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Hospital Topics

Vicki Moran, Rita Heuertz
Use of disposable nonsterile gloves in the hospital setting is second only to proper hand washing in reducing contamination during patient contact. Because proper handwashing is not consistently practiced, added emphasis on glove use is warranted. There is a growing body of evidence that glove boxes and dispensers available to healthcare workers are contaminated by daily exposure to environmental organisms. This finding, in conjunction with new and emerging antibiotic-resistant bacteria, poses a threat to patients and healthcare workers alike...
July 17, 2017: Hospital Topics
Rajeev Kumar Panda, Rama Koteswara Rao Kondasani
Changes in demographic and sociocultural environment, improved health awareness, and information technology have considerably changed the outlook of healthcare sector in India. While both the public and the private healthcare sectors have priority of increasing access while minimizing costs, they try hard to achieve goals without letting the quality suffer. Customers with rising disposable income no longer have faith in the public healthcare system and are willing to migrate to the private healthcare sector, which is more professional, technology savvy, and trustworthy...
July 13, 2017: Hospital Topics
Suryanto, Virginia Plummer, Malcolm Boyle
The cultural diversity, its archipelago, and the major religion being Muslim have all influenced the development of the healthcare in Indonesia. The authors' objective is to describe the evolution of the healthcare system in Indonesia. Community-based health service, called puskesmas, is the key of the healthcare service in the country. The World Health Organization estimated that 64% of all deaths in Indonesia are caused by noncommunicable diseases, which might relate to the mostly unorganized prehospital care system...
June 21, 2017: Hospital Topics
Antonio Siniscalchi, Roman Sztajzel, Giovanni Malferrari, Luca Gallelli
The National Institutes of Health Stroke Scale (NIHSS) is indispensable for both prognosis and treatment in patients with acute ischemic stroke. However, there is subtype of acute ischemic stroke (i.e., posterior circulation stroke) that is difficult to diagnose using the NIHSS. The authors report the limits of NIHSS in this stroke subtype, suggesting thereby the need to modify and render it more appropriate for the evaluation of the neurological signs occurring in posterior circulation stroke.
May 23, 2017: Hospital Topics
Manel Antelo, Francisco Reyes-Santiás, Carmen Cadarso-Suárez, María Xosé Rodríguez-Álvarez
To investigate the adequacy of the widely used Cobb-Douglas and transcendental logarithmic (translog) models of the production functions of hospital inpatient services, the authors fitted these and additive models to data for the four most productive health services of 10 public hospitals in Galicia, Spain (the same four in each). Production, measured as admissions weighted in accordance with their diagnosis-related groups (DRGs), was treated as a function of physician full-time equivalents as surrogate labor factor and number of beds as surrogate capital factor...
April 13, 2017: Hospital Topics
Robert L Edwards, Samuel B Wollner, Jessica Weddle, James W Zembrodt, Mark D Birdwhistell
The imperative for strategic change at academic health centers has never been stronger. Underpinning the success of strategic change is an effective process to implement a strategy. Healthcare organizations, however, often fail to execute on strategy because they do not activate the requisite capabilities and management processes. The University of Kentucky HealthCare recently defined its 2020 strategic plan to adapt to emerging market conditions. The authors outline the strategic importance of strengthening partnership networks and the initial challenges faced in executing their strategy...
April 13, 2017: Hospital Topics
James H Stephens, Gerald R Ledlow, Michael V Sach, Julie K Reagan
Healthcare in the United States has been one topic of the debates and discussion in the country for many years. The challenge for affordable, accessible, and quality healthcare for most Americans has been on the agenda of federal and state legislatures. There is probably no other state that has drawn as much individual attention regarding this challenge as the state of Massachusetts. While researching the topic for this article, it was discovered that financial and political perspectives on the success or failure of the healthcare model in Massachusetts vary depending on the aspect of the system being discussed...
April 5, 2017: Hospital Topics
Russell M Holstein, David P Paul
Patients with health insurance may find that obtaining an initial appointment for behavioral healthcare is an arduous process. A stratified sample of licensed New Jersey psychiatrists and psychologists was surveyed by telephone. Results revealed that patient access to care under 10 large insurance plans in New Jersey varies by plan, but overall was difficult. Suggestions for dealing with the problem are offered. Behavioral health practitioners and their professional organizations should address these issues more directly and vigorously...
April 5, 2017: Hospital Topics
Hasiholan Simorangkir, Stephen J J McGuire
The authors implemented a new discharge protocol to reduce readmission rates in a hospital in West Java, Indonesia. Forty nurses were trained in the use of the protocol. Results indicate that posttest group readmission rates were significantly lower after the implementation of protocol, from 6.11% to 4.21%. The protocol was effective in reducing readmissions for patients discharged from internal medicine, pulmonology, and women. Differences were also found by type of insurance or payment method, generally suggesting that the lower the socioeconomic status of the patients was, the more effective the discharge protocol was...
April 3, 2017: Hospital Topics
Andrea Garcia, Lee Revere, Sherene Sharath, Panos Kougias
Accurate and reliable medical records are necessary for assessing, improving, and reimbursing healthcare services. Clear and concise physician documentation is essential to assuring accurate and reliable medical records. Yet, prior literature reveals surgery residents do not receive adequate, beneficial education on medical record documentation and coding. This is concerning because the evaluation of and reimbursement for healthcare service delivery relies on the physician's ability to produce appropriate medical records, which then get translated into billable codes...
March 23, 2017: Hospital Topics
Susan L Calcaterra, Anne D Drabkin, Reina Doyle, Sarah E Leslie, Ingrid A Binswanger, Joseph W Frank, Jennifer A Reich, Stephen Koester
Hospital initiatives to promote pain management may unintentionally contribute to excessive opioid prescribing. To better understand hospitalists' perceptions of satisfaction metrics on pain management, the authors conducted 25 interviews with hospitalists. Transcribed interviews were systematically analyzed to identify emergent themes. Hospitalists felt institutional pressure to earn high satisfaction scores for pain, which they perceived influenced practices toward opioid prescribing. They felt tying compensation to satisfaction scores commoditized pain...
January 2017: Hospital Topics
Daniel Branco, Angela M Wicks, John K Visich
The authors identify the quality tools and methodologies most frequently used by quality-positioned hospitals versus nonquality hospitals. Northeastern U.S. hospitals in both groups received a brief, 12-question survey. The authors found that 93.75% of the quality hospitals and 81.25% of the nonquality hospitals used some form of process improvement methodologies. However, there were significant differences between the groups regarding the impact of quality improvement initiatives on patients. The findings indicate that in quality hospitals the use of quality improvement initiatives had a significantly greater positive impact on patient satisfaction and patient outcomes when compared to nonquality hospitals...
January 2017: Hospital Topics
Claudia Der-Martirosian, Laura Pinnock, Aram Dobalian
Natural disasters can lead to the closure of medical facilities including the Veterans Affairs (VA), thus impacting access to healthcare for U.S. military veteran VA users. We examined the characteristics of VA patients who reported having difficulty accessing care if their usual source of VA care was closed because of natural disasters. A total of 2,264 veteran VA users living in the U.S. northeast region participated in a 2015 cross-sectional representative survey. The study used VA administrative data in a complex stratified survey design with a multimode approach...
January 2017: Hospital Topics
Maggie Kennedy
Ward clerks are essential members of the healthcare team, providing administrative and organizational support to acute care units and clinics. This role influences such matters as nurses' direct patient-care time, timeliness of patient discharges, and patient safety. To support ward clerks in the varying responsibilities and complex scope of this role, a formal orientation and ongoing education program is imperative. Whereas corporate orientation informs new employees of overall organizational processes, a ward clerk-specific workplace education program prepares individuals for the demands of the position, ultimately supporting the healthcare team and patient safety...
July 2016: Hospital Topics
Ruiling Guo, Patrick M Hermanson, Tracy J Farnsworth
The authors' purpose was to explore hospital administrators' beliefs and attitudes toward the practice of evidence-based management (EBMgt) and to identify the needs for EBMgt training programs. A cross-sectional, nonexperimental design was utilized. Survey data were analyzed using descriptive statistics and Spearman's correlation. The results showed that hospital administrators had positive attitudes toward the practice of EBMgt. There was a significant correlation between attitudes and percentage of healthcare management decisions made using an evidence-based practice approach (p < ...
July 2016: Hospital Topics
Laquanda T Leaven
Laboratory services in healthcare systems play a vital role in inpatient care. Most hospital laboratories are facing the challenge of reducing cost and improving service quality. The author focuses on identifying test order patterns in a laboratory for a large urban hospital. The data collected from this facility consists of all tests ordered over a three-month time frame and contains test orders for approximately 17,500 patients. Poisson and negative binomial regression models are used to determine how well patient characteristics (patient length of stay and the medical units in which patients are placed) will predict the number of tests being ordered...
July 2016: Hospital Topics
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April 2016: Hospital Topics
Marisa Borelli, David P Paul, Michaeline Skiba
The incidence of end-stage renal disease (ESRD) and its associated comorbidities such as diabetes and hypertension continue to increase as the population ages. As most ESRD patients qualify for Medicare coverage, the U.S. government initiated reforms of the payment system for dialysis facilities in an effort to decrease expenditures associated with ESRD reimbursement. The effects of reduced reimbursement rates, bundled payment options, and quality incentives on the current dialysis system, including kidney dialysis units, physicians, and patients, are examined...
April 2016: Hospital Topics
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