Ethics and health planning: implications for education. Over the past decade in this country, there has been a rekindling of interest in the ethical questions of public policy. Moreover, the concern for ethical issues is nowhere more evident than in the field of health care. However, the ethical problems of health planning, particularly as practiced at the regional level, have scarcely received attention. This article explores the ethical dimensions of health planning and argues that health planners have not been adequately prepared, neither through their education nor through socialization in the profession, to deal with the complex ethical issues facing them. However, health planning theory can be enriched and practice improved if the ethical issues are confronted. Health planning is viewed as one means of achieving social justice because the benefits and burdens associated with health care are distributed to the members of society by the decisions made in the health planning process. However, planning decisions are not meekly accepted by the persons affected. More often than not, health planning decisions produce substantial political controversy, which is due, in part, to the planning methods commonly used. The synoptic or comprehensive planning approach avoids ethical questions by ignoring them. The incremental planning approach deals with them but only in terms of political process. Neither of these approaches is particularly useful for resolving health planning's ethical questions. The implications of these findings for education in health planning are discussed. The merits of the case study as a means of ethical education are presented.


Objectives of recertification.

Objectives of recertification. Recertification of physician competency is a major topic of discussion and debate in the U.S.A. today. Nearly all graduates of U.S. medical schools are eventually certified by an approved American Medical Specialty Board. Since the mid-1970's all of these Specialty Boards have endorsed the concept of recertification. This paper defines what is meant by periodic assessment of physician competence, why such an assessment is becoming a reality, and the principles which should be followed in implementing a system for the periodic assessment of physician competency. The evaluation of physician competency is a task of enormous proportions when one recognizes the difficulty of reliably and validly measuring all aspects of the skill and abilities of the practicing physician. The evaluation of intellectual capabilities is feasible, but somewhat limited with regard to the spectrum of abilities expected of the physician. In the U.S.A., both the public and the medical profession have placed pressure on physicians to implement programs of recertification. Unlike most of the other professions, medicine has taken upon itself to develop and implement programs for recertification of the medical specialist. To develop recertification programs of value, they should meet certain standards. These include: the need for clear specification of the criteria by which qualification for recertification will be judged or measured; the need to attempt to coordinate programs of recertification with programs of continuing medical education; the need to design evaluation tools that accurately reflect the skills and abilities needed by the physician in the practice of the medical specialties; and the need to be certain that all who participate in such a program have the opportunity to successfully complete the program (that standards for passing tests be absolute rather than normative).


Institutionalization of programs in medical education. Through the use of questionnaires and interview schedules during extended site visits, sixteen programs training residents in non-family medicine primary care were studied to determine what factors contributed to program success -- known as "institutionalization" -- or to program failure. The findings revealed that programs were initiated for either philosophic or pragmatic money reasons. For programs to begin, to continue, and to be institutionalized was due to several contributing key factors. These included the resolution of programmatic differences in regard to goals; development of a substantive quality program; presence of forceful and respected leadership; tangible support of the administration and key academic departments; commitment of the teaching staff; anticipation of potential conflicts; participation of the involved lay and professional community; and the availability of some continued funding. The study also revealed that one program was a complete failure and had to be aborted because none of the key factors were present. The study concluded that the best way for institutionalization to occur is to assure that sound and comprehensive planning takes place. With thorough and anticipatory planning, the conditions essential to program institutionalization can be met more easily.


Functional fiefdom, poverty model or individualism? Development of intergovernmental relations in health planning. The United States national government has the power under the National Health Planning and Development Act of 1974 to establish and exercise legal control over a system of Health System Agencies, State Health Planning and Development Agencies, and State Health Coordinating Councils. Although the national government appears to have the legal powers necessary to direct and control the health planning process, a federal system has difficulties in the implementation of planning which has centralized goals or direction. The states and regions have the potential power to weaken the strength of the national government. Three trends in the developing relationship between the national, state, and regional units in health planning are discussed. The first, the functional fiefdom, consists of self-perpetuating, narrow purpose agencies which are not responsible to local or state-wide elected officials. These are professional bureaucracies which create and reinforce cozy relationships with supportive interest groups. The second trend, the poverty model, includes the lack of control by local elected officials, a large role to nongovernmental actors, and a direct relationship between Washington and the regional planning agencies. The last trend appears to be an individualistic one with every unit fending for itself. A case study of Massachusetts along with supplemental materials from other states is presented to illustrate the trends.


Voluntary certification and the uniform guidelines on selection procedures: a potential problem for personnel managers. Employers in health care sometimes rely upon various standardized testing procedures in selecting, promoting, and training personnel. Within the health professions, voluntary certification programs have developed to permit individuals to demonstrate competence and become recognized as qualified practitioners. This article addresses the problems which can occur, but are not widely recognized, when employers use voluntary certification examinations in the selection process. The impact of the federal government's "Uniform Guidelines on Employee Selection Procedures" upon voluntary certification activities is uncertain at best, and frightening, at worst. While the Guidelines require employers to use only validated examinations where adverse impact upon protected minority groups exists, they do not effectively address the use of professional certifying examinations and fail to provide guidance for either certifying agencies or employers. This leaves great potential for conflict, since circumstances in which employment is terminated, an employee denied promotion, or even denied opportunities for entry into positions based on an employer's use of voluntary certifying examinations, are increasing daily. How does an employer validate a national certifying examination that he does not administer? How does the certifying agency protect itself from allegations of discrimination or anti-trust violations based on actions of an employer with whom the agency has no contact? This article offers no answers to these troublesome questions. However, it may help eliminate another problem noted by the author--widespread ignorance of the seriousness of these circumstances for employers and certifying agencies. From first-hand experience and research into the development of the Uniform Guidelines, the author points out many of the difficulties which await those who rely on non-validated examinations or choose to ignore the government's edict that examinations used in selection must have a demonstrated relationship to the job. Finally, the article proposes solutions to the dilemma faced by certifying organizations and suggests that, by becoming more aware of the Uniform Guidelines, employers and testing groups have the opportunity to protect themselves before a problem occurs.


Selected national economic indicators.

Selected national economic indicators.


The organization and management of medical education in Australia. The review highlights the interdependence among the various subsystems involved in medical education and hence the need for coordination. Observations and perceptions derived from interviews and the review of the literature were reported to underline the existing difficulties and factors which impede the integration of efforts of the various subsystems. Problems of coordination seem to relate to the functioning of the existing mechanisms rather than to the absence of structural arrangements. Hence, it seems necessary to improve the skill of committees and other coordinating bodies in the processes of mutual adjustment and responsiveness to changing conditions.


The controller's role in cost containment.


Can new capitation experiment cut hospitals costs?


Accounts receivable: patient refunds and credits needn't be a pain.


The mechanics of profit.

The mechanics of profit.


HFMA Principles and Practices Board Statement 3: supplementary reporting of hospital financial requirements.


Shaping healthcare financing and policy at Temple University.


One hospital's plan to improve cash flow.


Independent foundations: a source of innovation in healthcare delivery.


Tax-exempt hospitals explore new ways to attract equity.


Helping the dismissed executive: outplacement counseling advances in health care.


HFMEF revises its budgeting process packaged program.


Time to identify your costs.

Time to identify your costs.


Payment patterns: attitude.

Payment patterns: attitude.


Floating interest rate bonds--for some hospitals, an attractive alternative.


Flexible pricing--an essential tool.

Flexible pricing--an essential tool.


How hospital finances affect the bottom line.


Relevant performance appraisals.

Relevant performance appraisals.


Simple disaster plan makes dietary sense.


New liability stems from inappropriate drug therapy.


Part 2: Insulating your hospital from asbestos risk.


Resolving the conflict between duty to patient and duty to hospital.


Point of law: what is the currently held definition of death?


The role of consumer attitudes and preferences in the HMO planning process.


The impact of preventive health education programs on beliefs, attitudes and behavioral intentions: experimental investigation of a breast self-examination program.


Solving the long term care puzzle.

Solving the long term care puzzle.


Changing role of hospital boards: analysis of a triad member's perceptions.


Academy for Health Services Marketing.

Academy for Health Services Marketing.


The health of the Hospitals Corporation: the strange case of Dr. Kauvar and of New York's municipal hospitals.


The impact of trauma centers: what's the fair way to designate?


House calls.

House calls.


Factors influencing physician referral and satisfaction.


Without tears: the birth of a trauma center.


The effect of music and desensitization on preoperative anxiety in children. In this study, music was used as part of a comprehensive preoperative teaching session aimed at informing pediatric patients about events pertaining to surgery. The purpose of the study was to investigate whether music therapy can transmit adequate information about the surgical experience to the pediatric patient to help reduce his or her anxiety and fear behaviors during induction of preoperative medication. Subjects were 75 children ages 3 through 8 who were admitted for elective surgery. The experimental design incorporated a three-sample method, with the control group receiving only verbal preoperative instruction the evening before surgery, Experimental 1 group receiving the previously mentioned verbal instruction with added music, and Experimental 2 group receiving this treatment strategy plus music immediately prior to induction of preoperative medication on the morning of surgery. The group receiving music therapy just prior to induction of preoperative medication was consistently rated as indicating less anxiety before and during induction of preoperative medication.


Music therapy-assisted labor and delivery. This article describes a new clinical music therapy program for application in the labor and delivery setting, and presents results of a preliminary study to evaluate effectiveness of the treatment. Over 50 women participated in the project; however, inclusion of patients in the data collection portion of the project was limited by criteria designed to minimize the effects of spurious variables. An experimental group of 13 patients participated in six individual predelivery music therapy training sessions during the third trimester of pregnancy. Experimental patients listened to preselected musical works throughout labor and delivery, with the music therapist in attendance. A control group of seven subjects participated in labor and delivery according to regular hospital routines. Data consisted of patients' responses to questionnaire items reflecting subjective perceptions and recollections of the labor/delivery experience and reports of frequency and duration of home practice. Experimental subjects achieved significantly higher "success" scores than did control subjects on five of seven indices (p less than .05). A moderate correlation between music home practice and successful childbirth outcome was demonstrated, with frequency/length of music home practice revealed as a significant predictor of success in the childbirth experience.


Managing safety and health.

Managing safety and health.


Placements & salaries 1980: holding the line.


Controlling the costs of health care where it counts--from within the system.


Tough talk about health care and its costs...from a corporate chairman who also serves as a hospital trustee.


Child abuse and Ontario's new reporting register.


Geriatric, psychiatric, and legal aspects of the mental state of the aged.


High cost of renovating forces closing of two hospital laundries in Denver.


Sexual harassment can cost you money, productivity and employees.


Handicapped job trainees to work in hospital laundry for first time.


Art in hospitals.

Art in hospitals.


Movable compact shelving: a survey of U.S. suppliers and library users.


On-line acquisitions systems for libraries.


A sampling of marketing techniques.

A sampling of marketing techniques.


Effective advertising.

Effective advertising.


Marketing medical groups.

Marketing medical groups. Marketing has emerged in the literature of medical group management only recently, but to a significant degree. Typically, it is discussed in the context of developing new programs, such as industrial medicine services, or in terms of advertising and public relations. These are perfectly valid areas in which marketing applies, but by no means are they the limit of its potential contribution. Viewed in its broadest context, marketing may be employed to govern most, if not all, essential decisions and operations of the medical group--to plan and manage the group's overall success, prosperity, and survival.


Principles of HMO promotion and public relations: the CarleCare HMO experience.


Marketing occupational health care.

Marketing occupational health care. A very basic part of marketing success is determining areas of your business in which you have a competitive advantage. In drafting a marketing plan for the Denver Clinic, the competitive advantages group practices have in the area of occupational health were quickly realized. This competitive edge is presented along with the Denver Clinic's marketing strategies and plans to capitalize on occupational healthcare advantages.


Marketing in an over-physicianed community.


Turnaround for the Denver Clinic.

Turnaround for the Denver Clinic. By renovating its facility, the Denver Clinic was able to meet the needs of its present patient population and attract new patients. Marketing techniques were employed to redesign the facility and to capitalize on the clinic's competitive edge in the Denver market. Useful information is offered to other clinics who are considering facility renovation and on the advantages group practices have in the medical market plan.


Marketing via extended hours.

Marketing via extended hours. Group practices that extend their hours of service have a competitive edge over hospital emergency rooms and commercial minor emergency clinics that traditionally are the only facilities to offer after-hours patient care. By answering the need in communities for extended-hours service, many groups are not only experiencing significant patient retention, but a generation of new patients as well.


The physician meets the press.

The physician meets the press.


Launching a successful satellite clinic: a marketing approach.


Will your hospital turn to "spouse care"?


Microfilm readers.

Microfilm readers.


Selection of instruments for clinical laboratories.


Rhode Island proposes rule requiring 'emergency' freestanders to act like ERs.


Induction training--getting off to a good start.


Quality circles: a well-rounded approach to employee involvement.


Mommy rooms in with the newborn--and daddy does too.


A theoretical framework for change.

A theoretical framework for change.


International association promotes hospital security.


Two clinics of New Orleans.

Two clinics of New Orleans.


A checklist for developing an emergency plan.


Debate: the CS sprayer.

Debate: the CS sprayer.


Fire safety in hospitals: will the good record last?


Unemployed get help.

Unemployed get help.


Art enriches hospital.

Art enriches hospital.


Debate: some hospital security personnel dress casually.


Rx for security: "wellness".

Rx for security: "wellness".


Pilot study reveals changing concepts in hospital security.


Confusion, controversies stem from pre-trial screening panels.


Self-insure to tackle high rates.

Self-insure to tackle high rates.


North Carolina Memorial looks at moving into self-insurance.


Phil Gramm predicts more radical health changes by 1983 or 1984. Interview by Sheila L. Simler.


Court gives hospitals an important victory on union bargaining units.


Administrators must share power with frustrated middle managers.


Guard psychiatrists' patients' rights.

Guard psychiatrists' patients' rights.


Health insurer blasts pro-competition bill.


Ex-Affiliates managers launch new companies.


Lobbyists predict 1982's budget reconciliation will be less sweeping.


Hospital groups spread risk of starting HMOs.


Shared services business soars 31%.

Shared services business soars 31%.


Pooled assets expand debt capacity.

Pooled assets expand debt capacity.


Should everyone carry medical information? New card uses microfilm and built-in lens to provide detailed data.


Pricing health policies in an uncertain time: Part 2.


Construction financing woes block two hospitals until they're merged.


Inhouse program teaches management skills.


Risk management: hospitals' premiums are beginning to rise again.


The ethics and morality of leadership.

The ethics and morality of leadership.


Role perceptions, satisfaction, and performance: moderating effects of self-esteem and organizational level. The moderating effects of organizational level and self-esteem on the relationships between role perceptions (i.e., role ambiguity and role conflict) and employee satisfaction and performance were examined. Previous research suggested that self-esteem, as an indicator of perceived self-competence, should act as a buffering element contingent upon an individual's organizational level. To test this possibility, data were collected from a sample of 161 hospital professional and support personnel. It was hypothesized that the negative effects of role ambiguity and conflict on satisfaction and performance would be attenuated by high self-esteem at lower organizational levels. Two of the four predicted interactions (ambiguity-satisfaction and conflict-performance) were obtained. The importance of considering the combined effects of both situational and individual difference variables as potential buffers against aversive role perceptions was discussed.


Patient accounts department plays a major role in public relations.


Compensation and benefits: vision care plans.


A definition of human resources management.


Can alternatives to sick pay plans reduce absenteeism?


Delegation: the art of managing.

Delegation: the art of managing.


Comparable worth: an idea whose time has come?


Controversy over the issue of mandatory retirement.


Reimbursement: how to separate consulting from dispensing.


Heart attack victims--in the hospital & at home.


Warning label design.

Warning label design.


A new national health program: "Fitness 3".


Third-party payers: are they getting better, or...?


Former mental patients step back into the world.


Burnout: a real threat to human resources managers. Burnout, the total depletion of one's physical and mental resources, was first recognized as a syndrome among professionals in the helping professions: teaching, nursing, and social work, for example. Small wonder, then, that human resources managers, whose jobs are concerned with people and their problems, are prime candidates for burnout. To help human resources managers combat burnout in themselves and those for whom they are responsible, Oliver L. Niehouse, head of Niehouse & Associates Inc., management and organization development consultants, shows how to recognize the symptoms of burnout and the stress that precedes it and explains what can be done to prevent or cure it. The Niehouse prescription for counteracting stress symptoms that lead to burnout involves building supports that displace or drain off the stress. To build such supports, one must first recognize the need for support, acknowledge the potential for burnout, and then set realistic, achievable goals.


Time-off-with-pay practices.

Time-off-with-pay practices.


Fed employees' use of services stable.

Fed employees' use of services stable.


Art therapy seen as healing, not analytic.


On the front line--the therapy aide.

On the front line--the therapy aide.


The leadership role of hospitals.

The leadership role of hospitals.


Developing executive talent in health administration: the post-master's clinical practicum.


Issues in the educational and professional development of the minority administrator.


Exploratory seminar on post-master's management development programs.


The fellowship programme at St. Thomas' Hospital in London.


Ethical issues in health administration.


Public attitudes toward science and technology: what have the surveys told us? Surveys of public attitudes toward science and technology over the last two decades show a very high level of favorable response. Public confidence in science sagged in the seventies and, though science suffered considerably less than most other major social institutions, a larger tiny minority now view it as harmful than in the fifties. The most striking aspect of public attitudes toward science, and scientists, however, is that they appear to be based on nebulous and distorted conceptions which are dominated by themes of applied technology.


Wellness program reaps healthy benefits for sponsoring employer.


New York State blazes the trail to effective hospital cost containment.


A model for working with the elderly in institutions.


Practical accreditation process available to plastic surgery units.


Ambulatory surgery protocol guides maternity program development.


Labor relations and Texas hospitals.

Labor relations and Texas hospitals.


No solicitation - no distribution rules in hospitals.


Quality assurance report form.

Quality assurance report form.


The employees' right to engage in concerted activity.


Solving employee concerns: an open and credible management style can erase the appeal of unions.


Notice to employees: you have a right to refrain from union activities.


That's entertainment: California-style.

That's entertainment: California-style.


Why hospitals must focus on capital formation.


Home care agencies specializing, growing.


Hospital ship 'solution' drawn up.

Hospital ship 'solution' drawn up.


Patient abuse charged: VA hospital's affiliation at issue.


The context of country health programming. Prepared by the staff of the WHO Regional Office for the Eastern Mediterranean Region.


Hospital management and management training in Bahrain.


Volunteer administration as a career.

Volunteer administration as a career.


Maintenance and repair of medical equipment.


Preventive maintenance and repair of medical equipment and apparatus: an essential service.


Care programmes: straightjacket or panacea?


Hospitals and primary health care in the German Democratic Republic.


Hospitals and primary health care.

Hospitals and primary health care.


Health care planning in urban areas: Nottingham and Stockholm.


Developing medical services in Dubai.

Developing medical services in Dubai.


Hospital liability.

Hospital liability.


Variables related to outcome of treatment for inpatient alcoholics.


Laundry and linen manuals to be maintained (Part 2).


Latest HAS figures. In-house vs contract costs: a comparison of sorts.


Rural hospitals form new lobbying group.


New LM masters a high-technology plant.

New LM masters a high-technology plant.


Linen utilization: Part II.

Linen utilization: Part II.


Planning solved washer installation problems.


Million-dollar laundry serves 21-building hospital.


Video studio management: the basics of staffing, budgeting, maintenance and quality control.


Laundry and linen manuals to be maintained (Part 1).


New Orleans physician challenges hospital's policy on MD contracts.


An exchange program for scrub suits that is working.


Certification programs: measuring excellence in the professions.


Prehospital management of the seriously injured...by the Committee on Trauma of the American College of Surgeons.


'Unprofessional conduct:' a dubious legal term.


Between therapist and patient: the language of caring. It is essential for respiratory therapists within health care settings to understand who and what they care about. Yet these issues are infrequently discussed in school of in in-service programs. The purposes of this article are (1) to identify different types of relationships that may exist in the therapists' personal and professional lives; (2) to analyze the caring feelings that may be stimulated as they interact with different relationships; (3) to describe behavior that emerges as a result of caring feelings; and (4) to explore steps that respiratory therapists may take in reaching congruence between their feelings and their behavior patterns.


Letting them out one by one: using unit-dose systems to reduce drug administration errors.


War and peace.

War and peace.


Patient abandonment: reality or myth?

Patient abandonment: reality or myth?


Wounds without cause.

Wounds without cause.


Maintenance anxiety.

Maintenance anxiety.


Facility report: Los Angeles County-University of Southern California Medical Center.


The pros and cons of consensus statements.


Hospital privileges for gastrointestinal endoscopy.


The input-output approach to the analysis of delivery and allocation of health services.


A history of the Committee on Pre-and Postoperative Care.


Controlling professional fees.

Controlling professional fees.


Recertification: is it worthwhile?

Recertification: is it worthwhile?


Control of hemorrhage by use of the MAST suit.


Implications of the pro-competitive health service strategy.


General practice in West Germany.

General practice in West Germany.


Physician agreements to control medical prepayment plans: Federal Trade Commission. Adoption and publication of enforcement policy with respect to physician agreements to control medical prepayment plans. The Federal Trade Commission has adopted, and is publishing with this notice, a statement of enforcement policy with respect to physician agreements to control medical prepayment plans. The statement sets forth the general approach the Commission intends to use in its case-by-case enforcement program for evaluating physician agreements to form, operate, or control such plans and for evaluating the practices of plans that are controlled by a group of physicians.


Firms cite victories in battle over rising health care costs.


Hospital risk manager to fight high rates with self-insurance.


Pastoral services for the aged: an overlooked need?


Health care and public policy: where do trustees fit in?


Essential services during labour disputes.


Catholic hospitals: different? Role of the trustees.


Caring for the terminally ill: further initiatives in Quebec.


Safeguarding your social responsibility--part 1.


Ancient ways made new: health among the Chippewa of Rama.


Theory P--people management.

Theory P--people management.


Administration and the board: how should they interact?


More nukes--less kooks.

More nukes--less kooks.


Risk management: an evolving hospital tool.


Serving the interests of the community.

Serving the interests of the community.


Pray for the prey on record relief day.

Pray for the prey on record relief day.


Dollars and sense: effective negotiation.


Micro mania and the instant expert syndrome.


Harnessing computers to manage energy and contain costs.


Women's health, Sexual assault: an epidemic health problem.


Is competition the answer?

Is competition the answer?


Industry monitors health care.

Industry monitors health care.


Assessing health care needs in the community.


Career program for RNs.

Career program for RNs.


Is life living? Defining death in a technological age. Historically, humanity has assigned death to evil spirits, malevolent gods, and other supernatural agents; but by the eighteenth century, the scientific spirit began to manifest itself through more precise biologic definitions of death. Thanks to modern medical technology, these early scientific views, with their considerable margin for error, gave way in the twentieth century to criteria based on such diverse factors as total lack of response to external stimuli, absence of spontaneous muscular movements, absence of all reflexes, total collapse of the arterial blood pressure, flat electrocardiogram, and flat electroencephalograph tracings. Undoubtedly such difficult matters as organ transplants, wills, homicide, euthanasia, and abortion demand precise definitions of death; but modern medical advances have engendered visions of physical immortality with doctors as the arbiters who often define and determine death. Even so, such one-dimensional, scientific views fail to capture those nebulous social, religious, or spiritual definitions that pervade humanity's definition of death. Humanistic views of death resist the movement of death from the moral realm to a technological order that places people in a system, theory, or chart, where they are thus absolved from fear of freedom. Rather, humanistic definitions demand that humanity step beyond mechanistic definitions of death into a transcendent world of moral choices that guarantee human dignity and worth by ascribing meaning to life and death. These meanings counter the desiccating fear that something like biologic human might, through something called medical technology, defeat something called fate.


Where is the real priority in trauma?

Where is the real priority in trauma?


Video variety at the Kettering Medical Center.


Copter use in trauma transporting is on the rise.


Staff support group on a cancer ward: a pilot project. Despite strong evidence of high stress among oncology nursing staffs, few empirical intervention studies have been attempted. This study involved a pilot project to combine two anxiety-reducing aids--group support and the provision of pertinent information--into a single format for maximum stress reduction. Weekly groups producing both support and information lasted 8 months and covered a wide range of topics. Both unstructured and didactic sessions were used. Pre- and postquestionnaires were distributed to each participant to assess ward atmosphere, attitudes about cancer, and level of stress. Participants expressed great satisfaction with the project, but their enthusiasm was not supported by statistical evaluation. Various methodological and programmatic aspects that may account for the discrepancy between anecdotal and statistical results are discussed.


Protective equipment for EMT's.

Protective equipment for EMT's.


Specialized training produces hospital wide benefits.


EMT-P's attitudes toward emergency physicians: a case study.


Proposal for uniform system of EMS rank insignia.


Proposed format for collection of prehospital cardiac arrest data.


EMS transport to hospitals only.

EMS transport to hospitals only.


Company fitness program a good investment, study shows.


How do you decide what education programs to attend? Increasingly, constraints on resources require that any decision to participate in a continuing education program be scrutinized to ensure the most effective and efficient use of time, money, and personnel. In addition to these constraints, and complicating the decision-making process, are professional pressures to keep abreast of developments in the field. But deciding whether to attend a seminar or workshop can be facilitated if the program is evaluated according to the suggestions in this article.


Connecticut Health Care Associates joins 1199.


Preparation of an intravenous infusion admixture nursing reference. There has been a growing concern over the increasingly complex problem of incompatibility between intravenous drugs mixed extemporaneously by nursing staff. A considerable amount of data has been published although much of it has not included background on the criteria and conditions under which it was collected. The compatibility/incompatibility of a number of admixtures is known to depend on these conditions. The purpose of the present work was to compile and evaluate data on drugs which were most frequently requested to be mixed at the author's hospital. The results are presented in a chart with an accompanying guide to its use for the nursing staff. Use of the chart may require reference to more detailed information kept in the Pharmacy, although restrictions outlined in the guide minimize this.


Implementing a community-based cancer control program.


Community organization: a health education approach to cancer control.


Patient management guidelines: a rational approach to improving community cancer care.


New opportunities for hospitals in health promotion.


Patient education through patient counseling by pharmacists: a survival technique.


Canadian Society of Hospital Pharmacists guidelines for the handling of hazardous pharmaceuticals.


Triangulation: a three-dimensional model for continuing education. A variety of cultural phenomena have recently converged to create a demand for specialized adult education programs. One approach that can provide insights in adjusting traditional educational strategies is triangulation, a procedure that can help delineate both content and teaching approaches by assembling the perceptions of administrators, adult learners, and educators. This procedure can be especially helpful to educators in health care settings who must continually provide meaningful programs for adults.


Disaster planning at a Friesen concept hospital. Disaster planning is a task which will probably never be "completed", since to be effective, a disaster plan must constantly be reviewed and modified. The Hospital Disaster Working Committee at the Ottawa General Hospital has so far been presented with both challenge and opportunity. The challenge is to make best use of our new facility, while coping with the changes which a new site predicates. The opportunity is to take advantage of the past experience of our own people and others who are involved in disaster planning, and make a strong beginning.


Psychosocial support in screening and early detection programs.


Maybe it will go away: the five most dangerous words in the English language.


Education and communications for a community-based cancer control program.


Community health centers: a vanguard in the community control of cancer.


Evaluating cancer control programs in the community.


Administering cancer control programs in the community.


Save your training programs from today's economy.


A crystal ball that demands application from today: a hospital system leader looks at what may develop.


Health care in 2030 A.D.

Health care in 2030 A.D.


Competition and deregulation: an architect for change discusses their impact on group practice.


Business involvement in health care cost containment efforts gaining momentum.


Industry's health cost awareness programs range from cash bonuses to rehabilitation.


Corporate visitation program enables AMA to strengthen its ties with business.


Business participation is a key to progress of the VE's program to contain costs.


Cooperative efforts needed to find solutions to health cost problems.


Private sector solutions to problems urged by Business Roundtable health chairman.


Study challenges excess bed theory as big contributor to cost rise.


Fund reductions pose complex problems for the health industry.


Hospital medical staff privileges and antitrust: an overview.


Why Bill Vomvoris won't take 'no' for an answer.


Blood and money.

Blood and money.


Problem: how to handle the special demands of psychiatric hospitals. Solution: provide variety within individual diets.


Gray gold.

Gray gold.


Charitable giving in trust: why the new interest?


Some thoughts on reading the physician market. Marketing to physicians is still the key to a hospital's well being. This is anything but an exact science, but it does have its roots in data collection and research. The best way to market to physicians is to meet their expectations of the hospital and seek the cooperation of the physicians in getting the word out on new programs and services to their patients. The more the hospital can promote the physician out front with his or her patients, the more likely it is that those physicians will support the promotional efforts of the hospital.


Management company expansion spurs investor-owned growth.


Board reorganization, umbrella agencies, super boards: pro's and con's.


Plenty.

Plenty.


Bringing quality assurance to the pharmacy.


The flexibility of matrix management.

The flexibility of matrix management.


Profit in helping those who help the sick.


In search of better "boardsmanship": helping trustees assess their role.


Hospices: a living place.

Hospices: a living place.


Accident and emergency: why patients choose A and E.


Manchester's second private hospital.

Manchester's second private hospital.


Accident and emergency: patching up in Belfast.


Orthopaedic waiting lists: a smooth operation.


Index is only way to get objective measure of price performance.


Price deviations is supplier's invoice require quick action.


Hospital uses survey form to measure departments' satisfaction with M.M.


Work effectiveness program works.

Work effectiveness program works.


New moves in M.M.: who reports to whom?

New moves in M.M.: who reports to whom?


The future of the NHS.

The future of the NHS.


Reflections on eight years as administrator of a rural Christian mission hospital in India.


The neglect of planning in health districts.


The French hospital system at local level.


The pediatrician and preventive medicine.


Health information sources of the poorly informed: implications for health educators and communicators.


Personnel management tasklist: an index of basic personnel management tasks in district health authorities.


Incentive compensation for health executives.


Executive compensation -- state of the art.


The administrator's marketplace.

The administrator's marketplace.


Health care manager's notebook: creative problem-solving.


Management incentive plans: a hospital executive's primer.


The ethics of terminal care.

The ethics of terminal care.


Employee compensation in the hospital.

Employee compensation in the hospital.


Are you ready for a sabbatical?

Are you ready for a sabbatical?


Self-help for rural managers and trustees.


Will your medical staff be trained in ethics?


They gave us their best shot.

They gave us their best shot.


Equipment acts as reservoir for urinary tract infections.


Removal of pipework from vacuum plant installations: handling hazards.


Underfloor heating using plastic pipes: a survey of principles and current European practice.


Generic screening effective in problem identification.


The ethical side of advertising.

The ethical side of advertising.


Developing a hospital advertising campaign.


The CEO contract: how to assure the new CEO the authority he needs to be effective.


Setting accepted guidelines for antibiotic review.


Nurses responsible for discharge planning.


Medication errors noted as major source of incident reports.


Hospital's rehabilitation mission meets community's changing needs.


Tax-exempt hospital bonds, FHA loans: future legislation targets?


Living and dying with less: an ethic for the 1980s.


Doing justice: an encounter for our times.


Economics and ethics: delicate balance for providers.


Quality assurance council administers, evaluates hospital program.


Health care manager's notebook: performance appraisals.


A strategy for integrating hospice, hospital care.


Recovering legal expenses: implications of new federal law.


Disruptive behavior grounds for physician's dismissal.


Group purchasing makes sense: an administrator's perspective.


Hospital's evidence supports denial of staff privileges.


Suppliers liable for equipment defects.

Suppliers liable for equipment defects.


Group purchasing from the materiel manager's viewpoint...or what's wrong with group purchasing?


A reexamination of group purchasing.

A reexamination of group purchasing.


Evaluation of group purchasing programs: a proposed methodology.


Group purchasing: past, present and future.


Measuring savings from group purchasing.


The certainty of ambiguity.

The certainty of ambiguity.


Leadership: the key to group purchasing.


Viewpoint: group purchasing--a bed of roses?


Ideas for group purchasing in the eighties.


Group purchasing: a vendor's perspective.


Value analysis and standardization for group purchasing.


What an undercover operation in a nursing home discovered.


How to effectively use undercover operations.


Federal court refuses to honor state statutory privilege for proceedings of medical staff credentials committee.


Home-medication monitoring among older adults: the breach in services. Available studies reveal alarming rates of substance and medication abuse among older adults. Professionals addressing the substance and medication abuse problems of seniors have argued for a move to medication monitoring in the home. At present, however, there has been only scattered evidence to support the contention that adequate medication monitoring actually occurs. The present study reports two surveys of all home care agencies in the state of Michigan. The first study reports the medication monitoring practices of home care staff. The second study examines possible medication monitoring interventions that might be implemented in home care agencies. Those medication monitoring interventions with the highest likelihood of successful implementation among home care staff are discussed.


What is the administrator's responsibility in management of the hospital new function?


Role strain in hospice nursing.

Role strain in hospice nursing. This paper utilizes role theory to explore the nursing role at a northern California hospice which is licensed as a home health agency. The writers hypothesize that the special burdens of caring for dying patients, the numerous relationships assumed by the nurse, and the expanded nature of the rapidly developing hospice nursing role may contribute to role strain. Options for managing role strain are presented.


Cheltenham General Hospital: redevelopment.


Incineration of wastes.

Incineration of wastes.


Hospital PR--maybe it's time to shoot the messenger.


Hospice: staffing and cost implications for home health agencies. The authors describe a study done to evaluate the implementation of a home health agency-based hospice program. Forty-one hospice patients were compared with a group of terminally  ill patients receiving standard home care treatment. The differences in the type, frequency, and intensity of services required by the two groups were evaluated. While hospice care was found to be slightly more staff intensive than standard home care treatment, the differences were minimal. The results suggest that a home health agency with a multidisciplinary staff could implement a hospice program without making dramatic organizational, administrative, or resource change.


Put OR audits into operation.

Put OR audits into operation.


$105MM complex joins four hospitals.

$105MM complex joins four hospitals.


Test your PR skills.

Test your PR skills.


Waste treatment and disposal.

Waste treatment and disposal.


Shedding some light on lighting.

Shedding some light on lighting.


New telephone options prove more efficient.


Organizing the public relations function.


Certificate of need: an approach to the process.


Corporate restructuring of hospitals and multi-institutional arrangements.


Changing health care markets.

Changing health care markets.


The academic health center--a vertical organization.


Reality of health care planning.

Reality of health care planning.


The need for fundamental reform through competition and rational economic incentives.


The Hospital Commission of the State of Washington.


The validity of regulation.

The validity of regulation.


Public planning and regulation.

Public planning and regulation.


Antitrust aspects of the future health planning.


A third force of equal importance: cooperation.


Governance.

Governance.


Corporate restructuring of hospitals.

Corporate restructuring of hospitals.


Nursing homes--a future.

Nursing homes--a future.


Capital financing in the 1980s.

Capital financing in the 1980s.


Competition: prospects and challenges.

Competition: prospects and challenges.


Lifecare communities in the eighties.

Lifecare communities in the eighties.


Growth and financial pressures presage tough challenges for our health care system.


Hospital risk management: a Canadian perspective.


Zero-base budgeting--a management tool for the 1980s.


The Canadian health administrator: a profile.


Integrating institutional and medical staff goals.


The challenge of being a health administrator in a developmental centre.


Strategic planning in non-profit organizations.


Community based health programs and the organized system.


Inventory control: cost cutting through the EOQ.


Personal computers: affordable computing for financial managers.


Capital management: funding aspects of construction in U.S. hospitals (1973-1979).


Policy issues in healthcare capital management.


Contracting for materials management--is it right for everyone?


Growth and improvements in HFMA's Financial Analysis Service.


Payment patterns: midyear results.

Payment patterns: midyear results.


Capital management: the dilemma of debt.


Paperless processing: monitoring the growing wave.


The Internal Revenue Service and the healthcare specialist.


Short-term cash management: determining funds on a daily basis.


Tax-exempt revenue bonds--statistical trends by number of hospital beds.


Power of attorney -- tool for tightening receivables control.


Hospital asset investment: some guidelines for picking the right advisor.


Dealing with unfair insurance practices -- the NAIC approach.


Ongoing education: obligation with opportunity.


Trimming inevitable increases: a monetary incentive program could cut costs.


Payment patterns: value of your accounts receivable.


Capital infusion: lifeline to the future.


Forecasting.

Forecasting.


Managerial growth in an anxious age.

Managerial growth in an anxious age.


'Bare' physicians more likely to increase hospital liability.


Financial ratios: summary indicators for management decision-making.


Marketing an occupational health service.


Factors influencing student selection of rural health service administration.


A tripartite approach to hospital census management.


Motivating physicians to make the new JCAH standard really work.


Linking quality assurance with medical staff peer review.


Focus on safety: Part 1.

Focus on safety: Part 1.


The pharmacists' role in clarifying medication orders.


Hospitals receive premium credits for improved RM programs.


The use of outside consultants for QA--why, when, how.


Softening the 'perverse' effects of quality assurance. Interdisciplinary stress is a common, though unwelcome, by-product of quality assurance activities. The divergent lines of authority in a hospital are usually inadequate for dealing with interdisciplinary problems or with joint or contested matters, resulting in uneven treatment of those identified as having lapsed from accepted standards. If the purpose of quality assurance--improvement of patient care--is not to be perverted, current methods of dealing with identified problems must be revised.


An American in a Parisian P&T committee.


A multicenter survey of cefazolin usage.


Adverse reaction reviews (ARR).

Adverse reaction reviews (ARR).


Career planning for the hospital pharmacist.


Aseptic technique as a safety precaution in the preparation of antineoplastic agents. A subject of concern among personnel working in cancer chemotherapy treatment areas is the occupational hazard posed by the antineoplastic drugs. A review of the literature reveals a number of proposed safety precautions, including glove boxes, vertical air-flow hoods, masks, gloves, gowns, and routine medical examinations. The concept of using aseptic technique as a safety precaution is presented, with particular emphasis on the importance of maintaining negative pressure in vials. We also discuss the use of ultraviolet light to detect antineoplastic drug spills in a working environment and as a training and evaluation procedure.


Drug utilization review: a practical approach. Described is a method to perform drug utilization review retrospectively by using mutually exclusive categories. Drug use criteria were developed and structured in such a manner so that a patient's drug use experience could be readily and appropriately classified by medical records technicians during the routine medical record abstraction. Utilizing a contract abstracting service format, a summary by category of drug use experiences for the patients audited is provided monthly and used as the preliminary audit summary. The system represents an efficient and cost-conscious means of effectively monitoring selected portions of the drug utilization process.


Computer-oriented coding of medical data.


A proposal for a computer-based national medical information system.


The human element in computer-generated patient management plans.


Who uses the hospital emergency room: correcting a misconception.


Statistical confidentiality in microdata release.


Helping community mental health work: a model for the professional role of liaison. Community mental health centers were created to provide mental health services within the community. However, these centers have had difficulty delivering community-based services and have, all too often, become isolated from the communities they serve. A model for the role of professional liaison is presented. The liaison model is seen as providing a solution to service delivery problems by acting as an adjunctive agency providing broadly based referral and linking services between agencies in the community. Essential features of the liaison role include an ecological perspective, indirect service delivery, an emphasis on liaison role rather than technique, and the inappropriateness of advocacy.


Self-designed continuing education for supervisors in community mental health. This paper describes a continuing education program designed to meet the needs and interests of supervisors working in community mental health centers. As initial group of supervisors was recruited as consultants to design all aspects of their educational experience. The group used a modified nominal group technique to develop the curriculum. Subsequently 28 trainees in three separate groups participated in the training program; they represented 20 agencies and included directors, training coordinators, supervisory staff, and direct service workers. Methods employed were satisfaction measures, content retention measures, and interviews to evaluate program impact. Participants reported that they increased their knowledge and were satisfied with training, but that the program was only modestly effective in contributing to changes in their job and agency functioning. Training was most effective with agency directors, employees of private agencies, and workers with fewer years at a given work site.


The use of break-even analysis in long-term care facilities. For the most part, long-term care facilities operate in a negotiated rate environment. Under Public Law 92-603, these facilities are compensated for rendering care to Medicaid patients on a "cost-related" reimbursement formula. Therefore, there is a limit on the ability of the owners of these facilities to pass increased costs for their services on to the consumer on a current basis, as is done in most other industries. The owners attempt to negotiate an annual rate based on anticipated increased costs of operation, and then normally have to live with the rate for the remainder of the year. In some cases the increased costs exceed the increase in the negotiated rate on an annual basis. Since there is, in effect, a lid on the revenue per patient, the opportunities to increase net income are limited either to reducing costs, or increasing the number of patients served in the facility. In this industrial setting, it would be particularly meaningful to the owner of a facility to be aware of the profitability of the operation at different occupancy levels. Also, the feasibility of expanding his facility should perhaps be explored to determine the impact of an expansion on net income retention. Break-even analysis can be employed to help address these issues. In this paper, the author briefly discusses break-even analysis as a management tool and develops a model to illustrate and apply the analysis of a long-term care facility.


Capital maintenance and equity erosion in the nursing home industry: a study in one state. Federal contingencies charge states to regulate the reimbursement of the nursing home industry such that government reimbursement is at a minimal cost that reflects efficient operations, yet at amounts great enough to allow viability and ability to attract and maintain the investment of capital. This study discusses the regulation of the nursing home industry in terms of the significance and costs of financial capital, and the constraints imposed upon states as regulators of capital reimbursement policies. Descriptive financial profiles of nursing homes are provided in one state where the industry alleges inadequacies in the capital reimbursement formula. These financial profiles suggest that the nursing homes investigated have not been able to provide for capital maintenance; instead, the industry may be suffering from equity erosion. Also, the descriptive profiles of capital structure in the nursing home industry differ across three major segments--county, not-for-profit and proprietary homes.


Cost containment and terminal care: an essay into the ethics of 'appropriateness.'.


Energy management in long-term care facilities: a hot or cold issue? Conservation of energy resources through total energy management programs is receiving considerable attention in the health services sector. Although the total energy management concept has been favorably implemented in hospitals, the record is not entirely clear for other health care institutions. Thirty-one Arizona and 37 Minnesota long-term care facilities were surveyed to examine the attitudes, knowledge and practice of energy management in the nursing home context. Specific questions were directed toward average monthly energy costs, energy consumption, energy conservation methods implemented, energy conservation methods planned for future implementation, and administrator attitudes on the energy management problem. The results of this study indicate that energy is not perceived to be a major problem in long-term care facilities. Administrators generally lack basic knowledge about energy consumption and energy-related characteristics of their facilities. Few long-range plans and programs have been established to address energy problems. These results suggest the need for new energy policies in the health care system, particularly for institutions other than hospitals.


A hospital redefines its mission: a case study.


Is there still a place for independent research into issues of public policy in England and Wales in the 1980's? A case study from the field of health care: modelling hospital costs.


State-HSA relations: state-HSA cooperation on cost containment in rural areas.


The politics of HSA cost-containment efforts: a symposium.


Position statement: Hospital Toxic and Hazardous Waste Task Force, National Environmental Health Association, Institutional Section.


On public sector options for reducing hospital capacity.


Emergency medical services in a rural setting: attitudes of policy-makers and consumers.


Environmental health services in primary care centers. Primary Health care centers supported by the Public Health Service through the Community Health Center and Migrant Health Centers programs are now required to provide environmental hazards directly related to clinical findings, but correcting community and occupational environmental problems may be pursued through appropriate agencies. State and local health departments will play key roles in the program in providing professional expertise in environmental health, assisting patients in taking corrective action, and assisting in the coordination with state, local, federal and voluntary agencies. Some primary care centers in areas of great need and limited resources will have their own environmental health professionals, but most will depend on local health departments for this specialty.


The healthy people blueprint for health promotion and disease prevention.


Managing safety and health.

Managing safety and health.


The business office and the on-line terminal system.


Electronic insurance billing: a pilot project.


Why have an R. N. in admitting?

Why have an R. N. in admitting?


Skiptracing.

Skiptracing.


Patient service representative system.

Patient service representative system.


An effective cash management program can improve your cash flow.


The consultant: friend or foe? The fiscal director's view.


The consultant: friend or foe? The patient account manager's view.


Does American or European equipment better answer the industry's needs?


The consultant: friend or foe? The consultant's view.


Facts you should know before using a low-temperature washing formula.


Medical records:how private should they be?


Chinese hospitals use little linen.

Chinese hospitals use little linen.


The ER: new hot spot for malpractice claims.


Institutional laundries in Far East 'hunger' for American technology, states a globetrotting executive.


Fees: tracking the latest trends.

Fees: tracking the latest trends.


Why the bind on staff privileges may get even tighter.


These HMO opponents had to throw in the towel.


HMOs--medicine for feverish healthcare costs.


Hospital plays GP to the poor via storefront clinic.


New kind of paramedic takes over IV and injection tasks.


Tax-exempt bond ax won't cut deficit.

Tax-exempt bond ax won't cut deficit.


Tax act tosses crumb to nonprofits.

Tax act tosses crumb to nonprofits.


Threat to tax-exempt bonds forces hospitals to consider alternative.


Reagan administration disappoints competition advocates, opponents.


Methodist's prestigious position reflects its trustees' high stature.


High Court debate: does healthcare deserve special antitrust review?


Business coalitions bar providers.

Business coalitions bar providers.


Most significant breakthroughs in 8 years will be displayed at RSNA show.


Buying group contracts for services to hospitals.


HCA builds white knight image in its quest for new market.


HCA hospitals cost less (in 3 states)

HCA hospitals cost less (in 3 states)


Hospital chains become important providers.


Kaiser is shifting to outside contractors.


Beware of taxes on 'extra' revenues.

Beware of taxes on 'extra' revenues.


Chains fight for CONS; ads don't help much.


Hospitals win as vendors adapt.

Hospitals win as vendors adapt.


Quality assurance in the business office.


Advanced health systems' rates under fire in the West.


Vendors expect good demand for updated financial software.


Time-shared system answers hospitals' ad hoc data queries.


Markets at issue as trial concludes.

Markets at issue as trial concludes.


Assessing the merits of medical equipment.


Rx for lowering accident losses.

Rx for lowering accident losses.


PruCare's HMO stance stands despite losses.


Patient service representatives: a system to increase efficiency.


St. Joseph's Leprosy Hospital, Tuticorin.


National autopsy data bank: potentially useful to so many, for so little.


What pathologists should know and be able to do in laboratory data processing and computers: general theory.


Pathology education for patients, public, and peers: problem of the invisible pathologist.


NCCLS: objectives, organization, and activities. In the 1960s, representatives from the professions, industry, and government formed the National Committee for Clinical Laboratory Standards to promote the development and use of national and international standards in the clinical laboratory field. In June at the IV International Symposium on Quality Control in Osaka, Japan, the author of this article, a representative of the NCCLS international committee, provided symposium participants with, an overview of this unique organization. He recalled the events leading to its founding and detailed its structure, it voluntary process of standard setting, and its constituency.


What pathologists should know and be able to do in laboratory data processing and computers: peripheral devices and storages. This article is the second in a five-part educational series on laboratory data processing and computers. The authors describe the major components of peripheral storage and the limitations of input/output devices, and analyze in terms of laboratory workflow the type and placement of input/output devices. Preceding the article are competency areas and performance objectives, defined by the Laboratory Computer Applications and Data Processing Committee. Following the article are questions with which readers can test their understanding of the material. Next month the authors will focus on software.


Will profit-takers change the face of medicine?


St. Mary's Leprosy Centre, Bhimavaram.

St. Mary's Leprosy Centre, Bhimavaram.


The personnel audit.

The personnel audit.


The comparable worth issue: a salary administration bombshell.


Development & PR booklet series.

Development & PR booklet series.


Optimal control of a birth and death epidemic process. We employ a birth and death process to describe the spread of an infectious disease through a closed population. Control of the epidemic can be effected at any instant by varying the birth and death rates to represent quarantine and medical care programs. An optimal strategy is one which minimizes the expected discounted losses and costs resulting from the epidemic process and the control programs over an infinite horizon. We formulate the problem as a continuous-time Markov decision model. Then we present conditions ensuring that optimal quarantine and medical care program levels are nonincreasing functions of the number of infectives in the population. We also analyze the dependence of the optimal strategy on the model parameters. Finally, we present an application of the model to the control of a rumor.


A mixed-integer goal programming model for nursing service budgeting. This paper presents a mixed-integer goal programming model for expense budgeting in a hospital nursing department. The model incorporates several different objectives based upon such considerations as cost containment and providing appropriate nursing hours for delivering quality nursing care. Also considered are possible trade-offs among full-time, part-time and overtime nurses on weekdays as well as weekends. The budget includes vacation, sick leave, holiday, and seniority policies of a hospital and various constraints on a hospital nursing service imposed by nursing unions. The results are based upon data from a study hospital and indicate that the model is practical for budgeting in a hospital nursing department.


ER care packet.

ER care packet.


Story leads for the media: did you know goldfish can grow new brains?


A ticket to the hospital: new admissions handbook format goes a long way.


Jumbo admissions handbook: a patient handbook on every coffee table?


Medical staff attitude survey.

Medical staff attitude survey.


Determination of optimal variable-sized multiple-block appointment systems. The single-block appointment system is the most common method of scheduling ambulatory care clinics today. Several studies have examined various appointment systems ranging from single-block appointments on one extreme to individual appointments on the other, and including mixtures of these such as multiple-block (m-at-a-time) and block/individual systems. In this paper we analyze a general single-server multiple-block system, one permitting blocks of variable size. In the analysis we use a dynamic programming approach, with some modifications to compensate for the non-Markov nature of the problem. Analytical results and approximations which significantly reduce the computational requirements for a solution are obtained. Examples demonstrate that under certain weightings of the criteria of waiting, idle, and overtime, the generality of the system considered here allows performance superior to that of other commonly used systems.


Traveler's immunization clinic: introduce your hospital to the jet set.


Christmas greetings...and thanks for 365 days' service.


Happy birthday, hospital.

Happy birthday, hospital.


Fiscally and physically, this workbook's a winner.


Alumni baby club: don't neglect your youngest potential customers.


It's annual report time.

It's annual report time.


Booklets, volunteers and big money.

Booklets, volunteers and big money.


Production guide for publications: how one medical center helps their departments produce literature.


Launching a medical stress unit...with 60% census the first week!


Early intervention program: the continuing saga of a wonderfully worthwhile mental health program.


Advertising: reaching out. Going "across the border" for patients pays off.


Physician referral service: who else but a hospital would know its doctors?


A prescription for care.

A prescription for care.


Rehab booklet: the personal touch pays off.


Development enlists a radio station.

Development enlists a radio station.


Integrated strategies: a successful approach to hospital public relations.


Are doctors making emergency rooms their competitors?


How to adapt marketing strategies in health-care public relations.


Satellite TV: new way to educate physicians.


How to bring middle management into the communication process: come and talk shop.


Structural and operational factors affecting quality of patient care in nursing homes. This article inquires into structural and operational characteristics of nursing homes that have predictive power for the quality of direct patient care provided to their residents. Data are from nursing homes in the Phoenix, Arizona, metropolitan area. The data were analyzed using multivariate linear regression. Findings of policy interest are that, other things equal: (1) for-profit facilities provide lower levels of care than do nonprofit facilities; and (2) distantly headquartered chain operations provide lower care levels than locally owned facilities. These factors should be considered in long-term care planning and regulation.


A comparative physical evaluation of four X-ray films. In this study, four general purpose radiographic films (Agfa Gevaert Curix RP-1, duPont Cronex 4, Fuji RX, and Kodak XRP-1) were compared using three independent techniques. By examining the characteristic curves for the four films, film speed and contrast were compared over the diagnostically useful density range. These curves were generated using three methods: (1) irradiation of a standard film cassette lined with high-speed screens, covered by a twelve-step aluminum wedge; (2) direct exposure of film strips to an electro-luminescent sensitometer; and (3) direct irradiation of a standard film cassette lined with high-speed screens. The latter technique provided quantitative values for film speed and relative contrast. All three techniques provided virtually properly identical results and indicate that under properly controlled conditions simplified methods of film testing can give results equivalent to those obtained by more sophisticated techniques.


The role of the radiology manager in the VE.


Something new: a radiology policies and procedures outline guide. The American Hospital Radiology Administrators Midwest Region Education Committee felt the need for a guide to assist radiology administrators in developing departmental policies and procedures unique to their own institutions. The outline guide was undertaken as the education project for the committee of 1980/81. The completed guide was presented at the April, 1981 Midwest regional meeting. This article is presented to you to introduce the outline guide and also emphasize the importance of the development of a comprehensive policy and procedure manual for improved radiology management.


Delegation: the art of growing.

Delegation: the art of growing. Delegation is the most important tool we have, yet some managers hesitate to use it. As radiology administrators, we must translate our knowledge and experience to our employees through practice. If we do not achieve this translation through the delegation process, we will fail as managers. Therefore, we must give our personnel greater responsibility, a broader scope of activities and a greater challenge. Let them take as much responsibility as possible so that the feeling, "We're in this together," is shared. As a result, they will put forth the extra effort necessary to become outstanding employees.


Quality administration: the forgotten half of quality assurance.


The physical therapist's role in neonatal intensive care: a survey. A survey was undertaken to investigate the current practice and the actual need for physical therapy in the relatively new area of neonatal intensive care. The opinions of professionals within five groupings at six hospitals with neonatal intensive care units were solicited. A hypothetical situation of the ideal physical therapy service in neonatal intensive care was presented to the respondents who were then asked to compare such ideal services with those currently provided in the units surveyed. The results indicated that the majority of those surveyed consider the physical therapist to be an important member of the health team in a neonatal intensive care unit. Expansion of physical therapy services, with regard to both availability and areas of involvement, appears desirable. Both the conclusions derived from a review of the literature and the survey's results indicate that more research in neonatal physical therapy is needed.


FLEX I and II: the test of the future.

FLEX I and II: the test of the future.


The American Board of Medical Specialties: maintaining and promoting quality medical care.


Using psychodrama for information gathering. Based on the results presented here, psychodrama has a definite place in the treatment of acute and chronic psychiatric clients. It works especially well with these clients on an information-gathering level to elicit information about a client's past unresolved conflicts and feeling relating to them. This data is not often available in the social and psychological history. An additional benefit of this exercise is the accelerated acceptance of the new client into the open-ended, ongoing group. It has also proved to make future group sessions more meaningful to the new member. The implementation of psychodrama at the information gathering level has benefited the therapists clinically and, at the same time, enhanced the client's total participation in group.


Tremendous growth predicted in ambulatory surgery market.


SLA 1981 salary survey update.

SLA 1981 salary survey update.


How do you "assure" quality without promising the impossible?


Patient care data: are you using data processing, or is it using you?


Transporting the critically burned patient.


How to serve hospitals on an NOG basis.

How to serve hospitals on an NOG basis.


Triage of burn patients.

Triage of burn patients.


Ethical and practical considerations in decision making in burn care.


Stress management in burn cases.

Stress management in burn cases.


Cost containment in the operating room.

Cost containment in the operating room.


The auxilian as educator.

The auxilian as educator.


The volunteer's role in infection control.


Options for volunteers.

Options for volunteers.


Community health education: how the auxiliary can help.


Lubbock General's volunteer visitors.

Lubbock General's volunteer visitors.


Volunteers in St. Joseph's oncology unit.


Providence Memorial's TOTS project.

Providence Memorial's TOTS project.


Systems conceptualization of burn care on a regional basis.


Building relationships: the director of volunteer services, auxiliary and administration.


Issues: other views -- self-help mutual aid groups.


Informed consent requirements.

Informed consent requirements.


The case for patient education.

The case for patient education.


The auxiliary in the smaller hospital: volunteers can augment small staffs and be valuable liaisons.


A look at volunteering from one who's been there.


Patient education plays integral role in innovative acute care unit.


How should trustees prepare for corporate restructuring?


Associations let hospitals and trustees speak with a united voice.


The hospital auxilian.

The hospital auxilian.


Nonphysician practitioners in the hospital.


Questions and answers on corporate restructuring. In response to external pressures, many hospitals are changing from a single corporate entity to a system of related, but distinct, corporations. A successful corporate reorganization can allow a hospital to protect and increase revenue, to diversify activities, to avoid government interference, to compete in the marketplace, and to maintain quality of care. Although corporate reorganization is not a panacea, its benefits and disadvantages should be explored by every board.


Long-term care facilities provide home health care services.


Nutrition: in-service dietary education.


Planning has some new dimensions.

Planning has some new dimensions. The demise of the health systems agencies means that planning for institutional survival will take place in a more competitive environment, and that the components of the planning function have new dimensions. Planners must take into account not only the epidemiology of the population but also its economic characteristics, the extent to which the market for medical services will be reorganized by new corporate conglomerates and multiunit management systems, and the reluctance of physicians and patients to embrace the trend to corporate enterprise.


The patter of little footsteps: nursing home day care center mixes generations, returns residents' lives to 'normal'.


Manor Care: where quality meets quality.


The politics of preventive health.

The politics of preventive health.


Special effort, furniture avert falls, study says.


In-service in the dietetics service--part 2.


Volunteers reassure dental patients' families.


Year-end planning for reduced taxes.

Year-end planning for reduced taxes.


Politics a peril: 'national health policy' urged.


For some volunteers, imitation is sincerest form of flattery.


Volunteerism is good business.

Volunteerism is good business.


An outsider looking in: an anthropologist in rehabilitation settings. In assessing the contribution of anthropological investigation to health services, ethical review committees and health services personnel usually weigh the relationship between the risks to subjects from the research procedures and the benefits of the research results. While these reviews are important, attention should also focus on the benefits of the research process, itself. In rehabilitation settings, located at a Veterans Administration Medical Center, psychiatric-care facility, the anthropological research process benefits staff members and patients. Using the role of participant-observer, the anthropologist serves as an anonymous channel of communication and contributes to patient rehabilitation.


Well babies get loving, too.

Well babies get loving, too.


Strategies and procedures of a pain clinic.


Combatting the heat wave of 1980: lessons for the future. Throughout the summer of 1980, much of the nation suffered record-breaking, sustained hot and often humid weather. In cities throughout the country, the oppressive heat often led to crisis situations, and emergency procedures were hastily developed to provide shelter and medical assistance. The heat wave of 1980 was particularly severe in St. Louis, Missouri. On July 17, hospital visits and admissions related to the heat reached a peak of 54 cases. Death rates soared. During the period from June 21 to July 28, the number of deaths in St. Louis rose by 40.6 percent--from 864 deaths in 1979 to 1,215 in the same period in 1980--with the heaviest toll among the poor and elderly. Heat waves of significant medical and social implications are not new to St. Louis. Indeed, conditions similar to 1980 have occurred ten times since 1911, with the most recent heat wave prior to 1980 occurring in 1966. The long periods between crises have caused medical and social planners to neglect or overlook preparations for heat-related illness. Consequently, each new government and medical generation has to deal with these crises from "scratch."


Killed by the CAT?

Killed by the CAT?


Folk art as therapy with a group of old people.


U.S. to help private firms acquire HMOs.


Veteran economist casts critical eye at 'competition' plans. Interview by James Stacey.


Setting a standard for architecture in Islam: the Aga Khan School of Nursing in Karachi.


Colorful ceramic tile creates bold exterior on health center.


Management of high technology equipment in hospitals.


Twenty-five years of university education for health administration in Australia.


The newborn emergency transport service.


Comparative costs for alternative nurse training programmes.


"Voluntary accreditation: an international perspective.".


Hospital efficiency.

Hospital efficiency.


The ongoing pursuit of high quality.

The ongoing pursuit of high quality.


What the doctors say about stress.

What the doctors say about stress.


Establishment of disaster radio response program in the local government radio service for states, territories, and possessions: Federal Communications Commission. Final rule. This document amends 2, 90, and 99 to allocate high frequency (HF) frequencies to be used by the States, Territories, and Possessions in meeting disaster communications needs. This action is necessary to provide these entities with frequency resources needed to fulfill disaster communications requirements.


Qualification of health maintenance organizations: Public Health Service. Notice of proposed rulemaking. This notice proposes to amend the Public Health Service regulations on the qualification of health maintenance organizations (HMOs). These amendments are proposed as a result of the HMO Amendments of 1978 (Pub. L 95-559) and the Secretary's experience with he interim regulations published on June 8, 1977. The proposed changes would (1) modify the appeal procedures followed by the Secretary when an entity is denied qualification, (2) revise the requirements for the signing of assurances by qualified HMOs, (3) clarify how the Secretary treats information submitted by an applicant for qualification which may be requested under the Freedom of Information Act, and (4) make other clarifying and technical revisions regarding the qualification of HMOs.


Continuing treatment for Hansen's disease patients after closure or transfer of PHS facilities: Public Health Service, Final rule. This final rule amends Part 32 of 42 CFR to provide for continuity of care at PHS expense for Hansen's disease patients being treated at PHS hospitals and clinics which will be closed ro transferred pursuant to section 987 of the Omnibus Budget.


Health Resources Administration: announcement of amendments to PHS act; special project grants and contracts.


Hazardous waste management system: identification and listing of hazardous waste--Environmental Protection Agency. Interim final rule and request for comments. The Environmental Protection Agency [EPA] is today revising the regulations for hazardous waste management under the Resource Conservation and Recovery Act to exempt certain categories of mixtures of solid wastes and hazardous wastes from the presumption of hazardousness presently contained in the regulations. EPA is taking this action because the Agency believes that the risk posed to human health and the environment from the management of these waste mixtures is not substantial, so that automatically defining these waste mixtures as hazardous is inappropriate. This amendment will substantially reduce the regulatory burden to those persons who would otherwise have applied the regulations for hazardous waste management to these mixtures.


Container and waste pile standards for owners and operators of hazardous waste facilities: consolidated permit regulations--Environmental Protection Agency. Amendments to interim final rule. The Environmental Protection Agency (EPA) is today promulgating amendments to the hazardous waste management regulations regarding the management of hazardous waste in containers and piles and associated permit regulations (40 CFR Part 264, Subparts I and L, and Part 122, Subpart B). These amendments better tailor the standards to the particular type of hazard posed by specific situations. The standards for containers are amended to waive the containment system requirements for wastes that do not contain free liquids, provided that the wastes are protected from contact with accumulated liquid. The standards for waste piles are amended to waive the containment system requirements for wastes that do not contain free liquids, provided that the pile is protected from precipitation by a structure and from surface water run-on and wind dispersal of the waste by the structure or some other means. The Agency believes these amendments believes these amendments will not reduce the level of protection of human health and the environment.


Health Care Financing Administration; statement of organization, functions, and delegations of authority.


Interim status standards for owners and operators of hazardous waste treatment, storage, and disposal facilities--Environmental Protection Agency. Interim final rule and interim final amendments to rules and request for comments. The Environmental Protection Agency [EPA] has issued standards applicable to owners and operators of hazardous waste management facilities as required by the Resource Conservation and Recovery Act [RCRA]. One of these standards bans the disposal of most containerized liquid hazardous waste in landfills, effective November 19, 1981. As a result of reconsideration of this restriction, EPA is today promulgating an interim final rule to allow the disposal of small containers of liquid and solid hazardous waste in landfills provided that the wastes are placed in overpacked drums [lab packs] in the manner specified in today's rule. The purpose of today's rule is to provide an environmental sound disposal option for generators of small containers of hazardous wastes, such as laboratories.


Department of Health and Human Services--Grants and subgrants to for-profit organizations. Proposed rules. This rule proposed to remove regulatory bars to grants to for-profit organizations under three HHS grant programs in which the for-profit organizations are not barred by statute from receiving grants. It also proposes (1) to make HHS's Department-wide grants administration regulations, 45 CFR Part 74, apply automatically to grants and subgrants to for-profit organizations and (2) to add to those regulations additional provisions for grants and subgrants to for-profit organizations. These actions reflect a reversal of the Department's generally policy of not making for-profit organizations eligible for grants in those few programs where they are not statutorily barred from receiving grants.


Grants to for-profit organizations; implementing amendments--Public Health Service. Final rule. This issuance amends 42 CFR Part 52 applicable to grants made for research projects under sections 301 and 356 of the Public Health Service Act to delete the prohibition on eligibility for research awards to entities that are organized or operated for profit. Elsewhere in this issue of the Federal Register is a final rule which, among other things, amends 42 CFR Part 87 to allow for-profit organizations to apply for health research and demonstration grants under section 20 of the Occupational Safety and Health Act and section 501 of the Federal Mine Safety and Health Act.


Big losses force merger of Illinois Blue Cross plans.


Dental plans remain popular with employers, employees.


Federal fund cutback may slow HMO growth.


Additional standards for human blood and blood products; source plasma (human)--Food and Drug Administration. Final rule. The Food and Drug Administration [FDA] is amending the biologics regulations to make clear that an active plasmapheresis donor, who is to be immunized for the production of high-titer plasma, does not need to be reexamined before the first immunization injection if the same donor has previously received a physical examination for plasmapheresis in accordance with section 640.63(b)(1). This rule eliminates a burden on the individual plasmapheresis donor and the plasmapheresis center.


Hospice: employers consider home care for terminally ill.


Medical claims audits can stop the flow of costs leaks from group health care plans.


Mandated health coverage competition may create more ills than it would cure.


"Pro-competition' bills fail to recognize the problems pushing health costs up.


Drug usage review. Part one: designing the BC Pharmacare program.


Anxiety in the coronary care unit: assessment and intervention.


Five steps to cost containment.

Five steps to cost containment.


A community hospital sets the example in energy conservation.


Energy conservation and the responsibilities of health care institutions.


Healing is the biggest business.

Healing is the biggest business.


A profile of the volunteer board member.


Commitment to caring.

Commitment to caring.


Continuing education: how the board member sees it.


Anatomy of non-task seating: how to determine seated comfort for the body at rest.


Financial modeling: one hospital's experience.


Benefits of hospital based systems.

Benefits of hospital based systems.


Capacity planning guide for mainframes running the IBM patient care system (PCS).


El Camino Hospital: ten years later.

El Camino Hospital: ten years later.


HMOs look for increased private investments.


Red to black through computerization.

Red to black through computerization.


Efficient and effective abstracting: patient information reporting system is the answer.


Competitive tying arrangements: the case of medical insurance.


Medical information systems--can our current computers handle it?


Ease of administration, decreased costs persuade companies to adopt direct reimbursement dental.


Health risk estimation may provide cost-efficient alternative to periodic employee health exams.


An evaluation of the costs of pregnancy disability.


Calif. hospital nixes DOD bed request.

Calif. hospital nixes DOD bed request.


On-line embosser at UCSD Medical Center.


In-house versus contract cleaning.

In-house versus contract cleaning.


Low-key employee drive pulls 200% of goal.


Artifact in client satisfaction assessment: experience in community mental health settings. Artifact in client satisfaction assessment is discussed and the results of a study of three factors thought to mediate client satisfaction ratings; (a) general life satisfaction, (b) mode of administration, and (c) psychological symptomatology, are reported. A standard client satisfaction questionnaire (CSQ) was modified to yield parallel forms and was administered orally and in writing to 92 clients in two mental health day treatment programs. Satisfaction ratings obtained from these clients were quite similar to out-patient ratings obtained in previous studies conducted in this setting and using the same measures. Oral administration of the CSQ produced 10% higher satisfaction ratings than written administration (p less than .05) and less missing data (p less than .01). Satisfaction ratings were also obtained using a simple graphic instrument. Graphic ratings were comparable to CSQ ratings. Satisfaction with life in general and level of psychiatric symptoms together accounted for 25% of CSQ variance. The implication of these findings for future client satisfaction research is discussed.


Methodist Hospital automates dictation.

Methodist Hospital automates dictation.


"Transcendental" labor worries?

"Transcendental" labor worries?


Perseverance or pigheadedness?

Perseverance or pigheadedness?


The risky business of quality care.

The risky business of quality care.


Influencing the training of nurses.

Influencing the training of nurses.


A total approach to hospital budgeting and financial planning.


Learning about labor relations.

Learning about labor relations.


New directions for community hospitals: occupational and preventive healthcare.


There's no nurse shortage at Saint Joseph Medical Center.


Waiting lists: where does the time go?

Waiting lists: where does the time go?


Hospital closure; dismantling with care.


Product profile: more than a wound dressing.


Patient finance: how to pay patients.

Patient finance: how to pay patients.


Waiting lists: a test of stamina.

Waiting lists: a test of stamina.


Northern Ireland: high rise hospital.

Northern Ireland: high rise hospital.


The flying wardens.

The flying wardens.


NHS spending: maximizing resources.

NHS spending: maximizing resources.


Nurse management: the essential link.

Nurse management: the essential link.


Is group purchasing always best?

Is group purchasing always best?


Hospital purchasing in the era of the corporate takeover.


Budgeting techniques for materials managers.


Can group purchasing survive the 1980's? Part 1.


How to bid and contract for an RTSS UHF system.


Winter maintenance for ambulance vehicles.


The French hospital system at local level: the Centre Hospitalier Regional de St Etienne.


Monitoring hospital medicine expenditure.


CDC provides recommendations on vaccine-preventable diseases.


Unauthorised tampering with hospital equipment.


Infection risks of multiple dose vials examined.


Circulating fluid bed combustion: energy from waste materials and coal.


Installation of a Honeywell Delta 1000 building services management system: savings through central control.


Existing hospital stock: problems and solutions. Part I.


Economic and legal implications of multi-institutional arrangements.


Human life "federalism" amendments: its language, effects.


Existing hospital stock: problems and solutions. Part II.


Holy Cross Hospital, Nogales, AZ. Congregation, diocese collaborate to maintain Catholic hospital.


Performance review: essential tool for CEO, board accountability.


Resolving role confusion, a source of employee conflict.


Treating defective newborns: who judges extraordinary means?


Direct client communication useful libel defense.


Report of CHA divisional activities.

Report of CHA divisional activities.


Hospitals may remove unruly patients to protect others.


Evaluating an organization's disciplinary system.


Court rules blood bank is health care facility: bars NLRB bargaining order.


Human resource management and the energy crisis: an ostrich posture?


Economic Recovery Tax Act affects non-profit hospitals' informational tax reporting for fixed-asset depreciation.


Bills to deposit shareholders' dividends directly to charities could increase giving and increase investment returns.


Grant-in-aid success or research by the average practitioner is possible.


We've come a long way.

We've come a long way.


Student today; practitioner tomorrow.

Student today; practitioner tomorrow.


A biostatistical and epidemiologic perspective of an occupational health record system.


The practice of clinical education in medical record administration.


Screening hospice volunteers: using a psychiatric nurse as a consultant.


Medical care evaluation.

Medical care evaluation.


Reduce the risk of liability.

Reduce the risk of liability.


How to evaluate the finance function.

How to evaluate the finance function.


Care continuity between a general hospital and a community urgent care center.


"When you're thinking about communications---think big!".


Good playrooms take a crafty imagination.


Ten commandments of infection control.

Ten commandments of infection control.


Focusing on the human being.

Focusing on the human being.


Good health design: well in the open.

Good health design: well in the open.


Materiel management: multitudinous hospital forms.


Independent air flows.

Independent air flows.


Solve the nursing shortage with your available resources!


Government discusses alternatives.

Government discusses alternatives.


Good health design: technology for efficiency.


A pastoral care assessment for the psychiatric team in the age of DSM - III.


A model for determining the cost per use of multiple-use blood pressure transducers.


Alternatives to UCR: an internist's perspective.


Cost containment out the door.

Cost containment out the door.


Fee-for-service: an endangered species?

Fee-for-service: an endangered species?


UCR--the measure of all other systems?

UCR--the measure of all other systems?


Compensation by capitation.

Compensation by capitation.


Barriers to effective knowledge use in national mental health policy.


Designing health policy research for utilization.


Preserving alternate income: assessing IRS positions on lab services tax.


The CEO/COO model: dual leadership in hospitals gains momentum.


Collections: improving the self-pay balance picture.


Accounts receivable: using lock boxes to reduce float time.


Charging for services: using computers to determine unit costs.


Capital management: financing capital in a hospital-based prepayment plan.


Receivables decreasing.

Receivables decreasing.


New kid on the block?

New kid on the block?


Making friends with discretion.

Making friends with discretion.


Aggression in the healthcare environment: part II theories of aggression.


Chasing a rainbow: catching an arsonist.


Inventory management.

Inventory management.


Time for all things.

Time for all things.


Take the sting out of firing.

Take the sting out of firing.


Survival of the fattest.

Survival of the fattest.


Coping with block grants.

Coping with block grants.