How do you work with doctors and get doctors to work with you? Part II.


Understanding the problems which hospital administrators face.


Not for nurses only: how to communicate with doctors.


"Problem-focused" vs. "program-focused"--the light dawns!


Forecast 1981: our annual analysis and survey of healthcare supply and distribution.


Linen cost management.

Linen cost management.


Social work: why it's needed in intensive care units.


Volunteer recruitment.

Volunteer recruitment.


Clinical assessment in mental health settings.


A penny saved: efficient blood bank services.


Inside Russian hospitals.

Inside Russian hospitals.


Employer-sponsored child care: a service that benefits the hospital, employee and child.


Burnout! in the health care system.

Burnout! in the health care system.


The role of the multi-hospital system in the survival of the smaller hospital.


Financing America's health care.

Financing America's health care.


Meeting the special care needs of the elderly. Hospitals increasingly are recognizing the elderly as a growing portion of their patient population and are developing hospital-based services and programs as a response. To realize the hospital's potential for promoting the health of the elderly, hospital leadership can recognize the elderly as a major segment of the hospital's patient service population and can ensure effective health care for the elderly, not only as a provider but also as an innovator and coordinator.


The case for arbitrating hospital-physician disputes. An arbitral process that provides independent fact-finding and recommendation to hospital trustees in accordance with rules and regulations of the hospital is proposed as an alternative to internal peer review for resolving hospital-physician disputes. This approach should prove acceptable as a fair and impartial method to both parties, who may design appropriate rules for such disputes.


Getting your money's worth from your consultant. The relationship between hospital and consultant can be productive only if the expectations of both parties are clearly understood at the outset. This article presents guidelines on getting the most from a consultant, from developing the objectives of the project, through drafting a request for proposal and interviewing candidates, to follow-up once the project has been completed.


How board committees are responding to change: the planning and development committee.


Diversifying a rural hospital: 'a lot of work--and very rewarding'.


Tips on preventing or minimizing construction claims. With proper planning and use of successful techniques of claims avoidance, recognition, and resolution from the initial stages of the project, a hospital can prevent or minimize construction delays and claims and can complete its new construction in a reasonable atmosphere with a minimum of cost.


A hospital that takes care of well people. Swedish Medical Center's pioneering wellness program grew out of a long-standing commitment by its trustees to improving the health of their community. This article describes the genesis of the program and offers advice to boards considering such a move.


How board committees are responding to change: the planning committee.


Public facilities face rough financial seas.


Microsurgery: latest medical revolution.


Behind the scandals in science labs.

Behind the scandals in science labs.


How board committees are responding to change: the corporate relations committee.


Compensation for hospital trustees.

Compensation for hospital trustees.


When manpower is man power.

When manpower is man power.


Zero based budgeting offers survival strategies for the '80s.


Spend money to contain costs: offer free meals to volunteers.


Volunteerism, volunteer coordinators and continuing education.


Combatting child health problems in the public health sector.


Volunteers in Britain today.

Volunteers in Britain today.


Pharmacy education and health planning.

Pharmacy education and health planning.


Corporate volunteerism: the Helping Hands approach.


Problems and programs in high risk pregnancy.


Pre-med summer volunteer program: a rotation concept.


Understanding transitional volunteers.

Understanding transitional volunteers.


Clinical policy analysis: the mathematical approach. Interview by Dianne Hales.


The house that hernias built: Shouldice Hospital specializes in only one kind of surgery.


Health care funding: are the states able to take over?


On making decisions.

On making decisions.


The computer in your future.

The computer in your future.


Are you ready to automate?. Interview by Joe Breu.


NLRB coverage denied: Supreme Court rejects housestaff plea.


The things you hear about computers!

The things you hear about computers!


A case study on the competitive impact of HMOs in Detroit.


Migrant farmworkers, northerners put Texas medical care to the test.


Cost comparisons--are they possible?

Cost comparisons--are they possible?


Old myths--new myths.

Old myths--new myths.


Good laundries may come in small packages.


Linen purchasing.

Linen purchasing.


Teaching C.O.P.D. patients to live more comfortably. In Florida, programs to help chronic pulmonary disease patients cope better with their illness are now operating in 20 areas. Catalysts for the programs are the Florida Lung Association and local affiliates. The basic resource for this patient education effort is the Staff Manual for Teaching Patients about COPD, developed by the ALA and the American Hospital Association.


Updated TB care means patients get well. In many parts of the U.S., old-fashioned methods of TB care are imposed on patients. Some health professionals still think in terms of isolation and lifelong followup of TB patients. This causes serious interruption of patients' lives and is an inefficient use of scarce and ever-shrinking health resources. The reorganization of two clinic systems in New Jersey shows what can be done.


How to pick a good hospital.

How to pick a good hospital.


The dark side of GMENAC.

The dark side of GMENAC.


The doctors' dilemmas.

The doctors' dilemmas.


How to write a good job description.

How to write a good job description.


Internes and residents: "new breed of cat" knows exactly what it wants.


Privacy Act of 1974; new system of records--Department of Health and Human Services; Public Health Service. Notification of a new system of records: 09-25-0143. In accordance with the requirements of the Privacy Act, the Public Health Service (PHS) is publishing notice of a proposal to establish a new system of records, 09-25-0143, Biomedical Research: Records of Subjects in Clinical, Epidemiologic and Biometric Studies of the National Institute of Allergy and Infectious Diseases, HHS/NIH/NIAID. We are also proposing routine uses for this system. This system will be used to support (1) epidemiologic, clinical and biometric investigations into the causes, nature (morbidity and mortality), outcome, therapy and cost of infectious, immunologic and related diseases; (2) review and evaluation of the progress of these research projects, and identification and planning for improvements or for additional research. The population and statistical studies supported by this system may be conducted or managed by Institute staff as well as others outside the Institute. This system comprises records maintained in a number of distinct research projects. The number and specific nature of projects will change over time as new ones are started and as work on existing projects is completed.


Hospital system backers lose influential allies.


Self-help groups and mental health: a promising avenue.


How far can a rule bend?

How far can a rule bend?


Biomedical waste disposal--Nuclear Regulatory Commission. Final rule. The NRC is amending its regulations to permit licensees greater leeway in disposing of liquid scintillation media and animal carcasses containing tracer levels of hydrogen-3 (tritium) or carbon-14. These rule changes will primarily affect NRC licensed hospitals and medical research institutions. Most licensees presently dispose of these items by sending them to a radioactive waste burial ground or by obtaining special authorization from NRC for incineration or onsite burial. Under the new regulations, the licensee may dispose of specified concentrations of these materials without regard to their radioactivity. The NRC is also amending its regulations to raise the annual limits for disposal of hydrogen-3 and carbon-14 by release to the sanitary sewerage systems. The rule changes will conserve waste burial capacity that is already in short supply.


Social atmosphere in self-help groups: a case study.


Ten steps towards establishing a self-help group: a report from Montreal.


Living with schizophrenia: a group approach with relatives.


Experiments in dental coverage: no longer pulling teeth.


C/T scanning--what's it all about?

C/T scanning--what's it all about?


A model for alcohol clinics working with industry.


A power struggle in the department of surgery.


Management professionals vs. medical professionals.


Equalizing power within the medical staff.


Unifying the medical staff, full-time chiefs, and administration in a teaching hospital.


Delineation of privileges in a university teaching hospital.


Administration-medical staff communication.


Establishing a mechanism for implementing a medical staff moratorium.


Obtaining a discharge diagnosis in a medical center.


Hospital clinical computers: a Canadian experience.


Formulating medical staff budgets.

Formulating medical staff budgets.


A nonphysician permitted to practice medicine.


Suspension of a physician's hospital medical staff privileges in a Canadian hospital.


Quality assurance in a university teaching hospital.


Medical audit policy and procedure.

Medical audit policy and procedure.


The impaired physician.

The impaired physician.


Removal of medical staff privileges.

Removal of medical staff privileges.


Removal of a department head--abdicate or execute?


Administrative decision in medical staff ethics.


Physician recruitment for a rural hospital.


Physician recruiting in a small hospital.


Success and failure in physician recruitment.


Court-ordered hospital integration.

Court-ordered hospital integration.


Steps in negotiating for a hospital-based physicians' office building.


A search procedure for full-time physicians.


A hospital medical office building attracts physicians.


A financial plan for a hospital's professional office building and parking facility.


Two physician groups construct their own buildings through a hospital land lease arrangement.


Medical staff expansion with a new suburban satellite hospital.


Professional office building--why and how.


Maintaining cost-saving incentives in physician contracts.


The United States Supreme Court legalizes abortion.


A physician's group gives their office building to a hospital.


Cost savings result from a salary arrangement for radiologists and pathologists.


A hospital-based anesthesiology service.


Implementation of New York State Department of Health mandate: eliminate percentage of gross revenues financial agreement with hospital-based radiologists.


Conflict rationality in hospital management.


Anesthesiologist vs. administrator: a classic power struggle.


Administrator and pathologist conflict in contract negotiations.


Controlling compensation for hospital-based pathologists.


The pathologist fee crisis--Rx for relief.


Medical school affiliation brings full-time physician chiefs to a community hospital.


Full-time emergency physician service in a small hospital.


Creation of a patient terminal care review procedure.


A medical staff's reaction for a contract emergency service physician group.


Full-time emergency physician service in a 600-bed hospital.


Problems with a contract emergency physician services group.


Community-based medical service.

Community-based medical service.


Development of an ambulatory service department--a management failure.


Reorganization of ambulatory care programs in a university medical center hospital and clinics.


Establishing a free-standing ambulatory surgical facility.


Survival of an inner-city hospital through medical staff integration.


The development of a primary care group practice.


Development of a clinical department practice plan.


Medical center outpatient clinic generated fees--a physician payment plan.


Malpractice insurance premium increase causes a physician work stoppage.


One response to the Joint Commission on Accreditation of Hospitals.


Physicians as hospital trustees.

Physicians as hospital trustees.


Medical staff bylaws: a developing process.


Involvement of the medical staff in management.


Hospital dental staff organization.

Hospital dental staff organization.


Medical staff organization for a four-hospital merger.


Reorganization of the medical staff in a Canadian hospital.


AHSC seeks dismissal of antitrust charges.


Group director stresses need for good vendor evaluation.


Getting the most out of group purchasing.


Legal guides outlined by purchaser, lawyer.


In-service route to CS training.

In-service route to CS training.


Private health care fraud unit formed.

Private health care fraud unit formed.


Defining PA's role in capital acquisition.


Inventory management: establishing control.


Clarifying the concepts of research ethics: a second filtration.


High technology equipment needs.

High technology equipment needs.


The corporate viewpoint.

The corporate viewpoint.


Research and development needs.

Research and development needs.


Government policy--the present context of financial support.


The qualities and responsibilities of a trustee.


Multi-facility management in Canadian health care: what are the incentives?


Capital needs.

Capital needs.


Hospital boards: public trust in private hands.


HSA boards: how representation works in health planning.


Housing patients in nearby hotel cuts two thirds off per diem costs.


After successful start, 'patient rep' system falters, is abandoned by Tucson hospital.


Breaking productivity barriers: 'participative management' may hold key to American worker output.


CHA reports on accreditation.

CHA reports on accreditation.


Pharmacy technicians establish an independent national organization.


Attitudes about death in the nursing home: a research note. An increasing percentage of the U.S. population dies in nursing homes. Despite the increased attention given to the topic of death, most nursing homes practice a covert approach. A total of 86 residents and staff members from 2 nursing homes support this finding; yet many expressed an interest in modifying the policy. A majority believed that others should be told about the death of a resident. Respondents reported the interview process to be satisfying.


Perinatal mortality counseling program for families who experience a stillbirth. The emotional impact of a stillbirth on a family has only recently begun to be appreciated. Literature regarding the grieving process in these families has been relatively scant and does not often facilitate applied approaches. The Perinatal Mortality Counseling Program (PMCP) at Shands Teaching Hospital, Gainesville, Florida, provides crisis intervention and support for these families as well as serving a research function. This article outlines the program, including its history, composition, procedures, and research.


CCHA reports on accreditation.

CCHA reports on accreditation.


A school and a hospital join forces.

A school and a hospital join forces.


CME programming from the AMA--an update.


1st-rate EMS in Virgin Islands loses staff to higher U.S. pay.


Making your workplace OSHA-safe.

Making your workplace OSHA-safe.


Support system of health professionals as observed in the project of home care for the child with cancer. Crucial questions for health professionals include what constitutes social support, the sources of social support, and the parameters of social support. The preliminary findings from a research project that focused on the care of children dying of cancer indicate that these questions have concerned primary care nurses and physicians. Data acquired in personal interviews administered to 27 physicians and 32 nurses who participated in the first year of the Home Care for the Child with Cancer project provided descriptions of individual sources of social support. The results reveal a range of supportive mechanisms and networks within varied institutional contexts. While there were some within-group similarities in the forms of social support used by nurses and those used by physicians, numerous individual differences were evident. This is an area for extensive further study.


Safeguarding health rights of inmates.

Safeguarding health rights of inmates.


Good facility design should integrate aesthetics, program aspects.


Convenience, personal attention crucial to program success.


The saints come marching in: victories at St. Clare's in New York are latest in series of 1199 wins at Catholic hospitals.


Volunteers: Vanderbilt's "tour de force".


Legal responsibility of individual hospital trustees.


Volunteers and hospital libraries.

Volunteers and hospital libraries.


Rx for success: shared power is a positive force.


Turning media relations around.

Turning media relations around.


Long struggle brings 1199 contract for nurses in New Mexico.


Why nurses leave nursing.

Why nurses leave nursing.


Research approaches in health professions education: problems and prospects. Research in health professions education has been dominated by a research paradigm emphasizing controlled experimentation. Widespread criticism has been voiced by leaders in the research community concerning the adequacy of the paradigm to deal with complex human behavior occurring in complex social environments. This article is concerned with exploring the implications of controlled studies for health professions education and proposing an alternative research strategy.


The Woodhaven short-term model reconsidered: a study of developmental growth and criteria for discharge. This article concerns the issues surrounding discharge of mentally retarded clients from a short-term, intensive residential service setting. The Temple University Woodhaven Center is designed as a two-year setting for about 270 clients. They require intensive assistance in acquiring behaviors necessary for independent functioning and in learning appropriate social behavior, so that they can adapt to and thrive in a less restrictive, more integrated setting. Woodhaven, however, serves clients at all levels of retardation. The question arises: How is it decided who is to be discharged and when? Upon entry to Woodhaven, a contract is written with the family and client, specifying what behavioral changes are expected as preconditions for discharge. In this approach, a client should be discharged upon attainment of contract goals. A second approach uses adaptive behavior skills as a criterion of progress, and attempts to determine the level of skills displayed by other, similar clients who are already living in the community. This second, criterion-referenced approach is important not only for discharge decisions from one facility, but for broad service system planning as well. The results of the present study supported the notion of a two-year intensive residential program.


Utilizing nonparametric statistical techniques: evaluating management effectiveness of an alcoholic treatment center. A system of measures was designed to evaluate the effect of a change in management of an alcoholic treatment center. The measures also were used to indicate the causes for the changes in performance. Because the treatment center's physical plant is to be replaced in the near future, regression techniques, using one of the evaluation measures, were used to predict the size of the replacement facility and when it should become operational. The evaluation was made approximately a year after the management change occurred. Because only a limited amount of data was available, it was necessary to use nonparametric statistical techniques.


'Balloon' hospital definite success.

'Balloon' hospital definite success.


Who should abstract medical records? A study of accuracy and cost. The accuracy of patient record data depends not only on the quality of medical record keeping but also on the accuracy of the process of abstracting patient records to produce data suitable for analysis. This article reports results comparing record abstracts produced by four classes of abstracter: physicians, tumor registrars, nurses, and fourth-year medical students. The purpose of the comparison was to determine whether or not there were differences in accuracy among the four groups and, if accuracy was approximately equal, whether there were substantial differences among the costs of employing the four groups.


A residential continuum for the chronically mentally ill: a Markov probability model. The movement of a group of chronically mentally ill clients among various facilities for residential care was described with a Markov probability model. The results of a goodness-of-fit test indicated that the model accurately captured the flow of clients among the state psychiatric hospital, the in-patient units, the community, and three types of group homes. The model was then used to answer several policy-relevant questions about the functioning of the continuum of residential care, such as how often vacancies can be expected to arise and how efficiently clients are progressing along the continuum.


Problem characteristics, decision processes and evaluation activity: a preliminary study of mental health center directors.


Group practice dissolutions: a tale of two clinics.


Establishing a satellite clinic.

Establishing a satellite clinic.


Trustees in the Canadian health service: opportunities and problems.


A new look at an old report.

A new look at an old report.


Community foundations rally 'round a mental health project.


A logic tree approach to the Fairfield Home fire. In this paper, a logic-tree analysis model has been applied, though in a relatively simple and crude fashion, to the fire that occurred at the Fairfield Home, Nottinghamshire, in 1974.


Paging Dr. Adam Smith.

Paging Dr. Adam Smith.


Education, training creates effective board of trustees. The problems facing today's hospitals are not new - except in magnitude. To keep our institutions funded, the selection of the trustee development committee should receive the first priority of the board, according to this author.


Case statement: blueprint for fund raising success. The case statement is the primary document upon which an organization bases its appeal for financial and philosophical support. This author points out how a well-constructed case statement can impact on fund raising success.


Health non-profits face shift in foundation grants.


Giving USA qualifies bank study projections of giving. Giving USA, perhaps the most respected annual report of philanthropy, takes exception to some of the conclusions drawn by the Chemical Bank study. All non-profits are winners in their eyes.


Selectivity among large employer group members of a prepaid group practice model HMO: the relationship between employee premium contribution, medical care utilization and market penetration.


Effects of removing the waiting period for maternity benefits in an HMO: the Harvard Community Health Plan experience.


Gamma rays have a glowing future.

Gamma rays have a glowing future.


Relocating? Keep costs down and efficiency high.


What every head nurse should know about management.


How PAR can save $100,000 annually.

How PAR can save $100,000 annually.


Hospital at home: yesterday Bayonne, today Peterborough. A family crisis can loom up when a supportive adult is taken into hospital. It affects the elderly and the young especially. Peterborough district has taken steps towards resolving this problem by bringing the hospital to the patient. Pauline Drummond reports on phase II of 'Hospital at Home'.


Ambulance services: to Birmingham, by way of Beachy Head. Co-ordination of ambulance journeys on a country-wide basis is one of the possibilities opened up by the use of computers in ambulance control. Frederick Thornley, chief ambulance officer, Oxfordshire AHA(T) and Barry J. Lewis, assistant divisional officer and chief control officer, discuss the advantages and limitations of computer assistance.


Management of nursing services: financial control of establishments. After restructuring budgetary responsibility for nursing services will be pushed down to unit level. Peter Creighton, area nurse (service and capital planning), Redbridge and Waltham Forest AHA, draws attention to the problems created by special duty payments.


Improving maternity services: useful research--and the other kind. 'There is no room in the health service for impractical research,' says Elizabeth Perkins, research and development officer, Nottinghamshire Area Health Education Unit, and honorary research fellow, Department of Adult Education, Nottingham University. Her book 'Education for childbirth and parenthood' was reviewed in last week's 'Journal'.


Notes from the USA: fighting for survival. Hospitals in the US face competition for patients. The hospitals are responding to this pressure by expanding into new primary care services and organisations. First in a new monthly series.


Citizens Advice Bureau: advice on a trolley. To a hospital administrator, the way in which a Citizens Advice Bureau (CAB) and the hospital's social work department can complement each other is not immediately obvious. So when the social work department invited the Brent Mobile CAB to assess the possibilities of a bedside service to inpatients, the idea was greeted with some uncertainty. Graham Coomber, hospital administrator, Central Middlesex Hospital, and Denise Fears, organiser of the Brent Mobile CAB, describe the first three months.


Improved training for the Russian nurse. The Russians seem to be giving more attention to the training of nurses and to the quality of nursing services. Dr Michael Ryan, lecturer in social policy at the University College of Swansea, describes changes in system where hitherto the only path of advancement for the nurse was to become a doctor.


Medical device regulations 1981: do they dare to be different.


Clothing for staff: garments that guard. Much of the clothing worn in hospitals is designed for protection, either of the staff themselves, or of their everyday clothes, or their patients and the community generally. A. Smith, safety liaison officer, Haringey HD, reviews the requirements of legislation and good practice.


Analysis of the drug information needs in a 550 bed university hospital.


Computing to control the drug bill.

Computing to control the drug bill. The Derbyshire pharmaceutical computer system has been developed in collaboration with UniChem to give better stock control and thus make savings in the total drug bill. It is described by Mike Cullen, area pharmaceutical officer, and David Thomas, finance officer, South Derbyshire HD.


A measure of health status in an elderly population.


Health care and remedial professionalisation.


North Dakota pharmacists' use of drug information.


Achieving higher level wellness in the older population.


Geriatric day care--filling the service gap between home and nursing home.


Ingredients for a catering dispute.

Ingredients for a catering dispute.


The work done by doctors in the NHS.

The work done by doctors in the NHS.


Reorganisation: opportunity or impediment?


Evaluating glass and electronic thermometers.


Residential management and the personnel function.


Measuring purchasing performance: cost reduction/cost avoidance.


Establishing productivity goals.

Establishing productivity goals.


A look at an "Iron Curtain" hospital and its purchasing department.


Using value analysis to increase savings.


Peritoneal dialysis poses risk of hepatitis B transmission.


What qualities do ICC chairmen and epidemiologists need?


Behavorial modification program cuts asthmatic children's hospitalization.


St. Joseph Hospital, Inc., Towson, MD. Outreach and visitation programs enlarge hospital's service population.


Health care 2000 AD: the impact of conglomerates. Revamped organizational structures, revitalized lobbying strategies, expanded overseas developments, and new criteria for measuring hospitals' effectiveness will characterize the industry in 2000 AD.


Using epidemiological tools to compare QA and RM.


Social values, health care practices focus of China trip.


Alienation, reconciliation, and unity: dynamics in effective pastoral care. Alienation from one another, self, the environment, and God impedes the pastoral care team's effectiveness. Changing attitudes and implementing techniques to achieve reconciliation can bring about growth toward a more dynamic ministry.


Nurse staffing dilemma: analyzing objectives, recognizing constraints. Before designing and implementing a staffing methodology, health care institutions need to develop specifications and define needs. Without clear objectives, administrators may end up tackling symptoms instead of issues.


Credentialing ER physicians; priority for QA in hospitals.


Discovery rule requires plaintiff to prove facts.


Mexico's doctors.

Mexico's doctors.


Taking care in Mexico.

Taking care in Mexico.


Extraordinary care definition is individual determination.


The new health authorities: sandcastles below the tideline?


Training in the management of hospital supplies for overseas students.


Defending the Simpson.

Defending the Simpson.


Financial information for management.

Financial information for management.


The health service commissioner.

The health service commissioner.


A practical approach to an absentee problem.


Tighter control of medical gas handling saves money, improves patient care.


How to develop a complete nursing management program.


A brief and concise on-going reporting system.


Procedures for location and charge control of small rental equipment, which meets JCAH insurance carrier requirements.


Materiel management: what does the administrator expect of the materiel manager?


How to "talk" with vendors--place orders--avoid back orders--and save thousands!


How to control your time: personal time management (Part II--controlling time wasters).


Consultant's corner: are there any criteria for determining intensive care and coronary bed needs for individual hospitals?


Hospital renovation and maintenance operations: questionable companions.


Dealing with the problem of employee turnover.


Paper work can be at the heart of some of radiology's problems!


Paring down losses in food service.

Paring down losses in food service.


Oklahoma court approves City of Faith certification: cite "national constituency".


HCSC-Laundry has tax implications beyond laundries: shared service organizations should understand exemption revocation possibilities.


How a center for coordinating services to the elderly functions.


New York Court of Appeals reviews Eichner and companion termination of treatment case.


PPI regulations put on hold; HHS is sued by consumer groups.


Public relations: next 10 years could come as a surprise.


The pressure is on for outpatient services.


Action for the nursing shortage.

Action for the nursing shortage.


Hospital infection control committees--are they effective?: problems and possible solutions.


Hospital classes for couples adopting newborns.


Management science applied to nurse recruitment, or how to hire 66 nurses in 42 days.


Do we need IV guidelines?

Do we need IV guidelines?


Changing roles and mental health in women.


Ontario's hospital workers strike out.

Ontario's hospital workers strike out.


Lavatories--as part of patient room.

Lavatories--as part of patient room.


Special needs of women in health examinations.


Choosing a telecommunications consultant.


Challenges to corporate policy.

Challenges to corporate policy.


Control materials and you control costs.


Overview: the health of working women.

Overview: the health of working women.


The staffing requirements of employee assistance programs.


Insurance and insurability for mental health services.


Ethics in industrial mental health programs.


Trends in corporate mental health insurance.


Industry's response: a survey of employee assistance programs.


Case studies in mental wellness programming.


Some guidelines for employee assistance program development.


Promoting an employee assistance program in an HMO.


Last rights: the psychological needs of patients and physicians.


Mental wellness and the cost of health care.


Last rights: are physicians failing the dying?


Provider and consumer control: interpersonal power relations at board meetings.


Last rights: internist, physician, friend.


Hospice: caring when curing fails.

Hospice: caring when curing fails.


Pilferage control--a package pass policy.


Security in the rural hospital.

Security in the rural hospital.


Unionized professionals and the scope of bargaining: a study of nurses.


The cost of private-practice psychiatry under national health insurance.


A legal perspective on pregnancy leave and benefits.


Medical staff role in the 1980s.

Medical staff role in the 1980s.


Duties and responsibilities of trustees.


Thoughts on motivation in a nursing department.


Managing human resources in the 1980s.

Managing human resources in the 1980s.


Newfoundland study proposes new kind of partnership between government, hospitals.


Canadian health services administration in the 1980s.


Interaction management training.

Interaction management training.


Reassuring trustees about liability.

Reassuring trustees about liability.


Establish ethics committee to minimize liability, authority advises.


Reduce drug diversion with strict controls, expert advises.


Coping with direct apportionment reimbursement from feds.


Chemical hazards: focus on safety.

Chemical hazards: focus on safety.


The physician's stake in health care marketing. Better health care services will result when physicians become involved in hospital marketing plans, especially in selecting appropriate marketing targets and in improving patient care services. Once physicians recognize that marketing is an appropriate professional activity that may help them and their institutions care for their patients, their next responsibility is to ensure that the marketing activities are responsible and ethical.


Accreditation clinic: standard for Level I emergency services revised.


Survey: EMS in America's most populous 100 cities.


Cephalosporin cost reduction.

Cephalosporin cost reduction.


Patient consent.

Patient consent.


Psychotropic usage in long-term care facility geriatric patients.


Lightning strikes twice in Vegas.

Lightning strikes twice in Vegas.


Editorial: emergicenters--good or bad?

Editorial: emergicenters--good or bad?


Fringe benefits . . . the hidden payroll!


The effects of societal and legislative pressures on inpatient treatment.


The private psychiatric hospital: a matter of perspective.


Trade winds: good or bad?

Trade winds: good or bad?


Public policy and national health insurance options in the 1980s.


The performance, problems, and prospects of health systems agencies.


Deinstitutionalization in Florida.

Deinstitutionalization in Florida.


Hospitalized latency-age children: implications for psychosocial care. Hospitalized latency-age children (ages 5-12) are often forced to deal with emotional feelings surrounding their illness or hospitalization that can be psychologically damaging. Factors which interfere with a latency-age child's psychological growth are enumerated. Potential benefits of hospitalization and guidelines for working with this age child are provided.


Influencing attitudes toward children's emotional care. The development of play therapy programs and the passage of laws to support the psychosocial care of children in hospitals in Sweden is outlined in this article.


"Is this the liberry?".

"Is this the liberry?". The importance of a library in the hospital setting is discussed. Suggestions on how to start a library, build library holdings, develop a story hour, and promote a library are provided.


Nursing rehabilitation of the quadriplegic adolescent. The unique needs and problems of the adolescent with quadriplegia are discussed. Emphasis is placed on how the nurse and health care team can work together with the patient and the family in meeting these needs by establishing trusting relationships and by providing individualized, accountable care.


Health planning for deregulation: implementing the 1979 amendments.


Occupational exposure to ethylene oxide: effects and control. Ethylene oxide (EO) is widely used in the health care industry as a gas sterilant for medical products that cannot withstand the high temperature and humidity associated with conventional steam sterilization. As a consequence, approximately 100,000 health care workers are exposed to residual EO each year. The acute toxicity of exposure to EO has been well documented, and recent concern about the mutagenic potential of occupational exposure to EO has resulted in an effort to further reduce workplace exposure levels to EO. The Environmental Protection Agency has issued a rebuttal presumption against registration of EO as a pesticide and the American Conference of Governmental Industrial Hygienists (ACGIH) has proposed a sharp reduction in the threshold limit value permitted for EO. Recognizing the need for environmental health personnel to become more familiar with this workplace hazard, it is appropriate to briefly review the toxic effects of acute and chronic exposure to EO residuals. The authors describe a gas sterilization system successfully utilized at the U.S. Public Health Service Hospital in New Orleans, La., which has demonstrated exposure concentrations well below the EO threshold limit value recently proposed by the ACGIH, while preserving the principal goal of assuring the sterility of reusable medical products which cannot be subjected to steam sterilization.


Osteopathic Hospital of Maine: outpatient department-policies and procedures.


Efficient billing organization.

Efficient billing organization.


The computer--friend or foe of the credit manager.


Collection receivable management.

Collection receivable management.


Wash water temperature and sanitation in the hospital laundry. In view of energy shortages and high costs for heating water in hospitals for laundering, the advantages and disadvantages of using lower temperature water are explored. Including are discussions of cleaning power of water, detergents and bleaches, and microbial removal using a temperature range of 38 to 74 degrees C.


Institutional cleaning and maintenance: program at Rhode Island hospital unites quality assurance, training.


The impact of inflation on journal costs.


Role of housekeeping is essential to health-care infection control.


New regulations and responsibilities to challenge housekeepers in 1980s.


How you can decrease expenditures on housekeeping, maintenance products.


Health care in Saudi Arabia.

Health care in Saudi Arabia.


Malpractice in the 80s: what lawyers are saying.


Hospices: a new way of caring.

Hospices: a new way of caring.


Management engineering: techniques to keep your operations trim. Are you considering the employment of additional staff in an attempt to help manage heavy work loads? By applying management engineering techniques, you may simplify and improve clinic operations that can then be handled by existing personnel, while at the same time demonstrate your commitment to cutting costs.


Accrual accounting: recognize the pitfalls.


American attitudes toward health maintenance organizations. The growth of the health maintenance organization movement (HMO) in recent years is evidence of continuing interest by the American public in prepaid health care. The trustees and officers of the Henry J. Kaiser Family Foundation believe that up-to-date knowledge about consumer attitudes helps to address issues pertinent to HMOs as a viable, alternative healthcare delivery system. It was with this idea in mind that the foundation commissioned Louis Harris and Associates to conduct a national survey of consumer attitudes and opinions about HMOs. The survey findings were published in July 1980, in a report entitled "American Attitudes Toward Health Maintenance Organizations." MGMA received permission from the Henry J. Kaiser Family Foundation to reprint the introduction and summary/overview of the survey results. This information should prove to be of value to members, particularly those involved in an existing HMO or those still in the planning stages.


Management engineers help design center. Drawing on the valuable knowledge and skills at its management engineering department (the Section of Systems and Procedures), the Mayo Clinic recently designed, built, and occupied a highly efficient primary care center for local residents.


The Susquehanna Valley Health Care Consortium. Multihospital "systems" and "consortiums" are gaining widespread interest for a number of reasons. One such program involves the Geisinger Medical Center. Are there lessons to be learned and opportunities to be pursued for group practices in applying this new organizational concept?


Can advocates of competition make their health plans fly?


Medicine 1, chiropractic 0. But the war goes on.


Management by objectives.

Management by objectives. Are you interested in a system to facilitate the planning and control functions involved in directing the future of your organization? If so, you might find the management by objectives (MBO) approach to be a very useful management tool.


The final help we can offer a dying patient.


25th annual prescription survey: Albany College of Pharmacy of Union University.


Health care information review.

Health care information review.


Paediatric disease classification.

Paediatric disease classification.


Tracing the evolution of leadership styles.


Towards a better understanding of healthcare economics. Is the healthcare market governed by the classical laws of supply and demand? Healthcare experts, in general, say no. This author, however, argues that traditional economic principles are relevant and capable of explaining the current nature of the healthcare market.


The physician's right to due process in public and private hospitals: is there a difference?


Everyone wants nutrition on the team.

Everyone wants nutrition on the team.


Professional dietetic education: a consortium approach.


Dietetic rehabilitation for people who place a high value on time.


Volunteers bring lunch and kind attention.


Betty Ford shares alcoholism experience at dedication.


Multihospital system survey: hospitals adapt industries' financing techniques to expand their flexibility.


Multihospital system survey: must liberalize covenants to ease hospital corporate restructuring.


Proposed FmHA loan program cuts frighten small and rural hospitals.


Integration and systematism are key to effective cost containment.


Humana dollars seek acquisitions.

Humana dollars seek acquisitions.


Trustees sacrifice other civic roles to serve on multi system's board.


Courts weigh local, U.S. standards.

Courts weigh local, U.S. standards.


Nonprofit hospitals can finance taxable start-ups by selling stock.


Vendors hold out for more money, threaten to cancel agreements.


Cuts would dismantle Health Services Admin.


Schweiker erases doubts about his support for competition bills.


HCFA chief opposes cost control program.


Too late to change planning mood?

Too late to change planning mood?


Agencies experiment with contracts.

Agencies experiment with contracts.


Crisis ensures impact of nursing commission.


I.V. prices under new agreements jump 20%.


More abstracting planned on minis.

More abstracting planned on minis.


Architect emphasized teaching with university hospital's modular design.


Acquisition enhances Fairview and Brim's growth potential.


Multihospital system survey: +1.7 million Kaiser on top.


Multihospital system survey: nonprofits compete effectively with investor-owned contract firms.


Multihospital system survey: religious systems' local boards have more decision-making power.


Multihospital system survey: hospital chains grab psychiatric business from government facilities.


Consider corporate health care cost containment programs.


Keep 'em healthy,' and cut health care costs.


Management support vital to health cost control.


Insurers expanding efforts to curb health costs.


Management evaluation: is your system effective?


Energy plan battles hospital costs.

Energy plan battles hospital costs.


Rural hospitals can thrive through out-reach centers.


Choose a consultant as carefully as you plan your project.


Energy needs will define future health care system.


The Committee of Interns and Residents: New York's big, brash union.


Pipeline politics: the flow of corps scholarships and services could be shut off.


Precision performance standards: medical care and peer review criteria.


Why manage behavior? Supervisors need feedback, but are they prepared? In 1979, a study was conducted at a 400-bed acute care hospital (name withheld) in an attempt to uncover potential employee problems and provide managers with feedback that could be used to remedy such problems. The author of this article explains the format of the hospital-wide study, and examines specifically how employees and supervisors in the Department of Laboratory Medicine reacted to the project.


What to look for in a quality laboratory. Judging the quality of a laboratory is not easy, but that does not mean it should not be done. The author of this article sets forth criteria--subjective and objective--for judging a quality laboratory, and for evaluating your own image as others might perceive it. The discussion presented here is vital to residents and junior members.


The making of a pathologist.

The making of a pathologist. Numerous skills are required of pathologists today, skills so diverse that the traditional formats of residency programs no longer are functional. The author of this article explains what practice in pathology entails, the knowledge of which is essential if residents are to receive the proper training for practice in the field.


"I left an HMO for private practice".

"I left an HMO for private practice".


"I left private practice for an HMO".

"I left private practice for an HMO".


Job selection using task analysis.

Job selection using task analysis. Finding the right person for the right job is personnel's greatest challenge. In this article, Malinowski outlines a four-step technique that can help you meet this challenge.


Communicating company objectives.

Communicating company objectives. Knowing and understanding company objectives will not help employees solve every work-related problem, but, in the long run, such knowledge will contribute to more efficient and productive operations.


Performance appraisal: whose function?

Performance appraisal: whose function? Two of the major purposes of performance appraisal are to improve overall job performance and encourage career growth. According to our author, the training and development section of the personnel department can best fulfill these goals.


Employee attitude surveys: perception vs. reality. In order to correctly interpret employee perceptions, analysts must understand the organization's past, present, and future goals and policies, its performance and success, and its place in the business environment.


The personnel professional in the small organization.


Professional certification programs.

Professional certification programs.


How nursing chiefs view Rx services.

How nursing chiefs view Rx services.


Exactly to what extent do hospitals handle inpatient education activities?


Unions and hospitals--a bad mix?

Unions and hospitals--a bad mix?


Legal forum: implementing dress and grooming codes.


PR: a positive program, not professional rhetoric. A great deal of literature dealing with holistic medicine has been published in recent years. The proponents of holistic care seem concerned with treating the whole patient. Influencing factors such as environment, social background, individualism, etc. are all considered in establishing the patient's treatment. Traditional medicine appears to be more directly involved with the discovery and eradication of organic disease. It is proposed that one facet of the holistic concept be applied to our current system of health care delivery. A patient relations program takes manpower, time, money and a genuine interest in the patient. But the rewards far outweigh the costs. The patient, it is felt, is treated with greater understanding and concern. This elicits a positive comment from them to the attending technologist. The technologist is gratified that his efforts are noticed, and he continues to work at improving the professional services offered to a caring patient. It works! You can be justifiable proud of the radiology aides, secretaries, registered technologists and radiologists that continually strive to provide this personalized service to the "Whole Patient."


Are health maintenance organizations a viable solution to the health care cost crisis?


The sting of death in American society.

The sting of death in American society. A collective interest in death and dying has progressively developed in American society since the 1960s. Among the factors associated with it are demographic shifts; medical, scientific, and technological advances; changes in the statuses, roles, and outlook of medical professionals, patients, and women; and the affirmation and broadening of individual rights. Life-and-death issues have moved increasingly from private to public spheres of the society and are appearing more frequently in the courts, the media, and the arts. They are also principal foci of several social movements. This pervasive preoccupation with death seems related to deep cultural changes occurring in our society and in its world view.


Educational support groups of patients with ankylosing spondylitis: a preliminary report. Educational support groups (ESGs) for patients with ankylosing spondylitis were found to significantly (P less than 0.01) increase knowledge about the disease and its treatment. Compliance of participants with their prescribed exercise programs was improved, although the improvement did not achieve statistical significance. Compliance with prescribed application of heat to joints was not changed. Control patients showed no substantial changes in knowledge or compliance. Although analysis of pretest and posttest responses on a questionnaire did not indicate that the ESGs enhanced the patients' ability to cope with ankylosing spondylitis or their perception of the adequacy of family relationships with regard to the disease, verbal feedback concerning these areas was positive in most cases. Patients did not express negative feelings about the thought of meeting another person with ankylosing spondylitis whose disease was less severe or whose coping ability was greater or less than their own. Two patients who initially believed that they would feel threatened if they were to meet a more severely ill patient relinquished that concern after ESG participation.


The case for patient education: an update on recent court decisions affecting physicians and hospitals. Recent court decisions directly affect providers of patient education. Legal precedents emerging in the 1980s place increased emphasis on the individual patient in terms of the adequacy of information provided, the patient's level of understanding of that information, and the duty to inform patients of the risks of their refusal to undergo any form of treatment. Specific cases are cited, and the implications of the courts' decisions for providers are delineated. Key legal concepts of American law are reviewed as they relate to patient education, offering a framework for providers of patient education to evaluate their programs and activities with respect to assuring quality and reducing the incidence of litigation.


Defining hospital clusters and associated service communities in metropolitan areas.


Improving patient-education assessment skills of hospital staff: a case study in diabetes. While the importance of collecting patient education data of high quality is well established, few studies have examined the quality of patient educational assessment procedures. Utilizing a standardized instrument and assessment protocol, an observational trial of nine insulin-controlled adult diabetics was conducted using pairs of trained patient assessors. Although the overall mean percent agreement for the first trial was very good (90%), lack of agreement was noted for several important subcategories. A training program was conducted to improve accuracy, addressing the assessment problems found in the first trial. A second rater trial found an overall level of rater agreement of 99%. This study confirmed that routine assessment of patients should be periodically monitored using the quality control methods described to ensure program data of high quality.


Initial knowledge and attitudes as predictors of intervention effects: the individual management plan. This paper addresses questions concerning the effects of patient education strategies to increase adherence to antihypertensive medical regimens. It endeavors to fill gaps in our knowledge about intervention effects that may link research findings with health care applications. Data from a community intervention study of 432 hypertensives are used to address two broad questions relating research on patient education to health care practice: Do interventions have different effects on individuals who differ with respect to initial attitudes or knowledge, and to what extent do interventions produce changes in the factors thought to mediate their effects on behavior? This investigation tests a client-oriented approach to the delivery of interventions, the Individual Management Plan (IMP). The IMP approach is based on the hypothesis that interventions will be differentially effective for individuals with varying levels of initial attitudes and knowledge thought to mediate the effects of the interventions on behavior. Analysis of variance, correlational analyses, and analysis of covariance models are used to test various aspects of this hypothesis. Analyses are performed for adherence to medication regimens, dietary sodium restrictions, and weight-loss recommendations. The results of analyses offer only minimal support for the IMP hypothesis. The state of the art and constraining factors in the study are examined to guide future applications of the IMP approach.


QA standard adopted for ambulatory health care.


What is quality in patient education and how do we assess it?


Use of nonprofessional volunteers with pregnant teenagers. The future funding needs of perinatal programs for teenagers should motivate adolescent clinics to make creative use of nonprofessional volunteers. When adequately trained and supervised, volunteers can perform meaningful tasks with high-risk teenage patients. In this program, volunteer involvement not only has extended the staff's capacity to counsel effectively and to educate pregnant adolescents but also has augmented the program's effectiveness by providing rewards to reinforce patient compliance with nutrition and weight control. This paper provides some guidelines to medical professional who want to improve the volunteer efforts of other adolescent pregnancy programs. Such perinatal services must begin to capitalize on the resources of the volunteer sector if such programs are to continue and eventually expand to meet the needs of the pregnant teenager.


The course of activated patients.

The course of activated patients.


Self-management strategies.

Self-management strategies.


Coping with burnout in respiratory therapists.


Working through the territorial imperative in a hospital setting.


Active patient participation and dental health education.


Women's self-help programs.

Women's self-help programs.


Patient compliance an patient education: some fundamental issues.


Inquiry into action: what are the next steps?


The (already) activated patient: an alternative to medicocentrism.


The rationale and application of a needs assessment in patient education.


Writing and evaluating educational protocols.


Hospitals and public relations.

Hospitals and public relations.


Is low temperature washing safe and effective?


IRS gets tough with hospitals.

IRS gets tough with hospitals.


Rx for community: hospital fitness trail.


Hypertension-related mortality by health service area 1968-72.


Common sense and the board of directors.


Is the hospital beyond our understanding? For the modern hospital to operate effectively, it is becoming increasingly necessary for trustees, administrators, and clinical staff members to earn how they can function better in unison. Educational programs to help them understand how the unique organizational characteristics of the hospital affect their attitudes and behavior are becoming increasingly important to hospitals' future viability.


How to tell if your hospital is well run. Like their corporate counterparts, hospital board members need measurable assurance from management that their institutions are being well run. This article contains a partial listing of reports the board should see and issues it should address in its evaluation of institutional performance.


Focus on . . . consumer choice health plans.


Life skills program reacquaints patients with their environment.


Neighborhoods embrace local nursing homes.


Volunteer record-keeping.

Volunteer record-keeping.


Dining in style at the Daughters of Israel Home.


Nonprofit board basics--Part I. Diverse roles and broader involvement.


Nonprofit board basics--Part II. The preoccupation of boards--healthy or pathological?


A case study on the development of HMOs in Detroit: Chapter III-history of HMO development.


Grady Hospital reports ten-year success for inner-city diabetes clinic.


The John Hopkins diabetes clinics.

The John Hopkins diabetes clinics.


Community health education and screening resources for older American expand in spite of tight times.


The new professional--the human services worker--a survey of training needs.


An analysis of the managerial roles of the chief of physical therapy services.


Advocacy: an added dimension to treatment.


The physician and torture.

The physician and torture.


The role of educational therapy in rehabilitation.


Nursing home residents join RSVP.

Nursing home residents join RSVP.


Hawaii's leprosy patients struggle to keep their home.


The use of poetry therapy with older people.


Rubicon Programs, Inc.--Independent living programs.


Community interaction program: a vocational rehabilitation training model.


The residential treatment program.

The residential treatment program.


Human rights and torture: the medical profession's responsibility.


Progress Foundation--La Posada--acute treatment programs.


Creative arts for older people in the community.


Health care out of chaos.

Health care out of chaos.


Medicine teams up with business to cut health costs.


Purchasing considerations.

Purchasing considerations.


Progress Foundation--La Amistad--long term residential programs.


Health care in Napa, California: accommodation and integration.


Surgical public relations.

Surgical public relations.


Why INA is unloading Hospital Affiliates.


Whittaker: whittled back, it grows with a new emphasis on health care.


Cutting hospital costs through mandatory prior authorization.


Operating room illumination: the current state of the art.


The art and the science of OR management.


When to refer a patient to a specialist.


Employment discrimination: procedures for handling complaints--Equal Employment Opportunity Commission. Proposed rule. This proposed rule sets forth procedures for the handling of complaints of employment discrimination which are filed with Federal fund granting agencies under Title VI of the Civil Rights Act of 1964, Title IX of the Education Amendments of 1972 and other provisions of Federal law which prohibit discrimination on grounds of race, color, religion, age, sex or national origin in programs or activities receiving Federal financial assistance. The regulations allow the fund granting agency to refer complaints to the Equal Employment Opportunity Commission (EEOC). For complaints covered both by Title VII of the Civil Rights Act of 1964, as amended, or other statutes within EEOC's jurisdiction and by Title VI of the Civil Rights Act or Title IX, the regulations contemplate that most complaints of individual acts of discrimination will be referred to EEOC for investigation and conciliation, while most complaints of systemic discrimination will be retained by the fund granting agency. Employment discrimination complaints which are not covered by Title VI or Title IX will be transferred to EEOC. This proposed rule is not a "major rule" as defined by Section 1(b) of Executive Order 12291.


The new gene doctors.

The new gene doctors.


Private land mobile radio services; bio-medical telemetry operations--Federal Communications Commission. Final rule. This action changes rules in the Special Emergency Radio Service to permit the limited use of bio-medical telemetry systems on certain medical services VHF frequencies. The operation is to be allowed only beyond fifty miles from the center of urbanized areas of 600,000 or more population (U.S. Census of 1970). The bio-medical telemetry system is used to send electrocardiograms from patients to hospitals.


Designation of medically underserved areas--Health Services Administration. Notice. This notice is intended to clarify, for purposes of certain Federal health programs, the distinction between designation of an area as a Health Manpower Shortage Area (HMSA) and designation of an area as a Medically Underserved Area (MUA). Although it is possible for an area to be designated as both an HMSA and an MUA, the two designation processes are independent, each having its own established criteria and procedures. An area designated as an HMSA will be considered as an MUA only if it has been formally designated as an MUA under the criteria and procedures published in the Federal Register. The latest such publication is that of October 15, 1976 (41 FR 45718--45777), "Designation of Medically Underserved Areas."


Health Resources Administration: list of health manpower shortage areas designated under Section 332 of the Public Health Service Act.


Blue Cross warns the administration: move cautiously on health care changes. Interview by Linda E. Demkovich.


Personnel, payment, and technology: integrating our approach to the control of health care costs.


The nurses shortage--do we need to train more or just put them to work?


Association profile: American Association of Blood Banks.


Capital formation for hospitals: why more difficulty ahead?


Clinic's founder turns philosophy into caring.


When residents are mothers, too.

When residents are mothers, too.


The medical man as administrator: another opinion.


Physician, suffer thyself.

Physician, suffer thyself.


The five Rs of patient education.

The five Rs of patient education.


AHSC trial to continue: judge dismisses four counts.


Academic performance and job satisfaction. This paper investigates the possible relationship between job satisfaction and academic performance of occupational therapists who have graduated from the University of Western Ontario in the years 1975 to 1978. Fifty-four percent of the graduates of this time period filled out questionnaires eliciting information on their satisfaction with their jobs as occupational therapists and with the profession of occupational therapy. This information was analyzed with the therapists' academic performance of Grade XIII and their four years in the Occupational Therapy Program. The results indicated that although job satisfaction related significantly to three individual academic courses it did not relate to overall performance as measured by grade average.


Maintenance contracts: the biggest fix for the buck.


Computers terminate mail order buying.

Computers terminate mail order buying.


Analyst predicts communications equipment purchasing binge.


What do they think we do? O.T. functions as perceived by administrators and allied health professionals. Prior to preparing written material about the profession, hospital administrators in Alberta were surveyed by questionnaires in an attempt to ascertain the level of knowledge about occupational therapy roles and functions. Fifty-four respondents (administrators and other health professionals) replied to all sections of the questionnaire. Their responses have been analysed and compared to those of occupational therapists within the following areas: occupational therapists as prime agents in specific service areas, the occupational therapist's role in tasks relating specifically to physical medicine, tasks relating primarily to evaluation and treatment, tasks relating to consultation and teaching and tasks relating to administrative aspects of program management. There appears to be a lack of knowledge about the entire occupational therapy process; treatment techniques and media can be identified but how the client is assessed, goals set and the evaluation of the client's progress is not understood. Findings indicate that it is not advisable to publish and distribute information without first surveying the level of existing knowledge of the intended reader.


Preventative medicine for the EtO problem.


Establishing a prime supplier.

Establishing a prime supplier.


CS communication via newsletter.

CS communication via newsletter.


Practice patterns of male and female pharmacists. A survey was undertaken using sample alumni of the University of South Carolina College of Pharmacy and the Philadelphia College of Pharmacy and Science to attempt to determine practice parameters of male and female pharmacists. The study included male and female graduates during an 18-year period from 1961 through 1978. Data are presented relating sex to practice interruptions and the characteristics exhibited thereof. The results disclosed that 126 (34.7%) of the female and 21 (8.4%) of the male practitioners had interrupted their practices at one time or another following graduation. Furthermore, 88.8% of all practice interruptions among females was found to be linked to familial obligations.


Hospital steals a march on thieves by initiating ID program for equipment.


Automatic stop-order policy for PRN medications in skilled nursing facilities. From the data collected during this 4-month investigation of 37 skilled nursing facility (SNF) patients, one may conclude that using automatic stop-order policies for PRN medications is effective in controlling and eliminating unnecessary medications that are not being used by nursing home patients. PRN medications were reduced significantly from 4.1 to 2.1 per patient (p less than 0.01). Also, a significant amount of savings to these patients or their third-party payers, potentially $1500 per year in this SNF, resulted from the credit issued for discontinued unit-of-use medications. The reported potential cost savings could not have been obtained from medication being dispensed in traditional prescription packaging. Therefore, this study's data should influence state and governmental agencies to begin considering reimbursing vendor pharmacies for implementing unit-of-use packaging in their nursing homes. The data illustrate and support another method in which pharmacy consultants can prove cost-effectiveness when they are used properly in SNFs.


A patient-oriented diabetes education program. Successful control of diabetes mellitus requires that the patient assume primary responsibility for treatment of his or her disease. The University of Southern California Schools of Medicine and Pharmacy, using the Pico Rivera Health Center as a teaching site, instituted an educational program for diabetic members of the community. Pretests and posttests showed that there was an increase in knowledge for those who participated in the classes. The pharmacist and physician interns also gained experience in providing community education.


Understanding drug product selection legislation. While drug product selection legislation offers many opportunities for consumers to save money and pharmacists to use more professional prerogatives, it is possible that confusion in much of the legislation may create problems for the profession and consumers. Understanding the intent of the legislation may be a key to the pharmacist's decision to practice drug product selection.


Improving hospital training programs.

Improving hospital training programs.


Educational program provides cross-cultural health care.


The pharmacist in emergency medicine: poison information.


Interviewing techniques.

Interviewing techniques. The purpose of this paper is to summarize the numerous articles on interviewing techniques available in the literature. The interviewer will be able to conduct an interview in a consistent, fair and productive manner. The applicant will be able to anticipate the types of questions a good interviewer may ask and as a result be better prepared for the interview.


A systems approach to management development.


Disposal of hazardous pharmaceuticals.

Disposal of hazardous pharmaceuticals. The literature contains very little information regarding the disposal of pharmaceuticals. This article examines this topic from the viewpoint of hospital pharmacists. Environmental, safety and legal factors are discussed. Of the three most common disposal methods available (i.e. sewer, landfill, and incineration), incineration is the preferred method of destruction. If this method is unavailable, discriminate disposal via the sewer or garbage (landfill) systems is acceptable. Special disposal precautions are discussed for biologicals (autoclaving and then incineration), antineoplastics (incineration or neutralization before disposal via sewer or landfill systems), and radiopharmaceuticals (disposal according to the recommendations of the Atomic Energy Control Board).


"Totality"--right or wrong: the totality trilogy. Totality, or the concept that all evidence that may bear on a given case should be considered together in issuing a decision, has been applied inconsistently by the National Labor Relations Board, particularly with regard to three types of cases: "good faith doubt" cases, those involving employer statements made during a union election campaign, and employee discharge cases. In the following article, the author examines cases that demonstrate how the Board has vacillated in its application of the totality principle.


Steps to take preparing for radioactive patients.


Preparing pre-hospital medical coverage for a Papal visit.


Some thoughts on the future of health services in the United States.


Michigan EMS plan links 15 hospitals in Wayne County.


The development of emergency medicine residency programs: an overview.


Professional career characteristics of residency trained emergency physicians.


Development of the first emergency medicine residency.


The evolution of an emergency medicine residency at a new medical school.


Residency development at Charity Hospital: an organizational viewpoint.


An emergency medicine residency program in a semi-rural setting.


The demise of an emergency medicine residency at a community hospital.


Development of an emergency medicine residency program by an emergency medicine residency graduate.


General remarks on emergency residency development.


A consideration of emergency medicine manpower needs: past lessons and future challenges.


The 23rd specialty.

The 23rd specialty.


The bases of emergency medicine residency curriculum development.


Advanced driving maneuvers.

Advanced driving maneuvers.


A policy perspective on research in emergency medical services systems.


Emergency policy, fire, and medical services for the deaf.


EMT diagnostic accuracy and treatment protocol compliance.


Characteristics of a competent EMT instructor.


Your community and you.

Your community and you.


Current indications for medical antishock trousers.


Maintenance: the key to beautiful floors.


The family physician's role in detection and control of hypertension.


Who is responsible for the patient?

Who is responsible for the patient?


Institutional wet mops.

Institutional wet mops.


Selecting floor care equipment.

Selecting floor care equipment.


Flooring variables.

Flooring variables.


The nurse's role in hypertension control.


A rational approach to dietary control of hypertension: the role of the dietitian.


Social sciences in hypertension control.


The role of health education in hypertension control.


A model for the pharmacist's involvement in high blood pressure control.


Planning for community high blood pressure control.


Hypertension education: a federal perspective.


The selling of a foodservice: Bob Underwood beats the competition.


The selling of a foodservice: the body speaks.


Healthcare marketing: maximizing your competitive position.


A general service contract? Three checklists worth considering.


The Texas pool of big ideas.

The Texas pool of big ideas.


Centralization or decentralization? In patient care, both can work together.


Hospital philanthropy: the need is greater than ever.


Activity measurement program promotes productivity.


Flexible budgets: the next step in healthcare financial control.


Where volunteers wear uniform.

Where volunteers wear uniform. With increasing emphasis on the role that the voluntary services can play in our hospitals and social services Jo Jackson, voluntary services co-ordinator at Whittington Hospital, thought it was time to look at and perhaps learn from the American system.


Mental health: into the community.

Mental health: into the community. Ten years ago the Worcester Development Project was launched as a model reorganisation of mental illness services. Charles Barker, senior nursing officer, department of psychiatry, Worcester Royal Infirmary, looks at the progress of the project.


Social work in a health centre.

Social work in a health centre. For the last six years social workers have been attached to a health centre in Croydon, Surrey, from the General Practice Research Unit of the Institute of Psychiatry, University of London. Jennifer Winny and Andrée Rushton, research social workers, describe the pattern of relationships that has developed.


Hospital management teams--the proof of the pudding. The management arrangements at unit level proposed in HC(80)8 have given rise to widespread debate. Sixteen months ago the Journal published an account of devolution to a hospital management team at Claybury Hospital, in the West Roding HD. Now Gordon Davy, the district administrator, describes how the same approach has been adopted at Whipps Cross, a large general hospital.


Hospital energy management.

Hospital energy management. US hospitals are learning to deal with rising energy costs and uncertainties in the availability of energy supplies. Management responses to the challenge are affecting all aspects of design and operation.


Domestic services: a disease of our time. Brent Cross Shopping Centre and the Royal Free Hospital in Hampstead were both opened in the mid 70s. While the centre has remained almost vandal free, the hospital is showing signs of its age. Could this be a case of cutting building costs? Pauline Drummond investigates.


Capital works: designing for today and tomorrow. A recent (26 September 1980) Journal article by Pauline Drummond drew attention to some relatively new hospital buildings which developed structural and other faults which had to be put right at great cost. Now G.D. Kelly, area works officer, Bolton, explains the part that professional works staff play in the provision of new, and the improvement of old, buildings and underlines their responsibility to resist short-term economies which will lead to increased costs in the longer term.


Cottage hospital: 110 years of care.

Cottage hospital: 110 years of care.


Scottish restructuring: Scots' mystification.


Health care information: is PAS the answer to the problems of HAA? PAS--Professional Activity Study--is a patient care information system for short-stay patients, based in the USA, which is 'clinically rich'. By contrast the British, DHSS-sponsored system, HAA (Hospital ACtivity Analysis) is 'clinically impoverished'. This was the comparison drawn by Dr Brain Moores, of the University of Manchester Institute of Science and Technology, in an article which followed a visit he made last year to the headquarters of the Commission on Professional and Hospital Activities (CPHA) at Ann Arbor, Michigan (Journal, 5 December, 1980). Recently, senior officials of CPHA flew to Britain to discuss PAS with an invited audience of British statisticians, administrators, doctors and other information specialists at a two-day seminar in Manchester. It now seems likely that some British health authorities may want to experiment with the PAS approach as an alternative, or a supplement, to HAA. On the other hand, some participants felt that HAA could, potentially, do anything PAS can do.


Domestic management: a case for contract. contracting out is not new to the NHS and is now frequently used when a special but infrequent job needs to be tackled. Frances Campbell, a domestic services adviser, looks at the advantages and disadvantages of going out to contract.


The Russian solution.

The Russian solution.


Laundries of yesterday: a home for ancient irons... Eyhorne Manor, a 15th century yeoman's house at Hollingbourne in Kent, houses one of the largest collections of antique laundry equipment in the country. Joyce Galley visited the museum and describes part of the 'remarkable collection of laundry impedimenta' open to the public from Easter.


Health service administration: district-based training.


Hospital design: making the same mistakes twice.


Paramedical services: low cost efficiency.


Fund raising: charity begins at home.

Fund raising: charity begins at home.


The UCC and the "battle of the forms".

The UCC and the "battle of the forms".


The high cost of returns due to vendor error.


Part-time forms consultant can mean big-time savings.


Adopting forms of management.

Adopting forms of management.


Price-cutting in antibiotics causes HPM indexes to drift.


Marketing: letting the community's needs dictate a hospital's mission.


Commission studies nurse shortage: job satisfaction is big issue.


Service is the bottom line! One library's experience with a personal book order service and responsibility for operating a medical bookstore.


Salary survey of hospital librarians in the Midcontinental Regional Library Group.


Disputes procedure--success or failure?

Disputes procedure--success or failure?


Size and span of control in district health authorities.


Support services at the crossroads?

Support services at the crossroads?


Planning inaction?

Planning inaction?


Some aspects of hospital management.

Some aspects of hospital management.


Torrington Park Health Centre.

Torrington Park Health Centre.


The recruitment and career development of administrators: progress report.


Supplies information in the national health service.


Upgrading emergency training.

Upgrading emergency training.


The nursing staff shortage.

The nursing staff shortage.


When executives burn out.

When executives burn out. The military knows about burn-out--but calls it battle fatigue. To offset its devastating effects, the military routinely schedules its personnel for recreation and relaxation retreats, sends soldiers into combat in groups so they can support and help each other, and limits the number of flights that pilots fly. Managers are not soldiers but, according to this author and others who have researched the subject, they are prone to a similar exhaustion and sense of futility. Like other professionals, mental health workers, and policemen who work under severe pressure in people-oriented jobs for long periods of time--with little support and limited gains--managers are among the prime victims of burn-out. The author describes what burn-out is, discusses why he thinks that modern organizations are good breeding grounds for situations that lead to it, and offers some helpful ways top managers can combat it.


Memorial General expands staff development department.


Discharge planners provided with an alternative program.


Eickhoff describes methods for evaluating infection control programs.


Hepatitis B infections account for multi-million dollar loss.


Questionnaires determine patient satisfaction.


Evaluating medical records provides effective QA.


Holding company maintains strong central control of 12-hospital system.


Models of church, models of health apostolate.


An analysis of H.L. v. Matheson. Court upholds Utah law requiring preabortion notice of minors' parents.


Lay-religious collaboration essential in health ministry.


Legal and management options for struggling church-sponsored hospitals.


Sisters of Mercy of the Union. Sponsorship study reflects changing attitudes, ministries.


St. Francis Hospital and Medical Center, Hartford, CT. Children's psychosocial problems: a holistic approach.


Reflections on human suffering.

Reflections on human suffering.


Court affirms viable fetus has legal rights.


Broader coverage at lower cost: the case for Social Security.


Avoiding conflict-of-interest and related organization problems.


From burn-out to turn-on: improving the quality of hospital work life.


Group purchasing--the great debate.

Group purchasing--the great debate.


Supply, processing, and distribution: an overview.


How to negotiate a prime vendor contract.


Purchasing for the small hospital.

Purchasing for the small hospital.


Managing through values.

Managing through values.


Determination of use cost: a statistical approach.


Linen distribution can be controlled.

Linen distribution can be controlled.


A procedure for controlling hospital equipment.


Centralizing product recall notification and documentation.


A conversation with Tom Underriner.

A conversation with Tom Underriner.


Futurism--Part III: Application (continued).


How to conduct a physical inventory.

How to conduct a physical inventory.


Health care manager's notebook: catalytic management.


Stamp out risk taking and creativity.

Stamp out risk taking and creativity.


Children's hospital responds to changing times.


How to control linen costs, tips on linen conservation.


How to take a physical inventory.

How to take a physical inventory.


If you haven't yet done something about your hospitals' utility rates, here's another hospitals' successful experience.


School of Nursing: Broomfield.

School of Nursing: Broomfield.


New certificate of need rules increase regulatory pressures.


Steam sterilization of cordless surgical instruments.


How to expand your volunteer program profitably: role growth for volunteers and patient representatives.


Comparable worth theory endorsed by federal court.


Energy management: developments and trends: Part 2.


Putting together an applicable patient categorization system for a hospital and nursing home.


A case against malpractice self-insurance.


Male nurse denied obstetrical employment on account of gender.


Employee health record systems: personnel, components, function and interaction.


Preventing theft and loss of drugs.

Preventing theft and loss of drugs.


NJ Supreme Court drafts strict guidelines for sterilization of mental incompetents: hospitals should require court authorization.


The development of a profile of the medical record administrator.


Educational philosophies in medical record administration programs.


How to combine successfully a patient classification point system in a patient care plan.


Planning and evaluation of clinical learning experiences.


On managing music.

On managing music.


Quantitative records review in an outpatient mental health center.


Data retrieval in the new quality assurance program.


The lecture theatre--Manchester Royal Infirmary.


What are you doing on May 12? What are hospitals doing to celebrate Canada Hospital Day?


Fund raising--it's not manna from heaven.


Food for PR thought.

Food for PR thought.


Health manpower migration in the Americas. This paper discusses the international migration of physicians and nurses in the Americas in terms of dimensions, directions, salient characteristics of migrants, and possible consequences of migratory flow. The paper is based on information from a previous multinational study on the international migration of physicians and nurses, carried out by the World Health Organization; the study is both descriptive of this phenomenon and prescriptive of the type of measures that may be needed to control it. There is sufficient evidence to substantiate the order of magnitude of the outflow of medical and nursing manpower from Central and South American countries to provide a guide to policy and action. The information for most countries is, however, incomplete and inaccurate and, consequently, the net flow remains to be determined. A large part of the migration appears to be due to the imbalance between the supply of, and the effective economic demand for, physicians' and nurses' services. Perhaps the most important finding is that countries which produce far more physicians and nurses than they can economically afford to employ become donors of such manpower, and those which produce fewer than they can afford become recipients. Almost all other factors either derive from or are secondary to the economic factor. The paper suggests some alternative policy issues that countries having excessive migration of medical and nursing manpower may consider to control the flows. Among these, the most important is the formulation of realistic health manpower and educational policies and plans.


The private (mis-)management of public hospitals: feeding at the public trough.


Housekeeping--to contract or not?

Housekeeping--to contract or not?


The basics for a system of computers.

The basics for a system of computers.


Health planning--impact standards: who is measured?


Periodic health evaluations: the multiphasic approach.


Health planning: taking stock of the system.


Developing health resources: enough to go around?


From Ottawa, Uppsala, and Alma-Ata to Canberra, Australia: a rationale for a degree in health. The paper describes the principles of curriculum design applied in establishing the Degree of Bachelor of Applied Science in Health Education in Canberra, Australia in 1979. The design was based explicitly on three major initiatives in health planning and policy in the last decade: (i) the recommendations to the Canadian Government proposed by Lalonde in 1974, commonly called the Health Field Concept; (ii) the World Health Organization definition of Health, first stated in 1948, and reissued at Uppsala in 1977; and (iii) the World Health Organization policy statement from the Alma-Ata Seminar in 1978, which included social planning and legislative action among the legitimate concerns of health services. The authors, who are at present teaching the integrated units of the degree, describe the principal components, namely content, theoretical principles, professional skills and methods of knowledge integration which they are using to develop graduates who may be considered wither health educated or health educators. In either case, the program is intended to produce people who can provide a health development arm for, on the one hand, social planning and social change, and on the other, health-care services.


PIQuA program to field test.

PIQuA program to field test.


Certificate of need: a failed instrument.


Health education: structural vs. behavioral perspectives. A study of alternative definitions and interpretations of health education in public policy resulted in the identification of a typology of differing perspectives. The two perspectives, behavioral and structural, are described in this paper, along with the three levels of health education programs. The study found: (1) an over-emphasis of public health education policies on individual behavioral changes and (2) a lack of focus in health education programs at the federal level. An analysis was done of the National Consumer Health Information and Health Promotion Act of 1976 to demonstrate these findings. The paper concludes that a balance between the two perspectives is needed, and it offers policy direction to support this conclusion.


Planning a medical school teaching hospital in an era of cost containment. The CMDNJ-Rutgers Medical School experience. Rutgers Medical School was started in 1962 as a two year medical school. By 1976 its basic science enrollment had grown to 108 and it retained 56 students each year for clinical instruction. During the early 1970's the medical school had been frustrated on three different occasions in its attempts to build an on-campus teaching hospital. This paper describes the school's successful post-1976 planning efforts to provides its faculty and students with the appropriate clinical facilities by a model which would generate support among external constituencies. The history of the medical school prior to 1976 is presented briefly. The paper then develops the rationale for the new planning model and shows the relationship of the model to the educational bases of the institution. It then tracks the planning process from program development through approvals by the external constituencies and brings the school's experience to the present where ¿ million dollars of construction is under contract for health care delivery and medical education facilities.


Nurse shortage--do national surveys reveal fact or fiction?


Avoiding the pitfalls--new revenue sources and tax-exempt status.


A comparison of the professional values and career orientations of male and female medical students: some unintended consequences of U.S. public policy. During the 1970s, partly as a response to U.S. public policy which promoted the objective of equal opportunity for women, there was a dramatic increase in the proportion of women entering careers in medicine. Some observers have expressed the expectation that these women physicians will promote progressive changes in health care and that they will be more likely to emphasize "humanistic" aspects of treating patients. This paper presents data from a national survey of U.S. medical students which provides a comparison of several relevant characteristics of these male and female students. There are several important areas where significant differences are apparent. Women students are more likely to place greater importance on the desire to help people as a career motivation, for example, and are less likely to express satisfaction with the status quo in American health care. There are also significant male-female differences in career plans with respect to areas such as specialty choice and preference for practice setting. These findings are used to consider the question of the probable impact of increased numbers of women physicians on the future of American health care. Projections for the future are made more difficult because of important changes within the medical profession and in the context of health care organization, but it is clear that women physicians do represent some potential for progressive change in American medicine.


The private (mis-)management of public hospitals: the case of Highland Hospital.


Operational auditing--staying on top of hospital revenues.


Managing the public relations function.

Managing the public relations function.


Paperless processing: Part 2.

Paperless processing: Part 2.


Travel and expense reports--keep them simple.


Job description: vice president--marketing.


Stay current with HFMA's new certification maintenance program.


Hospitals: economic contributors.

Hospitals: economic contributors.


What do they have that we don't?

What do they have that we don't?


Payment patterns: Monitrend medians.

Payment patterns: Monitrend medians.


Oklahoma Chapter uses phone network to present program.


Involve your staff in plans for change.

Involve your staff in plans for change.


Nurse staffing changes benefit hospitals and employees.


Hospital-medical staff collaboration key to survival. Too often, an "us verus them" theme seems to dominate the relationship between hospital administration and the hospital medical staff. It is time to put aside differences, according to the physician-administrator who wrote this article, and to work collaboratively for the mutual benefit of each other as well as for the benefit of the institution. Indeed, he says, collaboration is the only alternative if hospitals are to survive in these troubled times.


Color in medical facilities.

Color in medical facilities.


Update on emergency department staffing requirements. This article outlines the various legal responsibilities attendant to a hospital's provision of emergency medical services. Specifically, the article focuses on various issues relating to emergency department staffing, including the hospital's duty to provide emergency medical services and the liability of various parties for patient injuries sustained during the course of emergency treatment.


A blueprint for antibiotic utilization review. Antibiotic usage recently has come under careful scrutiny because of its impact upon hospital costs and its effect upon patient care. This article describes the antibiotic utilization review program developed at Norton-Children's Hospitals, Louisville, to improve antibiotic prescribing and to meet the requirements of the Joint Commission on Accreditation of Hospitals.


Print, prepare, check, and deliver a 24-hour supply of unit dose medication for 600 patients in one hour. The development of a new drug delivery system featuring cost containment, increased accuracy, and savings of time was the goal of the hospital. Using an assembly line approach and preparing 24-hour medication supplies just prior to delivery, we are able to fill and check 600 patients' medications in one hour. Personnel requirements have been reduced and accuracy increased, resulting in cost effectiveness and improved patient care. The annual cost savings in a 600-bed hospital are $110,000, and time for clinical pharmacy projects has been created.


Developing a unit-of-use drug distribution system for the hospital emergency room. The development of a unit-of-use drug distribution system for hospital emergency rooms (ERs) is described. Initially, each emergency room physician was requested to compile a list of medications for an emergency room formulary. These lists were edited into a single list and presented to the ER Committee for review. This committee was to recommend the least number of medications possible per therapeutic category. During this time, the support of the ER staff was gained, policies and procedures were established, and a unit dose cart system was chosen. The final step was to present the recommended emergency room drug formulary to the Pharmacy and Therapeutics Committee for their review and approval. The advantages of this system are: establishment of pharmacy drug control in the ER; reduction of ER inventory; greatly improved drug security; proper drug labeling; and automatic restocking of medications in the ER, resulting in time savings for ER personnel.


Update in Neuilly: an addition to the American Hospital in Paris maintains a celebrated international reputation.


Competition: a new candidate for allocating resources to health care.


competition: no cause for alarm.

competition: no cause for alarm.


The competition alternative: the coming debate.


Police-referred psychiatric emergencies: advantages of community treatment. Police traditionally have brought persons they define to be in need of psychiatric intervention to state hospitals. However, as large state facilities decline, community mental health centers must be prepared to receive these individuals. The present study defines the client population that police bring to a large, urban community mental health center. In addition, a two-year follow-up compares the dispositions of those persons brought by police to the community mental health center with the outcomes for patients treated at a state facility. Treatment benefits inherent in such a community-based program are discussed.


Quality assurance for a small planet.

Quality assurance for a small planet.


A needs assessment of perceived life quality and life stressors among medical hospital employees. This study was designed to assist an employee-counseling program in a medical hospital by assessing the life quality and life stressors of its employees. 246 employees completed a written questionnaire which included a life events inventory and the Perceived Quality of Life (PQOL) Inventory (Andrews & Withey, 1976). Items on both inventories covered the areas of job, family/support, and financial affairs. Items measuring self-efficacy from the PQOL scale served as the criterion for potential counseling service utilization. Results indicated that family-support concerns were the most predictive of perceptions of self-efficacy. In addition, negatively perceived life changes were more powerful predictors of life quality than were life changes per se. Finally, employees who were identified as less satisfied in the various quality of life areas were separated from their spouses, over 55 years of age, and had lower education levels, large families, and low incomes.