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Galloro V. HCA initiates Texas two-step. Allegations spur Baylor joint-venture investigations. MODERN HEALTHCARE 2006; 36:8-10. [PMID: 16752858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
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Taylor M. Medicaid fraud settled in N.Y. MODERN HEALTHCARE 2005; 35:12. [PMID: 15938462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
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Chow KM, Szeto CC. Impact of enforcing the Labour Ordinance, with 1-in-7-day off for hospital doctors, on weekend hospital discharge rate. J Public Health (Oxf) 2005; 27:189-91. [PMID: 15774562 DOI: 10.1093/pubmed/fdi022] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND After enforcing the Labour Ordinance, hospital doctors must have 1 day off-work every week. In this study, we aimed to evaluate its impact on the discharge pattern from an acute medical hospital. METHODS We undertook a hospital-based ecologic study with before-after design using the clinical management database of patient discharge records of all acute medical wards in a hospital from January to March 2002 (1 year before new system) and from January to March 2004 (1 year after restricted weekend service). The main outcome measures were the daily discharge rates for the two periods. The odds of being discharged on a Saturday were estimated by multivariate analyses. RESULTS The number of patient discharge on a Saturday was substantially lower in 2004 as compared to 2002 (47.5 +/- 8.5 per Saturday versus 70.5 +/- 11.1 per Saturday, respectively, p < 0.001). A statistically significant decreased trend was noted in the weekend discharge rate in 2002 and 2004 (Poisson p-value for change in discharge rate, p < 0.001). On the other hand, the number of patient discharges on weekdays did not differ between the two periods. Consistently fewer patients were being discharged on Sundays and Mondays as compared to the rest of the week days in both periods. Compared with study period 2002, patients hospitalized in 2004 (with limited weekend service) had significantly lower multivariate-adjusted odds of being discharged on a Saturday (odds ratio of 0.70; 95 percent confidence interval 0.72-0.89, p < 0.0001). CONCLUSIONS Length of hospital stay is influenced by the health care system delivery apart from clinical factors. Restricted weekend services in an acute medical hospital setting substantially lengthen the hospital stay, and might therefore entail a major financial burden.
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Abstract
The direction of health organisations requires the coordination of diversified competencies, notably in administration, management and care. In France, for university hospitals, the law (decree) of 1958 is pivotal. Other approaches have been developed in other countries, depending on their history, traditions, and the organisation of their respective health care systems. These models can enlighten our current reflexions at a time when in France, the question of a new definition of governance for university hospitals is raised.
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Ulsenheimer K. In den M�hlen der Justiz... Anaesthesist 2004; 53:1001-5. [PMID: 15338041 DOI: 10.1007/s00101-004-0751-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Tami TA. Special features topic: the effects of limited work hours on surgical training in otolaryngology-head and neck surgery. Curr Opin Otolaryngol Head Neck Surg 2004; 12:217-21. [PMID: 15167032 DOI: 10.1097/01.moo.0000124935.46948.b1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW This paper reviews the historic events that culminated in the development of duty hour regulations, and then discusses many of the problems being encountered as the regulations are implemented. RECENT FINDINGS On July 3, 2003, the Accreditation Council for Graduate Medical Education (ACGME) instituted duty hour requirements for residency training programs in the United States. Although these regulations should have come as no surprise to graduate medical education programs, many were nevertheless unprepared for their implementation. In comparison to duty hour restrictions currently in place in European countries, those being implemented in this country are much more lenient. Both the fiscal and the educational impact of these requirements on graduate medical education are substantial. Recent accreditation actions taken against a training program at Johns Hopkins University clearly demonstrates that the ACGME is prepared to strictly enforce these standards. SUMMARY The impact of the new duty-hour requirements on residency training and education will be a matter of great interest as they are implemented throughout the graduate education system in the United States.
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Becker C. System: gainsharing not fair. RWJ wants pilot project shut down or open to all. MODERN HEALTHCARE 2004; 34:12. [PMID: 14983785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
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Ling A. Recent developments in health law. UCLA Willed Body Program comes under scrutiny as companies sued for the purchase of body parts. THE JOURNAL OF LAW, MEDICINE & ETHICS : A JOURNAL OF THE AMERICAN SOCIETY OF LAW, MEDICINE & ETHICS 2004; 32:532-534. [PMID: 15490601 DOI: 10.1111/j.1748-720x.2004.tb00168.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
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Jeppesen J, Green A, Steffensen BF, Rahbek J. The Duchenne muscular dystrophy population in Denmark, 1977–2001: prevalence, incidence and survival in relation to the introduction of ventilator use. Neuromuscul Disord 2003; 13:804-12. [PMID: 14678803 DOI: 10.1016/s0960-8966(03)00162-7] [Citation(s) in RCA: 122] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Mechanical ventilation of patients with Duchenne muscular dystrophy continues to be a subject of study. The purpose was to estimate prevalence, incidence, mortality and use of mechanical ventilation in the total Duchenne muscular dystrophy population in Denmark between 1977 and 2001 and further, to reconstruct the introduction of mechanical ventilation to assess the role of the patient organization. Study objects were collected from five sources and verifiable cases identified. Negotiations between health authorities and the patient organization constituted main empirical data for the reconstruction. While overall incidence remained stable at 2.0 per 10(5), prevalence rose from 3.1 to 5.5 per 10(5), mortality fell from 4.7 to 2.6 per 100 years at risk and prevalence of Duchenne muscular dystrophy ventilator users rose from 0.9 to 43.4 per 100. We conclude that survival of Duchenne muscular dystrophy patients has increased and ventilator use is probably a main reason. The patient organization exercised a key role but acted upon preconditions created by other players.
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Kotter E, Jäger D, Binder M, Roesner A, Zaiss A, Pelikan E, Ghanem N, Winterer J, Uhrmeister P, Klar R, Timmermann U, Langer M. [Electronic distribution of patient records and images through PACS: implementation of data protection at the University Hospital in Freiburg]. ROFO-FORTSCHR RONTG 2003; 175:849-54. [PMID: 12811700 DOI: 10.1055/s-2003-39919] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
In large installations of a Picture Archiving and Communication System (PACS), data protection becomes an issue. Above all, not every employee should have access to all data stored in the system. At the Freiburg University Hospital, we developed a concept of dynamic assignment of authorization, assuring that every physician is authorized to the data of all patients under his care. We describe the technical implementation of data protection developed for the integration of PACS and electronic patient records in Freiburg. The system was installed in January 2001 and the experience of its two years in operation is reported.
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Krogsgaard K, Andreasen PB. [How to establish GCP-units in Denmark?]. Ugeskr Laeger 2003; 165:1665-7. [PMID: 12756825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/20/2023]
Abstract
According to a new EU Directive investigator initiated drug trials are to comply with the guidelines for Good Clinical Practice (GCP) as of May 2004. This implies that trials should be conducted according to a set of Standard Operating Procedures (SOPs) and be subject to monitoring and auditing. In 2001, investigators in Denmark initiated 73 drug trials. In order to provide GCP services and guidance to the investigators it is proposed to establish 3-4 regional GCP units at the three university hospitals. The estimated annual cost for the 3-4 GCP units will be between DDK 7.5 and 10 million.
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Jørgensen A, Rønnow ILH, Nexø E. [Public GCP unit--experiences from the Aarhus University Hospital]. Ugeskr Laeger 2003; 165:1667-9. [PMID: 12756826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Abstract
According to the EU GCP-directive, all clinical trials involving medical products must adhere to the GCP-standards by May 2004. This may entail difficulties for investigator-initiated trials not sponsored by the industry. A public GCP-unit was established at Aarhus University Hospital in 1995. The unit offers researchers a monitoring system including discussion of the protocol, check of formalities, and verification of data and protocol compliance. As a contribution to the future work with GCP, experience from the GCP-unit at Aarhus University Hospital is presented here.
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Beholz S, Koch C, Konertz W. [Certification and quality management of a complex university cardiac center according to law EN ISO 9001: 2000]. ZEITSCHRIFT FUR ARZTLICHE FORTBILDUNG UND QUALITATSSICHERUNG 2003; 97:141-4. [PMID: 12806820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Abstract
Quality management systems can improve quality in health care units. The introduction of a quality management system according to ISO 9001: 2000 in a university department of cardiovascular surgery is described. First a thorough analysis of all processes of patient treatment and clinical research was obtained. Multiple interfaces had to be defined to different departments as well as to administration units. All necessary resources were evaluated and optimised. Customer satisfaction was evaluated by surveys of patients and collaborating physicians. Quality rounds including physicians, nurses and technicians were instituted. Based on these preparatory works all processes including their responsibilities and necessary resources were redefined and described in the quality manual. After 18 months' of certification of our quality management system according to ISO 9001: 2000 was recommended by an independent, accredited organisation. In summary, certification of a university department of cardiovascular surgery according to ISO 9001: 2000 is possible and may represent the first step towards total quality management. In complex health care units the certification of individual departments may help to generate a consciousness for quality on the road to total quality management.
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Albrecht H. [Life-saving amputation. Reform policy for Berlin university clinics demonstrates the future path of German university medicine: less patient care, more specialization--and perhaps also research]. Chirurg 2003; 74:M17-8. [PMID: 12643246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
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Neubauer A. [Consequences of the German anticorruption law for sponsorship at university hospitals]. Wien Med Wochenschr 2002; 152:246-8. [PMID: 12094401 DOI: 10.1046/j.1563-258x.2002.02038.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The cooperation between the pharmaceutical industry and clinical researchers has become an increasingly important public issue. Concerns are mainly focused around independence of clinical research and the dedication of clinical researches solely to the welfare of their patients. The declining public confidence in self-regulation has finally resulted in new legislation that has major impact on clinical research in Germany particularly at academic centers.
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Taylor M. UNOS records requested. Liver transplant programs of Chicago hospitals under probe. MODERN HEALTHCARE 2002; 32:12, 16. [PMID: 11989341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
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Ullén H, Höijer Y, Ainetdin T, Tillgren P. Focusing management in implementing a smoking ban in a university hospital in Sweden. Eur J Cancer Prev 2002; 11:165-70. [PMID: 11984135 DOI: 10.1097/00008469-200204000-00009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
To explore the impact of various steps when introducing a smoking ban at the Karolinska Hospital (1000 beds; 6000 employees) in Stockholm, Sweden, a multiple evaluation strategy was performed over 5 years. All heads of clinical departments (N = 41) and a random sample of employees (n = 517) and a convenience sample of hospital labour managers (n = 17) were separately addressed through questionnaire surveys at different time intervals after the introduction of the ban in 1992. An observational and interview study completed the follow-up. The implementation process was supplemented by a comprehensive information strategy over 5 years. The two most important steps during implementation were management support and focus on environmental tobacco. The ban was well known at introduction. Heads of clinical departments reported a third of staff to be satisfied with the restrictions. In contrast, the staff survey revealed 62% to be positive. A shift in favour of a radical tobacco-free hospital was perceived during follow-up. Co-operation between hospital board, heads of clinical departments and local labour managers proved successful. The consecutive evaluations served as tools in labour management and contributed to staff compliance. A total ban, including the selling of tobacco and smoking in the hospital grounds is still to be achieved.
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Bacon RF. Practical considerations for conducting effective billing audits. HEALTHCARE FINANCIAL MANAGEMENT : JOURNAL OF THE HEALTHCARE FINANCIAL MANAGEMENT ASSOCIATION 2002; 56:36-9. [PMID: 11963596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Abstract
Healthcare organizations need to ensure that they are in compliance with government regulations, especially with the increased vigilance by the HHS Office of Inspector General (OIG) in investigating fraud and abuse. After an OIG audit of claims submitted to Medicare by its teaching and resident physicians, the Clinical Practices of the University of Pennsylvania (CPUP), Philadelphia, Pennsylvania, entered into a settlement that included significant financial penalties and a five-year corporate integrity agreement. Lessons learned from the experience may be helpful to other providers in ensuring that their billing practices are in regulatory compliance. As a precautionary measure, providers can undertake their own audits, whether routine or focused. Audits can help providers uncover areas of potential abuse and take steps to correct the problems.
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Wolfberg D. Are latex allergies 'disabilities' under the ADA? JEMS : A JOURNAL OF EMERGENCY MEDICAL SERVICES 2002; 27:129. [PMID: 11913178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
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Appelbaum A. The drug thief at Georgetown U Medical Center. JOURNAL OF HEALTHCARE PROTECTION MANAGEMENT : PUBLICATION OF THE INTERNATIONAL ASSOCIATION FOR HOSPITAL SECURITY 2002; 17:117-24. [PMID: 11602979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Abstract
The article gives the anatomy of a $2 billion class-action lawsuit. A drug-abusing hospital employee may have exposed hundreds of patients to HIV, hepatitis, and other viruses during his period of employment. Not only has the episode been embarrassing for the prestigious medical center, but it also has focused attention on the potential consequences for hospitals that do not screen employees for drug use.
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Lezama LA. Research guidelines: Hopkins deals with research volunteer death and aftermath. THE JOURNAL OF LAW, MEDICINE & ETHICS : A JOURNAL OF THE AMERICAN SOCIETY OF LAW, MEDICINE & ETHICS 2002; 30:111-112. [PMID: 11905257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
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Texas immune from lawsuit about medical information. AIDS POLICY & LAW 2001; 16:9. [PMID: 11769194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
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Ronai SE. Growing public scrutiny of FDA clinical trials: ethical and regulatory compliance to avoid "uninformed consent" and financial conflicts of interest. CONNECTICUT MEDICINE 2001; 65:661-6. [PMID: 11766553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
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Wasserfallen JB, Droz PO, Tissot JD. [Risk management in the hospital milieu: needs and implications]. REVUE MEDICALE DE LA SUISSE ROMANDE 2001; 121:795-9. [PMID: 11765561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
Medicine can be dangerous for the patients, the caregivers, the visitors and the environment. Technological progress provides devices and drugs that are always more powerful, more efficacious, but at the same time able to lead to severe side effects. This paper describes the system set up in a university hospital to fulfill legal requirements. Specialists in specific fields build up commissions, which are united in a coordination office. A general policy for the hospital has been decided, but each commission is responsible for managing the risks in its field. The overall philosophy moved from a quality assurance to a quality management system, in which the employee involved in an incident or an accident is no longer considered the only culprit except in cases of obvious violation of established procedures. In order to be efficient, the system must be as simple as possible, and well known, so that collaborators gain confidence in it. Once this cultural revolution is accomplished, quality but also security of the procedures will be improved. Its impact on cost is more questionable, as the system generates running costs which might be higher than the savings it might bring.
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