Privacy Act; exempt record system--Office of the Secretary, DHHS. Notice of proposed rulemaking. The Office for Civil Rights of the Department of Health and Human Services maintains a system of records entitled "Complaint Files and Log. HHS/OS/OCR." The Department intends to exempt this system from certain provisions of the Privacy Act, 5 U.S.C. 552a. The proposed exemption is authorized by subsection (k)(2) of the Privacy Act, which applies to investigative materials compiled for law enforcement purposes. The Office for Civil Rights (OCR) is authorized to gather information for civil and administrative law enforcement purposes pursuant to several statutes requiring nondiscrimination in programs or activities receiving Federal financial assistance. In order to maintain the integrity of the OCR investigative process and to access to complete and accurate information, the Department proposes to exempt this system, under subsection (k)(2), from the notification, access, correction and amendment provisions of the Privacy Act. The Department is requesting public comments on the proposed exemption.


Reagan budget cuts leave non-profits slashing staff, scrambling for help.


List of primary care, dental and psychiatric health manpower shortage areas designated under Section 332 of the Public Health Service Act. This notice provides a list, updated as of December 31, 1982, of primary care, dental, and psychiatric health manpower shortage areas designated by the Secretary of Health and Human Services under the authority of section 332 of the Public Health Service Act.


Notice to federal publication users: supply is down and prices are up.


Self-insuring health benefits.

Self-insuring health benefits.


Practising in the North can renew your sense of purpose.


Behavioral medicine: an idea whose time is coming?


The Stephen Dawson case: judging the right to survive.


The pyjama game: placement in pyjamas in Canadian psychiatric hospitals.


Secondary prevention in child psychiatry: an overview with ideas for action.


Physical & mental problems turn into 'occupational illness'.


The revised Social Security law.

The revised Social Security law.


Restructuring materials management may look tough, but one hospital's labor bore fruit--and saved dollars.


Privacy Act of 1974; clarification of record system notice--Office of the Assistant Secretary for Personnel Administration, HHS. Notice of changes to routine uses. The Department is giving notice that it is deleting some and clarifying other existing routine use disclosures, clarifying the categories of individuals covered by the system, adding a restriction of the policy on access to the system by non-record subjects and non-Employee Counseling Service staff, and updating the list of system managers for the Privacy Act record system notice: 09-90-0010-Employee Counseling Service Program Records, HHS/OS/ASPER. Records in this system contain information on employees who have been counseled by the Employee Counseling Services for alcohol abuse, drug abuse or emotional problems.


Home care, who will benefit: the payor, the provider or the patient?


Group purchasing program helps participating hospitals save thousands.


Health maintenance organizations.

Health maintenance organizations.


On-line I.D. card embossing in four University of California medical centers.


Computers in British healthcare.

Computers in British healthcare.


Hospital computer trends for the 1980's.


An uninformed buyer--a thought process.

An uninformed buyer--a thought process.


Developing a materials management system.


From the basement to executive row.

From the basement to executive row.


'Save taxpayer dollars' is strict mandate to government designers.


ITV at Mercy Hospital--healthy and growing.


HMO: an acronym here to stay.

HMO: an acronym here to stay.


Hospital cost containment: a payer's prognosis.


Model policy: suction collection equipment. Nursing service policies and procedures.


Preferred provider organizations.

Preferred provider organizations.


Medical gas systems.

Medical gas systems.


'Flying hospital' ready for OR procedures after 700-mile trips.


4th-year students enthusiastic about EM clerkships.


Legal aspects of health care licensing and credentialing gain prominence.


Survey discloses options used for reducing personnel costs.


We must change to survive!

We must change to survive!


Keeping weather out and traffic moving.

Keeping weather out and traffic moving.


The bonnet method of carpet care: take a second look!


The selection and evaluation of supplies.


Carpet cleaning. What you really need to know.


Environmental services carpet specification.


The "image makers". Who are they?

The "image makers". Who are they?


Take the right steps to prevent slips, trips and falls.


Computers in emergency planning.

Computers in emergency planning.


Survival EMS.

Survival EMS.


Patient assessment--a new approach.

Patient assessment--a new approach.


Development of a computerized trauma registry.


Meeting responsibility: a safety program for housekeeping.


Atlantis: a disaster simulation exercise for training purposes.


House of hidden hazards.

House of hidden hazards.


Selecting an effective smoking cessation program.


The Travelers--insuring health promotion.


Hospital program blends lifestyle, occupational health.


Statistics unnecessary--Bonne Bell knows its program works.


Self-esteem through the life span.

Self-esteem through the life span.


A simple technique for collecting, analyzing, and interpreting evaluative data. Best Liked/Least Liked (BL/LL) is a straightforward technique for collecting information used in evaluation. The technique is composed of stages (data collection, data analysis, and data interpretation) that are characterized by the ease with which they are accomplished. Further, the technique admits of flexibility in both range of applicability (some achievement testing and the measuring of effect) and scope of use (it can be narrowly focused or used to collect information on unintended outcomes). The technique is described here and examples are presented of its use both narrowly and broadly focused, and in service of both achievement testing and affective measurement.


An evaluation of the impact of a continuing education course in diabetes. This article represents the results of an evaluation of a continuing education program for dietitians. The evaluation was built into the program at its inception and involved an assessment of participant satisfaction, short-term knowledge gain and a follow-up assessment of self-reported behavior change. The results of this evaluation indicate that the course did, indeed, impact on both knowledge and behavior. In addition, however, the evaluation also uncovered some problems in planning which minimized the potential impact of this course. These results suggest that there should be increased attention to rigorous educational needs assessment and both process and impact program evaluations in order to determine approaches to education that could make more effective use of the resources available for continuing education in health care.


Physical health and self-esteem.

Physical health and self-esteem.


Obtaining generalizability coefficients for clinical evaluations. This article discusses the determination of reliability coefficients for clinical evaluation forms by use of generalizability theory. This method is contrasted to some of the commonly used measures of interobserver agreement, interobserver reliability, and classical reliability. The value of this method in terms of making recommendations, such as the number of judges and the number of items on a form, in order to improve reliability is illustrated by two examples. Also, the difference between norm-referenced decisions and criterion-referenced decisions in determining reliability with this method is presented.


Alabama EMS communications.

Alabama EMS communications.


EMS management: improving communication through active listening.


The evaluation of self-esteem.

The evaluation of self-esteem.


Enhancement of self-esteem in adults.

Enhancement of self-esteem in adults.


Trauma centers: rationale.

Trauma centers: rationale.


Enhancement of self-esteem in children and adolescents.


Private ambulance. The third party problem.


Future needs for self-esteem research and services.


A "cutback" play in health stocks.

A "cutback" play in health stocks.


First certificate of need inventory released.


Humidification alternatives for air conditioning.


Health care supervision: a special kind of management?


Technology: guiding the hand that leads us.


Does an effective clinician make an effective manager?


Interviewing skills: selecting the right candidate.


The supervisor as a responsible listener.


Hospital purchasing: meeting the challenges of the 1980s.


Nontraditional work schedules: their use in the health care setting.


Job descriptions: development and use.

Job descriptions: development and use.


The visible supervisor.

The visible supervisor.


Team nursing for today's hospital.

Team nursing for today's hospital.


Liability and the supervisor.

Liability and the supervisor.


Introducing Preferred Providers of America.


The departmental budgeting process.

The departmental budgeting process.


The health care management triad: MBO, performance appraisal and compensation.


Productivity and the supervisor.

Productivity and the supervisor.


A supervisory challenge: the difficult employee.


Effective control of absenteeism.

Effective control of absenteeism.


A descriptive analysis of knowledge about breast cancer.


Update: marketing at Lovelace.

Update: marketing at Lovelace.


Value analysis: every supervisor's responsibility.


The overly dependent employee.

The overly dependent employee.


Women in health care management.

Women in health care management.


Introducing change effectively.

Introducing change effectively.


Organizational relationships: how the parts make up the system.


Perceptive communications.

Perceptive communications.


The head nurse as a first-line manager.

The head nurse as a first-line manager.


Emergency planning. Preparing for nuclear war.


Waste disposal: smoke, smuts and sharps.


Building contracts: proof of the pudding.


Explaining the house rules.

Explaining the house rules.


Tailor made budgeting.

Tailor made budgeting.


Caring for refugees: life and death on North West Frontier.


Administration at work, Part 1. Balancing the act.


Computer systems: a mix of modules.

Computer systems: a mix of modules.


Supplies: facing up to the challenge.

Supplies: facing up to the challenge.


Employment law: getting the contract right.


Development in computers: French lessons.


Caring for the elderly: old and the new.


Supervisor, manage yourself.

Supervisor, manage yourself.


Administration at work, Part 2. Catering cookie crumbles.


Maternity care compared.

Maternity care compared.


Patients' monies: think now buy later.

Patients' monies: think now buy later.


Planning alternative services: changing places.


Wizardry in Wessex. Interview by Alison Hyde.


Administration at work, Part 3. Are doctors managing?


On the road to health.

On the road to health.


Joint planning: Surrey with the forum on top.


Private health care: can't pay, must wait.


Administration at work, Part 4. Covering their tracks.


Employment law: burden of proof.

Employment law: burden of proof.


Law and the patients: subject to attack.


Estate management: opportunity cost knocks.


Health education: getting across the facts of life.


Estate management: ground rules for the sales rush.


Administration at work, Part 5. Imagining the unimaginable.


Cardiac rehabilitation: lift up your hearts.


Mental health law: protect and surmise.

Mental health law: protect and surmise.


Hospital clothing: dressing up the theatre.


Cutting hospitals down to size.

Cutting hospitals down to size.


Health education: pointing the way.

Health education: pointing the way.


Aids for the educator.

Aids for the educator.


Ward design: a mix of methods.

Ward design: a mix of methods.


Will Big Brother be watching those days off?


Learning to love the DIY sick note.

Learning to love the DIY sick note.


Estate management: property boom beckons.


Watch around the clock.

Watch around the clock.


Hospital information: redundant data?

Hospital information: redundant data?


Health education: choices for health.

Health education: choices for health.


Health in WHO's hands.

Health in WHO's hands.


Fast food with everything.

Fast food with everything.


On-the-job training.

On-the-job training.


Trouble over the time sheets.

Trouble over the time sheets.


NHS training: planning for performance.

NHS training: planning for performance.


NHS training: development agents.

NHS training: development agents.


Hospital information: help over HAA hurdles.


Who cares for machines?

Who cares for machines?


Immigrant health care: a little help from their friends.


Coping with the cancer crisis.

Coping with the cancer crisis.


Contract catering: a price for a job.

Contract catering: a price for a job.


Data protection: confidence trick.

Data protection: confidence trick.


Nursing organisation, Part 1. When the organisation needs a check-up.


Carry on caring for the staff.

Carry on caring for the staff.


Screen test scores high.

Screen test scores high.


Employment law: reorganisation's odd man out.


The gentle touch.

The gentle touch.


One-stop health shop.

One-stop health shop.


Anatomy of a medical complaint.

Anatomy of a medical complaint.


Nursing organisation, Part 2. Tangled web of responsibility.


High tech for hire.

High tech for hire.


Hearings with hearsay.

Hearings with hearsay.


Nursing organisation, Part 3. Power to the sisters.


Are unit administrators and directors of nursing services making the grade?


The contribution of the education centres to stronger unit management.


Strengthening unit management--the Solihull experience.


What are the chances for stronger unit management?


Financial management--a critical factor for effective delegation units.


Pay determination in the NHS--a system for the future.


The Review Body on Doctors' and Dentists' Remuneration--some lessons for the nurses?


Interview with Rodney Bickerstaffe, General Secretary of NUPE.


Test your knowledge of negotiating principles.


Drug price inflation slows but competition is limited.


Is it legal for a hospital to purchase supplies for physicians to use in their own offices?


Should purchasing groups offer warehousing to their members?


Gannon University offers purchasing/materials management correspondence course.


Administrative support: the key to effective materials management.


Reusable vs. disposable O.R. linen: which is really cheaper?


Reimbursement: the trend towards management contracts.


The mechanics of a post payment audit.

The mechanics of a post payment audit.


"Revolution" occurring in health care system, believes Deputy Administrator.


Hospitals should no longer be viewed as acute inpatient providers, says AHA expert.


Survey of small hospitals reveals admitting concerns.


Admitters double collections using expert strategies.


Very Important Patient card trims time spent in admitting.


Admitters devise ways to get discharge notice from nursing.


Admitters can find medical records with tracking system.


Experts give strategies for facing change without stress.


Medicolegal advice to admitters: don't turn away poor ER patients.


Admitters can help flag credit risk patients.


An interview with Gary Urbanowicz.

An interview with Gary Urbanowicz.


Profile of the Northern Region.

Profile of the Northern Region.


Protecting against infant kidnapping.

Protecting against infant kidnapping.


Health service building in the Northern Region.


Priorities in Newcastle--characters in a northern landscape.


How efficient is the NHS?

How efficient is the NHS?


Services for the mentally handicapped in Newcastle--an adventure in partnership.


Microcomputing resources for management in the NHS. Report of a survey.


Equity and an equal opportunity for treatment.


Catering in hospitals.

Catering in hospitals.


A cook-freeze catering system for peripheral units.


The role of the clinical representative on the unit management team.


Being businesslike.

Being businesslike.


Federal antitrust laws and hospital concerns.


The search for a new pay system.

The search for a new pay system.


Administrative manpower in the NHS: the 1979 survey.


Value for money in computers--an economic appraisal.


National computer strategy--is it achievable?


Successful forecasting for service planning.


The NHS and the consumer.

The NHS and the consumer.


Efficiency in the NHS. A regional chairman's view.


Hospitals-towards 2000. The development of the Mt. Druitt Community Hospital.


The Körner Report and its implementation.


The hospital and megatrends. Part 2.

The hospital and megatrends. Part 2.


ICPs face pressures from cost containment.


Problems identified for ICPs who do antibiotic review.


Energy saving from very high temperature refuse burning.


A miracle in Brooklyn.

A miracle in Brooklyn.


Health care design--the role of works staff.


Serving the poor: positive approaches from across the nation.


Unique solutions to infection control procedure deficiencies.


Colorado nurses train while patients sleep.


UR and MR responsibilities to increase under new Mass. law.


Health care manager's notebook. Managing growth.


Prompt drug distribution called vital part of quality assurance.


Charges and countercharges continue in pacemaker dispute.


Antibiotic monitors needed to prevent inappropriate uses.


Cost containment can preserve quality of care.


"Charge Doctor' policy ends buck-passing among physicians.


Reviews of surgical complications pay off in several different ways.


Education called key to rational antibiotic use.


Residence offers alternatives to unwed mothers.


SMHC system evaluates model's effectiveness.


Three Supreme Court rulings nullify several abortion restrictions.


Protestant clergy discuss pastoral care issues.


Layoffs: hospitals must be aware of age discrimination issues when laying off employees.


Physician-administrator collaboration slows hospital cost increases.


Christian approaches to employee performance problems.


Employer attention to employee complaints may avert labor disputes.


The Eucharist in health care settings: some pastoral care issues.


Shelter for homeless demonstrates hospital's mission.


Carner's codes. Directors.

Carner's codes. Directors.


Vicariously liable hospitals may obtain indemnity from contract physicians.


Most hospital records subject to pretrial discovery by adversaries.


Family/staff conferences open communication, resolve problems.


Urban hospital survives by corporate, medical merger.


Jesus: Model of ministry.

Jesus: Model of ministry.


Should Catholic health facilities encourage organ donations?


Employee committees enhance communications, productivity.


Lack of timely cesarean delivery constitutes actionable negligence.


Full disclosure required of manufacturer selling older equipment.


Hospitals have limited liability for unforeseeable violent acts.


State association heads foster Catholic values, care for poor.


Perspectives on standardization. A materiel manager's perspective.


Policies and procedures for product evaluation and standardization.


Who makes up the standardization committee?


Making the standardization committee effective.


A supply price index for single hospitals: development and application.


Determining the effectiveness of the standardization process.


Perspectives on standardization. A vendor's perspective.


Materiel distribution system: a step-by-step description.


Evaluation and selection of computerized alternatives for hospital materiel control.


The product standardization process: structuring for effectiveness.


The future of product evaluation.

The future of product evaluation.


Major functions, proper size and membership of the product evaluation and standardization committee.


Bioprosthetic heart valves: current status.


Building a referral base.

Building a referral base.


The CCU and coronary artery disease mortality.


Starting in practice--Part 1. Determining location and getting acclimated. Interview by George Pattison and Janice Jencarelli.


No freedom of religion violation in NLRB certification of bargaining unit in church hospital.


Psychology: implications for health care design.


Wildcat strike held protected activity.

Wildcat strike held protected activity.


California upholds hospital requirement that physicians obtain malpractice insurance with a "recognized insurance company".


Wisconsin and Maine adopt mandatory rate-setting systems to control hospital costs.


Prepare for the change.

Prepare for the change.


Computerization: when and how much?

Computerization: when and how much?


100,000 health fair volunteers offer $100 million in health education services. Congress calls on American people to take advantage of screening opportunities.


It works: advice for your internal medicine practice.


Survey finds EtO users 'informed' on gas' risks.


NME emphasizes committed volume.

NME emphasizes committed volume.


New concepts in managing meetings.

New concepts in managing meetings.


Reduce stress, increase productivity.

Reduce stress, increase productivity.


Accentuate the positive: eliminate the negative.


Product evaluation is cost-effective.

Product evaluation is cost-effective.


Control hazards before they cause problems.


Incident reporting systems: risk management components.


Improved psychiatric records cut liability.


Importance of two-way communication.

Importance of two-way communication.


Using hospital records to prove liability.


Cut risk, save money with hospital-wide credentialing.


Look out for number one. Illegal practices in the "ethical" medical supply industry.


Salaried doctors.

Salaried doctors.


No golden door: the health care and non-care of the undocumented.


Medicine and management: an evolving partnership.


One 'secret' to a successful reorganization: communication.


Hospital cost controls will stifle new drug technology.


Other viewpoints on the effects of cost controls.


Controlling moxalactam and cefotaxime use with a target drug program. A target drug program was utilized to prevent increasing costs associated with inappropriate use of moxalactam and cefotaxime. The cost saving abilities of pharmacists in this regard were calculated. Pharmacists consulted with physicians each time these drugs were prescribed to encourage cefazolin substitution when appropriate. Records of all cephalosporin piggyback doses dispensed were maintained along with quarterly purchase data. Excess costs of utilizing third generation cephalosporins in place of cefazolin were calculated for various usage levels. Actual third-generation usage was compared to usage predicted if no target program was in place, and cost saving was calculated. During the study period, combined moxalactam and cefotaxime use averaged 3.2% of total cephalosporin use at a cost of $4109 per month. Based on an expected predicted usage of 20% to 40%, an annualized cost savings of $91,071 to $202,815 was achieved. Clinical pharmacists were very effective in preventing inappropriate use of moxalactam and cefotaxime, preventing a rise in drug costs.


The strategic side of dividends.

The strategic side of dividends.


Twenty-four hour pharmacy service in hospitals with less than 300 beds--part 2.


Achieving the potential of decision support systems.


Reward preferences of nurses: a marketing concept viewpoint. A survey of 500 nurses in a midwestern urban area was conducted to determine their preferences for intrinsic and extrinsic rewards in their jobs. This study indicates that in light of the expectancy/valence principle of motivation, hospitals and other employers of nursing services that individualize reward offerings should be in a much better position to recruit, and retain, nurses.


Patient ties to ambulatory care providers: the concept of provider loyalty. This paper introduces a cognitive measure of provider loyalty. Correlates of provider loyalty are investigated, and results are presented comparing provider loyalty with traditionally used measures of patient ties for predicting interest in and choice of a new health care provider. Implications for planning and marketing new forms of ambulatory care delivery systems are discussed and directions for future research are suggested.


A community marketing survey of a proposed ambulatory care facility.


Legal guidelines to health services marketing: issues & checklists.


Improving the distribution of health care services by understanding nurse job choice decisions. The application of multi-attribute choice models in the field of nursing provides a method for health care administrators to use in coping with the high level of turnover and nurse shortage. By segmenting respondents via multi-attribute model importance characteristics, the problems of reducing turnover and attracting nurses can be approached with greater efficiency and effectiveness. This study found that the use of multi-attribute models for predicting employment, and for segmenting and nurses' attitudes toward hospital employment, can be applied in a meaningful and usable fashion.


Marketing hyperopia.

Marketing hyperopia.


Managers rank competence and integrity as most-desired values.


The pros and cons of participative management.


A Socratic dialogue on participative management.


Why quality circles failed at 21 firms.

Why quality circles failed at 21 firms.


How good a time-killer are you?

How good a time-killer are you?


Coaching...a management tool for a more effective work performance.


How to set up a corporate wellness program.


Day care: still waiting its turn as a standard benefit.


NJ hospital completes renovation of laundry at cost of $750,000.


Newly renovated prison laundry to service county nursing home.


Safety feature in hospital beds may be eliminated following death in Illinois.


First-year research findings from multihospital systems project.


The Knife and Gun Club: as usual, an emergency.


Medic Alert: Dr. Collins' good idea.

Medic Alert: Dr. Collins' good idea.


Ethical decisions in medicine.

Ethical decisions in medicine.


Whatever happened to medical unions?

Whatever happened to medical unions?


Purchasing chemotherapeutic drugs from independent pharmaceutical firms. The advent of a centralized chemotherapy department at a single-specialty private clinic solved many existing problems, but created a significant new one--purchasing the increased amount of necessary chemotherapeutic drugs. Sufficient quantities became difficult to procure, the cost fluctuated inexplicably, and too often expired drugs were received. Doctors, nurses, and patients alike became more and more frustrated, and the problem threatened the viability of the department. In this case study, the author relates the process of entering into purchasing agreements with independent pharmaceutical companies and a wholesale supply house, and the results of this arrangement.


The 9 ingredients of high productivity.

The 9 ingredients of high productivity. At a time when many groups are experiencing financial trauma, it has become mandatory to step back and review some of the basics of medical group practice operation. A fundamental of paramount importance to every group practice is high productivity. Similarities have been observed in nine specific areas among groups that are ranked consistently in the upper ten percentile of productivity: marketing strategy, workload scheduling, management environment, physician compensation plan, clinic layout, systems and procedures, staff support of personnel management, ancillary departments, and financial management. By summarizing the common characteristics in these nine areas found in groups that are consistently highly productive, the author has mapped out a road to success. If your group is experiencing financial problems, or perhaps just experiencing more slippage than you would like to admit, this article provides the perfect opportunity for you to sit back, take stock, and zero in on areas that could use some work.


Mediation. A problem-solving strategy.

Mediation. A problem-solving strategy. The medical group manager is an organizational problem solver. By using the centuries-old technique of mediation, the manager can increase the likelihood of achieving constructive results from problems. Mediation is not a vague counseling device; it is a process with clearly outlined stages requiring specific skills: restructuring, development of alternatives, agreement, and implementation. The goal of mediation is a "win-win" situation in which the adversaries have been guided to determine for themselves how they can both get what they want. By cultivating the art of mediation, the manager can become a more effective problem solver and foster an atmosphere of ongoing harmony in the medical group.


Evaluating your personal management style. Every medical group manager develops his own managerial leadership style. This style is based on personal background and education, an individual conception of what management and leadership are, and analysis and application of management theory. The author identifies many responsibilities that an administrator must assume to effectively manage--responsibilities which are closely tied to employee motivation. Motivational theories are discussed, as well as the application of techniques based on principles. The author has also distilled what he considers to be the essential qualities of a successful management style.


Advice leads to success. The Durwood Medical Clinic, Inc. When the Durwood Medical Clinic, Inc. of Charlotte, North Carolina, decided to either expand its existing facility or construct a new clinic, it sought the advice of administrators who had experienced the same situation. The group was advised to obtain assistance from experienced facility planners early in the project. By following the advice of consultants and builders, the group created not only a beautiful new building, but one that also was completed ahead of time and within budget.


Won by losing.

Won by losing. We are living in a fitness-conscious society. There is greater emphasis on looking and feeling our best. Though this is not a new concept, many more people are becoming involved in weight reduction and exercise programs. Some of these programs have been successful while others have failed. The experience of one medical group that sponsored a competitive team weight loss program is offered. The program provided just the incentive and support that its employees needed to make a commitment to their health. It also proved to be a great morale booster.


Financing through leasing equipment.

Financing through leasing equipment. Long-range planning through the acquisition of capital equipment basically involves considering two alternatives--buy or lease. Choosing which of these alternatives is more advantageous for a medical group will depend upon a number of factors including the specific financial terms associated with the purchase or lease of the equipment, potential technological obsolescence of the equipment, and the financial posture of the group at the time of the decision.


National health insurance--what price survival?


Managing and selling change.

Managing and selling change. The successful achievement of change has become a hallmark of the effective medical group manager. In the face of the inevitability of change, as dictated by the rapidly progressing healthcare industry and business environment, every manager must take a firm grip on the change process. The author presents an in-depth analysis of change, including a point-by-point description of the process and discussion of technical and systematic preparation, proper presentation and implementation, anticipation of personnel and priority problems, and behavioral implications. Out of this multitude of considerations comes a collection of wisdoms regarding the change process that will be useful to every manager as he implements change and prepares his organization for the future.


The state of automated information systems in ambulatory health care. The development of moderately priced microprocessors has led to a new and complex set of information processing alternatives within the healthcare sector. Small group practices and some solo practitioners now find it technologically possible and economically feasible to automate some parts of their information system. With the introduction of this new and highly complicated technology comes a series of opportunities and problems for the healthcare consumer and provider. The article examines a number of the issues related to computer utilization in the ambulatory care setting.


Wading through computerese.

Wading through computerese. Minicomputers, microcomputers, supercomputers, disks, disk drives, diskettes, bits, bytes, input, output, COBOL, FORTRAN, RPG, memory, "K", CRT, CRU, etc., etc. What does all this mean, and more importantly, what can it do for you, the medical group manager, possibly faced with your first hard decision regarding the use of computers in the day-to-day business of running your medical group? The author provides a glossary of these and many other terms for you and puts them in proper perspective so you are more easily able to wade through the morass of computerese jargon. Further, a number of considerations are presented which will give you a base from which to operate, and a series of questions are presented relative to each of the considerations. Your answers will generate enough information relative to any system to enable you to make a reasoned decision about that system. It is not the intent of this article to tell you which system is best--you must judge that for yourself as you evaluate the questions and considerations presented in the light of your unique setting.


The data processing dilemma.

The data processing dilemma. With the inevitability of automation at hand, today's medical groups must face the data processing dilemma with objectivity and thoroughness. The author sketches a background of the evolution of data processing for medical groups and briefly reviews the factors involved in the decision of whether to use a service bureau or buy a computer system. The essence of this article, however, is a discussion of the development of an RFP. A detailed outline of the elements necessary to include is provided, and format, distribution, and evaluation of proposals are all addressed. In conclusion, important considerations in the final selection, negotiation, and conversion processes are presented.


The right to die in peace.

The right to die in peace.


Don't treat the symptoms.

Don't treat the symptoms. All too often, managers base their decisions about purchasing computers on perceptions of needs rather than on examination of real needs and the factors which generated those needs. By thoroughly documenting and reviewing the group's present activities for potential computer application, the manager can make a well-informed study of possible solutions, and eventually assess which software packages will best meet the group's needs.


The competitive edge--group or solo practice? Although the general public has viewed the introduction of automation into business activities as depersonalizing, the Laconia Clinic addressed the issue of the patient/clinic relationship with a program of personalization through automation. In answer to competition from solo practitioners, the clinic developed an automated information traffic system combined with personal interaction.


The problems of health and hospital organisations in India--some administrative change--(change in structural-functional approach).


Trent RHA patient administration computer systems.


The computer--friend or foe?

The computer--friend or foe?


Computerised patient administration system--second generation.


The electronic medical assistant.

The electronic medical assistant. While the applications of computers for administrative procedures in the medical group practice is widely accepted, use of the computer for compiling purely clinical data has merit as well. A Denver-based physician shares his experience of using computers for such manual procedures as taking medical histories, generations of the physical examination record, diagnostic assessments, drug interaction searches, disease indexing, health education programs, and more.


Real world awaits chief residents in emerging class of '83.


Activist PAC formed as alternate medical voice on health issues.


Health within reach: some missing links in development.


In praise of the dai as a promoter of primary health care.


Trade restraint suit filed against AMA.

Trade restraint suit filed against AMA.


Guidelines for recall of blood from AIDS donors? FDA says no.


Doctors hope cut-rate 'preferred provider' organizations can fill empty waiting rooms.


Custom design.

Custom design. The most successful software programs are those that are developed through close interaction between programmers and industry professionals. The Cape Girardeau Surgical Clinic found that custom-tailored programs resulted in proper billing and handling of its patient population.


Eyeball to eyeball with indirect costs.

Eyeball to eyeball with indirect costs.


Generating revenues beyond taxation.

Generating revenues beyond taxation.


Consider a microcomputer.

Consider a microcomputer. Although computers have proven to be effective tools in managing the administrative aspects of a medical group practice, many groups are hesitant to invest in this new technology. They are concerned about huge capital expenditures for equipment, the consequences of the implementation period, and failures that many groups are reported to have experienced in this endeavor. Microcomputers are a low-cost method through which a medical group can experiment with computerized information systems without taking the risk of total conversion from a manual to an automated system. The experience of the Sterling Heights Center in implementing a microcomputer is helpful to any group considering such a system.


Medicine on the move.

Medicine on the move.


Is your lab ready for quality circles?

Is your lab ready for quality circles?


Focus on litigation support. Part 3: How to be an expert witness.


Using quality circles to spot and solve lab problems.


Build productivity into your work environment.


Focus on litigation support. Part 1: The rules of the game.


How cost accounting can help local governments.


Focus on litigation support. Part 2: How to use an expert witness.


Can employers cut the cost of health benefits?


Salary survey: how chief techs compare with other hospital managers.


Preparing for a potential personnel shortage.


Continuing education records made easy.

Continuing education records made easy.


Healthy, wealthy, and wise.

Healthy, wealthy, and wise.


Cost containment in microbiology.

Cost containment in microbiology.


Volunteers: keeping the heart in health care.


Plotting a course for laboratory improvements.


For better performance, try applied job descriptions.


You can change self-defeating attitudes.


A close-up look at the CLT proficiency exam.


Professional image: a self-fulfilling prophecy.


When imminent death is inevitable.

When imminent death is inevitable.


We have an image problem. Part I.

We have an image problem. Part I.


Shoring up a shaky image. Part II.

Shoring up a shaky image. Part II.


A look at the high attrition rate among technologists.


Troubleshooting lab-nursing service problems.


How to groom a new supervisor.

How to groom a new supervisor.


Dress up the profession.

Dress up the profession.


Sizing up your staff.

Sizing up your staff.


The medical-industrial complex.

The medical-industrial complex.


High tech anxiety.

High tech anxiety.


An alternative to Social Security: hospitals have a choice.


Quality assurance training in the RIA lab.


Visible means of support.

Visible means of support.


The benefits buzz word: cafeteria plans.


New system at DMC for spinal patients.

New system at DMC for spinal patients.


Hospital information in planning and control.


Malpractice premiums will reach new high.


A new era is here.

A new era is here.


New MHA data system to answer key questions for management.


Competitive forces in hospital care: the physician's, administrator's roles.


The MHA Interactive Data System: an overview.


Decision support systems in hospitals.

Decision support systems in hospitals.


Employee selection based on susceptibility to occupational illness.


Contract management/shared services survey. Hire/fire power is key to profits.


Contract management/shared services survey. Managers save hospitals money, but some may drop contractors.


Contract management/shared services survey. Shared service activity might spurt in '83 after sluggish '82.


Contract management/shared services survey. 'Super-group' slashes prices.


Contract management/shared services survey. Hospital alliance forays widen the realm of shared services.


Public hospitals need good offense to resist takeovers by for-profits.


Need more M.D.s? Here's how to tell.

Need more M.D.s? Here's how to tell.


Don't panic over pension plan ruling.

Don't panic over pension plan ruling.


Baxter shows hospitals how to use cost data to prepare for price competition.


Armed with real cost data, hospitals target least costly way to provide care.


System meets challenge of competition while it helps out inner city hospitals.


NMR dilemma: should a hospital be a technology 'leader' or 'follower'?


Start-up woes inherent in high tech.

Start-up woes inherent in high tech.


Networks cut costs, reliance on vendor.

Networks cut costs, reliance on vendor.


Competition's stiff, but interiors aren't.


Small group teaching via telephone in continuing medical education. Small (three to five members) group teleconferences led by consultants were used as one part of educational follow-up to individual medical audit studies in hypertension. The original studies were carried out in the offices of 51 private practice physicians. A number of techniques were used to improve physician acceptance of the teleconference method. Before the teleconference, participants received biographical information about the consultant as well as an outline describing how the call was to be structured. In practice, a varied format was used, beginning with questions from the physicians, followed by the consultant's discussion of study results, and ending with a period during which the physicians had an opportunity to raise additional questions. Evaluation of the calls showed that most physicians thought their study results had been kept anonymous by the consultant. Most thought the length of time (usually one hour) was satisfactory, and most agreed that they learned both from the consultant and other group members. Of all the educational components in the audit study (record review results, articles, or patient education materials), the telephone conference by far received the highest acceptance score.


Contract management/shared services survey. Contract revenue shooting up 21%.


Contract management/shared services survey. Use of management contracts climbs 16.7%; clients up 7.1%.


An assessment of an operational educational accountability system for continuing education in the health professions.


Competencies for continuing education faculty in the health professions. Formal pre- and postdoctoral health professional education and continuing health professional education are different in their designs, contents, and respective student bodies. Faculty must, therefore, acquire and use an appropriate teaching approach for each group. The competencies necessary in a continuing education setting may be unique to this setting or they may be modifications of skills used in the formal setting. They include: assessing needs, designing curricula, employing a learner-centered approach, insuring relevance, establishing a learning set, using flexible and varied methods, individualizing, and evaluating. This paper provides descriptions of rationales for these competencies.


Abortion politics and public policy.

Abortion politics and public policy.


The nursing home industry; at the center of change.


Nursing home buying group comes of age.

Nursing home buying group comes of age.


Career dynamics: managing the superior/subordinate relationship. Building on research and writing in the fields of career management and mentor relationships, Baird and Kram analyze the superior-subordinate relationship as an exchange to which each party brings different needs and resources. They point out that this relationship can be productive and satisfying--both for the parties concerned and for the organization--when the needs of one party match the resources of the other. The article includes a checklist for analyzing how the superior-subordinate relationship operates as an exchange and how the resources of the parties mesh or fail to mesh. They do on to show how the superior-subordinate relationship and the needs of the parties change as each moves through individual career and life cycles. What was once a productive relationship may, in time, become unproductive, or vice versa. In any event, its dynamic nature requires that it be managed. Baird and Kram suggest five steps for managing the relationship as it moves through these changes: (1) Recognizing that the relationship is an exchange; (2) identifying clearly one's own as well as the other party's needs; (3) understanding how the subordinate's and boss's needs fit together and recognizing that the relationship is likely to change; (4) understanding the constraints under which the boss operates; (5) establishing a feedback and evaluation process for continuously assessing the relationship.


Keeping them up in the air safely.

Keeping them up in the air safely.


Portable ladders. National Safety Council.


Guidelines for fire extinguishers.

Guidelines for fire extinguishers.


How to stretch your security dollar.

How to stretch your security dollar.


Security's bottom line--fire prevention.


Developing a fire safety surveillance checklist.


For cradle-to-grave protection assign hazardous materials duty.


Union helps establish local burn unit.

Union helps establish local burn unit.


Health cover pooling bill gains the approval of NAIC.


Insurers join the opposition to tax cap on health premiums.


Professor calls for national health insurance.


Supreme Court bans bias in pregnancy benefits.


'Phenomenal growth' in PPOs cited by Pru exec.


Partisan battle lines being drawn over health cover for unemployed.


Pacific Mutual launches attack on health costs.


UB-82 and state uniform billing committees.


Adult preoperative education program.

Adult preoperative education program.


The expanding rights of unrepresented employees.


The new technology: boon or boondoggle?

The new technology: boon or boondoggle?


Consumer rights education: where are we going?


Nurse recruiting: Part 2.

Nurse recruiting: Part 2.


Choosing the proper training medium.

Choosing the proper training medium.


Promoting self-control in patients.

Promoting self-control in patients.


Two alternatives to traditional sick leave programs.


Planning for recruitment advertising: Part 1.


Coordination of benefits: uncovering buried treasure.


Brainstorming as a flexible management tool.


How important is interpersonal communication?


The employer's role in alcoholism assistance.


Special roles of mental health professionals in self-help group development. Provision of services to self-help/mutual aid groups is a natural outgrowth of the goals, objectives and activities of consultation and education (C & E) departments of community mental health centers. The C & E services of the Ravenswood Community Mental Health Center has, during the past several years, provided several forms of assistance to a variety of developing and established self-help groups in the Chicago area. Through this experience, the roles of mental health professionals in facilitating the development and maintenance of self-help groups have been explored. The provision of assistance at several stages of group development without challenging the autonomy and voluntary nature of self-help groups is a basic requirement for all professionals involved in group development. With careful recognition of the needs and nature of such groups, mutually satisfactory long-term relationships can be established between self-help groups and mental health professionals.


Prevention research in field settings: a guide for practitioners. The need for research in prevention has never been greater, while the support for such research is declining. A partnership between prevention practitioners and researchers is recommended. To play an active role in this resource network practitioners must learn more about the applied research process. This paper describes the major phases of that process and discusses the decisions which practitioners must make at each research step. The paper makes recommendations for conducting research on a shoestring budget and emphasizes special problems encountered in field settings.


Couples counseling for the elderly.

Couples counseling for the elderly.


Stress, coping, and Black mental health: preliminary findings from a national study. Despite the fact that blacks are disproportionately exposed to social conditions considered to be antecedents of psychiatric disorder, epidemiologic studies have not conclusively demonstrated that blacks exhibit higher rates of mental illness than whites. The present paper employed a research approach which considered not only rates of psychological distress, but also the stressors that blacks face and the various coping strategies used to adapt to those stressors. The data were obtained from the National Survey of Black Americans, the first study of a national probability sample of the adult black population. The information on mental health and coping was collected within the context of a single stressful personal problem. The analysis indicates that prayer was an extremely important coping response used by blacks especially among those making less than $10,000, above the age of 55 and women. The informal social network was used quite extensively as a means of coping with problems. This was true for all sociodemographic groups studied. The young (18-34) were less likely than those age 35 and above to seek professional help, while women were more likely than men to seek formal assistance. Income was not related to professional help seeking. With respect to the use of specific professional help sources, hospital emergency rooms, private physicians and ministers were used most frequently. The implications of these findings for research on black mental health and primary prevention are discussed.


Rural mental health. A battered women's network.


Expanded information/referral services.

Expanded information/referral services.


Rural mental health. A partnership with physicians.


Natural helpers seminar.

Natural helpers seminar.


Oral histories. A nursing home project.

Oral histories. A nursing home project.


Emergency department medical history: principles and techniques.


A continuum of health care.

A continuum of health care.


Licensing and credentialing of health care providers.


Drug noncompliance in the elderly.

Drug noncompliance in the elderly.


A study of discharge delays in Rhode Island hospitals.


The Pride Long Term Home Health Care Institute of St. Vincent's Hospital.


The Chicago Five Hospital Homebound Elderly Program: a long term home care model.


Home health care for the rural elderly: experiences in Florida and Kentucky.


Life care retirement centers: a concept in development.


Teaching about home care in a geriatric education program: problem or panacea?


The role of the family in long term home health care.


How to write general and scientific papers: an outline.


On Lok Senior Health Services--a community care organization for dependent adults.


Public speaking: replace insecurity with persuasiveness.


Financing home care with home equity.

Financing home care with home equity.


Purchasing dilemma: replace or refurbish. X-ray systems reach a point when they no longer function properly, and a decision must be made as to whether to repair, replace or refurbish. Factors influencing this decision are the condition and performance of the system and its relationship to other apparatus in the department. Improvements in performance are often possible through the use of better tubes, collimators, generators, intensifiers and other major components. Consideration may also be given to applying newer technologies in digital imaging and beam filtration.


Quality circles: a tool for the radiology administrator. Quality Circles, a type of "international process consultation," can be of great assistance in dealing with conflicts, employee turnover and low productivity in radiology departments. Radiology administrators need to know how to implement Quality Circles in their departments and realize its associated benefits. Quality Circles could establish the needed psychological interdependence among radiographers as well as other staff in the hospital.


The relationship of organizational needs to leadership styles. Technologists bring to the radiology department individual needs which are incorporated into their work environment. These needs can be termed "satisfiers"; they can also be categorized. The ability to recognize individual or group needs gives a manager the opportunity to alter leadership style in conjunction with the situation. The ability to satisfy needs can be a beneficial tool towards group motivation for goal attainment.


Health care data in the United States.

Health care data in the United States. This article serves as an introduction to the following article, An Inventory of U.S. Health Care Data Bases. As an introduction, this article-reviews the characteristics of U.lS. Health Care Data. These characteristics include a lack of common definition and uniformity of reporting of observations, systems that are sometimes duplicative, and a resistance to data sharing on the part of collecting agencies, arising from the pluralistic American health care economy. Yet federal, state, and local governments as well as private organizations need health data to operate and evaluate their programs. Moreover, recent shifts to block grants and cutbacks in federal funding without accountability requirements will adversely affect our ability to adequately monitor the impact of these programs on the nation's health. The article discusses these data issues, but also emphasizes the need for coordination between the government and private sectors.


An inventory of U.S. health care data bases. This inventory presents brief descriptions of 144 current (1976-1982) nonbibliographic, computer-readable data bases containing national health care information that have been collected by public and private sector organizations and agencies throughout the United States and that are available to researchers outside the sponsoring organization. The descriptions include information about sponsors, purpose and scope, sampling procedures, frequency, and availability; they also include Medical Subject Headings (MeSH) indicating the content of each data base. In addition, names and telephone numbers of persons to be contacted for further information are provided. The descriptions are indexed by data base titles and by MeSH terms.


Rehabilitation of patients with chronic respiratory disease. The difficulties that face the patient with chronic respiratory disease are complex and interrelated. Caring for such patients requires a holistic approach, including psychologic support and education of patient and family, combined with physical therapy, administration of bronchodilators, and oxygen therapy.


St. Joseph Mercy Hospital's renovation.

St. Joseph Mercy Hospital's renovation.


Transporting patients with respiratory emergencies. The victim of a traffic accident, a person with severe respiratory distress secondary to chronic pulmonary disease, and a tiny neonate born in a hospital lacking the necessary facilities for intensive care all can benefit from recent developments in ground and air emergency transport.


Expert shares tips for writing policy manuals.


Options for ventilating the pediatric patient. Part 2. Choosing the right technique. The recommendations set forth here are based partly on empirical clinical data and partly on physiologic principles. Because both sources of information are incomplete, some of the advice offered will doubtless prove incorrect. The techniques must be individualized, and this requires first a good understanding of the pathophysiology involved and then a process of manipulation of variables with careful monitoring of their effect by appropriate "dependent variables." Optimal ventilator management is possible only with a good working relationship among physician, nurse, and respiratory technologist.


Government and voluntary agency relationships. The concept of "voluntary agency" is being radically but almost imperceptibly revised under the press of events in the world of social welfare organization and finance. The term now embraces traditional nonprofit social agencies, proprietary agencies offering similar services often financed by the public sector, social programs financed by industry for its employees, and the family as a primary service provider. This evolution demands a major reconsideration of the new relationship between government and the voluntary agency.


Policy sources of worker dissatisfactions: the case of human services in aging. This article explores job dissatisfaction experienced by service providers in the field of aging and the policy sources of such dissatisfactions. Workers interviewed identified four major areas of complaint about their jobs: lack of resources, agency problems, mandates and regulations, and client characteristics. Such problems, it is argued, are associated with specific characteristics of policies under which the respondents work. These characteristics include the symbolic nature of legislation, policy ambiguity, universal entitlement, and calculated fragmentation. Whether or not policy changes should be made to alleviate worker dissatisfactions is discussed in the concluding section of the article.


Managing 'minor' disorders: pathways to a hospital accident and emergency department. Empirical research examining the decision-making processes involved in the management of problematic signs and symptoms has either focused on a specific condition or examined more general decision rules. The problem with these approaches is the difficulty in identifying which elements are specific to certain complaints and which are more generally applicable. The study presented here shows a comparison of the processes involved in the decision to seek medical care for sufferers with different types of complaint. This comparison identified various different elements in the decision-making processes which were shown to have considerable implications for their pattern of help-seeking behaviour and their pathways to the hospital accident and emergency department.


Class, perceptions of 'disordered' behaviour, and suggestions for therapy: a tri-cultural comparison. This paper presents findings from a tri-cultural study in which we argue that class differences pertain not only to rates of mental illness but also to recognition of symptoms of mental illness and to recommendations concerning what should be done by those exhibiting 'disordered behaviour'. It is hypothesized that regardless of respondent's cultural background, the extent to which a deviant behaviour will be defined as a mental health problem, and professional therapy will be suggested as a source of help for that problem, will be positively related to class. Findings from a sample selected from two small West Texas communities, and samples selected from Durango, Mexico, and Juiz de Fora, Brazil, indicate strong support for the first prediction only among the West Texas sample, whereas the second hypothesis concerning therapy suggestions is strongly supported among respondents in all three cultural settings. We conclude that these class differences in perceptions and suggestions concerning five examples of 'disordered' behaviours read to respondents relate to conditions of lower-class life in general. Particularly, structural support found for our hypothesis leads us to suggest a need for informal, nonbureaucratic mental health care systems created to serve lower-class populations residing in class-oriented societies, regardless of cultural differences which may exist among these societies.


Loss of self: a fundamental form of suffering in the chronically ill. Physical pain, psychological distress and the deleterious effects of medical procedures all cause the chronically ill to suffer as they experience their illnesses. However, a narrow medicalized view of suffering, solely defined as physical discomfort, ignores or minimizes the broader significance of the suffering experienced by debilitated chronically ill adults. A fundamental form of that suffering is the loss of self in chronically ill persons who observe their former self-images crumbling away without the simultaneous development of equally valued new ones. As a result of their illnesses, these individuals suffer from (1) leading restricted lives, (2) experiencing social isolation, (3) being discredited and (4) burdening others. Each of these four scores of suffering is analysed in relation to its effects on the consciousness of the ill person. The data are drawn from a qualitative study of 57 chronically ill persons with varied diagnoses.


Retrofit electrical systems for greater reliability.


Viewpoint: sociology and medicine: a polemic.


From the illusion of quality assurance to the reality of accountability: don't miss out on the action!


As I see it: proper role of the board, the CEO, and the medical staff.


Too many boards neglect the import of labor on the hospital's success. Although human capital is decisive in the success of the hospital, the absence of an agenda item dealing with human capital characterizes too many board meetings. The author suggests several possible actions, including the development of board policies on human capital, a broadening of perspectives to embrace "an arithmetic of quality," and visibility for key staff members at board meetings.


Trustees' growing role in development explored at 'Future Options' meeting.


Does your board have labor policies for cutbacks, wages, and unions? The author suggests that it is time for boards' strategic planning committees to examine their hospitals' labor policies and merge their planning and personnel needs. Considerations concerning cutbacks, wages and benefits, and relationships with unions are discussed.


How to shape incentive plans for the hospital's top executives. Surprisingly few hospital boards use incentive payment plans for their top executives. In this article, the author provides a rationale for their use, reviews various incentive plan formats, and suggests a sample incentive contract.


New game turns therapy into fun.

New game turns therapy into fun.


Social Security plan digested by industry.


Facility tests new computerized patient care management system.


Dining program promotes dietary, mental health.


How to visit loved ones in a nursing home.


Study shows respite care helps homes and families.


Geriatric pharmacy needs assessed in Alabama.


States explore new inspection tools.

States explore new inspection tools.


Family responsibility: who should foot the bill!


Bill children for parents' nursing care?


Conscience, curiosity and compassion.

Conscience, curiosity and compassion.


Perspectives. Transplant technology outpaces policies.


Perspectives. AIDS and the blood supply.


Care of the elderly in New Zealand.

Care of the elderly in New Zealand.


Caring for the aged in Australia.

Caring for the aged in Australia.


Overdosing on medical technology.

Overdosing on medical technology.


Care of the elderly in the United Kingdom.


Care of the elderly in the USA.

Care of the elderly in the USA.


Care of the elderly in the Netherlands.

Care of the elderly in the Netherlands.


Meeting the challenge of an aging population in Sweden.


Health care in the Mexican Republic.

Health care in the Mexican Republic.


Innovations in health care delivery in two large cities of the United States.


Health care in English cities.

Health care in English cities.


Health care in Indian cities.

Health care in Indian cities.


Hospital practice in large cities in Canada.


Health care in the county of Stockholm.

Health care in the county of Stockholm.


The urban poor are also sick.

The urban poor are also sick.


The Centre for Research into Physical Resources for Health (CIRFS).


Design trends in Sweden.

Design trends in Sweden.


Design trends in USA.

Design trends in USA.


Design trends within the U.K. for new hospital buildings.


The hospital of the future.

The hospital of the future.


Computers in health care in Canada.

Computers in health care in Canada.


Report on the 15th IHF special study visit. Computerised hospital information systems.


Computers in the public hospitals in France.


Computers in health care in the United Kingdom.


Computerised information systems in health care in Latin America.


Encouraging trends in hypertension control.


A role for churches in hypertension management.


Selection, training, and utilization of health counselors in the management of high blood pressure.


An overview of the 1980 National Master Facility Inventory Survey of nursing and related care homes.


Medical advances raise ethical questions.


Resources urged for elderly.

Resources urged for elderly.


System offers Lifeline to elderly, disabled.


Good marketing is consistent with good medical care: seminar.


The Central Department of Information on Emergencies and Disasters (CIPEC).


In danger of closing: one hospital's story.


Interest booms in home health care.

Interest booms in home health care.


A renaissance for human services: marketing for survival.


Emergency center group hits AMA guidelines.


NMR: state of the art in medical imaging. The future of NMR imaging in medicine seems bright. Absence of known biologic hazard, lack of moving parts, and ability to measure multiple tissue parameters should make it the study of choice in many clinical situations, while its ability to create detailed tomographic images in any plane, with both anatomic detail and tissue specificity, should revolutionize diagnostic radiology. The additional information gained about metabolic processes in vivo may well change our entire understanding of health and disease.


In Washington, D.C. all-out attack launched on infant mortality.


American Hospital Radiology Administrators: a decade of progress. The AHRA in ten years has made much progress toward accomplishing its goals. The organization has established standards for professional conduct in hospital radiology department administration, fostered communication with other professional organizations, and expanded educational services to its members.


Trials and tribulations of the radiology administrator: purchasing. Half or more of a radiology department budget typically is taken up by supplies and capital equipment. Purchasing procedures differ for the two kinds of items, and so too does the role of the radiology administrator. Responses to Applied Radiology's survey of radiology administrators indicate that the differences are mainly due to the different degrees of involvement by radiologists and hospital administrators.


Using a hospital cancer registry effectively in a cancer management program.


NHS administration--are we getting the best graduates?


Portables: finding a market niche.

Portables: finding a market niche.


The dollars and sense of silver recovery.


Uses of tumor-registry data in program planning and administration.


Delegation without fear.

Delegation without fear.


The field liaison program: why bother?

The field liaison program: why bother?


Alternate workstyles: a solution to productivity problems?


Attitudes that work against you.

Attitudes that work against you.


The patterns of care study: a specialty effort to improve care. The Patterns of Care Study is a comprehensive ongoing review of radiation therapy practice in the United States. Outcome studies have established national benchmarks for six cancer sites. Analysis of the factors influencing recurrence and complications have established important causal relationships that the radiation oncologist can manipulate to improve results. Care processes have been identified, and outcome correlations established.


How to give feedback.

How to give feedback.


The potential for computerization of ultrasound images.


The importance of cooperation.

The importance of cooperation.


How to prepare for an arbitration hearing.


How to be an effective QC leader.

How to be an effective QC leader.


The technician-turned-manager.

The technician-turned-manager.


Who owns Barney Clark's legacy?

Who owns Barney Clark's legacy?


Should radiology administrators have MBAs?


Improving productivity in the x-ray film file room. A film filing system using color coding of the last two digits of assigned numbers was compared with a system designed around the current film file and readily available patient identifiers: name, sex, and date of examination. In the FASD system (filed alphabetically by sex and date), films are filed in time units by date of last activity and within these time units by sex and last name. The FASD system was shown to cut in half the routine work of film filing.


ARRT job analysis project.

ARRT job analysis project.


The stormy legacy of Baby Doe.

The stormy legacy of Baby Doe.


Standard costing and flexible budgeting applied to a radiology department.


NMR debuts in community hospital.

NMR debuts in community hospital.


Suffer the little children?

Suffer the little children?


Revision of health service area boundaries; interim regulation--PHS. This notice sets forth interim rules establishing criteria, procedures and requirements for the revision of existing health service area boundaries under section 1511(b)(4) of the Public Health Service Act, as amended by the Health Planning and Resources Development Amendments of 1979, Pub. L. 96-79. Interested persons are invited to submit written comments and suggestions concerning these interim rules.


Health maintenance organizations--PHS. Notice, July. This notice sets forth the names, addresses, service areas, and dates of qualification of entities determined by the Secretary to be qualified health maintenance organizations [HMOs]. In addition, this notice reports a service area expansion and name changes of previously qualified HMOs.


Dispensing controlled substances in institutional practitioner emergency rooms--Drug Enforcement Administration. Notice of proposed rulemaking. This is a proposal to amend Part 1306 of Title 21 of the Code of Federal Regulations to permit hospital emergency room personnel to dispense controlled substances to nonpatients when alternative pharmacy services are not available. Only persons authorized to dispense under state law would be permitted to dispense under the proposed regulation. Under current DEA regulations only physicians, medical or other persons acting as agents or employees under their direct supervision, or pharmacists filling their prescriptions, may dispense controlled substances. A physician may not call a local hospital emergency room and ask that personnel there dispense controlled substances to a patient whom the physician is sending over for that purpose alone. DEA has received numerous comments from members of the medical community and from state regulatory agencies concerning this matter. This proposal seeks to remedy the situation.


Revised federal allotments to states for social services expenditures pursuant to the Title XX--Social Services Block Grant Act; promulgation for fiscal year 1983-HHS. Revised notification. Public Law 97-248, enacted September 3, 1982, among other things, amended Sec. 1101(a) of the Social Security Act, as amended, (Act) to define the term State when used in Title XX to no longer include American Samoa and the Trust Territory of the Pacific Islands. The Federal allotments to States for social services under Section 2003 of the Act which were promulgated in Vol. 46, No. 229 of the Federal Register page 58186 on November 30, 1981, included American Samoa and the Trust Territory of the Pacific Islands. Accordingly, the promulgation contained in such document is rescinded and the promulgation, as revised, is set forth in this issuance.


Privacy Act of 1974; systems of records: annual publication--HCFA. Annual republication of notices of systems of records. In accordance with 5 U.S.C. 552(e)(4), we are publishing notices of systems of records which HCFA maintains. The notices are complete as of August 10, 1982 and do not contain any new routine uses or new material which would require a report to Congress and the Office of Management and Budget as described in OMB Circular A-108. The notices do, however, contain editorial and general clarifying changes which make them accurate and complete. If any errors appear in this publication, we will publish corrections in a later issue of the Federal Register.


New drug and antibiotic regulations--FDA. Proposed rule. The Food and Drug Administration (FDA) is proposing to revise its regulations governing the approval for marketing of new drugs and antibiotic drugs for human use. FDA is taking this action to improve the efficiency of the agency's drug approval process and to improve the agency's dealings with applicants for marketing approval of new drugs and antibiotic drugs, while still maintaining the high level of public health protection the drug approval process now provides. The improvements will help applicants prepare and submit higher quality applications and permit FDA to review them more efficiently and with fewer delays. This will benefit consumers through earlier availability of drugs and benefit applicants by permitting earlier marketing of new drugs and antibiotics. This action is one part of a larger effort by FDA to review all facets of the agency's drug approval process.


Privacy Act of 1974; annual publication of systems of records--NIH. Privacy Act; annual republication of notices systems of records. The National Institutes of Health (NIH) is publishing this document to meet the requirement of the Privacy Act (5 U.S.C. 552a(3)(4)) to publish a notice describing the existence and character of each system of records at least once a year. This publication covers systems of records for which NIH is responsible. This publication includes notices for new systems of records which have been published since the 1981 annual compilation. In addition, many of the notices which were published in the last annual publication have been modified to clarify the descriptions and to ensure that they are complete, accurate and timely. None of these changes requires a report of altered system to be sent to the Congress and the Office of Management and Budget. The notices are complete and accurate as of August 13, 1982.


Grants and subgrants to for-profit organizations--HHS. Final rules. This announces HHS's final decision to make for-profit organizations eligible for grants in all programs in which grants to those organizations are consistent with legislative intent and program purposes. For all such programs which we have identified and which still have regulatory bars to grants to for-profit organizations, this removes the bars. This also (1) makes HHS's Department-wide grants administration regulations, 45 CFR Part 74, apply to grants and subgrants to for-profit organizations and (2) adds to those regulations additional provisions for grants and subgrants to for-profit organizations. These actions reflect a reversal of the long standing HHS policy of not making grants to for-profit organizations even in programs where they are not barred by law. The new policy is intended to increase competition. This is likely to help the affected HHS programs achieve their objectives better, because they will be able to select from among a greater number of proposed projects.


Protection of human subjects; compensating for research injuries; request for comments on report of the President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research. This notice requests public comment on the Report of the President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research entitled "compensating Research Subjects," which was issued in June 1982.


Federal allotments to states for social services expenditures pursuant to the Title XX-Social Services Block Grant Act; promulgation for fiscal year 1984-HHS. Notification of allocation of Title XX. This issuance sets forth the individual allotments to States for Fiscal Year 1984 pursuant to Title XX of the Social Security Act, as amended. The allotments to the States published herein are based upon the authorization set forth in Section 2003 of the Act and are contingent upon congressional appropriations actions for the fiscal year. If the Congress enacts and the President approves an amount different from the authorization, the allotments would be adjusted proportionately.


Consultation with state and local officiaLs prior to awarding community health center grants--PHS. Notice. Section 1923 of the Public Health Service (PHS) Act (42 U.S.C. 300y-2) requires that if a State does not apply for a Primary Care Block Grant under section 1924 of the PHS Act (42 U.S.C. 300y-3), or does not qualify for such a grant, the Secretary of Health and Human Services will use those funds not allotted to States participating in the block grant to make grants under section 330 of the PHS Act (42 U.S.C. 254c) to individual community health centers (CHCs). Section 1923 also requires that the Secretary consult with the chief executive officer of the State and with appropriate local officials before making such grants for community health centers in a State. This notice describes the manner in which the Health Resources and Services Administration (HRSA) will fulfill the requirement for consultation. In addition, it solicits comments from local officials regarding CHCs in their areas.


Privacy Act of 1974; exempt record system--HHS. Final rule. The Office of the Secretary of the Department of Health and Human Services is amending its Privacy Act Regulations to exempt the system of records, "Civil and Administrative Investigative Files of the Inspector General, HHS/OS/OIG," from certain provisions of the Privacy Act. This exemption is authorized by subsection (k)(2) of the Privacy Act, which applies to investigative materials compiled for law enforcement purposes. The Office of Inspector General (OIG) is authorized to gather information for Civil and administrative law enforcement purposes under Pub. L. 94-505, establishing the HHS Office of Inspector General, and section 1128A of the Social Security Act, authorizing civil money penalties for the filing of false claims in certain health care financing programs. In order to maintain the integrity of the OIG investigative process and to assure that the OIG will be able to obtain access to complete and accurate information, the Department is exempting this system, under subsection (k)(2), from the notification, access, correction and amendment provisions of the Privacy Act.


Procurement forms and administrative matters--HHS. Proposed rule. The Office of the Secretary, Department of Health and Human Services, is proposing to amend 41 CFR Part 3-50, Administrative matters, by adding a new subpart, 3-50.8, Determination of Adequacy of Contractors' Accounting and Billing Systems and Preparation of Invoices. This new subpart will establish uniform Departmental billing and financial reporting requirements for inclusion in cost-reimbursement type contracts. The objective of the new subpart are: (a) Streamlining the reporting of financial data; (b) establishing the requirements for determination of the adequacy of a contractor's accounting and billing system; and (c) establishing guidelines for the preparation of invoices for cost-reimbursement type contracts. Part 3-16, Procurement Forms, will be amended by the addition of three subsections to Subpart 3-16.9, Illustration of Forms. These subsections illustrate the financial reporting form and contain instructions for filling out the form and preparing invoices under cost reimbursement type contracts. When issued as a final rule, this regulation will supersede Procurement Circular HEW-78.1, Billing Instructions and Financial Reporting Requirements dated April 12, 1978, except for Section 3-50.803(b). Paragraph 3-50.803(b) has been superseded by Procurement Circular HHS 82.04, Prompt Payment, dated October 1, 1982.


Nondiscrimination on the basis of age in programs or activities receiving federal financial assistance from HHS. Final rules. These final regulations implement provisions of the Age Discrimination Act of 1975, and the general, governmentwide regulation published in the Federal Register on June 12, 1979, codified at 45 CFR Part 90. The Age Discrimination Act of 1975 prohibits discrimination on the basis of age in programs or activities receiving federal financial assistance. The Act also contains certain exceptions that permit, under limited circumstances, use of age distinctions or factors other than age that may have a disproportionate effect on the basis of age. The Act applies to persons of all ages. These final regulations are designed to guide the actions of recipients of financial assistance from HHS. The regulations incorporate the basic standards for determining what is age discrimination that were set forth in the general regulations. They discuss the responsibilities of HHS recipients and the investigations, conciliation and enforcement procedures HHS will use to ensure compliance with the Act.


Privacy Act of 1974; systems of records, table of contents/index for the annual republication--HHS. On October 13, 1982, the Department made its annual republication of notices of systems of records to meet the requirements of 5 U.S.C. 552(e)(4). In order to assist the public, the Department publishes a consolidated lists of systems numbers, names, and Federal Register (FR) page numbers for the October 13 issue, as well as a subject/key word index.


Privacy Act of 1974; altered system of records--PHS. Notification of altered Privacy Act system of records 09-25-0074. In accordance with the requirements of the Privacy Act, the Public Health Service (PHS) is publishing notice of a proposal to alter system of records 09-25-0074, "Clinical Research: Veterans Administration Bladder and Prostate Cancer Clinical Trials, HHS/NIH/NCI." The purpose of the alteration is to modify an existing system of records into an umbrella system by broadening both the categories of individuals under this system and the purposes for which the system is used. The names of the system of records is also being changed to reflect the alteration. The new name is "Clinical Research: Division of Cancer Biology and Diagnosis Patient Trials, HHS/NIH/NCI."


Privacy Act of 1974; notification of new system of records--PHS. Notification of new system of records, "Health Resources and Services Administration Loan Repayment/Debt Management Records System. In accordance with the requirements of the Privacy Act, the Public Health Service (PHS) is publishing notice of a proposal to establish a new system of records entitled "Health Resources and Services Administration Loan Repayment/Debt Management Records System, HHS/HRSA/OA," 09-15-0045. PHS invites interested persons to submit comments on the proposed routine use established for the new system of records on or before August 10, 1983.


Medicaid program; early and periodic screening, diagnosis, and treatment (EPSDT) program--HCFA. Proposed rule. This proposal would modify present regulations to conform to recent legislative changes enacted by section 2181 of Pub. L. 97-35, the Omnibus Budget Reconciliation Act of 1981. That section eliminates the penalty which reduces by one percent Federal funds for a States's Title IV-A program, Aid to Families with Dependent Children (AFDC), for any quarter during which a State fails to: (1) inform all AFDC families of the availability of early and periodic screening, diagnosis, and treatment EPSDT services; (2) provide or arrange for requested screening services; and (3) arrange for corrective treatment of health problems found. In addition, section 2181 mandates that States incorporate these three requirements into their State Medicaid plan with respect to all EPSDT eligibles. Further, this proposed rule would modify current Medicaid EPSDT regulations to reflect Congressional intent that States should continue to develop fully effective EPSDT programs; however, current requirements which entail a large volume of paperwork should be significantly streamlined.


State hazardous waste programs; procedures for revision of state RCRA programs--EPA. Proposed rule. EPA is today proposing to amend its requirements under 40 CFR 271.21(e) (formerly Section 123.13(e)) for the approval and revision of authorized state hazardous waste programs. One purpose is to ensure that states applying for final authorization under the Resource Conservation and Recovery Act of 1976, as amended, (RCRA) do not have to revise their programs and applications to respond to federal regulatory changes occurring while the states' applications are being prepared or processed. The second purpose is to provide all authorized states with one full year (or two years, if there is a need for state legislative action) from the effective date of amended federal regulations to make the revisions in their programs required by such federal amendments. This action would provide the state with an additional six months since the existing regulation requires that program revisions be made within one year (or two years) after the promulgation of amended federal regulations.


Health Education Assistance Loan (HEAL) program--PHS. Final regulations. These regulations set forth the requirements for participating in the Health Education Assistance Loan (HEAL) program, a Federal program of insured loans to students in schools of medicine, osteopathic medicine, dentistry, podiatric medicine, public health, pharmacy, veterinary medicine, optometry, and chiropractic, and graduate students in health administration and clinical psychology.


Privacy Act of 1974; system of records--PHS. Waiver of advance notice period for a new system of records. FR Doc. 83-18581, appearing at page 31738 in the issue of Monday, July 11, 1983, provided notification of a new system of records proposed by the Health Resources and Services Administration (HRSA). That system is 09-15-0045, "Health Resources and Services Administration Loan Repayment/Debt Management Records System, HHS/HRSA/OA." The document stated that the Public Health Service had requested that the Office of Management and Budget (OMB) grant a waiver of the usual requirement that a system of records not be put into effect until 60 days after the report is sent to OMB and the Congress OMB granted the requested waiver on August 3, 1983. Accordingly, the new system of records, 09-15-0045, became effective upon the date of the waiver except for the routine uses established for the system. They became effective August 11, 1983, following the public comment period. However, in response to a comment received from the responsible oversight committee of the U.S. House of Representatives, we are adding a routine use to permit disclosure of information from these records to the General Accounting Office (GAO) and OMB for auditing financial obligations. We are also modifying one of the existing routine uses. PHS invites interested parties to submit comments on the proposed new routine use on or before September 29, 1983. In accordance with the Debt Collection Act of 1982 (Pub. L. 97-365), we are also adding the "special disclosure" statement. This statement does not require a public comment period.


Hill-Burton health facilities; review--HRSA. Notice of review. This notice announces a review of institutions and organizations which have received grants under the Hill-Burton Program (Title VI of the Public Health Service Act, 42 U.S.C. 291 et seq.) for the construction or modernization of hospitals or other health facilities.


Canada's Medicare flight.

Canada's Medicare flight.


Private sector moves in as Washington ends its financial assistance for HMOs.


Educate workers about health costs.

Educate workers about health costs.


Employer-sponsored PPOs attract attention.


Florida tightens HMO financial standards.


HMO exposures. One plan structure could trigger liability suits.


BC/BS top choice in four benefit areas.

BC/BS top choice in four benefit areas.


Group health plans trigger many E&O claims.


Florida comp pool turns its attention to health coverage.


Repeat analysis in radiology: a method of quality control.


What your writing shows...

What your writing shows...


A data management tool for reporting productivity. Hospital-based occupational therapy departments in the 1980's must be able to report productivity levels in terms of cost-effectiveness. Only the most efficient programmes are likely to succeed in this era of budgetary constraints. A data retrieval model. operating in a hospital-based occupational therapy department is described. The model reports departmental productivity and data for making cost estimates related to direct and indirect patient care by diagnostic category. In addition, the system shows individual therapists' input and output. This data system has made possible monthly management statements that provide an overview of productivity and indicate the complexity of occupational therapy services for specific diagnostic categories within an acute-care paediatric hospital.


A study of attitudes towards work: possible implications for delegating responsibility. An extensive survey was conducted among Ontario occupational therapists and auxillary personnel (assistants and aides). Part of the survey requested that members of each of the two groups rate its own group and the other group with respect to attitudes about motivation toward work and response to work. Numerous demographic characteristics were identified as well. Results show that both occupational therapists and auxillary personnel believe they are motivated primarily by the challenges of their jobs. Auxillary personnel rate occupational therapists very much as they rate themselves. However, occupational therapists believe auxillary personnel are motivated not by the challenge of their job but rather by money and job security issues. Implications of these findings are discussed.


How to pick winners--going beyond the obvious.


Disease in the elderly: social factors.

Disease in the elderly: social factors.


How to pick winners--getting the facts on the table.


Provincial pharmacy associations define methods of negotiating with government.


Where, oh where is the wisdom that the health-care system needs?


Increasing radiographer productivity by an incentive point system. Because of a very low technologist productivity in their Radiology Department, the authors describe a Productive Point System they developed and implemented to solve this personnel problem. After establishing the average time required to perform all exams, point credits (one point for every ten minutes utilized) were assigned to each exam performed, thereby determining an index of production. A Productive Index of 80% was considered realistic and was the equivalent of 192 points for a 40-hour work week. From 1975 to 1978 personal productivity increased from 79% to 113%. This resulted in an average yearly fiscal savings of over $20,000.00 for this three-year period. There was also a significant improvement in exam efficiency and quality, job attitude, personnel morale, and public relations. This program was highly successful because technologist acceptance and cooperation was complete, and this occurred mainly because the system supports the normal occupational goals and expectations of technologists.


Clinical application of the hand-held computer in respiratory intensive care.


Medicare a courageous step now in jeopardy?


Patches of hope.

Patches of hope.


Bioethics in the 80's: social consequences for physicians.


Statement on the proposed "Canada Health Act". Catholic Health Association of Canada.


The moral decision: notes on pastoral counselling.


The health professional: a person who cares.


Proposals to promote the viability and leadership of the Catholic health care facility in Canada.


Health care system in Canada and social justice.


Health is the business of the church.

Health is the business of the church.


Evaluation of a preadmission preparation program: goals clarification as the first step. Support for the importance of psychological preparation for pediatric patients and their families prior to hospitalization has resulted in the widespread development of preadmission preparation programs. Research aimed at evaluating these preparation programs has typically not utilized a systematic program evaluation approach. This study uses a qualitative method of goal clarification as a first step in evaluating one specific preparation program. Structured interviews were conducted with 20 respondents, 19 of whom were staff members at Children's Hospital National Medical Center in Washington, D.C. Interview questions consisted of two major categories: (1) specific program goals and the means to accomplish them; (2) personal views on the impact of hospitalization and effects of preparation. Responses were grouped according to common themes and are reported in a descriptive format. The importance of goal clarification is stressed, both as an evaluation tool and as an intervention in itself.


Coping with feelings: seriously ill children, their families, and hospital staff. Leukemia, aplastic anemia, sickle cell anemia, hemophilia, lymphoma, neuroblastoma, rhabdomyosarcoma, renal failure, cystic fibrosis, scoliosis, diabetes, and asthma. These are only a few of the many chronic diseases or handicapping conditions confronting children today. Little attention has been paid to children's emotional reactions to illness and hospitalization, important facets of the healing process. In the first part of this paper, children's characteristic emotional reactions to hospitalization are discussed within a developmental framework. Next, some of the emotional reactions elicited in hospital staff and parents by seriously ill children are discussed. It is hoped that an elucidation of the types of feelings hospitalized children experience, and the kinds of emotional responses they elicit in adult caretakers, can lead to more sensitive and effective child care-giving in hospital settings.


For parents and children only: a parent-child educational library. A Parent-Child Education Library was developed at a children's hospital to help fill the gap in communication between staff and families. The written materials supplement the staff's verbal explanations. Materials include both medical and other child-related, educational topics. The library was approved by the medical staff and is funded by donations. Counseling has become an appropriate adjunct to the library, as parents and/or children share their problems and feelings. The library is a service provided by the Child Life Program.


Academic programming for child life education: a case study. The Child Life Education Program at Case Western Reserve University provides a case study of the development of an innovative academic program for health professionals. This article describes the process of curriculum development and the integration of the curriculum into an existing academic program. The interdisciplinary and individualized nature of the program increases the likelihood of meeting the unique needs of health care workers. From the institutional perspective, benefits include improved communication between students, faculty, and departments, often resulting in expanded learning experiences and flexible approaches to the utilization of existing resources within a university.


What is a Catholic hospital?

What is a Catholic hospital?


Catholic hospitals in today's Canada.

Catholic hospitals in today's Canada.


Ministry to the sick: how one diocese organized its program.


Supervising child life students: practices of hospital supervisors. This paper describes the supervision practices of hospital-based child life supervisors. Interviews were conducted with 10 hospital supervisors and focused on several dimensions of the supervisory process. Supervision practices varied widely on all dimensions and it was clear that there was no common method of supervision. Implications for the training of child life professionals are discussed.


A study of the healing church and its ministry: the health care apostolate.


Parent created tape recordings for hospitalized children.


To prolong life or let die.

To prolong life or let die.


Effects of hospitalization on young children: implications of two theories. In this article the effects of hospitalization on the young child are analyzed from the perspective of two theoretical models of development. The first model, the critical periods model, asserts that there is an hypothesized critical period for the development of certain skills and competencies. In this model early experiences are crucial to the skills which either cannot develop or develop with much difficulty after the critical period has passed. The second model is a transactional model of development which asserts that, although early experiences are important, each interaction of the child and the environment makes a difference in development and only through continuous assessment of these transactions can we determine how the child changes and evolves. Data from studies of the effects of hospitalization on children are used to illustrate the utility of these models in the study and management of children who are hospitalized.