provider split and the transformation of public hospitals into 'autonomous state entities'. By design, the Colombian reform programme avoids the forces that produce equity losses in other developing countries. This paper reports the results of a study that has tried to track hospital performance in other dimensions in the post-reform period in Bogotá. Trends in hospital inputs, production and productivity, quality and patient satisfaction are presented, and qualitative data based on interviews with hospital workers are analyzed. The evidence we have been able to collect is capable of providing only a partial response to the study question. There is some evidence of increased activity and productivity and sustained quality despite declining staffing levels. Qualitative data suggest that hospital workers have noticed considerable changes, which include greater responsiveness to patients but also a heavier administrative burden. It is difficult to attribute specific causality to all of the changes measured and this reflects the inherent difficulty of judging the effects of large-scale reform programmes as well as weaknesses and gaps in the data

  4. K West integrated water treatment system subproject safety analysis document

    International Nuclear Information System (INIS)

    SEMMENS, L.S.

    1999-01-01

    This Accident Analysis evaluates unmitigated accident scenarios, and identifies Safety Significant and Safety Class structures, systems, and components for the K West Integrated Water Treatment System

  5. K West integrated water treatment system subproject safety analysis document

    Energy Technology Data Exchange (ETDEWEB)

    SEMMENS, L.S.

    1999-02-24

    This Accident Analysis evaluates unmitigated accident scenarios, and identifies Safety Significant and Safety Class structures, systems, and components for the K West Integrated Water Treatment System.

  6. Influence of All Inclusive System in the Turkish Hospitality Industry

    OpenAIRE

    ÜNER, M. Mithat; SÖKMEN, Alptekin; BİRKAN, İbrahim

    2014-01-01

    The all inclusive system, which is being used commonly in lodging operations in Antalya region, is the province of this study. In scope of this study, after giving detailed theoretically information about all inclusive system, the implementation of all inclusive system in four and five star hotels and holiday villages in Antalya and its effects over business activities were discussed empirically. Within this framework, total 111 lodging operations have been given inquiries in order to determi...

  7. Influence of All Inclusive System in the Turkish Hospitality Industry

    OpenAIRE

    ÜNER, M. Mithat; SÖKMEN, Alptekin; BİRKAN, İbrahim

    2006-01-01

    The all inclusive system, which is being used commonly in lodging operations in Antalya region, is the province of this study. In scope of this study, after giving detailed theoretically information about all inclusive system, the implementation of all inclusive system in four and five star hotels and holiday villages in Antalya and its effects over business activities were discussed empirically. Within this framework, total 111 lodging operations have been given inquiries in order to determi...

  8. Study on measuring social cost of water pollution: concentrated on Han River water system

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Kwang Im; Min, Dong Gee; Chung, Hoe Seong; Lim, Hyun Jeong; Kim, Mee Sook [Korea Environment Institute, Seoul (Korea)

    1999-12-01

    Following the economic development and the progress of urbanization, the damage on water pollution has been more serious but a social cost caused by water pollution cannot be measured. Although the need of water quality preservation is emphasized, a base material for public investment on enhancing water quality preservation is not equipped yet due to the absence of economic values of water resource. Therefore it measured a cost generated by leaving pollution not treated water quality in this study. To measure the usable value of water resource or the cost of water pollution all over the country should include a national water system, but this study is limited on the mainstream of Han River water system from North Han River through Paldang to Chamsil sluice gates. Further study on Nakdong River and Keum River water systems should be done. 74 refs., 4 figs., 51 tabs.

  9. Requirements for Successful Adoption of a Glucose Measurement System Into a Hospital POC Program.

    Science.gov (United States)

    Füzéry, Anna K; Cembrowski, George S

    2016-07-01

    Widespread and successful implementation of any glucose measurement system in a hospital point-of-care (POC) program requires a number of features in addition to accurate and reliable analytical performance. Such features include, but are not limited to, a system's glucose-hematocrit dependence, durability, information technology capabilities, and battery capacity and battery life. While the study of Ottiger et al in this issue supports the analytical accuracy and reliability of Bayer's CONTOUR XT® blood glucose monitoring system, the suitability of other features of this system for a hospital POC program remains to be established. © 2016 Diabetes Technology Society.

  10. Management Control Systems and Clinical Experience of Managers in Public Hospitals

    Directory of Open Access Journals (Sweden)

    Rogério Joao Lunkes

    2018-04-01

    Full Text Available Healthcare authorities are encouraging managers in hospitals to acquire clinical experience and knowledge in order to better carry out and coordinate healthcare service delivery. The main objective of this paper is to analyse how the clinical experience of hospital managers is related to public health institutions’ performance. It is proposed that the effect of the clinical experience on operative and financial organizational performance is indirect through the mediating variables of perceived utility of management information and horizontal management control system. This paper analyses how these variables impact hospital performance through the data from a survey sent to 364 hospital managers in Brazil. The results show that managers’ clinical experience is related to higher perceived utility of historical, financial, short-term, and internal information, but not with horizontal control adoption in hospitals. Furthermore, our results show that, in hospitals, perceived utility of forecasted, non-financial, long-term, and external managerial information positively affects hospitals’ financial performance, while adoption of horizontal control management positively affects operational performance. Through showing evidence that clinical background could explain the differences not only in hospital service management but also in information capabilities and management control processes, this study offer meaningful implications for healthcare authorities and hospital managers involved in the development and implementation of strategies in the health sector.

  11. Management Control Systems and Clinical Experience of Managers in Public Hospitals

    Science.gov (United States)

    Naranjo-Gil, David

    2018-01-01

    Healthcare authorities are encouraging managers in hospitals to acquire clinical experience and knowledge in order to better carry out and coordinate healthcare service delivery. The main objective of this paper is to analyse how the clinical experience of hospital managers is related to public health institutions’ performance. It is proposed that the effect of the clinical experience on operative and financial organizational performance is indirect through the mediating variables of perceived utility of management information and horizontal management control system. This paper analyses how these variables impact hospital performance through the data from a survey sent to 364 hospital managers in Brazil. The results show that managers’ clinical experience is related to higher perceived utility of historical, financial, short-term, and internal information, but not with horizontal control adoption in hospitals. Furthermore, our results show that, in hospitals, perceived utility of forecasted, non-financial, long-term, and external managerial information positively affects hospitals’ financial performance, while adoption of horizontal control management positively affects operational performance. Through showing evidence that clinical background could explain the differences not only in hospital service management but also in information capabilities and management control processes, this study offer meaningful implications for healthcare authorities and hospital managers involved in the development and implementation of strategies in the health sector. PMID:29673192

  12. Understanding Technology and People Issues in Hospital Information System (HIS Adoption: Case study of a tertiary hospital in Malaysia

    Directory of Open Access Journals (Sweden)

    Nasriah Zakaria

    2016-11-01

    Full Text Available Summary: Background: 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. Methods: 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. . Results: 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. Conclusions: 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. Keywords: HIS adoption, Technology and people issues, Case study

  13. 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.

  14. Power and resistance within the hospital's hierarchical system: the experiences of chronically ill patients.

    Science.gov (United States)

    Griscti, Odette; Aston, Megan; Warner, Grace; Martin-Misener, Ruth; McLeod, Deborah

    2017-01-01

    To explore experiences of chronically ill patients and registered nurses when they negotiate patient care in hospital settings. Specifically, we explored how social and institutional discourses shape power relations during the negotiation process. The hospital system is embedded in a hierarchical structure where the voice of the healthcare provider as expert is often given more importance than the patient. This system has been criticised as being oppressive to patients who are perceived to be lower in the hierarchy. In this study, we illustrate how the hospital's hierarchical system is not always oppressing but can also create moments of empowerment for patients. A feminist poststructuralist approach informed by the teaching of Foucault was used to explore power relations between nurses and patients when negotiating patient care in hospital settings. Eight individuals who suffered from chronic illness shared their stories about how they negotiated their care with nurses in hospital settings. The interviews were tape-recorded. Discourse analysis was used to analyse the data. Patients recounted various experiences when their voices were not heard because the current hospital system privileged the healthcare provider experts' advice over the patients' voice. The hierarchical structure of hospital supported these dynamics by privileging nurses as gatekeepers of service, by excluding the patients' input in the nursing notes and through a process of self-regulation. However, patients in this study were not passive recipients of care and used their agency creatively to resist these discourses. Nurses need to be mindful of how the hospital's hierarchical system tends to place nurses in a position of power, and how their authoritative position may positively or adversely affect the negotiation of patient care. © 2016 John Wiley & Sons Ltd.

  15. Detection system for continuous 222Rn monitoring in waters

    International Nuclear Information System (INIS)

    Holy, K.; Patschova, E.; Bosa, I.; Polaskova, A.; Hola, O.

    2001-01-01

    This contribution presents one of the high-sensitive systems of continuous radon monitoring in waters. The device can be used for the continual control of 222 Rn activity concentration in water sources, for a study of the daily and seasonal variations of radon activity concentration in water systems, for the determination of the infiltration time of surface water into the ground water and for the next untraditional applications. (authors)

  16. 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

  17. A technology ecosystem perspective on hospital management information systems: lessons from the health literature.

    Science.gov (United States)

    Bain, Christopher A; Standing, Craig

    2009-01-01

    Hospital managers have a large range of information needs including quality metrics, financial reports, access information needs, educational, resourcing and decision support needs. Currently these needs involve interactions by managers with numerous disparate systems, both electronic such as SAP, Oracle Financials, PAS' (patient administration systems) like HOMER, and relevant websites; and paper-based systems. Hospital management information systems (HMIS) can be thought of sitting within a Technology Ecosystem (TE). In addition, Hospital Management Information Systems (HMIS) could benefit from a broader and deeper TE model, and the HMIS environment may in fact represents its own TE (the HMTE). This research will examine lessons from the health literature in relation to some of these issues, and propose an extension to the base model of a TE.

  18. POOL WATER TREATMENT AND COOLING SYSTEM DESCRIPTION DOCUMENT

    International Nuclear Information System (INIS)

    King, V.

    2000-01-01

    The Pool Water Treatment and Cooling System is located in the Waste Handling Building (WHB), and is comprised of various process subsystems designed to support waste handling operations. This system maintains the pool water temperature within an acceptable range, maintains water quality standards that support remote underwater operations and prevent corrosion, detects leakage from the pool liner, provides the capability to remove debris from the pool, controls the pool water level, and helps limit radiological exposure to personnel. The pool structure and liner, pool lighting, and the fuel staging racks in the pool are not within the scope of the Pool Water Treatment and Cooling System. Pool water temperature control is accomplished by circulating the pool water through heat exchangers. Adequate circulation and mixing of the pool water is provided to prevent localized thermal hotspots in the pool. Treatment of the pool water is accomplished by a water treatment system that circulates the pool water through filters, and ion exchange units. These water treatment units remove radioactive and non-radioactive particulate and dissolved solids from the water, thereby providing the water clarity needed to conduct waste handling operations. The system also controls pool water chemistry to prevent advanced corrosion of the pool liner, pool components, and fuel assemblies. Removal of radioactivity from the pool water contributes to the project ALARA (as low as is reasonably achievable) goals. A leak detection system is provided to detect and alarm leaks through the pool liner. The pool level control system monitors the water level to ensure that the minimum water level required for adequate radiological shielding is maintained. Through interface with a demineralized water system, adequate makeup is provided to compensate for loss of water inventory through evaporation and waste handling operations. Interface with the Site Radiological Monitoring System provides continuous

  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. Longitudinal analysis on utilization of medical document management system in a hospital with EPR implementation.

    Science.gov (United States)

    Kuwata, Shigeki; Yamada, Hitomi; Park, Keunsik

    2011-01-01

    Document management systems (DMS) have widespread in major hospitals in Japan as a platform to digitize the paper-based records being out of coverage by EPR. This study aimed to examine longitudinal trends of actual use of DMS in a hospital in which EPR had been in operation, which would be conducive to planning the further information management system in the hospital. Degrees of utilization of electronic documents and templates with DMS were analyzed based on data extracted from a university-affiliated hospital with EPR. As a result, it was found that the number of electronic documents as well as scanned documents circulating at the hospital tended to increase. The result indicated that replacement of paper-based documents with electronic documents did not occur. Therefore it was anticipated that the need for DMS would continue to increase in the hospital. The methods used this study to analyze the trend of DMS utilization would be applicable to other hospitals with with a variety of DMS implementation, such as electronic storage by scanning documents or paper preservation that is compatible with EPR.

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

    Science.gov (United States)

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

    2014-09-01

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

  2. Automated surveillance system for hospital-acquired urinary tract infections in Denmark

    DEFF Research Database (Denmark)

    Condell, Orla; Gubbels, Sophie; Nielsen, J

    2016-01-01

    BACKGROUND: The Danish Hospital-Acquired Infections Database (HAIBA) is an automated surveillance system using hospital administrative, microbiological, and antibiotic medication data. AIM: To define and evaluate the case definition for hospital-acquired urinary tract infection (HA-UTI) and to de......BACKGROUND: The Danish Hospital-Acquired Infections Database (HAIBA) is an automated surveillance system using hospital administrative, microbiological, and antibiotic medication data. AIM: To define and evaluate the case definition for hospital-acquired urinary tract infection (HA-UTI......) and to describe surveillance data from 2010 to 2014. METHODS: The HA-UTI algorithm defined a laboratory-diagnosed UTI as a urine culture positive for no more than two micro-organisms with at least one at ≥10(4)cfu/mL, and a probable UTI as a negative urine culture and a relevant diagnosis code or antibiotic...... treatment. UTI was considered hospital-acquired if a urine sample was collected ≥48h after admission and UTI was calculated per 10,000 risk-days. For validation, prevalence was calculated for each day and compared to point prevalence survey (PPS) data. FINDINGS: HAIBA...

  3. Integrating Product Water Quality Effects In Holistic Assessments Of Water Systems

    OpenAIRE

    Rygaard, Martin

    2011-01-01

    While integrated assessments of sustainability of water systems are largely focused on quantity issues, chemical use, and energy consumption, effects of the supplied water quality are often overlooked. Drinking water quality affects corrosion rates, human health, applicability of water and aesthetics. Even small changes in the chemical composition of water may accumulate large impacts on city scale. Here, a method for integrated assessment of water quality is presented. Based on dose-response...

  4. A study of Cirus heavy water system isotopic purity

    International Nuclear Information System (INIS)

    Thomas, Shibu; Sahu, A.K.; Unni, V.K.P.; Pant, R.C.

    2000-01-01

    Cirus uses heavy water as moderator and helium as cover gas. Approximately one tonne of heavy water was added to the system every year for routine make up. Isotopic purity (IP) of this water used for addition was always higher than that of the system. Though this should increase IP of heavy water in the system, it has remained almost at the same level, over the years. A study was carried out to estimate the extent of improvement in IP of heavy water in the system that should have occurred because of this and other factors in last 30 years. Reasons for non-occurrence of such an improvement were explored. Ion exchange resins used for purification of heavy water and air ingress into helium cover gas system appear to be the principal sources of entry of light water into heavy water system. (author)

  5. 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.

  6. Physician practice management companies: implications for hospital-based integrated delivery systems.

    Science.gov (United States)

    Burns, L R; Robinson, J C

    1997-01-01

    Physician practice management companies (PPMCs) are one of the most visible entrants into the industry of managing physician practices, and anywhere from 100-150 are already in operation. Although PPMCs and hospital-based integrated delivery systems (IDSs) differ from each other in many ways, they share a number of common features, including the pursuit of capitation contracts from payors. As a result, PPMCs pose a growing, direct threat to hospital systems in competing for managed care contracts that cover physician service. PPMCs also provide an alternative to hospital-based IDSs at the local market level for physician group consolidation. This article looks at the structure, operation, and strategy of PPMCs and examines what implications their growth will have for hospital-based IDSs.

  7. Ensuring the security and availability of a hospital wireless LAN system.

    Science.gov (United States)

    Hanada, Eisuke; Kudou, Takato; Tsumoto, Shusaku

    2013-01-01

    Wireless technologies as part of the data communication infrastructure of modern hospitals are being rapidly introduced. Even though there are concerns about problems associated with wireless communication security, the demand is remarkably large. Herein we discuss security countermeasures that must be taken and issues concerning availability that must be considered to ensure safe hospital/business use of wireless LAN systems, referring to the procedures introduced at a university hospital. Security countermeasures differ according to their purpose, such as preventing illegal use or ensuring availability, both of which are discussed. The main focus of the availability discussion is on signal reach, electromagnetic noise elimination, and maintaining power supply to the network apparatus. It is our hope that this information will assist others in their efforts to ensure safe implementation of wireless LAN systems, especially in hospitals where they have the potential to greatly improve information sharing and patient safety.

  8. Installation of secure, always available wireless LAN systems as a component of the hospital communication infrastructure.

    Science.gov (United States)

    Hanada, Eisuke; Kudou, Takato; Tsumoto, Shusaku

    2013-06-01

    Wireless technologies as part of the data communication infrastructure of modern hospitals are being rapidly introduced. Even though there are concerns about problems associated with wireless communication security, the demand is remarkably large. In addition, insuring that the network is always available is important. Herein, we discuss security countermeasures and points to insure availability that must be taken to insure safe hospital/business use of wireless LAN systems, referring to the procedures introduced at Shimane University Hospital. Security countermeasures differ according to their purpose, such as for preventing illegal use or insuring availability, both of which are discussed. It is our hope that this information will assist others in their efforts to insure safe implementation of wireless LAN systems, especially in hospitals where they have the potential to greatly improve information sharing and patient safety.

  9. 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.

  10. Enhanced monitor system for water protection

    Science.gov (United States)

    Hill, David E [Knoxville, TN; Rodriquez, Jr., Miguel [Oak Ridge, TN; Greenbaum, Elias [Knoxville, TN

    2009-09-22

    An automatic, self-contained device for detecting toxic agents in a water supply includes an analyzer for detecting at least one toxic agent in a water sample, introducing a means for introducing a water sample into the analyzer and discharging the water sample from the analyzer, holding means for holding a water sample for a pre-selected period of time before the water sample is introduced into the analyzer, and an electronics package that analyzes raw data from the analyzer and emits a signal indicating the presence of at least one toxic agent in the water sample.

  11. [Hospitalizations for ambulatory care-sensitive conditions: validation study at a Hospital Information System (SIH) in the Federal District, Brazil, in 2012].

    Science.gov (United States)

    Cavalcante, Danyelle Monteiro; de Oliveira, Maria Regina Fernandes; Rehem, Tânia Cristina Morais Santa Bárbara

    2016-03-01

    This study analyzes hospitalizations due to ambulatory care-sensitive conditions with a focus on infectious and parasitic diseases (IPDs) and validates the Hospital Information System, Brazilian Unified National Health System (SIH/SUS) for recording hospitalizations due to ambulatory care-sensitive conditions in a hospital in the Federal District, Brazil, in 2012. The study estimates the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the SIH for recording hospitalizations due to ambulatory care-sensitive conditions, with the patient's medical file as the gold standard. There were 1,604 hospitalizations for hospitalizations due to ambulatory care-sensitive conditions (19.6%, 95%CI: 18.7-20.5), and the leading IPDs were renal and urinary tract infection, infection of the skin and subcutaneous tissue, and infectious gastroenteritis. IPDs were the leading cause of hospitalization in the 20 to 29-year age bracket and caused 28 deaths. Sensitivity was 70.1% (95%CI: 60.5-79.7), specificity 88.4% (95%CI: 85.6-91.2), PPV = 51.7% (95%CI: 42.7-60.7), and NPV = 94.3% (95%CI: 92.2-96.4). The findings for admissions due to ACSCs in this hospital were similar to those of other studies, featuring admissions for IPDs. The SIH/SUS database was more specific than sensitive.

  12. Patient, hospital, and local health system characteristics associated with the use of observation stays in veterans health administration hospitals, 2005 to 2012.

    Science.gov (United States)

    Wright, Brad; OʼShea, Amy M J; Glasgow, Justin M; Ayyagari, Padmaja; Vaughan-Sarrazin, Mary

    2016-09-01

    Recent studies have documented that a significant increase in the use of observation stays along with extensive variation in patterns of use across hospitals.The objective of this longitudinal observational study was to examine the extent to which patient, hospital, and local health system characteristics explain variation in observation stay rates across Veterans Health Administration (VHA) hospitals.Our data came from years 2005 to 2012 of the nationwide VHA Medical SAS inpatient and enrollment files, American Hospital Association Survey, and Area Health Resource File. We used these data to estimate linear regression models of hospitals' observation stay rates as a function of hospital, patient, and local health system characteristics, while controlling for time trends and Veterans Integrated Service Network level fixed effects.We found that observation stay rates are inversely related to hospital bed size and that hospitals with a greater proportion of younger or rural patients have higher observation stay rates. Observation stay rates were nearly 15 percentage points higher in 2012 than 2005.Although we identify several characteristics associated with variation in VHA hospital observation stay rates, many factors remain unmeasured.

  13. Employee reactions to the use of management control systems in hospitals: motivation vs. threat.

    Science.gov (United States)

    Lopez-Valeiras, Ernesto; Gomez-Conde, Jacobo; Lunkes, Rogerio Joao

    Management control systems (such as budgets or balanced scorecards) are formal procedures used by managers to promote employee behavior aligned with organisational objectives. Employees may react to these control systems by either becoming more motivated or perceiving them as a threat. The aim of this paper is to determine the extent to which hospital ownership (public or private), professional group (physician, nurse, pharmacist or administrative employee), type of contract (fixed or temporary), gender and tenure can condition employee reaction to management control systems. We conducted the study in the three largest hospitals in the State of Santa Catarina (Brazil), two public (federal and state-owned) and one private (non-profit organisation). Physicians, nurses, pharmacists and administrative employees received a questionnaire between October 2013 and January 2014 concerning their current perceptions. We obtained 100 valid responses and conducted an ANOVA variance analysis. Our results show that the effect of management control systems on employees differs according to hospital ownership, professional group and type of contract. However, no significant evidence was found concerning gender or tenure. The results obtained contribute to creating specific knowledge on the reactions of employees to the use of management control systems in hospitals. This information may be important in adapting management control systems to the characteristics of the hospital and its employees, which may in turn contribute to reducing dysfunctional worker behavior. Copyright © 2017 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

  14. Water hammers in direct contact heater systems

    International Nuclear Information System (INIS)

    Uffer, R.

    1983-01-01

    This paper discusses the causes and mitigation or prevention of water hammers occurring in direct contact heaters and their attached lines. These water hammers are generally caused by rapid pressure reductions in the heaters or by water lines not flowing full. Proper design and operating measures can prevent or mitigate water hammer occurrence. Water hammers often do not originate at the areas where damage is noted

  15. Lessons learned from a whole hospital PACS installation. Picture Archiving and Communication System.

    Science.gov (United States)

    Pilling, J R

    2002-09-01

    The Norfolk and Norwich University Hospital has incorporated a fully filmless Picture Archiving and Communication System (PACS) as part of a new hospital provision using PFI funding. The PACS project has been very successful and has met with unanimous acclaim from radiologists and clinicians. A project of this size cannot be achieved without learning some lessons from mistakes and recognising areas where attention to detail resulted in a successful implementation. This paper considers the successes and problems encountered in a large PACS installation.

  16. Contract-program evaluation: Impact of the DRG classification system on hospitals' outputs

    OpenAIRE

    Alves, Helder António Pereira Gomes

    2010-01-01

    A Work Project, presented as part of the requirements for the Award of a Masters Degree in Management from the NOVA – School of Business and Economics The present work project aims at evaluating the impact of contract-program implementation in 2003 and of incentives created in 2007 on hospital output, under the DRG inpatient classification system. A sample of five Portuguese acute public district hospitals was chosen as sample, between 2002 and 2007. Results of hypothesis testing ...

  17. A KPI framework for process-based benchmarking of hospital information systems.

    Science.gov (United States)

    Jahn, Franziska; Winter, Alfred

    2011-01-01

    Benchmarking is a major topic for monitoring, directing and elucidating the performance of hospital information systems (HIS). Current approaches neglect the outcome of the processes that are supported by the HIS and their contribution to the hospital's strategic goals. We suggest to benchmark HIS based on clinical documentation processes and their outcome. A framework consisting of a general process model and outcome criteria for clinical documentation processes is introduced.

  18. Analysis of the quality of hospital information systems in Isfahan teaching hospitals based on the DeLone and McLean model.

    Science.gov (United States)

    Saghaeiannejad-Isfahani, Sakineh; Saeedbakhsh, Saeed; Jahanbakhsh, Maryam; Habibi, Mahboobeh

    2015-01-01

    Quality is one of the most important criteria for the success of an information system, which refers to its desirable features of the processing system itself. The aim of this study was the analysis of system quality of hospital information systems (HIS) in teaching hospitals of Isfahan based on the DeLone and McLean model. This research was an applied and analytical-descriptive study. It was performed in teaching hospitals of Isfahan in 2010. The research population consisted of the HIS's users, system designers and hospital information technology (IT) authorities who were selected by random sampling method from users' group (n = 228), and system designers and IT authorities (n = 52) using census method. The data collection tool was two researcher-designed questionnaires. Questionnaires' reliability was estimated by using Cronbach's alpha was calculated. It was 97.1% for the system designers and IT authorities' questionnaire and 92.3% for system users' questionnaire. Findings showed that the mean of system quality score in a variety of HIS and among different hospitals was significantly different and not the same (P value ≥ 0.05). In general, Kosar (new version) system and Rahavard Rayaneh system have dedicated the highest and the lowest mean scores to themselves. The system quality criterion overall mean was 59.6% for different HIS and 57.5% among different hospitals respectively. According to the results of the research, it can be stated that based on the applied model, the investigated systems were relatively desirable in terms of quality. Thus, in order to achieve a good optimal condition, it is necessary to pay particular attention to the improving factors of system quality, type of activity, type of specialty and hospital ownership type.

  19. Accreditation of Management Communication and Information Systems in Public Hospitals of Sabzevar City, Iran.

    Science.gov (United States)

    Farzianpour, Fereshteh; Shojaei, Saeed; Arab, Mohammad; Foroushani, Abbas Rahimi

    2016-04-01

    Information systems are "computer systems that collect, store, process, retrieve, show, and provide timely information required in practice, education, management, and research". The purpose of these systems is to support hospital activities in practical, tactical, and strategic levels in order to provide better service to patients. This study aimed to evaluate the communication and information system (MCI) in public hospitals in Sabzevar city in 2014 from the perspective of human resources according to international standards of the Joint Commission Accreditation Hospital (JCAH). This study was a practical, descriptive, cross-sectional study. The study population consisted of Sabzevar nurses who used hospital information system. Sampling was done by classification method and in proportion to the number of nurses in each health care units in hospitals in 2014. The sample size was 200 and after referring to hospitals, 200 questionnaires were completed. Sample size was calculated by the formula n=Z(2)P (1-P)/d(2) with P=0.5, α=0.05, d=0.05, and Z=1.96. Data collection tool was the questionnaire of assessment of hospital information systems of JCAH, which has 124 specific questions, including 6 areas. To assess the effect of demographic variables with MCI standards of two questionnaires (feasibility and implementation), the following steps were taken. 1. Kolmogorov-Smirnov test was used to determine whether responses were normal or not. 2. In case of normal data, t-test was used for dual groups and one-way ANOVA test for groups of three or more. 3. If not normal, Mann-Whitney test was used for dual groups and Kruskal-Wallis test for groups of three or more. Research findings show the mean results of feasibility and implementation of all 6 areas of international standards MCI have feasibility in three hospitals in Sabzevar in 20 sections (H1=105.01±10.468), (H1=196.31±4.662), (H2=104.26±9.099), (H2=195.33±3.778) (H3=106.48±11.545) and (H3=197.57±4

  20. INTEGRATED WATER TREATMENT SYSTEM PERFORMANCE EVALUATION

    International Nuclear Information System (INIS)

    Sexton, R.A.; Meeuwsen, W.E.

    2009-01-01

    This document describes the results of an evaluation of the current Integrated Water Treatment System (IWTS) operation against design performance and a determination of short term and long term actions recommended to sustain IWTS performance. The KW IWTS was designed to treat basin water and maintain basin clarity during fuel retrieval, washing, and packaging activities in the KW Basin. The original design was based on a mission that was limited to handling of KW Basin fuel. The use of the IWTS was extended by the decision to transfer KE fuel to KW to be cleaned and packaged using KW systems. The use was further extended for the packaging of two more Multi-Canister Overpacks (MCOs) containing legacy fuel and scrap. Planning is now in place to clean and package Knock Out Pot (KOP) Material in MCOs using these same systems. Some washing of KOP material in the Primary Cleaning Machine (PCM) is currently being done to remove material that is too small or too large to be included in the KOP Material stream. These plans will require that the IWTS remain operational through a campaign of as many as 30 additional MCOs, and has an estimated completion date in 2012. Recent operation of the IWTS during washing of canisters of KOP Material has been impacted by low pressure readings at the inlet of the P4 Booster Pump. The system provides a low pressure alarm at 10 psig, and low-low pressure interlock at 5 psig. The response to these low readings has been to lower total system flow to between 301 and 315 gpm. In addition, the IWTS operator has been required to operate the system in manual mode and make frequent adjustments to the P4 booster pump speed during PCM washes. The preferred mode of operation is to establish a setpoint of 317 gpm for the P4 pump speed and run IWTS in semi-automatic mode. Based on hydraulic modeling compared to field data presented in this report, the low P4 inlet pressure is attributed to restrictions in the 2-inch KOP inlet hose and in the KOP itself

  1. Monitoring Performance of a combined water recycling system

    OpenAIRE

    Castleton, H.F.; Hathway, E.A.; Murphy, E.; Beck, S.B.M.

    2014-01-01

    Global water demand is expected to outstrip supply dramatically by 2030, making water recycling an important tool for future water security. A large combined grey water and rainwater recycling system has been monitored in response to an identified knowledge gap of the in-use performance of such systems. The water saving efficiency of the system was calculated at −8ṡ5% in 2011 and –10% in 2012 compared to the predicted 36%. This was due to a lower quantity of grey water and rainwater being col...

  2. 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.

  3. Integrated water management system - Description and test results. [for Space Station waste water processing

    Science.gov (United States)

    Elden, N. C.; Winkler, H. E.; Price, D. F.; Reysa, R. P.

    1983-01-01

    Water recovery subsystems are being tested at the NASA Lyndon B. Johnson Space Center for Space Station use to process waste water generated from urine and wash water collection facilities. These subsystems are being integrated into a water management system that will incorporate wash water and urine processing through the use of hyperfiltration and vapor compression distillation subsystems. Other hardware in the water management system includes a whole body shower, a clothes washing facility, a urine collection and pretreatment unit, a recovered water post-treatment system, and a water quality monitor. This paper describes the integrated test configuration, pertinent performance data, and feasibility and design compatibility conclusions of the integrated water management system.

  4. 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

  5. The Main Subsystems Involved in Defining the Quality Management System in a Hospital

    Directory of Open Access Journals (Sweden)

    Dobrea Valentina Alina

    2010-06-01

    Full Text Available The hospital is the most important organization in health field, so they have to improve the quality in all the activities deployed. A very suitable way to show the hospital’s preoccupation for quality of health services is the quality management system certificate according ISO 9001/2000. In understanding the architecture of the hospital quality management system is necessary to decompose this system in subsystems and analyze each separately: the managerial subsystem, the human subsystem, the social subsystem, thetechnical subsystem, the informative subsystem. The relationship between those subsystems leads to the continuous improvement of quality in health services.

  6. 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...... scenarios using the objects. Results: Full scale mock-ups significantly addressed the local space and technology/tool elements of a work system. In contrast, the table-top simulation object addressed the organizational issues of the future work system. The blueprint based simulation addressed...

  7. Identification and characterization of steady and occluded water in drinking water distribution systems.

    Science.gov (United States)

    Tong, Huiyan; Zhao, Peng; Zhang, Hongwei; Tian, Yimei; Chen, Xi; Zhao, Weigao; Li, Mei

    2015-01-01

    Deterioration and leakage of drinking water in distribution systems have been a major issue in the water industry for years, which are associated with corrosion. This paper discovers that occluded water in the scales of the pipes has an acidic environment and high concentration of iron, manganese, chloride, sulfate and nitrate, which aggravates many pipeline leakage accidents. Six types of water samples have been analyzed under the flowing and stagnant periods. Both the water in the exterior of the tubercles and stagnant water carry suspended iron particles, which explains the occurrence of "red water" when the system hydraulic conditions change. Nitrate is more concentrated in occluded water under flowing condition in comparison with that in flowing water. However, the concentration of nitrate in occluded water under stagnant condition is found to be less than that in stagnant water. A high concentration of manganese is found to exist in steady water, occluded water and stagnant water. These findings impact secondary pollution and the corrosion of pipes and containers used in drinking water distribution systems. The unique method that taking occluded water from tiny holes which were drilled from the pipes' exteriors carefully according to the positions of corrosion scales has an important contribution to research on corrosion in distribution systems. And this paper furthers our understanding and contributes to the growing body of knowledge regarding occluded environments in corrosion scales. Copyright © 2014 Elsevier Ltd. All rights reserved.

  8. Alkali metal and ammonium chlorides in water and heavy water (binary systems)

    CERN Document Server

    Cohen-Adad, R

    1991-01-01

    This volume surveys the data available in the literature for solid-fluid solubility equilibria plus selected solid-liquid-vapour equilibria, for binary systems containing alkali and ammonium chlorides in water or heavy water. Solubilities covered are lithium chloride, sodium chloride, potassium chloride, rubidium chloride, caesium chloride and ammonium chloride in water and heavy water.

  9. Assessment on security system of radioactive sources used in hospitals of Thailand

    Science.gov (United States)

    Jitbanjong, Petchara; Wongsawaeng, Doonyapong

    2016-01-01

    Unsecured radioactive sources have caused deaths and serious injuries in many parts of the world. In Thailand, there are 17 hospitals that use teletherapy with cobalt-60 radioactive sources. They need to be secured in order to prevent unauthorized removal, sabotage and terrorists from using such materials in a radiological weapon. The security system of radioactive sources in Thailand is regulated by the Office of Atoms for Peace in compliance with Global Threat Reduction Initiative (GTRI), U.S. DOE, which has started to be implemented since 2010. This study aims to perform an assessment on the security system of radioactive sources used in hospitals in Thailand and the results can be used as a recommended baseline data for development or improvement of hospitals on the security system of a radioactive source at a national regulatory level and policy level. Results from questionnaires reveal that in 11 out of 17 hospitals (64.70%), there were a few differences in conditions of hospitals using radioactive sources with installation of the security system and those without installation of the security system. Also, personals working with radioactive sources did not clearly understand the nuclear security law. Thus, government organizations should be encouraged to arrange trainings on nuclear security to increase the level of understanding. In the future, it is recommended that the responsible government organization issues a minimum requirement of nuclear security for every medical facility using radioactive sources.

  10. Assessment on security system of radioactive sources used in hospitals of Thailand

    Energy Technology Data Exchange (ETDEWEB)

    Jitbanjong, Petchara, E-mail: petcharajit@gmail.com; Wongsawaeng, Doonyapong [Nuclear Engineering Department, Faculty of Engineering, Chulalongkorn University, 254 Phayathai Road, Pathumwan, Bangkok 10330 (Thailand)

    2016-01-22

    Unsecured radioactive sources have caused deaths and serious injuries in many parts of the world. In Thailand, there are 17 hospitals that use teletherapy with cobalt-60 radioactive sources. They need to be secured in order to prevent unauthorized removal, sabotage and terrorists from using such materials in a radiological weapon. The security system of radioactive sources in Thailand is regulated by the Office of Atoms for Peace in compliance with Global Threat Reduction Initiative (GTRI), U.S. DOE, which has started to be implemented since 2010. This study aims to perform an assessment on the security system of radioactive sources used in hospitals in Thailand and the results can be used as a recommended baseline data for development or improvement of hospitals on the security system of a radioactive source at a national regulatory level and policy level. Results from questionnaires reveal that in 11 out of 17 hospitals (64.70%), there were a few differences in conditions of hospitals using radioactive sources with installation of the security system and those without installation of the security system. Also, personals working with radioactive sources did not clearly understand the nuclear security law. Thus, government organizations should be encouraged to arrange trainings on nuclear security to increase the level of understanding. In the future, it is recommended that the responsible government organization issues a minimum requirement of nuclear security for every medical facility using radioactive sources.

  11. Pathways to DRG-based hospital payment systems in Japan, Korea, and Thailand.

    Science.gov (United States)

    Annear, Peter Leslie; Kwon, Soonman; Lorenzoni, Luca; Duckett, Stephen; Huntington, Dale; Langenbrunner, John C; Murakami, Yuki; Shon, Changwoo; Xu, Ke

    2018-05-07

    Countries in Asia are working towards achieving universal health coverage while ensuring improved quality of care. One element is controlling hospital costs through payment reforms. In this paper we review experiences in using Diagnosis Related Groups (DRG) based hospital payments in three Asian countries and ask if there is an "Asian way to DRGs". We focus first on technical issues and follow with a discussion of implementation challenges and policy questions. We reviewed the literature and worked as an expert team to investigate existing documentation from Japan, Republic of Korea, and Thailand. We reviewed the design of case-based payment systems, their experience with implementation, evidence about impact on service delivery, and lessons drawn for the Asian region. We found that countries must first establish adequate infrastructure, human resource capacity and information management systems. Capping of volumes and prices is sometimes essential along with a high degree of hospital autonomy. Rather than introduce a complete classification system in one stroke, these countries have phased in DRGs, in some cases with hospitals volunteering to participate as a first step (Korea), and in others using a blend of different units for hospital payment, including length of stay, and fee-for-service (Japan). Case-based payment systems are not a panacea. Their value is dependent on their design and implementation and the capacity of the health system. Copyright © 2018 Elsevier B.V. All rights reserved.

  12. Assessment on security system of radioactive sources used in hospitals of Thailand

    International Nuclear Information System (INIS)

    Jitbanjong, Petchara; Wongsawaeng, Doonyapong

    2016-01-01

    Unsecured radioactive sources have caused deaths and serious injuries in many parts of the world. In Thailand, there are 17 hospitals that use teletherapy with cobalt-60 radioactive sources. They need to be secured in order to prevent unauthorized removal, sabotage and terrorists from using such materials in a radiological weapon. The security system of radioactive sources in Thailand is regulated by the Office of Atoms for Peace in compliance with Global Threat Reduction Initiative (GTRI), U.S. DOE, which has started to be implemented since 2010. This study aims to perform an assessment on the security system of radioactive sources used in hospitals in Thailand and the results can be used as a recommended baseline data for development or improvement of hospitals on the security system of a radioactive source at a national regulatory level and policy level. Results from questionnaires reveal that in 11 out of 17 hospitals (64.70%), there were a few differences in conditions of hospitals using radioactive sources with installation of the security system and those without installation of the security system. Also, personals working with radioactive sources did not clearly understand the nuclear security law. Thus, government organizations should be encouraged to arrange trainings on nuclear security to increase the level of understanding. In the future, it is recommended that the responsible government organization issues a minimum requirement of nuclear security for every medical facility using radioactive sources

  13. Water chemistry diagnosis system for nuclear power plants

    International Nuclear Information System (INIS)

    Igarashi, Hiroo; Koya, Hiroshi; Osumi, Katsumi.

    1990-01-01

    The water quality control for the BWRs in Japan has advanced rapidly recently, and as to the dose reduction due to the decrease of radioactivity, Japan takes the position leading the world. In the background of the advanced water quality control like this and the increase of nuclear power plants in operation, the automation of arranging a large quantity of water quality control information and the heightening of its reliability have been demanded. Hitachi group developed the water quality synthetic control system which comprises the water quality data management system to process a large quantity of water quality data with a computer and the water quality diagnosis system to evaluate the state of operation of the plants by the minute change of water quality and to carry out the operational guide in the aspect of water quality control. To this water quality diagnosis system, high speed fuzzy inference is applied in order to do rapid diagnosis with fuzzy data. The trend of development of water quality control system, the construction of the water quality synthetic control system, the configuration of the water quality diagnosis system and the development of algorithm and the improvement of the reliability of maintenance are reported. (K.I.)

  14. The effect of water purification systems on fluoride content of drinking water

    Directory of Open Access Journals (Sweden)

    Prabhakar A

    2008-03-01

    Full Text Available Objective: The purpose of the present study was to determine the effect of different water purification systems on the fluoride content of drinking water and to compare the efficacy of these water purification systems in reducing the fluoride content. Materials and Methods: Five different water purification systems were tested in this study. They were reverse osmosis, distillation, activated carbon, Reviva ® , and candle filter. The water samples in the study were of two types, viz, borewell water and tap water, these being commonly used by the people of Davangere City, Karnataka. The samples were collected before and after purification, and fluoride analysis was done using fluoride ion-specific electrode. Results: The results showed that the systems based on reverse osmosis, viz, reverse osmosis system and Reviva ® showed maximum reduction in fluoride levels, the former proving to be more effective than the latter; followed by distillation and the activated carbon system, with the least reduction being brought about by candle filter. The amount of fluoride removed by the purification system varied between the system and from one source of water to the other. Interpretation and Conclusion: Considering the beneficial effects of fluoride on caries prevention; when drinking water is subjected to water purification systems that reduce fluoride significantly below the optimal level, fluoride supplementation may be necessary. The efficacy of systems based on reverse osmosis in reducing the fluoride content of water indicates their potential for use as defluoridation devices.

  15. 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

  16. Catering in a large hospital--does serving from a buffet system meet the patients' needs?

    DEFF Research Database (Denmark)

    Hansen, M.F.; Nielsen, M.A.; Biltz, C.

    2008-01-01

    BACKGROUND & AIMS: It has been suggested that serving from a buffet system may increase food intake. This observational study estimates the energy intake in a representative group of patients admitted to a hospital, where the food is served from a buffet system. MATERIAL: One hundred and sixteen ...

  17. A brief survey on problems and countermeasures of electronic medical record system in basic hospitals

    OpenAIRE

    You-bo JIA; Nan LI

    2014-01-01

    The paper, which took Yanggu People’s hospital’s EPR system in the information construction as a case,analyzed domestic EPR system’s current situation, summarized the problems of the EPR system in its implementation process, and some changes to our hospitals it brought.

  18. 42 CFR 403.321 - State systems for hospital outpatient services.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false State systems for hospital outpatient services. 403.321 Section 403.321 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND... application for approval of an outpatient system if the following conditions are met: (a) The State's...

  19. Information System Training, Usage, and Satisfaction: An Exploratory Study of the Hospitality Industry.

    Science.gov (United States)

    Gardner, William L., III; Gundersen, David E.

    1995-01-01

    Discusses use of a mail survey to study the extent to which the hospitality industry employs various information technologies, including computer-mediated communication systems. Finds that hotel/motel size and chain affiliation are related to information system complexity, and that chain-affiliated hotels provide less computer and…

  20. The Role of Group Learning in Implementation of a Personnel Management System in a Hospital

    NARCIS (Netherlands)

    Bondarouk, Tatiana; Sikkel, Nicolaas; Sarmento, Anabela

    2004-01-01

    A new HR system was introduced in a Dutch hospital. The system implied collaborative work among its users. The project planning seemed to be reasonably straightforward: the system’s introduction was intended to take place gradually, including pilots in different departments and appropriate feedback.

  1. Information Theory for Risk-based Water System Operation

    NARCIS (Netherlands)

    Weijs, S.V.

    2011-01-01

    Operational management of water resources needs predictions of future behavior of water systems, to anticipate shortage or excess of water in a timely manner. Because the natural systems that are part of the hydrological cycle are complex, the predictions inevitably are subject to considerable

  2. The Process of Participatory Ergonomics Simulation in Hospital Work System Design

    OpenAIRE

    Andersen, Simone Nyholm

    2016-01-01

    Participatory ergonomics simulation (PES) is a method to involve workers in simulation and design of their own future work system. Understanding of the process of PES is crucial in order to plan and facilitate the process towards creating an ergonomics work system design supporting both human well-being and overall system performance. With outset in two cases of PES in hospital work system design, this study investigates the elements of the PES process and their interrelations. The aim is to ...

  3. Physician Acceptance of a Computerized Outpatient Medication System in a Teaching Hospital Group Practice

    OpenAIRE

    Blish, Christi; Proctor, Rita; Fletcher, Suzanne W.; O'Malley, Michael

    1983-01-01

    As part of a new automated ambulatory medical record, a computerized outpatient medication system was developed for a teaching hospital general medicine group practice. Seven months after its implementation, the system was evaluated to determine physician acceptance and approval. Practice physicians were surveyed, and 94% of the respondents approved of the system. Over 90% thought that the computerized system had improved the completeness and accuracy of medication information as well as thei...

  4. Optimal water meter selection system | Johnson | Water SA

    African Journals Online (AJOL)

    Economic/financial analysis based on an income statement together with capital budgeting techniques assist with the determination of the financial suitability of investing in a new replacement water meter. This financial analysis includes various potential income and expenditure components that will result from the ...

  5. Quality of Tourism and Hospitality Management Systems in Russia

    Directory of Open Access Journals (Sweden)

    Irina N. Markaryan

    2013-01-01

    Full Text Available This article describes the features of quality standards (ISO, their application in Russia, analyzes Quality Awards, awarded to Russian producers, such as the Award of the Government of the Russian Federation in the field of Quality, National Tourism Award named after Yu. Senkevich, Travel Award «Golden Meridian», Moscow “Guiding Star” Award. The objectives of management system for Sochi resorts and hotels were determined

  6. Design of Pumps for Water Hydraulic Systems

    DEFF Research Database (Denmark)

    Klit, Peder; Olsen, Stefan; Bech, Thomas Nørgaard

    1999-01-01

    This paper considers the development of two pumps for water hydraulic applications. The pumps are based on two different working principles: The Vane-type pump and the Gear-type pump. Emphasis is put on the considerations that should be made to account for water as the hydraulic fluid.......KEYWORDS: water, pump, design, vane, gear....

  7. Perceptions and attitudes of hospital staff toward paging system and the use of mobile phones.

    Science.gov (United States)

    Haroon, Muhammad; Yasin, Faiza; Eckel, Rachael; Walker, Frank

    2010-10-01

    Our objective was to document the pattern of mobile phone usage by medical staff in a hospital setting, and to explore any perceived benefits (such as improved communications) associated with mobile phones. This cross-sectional survey was conducted in Waterford Regional Hospital, Ireland, where bleep is the official system of communication. All non-consultant hospital doctors, of medical disciplines only, were asked to participate. The questionnaire was designed to explore the pattern and different aspects of mobile phone usage. At the time of study, there were sixty medical junior doctors, and the response rate was 100 percent. All participants used mobile phones while at work, and also for hospital-related work. For 98.3 percent the mobile phone was their main mode of communication while in the hospital. Sixty-two percent (n = 37) made 6-10 calls daily purely for work-related business, and this comprised of ≥ 80 percent of their daily usage of mobile phones. For 98 percent of participants, most phone calls were work-related. Regarding reasons for using mobile phones, all reported that using mobile phone is quicker for communication. Mobile phone usage is very common among the medical personnel, and this is regarded as a more efficient means of communication for mobile staff than the hospital paging system.

  8. Perceptions and attitudes of hospital staff toward paging system and the use of mobile phones.

    LENUS (Irish Health Repository)

    Haroon, Muhammad

    2012-02-01

    OBJECTIVES: Our objective was to document the pattern of mobile phone usage by medical staff in a hospital setting, and to explore any perceived benefits (such as improved communications) associated with mobile phones. METHODS: This cross-sectional survey was conducted in Waterford Regional Hospital, Ireland, where bleep is the official system of communication. All non-consultant hospital doctors, of medical disciplines only, were asked to participate. The questionnaire was designed to explore the pattern and different aspects of mobile phone usage. RESULTS: At the time of study, there were sixty medical junior doctors, and the response rate was 100 percent. All participants used mobile phones while at work, and also for hospital-related work. For 98.3 percent the mobile phone was their main mode of communication while in the hospital. Sixty-two percent (n = 37) made 6-10 calls daily purely for work-related business, and this comprised of >\\/= 80 percent of their daily usage of mobile phones. For 98 percent of participants, most phone calls were work-related. Regarding reasons for using mobile phones, all reported that using mobile phone is quicker for communication.Conclusions: Mobile phone usage is very common among the medical personnel, and this is regarded as a more efficient means of communication for mobile staff than the hospital paging system.

  9. Strategic interaction among hospitals and nursing facilities: the efficiency effects of payment systems and vertical integration.

    Science.gov (United States)

    Banks, D; Parker, E; Wendel, J

    2001-03-01

    Rising post-acute care expenditures for Medicare transfer patients and increasing vertical integration between hospitals and nursing facilities raise questions about the links between payment system structure, the incentive for vertical integration and the impact on efficiency. In the United States, policy-makers are responding to these concerns by initiating prospective payments to nursing facilities, and are exploring the bundling of payments to hospitals. This paper develops a static profit-maximization model of the strategic interaction between the transferring hospital and a receiving nursing facility. This model suggests that the post-1984 system of prospective payment for hospital care, coupled with nursing facility payments that reimburse for services performed, induces inefficient under-provision of hospital services and encourages vertical integration. It further indicates that the extension of prospective payment to nursing facilities will not eliminate the incentive to vertically integrate, and will not result in efficient production unless such integration takes place. Bundling prospective payments for hospitals and nursing facilities will neither remove the incentive for vertical integration nor induce production efficiency without such vertical integration. However, bundled payment will induce efficient production, with or without vertical integration, if nursing facilities are reimbursed for services performed. Copyright 2001 John Wiley & Sons, Ltd.

  10. Hospitalization flow in the public and private systems in the state of Sao Paulo, Brazil.

    Science.gov (United States)

    Rocha, Juan Stuardo Yazlle; Monteiro, Rosane Aparecida; Moreira, Marizélia Leão

    2015-01-01

    OBJECTIVE To describe the migration flows of demand for public and private hospital care among the health regions of the state of Sao Paulo, Brazil.METHODS Study based on a database of hospitalizations in the public and private systems of the state of Sao Paulo, Southeastern Brazil, in 2006. We analyzed data from 17 health regions of the state, considering people hospitalized in their own health region and those who migrated outwards (emigration) or came from other regions (immigration). The index of migration effectiveness of patients from both systems was estimated. The coverage (hospitalization coefficient) was analyzed in relation to the number of inpatient beds per population and the indexes of migration effectiveness.RESULTS The index of migration effectiveness applied to the hospital care demand flow allowed characterizing health regions with flow balance, with high emigration of public and private patients, and with high attraction of public and private patients.CONCLUSIONS There are differences in hospital care access and opportunities among health regions in the state of Sao Paulo, Brazil.

  11. Managerial attitude to the implementation of quality management systems in Lithuanian support treatment and nursing hospitals

    Directory of Open Access Journals (Sweden)

    Lydeka Zigmas

    2006-09-01

    Full Text Available Abstract Background The regulations of the Quality Management System (QMS implementation in health care organizations were approved by the Lithuanian Ministry of Health in 1998. Following the above regulations, general managers of health care organizations had to initiate the QMS implementation in hospitals. As no research on the QMS implementation has been carried out in Lithuanian support treatment and nursing hospitals since, the objective of this study is to assess its current stage from a managerial perspective. Methods A questionnaire survey of general managers of Lithuanian support treatment and nursing hospitals was carried out in the period of January through March 2005. Majority of the items included in the questionnaire were measured on a seven-point Likert scale. During the survey, a total of 72 questionnaires was distributed, out of which 58 filled-in ones were returned (response rate 80.6 per cent; standard sampling error 0.029 at 95 per cent level of confidence. Results Quality Management Systems were found operating in 39.7 per cent of support treatment and nursing hospitals and currently under implementation in 46.6 per cent of hospitals (13.7% still do not have it. The mean of the respondents' perceived QMS significance is 5.8 (on a seven-point scale. The most critical issues related to the QMS implementation include procedure development (5.5, lack of financial resources (5.4 and information (5.1, and development of work guidelines (4.6, while improved responsibility and power sharing (5.2, better service quality (5.1 and higher patient satisfaction (5.1 were perceived by the respondents as the key QMS benefits. The level of satisfaction with the QMS among the management of the surveyed hospitals is mediocre (3.6. However it was found to be higher among respondents who were more competent in quality management, were familiar with ISO 9000 standards, and had higher numbers of employees trained in quality management. Conclusion

  12. The water energy nexus, an ISO50001 water case study and the need for a water value system

    Directory of Open Access Journals (Sweden)

    Brendan P. Walsh

    2015-06-01

    Full Text Available The world’s current utilisation of water, allied to the forecasted increase in our dependence on it, has led to the realisation that water as a resource needs to be managed. The scarcity and cost of water worldwide, along with water management practices within Europe, are highlighted in this paper. The heavy dependence of energy generation on water and the similar dependence of water treatment and distribution on energy, collectively termed the water–energy nexus, is detailed. A summary of the recently launched ISO14046 Water Footprint Standard along with other benchmarking measures is outlined and a case history of managing water using the Energy Management Standard ISO50001 is discussed in detail. From this, the requirement for a methodology for improvement of water management has been identified, involving a value system for water streams, which, once optimised will improve water management including efficiency and total utilisation.

  13. The Hospital Water Environment as a Reservoir for Carbapenem-Resistant Organisms Causing Hospital-Acquired Infections-A Systematic Review of the Literature.

    Science.gov (United States)

    Kizny Gordon, Alice E; Mathers, Amy J; Cheong, Elaine Y L; Gottlieb, Thomas; Kotay, Shireen; Walker, A Sarah; Peto, Timothy E A; Crook, Derrick W; Stoesser, Nicole

    2017-05-15

    Over the last 20 years there have been 32 reports of carbapenem-resistant organisms in the hospital water environment, with half of these occurring since 2010. The majority of these reports have described associated clinical outbreaks in the intensive care setting, affecting the critically ill and the immunocompromised. Drains, sinks, and faucets were most frequently colonized, and Pseudomonas aeruginosa the predominant organism. Imipenemase (IMP), Klebsiella pneumoniae carbapenemase (KPC), and Verona integron-encoded metallo-β-lactamase (VIM) were the most common carbapenemases found. Molecular typing was performed in almost all studies, with pulse field gel electrophoresis being most commonly used. Seventy-two percent of studies reported controlling outbreaks, of which just more than one-third eliminated the organism from the water environment. A combination of interventions seems to be most successful, including reinforcement of general infection control measures, alongside chemical disinfection. The most appropriate disinfection method remains unclear, however, and it is likely that replacement of colonized water reservoirs may be required for long-term clearance. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

  14. Code development of the national hemovigilance system and expansion strategies for hospital blood banks

    Directory of Open Access Journals (Sweden)

    Kim Jeongeun

    2012-01-01

    Full Text Available Objectives : The aims of this study were to develop reportable event codes that are applicable to the national hemovigilance systems for hospital blood banks, and to present expansion strategies for the blood banks. Materials and Methods : The data were obtained from a literature review and expert consultation, followed by adding to and revising the established hemovigilance code system and guidelines to develop reportable event codes for hospital blood banks. The Medical Error Reporting System-Transfusion Medicine developed in the US and other codes of reportable events were added to the Korean version of the Biologic Products Deviation Report (BPDR developed by the Korean Red Cross Blood Safety Administration, then using these codes, mapping work was conducted. We deduced outcomes suitable for practice, referred to the results of the advisory councils, and conducted a survey with experts and blood banks practitioners. Results : We developed reportable event codes that were applicable to hospital blood banks and could cover blood safety - from blood product safety to blood transfusion safety - and also presented expansion strategies for hospital blood banks. Conclusion : It was necessary to add 10 major categories to the blood transfusion safety stage and 97 reportable event codes to the blood safety stage. Contextualized solutions were presented on 9 categories of expansion strategies of hemovigilance system for the hospital blood banks.

  15. Health system professionals, attitude towards necessary criteria for hospitals managers, performance assessment

    Directory of Open Access Journals (Sweden)

    ali janati

    2012-09-01

    Materials and Methods: This study was a qualitative research with thematic analysis method. By using semi structured questionnaire with 2 health system experts interview was conducted and 20 experts participated in focus group discussion. After each interview and group discussion withdrawals were checked with participants. The initial interviews were analyzed by two faculty members and then were combined. Results: 7 main themes about necessary criteria for hospital managers, performance assessment were obtained from experts, views. These themes are: skills related to planning, organization and staff performance management, leadership, information management, clinical governance and performance indicators. Conclusion: All participants in the study had a history of hospital management therefore their comments will be an effective step in identifying the criteria for making hospital managers, performance assessment tool. In addition to Professionals, perspectives and studies done in other countries, in order to design this kind of tools, it is necessary to adjust the obtained findings according to the local hospital conditions.

  16. Some correlates of electronic health information management system success in nigerian teaching hospitals.

    Science.gov (United States)

    Ojo, Adebowale I; Popoola, Sunday O

    2015-01-01

    Nowadays, an electronic health information management system (EHIMS) is crucial for patient care in hospitals. This paper explores the aspects and elements that contribute to the success of EHIMS in Nigerian teaching hospitals. The study adopted a survey research design. The population of study comprised 442 health information management personnel in five teaching hospitals that had implemented EHIMS in Nigeria. A self-developed questionnaire was used as an instrument for data collection. The findings revealed that there is a positive, close relationship between all the identified factors and EHIMS's success: technical factors (r = 0.564, P < 0.05); social factors (r = 0.616, P < 0.05); organizational factors (r = 0.621, P < 0.05); financial factors (r = 0.705, P < 0.05); and political factors (r = 0.589, P < 0.05). We conclude that consideration of all the identified factors was highly significant for the success of EHIMS in Nigerian teaching hospitals.

  17. [Practical aspects of implementation quality management system ISO 9001:2000 by hospital infection control team].

    Science.gov (United States)

    Kuziemski, Arkadiusz; Czerniak, Beata; Frankowska, Krystyna; Gonia, Ewa; Salińska, Teresa; Motuk, Andrzej; Sobociński, Zbigniew

    2009-01-01

    In 2006 the Board of the Jan Biziel Hospital in Bydgoszcz decided to include procedures of health services in the implementation process within the confines of ISO 9001:2000 certification. The hospital infection control team that has operated in the hospital since 1989 performed the analysis of the forms of activities to date and on that basis the team prepared original plan of quality management. In April 2007, this plan was successfully accepted by the certifying team. The aim of this study is to present the aforementioned plan which is the result of 18 years experience of the team. At the same time, I hope that this study will be very helpful for all professionals interested in hospital epidemiology, especially in the context of implementing quality management systems.

  18. Water removal from a dry barrier cover system

    International Nuclear Information System (INIS)

    Stormont, J.C.; Ankeny, M.D.; Tansey, M.K.

    1994-01-01

    The results of the numerical simulations reveal that horizontal air flow through the coarse with reasonable pressure gradients can remove large quantities of water from the cover system. Initially, the water removal from the cover system is dominated by the evaporation and advection of water vapor out of the coarse layer. Once the coarse layer is dry, removal of water by evaporation near the fine/coarse layer interface reduces the local water content and water potential, and water moves toward the fine-coarse layer interface and becomes available for evaporation. This result is important in that it suggests the fine layer water content may be moderated by air flow in the coarse layer. Incorporating diffusion of water vapor from the fine layer into the coarse layer substantially increases the water movement out of the fine layer

  19. Drying of heavy water system and works of charging heavy water in Fugen

    International Nuclear Information System (INIS)

    Matsushita, Tadashi; Iijima, Setsuo

    1980-01-01

    The advanced thermal reactor ''Fugen'' is the first heavy water-moderated, boiling light water-cooled nuclear reactor for power generation in Japan. It is a large heavy water reactor having about 130 m 3 of heavy water inventory and about 300 m 3 of helium space as the cover gas of the heavy water system. The heavy water required was purchased from FRG, which had been used for the power output test in the KKN, and the quality was 99.82 mol % mean heavy water concentration. The concentration of heavy water for Fugen used for the nuclear design is 99.70 mol%, and it was investigated how heavy water can be charged without lowering the concentration. The matters of investigation include the method of bringing the heavy water and helium system to perfect dryness after washing and light water test, the method of confirming the sufficient dryness to prevent the deterioration, and the method of charging heavy water safely from its containers. On the basis of the results of investigation, the actual works were started. The works of drying the heavy water and helium system by vacuum drying, the works of sampling heavy water and the result of the degree of deterioration, and the works of charging heavy water and the measures to the heavy water remaing in the containers are described. All the works were completed safely and smoothly. (J.P.N.)

  20. Thermo-economic performance of inclined solar water distillation systems

    Directory of Open Access Journals (Sweden)

    Agboola Phillips O.

    2015-01-01

    Full Text Available This study investigates the thermo-economic performance of different configurations of inclined solar water desalination for parameters such as daily production, efficiency, system cost and distilled water production cost. The four different configurations considered for this study are as follows; 1. Inclined solar water distillation with bare absorber plate (IISWD with daily production of 5.46 kg/m2 day and daily efficiency of 48.3%. 2. Inclined solar water distillation with wick on absorber plate (IISWDW with daily production of 6.41kg/m2 day and daily efficiency 50.3%. 3. Inclined solar water distillation with wire mesh on absorber plate (IISWDWM with daily production n of 3.03 kg/m2 day and daily efficiency 32.6%. 4. Inclined solar water distillation with bare absorber plate (ISWD. (Control System with daily production of 3.25 kg/m2 day and daily efficiency of 40.1%. The systems potable water cost price ranges from 0.03 $/L for IISWDW to 0.06$/L for IISWDWM System. All the systems are economically and technically feasible as a solar distillation system for potable water in Northern Cyprus. The price of potable water from water vendors/hawkers ranges from 0.11-0.16 $/L. It is more economically viable to have the rooftop inclined solar water desalination system than procuring potable water from vendors.`