Smoking and schooling: in search of the missing link.


Health care and the market: a British lament.


Teaching and hospital costs: the case of radiology. Investigates production and cost effects of teaching in radiology departments. If students are substitutes for physicians, production costs may be less in teaching than in non-teaching hospitals for a given level of output. Empirical results for Veterans Administration hospitals suggest that teaching reduces costs for most radiology procedures. If teaching can reduce costs of primary products, teaching hospitals may be able to provide a given program of patient care at lower costs than non-teaching hospitals. However, costs might still be higher at teaching hospitals than non-teaching hospitals because of differences in case mix, medical techniques, or quality of care.


Teaching and hospital costs.

Teaching and hospital costs.


Health insurance and the demand for medical care. With rare exceptions the provision of actuarially fair health insurance tends to substantially increase the demand for medical care by redistributing income from the healthy to the sick. This suggests that previous studies which attribute all the extra demand for medical care to moral hazard effects may overestimate the efficiency costs of health insurance.


Theoretical considerations on the cost of illness. This paper explores the measurement of the cost of illness from a theoretical perspective. It is shown that under a wide range of circumstances the aggregate willingness to pay ex ante to reduce the probability of an illness exceeds (1) the consumer surplus gained ex post from such a reduction, and also (2) the sum of medical expenditure saved and output gained. These results are of interest because they provide a stronger basis for presuming that conventional empirical studies estimate lower bounds on the true cost of illness, and because they hold even if medical insurance distorts expenditure decisions.


Reimbursement policy, cost containment and non-price competition.


How to determine cost savings for a records/files management program. This article provides some guidelines for distinguishing between feelings and facts in order to determine the cost savings potential for a particular system, first to convince oneself of the "rightness" of the new approach and second, to convince other decision makers in the organization of the true benefits, including economic benefits of the change.


Choosing an information system to meet specific needs. Because of the increasing number of information systems on the market today, the user must select the system wisely according to the vendor's ability to solve specific company needs. An organization must know its filing and retrieval requirements, its potential for growth, etc., and must then contact only those vendors that fit specific company requirements. The vendor's reputation in the field, service history, "after-sales support," and ability to supply cost analyses should all be examined.


More on moral hazard.

More on moral hazard.


Selecting a computer-assisted retrieval system: one answer to office automation. Computer-assisted retrieval (CAR) systems combine computers with microfilm to create a cost-effective, productive method of managing information. CAR systems range in size from large computerized mass-storage systems utilizing image scanning and digitized technologies to small, tabletop, standalone microprocessor-driven systems. When properly configured, a CAR system can not only provide vital information today, but will also be able to grow and expand into a total office system.


Buying information systems.

Buying information systems. When purchasing information systems, the buyer or manager must be able to account for many types of details. Major considerations include a total awareness of costs relating to conversion, site preparation, equipment, software, maintenance, and supplies. The buyer's needs, as well as the system's capabilities, must be carefully weighed. In addition, a hidden element, the true cost of making the purchasing decision, is a vital consideration in the process of choosing the best available information system.


X-ray minification systems--an international commodity. Crowded hospital X-ray file rooms and the increasing economic value of silver have contributed to the need to substitute microfilm for original X-rays. X-ray minification, already successful in the United States, will be increasing worldwide as governments begin to understand the art of X-ray microfilming and as economic pressures force the decline of hospital X-ray holdings.


What records managers should know about quality control. This article has been written to assist the records manager who may be faced with the task of determining qualitative standards for microfilm services. While the discussion will cover a wide spectrum of microform products, it is aimed primarily at those who are considering the conversion of source documents to conventional roll film or jackets. It includes an explanation of the impact of poor quality on the use of film in a records management program, and offers suggestions for the establishment of minimum standards for both inhouse and service bureau filming. A sample contract is provided to aid in developing a more specific contract. The article is based on experience gained in the operation of a microfilm service bureau, and is a result of having observed the consequences of microfilm conversion efforts which were entered into without adequate preparation and without a definition of specific standards. Recommended standards are based upon AIIM criteria for source document microfilm and articulated in such a manner as to permit inclusion in a contract proposal or inhouse working policy.


Economic advantages of board certification. While several recent studies have examined selected characteristics of board certified physicians, none have directly and completely examined the economic advantages it conveys. Using data from a nationwide survey of physicians, estimates of the empirical relationship between income and board certification are shown. Being board eligible increases annual practice income by about $8000 and being board certified increases income by almost $13,000, holding other factors constant. The economic advantages of board certification thus appear to be substantial.


The Foundation Course in sterile supply services management.


Among the archives--1967 to 1971.

Among the archives--1967 to 1971.


Notes on low temperature steam and formaldehyde sterilization cycle details, steam supply, control and reliability.


Theatre tray optimisation in TSSU systems.


Competition and efficiency in the end stage renal disease program. Estimated coefficients for medical service production or cost functions are subject to a 'competitive amenity bias' which may result in the failure to identify factors that affect economic efficiency. Our investigation of productivity of dialysis facilities did indeed indicate both the likelihood of bias and some qualitative results. These results suggest that it will be difficult to estimate cost and that variation in the level of reimbursement will, in competitive markets, affect the level of amenity delivered to patients. Incurred cost, amenity, and patient well-being will all vary positively with the reimbursement level. Determining the 'right' level of reimbursement requires a policy decision on how much total amenity society wishes to deliver to beneficiaries of public programs.


Quality control of theatre linen barrier drapes.


Spore structure and destruction.

Spore structure and destruction.


Sterile packs--commercial v. local production.


H.S.D.U. (hospital sterilizing and disinfection units)--an alternative method.


Bacterial spores as biological monitors of sterilisation processes.


Role of the environment in hospital infections--design of C.S.S.D.


Dangerous pathogens: implications for staff and patients.


Laboratory autoclaves and the safe handling of micro-organisms.


Organizations as volunteers for the rural frail elderly.


Hospitals owned by for-profit companies determine own method of laundry service.


An aggressive management approach to healthcare cost containment.


DC hospital abolishes 20 laundry positions as part of layoff plan involving 440 posts.


The big business of hospital security.

The big business of hospital security.


Why 3 out of 5 patients switch.

Why 3 out of 5 patients switch.


Government volunteers: who and how?

Government volunteers: who and how?


Special report: how the health-cost backlash is hurting you.


The surprising swing to non-physicians.

The surprising swing to non-physicians.


Special report: if you're not ready, walk-in clinics are.


Who'll decide which patients you hospitalize?


Whose side is your hospital's lawyer on?


Is the doctor surplus for real?

Is the doctor surplus for real?


Some issues fade, but new ones emerge.

Some issues fade, but new ones emerge.


An HMO surge may be under way.

An HMO surge may be under way.


Group practice poised to flourish--at last.


When this HMO advertises, people snap to attention.


A new storm is looming.

A new storm is looming.


The new route to owning your office.

The new route to owning your office.


Malpractice premiums: hefty today, huge tomorrow.


One doctors' union hangs on.

One doctors' union hangs on.


No charge for a hospital room? It pays off!


Ready or not, you're on the transplant team.


I paid my dues in prepaid care.

I paid my dues in prepaid care.


What influences acceptance of new medical technology?


Keeping your instruments happy.

Keeping your instruments happy.


The 10 commandments of laboratory coaching.


Bayesian analysis: an objective approach to hiring.


Performing safe phlebotomy on AIDS patients.


This city's supervisors share their problems and resources.


A new look at hospital salaries.

A new look at hospital salaries.


Let's build job satisfaction into the MT curriculum.


A do-it-yourself approach to scheduling.


Performance appraisals: beware the numbers game.


Therapeutic drug consultations based in the lab.


Credential review: it's worth the effort.


MHAMIC: eight years old, healthy and growing.


Trend survey reveals attitude change.

Trend survey reveals attitude change.


A mandatory liability insurance success story.


Malpractice dilemmas, legislative solutions.


Alternative services. Opportunities--and competition--in home healthcare are on the rise.


Alternative services. Hospitals move into home care by striking partnership deals.


Hospices cost less than hospitals.

Hospices cost less than hospitals.


Alternative services. Joint ventures ease access to NMR.


Alternative services. 40% of births in hospitals could be borne by birthing centers.


Human resources management. Environmental trauma shakes hospital executive career leader.


Human resources management. More seminars, higher prices and maybe lagging attendance in '84.


Human resources management. Hospitals must change policies to recognize RNs as professionals.


Human resources management. Systems cue in on education to strengthen market positions.


Systemwide refinancing cuts costs.

Systemwide refinancing cuts costs.


Hospital can require that M.D. get insurance from 'recognized' insurer.


Candidates urge cost containment.

Candidates urge cost containment.


Publicity on prices has little impact.

Publicity on prices has little impact.


Group pushes evaluation of providers.

Group pushes evaluation of providers.


Competition is driving down prices of many high-volume pharmaceuticals.


New laws prohibit patient diversion.

New laws prohibit patient diversion.


M.D.s' qualms about profit motive scuttle HCA's bid to buy Harvard-affiliated unit.


Rising competition spurs Lifemark deal.

Rising competition spurs Lifemark deal.


VHA pushes regional 'clones' that could add 300 hospitals to the cooperative.


Republic trims fat from its hospitals to get them in shape for competition.


MacNeal builds on cost containment efforts with new, $62 million facility.


A hospital by any other name . . . franchise names for hospitals.


What's a hospital worth?

What's a hospital worth?


R & D, systems style.

R & D, systems style.


Communication is not a four-letter word. Interview by Kelly F. Guncheon.


FECs face backlash from rapid growth.

FECs face backlash from rapid growth.


Surgical centers advocated.

Surgical centers advocated.


Pace quickens on product bar coding.

Pace quickens on product bar coding.


Free medical care offers no good health guaranty.


Hospitals seen routinely overcharging.

Hospitals seen routinely overcharging.


Patient accounts explains 'charging errors'.


Laboratory Proficiency Testing Program--Ontario Medical Association.


PPOs: an emerging alternative delivery system.


Autopsy: the path to progress.

Autopsy: the path to progress.


Quality assurance and surgical pathology.


Paying the price. 1983 estimated income from hospital sources.


Diabetes care and education: a creative approach. The patient education program developed by the Indiana University Diabetes Research and Training Center in its Diabetes Education Study utilized a variety of teaching methods--each chosen to have an anticipated effect on knowledge, skill, or adherence. By themselves, none of these techniques can be considered revolutionary. What was innovative about DIABEDS patient education were the priorities under which instruction was designed and the methodical allotment of instruction according to the needs of individual patients.


Pharmacist patient education: what strategies work? Previous research reveals that pharmacist-coordinated patient education programs have been effective only if they go beyond providing information to patients. Effective programs must include strategies that assist and encourage patients to incorporate this new information into their life styles.


Enhancing patients' social support systems. Social support systems are a valuable asset to changing and improving patient health behavior. The educator must be aware of the potential benefits that exist for patients through family involvement. Individual circumstances must define the exact role a family plays in the patient's education and care. Finally, patient educators should constantly evaluate the involvement of social support systems in the educational and treatment plans. Needed suggestions and changes should be addressed promptly in order to preserve a workable situation for all involved.


Diabetes patient education: the state of the art. In the relatively short time it has existed, the Diabetes Care and Resource Center has helped to decrease hospital length of stay for the person with diabetes from 9.1 to 7.4 days and to decrease hospital readmissions. Patients, physicians, and the community have been extremely supportive of the program and the increase in staff and patient morale promotes a positive approach to a chronic condition. With the increased emphasis on cost containment and prevention, it would seem that a multidisciplinary approach to diabetes is an ideal way to meet these goals.


Better hiring decisions.

Better hiring decisions.


Train first-line supervisors to handle discipline.


Hospital/physician partnership: a blueprint for success of the osteopathic hospital.


Opportunities for prevention of domestic neglect and abuse of the elderly. Recent research has demonstrated that domestic neglect and abuse of the elderly is not uncommon in the United States. It is a social problem that has not been extensively researched, however. One of the few studies, conducted in Michigan, found that the oldest and most frail elderly were a target group of elevated risk. Victims of neglect or abusive tend to be living with adult children or other informal caretakers who become neglectful or abuse when the burdens of providing care for a frail, elderly person interact with stress, little or no preparation for providing personal care over a long time span, medical problems of the caretaker, alcohol abuse, financial difficulties, and other situational factors. Family histories of neglect or abuse and other causal hypotheses have also been investigated. Recent studies are reviewed and found to be in general agreement regarding the nature and apparent dynamics of this emerging problem among the elderly. Opportunities for prevention are discussed in terms of current models of service to the aging and redirection of other public health and social services.


Quality assurance & physician relations.


Social policies and programs for the elderly as mechanisms of prevention. The concept of prevention is defined and the role of social policy as a primary prevention mechanism is explored. Common programs for the elderly and their strengths and limitations are described. Recommendations are made for new social policies, based on the philosophy of prevention, which are comprehensive, flexible, responsive, and informed by the elderly themselves.


Meet the chairman: Adams selects CEO security as theme.


Prevention of unnecessary geriatric deaths: differential rate of morbidity/mortality on admission to long term care facilities. The amount of trauma experienced by elderly entering nursing homes appears to be a function of a number of environmental factors. The present study uses physician visits, PRN medication requests, the number of prescription medications administered, and mortality to compare the effects of two nursing home types, nonprofit and proprietary, on the elderly over a period of seven months. Physician visits, medication requests, and the number of prescription medications administered fluctuated in the nonprofit homes over the seven months while they decreased and then stabilized in the proprietary homes. Mortality was significantly higher in the proprietary homes. The implications of these findings for preventive interventions are discussed.


An alternative health delivery system for the chronically ill elderly. The present health care system is fragmented, uncoordinated, and too costly for the chronically ill, elderly patient. Project OPEN provides preventive health and social services in order to reduce costs and provide more effective care. This alternative delivery system is based on a consortium brokerage model which provides functional assessment, care plan development and service coordination. A randomized sample of 338 elderly individuals participated in a time series experiment. Client functional status, service utilization, and all health costs were collected for six months. The results indicated a maintenance in functioning levels, a decrease in acute hospitalizations, and a 20% reduction in health care costs for the demonstration participants as compared to the control group. Project OPEN provided more effective care while simultaneously reducing health expenditures to the chronically ill elderly.


First steps in the selection of supplies.


Doctor-patient rapport: key to avoiding a malpractice suit.


Is it time to slam the door on FMGs?

Is it time to slam the door on FMGs?


For-profit hospitals: opportunity or threat?


Heroic measures: who decides?

Heroic measures: who decides?


The emergency centers' emergency.

The emergency centers' emergency.


New approach to hard floor stripping and a preventive maintenance program.


Make your medical records malpractice proof.


In crowded market, hospital looks to wellness for competitive edge.


Quality assurance--a result oriented approach.


The selection of germicidal detergents.

The selection of germicidal detergents.


The robots are coming to housekeeping.

The robots are coming to housekeeping.


10 questions doctors ask most about malpractice.


Cost-savings: is there a better argument for health promotion?


HMOs: competitor or investment opportunity?


A new physician PAC: Health USA. Interview by James D. Snyder and Chris Bale.


Court upholds NY commitment laws in case brought by patient.


Motivating hospital employees the Cedars-Sinai way.


Dietetic assistants question title: 'assistant to whom?'.


Ohio Department of Health halts SDS expansion.


Beverly Enterprises nursing homes: health care's booming billion-dollar baby.


Recruitment guides can ease the burden of selecting staff.


Metering and instruments.

Metering and instruments.


State regulation as a threat to education for the professions: a case in nursing education.


Volunteer program reaches into the community to overcome limits of inpatient education.


Teaching managers to motivate: when theory isn't enough.


Your records--who has a right to them?

Your records--who has a right to them?


Toward a Copernican revolution in our thinking about life's beginning and life's end. This article attempts to narrow the range of moral disagreement surrounding the issue of abortion by exploring current assumptions and comparing thinking about abortion with our thinking about death.  Focusing the abortion debate on questions such as when life begins or whether the fetus is a person has thrust us into scientific uncertainty and definitional disputes.  It is suggested that the focus of the debate should be shifted to the issue of whether the fetus merits our protection.  Moral judgements regarding personhood represent a complex balancing that involves weighing our interests in protecting an entity against the loss to our liberty implied by such protection.  This approach requires a Copernican revolution in our thinking about abortion, in which 3 major factors--the nature of the entity, the impact of its mistreatment on our broadest human interests, and the specific implications of its protection for our liberty--are considered in a relational whole.  Similarly, the continuum in the dying process requires us to determine which aspect of human death will be recognized as morally significant.  Since determinations with regard to life and death are arbitrary, societies must select their own moral values and take responsibility for collective moral decisions.  It is concluded that the US Supreme Court decision that allows free access to abortion in the 1st trimester, imposes a requirement of medical supervision in the 2nd, and prohibits abortion in most cases in the 3rd trimester represents a reasonable response to the moral issues at stake.


Sports. The Texas Sports Medicine Center fulfills a prescription for recovery, rehabilitation, and robustness.


Safety rules for electrical equipment, gas delivery.


Documenting unit dose delivery systems.

Documenting unit dose delivery systems.


Saint Joseph's Sports Medicine Center.

Saint Joseph's Sports Medicine Center.


Sports medicine.

Sports medicine.


Contemporary educators do more than just teach.


Youth center for sports medicine.

Youth center for sports medicine.


Schepps v. Presbyterian Hospital of Dallas.


Managing the cost of change.

Managing the cost of change.


The construction management approach to hospital expansions.


Planning special events with flair, ease, economy.


How to avoid legal traps when buying a computer.


Reflections on the root causes of fraud, abuse, and waste in federal social programs.


Those changing medical staffs: survey shows some surprising trends. Part 1.


The outlook for tax exempt financing.

The outlook for tax exempt financing.


How one RT department reduced absenteeism.


Nursing home sues workers for staying on the job.


As I see it. "Dues paying time.".

As I see it. "Dues paying time.".


The facility planning team: how does it operate?


Clinical simulations as a tool for continuing medical education.


The heir apparent.

The heir apparent.


The pharmacist's role in monitoring urinary tract infections.


Hospital ship deal 'proper,' Lehman says.


Unit-dose drug systems.

Unit-dose drug systems.


Hospitals buy nursing homes: move from neighbor to owner.


Behind the surge of walk-in medical clinics.


For doctors, too, it's a surplus.

For doctors, too, it's a surplus.


Alternatives to 'Baby Doe' offered.

Alternatives to 'Baby Doe' offered.


The care of the poor. Efficiency in health care.


Selecting the right construction firm.

Selecting the right construction firm.


Oncology outreach program: a community and hospital effort.


Language banks.

Language banks.


TV rental program worth the risk.

TV rental program worth the risk.


Ethics and medicine.

Ethics and medicine.


Discharge status of inpatients discharged from short-stay hospitals: United States, 1965-81.


The organizational context of human factors engineering. Human factors engineering concerns the design of equipment in accordance with the mental and physical characteristics of operators. Human factors engineers advise design engineers, but the organizational context limits their influence and restricts their perspective. The discussion of organizational context in this paper explains why military and industrial top management personnel are indifferent to good human factors design and shows how the social structure favors the choice of technologies that centralize authority and deskill operators and how it encourages unwarranted attributions of operator error. The role of equipment and system design in shaping cognitive maps and mental models is explored, and the technology-social structure paradigm is questioned.


In vitro fertilization and embryo transplants in man: ethical guidelines.


Uses of mortality rates and mortality indexes in planning alcohol programs.


Legal aspects of artificial conception (artificial insemination and in vitro fertilization) in Australia.


California earthquake jars hospital.

California earthquake jars hospital.


Effects of shift work on health studied.


Competition breeds tensions among Albuquerque MDs.


New fraud crackdown saving Blues millions, officials say.


Health center on wheels. Medically underserved focus of project.


Will hospitals close? Industry experts at odds.


Should hospitals form HMOs?

Should hospitals form HMOs?


'Baby Doe' rule's successes told.

'Baby Doe' rule's successes told.


Nation's top federal physician represents traditional values. Interview by Lisa Krieger.


D.C. mental hospital in trouble.

D.C. mental hospital in trouble.


Health insurance tax plan backed.

Health insurance tax plan backed.


Medical society programs aid the needy.

Medical society programs aid the needy.


Congress eyeing ways to ease path for faster growth of PPOs.


Physician notes effects of music on patients' health.


In New York hospitals cited for failure to report impaired MDs.


PPOs: interest high, action low so far.

PPOs: interest high, action low so far.


Business aims to trim health costs.

Business aims to trim health costs.


Arizona firms seek hospital regulation.

Arizona firms seek hospital regulation.


Allied health workers seek staff privileges.


In Michigan unique agency aims to trim beds.


Health bills pending at adjournment.

Health bills pending at adjournment.


Cuts could imperil alcoholism treatment gains.


Finding the definition of low temperature washing.


NJ internists ask: What's become of 'benign neglect'?


A look at for-profit hospital chains.

A look at for-profit hospital chains.


Rain, sleet, hail cannot stop electronic mail.


Environmental scanning detects signals of change.


Let's clear the air about public service announcements.


Private hospitals in US may go broke.

Private hospitals in US may go broke.


The most painful question.

The most painful question.


Revised federal allotments to states for social services expenditure pursuant to Title XX--Social Services Block Grant Act; promulgation for fiscal year 1985--HHS. The FY 1985 Federal allotments of $2.6 billion to States for social services under Section 2003 of the Social Security Act (Act) which were published in the Federal Register on October 27, 1983 (48 FR 49697) were based upon the authorization set forth in Section 2003 of the Act at the time they were prepared. Pub. L. 98-135, enacted October 24, 1983, amended Section 2003 of the Act by increasing the authorization to $2.7 billion for Fiscal Year 1984 and each succeeding fiscal year. Accordingly, the initial promulgation is rescinded and the promulgation as revised is set forth in the table below. These allotments are contingent upon Congressional appropriations actions for the year. If the Congress enacts, and the President approves, an amount different from the authorization, the allotments will be adjusted proportionately.


Availability of funds for home health services and training--HRSA. The Health Resources and Services Administration (HRSA) announces that funds are available for grants and loans for the development and expansion of home health programs and services. Public Law (Pub. L.) 98-139, the Labor, Health and Human Services, and Education Appropriations Act of 1984, signed on October 31, 1983, appropriates $5 million under section 339 of the Public Health Service (PHS) Act (42 U.S.C. 255) to provide home health services and for the training of paraprofessionals to provide home health services. This notice contains information of interest to prospective applicants for such funding.


Privacy Act of 1974; report of new system--HCFA. In accordance with the requirements of the Privacy Act of 1974, we are proposing to establish a new system of records, Evaluation of the Medicare Competition Demonstrations, HHS/HCFA/ORD No. 09-70-0029. We have provided background information about the proposed system in the "Supplementary Information" section below. HCFA invites public comments by January 23, 1984, with respect to routine uses of the system. Dates: HCFA filed a new system report with the Speaker of the House, the President of the Senate, and the Director, Office of Management and Budget (OMB) on December 16, 1983. The new system of records, including routine uses, will become effective 60 days from December 16, 1983, unless HCFA receives comments which would convince us to make a contrary determination.


Coalitions: employers' groups nationwide use different tactics to persuade providers to contain health care costs.


Grant application cycles; health systems agency grants and state health planning and development agency grants--HRSA. This Notice is issued in accordance with Executive Order 12372, Intergovernmental Review of Federal Programs as implemented by HHS in 45 CFR Part 100. The scheduled application due dates and funding dates for health systems agencies (HSAs) and State Health Planning and Development Agencies (SHPDAs) are provided below to assist States and other entities within a State in determining the comment period as required under 45 CFR Part 100.


Prepaid plan enrollment now tops 12.5 million.


Will the advent of PPOs hurt or help HMOs?


Government nurtured growth of HMOs.

Government nurtured growth of HMOs.


Deflating health care costs. Competition, legislation will spur a better medical services system.


Firms basing health deductibles on pay.

Firms basing health deductibles on pay.


Ottawa's "on the fence" stance will keep abortion decisions within your community.


Softening the blow: how to deliver bad news.


Quality of life after treatment for laryngeal cancer: the patient's viewpoint.


The future of the imaging technologist.

The future of the imaging technologist.


How to pick winners--visualizing future performance.


Digital imaging--the technology of the future.


Managing stress and burnout in clinical gerontology. Stress and burnout is a prevalent feature of the helping profession. The toll that these phenomena take on the individual can be devastating. This article explains the stress reaction from an appraisal model and discusses how the clinic can initiate a stress reduction strategy. A three point intervention plan is recommended. Strategies for changing the occupational environment, individual characteristics, and coping mechanisms constitute three points in a comprehensive plan.


Difficulties in senior center life: group behaviors. In the past, the literature regarding senior centers has generally directed itself towards environmental or ecological issues. This article, however, looks at problem behaviors which reportedly occur in senior centers. A review of some possible causes and examples of these behaviors, is presented, along with some suggestions for change. The authors feel that individual problem behaviors can best by changed by setting group goals in which all program participants may be acknowledged and rewarded.


The epidemiology of selected chronic childhood health conditions. The chronic illnesses of childhood as a whole show similar trends in rates of incidence and prevalence; within this general class, subgroups of the illnesses have distinct epidemiological characteristics and different histories of response to improvements in medical technology. This article selects 11 disorders as representative of the large class of childhood chronic illnesses. It reviews trends in the contribution of these illnesses to the overall morbidity and mortality rates among children. The current survival patterns for children with these illnesses are detailed in light of the probable demands generated for health care providers by similar patterns of survival. It is likely that these children will place heavy demands on the health care system for the foreseeable future. Epidemiological trends and improvements in survival patterns associated with these illnesses raise perplexing questions of resource allocation. New knowledge is needed to address emerging problems.


The REACH Project: an innovative health delivery model for medically dependent children. Rural Efforts to Assist Children at Home (REACH) is a service/demonstration and training project designed to provide specialized health care and case management services to medically dependent children in a 16-county area in central FLorida. REACH nurses, acting as Health Care Coordinators, provide instruction, consultation, coordination, and supervision of health care services in collaboration with tertiary care physicians and services at the University of Florida Health Center. Patients include infants, children, and adolescents with a wide variety of chronic illnesses including leukemia, muscular dystrophy, pulmonary disorders, failure to thrive, and seizure disorders. In addition to extensive work with families in the home, the REACH program incorporates a feedback system for its nurses, a progress-oriented record system, carefully designed agreements between tertiary care centers and community agencies, and an innovative training program for its nurses. REACH intends to serve about 1000 children during its 3-year demonstration phase. Success will be based on careful monitoring of costs, family functioning, and school attendance. If successful, the project will provide a model for the structured utilization of health and social services for families with medically dependent children.


Community networking for improved services to children with chronic illnesses and their families. The authors describe a program, developed under the auspices of the Association for the Care of Children's Health (ACCH), that focuses on community networking among children with chronic illnesses and their families. The program rests on two beliefs: (a) that a network can successfully focus on the generic needs of children with chronic or handicapping conditions and of their families; and (b) that a network can improve care by enhancing coordinating collaboration among existing services without creating new ones. Efforts of the past two years have centered on three specific areas: preparation and dissemination of written materials; creation of new links among families, health and education professionals, organizations, associations, and community institutions; and training in networking techniques. ACCH has prepared two pamphlets for families, schools, and health professionals on community issues and on hospitalization. In addition, a demonstration model for community networking has been established in the Houston/Galveston area. Finally, training programs in the skills of community networking have been established. Work is beginning to replicate the community networking model through other ACCH regional affiliates.


There's no place like home.

There's no place like home. Many children with chronic illness or handicapping conditions may not need continual or frequent institutional care, provided that suitable home care services are available. Yet, planning and experimentation with the concept of pediatric home care is just beginning on both the national and local levels and the concept of home care has yet to become widely understood and accepted. As a result, health planners and policy markers often fail to realize the potential advantage of home care to children, to families, and to society. Instead of seeing it as the most humane and effective way of caring for the chronically ill child, they see it as an increased financial burden. They also lack the perspective needed to realize that home care is ultimately the most cost-effective health care alternative, since it involves investing in people rather than in buildings or equipment. This report attempts to disseminate more widely the concept of home care by recounting a 2-year experience with a hospital-based pediatric home care service.


A home care program for children with chronic illness. Pediatric Home Care (PHC) of Albert Einstein College of Medicine was designed as a special ambulatory care unit for children who are seriously or chronically ill and whose needs were not being met successfully through conventional programming. Services include: monitoring the patient's care: delivering direct services in the home, clinic, and hospital; teaching therapeutic programs to the family and patient; coordinating services; patient advocacy; health education; and supportive counseling. Each patient has a core team consisting of a generalist pediatrician, a PNP, and the patient's family. Visits are provided in the patient's home as needed, as well as in the traditional locations of the clinic, the inpatient units, and the PHC office. The program accepts patients with serious medical problems and who face any of a series of other difficulties, including: especially complex management problems that cannot be handled well in the customary outpatient settings; unstable family settings; or extended hospitalizations. Because it is not restricted to any single type of disease, the PHC provides a model that is applicable in a wide range of medical and community settings. Results of a program evaluation show that PHC is an effective intervention that has positive mental health outcomes and improves satisfaction with care.


California issues home health survey results.


Needs assessment survey: education and training.


Antitrust concerns in home care.

Antitrust concerns in home care.


Payson Home Health Agency--caring in the Old West style.


Creating persuasive fund raising documents for nonprofit organizations.


Clinicare Family Health Services, Inc.

Clinicare Family Health Services, Inc.


Creating alternative care in a competitive market.


Designing an armed robbery policy for the hospital.


Involvement of the blood bank technologist in the investigation and management of transfusion reactions.


Public relations and the medical laboratory.


Focus: a model for international technology transfer.


Changes in the doctrine of employment-at-will and preventive action and policies.


Hospital cost-cutting pressures fuel 21% annual growth in contract services market.


The risk of anesthesia.

The risk of anesthesia.


Coping with constraints: planning for the future. Part 3.


Designing facilities: trends for the future.


Is there a holding company in your hospital's future?


New legislation for charities proposed--CHA reacts.


Picking the right legal counsel.

Picking the right legal counsel.


Productivity improvement: health care challenge of the 1980's.


Eliminating delays in radiology reporting.


Computer fraud--are we really vulnerable?


Employee timekeeping: is there a better way?


On-line system streamlines patient accounts management system.


Hospital audits vital in changing health care field.


BC/BS plans to expand hospice programs; documents savings.


Pioneers provide preliminary PPO program profiles.


Dental preferred provider groups are beginning.


Cost savings explored with preferred providers.


Taxation of fringe benefits.

Taxation of fringe benefits.


Selecting the right medical claim administrator--a method to rate the performance and capabilities of insurance companies.


Jewish Hospital Skycare: taking flight with a new service.


Synthesized radio communications: looking back, looking forward.


Extending the "good life".

Extending the "good life".


Hepatitis B.

Hepatitis B.


How to be an effective buyer--the executive housekeeper's role.


Acquired immune deficiency syndrome (AIDS): precautions for clinical and laboratory staffs. Centers for Disease Control.


Close-up: saving with dispensers.

Close-up: saving with dispensers.


Quality assessment from an economic perspective. A taxonomy of approaches with applications to nursing home care. Since people do not rank goods identically, there is no theoretically correct way for public agencies to assess the quality of goods or services. Yet, from a social perspective, it is often important to evaluate quality. The traditional categorization of quality assessment approaches in health care is by structure, process and outcome variables. A somewhat different taxonomy is presented here: (a) market variables; (b) questionnaire results; (c) output measures; and (d) input measures. The market approach is rare in the health care field, but it is the approach most consonant with the economic way of thinking. All four approaches are examined from an economic perspective. Studies of nursing home care are classified by this new taxonomy. While all approaches to quality assessment have limitations, and are not necessarily consistent within or among themselves, they can provide useful insights concerning levels of quality.


The quality of maintenance therapy for end-stage renal disease. A review of social adjustment and rehabilitation. Prior to 1972, ESRD patients selected for maintenance dialysis or renal transplantation were generally young, emotionally and socially well-adjusted, and physically healthy except for their renal disease. Following the enactment of Public Law 92-603 (1972), which extended Medicare coverage to virtually all ESRD patients, the criteria for the selection of patients were substantially liberalized. During the past decade, maintenance therapy has increasingly been provided for severely debilitated ESRD patients whose reported levels of rehabilitation have been less than desired. While the majority of the current ESRD patient population have not been restored to their premorbid levels of individual and social functioning, recent studies suggest this may be the result of initiating rehabilitation efforts too late in the disease process. For optimal social functioning to be achieved by ESRD patients, it is concluded that psychosocial intervention and support must be initiated at the time ESRD is diagnosed and be focused on the maintenance, rather than rehabilitation, of the patient's functioning.


Conducting state and local health needs assessments. Designs and strategies. A comprehensive set of five needs assessment techniques designed to facilitate informed decisions about mental health services planning at the state or local level are presented. These include: (1) estimating the size of the target population based on statistical extrapolations from prevalence rates or inferences from indirect indicators; (2) surveys of institution-based populations; (3) surveys of service providers; (4) client-targeted surveys; and (5) surveys of key informants. Each technique is discussed in terms of its unique design considerations, strengths and weaknesses, the phase's association with its application, and estimated resource requirements. Mental health needs assessments can be conducted in a cost-effective manner, especially important in an era when rational decisions about the allocation of scarce resources are essential.


Ensuring quality of care in a comprehensive mental health center. A six-phase process is currently being utilized by a large comprehensive mental health center to ensure delivery of the highest quality of care to its patients. In the first phase, during the admission process, each patient's assets and liabilities are determined. The second phase involves a disposition team that reviews and assigns each case. The third phase involves both the clinician and patient in developing a treatment plan. The fourth phase is a periodic review of each patient's file by the clinician's supervisor. The fifth phase involves a peer review of randomly selected files. The final phase is a retrospective review of randomly selected patients who are no longer receiving services, comparing the current assets and liabilities with those on the initial assessment to determine if progress did occur and was sustained.


Medical care in developing countries. Assessment and assurance of quality. In recent years attention in developing countries has concentrated upon strategies to improve the equitable provision of essential health care--the primary health care approach. Very little work has been reported in connection with the quality of medical care, and yet for the successful outcome of care it is necessary that adequate health care processes be carried out. Conceptual, methodological, data, and organizational issues related to quality assessment and assurance are presented. The few examples of reported work concerned with these important aspects of medical care in developing countries are reviewed. Suggestions are made as to how measures to ensure reasonable quality might be further developed and refined.


Roles ascribed to volunteers. An examination of different types of hospice organizations. Volunteers have been the hallmark of the hospice movement since its U.S. inception in 1973. As part of the National Hospice Study, volunteer hours and activities were reported monthly in forth participating hospices nationwide. Most volunteers were white females with at least a high school education. The attitude of paid staff toward volunteers was overwhelmingly positive. Overall, the level of volunteer involvement is approximately 1.5 hours per patient each day he or she spends in the hospice program. This breaks down to nearly .80 hours of direct patient care and .70 hours devoted to other activities. While the most prevalent use of volunteers is in the provision of direct patient care in freestanding hospices, volunteers also spend a large proportion of their time in the performance of administrative activities.


Monitoring simultaneously two or more indices of health care. Multivariate quality control procedures. Often the data collected in a health care evaluation program consist of a number of indices, each of which represents a different component of a health care process. The question, "Is the health care process in control," to be answered effectively, must be answered in terms of the effect of the several indices considered jointly rather than in terms of each variable considered separately. This article describes the nature of the problem of monitoring jointly several indices of health care and presents two quality control methods, the control ellipse and Hotelling's T2, which are applicable to the multivariable setting. The discussion focuses on the case of monitoring simultaneously two related indices of health care, and extension of the two techniques to more than two indices is discussed briefly.


Fire protection and computers: now and in the future.


The effect of nonlinear transformations on a Likert scale. The analysis of data collected from behavioral assessment instruments is typically conducted using parametric statistics, with little or no reference given to the underlying nature of the scale being used. If the nature of the distances between the scale points is not understood, the concept of normality of the distribution becomes clouded. An empirical approach to studying this problem was developed, using responses to a clinical performance evaluation instrument that uses a four-point behaviorally-anchored scale. Various combinations of nonlinear transformations were applied to the evaluation responses. The factorial structure of the fifteen items constituting the evaluation form was minimally affected by the transformations, suggesting that parametric statistics can be applied to behaviorally-anchored rating scales.


Protection from hazards.

Protection from hazards.


Industrial techniques & foodservice.

Industrial techniques & foodservice.


The older employee: risks, rights & responsibilities.


Refusal of care and treatment.

Refusal of care and treatment.


The older employee & the law.

The older employee & the law.


Urban hospital's rehab efforts lead health trend. Interview by John McIlquham.


Guidelines for the paramedic coordinator.


Medical foundation finds membership club successful.


Roundtable consultant panel confronts development issues. Interview by Raymond Roel.


New health care strategy outgrowth of marketing focus.


Strategic income unit indicators identify most profitable paths.


The changing face of volunteer EMS.

The changing face of volunteer EMS.


Development and marketing share similar characteristics.


FLEX Task Force II update.

FLEX Task Force II update.


HHS sets controversial rates for hospice services.


SLOF: a behavioral rating scale for assessing the mentally ill. Rating scales for assessing the mentally ill usually focus on the role functioning of clients and their psychiatric symptomatology. This article introduces a rating scale to measure more directly observable behavioral functioning and daily living skills of clients in mental hospitals and in the community. Results are presented from a series of studies designed to test the instrument's psychometric properties.


Nonprofit hospitals face capital crisis.


Continuing problems with examination security: FLEX June 1983.


Survey findings: strategic planning main concern.


Case in point. The Bobbs Hospital.

Case in point. The Bobbs Hospital.


Tax reform bill of 1983 will alter charitable giving.


Case in point--the answer. The Bobbs Hospital.


What demographic changes do you feel a hospital should monitor as part of its planning effort? In house.


Environmental continuity: a social-geographic approach to structural change in lowering health care cost through elderly participation. Tremendous growth in the number of elderly has resulted in the need to consider options for decreasing their need for dependent living, while increasing their level of health. Environmental continuity is supported as one such alternative. An examination of how the elderly relate to their surroundings and their relationships with others enables the identification of social and cultural thresholds beyond which the elderly cannot be expected to predict, participate in, or control events in their environment. "Threshold management" is suggested as a preventive health measure for reducing social disintegration in the elderly and concomitant strains to the health care system and society.


Society for Hospital Planning. AHA Fifth Annual Meeting. Part II.


External environmental analysis: theory and practice. The tendency of the hospital industry to plan by default--reacting to environmental change--is gradually evolving toward formal processes for monitoring change. External environmental analysis, a crucial component of strategic planning, is evaluated from a theoretical point of view. The need for developing and implementing systematic processes, their essential elements, and potential benefits are explored. The concept in practice is examined at the design and implementation stages using Sinai Hospital in Detroit, Michigan as an example.


Strategic planning. Local anaesthetics?

Strategic planning. Local anaesthetics?


A hospital planning response to the "geriatric imperative". The emerging geriatric patient population, a situation for which few hospitals are adequately prepared, is examined within the context of the "geriatric imperative." Reductions in morbidity and increases in the elderly population and the chronic diseases and disabilities associated with aging are causing hospitals to reexamine their orientation to short-term episodic care to adapt to the needs of a more elderly patient population. A geriatric care planning framework is presented to assist hospitals with this process.


Alcohol abuse. Last orders at work.

Alcohol abuse. Last orders at work.


Models for building.

Models for building.


Any questions for the computer?

Any questions for the computer?


Furniture that eases the strain.

Furniture that eases the strain.


Getting along: department heads talk to admitters.


Hands of NHS property.

Hands of NHS property.


An interview with: Jane Hendricks, Esq.

An interview with: Jane Hendricks, Esq.


Managing AIDS and AIDS hysteria in hospitals.


A certain electricity in the air.

A certain electricity in the air.


Systems contracts: one approach to material management problems resolution.


When a PPO goes bankrupt, who pays the patient's bill?


Pneumococcal vaccine is not being used, study shows.


Society for Hospital Planning. AHA Fifth Annual Meeting. Part I.


Should we shrink the health care system? As this director of a large eastern medical center has traveled about the country, talked many times on the subject of health cost management, and examined various cost-containment plans, he has come to realize that most, if not all, of those isolated programs stand little chance of more than marginal success. True cost management can come only from a hospital system shrinkage that involves loss of jobs and closings. There is no simple way out of that box, he argues, and people should begin to realize it. Whether there is the national resolve to put the lid on accelerating health costs is questionable, but at least a clear understanding of that fact and its consequences may lead to a few successful hardheaded programs and provide preventive medicine for the numerous trivial programs that no doubt will continue to spring up.


Selecting a small business computer.

Selecting a small business computer. In this age of information, growing businesses have the opportunity at a very early stage to computerize their operations. Today's entrepreneurs must choose what computer services to buy amid a bewildering variety of products and programs, each proclaimed, brassily, as the best, the latest, or the next generation. In this article, the author advises entrepreneurs and managers to make sure that the computer can handle everyday demands. He counsels that good software, service, and support are more important than the latest hardware.


R&D: how many times do we get so involved in "the details" that we forget what it was we were really intending to accomplish?


Some key aspects of utilizing marketing consultants for group practices.


The PPO: how to market it and to whom.

The PPO: how to market it and to whom.


Differences in marketing a new practice versus marketing an established practice.


Preparing the financial/business plan for marketing the group practice.


Health care manager's notebook. Lessons in customer service.


Building a new or better image for your practice through solid media relations (public relations and publicity).


Carner's codes. Setting the pace.

Carner's codes. Setting the pace.


Career mobility in health field requires occupational restructuring.


Guest relations as corporate strategy. "People-to-People" is hospital-wide system.


Patent roofing systems.

Patent roofing systems.


How to promote and advertise a new or existing clinic.


Bournemouth DGH.

Bournemouth DGH.


Basic marketing research for the group practice or, what on earth is targeting and why should I care?


Quality-of-work-life efforts help hospitals manage change.


Professional recognition advances managers, hospitals.


Common courtesy: the ultimate barrier to entry.


Resolving employee grievances in nonunion environment attainable.


Professional advertising--how professional is it?


A legal viewpoint on marketing for group practices.


The best malpractice insurance of them all: consumer satisfaction.


Physician recruiting for group practices.


Court of Appeals reviews decision denying government access to records in case of Baby Jane Doe; AHA files brief in support of hospital.


Examining corporate expenditures for health care.


Second Circuit sets new inquiry standards for certifying collective bargaining representatives.


1983 tax wrap-up.

1983 tax wrap-up.


U.S. District Court finds for West Virginia hospitals in challenge to new West Virginia rate-setting statute.


Federal court limits federal antitrust jurisdiction over medical staff decisions.


Changing times.

Changing times.


Influencing health behavior: how significant is the general practitioner?


On the road to NHI?

On the road to NHI?


Health education and the short, sharp shock.


Public response to cancer education in the press.


Health education in the general practice consultation: doctors' advice on diet, alcohol and smoking.


Planning for hospital diversification.

Planning for hospital diversification.


The impact of technology on health care.


Monitoring and evaluating new programs.

Monitoring and evaluating new programs.


A case study in technology management in the health care industry.


The impact of technology on medicine.

The impact of technology on medicine.


The impact of financing on technology.

The impact of financing on technology.


The impact of technology on hospital marketing.


Markets, planning and data.

Markets, planning and data.


The responsibilities of trustees.

The responsibilities of trustees.


Preparing and presenting information to hospital trustees.


How we finance care.

How we finance care.


Understanding information systems.

Understanding information systems.


New revenue sources and new methods of capital formation.


Improving the bottom line.

Improving the bottom line.


Maternal care receptivity--an innovative approach for the evaluation of MCH services. Despite rapid expansion in the maternal and child health and family planning services, there have been few attempts made to study the extent of utilisation of these services and their impact. The present study reports a simple method evolved in the quantification of utilisation of maternal care services (called maternal care receptivity - MCR), the relationship of factors such as age, parity, caste of the women and the distance of the health centre on the MCR and the impact of MCR on perinatal and neonatal mortalities. An inverse relationship was observed between MCR and perinatal and neonatal mortality rates and the two rates were three times less among babies born to mothers with high MCR scores compared to those with poor MCR scores. Despite rapid expansion in the maternal and child heatlh and family planning services, there have been few attempts made to study the extent of utilization of these services and their impact at a rural Health Center.  The present study reports a simple method evolved in the quantification of utilization of maternal care services (called maternal care receptivity-MCR), the relationship of factors such as age, parity, caste of the women, religion, and the distance of the health center on the MCR and the impact of MCR on perinatal and neonatal mortality rates.  An inverse relationship was observed between MCR and perinatal and neonatal mortality rates and the 2 rates were 3 times less among babies born to mothers with high MCR scores compared to those with poor MCR scores.  MCR scores are based on:  1) time of commencement of antepartum care; 2) number of antenatal clinic visits; 3) tetanus toxoid immunization; and 4) place of and person attending delivery.  An appendix describes the scoring procedure.  (author's modified)


How we deliver care.

How we deliver care.


The health executive and the new medical technologies.


The Dubin report: issues for hospital management.


Our health care problems: one editor's perspective.


Computerizing a community general hospital: a case history.


A process for establishing health care priorities.


The house organ: a valuable resource.

The house organ: a valuable resource.


Reach for the moon.

Reach for the moon.


Stop thief.

Stop thief.


The ABCs of buying.

The ABCs of buying.


An alternative to keystoning.

An alternative to keystoning.


Light fingers = heavy losses.

Light fingers = heavy losses.


A labor of love in the wild, wild west. The Benson Hospital Gift Bar.


Gift shop design.

Gift shop design.


I'll try anything!... If it doesn't work, I'll try something else!


New shop talk.

New shop talk.


On the present state of medical malpractice.


A survey of hospital medical staffs--Part 2. As shown by the survey, from 1973 to 1982: . The percentage of hospitals requiring certification of some or all specialties has nearly quadrupled. . During the same period, the percentage of hospitals compensating the chief of the medical staff and the director of medical education approximately doubled. . In 1981, the primary care physicians at more than 50 percent of the responding hospitals sent over half of their admissions elsewhere. . Approximately 22 percent of hospital admissions were generated by the top five admitters in 1981.


How medical staffs fare in acquisitions.


Corporate reorganization--a case study.

Corporate reorganization--a case study.


A proposal to industrial employers and healthcare providers: unite and prosper.


P & T Committee roundtable discussion: Great Lakes region, Part I.


Matrix organization: design and development for a hospital organization.


Mentoring among hospital administrators.


Final in-line filtration: removal of contaminants from IV fluids and drugs. The administration of intravenous fluids or drugs may allow particulate and microbiologic contamination to enter the bloodstream. Studies have implicated injected particles as a cause of postinfusion phlebitis. The process of manufacturing the infusion product will influence the type and quantify of injected particles. Particles greater than 8 microns are filtered by the lung, and depending on their reactivity, can cause pulmonary granulomas. Particles below 8 microns are initially filtered, cleared by phagocytosis, and ultimately migrate to the liver and spleen. Both nonvisible particles and microbial contaminants of fluids and drugs can be effectively removed by 0.45- or 0.22-micron in-line final filtration. When filters are employed, problems can occur, including air locking, clogging, and drug-binding. A knowledge of why and to what extent these problems can occur will allow in-line filters to be used effectively by health care practitioners.


Twenty-four hour pharmacy service in hospitals with less than 300 beds--Part 6.


Intravenous theophylline?

Intravenous theophylline? Aminophylline (theophylline ethylenediamine) has been widely used orally, intravenously, and rectally as a bronchodilator of choice in patients with asthma or chronic obstructive pulmonary disease. Its popularity for chronic oral administration has declined in recent years due to the development of a multitude of conventional and sustained release anhydrous theophylline preparations. The availability of a premixed intravenous theophylline product may further reduce aminophylline usage. This article reviews the potential usefulness of premixed intravenous theophylline.


Space requirements for pharmaceutical functions in selected nonuniversity hospitals. The size of the average pharmacy is normally developed by gathering information from a large number of hospital pharmacies. The services provided by these pharmacies vary significantly. This tabulation is from selected hospitals that provided comprehensive pharmacy services. Fifty-four responses were tabulated. The results presented in this article indicate that these pharmacies require additional staff members and greater space allocation than the average hospital pharmacy department reported in other studies. Hospitals between 100-199 beds averaged 9.8 sq ft per bed, 200-299 bed hospitals averaged 10.1, 300-399 bed hospitals averaged 9, 400-499 bed hospitals averaged 8, and those over 500 beds averaged 9.4 sq ft per bed.


A standard aminophylline intravenous solution with flow rate label adapted to a manufacturer's standard solution. The development of a standard aminophylline intravenous solution system utilizing a flow rate label is described. The original system was developed using 500 mg aminophylline in 250 ml of 5% dextrose injection in a polyvinyl chloride bag (PVC). An ancillary label was developed to be affixed to the bag to assist in maintaining flow rates. Later, this system was adapted to a premixed solution prepared by Travenol Laboratories. The difference, though, was the fact that a solution of 400 mg theophylline (equivalent to 500 mg of aminophylline) in 250 ml of 5% dextrose solution (PVC) was used. Hence, a new auxiliary label indicating flow rates between aminophylline and theophylline was developed. The success of both systems gave us more advantages than disadvantages. This was especially true with the premixed system. We feel that the auxiliary flow rate label helped maintain rates whether the physicians orders were written in theophylline or aminophylline. With proper nursing inservice, this standard aminophylline program could be successful using this auxiliary flow rate label.


Basics of videodisc and optical disk technology. This article outlines basic videodisc and optical disk technology. Both optical and capacitance videodisc technology are described. Optical disk technology as a mass digital image and data storage device is defined and briefly compared with other established information storage media including magnetic tape and microforms. The article includes a look into the future of videodisc and optical disk.


Information providers and videodisc/optical disk technology. Although industrial and consumer videodisc technology has been available since 1978, information providers are now just beginning to explore the possibilities of using videodisc and optical disk technology as publishing media. Firms involved in the design, development, and delivery of information products and services are looking at these technologies as new business opportunities and distribution channels. The areas in which information providers are using videodisc and optical disk technology are covered briefly.


Employee assistance programs in Australia and the United States: comparisons of origin, structure, and the role of behavioral science research.


Information management in the insurance industry.


A decade of service. MAST--Military Assistance to Safety and Traffic.


FLATIRON. A MAST service for rural Alabama.


New laundry at Baptist Hospital projected to reduce labor costs.


County awards incentives to laundry staff at hospital for contributing to cost saving.


CAR speeds Medicare forms processing at Nationwide Mutual Insurance.


NJ hospital to market laundry services to local hospitals in move to cut costs.


Hospital officials seek state approval for nation's first LM training program.


Reusable vs. disposable OR pack wrappers now under study at major Memphis hospital.


The service sector revolution: the automation of services. This paper describes the service sector revolution in the United States and covers the automation of 10 U.S. service industries. It discusses the implications of the simultaneous automation of goods and services and suggests action required to smooth the transition for the worker as the United States becomes an automated society.


We opened a walk-in clinic--and nobody walked in.


Instrument for measuring the temporal characteristics of therapeutic ultrasound fields. An instrument is described that measures the ultrasonic frequency; pulse repetition rate; pulse duration; timer accuracy; peak-to-rms pressure amplitude ratio; and, peak-to-average intensity ratio for ultrasonic therapy devices designed for use in physical medicine. These temporal beam characteristics are included in a Food and Drug Administration performance standard for ultrasonic therapy products. They can be measured conveniently and efficiently when the instrument is used with an ultrasound transducer (hydrophone) to detect the radiated ultrasound beam. Instrument design is straightforward, employing standard analog and digital circuit components and modules. Frequency and time measurement errors are typically 1% or better. Pressure and intensity ratio errors are less than 2% and 4%, respectively.


Computer applications for patient care--an overview. The importance of the computer in areas of patient care is widely recognized today. This review outlines the information processing tasks which involve the interaction between the patient and the provider of health care services. These areas include the clinical laboratory, automated multiphasic health testing, medical records, patient monitoring, diagnostic support systems, and medical imaging. Health care professionals, including clinical engineers, must recognize the potential, understand basic principles, and utilize computers effectively during the next decade's rapid advances.


How to get your staff and patients on the same team.


Hospital politics won't let me stop a dangerous doctor.


Developing an ethylene oxide quality assurance program. Regulations concerning the acceptable levels of Ethylene Oxide (EtO) in the hospital work environment have been tightened. The need has increased for both monitoring equipment and for programs to evaluate the results obtained. Development of a program at a community hospital is discussed, with a consideration of equipment cost-effectiveness, availability, and ease of use. The program developed includes both installation of equipment to reduce the levels of EtO in the work area, and purchase of equipment to monitor the EtO levels in the air, and to monitor EtO levels in the "breathing zone" for individual employees. This program also includes the establishment and review of policies concerning the purposes and procedures for EtO use in the hospital. An inservice education program is described, which includes documentation of employee attendance and comprehension, with follow-up to assure compliance with procedures. Monitoring the personnel for exposure to EtO can support the value of instituting such policies.


Capital caps a return to basics.

Capital caps a return to basics.


Showcasing your statistics. Report the essentials, not the excess.


MDPH reforms: is 'appropriate' care lost in the cracks?


The pocket medical record--do we need a centralized medical data base? A microprocessor-generated portable medical record has been developed as an alternative to a centralized digital medical data base. The medical information in this data base is processed and selected by physicians or nurses, with direct entry to the computer. Speed and accuracy of input are aided by this software program. Implementation of the program in several medical institutions has shown that the portable medical data base is useful in transfer of medical information among such institutions, and that the data base is adaptable to a variety of practice settings.


Seniors call for needed reform.

Seniors call for needed reform.


Capital reform.

Capital reform.


Credit ratings a cap casualty.

Credit ratings a cap casualty.


Business outlook. M.D.s deny, finally accept change.


Suppliers retool their sales pitches to show how products can cut costs.


Business outlook. 21% call marketing top priority.


Capital cap proposal: why hospitals are against it.


Business outlook. Where will interest rates, stock prices go? Crystal ball is murky.


Equipment planning. Faster scanner lets hospitals boost volume of heart studies.


Equipment planning. Community hospitals cautioned to put off buying 'Model-T' NMR.


Equipment planning. Imaging technology puts focus on cost savings, not new tech.


Equipment planning. 2 technologies wed to produce non-invasive option to cath lab.


Equipment planning. Hospital preps for outpatient laser.


Stock proceeds will spur expansion of surgicenter, emergicenter chains.


Chiropractors' antitrust lawsuit hangs on whether competition was quashed.


Profit: whether it's desirable or dirty word depends on corporate roots.


Chain's parent company fights competitor's stock tender offer.


Emergicenter contract managers adopt low profiles to calm hospitals.


AMI sees 1,100 potential buyouts; sellers seeking out hospital chain.


HMOs predict rapid enrollee growth as consumers' cost concerns mount.


Hospitals experiment with discounts, capitation rates under HMO contracts.


HMO will engineer enrollment gains with clinic in renovated train building.


Healthcare community recoils from 'free market' for transplant organs.


Implications of corporate culture: a manager's guide to action. Drawing on cultural anthropology, Sathe develops a way of thinking about corporate culture that makes the concept analytically useful for dealing with managerial problems. He shows that by distinguishing between culture and behavior, and examining both simultaneously, it is possible to see more clearly why culture can be both an asset and a liability, and why it has such a subtle but powerful influence on organizational life. Not all cultures are equally powerful, however; Sathe presents some approaches for diagnosing a culture and understanding its strengths along with some implications for managerial action. Noting that a "perfect" culture-person fit is difficult to engineer, he makes suggestions for avoiding such mismatches and for better managing the culture shocks that inevitably hit the newcomer to an organization. He then turns to the question of how culture/person misfits may be understood and managed and what it takes to successfully deviate from the organization's culture when one is required to do so.


Health incentive plan. Employees share cost.


Fitness program benefits both company and employee.


M.D. vacancies set record in 1983; continued strong demand expected.


Health cover tax cap said unproductive, ill-advised.


Blues plans leaning toward prior approval.


Designing reduced hospital costs.

Designing reduced hospital costs.


Joint ventures--shared successes.

Joint ventures--shared successes.


Policy implications of the cost of iatrogenic diseases.


Strong osteopathic identity yields some legal clout.


Advising Congress mixes politics and health. Interview by Valerie Stone.


Be prepared--legally and medically--for AIDS.


Health technology assessment in Belgium, France, Germany and Japan.


Too many doctors.

Too many doctors.


Decisions to prolong life.

Decisions to prolong life.


Planning for telecommunications service.


Microcomputer basics. Hardware. Part I.

Microcomputer basics. Hardware. Part I. Microcomputers are invading every aspect of life including the practice of pathology. This first in a series of articles is designed to help neophytes make effective use of these new tools. A list of references, intended to provide readers with more information on the subject of microcomputers and their applications to pathology, will be furnished at the conclusion of the series.


Academia enrolls computers.

Academia enrolls computers.


Computing the advantages of detailed datasystems.


Plug into the world with telecommunications.


Considering a microcomputer? Beware the problems and risks. The use of microcomputers, although increasingly common in the clinical laboratory, is not problem- or risk-free. Some of these problems and risks are discussed in this article and suggestions for minimizing them are offered. Forewarned is forearmed. The author hopes that pointing out the risks and deficiencies of microcomputers will promote their intelligent application in the clinical laboratory.


Finding the "right person.".

Finding the "right person.".


Grace Commission issues first reports.

Grace Commission issues first reports.


Helping the elderly live with cancer.

Helping the elderly live with cancer.


Making sure you don't miss AIDS.

Making sure you don't miss AIDS.


Handling health costs by reducing health risks.


Effective delegation.

Effective delegation.


Federal antitrust laws and hospital concerns.


Diagnose your health benefit program.

Diagnose your health benefit program.


Is education the key to lower health care costs?


The statistical procedures for calculating adverse impact. A guide for equal opportunity specialists.


How many Rxs do physicians write per office visit?


Coping with stress in cancer patients.

Coping with stress in cancer patients.


Patient education in general practice: opinions of general practitioners. Fifty-two general practitioners were interviewed regarding their task in patient education and various aspects of it. The view general practitioners have on patient education is complex. Although they consider it a central task, the range of methods they are willing to use is limited. Many general practitioners tend to overlook the fact that they are not the only source of information and explanation for patients. They would prefer to keep control over information given patients, fearing that patients might be confused. It is notable that many general practitioners have no clear standards of what patients need to know. Much depends on the questions the individual patient asks. There are several kinds of information that general practitioners are disinclined to give, particularly relating to uncertainties or information that might alarm the patient. The outlook for improvement must not be overestimated. Some directions are given for supporting the development of patient education.


Here's a quick review of the hospice concept.


How we operate pharmacokinetic dosing in our hospital.


A model for assessing patient education. Patient education is becoming a more visible activity. The Michigan Hospital Association and the Michigan state health planning and resource development agency (Office of Health and Medical Affairs) agreed to jointly pursue a patient-education project to determine its effectiveness. The overall goal of the project is to determine generically what constitutes a quality hospital-based patient-education program. This paper focuses on the development of a model for assessing patient-education programs. Through a multistep process 18 criteria were ultimately selected to serve for patient-education assessment. An analysis and description of the utility of the criteria is presented. The need for establishing and maintaining quality in patient-education programs has been established. The criteria developed for the project offer the potential of meeting this need.


Factors affecting criteria met by hospital-based patient-education programs: a Michigan experience. A patient-education program model with 18 criteria was refined into a survey instrument and sent to 217 Michigan hospitals. Of these, 181 hospitals and one free-standing clinic responded, with 47 indicating they had no applicable programs and 135 providing data on 281 existing patient-education programs. A mean (+/- SD) of 12.1 +/- 3.9 criteria were met. The range included two programs that met only one criterion and 15 that met all 18. After it was established that the criteria operated independently of each other, six factors were analyzed to observe their impact on the number of criteria met by the 281 programs. Analysis of variation (ANOVA) showed that presence and type of program coordinator accounted for 17% of explained variance, subject for 8%, hospital size for 4.4%, existence of a defined budget for 4%, and geographic location for 3%. Because of unequal numbers, the full-time/part-time coordinator factor was not included in the ANOVA. More than one third of the variance affecting numbers of criteria met by patient-education programs was explained by these factors.


Occupational health center.

Occupational health center.


Health care advertising.

Health care advertising.


Commercials for caring.

Commercials for caring.


Testimonial ads.

Testimonial ads.


Character printers for library systems.

Character printers for library systems.


Special event with heart.

Special event with heart.


Signs for an effective and inexpensive face lift.


Annual report communicating specialties.


"Thank-you" can be golden.

"Thank-you" can be golden.


More annual reports.

More annual reports.


Community wellness over-well-ming.

Community wellness over-well-ming.


A painless process for developing corporate identity.


Chicken wings for cowards en'COURAG'ing blood donors.


Community access TV. A new tool for hospital PR.


Birthday calendar remembering and recognizing employees.


Across the board. Keeping them informed in trends and issues.


Personnel publications coordinating communications.


I know doctors are critical to the success of our hospital, but I have trouble getting them to participate in our marketing activities, let alone listen to our presentations. Help!


Gallery accomplishment in black and white.


Community education.

Community education.


What are the criteria used to evaluate a person's competency to manage his or her own affairs?


Ebenezer Society: an interdependent caring community.


Psychosis in the intensive care unit.

Psychosis in the intensive care unit.


Natof, Northwest Surgicare join national chain; trend continues.


SMR forum: Too many hands in the corporate cookie jar. Theft by employees costs American businesses and their customers many billions of dollars each year. Despite concerted efforts to reduce the problem, it appears to continue to grow. Most of these efforts concentrate on limiting the opportunity to steal. However, because the motivations for theft are varied, preventing it often requires more than tighter security. In this paper, the authors explore the extent of the problem, its causes, motivations behind employee theft, and some cost-effective ways of reducing the incidence of theft.


Orbiting emergency room.

Orbiting emergency room.


Team service to the elderly.

Team service to the elderly.


Deterrence in the workplace: perceived certainty, perceived severity, and employee theft. The phenomenon of employee theft is examined empirically, utilizing a deterrence paradigm. Employees selected randomly from three different industry sectors and metropolitan areas were asked to self-report their involvement in a number of property theft activities within the employment setting. Using a weighted least-squares logit regression analysis, the study found that the perception of both the certainty and severity of organizational sanctions were related to employee theft. Males reported more theft than did females, but contrary to previous research, no gender/certainty or gender/severity interactions were observed. The best-fit model did, however, contain two significant first-order interactions: age/certainty and age/severity. These interactions strongly suggest that younger employees are not as deterrable as their older peers, especially under conditions of both high certainty and high severity of punishment. While a number of possible explanations might account for differential deterrability according to age, a commitment to or stakes in conformity explanation is proposed.


Pay equity and American nurses: a legal analysis.


The housekeeping department. A partner in health care delivery.


Nursing and ancillary orientation to the environmental service department.


Management rapport.

Management rapport.


Everyone is on welfare: 'The Role of Redistribution in Social Policy' revisited.


Women and medicalization: a new perspective.


Self-care and empowerment: a case study.


The social work practitioner and antipsychotic medications.


Managing the violent patient in the ER.

Managing the violent patient in the ER.


Medical monopoly vs. alternative health care.


Professional licensure--one diagnosis, two cures.


Overcharges or undercharges.

Overcharges or undercharges.


A strategic analysis of the textile rental industry. 1984 update. Health care.


Self-funded health insurance.

Self-funded health insurance.


"I came here to die:" a look at the function of therapeutic recreation in nursing homes. Generally the elderly are identified as a stigmatized subculture victimized by society's denial or avoidance of their physical problems, social needs and psychological issues. So much more the case for the nursing home resident, who is characterized as helpless, passive and socially insensible. The article questions the efficacy of recreational activities as they exist in the nursing home milieu today. Does therapeutic recreation take into account the physical, social and emotional needs of the nursing home resident? What is the basis for rationale in building therapeutic recreation programs? Where is the didactic emphasis in university programs designed to educate the recreational therapist? It is concluded that recreational activities become therapeutic only when they have evolved from a detailed knowledge of the problems germane to a given population.


Exploring quality circles in the provision of therapeutic recreation services. This article provides a discussion of the advantages of implementing a Quality Circles program into a therapeutic recreation setting. Quality Circles, a Japanese management concept, has received increased support in American industry and human service organizations. It is founded on the principle of employee involvement and concern for the improvement of the organization. Disadvantages of Quality Circles include: (1) lack of management support; (2) time required to implement; (3) failure to hire consultants; and (4) improper composition of Circles. Advantages of Quality Circles are (1) improved communication; (2) management awareness of employee job-related concerns; (3) personal growth and development; (4) enhanced decision making skills; (5) increased individual power; (5) improved motivation; and (6) opportunities for recognition of individual improvement.


Issues in overturning a medical model of social work practice.


Coping and complying: a challenge in health care.


Improvement of the emergency department through teamwork.


Science aids pest control.

Science aids pest control.


Computers in health care. Part II.

Computers in health care. Part II.


Planning: administrators name top three concerns of 1984.


Aortic valve replacement.

Aortic valve replacement.


Plugging into Washington: how to communicate with Congress.


Can today's equity take care of tomorrow's capital needs?


As I see it: Baby Doe.

As I see it: Baby Doe.


More hospitals compensate physicians for administrative role: survey. Part 2. This is the second part of a two-part article reporting the results of the 1982 Medical Staff Organization Survey conducted by the American Hospital Association. Part 1, which appeared in the December 1983 issue of Trustee, discussed the size and specialty composition of the medical staff, its role in hospital governance and administration, and the nature of medical staff committees. This part addresses staff credentialing, compensation arrangements, physician multiple-hospital appointments, and the dependence of hospitals on the top five admitting physicians.


Physicians advised to give peer review 'another try'.


Legionnaires disease seen nosocomial infection culprit.


OSHA staff disagrees. Ethylene oxide 'rift'.


The non-profit multi-hospital computer utility model.


Managing the multidisciplinary program.

Managing the multidisciplinary program.


A computerised information system at a regional teaching hospital.


Integration of clinical and financial data in hospital decision-making.


Computer applications in education and training in the health professions.


A data base approach to a common utilisation system of hospital information in Osaka.


Hospitals, their communities and the aged: South Australian experiences.


Use of automation in improving nursing efficiency and operations.


Social and medical care of the elderly in the German Democratic Republic.


Summary of Group 3: The role of computers and data-processing in improving hospital efficiency.


Where should old people be cared for?

Where should old people be cared for?


The integrated real-time hospital information system: DIOGENE.


Data processing as a tool in human resource management.


Summary of Group 1: Care of the elderly in hospital and community--achieving the most effective balance.


John Hancock officials give insights into rise of prepaid health plans: illustrate 'directions for future'. Looking back on a year that has seen Atlanta's HMO enrollment increase 137 percent and their own AmeriPlan up by 300 percent, and with the financial break-even point reached a year ahead of schedule, officials of John Hancock's AmeriPlan Health Services spoke in glowing terms of the role and future of IPA HMOs in a recent Atlanta press conference. By year's end, they predict, "membership will easily exceed 100,000," about eight percent of the metro Atlanta population. These excerpts from speakers at a press conference for corporate employee benefits executives provide an insight into the insurance company's rationale for HMO development and point out how one major company is marketing its services to physicians, industry and consumers.


Why nonprofit businesses are booming.

Why nonprofit businesses are booming.


Slaying the VDT dragons.

Slaying the VDT dragons.


Relating to robots.

Relating to robots.


Social support networks of the elderly: racial differences and health care implications. Interest in social support networks has increased in recent years. A configuration of family, friendships, neighbors, neighborhood groups, comprise the social support network of individuals and families. Other entities referred to in social network of individuals and families. Other entities referred to in social support literature include self-help and mutual help organizations. Interest in descriptive studies of social support networks includes both structural and interactional factors. In analyses of structural factors in social support networks, the focus is most frequently on size (number of persons), density (proportion of linkages) and centrality (extent of accessibility).


A primer on hiring a home companion.

A primer on hiring a home companion.


A support group for the sandwich generation.


Making a nursing home more like home.

Making a nursing home more like home.


Group art therapy in short-term hospital settings.


Art therapy in an interdisciplinary program for long-term institutionalized mental patients.


Better cubicle curtains.

Better cubicle curtains.


Older plant keeps pace with changes at hospital.


ACP: Baby Doe rule should be revised.

ACP: Baby Doe rule should be revised.


Project Health Care: finding low-cost services for Detroit's unemployed and uninsured.


Professional liability. A positive approach to the crisis.


The impact of doctor-owned insurance firms.


Professional liability. The crisis of affordability.


Professional liability. Searching for solutions to the crisis of the 80s.


The challenge of health promotion for the elderly.


On the job: a program for senior workers.


Redesigning benefits stimulates cost consciousness.


Money in the bank: how a medical expense account works.


An apple a day ...

An apple a day ...


Options for cost control: a doctor's view. Interview by Jane Stein.


Will state hospital rules hurt care?

Will state hospital rules hurt care?


AIDS: hospital guidelines, clinical clues. AHA panel hits exaggerated precautions.


Coalition activities raise antitrust issues, but they are usually manageable ones.


Providing health coverage is a growing problem for small business.


It sounds trendy--but "culture" can determine a company's health policy.


The ethical dimensions of aging.

The ethical dimensions of aging.


New theories about AIDS.

New theories about AIDS.


Pushing the law to new limits.

Pushing the law to new limits.


David's second birth.

David's second birth.


Privacy Act of 1974; exempt record system--DHHS. Notice of proposed rulemaking. The Assistant Secretary for Personnel Administration, through the Office of Personnel systems Integrity of the Department of Health and Human Services, by separate Federal Register notice is proposing alteration in the system of records entitled. "Management Information System Efficiency Report (MISER), HHS/OS/ASPER/OPSI", 09-90-0095. The Department intends to exempt portions of 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 ect, which applies to investigative materials compiled for law enforcement purposes. The Offices of Personnel Systems Integrity (OPSI) is authorised to gather information for personnel, legal and regulatory enforcement purposes under Title 5 U.S.C., Chapter 12. In order to maintain the integrity of the OPSI process of merit system and prohibited personnel practice complaints investigations, and to ensure that the Office of Personnel Systems Integrity will be able to obtain access to complete and accurate information, the Department proposes to exempt from the notification, access, correction, and amendment provisions of the Privacy Act those portions of Management Information System Efficiency Report (MISER) which contain personal information that would identify either a confidential source or an individual other than the complainant or subject of an investigation.


Privacy Act of 1974; systems of records--PHS. In accordance with the requirements of the Privacy Act and the Debt Collection Act of 1932 (Pub. L. 97-365), the Public Health Service (PHS) is publishing a notice of a proposal to add three routine uses and a "special disclosure" statement to four systems of records in the Alcohol, Drug Abuse, and Mental Health Administration (ADAMHA). PHS invites interested persons to submit comments on the proposed routine uses on or before February 27, 1984.


Privacy Act of 1974: amendment of existing system of records--HHS. Notice of intent to amend a Privacy Act system of record for purposes of the Debt Collection Act of 1982. The Department of Health and Human Services is amending system of records 09-90-0024 to add new routine uses for the purpose of collecting debts owed the Federal Government, and to add a disclosure to consumer reporting agencies as authorized by 5 U.S.C. 552a(b) (12) as added by the Debt Collection Act of 1982 (Pub. L. 97-365). A number of other amendments have been made to reflect changes of organization and titles. We invite public comment on these routine uses.


Medicare program; list of covered surgical procedures for ambulatory surgical centers--HCFA. Proposed notice and request for comment. HCFA is seeking suggestions for possible additions or revisions to the current list of ambulatory surgical center (ASC) procedures covered under Medicare. Our current list of covered ASC procedures was published in the Federal Register on August 5, 1982 (47 FR 34099). In this notice we are also soliciting comments on additional ASC procedures that have been suggested by the public since publication of our current list.


Privacy Act of 1974; system of records--PHS. Notification of a new system of records: 09-30-0046, "Survey of alcohol use among youth and young adults". 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, "Survey of Alcohol Use Among Youth and Young Adults, HHS/ADAMHA/NIAAA," to create a single comprehensive research data base so that critical issues associated with alcohol use among 16- to 27-year-olds can be analyzed. PHS invites interested persons to submit comments on the proposed routine uses on or before March 19, 1984. DATES: PHS has sent a Report of a New System to the Congress and to the Office of Management and Budget (OMB) on Februrary 8, 1984 PHS has requested that 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 Congress (If this waver is granted, PHS will publish a notice to that effect in the Federal Register.)


IRAs for health expenses proposed.

IRAs for health expenses proposed.


Aging Americans seek a new niche.

Aging Americans seek a new niche.


Professional certification procedures: a developmental forecast for the year 2000. This paper presents the technique of future forecasting through the development of a scenario based on the process of certification. The paper focuses on the demands of consumer groups. influence of world events, actions taken by Government, and developments within medicine, nursing and occupational therapy through the presentation of a scenario which spans the years 1983-2000. No claim is made that the contents of the scenario will become reality. Rather, the technique is presented as another tool that could be used by the profession in the development of future plans and policies.


DSM III diagnosis in the geropsychiatric patient.


Problems facing multidisciplinary teams in a large psychiatric facility.


Problems of an interdisciplinary training team.


Interdisciplinary care plans: looking for the mark.


Multidisciplinary teams: the positive aspects.


Using visible recording to facilitate teamwork.


Multi-disciplinary team success: the role of mutual respect.


Drugs and the elderly: breaking through health-care hazards.


Ethical reflections on respect for life.


The apostolate of Catholic health care facilities.


The Gospel and our commitment to health care.


New hope in Christ. A pastoral message on sickness and healing.


What should you know about computers now that everyone has one?


Church presence in the health system--a future imperative. Antigonish Diocesan Health Care Council.


Is administrative immunity a destructive shield in your department?


Dialogues with hospital pharmacists: John W. Webb.


Developing a group for friends and families of schizophrenics: a hospital model. The article describes the experience of one psychiatric team in considering and then organizing a group for friends and families of schizophrenics for their psychiatric ward in a general hospital. Included in the article are suggested procedures, program areas to develop, and estimated costs. The benefits to patients, families and friends as well as staff are highlighted.