Department of Homeland Security — This database contains locations of Hospitals for 50 states and Washington D.C. , Puerto Rico and US territories. The dataset only includes hospital facilities and...
The challenge could be briefly seen in these terms: hospitals as places for treatment where there’s a technology focus and hospitals for healing where there’s a human focus. In the 60s - 70s wave of new hospital building, an emphasis on technology can be seen. It’s time to move from the technology....... Documentation exists in; well-being of patients and staff, sleep disorders, pain distraction, confidentiality and privacy, levels of errors in hospitals. Art and the use of color: Art can be context related so one should be aware whether it is in a private ward or the foyer and related to the experience...... of the patient. Art can be used as a stress reducing factor, pain distracter, and also to orientate and to provide landmarks in the hospital landscape. Air, the use of natural ventilation as much as possible, complemented by mechanical ventilation in most cases, particularly in northern Europe; the emphasis...
Burkitt's lymphoma of the head and neck region in a Nigerian tertiary. Hospital ... Some complications of treatment were noted. Discussion: ..... Cancer. Biother Radiopharm 1999 14: 251-62 (Medline). Reece DE. Evidence based management of Hodgkin's disease. The role of autologous stem cell transplantation. Cancer ...
U.S. Department of Health & Human Services — Unplanned Hospital Visits â provider data. This data set includes provider data for the hospital return days (or excess days in acute care) measures, the unplanned...
University of Rhode Island Geospatial Extension Program — Hospital Facilities information was compiled from several various sources. Main source was the RI Department of Health Facilities Regulation database, License 2000....
U.S. Department of Health & Human Services — A list of hospital ratings for the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS). HCAHPS is a national, standardized survey of hospital...
U.S. Department of Health & Human Services — Hospital Compare has information about the quality of care at over 4,000 Medicare-certified hospitals across the country. You can use Hospital Compare to find...
Gastroenteritis - norovirus; Colitis - norovirus; Hospital acquired infection - norovirus ... fluids ( dehydration ). Anyone can become infected with norovirus. Hospital patients who are very old, very young, or ...
Not long after the word hospitality emerged as a collective noun to describe the commercial provision of services associated with accommodation, drinking and eating, some academics began to investigate the meanings of hospitality and hospitableness. Whilst most academic programme provision related to developing ...
Research in Hospitality Management. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 5, No 1 (2015) >. Log in or Register to get access to full text downloads.
Andrew, R R
A comparative study of costs per bed per day in teaching hospitals affiliated with Monash University compared with large non-teaching metropolitan hospitals (1964 to 1974) shows they are much higher in teaching hospitals. There is no evidence that this is due to the additional costs arising from the clinical schools. Research in the teaching hospitals and the accompanying high professional standards and demands on services are major factors accounting for the difference. Over the decade studied, the resident staff have increased by 77% and other salaried staff by 24%. The index of expenditure for the three teaching hospitals in the decade has increased by 386%.
U.S. Department of Health & Human Services — Welcome to hospitalinspections.org, a website run by the Association of Health Care Journalists (AHCJ) that aims to make federal hospital inspection reports easier...
Smith, Dean G; Clement, Jan P
It remains an open question whether hospital spending on fundraising efforts to garner philanthropy is a good use of funds. Research and industry reports provide conflicting results. We describe the accounting and data challenges in analysis of hospital philanthropy, which include measurement of donations, measurement of fundraising expenses, and finding the relationships among organizations where these cash flows occur. With these challenges, finding conflicting results is not a surprise.
This article looks at a prescribed academic framework for various criteria that serve as a checklist for marketing performance that can be applied to hospital marketing organizations. These guidelines are drawn from some of Dr. Noel Capon of Columbia University's book Marketing Management in the 21st Century and applied to actual practices of hospital marketing organizations. In many ways this checklist can act as a "marketing" balanced scorecard to verify performance effectiveness and develop opportunities for innovation.
College of the Canyons, Valencia, CA.
A project was conducted at College of the Canyons (Valencia, California) to initiate a new 2-year hospitality program with career options in hotel or restaurant management. A mail and telephone survey of area employers in the restaurant and hotel field demonstrated a need for, interest in, and willingness to provide internships for such a program.…
Phipps, Alison; Barnett, Ronald
Academic hospitality is a feature of academic life. It takes many forms. It takes material form in the hosting of academics giving papers. It takes epistemological form in the welcome of new ideas. It takes linguistic form in the translation of academic work into other languages, and it takes touristic form through the welcome and generosity with…
Malnutrition seen in hospitals usually occurs as some form of protein-energy malnutrition (PEM). Primary PEM results from an acute or chronic deficiency of both protein and calories. Secondary PEM, or cachexia, results from a disease or medical condition such as cancer or gastrointestinal disease that alters requirements or impairs utilization of nutrients. This record was migrated from the OpenDepot repository service in June, 2017 before shutting down.
U.S. Department of Health & Human Services — Hospital Outpatient Prospective Payment System (OPPS) Partial Hospitalization Program LDS This file contains select claim level data and is derived from 2010 claims...
U.S. Department of Health & Human Services — A list of hospitals and the availability of structural measures at that hospital. A structural measure reflects the environment in which hospitals care for patients....
U.S. Department of Health & Human Services — A list of hospital ratings for the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS). HCAHPS is a national, standardized survey of hospital...
... medlineplus.gov/ency/patientinstructions/000881.htm Understanding your hospital bill To use the sharing features on this ... help you save money. Charges Listed on Your Hospital Bill A hospital bill will list the major ...
The objectives of a hospital are to improve patient care, while the objectives of a hospital library are to improve services to the staff which will support their efforts. This handbook dealing with hospital administration is designed to aid the librarian in either implementing a hospital library, or improving services in an existing medical…
Anderson, David W.
This paper contributes to a Christian hermeneutic of special education by suggesting the biblical concept of hospitality as a necessary characteristic of classroom and school environments in which students with disabilities and other marginalized students can be effectively incorporated into the body of the classroom. Christian hospitality, seen…
van Lanschot, J. J.; Hulscher, J. B.; Buskens, C. J.; Tilanus, H. W.; ten Kate, F. J.; Obertop, H.
Hospital mortality after esophagectomy has decreased from 29% to 7.5% over the last decades because of improved surgical techniques and better perioperative care. Suggestions have been made that a further decrease in hospital mortality may be achieved by centralization of esophagectomies in high
Wu, Ziqi; Robson, Stephani; Hollis, Brooke
In the last decade, many hospital designs have taken inspiration from hotels, spurred by factors such as increased patient and family expectations and regulatory or financial incentives. Increasingly, research evidence suggests the value of enhancing the physical environment to foster healing and drive consumer decisions and perceptions of service quality. Although interest is increasing in the broader applicability of numerous hospitality concepts to the healthcare field, the focus of this article is design innovations, and the services that such innovations support, from the hospitality industry. To identify physical hotel design elements and associated operational features that have been used in the healthcare arena, a series of interviews with hospital and hotel design experts were conducted. Current examples and suggestions for future hospitality elements were also sought from the experts, academic journals, and news articles. Hospitality elements applied in existing hospitals that are addressed in this article include hotel-like rooms and decor; actual hotels incorporated into medical centers; hotel-quality food, room service, and dining facilities for families; welcoming lobbies and common spaces; hospitality-oriented customer service training; enhanced service offerings, including concierges; spas or therapy centers; hotel-style signage and way-finding tools; and entertainment features. Selected elements that have potential for future incorporation include executive lounges and/or communal lobbies with complimentary wireless Internet and refreshments, centralized controls for patients, and flexible furniture. Although the findings from this study underscore the need for more hospitality-like environments in hospitals, the investment decisions made by healthcare executives must be balanced with cost-effectiveness and the assurance that clinical excellence remains the top priority.
U.S. Department of Health & Human Services — Unplanned Hospital Visits – national data. This data set includes national-level data for the hospital return days (or excess days in acute care) measures, the...
Justesen, Lise; Overgaard, Svend Skafte
-ended approach towards meal experiences. The underlying purpose of The Hospitable Meal Model is to provide the basis for creating value for the individuals involved in institutional meal services. The Hospitable Meal Model was developed on the basis of an empirical study on hospital meal experiences explored......This article presents an analytical model that aims to conceptualize how meal experiences are framed when taking into account a dynamic understanding of hospitality: the meal model is named The Hospitable Meal Model. The idea behind The Hospitable Meal Model is to present a conceptual model...... that can serve as a frame for developing hospitable meal competencies among professionals working within the area of institutional foodservices as well as a conceptual model for analysing meal experiences. The Hospitable Meal Model transcends and transforms existing meal models by presenting a more open...
U.S. Department of Health & Human Services — Unplanned Hospital Visits â state data. This data set includes state-level data for the hospital return days (or excess days in acute care) measures, the unplanned...
The Community Hospital Telehealth Consortium is a unique, forward-thinking, community-based healthcare service project organized around 5 not-for-profit community hospitals located throughout Louisiana and Mississippi...
U.S. Department of Health & Human Services — Hospital Compare is a consumer-oriented website that provides information on how well hospitals provide recommended care to their patients. This information can help...
Justesen, Lise; Overgaard, Svend Skafte
This article presents an analytical model that aims to conceptualize how meal experiences are framed when taking into account a dynamic understanding of hospitality: the meal model is named The Hospitable Meal Model. The idea behind The Hospitable Meal Model is to present a conceptual model...... that can serve as a frame for developing hospitable meal competencies among professionals working within the area of institutional foodservices as well as a conceptual model for analysing meal experiences. The Hospitable Meal Model transcends and transforms existing meal models by presenting a more open......-ended approach towards meal experiences. The underlying purpose of The Hospitable Meal Model is to provide the basis for creating value for the individuals involved in institutional meal services. The Hospitable Meal Model was developed on the basis of an empirical study on hospital meal experiences explored...
U.S. Department of Health & Human Services — Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) Hospital Survey The intent of the HCAHPS initiative is to provide a standardized survey...
Williams, Jr, Elton L
The Community Hospital Telehealth Consortium is a unique, forward-thinking, community-based healthcare service project organized around 5 not-for-profit community hospitals located throughout Louisiana and Mississippi...
This booklet is concerned with radiation safety of radiologist and other hospital personnel. Part 1 deals with properties of radiation in general (especially of ionizing radiation). In part 2, different applications of radiation in hospitals are discussed. Part 3 indicates what to do to make improvements to not totally safe situations in hospitals. (Auth./G.J.P.)
U.S. Department of Health & Human Services — The "Medicare hospital spending per patient (Medicare Spending per Beneficiary)" measure shows whether Medicare spends more, less or about the same per Medicare...
Research in Hospitality Management. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 5, No 1 (2015) >. Log in or Register to get access to full text downloads.
Maximiliano Emanuel Korstanje
Full Text Available Modern studies emphasized on the needs of researching the hospitality as relevant aspects of tourism and hospitality fields. Anyway, these approaches are inextricably intertwined to the industry of tourism and do not take seriously the anthropological and sociological roots of hospitality. In fact, the hotel seems to be a partial sphere of hospitality at all. Under this context, the present paper explores the issue of hospitality enrooted in the political and economic indo-European principle of free-transit which is associated to a much broader origin. Starting from the premise etymologically hostel and hospital share similar origins, we follow the contributions of J Derrida to determine the elements that formed the hospitality up to date.
van der Geest, Sjaak; Finkler, Kaja
The introduction sets out two central ideas around which this collection of articles on hospital ethnography has been organised. The first is that hospitals are not identical clones of a global biomedical model. Hospitals take on different forms in different cultures and societies. Medical views and technical facilities may vary considerably leading to different diagnostic and therapeutic traditions. The second idea, related to the first, is that biomedicine and the hospital as its foremost institution is a domain where the core values and beliefs of a culture come into view. Hospitals both reflect and reinforce dominant social and cultural processes of their societies. The authors further discuss some methodological and ethical complexities of doing fieldwork in a hospital setting and present brief summaries of the contributions, which deal with hospitals in Ghana, South Africa, Bangladesh, Mexico, Italy, The Netherlands, Papua New Guinea, Egypt and Lebanon.
Fox, Lindy P
Inpatient dermatology is emerging as a distinct dermatology subspecialty where dermatologists specialize in caring for patients hospitalized with skin disease. While the main focus of inpatient dermatology is the delivery of top-quality and timely dermatologic care to patients in the hospital setting, the practice of hospital-based dermatology has many additional components that are critical to its success. ©2017 Frontline Medical Communications.
Musau, Steve; Vian, Taryn
Hospitals are vulnerable to corruption. In the U.S., health care fraud has been stimated to cost $60 billion per year, or 3% of total health care expenditures - much of it in the hospital sector. Hospitals account for 50% or more of health care pending in many countries. Fraud and corruption in hospitals negatively affect access and quality, as public servants make off with resources which could have been used to reduce out-of-pocket expenditures for patients, or improve needed services. This...
Justesen, Lise; Gyimóthy, Szilvia; Mikkelsen, Bent Egberg
Hospital meals have increasingly become part of the political and scientific agenda of the welfare discussions in Denmark and other European countries. This article employs non-representational theory to analyse hospitalityscapes in order to explore opportunities for adding value to the hospital...... meal experience. By drawing on research carried out in two Danish hospital wards, this article explores how hospitalityscapes are socio-materially constructed. The research strategy was based on performative participant observations, visual ethnography and semi-structured interviews. The empirical data...... that a focus on disruptive micro-events might create opportunities for hospitalityscapes and add value to future hospital meal experiences....
Prynne, T. A.
Designed for both hospital personnel interested in television and audiovisual personnel entering the medical field, this handbook is a verbal and pictorial survey of what is being done with TV within the medical profession. After an introduction which answers technical questions about medical TV posed during the American Hospital Association's…
The Northern Arizona Hospitality Education Program is an exemplary three-year project designed to help students, mainly Indian, obtain job skills and attitudes necessary for successful employment in the hospitality industry. Nine high schools from Apache, Coconino, and Navajo Counties participated in the project. Objectives included providing an…
Texas Tech Univ., Lubbock. Home Economics Curriculum Center.
This guide, which was developed as part of Texas' home economics education program, is intended to assist teachers of a hospitality services course focusing on the food and lodging segments of the hospitality and tourism industry. The first 40% of the approximately 600-page guide consists of strategies for teaching each of 29 essential…
Texas Tech Univ., Lubbock. Home Economics Curriculum Center.
This reference book provides information needed by employees in hospitality services occupations. It includes 29 chapters that cover the following topics: the hospitality services industry; professional ethics; organization and management structures; safety practices and emergency procedures; technology; property maintenance and repair; purchasing…
An increasing number of hospitals are undertaking external revenue-generating activities to supplement their shrinking budgets. Written at the request of Leadership, this article outlines an example of a successful catering service -- a money-generating business that more Canadian hospitals could profitably consider.
Prætorius, Thim; Hasle, Peter; Edwards, Kasper
Hospitals are increasingly faced with conflicting demands as they have to respond to increasing patient demands as well as financial, clinical and quality challenges. To handle these demands the hospital need to reconfigure its organization, and we propose to build on a concept for the collaborat......Hospitals are increasingly faced with conflicting demands as they have to respond to increasing patient demands as well as financial, clinical and quality challenges. To handle these demands the hospital need to reconfigure its organization, and we propose to build on a concept...... for the collaborative hospital as new organizational form which is better equipped to respond to the challenges facing modern hospitals. The collaborative hospital is an ambidextrous organization that opens for pursuing both exploration and exploitation within the same organizational structure. The basic principles...... of the collaborative hospital concern the creation of an appropriate balance between standardization and local autonomy, shared purpose centred around providing the best possible care, and use of enabling structures that sustain the new ways of collaborative work. The chapter builds on the theoretical framework...
Giraldo Valencia, Juan Carlos; Delgado, Liliana Claudia
There are forces that are greater than the individual performance of each hospital institution and of the health system structural of each country. The world is changing and to face up to the future in the best possible way, we need to understand how contexts and emerging trends link up and how they affect the hospital sector. The Columbian Association of Hospitals and Clinics, ACHC, has thus come up with the Hospital 360° concept which uses hospitals capable of anticipating changing contexts by means of the transition between present and future and takes on board the experience of global, socio-economic, demographic, political, environmental and technological fields as its model. Hospital 360° is an invitation to reinvent processes and institution themselves allowing them to adapt and incorporate a high degree of functional flexibility. Hospital 360° purses goals of efficiency, effectiveness and relevance, but also of impact and sustainability, and is coherent with the internal needs of hospital institutions and society for long-term benefits.
interpersonal relationships, virtue, rites and commercial/non-commercial exchange. In doing so it ... aspects of hospitality, and the approach of the social sciences, which study the dynamics of hospitality within the context of relationships in ..... in the virtual media, the ritual always begins with an invitation or a request to be ...
Current state. Traditionally hospital systems. especially in the government sector, have been unable to provide management with the necessary timely and meaningful information with which to manage. In the public sector the hospitals are almost totally devoid of useful ongoing information. Managers are not in a position.
California State Dept. of Education, Sacramento. Bureau of Homemaking Education.
This curriculum guide on the hospitality occupations was developed to help secondary and postsecondary home economics teachers prepare individuals for entry-level jobs in the hospitality industry. The content is in seven sections. The first section presents organizational charts of a medium-size hotel, food and beverage division, housekeeping and…
... Imaging Encyclopedia of Pediatric Thoracic Disease Virtual Pediatric Hospital is the Apprentice's Assistant Last revised on February ... GeneralPediatrics.com | PediatricEducation.org | SearchingPediatrics.com Virtual Pediatric Hospital is curated by Donna M. D'Alessandro, M. ...
Research in Hospitality Management (RHM) is a peer-reviewed journal publishing articles that make an original contribution to the ... study for hospitality refers to a more disciplinary approach according to the quintessential managerial areas of Finance, Human Resources, Operations, Marketing & Sales, and Technology;.
Corporate Policy. Approved by the Management Executive Committee. - 1 -. Version 3.0.1 effective 2016-05-01. Official Centre Hospitality. 1. Objective. 2. ... and social interaction. 4. Roles and Responsibilities ... Authorization. The prime level of managerial responsibility for authorizing hospitality expenses rests with the.
Although specialists in hospitality have worked extensively on hospitality with respect to relations between different nations or between nations and individuals of a different nationality, for instance when they seek asylum, Jacques Derrida preferred to focus instead upon the relationship between...... the guest and the host. This has provided a much-needed rethinking of how to understand hospitality as a way of relating, as an ethics and as a politics. Within this work, there have often appeared discussions of ‘spaces of hospitality’, but these spaces have remained largely abstract. This is where...... this paper comes in: It will re open discussions of spaces of hospitality with an introduction into an on-going research project that studies the performative, structural and social dynamics of cultural encounters focusing on forms of hospitality that are related to particular sites in the city, namely...
this paper comes in: It will re open discussions of spaces of hospitality with an introduction into an on-going research project that studies the performative, structural and social dynamics of cultural encounters focusing on forms of hospitality that are related to particular sites in the city, namely......Although specialists in hospitality have worked extensively on hospitality with respect to relations between different nations or between nations and individuals of a different nationality, for instance when they seek asylum, Jacques Derrida preferred to focus instead upon the relationship between...... the guest and the host. This has provided a much-needed rethinking of how to understand hospitality as a way of relating, as an ethics and as a politics. Within this work, there have often appeared discussions of ‘spaces of hospitality’, but these spaces have remained largely abstract. This is where...
Kraetschmer, Nancy; Jass, Janak; Woodman, Cheryl; Koo, Irene; Kromm, Seija K; Deber, Raisa B
This study aimed to enhance understanding of the dimensions of accountability captured and not captured in acute care hospitals in Ontario, Canada. Based on an Ontario-wide survey and follow-up interviews with three acute care hospitals in the Greater Toronto Area, we found that the two dominant dimensions of hospital accountability being reported are financial and quality performance. These two dimensions drove both internal and external reporting. Hospitals' internal reports typically included performance measures that were required or mandated in external reports. Although respondents saw reporting as a valuable mechanism for hospitals and the health system to monitor and track progress against desired outcomes, multiple challenges with current reporting requirements were communicated, including the following: 58% of survey respondents indicated that performance-reporting resources were insufficient; manual data capture and performance reporting were prevalent, with the majority of hospitals lacking sophisticated tools or technology to effectively capture, analyze and report performance data; hospitals tended to focus on those processes and outcomes with high measurability; and 53% of respondents indicated that valuable cross-system accountability, performance measures or both were not captured by current reporting requirements. Copyright © 2014 Longwoods Publishing.
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...
Justesen, Lise; Strøjer, Anna-Lise
on an experimental design, in which 10 bachelor students in Nutrition and Health organized and participated as both hosts and guests in four self-selected meal events. The events included a Housing Community event, a Children’s Birthday party, an Art Exhibition event and a Family Easter lunch. Based on a semi......Abstract: There is a growing interest in articulating institutional meal serving practices as a hospitality activity involving host and guest interactions. This study aims to qualify institutional hospitality and meal activities by exploring private hospitality events. The study is based...... was transformed into a guest. Information on purpose of the event and other information given in the invitation were part of this process. Furthermore, hospitality activities could be characterized by blurred host-guest relations and by being able to embrace unexpected events as well. The activities were...
U.S. Department of Health & Human Services — Section 6001 of the Affordable Care Act of 2010 amended section 1877 of the Social Security Act to impose additional requirements for physician-owned hospitals to...
U.S. Department of Health & Human Services — To provide a historical overview of the participating hospitals, before the first project report, Premier Healthcare Informatics has used data already available for...
U.S. Department of Health & Human Services — These are the official datasets used on the Medicare.gov Hospital Compare Website provided by the Centers for Medicare and Medicaid Services. These data allow you to...
U.S. Department of Health & Human Services — Section 4523 of the Balanced Budget Act of 1997 (BBA) provides authority for CMS to implement a prospective payment system (PPS) under Medicare for hospital...
Vermont Center for Geographic Information — (Link to Metadata) This data layer contains point locations of all major community, regional, comprehensive health, and healthcare provider hospitals in the state of...
Allegheny County / City of Pittsburgh / Western PA Regional Data Center — The data on health care facilities includes the name and location of all the hospitals and primary care facilities in Allegheny County. The current listing of...
Research in Hospitality Management. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 5, No 1 (2015) >. Log in or Register to get access to full text downloads.
... Featured Resource Hospital-Community Partnerships to Build a Culture of Health: A Compendium of Case Studies ... Senate Republican Leaders Release Tax Bill (Members-Only) Special Bulletin: CMS Releases CY ...
U.S. Department of Health & Human Services — In October 2012, CMS began reducing Medicare payments for Inpatient Prospective Payment System hospitals with excess readmissions. Excess readmissions are measured...
U.S. Department of Health & Human Services — In October 2012, CMS began reducing Medicare payments for Inpatient Prospective Payment System hospitals with excess readmissions. Excess readmissions are measured...
Research in Hospitality Management. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 6, No 1 (2016) >. Log in or Register to get access to full text downloads.
Research in Hospitality Management. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 1, No 1 (2011) >. Log in or Register to get access to full text downloads.
U.S. Department of Health & Human Services — Use of medical imaging - provider data. These measures give you information about hospitals' use of medical imaging tests for outpatients. Examples of medical...
Özkil, Ali Gürcan
services to maintain the quality of healthcare provided. This thesis and the Industrial PhD project aim to address logistics, which is the most resource demanding service in a hospital. The scale of the transportation tasks is huge and the material flow in a hospital is comparable to that of a factory. We...... believe that these transportation tasks, to a great extent, can be and will be automated using mobile robots. This thesis consequently addresses the key technical issues of implementing service robots in hospitals. In simple terms, a robotic system for automating hospital logistics has to be reliable...... manual work and offer many advantages beyond robotics. Finally, this thesis outlines our contributions in representation of multi-floor buildings, which is a vital requirement to achieve robust and practical, real-world service robot applications....
Nutrition support in hospitals is becoming an area of focus because of the evidence showing improved clinical outcome with nutrition support, its status as a human rights issue and its integration into quality assurance.......Nutrition support in hospitals is becoming an area of focus because of the evidence showing improved clinical outcome with nutrition support, its status as a human rights issue and its integration into quality assurance....
Morrison, A; Lynch, P; Lugosi, P
This paper discusses the development of critical hospitality management research (CHMR) and explores key issues that such approaches raise. The paper is split into two parts. The first reviews contemporary writings that reflect the changing nature of hospitality management research and accounts for the emergence of a critical tradition. The second part identifies eight areas which are central concerns for the future development of CHMR: criticality, ethics and advocacy, scale, claims of legit...
Blok, K.; Ginkel, G. van; Leun, K. van der; Muller, H.; Oude Elferink, J.; Vesseur, A.
This booklet dels with the risks of the use of ionizing radiation for people working in a hospital. It is subdivided in three parts. Part 1 treats the properties of ionizing radiation in general. In part 2 the various applications are discussed of ionizing radiation in hospitals. Part 3 indicates how a not completely safe situation may be improved. (H.W.). 14 figs.; 4 tabs
Stephen W. Litvin
Government policy has a significant impact on the hospitality and tourism industry, but it is unclear if political leaders fully understand this economic sector when crafting policies. This article offers new research about the direct involvement of industry practitioners in the political process, by analyzing the backgrounds of legislators in the six New England states. The data indicate that only 3% of these legislators have current or former careers related to hospitality and tourism. The ...
Manish Kumar Manar
Full Text Available Objective: To assess hospital waste management in nonteaching hospitals of Lucknow city. Materials and Methods: A cross-sectional, descriptive study was conducted on the staffs of nonteaching hospitals of Lucknow from September 2012 to March 2013. A total of eight hospitals were chosen as the study sample size. Simple random sampling technique was used for the selection of the nonteaching hospitals. A pre-structured and pre-tested interview questionnaire was used to collect necessary information regarding the hospitals and biomedical waste (BMW management of the hospitals. The general information about the selected hospitals/employees of the hospitals was collected. Results: Mean hospital waste generated in the eight nonteaching hospitals of Lucknow was 0.56 kg/bed/day. About 50.5% of the hospitals did not have BMW department and colored dustbins. In 37.5% of the hospitals, there were no BMW records and segregation at source. Incinerator was used only by hospital A for treatment of BMW. Hospital G and hospital H had no facilities for BMW treatment. Conclusion: There is a need for appropriate training of staffs, strict implementation of rules, and continuous surveillance of the hospitals of Lucknow to improve the BMW management and handling practices.
Hospitals that hire contract service firms to manage one or all aspects of their hospitality service departments increasingly expect those firms to help meet total quality management goals as well as offer the more traditional cost reduction, quality improvement and specialized expertise, finds the 1992 Hospital Contract Services Survey conducted by Hospitals.
In the counselling of patients by the hospital social service, personal assistance and initiation of medical, vocational and social rehabilitation measures are intertwined. Counselling methods, scope, contents and goals are determined by the objective medical facts at hand as well as the subjective needs present in the individual case, and are limited by the structure of the hospital and its responsibility for acute care. Complementary to person- and problem-centered counselling with patients and their relatives as the nucleus of psychosocial coping with illness and disability, the hospital social service cooperates with the whole range of clinical professions involved in the individual case in reintegrating the patient, in particular with the physicians in charge of establishing the indication for rehabilitative measure, as well as with the entire range of rehabilitation carriers, with extra-clinical facilities and services within the health care/social protection system. Evaluation, which would be necessary in view of outcome control and increased effectiveness of the counselling services provided in the hospital, does not occur so far. (Case examples are given to illustrate hospital-based counselling work.)
Haberey-Knuessi, Véronique; Heeb, Jean-Luc; De Morgan, Paula Emilie
New management styles imposed on hospital institutions in recent years, have fundamentally changed the organization of the latter. Many texts discuss the consequences, specifically on the field of communication. The aim of this study was to understand the real impact of new management methods on communication by managers in hospital, but also on care teams in termes of satisfaction and/or stress. This two-year study was conducted among 900 executives in hospitals in Western Switzerland using a mixed methodology. A first phase of questionnaires highlighted the problematic areas, while a second phase in the form of organized group interviews in each hospital, had the objective of achieving a better understanding of the relationship between management and communication. The latter proved to be particularly significant in terms of results, and this is the one we focused on in this article.These results indeed show that a crucial role is given to communication by carers, and, at the same time a lessening of the time devoted to relationships, both among peers and with patients. Frustration then arises, which is not without consequences both for the management of patients and the institutions themselves. It is by means of these results that awareness is raised of the omnipresence of communication at all levels and the major advantages that positive dynamic supports. And, on the contrary, of the serious problems which may arise from management practice that do not give due importance to the dimension of communication, present in all sectors of the hospital.
Full Text Available Byrne’s paper consists of two parallel texts. The first explores the limits of cosmopolitanism in practice, taking as its subject the Life in the UK Citizenship Test, inaugurated under the Labour Government in 2005. It argues that the test exemplifies the predicament of all attempts at cosmopolitan hospitality as unconditional welcoming, through a discussion of the relation between questioning and welcoming the stranger. Establishing the relationship between cosmopolitanism and hospitality as envisaged in Derrida’s reading of Kant it asks what kind of cosmopolitan hospitality is either possible or desirable by exploring what Derrida calls the ‘perversions’ inherent in the structures of hospitality. It focuses on the concept of the ‘trick questions’ that the state asks the foreigner observed by Derrida in his reading of The Apology of Socrates; questions that seem to invite answers but foreclose the possibilities of a free response. The second text asks how this logic that Derrida identifies can be pushed or coaxed into new ways of addressing the perceived threats of ‘unconditional’ hospitality through a reading of ‘unconditional hospitality’ as queer in the work of Tove Jansson.
Stephen W. Litvin
Full Text Available Government policy has a significant impact on the hospitality and tourism industry, but it is unclear if political leaders fully understand this economic sector when crafting policies. This article offers new research about the direct involvement of industry practitioners in the political process, by analyzing the backgrounds of legislators in the six New England states. The data indicate that only 3% of these legislators have current or former careers related to hospitality and tourism. The author suggests that practitioners should seek election to political office, to better influence government policy.
Many librarians do not see themselves as marketers, but marketing is an essential role for hospital librarians. Library work involves education, and there are parallels between marketing and education as described in this article. It is incumbent upon hospital librarians actively to pursue ways of reminding their customers about library services. This article reinforces the idea that marketing is an element in many of the things that librarians already do, and includes a list of suggested marketing strategies intended to remind administrators, physicians, and other customers that they have libraries in their organizations.
Hospital mergers in Europe and North America have been launched to scale down expenditure, enhance the delivery of health care and elevate quality. However, the outcome of mergers suggest that they neither generated cost savings nor improved the quality of care. Almost all consolidations fall short, since those in leadership positions lack the necessary understanding and appreciation of the differences in culture, values and goals of the existing facilities. In spite of these shortcomings, hospital mergers will continue to be pursued in order to improve market share, eliminate excess capacity, gain access to capital and enhance the personal egos of the organizations' leaders.
Caracuel García, Ángel Manuel
Normalization can be understood as the establishing measures against repetitive situations through the development, dissemination, and application of technical design documents called standards. In Andalusia there are 45 public hospitals with 14,606 beds, and in which 11,700 full pensions / day are served. The Working Group on Hospital Food Standardization of the Andalusian Society for Clinical Nutrition and Dietetics, started in 2010, working on the certification of suppliers, product specifications, and meals technical card. - Develop a specific tool to help improving food safety through the certification of their suppliers. - Develop a standardized technical specifications of foodstuffs necessary for the development of menus established codes diets Andalusian hospitals document. - Develop a catalog of data sheets plates of hospital meals, to homogenize menus, respecting local and unifying criteria for qualitative and quantitative ingredients. - Providing documentation and studying of several public hospitals in Andalusia: • Product specifications and certification of suppliers. • International standards certification and distribution companies. • Legislation. • Data sheets for the menu items. • Specifications of different product procurement procedures. - Development of the draft standard HOSPIFOOD®, and approval of the version “0.0”. - Training course for auditors to this standard. - Development of a raw materials catalog as technical cards. - Meals Technical cards review and election of the ones which will be part of the document. After nearly three years of work, we have achieved the following products: - Standardized database of technical specifications for the production of food dietary codes for: fish, seafood, meat and meat products, meats and pates, ready meals, bread and pastries, preserves, milk and dairy products, oils, cereals, legumes , vegetables, fruits, fresh and frozen vegetables, condiments and spices. - Standardized database of
Tvedebrink, Tenna Doktor Olsen; Fisker, Anna Marie; Kirkegaard, Poul Henning
This poster presents a series of drawings depicting the initial considerations made with the Ph.D. project for an improved ‘Interior Design for Food’ in a Danish hospital ward. The project concerns a study on the ontological and symbolic interrelationship possibly existing between food and archit......This poster presents a series of drawings depicting the initial considerations made with the Ph.D. project for an improved ‘Interior Design for Food’ in a Danish hospital ward. The project concerns a study on the ontological and symbolic interrelationship possibly existing between food...
Poulsen, Signe; Jørgensen, Michael Søgaard
also identified. Research limitations: The assessment of the dietary changes based on the canteen take-away food was only based on indirect assessments based on interviews with users and non-users and furthermore based on a questionnaire at one of the hospitals. Value/originality: Canteen take......Purpose: To analyse the interaction between hospital employees’ working conditions, and their health and dietary habits, including the role of canteen take-away schemes. Design/Methodology/approach: An international literature review combined with case studies based on stakeholder research...
Glenn A. Melnick PhD
Full Text Available A surge in hospital consolidation is fueling formation of ever larger multi-hospital systems throughout the United States. This article examines hospital prices in California over time with a focus on hospitals in the largest multi-hospital systems. Our data show that hospital prices in California grew substantially (+76% per hospital admission across all hospitals and all services between 2004 and 2013 and that prices at hospitals that are members of the largest, multi-hospital systems grew substantially more (113% than prices paid to all other California hospitals (70%. Prices were similar in both groups at the start of the period (approximately $9200 per admission. By the end of the period, prices at hospitals in the largest systems exceeded prices at other California hospitals by almost $4000 per patient admission. Our study findings are potentially useful to policy makers across the country for several reasons. Our data measure actual prices for a large sample of hospitals over a long period of time in California. California experienced its wave of consolidation much earlier than the rest of the country and as such our findings may provide some insights into what may happen across the United States from hospital consolidation including growth of large, multi-hospital systems now forming in the rest of the rest of the country.
haematocrit, cord bilirubin, number of liveborn babies, birth weight, neonatal death, hyaline membrane disease .... report the outcome of babies of mothers with severe. Rh disease treated at Tygerberg Hospital since 1980 by ..... Walker W. Haemolytic disease of the newborn. In: Gairdner D, Hull 0, eds. Recent Advances iD ...
Responsible Hospitality (RH)--also called Responsible Beverage Service (RBS)--encompasses a variety of strategies for reducing risks associated with the sale and service of alcoholic beverages. RH programs have three goals: (1) to prevent illegal alcohol service to minors; (2) to reduce the likelihood of drinkers becoming intoxicated; and (3) to…
... the mattress end Subscribe: FDA Consumer Health Information "Hospital beds are found in nearly all patient care settings or environments," says Joan Ferlo Todd, RN, a senior nurse-consultant at the Food and Drug Administration’s (FDA) Center for Devices and Radiological Health (CDRH). " ...
It also publishes miscellaneous articles – hospital administration, business practice, accounting, Law for health practitioners and letters about published papers. All manuscript will be subject to blinded peer-review and the decision of the editor would be final. Articles submitted for consideration by the author should not have ...
Dzhandzhugazova, Elena A.; Blinova, Ekaterina A.; Orlova, Liubov N.; Romanova, Marianna M.
The article focuses on the study of the role and importance of innovation, its classification, the problems of its application in the hotel industry with emphasis on the application of sensory marketing tools in the development of the innovative marketing mix within the hospitality industry. The article provides an analysis of the "seven…
Holst, Malene Kirstine
This PhD project presents a design model that generates and evaluates hospital designs with respect to long-term performances and functionalities. By visualizing and quantifying costs and performances in the early design phases, it is possible to make design choices based on a qualified, profound...
Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives. Journal Homepage Image. The aim of the Nigerian Hospital Practice Journal is to aid in enhancing the advancement of medicine globally by acting as a medium for disseminating information on current clinical and drug practices in ...
Full Text Available En los alrededores de Belfast, en Dundonals (Inglaterra, se construirá en breve el nuevo hospital Ulster. El nuevo edificio, de cuya maqueta mostramos unas fotos, está formado por diversos cuerpos de distinta función enlazados por pasillos cubiertos que determinan la creación de patios íntimos y zonas ajardinadas.
Tihomira Zlatanova; Ralitsa Zlatanova-Velikova; Angelina Cheshmedzieva; Natalia Shtereva
In this article are presented and analyzed planning of hospital activity. Introduced planning process depending on the type of health care system - countries with national health systems there is a tendency to set targets backed by norms, while in countries with fully or partially liberalized system developed a variety of techniques for strategic planning.
... in the case of mountainous terrain or secondary roads). This provision excludes Rural Health Clinics, as defined under 405.2401(b), ... HUD Section 242: Hospital Mortgage Insurance Program – helps rural healthcare facilities finance new construction, refinance debt, or purchase new equipment such as ...
Boisen, Kirsten A; Boisen, Anne Bank; Thomsen, Stine Legarth
BACKGROUND: There is a need for youth-friendly hospital environments as the ward environment may affect both patient satisfaction and health outcomes. OBJECTIVE: To involve young people in designing youth-friendly ward environment. METHODS: We arranged a design competition lasting 42 h (Hackathon...
Approved by the Management Executive Committee. - 1 -. Version 3.1.0 effective 2017-06-28. Official Centre Hospitality. 1. Objective. 2. Application. 3. Definitions. 4. Roles and Responsibilities. 5. Authorization. 6. Consultants and Contractors. 7. Reimbursement. 1. Objective. To define the circumstances under which ...
... have playrooms, where you'll find toys, books, arts and crafts, and games. Someone will be there to help you find something to do. If you can't go to the playroom, someone can bring toys to your room. Most hospitals have TVs or video games, and many have computers (with games!) that ...
José Félix Patiño-Restrepo
Full Text Available Según el Diccionario de la Real Academia Española (1, el vocablo hospital viene del latín hospitālis y en su primera acepción se define como: “1. m. Establecimiento destinado al diagnóstico y tratamiento de enfermos, donde a menudo se practican la investigación y la docencia”. Sin embargo, las otras acepciones se refieren a sus orígenes medievales: “2. m. Casa que servía para recoger pobres y peregrinos por tiempo limitado. 3. adj. ant. Afable y caritativo con los huéspedes. 4. adj. ant. Perteneciente o relativo al buen hospedaje”. El hospital moderno, en realidad, es la combinación de ciencia, tecnología, hospedaje y humanitarismo. ¿Cuándo nació el hospital y cuál es su historia? En la Edad Media temprana surgieron los xenodochia, albergues para pobres y peregrinos fundados por la iglesia católica en el marco del sentido humanitario del cristianismo. En los comienzos del siglo XIII, cuando las ciudades acumularon riqueza para sostener sus propios ejércitos, se presentó un fenómeno de crecimiento en el número de albergues y estos empezaron a caracterizarse por atender enfermos; ya para esta época no eran solo fundados por la iglesia, sino también por autoridades civiles. Aunque se siguió el modelo del Hospital del Santo Spirito de Roma, construido por orden del papa Inocencio III (1161-1216, en Francia se fundaron los Hôtel-Dieu, generalmente en la vecindad de las catedrales, que aún conservaban la característica de ser más bien albergues para los más necesitados y desamparados.
Milanović, Jasmina; Milenković, Sanja; Pavlović, Momcilo; Stojanović, Dragos
This year Zemun Hospital--Clinical Hospital Center Zemun celebrates 230th anniversary of continuous work, thus becoming the oldest medical facility in Serbia.The exact date of the hospital founding has been often questioned in history. Various dates appeared in the literature, but the most frequent one was 25th of February 1784. Until now, the document which confirms this has never been published. This article represents the first official publication of the document which confirms that Zemun Hospital was indeed founded on this date. The first hospitals started emerging in Zemun when the town became a part of the Habsburg Monarchy. The first sanitary facility ever formed was the"Kontumac"--a quarantine established in 1730. Soon after, two more confessional hospitals were opened.The Serbian (Orthodox) Hospital was founded before 1769, whereas the German (Catholic) Hospital started working in 1758. Both hospitals were financed, amongst others, by the Town Hall--the Magistrate. In order to improve efficiency of these hospitals, a decision was made to merge them into a single City Hospital. It was founded on 25th February 1784, when the General Command ordered the Magistrate of Zemun to merge the financess of all existing hospitals and initiate the construction of a new building. Although financially united, the hospitals continued working in separate buildings over a certain period of time.The final, physical merging of these hospitals was completed in 1795.
Santos, Thiago R; Penm, Jonathan; Baldoni, André O; Ayres, Lorena Rocha; Moles, Rebekah; Sanches, Cristina
This study aims to describe the distribution of the hospital pharmacy workforce in Brazil. Data were acquired, during 2016, through the Brazilian National Database of Healthcare Facilities (CNES). The following variables were extracted: hospital name, registry number, telephone, e-mail, state, type of institution, subtype, management nature, ownership, presence of research/teaching activities, complexity level, number of hospital beds, presence of pharmacists, number of pharmacists, pharmacist specialization. All statistical analyses were performed by IBM SPSS v.19. The number of hospitals with a complete registry in the national database was 4790. The majority were general hospitals (77.9%), managed by municipalities (66.1%), under public administration (44.0%), had no research/teaching activities (90.5%), classified as medium complexity (71.6%), and had no pharmacist in their team (50.6%). Furthermore, almost 60.0% of hospitals did not comply with the minimum recommendations of having a pharmacist per 50 hospital beds. The Southeast region had the highest prevalence of pharmacists, with 64.4% of hospitals having a pharmaceutical professional. This may have occurred as this region had the highest population to hospital ratio. Non-profit hospitals were more likely to have pharmacists compared to those under public administration and private hospitals. This study mapped the hospital pharmacy workforce in Brazil, showing a higher prevalence of hospital pharmacists in the Southeast region, and in non-profit specialized hospitals.
Information is an increasingly important resource in an academic hospital. Effective planning and control of this resource are essential in order to maximize its usefulness. Tile HOspital Information Planning Study (HIPS) undertaken at Groote Schuur Hospital, and based on. the Business Systems Planning (BSP) ...
Background: Out-of-hospital death among children living in resource poor settings occurs frequently. Little is known about the location and circumstances of child death following a hospital discharge. Objectives: This study aimed to understand the context surrounding out-of-hospital deaths and the barriers to accessing ...
Toode, Kristi; Routasalo, Pirkko; Helminen, Mika; Suominen, Tarja
The knowledge surrounding nurses' work motivation is currently insufficient, and previous studies have rarely taken into account the role of many influential background factors. This study investigates the motivation of Estonian nurses in hospitals, and how individual and organisational background factors influence their motivation to work. The study is quantitative and cross-sectional. An electronically self-reported questionnaire was used for data collection. The sample comprised of 201 Registered Nurses working in various hospital settings in Estonia. Data were analysed using descriptive statistics, two-sample Wilcoxon rank-sum (Mann-Whitney) test, Kruskal-Wallis equality-of-populations rank test and Spearman's correlation. Both extrinsic and intrinsic motivations were noted among hospital nurses. Nurses were moderately externally motivated (M = 3.63, SD = 0.89) and intrinsically strongly motivated (M = 4.98, SD = 1.03). A nurses' age and the duration of service were positively correlated with one particular area of extrinsic work motivation, namely introjected regulation (p motivation (p = 0.016) and intrinsic work motivation (p = 0.004). The findings expand current knowledge of nurses' work motivation by describing the amount and orientation of work motivation among hospital nurses and highlighting background factors which should be taken into account in order to sustain and increase their intrinsic work motivation. The instrument used in the study can be an effective tool for nurse managers to determine a nurse's reasons to work and to choose a proper motivational strategy. Further research and testing of the instrument in different countries and in different contexts of nursing is however required. © 2014 Nordic College of Caring Science.
Earth Data Analysis Center, University of New Mexico — Hospitals in New Mexico The term "hospital" ... means an institution which- (1) is primarily engaged in providing, by or under the supervision of physicians, to...
Holst, Malene Kirstine; Kirkegaard, Poul Henning; Christoffersen, L.D.
Present paper presents a parametric performancebased design model for optimizing hospital design. The design model operates with geometric input parameters defining the functional requirements of the hospital and input parameters in terms of performance objectives defining the design requirements...
Throughout the past 30 years, there has been a lot of controversy surrounding the proliferation of new forms of health care delivery organizations that challenge and compete with general NFP community hospitals. Traditionally, the health care system in the United States has been dominated by general NFP (NFP) voluntary hospitals. With the number of for-profit general hospitals, physician-owned specialty hospitals, and ambulatory surgical centers increasing, a question arises: “Why is the general NFP community hospital the dominant model?” In order to address this question, this paper reexamines the history of the hospital industry. By understanding how the “general NFP hospital” model emerged and dominated, we attempt to explain the current dominance of general NFP hospitals in the ever changing hospital industry in the United States.
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.
ABSTRACT This paper reflects the application of visual methodologies adapted in an explorative study on hospitality and hospital meals. It takes point of departure in a multi-sited ethnographic fieldwork placed at a general hospital in 2012. Visual methodologies were applied in multiple ways....... This includes visual methodologies as part of observation and interview strategies. The paper presents and discusses how the application of different visual methodologies can contribute to the construction of ethnographical knowledge on hospitality and hospital meals. Finally ethical considerations as well...
Holst, Malene Kirstine; Kirkegaard, Poul Henning; Christoffersen, Lars D.
The present paper surveys the input parameters in hospital design and describes them formally as building attributes in preparation for facilitating planning and designing of hospitals with the aim of a more optimal design process. The overview of the hospital functionalities, bonds, logistics...... and needs is based on an approach of understanding the complexity of the hospital functionalities based on capacities, qualities and times beforehand specific department or units are described. This approach attempts to create an overview of the hospital functionalities respecting capacities, qualities...
Johnson, Eric D. M.; Kazmer, Michelle M.
Library scholars and practitioners have frequently reflected on the various factors that in combination make up a hospitable library, but there has been little theoretical synthesis of the notion of the library as a place of hospitality. The hospitality industry provides a rich vein of theoretical material from which to draw definitions of…
Purpose: The purpose of this paper is to explore current strands in hospitality management education and research, and suggest that future programs should reflect a more social science informed content. Design/methodology/approach: The paper reviews current research in hospitality management education and in the study of hospitality and…
Haswell, Janis; Haswell, Richard; Blalock, Glenn
There has been little discussion of hospitality as a practice in college writing courses. Possible misuses of hospitality as an educational and ethical practice are explored, and three traditional and still tenable modes of hospitality are described and historicized: Homeric, Judeo-Christian, and nomadic. Application of these modes to…
Texas Tech Univ., Lubbock. Home Economics Curriculum Center.
This student activity book contains pencil-and-paper activities for use in a hospitality services course focusing on the food and lodging segments of the hospitality and tourism industry. The activities are organized into 29 chapters on the following topics: hospitality services industry; professional ethics; organization/management structures in…
Justesen, Lise; Gyimóthy, Szilvia; Mikkelsen, Bent E.
Hospital meals and their role in nutritional care have been studied primarily from a life and natural science perspective. This article takes a different approach and explores the idea of hospitality inspired by Jacques Derrida’s work on the ontology of hospitality. By drawing on ethnographic fie...... and management involved in hospital food service and in nutritional care to work more systematically with the environment for improved hospital meal experiences in the future......Hospital meals and their role in nutritional care have been studied primarily from a life and natural science perspective. This article takes a different approach and explores the idea of hospitality inspired by Jacques Derrida’s work on the ontology of hospitality. By drawing on ethnographic...... fieldwork in a Danish hospital, hospitality practices were studied using a socio-material assemblage approach. The study showed that rethinking the meal event could change the wards into temporary “pop-up-restaurants,” transcending the hospital context and providing a scene for shifting host...
Full Text Available Background: There has been conflicting data on whether Nursing Magnet Hospitals (NMH provide better care. Methods: NMH in the Southwest USA (Arizona, California, Colorado, Hawaii, Nevada, and New Mexico were compared to hospitals not designated as NMH using the Centers for Medicare and Medicaid (CMS hospital compare star designation. Results: NMH had higher star ratings than non-NMH hospitals (3.34 + 0.78 vs. 2.86 + 0.83, p<0.001. The hospitals were mostly large, urban non-critical access hospitals. Academic medical centers made up a disproportionately large portion of the NMH. Conclusions: Although NMH had higher hospital ratings, the data may favor non-critical access academic medical centers which are known to have better outcomes.
Strategic management is concerned with strategic choices and strategic implementation; it provides the means by which organizations meet their objectives. In the case of hospitals it helps executives and all employees to understand the real purpose and long term goals of the hospital. Also, it helps the hospital find its place in the health care service provision chain, and enables the hospital to coordinate its activities with other organizations in the health care system. Strategic management is a tool, rather than a solution, that helps executives to identify root causes of major problems in the hospital.
Knoll, K H
For the classification of hospital-wastes in the categories infectious-contaminate or special waste are only significant views of the prevention by nosocomial infection in the hospital. Solely infectious waste become removed hospital-intern and -extern on conditions of hygienic prevention, namely through secure packing during the transport, combustion or desinfection. Special wastes to be defeated by special-conditions. The hygienist of the hospital is only competent for the classification of the wastes in the hospital as well as for their refuse.
Frandsen, F; Nielsen, J R; Gram, L
of treatment include: 1. Information to the population. 2. Training of first-aid staff in treatment of cardiac arrest. 3. Quicker arrival of ambulances and 4. Better staffing and training of ambulance staff in the use of a defibrillator possibly with participation of a doctor....... arrest for less than six minutes and staffing of the ambulance with three first-aid men were factors of decisive importance for survival of the patients. The results of this investigation demonstrate that treatment of cardiac arrest outside hospital is unsatisfactory. Proposals for improvement...
Ludvigsen, Mette Spliid
Patient life in hospital.A qualitative study of informal relationships between hospitalised patients Introduction Within a patientology framework, this PhD dissertation is about an empirical study on patient life that provides insight into the nature of informal relationships between patients...... and nine females were selected for qualitative interviews. The analysis involved a phenomenological hermeneutic analytical three-stage method. Findings The personal experience of waiting expresses itself in patients' interactions and behaviour that communicate an emplotted message of waiting. The most...
McCue, Michael J; Thompson, Jon M; Kim, Tae Hyun
The hospital industry has experienced increased consolidation in the past 20 years. Since 2010, in particular, there has been a large rise in the number of hospital acquisitions, and observers have suggested this is due in part to the expected impact of federal healthcare reform legislation. This article reports on a study undertaken to identify the market, management, and financial factors affecting acute care, community hospitals acquired between 2010 and 2012. We identified 77 such hospitals and compared them to other acute care facilities. To assess how different factors were associated with acquisitions, the study used multiple logistic regressions whereby market factors were included first, followed by management and financial factors. Study findings show that acquired hospitals were located in markets with lower rates of preferred provider organization (PPO) penetration compared with nonacquired hospitals. Occupancy rate was found to be inversely related to acquisition rate; however, case-mix index was significantly and positively related to a hospital's being acquired. Financial factors negatively associated with a hospital's being acquired included age of plant and cash flow margin. In contrast to the findings from earlier studies of hospital acquisitions, our results showed that acquired hospitals possessed newer assets. However, similar to the findings of other studies, the cash flow margin of acquired hospitals was lower than that of nonacquired facilities.
Martha Isabel Riaño-Casallas
Full Text Available Introduction: There are several approaches and schools that support strategic management processes. University hospitals require the implementation of a strategic approach to their management, since they are a particular type of organization with the triple mission of providing health care, education and research. Objective: To propose a strategic profile for a university hospital. Materials and methods: The theoretical framework of strategic management was analyzed and some particular components of hospital management were studied; based on these criteria, the strategic management process in three high complexity hospitals of Bogotá, D.C. was examined and a profile of both the objectives and the functional strategies for the hospital was proposed. Results: The main strategic thinking schools are presented; the processes and components of strategic management are described, and a strategic management profile for a university hospital is proposed. Conclusion: The strategic orientation of management for an institution with the characteristics of a university hospital facilitates achieving organizational objectives.
Rózańska, Anna; Wójkowska-Mach, Jadwiga; Bulanda, Małgorzata; Heczko, Piotr B
The aim of this work is to analyze epidemiology of hospital acquired infections in Polish hospitals, according to type and size of hospital. Data gathered between year 2002 and 2004 in the Active Nosocomial Infections Surveillance System, developed and conducted by Polish Society of Hospital Infections, were used in the analysis. Epidemiology of PNEU was described with the usage of cumulative incidence and incidence density rates. The average cumulative incidence rate was 0.29%; incidence density rate: 0.41 per thousand, and incidence density among ventilated patients: 1.57 per thousand. Differences in morbidity detected in hospitals were statistically important only in hospitals of different size. Morbidity of PNEU in intensive care units was much higher than in other wards, and differences were statistically important. PNEU and VAP epidemiology in Polish intensive care units indicates serious problems in hospital infections control: high values of morbidity in non-teaching ICUs reflect the huge risk of developing infections in Polish hospitals. Low rates in ICUs of teaching hospitals reflect lack of surveillance and detection of infections in such hospitals.
NSGIC State | GIS Inventory — HOSPITALS_HAZUS_IN is a point shapefile that shows locations of hospitals and clinics in Indiana. HOSPITALS_HAZUS_IN was derived from the shapefile named "HOSPITAL."...
Blanco Meza, A.; Bonilla Jimenez, S.
The main objective of this investigation is the characterization of the solid residuals. A description of the handling of the liquid and gassy waste generated in hospitals is also given, identifying the source where they originate. To achieve the proposed objective the work was divided in three stages: The first one was the planning and the coordination with each hospital center, in this way, to determine the schedule of gathering of the waste can be possible. In the second stage a fieldwork was made; it consisted in gathering the quantitative and qualitative information of the general state of the handling of residuals. In the third and last stage, the information previously obtained was organized to express the results as the production rate per day by bed, generation of solid residuals for sampled services, type of solid residuals and density of the same ones. With the obtained results, approaches are settled down to either determine design parameters for final disposition whether for incineration, trituration, sanitary filler or recycling of some materials, and storage politics of the solid residuals that allow to determine the gathering frequency. The study concludes that it is necessary to improve the conditions of the residuals handling in some aspects, to provide the cleaning personnel of the equipment for gathering disposition and of security, minimum to carry out this work efficiently, and to maintain a control of all the dangerous waste, like sharp or polluted materials. In this way, an appreciable reduction is guaranteed in the impact on the atmosphere. (Author) [es
Full Text Available The hospital antibiogram is a periodic summary of antimicrobial susceptibilities of local bacterial isolates submitted to the hospital′s clinical microbiology laboratory. Antibiograms are often used by clinicians to assess local susceptibility rates, as an aid in selecting empiric antibiotic therapy, and in monitoring resistance trends over time within an institution. Antibiograms can also used to compare susceptibility rates across institutions and track resistance trends. Some hospitals have adequate support from the computer department to be able to extract data from their reporting module. The WHONET software can be freely downloaded and used for analysis. Consensus guidelines have been developed by the Clinical and Laboratory Standards Institute (CLSI to standardise methods used in constructing antibiograms. These guidelines can be incorporated into the WHONET software for analysis. Only the first isolate from the patient is to be included in the analysis. The analysis should be done on the basis of patient location and specimen type. The percentage susceptibility of the most frequently isolated bacteria should be presented in the antibiogram, preferably in a tabular form. The antibiogram must be printed or put up in the intranet for easy access to all clinicians. Antibiotic policy is one of the mandatory requirements for accreditation, and making an antibiogram is the first step before framing the antibiotic policy. The future of antibiograms would be the incorporation of patient related data to make information more reliable and for predicting outbreaks.
Sihuin-Tapia, Elsa Yudy; Gómez-Quispe, Oscar Elisban; Ibáñez-Quispe, Vladimiro
In order to determine the satisfaction of hospitalized patients in the Sub-regional Hospital of Andahuaylas, 175 patients were surveyed using the Servqual multidimensional model. The estimate of variables associated with the satisfaction of the hospitalized patients was performed by using bivariate and multivariate logistic regression analysis. We found 25.0% satisfaction. Lower levels of satisfaction were associated with having a secondary level education (aOR: 0.05; 95% CI: 0.01 to 0.64) and with having been hospitalized in the surgery department (aOR 0.14, CI: 95%: 0.04 to 0.53). It was concluded that there was a low level of satisfaction with the quality of care received by hospitalized patients and this was associated with the level of education and type of hospital department.
Plancke, L; Amariei, A
Long-term hospitalizations in psychiatry raise the question of desocialisation of the patients and the inherent costs. Individual indicators were extracted from a medical administrative database containing full-time psychiatric hospitalizations for the period 2011-2013 of people over 16 years old living in the French region of Nord-Pas-de-Calais. We calculated the proportion of people who had experienced a hospitalization with a duration of 292 days or more during the study period. A bivariate analysis was conducted, then ecological data (level of health-care offer, the deprivation index and the size of the municipalities of residence) were included into a multilevel regression model in order to identify the factors significantly related to variability of long-term hospitalization rates. Among hospitalized individuals in psychiatry, 2.6% had had at least one hospitalization of 292 days or more during the observation period; the number of days in long-term hospitalization represented 22.5% of the total of days of full-time hospitalization in psychiatry. The bivariate analysis revealed that seniority in the psychiatric system was strongly correlated with long hospitalization rates. In the multivariate analysis, the individual indicators the most related to an increased risk of long-term hospitalization were: total lack of autonomy (OR=9.0; 95% CI: 6.7-12.2; Phospitalization (OR=1.7; CI95%: 1.4-2.1; Plong-term hospitalization rates depending on the type of establishment were very high, but the density of hospital beds or intensity of ambulatory activity services were not significantly linked to long-term hospitalization. The inhabitants of small urban units had significantly less risk of long-term hospitalization than those of large cities. We found no influence of material and social deprivation in the long-term hospitalizations. Long-term hospitalization in psychiatry only concerns a minority of patients but represents the fifth of the total number of days of
Bennett, John B.
Explains a collegial ethic of hospitality as a cardinal academic virtue and suggests a way of building a "collegium," the covenantal community of academe. Discusses how academicians can develop hospitable teaching, hospitable scholarship, and hospitable service. (Author/SLD)
Full Text Available Smoke and tobacco-free policies on hospital campuses have become more prevalent across the U.S. and Europe, de-normalizing smoking and reducing secondhand smoke exposure on hospital grounds. Concerns about the increasing use of electronic cigarettes (e-cigarettes and the impact of such use on smoke and tobacco-free policies have arisen, but to date, no systematic data describes e-cigarette policies on hospital campuses. The study surveyed all hospitals in North Carolina (n = 121 to assess what proportion of hospitals have developed e-cigarette policies, how policies have been implemented and communicated, and what motivators and barriers have influenced the development of e-cigarette regulations. Seventy-five hospitals (62% completed the survey. Over 80% of hospitals reported the existence of a policy regulating the use of e-cigarettes on campus and roughly half of the hospitals without a current e-cigarette policy are likely to develop one within the next year. Most e-cigarette policies have been incorporated into existing tobacco-free policies with few reported barriers, though effective communication of e-cigarette policies is lacking. The majority of hospitals strongly agree that e-cigarette use on campus should be prohibited for staff, patients, and visitors. Widespread incorporation of e-cigarette policies into existing hospital smoke and tobacco-free campus policies is feasible but needs communication to staff, patients, and visitors.
Baceviciute, Sarune; Bruni, Luis Emilio; Burelli, Paolo
The idea of this pilot experiment within the context of the “Art in Hospitals” project was to explore the fruitfulness and future perspectives for integrating psychophysiological methods to the ethnographic approach so far implemented in the project. As a pilot study it serves to open the doors...... to experimental avenues that can support the ethnographic investigation. Therefore in order to form a basis for applications of these methodologies in future studies in the field, this pilot was concentrated in one of the initial premises of the project, which intended to challenge current recommendations for art...... in hospitals. Most of these guidelines favor figurative over abstract art, based on ideas leaning to the emotional congruence theory, which would claim that abstract art leads to ambiguity and therefore it could augment the current emotional base-line of an already stressed patient. The early ethnographic...
In this paper we outline the possibilities of an ethic of care based on our self-affection and subjectivity in the ethical spaces between-two. In this we first refer to three Irigarayan concepts - breath, silence and listening from the third phase of her philosophy, and discuss them within the methodological framework of an ethics of intersubjectivity and interiority. Together with attentiveness, we analyse them as four categories of our ethical becoming. Furthermore, we argue that self-affection is based on our inchoate receptivity for the needs of the other(s) and is thus dialectical in its character. In this we critically confront some epistemological views of our ethical becoming. We wind up this paper with a proposal for an ethics towards two autonomous subjects, based on care and our shared ethical becoming - both as signs of our deepest hospitality towards the other.
Koys, Daniel J; Martin, Wm Marty; LaVan, Helen; Katz, Marsha
The authors address the hospital outcomes of patient satisfaction, healthcare quality, and net income per bed. They define union density as the percentage of a hospital's employees who are in unions, healthcare quality as its 30-day acute myocardial infraction (AMI; heart attack) mortality rate, and patient satisfaction as its overall Hospital Consumer Assessment of Healthcare Providers and Systems score. Using a random sample of 84 union and 84 nonunion hospitals from across the United States, multiple regression analyses show that union density is negatively related to patient satisfaction. Union density is not related to healthcare quality as measured by the AMI mortality rate or to net income per bed. This implies that unions per se are not good or bad for hospitals. The authors suggest that it is better for hospital administrators to take a Balanced Scorecard approach and be concerned about employee satisfaction, patient satisfaction, healthcare quality, and net income.
This bachelor's thesis deals with the care of oral cavity for hospitalized children and compares the standards of oral cavity care for children hospitalized in standard pediatric wards with those for children hospitalized in the pediatric bone marrow transplant unit. The thesis provides the anatomical and physiological beckground information on oral care, describes the most common pathological issues, stresses the importance of proper mouth care and explains how to practise oral hygiene and s...
Keeping track of thousands of pieces of equipment in a busy hospital environment is a considerable challenge, but, according to RFID tagging and asset tracking specialist, Harland Simon, RFID technology can make the task considerably simpler. Here Andrew James, the company's RFID sales manager, describes the positive benefits the technology has brought the Medical Equipment Library (MEL) at Addenbrooke's Hospital, one of the world's most famous teaching hospitals.
McHugh, Matthew D.; Kelly, Lesly A.; Smith, Herbert L.; Wu, Evan S.; Vanak, Jill M.; Aiken, Linda H.
Background Although there is evidence that hospitals recognized for nursing excellence—Magnet hospitals—are successful in attracting and retaining nurses, it is uncertain whether Magnet recognition is associated with better patient outcomes than non-Magnets, and if so why. Objectives To determine whether Magnet hospitals have lower risk-adjusted mortality and failure-to-rescue compared with non-Magnet hospitals, and to determine the most likely explanations. Method and Study Design Analysis of linked patient, nurse, and hospital data on 56 Magnet and 508 non-Magnet hospitals. Logistic regression models were used to estimate differences in the odds of mortality and failure-to-rescue for surgical patients treated in Magnet versus non-Magnet hospitals, and to determine the extent to which differences in outcomes can be explained by nursing after accounting for patient and hospital differences. Results Magnet hospitals had significantly better work environments and higher proportions of nurses with bachelor's degrees and specialty certification. These nursing factors explained much of the Magnet hospital effect on patient outcomes. However, patients treated in Magnet hospitals had 14% lower odds of mortality (odds ratio 0.86; 95% confidence interval, 0.76–0.98; P = 0.02) and 12% lower odds of failure-to-rescue (odds ratio 0.88; 95% confidence interval, 0.77–1.01; P = 0.07) while controlling for nursing factors as well as hospital and patient differences. Conclusions The lower mortality we find in Magnet hospitals is largely attributable to measured nursing characteristics but there is a mortality advantage above and beyond what we could measure. Magnet recognition identifies existing quality and stimulates further positive organizational behavior that improves patient outcomes. PMID:24022082
Becker, Edmund R.; Steinwald, Bruce
Using the Commission on Professional and Hospital Activities' Resource Need Index as a measure of casemix complexity, this paper examines the relative contributions of teaching commitment and other hospital characteristics, hospital service and insurer distributions, and area characteristics to variations in casemix complexity. The empirical estimates indicate that all three types of independent variables have a substantial influence. These results are discussed in light of recent casemix res...
Infection control - wearing gloves; Patient safety - wearing gloves; Personal protective equipment - wearing gloves; PPE - wearing gloves; Nosocomial infection - wearing gloves; Hospital acquired infection - ...
Armond, Lindalva Carvalho; Boemer, Magali Roseira
This study aimed to understand the experience of parents living with a hospitalized adolescent. Fifteen parents of hospitalized adolescents were interviewed from August to October of 2002. Data were analyzed through Martin Heidegger's phenomenological approach. Four themes were identified: the impact of the illness on the family, the feelings of the family members and the adaptation to the hospital world, religiousness and the presence of friends in the process of coping with hospitalization; changes in the adolescent. The results showed the importance of seeing the adolescent and his/her family as a being there, being-in-the-world and being-in-the-world-with-others.
de Quevedo, Francisco Vázquez
The history of the hospitals and general surgeons that best represent the centres in Madrid are here in reviewed, comprising the period between 1940 and the closure of the Hospital Clinico (1957) as well as the Hospital General (General Hospital) (1967), both in Atocha. Other hospitals which are reviewed and highlighted are: the H. de la Princesa (the Princess Hospital), the H. del Nifio Jesus (Hospital of the Child Jesus), the H. Militar (Military Hospital) and the Cruz Roja (Red Cross). Data is provided on the permanent surgeons in the following centres: H. General: J. Goyanes, J. Die, J. de la Villa, T. Rodriguez, E. Diaz, G. Bueno e H. Huerta; H. Clinico: L. de la Peña, L. Cardenal, L. Olivares, R. Argüelles, J. Estella y M. F. Zumel; H. Militar: M. G. Ulla, M. Bastos, M. G. Durán, J. S. Galindo, y A. G. Durán; Hospital de la Cruz Roja: V. M. Noguera, L. Serrada, F. Luque y L. L. Durán; H. de la Princesa: P. Cifuentes, P. G. Duarte, L. Estella y R. Aiguabella; H. del Niño Jesús: J. Garrido Lestache; H. Clinico, last time, Atocha: F. M. Lagos, R. Vara y A. de la Fuente.
dent of Groote Schuur Hospital, commissioned the Hospital. Information Planning Study (HIPS) in the belief that modern information management techniques and existing computer technology can be of considerable benefit in dealing with these issues. The objectives of the HIPS included a review of the existing information ...
Shafik, Magdy H; Seoudi, Tarek M M; Raway, Tarek S; Al Harbash, Nowair Z; Ahmad, Meshal M A; Al Mutairi, Hanan F
To determine the rate of inappropriate pediatric admissions using the Pediatric Appropriateness Evaluation Protocol (PAEP) and to examine variables associated with inappropriateness of admissions. A prospective study was conducted in the Department of Pediatrics, Farwania General Hospital, Kuwait, to examine successive admissions for appropriateness of admission as well as several sociodemographic characteristics over a 5-month period (August 2010 to December 2010). A total of 1,022 admissions were included. Of the 1,022 admissions, 416 (40.7%) were considered inappropriate. Factors associated with a higher rate of inappropriate admission included older age of patients and self-referral. The rate of inappropriate hospitalization of children was high in Farwania Hospital, Kuwait, probably due to the relatively free health care services, parental preference for hospital care, easy access to hospital services, and insufficient education about the child's condition. Copyright © 2012 S. Karger AG, Basel.
Scanlon, Dennis P; Lindrooth, Richard C; Christianson, Jon B
To determine if a tiered hospital benefit and safety incentive shifted the distribution of admissions toward safer hospitals. A large manufacturing company instituted the hospital safety incentive (HSI) for union employees. The HSI gave union patients a financial incentive to choose hospitals that met the Leapfrog Group's three patient safety "leaps." The analysis merges data from four sources: claims and enrollment data from the company, the American Hospital Association, the AHRQ HCUP-SID, and a state Office of the Insurance Commissioner. Changes in hospital admissions' patterns for union and nonunion employees using a difference-in-difference design. We estimate the probability of choosing a specific hospital from a set of available alternatives using conditional logistic regression. Patients affiliated with the engineers' union and admitted for a medical diagnosis were 2.92 times more likely to select a hospital designated as safer in the postperiod than in the preperiod, while salaried nonunion (SNU) patients (not subject to the financial incentive) were 0.64 times as likely to choose a compliant hospital in the post- versus preperiod. The difference-in-difference estimate, which is based on the predictions of the conditional logit model, is 0.20. However, the machinists' union was also exposed to the incentive and they were no more likely to choose a safer hospital than the SNU patients. The incentive did not have an effect on patients admitted for a surgical diagnosis, regardless of union status. All patients were averse to travel time, but those union patients selecting an incentive hospital were less averse to travel time. Patient price incentives and quality/safety information may influence hospital selection decisions, particularly for medical admissions, though the optimal incentive level for financial return to the plan sponsor is not clear.
Luis Carlos Alvarez Barranco
Full Text Available Objetivo: Determinar el comportamiento epidemiológico de las Infecciones de Vías Urinarias y cambios en sensibilidad y resistencia antibiótica de la Escherichia coli en el Hospital Universidad del Norte, Soledad (Atlántico, Colombia, desde enero de 2005 a diciembre de 2006. Materiales y métodos: Estudio descriptivo de tipo retrospectivo, con muestra de 537 urocultivos de pacientes que consultan al Hospital Universidad del Norte. Se evaluaron a través del recuento de unidades formadores de colonias (UFC y se analizaron los reportes de antibiogramas anotando la resistencia, sensibilidad antibiótica y evaluando el comportamiento epidemiológico de los principales antibióticos utilizados en la práctica clínica en la institución. Resultados: Distribución porcentual de infección del tracto urinario (ITU para el 2005 en mujeres: 72.9%, en hombres: 27.1%; para 2006, en mujeres 73.8% y en hombres 26.2%. Los microorganismos más frecuentemente aislados en el 2005 fueron: Escherichia coli (66.24% y Klebsiella (10.63%, y para el 2006: Escherichia coli (85 % y Proteus (5.29%. Las mayores tasas de resistencia antibiótica de Escherichia coli en el 2005 fue: ampicilina, trimetoprim sulfa y ciprofloxacina. En el 2006, el comportamiento fue similar, y hubo además disminución en la resistencia a fluoroquinolonas. Las mayores tasas de sensibilidad en el 2005 incluyen nitrofurantoína, ampicilina/sulbactam y aminoglucósidos en relación con el 2006, en el cual hubo disminución en la sensibilidad a los dos primeros. Conclusión: La ITU se presenta con más frecuencia en mujeres. La mayoría de las ITU son causada por Escherichia coli. En el 2006 disminuyó la resistencia a la ampicilina, trimetoprim sulfametaxol, cefalosporinas de primera generación y ciprofloxacina con relación al 2005. También redujeron las tasas de sensibilidad a nitrofurantoína, ampicilina/sulbactam y gentamicina.
Full Text Available Background. Bevacizumab (BEV, a humanized immunoglobulin G1 monoclonal antibody that inhibits VEGF has demonstrated activity against recurrent high-grade gliomas (HGG in phase II clinical trials. Patients and Methods. Data were collected from patients with recurrent HGG who initiated treatment with BEV outside a clinical trial protocol at two Belgian university hospitals. Results. 19 patients (11 M/8 F were administered a total of 138 cycles of BEV (median 4, range 1–31. Tumor response assessment by MRI was available for 15 patients; 2 complete responses and 3 partial responses for an objective response rate of 26% for the intent to treat population were observed on gadolinium-enhanced T1-weighted images; significant regressions on T2/FLAIR were documented in 10 out of 15 patients (67%. A reduced uptake on PET was documented in 3 out of 4 evaluable patients. The six-month progression-free survival was 21% (95% CI 2.7–39.5. Two patients had an ongoing tumor response and remained free from progression after 12 months of BEV treatment. Conclusions. The activity and tolerability of BEV were comparable to results from previous prospective phase II trials. Reduced uptake on PET suggests a metabolic response in addition to an antiangiogenic effect in some cases with favorable clinical outcome.
Brotherton, Bob, Ed.; And Others
Seven articles on hospitality management training discuss the following: computerized management games for restaurant manager training, work placement, real-life exercises, management information systems in hospitality degree programs, modular programming, service quality concepts in the curriculum, and General National Vocational Qualifications…
Dranove, D; White, W D; Wu, L
This study examines evidence of market segmentation on the basis of patients' insurance status, demographic characteristics, and medical condition in selected local markets in California in the years 1983 and 1989. Substantial differences exist in the probability patients may be admitted to particular hospitals based on insurance coverage, particularly Medicaid, and race. Segmentation based on insurance and race is related to hospital characteristics, but not the characteristics of the hospital's community. Medicaid patients are more likely to go to hospitals with lower costs and fewer service offerings. Privately insured patients go to hospitals offering more services, although cost concerns are increasing. Hispanic patients also go to low-cost hospitals, ceteris paribus. Results indicate little evidence of segmentation based on medical condition in either 1983 or 1989, suggesting that "centers of excellence" have yet to play an important role in patient choice of hospital. The authors found that distance matters, and that patients prefer nearby hospitals, moreso for some medical conditions than others, in ways consistent with economic theories of consumer choice.
Author Guidelines. Original research papers, substantive topic reviews, viewpoints and short communications that make an original contribution to the understanding of hospitality and hospitality management in a global context will be considered for publication in the Journal. Submissions should be e-mailed to the ...
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Haverkort, J. J Mark; Biesheuvel, Tessa H.; Bloemers, Frank W.; de Jong, MB; Hietbrink, Falco; van Spengler, Lukas L.; Leenen, Luke P H
Introduction: The Dutch Major Incident Hospital (MIH) is a standby, highly prepared, 200-bed hospital strictly reserved to provide immediate, large-scale, and emergency care for victims of disasters and major incidents. It has long-standing experience training for various major incident scenarios,
Larson, Paul C.
Explores integration of counseling psychology and neuropsychology in hospital setting. Sees example of such interchange occurring in rehabilitation unit or hospital where psychologist has responsibilities for helping patients, families, and staff to understand implications of central nervous system dysfunction and to adapt to changes. Discusses…
LATEX in the Hospital Environment Updated Fall 2015 This list provides a guide to some of the most common objects containing latex and offers some ... remover–Sepha Pharm) 1 LATEX in the Hospital Environment (continued) Frequently contains LATEX OR/Infection Control masks, ...
Page 1 ... Abstract Three hundred and fifty-nine consecutive referral letters to Baragwanath Hospital's gynaecological outpatients' departn:lent were analysed. Letters. frOIIl private doctors contained significantly less clinical infonnation ... Patient referral letters from private doctors to South. African government hospitals are ...
This paper examines user-involvement in the process used to design new hospitals. Denmark is in the midst of a phase of hospital building. This recent experience is studied by means of expert interviews with senior practitioners involved in three projects. Examined thematically, the data covers t...
Burwell, Rebecca; Huyser, Mackenzi
This article explores pedagogical approaches to teaching students how to practice hospitality toward the other. Using case examples from the college classroom, the authors discuss the roots of Christian hospitality and educational theory on transformative learning to explore how students experience engaging with others after they have…
Lynn, Christine; Hales, Jonathan A; Wiener, Paul
Internships can help hospitality faculty build industry relationships while also ensuring the best and most current training for their students. Many hospitality organizations have structured faculty internships available or are willing to work with faculty to provide individualized internship opportunities. Career and technical educators in…
Søbjerg, Lene Mosegaard; Noesgaard, Susanne; Henriksen, Jan Erik
This article presents a study of an RCT comparing video interpretation with in-person interpretation at the Endocrinology Ward at Odense University Hospital.......This article presents a study of an RCT comparing video interpretation with in-person interpretation at the Endocrinology Ward at Odense University Hospital....
Burr, T.L.; Rivenburgh, R.D.; Scovel, J.C.; White, J.M.
We present graphical and analytical methods that focus on multivariate outlier detection applied to the hospital report cards data. No two methods agree which hospitals are unusually good or bad, so we also present ways to compare the agreement between two methods. We identify factors that have a significant impact on the scoring.
Sylvia Gallegos Espinosa; Marcelo Nicolalde Cifuentes; Sergio Santana Porbén
Rationale: Hospital malnutrition is a global health problem affecting 30-50% of hospitalized patients. There are no estimates of the size of this problem in Ecuadorian hospitals. Hospital malnutrition might influence the quality of medical assistance provided to hospitalized populations. Objectives: To estimate the current frequency of malnutrition among patients admitted to Ecuadorian public hospitals. Materials and methods: The Ecuadorian Hospital Malnutrition Study was conducted between No...
Prætorius, Thim; Hasle, Peter; Nielsen, Anders Paarup
highlights a management paradox that calls for balancing a both/and approach to bureaucratization and collaboration in hospitals. Through a qualitative multiple, embedded case study of four hospitals, the paper investigates how standardized processes and structural arrangements—instances of organizational...... design to foster and maintain collaboration, thereby pointing towards mechanisms for developing the collaborative hospital. The findings also provide insights to managers which can be utilized for the further development of hospitals.......To meet demands for high quality and efficient care, hospitals increasingly organize horizontally around standardized processes (like lean and care pathways) and/or set-up formal structural arrangements such as using performance boards, having daily huddles or assigning specific roles. This trend...
This PhD thesis explores the possibilities and design qualities of using functional textiles in the interior of hospital environments, and is the result of a three years collaboration between Aalborg University, Department of Civil Engineering, and VIA University College, VIA Design. The project...... that the physical environments affect the patients’ level of stress and influence their process of recovery and healing. However, although research in this field of hospital design has increased substantially in recent years, knowledge on the use of new materials and textiles in hospital interiors is still rather...... limited. Concerned with the design potentials of using textiles in hospital interiors, the purpose of the PhD project has been to explore the possibilities and design qualities of using these materials in hospital design. Relating to both technical and aesthetic aspects of using functional textiles...
Kwong Wah Hospital was founded by the charity organisation Tung Wah Group of Hospitals some 88 years ago, with management transfer to the Hong Kong Hospital Authority in 1991. Capitalizing both from the traditional caring culture of its founder, as well as opportunities in the new management environment, the hospital has scored remarkable successes in service quality, community partnership, organisational effectiveness, and staff development. Underpinning these transformations were Structure, Process, People, and Culture strategies. The learning imperative is heavily mandated or the success of each of these strands of development. Indeed, the embodiment of a learning organisation culture provides the impetus in sustaining the change momentum, towards achieving the Vision of becoming a 'Most Preferred Hospital' in Hong Kong.
Özkil, Ali Gürcan
services to maintain the quality of healthcare provided. Logistics is the most resource demanding service in a hospital. The scale of the transportation tasks is huge and the material flow in a hospital is comparable to that of a factory. We believe that these transportation tasks, to a great extent, can...... be and will be automated using mobile robots. This talk consequently addresses the key technical issues of implementing service robots in hospitals. In simple terms, a robotic system for automating hospital logistics has to be reliable, adaptable and scalable. Robots have to be semi-autonomous, and should reliably...... for localization. The system features automatic annotation, which significantly reduces manual work and offer many advantages beyond robotics. A case study on logistics solutions is finally presented. A robotic solution is tested in a hospital to handle the transportation of blood samples between the clinic...
Chang, C F; Tuckman, H P
This article focuses on a hospital group that has not received adequate attention in the literature: the sole provider of short-term, acute hospital care located in a county. In Tennessee, SPHs (single provider hospitals) are fewer in number but are present in more counties than multiprovider hospitals (MPHs). They are smaller in size, less labor and capital intensive, more likely to be a government hospital, and more likely to be in a rural area with low income and limited health care resources. SPHs operate with lower costs, charge patients less, and have lower revenue write-offs than MPHs. As a result, their cash flow is sufficient to fund their depreciation and they consistently earn modest returns. Between 1982 and 1988, a total of 16 hospitals failed in Tennessee but only 3 were SPHs. While SPHs have not been profitable enough to make them ideal candidates for takeover by major hospital systems, they are not a population that is unduly at risk. PMID:1905685
Hirsh, H L
The liability of hospitals in tort law has been a fairly recent development. Formerly, hospitals were protected from liability under the doctrine of charitable immunity. Legal "immunity" avoids liability in tort essentially under all circumstances. It is conferred not because of the particular facts of the situation but because of the status or position of the favored defendant. It does not deny the tort, merely the resulting liability. Such immunity does not mean that conduct that would amount to a tort on the part of other defendants is not still equally tortious in character, but merely that for the protection of the particular defendant, or of the interests which he represents, he is given absolution from liability. Similarly, the "captain-of-the-ship" and the attendant "borrowed or lent servant" doctrine is being abandoned. As medical technology continues to advance, the modern hospital will undoubtedly assume a greater responsibility toward its patients--with amplified medical-legal implications. The hospital is no longer a hotel where patients stay, awaiting treatment by their private physicians. The theory that the hospital does not act through its employees--physicians, nurses, and others--no longer reflects the trend in judicial philosophy. The decisions cited reflect the current trend in judicial analysis and thinking. Medical science has provided numerous benefits to humankind, but along with those benefits, numerous risks have accrued. Whether hospitals should have to bear the responsibilities inherent in such risks is a much-argued matter. However, hospital liability, in fact, is the trend of our judicial determination. The ramifications of this trend have been many. Hospitals and physicians will closely scrutinize surgical operations and other hospitals procedures and practices. The fact remains clear that responsibility for every patient is now shared by both the physicians and the hospital--share and share alike. The present thinking is that the
Full Text Available BACKGROUND: Experience curve effects were first observed in the industrial arena as demonstrations of the relationship between experience and efficiency. These relationships were largely determined by improvements in management efficiency and quality of care. In the health care industry, volume-outcome relationships have been established with respect to quality of care improvement, but little is known about the effects of experience on management efficiency. Here, we examine the relationship between experience and hospital management in Japanese hospitals. METHODS: The study sample comprised individuals who had undergone surgery for unruptured abdominal aortic aneurysms and had been discharged from participant hospitals between April 1, 2006 and December 31, 2008. We analyzed the association between case volume (both at the hospital and surgeon level and postoperative complications using multilevel logistic regression analysis. Multilevel log-linear regression analyses were performed to investigate the associations between case volume and length of stay (LOS before and after surgery. RESULTS: We analyzed 909 patients and 849 patients using the hospital-level and surgeon-level analytical models, respectively. The odds ratio of postoperative complication occurrence for an increase of one surgery annually was 0.981 (P < 0.001 at the hospital level and 0.982 (P < 0.001 at the surgeon level. The log-linear regression analyses showed that shorter postoperative LOS was significantly associated with high hospital-level case volume (coefficient for an increase of one surgery: -0.006, P = 0.009 and surgeon-level case volume (coefficient for an increase of one surgery: -0.011, P = 0.022. Although an increase of one surgery annually at the hospital level was statistically associated with a reduction of preoperative LOS by 1.1% (P = 0.006, there was no significant association detected between surgeon-level case volume and preoperative LOS (P = 0
De Cauwer, Harald; Somville, Francis; Sabbe, Marc; Mortelmans, Luc J
In recent years, the world has been rocked repeatedly by terrorist attacks. Arguably, the most remarkable were: the series of four coordinated suicide plane attacks on September 11, 2001 on buildings in New York, Virginia, and Pennsylvania, USA; and the recent series of two coordinated attacks in Brussels (Belgium), on March 22, 2016, involving two bombings at the departure hall of Brussels International Airport and a bombing at Maalbeek Metro Station located near the European Commission headquarters in the center of Brussels. This statement paper deals with different aspects of hospital policy and disaster response planning that interface with terrorism. Research shows that the availability of necessary equipment and facilities (eg, personal protective clothing, decontamination rooms, antidotes, and anti-viral drugs) in hospitals clearly is insufficient. Emergency teams are insufficiently prepared: adequate and repetitive training remain necessary. Unfortunately, there are many examples of health care workers and physicians or hospitals being targeted in both political or religious conflicts and wars. Many health workers were kidnapped and/or killed by insurgents of various ideology. Attacks on hospitals also could cause long-term effects: hospital units could be unavailable for a long time and replacing staff could take several months, further compounding hospital operations. Both physical and psychological (eg, posttraumatic stress disorder [PTSD]) after-effects of a terrorist attack can be detrimental to health care services. On the other hand, physicians and other hospital employees have shown to be involved in terrorism. As data show that some offenders had a previous history with the location of the terror incident, the possibility of hospitals or other health care services being targeted by insiders is discussed. The purpose of this report was to consider how past terrorist incidents can inform current hospital preparedness and disaster response planning
Byhahn, C; Meininger, D; Bueck, M; Kessler, P; Füllner, M; Lischke, V
Many hospitals have a special resuscitation service that is responsible for life-threatening emergencies outside the hospitals intensive care unit, i.e. in the wards and in patient-treatment areas. In contrast, there is generally no emergency service caring for patients, visitors or personnel outside of these areas. In order to provide emergency medical help in the entire hospital area, in 1999 we instituted an additional in-hospital emergency service to cover the larger hospital area. This paper describes the structure of our in-hospital emergency service and our experience in the first 26 months after its establishment. We analysed the emergency protocols of all 147 episodes, that had occurred within the first 26 months. We classified them according to type of disease and/or injury by using the NACA score (range 1 to 7) to assess the severity of disease and/or injury. 45 episodes took place within one of the 17 hospital buildings. 92 requests for help came from the hospital service and treatment areas including walkways and passages, while 3 came from the immediate vicinity outside of the hospital. A total of 7 requests turned out to be pranks, and 31.3% responses proved to be unnecessary when the team arrived at the scene. Of the total of 125 treated cases, 30 had a NACA score between 4 and 6, denoting life-threatening injury and/or disease. 6 patients were found dead at the scene or died shortly after arrival of the team. 101 of the patients had to be admitted to the hospital's emergency room. Since its establishment, knowledge of the existence of our in-hospital emergency service has steadily increased within the hospital community. As a consequence, number of events have likewise steadily increased. We believe that a total of 20.4% life-threatening events underscores the importance of the service in our large and extended hospital area. We also feel that our adherence to the training and personnel requirements demanded of public emergency services is
Pirlich, Matthias; Schütz, Tatjana; Norman, Kristina; Gastell, Sylvia; Lübke, Heinrich Josef; Bischoff, Stephan C; Bolder, Ulrich; Frieling, Thomas; Güldenzoph, Helge; Hahn, Kristian; Jauch, Karl-Walter; Schindler, Karin; Stein, Jürgen; Volkert, Dorothee; Weimann, Arved; Werner, Hansjörg; Wolf, Christiane; Zürcher, Gudrun; Bauer, Peter; Lochs, Herbert
Malnutrition is frequently observed in chronic and severe diseases and associated with impaired outcome. In Germany general data on prevalence and impact of hospital malnutrition are missing. Nutritional state was assessed by subjective global assessment (SGA) and by anthropometric measurements in 1,886 consecutively admitted patients in 13 hospitals (n=1,073, university hospitals; n=813, community or teaching hospitals). Risk factors for malnutrition and the impact of nutritional status on length of hospital stay were analyzed. Malnutrition was diagnosed in 27.4% of patients according to SGA. A low arm muscle area and arm fat area were observed in 11.3% and 17.1%, respectively. Forty-three % of patients 70 years old were malnourished compared to only 7.8% of patients malnutrition was observed in geriatric (56.2%), oncology (37.6%), and gastroenterology (32.6%) departments. Multivariate analysis revealed three independent risk factors: higher age, polypharmacy, and malignant disease (all PMalnutrition was associated with an 43% increase of hospital stay (PMalnutrition is associated with increased length of hospital stay. Higher age, malignant disease and major comorbidity were found to be the main contributors to malnutrition. Adequate nutritional support should be initiated in order to optimize the clinical outcome of these patients.
Jahanbakhsh, Maryam; Sharifi, Mohammed; Ayat, Masar
The area of e-Health is broad and has an excellent growth potential. An increasing number of experts believe that e-Health will fuel the next breakthroughs in health system improvements throughout the world, but there is frequent evidence of unsustainable use of e-Health systems in medical centres, particularly hospitals, for different reasons in different countries. Iran is also a developing country which is presently adopting this promising technology for its traditional healthcare delivery but there is not much information about the use of e-Health systems in its hospitals, and the weakness and opportunities of utilization of such Hospital Information Systems (HIS). For this research, a number of Hospitals from Isfahan, Iran, are selected using convenient sampling. E-health research professionals went there to observe their HIS and collect required data as a qualitative survey. The design of interview questions was based on the researchers' experiences and knowledge in this area along with elementary interviews with experts on HIS utilization in hospitals. Efficient administration of e-health implementation improves the quality of healthcare, reduces costs and medical errors, makes healthcare resources available to rural areas, etc. However, there are numerous issues affecting the successful utilization of e-health in Hospitals, such as a lack of a perfect HIS implementation plan and well-defined strategy, inadequate IT-security for the protection of e-health-related data, improper training and educational issues, legal challenges, privacy concerns, improper documentation of lessons learned, resistance to the application of new technologies, and finally a lack of recovery plan and disaster management. These results along with some informative stories are extracted from interview sessions to uncover associated challenges of HIS utilization in Iranian hospitals. The utilization of e-health in Iranian hospitals, particularly those in Isfahan, is subject to several
Haghighathoseini, Atefehsadat; Bobarshad, Hossein; Saghafi, Fatehmeh; Rezaei, Mohammad Sadegh; Bagherzadeh, Nader
Nowadays developing smart and fast services for patients and transforming hospitals to modern hospitals is considered a necessity. Living in the world inundated with information systems, designing services based on information technology entails a suitable architecture framework. This paper aims to present a localized enterprise architecture framework for the Iranian university hospital. Using two dimensions of implementation and having appropriate characteristics, the best 17 enterprises frameworks were chosen. As part of this effort, five criteria were selected according to experts' inputs. According to these criteria, five frameworks which had the highest rank were chosen. Then 44 general characteristics were extracted from the existing 17 frameworks after careful studying. Then a questionnaire was written accordingly to distinguish the necessity of those characteristics using expert's opinions and Delphi method. The result showed eight important criteria. In the next step, using AHP method, TOGAF was chosen regarding having appropriate characteristics and the ability to be implemented among reference formats. In the next step, enterprise architecture framework was designed by TOGAF in a conceptual model and its layers. For determining architecture framework parts, a questionnaire with 145 questions was written based on literature review and expert's opinions. The results showed during localization of TOGAF for Iran, 111 of 145 parts were chosen and certified to be used in the hospital. The results showed that TOGAF could be suitable for use in the hospital. So, a localized Hospital Enterprise Architecture Modelling is developed by customizing TOGAF for an Iranian hospital at eight levels and 11 parts. This new model could be used to be performed in other Iranian hospitals. Copyright © 2018 Elsevier B.V. All rights reserved.
Full Text Available Objectives: This paper evaluates the drivers of profitability for a large sample of U.S. hospitals. Following a methodology frequently used by financial analysts, we use a DuPont analysis as a framework to evaluate the quality of earnings. By decomposing returns on equity (ROE into profit margin, total asset turnover, and capital structure, the DuPont analysis reveals what drives overall profitability. Methods: Profit margin, the efficiency with which services are rendered (total asset turnover, and capital structure is calculated for 3,255 U.S. hospitals between 2007 and 2012 using data from the Centers for Medicare & Medicaid Services’ Healthcare Cost Report Information System (CMS Form 2552. The sample is then stratified by ownership, size, system affiliation, teaching status, critical access designation, and urban or non-urban location. Those hospital characteristics and interaction terms are then regressed (OLS against the ROE and the respective DuPont components. Sensitivity to regression methodology is also investigated using a seemingly unrelated regression. Results: When the sample is stratified by hospital characteristics, the results indicate investor-owned hospitals have higher profit margins, higher efficiency, and are substantially more leveraged. Hospitals in systems are found to have higher ROE, margins, and efficiency but are associated with less leverage. In addition, a number of important and significant interactions between teaching status, ownership, location, critical access designation, and inclusion in a system are documented. Many of the significant relationships, most notably not-for-profit ownership, lose significance or are predominately associated with one interaction effect when interaction terms are introduced as explanatory variables. Results are not sensitive to the alternative methodology. Conclusion: The results of the DuPont analysis suggest that although there appears to be convergence in the behavior of
Rognås, Leif Kåre; Christensen, Erika Frischknecht; Sloth, Erik
Danish anaesthesiologists use ultrasound (US) to examine and treat acutely ill or traumatized patients in the emergency room, operating theatre and intensive care unit. They are also involved in pre-hospital care where US may theoretically be beneficial for both diagnostic and therapeutic purpose....... The literature concerning the potential use of emergency US in the pre-hospital setting is evaluated. Evidence from both Europe and the USA indicates that pre-hospital US improves diagnosis and visitation of acutely ill or traumatized patients. Udgivelsesdato: 2009-Aug-31...
Egeberg, Alexander; Thyssen, Jacob P; Gislason, Gunnar H
Erythrodermic psoriasis (EP) and erythroderma exfoliativa (EE) are acute and potentially life-threatening inflammatory reactions. We estimated hazard ratios (HRs) of 3-year mortality following hospitalization for EP or EE compared with general population controls, patients hospitalized...... for psoriasis vulgaris, and toxic epidermal necrolysis (TEN), respectively. We identified 26 and 48 patients with a first-time hospitalization (1997-2010) for EP and EE, respectively (10 matched population-controls for each patient), 1,998 patients with psoriasis vulgaris, and 60 patients with TEN. During...
Full Text Available This article is based on the history of an Italian psychiatric hospital (Arezzo that closed in 1989 and was turned into a university. The illegal and inhumane treatment in asylum-type institutions is condemned. In particular the treatment of those patients who, according to the analysis, hospital directors referred to as “social cases.” These individuals did not stay in hospital because of health problems but only due to the lack of social care by the state. AS a consequence they are condemned to be “prisoners” without committing any crimes.
Coye, Molly Joel; Kell, Jason
Hospital technology decision makers now confront a growing pipeline of information technology (IT) and major medical equipment that challenges traditional capital allocation processes. In a highly fragmented industry that is driven by coverage and reimbursement policies set by the Centers for Medicare and Medicaid Services (CMS) and private insurers, the cumulative impact of hospitals' technology investment decisions shapes health care for decades.We propose a framework for the development of a national collaboration for the planning and assessment of emerging technologies, designed to improve the quality and efficiency of hospital decisions. Broader application of technology assessment would restrain inappropriate technology adoption and use.
Bergenholtz, Heidi; Jarlbæk, Lene; Hølge-Hazelton, Bibi
hospital with 29 department managements and one hospital management. Results: Two overall themes emerged: (1) ‘generalist palliative care as a priority at the hospital’, suggesting contrasting issues regardingprioritisation of palliative care at different organisational levels, and (2) ‘knowledge and use......Background: It can be challenging to provide generalist palliative care in hospitals, owing to difficulties in integrating disease-orientedtreatment with palliative care and the influences of cultural and organisational conditions. However, knowledge on the interactionsthat occur is sparse. Aim......: To investigate the interactions between organisation and culture as conditions for integrated palliative care in hospital and, ifpossible, to suggest workable solutions for the provision of generalist palliative care. Design: A convergent parallel mixed-methods design was chosen using two independent studies...
Vermont Center for Geographic Information — Hospital service areas (HSAs) are organized by towns and are based on inpatient discharges where the diagnosis indicated the need for immediate care. Plurality...
U.S. Department of Health & Human Services — Medicaid Disproportionate Share Hospital (DSH) Payments This link provides you with information about Medicaid DSH Payments. You can find information on DSH Audit...
Principal Contact. Dr Sjoerd A Gehrels Editor-in-Chief Stenden Hotel Management School, Academy of International Hospitality Research, Leeuwarden, The Netherlands Email: email@example.com ...
Full Text Available How do European governments conceptualize what they call "hospitality" when they draft immigration laws and when they allow the concepts of asylum, of illegal immigrants, to change according to a constantly evolving political context? What consequences…
U.S. Department of Health & Human Services — In the interest of promoting high-quality, patient-centered care and accountability, the Centers for Medicare and Medicaid Services (CMS) and Hospital Quality...
U.S. Department of Health & Human Services — Hospital Value-Based Purchasing (VBP) is part of the Centers for Medicare and Medicaid Services (CMS) long-standing effort to link Medicares payment system to a...
Walther-Larsen, S; Pedersen, M T; Friis, S M
BACKGROUND: Pain management in hospitalized children is often inadequate. The prevalence and main sources of pain in Danish university hospitals is unknown. METHODS: This prospective mixed-method cross-sectional survey took place at four university hospitals in Denmark. We enrolled 570 pediatric...... patients who we asked to report their pain experience and its management during the previous 24 hours. For patients identified as having moderate to severe pain, patient characteristics and analgesia regimes were reviewed. RESULTS: Two hundred and thirteen children (37%) responded that they had experienced...... pain in the previous 24 hours. One hundred and thirty four (24%) indicated moderate to severe pain and 43% would have preferred an intervention to alleviate the pain. In children hospitalized for more than 24 hours, the prevalence of moderate/severe pain was significantly higher compared to children...
mother allegedly mistreated for preeclampsia at Tripler Army Medical Center could maintain an action for medical malpractice nothwithstanding Feres.1 2...perinatologists at most military hospitals perform genetic counseling. Due to their primary responsibilities fo management of high risk pregnancies
This manual is designed to aid in the training of hospital personnel engaged in work with the more common sources of ionizing radiation. It emphasizes the essentials of safety procedures for users of radioisotopes and x-rays
Zarb, P; Amadeo, B; Muller, A
The study aimed to identify targets for quality improvement in antifungal use in European hospitals and determine the variability of such prescribing. Hospitals that participated in the European Surveillance of Antimicrobial Consumption Point Prevalence Surveys (ESAC-PPS) were included. The WHO...... of 40,878 (3.7%) antimicrobials. Antifungals were mainly (54.2%) administered orally. Hospital-acquired infections represented 44.5% of indications for antifungals followed by medical prophylaxis at 31.2%. The site of infection was not defined in 36.0% of cases but the most commonly targeted sites were...... respiratory (19.2%) and gastrointestinal (18.8%). The most used antifungal was fluconazole (60.5%) followed by caspofungin (10.5%). Antifungal-antibacterial combinations were frequently used (77.5%). The predominance of fluconazole use in participating hospitals could result in an increase in prevalence...
The use of aerospace medical techniques to improve the quality of earth health care systems is discussed. Data are focused on physiological measurements and monitoring, medical information management, clean room technology, and reliability and quality assurance for hospital equipment.
Bauerschmidt, A D; Jacobs, P
This article reports on a survey of 60 financial managers of nonprofit hospitals in the eastern United States relating to the importance of a number of factors which influence their pricing decisions and the pricing objectives which they pursue. Among the results uncovered by the responses: that trustees are the single most important body in the price-setting process (doctors play a relatively unimportant role); that hospital pricing goals are more related to target net revenue than profit ma...
Strømgaard, Sofie; Rasmussen, Søren Wistisen; Schmidt, Thomas Andersen
BACKGROUND: Crowded departments are a common problem in Danish hospitals, especially in departments of internal medicine, where a large proportion of the patients are elderly. We therefore chose to investigate the number and character of hospitalizations of elderly patients with a duration of les...... care sector, yet who do not belong at the emergency department. Further studies are needed to create a suitable service for these patients, and to improve the continuity of the treatment and the cooperation between hospitals and the primary health care sector.......BACKGROUND: Crowded departments are a common problem in Danish hospitals, especially in departments of internal medicine, where a large proportion of the patients are elderly. We therefore chose to investigate the number and character of hospitalizations of elderly patients with a duration of less...... than 24 hours, as such short admissions could indicate that the patients had not been severely ill and that it might have been possible in these cases to avoid hospitalization. METHODS: Medical records were examined to determine the number of patients aged 75 or more who passed through the emergency...
This PhD thesis is a contribution to an ongoing debate in Denmark about improving the building design processes of complex buildings, especially in relation to the current hospital developments. It provides knowledge about capturing user needs and defines the process model for usability briefing ...... of complex buildings, such as hospitals. The research results have relevance to researchers, architects, facility managers and client organizations planning new complex facilities, and especially for professionals working with briefing and design of hospitals.......This PhD thesis is a contribution to an ongoing debate in Denmark about improving the building design processes of complex buildings, especially in relation to the current hospital developments. It provides knowledge about capturing user needs and defines the process model for usability briefing...... for hospital architecture from a user perspective. The thesis is based on comprehensive literature studies, three main case studies at hospitals,numerous expert interviews and workshops. The research results generate a better understanding of how knowledge about user needs, acquired from workshops...
Research in Hospitality Management: Journal Sponsorship. Journal Home > About the Journal > Research in Hospitality Management: Journal Sponsorship. Log in or Register to get access to full text downloads.
Bravi, F; Gibertoni, D; Marcon, A; Sicotte, C; Minvielle, E; Rucci, P; Angelastro, A; Carradori, T; Fantini, M P
Hospital networks are an emerging organizational form designed to face the new challenges of public health systems. Although the benefits introduced by network models in terms of rationalization of resources are known, evidence about stakeholders' perspectives on hospital network performance from the literature is scanty. Using the Competing Values Framework of organizational effectiveness and its subsequent adaptation by Minvielle et al., we conducted in 2009 a survey in five hospitals of an Italian network for oncological care to examine and compare the views on hospital network performance of internal stakeholders (physicians, nurses and the administrative staff). 329 questionnaires exploring stakeholders' perspectives were completed, with a response rate of 65.8%. Using exploratory factor analysis of the 66 items of the questionnaire, we identified 4 factors, i.e. Centrality of relationships, Quality of care, Attractiveness/Reputation and Staff empowerment and Protection of workers' rights. 42 items were retained in the analysis. Factor scores proved to be high (mean score>8 on a 10-item scale), except for Attractiveness/Reputation (mean score 6.79), indicating that stakeholders attach a higher importance to relational and health care aspects. Comparison of factor scores among stakeholders did not reveal significant differences, suggesting a broadly shared view on hospital network performance. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.
There are so many obvious delays and inefficiencies in our traditional system of acute hospital care; it is clear that if outcomes are to be improved prompt accurate assessment immediately followed by competent and efficient treatment is essential. Early warning scores (EWS) help detect acutely ill patients who are seriously ill and likely to deteriorate. However, it is not known if any EWS has universal applicability to all patient populations. The benefit of Rapid Response Systems (RRS) such as Medical Emergency Teams has yet to be proven, possibly because doctors and nurses are reluctant to call the RRS for help. Reconfiguration of care delivery in an Acute Medical Assessment Unit has been suggested as a "proactive" alternative to the "reactive" approach of RRS. This method ensures every patient is in an appropriate and safe environment from the moment of first contact with the hospital. Further research is needed into what interventions are most effective in preventing the deterioration and\\/or resuscitating seriously ill patients. Although physicians expert in hospital care decrease the cost and length of hospitalization without compromising outcomes hospital care will continue to be both expensive and potentially dangerous.
Full Text Available Introduction: Severe Psychiatricillness is accompanied by gross disturbances in patient's occupational role. This study presents a comparative picture of work performance before and after psychiatric hospitalization. Method: Subjects comprised 440 psychiatric admitters from Noor Medical center - Isfahan - Iran, who were followed from November 1999 to November 2000. Their work adjustment was measured by means of Weiss man's index. Data were computer analyzed using SPSS by running paired t- student and ANOVA. Results: Majority of the patients (53 % were without permanent sources of income before psychiatric hospitalization, about 12 percent of those who were working prior to hospitalization lost their job after being discharged from hospital. Better work adjustment before hospitalization was positively correlated with better work adjustment after discharge for working patients (r =0/66. Working ability of the patients after discharge was lesser than before the attack f9r patients with regular and irregular job (P < 001. Discussion: Job loss or poor working ability after psychiatric admission reported by several researchers and has bean confirmed in this study as well. These observatoins have been discussed in view of the current socio economic problems in the society and nature of psychiatric disturbances.
Full Text Available Hospital ships are operated by the Naval forces in or near war zones to provide medical assistance to the wounded personnel of all nationalities and not be used for any military purpose. Hospital ships possibly existed in ancient times and the Athenian Navy had a ship named Therapia. However, it was only during the 17th century that it became a common practice for the naval squadrons to be accompanied by large ships with the facilities of carrying the wounded after each engagement. In 1860, the steamships HMS Melbourne and HMS Mauritius were equipped with genuine medical facilities. They were manned by the Medical Staff Corps and provided services to the British expedition to China. During the World War I and World War II, passenger ships were converted for use as hospital ships and were started to be used on a massive scale. RMS Aquitania and HMHS Britannic were two famous examples of hospital ships used extensively. Modern US hospital ships USNS Mercy and USNS Comfort are operated by Military Sealift Command of the US Navy. Their primary mission is to provide emergency on-site care for US combatant forces deployed in war or other operations.
Hospitality is often understood as an ethical openness towards the other. Hospitality, in this way, is a gift. But is this really the situation of hospitality in the world today? Europeans have created another, bespoke hospitality and they insist on being given a generous welcome all over the world
... 46 Shipping 4 2010-10-01 2010-10-01 false Hospital spaces. 108.209 Section 108.209 Shipping COAST... Construction and Arrangement Accommodation Spaces § 108.209 Hospital spaces. (a) Each unit carrying twelve or more persons on a voyage of more than three days must have a hospital space. (b) Each hospital space...
according to focus areas and proposes which evaluation methods to use in different building phases of healthcare facilities. Hospital evaluations with experts and users are also considered; their subjective view on space, function, technology, usability and aesthetics. Results & solutions: This paper...... presents the different methods for evaluating buildings in use in a new model, the Evaluation Focus Flower, and proposes which evaluation methods are suitable for various aims and building phases, i.e. which is giving best input for the initial briefing process of new hospital facilities with ambition...... of creating buildings with enhanced usability. Additionally various evaluation methods used in hospital cases in Denmark and Norway are presented. Involvement of users is proposed, not just in defining requirements but also in co-creation/design and evaluation of solutions. The theories and preliminary...
van Merode, Godefridus G; Groothuis, Siebren; Hasman, Arie
Integrated hospitals need a central planning and control system to plan patients' processes and the required capacity. Given the changes in healthcare one can ask the question what type of information systems can best support these healthcare delivery organizations. We focus in this review on the potential of enterprise resource planning (ERP) systems for healthcare delivery organizations. First ERP systems are explained. An overview is then presented of the characteristics of the planning process in hospital environments. Problems with ERP that are due to the special characteristics of healthcare are presented. The situations in which ERP can or cannot be used are discussed. It is suggested to divide hospitals in a part that is concerned only with deterministic processes and a part that is concerned with non-deterministic processes. ERP can be very useful for planning and controlling the deterministic processes.
Clement, J P; Grazier, K L
The purpose of this study is to determine the extent to which health maintenance organization (HMO) penetration within the public hospitals' market area affects the financial performance and viability of these institutions, relative to private hospitals. Hospital- and market-specific measures are examined in a fully interacted model of over 2,300 hospitals in 321 metropolitan statistical areas (MSAs) in 1995. Although hospitals located in markets with higher HMO penetration have lower financial performance as reflected in revenues, expenses and operating margin, public hospitals are not more disadvantaged than other hospitals by managed care.
Sweigart, Joseph R; Tad-Y, Darlene; Kneeland, Patrick; Williams, Mark V; Glasheen, Jeffrey J
Hospital medicine (HM) is rapidly evolving into new clinical and nonclinical roles. Traditional internal medicine (IM) residency training likely does not optimally prepare residents for success in HM. Hospital medicine residency training tracks may offer a preferred method for specialized HM education. Internet searches and professional networks were used to identify HM training tracks. Information was gathered from program websites and discussions with track directors. The 11 HM tracks at academic medical centers across the United States focus mostly on senior residents. Track structure and curricular content are determined largely by the structure and curricula of the IM residency programs in which they exist. Almost all tracks feature experiential quality improvement projects. Content on healthcare economics and value is common, and numerous track leaders report this content is expanding from HM tracks into entire residency programs. Tracks also provide opportunities for scholarship and professional development, such as workshops on abstract creation and job procurement skills. Almost all tracks include HM preceptorships as well as rotations within various disciplines of HM. HM residency training tracks focus largely on quality improvement, health care economics, and professional development. The structures and curricula of these tracks are tightly linked to opportunities within IM residency programs. As HM continues to evolve, these tracks likely will expand to bridge clinical and extra-clinical gaps between traditional IM training and contemporary HM practice. Journal of Hospital Medicine 2017;12:173-176. © 2017 Society of Hospital Medicine
Kini, K.S.; Gaur, P.K.
Short-lived radiopharmaceuticals, such as 99m Tc labelled compounds, are prepared in the in-house pharmacy of the hospital. In addition, preparation of smaller doses for administration from the bulk material of the finished product received from the manufacturers, also involves considerable work for the radiopharmacist in the hospital. Hence they should be well informed about the radiation hazards and should be aware of the protective measures to be taken while handling radioactive materials for keeping the radiation levels in the laboratory and their personnel doses well within the specified limits. 3 refs., 5 tabs
Haindl, Friedrich F.
Full Text Available It consists of: the actual hospital, one house for the staff, one service yard and underground garage. The hospital comprises four storeys and two basements, whilst the other building only has three floors. On the ground floor of the hospital are we located: the entrance; the nucleus of vertical communication; work rooms for the doctors and nurses; the administration section; X-ray and cobalt installations; and a small chapel. The three remaining upper floors contain 160 beds distributed over 6 wards and in single, double or triple rooms. Each floor is equipped with a service section. The first basement includes the ambulance entrance, the medical wards of the hospital, the staff dining-room, a kitchen and the heating installation. The second basement is reserved for kitchen storage rooms and the remaining installations of the building. Structure of reinforced concrete and outer walls of brick covered with panels of washed concrete.Está formado por: el hospital propiamente dicho, un edificio destinado a viviendas para el personal, patio de servicio y garaje subterráneo. El hospital consta de cuatro plantas y dos sótanos, mientras que el otro edificio sólo tiene tres plantas. En la planta baja del hospital se encuentran: la entrada; el núcleo de comunicación vertical; las salas de trabajo de médicos y enfermeras; la zona de administración; las instalaciones de rayos X y bomba de cobalto; y una pequeña capilla. En las tres plantas superiores se distribuyen 160 camas repartidas en seis unidades de hospitalización, con habitaciones de 1, 2 ó 3 camas. Cada planta cuenta, además, con una zona de servicio. En el primer sótano se hallan, además de la entrada de ambulancias, los servicios médicos del hospital, los comedores del personal, una cocina, y la instalación de calefacción. El segundo sótano se dedica, en su totalidad, a almacenes de la cocina y del resto de las instalaciones del edificio. Estructura de
Gargallo, Ana; Gómez-Varela, Ana I.; González-Nuñez, Hector; Delgado, Tamara; Almaguer, Citlalli; Cambronero, Ferran; Garcia-Sanchez, Angel; Flores-Arias, Maria T.
USC-OSA is a student chapter whose objective is to bring Optics knowledge closer to the non-optics community. The activity developed at the Hospital school was one of the most important last year. It was consisted in a few Optics experiments and workshops with hospitalized children of different ages and pathologies. The experiments had to be adapted to their physical conditions with the aim of everyone could participate. We think this activity has several benefits including spreading Optics through children meanwhile they have fun and forget their illness for a while.
Henríquez Martínez, T; Armero Fuster, M
A review of the following points was performed: Factors favouring the development and presence of malnutrition among hospitalized patients. Useful parameters in nutritional evaluation. Types of malnutrition. The Chang nutritional evaluation protocol is used in our Hospital, which is simple, inexpensive, reliable, specific and easily reproduced. This is based on five variables (three anthropometric and two biochemical), randomized and based on reference tables and values. A study was made on data corresponding to 70 patients, in whom a prevalence of malnutrition was observed in critical patients. The patients were classified based on three different definitive possibilities (Marasmo, Kwashiorkor and combined), and three grades of malnutrition (slight, moderate and severe).
Computers have been used to automate complex and repetitive tasks in veterinary hospitals since the 1960s. Early systems were expensive, but their use was justified because they performed jobs which would have been impossible or which would have required greater resources in terms of time and personnel had they been performed by other methods. Systems found in most veterinary hospitals today are less costly, magnitudes more capable, and often underused. Modern multitasking operating systems and graphical interfaces bring many opportunities for automation. Commercial and custom programs developed and used in a typical multidoctor mixed species veterinary practice are described.
Full Text Available Responsible management of global hospitality companies increasingly recognizes how important are concerns about the society, the environment as well as all stakeholders in maintaining a good market position. In Serbia, the concept of corporate social responsibility is relatively unknown and insufficiently researched in all business areas, especially in the hospitality industry where small businesses are dominated. The papers task is to present particular activities that demonstrate social responsibility to employees, customers-guests, local communities as well as the environment. The paper aims to highlight the benefits of adopting the principles of corporate social responsibility and innovation applied in catering enterprises as an example of good corporate social responsibility practices.
Toomey, Sara L; Peltz, Alon; Loren, Samuel; Tracy, Michaela; Williams, Kathryn; Pengeroth, Linda; Ste Marie, Allison; Onorato, Sarah; Schuster, Mark A
Hospital readmission rates are increasingly used to assess quality. Little is known, however, about potential preventability of readmissions among children. Our objective was to evaluate potential preventability of 30-day readmissions using medical record review and interviews. A cross-sectional study in 305 children (<18 years old) readmitted within 30 days to a freestanding children's hospital between December 2012 and February 2013. Interviews (N = 1459) were conducted with parents/guardians, patients (if ≥13 years old), inpatient clinicians, and primary care providers. Reviewers evaluated medical records, interview summaries, and transcripts, and then rated potential preventability. Multivariate regression analysis was used to identify factors associated with potentially preventable readmission. Adjusted event curves were generated to model days to readmission. Of readmissions, 29.5% were potentially preventable. Potentially preventable readmissions occurred sooner after discharge than non-potentially preventable readmissions (5 vs 9 median days; P < .001). The odds of a readmission being potentially preventable were greatest when the index admission and readmission were causally related (adjusted odds ratio [AOR]: 2.6; 95% confidence interval [CI]: 1.0-6.8) and when hospital (AOR: 16.3; 95% CI: 5.9-44.8) or patient (AOR: 7.1; 95% CI: 2.5-20.5) factors were identified. Interviews provided new information about the readmission in 31.2% of cases. Nearly 30% of 30-day readmissions to a children's hospital may be potentially preventable. Hospital and patient factors are associated with potential preventability and may provide targets for quality improvement efforts. Interviews contribute important information and should be considered when evaluating readmissions. Copyright © 2016 by the American Academy of Pediatrics.
Gilden, D. J.; Scissors, K. N.; Reuler, J. B.
Use of disposable products in hospitals continues to increase despite limited landfill space and dwindling natural resources. We analyzed the use and disposal patterns of disposable hospital products to identify means of reducing noninfectious, nonhazardous hospital waste. In a 385-bed private teaching hospital, the 20 disposable products of which the greatest amounts (by weight) were purchased, were identified, and total hospital waste was tabulated. Samples of trash from three areas were so...
... Administration (FHA): Hospital Mortgage Insurance Program--Refinancing Hospital Loans; Proposed Rule #0;#0... Housing Administration (FHA): Hospital Mortgage Insurance Program--Refinancing Hospital Loans AGENCY.... SUMMARY: This rule proposes to revise the regulations governing FHA's Section 242 Hospital Mortgage...
..., Hospital Inpatient Quality Reporting and Hospital Value-Based Purchasing--Program Administration... for Medicare & Medicaid Services 42 CFR Parts 412, 413, 424, et al. Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective...
technology to improve and expand the opportunity for rural and urban underserved populations to receive quality, affordable health care....The Community Hospital Telehealth Consortium (CHTC) is a unique, forward-thinking, community-based healthcare service project organized around 6 not
Anaesthesiology: Expertise that has already been developed at existing hospitals will be concentrated at NMCH. This will be expanded as the surgical services in the various specialties develop. • Imaging: State-of-the-art magnetic resonance imaging, computed tomography and positron emission tomography-computed.
Turnbull, Angus; Osborn, Michael; Nicholas, Nick
To determine the hospital autopsy rate for the UK in 2013. A study of data from a 'Freedom of Information' request to all (n=186) acute NHS Trusts within England (n=160), NHS Boards in Scotland (n=14) and Wales (n=7) and Social Care Trusts in Northern Ireland (n=5). Hospital autopsy rates were calculated from the number of hospital autopsies performed in 2013 as a percentage of total inpatient deaths in the Trust that year. The UK response rate was 99% (n=184), yielding a mean autopsy rate of 0.69%. The mean rates were 0.51% (England), 2.13% (Scotland), 0.65% (Wales) and 0.46% (Northern Ireland). 23% (n=38) of all included respondents had a rate of 0% and 86% (n=143) a rate less than 1%. The decline in hospital autopsy has continued relentlessly and, for better or for worse, the practice is on the verge of extinction in the UK. The study highlights to health professionals and policy makers the magnitude of this decline. Further research should investigate the impact of this on patient safety, clinical audit, public health and medical education. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
... successful safe patient handling program. Journal of Nursing Administration . 39(4): 170-175. 4 Charney, W., B. Simmons, M. Lary, and S. Metz. 2006. Zero lift programs in small rural hospitals in Washington state: Reducing back injuries among health ...
from arrival in hospital to review by a clinician. Figure i of adequate cervical spine X-rays(22, 25). High pick-up summarizes our findings. rates are only attained with adequate X-rays. Studies done elsewhere have shown that up to 45% of initial. Clinical evaluation: Not all patients were assessed for. X-rays are inadequate.
ﬂt the remaining E? uncleared patients, iii'. Siiei had severe cervical spine injuries which had been missed. Conciu.-riorr.'This study concluded that the initial clinical and radiological evaluation of patients with suspected CSI in iiilulago Hospital ...
Li, Yuguo; Nielsen, Peter V.; Sandberg, Mats
Hospital differ from conventional buildings in terms of ventilation needs. Exhaled infectious droplets or droplet nuclei of an infected patient need to be removed in general wards, waiting areas and isolation rooms to minimize transmission to health-care workers, other patients and visitors...
The Nigerian Hospital Practice Journal serves in enhancing advancement of medicine globally, a medium for disseminating information about current clinical and ... Article received, is sent to either a professor, associate professor, senior lecturer who is an authority on the particular subject of the article for review, it may be ...
van Merode, Godefridus G.; Groothuis, Siebren; Hasman, Arie
Integrated hospitals need a central planning and control system to plan patients' processes and the required capacity. Given the changes in healthcare one can ask the question what type of information systems can best support these healthcare delivery organizations. We focus in this review on the
Bloom, Thomas A.
The use of advisory committees for the development, maintenance, and continued exchange of information for hospitality education programs is discussed. Two types of committees are the general advisory type, which can deal with entire programs on institutional and community levels, and the single-field type, which helps develop programs in specific…
HEJ reports on the major benefits seen at Basildon University Hospital in Essex through the installation of a sophisticated building energy management system, which also integrates features such as access control, security, and lighting control, and whose advantages are increasingly being experienced by an ever broader range of Trust users.
The article discusses interference problems of mobile telephones and other electromagnetic pollution sources with medical equipment in Norwegian hospitals. Studies show that significant interference from mobile phones may not be registered before the distance between the appliances are about 2 cm
and challenges of the participant within the health care system of the hospital, as well as the attitudes and ... Guardians spoke of the stress that being a Guardian put on their family back home. Many Guardians brought .... supplies, which were major hindrances to their ability to stay for the duration of a long chemotherapy ...
In addition to the behind-the-scenes work involved with planning and implementing continuing nursing education activities, there are additional ways we can enhance the learner's experience. This article presents ideas on how to improve your hospitality quotient. Copyright 2015, SLACK Incorporated.
Is there something distinct about the traditional Hospitality Management curriculum? First offered in 1893 at the Ecole Hoteliere Lausanne in Switzerland and launched in the United States at The School of Hotel Administration at Cornell University in 1922, has this course of study evolved over time to focus on both of Meyer's skills - originally based on technical skills but now transforming to emotional skills?
Shaffer, F A; Preziosi, P
The health care marketplace is becoming increasingly competitive. The hospital has a built-in marketing force with the nursing department, because nurses are in constant, direct contact with the customer. Nursing must identify the case mix profile of the community and focus the hospital product lines to meet community needs. The nursing department should decentralize, change, measure, and innovate the staff mix needed to operationalize these product lines. The development of nursing practice standards for the case mix will help to identify the staff mix needed and create systems to efficiently manage the product lines. Nursing management must become aware of cross-subsidization and downward skill substitution of nursing personnel. Nursing information systems must generate quality reports that invoke cost consciousness on the part of nursing staff. Quality assurance programs must become unit based and complete with frequent audits to correlate length of stay with nursing quality. Correlations must be determined between nursing productivity and case mix to determine the hospital's niche in the marketplace. The transformation of health care into a competitive business industry has created many opportunities for nursing. The health care industry's incentives for efficiency along with the decreasing demand for inpatient hospital services will be the forces driving health care toward a competitive marketplace. The hospital's nursing department should be strategically positioned to become accountable for increasing market share and enhancing quality patient outcomes. The focus has shifted from the theoretical to the tactical, which is a step in the right direction, particularly for nursing. Nursing, if strategically positioned, will not only thrive but will also excel in this chaotic environment by capturing the opportunities and being innovative.
Hospital capital investment is important for acquiring and maintaining technology and equipment needed to provide health care. Reduction in capital investment by a hospital has negative implications for patient outcomes. Most hospitals rely on debt and internal cash flow to fund capital investment. The great recession may have made it difficult for hospitals to borrow, thus reducing their capital investment. I investigated the impact of the great recession on capital investment made by California hospitals. Modeling how hospital capital investment may have been liquidity constrained during the recession is a novel contribution to the literature. I estimated the model with California Office of Statewide Health Planning and Development data and system generalized method of moments. Findings suggest that not-for-profit and public hospitals were liquidity constrained during the recession. Comparing the changes in hospital capital investment between 2006 and 2009 showed that hospitals used cash flow to increase capital investment by $2.45 million, other things equal. PMID:28617202
Hospital capital investment is important for acquiring and maintaining technology and equipment needed to provide health care. Reduction in capital investment by a hospital has negative implications for patient outcomes. Most hospitals rely on debt and internal cash flow to fund capital investment. The great recession may have made it difficult for hospitals to borrow, thus reducing their capital investment. I investigated the impact of the great recession on capital investment made by California hospitals. Modeling how hospital capital investment may have been liquidity constrained during the recession is a novel contribution to the literature. I estimated the model with California Office of Statewide Health Planning and Development data and system generalized method of moments. Findings suggest that not-for-profit and public hospitals were liquidity constrained during the recession. Comparing the changes in hospital capital investment between 2006 and 2009 showed that hospitals used cash flow to increase capital investment by $2.45 million, other things equal.
Zijlker-Jansen, Pauline Y.; Janssen, M. P.; van Tilborgh-de Jong, A. J W; Schipperus, M. R.; Wiersum-Osselton, J. C.
Background: The 2011 Dutch Blood Transfusion Guideline for hospitals incorporates seven internal quality indicators for evaluation of the hospital transfusion chain. The indicators aim to measure guideline compliance as shown by the instatement of a hospital transfusion committee and transfusion
Guzmán Laura, K P; Periañez Vasco, A; Falcón Neyra, M D; Croche Santander, B
Varicella (chickenpox) can cause serious complications and admission to hospital. Several countries included the varicella vaccine in their immunization schedules. A descriptive and retrospective study of hospitalizations due to varicella and its complications was conducted in a referral center from 2005 to 2011. A total of 1192 children with varicella were seen in the emergency room, of which 99 (8.5%) required admission. The annual incidence of admissions due to varicella and varicella complications was, 19.4 and 15.3 cases per 100,000 children under 14 years, respectively. Complications were more common in children under 5 years (79.5%), and with no underlying disease (78.2%). Infection of skin and soft tissue was the most common complication (62%). The mean hospital stay was 4.5 days (SD 4). Varicella causes high morbidity, and is more frequent in absolute terms in healthy children under 5 years of age. Therefore, routine vaccination recommended by the Immunization Advisory Committee should be mandatory. Copyright © 2013 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.
Fajardo-Ortiz, Guillermo; Salcedo-Alvarez, Rey Arturo
This study attempts to recount the history of the main hospitals of the port of Acapulco from colonial times until the end of the 20th century. The Augustine friars began hospital care at the end of the first part of the 16th century. Later, Bernardino Alvarez (1514?-1584), with the support of the Spanish crown, founded the first formal hospital in Acapulco called Hospital de Nuestra Señora de la Consolación (Our Lady of Consolation Hospital). During the 16th and 17th centuries, the sick were attended by friars, and by the end of the 19th century there were physicians and surgeons. From the end of the Independence War until the end of the 19th century, the port did not have any true hospital. The first degreed physicians and surgeons arrived and resided in Acapulco in 1920. In 1938, the Hospital Civil Morelos (Morelos Civil Hospital) began providing services. It was replaced by the Hospital General de Acapulco (General Hospital of Acapulco). At the fourth decade of the past century the Cruz Roja (Red Cross) was created. In 1957 the hospital services of the Instituto Mexicano del Seguro Social (IMSS, Mexican Institute of Social Security), which was founded in 1963, was inaugurated with the Unidad Medico/Social (Medical and Social Unit) of the IMSS in Acapulco. This began the journey of modernity in Acapulco. In 1992, Hospital Regional Vicente Guerrero (Regional Hospital Vicente Guerrero) of the IMSS, initiated its services. In 1960, medical services for civil workers and their families were housed in the Hospital Civil Morelos (Morelos Civil Hospital). Shortly afterwards, the Instituto de Seguridad y Servicios Sociales para los Trabajadores del Estado (ISSSTE, Security and Social Services Institute for State Employees) had their own hospital. During the 20th century, Acapulco has added other hospital services to care for members of the navy and armed forces, as well as for those persons with financial resources for private care.
Full Text Available The aim of this work was to analyse the medication process and the potential for errors during the process steps. For this purpose, a literature review was conducted and a questionnaire was developed to compare the results from the literature with the current medication process in Styrian hospitals. The questionnaire was divided into four different parts with a total of 29 questions. For the survey all 37 Styrian hospitals were contacted whereas 11 filled out the questionnaire. The survey showed that there is no standardized medication process defined and that the rate of medication errors is generally underestimated. In addition, technical solutions may help to reduce errors but are expected to be hardly used in clinical practice.
Millsap, P; Brown, E; Kiser, L; Pruitt, D
Health-care professionals are currently operating in the context of a rapidly changing health-care delivery system, including the move away from inpatient services to outpatient services in order to control costs. Those who practice in partial-hospital settings are in a position to offer effective, cost-efficient services; however, there continue to be obstacles which hinder appropriate utilization of the modality. The development and use of a well-designed marketing plan is one strategy for removing these obstacles. This paper presents a brief overview of the marketing process, ideas for developing a marketing plan, and several examples of specific marketing strategies as well as ways to monitor their effectiveness. Partial-hospital providers must take an active role in answering the calls for alternative sources of psychiatric care. A comprehensive, education-oriented marketing approach will increase the public's awareness of such alternatives and enable programs to survive in a competitive environment.
Falstie-Jensen, Anne Mette; Bogh, Søren Bie; Johnsen, Søren Paaske
Healthcare Quality Programme. Main outcome measures: A 30-day mortality, length of stay (LOS) and all-cause acute readmission. We computed adjusted odds ratios (OR) and hazard ratios (HR) using logistic and Cox Proportional Hazard regression including adjustment for six potential patient-related confounders...... admission (adjusted OR: 1.26 (95% CI: 1.11-1.43) and a longer LOS (adjusted HR of discharge: 0.89 (95% CI: 0.82-0.95) than in-patients at high compliant hospitals. No difference was seen for acute readmission (adjusted HR: 0.98 (95% CI: 0.90-1.06)). Focusing on the second cycle alone, in-patients......Objective: To examine the association between compliance with consecutive cycles of accreditation and patient-related outcomes. Design: A Danish nationwide population-based study from 2012 to 2015. Setting: In-patients admitted with one of the 80 diagnoses at public, non-psychiatric hospitals...
Full Text Available Hospitality industry is a complex product-service economic activity which besides accommodation, food and beverages offers a variety of complementary and ancillary services in order to meet modern needs, demands and desires of tourists consumers. Contemporary needs, demands and desires of tourists consumers (increased need for security and preservation of health; emphasis on ecology and healthy food; pure nature stay; growing demand for adventure activities and excitement; convention facilities and incentive offerings; visits to towns, big sports, cultural, religious, business events; new travel motivation have led to the emergence of new trends in hospitality offering design. Wellness and spa hotels, boutique hotels, all inclusive hotels, slow-food restaurants, and wine and lounge bars are just some of the main trends, and successful hoteliers and caterers will examine each of the trends and devise development politics in accordance with the new requirements and global market needs.
Stidsen, Lone Mandrup
by the patients in the ward. The project is based on the Danish Regulation for light in hospitals (DS703), which is a supplement to the regulation of artificial lighting in workplaces (DS700). The kick-off to the project was reading the DS703, second paragraph, chapter 2 about general requirements for lighting...... the hospitals by research base the design of the buildings. The present PhD project expands the existing knowledge of lighting research by focusing on the experienced light atmosphere. The project uses multi strategies of methodology based on a flexible design to elaborate on the sociocultural aspect of light...... and the sensory impact of light. To frame the work, the “Model of Light Atmosphere” is created and improved throughout the study, first as an abstract model and then it is exposed for detailed study. The detailed study first of all creates a theoretical and visual context. Then explorative studies seek...
Gagić Snježana; Kalenjuk Bojana; Jovičić Ana; Petrović Marko
The continuous growth of competition in the hospitality sector has created the need to retain guests and prevent them from switching company due to better offer or saturation. Loyal customers are a valuable asset for catering companies, not only because of the awareness of the effects of customer loyalty. They tend to spread word-of-mouth advertising, more tolerant to price changes, as well as they casually create a linkage to their friends, relatives, colleagues, and other probable consumers...
Woo, Gon Kima, 1,; Hyunjung, Limb,; Robert, A. Brymerc, 2,
This paper investigates how managing online reviews affects hotel performance. An international hotel chain provided the hotel performance data and the online review data. A leading social media firm for the hospitality industry collected the online review data, which the hotel company purchased. The results indicate that overall ratings are the most salient predictor of hotel performance, followed by response to negative comments. The better the overall ratings and the higher the response ra...
The experience and practice of the author is described in her appointment as a breast feeding advisor to the paediatric and obstetric units at University College Hospital with special responsibility for supervising infant feeding, especially breast feeding in the maternity unit. During 1980-5 there were 13,185 mothers whose babies fed. The feeding method of 12,842 mothers was recorded on discharge from the postnatal wards and 77% were breast feeding; only 3% of these mothers gave complement f...
Escher, Achim; Hainc, Nicolin; Boll, Daniel
Business intelligence (BI) is a worthwhile investment, and will play a significant role in hospital management in the near future. Implementation of BI is challenging and requires resources, skills, and a strategy, but enables management to have easy access to relevant analysis of data and visualization of important key performance indicators (KPI). Modern BI applications will help to overcome shortages of common "hand-made" analysis, save time and money, and will enable even managers to do "self-service" analysis and reporting.
Full Text Available Is there something distinct about the traditional Hospitality Management curriculum? First offered in 1893 at the Ecole Hoteliere Lausanne in Switzerland and launched in the United States at The School of Hotel Administration at Cornell University in 1922, has this course of study evolved over time to focus on both of Meyer's skills - originally based on technical skills but now transforming to emotional skills?
Hospitality industry is a complex product-service economic activity which besides accommodation, food and beverages offers a variety of complementary and ancillary services in order to meet modern needs, demands and desires of tourists consumers. Contemporary needs, demands and desires of tourists consumers (increased need for security and preservation of health; emphasis on ecology and healthy food; pure nature stay; growing demand for adventure activities and e...
Katona, Katalin; Canoy, Marcel
There is a broad literature on the consequences of applying different welfare standards in merger control. Total welfare is usually defined as the sum of consumer and provider surplus, i.e., potential external effects are not considered. The general result is then that consumer welfare is a more restrictive standard than total welfare, which is advantageous in certain situations. This relationship between the two standards is not necessarily true when the merger has significant external effects. We model mergers on hospital markets and allow for not-profit-maximizing behavior of providers and mandatory health insurance. Mandatory health insurance detaches the financial and consumption side of health care markets, and the concept consumer in merger control becomes non-evident. Patients not visiting the merging hospitals still are affected by price changes through their insurance premiums. External financial effects emerge on not directly affected consumers. We show that applying a restricted interpretation of consumer (neglecting externality) in health care merger control can reverse the relation between the two standards; consumer welfare standard can be weaker than total welfare. Consequently, applying the wrong standard can lead to both clearing socially undesirable and to blocking socially desirable mergers. The possible negative consequences of applying a simple consumer welfare standard in merger control can be even stronger when hospitals maximize quality and put less weight on financial considerations. We also investigate the implications of these results for the practice of merger control.
Hornik, Christoph P; Graham, Eric M; Hill, Kevin; Li, Jennifer S; Ofori-Amanfo, George; Clark, Reese H; Smith, P Brian
Hospitalized infants requiring cardiopulmonary resuscitation (CPR) represent a high-risk group. Recent data on risk factors for mortality following CPR in this population are lacking. We hypothesized that infant demographic characteristics, diagnoses, and levels of cardiopulmonary support at the time of CPR requirement would be associated with survival to hospital discharge following CPR. Retrospective cohort study. All infants receiving CPR on day of life 2 to 120 admitted to 348 Pediatrix Medical Group neonatal intensive care units from 1997 to 2012. We collected data on demographics, interventions, center volume, and death prior to NICU discharge. We evaluated predictors of death after CPR using multivariable logistic regression with generalized estimating equations to account for clustering of the data by center. Our cohort consisted of 2231 infants receiving CPR. Of these, 1127 (51%) survived to hospital discharge. Lower gestational age, postnatal age, 5-min APGAR, congenital anomaly, and markers of severity of illness were associated with higher mortality. Mortality after CPR did not change significantly over time (Cochran-Armitage test for trend p=0.35). Mortality following CPR in infants is high, particularly for less mature, younger infants with congenital anomalies and those requiring cardiopulmonary support prior to CPR. Continued focus on at risk infants may identify targets for CPR prevention and improve outcomes. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
Guevara, L. T.
Functional collapse of hospitals (FCH) occurs when a medical complex, or part of it, although with neither structural nor nonstructural damage, is unable to provide required services for immediate attention to earthquake victims and for the recovery of the affected community. As it is known, FCH during and after an earthquake, is produced, not only by the damage to nonstructural components, but by an inappropriate or deficient distribution of essential and supporting medical spaces. This paper presents some conclusions on the analysis of the traditional architectural schemes for the design and construction of hospitals in the 20th Century and some recommendations for the establishment of evaluation parameters for the remodeling and seismic upgrade of existing hospitals in seismic zones based on the new concepts of: a) the relative location of each essential service (ES) into the medical complex, b) the capacity of each of these spaces for housing temporary activities required for the attention of a massive emergency (ME); c) the relationship between ES and the supporting services (SS); d) the flexibility of transformation of nonessential services into complementary spaces for the attention of extraordinary number of victims; e) the dimensions and appropriateness of evacuation routes; and d) the appropriate supply and maintenance of water, electricity and vital gases emergency installations.
Research in Hospitality Management is a peer-reviewed journal publishing papers that make an original contribution to the understanding of hospitality and ... resources management, financial management, marketing, strategic management, economics, business forecasting, information technology and development, ...
Rural hospitals serve as major sources of health care and employment for their communities, but recently they have been under increased financial stress. What are the causes of this stress, and how have hospitals and their communities responded?
U.S. Department of Health & Human Services — In October 2014, CMS began reducing Medicare payments for subsection (d) hospitals that rank in the worst performing quartile with respect to hospital-acquired...
Schuurman, B.; IJtsma, D.; Zwigt, A.
Interviews were made with radiation experts working at hospitals about the treatment and limiting of radioactive wastes. The authors conclude that with the aid of hospital personnel a decrease of the volume of radioactive waste is possible. 25 refs
U.S. Department of Health & Human Services — Hospital Outpatient Prospective Payment System (OPPS) Limited Data Set This file contains select claim level data and is derived from 2010 hospital outpatient PPS...
U.S. Department of Health & Human Services — The National Hospital Ambulatory Medical Care Survey (NHAMCS) is designed to collect data on the utilization and provision of ambulatory care services in hospital...
Relation Between Demographic Factors And Hospitalization In Patients With Gastrointestinal Disorders, Using Quantail Regression Analysis. ... East African Journal of Public Health ... Objective: The aim of this study is to investigate relation between demographic factors and hospitalization in gastrointestinal disorders.
U.S. Department of Health & Human Services — There are two methods for a hospital to qualify for the Medicare DSH adjustment. The primary method is for a hospital to qualify based on a statutory formula that...
... to help hospitals improve maternity care practices. Tracking hospital policies and practices that support breastfeeding using CDC’s Maternity Practices in Infant Nutrition and Care (mPINC) survey to evaluate federal, state ...
Five-rights - medication; Medication administration - hospital; Medical errors - medication; Patient safety - medication safety ... right dose, at the right times. During your hospital stay, your health care team needs to follow ...
Nigerian Quarterly Journal of Hospital Medicine: Submissions. Journal Home > About the Journal > Nigerian Quarterly Journal of Hospital Medicine: Submissions. Log in or Register to get access to full text downloads.
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...
U.S. Department of Health & Human Services — The current Medicare policy of non-payment to hospitals for Hospital Acquired Conditions (HAC) seeks to avoid payment for preventable complications identified within...
Items 1 - 50 of 50 ... Archives: Nigerian Quarterly Journal of Hospital Medicine. Journal Home > Archives: Nigerian Quarterly Journal of Hospital Medicine. Log in or Register to get access to full text downloads.
Brown, Thomas C; Werling, Krist A; Walker, Barton C; Burgdorfer, Rex J; Shields, J Jordan
Healthcare reform will impact hospital consolidation in three key areas: Payment rates will decrease, indirectly encouraging consolidation by forcing hospitals to find new ways to reduce costs and increase negotiating clout with suppliers and payers. The cost of doing business will increase as hospitals spend more on compliance, technology, and physician employment. The ACO model will encourage hospital network formation by rewarding integrated healthcare systems that can reduce costs and improve quality.
C. L. Chua; Alfons Palangkaraya; Jongsay Yong
This paper studies the link between competition and technical efficiency of public hospitals in the State of Victoria, Australia by accounting both quantity and quality of hospital output using a two-stage semi-parametric model of hospital production and Data Envelopment Analysis. On the one hand, it finds a positive relationship between efficiency and competition measured by the Hirschman-Herfindahl Index (HHI). On the other, it finds that efficiency and the number of competing hospitals, in...
Maslow, Katie; Mezey, Mathy
Many hospital patients with dementia have no documented dementia diagnosis. In some cases, this is because they have never been diagnosed. Recognition of Dementia in Hospitalized Older Adults proposes several approaches that hospital nurses can use to increase recognition of dementia. This article describes the Try This approaches, how to implement them, and how to incorporate them into a hospital's current admission procedures. For a free online video demonstrating the use of these approaches, go to http://links.lww.com/A216.
Ponton, Kevin T; Sandrick, Karen M
Hospitals need to actively position themselves in the next 18 to 24 months to ensure continued access to financing. Hospitals need to shift their focus from investment income to operations. Hospitals should recognize the importance of balance-sheet liquidity to institutional investors. Not-for-profit hospitals should focus on both sides of the balance sheet. Healthcare executives need to develop effective leadership and investor-relations skills.
Arostegui, M.; Borba, M.; Caldarelli, D.; Eguiia, A.; Fernandez, E.; Peleteiro, M.; Pereira, C.; Vico, M.
This work was carried out by a nursery licensed group in the Clinicas Hospital - Dr. Manuel Quintela.The nature and functioning of Services and the allocation of resources, are essential for the analysis of the Survey of the hospitalized oncology patients in the Institution. To develop a model of care that constitutes a health care as well as teaching and research in the country regarding the quality of care was defined the following topics: lower risks for the patient, safer care, personal trained and specialized to promote relationship between the offering and the person receiving the service. The assessment and management performance of the services involved in the operation are the result of the degree of user satisfaction. Objective: To determine the human and material necessary for the care of cancer resources users, considering their number, treatment, complications and nursing care derived from each pathology and stage of disease. Methodology: A comparative descriptive study of the same population was conducted in two transverse sections in relation to two different times which are based on the design of a form that allowed hospitalized to collect information on users 6/12/03 and 6/16/04. Other instruments used were the clinical history and the daily census staff Patients and Nursing Division. Results and conclusions: A comparative descriptive analysis already mentioned are: increased internships and cancer patients; between 50 and 64 is the highest number of patients; diagnoses Face and Neck and maintain the Digestive System more cases; the number of patients doubles and Hematology Neurological from one to another period. Chemotherapy is the treatment choice and there is a decrease in the surgical and medical; more patients in the study; in the origin, Montevideo has the largest number of patients followed by Canelones. Line of nursing intervention will be carried out in short, medium and long term
Aspects of present state policy on private hospitals. Two major Commissions of Inquiry have examined the role of private hospitals in South Africa over the last 2 decades. ..... for private hospitals would result in significant improvements in financial .... lem is the potential shonage of skilled management required to take over ...
Pijls-Hoekstra, Ruth; Groen, Brenda H.; Galetzka, Mirjam; Pruyn, Ad T.H.
Hospitality is a much-researched topic, but its definition is still debated. This paper is part of a larger research project into the perception of hospitality. Previous research using the Delphi-method (hospitality providers and experts) and the Critical Incident Technique (guests and consumers)
Pink, George H.; Holmes, G. Mark; D'Alpe, Cameron; Strunk, Lindsay A.; McGee, Patrick; Slifkin, Rebecca T.
Context: There is a growing recognition of the need to measure and report hospital financial performance. However, there exists little comparative financial indicator data specifically for critical access hospitals (CAHs). CAHs differ from other hospitals on a number of dimensions that might affect appropriate indicators of performance, including…
Since 1989 there has been a burgeoning of the visual arts in Northern Ireland hospitals. This paper compares the three organisational models for hospital arts currently operating within the Province and in an overview discusses ways to coordinate working practice for future development of the visual arts in local hospitals. Images Fig 1 Fig 2 Fig 3
Since 1989 there has been a burgeoning of the visual arts in Northern Ireland hospitals. This paper compares the three organisational models for hospital arts currently operating within the Province and in an overview discusses ways to coordinate working practice for future development of the visual arts in local hospitals.
Since 1989 there has been a burgeoning of the visual arts in Northern Ireland hospitals. This paper compares the three organisational models for hospital arts currently operating within the Province and in an overview discusses ways to coordinate working practice for future development of the visual arts in local hospitals. Images Fig 1 Fig 2 Fig 3 PMID:8533183
Gallegos Espinosa, Sylvia; Nicolalde Cifuentes, Marcelo; Santana Porbén, Sergio
Hospital malnutrition is a global health problem affecting 30-50% of hospitalized patients. There are no estimates of the size of this problem in Ecuadorian hospitals. Hospital malnutrition might influence the quality of medical assistance provided to hospitalized populations. To estimate the current frequency of malnutrition among patients admitted to Ecuadorian public hospitals. The Ecuadorian Hospital Malnutrition Study was conducted between November 2011 and June 2012 with 5,355 patients (Women: 37.5%; Ages ≥ 60 years: 35.1%; Length of stay ≤ 15 days: 91.2%) admitted to 36 public hospitals located in the prominent cities of 22 out of the 24 provinces of the country. Malnutrition frequency was estimated by means of the Subjective Global Assessment survey. Malnutrition affected 37.1% of the surveyed patients. Malnutrition was dependent upon patient's age and education level; as well as the presence of cancer, sepsis, and chronic organic failure. Hospital areas showed different frequencies of hospital malnutrition. Health condition leading to hospital admission influenced negatively upon nutritional status. Malnutrition frequency increased as length of stay prolonged. Malnutrition currently affects an important proportion of patients hospitalized in public health institutions of Ecuador. Policies and actions are urgently required in order to successfully deal with this health problem and thus to ameliorate its negative impact upon quality of medical care. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.
Evans, Janet; Dummer, Verena; Kinzl, Johann
This paper on psychiatric and psychosomatic day hospitals in Austria first looks at the overall situation of Austrian day clinics then, in a second step, compares psychiatric and psychosomatic day hospitals. For this purpose, a questionnaire was developed and sent to all psychiatric and psychosomatic day hospitals in Austria. The first part consisted of closed questions and was used to gather and evaluate the categories: general conditions for treatment in day hospitals, tasks of day hospitals, therapeutic paradigms, indication and contraindication, diagnostics, day hospital organisation, interdisciplinary cooperation and the offering in day hospitals. The second section consisted of open questions which were used to gather and evaluate active factors, difficulties, specifics and requests for future treatment in day hospitals. The results show that there is a trend towards more day hospitals. Psychosomatic day hospitals are a rather new phenomenon. Furthermore, the distinction between psychiatric and psychosomatic day hospitals is important in order to offer patients distinguishable treatment options in future. The results show that psychiatric and psychosomatic day hospitals both have a strong focus on psychotherapy and both fulfill the active factors for psychotherapy by Grawe.
Messerly, Sally; King, Michalene A; Hughes, Suzanne
A Faith Community Nurse (FCN) Program was initiated by a Magnet hospital and developed through collaboration between hospital departments and a university nurse educator. This article describes the program's development and activities that offer FCNs networking, free continuing education, and are an extension of the hospital's mission and values.
Adler-Milstein, Julia; DesRoches, Catherine M; Jha, Ashish K
To determine the proportion of US hospitals engaged in health information exchange (HIE) with unaffiliated providers and to identify key hospital-level and market-level factors associated with participating in exchange. Using the 2009 American Hospital Association Information Technology survey, supplemented by Dartmouth Atlas, Area Resource File, and other national data, we examined which hospitals participated in regional efforts to electronically exchange clinical data. We used logistic regression models to determine hospital-level characteristics and market-level characteristics associated with hospitals' likelihood of participating in HIE. We found that 10.7% of US hospitals engaged in HIE with unaffiliated providers. In communities where exchange occurred, for-profit hospitals and those with a small market share were far less likely to engage in HIE than nonprofit hospitals or those with a larger market share. Hospitals in more concentrated markets were more likely to exchange and hospitals in markets with higher Medicare spending were less likely to exchange. At the start of implementation of the Health Information Technology for Economic and Clinical Health (HITECH) Act, only a small minority of US hospitals electronically exchange clinical data with unaffiliated providers. Health information exchange is a key part of reforming the healthcare system, and factors related to competitiveness may be holding some providers back.
... Pharmacy (40.7%) and Theatre (18.5%). This study showed that Kwale General Hospital environment is heavily contaminated and therefore underlies the necessity for regular evaluation of the hospital environment. Keywords: Bacteriological evaluation, hospital, environment. Journal of Medical Laboratory Sciences Vol.
Vaughan-Sarrazin Mary S
Full Text Available Abstract Background The emergence of physician owned specialty hospitals focusing on high margin procedures has generated significant controversy. Yet, it is unclear whether physician owned specialty hospitals differ significantly from non physician owned specialty hospitals and thus merit the additional scrutiny that has been proposed. Our objective was to assess whether physician owned specialty orthopedic hospitals and non physician owned specialty orthopedic hospitals differ with respect to hospital characteristics and patient populations served. Methods We conducted a descriptive study using Medicare data of beneficiaries who underwent total hip replacement (THR (N = 10,478 and total knee replacement (TKR (N = 15,312 in 29 physician owned and 8 non physician owned specialty orthopedic hospitals during 1999–2003. We compared hospital characteristics of physician owned and non physician owned specialty hospitals including procedural volumes of major joint replacements (THR and TKR, hospital teaching status, and for profit status. We then compared demographics and prevalence of common comorbid conditions for patients treated in physician owned and non physician owned specialty hospitals. Finally, we examined whether the socio-demographic characteristics of the neighborhoods where physician owned and non physician owned specialty hospitals differed, as measured by zip code level data. Results Physician owned specialty hospitals performed fewer major joint replacements on Medicare beneficiaries in 2003 than non physician owed specialty hospitals (64 vs. 678, P Conclusion Physician owned specialty orthopedic hospitals differ significantly from non physician owned specialty orthopedic hospitals and may warrant the additional scrutiny policy makers have proposed.
... prospective payment system is as follows: For FY 2013, the percentage increase for long term care hospitals is... Hospitals and FY 2013 Rates and to the Long Term Care Hospital PPS and FY 2013 Rates'' (77 FR 53257... CY 2013 will be: $296 for the 61st through 90th day of hospitalization in a benefit period; $592 for...
... follows: For FY 2014, the percentage increase for long term care hospitals is the market basket percentage... for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Fiscal Year... CY 2014 will be: $304 for the 61st through 90th day of hospitalization in a benefit period; $608 for...
... prospective payment system is as follows: For FY 2012, the percentage increase for long term care hospitals is... Prospective Payment Systems for Acute Care Hospitals and FY 2012 Rates and to the Long Term Care Hospital PPS...--(1) $289 for the 61st through 90th day of hospitalization in a benefit period; (2) $578 for lifetime...
... percentage increase reduced by .5 percentage points for Long Term Care Hospitals and reduced by .25... Hospitals and Fiscal Year 2011 Rates; and Changes to the Long-Term Care Hospital Prospective Payment System... coinsurance amounts for CY 2011 will be--(a) $283 for the 61st through 90th day of hospitalization in a...
... from the governing body of the hospital occupying space in the same building or on the same campus. The hospital's governing body is not under the control of the hospital occupying space in the same building or... body is under the control of the State hospital with which it shares a building or a campus, or is...
McCarthy, Aidan; Maor, Dorit; McConney, Andrew
The aim of this study was to identify hospital teachers' professional learning needs to enable effective use of mobile technology in hospital schools. Hospitalized students cannot attend their regular schools and as a result their educational progress and development can suffer. In an attempt to address this, hospital schools provide learning…
... 42 Public Health 3 2010-10-01 2010-10-01 false Hospital outpatient services excluded from payment under the hospital outpatient prospective payment system. 419.22 Section 419.22 Public Health CENTERS... PROSPECTIVE PAYMENT SYSTEM FOR HOSPITAL OUTPATIENT DEPARTMENT SERVICES Categories of Hospitals and Services...
Özkil, Ali Gürcan; Fan, Zhun; Dawids, Steen
In this paper, the need for automated transportation systems for hospitals is investigated. Among other alternatives, mobile robots stand out as the most prominent means of automation of transportation tasks in hospitals. Existing transportation routines of a hospital are analyzed in order to ver...... for implementing mobile service robots for transportation tasks in hospitals....
de Moura, Gisela Maria Schebella Souto; Luce, Fernando Bins
This research is about service encounters and customer satisfaction in hospitals. The study is exploratory and was aimed at identifying the service encounters maintained in hospitals and the satisfaction attributes related to them. The data were collected with hospital professionals and customer, in 2003, by means of interviews using the critical incident technique. The content analysis evidentiated the satisfaction attributes of the service encounters regarding admission, hospitalization and discharge procedures. The results provide important information to hospital service managers, allowing for the planning of customer-focused actions.
Alkibay, Sanem; Ozdogan, F Bahar; Ermec, Aysegul
This paper aims to present a perspective to better understand corporate identity through examining the perceptions of Turkish patients and develop a corporate visual identity scale. While there is no study related to corporate identity research on hospitals in Turkey as a developing country, understanding consumer's perceptions about corporate identity efforts of hospitals could provide different perspectives for recruiters. When the hospitals are considered in two different groups as university and state hospitals, the priority of the characteristics of corporate visual identity may change, whereas the top five characteristics remain the same for all the hospitals.
Hao, Aimin; Yi, Tao; Li, Xia; Wei, Lei; Huang, Pei; Xu, Xinzhou; Yi, Lihua
Purpose: The quality of medical services provided by competing public hospitals is the primary consideration of the public in determining the selection of a specific hospital for treatment. The main objective of strategic planning is to improve the quality of public hospital medical services. This paper provides an introduction to the history, significance, principles and practices of public hospital medical service strategy, as well as advancing the opinion that public hospital service strategy must not merely aim to produce but actually result in the highest possible level of quality, convenience, efficiency and patient satisfaction.
Full Text Available Hospital infections are the most frequent and important complications occurring in hospitalized patients. The concern is greater when the affected hospital infection are neonates admitted to intensive care units where the risk increases due to factors such as prematurity, low birth weight, types of procedures adopted and susceptibility due to their immature immune system. The prevention and control measures involve detection of hospital infection, development of norms of standardization, collaboration with the training of all health professionals, achieving control of antibiotic prescription and technical support for hospital administration.
Wig, Eldon D.
The information processing needs of a hospital are many, with varying degrees of complexity. The prime concern in providing an integrated hospital information management system lies in the ability to process the data relating to the single entity for which every hospital functions - the patient. This paper examines the PRIMIS computer system developed to accommodate hospital needs with respect to a central patient registry, inpatients (i.e., Admission/Transfer/Discharge), and out-patients. Finally, the potential for expansion to permit the incorporation of more hospital functions within PRIMIS is examined.
Full Text Available Objectives: In this study, our aim was to evaluate and classify the voluntary error reports in the hospitals of Mashhad University of Medical Sciences. Patients have the right to receive health care in accordance to the best standards. Health care carries a risk of harm for patient safety, and with respect to today’s stressful systems with a large number of patients, it would be inevitable. The meaning of risk management is to predict adverse events and reduce their occurrence.Materials and Methods: A voluntary medical error reporting form was designed and approved by the clinical governance team of Mashhad Medical University. They were then distributed inside hospitals in the way in which everyone (health providers and patients could access them easily. The forms were collected and classified monthly in all wards. Classification was performed on the base of type, outcome and reporter. Data gathering took place from spring to autumn 2012. The data was analyzed by the SPSS software. Results: 2500 errors were extracted from 1000 voluntary error reporting forms of the 12 hospitals of Mashhad Medical University. The most frequent error type was treatment errors (36% related to drug administration, standard procedures and surgical events. Conclusions: Error reporting as a basic activity has an important role in discovering pitfalls of the health care system. To promote the reporting culture, its non punitive base must become clear for all professors and staff members, because this kind of reporting could lead to fewer medical errors and higher staff awareness about probable errors.
integrated and detailed analysis and description model for hospital materials management data and tasks, which is able to tackle information from patient requirements to usage, from replenishment requests to supplying and handling activities. The model takes account of medical risk reduction, traceability and streamlined processes perspectives. Second, the paper translates this information into a business process model and mathematical formalization.The study provides a useful guide to the various relevant technology‐related, management and business issues, laying the foundations of an efficient reengineering of the supply chain to reduce healthcare costs and improve the quality of care.
Mahmood, S.; Din, N.U.; Mohsin, J.
Health care (Biomedical) waste is a term used for all waste arising from health care establishments. In most of health care centers of Pakistan, including Lahore, hospital wastes are simply mixed with the municipal waste in collecting bins at road-sides and disposed off similarly. Proper Management of biomedical waste, especially the hazardous one, being produced in hospital settings is important in terms of their ability to cause harm to the related per-sons and the environment as well. To Observe and compare the practices regarding Hospital Waste management of the public sector hospital with private sector hospital. Descriptive, Cross sectional. Methodology: Standardized checklist was used to assess the practices of nursing and sanitary staff. Practices regarding waste segregation were same at both hospitals. While practices regarding waste collection and transportation were better at The Children's Hospital. Public sector hospital has, paradoxically, better practices regarding hospital waste management in comparison to private sector hospital. (author)
Chandawarkar, Rajiv Y; Dutta, Satyajit
Legislative regulations, decreasing reimbursements for office procedures, and malpractice premiums have transformed plastic surgery from an office-based specialty into a hospital-based one. Simultaneously, hospital economics has altered, wherein the "business model" has all but subsumed the old "medical care" model. Integration between plastic surgeons and the new hospital structure has been difficult for both. Limited understanding of the financial dynamics of hospital-based practices, unfamiliarity with the administrative processes, and resistance to accept and assimilate changes by both sides pose hurdles, in some situations even forcing plastic surgeons out of hospital settings. Using well-defined financial terminology, changing national development in health care policy, and hospital-based administrative strategies as a backdrop, this study finds common ground for the plastic surgery specialty to coapt with the hospital. Key missing elements in the interaction between plastic surgeons and hospital administrations and ways of integrating these components are identified. To do so effectively, plastic surgeons must first understand the basic tenets of management that drive hospital administrators, participate at every level they can in guiding these processes, and assume leadership roles that will ultimately dictate the way they work and conduct their professional lives. It is critical that plastic surgeons engage in important processes that govern the economics of hospital-based health care delivery. This commitment will also ensure that all three groups (the patients, physicians, and hospital administrators) achieve a degree of satisfaction. The message to plastic surgeons is clear: be proactive and lead a campaign of change.
The patient's request for urgent care in ophthalmology (PRUCO) at health care centers is constantly growing. In France, university hospitals are managing 75% of these cases. We sought to quantify PRUCO referred to French university hospital emergency units as well as to approach the structure and the territorial distribution of emergency eye care provided by French university hospitals. We conducted a quick cross-sectional survey sent to the 32 metropolitan and overseas French university hospitals. It inquired for each hospital whether emergency eye care units were available, whether ophthalmologists were on duty or on call overnight and how many PRUCO were managed in 2016. The 32 university hospitals completed the survey. A total of 398650 PRUCO were managed in French university hospitals in 2016. The emergency unit was exclusively dedicated to eye care for 70% of the hospitals, with 47% (15/32) of them employing an ophthalmologist on duty overnight. Every hospital but one had at least one ophthalmologist on call. The city of Paris set aside, university hospitals took care of an annual mean of 9000 PRUCO (min=500; max=32,250). The 32 French university hospitals are actively responding to patient's requests for urgent care in ophthalmology with very heterogeneous patient volumes and organizational systems. Half of them employ ophthalmologists on duty. Copyright © 2018 Elsevier Masson SAS. All rights reserved.
Full Text Available A prospective study was undertaken to compare the patterns of psychiatric referrals in two general hospitals in Bombay viz. the King Edward Memorial Hospital (64 cases and the Jaslok Hospital and Research Centre (62 cases. It was observed that depressive symptoms were the most common presenting symptoms in these patients attending either of the hospitals. Similarly, the commonest diagnoses were depression and organic mental disorder. Attempted suicide with organophosphorous compounds was the commonest reason for hospitalization at K.E.M. Hospital (p less than 0.001. A significant number of these patients were females (p less than 0.05. The psychiatric referrals at Jaslok had been hospitalized mainly for suspected medical or neurological illness (p less than 0.001. These patients belonged to higher economic strata and hence had a better paying capacity compared to patients at KEM hospital, a significant number of whom were unemployed (p less than 0.001. The duration of pre-referred illness of patients and their stay at Jaslok hospital were longer as compared to those at KEM Hospital (p less than 0.01. The number of non-relevant special investigations carried out on patients in Jaslok was more (p less than 0.01. Further analysis of diagnoses revealed that a significant number of patients at KEM Hospital were admitted as primary psychiatric illness (p less than 0.05.
O'Neil, Mary Lou
Despite the existence of a liberal law on abortion in Turkey, there is growing evidence that actually securing an abortion in Istanbul may prove difficult. This study aimed to determine whether or not state hospitals and private hospitals that accept state health insurance in Istanbul are providing abortion services and for what indications. Between October and December 2015, a mystery patient telephone survey of 154 hospitals, 43 public and 111 private, in Istanbul was conducted. 14% of the state hospitals in Istanbul perform abortions without restriction as to reason provided in the current law while 60% provide the service if there is a medical necessity. A quarter of state hospitals in Istanbul do not provide abortion services at all. 48.6% of private hospitals that accept the state health insurance also provide for abortion without restriction while 10% do not provide abortion services under any circumstances. State and private hospitals in Istanbul are not providing abortion services to the full extent allowed under the law. The low numbers of state hospitals offering abortions without restriction indicates a de facto privatization of the service. This same trend is also visible in many private hospitals partnering with the state that do not provide abortion care. While many women may choose a private provider, the lack of provision of abortion care at state hospitals and those private hospitals working with the state leaves women little option but to purchase these services from private providers at some times subtantial costs.
Hook, Joshua N; Boan, David; Davis, Don E; Aten, Jamie D; Ruiz, John M; Maryon, Thomas
Hospital safety culture is an integral part of providing high quality care for patients, as well as promoting a safe and healthy environment for healthcare workers. In this article, we explore the extent to which cultural humility, which involves openness to cultural diverse individuals and groups, is related to hospital safety culture. A sample of 2011 hospital employees from four hospitals completed measures of organizational cultural humility and hospital safety culture. Higher perceptions of organizational cultural humility were associated with higher levels of general perceptions of hospital safety, as well as more positive ratings on non-punitive response to error (i.e., mistakes of staff are not held against them), handoffs and transitions, and organizational learning. The cultural humility of one's organization may be an important factor to help improve hospital safety culture. We conclude by discussing potential directions for future research.
Full Text Available Abstract Background The aim of the present study is to analyze the incidence of hip fracture as a complication of admissions to internal medicine units in Spain. Methods We analyzed the clinical data of 2,134,363 adults who had been admitted to internal medicine wards. The main outcome was a diagnosis of hip fracture during hospitalization. Outcome measures included rates of in-hospital fractures, length of stay and cost. Results A total of 1127 (0.057% admittances were coded with an in-hospital hip fracture. In hospital mortality rate was 27.9% vs 9.4%; p Conclusions In-hospital hip fracture notably increased mortality during hospitalization, doubling the mean length of stay and mean cost of admission. These are reasons enough to stress the importance of designing and applying multidisciplinary plans focused on reducing the incidence of hip fractures in hospitalized patients.
Full Text Available Background: Organizational culture influences employees’ job satisfaction, commitment and performance. A strong corporate culture enhances organizational performance. Objective: The aim of this study was to determine the type of organizational culture in Qazvin hospitals. Methods: A descriptive and cross-sectional study was conducted by a survey questionnaire in Qazvin (2013 that was distributed among 800 hospital employees and managers based on stratified random sampling. Findings: The mean of hospitals’ organizational culture was 2.95 out of 5 score. Hospitals' organizational cultures were evaluated as strong in attention to details and stability dimensions and moderate in creativity, risk taking, team working and power distance dimensions. Attention to details in public hospitals was higher than private and social security hospitals. Conclusion: Organizational culture of Qazvin hospitals was evaluated as moderate. Managers for improving hospitals' performance and enhancing employees' and patients' satisfaction should create a culture of higher creativity, innovation, team working and risk taking and lower power distance.
Zavadil, Martin; Rogalewicz, Vladimír; Kubátová, Ivana; Matloňová, Veronika; Salačová, Kristýna
Hospital-based HTA (HB-HTA) consists in implementation of assessment activities "in" or "for" hospitals; hence, it covers processes and methods supporting organization and execution of health technology assessment (HTA) at the level of individual hospitals. This process is multidisciplinary, systematic and evidence-based.HB-HTA objectives and methods differ from the classic utilization of HTA at the national regulator level. Most experience and information concerning HB-HTA has originated in two large recent projects: activities of the HB-HTA Interest Group of the HTAi international association established in 2006, and the AdHopHTA European research project (20122015).This paper describes four basic organizational models of HB-HTA, their characteristics and utilization in various countries and hospital types. Results of the AdHopHTA project are analyzed, and recommendations for HB-HTA implementation in Czech hospitals are formulated.Key words: hospital-based HTA, medical device, implementation, hospital strategy.
Shih, Terry; Ryan, Andrew M; Gonzalez, Andrew A; Dimick, Justin B
To project readmission penalties for hospitals performing cardiac surgery and examine how these penalties will affect minority-serving hospitals. The Hospital Readmissions Reduction Program will potentially expand penalties for higher-than-predicted readmission rates to cardiac procedures in the near future. The impact of these penalties on minority-serving hospitals is unknown. We examined national Medicare beneficiaries undergoing coronary artery bypass grafting in 2008 to 2010 (N = 255,250 patients, 1186 hospitals). Using hierarchical logistic regression, we calculated hospital observed-to-expected readmission ratios. Hospital penalties were projected according to the Hospital Readmissions Reduction Program formula using only coronary artery bypass grafting readmissions with a 3% maximum penalty of total Medicare revenue. Hospitals were classified into quintiles according to proportion of black patients treated. Minority-serving hospitals were defined as hospitals in the top quintile whereas non-minority-serving hospitals were those in the bottom quintile. Projected readmission penalties were compared across quintiles. Forty-seven percent of hospitals (559 of 1186) were projected to be assessed a penalty. Twenty-eight percent of hospitals (330 of 1186) would be penalized less than 1% of total Medicare revenue whereas 5% of hospitals (55 of 1186) would receive the maximum 3% penalty. Minority-serving hospitals were almost twice as likely to be penalized than non-minority-serving hospitals (61% vs 32%) and were projected almost triple the reductions in reimbursement ($112 million vs $41 million). Minority-serving hospitals would disproportionately bear the burden of readmission penalties if expanded to include cardiac surgery. Given these hospitals' narrow profit margins, readmission penalties may have a profound impact on these hospitals' ability to care for disadvantaged patients.
Acharya, Jeevan; Kaehler, Nils; Marahatta, Sujan Babu; Mishra, Shiva Raj; Subedi, Sudarshan; Adhikari, Bipin
Introduction Hospital based delivery has been an expensive experience for poor households because of hidden costs which are usually unaccounted in hospital costs. The main aim of this study was to estimate the hidden costs of hospital based delivery and determine the factors associated with the hidden costs. Methods A hospital based cross-sectional study was conducted among 384 post-partum mothers with their husbands/house heads during the discharge time in Manipal Teaching Hospital and Weste...
Lee, S Y; Alexander, J A
To examine (1) the degree to which organizational changes affected hospital survival; (2) whether core and peripheral organizational changes affected hospital survival differently; and (3) how simultaneous organizational changes affected hospital survival. AHA Hospital Surveys, the Area Resource File, and the AHA Hospital Guides, Part B: Multihospital Systems. The study employed a longitudinal panel design. We followed changes in all community hospitals in the continental United States from 1981 through 1994. The dependent variable, hospital closure, was examined as a function of multiple changes in a hospital's core and peripheral structures as well as the hospital's organizational and environmental characteristics. Cox regression models were used to test the expectations that core changes increased closure risk while peripheral changes decreased such risk, and that simultaneous core and peripheral changes would lead to higher risk of closure. Results indicated more peripheral than core changes in community hospitals. Overall, findings contradicted our expectations. Change in specialty, a core change, was beneficial for hospitals, because it reduced closure risk. The two most frequent peripheral changes, downsizing and leadership change, were positively associated with closure. Simultaneous organizational changes displayed a similar pattern: multiple core changes reduced closure risk, while multiple peripheral changes increased the risk. These patterns held regardless of the level of uncertainty in hospital environments. Organizational changes are not all beneficial for hospitals, suggesting that hospital leaders should be both cautious and selective in their efforts to turn their hospitals around.
Maurice E Pouw
Full Text Available BACKGROUND: The hospital standardized mortality ratio (HSMR is developed to evaluate and improve hospital quality. Different methods can be used to standardize the hospital mortality ratio. Our aim was to assess the validity and applicability of directly and indirectly standardized hospital mortality ratios. METHODS: Retrospective scenario analysis using routinely collected hospital data to compare deaths predicted by the indirectly standardized case-mix adjustment method with observed deaths. Discharges from Dutch hospitals in the period 2003-2009 were used to estimate the underlying prediction models. We analysed variation in indirectly standardized hospital mortality ratios (HSMRs when changing the case-mix distributions using different scenarios. Sixty-one Dutch hospitals were included in our scenario analysis. RESULTS: A numerical example showed that when interaction between hospital and case-mix is present and case-mix differs between hospitals, indirectly standardized HSMRs vary between hospitals providing the same quality of care. In empirical data analysis, the differences between directly and indirectly standardized HSMRs for individual hospitals were limited. CONCLUSION: Direct standardization is not affected by the presence of interaction between hospital and case-mix and is therefore theoretically preferable over indirect standardization. Since direct standardization is practically impossible when multiple predictors are included in the case-mix adjustment model, indirect standardization is the only available method to compute the HSMR. Before interpreting such indirectly standardized HSMRs the case-mix distributions of individual hospitals and the presence of interactions between hospital and case-mix should be assessed.
Limbu, Senchhema; Dikshit, Parajeeta; Gupta, Sujaya
Background: A mesiodens, is the most frequent supernumerary tooth present in the maxillary central incisor region. This study is conducted to know the radiographic characteristics and management of mesiodens in children visiting hospital. A cross-sectional retrospective data collection was done from hospital dental records of children who visited the institution from December 2015-December 2016. Radiographic characteristic of mesiodens including the number, shape, position, direction of crown and complication caused by mesiodens were recorded. Data were analyzed using IBM SPSS v.20.0. Out of 1871 dental records, it was found that 40 children had 53 mesiodens, with male female ratio of 3:1 and most of them were discovered at 8 years. Majority of mesiodens, 54.7% were erupted, conical, palatally placed with 77.3% vertically directed crown.Complications associated with it were crowding followed by diastema and delayed eruption. Among 40 children, one had three mesiodens, eleven had two mesiodens and rest had one each. Radiographically fully formed tooth was seen in 29 mesiodens. Immature apex was seen in 38 central incisors associated with mesiodens. Management undertaken was simple/surgical extraction and only few cases were kept for periodic observation. Periodic radiographs act as an important tool for clinicians in detecting and managing mesiodens.
Full Text Available The continuous growth of competition in the hospitality sector has created the need to retain guests and prevent them from switching company due to better offer or saturation. Loyal customers are a valuable asset for catering companies, not only because of the awareness of the effects of customer loyalty. They tend to spread word-of-mouth advertising, more tolerant to price changes, as well as they casually create a linkage to their friends, relatives, colleagues, and other probable consumers and thus enable businesses to uphold a guest's base. By recognizing loyalty guests' importance, the global hospitality industry created monetary and non-monetary rewards for loyal visitors, delayed gratification (points collection and immediate rewards, as well as numerous other reward systems that try to keep them. To win customer loyalty, together with all benefits arising from it, caterers need to become familiar with factors, which determine guests' loyalty. The paper will show the results of research regarding the impact of the service quality and guests' satisfaction to their loyalty. Many authors have confirmed that employees' satisfaction affected customers' satisfaction, so this paper will give an answer does it influence on customers' loyalty as well.
Sánchez Bisonó, J R; Gómez Rosich, A; Amor Gea, J F; García Sánchez, M J; Campoy Domene, L F; Peña Migallón-Sánchez, P
The hospital mortality rate in our centre es 2.34% (264 deaths from a total of 11,336 discharges between 1991 and 1993). The most frequent causes are acute myocardial infarction and cerebrovascular accidents, followed in descending order by pneumonia, chronic bronchitis, congestive heart failure, upper GI haemorrhage, GI tumours, liver cirrhosis, lung tumours and arrhythmias. Our analysis reflects a mortality pattern of a rural population with an age pyramid in which 52% of the patients are older than 45 years. The pattern also reflects the little impact of accidents on our mortality. A 87% of the deaths were older than 65 years with a male to female ratio of 1, 6 and a Swaroop index of 93% and 94% for males and females respectively.
Memon, S.; Sheikh, M.
Hospital waste management is a huge problem in Pakistan. The annual production of medical waste produced from health care facilities, in Pakistan, is around 250,000 tons. This research paper is intended to evaluate the feasibility of using of hospital waste ash obtained from Pakistan Institute of Medical Sciences, Rawalpindi, Pakistan, as partial replacement of cement. The main variable in this research is the amount of hospital waste ash (2, 4, 6 and 8% by weight of cement) while the amount of cementitious material, water to cementitious material ratio, fine and coarse aggregate content were kept constant. Test results substantiate that hospital waste ash can be used in concrete. XRD (X-Ray Diffraction) of hospital waste ash showed that it is rich in calcite while scanning electron micrographs indicated that the particles of hospital waste ash have highly irregular shape. The slump value, density of fresh concrete and water absorption decreased with the increase in the quantity of hospital waste ash in the mix. At 3 days of testing, the compressive strength of mixes with hospital waste ash was higher than the control mix while at 7 and 28 days the CM (Control Mix) showed higher strength than the hospital waste ash mixes except the mix containing 2% hospital waste ash by weight of cement. (author)
McHenry, Peter; Mellor, Jennifer
Despite the importance of the nursing profession for healthcare delivery, costs, and quality, there is relatively little research on how provider payments to hospitals affect the labor market for nurses. This study deals with the hospital wage index (HWI) adjustment to Medicare hospital payments, an area-level adjustment intended to compensate hospitals in high-cost labor markets. Since the HWI adjustment is based on hospital-reported labor costs, some argue that it incentivizes hospitals in concentrated markets to pay higher wages to nurses and other workers (the "circularity" critique). We investigate this critique using market-level data on the relative wages reported by nurses and hospital-level data on the average hourly wage for healthcare workers. For identification, we exploit a 2005 change in the geographic area used to define labor markets, which resulted in exogenous changes in the ability of some hospitals to influence their area's wage index. We find that worker-reported relative nurse wages and hospital-reported healthcare worker wages are higher in some locations where hospitals experienced increased opportunities to game the circularity of the wage index, but these effects appear to be driven by pre-existing wage growth. Medicare's HWI adjustment method does not appear to suffer from inefficiency due to circularity.
Bernardo, Merce; Valls, Jaume; Casadesus, Marti
To analyze the strategic alliances that Catalan hospitals form with other health care entities and other types of institutions to foster technological and organizational innovation. Qualitative case studies were conducted at a sample of 16 public hospitals in Catalonia, Spain. The sample was limited to three (Level 1-3) of Catalonia's four levels of hospitals (classified according to the complexity of the diagnoses and treatments they provide), but Level 4 hospitals were considered as part of the network in the analysis of the alliances. At each hospital, interviews were conducted with the manager, the medical director, and the service director, using a questionnaire that gathered information on strategic alliances with a focus on telemedicine. Qualitative data processing was applied to identify patterns of alliances between hospitals and other institutions. Catalan hospitals interact with other health care agents through three main types of associations: alliances with other hospitals (the most frequent type); alliances with primary care centers (reported mostly by Level 2 hospitals); and alliances with other institutions (e.g., local government, medical companies, and universities). Human resource-sharing (staff mobility) and training were reported most frequently as reasons for creating the alliances. Strategic alliances are formed between hospitals and other health care agents to help improve performance, competitiveness, and services provided to users. These results may help health care system managers promote strategic alliances as a means of optimizing system efficiency without reducing user satisfaction-a key challenge within the context of the current economic situation.
Dong, Gang Nathan
This paper examines the hospital management practices of manipulating financial earnings within the bounds of generally accepted accounting principles (GAAP). We conduct regression analyses that relate earnings management to hospital characteristics to assess the economic determinants of hospital earnings management behavior. From the CMS Cost Reports we collected hospital financial data of all U.S. hospitals that request reimbursement from the federal government for treating Medicare patients, and regress discretionary accruals on hospital size, profitability, asset liquidity, operating efficiency, labor cost, and ownership. Hospitals with higher profit margin, current ratio, working capital, days of patient receivables outstanding and total wage are associated with more earnings management, whereas those with larger size and higher debt level, asset turnover, days cash on hand, fixed asset age are associated with lower level of earnings manipulation. Additionally, managers of non-profit hospitals are more likely to undertake some form of window-dressing by manipulating accounting accruals without changing business models or pricing strategies than their public hospital counterparts. We provide direct evidence of the use of discretionary accruals to manage financial earnings among U.S. hospitals and the finding has profound policy implications in terms of assessing the pervasiveness of accounting manipulation and the overall integrity of financial reporting in this very special public and quasi-public service sector.
Audebert, Heinrich; Fassbender, Klaus; Hussain, M Shazam; Ebinger, Martin; Turc, Guillaume; Uchino, Ken; Davis, Stephen; Alexandrov, Anne; Grotta, James
Background The PRE-hospital Stroke Treatment Organization was formed in 2016 as an international consortium of medical practitioners involved in pre-hospital treatment of patients with acute stroke. Aims PRE-hospital Stroke Treatment Organization's mission is to improve stroke outcomes by supporting research and advocacy for pre-hospital stroke treatment in Mobile Stroke Units. PRE-hospital Stroke Treatment Organization will provide a platform to enhance collaborative research across the spectrum of acute stroke management in the pre-hospital setting. PRE-hospital Stroke Treatment Organization will also facilitate the appropriate proliferation and distribution of Mobile Stroke Units by providing a forum for professional communication, resource for public education, and stimulus for government, industry, and philanthropic support. Summary of review In this "white paper", we describe the evidence supporting pre-hospital stroke treatment, progress to date, practical issues such as application in various environments and staffing, planned research initiatives, and organizational structure. Conclusions PRE-hospital Stroke Treatment Organization is not-for-profit, with membership open to anyone involved (or hoping to become involved) in pre-hospital stroke care. PRE-hospital Stroke Treatment Organization has a Steering Committee comprised of members from Europe, U.S., Canada, Australia, and other regions having a Mobile Stroke Unit in operation. PRE-hospital Stroke Treatment Organization convenes satellite meetings for membership at the International Stroke Conference and European Stroke Congress each year to address the PRE-hospital Stroke Treatment Organization mission. The first research collaborations agreed upon are to: (1) develop a list of common data elements to be collected by all Mobile Stroke Unit programs and entered into a common research database, and (2) develop a protocol for investigating the natural history of hyper-acute Intracerebral Hemorrhage.
The Norwegian hospital reform of 2002 was an attempt to make restructuring of hospitals easier by removing politicians from the decision-making processes. To facilitate changes seen as necessary but politically difficult, the central state took over ownership of the hospitals and stripped the county politicians of what had been their main responsibility for decades. This meant that decisions regarding hospital structure and organization were now being taken by professional administrators and not by politically elected representatives. The question raised here is whether this has had any effect on the speed of restructuring of the hospital sector. The empirical part is a case study of the restructuring process in Innlandet Hospital Trust (IHT), which was one of the largest enterprise established after the hospital reform and where the vision for restructuring was clearly set. Different sources of qualitative data are used in the analysis. These include interviews with key actors, observational data and document studies. The analysis demonstrates how the new professional leaders at first acted in accordance with the intentions of the hospital reform, but soon chose to avoid the more ambitious plans for restructuring the hospital structure and in fact reintroduced local politics into the decision-making process. The analysis further illustrates how local networks and engagement of political representatives from all levels of government complicated the decision-making process surrounding local structural reforms. Local political representatives teamed up with other actors and created powerful networks. At the same time, national politicians had incentives to involve themselves in the processes as supporters of the status quo. Because of the incentives that faced political actors and the controversial nature of major hospital reforms, the removal of local politicians and the centralization of ownership did not necessarily facilitate reforms in the hospital structure
Full Text Available Abstract Background The Norwegian hospital reform of 2002 was an attempt to make restructuring of hospitals easier by removing politicians from the decision-making processes. To facilitate changes seen as necessary but politically difficult, the central state took over ownership of the hospitals and stripped the county politicians of what had been their main responsibility for decades. This meant that decisions regarding hospital structure and organization were now being taken by professional administrators and not by politically elected representatives. The question raised here is whether this has had any effect on the speed of restructuring of the hospital sector. Method The empirical part is a case study of the restructuring process in Innlandet Hospital Trust (IHT, which was one of the largest enterprise established after the hospital reform and where the vision for restructuring was clearly set. Different sources of qualitative data are used in the analysis. These include interviews with key actors, observational data and document studies. Results The analysis demonstrates how the new professional leaders at first acted in accordance with the intentions of the hospital reform, but soon chose to avoid the more ambitious plans for restructuring the hospital structure and in fact reintroduced local politics into the decision-making process. The analysis further illustrates how local networks and engagement of political representatives from all levels of government complicated the decision-making process surrounding local structural reforms. Local political representatives teamed up with other actors and created powerful networks. At the same time, national politicians had incentives to involve themselves in the processes as supporters of the status quo. Conclusion Because of the incentives that faced political actors and the controversial nature of major hospital reforms, the removal of local politicians and the centralization of ownership did
Full Text Available Abstract Objective In-hospital mortality is an important performance measure for quality improvement, although it requires proper risk adjustment. We set out to develop in-hospital mortality prediction models for acute hospitalization using a nation-wide electronic administrative record system in Japan. Methods Administrative records of 224,207 patients (patients discharged from 82 hospitals in Japan between July 1, 2002 and October 31, 2002 were randomly split into preliminary (179,156 records and test (45,051 records groups. Study variables included Major Diagnostic Category, age, gender, ambulance use, admission status, length of hospital stay, comorbidity, and in-hospital mortality. ICD-10 codes were converted to calculate comorbidity scores based on Quan's methodology. Multivariate logistic regression analysis was then performed using in-hospital mortality as a dependent variable. C-indexes were calculated across risk groups in order to evaluate model performances. Results In-hospital mortality rates were 2.68% and 2.76% for the preliminary and test datasets, respectively. C-index values were 0.869 for the model that excluded length of stay and 0.841 for the model that included length of stay. Conclusion Risk models developed in this study included a set of variables easily accessible from administrative data, and still successfully exhibited a high degree of prediction accuracy. These models can be used to estimate in-hospital mortality rates of various diagnoses and procedures.
Yang, Lianping; Liu, Chaojie; Huang, Cunrui; Mukamel, Dana B
Reducing 30-day hospital readmissions has become a focus of the current national payment policies. Medicare requires that hospitals collect and report patients' experience with their care as a condition of payment. However, the extent to which patients' experience with hospital care is related to hospital readmission is unknown. We established multivariate regression models in which 30-day risk-adjusted readmission rates were the dependent variables and patients' perceptions of the responsiveness of the hospital staff and communication (as measured by the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores) were the independent variables of interest. We selected six different clinical conditions for analyses, including acute myocardial infarction (AMI), chronic obstructive pulmonary disease (COPD), heart failure, hip/knee surgery, pneumonia, and stroke. Data included all acute care hospitals reporting in Hospital Compare in 2014. The number of hospitals with reported readmissions ranged from 2234 hospitals for AMI to 3758 hospitals for pneumonia. The average 30-day readmission rates ranged from 5.19% for knee/hip surgery to 22.7% for COPD. Patient experience of hospital-staff responsiveness as "top-box" ranged from 64% to 67% across the six clinical conditions, communication with nurses ranged from 77% to 79% and communication with doctors ranged from 80% to 81% (higher numbers are better). Our finding suggests that hospitals with better staff responsiveness were significantly more likely to have lower 30-day readmissions for all conditions. The effect size depended on the baseline readmission rates, with the largest effect on hospitals in the upper 75th quartile. A ten-percentage-point increase in staff responsiveness led to a 0.03-0.18 percentage point decrease in readmission rates. We found that neither communication with physicians nor communication with nurses was significantly associated with hospital readmissions. Our findings
Cho, Na-Eun; Chang, Jongwha; Atems, Bebonchu
To determine the impact of health information technology (HIT) adoption and hospital-physician integration on hospital efficiency. Using 2010 data from the American Hospital Association's (AHA) annual survey, the AHA IT survey, supplemented by the CMS Case Mix Index, and the US Census Bureau's small area income and poverty estimates, we examined how the adoption of HIT and employment of physicians affected hospital efficiency and whether they were substitutes or complements. The sample included 2173 hospitals. We employed a 2-stage approach. In the first stage, data envelopment analysis was used to estimate technical efficiency of hospitals. In the second stage, we used instrumental variable approaches, notably 2-stage least squares and the generalized method of moments, to examine the effects of IT adoption and integration on hospital efficiency. We found that HIT adoption and hospital-physician integration, when considered separately, each have statistically significant positive impacts on hospital efficiency. Also, we found that hospitals that adopted HIT with employed physicians will achieve less efficiency compared with hospitals that adopted HIT without employed physicians. Although HIT adoption and hospital-physician integration both seem to be key parts of improving hospital efficiency when one or the other is utilized individually, they can hurt hospital efficiency when utilized together.
Roberts, Eric T; Hatfield, Laura A; McWilliams, J Michael; Chernew, Michael E; Done, Nicolae; Gerovich, Sule; Gilstrap, Lauren; Mehrotra, Ateev
In a substantial shift in payment policy, the State of Maryland implemented a global budget program for acute care hospitals in 2010. Goals of the program include controlling hospital use and spending. Eight rural hospitals entered the program in 2010, while urban and suburban hospitals joined in 2014. Prior analyses, which focused on urban and suburban hospitals, did not find consistent evidence that Maryland's program had contributed to changes in hospital use after two years. However, these studies were limited by short follow-up periods, may have failed to isolate impacts of Maryland's payment change from other state trends, and had limited generalizability to rural settings. To understand the effects of Maryland's global budget program on rural hospitals, we compared changes in hospital use among Medicare beneficiaries served by affected rural hospitals versus an in-state control population from before to after 2010. By 2013-three years after the rural program began-there were no differential changes in acute hospital use or price-standardized hospital spending among beneficiaries served by the affected hospitals, versus the within-state control group. Our results suggest that among Medicare beneficiaries, global budgets in rural Maryland hospitals did not reduce hospital use or price-standardized spending as policy makers had anticipated.
Guerci, Alba M.; Pinero, Adalberto; Zubiria, M. Guillermina; Sanz, Vanesa; Larragueta, Nicolas; Puntigliano, Diego
Full text: Previous studies realized by our group have demonstrated radio-induction of genotoxic damage in peripheral blood of hospital workers exposed to chronic X-ray. The cytogenetic and cytomolecular damage was significant in the radiologists evaluated. Accordingly, we have researched the knowledge of risk radiation in 57 workers to different health centres, private and public, in La Plata city. Most of respondents (96.4%) answered to know the risk of working with radiation ionizing, but a large portion do not carry out with the appropriate safety rules. The workers have not interest in this rules, it is evidenced by negligence in the use of protective clothing and personal dosimeters. These results suggested that individuals could be sensitising to minimize their risk. For this purpose we are working in scientific literacy conferences which are organized by 'Asociacion de Tecnicos Radiologos y de Diagnostico por Imagenes de La Plata (ASTEDIRLP)'. (author)
Gervais, Pierre; Pooler, Charlotte; Merryweather, Andrew; Doig, Alexa K.; Bloswick, Donald
To explore the safety of the standard and the low hospital bed, we report on a microanalysis of 15 patients’ ability to ingress, move about the bed, and egress. The 15 participants were purposefully selected with various disabilities. Bed conditions were randomized with side rails up or down and one low bed with side rails down. We explored the patients’ use of the side rails, bed height, ability to lift their legs onto the mattress, and ability to turn, egress, and walk back to the chair. The standard bed was too high for some participants, both for ingress and egress. Side rails were used by most participants when entering, turning in bed, and exiting. We recommend that side rails be reconsidered as a means to facilitate in-bed movement, ingress, and egress. Furthermore, single deck height settings for all patients are not optimal. Low beds as a safety measure must be re-evaluated. PMID:28462302
I. A. ATUDOREI
Full Text Available Social discrimination stands for one of the phenomena that social policies attempt to counteract by legislation, with a view to impeding its effects. Nevertheless, at institutional level, the decisions perpetuate and encourage discrimination, being practically a norm in an abnormal situation. Abnormality is represented by a series of deficiencies falling within the scope of perverse effects. Having analyzed institutional policies in the field of child health, we have identified a series of issues that fall under social discrimination. The paper submits the reasons for institutional discrimination in paediatric hospitals. The purpose of the research is to identify the discriminated persons and to report the repercussions of institutional discrimination at social level.
Lucélia Ferreira Lima
Full Text Available Objective: To identify the risks reported at a public institution andto know the main patient risks from the nursing staff point of view.Methods: A retrospective, descriptive and exploratory study. Thesurvey was developed at a hospital in the city of Taboão da Serra, SãoPaulo, Brazil. The study included all nurses working in care areas whoagreed to participate in the study. At the same time, sentinel eventsoccurring in the period from July 2006 to July 2007 were identified.Results: There were 440 sentinel events reported, and the main risksincluded patient falls, medication errors and pressure ulcers. Sixty-fivenurses were interviewed. They also reported patient falls, medicationerrors and pressure ulcers as the main risks. Conclusions: Riskassessment and implementation of effective preventive actions arenecessary to ensure patient’s safety. Involvement of a multidisciplinaryteam is one of the steps for a successful process.
Health care administration in many OECD countries has undergone substantial changes in recent years as a consequence of NPM reforms, rising costs, the pace of technological innovation, heightened competition for patients and resources, quality of managed care and demographic shifts. Hospitals...... especially have been reformed due to the high proportion of resources they absorb and the apparent difficulty of prioritizing and coordinating health care within hospitals. There is abundant research literature on the topic of reforming hospital management models. Lacking from the literature, however......, is insight into how we can understand and explain how medical professionals adapt hospital management over time in relation to changing hospital management models that are global in their influence in hospital organizations. The aim of this dissertation is to understand and explain how medical professionals...
Bhatti, A.Q.; Memon, A.A.; Mahar, R.B.
Hazardous hospital waste is a unique in several ways. There are a large variety of wastes but volume is a small relative to industrial wastes. Hospital infections solid waste is getting to be serious problem day by day. This waste contribute to the overall pollution in the city; much of it is also hazardous, thus putting at risk the health of those who come into contact with it. This paper addresses the various aspects of incineration, recycling and landfill process with detailed illustration. Hospital waste management in rural hospitals of Pakistan with particular reference to Gambat Hospital is discussed in this paper, including study of existing waste management system, estimation of waste production per day from different sources of Hospital and suitable waste management system is recommended. (author)
Smith, H L; Haley, D; Piland, N F
Rural hospitals confront an inauspicious environment due to changes in patient reimbursement and medical practice. Facing a situation of declining revenues, marketing presents an option for rural hospitals to adapt to the growing constraints. This paper analyzes the determinants of marketing strategy emphasis in rural hospitals. The conceptual model adopted in this study predicts that prior performance and contextual variables explain marketing strategy emphasis. The relationships are examined in a case study of rural New Mexico hospitals. Results suggest that prior performance and several contextual variables explain variations in marketing strategy emphasis. In particular, higher gross patient revenues are associated with more emphasis on television and radio advertising. Furthermore, rural New Mexico hospitals with high numbers of licensed beds and medical staff members, or that are affiliated with a chain organization, place greater emphasis on market research and market planning. The implications for marketing practice in rural hospitals are discussed.
Wright, Donald J
A soft budget constraint arises when a government is unable to commit to not 'bailout' a public hospital if the public hospital exhausts its budget before the end of the budget period. It is shown that if the political costs of a 'bailout' are relatively small, then the public hospital exhausts the welfare-maximising budget before the end of the budget period and a 'bailout' occurs. In anticipation, the government offers a budget to the public hospital that may be greater than or less than the welfare-maximising budget. In either case, the public hospital treats 'too many' elective patients before the 'bailout' and 'too few' after. The introduction of a private hospital reduces the size of any 'bailout' and increases welfare. Copyright © 2015 John Wiley & Sons, Ltd.
Lu, Xudong; Duan, Huilong; Li, Haomin; Zhao, Chenhui; An, Jiye
Because of the complexity of the hospital environment, there exist a lot of medical information systems from different vendors with incompatible structures. In order to establish an enterprise hospital information system, the integration among these heterogeneous systems must be considered. Complete integration should cover three aspects: data integration, function integration and workflow integration. However most of the previous design of architecture did not accomplish such a complete integration. This article offers an architecture design of the enterprise hospital information system based on the concept of digital neural network system in hospital. It covers all three aspects of integration, and eventually achieves the target of one virtual data center with Enterprise Viewer for users of different roles. The initial implementation of the architecture in the 5-year Digital Hospital Project in Huzhou Central hospital of Zhejiang Province is also described.
Xuzhou Center Hospital is in a competing medical market in Xuzhou city. This hospital has been dedicating to improve the medical skills and provide professional and individualized service to the patients in order to improve the patient's experience and increase the patient's satisfaction. On the other side, this hospital has provided an all-round marketing campaign to build up the social influence and public reputation through public-praise marketing, web marketing, media marketing, and scholar marketing. Besides, this hospital has been cooperating with foreign medical institutions and inviting foreign medical specialists to academic communication. With the combined effects of improving medical service and all-round marketing, the hospital's economic performance has been enhanced significantly and laid a solid foundation for its ambition to become the first-class hospital in Huaihai Economic Zone.
Bertoli, Paola; Grembi, Veronica
the exogenous variation in the proximity to cities that are allowed by law to have a hospital based on their population size. Our instrumental variable results, based on Italian municipalities data from 2000 to 2012, show that an increase by a standard deviation of distance to the nearest hospital (5 km......We assess the lifesaving effect of hospital proximity using data on fatality rates of road-traffic accidents. While most of the literature on this topic is based on changes in distance to the nearest hospital triggered by hospital closures and use OLS estimates, our identification comes from......) increases the fatality rate by 13.84% on the sample average. This is equal to a 0.92 additional death per every 100 accidents. We show that OLS estimates provide a downward biased measure of the real effect of hospital proximity because they do not fully solve spatial sorting problems. Proximity matters...
Ayodeji, Sesan P.; Adeyeri, Michael K.; Omoniyi, Olaoluwa
Hospital meal carts are used to deliver meals, drugs and some other materials to patients in the hospital environment. These carts which are moved manually by operators, the health workers, mostly do not comply with ergonomics guidelines and physical requirements of the equipment users in terms of anthropometry data of the region thus increasing the risk of musculoskeletal disorder among the meal cart users. This study carried out ergonomic evaluation of the available meal carts in some western Nigeria hospitals. A well-structured questionnaire has two major segments: Operational survey and biomechanical survey, which were administered to the health workers using hospital meal carts in some hospitals in southwestern Nigeria, and physical assessment, which was undertaken to collect data for the ergonomic evaluation. The responses from the questionnaires show that some areas on the existing hospital meal carts are of concern to the users which need to be improved upon.
Reiter, Kristin L; Sandoval, Guillermo A; Brown, Adalsteinn D; Pink, George H
Growing interest in pay-for-performance and the level of chief executive officers' (CEOs') pay raises questions about the link between performance and compensation in the health sector. This study compares the compensation of nonprofit hospital CEOs in Ontario, Canada to the three longest reported and most used measures of hospital financial performance. Our sample consisted of 132 CEOs from 92 hospitals between 1999 and 2006. Unbalanced panel data were analyzed using fixed effects regression. Results suggest that CEO compensation was largely unrelated to hospital financial performance. Inflation-adjusted salaries appeared to increase over time independent of hospital performance, and hospital size was positively correlated with CEO compensation. The apparent upward trend in salary despite some declines in financial performance challenges the fundamental assumption underlying this article, that is, financial performance is likely linked to CEO compensation in Ontario. Further research is needed to understand long-term performance related to compensation incentives.
This report documents the findings of a survey of Canadian hospitals conducted by Social Data Research Ltd. during the Spring and Summer, 1995. The main objective of the survey was to determine the state of readiness of Canadian hospitals in respect of radiation emergency planning. In addition, the AECB was interested in knowing the extent to which a report by the Group of Medical Advisors, 'GMA-3: Guidelines on Hospital Emergency Plans for the Management of Minor Radiation Accidents', which was sponsored and distributed in 1993, was received and was useful to hospital administrators and emergency personnel. A self-administered questionnaire was distributed to 598 acute care hospitals, and 274 responses were received. The main conclusion of this study is that, with the exception of a few large institutions, hospitals generally do not have specific action plans to handle minor radiation accidents. (author)
Bodina, A.; Pavan, A.; Castaldi, S.
Summary Introduction. Allocate fixed resources among competing users is a challenge in terms of hospital management in order to obtain the best performance considering strategic objectives. In order to address this need, a system of evaluation in an important research and teaching hospital was designed. This study describes resource allocation criteria in a hospital focusing on the evaluation system and its developed application methodology. Methods. The indicator system allows the strategic ...
Kansakar, Prasanna; Munir, Arslan; Shabani, Neda
The leisure and hospitality industry is one of the driving forces of the global economy. The widespread adoption of new technologies in this industry over recent years has fundamentally reshaped the way in which services are provided and received. In this paper, we explore some of the state-of-the-art technologies currently employed in the hospitality industry and how they are improving guest experiences and changing the hospitality service platform. We also envision some potential future hos...
Quality control analysis is an integral part of quality assurance. In a system as with radiopharmaceuticals where part of the finishing of the product takes place at individual hospitals, the need for quality control analysis at the hospital can be discussed. Data are presented that stresses the importance of quality control by the manufacturer as a basis for limitation of such work at hospitals. A simplified programme is proposed
Nero C Wabo; P Örtenwall; A Khorram-Manesh
Objective: Malfunction in hospitals' complex internal systems, or extern threats, may result in a hospital evacuation. Factors contributing to such evacuation must be identified, analyzed and action plans should be prepared. Our aims in this study were 1) to evaluate the use of risk and vulnerability analysis as a basis for hospital evacuation plan, 2) to identify risks/hazards triggering an evacuation and evaluate the respond needed and 3) to propose a template with main key points for plann...
Brotman, Billie Ann
This article examines demand factors for sophisticated medical treatments offered by private hospitals operating in India. Three types of medical tourism exist: Outbound, Inbound, and Intrabound. Increased profitability and positive growth trends by private hospital chains can be attributed to rising domestic income levels within India. Not all of the chains examined were financially solvent. Some of the hospital groups in this sample that advertised directly to potential Inbound medical tourists appear to be experiencing negative cash flows.
Leader, Hadassa; Singh, Jasmine; Ghaffar, Ayesha; de Silva, Cheryl
Objectives: Bullying is a serious public health issue. We sought to demonstrate an association between bullying victimization and hospital admissions for acute psychiatric problems. We described the demographics and types of bullying in a sample of hospitalized patients in Staten Island, NY, and compared bullying victimization scores with psychiatric versus medical admissions. Methods: Patients in grades 3–12 were recruited from the Staten Island University Hospital Inpatient Pediatrics unit ...
Are laboring and birthing women treated abusively in the hospital? Although seldom recognized as abuse or violence against women, bullying and medical treatments under false pretenses, even in a hospital, constitute abuse and a basic human rights issue that needs attention. Naming the problem is a first step. The power of medical authority, the lack of accountability in the hospital hierarchical system, policies and protocols, and expectations of compliancy all make an environment ripe for ab...
Handayani, P W; Hidayanto, A N; Pinem, A A; Hapsari, I C; Sandhyaduhita, P I; Budi, I
The purpose of this study is to develop a model of Hospital Information System (HIS) user acceptance focusing on human, technological, and organizational characteristics for supporting government eHealth programs. This model was then tested to see which hospital type in Indonesia would benefit from the model to resolve problems related to HIS user acceptance. This study used qualitative and quantitative approaches with case studies at four privately owned hospitals and three government-owned hospitals, which are general hospitals in Indonesia. The respondents involved in this study are low-level and mid-level hospital management officers, doctors, nurses, and administrative staff who work at medical record, inpatient, outpatient, emergency, pharmacy, and information technology units. Data was processed using Structural Equation Modeling (SEM) and AMOS 21.0. The study concludes that non-technological factors, such as human characteristics (i.e. compatibility, information security expectancy, and self-efficacy), and organizational characteristics (i.e. management support, facilitating conditions, and user involvement) which have level of significance of ptechnological factors to better plan for HIS implementation. Support from management is critical to the sustainability of HIS implementation to ensure HIS is easy to use and provides benefits to the users as well as hospitals. Finally, this study could assist hospital management and IT developers, as well as researchers, to understand the obstacles faced by hospitals in implementing HIS. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
Folmann, Nana Bro; Bossen, Kristine Skovgaard; Willaing, Ingrid
To quantify the association between obesity and somatic hospital costs and number of overall somatic hospital contacts--number of inpatient admissions, number of outpatient visits, and number of emergency department visits--based on anthropometric measurements of waist circumference (WC) and info......To quantify the association between obesity and somatic hospital costs and number of overall somatic hospital contacts--number of inpatient admissions, number of outpatient visits, and number of emergency department visits--based on anthropometric measurements of waist circumference (WC...
Kristensen, Troels; Bogetoft, Peter; Pedersen, Kjeld Moeller
The Danish hospital sector faces a major rebuilding program to centralize activity in fewer and larger hospitals. We aim to conduct an efficiency analysis of hospitals and to estimate the potential cost savings from the planned hospital mergers. We use Data Envelopment Analysis (DEA) to estimate a cost frontier. Based on this analysis, we calculate an efficiency score for each hospital and estimate the potential gains from the proposed mergers by comparing individual efficiencies with the efficiency of the combined hospitals. Furthermore, we apply a decomposition algorithm to split merger gains into technical efficiency, size (scale) and harmony (mix) gains. The motivation for this decomposition is that some of the apparent merger gains may actually be available with less than a full-scale merger, e.g., by sharing best practices and reallocating certain resources and tasks. Our results suggest that many hospitals are technically inefficient, and the expected "best practice" hospitals are quite efficient. Also, some mergers do not seem to lower costs. This finding indicates that some merged hospitals become too large and therefore experience diseconomies of scale. Other mergers lead to considerable cost reductions; we find potential gains resulting from learning better practices and the exploitation of economies of scope. To ensure robustness, we conduct a sensitivity analysis using two alternative returns-to-scale assumptions and two alternative estimation approaches. We consistently find potential gains from improving the technical efficiency and the exploitation of economies of scope from mergers.
Hachesu, Peyman Rezaei; Zyaei, Leila; Hassankhani, Hadi
Lack of attention to the proper barcode using leads to lack of use or misuse in the hospitals. The present research aimed to investigate the requirements and barrier for using barcode technology and presenting suggestions to use it. The research is observational-descriptive. The data was collected using the designed checklist which its validity was assessed. This check list consists of two parts: "Requirements" and "barrier" of using the barcodes. Research community included 10 teaching hospitals and a class of 65 participants included people in the hospitals. The collected data was analyzed using descriptive statistics. Required changes of workflow processes in the hospital and compliance them with the hospital policy are such requirements that had been infringed in the 90 % of hospitals. Prioritization of some hospital processes for barcoding, system integration with Hospital Information system (HIS), training of staff and budgeting are requirements for the successful implementation which had been infringed in the 80% of hospitals. Dissatisfaction with the quality of barcode labels and lacks of adequate scanners both whit the rate of 100 %, and the lack of understanding of the necessary requirements for implementation of barcodes as 80% were the most important barrier. Integrate bar code system with clinical workflow should be considered. Lack of knowledge and understanding toward the infrastructure, inadequate staff training and technologic problems are considered as the greatest barriers.
Layde, Peter M; Meurer, Linda N; Guse, Clare; Meurer, John R; Yang, Hongyan; Laud, Prakash; Kuhn, Evelyn M; Brasel, Karen J; Hargarten, Stephen W
.... The development, validation, and testing of screening criteria for medical injury was based on International Classification of Disease code discharge diagnoses using 2001 patient data from Wisconsin hospitals...
Beck, Anne Marie; Balknäs, Ulla N.; Camilo, Maria E.
of clearly defined responsibilities, 2) lack of sufficient education, 3) lack of influence and knowledge of the patients, 4) lack of cooperation between different staff groups, and 5) lack of involvement from the hospital management. To solve the problems highlighted, a combined timely and concerted effort...... is required from national authorities and hospital staff, including managers, to ensure appropriate nutritional care and support.......Disease-related undernutrition is significant in European hospitals but is seldom treated or prevented. In 1999, the Council of Europe decided to collect information regarding nutrition programs in hospitals, and for this purpose, a network consisting of national experts from 12 of the Partial...
Galvin, Eileen Catherine; Wills, Teresa; Coffey, Alice
To report on an analysis on the concept of 'readiness for hospital discharge'. No uniform operational definition of 'readiness for hospital discharge' exists in the literature; therefore, a concept analysis is required to clarify the concept and identify an up-to-date understanding of readiness for hospital discharge. Clarity of the concept will identify all uses of the concept; provide conceptual clarity, an operational definition and direction for further research. Literature review and concept analysis. A review of literature was conducted in 2016. Databases searched were: Academic Search Complete, CINAHL Plus with Full Text, PsycARTICLES, Psychology and Behavioural Sciences Collection, PsycINFO, Social Sciences Full Text (H.W. Wilson) and SocINDEX with Full Text. No date limits were applied. Identification of the attributes, antecedents and consequences of readiness for hospital discharge led to an operational definition of the concept. The following attributes belonging to 'readiness for hospital discharge' were extracted from the literature: physical stability, adequate support, psychological ability, and adequate information and knowledge. This analysis contributes to the advancement of knowledge in the area of hospital discharge, by proposing an operational definition of readiness for hospital discharge, derived from the literature. A better understanding of the phenomenon will assist healthcare professionals to recognize, measure and implement interventions where necessary, to ensure patients are ready for hospital discharge and assist in the advancement of knowledge for all professionals involved in patient discharge from hospital. © 2017 John Wiley & Sons Ltd.
Dychtwald, K; Zitter, M
The initial stages of developing a strategic marketing plan for hospitals are explored in this excerpt from the book, The Role of the Hospital in an Aging Society: A Blueprint for Action. The elderly have unique perceptual, cognitive, social, and psychological needs and preferences, and a marketing strategy for eldercare services must reflect these factors, as well as the financial role of third-party payers and the decision-making influence of families and physicians. Among the elements the hospital must address when developing a marketing strategy are market selection and segmentation, targeting markets with specific services, pricing, and positioning the hospital for a maximum share of the eldercare market.
Rayburn, J M; Rayburn, L G
This research traces the origins, development, and reasons for change in the power equation in the U.S. hospitals between physicians, administrators and accountants. The paper contains three major sections: a review of the literature concerning authority, power, influence, and institutional theory; a review of the development of the power of professions, especially physicians, accounting and healthcare administrators, and the power equilibrium of a hospital; and, a discussion of the social policy implications of the power struggle. The basis for physicians' power derives from their legal ability to act on which others are dependent, such as choosing which hospital to admit patients, order tests and procedures for their patients. The Federal Government's prospective payment system and the hospitals' related case-mix accounting systems appear to influence the power structure in hospitals by redistributing that power. The basis of the accountants' power base is control of financial information. Accountants have a definite potential for influencing which departments receive financial resources and for what purpose. This moves hospital accountants into the power equation. The basis of the hospital administrators' power is their formal authority in the organization. Regardless of what actions federal government agencies, hospital accountants, or hospital administrators take, physicians are expected to remain the dominant factor in the power equation. Without major environmental changes to gain control of physician services, only insignificant results in cost containment will occur.
Adwell, James P
The purpose of this study was to develop a baseline measurement tool by assessing individual attitudes regarding hospital preparedness, departmental preparedness, and preparedness through education and training...
Rosolio, Charles E
Relationships with hospitals and outpatient medical facilities have always been an important part of the business model for private medical practices. As healthcare delivery to patients has evolved in the United States (much of it driven by the new government mandates, regulations, and the Affordable Care Act), the delivery of such services is becoming more and more centered on the hospital or institutional setting, thus making contractual relationships with hospitals even more important for medical practices. As a natural outgrowth of this relationship, attention to hospital contracts is becoming more important.
Phipps, W E
Hospices/hospitals in Western civilization are primarily an outgrowth of the teachings of Jesus. Soon after Greek monastic orders constructed buildings for the sick and dying, noblewoman Fabiola established the first hospices in the western Mediterranean. The hospice/hospital movement spread widely in medieval Europe. In modern society a distinction has been made between hospitals and hospices. Hospitals are devoted mostly to curing patients while hospices are concerned with terminal care. St. Christopher's Hospice is the acclaimed model of what a hospice program should contain. Caring for the sick and dying has contributed greatly to the positive influence of Christianity.
Weil, T P; Pearl, G M
A review of America's "best" teaching hospitals shows a huge disparity in their fiscal positions. Among the 15 hospitals studied, roughly half experience some fiscal distress. However, a somewhat similar fiscal analysis of the nation's largest investor-owned hospital chains, HMOs, and physician practice management corporations shows an even more serious weakness in operating margins and debt-equity ratios. Aside from raising possible ethical, quality, and cost issues, this financial analysis suggests that conversion from nonprofit to for-profit ownership of America's top teaching hospitals might not guarantee an improvement in their long-term fiscal outlook.
Martinussen, Pål E; Midttun, Linda
Day surgery has gained increasing significance in Norwegian health care during the 1990s, and now constitutes more than 50% of all elective surgery. Although the underlying general assumption is that this mode of delivering surgery will increase the efficiency of hospitals, most former studies have focused only on the cost-efficiency for specific types of surgical operations. The present study therefore uses data from Norwegian hospitals to test whether the proposition that day surgery spells efficiency also holds true at the hospital level. Hospital efficiency is measured as the technical efficiency of hospitals. This indicator captures how efficient hospitals are in utilising their total resources, and builds on a variety of hospital inputs (inpatient care, outpatient care) and hospital outputs (physician full-time equivalents (FTEs), other labour equivalents, medical expenses). Our empirical analysis is based on a simple decision model where the hospitals maximise utility functions of income, patients and effort under the constraint of the budget and various structural characteristics. The empirical model thus controls for several other important determinants of efficiency, such as hospital budget, the outpatient revenue share, irregularly long length of stay, hospital type and the share of emergency admissions. After accounting for these variables, our results document significant effects of day surgery on technical efficiency. The results furthermore show that the positive effect of day surgery is contingent upon hospital budget, as hospitals with large budgets experience stronger efficiency effects of day surgery.
... Interventional and Therapeutic Neuroradiology BBA Balanced Budget Act of 1997, Public Law 105-33 BBRA Medicare... Ultrasound (IVUS) III. Changes to the Hospital Wage Index for Acute Care Hospitals A. Background B. Wage...
Holmes, George M; Pink, George H; Friedman, Sarah A
To compare the financial performance of rural hospitals with Medicare payment provisions to those paid under prospective payment and to estimate the financial consequences of elimination of the Critical Access Hospital (CAH) program. Financial data for 2004-2010 were collected from the Healthcare Cost Reporting Information System (HCRIS) for rural hospitals. HCRIS data were used to calculate measures of the profitability, liquidity, capital structure, and financial strength of rural hospitals. Linear mixed models accounted for the method of Medicare reimbursement, time trends, hospital, and market characteristics. Simulations were used to estimate profitability of CAHs if they reverted to prospective payment. CAHs generally had lower unadjusted financial performance than other types of rural hospitals, but after adjustment for hospital characteristics, CAHs had generally higher financial performance. Special payment provisions by Medicare to rural hospitals are important determinants of financial performance. In particular, the financial condition of CAHs would be worse if they were paid under prospective payment. © 2012 National Rural Health Association.
Salahuddin, Lizawati; Ismail, Zuraini; Hashim, Ummi Rabaah; Raja Ikram, Raja Rina; Ismail, Nor Haslinda; Naim Mohayat, Mohd Hariz
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.
Aghaei Hashjin, A.
This thesis concentrates on the subject of quality assurance strategies in hospitals; exploring the development, implementation and impact of quality assurance (QA) methods in Iranian hospitals. A series of descriptive and analytical studies using qualitative and quantitative data were performed.
Nguyen, Kaylin T; Olgin, Jeffrey E; Pletcher, Mark J; Ng, Madelena; Kaye, Leanne; Moturu, Sai; Gladstone, Rachel A; Malladi, Chaitanya; Fann, Amy H; Maguire, Carol; Bettencourt, Laura; Christensen, Matthew A; Marcus, Gregory M
Ascertainment of hospitalizations is critical to assess quality of care and the effectiveness and adverse effects of various therapies. Smartphones, mobile geolocators that are ubiquitous, have not been leveraged to ascertain hospitalizations. Therefore, we evaluated the use of smartphone-based geofencing to track hospitalizations. Participants aged ≥18 years installed a mobile application programmed to geofence all hospitals using global positioning systems and cell phone tower triangulation and to trigger a smartphone-based questionnaire when located in a hospital for ≥4 hours. An in-person study included consecutive consenting patients scheduled for electrophysiology and cardiac catheterization procedures. A remote arm invited Health eHeart Study participants who consented and engaged with the study via the internet only. The accuracy of application-detected hospitalizations was confirmed by medical record review as the reference standard. Of 22 eligible in-person patients, 17 hospitalizations were detected (sensitivity 77%; 95% confidence interval, 55%-92%). The length of stay according to the application was positively correlated with the length of stay ascertained via the electronic medical record ( r =0.53; P =0.03). In the remote arm, the application was downloaded by 3443 participants residing in all 50 US states; 243 hospital visits at 119 different hospitals were detected through the application. The positive predictive value for an application-reported hospitalization was 65% (95% confidence interval, 57%-72%). Mobile application-based ascertainment of hospitalizations can be achieved with modest accuracy. This first proof of concept may ultimately be applicable to geofencing other types of prespecified locations to facilitate healthcare research and patient care. © 2017 American Heart Association, Inc.
Houy, J.C.; Rimbert, J.C.; Bouvet, C.; Laugle, S.
The hospital radioactive wastes are of three types: solid, liquid and gaseous. Prior to final evacuation all these wastes are checked by a detector the threshold of which is lower than the standard. This system allows detecting activities very low under the daily recommended threshold of 37 kBq (1μ Ci), for the group II. In metabolic radiotherapy the unsealed sources of iodine 131 will form mainly the wastes arising from the rooms contaminated by the patient himself. In this service anything touching the patient's room most by systematically checked. All the rooms are provided with toilette with two compartments, one connected traditionally to the sewerage system for faeces and the other coupled to tanks for urine storing. The filled reservoirs waits around 10 month span prior to being emptied, after checking, into the sewerage system. The volume activity most be lower than 7 Bq per liter (standard). For the hot labs, injection room and in-vitro lab, the liquid waste retrieved from dedicated stainless sinks are stored in storage tanks and will waits for 2 years before evacuation. The undies coming from the metabolic radiotherapy service are possible contaminated by the patient sheets, pillow cases, etc. These undies freshly contaminated may be contaminating if the contamination is non fixated. All the undies coming from this service are checked like all the wastes by means of the fixed detector. For the solid wastes two evacuation channels are possible: the urban garbage repository for household wastes and the Brest waste repository for hospital wastes. For the liquid waste arising for urines, used washing water, etc, the evacuation will be done towards city sewerage system after storing or dilution. Concerning the liquid wastes presenting chemical risks, they will be evacuated in cans by NETRA. Concerning the gaseous wastes, trapped on active carbon filters, they will be handled like solid wastes and will be directed to the waste repository of Brest. The other
Paul L Delamater
Full Text Available BACKGROUND: Roemer's Law, a widely cited principle in health care policy, states that hospital beds that are built tend to be used. This simple but powerful expression has been invoked to justify Certificate of Need regulation of hospital beds in an effort to contain health care costs. Despite its influence, a surprisingly small body of empirical evidence supports its content. Furthermore, known geographic factors influencing health services use and the spatial structure of the relationship between hospital bed availability and hospitalization rates have not been sufficiently explored in past examinations of Roemer's Law. We pose the question, "Accounting for space in health care access and use, is there an observable association between the availability of hospital beds and hospital utilization?" METHODS: We employ an ecological research design based upon the Anderson behavioral model of health care utilization. This conceptual model is implemented in an explicitly spatial context. The effect of hospital bed availability on the utilization of hospital services is evaluated, accounting for spatial structure and controlling for other known determinants of hospital utilization. The stability of this relationship is explored by testing across numerous geographic scales of analysis. The case study comprises an entire state system of hospitals and population, evaluating over one million inpatient admissions. RESULTS: We find compelling evidence that a positive, statistically significant relationship exists between hospital bed availability and inpatient hospitalization rates. Additionally, the observed relationship is invariant with changes in the geographic scale of analysis. CONCLUSIONS: This study provides evidence for the effects of Roemer's Law, thus suggesting that variations in hospitalization rates have origins in the availability of hospital beds. This relationship is found to be robust across geographic scales of analysis. These findings
Kamp-Hopmans, Titia E. M.; Blok, Hetty E. M.; Troelstra, Annet; Gigengack-Baars, Ada C. M.; Weersink, Annemarie J. L.; Vandenbroucke-Grauls, Christina M. J. E.; Verhoef, Jan; Mascini, Ellen M.
OBJECTIVES: To determine incidence rates of hospital-acquired infections and to develop preventive measures to reduce the risk of hospital-acquired infections. METHODS: Prospective surveillance for hospital-acquired infections was performed during a 5-year period in the wards housing general and
... basket index for IPPS hospitals in all areas less 2.0 percentage for hospitals that fail to submit...: Final Fiscal Year 2010 Wage Indices and Payment Rates Implementing the Affordable Care Act AGENCY... final wage indices, hospital reclassifications, payment rates, impacts, and other related tables...
... the conditions of participation (CoPs) for hospitals relating to the administration of vaccines by...--Program Administration, Validation, and Reconsideration Issues. Shaheen Halim, (410) 786-0641, Hospital... Federation of American Hospitals FDA Food and Drug Administration FFY Federal fiscal year FPL Federal poverty...
... allowed hospitals to have an optional program for patient(s)/support person(s) on self- administration of... Regulatory Flexibility Act RPCH Rural Primary Care Hospital SBA Small Business Administration SBREFA Small... and the hospital's administration. At that time, we decided to leave decisions about liaison and...
... are revising the conditions of participation (CoPs) for hospitals relating to the administration of... and Hospital Value-Based Purchasing--Program Administration, Validation, and Reconsideration Issues... Financing Administration HCO High-cost outlier HCRIS Hospital Cost Report Information System HHA Home health...
... Part 242 Federal Housing Administration (FHA): Hospital Mortgage Insurance Program--Refinancing Hospital Loans; Final Rule #0;#0;Federal Register / Vol. 78, No. 24 / Tuesday, February 5, 2013 / Rules and...-5334-F-02] RIN 2502-AI74 Federal Housing Administration (FHA): Hospital Mortgage Insurance Program...
Koskela, Lauri; Raatiniemi, Lasse; Bakke, Håkon Kvåle; Ala-Kokko, Tero; Liisanantti, Janne
Most fatal poisonings occur outside the hospital and the victims found dead. The purpose of this study was to determine the general pattern and patient demographics of fatal poisonings in Northern Finland. In particular, we wanted to analyze differences between pre-hospital and in-hospital deaths. All fatal poisonings that occurred in Northern Finland in 2007-2011 were retrieved from the Cause of Death Registry provided by Statistics Finland. We noted the patient demographics, causal agents, and other characteristics of the poisoning events. A total of 689 fatal poisonings occurred during the study period, of which only 42 (6.1%) reached the hospital alive. Those who died pre-hospital were significantly younger (50 vs. 56 years, p = 0.04) and more likely to be male (77% vs. 57%, p = 0.003). Cardiopulmonary resuscitation was attempted less often in pre-hospital cases (9.9% vs. 47.6%, p pre-hospital deaths (58.4% vs. 26.2%, p pre-hospital deaths. Most of the pre-hospital fatal poisoning victims are found dead and the majority of in-hospital victims are admitted to hospital in an already serious condition. According to results of this and former studies, prevention seems to be the most important factor in reducing deaths due to poisoning. The majority of poisoning-related deaths occur pre-hospital and are related to alcohol intoxication and multiple ingestions.
Pijls-Hoekstra, Ruth; Groen, Brenda H.; Galetzka, Mirjam; Pruyn, Ad T.H.
What is hospitality? Only few academic articles tap into the meaning of the concept of hospitality. Especially academic investigation of hospitality from a guest perspective is scarce; the combination of ‘hospitality’ and ‘experience’ has received hardly any attention. The present paper describes a
Georges, Patrick M; Samson, Julien
Leadership methods can be understood and applied by hospital managers in the same way teachers and the seminar's participants respect certain conventions. Each method should be discussed and adapted, recognizing its limitations for use within hospitals. This article first presents what is taught in a traditional leadership course and then, discusses ways the course can be adapted for use by hospital managers.
Li, Yongjun; Lei, Xiyang; Morton, Alec
Throughout the world, hospitals are under increasing pressure to become more efficient. Efficiency analysis tools can play a role in giving policymakers insight into which units are less efficient and why. Many researchers have studied efficiencies of hospitals using data envelopment analysis (DEA) as an efficiency analysis tool. However, in the existing literature on DEA-based performance evaluation, a standard assumption of the constant returns to scale (CRS) or the variable returns to scale (VRS) DEA models is that decision-making units (DMUs) use a similar mix of inputs to produce a similar set of outputs. In fact, hospitals with different primary goals supply different services and provide different outputs. That is, hospitals are nonhomogeneous and the standard assumption of the DEA model is not applicable to the performance evaluation of nonhomogeneous hospitals. This paper considers the nonhomogeneity among hospitals in the performance evaluation and takes hospitals in Hong Kong as a case study. An extension of Cook et al. (2013)  based on the VRS assumption is developed to evaluated nonhomogeneous hospitals' efficiencies since inputs of hospitals vary greatly. Following the philosophy of Cook et al. (2013) , hospitals are divided into homogeneous groups and the product process of each hospital is divided into subunits. The performance of hospitals is measured on the basis of subunits. The proposed approach can be applied to measure the performance of other nonhomogeneous entities that exhibit variable return to scale.
Löwenberg, Mark; Duijvis, Nicolette W.; Ponsioen, Cyriel; van den Brink, Gijs R.; Fockens, Paul; D'Haens, Geert R. A. M.
Cyclosporine and infliximab (IFX) seem equally effective as rescue therapy in hospitalized patients with severe ulcerative colitis (UC), although associated hospital stay and costs may differ. The aim of this study was to compare the duration of hospital stay and associated costs from initiation of
Smith, Y R; Quint, E H; Hertzberg, R B
This study was undertaken to assess the causes and treatments of menorrhagia in adolescents hospitalized for this menstrual disorder. A retrospective chart review was performed of all adolescents adolescents with 46 admissions for menorrhagia were identified. The average age of menarche was 12.9 years and the average age at admission was 15.9 years. Nineteen adolescents had significant medical diseases. For the 46 admissions, causes of menorrhagia were anovulation (21), hematologic disease (15), chemotherapy-related (5), and infections (5). Transfusions of blood products were performed in 28 of the admissions. Treatments included oral contraceptive pills or progestins (30), intravenous conjugated estrogens (8), antibiotics (4), immune gammaglobulin (3), DDAVP (3), and prednisone (1). Twelve surgical procedures were performed, including eight dilatation and curettages (D&Cs), three laparoscopies, and one hysterectomy. Sixty-one percent of admissions for adolescent menorrhagia were in adolescents with significant medical problems. The patients with menorrhagia who required admission had severe anemia and were transfused in 63% of cases. The predominant causes for these admissions included anovulation in 46%, hematologic disease in 33%, chemotherapy in 11%, and infection in 11%. Hormonal regulation or suppression of menses should be considered in adolescents with significant medical disease.
Olivera, J. M.; Rocha, L. A.; Rotger, V. I.; Herrera, M. C.
There are many different services within a hospital. This means different types of noise which can be considered as acoustic pollution. Knowing that preterm infants exposed to high amounts of noise in the NICU are at a much higher risk because of their neurologic immaturity and physiologic instability, that excessive levels of noise also affect the persons and it can also impede some studies on patients, it was proposed to evaluate the Sound Pressure Level in some services of the Instituto de Maternidad, Tucumán, Argentina. There were evaluated the Level III NICU, the laundry service, a physical space destined for a service of evoked potential and a neonatal incubator under working conditions. The measurements were performed with a type II sonometer (CENTER 322) and it was also used an incubator analyzer (FLUKE INCU) for the incubator. The average values obtained were of 63.6 dBA for the NICU, 82.5dBA for the laundry room, 52.7 dBA for the evoked potential room and 62.8 dBA in the inside of the incubator under 64 dBA in the outside. The reports were documented in compliance with the appropriate standards.
Thomairy, Noora Al; Mummaneni, Mounica; Alsalamah, Sami; Moussa, Nicole; Coustasse, Alberto
Mobile technology has begun to change the landscape of the medical profession, with more than two-thirds of physicians regularly using smartphones. Smartphones have allowed health care professionals and the general public to communicate more efficiently, collect data, and facilitate clinical decision making. The methodology for this study was a qualitative literature review following a systematic approach of smartphone use among physicians in hospitals. Fifty-one articles were selected for this study based on inclusion criteria. The findings were classified and described into 7 categories: use of smartphone in obstetrics, pediatrics, surgery, internal medicine, radiology, and dermatology, which were chosen based on the documented use of smartphone application in different health care practices. A last section of patient safety and issues with confidentiality is also described. This study suggests that smartphones have been playing an increasingly important role in health care. Medical professionals have become more dependent upon medical smartphone applications. However, concerns of patient safety and confidentiality will likely lead to increased oversight of mobile device use by regulatory agencies and accrediting bodies.
Klingner, Jill; Moscovice, Ira; Tupper, Judith; Coburn, Andrew; Wakefield, Mary
Implementation of patient safety initiatives can be costly in time and energy. Because of small volumes and limited resources, rural hospitals often are not included in nationally driven patient safety initiatives. This article describes the Tennessee Rural Hospital Patient Safety Demonstration project, whose goal was to strengthen capacity for…
Jul 3, 2016 ... development of Hospital waste management plan, procurement of waste management materials, design and construction of special carte for on-site transportation. The initial successes from these steps facilitated the establishment of an Environmental Unit. Fortuitously, the Hospital became a recipient of.
Norwegian hospitals have been characterised by increasing activity, expansion of services and increasing costs for a long time. Differences in quality and accessibility have been documented between hospitals in various geographic locations. Transferral of hospital ownership to the state (from 2002) aimed at increasing capacities and improving quality of services, but also at restricting the increase of costs. These goals have only been partly met. The structure of hospital trusts and organisation of services are therefore continuously debated. This literature review aims at examining whether hospital mergers can reduce costs and at the same time increase the quality of services offered. Literature was identified through a Medline search using the terms "hospital", "merger" and "cost saving". The results are summarized and discussed. Seven original studies of totally 476 hospital mergers (in the USA, Great Britain and Norway) were identified in the period 1982 - 2000. The literature indicates that hospital mergers have a potential to reduce costs by about 10 % if the process achieves complete fusion of previously independent organisations, with a more optimal dimensioning of services and development of a common organizational culture. Collaboration between top management and the professional bureaucracy are prerequisites for success. Mergers are associated with a significant risk of unexpected problems and temporary reduced quality of the services.
Bodilsen, Ann Christine; Pedersen, Mette Merete; Petersen, Janne
OBJECTIVE: Acute hospitalization of older patients may be associated with loss of muscle strength and functional performance. The aim of this study was to investigate the effect of acute hospitalization as a result of medical disease on muscle strength and functional performance in older medical ...
Learning the C-A-Bs: Resuscitation Training at Rwanda Military Hospital. Kathryn Norgang1, Auni Idi Muhire1, Sarah Howrath1. 1Rwanda Military Hospital, Rwanda. Background. There is a lack of trained staff to respond to critically ill patients and cardiac and respiratory arrests in a health facility in Rwanda. This lack of ...
Zahedpisheh, Nahid; Abu Bakar, Zulqarnain B.; Saffari, Narges
The quick development of the tourism and hospitality industry can straightly influence the English language which is the most widely used and spoken language in international tourism in the twenty-first century. English for tourism has a major role in the delivery of quality service. Employees who work in the tourism and hospitality industry are…
Folmann, Nana Bro; Bossen, Kristine Skovgaard; Willaing, Ingrid
To quantify the association between obesity and somatic hospital costs and number of overall somatic hospital contacts--number of inpatient admissions, number of outpatient visits, and number of emergency department visits--based on anthropometric measurements of waist circumference (WC...
increases and use summary statistics to compare market performance in both sectors. The market for hospital medicine is more concentrated than the pharmaceutical retail sector and the share of generics and parallel imported products is significantly lower. Between 2005 and 2009 expenditures for hospital...
Walker, Susan S.
This teacher's guide is the core publication of a series of instructional materials developed for the hospitality and tourism industry. It includes the entry-level competencies students will need to enter any of the occupational areas identified in the four cluster areas of the hospitality and tourism industry: lodging, food service, travel and…
A pre-intervention situation analysis was conducted to assess Hospital Waste Management (HWM) practices, solutions were proffered for the observed inadequacies and advocacy was made to Hospital administration for which a number of interventional measures were instituted. A post interventional survey was conducted ...
Fleming, Jeanne Hmura
Hospital organization, administration and planning, and implementation program procedures are reviewed in this article. Hospitals and medical centers are changing their strategies in the area of wellness programming since they offer the appropriate facilities for these programs. Various types of wellness programs currently being promoted are…
Whilst it has been possible to describe the behaviour of hospitable individuals, there has not been until now an instrument to measure the strength of genuine hospitality in individuals. This paper describes the development of a suite of questions designed to measure these qualities in individuals. This paper describes the ...
Although hospitals are increasingly recognizing the importance of marketing, many have difficulty assimilating what has been primarily an industrial concern into a health care environment. The author explains the function of marketing in health care, the outlook and expectations of a good marketing executive, and why hospital management and the medical staff may have difficulty accepting marketing and the expectations of the marketing executive.
Weld, Tim; Klein, Gina
Proposed rules in accounting for defined benefit plans may affect hospitals' statement of operations and affect the time, effort, and cost to comply with periodic financial reporting requirements. The new standard would require immediate recognition of the full amount of plan amendments in determining operating income. Hospitals should consider the role of pension plans in their compensation programs.
Full Text Available Background: Instead of waiting for challenges to confront hospital management, doctors and managers should act in advance to optimize and sustain value-based health. This work highlights the importance of scenario planning in hospitals, proposes an elaborated definition of the stakeholders of a hospital and defines the influence factors to which hospitals are exposed to. Methodology: Based on literature analysis as well as on personal interviews with stakeholders we propose an elaborated definition of stakeholders and designed a questionnaire that integrated the following influence factors, which have relevant impact on hospital management: political/legal, economic, social, technological and environmental forces. These influence factors are examined to develop the so-called critical uncertainties. Thorough identification of uncertainties was based on a “Stakeholder Feedback”. Results: Two key uncertainties were identified and considered in this study: According to the developed scenarios, complementary education of the medical staff as well as of non-medical top executives and managers of hospitals was the recommended core strategy. Complementary scenario-specific strategic options should be considered whenever needed to optimize dealing with a specific future development of the health care environment. Conclusion: Strategic planning in hospitals is essential to ensure sustainable success. It considers multiple situations and integrates internal and external insights and perspectives in addition to identifying weak signals and “blind spots”. This flows into a sound planning for multiple strategic options. It is a state of the art tool that allows dealing with the increasing challenges facing hospital management.
Kumar, Sameer; Livermont, Gregory; McKewan, Gregory
The use of radio frequency identification device (RFID) technology within the healthcare industry was researched and specific instances of implementation of this technology in the hospital environment were examined. The study primarily makes use of ideas from operations and supply chain management, such as work flow diagrams, value stream mapping, and poka-yokes (mistake proofing measures) for investigations of processes, failures, and solutions. This study presents a step-by-step approach of how to implement the use of RFID tracking systems within the entire hospital. A number of poka-yokes were also devised for improving the safety of the patient and cost effectiveness of the hospital to insure the success of the hospital health care delivery system. Many players in the hospital environment may be impacted. This includes patients, doctors, nurses, technicians, administrators, and other hospital personnel. Insurance and government agencies may be impacted as well. Different levels of training of hospital personnel will be required based on the degree of interaction with the RFID system. References to costs, Return On Investment, change management, ethical and legal considerations are also made to help the reader understand the benefits and implications of the technology in the hospital environment.
Anunciação, Alan Lira da; Zoboli, Elma
The hospital, as a unique type of social organization requires elevated values for management. This paper shows the result of a documented, qualitative, exploratory and descriptive survey about hospitals and their value statements. Identify values expected for hospitals by a search of literature; identify values expressed by hospitals on their web pages and compare results of both. Critical reading of theses, books and articles. A bibliographic search was carried out on BVS (Health Virtual Library) using keywords such as ethics and healthcare management. The values stated by hospitals on web pages were found in sections such as social responsibility, mission, view, principles, and our values. The categories care, healthcare management and accountability were defined after content analysis of empirical data. Values stated by hospitals on web pages express social expectations for an organization that deals with issues as elevated as health and life. Although hospitals have a bureaucratic and organizational structure that resembles those of business enterprises, they are different due to their 'duties to patients' rights and life. Healthcare managers, as well as health professionals, must imprint an ethical attitude on their job and daily work. Only such an attitude will permit patients to trust the hospital and its services.
Pham, Thuy Linh
The purpose of this paper is to examine the relative efficiency and productivity of hospitals during the health reform process. Data envelopment analyses method (DEA) with the input-oriented variable-returns-to-scale model was used to calculate efficiency scores. Malmquist total factor productivity index approach was then employed to calculate productivity of hospitals. Data of 101 hospitals was extracted from databases of the Ministry of Health, Vietnam from the years 1998 to 2006. There was evidence of improvement in overall technical efficiency from 65 per cent in 1998 to 76 per cent in 2006. Hospitals' productivity progressed around 1.4 per cent per year, which was mainly due to the technical efficiency improvement. Furthermore, provincial hospitals were more technically efficient than their central counterparts and hospitals located in different regions performed differently. The paper provides an insight in the performance of Vietnamese public hospitals that has been rarely examined before and contributes to the existing literature of hospital performance in developing countries
pathogens in pyogenic meningitis. Most of the delivery occurred outside the teaching hospital, even those that delivered in the hospital, some come in during labour. ' _ Conclusion: Neonatal bacterial infections are still a cause of high morbidity and mortality of the newborn in our setting. To reduce the morbidity and mortality ...
To document the presentation and course of organophosphate poisoning (OPP) in children and to record the frequency of atropine toxicity during treatment. ... The study was conducted at Eben Donges Hospital, a regional hospital in the Boland/Overberg area of the Western Cape, where pesticide-intensive fruit farming ...
Public hospitals are subject to specific regulations with regard to secularism, which must respect the nursing staff as well as the patients. The relevant legislation attempts to find a balance between freedom of belief and religious expression on the one hand, and the smooth running of the public hospital service on the other. Copyright © 2016 Elsevier Masson SAS. All rights reserved.
Brennen, Paul George
The research study recognized that, although the knowledge obtained from academic textbooks and traditional classes are important to post-secondary hospitality management curriculum as they provide numerous insights and perspectives of different methods to manage a particular avenue within the hospitality industry; it is not the only aspect of the…
None of the patients received snake antivenom since it was unavailable at the hospital. All the 108 patients (100 %) improved and were discharged. The duration of hospital stay was 2 to 17 days with a mean of 3.8 days. Conclusion: Supportive therapy is simple, safe and effective treatment for snakebite without serious ...
Beck, Anne Marie; Balknäs, Ulla N.; Camilo, Maria E.
Disease-related undernutrition is significant in European hospitals but is seldom treated or prevented. In 1999, the Council of Europe decided to collect information regarding nutrition programs in hospitals, and for this purpose, a network consisting of national experts from 12 of the Partial Ag...
Yarbrough, Charles R.
The Rehabilitation Hospital of the Pacific (REHAB) is a highly-specialized medical hospital dedicated to the rehabilitation of the handicapped. Its primary concern is with the care of neurological, orthopedic, or cardiovascular conditions which result in physical impairment. Discusses its personnel, goals, and services. (Author/RK)
EPIDEMIOLOGY OF HOSPITALIZED PATIENTS IN NEUROLOGY: EXPERIENCE OF COCODY TEACHING HOSPITAL AT ABIDJAN (CÔTE-D\\'IVOIRE). Pascale Cowppli-Bony, Thérèse Sounan-Douayoua, François Akani, Ange-Michel Datie, Berthe Assi, Evelyne Aka-Diarra, Félix Boa Yapo, Ernest Beugré Kouassi ...
Full Text Available In prior quarterly reports, Pinnacle Advisory Group presented timely updates about the New England lodging industry, which included focused profiles on particular cities. In this issue, the firm offers more general insight about the hospitality industry. Several Pinnacle executives recently participated in a panel discussion about investment, management, and careers in the hospitality industry.
Full Text Available Children with Down syndrome present with multiple medical problems in a higher prevalence compared with the general population, which may lead to hospitalizations. Methods: Analysis of 560 hospitalizations of 162 children aged 0-16 years with Down syndrome at Hadassah Medical Center during the years 1988-2007 compared with data on children in the general population, hospitalized at the same period. Data was collected from patient files and statistical data from the Ministry of Health. Results: Respiratory infections were the leading cause for hospitalization of children with Down syndrome. The number of hospitalizations of children with Down syndrome compared to the number of all children, who were hospitalized was surprisingly similar to their proportion in the general population. Eleven children died during their hospitalization (five heart failure, three sepsis, one respiratory tract infection and one due to complication after surgery. Nine of the eleven had a congenital heart anomaly. Conclusions: Children with Down syndrome can present with complex medical issues and we support the concept of a multidisciplinary team that has experience and knowledge to serve as a one stop shop for these individuals and their families, with timely visits in which a comprehensive evaluation is performed, problems attended to and prevention plans applied. In this way we may prevent morbidity, hospitalizations and mortality.
Nigerian Quarterly Journal of Hospital Medicine is published quarterly and the contents include articles in Medicine, Dentistry, Pharmaceutical and Basic Medical Sciences with emphasis on health problems and solutions relating to developing countries. The readership are in - Libraries, Teaching Hospitals, Universities, ...
Within the hospitality industry, as in other industries, attention is given to environmental sustainability. Unfortunately, however, most hospitality companies are lagging behind in the process of becoming more sustainable (van Rheede & Blomme, 2012a). According to Myung, McClaren, and Li (2012) and van Rheede.
Li, L. (2016). Are social media applications a facilitator or barrier to learning for tourism and hospitality management students? Research in Hospitality Management, 6 (2), 195–202. https://doi.org/10.1080/22243534.2016.1253289. Acknowledgement — I thank University of Surrey, University of Derby, and Bath Spa ...
Full Text Available Background: Hospital waste contains a large quantity of dangerous pathogenic agents, which are hazardous to the health of man, animal, plant and the environment. In Iran, like many other developing countries, not enough attention is paid to this matter and available information regarding the generation and disposal of medical wastes are low. The existing information about production and disposal of wastes in our hospitals is little and incomplete. In this study, a survey on hospital waste management system in Bushehr province hospitals was conducted. Methods: In this cross-sectional study, 8 hospitals in Bushehr province were investigated during a period of 6 months using a questionnaire, interviews and direct observations. The questionnaire had 93 questions (open and closed about general information on the hospitals and about various systems of managing hospital waste according to the World Health Organization suggested survey questionnaire for hospital waste management in developing countries. Results: In hospitals of bushehr province, waste generation rate was 2615 kg/day, including domestic waste (51.7%, infectious waste (20.8%, sharps (15.2% and chemical and drugs wastes (12.3%. In almost all hospitals, segregation of infectious waste from domestic waste at the place of origin and putting them in special containers had been done but this segregation wasn’t complete and sometimes some hazardous waste were disposed of in domestic waste containers. All hospitals used a color coding system for waste containers, 75 % of hospitals had incinerators. In others, waste was carried out by municipal service daily. In all hospitals, all workers were trained about hospital waste management. In none of the surveyed hospitals, there was an obvious policy and plan for purchasing equipment and necessary facilities in order to dispose hospital waste correctly and also no clear budget was allocated for hospital waste management. In none of these hospitals
Dobkin, Carlos; Finkelstein, Amy; Kluender, Raymond; Notowidigdo, Matthew J
We use an event study approach to examine the economic consequences of hospital admissions for adults in two datasets: survey data from the Health and Retirement Study, and hospitalization data linked to credit reports. For non-elderly adults with health insurance, hospital admissions increase out-of-pocket medical spending, unpaid medical bills and bankruptcy, and reduce earnings, income, access to credit and consumer borrowing. The earnings decline is substantial compared to the out-of-pocket spending increase, and is minimally insured prior to age-eligibility for Social Security Retirement Income. Relative to the insured non-elderly, the uninsured non-elderly experience much larger increases in unpaid medical bills and bankruptcy rates following a hospital admission. Hospital admissions trigger less than 5 percent of all bankruptcies.
Mick, S S; Morlock, L L; Salkever, D; de Lissovoy, G; Malitz, F E; Wise, C G; Jones, A
This study examines the association of characteristics of rural hospital administrators and the adoption of seven strategic activities in a national sample of 797 U.S. rural hospitals during the period 1983-1988. Based on the premise that managerial activities can affect organizational change, we test five hypotheses relating head administrator characteristics to strategic adaptation, controlling for environment-market and hospital-related variables. Bivariate analysis of the strategic adoption showed a positive association with administrative turnover and a negative association with head administrator age. Multivariate logistic regression showed that only high levels of turnover were associated with strategic activities, net of control variables. The implications of these findings and the lack of predictive power of other rural hospital administrator characteristics--especially affiliation with the American College of Healthcare Executives--are discussed within the context of a "strategic management policy" for rural hospitals.
Thiel, Andrea; Winter, Vera; Büchner, Vera Antonia
BACKGROUND: There is a growing need for hospital supervisory boards to support hospital management in different areas, including (financial) monitoring, resource provision, stakeholder relationships, and strategic decision-making. Little is currently known about how boards' emphases...... on these various governance objectives contribute to performance. PURPOSE: Using a dominant logics perspective, this article aims to detect the governance logics that hospital boards emphasize, to determine whether there are distinct clusters of hospitals with the same sets of emphases, and to show how cluster...... theory, and stakeholder theory-can be distinguished, and hospitals can be divided into four clusters based on their board's relative emphasis on the classes. Cluster membership is significantly associated with board characteristics. There is also a significant association between cluster membership...
Enquiries performed by nuclear medicine services together with ANDRA in order to characterize the radioactive wastes from hospital origin have led to suggest some improvements in the management of these products: improved screening on the production site by rationalized collection, planning of a local storage installation for decay of 125 I-containing products, systematic education of concerned hospital staff, in particular to prevent infectious risks, obtaining legislatively a change of class for tritiated and carbonated hospital radioactive wastes, which will be then considered as common wastes. The practical application of these arrangements in hospital by the 'radiation protection competent person' would liberate hospital departments from systematic appeal to ANDRA and thus result in money saving
Shortell, S M; Getzen, T E
Based on organization theory and the work of Roemer and Friedman, seven dimensions of hospital medical staff organization structure are proposed and examined. The data are based on a 1973 nationwide survey of hospital medical staffs conducted by the American Hospital Association. Factor analysis yielded six relatively independent dimensions supporting a multidimensional view of medical staff organization structure. The six dimensions include 1) Resource Capability, 2) Generalist Physician Contractual Orientation, 3) Communication/Control, 4) Local Staff Orientation, 5) Participation in Decision Making, and 6) Hospital-Based Physician Contractual Orientation. It is suggested that these dimensions can be used to develop an empirical typology of hospital medical staff organization structure and to investigate the relationship between medical staff organization and public policy issues related to cost containment and quality assurance. PMID:511580
Beck, Anne Marie; Balknäs, Ulla N.; Camilo, Maria E.
Disease-related undernutrition is significant in European hospitals but is seldom treated or prevented. In 1999, the Council of Europe decided to collect information regarding nutrition programs in hospitals, and for this purpose, a network consisting of national experts from 12 of the Partial...... Agreement member states was established. The aim was to review the current practices in Europe regarding hospital food provision, to highlight deficiencies, and to issue recommendations to improve the nutritional care and support of hospitalized patients. Five major common problems were identified: 1) lack...... of clearly defined responsibilities, 2) lack of sufficient education, 3) lack of influence and knowledge of the patients, 4) lack of cooperation between different staff groups, and 5) lack of involvement from the hospital management. To solve the problems highlighted, a combined timely and concerted effort...
Martelli, Nicolas; Lelong, Anne-Sophie; Prognon, Patrice; Pineau, Judith
Several models of hospital-based health technology assessment (HTA) have been developed worldwide, for the introduction of innovative medical devices and support evidence-based decision making in hospitals. Two such models, the HTA unit and mini-HTA models, are widespread in university hospitals and involve various stakeholders. The purpose of this work was to highlight the potential role of hospital pharmacists in hospital-based HTA activities. We searched for articles, reviews, and letters relating to hospital-based HTA, as defined by the Hospital-Based Health Technology Assessment Worldwide Survey published by the Health Technology Assessment International (HTAi) Society, in the Health Technology Assessment database, MEDLINE, EMBASE, and hospital pharmacy journals. The number of university hospitals performing hospital-based HTA has increased since the 2008 Hospital-Based Health Technology Assessment Worldwide Survey. Our own experience and international findings show that hospital pharmacists already contribute to hospital-based HTA activities and have developed study interpretation skills and a knowledge of medical devices. Promoting multidisciplinary approaches is one of the key success factors in hospital-based HTA. Hospital pharmacists occupy a position between hospital managers, clinicians, health economists, biomedical engineers, and patients and can provide a new perspective. In the future, hospital pharmacists are likely to become increasingly involved in hospital-based HTA activities.
Doran, Kelly M; Ragins, Kyle T; Iacomacci, Andrea L; Cunningham, Alison; Jubanyik, Karen J; Jenq, Grace Y
National attention is increasingly focused on hospital readmissions. Little prior research has examined readmissions among patients who are homeless. The aim of the study was to determine 30-day hospital readmission rates among patients who are homeless and examine factors associated with hospital readmissions in this population. We conducted a retrospective chart review of patients who were homeless and hospitalized at a single urban hospital from May-August 2012. Homelessness was identified by an electronic medical record flag and confirmed by manual chart review. The primary outcome was all-cause hospital readmission to the study hospital within 30 days of hospital discharge. Patient-level and hospitalization-level factors associated with risk for readmission were examined using generalized estimating equations. There were 113 unique patients who were homeless and admitted to the hospital a total of 266 times during the study period. The mean age was 49 years, 27.4% of patients were women, and 75.2% had Medicaid. Half (50.8%) of all hospitalizations resulted in a 30-day hospital inpatient readmission and 70.3% resulted in either an inpatient readmission, observation status stay, or emergency department visit within 30 days of hospital discharge. Most readmissions occurred early after hospital discharge (53.9% within 1 week, 74.8% within 2 weeks). Discharge to the streets or shelter versus other living situations was associated with increased risk for readmission in multivariable analyses. Patients who were homeless had strikingly high 30-day hospital readmission rates. These findings suggest the urgent need for further research and interventions to improve postdischarge care for patients who are homeless.
Rentoumis, Anastasios; Mantzoufas, Nikolaos; Kouris, Gavriil; Golna, Christina; Souliotis, Kyriakos
To investigate whether the long term lease of public hospital owned land could be an additional financing mechanism for Greek public (mental) health hospitals. We performed a financial analysis of the official 2008 data of a case - study hospital (Mental Health Hospital of Chania). We used a capital budgeting approach to investigate whether value is created for the public hospital by engaging its assets in a project for the development of a private renal dialysis Unit. The development of the private unit in hospital owned land is a good investment decision, as it generates high project Net Present Value and Internal Rate of Return. When the project commences generating operating cash flows, nearly €400.000 will be paid annually to the Mental Health Hospital of Chania as rent, thereby gradually decreasing the annual deficit of the hospital. Revenue generated from the long term lease of public hospital land is crucial to gradually eliminate hospital deficit. The Ministry of Health should encourage similar forms of Public Private Partnerships in order to ensure the sustainability of public (mental) hospitals.
von Hahn, Ludwig; Linse, Caroline; Hafler, Janet
The schooling of 1 of every 8 children is influenced by the Individuals with Disabilities Education Act (IDEA). The IDEA also governs, to a degree, the relationship between interdisciplinary hospital clinics that evaluate many of these children and the schools that provide educational services. Little is known about how this relationship functions or how educational personnel perceive reports from hospital settings. To describe special education administrator and hospital evaluator perspectives on hospital assessments of children with learning problems. A survey of attendees at a 1998 meeting of the Massachusetts Association of Special Education Administrators was conducted by use of a questionnaire using closed and open-ended questions. Subsequently, focus groups were held with hospital evaluators. Special education administrators describe a high level of frustration with hospital-school relations. They state that hospital reports do not meet the needs of children in the educational setting. They seek closer collaboration with medical evaluators. Evaluators working in hospital settings acknowledge frustration perceived by school personnel. They state that communication with educational personnel improves the quality of their reports and outcomes for the child. Hospital assessments of children with learning problems are associated with high levels of frustration among special education administrators. These assessments might be made more useful if careful attention were paid to the needs of educators. Greater communication between hospital evaluators and school personnel may increase the usefulness of hospital clinic assessments of children with learning problems.
Full Text Available Abstract Objectives To investigate whether the long term lease of public hospital owned land could be an additional financing mechanism for Greek public (mental health hospitals. Methods We performed a financial analysis of the official 2008 data of a case - study hospital (Mental Health Hospital of Chania. We used a capital budgeting approach to investigate whether value is created for the public hospital by engaging its assets in a project for the development of a private renal dialysis Unit. Results The development of the private unit in hospital owned land is a good investment decision, as it generates high project Net Present Value and Internal Rate of Return. When the project commences generating operating cash flows, nearly €400.000 will be paid annually to the Mental Health Hospital of Chania as rent, thereby gradually decreasing the annual deficit of the hospital. Conclusions Revenue generated from the long term lease of public hospital land is crucial to gradually eliminate hospital deficit. The Ministry of Health should encourage similar forms of Public Private Partnerships in order to ensure the sustainability of public (mental hospitals.
Hemsley, Bronwyn; Lee, Sabrena; Munro, Kathleen; Seedat, Nadeera; Bastock, Kaely; Davidson, Bronwyn
Objective We aimed to investigate the views of allied health and nursing staff on supporting the communication of children with cerebral palsy (CP) and complex communication needs (CCN) in hospital. Method We conducted 12 focus groups with 49 community- and hospital-based allied health professionals and hospital nurses. Results Participants reported having active roles in supporting children’s seating, mobility, equipment, mealtime management and psychosocial needs, but not in supporting the children’s communication in hospital. Participants described several environmental barriers to supporting children’s augmentative and alternative communication (AAC) in hospital, and suggested a range of strategies to ease communication difficulties at the bedside. Conclusion Results indicate a potential new role for community- and hospital-based health professionals in supporting nurses to implement AAC strategies at the bedside. Supporting nursing staff to remove environmental barriers and use communication technologies might create a more communicatively accessible hospital ward for children with CP and CCN. PMID:24102353
Introduction: A devastating earthquake is inevitable in the long term and likely in the near future in Iran. The objective of the study was to assess the knowledge of hospital staff to disaster management system in hospital and to determine nonstructural safety assessment in Shahid Mohammadi hospital in Bandar Abbas city of Iran. This hospital is the main referral hospital in Hormozgan province with a capacity of about 450 beds and the highest patient admissions. Methods: The cross-sectional study was conducted in 2013 on 200 healthcare workers at Shahid Mohammadi hospital, in the city of Bandar Abbas, Iran. This hospital is the main referral hospital in Hormozgan province and has a capacity of about 450 beds with highest numbers of patient admissions. Questionnaire and checklist used for assessing health workers knowledge and awareness towards disaster management and nonstructural safety this hospital. Results: This study found that knowledge, awareness, and disaster preparedness of hospital staff need continual reinforcement to improve self efficacy for disaster management. Equipping health care facilities at the time of natural disasters, especially earthquakes are of great importance all over the world, especially in Iran. This requires the national strategies and planning for all health facilities. Conclusion: It seems due to limitations of hospital beds, insufficient of personnel, and medical equipment, health care providers paid greater attention to this issue. Since this hospital is the only educational public hospital in the province, it is essential to pay much attention to the risk management not only to this hospital but at the national level to health facilities. PMID:26573039
Japanese health care is characterized by a pluralistic system with a high degree of private producers. Central government regulates the prices and the financing system. All citizens are covered by a mandatory employment-based health insurance operating on a non-profit basis. The consumer has a free choice of physician and hospital. A comparison between Japan, Sweden and some other countries shows significant dissimilarities in the length of stay, number of treatments per hospital bed and year and the staffing of hospitals. About 80 per cent of the hospitals and 94 per cent of the clinics are privately owned. The typical private hospital owned by a physician has less than 100 beds. In this paper, data collected (1992/93) in an empirical study of Japanese hospitals and their leadership is presented. Also discussed are the hospitals' style of management, tools and strategies for competition and competences--personal and formal skills required of the leadership in the hospital. There follows a study of ten hospitals, among which hospital directors and chief physicians were interviewed. Interviews are also made with key persons in the Ministry of Health and Welfare and other organizations in the health care field. The result is also analysed from a cultural perspective--'what kind of impact does the Japanese culture have on the health care organization?' and/or 'what kind of sub-culture is developed in the Japanese hospitals'. Some comparisons are made with Sweden, USA, Canada and Germany. The different roles of the professions in the hospital are included in the study as well as the incentives for different kinds of strategies--specialization, growing in size, investments in new equipment, different kind of ownership and hospitals. Another issue discussed is the attempt to uncover whether there is an implicit distribution of specialties--silent agreements between hospitals, etc.
Gilden, D J; Scissors, K N; Reuler, J B
Use of disposable products in hospitals continues to increase despite limited landfill space and dwindling natural resources. We analyzed the use and disposal patterns of disposable hospital products to identify means of reducing noninfectious, nonhazardous hospital waste. In a 385-bed private teaching hospital, the 20 disposable products of which the greatest amounts (by weight) were purchased, were identified, and total hospital waste was tabulated. Samples of trash from three areas were sorted and weighed, and potential waste reductions from recycling and substituting reusable items were calculated. Business paper, trash liners, diapers, custom surgical packs, paper gowns, plastic suction bottles, and egg-crate pads were among the 20 top items and were analyzed individually. Data from sorted trash documented potential waste reductions through recycling and substitution of 78, 41, and 18 tonnes per year (1 tonne = 1,000 kg = 1.1 tons) from administration, the operating room, and adult wards, respectively (total hospital waste was 939 tonnes per year). We offer specific measures to substantially reduce nonhazardous hospital waste through substitution, minimization, and recycling of select disposable products.
M. Abdi Talarposht
Full Text Available Background: Agility is an effective response to the changing and unpredictable environment and using these changes as opportunities for organizational improvement. Objective: The aim of the present study was to rank the factors affecting agile supply chain of hospitals of Iran. Methods: This applied study was conducted by cross sectional-descriptive method at some point of 2015 for one year. The research population included managers, administrators, faculty members and experts were selected hospitals. A total of 260 people were selected as sample from the health centers. The construct validity of the questionnaire was approved by confirmatory factor analysis test and its reliability was approved by Cronbach's alpha (α=0.97. All data were analyzed by Kolmogorov-Smirnov, Chi-square and Friedman tests. Findings: The development of staff skills, the use of information technology, the integration of processes, appropriate planning, and customer satisfaction and product quality had a significant impact on the agility of public hospitals of Iran (P<0.001. New product introductions had earned the highest ranking and the development of staff skills earned the lowest ranking. Conclusion: The new product introduction, market responsiveness and sensitivity, reduce costs, and the integration of organizational processes, ratings better to have acquired agility hospitals in Iran. Therefore, planners and officials of hospitals have to, through the promotion quality and variety of services customer-oriented, providing a basis for investing in the hospital and etc to apply for agility supply chain public hospitals of Iran.
Karam, R.; Oueida, F.; Tissot-Guerraz, F.; Trepo, D.; Collombel, C.
author.The existing management of hospital waste in Lebanon currently poses both an environmental hazard as well as a public health risk. This is due mainly to lack of legislation, information and modern treatment and disposal facilities designed for this purpose. A nation-wide questionnaire survey was conducted to asses the status of hospital waste management. The study started from October 1997 till August 1998. We found that 75% of the surveyed hospitals completely ignore their total waste quantity: 73% of hospitals surveyed practice segregation at source of infectious, pathological, sharps and pharmaceuticals; more than 40% dispose of their hospital risk wastes through the municipality waste disposal, 24% by burning in open fires, 14% by on-site hospital incinerators, 11% in on-site dumping, 8% handled by a private contractor and 1% in uncontrolled landfill. We conclude that with some exceptions, the hospital waste management situation in Lebanon is very far from being satisfactory and therefore needs to be reconsidered. 1 Fig., 6 tabs., 18 refs
Kirkland, Lisa L; Parham, William M; Pastores, Stephen M
The purpose of this article is to provide intensivists with information and examples regarding cooling technology selection, cost assessment, adaptation, barriers, and presentation to hospital administrators. A review of medical and business literature was conducted using the following search terms: technology assessment, organizational innovation, intensive care, critical care, hospital administration, and presentation to administrators. General recommendations for intensivists are made for assessing cooling technology with descriptions of common new technology implementation stages. A study of 16 hospitals implementing a new cardiac surgery technology is described. A description of successful implementation of an induced hypothermia protocol by one of the authors is presented. Although knowledgeable about the applications of new technologies, including cooling technology, intensivists have little guidance or training on tactics to obtain a hospital administration's funding and support. Intensive care unit budgets are usually controlled by nonintensivists whose interests are neutral, at best, to the needs of intensivists. To rise to the top of the large pile of requisition requests, an intensivist's proposal must be well conceived and aligned with hospital administration's strategic goals. Intensivists must understand the hospital acquisition process and administrative structure and participate on high-level hospital committees. Using design thinking and strong leadership skills, the intensivist can marshal support from staff and administrators to successfully implement cooling technology.
Lucas, M; Germain, J-M; Rémy, E; Lottin, M; Etienne, M; Czernichow, P; Merle, V
French national guidelines state that antibiotic therapies should be reassessed between 48 and 72hours after treatment initiation and that reassessment of antibiotic therapy (RA) must be recorded in patients' files. To determine whether RA is performed and recorded in patients' files in hospitals in a region of France. Setting: hospitals participating in the National nosocomial infection point- prevalence survey (NPS) in Upper-Normandy, France. Patients included those receiving antibiotic therapy (excluding antibiotic prophylaxis) on NPS day, started in the hospital in which the survey was conducted and ongoing for more than 72hours. Data collected included characteristics of participating hospitals and, for each included patient, characteristics of ward, infection and antibiotic therapy, and mention in the patients' files of explicit or implicit RA. The rate of explicit and implicit RA was calculated and factors associated with explicit or implicit RA were evaluated using a univariate analysis. Thirty-three hospitals representing 87% of hospital beds region-wide were included in the study. In addition, 933 prescriptions were assessed for 724 infections in 676 patients. The overall rate of RA was 67.6% (49.3% of explicit RA and 18.3% of implicit RA). The rate of RA differed significantly according to infection and antibiotic class but not according to hospital or ward characteristics. Our study provides new and reassuring results regarding reassessment of antibiotic therapy. Copyright © 2017 Elsevier Masson SAS. All rights reserved.
Chowdhary, N R
Recently, I have noted ubiquitous trends that lead me to conclude that we are on the brink of a fundamental change in the structure of healthcare delivery. Hospitals are changing. The hospital, that enduring and pervasive organization, which for decades has delivered the vast majority of acute care services is being re-conceptualized. Administrators and executives in today's hospitals are beginning to recognize the disaffection of constituents and the necessity to change from placing their own agenda or that of their profession over the needs of the customer. A lesson that is increasingly being heeded, particularly by the leading hospitals, is that a belief in one's own importance or a feeling of invulnerability represents an anachronistic stance. No hospital today can afford to retain a view that it is more important than the patients it serves, or that it is invulnerable. The external pressures are already clear--the actors, factors and forces in the external environment are forcing hospitals to re-evaluate efficiency, effectiveness and delivery arrangements. The rise to prominence of the outcomes movement is part of this trend. The present study was an attempt to assess the practices and trends in the modern smaller hospitals as a part of their strategy to match the competitive pressures.
Barreto Penié, Jesús
We assessed the current state of undernutrition as observed in 1905 patients hospitalized in 12 Cuban health care institutions, as part of a Latin American, multinational survey similar in design and goals. We surveyed 1905 randomly selected patients from 12 Cuban hospitals in a two-phase study. Patients' clinical charts were audited in phase 1, the Subjective Global Assessment was used to assess patients' nutritional status in phase 2. The study was locally conducted by a properly trained team. The frequency of undernutrition in Cuban hospitals was 41.2% (95% confidence interval = 38.9 to 43.4), and 11.1% of patients were considered severely undernourished. Statistically significant (P hospital services/specialties were identified: geriatrics (56.3%), critical care (54.8%), nephrology (54.3%), internal medicine (48.6%), gastroenterology (46.5%), and cardiovascular surgery (44.8%). Malnutrition rates increased progressively with prolonged length of stay. A high malnutrition rate was observed among participating hospitals. The design and inception of policies that foster intervention programs focusing on early identification of hospital malnutrition and its timely management is suggested to decrease its deleterious effects on outcomes of health care in the participating hospitals.
Mackay, J M; Lamb, C W
Marketing has become widely recognized as an important component of hospital management (Kotler and Clarke 1987; Ludke, Curry, and Saywell 1983). Physicians are becoming recognized as an important target market that warrants more marketing attention than it has received in the past (Super 1987; Wotruba, Haas, and Hartman 1982). Some experts predict that hospitals will begin focusing more marketing attention on physicians and less on consumers (Super 1986). Much of this attention is likely to take the form of practice management assistance, such as computer-based information system support or consulting services. The survey results reported here are illustrative only of how one hospital addressed the problem of physician need assessment. Other potential target markets include physicians who admit patients only to competitor hospitals and physicians who admit to multiple hospitals. The market might be segmented by individual versus group practice, area of specialization, or possibly even physician practice life cycle stage (Wotruba, Haas, and Hartman 1982). The questions included on the survey and the survey format are likely to be situation-specific. The key is the process, not the procedure. It is important for hospital marketers to recognize that practice management assistance needs will vary among markets (Jensen 1987). Therefore, hospitals must carefully identify their target physician market(s) and survey them about their specific needs before developing and implementing new physician marketing programs. Only then can they be reasonably confident that their marketing programs match their customers' needs.
Full Text Available Our paper empirically examines how the decision to purchase private insurance and hospitalization are made based on household income, socio-demographic factors, and private health insurance factors in both Japan and the USA. Using these two data-sets, we found some similarities and dissimilarities between Japan and the United States. As income of households rises, households have a positive effect on purchasing health insurance as a normal good. Another similarity between the two countries is seen in the income effect on risk of hospitalization, which is negative for both Japanese and US cases. For dissimilarity, the insurance premium effect on risk of hospitalization is positive for the Japanese case, while negative for the US case. Since the Japanese insurance data had variables such as payments per day of hospitalization if household gets hospitalized, insurance payments upon death of an insured person, and annuity payments at maturity, we tested to see if these characteristics affect the risk of hospitalization for households; we do not eliminate a possibility of adverse selection. For the US pure health issuance characteristics, an increase in premium of health insurance policies cause individuals to substitute more health capital investment which causes lower risk of hospitalization.
The average length of hospital stay was 3 days. Of the inguinal ... on hernia disease with reference to prevalence, pattern and management at a provincial general hospital in Kenya. Methods. After obtaining permission from the hospital administration, we .... financial constraint on hospitals, length of hospital stay and enable ...
... 42 Public Health 3 2010-10-01 2010-10-01 false Hospital election to reduce coinsurance. 419.42... SERVICES Payments to Hospitals § 419.42 Hospital election to reduce coinsurance. (a) A hospital may elect to reduce coinsurance for any or all APC groups on a calendar year basis. A hospital may not elect to...
... 42 Public Health 3 2010-10-01 2010-10-01 false Payment to a nonparticipating hospital. 424.52... § 424.52 Payment to a nonparticipating hospital. Medicare pays a nonparticipating hospital for the... services furnished by a U.S. hospital, if the hospital has in effect an election to claim payment in...
Full Text Available This study analyzed the efficiency of cholera treatment in three hospitals representative of the Ecuadorian public health system in order to provide hospital directors and administrators and health service policy-makers with information to plan responses to future epidemics and to reduce the costs of cholera treatment in general. For the study, total and excess cholera treatment costs were calculated using hospital files and statistics and an in-hospital surveillance system of the cholera cases. The type and quantity of each input used for each treatment were analyzed, as well as the number of days hospitalized, according to the severity of the illness. With this process, excess costs were determined in relation to a "treatment norm" that would have been appropriate for each patient. The researchers found that 45% of the cholera treatment costs were excessive. The most important contributor was excess recurrent costs (90%, including extended hospital stays, disproportionate use of intravenous rehydration solutions, and unnecessary laboratory tests. Excess capital costs, from land, buildings, and hospital equipment, represented 10% of the total excess treatment costs. No significant relationship was found between treatment costs and the severity of the illness, nor between costs and a patient's age. A patient's sex appeared to be an important variable, with the cost of treating women being notably higher than for men. An inverse relationship was found between treatment costs and the complexity of the hospital. The researchers concluded there was an inefficient use of resources in the treatment of cholera in the three hospitals where the research was performed.
Full Text Available Context Over the past decade the number of accidents and disasters has been growing around the world. In addition to damaging communities and infrastructures, unexpected disasters also affect service providers. This study aimed to evaluate the readiness of hospitals when confronted with unexpected disasters. Evidence Acquisition The present study was a simple review article, which was conducted via searching different sites, such as: Web of Science, Scopus, Science Direct and PubMed, using different key words such as: Disasters, Crisis, Hospital and preparedness. The relationship between the articles found in relation to our subject was investigated through the title and abstract of articles. The relationship between the articles, which were found in relation to our subject, was investigated through the title and abstract of the articles. Our search included papers published during the period between 2007 and 2015 and we only considered studies that measured the preparedness of hospitals in critical conditions. Among the 30 articles, which were found, 17 were excluded from the study due to lack of relevant data. Hence, 15 papers, which were of proper design and robust data analysis, were included in the current study. Results Hospital preparedness in disaster was evaluated in three dimensions: structural, non-structural factors and vulnerability management performance. A total of readiness of hospitals in three dimensions was mediocre. Conclusions Overall, the results derived from these studies indicated that hospital safety levels in most of the surveyed hospitals were moderate. Although the situation in hospitals is not critical, there is a need to plan and take appropriate measures to improve the safety level of the hospitals.
Cardwell, R; Bolon, D
The number of hospital providers in the USA is shrinking and the market is becoming increasingly competitive. Many financially challenged hospital institutions are searching for a better way to compete. Contends that strategic alliances offer many attractive solutions for hospital management which include: scale economies, relative low cost for risk sharing and improved efficiency. Argues that the future of alliances focuses on capitation, quality information systems for co-ordination, and the continuum of care which a strategic alliance can provide to a community.
Frank, W G
Variance analysis, an accounting technique, is applied to an eight-component model of hospital costs to determine the contribution each component makes to cost increases. The method is illustrated by application to data on total costs from 1950 to 1973 for all U.S. nongovernmental not-for-profit short-term general hospitals. The costs of a single hospital are analyzed and compared to the group costs. The potential uses and limitations of the method as a planning and research tool are discussed.
Escrivão Junior, Alvaro
This study investigates managerial perceptions of the use of information in health management and planning in 24 Public Hospitals in the São Paulo Metropolitan Region, analyzing its usefulness for the decision-making process. In addition, some characteristics of the existing information system are studied. The findings show that ample amounts of information and data are available in the hospitals covered by this study, despite some gaps, and that managers do not know about the existing data and do not use this information to guide hospital management.
In the French health system, social security is the same for both public and private hospitals regardless of their status. In terms of number of patients screened, diagnosed, or treated, independant medicine is the most important sector in the French oncology. The multitude of organizations representing private hospitals or independant oncologists, physicians, radiologists or pathologists have a common organization, the National Union for Private Hospital Oncology (UNHPC). It bases its action on two founding postulates to ensure the quality of the oncology practice : the medical and managerial cultures are complementary and should be articulated ; the quality of organizations is as important as professional competence.
Bossen, Claus; Foss, Martin
In this paper, we describe the collaborative work of hospital porters. The profession of hospital porter is understudied in sociology and in Computer Supported Cooperative Work, despite numerous studies of healthcare IT. We describe how a new IT system for hospital logistics provided porters...... with more influence on, and responsibility for their work; supported collaboration among porters, clinicians, and middle management; and effected a new ecology of visibility and accountability of porters’ work. We discuss how the new system simultaneously supported collaboration and generated...
Jacobsen, Peter; Ebbehøj, Niels Erik
BACKGROUND: Hospitals are rarely reported as settings for mass psychogenic illness (MPI). The present report scrutinizes an outbreak of probable MPI among hospital staff, with medical intervention reinforcing the course of the illness. CASE REPORT: Four of seven staff members in an emergency...... the following 9 days, 14 possible poisoning victims were identified, 6 of whom were transferred for HBO. After hospital stays with repeated HBO treatment and examinations without identification of significant physical disease, the majority of the 10 HBO-treated victims remained symptomatic, some on prolonged....... Outbreaks of illness in a group of symptomatic victims without indication of significant physical disease should be managed by observation and limited intervention....
Energy usage--particularly electricity--in hospitals is a hot topic, and the sector is under increasing pressure to reduce load and carbon emissions. The cost of 'going green' can, however, be high, and many hospitals shy away from more costly energy-efficient solutions, instead selecting cheaper options to suit the short term. One Hampshire healthcare facility, however, bucked the trend when selecting new chilled water plant, thanks to the advice and expertise of chartered consulting engineers, Henderson Green. Examining whether other hospitals should follow suit, managing director, Russ Pitman, explains 'why considering the bigger picture perspective does pay off'.
Goldberger, Nehama; Haklai, Ziona; Pugachova, Inna; Levav, Itzhak
Persons with severe mental disorders have higher suicide rates than the general population. Their risk profile needs to be fully explored to better guide suicide preventive efforts. Downsizing the number of beds in psychiatric hospitals and high bed turnover may also affect the suicide risk. To investigate 1) Suicide rates among persons who were ever hospitalized in psychiatric facilities compared to the general population, 2) Associated sociodemographic and psychiatric factors, 3) Changes in rate over time, and 4) Timing of suicide deaths. We linked the National Psychiatric Case Register (NPCR) with the national database on causes of death. Suicides in the years 1981-2009 were analyzed for the study group of Israelis aged 18 and over ever hospitalized (N= 158,800). Suicide rates were computed by age, gender, psychiatric diagnosis and year of death, as well as agestandardized rates and rate ratios (RR) for persons in the NPCR compared with those never hospitalized. The proportion of suicides committed by the ever hospitalized from all suicides in the population was calculated. Standardized mortality ratios (SMR) for suicide were computed for the ever hospitalized based on the total suicide rates of the population. A multivariate logistic model investigated risk factors associated with suicide in the ever-hospitalized population. The age-standardized suicide rate of Jews and Others with a psychiatric hospitalization was 17.6 times higher than that of the non-hospitalized (95% CI 16.7-18.6) and 29.7 times higher for Arabs (95% CI 23.4- 37.9). The rates were higher among females and younger persons. In the years 2007-2009, 30% of all suicides of Jews and Others were committed by persons who had been hospitalized in psychiatric facilities. The SMRs of Jews and Others, which increased at the beginning of the study period, fell steadily until 1995. In recent years they have been rising since 2000 and 2005 among females and males, respectively. One fifth (19%) of suicides
Chow-Chua, C F; Goh, M
This paper presents a quality roadmap of a restructured hospital. Specifically, a case study is showcased to reveal how a FOCUS-PDCA model is applied to the Central Portering Services (CPS) within a restructured hospital, to provide better service to other departments within the hospital who can then in turn value add to the patient care delivery chain. The preliminary results suggest that implementers of quality and service improvement programmes using the FOCUS-PDCA approach should note some of the key implementation difficulties. These difficulties occur at all levels and include issues relevant to change management, process improvement programmes, accessibility to data, communication and judicious execution of the change process.
Krueckeberg, H F; Hubbert, A
Customer satisfaction (patient satisfaction) with hospital outpatient or ambulatory services is an important factor in influencing patient patronage and loyalty. Based on an empirical study, this article examines the attributes of the ambulatory care experience which were significantly associated with the level of satisfaction resulting from the most recent hospital ambulatory visit. This study focuses on identifying attributes of ambulatory services. This article brings to the health care marketing literature information on ambulatory satisfaction comparable to that which has been contributed to the literature regarding satisfaction with physician and hospital experiences.
Kahn, Charles N
A specialty hospital joint venture between a health system and physician investors may implicate anti-kickback and tax laws when physicians self-refer patients to the hospital, raising the issue of conflict of interest. Physician self-referral can motivate behavior, such as cherry-picking patients and increased utilization, which in turn leads to windfall profits for physician owners and weakens classic community hospitals. Hopitals can best serve the interests of patients and improve performance by building enduring partnerships with physicians.
Aarseth, S; Vatn, S; Aarseth, H P
66% of the hospital doctors at the Central Hospital, Akershus and Ullevål Hospital responded to a questionnaire concerning different aspects of a doctor's work situation and health. The investigation revealed a large work load and lack of consulting rooms and equipment. Violence, threats, abusive language, risk of infection, high temperatures, cytostatic drugs, narcosic gases, irradiation are all risk factors during daily work for a large percentage of the doctors. Even so, they seem to be fairly satisfied with the organization of the work, and nearly all of them enjoy their work.
Fabiana Rossi Varallo
Full Text Available OBJECTIVES: Drug safety problems can lead to hospital admission. In Brazil, the prevalence of hospitalization due to adverse drug events is unknown. This study aims to estimate the prevalence of hospitalization due to adverse drug events and to identify the drugs, the adverse drug events, and the risk factors associated with hospital admissions. METHOD: A cross-sectional study was performed in the internal medicine ward of a teaching hospital in São Paulo State, Brazil, from August to December 2008. All patients aged ≥18 years with a length of stay ≥24 hours were interviewed about the drugs used prior to hospital admission and their symptoms/complaints/causes of hospitalization. RESULTS: In total, 248 patients were considered eligible. The prevalence of hospitalization due to potential adverse drug events in the ward was 46.4%. Overprescribed drugs and those indicated for prophylactic treatments were frequently associated with possible adverse drug events. Frequently reported symptoms were breathlessness (15.2%, fatigue (12.3%, and chest pain (9.0%. Polypharmacy was a risk factor for the occurrence of possible adverse drug events. CONCLUSION: Possible adverse drug events led to hospitalization in a high-complexity hospital, mainly in polymedicated patients. The clinical outcomes of adverse drug events are nonspecific, which delays treatment, hinders causality analysis, and contributes to the underreporting of cases.
Harb, H; Habil, I
To determine the frequency and profile of induced abortions among hospitalized cases of abortions in three tertiary hospitals in Egypt. A total of 517 consecutive cases of abortions with complete records were enrolled from three tertiary hospitals in Egypt: two hospitals in Cairo and one hospital in Alexandria. A data extraction sheet was designed to extract the required information from the records. It included: File No., Age, marital status, occupation, parity, number of children, previous abortion, history of contraception, trial of induction for this abortion and management of abortion in the hospital. The World Health Organization (WHO) criteria of categorizing the abortion as possible, probable or certainly induced abortion was used for classification of abortion cases. The proportion of classified induced abortions (certainly, probably and possibly induced abortions) was 30.6% in the total sample, being higher in Alexandria hospital (60.9%) compared to 14 and 19% in the other two hospitals respectively. Using the multiple logistic regression, the following factors were found independently related to induced abortions: Alexandria hospital (as proxy for residence), age > or = 30 years and having more than 2 children. The current study revealed that about one third of hospitalized cases of abortion can be suspected of being induced. Induced abortion may be linked to elder age, higher number of children in the family and probably have geographical variation in Egypt.
Thibodeau, Patricia L; Funk, Carla J
The research studied the status of hospital librarians and library services to better inform the Medical Library Association's advocacy activities. The Vital Pathways Survey Subcommittee of the Task Force on Vital Pathways for Hospital Librarians distributed a web-based survey to hospital librarians and academic health sciences library directors. The survey results were compared to data collected in a 1989 survey of hospital libraries by the American Hospital Association in order to identify any trends in hospital libraries, roles of librarians, and library services. A web-based hospital library report form based on the survey questions was also developed to more quickly identify changes in the status of hospital libraries on an ongoing basis. The greatest change in library services between 1989 and 2005/06 was in the area of access to information, with 40% more of the respondents providing access to commercial online services, 100% more providing access to Internet resources, and 28% more providing training in database searching and use of information resources. Twenty-nine percent (n = 587) of the 2005/06 respondents reported a decrease in staff over the last 5 years. Survey data support reported trends of consolidation of hospitals and hospital libraries and additions of new services. These services have likely required librarians to acquire new skills. It is hoped that future surveys will be undertaken to continue to study these trends.
Zhou, Ping; Bundorf, Kate; Le Chang, Ji; Huang, Jin Xin; Xue, Di
To measure perceptions of organizational culture among employees of public hospitals in China and to determine whether perceptions are associated with hospital performance. Hospital, employee, and patient surveys from 87 Chinese public hospitals conducted during 2009. Developed and administered a tool to assess organizational culture in Chinese public hospitals. Used factor analysis to create measures of organizational culture. Analyzed the relationships between employee type and perceptions of culture and between perceptions of culture and hospital performance using multivariate models. Employees perceived the culture of Chinese public hospitals as stronger in internal rules and regulations, and weaker in empowerment. Hospitals in which employees perceived that the culture emphasized cost control were more profitable and had higher rates of outpatient visits and bed days per physician per day but also had lower levels of patient satisfaction. Hospitals with cultures perceived as customer-focused had longer length of stay but lower patient satisfaction. Managers in Chinese public hospitals should consider whether the culture of their organization will enable them to respond effectively to their changing environment. © Health Research and Educational Trust.
Annetta, M G; Pittiruti, M; De Rosa, S; Franchi, P; Pintaudi, G; Caricato, A; Antonelli, M
A proper strategy for fighting hospital malnutrition should include nutritional screening of all hospitalized patients, adequate utilization of the Hospital facilities - such as Clinical Nutrition Services or Nutrition Teams - and an adequate algorithm for the adoption of proper nutrition support (oral, enteral or parenteral) with proper timing. The main aim of the present study was to investigate the current policies of different non-intensive wards of our institution (a 1100 beds University Hospital) in terms of prevention of hospital malnutrition. We conducted a one-day survey to verify the current policies of nutritional screening and the indication to nutritional support in adult patients, interviewing nurses and physicians of our non-intensive hospital wards. A total of 29 wards were considered, which sum up to 755 hospitalized patients. We found that nutritional screening at admission is routinely assessed only in 41% of wards and that oral nutrient intake is controlled regularly only in 72%. Indication to clinical nutrition support and specifically to artificial nutrition is not consistent with the current international guidelines. Only 14% of patients were receiving artificial nutrition at the moment of the survey and the majority of them were given parenteral nutrition rather than enteral feeding. Our survey confirmed that in large hospitals the main barriers to the fight against hospital malnutrition are the lack of knowledge and/or commitment by nurses and physicians as well as the lack of well-defined hospital policies on early nutritional screening, surveillance of nutritional status and indication to nutrition support.
Gu, Qian; Koenig, Lane; Faerberg, Jennifer; Steinberg, Caroline Rossi; Vaz, Christopher; Wheatley, Mary P
Objective To explore the impact of the Hospital Readmissions Reduction Program (HRRP) on hospitals serving vulnerable populations. Data Sources/Study Setting Medicare inpatient claims to calculate condition-specific readmission rates. Medicare cost reports and other sources to determine a hospital's share of duals, profit margin, and characteristics. Study Design Regression analyses and projections were used to estimate risk-adjusted readmission rates and financial penalties under the HRRP. Findings were compared across groups of hospitals, determined based on their share of duals, to assess differential impacts of the HRRP. Principal Findings Both patient dual-eligible status and a hospital's dual-eligible share of Medicare discharges have a positive impact on risk-adjusted hospital readmission rates. Under current Centers for Medicare and Medicaid Service methodology, which does not adjust for socioeconomic status, high-dual hospitals are more likely to have excess readmissions than low-dual hospitals. As a result, HRRP penalties will disproportionately fall on high-dual hospitals, which are more likely to have negative all-payer margins, raising concerns of unintended consequences of the program for vulnerable populations. Conclusions Policies to reduce hospital readmissions must balance the need to ensure continued access to quality care for vulnerable populations. PMID:24417309
Al-Ahmadi, Talal A
The issue of patient safety has received an increasing attention worldwide. In Saudi Arabia, policy makers and health organizations continually strive to substantially reduce medical errors and improve quality of health care. The aim of this research was to explore the perceptions of Riyadh hospitals' staff on patient safety and error reporting and to identify factors that influence the levels of frequency of events reported. A cross-sectional survey, using Hospital Survey on Patient Safety Culture (HSPSC), was carried out in 2008. The questionnaire was distributed to all hospitals' staff in Riyadh, which included nine public hospitals and two private hospitals. A total of 1224 questionnaires were returned over a six-month period, giving a response rate of 47.4%. Organizational learning was the safety culture dimension with the highest positive response (75.9%), while the non-punitive response to error received the lowest positive response (21.1%). The key areas that need improvement in public hospitals include handoffs and transitions, communication openness, staffing, and non-punitive response to error. The private hospitals need an improvement in two aspects; staffing and non-punitive response to error. The results show that all types of mistakes were reported more frequency in private hospitals than in public hospitals. Most respondents reported "no events" in the twelve months preceding the survey, with the percentage of not reporting being higher in private sector compared to public hospitals. The high percent of "no event" reports may represent under-reporting in all hospitals. Regression analysis indicated that event reporting was influenced by feedback and communication about error, staff position, teamwork across units, non- punitive response to error, supervisor/managers expectations and actions promoting patients safety, and type of hospital. Areas needs improvement in Riyadh hospitals includes handoffs and transitions, communication openness, staffing
Chandler, Justin V; George, Benjamin P; Kelly, Adam G; Holloway, Robert G
Carotid artery stenting may be an economically attractive procedure for hospitals and physicians. We sought to identify the association of hospital ownership (nonprofit versus for-profit) on carotid artery stenting (CAS) versus carotid endarterectomy utilization in US hospitals. Using the Nationwide Inpatient Sample admissions for cerebrovascular disease from 2008 to 2011, we identified all private, nonfederal US hospitals performing at least 20 carotid revascularization procedures annually, including carotid artery stenting ( International Classification of Diseases -Ninth Revision 00.63) or carotid endarterectomy ( International Classification of Diseases -Ninth Revision 38.12). We used a multilevel multivariable logistic regression controlling for patient demographics, comorbidities, and hospital characteristics, to assess the effect of hospital ownership on CAS use. Across 723 hospitals (600 nonprofit, 123 for-profit), 66 731 carotid revascularization admissions were identified. Approximately 1 in 5 (n=11 641; 17.4%) revascularizations received CAS. The mean CAS rate among nonprofit hospitals was 17.5 per 100 revascularizations (median, 11.5; interquartile range, 5.2-24.5), and the mean CAS rate among for-profit hospitals was 24.2 per 100 revascularizations (median, 16.0; interquartile range, 6.7-33.3; P hospital characteristics, for-profit hospital designation was associated with greater odds of CAS (adjusted odds ratio, 1.45; 95% confidence interval, 1.07-1.98). For-profit hospital ownership is associated with a higher rate of CAS compared to nonprofit hospitals in those receiving carotid revascularization. Further research is needed to understand the individual- and system-level factors driving this difference. © 2017 American Heart Association, Inc.
Girotra, Saket; Cram, Peter; Spertus, John A.; Nallamothu, Brahmajee K.; Li, Yan; Jones, Philip G.; Chan, Paul S.
Background During the past decade, survival after in‐hospital cardiac arrest has improved markedly. It remains unknown whether the improvement in survival has occurred uniformly at all hospitals or was driven by large improvements at only a few hospitals. Methods and Results We identified 93 342 adults with an in‐hospital cardiac arrest at 231 hospitals in the Get With The Guidelines®‐Resuscitation registry during 2000–2010. Using hierarchical regression models, we evaluated hospital‐level trends in survival to discharge. Mean age was 66 years, 59% were men, and 21% were black. Between 2000 and 2010, there was a significant decrease in age, prevalence of heart failure and myocardial infarction, and cardiac arrests due to shockable rhythms (Phospital rates of in‐hospital cardiac arrest survival improved by 7% per year (odds ratio [OR] 1.07, 95% CI 1.06 to 1.08, Phospital quartile to 11% in the top hospital quartile. Compared with minor teaching hospitals (OR 1.04, 95% CI 1.02 to 1.06), hospital rate of survival improvement was greater at major teaching (OR 1.08, 95% CI 1.06 to 1.10) and nonteaching hospitals (OR 1.07, 95% CI 1.05 to 1.09, P value for interaction=0.03). Conclusion Although in‐hospital cardiac arrest survival has improved during the past decade, the magnitude of improvement varied across hospitals. Future studies are needed to identify hospital processes that have led to the largest improvement in survival. PMID:24922627
patients of a tertiary hospital in Nigeria. Materials and Methods: This is a 10‑year retrospective survey conducted at the Nnamdi Azikiwe University Teaching. Hospital in which the death records of the hospital were accessed from ...
HOSPITAL TO HOME Plan for a Smooth Transition R eturning home from a hospital stay can result in unexpected challenges for many seniors. Finding themselves back at home after a hospital stay, many older adults struggle to manage their ...
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Tayyari Dehbarez, Nasrin; Lou, Stina; Uldbjerg, Niels
and they relied extensively on their own or peers' experiences. Travel distance played a role, but some women were willing to incur longer travel times to give birth at a specialized hospital in order to try to reduce the risks (in case of unexpected events). The women associated the presence of specialized......OBJECTIVE: To investigate pregnant women's decision making in relation to their choice of birthing hospital and, in particular, their priorities regarding hospital characteristics. METHODS: The focus of this study was the choice of birthing hospital among pregnant women. A qualitative interview...... services and staff that were more qualified and experienced with increased safety. Other priorities included continuity of care (i.e., being seen by the same midwife) as well as service availability, which in this case referred to the possibility of a water birth and postnatal hoteling services...
Lima, Sheyla Maria Lemos; Barbosa, Pedro Ribeiro; Portela, Margareth C; Ugá, Maria Alicia Dominguez; Vasconcellos, Miguel Murat; Gerschman, Silvia
This paper presents the management characteristics of charity hospitals in Brazil, based on data from a national survey developed in 2001. The sample accounted for the random inclusion of 66 Brazilian Unified Health System (SUS) inpatient care providers with less than 599 beds and all 26 hospitals with at least 599 beds. It also included 10 institutions assumed as non-providers of services to the SUS. The analyses are descriptive, focusing on the classification of the hospitals according to their managerial development level, as well as selected issues regarding the utilization of specific managerial technologies, human resources, technical services, and services contracting. Distinct managerial levels were identified, but it is important to note that 83% of the SUS providers with less than 599 beds were classified as having incipient management. The authors discuss implications of the findings for inpatient care policies, considering the importance of charity hospitals for the Brazilian Health System.
The Virtual Naval Hospital (VNH) is a digital medical library administered over the Internet by the Electronic Differential Multimedia Laboratory, University of Iowa College of Medicine in collaboration with the U.S...
U.S. Department of Health & Human Services — The "Medicare hospital spending per patient (Medicare Spending per Beneficiary)" measure shows whether Medicare spends more, less or about the same per Medicare...
Skov Benthien, Kirstine; Nordly, Mie; von Heymann-Horan, Annika
CONTEXT: Avoidable hospital admissions are important negative indicators of quality of end-of-life care. Specialized palliative care (SPC) may support patients remaining at home. OBJECTIVES: Therefore, the purpose of this study was to investigate if SPC at home could prevent hospital admissions...... options and their caregivers. They were included from the Department of Oncology, Rigshospitalet, Denmark, between 2013 and 2016. The control group received usual care. Outcomes were hospital admissions, causes thereof, and patient and caregiver perceptions of place of care (home, hospital, etc...... in patients with incurable cancer. METHODS: These are secondary results of Domus: a randomized controlled trial of accelerated transition to SPC with psychological intervention at home (Clinicaltrials.gov: NCT01885637). Participants were patients with incurable cancer and limited antineoplastic treatment...
Sui Pheng, Low
This book examines the Facilities Management (FM) of hospitals and healthcare facilities, which are among the most complex, costly and challenging kind of buildings to manage. It presents and evaluates the FM service quality standards in Singapore’s hospitals from the patient’s perspective, and provides recommendations on how to successfully improve FM service quality and achieve higher patient satisfaction. The book also features valuable supplementary materials, including a checklist of 32 key factors for successful facilities management and another checklist of 24 service attributes for hospitals to achieve desirable service quality in connection with facilities management. The book adopts a unique approach of combining service quality and quality theory to provide a more holistic view of how FM service quality can be achieved in hospitals. It also integrates three instruments, namely the SERVQUAL model, the Kano model and the QFD model to yield empirical results from surveys for implementation in hosp...
Roelsgaard Obling, Anne
Modern health care is coupled with the management of ever-expanding institutions, staff and clients, and with recent development of rehabilitation facilities health care becomes more and more intertwined with the administration of citizens’ everyday life. Most of existing literature has been...... different fields: a cancer department (located at a major teaching hospital); a rehabilitation castle (located on the countryside) and a cancer and health centre (located across the road of the teaching hospital). In the paper’s analyses a repeated truism coined in the case study is followed. The truism...... tells: ‘This is definitely not a hospital’ and points to the fact that cancer staff and clientele use the presence/non-presence of the hospital institution to either align or differentiate from it. It is suggested in the paper that the more the hospital is manifest, i.e., discursively, physically...
Jäger, Matthias; Ospelt, Isabelle; Kawohl, Wolfram; Theodoridou, Anastasia; Rössler, Wulf; Hoff, Paul
This study aims at investigating the formal and content-related quality of medical certificates directing compulsory hospital admissions before the scheduled alteration of the Swiss civil legislation in January 2013. A comparison between physicians with different professional backgrounds concerning certificates and patients was conducted. Retrospective investigation of medical records of involuntary inpatients at the University Hospital of Psychiatry in Zurich during a period of six months (N=489). Considerable deficits concerning formal and particularly content-related aspects of the certificates were found. Psychiatrists issued certificates of the highest quality followed by emergency physicians, hospital doctors and general practitioners. Patients differed with respect to several sociodemographic and clinical variables. The quality of certificates directing involuntary hospital admission has to be improved considering the impact on the individual concerned. The consequences of the new legislation on the quality of the admission practices should be inquired in order to improve professional training on the issue.
Mullot, J.U.; Chaulet, J.F.; Thual, A.; Lafon, M.
This work deals with the implications of different French rules and regulations concerning the environmental protection in hospitals. A special place is given to listed installations for environmental protection, because of their importance. A summary of important regulatory texts is presented concerning these installations, and also an inventory of installations or activities concerned, and the definition of the necessary procedures. Some ideas are also given about the much needed creation of an 'environmental network' inside hospitals, in order to cope with these concerns. Then, we briefly deal with more recent developments concerning the environmental protection, which will, no doubt, extend to hospitals, such as the French water law, air law, and procedures for the management of medical waste. Finally, the stakes of environmental decisions in hospitals and the chemist's place in these decisions are debated. (authors)
U.S. Department of Health & Human Services — MedPAR consolidates Inpatient Hospital or Skilled Nursing Facility (SNF) claims data from the National Claims History (NCH) files into stay level records.
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U.S. Department of Health & Human Services — About 25 percent of the hospitalizations for dual eligible beneficiaries in 2005 were potentially avoidable. Medicare and Medicaid spending for those potentially...
Agarwal, Divya; Garg, Poonam
In a competitive healthcare sector, hospitals have to focus on their processes in order to deliver high-quality care while at the same time reducing costs. Many hospitals have decided to adopt one or another Enterprise Resource Planning (ERP) system to improve their businesses, but implementing an ERP system can be a demanding endeavour. The systems are so difficult to implement that some are successful; many have failed, causing multimillion dollar losses. The challenge of ERP solutions lie in implementation because they are complex, time consuming and expensive too. This paper describes the various process workflows and phases of ERP implementation at Fortis Hospital Cunningham Road, Bangalore, India. This knowledge will provide valuable insights for the researchers and practitioners to understand the different process workflows and to make informed decisions when implementing ERP in any hospital.
U.S. Department of Health & Human Services — In FY 2016, 758 out of 3,308 hospitals subject to the HAC Reduction Program are in the worst performing quartile and will have a one percent payment reduction...
U.S. Department of Health & Human Services — The "Medicare hospital spending per patient (Medicare Spending per Beneficiary)" measure shows whether Medicare spends more, less or about the same per Medicare...
Jensen, G V; Torp-Pedersen, C; Køber, L
In a retrospective study of 520 patients with in-hospital ventricular fibrillation 421 (81%) had acute myocardial infarction (MI), 66 (13%) had ischaemic heart disease (IHD) without MI, 33 (6%) had no signs of IHD. The in-hospital mortality of these three groups was 51%, 52%, and 27%, respectively...... (P = 0.01). Logistic regression analysis demonstrated that heart failure and cardiogenic shock were significant risk factors for in-hospital death among patients with IHD. Among discharged patients 1 and 5 years survival was 78% and 51% for patients with MI, 63% and 25% for patients with IHD, 67...... with known IHD suffering in-hospital VF without AMI have a very poor short- and long-term prognosis. These patients need extensive cardiac examination....
antemortem diagnosis) with autopsies (post-mortem diagnosis) on patients managed at Lagos University Teaching Hospital (LUTH) between October 1999 and November, 2000. In the study period, a total of 1843 deaths were registered out of which ...
Mogensen, Jeppe Emil; Fisker, Anna Marie; Poulsen, Søren Bolvig
With the construction of new hospitals, the design principle healing architecture is introduced, representing the humanistic vision of improving hospitalised patients’ healing process, supported by stimulating architecture. In this regard, we address focus on the potential influence of the design...
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Herbst, H.; Roy, J.C.
This paper describes waste management in hospitals and other waste producers. Low-level radioactive wastes are collected by ANDRA (French Agency for radioactive waste management) and informations on waste processing or regulations on radiation sources are given
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Barra, Daniela Couto Carvalho; Waterkemper, Roberta; Kempfer, Silvana Silveira; Carraro, Telma Elisa; Radünz, Vera
Qualitative research whose purpose was to reflect and argue about the relationship between hospitality, care and nursing according to experiences of PhD students. The research was developed from theoretic and practical meeting carried through by disciplines "the care in Nursing and Health" of PhD nursing Program at Santa Catarina Federal University. Its chosen theoretical frame of Hospitality perspective while nursing care. Data were collected applying a semi-structured questionnaire at ten doctoral students. The analysis of the data was carried through under the perspective of the content analysis according to Bardin. Hospitality it is imperative for the individuals adaptation in the hospital context or any area where it is looking for health care.
there are limits to its financial resources. What is more, the focus on claim-making and extended rights of the migrant produces a tendency for the language and practice of hospitality to ‘turn’ against the guest today, and notably the construction of the figure of guests who not only fail to fulfil their duties...... (welfare ‘parasites’) but even betray the host. Next, an enquiry of the concept of hospitality as possible lens for migration studies; it implies a twofold analyses with two levels, a macro level, to focus our attention to the modalities of hospitality given by the juridical status of the stranger and its...... influence on civil inclusion (Sassen 2007; Brenner 2011); and a meso level, to focus instead upon hospitality as an inter-subjective relationship between the host and the guest as a way to relate, as an experience and as an ethics (Derrida 2001). Finally the paper gives a short introduction into an on...
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Moore, R W
The power and influence of financial officers in large, independent hospitals was examined through their involvement in decisions. Chief financial officers (CFOs) find their role as members of the management team relatively ambiguous and probably underutilized.
Søeby, Karen; Jensen, Peter Bjødstrup; Werge, Thomas
Abstract Background: The knowledge of physiological fluctuation and variation of even commonly used biochemical quantities in extreme age groups and during development is sparse. This challenges the clinical interpretation and utility of laboratory tests in these age groups. To explore the utility...... of hospital laboratory data as a source of information, we analyzed enzymatic plasma creatinine as a model analyte in two large pediatric hospital samples. Methods: Plasma creatinine measurements from 9700 children aged 0-18 years were obtained from hospital laboratory databases and partitioned into high...... in creatinine levels at different time points after birth and around the early teens, which challenges the establishment and usefulness of reference intervals in those age groups. Conclusions: The study documents that hospital laboratory data may inform on the developmental aspects of creatinine, on periods...
Full Text Available The physical design and infrastructure of a hospital or institution is an essential component of its infection control measure. Thus is must be a prerequisite to take these into consideration from the initial conception and planning stages of the building. The balance between designing a hospital to be an open, accessible and public place and the control to reduce the spread of infections diseases is a necessity. At Singapore General Hospital, many lessons were learnt during the SARS outbreak pertaining to this. During and subsequent to the SARS outbreak, many changes evolved in the hospital to enable us to handle and face any emerging infectious situation with calm, confidence and the knowledge that staff and patients will be in good stead. This paper will share some of our experiences as well as challenges
Feb 2, 2000 ... Objective: To determine the prevalence, clinical characteristics, management methods and prognosis of testicular cancer at ... component of testicular cancer management at Kenyatta National Hospital. INTRODUCTION ..... adenopathy, haemoptysis from lung metastasis, back pain from retroperitoneal ...
Digestive system complications among hospitalized children with sickle cell anaemia in Enugu, Nigeria. Christopher B Eke, Bartholomew F Chukwu, Benedict O Edelu, Osita U Ezenwosu, Anthony N Ikefuna, Ifeoma J Emosi ...