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Jego M, Gentile G, Giusiano B, Sambuc R, Balique H, Gentile S. [Value of shared electronic health records for the management of homeless people]. Sante Publique 2018; 30:233-242. [PMID: 30148311 DOI: 10.3917/spub.182.0233] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
AIM To assess the acceptability for GPS to use the French shared Electronic Health Record (Dossier Médical Partagé, "DMP") when caring for Homeless People (HP). METHODS Mixed, sequential, qualitative-quantitative study. The qualitative phase consisted of semi-structured interviews with GPs involved in the care of HP. During the quantitative phase, questionnaires were sent to 150 randomized GPs providing routine healthcare in Marseille. Social and practical acceptability was studied by means of a Likert Scale. RESULTS 19 GPs were interviewed during the qualitative phase, and 105 GPs answered the questionnaire during the quantitative phase (response rate: 73%). GPs had a poor knowledge about DMP. More than half (52.5%) of GPs were likely to effectively use DMP for HP. GPs felt that the "DMP" could improve continuity, quality, and security of care for HP. They perceived greater benefits of the use the DMP for HP than for the general population, notably in terms of saving time (p = 0.03). However, GPs felt that HP were vulnerable and wanted to protect their patients; they worried about security of data storage. GPs identified specific barriers for HP to use DMP: most of them concerned practical access for HP to DMP (lack of social security card, or lack of tool for accessing internet). CONCLUSION A shared electronic health record, such as the French DMP, could improve continuity of care for HP in France. GPs need to be better informed, and DMP functions need to be optimized and adapted to HP, so that it can be effectively used by GPs for HP.
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Brokloff M, McDermott P, Hegwer LR. How Sutter Health Built a Shared Services Organization Focused on the Future. Revenue-cycle Strateg 2015; 12:1-4. [PMID: 26521635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
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Robbins VD. The hospital cooperative model for EMS. What are the benefits of bringing multiple hospitals together to deliver emergency medical services? EMS World 2013; 42:30-31. [PMID: 24308170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
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Morrissey J. Telemedicine:'If you aren't doing anything now, you're way behind'. Hosp Health Netw 2013; 87:22-2. [PMID: 24303630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Any health care provider that's not taking advantange of the many advances in audiovisual tools to connect with patients is woefully behind the curve, experts warn. Here's what some hospitals are up to in both rural communities and urban areas.
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Technology: case studies. Maturing fast. Health Serv J 2013; 123:suppl 8-9. [PMID: 24383176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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Regulatory proposal remains in limbo. Nurs N Z 2013; 19:10. [PMID: 24199239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
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Gilman G. In conversation with Gord Gilman. Interview by Ken Tremblay. Healthc Q 2012; 15:26-28. [PMID: 22688202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
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Wallace BB. The value of shared services. Healthc Financ Manage 2011; 65:58-62. [PMID: 21789944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
A multisite shared services organization, combined with a robust business continuity plan, provides infrastructure and redundancies that mitigate risk for hospital CFOs. These structures can position providers to do the following: move essential operations out of a disaster impact zone, if necessary. Allow resources to focus on immediate patient care needs. Take advantage of economies of scale in temporary staffing. Leverage technology. Share in investments in disaster preparedness and business continuity solutions
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Galloro V. Coalition building. Kentucky's biggest providers have chosen sides as two partnerships are formed to compete regionally. Mod Healthc 2011; 41:6-1. [PMID: 21805713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Big things are happening in Kentucky, where the state's two academic medical centers are taking separate paths to build regional organizations and partnerships to deliver care. "In a fundamental way, they are trying to understand how to look to the future. Larger, broader networks and geographic span are going to be important," says Dr. Michael Karpf, left, of the University of Kentucky.
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McDowell J. Shared services centers can drive significant savings. Healthc Financ Manage 2011; 65:118-124. [PMID: 21692384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
A study of more than 30 U.S. integrated delivery systems (IDSs) found that implementing effective shared services centers can drive significant cost savings in human resources, accounts payable, and procurement. Many IDSs have not adopted effective shared services strategies. Implementing administrative shared services involves low risk and a relatively low start-up investment.
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Hagland M. Building bridges. When it comes to physician navigation issues around the inpatient-outpatient divide, hospital organizations nationwide are following widely divergent strategies. Healthc Inform 2010; 27:10-15. [PMID: 21049713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
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Prestigiacomo J. Taking it to the clouds. The image movement of Montana starts sharing images via cloud-based solution. Healthc Inform 2010; 27:30-55. [PMID: 20931938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
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Charet GP. Tecnology. E-IU programs expand thanks to new business partnerships. Hosp Health Netw 2010; 84:20-22. [PMID: 20700930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
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Inoue K, Sato M, Nakane Y, Miki H, Mukaide H, Michiura T, Tokuhara K, Kon M. [Effectiveness of between--hospital cooperation in staging laparoscopy]. Gan To Kagaku Ryoho 2010; 37:479-481. [PMID: 20332687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
INTRODUCTION It is difficult to perform the staging of laparoscopy within the restricted time at a high-volume center. We thus started between-hospital cooperation as of April 2008. In this hospital cooperation, we perform surgery after laparoscopic examination at a cooperating hospital. MATERIALS AND METHODS Staging laparoscopy was indicated for patients with T3 or T4 gastric cancer. These patients underwent staging laparoscopy at Maki Hospital before their scheduled surgery at our own hospital. RESULTS Between April 2008 and January 2009, 14 patients underwent staging laparoscopy. We received the laparoscopic findings and confirmed the histopathological examination for median 11 days. The median duration from the day that we requested Maki Hospital to the day that patients underwent surgery was 34 days. No patient had laparoscopic complications. Of the 14 patients, 4 patients had peritoneal metastasis. Ten patients did not have peritoneal metastasis or positive cytology. Of these patients, 9 patients underwent surgery. R0 resection was achieved in 7 of 9 patients. False-negative results were obtained in two cases because of positive peritoneal cytology. CONCLUSION Hospital cooperation may enable us to perform short-term staging laparoscopy. However, false-negative results were obtained in two cases because of positive peritoneal cytology. Further improvement must be made to assure the diagnostic accuracy of this procedure.
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Blesch G. Hoosiers unite. Indiana doc-owned hospitals form association. Mod Healthc 2009; 39:18-19. [PMID: 20058365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
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Johnson EO, Mitchell MB. Growing clinical informatics in a multifacility environment. Nurs Manag (Harrow) 2009; 40:18-21. [PMID: 19581781 DOI: 10.1097/01.numa.0000357797.53763.26] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Affiliation(s)
- Elizabeth O Johnson
- Applied Clinical Informatics, Tenet Healthcare Corporation in Dallas, TX, USA
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Contrino L. Decontamination supercentres: your top ten questions. J Perioper Pract 2007; 17:572-576. [PMID: 18201028 DOI: 10.1177/175045890701701203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
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Information-based decision making. Winner: Leicestershire, Northamptonshire and Rutland Cancer Network. Health Serv J 2007; Suppl:36-7. [PMID: 18159873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
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Affiliation(s)
- D M Albrecht
- Universitätsklinikum Carl Gustav Carus, Technische Universität, Dresden
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v Frankenberg M, Schmitz-Winnenthal H, Bornemann T, Köninger J, Büchler MW. Projekt Partnerschaft – Universitätsklinik und Krankenhaus der Grund- und Regelversorgung. Chirurg 2007; 78:368-73. [PMID: 17187258 DOI: 10.1007/s00104-006-1266-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Over the last 20 years, urgently needed changes in the German health care system have forced hospitals to make a flexible adjustment to rising costs and the single handed, almost unmanageable dynamics of technical innovation in medicine. The partnership between the Salem Hospital and the Heidelberg University Hospital represents a pioneering management concept for the future. The alliance between a university surgical department with a basic peripheral hospital provides large advantages to patients, staff, hospitals and cost carriers.
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Evans M. Maine systems huddle up. Joint agreement will combine supplies, IT spending. Mod Healthc 2007; 37:18. [PMID: 17381000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
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Leal AL, Eslava-Schmalbach J, Alvarez C, Buitrago G, Méndez M. [Endemic tendencies and bacterial resistance markers in third-level hospitals in Bogotá, Colombia]. Rev Salud Publica (Bogota) 2006; 8 Suppl 1:59-70. [PMID: 16925122 DOI: 10.1590/s0124-00642006000400006] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE Determining antimicrobial resistance profiles and endemic channels in 14 third-level hospitals. METHODS A high complexity hospital network was created between 2001 and 2003 in Bogotá, Colombia, comprising 14 hospitals belonging to the Bogotá Bacterial Resistance Control Group (BBRCG) and a database was established from participating institutions' microbiology laboratory data (using automated and manual methods) using BacLink 2.0 and Whonet 5.3. Isolate susceptibility profiles were determined according to NCCLS (2003). A descriptive analysis was made of the different resistance markers and such resistance's endemic channel was determined for all hospitals using a 25% to 75% range for every month during the study period. RESULTS 84,664 isolates were analysed, the most frequently found being Escherichia coli, Staphylococcus aureus, coagulase negative Staphylococcus, Klebsiella pneumoniae and Pseudomonas aeruginosa. S. aureus resistance to oxacillin in 2001, 2002 and 2003 was 41%, 48% and 48%, respectively, Staphylococcus coagulasa negative resistance to oxacillin 75%, 73% and 72%, E. faecium resistance to vancomycin was 14%, 9%, 3%, K. pneumoniae resistance to third-generation cephalosporins 37%, 25% and 23%, P. aeruginosa resistance to imipenem 24%, 22% and 17%, P. aeruginosa resistance to ciprofloxacin 46%, 46% and 35% and A. baumannii resistance to imipenem 11%, 29% and 39%, respectively. The problem of bacterial resistance became evident in the endemic channels; this was centred on the presence of oxacillin-resistant S. aureus and a marked increase in A. baumanni resistance to imipenem. CONCLUSIONS High resistance levels were observed in epidemiologic impact markers, especially in Intensive Care Units.
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Affiliation(s)
- Aura Lucia Leal
- Departamento de Microbiología, Facultad de Medicina, Universidad Nacional de Colombia.
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Haugh R. Access & coverage. Saving a safety net. Hosp Health Netw 2006; 80:24-5. [PMID: 17089631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
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Mycek S. Gimme five. Community hospitals collaborate in the midst of competition. Trustee 2006; 59:14-6, 21, 1. [PMID: 16802667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Community Care 5, a collaboration among five Ohio hospitals, proves that hospital leaders can come together for the common good and still maintain a healthy competition with one another.
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Abstract
Collaboration is a key element to success in the provision of sustainable and integrated healthcare services. Among the many initiatives undertaken to improve service quality and reduce costs, collaboration among hospitals in Ontario has been difficult to achieve; however, voluntary collaboration is vital to achieving transformation of the magnitude envisioned by system leaders.
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Affiliation(s)
- Mike Rosser
- Healthcare Materials Management Services, London, Ontario.
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Mantone J. Aiming for transparency. GPO association pushes suppliers off board to lure new members. Mod Healthc 2006; 36:18. [PMID: 16447363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
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Becker C. Above-board? Governing bodies for GPOs come in many forms, but how they're formed can be less than transparent. Mod Healthc 2005; 35:28, 30, 32. [PMID: 16250153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
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Abstract
Having a centralized access service results in a daily interconnetedness between hospital sites, which can create many benefits but also much controversy. Knowing the pros and cons of a centralized service and understanding the role and work environment of the access coordinator will assist you in deciding if this service would be of benefit to your health region. In this descriptive analysis of a centralized access model, a regional perspective is presented; however many of the strategies can be adopted to a single hospital service resulting in improved flow in clinical areas.
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Laff P, Castellano R. The future of hospital based homecare is in a free standing structure! BJC health care has proof--part II. Caring 2005; 24:30-2, 34, 36-7. [PMID: 16358532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Affiliation(s)
- Pat Laff
- Laff Associates, Consultants in Home Care, Hilton Head Island, SC, USA.
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Becker C. VHA touts new look. But systems take wait-and-see attitude. Mod Healthc 2005; 35:8-9. [PMID: 15938461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
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Ubink-Veltmaat LJ, Bilo HJG, Groenier KH, Rischen RO, Meyboom-de Jong B. Shared care with task delegation to nurses for type 2 diabetes: prospective observational study. Neth J Med 2005; 63:103-10. [PMID: 15813422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
BACKGROUND To study the effects of two different structured shared care interventions, tailored to local needs and resources, in an unselected patient population with type 2 diabetes mellitus. METHODS A three-year prospective observational study of two interventions and standard care. The interventions involved extensive (A) or limited (B) task delegation from general practitioners to hospital-liaised nurses specialised in diabetes and included a diabetes register, structured recall, facilitated generalist-specialist communication, audit and feedback, patient-specific reminders, and emphasised patient education. The target population consisted of 2660 patients with type 2 diabetes treated in the primary care setting. Patients who were terminally ill or who had been diagnosed with dementia were excluded from the study. RESULTS The participation rates were high (90%) for patients, and none of the 64 GPs discontinued their participation in the study. Longitudinal analyses showed significant improvements in quality indicators for both intervention groups (process parameters and achieved target values on the individual patient level); in standard care, performance remained stable or deteriorated. Both patients and caregivers appeared satisfied with the project. CONCLUSION This study shows that structured shared care with task delegation to nurses, targeted at a large unselected general practice population, is feasible and can positively affect the quality of care for patients with type 2 diabetes.
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Affiliation(s)
- L J Ubink-Veltmaat
- Department of Family Practice, University of Groningen, Groningen, The Netherlands.
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Sussman AJ, Otten JR, Goldszer RC, Hanson M, Trull DJ, Paulus K, Brown M, Dzau V, Brennan TA. Integration of an academic medical center and a community hospital: the Brigham and Women's/Faulkner hospital experience. Acad Med 2005; 80:253-260. [PMID: 15734807 DOI: 10.1097/00001888-200503000-00009] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Brigham and Women's Hospital (BWH), a major academic tertiary medical center, and Faulkner Hospital (Faulkner), a nearby community teaching hospital, both in the Boston, Massachusetts area, have established a close affiliation relationship under a common corporate parent that achieves a variety of synergistic benefits. Formed under the pressures of limited capacity at BWH and excess capacity at Faulkner, and the need for lower-cost clinical space in an era of provider risk-sharing, BWH and Faulkner entered into a comprehensive affiliation agreement. Over the past seven years, the relationship has enhanced overall volume, broadened training programs, lowered the cost of resources for secondary care, and improved financial performance for both institutions. The lessons of this relationship, both in terms of success factors and ongoing challenges for the hospitals, medical staffs, and a large multispecialty referring physician group, are reviewed. The key factors for success of the relationship have been integration of training programs and some clinical services, provision of complementary clinical capabilities, geographic proximity, clear role definition of each institution, commitment and flexibility of leadership and medical staff, active and responsive communication, and the support of a large referring physician group that embraced the affiliation concept. Principal challenges have been maintaining the community hospital's cost structure, addressing cultural differences, avoiding competition among professional staff, anticipating the pace of patient migration, choosing a name for the new affiliation, and adapting to a changing payer environment.
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Abstract
A recent requirement from the Accreditation Council for Graduate Medical Education that internal medicine residents must provide care for a minimum of 25% of female patients in their longitudinal clinics has posed difficulties for Internal Medicine programs that utilize Department of Veterans Affairs (VA) hospitals for outpatient training. The authors report an innovative program developed at a Connecticut VA hospital for internal medicine residents at the Yale University School of Medicine. Residents participate in the clinic at the VA Women's Health Center every fourth week instead of attending their usual VA primary care clinic. To increase the numbers of patients being seen by residents, the "Sharing Program" was initiated in 2001 so that wives of veterans could be seen in the VA women's clinic. Sharing Program patients are billed for their care by the Yale University Medical Group and the VA is reimbursed by the University Medical Group for the cost of providing care to these patients. As a result of the Sharing Program, the mean proportion of female patients assigned to residents has reached 25%. Surveys showed high levels of patient and resident satisfaction, and that residents perceived an improvement in their education in the outpatient care of women.
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Affiliation(s)
- Sally G Haskell
- VA Connecticut West Haven, Women's Health Center, 950 Campbell Avenue, West Haven, CT 06516, USA.
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Shannon C. Sterilisation services. Knife point. Health Serv J 2004; 114:28-9. [PMID: 15270174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Abstract
Sterile services departments are in such a poor state that new centres are needed. A super-centre, shared between local trusts, is to be tried in Bradford and Leeds. Stocks and movement of instruments will need close monitoring under a centralised system.
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Carter E, Stubbs JR, Bennett B. A model for consolidation of clinical microbiology laboratory services within a multihospital health-care system. Clin Leadersh Manag Rev 2004; 18:211-5. [PMID: 15354810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Abstract
To determine the cost-effectiveness of consolidating clinical microbiology services in a three-hospital health-care network while maintaining high-quality laboratory services, a retrospective review of the total costs of maintaining separate clinical microbiology laboratories within our health-care system was compared to the cost of providing these services after consolidation. Turnaround times before and after consolidation were compared to assess efficiency of the consolidated services. Input of clinicians was also solicited to ensure that quality of services and customer satisfaction remained high. The results of the consolidation project show that the net fiscal saving because of consolidation of clinical microbiology services within our health-care system will be approximately 100,000 dollars per fiscal year. This value includes increased courier charges as well as personnel savings. Although fiscal savings are an integral part of any laboratory consolidation plan, the financial considerations must be balanced by quality of service. The response to consolidation from clinicians was decidedly mixed before implementation of the plan because of fear of increased turnaround times and limited access to laboratory information. The consolidation process, however, was smooth with few physician complaints. The consolidation of our clinical microbiology services illustrates that significant financial savings can be achieved without compromise of efficiency or quality of service.
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Affiliation(s)
- Elliot Carter
- Department of Pathology, University of South Alabama, Mobile, AL, USA
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Roeder KH, Herron S. CMS issues proposed rule for hospital-within-a-hospital. GHA Today 2004; 48:3. [PMID: 15382881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Affiliation(s)
- Kim H Roeder
- Powell, Goldstein, Frazer & Murphy LLP, Atlanta, USA
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Tobey ME. Paperless medical records: reinventing the patient experience. Radiol Manage 2004; 26:32-5. [PMID: 15259685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Abstract
At North Shore Magnetic Imaging Center, the patient paper medical record system was becoming very cumbersome, and it served as a source of frustration for everyone involved: patients, technologists, radiologists, and staff members. The center's mapping of a typical patient experience indicated that, from the initial phone call scheduling an exam to a completed visit (claim processed and payment received), a record could be handled by as many as 20 sets of hands! In June 2002, the center's growth and a concern that patients were losing a one-on-one experience with the medical staff led to an evaluation of workflow processes existing at that time. The evaluation began with a survey of staff members, center management, radiologists, and referring physicians. Their responses indicated 3 common themes: stress, overload, and frustration over systems in place. Comments from the survey were grouped into 3 areas: Continue to Do, Stop Doing, and Start Doing. The Start Doing responses provided solid objectives. The center set out to establish a breakthrough project that included all stakeholders--patients, staff, management, and radiologists. The Reinvention Project had 2 primary goals: move to a paperless environment and increase the level of patient care. The project was divided into internal and external teams. The internal team, called the Reinvention Team, was responsible for the actual hands-on aspects of the process. There were numerous external teams; each had defined roles and specific outcomes for achievement. The external teams' responsibilities included implementing an Internet protocol telephone system; researching voice recognition; restructuring job descriptions, training manuals, and performance evaluations; and conducting a patient-centered focus group.
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Schabetsberger T, Gross E, Haux R, Lechleitner G, Pellizzari T, Schindelwig K, Stark C, Vogl R, Wilhelmy I. Approaches towards a regional, shared electronic patient record for health care facilities of different health care organizations--IT-strategy and first results. Stud Health Technol Inform 2004; 107:979-82. [PMID: 15360959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Abstract
Today, information processing in healthcare facilities is usually primarily directed towards the information needs of the respective institution. This stands in apparent contradiction to the fact that patients may not be solely treated in one general practice or hospital. More information processing towards patient-centered, shared care would better support high quality as well as efficient health care. We developed a stepwise approach transforming trans-institutional information system architectures (TISAs) from an inefficient state caused by redundancy and media cracks towards a state which better supports patient centered, shared care. In a total of three steps we want to establish electronic communication between existing information systems of different healthcare facilities for transmission of discharge summaries and diagnostic results. In further stages we plan to expand this communication solution to a regional comprehensive and consistent electronic patient record for multiple hospitals and general practices in Tyrol, Austria. In addition, two related approaches towards supporting shared care have been compared with our approach. The aim of this paper is to report on our approach and first experiences.
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Affiliation(s)
- Thomas Schabetsberger
- University for Health Informatics and Technology, Tyrol Institute for Health Information Systems, Innsruck, Austria.
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Abstract
Qualitative interviews were performed with 26 resource persons with experience of picture archiving and communication systems and teleradiology. The results reported here concern the different types of networks there was interest in establishing. Eight types of networks were considered to be of interest. The two main reasons for wanting the networks were related to clinical communication and improved exploitation of resources. Use of such networks means cooperation across organizational boundaries. Networks can play an organizational role and this raises questions concerning the future organization of radiology services.
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Renton M. Networking neonatal units. Pract Midwife 2003; 6:4-5. [PMID: 12852132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
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Helbich TH, Fuchsjäger MH. [Mammography referral center combined with breast cancer center]. Wien Med Wochenschr Suppl 2003:82-4. [PMID: 12621849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
Carcinoma of the breast is, with 26.7% of all malignancies, the most commonly diagnosed tumour in women, every eighth female Austrian suffers from this disease. Similar figures are reported from other European countries. Following recommendations of scientific societies like the European School of Mastology (ESOMA) or the British Breast Group, breast diseases should be treated by interdisciplinary teams in dedicated breast centers. Many such institutions exist in Austria and international, but only few of them are organized optimally and fulfill the requirements of an internationally accredited breast cancer centre.
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Affiliation(s)
- T H Helbich
- Universitätsklinik für Radiodiagnostik, Währinger Gürtel 18-20, A-1090 Wien.
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Lesar T, Mattis A, Anderson E, Avery J, Fields J, Gregoire J, Vaida A. Using the ISMP Medication Safety Self-Assessment to improve medication use processes. Jt Comm J Qual Saf 2003; 29:211-26. [PMID: 12751302 DOI: 10.1016/s1549-3741(03)29026-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND The 194-item Institute for Safe Medication Practices (ISMP) Medication Safety Self-Assessment for hospitals is being used by a 21-hospital collaborative as a framework for understanding, evaluating, and systematically implementing medication use system safety improvements. METHODS The results of the self-assessment were used to prioritize and organize the review of medication use processes, in which each self-assessment-defined "representative characteristic" is reviewed in detail, and "best implementation practices" for the characteristic are established. The collaborative concurrently identifies educational needs and develops tools to assist organizations in implementing improvements. RESULTS By December 2002 participating organizations had implemented a wide variety of medication safety improvements. Collaborative member scores for the self-assessment increased approximately 20% during the initial assessment when the self-assessment was repeated by members in the second quarter of 2002. SUMMARY Participant progress in improving medication safety practices is supportive of collaborative methods and the value of completing the ISMP self-assessment, expanding on the knowledge gained, developing effective implementation tools, and systematically applying lessons learned.
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Wiest JY. PinnacleHealth Heart and Vascular Institute: how one hospital successfully survived a merger of two major cardiovascular programs. J Cardiovasc Manag 2003; 14:13-6. [PMID: 12800632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
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Harty-Golder B. Telemedicine: look before you leap. MLO Med Lab Obs 2003; 35:40. [PMID: 12705211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/20/2023]
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Schmidt MD. Advantages of a multi-facility information technology consortium. J Healthc Inf Manag 2003; 17:64-7. [PMID: 12553224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/20/2023]
Abstract
The formation of an information technology consortium has proven to be a way for several rural hospitals in Northern Minnesota to purchase and successfully install the right technology solutions for their facilities. The concept described is very similar to that used by the Independent Grocer Alliance (IGA), which allows local independent grocers to buy products at prices comparable to these obtained by larger chain stores.
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Affiliation(s)
- Mark D Schmidt
- Sisu Medical Systems and Sisu Medical Solutions, Duluth, Minnesota, USA
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Myers SR. Do consortiums work? Air Med J 2002; 21:17-9. [PMID: 12196735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
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Abstract
OBJECTIVE Nurse-led prostate clinics (NPCs) have proved to be a highly effective method of assessing patients with lower urinary tract symptoms (LUTS) and most urology units now run such clinics. However, it was not known whether they are cost-effective and this analysis ansWers that question. PATIENTS AND METHODS During one year, a trained urology nurse assessed 1,080 patients in our NPC following GP referral using a standard pro forma. Costs included those incurred for the salary of a grade D nurse at 30 min per patient, all investigations, indirect charges and overheads. This was compared to the cost of seeing all patients in clinic directly, either by a consultant, staff grade urologist or registrar. Of these 1,080 patients, 350 were sent back to their GPs after NPC assessment. RESULTS The NPC cost of 44.25 pounds per patient compared favourably with an average medical out-patient clinic cost of 50.46 pounds per patient, yielding an actual annual saving of 6,706.80 pounds. Since a third of the patients assessed in the NPC were sent directly back to primary care, saving the cost of a medical follow-up appointment, the true savings in secondary care were 17,661.00 pounds (50.46 x 350pounds), giving a total annual saving of 24,367.80 pounds. CONCLUSIONS A nurse-led shared-care prostate clinic is a cost effective, thorough and speedy method of assessing men presenting with suspected bladder outflow obstruction. The approach used has a wider generic, cost-benefit potential for the NHS.
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Affiliation(s)
- P Dasgupta
- Department of Urology, Colchester General Hospital, Essex, UK
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Abstract
In past years, many SHAs formed in local urban markets to better compete for managed care contracts. In response to 1990s forces, these SHAs appear to have adapted product, production, and selling orientations to their markets, aimed at large institutional purchasers of health care. However, health care markets have evolved differently than anticipated. SHAs and their hospitals should now adopt the marketing orientation and focus more on patients and enrollees.
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Affiliation(s)
- Peter C Olden
- Graduate Health Administration Program, University of Scranton, Pennsylvania, USA
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