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.

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.

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).

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.

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.

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.

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.

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

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.

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.

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

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.

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.

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.

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

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

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.

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...

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.

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...

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.

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.

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...

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...

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).

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.

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)

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.

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...

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...

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.

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

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...

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.

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.

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...

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.

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.

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.

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.

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.

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.

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

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

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.

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.

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...

[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".

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.

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.

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

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

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...

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...

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...

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.

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.

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.

[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.

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.

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.

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

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

[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.

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.

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.

Can soda fountains be recommended in hospitals?

Science.gov (United States)

Chaberny, Iris F; Kaiser, Peter; Sonntag, Hans-Günther

2006-09-01

Mineral water (soda water) is very popular in Germany. Therefore, soda fountains were developed as alternatives to the traditional deposit bottle system. Nowadays, different systems of these devices are commercially available. For several years, soda fountains produced by different companies have been examined at the University Hospital of Heidelberg. In 1998, it was possible for the first time to observe and evaluate one of these systems over a period of 320 days in a series of microbiological examinations. The evaluation was implemented on the basis of the German drinking water regulation (Anonymous, 1990. Gesetz über Trinkwasser und Wasser für Lebensmittelbetriebe (Trinkwasserverordnung - TrinkwV) vom 12. Dezember 1990. Bundesgesetzblatt 66, 2613ff). Initially, the bacteria counts exceeded the reference values imposed by the German drinking water regulation in almost 50% of the analyses. Pseudomonas aeruginosa was also detected in almost 38% of the samples. After a re-arrangement of the disinfection procedure and the removal of the charcoal filter, Pseudomonas aeruginosa was not detectable any more. However, the bacteria counts still frequently exceeded the reference values of the German drinking water regulation. Following our long-term analysis, we would not recommend soda fountains in high-risk areas of hospitals. If these devices are to be used in hospitals, the disinfection procedures should be executed in weekly or fortnightly intervals and the water quality should be examined periodically.

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

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.

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...

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

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.

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.

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.

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...

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)

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)

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.

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.

Non-tuberculous mycobacteria and microbial populations in drinking water distribution systems

Directory of Open Access Journals (Sweden)

Rossella Briancesco

2010-01-01

Full Text Available Data on the occurrence of non-tuberculous mycobacteria (NTM, in parallel with those obtained for bacterial indicators and amoebae, are presented with the aim to collect information on the spread of NTM in drinking water distribution systems in Italy. Samples were collected from taps of hospitals and households in Central and Southern Italy. The concentration values obtained for the more traditional microbial parameters complied with the mandatory requirements for drinking water. Conversely, moderate-to-high microbial loads (till 300 CFU/L were observed for the NTM. Positive samples were obtained from 62% of the investigated water samples. Analogous results were observed for amoebae showing a higher percentage of positive samples (76%. In terms of public health, the presence of mycobacteria in water distribution systems may represent a potential risk especially for vulnerable people such as children, the elderly or immunocompromised individuals.

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...

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.

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

[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.

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

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.

Survival and multiplication of Legionella pneumophila in municipal drinking water systems.

Science.gov (United States)

States, S J; Conley, L F; Kuchta, J M; Oleck, B M; Lipovich, M J; Wolford, R S; Wadowsky, R M; McNamara, A M; Sykora, J L; Keleti, G

1987-05-01

Studies were conducted to investigate the survival and multiplication of Legionella spp. in public drinking water supplies. An attempt was made, over a period of several years, to isolate legionellae from a municipal system. Sampling sites included the river water supply, treatment plant, finished water reservoir system, mains, and distribution taps. Despite the use of several isolation techniques, Legionella spp. could not be detected in any of the samples other than those collected from the river. It was hypothesized that this was due to the maintenance of a chlorine residual throughout the system. To investigate the potential for Legionella growth, additional water samples, collected from throughout the system, were dechlorinated, pasteurized, and inoculated with Legionella pneumophila. Subsequent growth indicated that many of these samples, especially those collected from areas affected by an accumulation of algal materials, exhibited a much greater ability to support Legionella multiplication than did river water prior to treatment. Chemical analyses were also performed on these samples. Correlation of chemical data and experimental growth results indicated that the chemical environment significantly affects the ability of the water to support multiplication, with turbidity, organic carbon, and certain metals being of particular importance. These studies indicate that the potential exists for Legionella growth within municipal systems and support the hypothesis that public water supplies may contaminate the plumbing systems of hospitals and other large buildings. The results also suggest that useful methods to control this contamination include adequate treatment plant filtration, maintenance of a chlorine residual throughout the treatment and distribution network, and effective covering of open reservoirs.

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.

Legionella prevalence and risk of legionellosis in Hungarian hospitals.

Science.gov (United States)

Barna, Zsófia; Kádár, Mihály; Kálmán, Emese; Róka, Eszter; Szax, Anita Sch; Vargha, Márta

2015-12-01

Nosocomial legionellosis is a growing concern worldwide. In Hungary, about 20% of the reported cases are health-care associated, but in the absence of legal regulation, environmental monitoring of Legionella is not routinely performed in hospitals. In the present study, 23 hospitals were investigated. The hot water distribution system was colonized by Legionella in over 90%; counts generally exceeded the public health limit value. Hot water temperature was critically low in all systems (Legionella prevalence (OR = 28.0, 27.3, 27.7, respectively). Risk management interventions (including thermal or chemical disinfection) were only efficient if the system operation was optimized. Though the risk factors were similar, in those hospitals where nosocomial legionellosis was reported, Legionella counts and the proportion of L. pneumophila sg 1 isolates were significantly higher. The results of environmental prevalence of legionellae in hospitals suggest that the incidence of nosocomial legionellosis is likely to be underreported. The observed colonization rates call for the introduction of a mandatory environmental monitoring scheme.

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.

Design of patient rooms and automatic radioiodine-131 waste water management system for a thyroid cancer treatment ward: 'Suandok Model'.

Science.gov (United States)

Vilasdechanon, N; Ua-Apisitwong, S; Chatnampet, K; Ekmahachai, M; Vilasdechanon, J

2014-09-01

The great benefit of (131)I radionuclide treatment for differentiated thyroid cancer (DTC) was acknowledged by the long survival rate. The main requirements for (131)I therapy in hospital were treatment facilities and a radiation safety plan that assured radiation protection and safety to patient, hospital worker, public, and environment. To introduce the concepts and methods of radiation safety design for a patient's room in a (131)I treatment ward and a system of radioactive waste water management in hospital. The design was based on principles of external and internal radiation protection for unsealed source and radioactive waste management. Planning for treatment facilities was concluded from clinical evidence, physical and physiological information for (131)I, radiation safety criteria, hospital resources and budget. The three phases of the working process were: construction, software development, and radiation safety assessment. The (131)I treatment facility and automatic radioactive waste water management system was completely implemented in 2009. The radiation waste water management system known as the 'Suandok Model' was highly recommended by the national regulator to hospitals who desire to provide (131)I treatment for thyroid cancer. In 2011, the Nuclear Medicine Division, Chiang Mai University was rewarded by the national authority for a very good radiation practice in development of safe working conditions and environment. The Suandok Model was a facility design that fulfilled requirements for the safe use of high radiation (131)I doses for thyroid cancer treatment in hospital. The facility presented in this study may not be suitable for all hospitals but the design concepts could be applied according to an individual hospital context and resources. People who use or gain benefit from radiation applications have to emphasise the responsibility to control and monitor radiation effects on individuals, communities and the environment.

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

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.

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

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

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.

Design of patient rooms and automatic radioiodine-131 waste water management system for a thyroid cancer treatment ward: ‘Suandok model’

International Nuclear Information System (INIS)

Vilasdechanon, N; Ua-apisitwong, S; Chatnampet, K; Ekmahachai, M; Vilasdechanon, J

2014-01-01

The great benefit of 131 I radionuclide treatment for differentiated thyroid cancer (DTC) was acknowledged by the long survival rate. The main requirements for 131 I therapy in hospital were treatment facilities and a radiation safety plan that assured radiation protection and safety to patient, hospital worker, public, and environment. Objective: To introduce the concepts and methods of radiation safety design for a patient’s room in a 131 I treatment ward and a system of radioactive waste water management in hospital. Methods: The design was based on principles of external and internal radiation protection for unsealed source and radioactive waste management. Planning for treatment facilities was concluded from clinical evidence, physical and physiological information for 131 I, radiation safety criteria, hospital resources and budget. The three phases of the working process were: construction, software development, and radiation safety assessment. Results: The 131 I treatment facility and automatic radioactive waste water management system was completely implemented in 2009. The radiation waste water management system known as the ‘Suandok Model’ was highly recommended by the national regulator to hospitals who desire to provide 131 I treatment for thyroid cancer. In 2011, the Nuclear Medicine Division, Chiang Mai University was rewarded by the national authority for a very good radiation practice in development of safe working conditions and environment. Conclusion: The Suandok Model was a facility design that fulfilled requirements for the safe use of high radiation 131 I doses for thyroid cancer treatment in hospital. The facility presented in this study may not be suitable for all hospitals but the design concepts could be applied according to an individual hospital context and resources. People who use or gain benefit from radiation applications have to emphasise the responsibility to control and monitor radiation effects on individuals, communities

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.

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.

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...

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

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.)

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.

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.

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.

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.

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

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...

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.

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.

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.

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

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.

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.

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.

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.

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.)

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

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

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.

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.

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...

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.

[Outbreak of hospital acquired Legionnaires' disease in patients of ophthalmic ward. Nosocomial Legionella infections for the first time observed in Poland].

Science.gov (United States)

Stypułkowska-Misiurewicz, Hanna; Pancer, Katarzyna; Krogulska, Bozena; Matuszewska, Renata

2007-01-01

The aim of the paper is to describe the criteria used for identification of first and so far the only one outbreak of hospital bacterial infections due to L. pneumophila. The infected persons were patients hospitalized at ophthalmic ward for more than 10 days. Four patients were found ill among 27 hospitalized (15%) at ophthalmic ward and 3 of them died (75%) in spite treatment in intensive care unit. The source of infection was found in the hospital hot water system. It was shown that L. pneumophila sg 1 and sg 2-14 were settled in the tanks and pipelines of hot water installations. The high number of L. pneumophila sg I and sg 2-14 colony forming units (> 10 000 cfu /100 ml) were found in the water specimens taken from the hospital water system, showing the high risk of Legionella infection for patients. Cleaning and disinfection of hot water system was repeated three times using composition every time modified as stronger mechanical, thermal and chemical methods. Complete elimination of Legionella from hot water system was achieved after cutting off deadlegs of water and replacement of both old hot water reservoirs with new ones. Collected experience served for preparation of guidelines for control and prevention of Legionella infections in hospital buildings, published on National Institute of Hygiene web site A month later Polish Ministry of Health published the Directives concerning the quality of drinking water to which the control of Legionella infection has been included.

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.

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.

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.

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.

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...

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.

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...

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.

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.

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.

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.

Medicare program; hospital inpatient prospective payment systems for acute care hospitals and the long-term care hospital prospective payment system and Fiscal Year 2014 rates; quality reporting requirements for specific providers; hospital conditions of participation; payment policies related to patient status. Final rules.

Science.gov (United States)

2013-08-19

We are revising the Medicare hospital inpatient prospective payment systems (IPPS) for operating and capital-related costs of acute care hospitals to implement changes arising from our continuing experience with these systems. Some of the changes implement certain statutory provisions contained in the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010 (collectively known as the Affordable Care Act) and other legislation. These changes will be applicable to discharges occurring on or after October 1, 2013, unless otherwise specified in this final rule. We also are updating the rate-of-increase limits for certain hospitals excluded from the IPPS that are paid on a reasonable cost basis subject to these limits. The updated rate-of-increase limits will be effective for cost reporting periods beginning on or after October 1, 2013. We also are updating the payment policies and the annual payment rates for the Medicare prospective payment system (PPS) for inpatient hospital services provided by long-term care hospitals (LTCHs) and implementing certain statutory changes that were applied to the LTCH PPS by the Affordable Care Act. Generally, these updates and statutory changes will be applicable to discharges occurring on or after October 1, 2013, unless otherwise specified in this final rule. In addition, we are making a number of changes relating to direct graduate medical education (GME) and indirect medical education (IME) payments. We are establishing new requirements or have revised requirements for quality reporting by specific providers (acute care hospitals, PPS-exempt cancer hospitals, LTCHs, and inpatient psychiatric facilities (IPFs)) that are participating in Medicare. We are updating policies relating to the Hospital Value-Based Purchasing (VBP) Program and the Hospital Readmissions Reduction Program. In addition, we are revising the conditions of participation (CoPs) for hospitals relating to the

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)

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...

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.

Assessing Performance of Botswana’s Public Hospital System: The Use of the World Health Organization Health System Performance Assessment Framework

Directory of Open Access Journals (Sweden)

Onalenna Seitio-Kgokgwe

2014-09-01

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

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)

Effects of metals on Legionella pneumophila growth in drinking water plumbing systems.

Science.gov (United States)

States, S J; Conley, L F; Ceraso, M; Stephenson, T E; Wolford, R S; Wadowsky, R M; McNamara, A M; Yee, R B

1985-11-01

An investigation of the chemical environment and growth of Legionella pneumophila in plumbing systems was conducted to gain a better understanding of its ecology in this habitat. Water samples were collected from hospital and institutional hot-water tanks known to have supported L. pneumophila and were analyzed for 23 chemical parameters. The chemical environment of these tanks was found to vary extensively, with the concentrations of certain metals reaching relatively high levels due to corrosion. The effect of various chemical conditions on L. pneumophila growth was then examined by observing its multiplication in the chemically analyzed hot-water tank samples after sterilization and reinoculation with L. pneumophila. L. pneumophila and associated microbiota used in these experiments were obtained from a hot-water tank. These stains were maintained in tap water and had never been passaged on agar. The results of the growth studies indicate that although elevated concentrations of a number of metals are toxic, lower levels of certain metals such as iron, zinc, and potassium enhance growth of naturally occurring L. pneumophila. Parallel observations on accompanying non-Legionellaceae bacteria failed to show the same relationship. These findings suggest that metal plumbing components and associated corrosion products are important factors in the survival and growth of L. pneumophila in plumbing systems and may also be important in related habitats such as cooling towers and air-conditioning systems.

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.

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.

[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.

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.

[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.

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.

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.

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.

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.

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.

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

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.

Sustained Uptake of a Hospital-Based Handwashing with Soap and Water Treatment Intervention (Cholera-Hospital-Based Intervention for 7 Days [CHoBI7]): A Randomized Controlled Trial.

Science.gov (United States)

George, Christine Marie; Jung, Danielle S; Saif-Ur-Rahman, K M; Monira, Shirajum; Sack, David A; Mahamud-ur Rashid; Mahmud, Md Toslim; Mustafiz, Munshi; Rahman, Zillur; Bhuyian, Sazzadul Islam; Winch, Peter J; Leontsini, Elli; Perin, Jamie; Begum, Farzana; Zohura, Fatema; Biswas, Shwapon; Parvin, Tahmina; Sack, R Bradley; Alam, Munirul

2016-02-01

Diarrhea is the second leading cause of death in children under 5 years of age globally. The time patients and caregivers spend at a health facility for severe diarrhea presents the opportunity to deliver water, sanitation, and hygiene (WASH) interventions. We recently developed Cholera-Hospital-Based Intervention for 7 days (CHoBI7), a 1-week hospital-based handwashing with soap and water treatment intervention, for household members of cholera patients. To investigate if this intervention could lead to sustained WASH practices, we conducted a follow-up evaluation of 196 intervention household members and 205 control household members enrolled in a randomized controlled trial of the CHoBI7 intervention 6 to 12 months post-intervention. Compared with the control arm, the intervention arm had four times higher odds of household members' handwashing with soap at a key time during 5-hour structured observation (odds ratio [OR]: 4.71, 95% confidence interval [CI]: 2.61, 8.49) (18% versus 50%) and a 41% reduction in households in the World Health Organization very high-risk category for stored drinking water (OR: 0.38, 95% CI: 0.15, 0.96) (58% versus 34%) 6 to 12 months post-intervention. Furthemore, 71% of observed handwashing with soap events in the intervention arm involved the preparation and use of soapy water, which was promoted during the intervention, compared to 9% of control households. These findings demonstrate that the hospital-based CHoBI7 intervention can lead to significant increases in handwashing with soap practices and improved stored drinking water quality 6 to 12 months post-intervention. © The American Society of Tropical Medicine and Hygiene.

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.

Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs; Short Inpatient Hospital Stays; Transition for Certain Medicare-Dependent, Small Rural Hospitals Under the Hospital Inpatient Prospective Payment System; Provider Administrative Appeals and Judicial Review. Final rule with comment period; final rule.

Science.gov (United States)

2015-11-13

This final rule with comment period revises the Medicare hospital outpatient prospective payment system (OPPS) and the Medicare ambulatory surgical center (ASC) payment system for CY 2016 to implement applicable statutory requirements and changes arising from our continuing experience with these systems. In this final rule with comment period, we describe the changes to the amounts and factors used to determine the payment rates for Medicare services paid under the OPPS and those paid under the ASC payment system. In addition, this final rule with comment period updates and refines the requirements for the Hospital Outpatient Quality Reporting (OQR) Program and the ASC Quality Reporting (ASCQR) Program. Further, this document includes certain finalized policies relating to the hospital inpatient prospective payment system: Changes to the 2-midnight rule under the short inpatient hospital stay policy; and a payment transition for hospitals that lost their status as a Medicare-dependent, small rural hospital (MDH) because they are no longer in a rural area due to the implementation of the new Office of Management and Budget delineations in FY 2015 and have not reclassified from urban to rural before January 1, 2016. In addition, this document contains a final rule that finalizes certain 2015 proposals, and addresses public comments received, relating to the changes in the Medicare regulations governing provider administrative appeals and judicial review relating to appropriate claims in provider cost reports.

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.

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...

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.

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.

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.

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.

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.

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

A Comprehensive Evaluation System for Military Hospitals' Response Capability to Bio-terrorism.

Science.gov (United States)

Wang, Hui; Jiang, Nan; Shao, Sicong; Zheng, Tao; Sun, Jianzhong

2015-05-01

The objective of this study is to establish a comprehensive evaluation system for military hospitals' response capacity to bio-terrorism. Literature research and Delphi method were utilized to establish the comprehensive evaluation system for military hospitals' response capacity to bio-terrorism. Questionnaires were designed and used to survey the status quo of 134 military hospitals' response capability to bio-terrorism. Survey indicated that factor analysis method was suitable to for analyzing the comprehensive evaluation system for military hospitals' response capacity to bio-terrorism. The constructed evaluation system was consisted of five first-class and 16 second-class indexes. Among them, medical response factor was considered as the most important factor with weight coefficient of 0.660, followed in turn by the emergency management factor with weight coefficient of 0.109, emergency management consciousness factor with weight coefficient of 0.093, hardware support factor with weight coefficient of 0.078, and improvement factor with weight coefficient of 0.059. The constructed comprehensive assessment model and system are scientific and practical.

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/.

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.

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...

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.

[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.

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

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.

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.

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.

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.

Whole-Genome Sequences of Four Strains Closely Related to Members of the Mycobacterium chelonae Group, Isolated from Biofilms in a Drinking Water Distribution System Simulator

Science.gov (United States)

We report the draft genome sequences of four Mycobacterium chelonae group strains from biofilms obtained after a ‘chlorine burn’ in a chloraminated drinking water distribution system simulator. These opportunistic pathogens have been detected in drinking and hospital water distr...

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.

Experimental Research of a Water-Source Heat Pump Water Heater System

Directory of Open Access Journals (Sweden)

Zhongchao Zhao

2018-05-01

Full Text Available The heat pump water heater (HPWH, as a portion of the eco-friendly technologies using renewable energy, has been applied for years in developed countries. Air-source heat pump water heaters and solar-assisted heat pump water heaters have been widely applied and have become more and more popular because of their comparatively higher energy efficiency and environmental protection. Besides use of the above resources, the heat pump water heater system can also adequately utilize an available water source. In order to study the thermal performance of the water-source heat pump water heater (WSHPWH system, an experimental prototype using the cyclic heating mode was established. The heating performance of the water-source heat pump water heater system, which was affected by the difference between evaporator water fluxes, was investigated. The water temperature unfavorably exceeded 55 °C when the experimental prototype was used for heating; otherwise, the compressor discharge pressure was close to the maximum discharge temperature, which resulted in system instability. The evaporator water flux allowed this system to function satisfactorily. It is necessary to reduce the exergy loss of the condenser to improve the energy utilization of the system.

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.

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)

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.

Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Policy Changes and Fiscal Year 2018 Rates; Quality Reporting Requirements for Specific Providers; Medicare and Medicaid Electronic Health Record (EHR)

Science.gov (United States)

2017-08-14

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

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.

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.

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

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.

Environmental surveillance of Legionella pneumophila in two Italian hospitals

Directory of Open Access Journals (Sweden)

Marina Tesauro

2010-01-01

Full Text Available The aim of this study was to identify the most effective disinfection protocol to reduce the presence of Legionella pneumophila in the water system of two Italian hospitals. From 2004 to 2009, 271 samplings of hot water were carried out in 11 hospital units to detect the presence of L. pneumophila. Additionally, water samples collected from one boiler outlet and the hot water recirculation were tested. From 2004 to 2009, L. pneumophila was present in 37% of the samples. Of these, 68.3% and 18.8% were positive for serogroups 2-14 and 1, respectively. Furthermore, 12.9% of the samples were positive for both serogroups. Finally, a maximal count of 10(4 CFU/L was measured in the most distal sites. To reduce L. pneumophila colonization, a two-year long hyperchlorination (2004-2006 was carried out. Moreover, from June 2005 until now, continuous maintenance of boilers and tanks, substitution of the shower heads and increase of the boiler outlet temperature to 60 ºC were performed. All these treatments led to a marked reduction of L. pneumophila colonization in the short but not in the medium-long term. Only the use of chlorine dioxide led, after four years, to a reduction of the loads of L. pneumophila to values below 100 CFU/L. However, in the distal sites a persistent degree of colonization (maximum value 700 CFU/L, average 600 CFU/L was observed probably due to the presence of L. pneumophila in the stagnant water in dead legs. In conclusion, data show that long-term chlorination of hot water sources together with carefully aimed maintenance of water pipes can lead to an effective reduction of L. pneumophila concentration in hospital water systems.

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.

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.

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.

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.

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.

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.

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

The role of non-financial performance measures in predicting hospital financial performance: the case of for-profit system hospitals.

Science.gov (United States)

Vélez-González, Heltie; Pradhan, Rohit; Weech-Maldonado, Robert

2011-01-01

Non-financial measures have found increasing acceptance in the business world--however, their application in the health care industry remains limited. The purpose of this article is to understand the influence of non-financial measures (efficiency, productivity, and quality) on the financial performance of for-profit system hospitals. The sample consists of 499 for-profit system hospitals in the United States from 1999 to 2002. Data analyzed include the American Hospital Association's Annual Survey, Medicare Cost Reports, Joint Commission's quality scores, and the Centers for Medicare & Medicaid Services' Hospital Case Mix Index. Dependent variables consist of financial measures (operating and total margins), while independent variables include measures of efficiency, productivity, and quality. Our results suggest the influence of non-financial performance measures on financial performance; occupancy rate positively influences financial performance while greater labor intensity may have negative implications for financial performance. In addition, we show that quality positively influences financial performance thereby offering a potential business case for quality. This result has important managerial and policy implications as it may incentivize capital and human resource investments required to improve hospital quality of care.

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' resident caps for graduate medical education payment purposes; quality reporting requirements for specific providers and for ambulatory surgical centers. final rule.

Science.gov (United States)

2012-08-31

We are revising the Medicare hospital inpatient prospective payment systems (IPPS) for operating and capital-related costs of acute care hospitals to implement changes arising from our continuing experience with these systems. Some of the changes implement certain statutory provisions contained in the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010 (collectively known as the Affordable Care Act) and other legislation. These changes will be applicable to discharges occurring on or after October 1, 2012, unless otherwise specified in this final rule. We also are updating the rate-of-increase limits for certain hospitals excluded from the IPPS that are paid on a reasonable cost basis subject to these limits. The updated rate-of-increase limits will be effective for cost reporting periods beginning on or after October 1, 2012. We are updating the payment policies and the annual payment rates for the Medicare prospective payment system (PPS) for inpatient hospital services provided by long-term care hospitals (LTCHs) and implementing certain statutory changes made by the Affordable Care Act. Generally, these changes will be applicable to discharges occurring on or after October 1, 2012, unless otherwise specified in this final rule. In addition, we are implementing changes relating to determining a hospital's full-time equivalent (FTE) resident cap for the purpose of graduate medical education (GME) and indirect medical education (IME) payments. We are establishing new requirements or revised requirements for quality reporting by specific providers (acute care hospitals, PPS-exempt cancer hospitals, LTCHs, and inpatient psychiatric facilities (IPFs)) that are participating in Medicare. We also are establishing new administrative, data completeness, and extraordinary circumstance waivers or extension requests requirements, as well as a reconsideration process, for quality reporting by ambulatory surgical centers

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.

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.

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.

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

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.

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.

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...

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.

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...

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.

Effects of metals on Legionella pneumophila growth in drinking water plumbing systems

Energy Technology Data Exchange (ETDEWEB)

States, S.J.; Conley, L.F.; Ceraso, M.; Stephenson, T.E.; Wolford, R.S.; Wadowsky, R.M.; McNamara, A.M.; Yee, R.B.

1985-11-01

Water samples were collected from hospital and institutional hot-water tanks known to have supported L. pneumophila and were analyzed for 23 chemical parameters. The chemical environment of these tanks was found to vary extensively, with the concentrations of certain metals reaching relatively high levels due to corrosion. The effect of various chemical conditions on L. pneumophila growth was then examined by observing its multiplication in a series of tap water samples artificially supplemented with various concentrations of metals. Additionally, growth of L. pneumophila was examined in a more natural setting by monitoring its multiplication in the chemically analyzed hot-water tank samples after sterilization and reinoculation with L. pneumophila. L. Pneumophila and associated microbiota used in these experiments were obtained from a hot-water tank. These strains were maintained in tap water and had never been passaged on agar. The results of the growth studies indicate that although elevated concentrations of a number of metals are toxic, lower levels of certain metals such as iron, zinc, and potassium enhance growth of naturally occurring L. pneumophila. Parallel observations on accompanying non-Legionellaceae bacteria failed to show the same relationship. These findings suggest that metal plumbing components and associated corrosion products are important factors in the survival and growth of L. pneumophila in plumbing systems and may also be important in related habitats such as cooling towers and air-conditioning systems. 1 figure, 2 tables.

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...

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

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....

Biofilm formation in an experimental water distribution system: the contamination of non-touch sensor taps and the implication for healthcare.

Science.gov (United States)

Moore, Ginny; Stevenson, David; Thompson, Katy-Anne; Parks, Simon; Ngabo, Didier; Bennett, Allan M; Walker, Jimmy T

2015-01-01

Hospital tap water is a recognised source of Pseudomonas aeruginosa. U.K. guidance documents recommend measures to control/minimise the risk of P. aeruginosa in augmented care units but these are based on limited scientific evidence. An experimental water distribution system was designed to investigate colonisation of hospital tap components. P. aeruginosa was injected into 27 individual tap 'assemblies'. Taps were subsequently flushed twice daily and contamination levels monitored over two years. Tap assemblies were systematically dismantled and assessed microbiologically and the effect of removing potentially contaminated components was determined. P. aeruginosa was repeatedly recovered from the tap water at levels above the augmented care alert level. The organism was recovered from all dismantled solenoid valves with colonisation of the ethylene propylene diene monomer (EPDM) diaphragm confirmed by microscopy. Removing the solenoid valves reduced P. aeruginosa counts in the water to below detectable levels. This effect was immediate and sustained, implicating the solenoid diaphragm as the primary contamination source.

[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.

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

Evaluation of the frequency of Candida spp. in hospitalized and non-hospitalized subjects

Directory of Open Access Journals (Sweden)

J. N. Vieira

2018-02-01

Full Text Available Abstract The aim of this study was to evaluate the frequency of Candida species between a non-hospitalized and a hospitalized population. For this purpose, samples of saliva were sampled through sterile swabs, moistened in peptone water and rubbed in the oral cavity of 140 individuals, from which, 70 were hospitalized patients from the Medical Clinic of a Teaching Hospital and the other 70 were non-hospitalized subjects. All saliva samples were plated in Sabouraud Dextrose agar added with Chloramphenicol and incubated at 36 °C for 48 hours. The morphology identification was performed through macroscopic and microscopic characterization, the CHROMagar Candida medium and the VITEK® system Yeast Biochemical Card (bio Mérieux SA, France. The results showed a colonization of Candida spp. in 85.7% the hospitalized individuals, where the species found were C. albicans (60%, C. tropicalis (23.4%, C. krusei (3.3% and Candida spp. (13.3%. In the non-hospitalized individuals the colonization by Candida spp was 47.1%, and the species found were: C. albicans (45.5%, C.krusei (9.1%, C. guilliermondii (9.1% %, C. tropicalis (3.0%, C. famata (3.0% and Candida spp. (30.3%. In spite of their presence in oral cavity in both groups, Candida spp. was more frequently isolated in hospitalized individuals, who were 6.73 times more likely to have this fungus in the oral cavity and were 3.88 times more likely to have Candida albicans.

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.

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.

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%.

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.

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

Science.gov (United States)

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

2015-01-01

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

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...

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.

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.

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.

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.

Simple Scoring System to Predict In-Hospital Mortality After Surgery for Infective Endocarditis.

Science.gov (United States)

Gatti, Giuseppe; Perrotti, Andrea; Obadia, Jean-François; Duval, Xavier; Iung, Bernard; Alla, François; Chirouze, Catherine; Selton-Suty, Christine; Hoen, Bruno; Sinagra, Gianfranco; Delahaye, François; Tattevin, Pierre; Le Moing, Vincent; Pappalardo, Aniello; Chocron, Sidney

2017-07-20

Aspecific scoring systems are used to predict the risk of death postsurgery in patients with infective endocarditis (IE). The purpose of the present study was both to analyze the risk factors for in-hospital death, which complicates surgery for IE, and to create a mortality risk score based on the results of this analysis. Outcomes of 361 consecutive patients (mean age, 59.1±15.4 years) who had undergone surgery for IE in 8 European centers of cardiac surgery were recorded prospectively, and a risk factor analysis (multivariable logistic regression) for in-hospital death was performed. The discriminatory power of a new predictive scoring system was assessed with the receiver operating characteristic curve analysis. Score validation procedures were carried out. Fifty-six (15.5%) patients died postsurgery. BMI >27 kg/m 2 (odds ratio [OR], 1.79; P =0.049), estimated glomerular filtration rate 55 mm Hg (OR, 1.78; P =0.032), and critical state (OR, 2.37; P =0.017) were independent predictors of in-hospital death. A scoring system was devised to predict in-hospital death postsurgery for IE (area under the receiver operating characteristic curve, 0.780; 95% CI, 0.734-0.822). The score performed better than 5 of 6 scoring systems for in-hospital death after cardiac surgery that were considered. A simple scoring system based on risk factors for in-hospital death was specifically created to predict mortality risk postsurgery in patients with IE. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

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

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.

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

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...

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

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...

Development of an effective risk management system in a teaching hospital.

Science.gov (United States)

Adibi, Hossein; Khalesi, Nader; Ravaghi, Hamid; Jafari, Mahdi; Jeddian, Ali Reza

2012-09-21

Unsafe health care provision is a main cause of increased mortality rate amongst hospitalized patients all over the world. A system approach to medical error and its reduction is crucial that is defined by clinical and administrative activities undertaken to identify, evaluate, and reduce the risk of injury. The aim of this study was to develop and implement a risk management system in a large teaching hospital in Iran, especially of the basis of WHO guidelines and patient safety context. WHO draft guideline and patient safety reports from different countries were reviewed for defining acceptable framework of risk management system. Also current situation of mentioned hospital in safety matter and dimensions of patient safety culture was evaluated using HSOPSC questionnaire of AHRQ. With adjustment of guidelines and hospital status, the conceptual framework was developed and next it was validated in expert panel. The members of expert panel were selected according to their role and functions and also their experiences in risk management and patient safety issues. The validated framework consisted of designating a leader and coordinator core, defining communications, and preparing the infrastructure for patient safety education and culture-building. That was developed on the basis of some values and commitments and included reactive and proactive approaches. The findings of reporting activities demonstrated that at least 3.6 percent of hospitalized patients have experienced adverse events and 5.3 percent of all deaths in the hospital related with patient safety problems. Beside the average score of 12 dimensions of patient safety culture was 46.2 percent that was considerably low. The "non-punitive responses to error" had lowest positive score with 21.2 percent. It is of paramount importance for all health organizations to lay necessary foundations in order to identify safety risks and improve the quality of care. Inadequate participation of staff in education

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.

Comparative analysis of the current payment system for hospital services in Serbia and projected payments under diagnostic related groups system in urology.

Science.gov (United States)

Babić, Uroš; Soldatović, Ivan; Vuković, Dejana; Milićević, Milena Šantrić; Stjepanović, Mihailo; Kojić, Dejan; Argirović, Aleksandar; Vukotić, Vinka

2015-03-01

Global budget per calendar year is a traditional method of funding hospitals in Serbia. Diagnose related groups (DGR) is a method of hospital payment based on classification of patients into groups with clinically similar problems and similar utilization of hospital resources. The aim of this study was to compare current methods of hospital services payment with the projected costs by DRG payment method in urology. The data were obtained from the information system used in the Clinical Hospital Center "Dr. Dragiša Mišović"--Dedinje in Belgrade, Serbia. The implemented hospital information system was the main criterion for selection of healthcare institutions. The study included 994 randomly selected patients treated surgically and conservatively in 2012. Average costs under the current payment method were slightly higher than those projected by DRG, however, the variability was twice as high (54,111 ± 69,789 compared to 53,434 ± 32,509, p payment method as well as with the projected one by DRG was observed in relation to the number of days of hospitalization (ρ = 0.842, p payment system (β = 0.843, p payment system (β = 0.737, p payment method and the pro- jected DRG payment methods (β = 0.501, p Payment under the DRG system is administratively more complex because it requires detailed and standardized coding of diagnoses and procedures, as well as the information on the average consumption of resources (costs) per DRG. Given that aggregate costs of treatment under two hospital payment methods compared in the study are not significantly different, the focus on minor surgeries both under the current hospital payment method and under the introduced DRG system would be far more cost-effective for a hospital as great variations in treatment performance (reductions of days of hospitalization and complications), and consequently invoiced amounts would be reduced.

Prevalence of dependent loops in urinary drainage systems in hospitalized patients.

Science.gov (United States)

Danek, Gale; Gravenstein, Nikolaus; Lizdas, David E; Lampotang, Samsun

2015-01-01

The purpose of this study was to measure the prevalence and configuration of dependent loops in urinary drainage systems in hospitalized, catheterized adults. The study sample comprised 141 patients with indwelling urinary catheters; subjects were hospitalized at an academic health center in northern Florida. We measured the prevalence of dependent loops in urine drainage systems and the incidence of urine-filled dependent loops over a 3-week period. We measured the heights of the crest (H(c)), trough (H(t)), and, when urine-filled dependent loops were present, the patient-side (H(p)) and bag-side (H(b)) menisci with a laser measurement system. All variables were measured in centimeters. The majority of observed urine drainage systems (85%) contained dependent loops in the drainage tubing and 93.8% of the dependent loops contained urine. H(c) and H(t) averaged 45.1 ± 11.1 and 27 ± 16.7 cm, respectively. Meniscus height difference (H(b) - H(p)) averaged 8.2 ± 5.8 and -12.2 ± 9.9 cm when H(p) H(b) (32.7%), respectively. We found that dependent loops are extremely common in urinary drainage systems among hospitalized patients despite the manufacturer recommendations and nursing and hospital policies. Maintaining the urine drainage tubing free of dependent loops would require incorporation into nursing care priorities and workflow as inadvertent force on the tubing, for example, patient movement or nurse contact can change tubing configuration and allow excess drainage tubing to re-form a dependent loop.

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.

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.

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.

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.

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.

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

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

[A study on facilitators and inhibitors to the introduction of outsourcing in the hospital information systems in Korea].

Science.gov (United States)

Choy, Soon; Shin, Hyeong-Sik; Choi, Inyoung; Kim, Sukil

2007-01-01

This study was conducted to investigate the current status of outsourcing in Korean hospital information systems and the factors influencing its introduction. The authors surveyed 136 hospitals located in Seoul and its surrounding vicinities from June 7 to June 23, 2006. The facilitators and inhibitors to outsourcing in hospital information systems were derived from literature and expert reviews. Multiple logistic regression analysis was applied to identify the major influencing factors on outsourcing in hospital information systems. Eighty-six (63.2%) of the 136 hospitals surveyed, which were mainly tertiary hospitals, responded to using outsourcing for their hospital information systems. "Hardware and software maintenance and support," "application development," and "management of service and staff" were the major areas of outsourcing. Outsourcing had been employed for 4-7 years by 45.5% of the hospitals and the proportion of the budget used for outsourcing was less than 20%. A need for an extension in outsourcing was agreed on by 76.5% of the hospitals. The multiple logistic regression analysis showed that both consumer satisfaction and security risk have an influence on hospital information system outsourcing. Outsourcing in hospital information systems is expected to increase just as in other industries. One primary facilitator to outsourcing in other industries is consumer satisfaction. We found that this was also a facilitator to outsourcing in hospital information systems. Security risk, which is usually considered an inhibitor to information technology outsourcing, was proven to be an inhibitor here as well. The results of this study may help hospital information systems establish a strategy and management plan for outsourcing.

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.

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.

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.

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

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.

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

Science.gov (United States)

Crainich, David; Leleu, Hervé; Mauleon, Ana

2011-10-01

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

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.

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.

System for radiation emergency medicine. Activities of tertiary radiation emergency hospitals

International Nuclear Information System (INIS)

Kamiya, Kenji; Tanigawa, Koichi; Hosoi, Yoshio

2011-01-01

Japanese system for radiation emergency medicine is primarily built up by Cabinet Nuclear Safety Commission in 2001 based on previous Tokai JCO Accident (1999) and is composed from the primary, secondary and tertiary medical organizations. This paper describes mainly about roles and actions of the tertiary facilities at Fukushima Nuclear Power Plant Accident and tasks to be improved in future. The primary and secondary organizations in the system above are set up in the prefectures with or neighboring the nuclear facility, and tertiary ones, in two parts of western and eastern Japan. The western organization is in Hiroshima University having its cooperating 7 hospitals, and is responsible for such patients as exposed to high dose external radiation, having serious complication, and difficult to treat in the primary/secondary hospitals. The eastern is in National Institute of Radiological Sciences (NIRS) with 6 cooperating hospitals and responsible for patients with internal radiation exposure difficult to treat, with contaminated body surface with difficulty in decontamination and/or with causable of secondary contamination, and difficult to treat in the secondary hospitals. The tertiary organizations have made efforts for the education and training of medical staff, for network construction among the primary, secondary and other medicare facilities, for establishment of transferring system of patients, and for participation to the international network by global organizations like Response Assistance Network (RANET) in International Atomic Energy Agency (IAEA), and Radiation Emergency Preparedness and Network (REMPAN) in World Health Organization (WHO). At the Fukushima Accident, staffs of the two tertiary hospitals began to conduct medicare on site (Mar. 12-) and learned following tasks to be improved in future: the early definition of medicare and its network system, and Emergency Planning Zone (EPZ); urgent evacuation of residents weak to disaster like elderly

[Nordic accident classification system used in the Danish National Hospital Registration System to register causes of severe traumatic brain injury].

Science.gov (United States)

Engberg, Aase Worsaa; Penninga, Elisabeth Irene; Teasdale, Thomas William

2007-11-05

The purpose was to illustrate the use of the accident classification system worked out by the Nordic Medico-Statistical Committee (NOMESCO). In particular, registration of causes of severe traumatic brain injury according to the system as part of the Danish National Hospital Registration System was studied. The study comprised 117 patients with very severe traumatic brain injury (TBI) admitted to the Brain Injury Unit of the University Hospital in Hvidovre, Copenhagen, from 1 October 2000 to 30 September 2002. Prospective NOMESCO coding at discharge was compared to independent retrospective coding based on hospital records, and to coding from other wards in the Danish National Hospital Registration System. Furthermore, sets of codes in the Danish National Hospital Registration System for consecutive admissions after a particular accident were compared. Identical results of prospective and independent retrospective coding were found for 65% of 588 single codes, and complete sets of codes for the same accident were identical only in 28% of cases. Sets of codes for the first admission in a hospital course corresponded to retrospective coding at the end of the course in only 17% of cases. Accident code sets from different wards, based on the same injury, were identical in only 7% of cases. Prospective coding by the NOMESCO accident classification system proved problematic, both with regard to correctness and completeness. The system--although logical--seems too complicated compared to the resources invested in the coding. The results of this investigation stress the need for better management and for better instruction to those who carry out the registration.

Hospital accreditation, reimbursement and case mix: links and insights for contractual systems.

Science.gov (United States)

Ammar, Walid; Khalife, Jade; El-Jardali, Fadi; Romanos, Jenny; Harb, Hilda; Hamadeh, Ghassan; Dimassi, Hani

2013-12-05

Resource consumption is a widely used proxy for severity of illness, and is often measured through a case-mix index (CMI) based on Diagnosis Related Groups (DRGs), which is commonly linked to payment. For countries that do not have DRGs it has been suggested to use CMIs derived from International Classification of Diseases (ICD). Our research objective was to use ICD-derived case-mix to evaluate whether or not the current accreditation-based hospital reimbursement system in Lebanon is appropriate. Our study population included medical admissions to 122 hospitals contracted with the Lebanese Ministry of Public Health (MoPH) between June 2011 and May 2012. Applying ICD-derived CMI on principal diagnosis cost (CMI-ICDC) using weighing similar to that used in Medicare DRG CMI, analyses were made by hospital accreditation, ownership and size. We examined two measures of 30-day re-admission rate. Further analysis was done to examine correlation between principal diagnosis CMI and surgical procedure cost CMI (CMI-CPTC), and three proxy measures on surgical complexity, case complexity and surgical proportion. Hospitals belonging to the highest accreditation category had a higher CMI than others, but no difference was found in CMI among the three other categories. Private hospitals had a higher CMI than public hospitals, and those more than 100 beds had a higher CMI than smaller hospitals. Re-admissions rates were higher in accreditation category C hospitals than category D hospitals. CMI-ICDC was fairly correlated with CMI-CPTC, and somehow correlated with the proposed proxies. Our results indicate that the current link between accreditation and reimbursement rate is not appropriate, and leads to unfairness and inefficiency in the system. Some proxy measures are correlated with case-mix but are not good substitutes for it. Policy implications of our findings propose the necessity for changing the current reimbursement system by including case mix and outcome indicators in

Multiple physical signs detection and decision support system for hospitalized older adults

International Nuclear Information System (INIS)

Baig, Mirza Mansoor; GholamHosseini, Hamid; Connolly, Martin J

2015-01-01

Health monitoring systems have rapidly evolved during the past two decades and have the potential to change the way healthcare is currently delivered. Smart monitoring systems automate patient monitoring tasks and thereby improve patient workflow management. Moreover, expert systems have the potential to assist clinicians and improve their performance by accurately executing repetitive tasks, to which humans are ill-suited. Clinicians working in hospital wards are responsible for conducting a multitude of tasks which require constant vigilance, and thus the need for a smart decision support system has arisen. In particular, wireless patient monitoring systems are emerging as a low cost, reliable and accurate means of healthcare delivery.Vital signs monitoring systems are rapidly becoming part of today’s healthcare delivery. The paradigm has shifted from traditional and manual recording to computer-based electronic records and, further, to handheld devices as versatile and innovative healthcare monitoring systems. The current study focuses on interpreting multiple physical signs and early warning for hospitalized older adults so that severe consequences can be minimized. Data from a total of 30 patients have been collated in New Zealand hospitals under local and national ethics approvals. The system records blood pressure, heart rate (pulse), oxygen saturation (SpO2), ear temperature and blood glucose levels from hospitalized patients and transfers this information to a web-based software application for remote monitoring and further interpretation. Ultimately, this system is aimed to achieve a high level of agreement with clinicians’ interpretation when assessing specific physical signs such as bradycardia, tachycardia, hypertension, hypotension, hypoxaemia, fever and hypothermia to generate early warnings. The performance of the vital signs interpretation system was validated through off-line as well as real-time tests with a high level of agreement between

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...

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.

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

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

Advantages of a Web-Based Real-Time Bed-Management System for Hospital Admission Monitoring in Iran.

Science.gov (United States)

Abedian, Somayeh; Bitaraf, Ehsan; Askari, Marjan

2018-01-01

Lack of up-to-date information of hospitals beds, specifically in emergencies, is a significant problem in many large countries; The Ministry of Health and Medical Education of Iran (MOHME) designed and implemented a dynamic system that reports the status of beds in 2012. This system created great opportunities for national bed management, including real-time hospital admission monitoring, especially for emergency departments, ICUs and CCUs. Therefore, an additional online system was planned to be implemented for monitoring hospital admissions, including a national alert system. Prior to the design of this system, a study was done using literature study and expert opinion to investigate the advantages and features that this monitoring system was required to have. We used the MoSCoW method to prioritize the requirements of the system. This system was designed to have the following advantages, among other things: the hospitals as well as government should be able to track the patients, manage patient distribution in healthcare centers, and make policy for supplying extra beds. It should also be possible for the hospitals executive board, as well as the government, to monitor the performance of the hospitals regarding patient admissions (i.e., the rate of rejection of patients with severe conditions).

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

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.

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.

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...

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.

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...

Research on Legionella pneumophila in hospital supply networks - DOI: 10.3395/reciis.v1i2.85en

Directory of Open Access Journals (Sweden)

Aldo Pacheco Ferreira

2007-12-01

Full Text Available The species of Legionella (gram-negative aerobic bacillus are widely distributed in water environments. The Legionellaceae family comprises a group of fastidious bacteria that requires special isolation techniques, and of which the Legionella pneumophila is the member which is most commonly identified as the cause of human diseases or of the worsening of health conditions. The purpose of this work is to verify conditions in randomly chosen hospitals from the public system for the development of Legionella pneumophila, and, thus, contribute to the debate on legislation and technical standardization in the network, with the purpose of controlling and preventing the presence of this bacillus in the Brazilian hospital system. At the same time, some physicochemical and colimetric parameters (total and thermo-tolerant coliforms were evaluated aiming at defining the total quality of water used. The results show the presence of coliforms and Legionella sp in the water used in the monitored hospitals. In this way, it is shown that the maintenance of the quality of water used in hospitals is fundamental, as well as the carrying out of biological tests for the detection of Legionella pneumophila so that the necessary safety of the hospital environment can be achieved.

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.

Heat transmission systems for heating and potable water. New requirements and problem solutions for hygiene, safety and improved heat utilization. Waermeuebertragungssysteme fuer Heizung und Trinkwasser. Neue Anforderungen und Problemloesungen bezueglich Hygiene, Sicherheit und besserer Waermenutzung

Energy Technology Data Exchange (ETDEWEB)

Kremer, R

1989-10-01

In the past, additional demands were made on heat transmission systems regarding hygienic requirements in potable water heating plant for hospitals, hotels, sanatoriums and old-age homes, safety requirements to protect the potable water from the penetration of hazardous substances and requirements for improved heat utilization through return flow cooling and condensate cooling in the district heating. Where potable water heaters are concerned, safety radiators for heat transfer which comply with the requirements of DIN 1988 Part 2 and Part 4, as well as water heaters with permanent disinfection which are legionnaires' disease-proof, are now available for use in hospitals, old age homes and sanatoriums. For the district heating sector, improved range systems with low concentration in the hot water sector as well as condensate heat utilizing systems have been further developed in the steam heating sector. (orig.).

Comparative analysis of current payment system for hospital services in Serbia and projected payments under diagnostic related groups system in urology

Directory of Open Access Journals (Sweden)

Babić Uroš

2015-01-01

Full Text Available Background/Aim. Global budget per calendar year is a traditional method of funding hospitals in Serbia. Diagnose related groups (DGR is a method of hospital payment based on classification of patients into groups with clinically similar problems and similar utilization of hospital resources. The aim of this study was to compare current methods of hospital services payment with the projected costs by DRG payment method in urology. Methods. The data were obtained from the information system used in the Clinical Hospital Center “Dr. Dragiša Mišović” - Dedinje in Belgrade, Serbia. The implemented hospital information system was the main criterion for selection of healthcare institutions. The study included 994 randomly selected patients treated surgically and conservatively in 2012. Results. Average costs under the current payment method were slightly higher than those projected by DRG, however, the variability was twice as high (54,111 ± 69,789 compared to 53,434 ± 32,509, p < 0,001 respectively. The univariate analysis showed that the highest correlation with the current payment method as well as with the projected one by DRG was observed in relation to the number of days of hospitalization (ρ = 0.842, p < 0.001, and ρ = 0.637, p < 0.001, respectively. Multivariate regression models confirmed the influence of the number of hospitalization days to costs under the current payment system (β = 0.843, p < 0.001 as well as under the projected DRG payment system (β = 0.737, p < 0.001. The same predictor was crucial for the difference in the current payment method and the projected DRG payment methods (β = 0.501, p <0.001. Conclusion. Payment under the DRG system is administratively more complex because it requires detailed and standardized coding of diagnoses and procedures, as well as the information on the average consumption of resources (costs per DRG. Given that aggregate costs of treatment under two hospital payment methods compared

Hospital Information System and its Role in the Development of Medical and Health Services: A Review Article

Directory of Open Access Journals (Sweden)

Hosein Vakili Mofrad

2012-12-01

Full Text Available Increasing growth of communication industries and informatics, cause the world is facing with a new revolution. Revolution of information and communication technologies in all sectors of the economy, society, politic and security of countries has left a significant effect. One of the most important application areas of information technology is the field of health and treatment. Hospital information system is the first and most important system of health care delivery. Hospital information systems are the computer systems that are easy to manage medicine and hospital management information and are designed to improve health care. Investigations have shown that using a hospital information system caused to improve quality of health care and increase satisfaction of clients. Some problems of the health care system are distribution of patients’ information and Lack of access to their records, Weak cooperation between physicians and health care workers, and also weakness of access to necessary medical information. These problems are solvable through the development of information technology and especially hospital (Health information systems. This paper studies the hospital information systems, implementation of these systems and their role in the development of medical and health services.

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

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...

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

Development of an effective risk management system in a teaching hospital

Directory of Open Access Journals (Sweden)

Adibi Hossein

2012-09-01

Full Text Available Abstract Background Unsafe health care provision is a main cause of increased mortality rate amongst hospitalized patients all over the world. A system approach to medical error and its reduction is crucial that is defined by clinical and administrative activities undertaken to identify, evaluate, and reduce the risk of injury. The aim of this study was to develop and implement a risk management system in a large teaching hospital in Iran, especially of the basis of WHO guidelines and patient safety context. Methods WHO draft guideline and patient safety reports from different countries were reviewed for defining acceptable framework of risk management system. Also current situation of mentioned hospital in safety matter and dimensions of patient safety culture was evaluated using HSOPSC questionnaire of AHRQ. With adjustment of guidelines and hospital status, the conceptual framework was developed and next it was validated in expert panel. The members of expert panel were selected according to their role and functions and also their experiences in risk management and patient safety issues. The validated framework consisted of designating a leader and coordinator core, defining communications, and preparing the infrastructure for patient safety education and culture-building. That was developed on the basis of some values and commitments and included reactive and proactive approaches. Results The findings of reporting activities demonstrated that at least 3.6 percent of hospitalized patients have experienced adverse events and 5.3 percent of all deaths in the hospital related with patient safety problems. Beside the average score of 12 dimensions of patient safety culture was 46.2 percent that was considerably low. The “non-punitive responses to error” had lowest positive score with 21.2 percent. Conclusion It is of paramount importance for all health organizations to lay necessary foundations in order to identify safety risks and improve

[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.

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.

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.

Water sensors with cellular system eliminate tail water drainage in alfalfa irrigation

Directory of Open Access Journals (Sweden)

Rajat Saha

2011-10-01

Full Text Available Alfalfa is the largest consumer of water among all crops in California. It is generally flood-irrigated, so any system that decreases runoff can improve irrigation efficiency and conserve water. To more accurately manage the water flow at the tail (bottom end of the field in surface-irrigated alfalfa crops, we developed a system that consists of wetting-front sensors, a cellular communication system and a water advance model. This system detects the wetting front, determines its advance rate and generates a cell-phone alert to the irrigator when the water supply needs to be cut off, so that tail water drainage is minimized. To test its feasibility, we conducted field tests during the 2008 and 2009 alfalfa growing seasons. The field experiments successfully validated the methodology, producing zero tail water drainage.

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...

Household pasteurization of drinking-water: the chulli water-treatment system.

Science.gov (United States)

Islam, Mohammad Fakhrul; Johnston, Richard B

2006-09-01

A simple flow-through system has been developed which makes use of wasted heat generated in traditional clay ovens (chullis) to pasteurize surface water. A hollow aluminium coil is built into the clay chulli, and water is passed through the coil during normal cooking events. By adjusting the flow rate, effluent temperature can be maintained at approximately 70 degrees C. Laboratory testing, along with over 400 field tests on chulli systems deployed in six pilot villages, showed that the treatment completely inactivated thermotolerant coliforms. The chulli system produces up to 90 litres per day of treated water at the household level, without any additional time or fuel requirement. The technology has been developed to provide a safe alternative source of drinking-water in arsenic-contaminated areas, but can also have wide application wherever people consume microbiologically-contaminated water.

MUWS (Microbiology in Urban Water Systems – an interdisciplinary approach to study microbial communities in urban water systems

Directory of Open Access Journals (Sweden)

P. Deines

2010-07-01

Full Text Available Microbiology in Urban Water Systems (MUWS is an integrated project, which aims to characterize the microorganisms found in both potable water distribution systems and sewer networks. These large infrastructure systems have a major impact on our quality of life, and despite the importance of these systems as major components of the water cycle, little is known about their microbial ecology. Potable water distribution systems and sewer networks are both large, highly interconnected, dynamic, subject to time and varying inputs and demands, and difficult to control. Their performance also faces increasing loading due to increasing urbanization and longer-term environmental changes. Therefore, understanding the link between microbial ecology and any potential impacts on short or long-term engineering performance within urban water infrastructure systems is important. By combining the strengths and research expertise of civil-, biochemical engineers and molecular microbial ecologists, we ultimately aim to link microbial community abundance, diversity and function to physical and engineering variables so that novel insights into the performance and management of both water distribution systems and sewer networks can be explored. By presenting the details and principals behind the molecular microbiological techniques that we use, this paper demonstrates the potential of an integrated approach to better understand how urban water system function, and so meet future challenges.

The real world of blood glucose point-of-care testing (POCT) system running in China teaching hospital.

Science.gov (United States)

Li, Feng-Fei; Xie, Yun; Shi, Bing-Yin; Niu, Min; Guo, Hui; Cao, Yan; Liu, Bing-Li; Yan, Reng-Na; Su, Xiao-Fei; Wu, Jin-Dan; Zhang, Dan-Feng; Chen, Li-Ming; Ma, Jian-Hua

2018-06-01

 The blood glucose point-of-care testing (POCT) system is important in the decision-making process involving patients suspected of having hypoglycemia. To investigate the real world of the POCT system being used in teaching hospitals in China. The survey was conducted by Hisend Research Group from May 2015 to July 2015 in four teaching hospitals in China. The survey questions were referred to the ISO 15197:2013 standard requirements for the use of the POCT system in a hospital setting. A total of 170 subjects were included from 4 hospitals, which included nursing staff, nurse unit managers, employees from the department of medical instruments, and staff members employed by the clinical laboratories in the Tianjin Metabolism Hospital, Nanjing First Hospital, First Affiliated Hospital of Dalian Medical University, and the First hospital affiliated with the Xi'an Transportation University. The average score for the four hospitals surveyed in this study was 66.6, which varied from 46.1 to 79.7. The main factors influencing the scores were the multiple choices of blood-glucose meters, and the quality control assessment. Our data indicates that the real world use of the POCT system in hospital settings in China needs more closer adherence to a quality management framework.

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...

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.

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...

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…

Steam generation: fossil-fired systems: utility boilers; industrial boilers; boiler auxillaries; nuclear systems: boiling water; pressurized water; in-core fuel management; steam-cycle systems: condensate/feedwater; circulating water; water treatment

International Nuclear Information System (INIS)

Anon.

1982-01-01

A survey of development in steam generation is presented. First, fossil-fired systems are described. Progress in the design of utility and industrial boilers as well as in boiler auxiliaries is traced. Improvements in coal pulverizers, burners that cut pollution and improve efficiency, fans, air heaters and economisers are noted. Nuclear systems are then described, including the BWR and PWR reactors, in-core fuel management techniques are described. Finally, steam-cycle systems for fossil-fired and nuclear power plants are reviewed. Condensate/feedwater systems, circulating water systems, cooling towers, and water treatment systems are discussed

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...

How satisfied are hospital systems with their ownership of retail clinics?

Science.gov (United States)

Kaissi, Amer; Charland, Thomas A

2013-01-01

Retail clinics--while innovative--can no longer be considered a new model of healthcare delivery, as an increasing number of hospitals and health systems now own them. The purpose of this article is to explore the extent to which hospital systems are satisfied with their ownership of retail clinics. In terms of operational challenges, respondents to our survey, administered to representatives from 19 health systems, were relatively satisfied with clinic staffing and their relationship with the retailers regarding lease terms, store locations, and shopper demographics. They expressed mostly neutral levels of satisfaction with regulations and laws related to retail clinics and low satisfaction with insurance reimbursement and clinics' seasonal patterns. The two areas that received the lowest respondent satisfaction ratings were patient volume and response to marketing initiatives. When asked to share their perceptions of their organization's satisfaction with various strategic aspects of retail clinic ownership, respondents revealed that the clinics were achieving several important strategic goals, such as improved access, increased referrals, defense against competitors, and increased brand exposure. They indicated overall dissatisfaction with profitability and cost-reduction outcomes. We conclude that serious operational challenges and strategic threats must be overcome if retail clinics are to be a successful service line for hospitals and health systems.

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

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.

Assessing the Performance of Imaging Health Systems in Five Selected Hospitals in Uganda

Directory of Open Access Journals (Sweden)

Michael G Kawooya

2012-01-01

Full Text Available Objectives : The first objective of the study was to develop an index termed as the ′Imaging Coverage′ (IC, for measuring the performance of the imaging health systems. This index together with the Hospital-Based Utilization (HBU would then be calculated for five Ugandan hospitals. Second, was to relate the financial resources and existing health policy to the performance of the imaging systems. Materials and Methods: This was a cross-sectional survey employing the triangulation methodology, conducted in Mulago National Referral Hospital. The qualitative study used cluster sampling, in-depth interviews, focus group discussions, and self-administered questionnaires to explore the non-measurable aspects of the imaging systems′ performances. Results: The IC developed and tested as an index for the imaging system′s performance was 36%. General X-rays had the best IC followed by ultrasound. The Hospital-Based Utilization for the five selected hospitals was 186 per thousand and was the highest for general radiography followed by ultrasound. Conclusion: The IC for the five selected hospitals was 36% and the HBU was 186 per thousand, reflecting low performance levels, largely attributable to inadequate funding. There were shortfalls in imaging requisitions and inefficiencies in the imaging systems, financing, and health policy. Although the proportion of inappropriate imaging was small, reducing this inappropriateness even further would lead to a significant total saving, which could be channeled into investigating more patients. Financial resources stood out as the major limitation in attaining the desired performance and there is a need to increase budget funding so as to improve the performance of the imaging health systems.

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.

[Implementation of a safety and health planning system in a teaching hospital].

Science.gov (United States)

Mariani, F; Bravi, C; Dolcetti, L; Moretto, A; Palermo, A; Ronchin, M; Tonelli, F; Carrer, P

2007-01-01

University Hospital "L. Sacco" had started in 2006 a two-year project in order to set up a "Health and Safety Management System (HSMS)" referring to the technical guideline OHSAS 18001:1999 and the UNI and INAIL "Guidelines for a health and safety management system at workplace". So far, the following operations had been implemented: Setting up of a specific Commission within the Risk Management Committee; Identification and appointment of Departmental Representatives of HSMS; Carrying out of a training course addressed to Workers Representatives for Safety and Departmental Representatives of HSMS; Development of an Integrated Informative System for Prevention and Safety; Auditors qualification; Inspection of the Occupational Health Unit and the Prevention and Safety Service: reporting of critical situations and monitoring solutions adopted. Short term objectives are: Self-evaluation through check-lists of each department; Sharing of the Improvement Plan among the departments of the hospital; Planning of Health and Safety training activities in the framework of the Hospital Training Plan; Safety audit.

Formative evaluation of Hospital Information System According to ISO 9241-10: A case study from Iran

Directory of Open Access Journals (Sweden)

Narjes Mirabootalebi1

2012-09-01

Full Text Available Introduction: Today, different information systems are operated in hospitals in Iran to manage the admission,discharge, radiology, pharmacy, accounting and other procedures. Inappropriate HIS system causes wasting of time,consumption of more energy and increasing the costs.Methodology: This study was conducted in Dr. Ali Shariati Hospital in Iran. We employed Isometric FormativeEvaluation questionnaire to analyze the hospital information system. Also, interviewing method was applied tocomplete information from departments' officials.Results: From 101 people under investigation in this study, it was agreed on 27 people (26.7% suitability for taskcriteria, 46 people (45.5% by controllability criteria, 27 people (26.7% to suitability for individualization criteria,69 people (68.3% to suitability for learning criteria, 41 people (40.6% by error tolerant criteria, 46 people (45.5%by self description criteria, 53 people (52.5% by conformity whit user expectation of Hospital Information Systemin Dr. Ali Shariati Hospital.Conclusion: Findings indicate Hospital Information System criteria are not efficient. It is necessary either to usenationally applicable software in information system of Medical Sciences Universities across the country ordifferent software having international standards of medical information should be used.

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...

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.

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.

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...

Does a new steam meal catering system meet patient requirements in hospital?

Science.gov (United States)

Hickson, M; Fearnley, L; Thomas, J; Evans, S

2007-10-01

It has been consistently observed that a significant proportion of hospital inpatients are malnourished and many actually develop malnutrition in hospital. The NHS provides over 300 million meals each year at a cost of pound 500 million, yet there is relatively little research evaluating how well different catering systems provide for the needs of hospital inpatients. The aim of the study was to: (i) evaluate whether a new steam meal catering system (Steamplicity) enables patients in theory to meet their energy requirements in hospital and (ii) compare energy and protein intake using Steamplicity with a traditional bulk cook-chill system. Patients not at nutritional risk had their food intake at one lunchtime assessed. Energy intake was compared with the patients' energy requirements and energy and protein intake were compared with previous data from a bulk system. Fifty-seven patients had a median daily energy requirement of 7648 kJ (1821 kcal) [inter-quartile range (IQR): 6854-9164 kJ]. Assuming 30% [2293 kJ (546 kcal)] should be supplied by the lunch meal the average intake of 1369 kJ (326 kcal) fell short by 40%. Patients served meals from Steamplicity ate less energy [1369 kJ versus 1562 kJ (326 kcal versus 372 kcal) P = 0.04] but similar protein (18 g versus 19 g P = 0.34) to the bulk system. The largest difference was the energy provided by the dessert since the bulk system served more hot high-calorie desserts. Patient intakes did not meet their estimated requirements. The patients in this study were eating well and not at nutritional risk, thus patients with a poor appetite will be even less likely to meet their nutritional requirements. Steamplicity meals result in a lower energy intake than meals from a bulk cook-chill system, but similar protein intakes.

[Water-saving mechanisms of intercropping system in improving cropland water use efficiency].

Science.gov (United States)

Zhang, Feng-Yun; Wu, Pu-Te; Zhao, Xi-Ning; Cheng, Xue-Feng

2012-05-01

Based on the multi-disciplinary researches, and in terms of the transformation efficiency of surface water to soil water, availability of cropland soil water, crop canopy structure, total irrigation volume needed on a given area, and crop yield, this paper discussed the water-saving mechanisms of intercropping system in improving cropland water use efficiency. Intercropping system could promote the full use of cropland water by plant roots, increase the water storage in root zone, reduce the inter-row evaporation and control excessive transpiration, and create a special microclimate advantageous to the plant growth and development. In addition, intercropping system could optimize source-sink relationship, provide a sound foundation for intensively utilizing resources temporally and spatially, and increase the crop yield per unit area greatly without increase of water consumption, so as to promote the crop water use efficiency effectively.

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.

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

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

Integrated management of water resources in urban water system: Water Sensitive Urban Development as a strategic approach

Directory of Open Access Journals (Sweden)

Juan Joaquín Suárez López

2014-08-01

Full Text Available The urban environment has to be concerned with the integrated water resources management, which necessarily includes the concept of basin unity and governance.  The traditional urban water cycle framework, which includes water supply, sewerage and wastewater treatment services, is being replaced by a holistic and systemic concept, where water is associated with urbanism and sustainability policies. This global point of view cannot be ignored as new regulations demand systemic and environmental approaches to the administrations, for instance, in the management of urban drainage and sewerage systems. The practical expression of this whole cluster interactions is beginning to take shape in several countries, with the definition of Low Impact Development and Water Sensitivity Urban Design concepts. Intends to integrate this new strategic approach under the name: “Water Sensitive Urban Development” (WSUD. With WSUD approach, the current urban water systems (originally conceived under the traditional concept of urban water cycle can be transformed, conceptual and physically, for an integrated management of the urban water system in new models of sustainable urban development. A WSUD implementing new approach to the management of pollution associated with stormwater in the urban water system is also presented, including advances in environmental regulations and incorporation of several techniques in Spain.

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.

[Effects of long-term fluoride in drinking water on risks of hip fracture of the elderly: an ecologic study based on database of hospitalization episodes].

Science.gov (United States)

Park, Eun Young; Hwang, Seung Sik; Kim, Jai Yong; Cho, Soo Hun

2008-05-01

Fluoridation of drinking water is known to decrease dental caries, particularly in children. However, the effects of fluoridated water on bone over several decades are still in controversy. To assess the risk of hip fracture related to water fluoridation, we evaluated the hip fracture-related hospitalizations of the elderly between a fluoridated city and non-fluoridated cities in Korea. Cheongju as a fluoridated area and Chungju, Chuncheon, Suwon, Wonju as non-fluoridated areas were chosen for the study. We established a database of hip fracture hospitalization episode based on the claims data submitted to the Health Insurance Review Agency from January 1995 to December 2002. The hip fracture hospitalization episodes that satisfied the conditions were those that occurred in patients over 65 years old, the injuries had a hip fracture code (ICD-9 820, ICD-10 S72) and the patients were hospitalized for at least 7days. A total of 80,558 cases of hip fracture hospitalization episodes were analyzed. The admission rates for hip fracture increased with the age of the men and women in both a fluoridated city and the non-fluoridated cities (phip fracture increased significantly both for men and women as their age increased. However, any difference in the hip fracture admission rates was not consistently observed between the fluoridated city and the nonfluoridated cities. We cannot conclude that fluoridation of drinking water increases the risk of hip fracture in the elderly.

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)

Emergy evaluation of water utilization benefits in water-ecological-economic system based on water cycle process

Science.gov (United States)

Guo, X.; Wu, Z.; Lv, C.

2017-12-01

The water utilization benefits are formed by the material flow, energy flow, information flow and value stream in the whole water cycle process, and reflected along with the material circulation of inner system. But most of traditional water utilization benefits evaluation are based on the macro level, only consider the whole material input and output and energy conversion relation, and lack the characterization of water utilization benefits accompanying with water cycle process from the formation mechanism. In addition, most studies are from the perspective of economics, only pay attention to the whole economic output and sewage treatment economic investment, but neglect the ecological function benefits of water cycle, Therefore, from the perspective of internal material circulation in the whole system, taking water cycle process as the process of material circulation and energy flow, the circulation and flow process of water and other ecological environment, social economic elements were described, and the composition of water utilization positive and negative benefits in water-ecological-economic system was explored, and the performance of each benefit was analyzed. On this basis, the emergy calculation method of each benefit was proposed by emergy quantitative analysis technique, which can realize the unified measurement and evaluation of water utilization benefits in water-ecological-economic system. Then, taking Zhengzhou city as an example, the corresponding benefits of different water cycle links were calculated quantitatively by emergy method, and the results showed that the emergy evaluation method of water utilization benefits can unify the ecosystem and the economic system, achieve uniform quantitative analysis, and measure the true value of natural resources and human economic activities comprehensively.

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.)

Demonstration of Advanced Technologies for Multi-Load Washers in Hospitality and Healthcare -- Wastewater Recycling Technology

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); Foley, K. J. [Navigant Consulting, Inc. (United States); Sutherland, T. A. [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 a wastewater recycling system installed in the Grand Hyatt Seattle.

Hospital non-price competition under the Global Budget Payment and Prospective Payment Systems.

Science.gov (United States)

Chen, Wen-Yi; Lin, Yu-Hui

2008-06-01

This paper provides theoretical analyses of two alternative hospital payment systems for controlling medical cost: the Global Budget Payment System (GBPS) and the Prospective Payment System (PPS). The former method assigns a fixed total budget for all healthcare services over a given period with hospitals being paid on a fee-for-service basis. The latter method is usually connected with a fixed payment to hospitals within a Diagnosis-Related Group. Our results demonstrate that, given the same expenditure, the GBPS would approach optimal levels of quality and efficiency as well as the level of social welfare provided by the PPS, as long as market competition is sufficiently high; our results also demonstrate that the treadmill effect, modeling an inverse relationship between price and quantity under the GBPS, would be a quality-enhancing and efficiency-improving outcome due to market competition.

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.

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.

The casemix system of hospital funding can further disadvantage Aboriginal children.

Science.gov (United States)

Ruben, A R; Fisher, D A

1998-10-19

The Northern Territory Health Service implemented a casemix system of hospital funding in 1996 using national averages and national cost weights as benchmarks for length of stay and funding. Clinicians and health administrators were concerned about the potential of this model to impair health service delivery, especially to children of Aboriginal or Torres Strait Islander (ATSI) descent, whose current poor health has been well described. Data were collected on children aged under 10 years who were discharged from the Royal Darwin Hospital between 1 July 1991 and 30 June 1996 and assigned one of four DRGs (simple pneumonia, bronchitis and asthma, gastroenteritis, nutritional and metabolic disorders). Data collected included age, sex, ethnicity, duration of hospital stay, location of residence and presence of comorbidities. There were significant differences in the proportion of children with multiple comorbidities between ATSI and non-ATSI children, as well as between rural- and urban-dwelling ATSI children. A higher proportion of ATSI compared with non-ATSI children had prolonged hospital stays (22.6% v. 1.5%), with the variables influencing length of stay in ATSI children including "age casemix classification system for a "typical" Australian population on a region with a high proportion of people of ATSI descent.

Waterborne Campylobacter jejuni epidemic in a Finnish hospital for rheumatic diseases.

Science.gov (United States)

Rautelin, H; Koota, K; von Essen, R; Jahkola, M; Siitonen, A; Kosunen, T U

1990-01-01

A waterborne Campylobacter jejuni outbreak in the Rheumatism Foundation Hospital in Heinola, Finland, in November-December 1986 is described. 32 patients and 62 members of the staff developed gastrointestinal symptoms. C. jejuni heat-stable serotype 45 was isolated from the faeces of 32 enteritis patients and from none of the controls. No other enteropathogens were found. Positive serological responses to C. jejuni acid extract antigen were detected by enzyme immunoassay in 34% of the symptomatic hospital patients, in 40% of the symptomatic staff members, and in 10% of the controls. The clinical course of the illness was mostly mild and self-limited. No striking progress in the arthritis symptoms of the patients was found after the outbreak. The hospital has its own water supply. C. jejuni of the same serotype as the epidemic strain was isolated from the water of the pipeline system. After a careful examination some aged components of the waterworks were found to be responsible for leaks that resulted in the contamination of the water.

A management system integrating radiation protection and safety supporting safety culture in the hospital

International Nuclear Information System (INIS)

Almen, A.; Lundh, C.

2015-01-01

Quality assurance has been identified as an important part of radiation protection and safety for a considerable time period. A rational expansion and improvement of quality assurance is to integrate radiation protection and safety in a management system. The aim of this study was to explore factors influencing the implementing strategy when introducing a management system including radiation protection and safety in hospitals and to outline benefits of such a system. The main experience from developing a management system is that it is possible to create a vast number of common policies and routines for the whole hospital, resulting in a cost-efficient system. One of the key benefits is the involvement of management at all levels, including the hospital director. Furthermore, a transparent system will involve staff throughout the organisation as well. A management system supports a common view on what should be done, who should do it and how the activities are reviewed. An integrated management system for radiation protection and safety includes key elements supporting a safety culture. (authors)

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.

Antimicrobial activity of copper against organisms in aqueous solution: a case for copper-based water pipelines in hospitals?

Science.gov (United States)

Cervantes, Hilda I; Alvarez, Jose A; Muñoz, Juan M; Arreguín, Virginia; Mosqueda, Juan L; Macías, Alejandro E

2013-12-01

An association exists between water of poor quality and health care-associated infections. Copper shows microbiocidal action on dry surfaces; it is necessary to evaluate its antimicrobial effect against organisms in aqueous solution. The objective was to determine the in vitro antimicrobial activity of copper against common nosocomial pathogens in aqueous solution. Copper and polyvinyl chloride containers were used. Glass was used as control material. Fourteen organisms isolated from hospital-acquired infections, and 3 control strains were tested. Inocula were prepared by direct suspension of colonies in saline solution and water in each container tested. Bacterial counts in colony-forming units (CFU)/mL were determined at the beginning of the experiment; at 30 minutes; and at 1, 2, 24, and 48 hours. Organisms in glass and polyvinyl chloride remained viable until the end of the experiment. Organisms in copper showed a reduction from more than 100,000 CFU/mL to 0 CFU/mL within the first 2 hours of contact (F > 4.29, P water for human use, particularly in hospitals. Copyright © 2013 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

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.

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

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.

Pseudomonas aeruginosa from hospital environment

Directory of Open Access Journals (Sweden)

Milind Davane

2014-03-01

Full Text Available Hospital acquired infection is an additional affliction to the patient admitted to the hospital for some serious illness and is caused by pathogens which are prevalent in hospital environment. In the hospital, microbes are ubiquitous; and can reach the sick patient through various sources, such as air, water, food, contaminated equipments, linen, catheters, scopes, ventilators, contaminated disinfectants and other preparations used for treatment, visitors, infected patients, etc.

Integration of radiology and hospital information systems (RIS, HIS) with PACS

International Nuclear Information System (INIS)

Mosser, H.; Urban, M.; Hruby, W.; Duerr, M.; Rueger, W.

1992-01-01

PACS development has now reached a stage where it can clearly be stated that the technology for storage, networking and display in a fully digital environment is available. This is reflected by an already large and rapidly increasing number of PACS installations in USA, Western Europe and Japan. Such installations consist of a great variety of information systems, more or less interconnected, like PACS, HIS, RIS and other departmental systems, differing in both hardware and software. Various data -even if they only concern one person- are stored in different systems distributed in the hospital. The integration of all digital systems into a functional unit is determined by the radiologist's need of quick access to all relevant information regardless where it is stored. The interconnection and functional integration of all digital systems in the hospital determine the clinical benefits of PACS. This paper describes the radiologist's requirements concerning this integration, and presents some realistic solutions such as the Siemens ISI (Information System Interface), and a mobile viewing station for the wards (visitBox). (author). 9 refs., 4 figs

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...

Tripartite Evolutionary Game Analysis on Selection Behavior of Trans-Regional Hospitals and Patients in Telemedicine System

Directory of Open Access Journals (Sweden)

Yuxuan Gao

2017-01-01

Full Text Available This study applies the game theory to the discussion and analysis of trans-regional Telemedicine System, builds the game model of the selection strategies of trans-regional hospitals and patients and analyzes evolving paths, equilibrium states and influencing factors of the three parties. It is derived that medical insurance reimbursement proportion of specialized hospitals, government support for general hospitals and medical expenses in specialized hospitals, operating costs of general hospitals are the influential factors in the Telemedicine System. Finally, a numerical stimulation is conducted with Matlapb based on the data from ligChina Health and Family Planning Statistical Yearbook 2015l/ig.

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...

Water Hammer Mitigation on Postulated Pipe Break of Feed Water System