High technology: wave of the future or a market flash in the pan?


Controlling medical technology. Can we? Should we?


Better controls cut linen costs.

Better controls cut linen costs.


A bright prognosis for the once-frail HMOs.


How to tell when a good employee is job hunting.


Let's talk: discussing job performance.

Let's talk: discussing job performance.


Influx of refugees causes overcrowding at big Miami hospital.


Food and Drug Administration--General hospital and personal use devices; general provisions. Final rule. Food and Drug Administration [FDA] is issuing a final rule regarding general provisions applicable to the classification of general hospital and personal use devices. The preamble to this rule responds to general comments received on the proposals regarding classification of general hospital and personal use devices. This action is being taken under the Medical Device Amendments of 1976.


Immigration and Naturalization Service--documentary requirements: derivative third and sixth preference and nonpreference immigrants; reference to form 1-551. Final rule. This rule limits the exclusion provision contained in section 212(a)(32) of the Immigration and Nationality Act (8 U.S.C. 1182(a)(32) to aliens who are coming to the United States principally to perform services as members of the medical profession and not to their derivative beneficiaries.


Hospices seek insurer, buyer support.

Hospices seek insurer, buyer support.


Toward safer medical x-ray exams.

Toward safer medical x-ray exams.


Health Resources Administration--Hill-Burton "uncompensated services" assurance; priorities for handling complaints. Notice. This notice announces the establishment of priorities for handling complaints of noncompliance by assisted medical facilities with their "uncompensated services" assurances under Titles VI and XVI of the Public Health Service Act. The priorities will determine the allocation of the Department's investigative and decision-making resources to certain complaints where the resources available are insufficient to handle all complaints.


Patient rights and the Dutch Clientenbond.


Public Health Service--Health systems agency and state health planning and development agency reviews: certificate of need programs. Final regulation. These rules amend the Public Health Service regulations on health systems agency and State health planning and Development agency (State Agency) certificate of need reviews.  These final regulations implement changes to Title XV of the Public Health Service Act made by the Health Planning and Resources Development Amendments of 1979 (Pub L. 96-79).  Under the amended provisions of the Public Health Service Act, the planning agencies are required to review and determine the need for proposed capital expenditures, institutional health services and major medical equipment.  These regulations set forth the minimum requirements for satisfactory certificate of need programs.


HMOs need employer support; study.

HMOs need employer support; study.


Benefits getting too costly: consultant.


Health care expansion helps INA turn a profit.


Sanctity and quality of life recognized by physicians.


New Jersey's project energy: the garden state's hospitals offer a blueprint for slashing fuel costs.


Caught in the credit crunch? Paying higher rates may be smarter than scrapping plans.


Ethnic differences in death anxiety among the elderly. The Dickstein Death Concern Scale was used to examine the death anxieties of a sample of elderly people in north and central Florida consisting of whites and blacks, males and females. Analysis of the data revealed that black elderly males display the greatest death anxiety, followed in decreasing order by black females, white females, and white males. Analysis of variance yielded a statistically significant main effect attributable to race. The overall effects attributed to sex were not significant, nor were there any significant interactions. The implications of these findings for practicing counselors were considered.


The short of it: survey examines sick leave, accident and sickness, short term disability plans.


The effects of a course on death and grief on nurses' attitudes toward dying patients and death. The purpose of this study was to measure the effects of a course on death and grief on the attitudes toward death and toward dying patients of nurses who work in high-risk death areas of hospitals. This quasi-experimental design used four groups of subjects. One group experienced the treatment. Another group served as a waiting-list control group and then experienced the treatment. Two groups were control groups. The treatment consisted of attendance at a 6-week continuing education course entitled "Coping with Death and Dying in High-risk Areas of Hospitals." The Death Anxiety Semantic Differential, Parts I and II, was used as the dependent variable. The results indicate that the small-group counseling and education experience did have an impact on attitudes toward death and dying patients of nurses who attended. The discussion of the findings and recommendations for further study are presented.


Kaiser-Permanente assumes HMO management: Georgetown University health plan is bailed out.


Pamphlets involve staff in patient education. Hospital staff involvement in a patient education program is critical to the program's success. Unfortunately, prepackaged programs, although attractive, ignore this important component. Pamphlet construction can be a convenient way to include various staff members in the development of a patient education program.


Prepaid mental health succeeds in California.


The practical labor lawyer: an employers' guide to strike contingency planning. An employer's capacity successfully to survive a strike will depend largely on the extent to which it has anticipated the strike and taken the steps necessary to defend against it. It is the purpose of this article to catalog the factors employers should consider in approaching an imminent strike and devising contingency plans. It attempts to focus on the types of problems, legal and practical, that frequently arise in strike situations, and suggests certain measures that employers may adopt in preparing for, and defending against, the economic impact of a strike.


Built-in career ladder alleviates staffing problems. The central service department of Saint Marys Hospital, Rochester, MN, was faced with a high employee turnover rate and low priority within the hospital structure. An impending expansion of the department's facility forced the managers to reassess staffing needs and develop an action plan to build stability into the department.


In my opinion...education and training functions of hospitals.


Responding with alacrity.

Responding with alacrity.


The EMT and infectious disease.

The EMT and infectious disease.


Management of the emergency scene.

Management of the emergency scene.


Response of a regional emergency medical system to a local disaster: derailment of the Southern Crescent.


1980 Lilly lecture: the pharmacist as manager.


Patient interviewing.

Patient interviewing.


Introduction to EKG interpretation.

Introduction to EKG interpretation.


High-risk retirement for paramedics: an urgent need.


Humanistic education for the EMT.

Humanistic education for the EMT.


Utilizing the media to improve public relations.


Death and the dying, trauma, critical illness, and the EMT: management aspects.


Clinical evaluation of EMT-P's: taking the guesswork out of grading.


Wakulla ambulance service.

Wakulla ambulance service.


The prehospital care system in behavioral emergencies.


Inservice paramedic training: the emergency department as a teaching institution.


National Registry of Emergency Medical Technicians: new certification gains approval.


Responding to a scheduled disaster.

Responding to a scheduled disaster.


Mobile intensive care continuing education.


Rescue, sea rescue and EMS at the University of California.


Assessing emergency medical preparedness for hostage-taking and terrorism.


The Mid-Atlantic Emergency Medical Services Council, Inc.


Survival of the fittest in hospital food service 1980-81.


The art of 'prudent' buying.

The art of 'prudent' buying.


The art of feeding the aged.

The art of feeding the aged.


Guess who's coming to breakfast?!

Guess who's coming to breakfast?!


Problem: how to control beverage consumption.


Problem: how to reduce stress & increase productivity.


Make giving meaningful: key to development success. Interview by Larry Kofsky. Starting virtually from scratch in 1975, Berkshire Medical Center has built a fund raising success story. Its multi-faceted development program centers around the philosophy that donors must feel their gifts have purpose and are appreciated.


Revolution in diagnostic imaging technology is expected to continue unabated in 1980s.


Humana's hard-sell hospitals.

Humana's hard-sell hospitals.


Technological progress, regulation here to stay; management will be the key to the future.


Cost containment plan of Du Pont Division is tied to effectiveness of its technology.


Expansion of dialysis technology to other disease areas now under study.


National Technology Center is not a regulatory agency, director says.


Delays in California CON process add $25 million to costs.


A right to health?

A right to health?


Medical technology--the role of Congress.


Energy conservation in plumbing.

Energy conservation in plumbing.


Collective bargaining: when is a supervisor a manager?


Making meetings effective: it's a matter of control.


Corporate executive says era of the "bionic" man is now a scientific fact.


Medical technology of the future: will regulatory jungle trap bionic man?


Where does you day go?

Where does you day go?


Have HMOs finally come of age?

Have HMOs finally come of age?


The truth about intergration--horizontal versus vertical.


Using results to rate performance.

Using results to rate performance.


Mastering the techniques of two-way communication.


Black mark for health care priorities.

Black mark for health care priorities. Social class and health are inextricably linked, so it will take more than improvements in direct health care to reduce inequalities, says the report of Sir Douglas Black's working party. Its recommendations, therefore, go beyond health and social service provision and have given the report broader political implications than had been expected. Here, Stephen Halpern looks in detail to the Black report's findings and proposals and the reactions to it.


An S.D.I. for drug information.

An S.D.I. for drug information.


Shetland's strategic plan: looking ten years ahead. High employment, a rising resident population, the rapid growth of the oil industry and the need to cater for tourists are just some of the factors which affect health planning in Shetland. David March, secretary, Shetland Health Board, describes the background to and recommendations of a draft strategic plan which sets out the changes proposed for the coming decade.


Supplies and services: little fish and large pools. Centralisation of stores and services does not always work smoothly in the NHS and, even when it does, can we be sure that the expected cost advantages will be reaped? Hazel Grayson, senior research officer at the Medical Architecture Research Unit, Polytechnic of North London, discusses some of the questions raised in research carried out by the unit.


A practical approach to selecting and implementing a clinical information system.


Medical records: a PET computer of your own. The prospect of computerising medical records might seem a daunting one for many hospitals. However, when the patient services manager at North Tees General Hospital, Brian Lund, and his colleagues, looked closely at the current technology, they found they did not need vast machines nor vast outlay.


Medical records: disclosing what law permits. Confidentiality and medical records is an issue which gives rise to real problems for staff who are called upon to reveal or disclose information. Here A.P. Andrews, principal law lecturer, SW Thames RHA, shows that while it is not possible to foresee every eventuality a clear understanding of the legal principles involved will help staff resolve some, if not all, their dilemmas.


Medical records: new approach to training records staff. One of the primary objects of the Association of Health Care Information and Medical Records Officers is to ensure the supply of qualified personnel. Frank Sargeant, the association's chairman describes how it fulfils that role.


Medical records: speeding up the system. Two years ago, Norwich and Norfolk Hospital was given the go-ahead to develop a computer-based radiology system. Mike Prees, chief systems designer, East Anglian Regional Health Authority, describes in detail how the system works.


Ordering by telephone: convenience or confusion?


How to avoid unused stock: two views. Hospital policy or committee rule?


Vendor evaluation systems for hospitals.


Materials management: alive and growing.


A clue for improved reference service.

A clue for improved reference service.


Lending & routing current serials.

Lending & routing current serials.


Survey of New England hospital libraries.


Author! Author! Day: a National Library Week success story.


How to avoid unused stock: two views. Preventing obsolete inventory.


Induction training at the Royal Edinburgh Hospital.


The Netherlands experience.

The Netherlands experience.


Do-it-yourself evaluation.

Do-it-yourself evaluation.


NHS planning: an assessment concluded.

NHS planning: an assessment concluded.


Motivation and the manager in the NHS.

Motivation and the manager in the NHS.


The approaching revolution in health care technology.


How GPs are paid.

How GPs are paid.


Keep that nurse.

Keep that nurse.


Developments in the production of sterile goods--appropriate technology.


Conference reviews mechanisms of antibiotic audits.


Arkansas adds PPD tests as nursing home entrance requirement.


Advances in x-ray equipment design.

Advances in x-ray equipment design.


Economic thickness of pipework insulation.


The inter-relationship between engineering plant replacement and energy conservation.


Characteristics of clients referred for post-hospital health care.


Projecting demand for home health care in one health service area.


Cabrini Medical Center, New York City -- terminally ill pastoral care director founds hospice.


A model for the development of an extended service unit.


St. Mary's Hospital, Troy, NY -- cherub corner helps change fear to understanding.


St. Joseph's Hospital and St. Mary Hospital, Philadelphia -- joint venture supports OB care.


Auditing antibiotics in the '80s.

Auditing antibiotics in the '80s.


Mercy Hospital, Cedar Rapids, IA -- family orientation: a criterion of programs, policies. When a family member is hospitalized, family dynamics change. One hospital seeks to help a family better cope with one member's illness through educational programs and hospital policies that seek to strengthen the family unit and to involve the family in patient care.


The nurse and the union.

The nurse and the union.


Canadian Catholic health care leaders face the issues: government relations, sponsorship, Catholic identity, medical-moral problems, health insurance programs.


Risk-free society avoids real issue of improved public health. National health policy, confusing the distribution of medicine with health, supports a risk-free society with a right to health. Self-help, rather than new medical technologies, is responsible for improved public health. Individuals must take their health into their own hands and reform their behavior.


Cardinal Glennon Memorial Hospital for Children, St. Louis -- genetic unit offers diagnosis, counseling. A prenatal history, complete family pedigree, physical examination, and laboratory studies help to determine whether patients' traits and diseases are hereditary or environmental. The geneticist offers genetic counseling to inform couples of the risks entailed in their bearing a child.


Some moral dimensions in genetic counseling. Diagnostic techniques such as fetoscopy and amniocentesis raise moral questions about the propriety of genetic testing and the content of genetic counseling. A Christian genetic counselor must make ethical decisions about what information to convey to clients.


NFP programs provide consumer choice, benefit hospital. Now that principles of NFP have been established specific programs are necessary to disperse information and to teach techniques. The hospital-based NFP program offers the community a needed service and benefits the hospital.


Contract surgeon sued by hospital patient.


St. Vincent Wellness Center, Carmel, IN -- hospital-affiliated wellness center stresses wholistic approach. Wellness--physical, mental, and spiritual well-being--requires self-responsibility and a focus on maintaining health rather than treating disease. A hospital-affiliated wellness center helps participants to manage stress, improve physical fitness, follow good nutrition, and learn environmental sensitivity.


Hospitals and unions: places for evangelization.


Patient with embedded object sues surgeon, hospital.


Nursing shortage: a solution--a comprehensive program of practical, cost-effective remedies.


Catholic health care delivery in Germany: less technology, more regulation.


HHS construction approval: a costly new layer of federal control.


Bringing old and young together and improving life for both.


Catherine McAuley Health Center, Ann Arbor, MI--pastoral care in psychiatric unit emphasizes team approach.


A nursing resource: news and tips.

A nursing resource: news and tips.


Strong Catholic identity key to effective health care apostolate. Catholic health care facilities must define what it means to be human and what it means to be Catholic before confronting current moral and ethical issues.


IRS vow of poverty rulings: inconsistent, confused. The determinant in taxing the income that members of religious congregations receive for services should not be whether the member is an employee, but rather the congregation's direction and control of the member. On the basis of the current IRS focus on the member's employment status, logic suggests that employers are taxable on the wages they pay their employees. On the following pages attorney Albert Feuer analyzes the problem's legal history and highlights the ambiguity flowing from recent revenue rulings.


Foreign nurses help fill gaps.

Foreign nurses help fill gaps.


Pluralism, loss of identity: critical issues in Catholic health care. Trustees, administrators, and staff members must keep in mind the obligations of their Catholic institutions to bear prophetic witness to Christian principles. The Catholic health care facility presents a counterculture in a depersonalized world.


Consolidating medical staff and administrative requirements eliminates potential problems. If policies and procedures relative to a single function are scattered among hospital documents, the potential for conflict and inconsistency between administration and medical staff is enhanced. Incorporation in one reference source can help clarify responsibilities and facilitate conformity.


Hospital-industry partnership essential commitment in controlling costs. Industry and other third party payers need hospitals' help to encourage cost containment. Subjects for joint reveiw are monitoring hospital utilization, seeking alternatives to inpatient care, eliminating excess beds, and encouraging increased productivity within viable institutions.


What do trustees think about their board membership and board functioning?


Nurses are talking...

Nurses are talking...


Hospital drops Social Security, adopts alternative. Social Security coverage faces economic hard times with a changing proportion of workers and elderly. An alternative plan can provide better retirement, survivorship, and disability benefits at reasonable cost.


Hospital closings, conversions: where do employees go? Rising hospital costs in New York have mandated closing or converting excess hospital beds. An evaluation of two state-subsidized programs for displaced employees shows a successful adaptation to the changes, despite personnel problems relating to salary, benefits, and work schedules.


Widow appeals decision prohibiting attending physician's testimony.


Patient charges negligence in diagnosing spinal injury.


Malpractice suit follows death of discharged patient.


Exchange carts really work.

Exchange carts really work.


Case carts in surgery can bring about cost containment.


But my hospital is too old...

But my hospital is too old...


Automation and computerization: milestones or millstones for the vendor?


Design considerations for work simplification.


A simple approach to controlling inventory dollars.


Effective control and establishment of patient charges.


Supply distribution options--a new perspective.


President's report: the need to focus on patient care.


What's new in skin banking?

What's new in skin banking?


Final CON rules hold to tight deadline for state compliance.


FCC rejects DOT petition; cites AHA comments.


Equal Access to Justice Act evidences Congressional intent to improve responsiveness of federal regulatory process.


A county wide disaster drill--team work between two hospitals.


Application of Good Samaritan laws to in-hospital emergencies.


AHA supports health manufacturers' request for FCC waiver of warning label for hospital digital equipment.


Decentralized, departmental library collections, in health care systems.


Prepaying Hill-Burton loans reduces compliance burden.


Favorable shared services laundry decision reversed by court appeals.


The reliability of medical records.

The reliability of medical records.


This type of Employee Benefits Week creates informed participants--not uninformed guests!


"Clarification of nursing activities and the nurse shortage".


Patient care computer in 68-bed hospital.


How long should you keep your patients' medical records?


The development of a quality control program: activity reporting and performance standards.


Effective time management.

Effective time management.


'Sterile' is now a dirty word.

'Sterile' is now a dirty word.


Renovation--a feasible alternative to physical obsolescence!


Mutual benefits in hospital-based clinical education for the allied health professions: a position. Hospitals are traditionally centers for health care as well as institutions for health education. This latter function has been changing during the last few decades and continues to change with regard to both type and form of education offered. By providing clinical training sites, an increasingly involved association with higher education institutes has emerged. In this paper, it is argued that student, college, hospital and society all benefit from this cooperation.


Cost containment: is it unjustly cutting therapeutic mental health services? The plight of neighborhood organizations. A national emphasis on cost containment has resulted in the reduction of a host of activities at settlement houses and community centers that were formerly funded by mental health agencies. It is contended that this is penny wise and pound foolish because the neighborhood organizations provide preventive and therapeutic services. A rationale is developed to support this contention with an eleven point chart showing settlement--mental health links, a discussion of the urban condition and population disturbances, a foundation of medical and social models that support the value of settlement house activities, a review of current community mental health concepts that echo the goals of neighborhood organizations and a discussion of the roles of settlements in mental health programs. It is concluded that strong evidence exists to support the continued funding of the preventive and therapeutic mental health activities of neighborhood organizations such as settlement houses and community centers.


Medical care prices.

Medical care prices.


Employment, hours, and earnings in the health care sector.


A call for moral leadership in health service administration.


Community medicine: the "first-born" of a marriage between medical education and medical care. In Southern Israel, rapid development and industrialization have generated strains affecting both the population (ca. 0.5 million immigrants and ca. 50,000 Bedouin) and the medical care agencies (of the General Labour Federation and other Sick funds, the Health and other Ministries, etc.). In Beer-Sheva, the Center of Health Sciences (CHS) of the Ben-Gurion University of the Negev (BGUN) is the scene of a concerted effort to change the orientation of health care. The direction of change is away from the impersonal (the hospital and the disease) and towards that demanded by the public (the community and the person). It is being accomplished by fundamentally changing the education of health personnel. Change is being implemented and mediated by a coordinating consortium of in-region and BGUN care and/or welfare agencies, that plans and evaluates the process and progress of change for which each agency is responsible. Infrastructural innovation, somewhat hampered by the inertias of tradition, consists of making the university hospital effectively serve the regional network of hospital-affiliated, community-oriented primary care clinics. Curricular innovation, enthusiastically accepted and flourishing, uses the concept of "the natural history of disease" in basic-science and clinical teaching. Teaching takes place not only in the wards, but also in outpatient and primary care clinics, and in the facilities for occupational health, rehabilitation and public health.


The realities of Medicare.

The realities of Medicare.


Canada's role in health care in developing nations.


Worldwide health: quality, availability, resources and opportunities for international collaboration.


Health care in the 1980s: consumer contamination or purposeful planning?


Accountability in the nursing profession.


Health care issues in the 1980s.

Health care issues in the 1980s.


Materiel management Q's & A's: management audit.


Management education--an essential priority for health care?


A comparison of skin pressures produced by three different brands of stretchable tape.


San Diego hospital builds $80,000 walking/jogging track for cardiac rehabilitation.


Nursing station inventory analysis.

Nursing station inventory analysis.


Short-term cash management for hospitals.


Technology and human choices in health care.


Innovation in a time of restraint.

Innovation in a time of restraint.


Who should review your programs?

Who should review your programs?


Women in health administration in Canada.


Organizational leadership and the development of dynamic organizations.


Managing the health system: Quebec style.


Will the real director of education please stand up!


Impacting the product: staff involvement in a health care marketing strategy.


Preventing "job burnout" at the University of Wisconsin-Madison.


DRGs--a poor prognosis?

DRGs--a poor prognosis?


Payment patterns: contractual allowances as a percent of total revenue.


Does your public know the facts?

Does your public know the facts?


Tax-exempt hospital revenue bonds: a database.


Flexible budgeting for small hospitals.

Flexible budgeting for small hospitals.


ROI: a diagnostic tool for a healthy bottom line.


A new organizational model: breaking the three-legged stool.


An alternate approach--capital budgeting and financial planning.


HFMEF, universities help financial managers prepare for the 80s.


Payment patterns: image being presented to patients through credit and collection activities.


AHR: an ominous intrusion.

AHR: an ominous intrusion.


Hospital Financial Management Association: constitution/by laws.


A delicate balance: quality care, cost efficiency, growth programs.


The contractual flexibility between physicians and hospitals.


Using the matrix method to allocate service department overhead.


A new dimension: on-line, real-time, direct communication.


Centralized purchasing and materials management--an aid to cost containment.


University of South Carolina offers healthcare graduate degrees.


Payment patterns: the management of patient accounts begins with "policies".


Marketing--a tool for survival.

Marketing--a tool for survival.


Is there equity in preferential pricing?


Physicians' office condos--a unique approach to capital development.


In the radiology department trim costs with two management tools.


Write your own insurance reference book.


Hospital internal auditing--the extent and state of the art.


Management cost analyses--keeping the goals in view.


Cost containment through better materials management.


Ohio State offers nontraditional education for healthcare executives.


Health care's future--will you help shape it?


Payment patterns: time for the training of their employees.


Accreditation may hinge on QA, experts maintain.


Infection control program essential to quality assurance.


Providers learn hard lessons from major court decisions. Several major court decisions in medical malpractice suits have affected the practices of hospitals and individual health care providers. These decisions have prompted hospitals, physicians, nurses, and other health care providers to reassess the way health care services are delivered in the light of the potential for liability.


Programs educate physicians on costs, use of blood. Excessive preoperative ordering of cross-matched blood that is not transfused has been shown to increase outdating of blood; several programs, including blood ordering guidelines, "type and screen" procedures, and direct physician education are achieving some success in reducing unnecessary ordering and cross-matching.


What is the current status of the law concerning the right of parents who are Jehovah's Witnesses to refuse blood transfusions for their minor children?


Building blocks to comprehensive quality assurance. As a result of the new quality assurance standard recently introduced by the Joint Commission on Accreditation of Hospitals (JCAH), a new emphasis has been placed on the development of comprehensive studies in quality assurance programs. Considerable planning is necessary to establish an overall institutional quality assurance program, but equally important is the need to delineate suitable techniques for individual studies within a program.


Good Samaritan laws: do state statutes protect your EMS staff? Most state Good Samaritan laws are vague on the question of whether or not Good Samaritan immunities apply to emergencies that occur within a hospital or other medical facility. In general, such laws are broadly interpreted by state courts because their purpose is to encourage medical professionals to respond in emergencies. However, some state laws may need to be updated to meet the conditions of modern emergency medical care systems.


New medical staff leadership roles emerging. The forces that have come to bear on the health care industry in the '80s have had a marked effect on the dynamics and dimensions of hospital administrative-board-medical staff relationships. Although sometimes the source of conflict, these forces have been an impetus for medical staff strengthening and leadership.


Care of the dying: a challenge to physicians.


Guidelines for reviewing applications for privileges. Although final authority for granting medical staff membership lies with a hospital's governing body, the medical staff plays a major role in such decision making. Medical staff reviewers need to examine each medical staff application with a critical eye in order to keep performance standards high.


Physicians plan for change with clearly defined goals. A goal-setting approach to medical staff activity has helped the medical staff at San Jose Hospital to define their relationships with hospital administrators, patients, hospital personnel, and with the community. For the first time, the medical staff has a clear set of standards against which to measure their performance.


Aging America: new responses needed urgently.


A comparison of formulated liquid diets. A wide variety of formulated liquid diets are currently available on the Canadian market. Used for oral and tube feedings, they are nutritionally complete diets when offered as the sole source of nourishment for patients who are unable or unwilling to take solid food. To assist dietitians in identifying formulas most suited to patients' requirements, products are listed according to nutrient composition, caloric density, osmolality and packaging.


Utility of an on-line computer system in a clinical setting for nutrient intake analyses. The present report describes a four-week trial at the Victoria General Hospital, Halifax, to determine the effect of access to a computer system on nutrient intake analyses, the problems in implementation of the system, and the response of the staff dietitians. An on-line system was obtained from the Ohio State University Hospitals and modified to reflect Canadian food and nutrient content, and to include some additional program features. Twelve hundred and eighty-six foods were characterized according to 15 food components, the system was responsive to nine interactive commands, and there were nine possible print-out formats of calculations. The results of the trial reinforced the expectation of greatly increased work efficiency, however, the system was not utilized to its potential. Some technical problems were largely overcome within the first week of operation. However, needs relating to the extensiveness of the food and nutrient data base, and the methodologies and time for obtaining and evaluating individual dietary intake information prevented maximum efficiency. The dietitians liked the comprehensiveness and detail of the system, however, routine dietary intake collections were too time-consuming for their present work schedules.


Trying out the competency profile for entry-level nutrition/dietetics practice. The Ontario Regional Dietetic Internship Committee sponsored a workshop on "The Competency Based Profile", for Internship Directors and other dietitians involved with interns. The objectives of the workshop were: 1. to define the effects of implementation of some aspects of the competency profile into existing internship programs, 2. to exchange ideas regarding implementation, and 3. to give Internship Directors a further insight into the pros and cons of competency based education. Nine internship programs implemented some aspects of the profile. From one to seven dietetic interns and one to eleven dietitians were involved per program. Their findings were that the profile took on the average more time to complete than the regular CDA Dietetic Interns' Evaluation Forms. The profile could not be used as the sole evaluation tool. It was however an effective diagnostic tool. The rating scale is not well worded nor is its numerical system an effective way to evaluate dietetic interns. The competency profile is not suitable for all types of internship programs. Specialized internships have to expand on the profile to meet their own needs.


The evolution of an in house biomedical department. The Biomedical Instrumentation Services Department (BIS) at City of Hope Medical Center has been in a continuous process of development since its beginning in 1969. Its initial formation was based on a need for consolidation of repair services, the necessity of a strong engineering program to support clinical activities, and the need for instrumentation planning support. With the advent of cost containment, the department has been required to become more business oriented by streamlining organization, providing technician training, and developing income alternatives to reduce net operating cost. All of this was to be accomplished in a high-technology, rapidly-changing, competitive industry. The demands upon the department parallel the demands upon the entire health care industry today.


Health insurance in the public sector.

Health insurance in the public sector. As the development of collective bargaining in the public sector continues, concern mounts over the problem of providing public employees with high quality medical care without skyrocketing costs. A recent survey reflects a trend away from traditional Blue Cross/Blue Shield plans toward employer-funded comprehensive benefits.


Professional development of the BMET.

Professional development of the BMET. Acceptance of the BMET into the patient care picture, and recognition of the BMET as an equal contributor to quality patient care are central to the advancement of this relatively new career field. One factor in gaining this acceptance is the overall image presented by those who call themselves BMET's. An understanding of emerging professions and the effect of dress on image enhancement can provide useful insight into the phenomena of professional recognition. A second aspect of development important to any professional is continuing educational growth. A performance-evaluation scheme, stressing and promoting continuing education, is described in this paper.


A data base management system for clinical records of renal failure. This paper describes a computerized data-base management system (DBMS) for keeping medical records of kidney failure patients. The system allows simple data entry by untrained medical personnel as well as automatic feeding of data from computer generated data files. The system allows easy retrieval which is enhanced by graphic displays and statistical analyses of the data. The DBMS uses a relational model of data representation and is based on an existing system which was developed to run under the UNIX operating system on DEC PDP 11's. Previous attempts by the authors and others to create such a medical record system are described. A description of the hardware and software environment of the medical record system is provided. The system is then described, and examples of data manipulations are given.


The need for technology assessment in voluntary cost containment. Health care cost containment is a national concern. This concern is displayed through extensive regulations controlling hospital operations. Regulation has spread to include the purchase and usage of technology. Unfortunately, the extensive regulations are costly, with questionable effectiveness. The environmental influences on health care must be considered. In addition, better management and planning by individual institutions must be encouraged. Since the development and utilization of technology play a critical role, the Voluntary Effort to cost containment by hospitals must include provisions for the assessment of technology.


Research brief: training geriatric nursing assistants--a solution.


Nursing homes as a training site for LPNs/LVNs. It is evident that a maldistribution of nursing personnel exists. Varying factors have influenced the failure to attract nurses into the long-term care field. The only solution to alleviating the shortage lies in the expanding of school curriculum to include more courses in gerontology and in requiring that part of the clinical training to be done in nursing homes. Results of the modest survey recently initiated are reasonably conclusive as to the lack of involvement of the schools and the lack of understanding and knowledge of long-term care on the part of the school staff. It is also evident that even brief exposure to long-term care is helpful in relieving the shortage of nurses and results in a change in attitude toward the aging process and the care of the aged. The future of long-term care depends on how well we do our job in attracting and training nurses in this very vital aspect of the health care delivery system.


Survey of duties and responsibilities of current music therapy positions. Survey questionnaires examining the duties and responsibilities of current music therapy positions were mailed to 200 active registered and nonregistered music therapists randomly selected from the 1978-70 NAMT membership directory. The information was sought to: (a) enrich communication among active music therapists and persons interested in the field; (b) act as a possible reference basis for curriculum development; and (c) examine the potential of a classification plan for music therapy positions entailing similar duties and responsibilities. Surveys completed as directed were received from 127 (63.5%) of those music therapists sampled. Analysis of these surveys identified several practical skill areas common to many of the respondents. Certain position responsibilities were identified as significantly related to existing levels of music therapy positions, as implied by official job titles. These findings warrant further discussion of a national classification plan for music therapy positions.


Psychological impact of medical equipment on patients. This study involves the analysis of interviews with patients who are using complex medical machines. In particular, personal interviews were conducted with twenty-six patients who have undergone cardiac catheterization, ten patients utilizing a cardiac monitor, and ten people currently receiving renal dialysis treatments. The variables selected for this study fit into five general categories: 1) environment; 2) patient's personal anxiety; 3) staff interaction; 4) approach to machine; and 5) machine's function. The results of the study indicate that medical equipment does have a psychological impact on patients. The more modern and clean looking the hospital and its equipment are, the more at ease the patients will be. The staff is also very important. A method for keeping the patient's mind occupied with a portion of the particular procedure may relax him.


A structural analysis of performance deviations: a time series perspective.


Documenting the value of supervised play in a pediatric ambulatory care clinic. This study tested the hypothesis that supervision of play in a pediatric ambulatory clinic would increase positive resonses and decrease negative responses in outpatients. During the control week, children played unsupervised in the unaltered clinic waiting area; selected behaviors were recorded then and during the experimental week, in which changes introduced in the clinical environment facilitated supervised play. Significant increases in positive responses and significant decreases in negative responses were noted during the experimental week (X2=474.4; p. <. 001.). A second study demonstrated that significant changes were not caused by environment alteration alone. The resultant outpatient program and its benefits are described.


Health care engineering management.

Health care engineering management. Today, health care engineering management is merely a concept of dreamers, with most engineering decisions in health care being made by nonengineers. It is the purpose of this paper to present a rationale for an integrated hospital engineering group, and to acquaint the clinical engineer with some of the salient features of management concepts. Included are general management concepts, organization, personnel management, and hospital engineering systems.


Association for the Care of Children's Health: position statement on the care of adolescents and families in health care settings.


Environmental health and safety at the University of Michigan medical campus. The Nation's acute care hospitals represent a significant source of employment. Like other communities, most traditional environmental concerns require attention, but because of the unique combination of an evolving and increasingly complex technology with an at-risk resident population, special environmental services are also required. Recognizing these facts, various agencies with the responsibility of overseeing the health and safety of the total population have developed rigorous standards to assure the safety of hospital employees, patients and visitors. There is need for improved organization of environmental services to reduce the inefficiencies so often present where responsibilities for environmental management are fragmented. The University of Michigan Hospital organizational system illustrates an attempt to comprehensively address environmental health issues, including the management of regulatory liaison functions.


Preparation for elective surgery: does it make a difference. This study postulated that children prepared for elective surgery would show less stress in physiological terms while in the hospital and fewer postdischarge behavior changes than children in a control group not being systematically prepared for pending surgery. It was also postulated that younger children would be more anxious than older children. Actual findings supported only a few of the original hypotheses, but the study itself raises major questions for those interested in the overall impact of hospitalization and the reduction of psychological trauma for children who may be particularly vulnerable to stress.


The use of behavioral observation in rating short-term adjustment in three nursing home settings.


One more time: how do we motivate nursing home employees?


A visit to St. Christopher's Hospice.

A visit to St. Christopher's Hospice.


Nebraska laundry supervisor designs services center for hospital complex.


Milwaukee hospital ups production, reduces staff through renovation.


Is there a future for social forecasting?


Doctor surplus: what 1990 will look like.


Doctor surplus: where things stand now.

Doctor surplus: where things stand now.


Fees: where they stand in 11 specialties.


Doctor surplus: close-up of a town that's feeling the crunch.


Telemedicine: the Ontario Project.

Telemedicine: the Ontario Project.


'Magic walk': hospital's half-mile exercise stretch.


Compensation of nurses in Michigan.

Compensation of nurses in Michigan.


Nurses wanted: STAT.

Nurses wanted: STAT.


Interdisciplinary teams.

Interdisciplinary teams.


Nursing educators and nursing service administrators should be partners.


Auxilians influential in state's legislative process.


Where have all the nurses gone?

Where have all the nurses gone?


Many hospitals use independent auditors for management consulting.


Management: make room for aggression, conflict.


Healthcare law: good motive isn't always welcome.


Are nurses' objectives achievable--at what costs, and who will pay?


Management fees vary widely, GAO reports.


Best drug prices won nationally.

Best drug prices won nationally.


Group members' prices vary widely.

Group members' prices vary widely.


Nursing home conditions will cost seven times HHS' estimate: study.


Unions increasingly target hospitals' use of consultants in election battles.


Adventist hospital groups get the urge to merge.


Regional services: more processing shifts in-house.


Computer time-sharing: 73 groups provide full financial functions.


Vendors promote hospitals' HIS sharing with regional data centers.


Abstracting: technology boosts accuracy, speed.


Hospital chain slices business office costs with shared financial system.


Hospital bonds make cyclical slide.

Hospital bonds make cyclical slide.


FDA and the small manufacturer.

FDA and the small manufacturer.


Carter NHI: $6.9 M from employers, $17.6 B from gov't.


Contemporary home childbirth.

Contemporary home childbirth.


The stalled hospice movement.

The stalled hospice movement.


Regional associations: recent changes in blood services. In this article, the authors describe the American Blood Commission's organizational and operational model of blood service regionalization, applied through the ABC's Regionalization Program. Explained are the criteria by which regional associations can obtain ABC "recognition," which acknowledges status as an approved regional association of blood service units.


The pre-employment inquiry guide.

The pre-employment inquiry guide. In recent years, government regulation of both EEO and affirmative action has grown rapidly. As a result, the road to hiring an employee is strewn with pitfalls for the unaware and the uninitiated. This practical guide, written for the practicing personnel manager, takes account of the latest government directives in the field and should prove a valuable tool for anyone involved in the business of hiring.


The annual human resource review (a career-planning system). The success of an organization depends, to some extent, on a satisfied, challenged workforce. Career planning is a key element in personnel's efforts to reach this goal, and in this article, Vosburgh presents a strategy for developing a career-planning system which takes account of the individual employee's needs within the corporate structure.


Safety and OSHA.

Safety and OSHA.


4 publications constitute the core of a hospital-wide information program.


Avoid CME ripoffs.

Avoid CME ripoffs.


Advisory panel projects need for 50,000 psychiatrists in 1990.


IRS eyes physicians' arrangements with hospitals.


Hot vs cool systems.

Hot vs cool systems.


Cable TV as a teach-in tool.

Cable TV as a teach-in tool.


A stochastic model for predicting discharges: applications for achieving occupancy goals in hospitals.


The school-age traction patient: toward better behavior patterns. Being confined to bed in traction is a decidedly frustrating experience for the pediatric patient. Following the initial adjustment of the trauma of the accident that precipitated the present limited environment, the patient assumes a behavior pattern that he thinks will enable him to cope with the predicament. One of the following three roles is usually exhibited: 1) reasonable independence, 2) problem dependency, 3) manipulation. The awareness and understanding of these patterns and their variations with a practical response from the hospital staff will help the patient to project his natural personality and to develop an acceptable level of self-sufficiency even during this time of physical restriction.


Conserving energy without patient discomfort.


Solar heating/cooling systems.

Solar heating/cooling systems.


Effects of governmental health policies in determining the size of a hospital at Chinle in the Navajo Indian Reservation.


Hospital service guidelines.

Hospital service guidelines.


Personal health care or preventive care: distributing scarce medical resources.


The devastating costs of professional burnout.


Convincing a hospital that rental is best.


Simulations in therapeutic recreation training programs.


The impact of legislation on the personnel function.


Emergency care of the future: trauma centers.


Educators in action: two-day health fair.


Emergency medical services.

Emergency medical services.


Buggin' around TSICP: departmental infection control policies.


Tips for dealing with the radiation accident victim.


A penny saved: emergency room personnel--a referral network.


Is there life after high school? Tracking system helps to guide students' career paths.


Direct mail: reaching your market.

Direct mail: reaching your market.


Designing the ideal emergency room.

Designing the ideal emergency room.


Psychiatric emergencies: a new demand on the hospital.


An employee motivational system that leads to excellent performance.


Conference on health planning and development.


Providing emergency services in the small or rural hospital.


How to interview supervisory candidates from the ranks.


Hospital harnesses computers' capabilities to spot, solve problems in patient education programs.


Hurricane watch: how Spohn Hospital prepared for the big one.


Heat wave.

Heat wave.


A lot of planning, a little luck help launch employee health promotion program.


Emergency rooms: duty to render emergency care.


Coping with the capital shortage.

Coping with the capital shortage. A growing capital shortage problem is affecting the long-range financial viability of hospitals. Trustees can ensure their hospital's future financial viability by asking key questions and by participating in the development of a long-range financial plan.


Federal union-management relations: a longitudinal study.


Government moves to tighten capital investment. In recent years, programs designed to control hospital capital investment have become a highly visible aspect of federal health policy. This article describes federal efforts to limit capital expenditures; describes the effect on hospitals of such capital limitation policies; and suggests how hospitals can deal with them.


Capital financing in an uncertain future. A critical test of the hospital's ability to survive will be its ability to raise capital in private debt markets as traditional funding sources (philanthropy and government) continue to shrink. This article assesses the impact of inflation and recession on hospital capital financing and investment, describes what a commercial banker looks for in evaluating a hospital's ability to borrow, and suggests a role for trustees in meeting the hospital's capital needs.


How the rating agencies size up your hospital. Analysts from Standard & Poor's Corporation and Moody's Investors Service, Inc., discuss some of the factors they consider in rating hospital bonds.


Maximize your fund-raising potential.

Maximize your fund-raising potential. Of all the capital financing alternatives, fund raising is the most profitable. To be successful fund raisers, hospital trustees should adopt a corporate orientation, recognizing that donors, like stockholders, expect a return on their investment. Trustees also need to be aware of three aspects of donor psychology that are representative of the new emphasis on "return" accountability.


Who dies of what, where--and why?

Who dies of what, where--and why?


Doctors as entrepreneurs: let the patient beware.


Major issues in national health policy.

Major issues in national health policy.


Study tour of the German Federal Republic: a medical view.


Study tour of the German Federal Republic--psychiatric institutions: an impression.


Study tour of the German Federal Republic: a nursing view.


Study tour of the German Federal Republic financial aspects and the use of EDP in hospitals.


Study tour of the German Federal Republic: an architect's view.


Study tour of the German Federal Republic.


Study tour of the German Federal Republic: an administrator's diary.


The organisation of hospitals in the People's Republic of China.


From foundry to medical centre: a new venture in community health.


Study tour of the German Federal Republic: general report.


The legal obligations of nurses an R.N- lawyer analyzes ethical dilemma.


Some methodological issues concerning comparative hospital-organization studies. There are methodological issues associated with using hospital ownership and size as determinants of the structure and behaviors of hospitals. Theoretical and empirical inconsistencies reported in the literature prompted me to examine the relationships between ownership and size for a large sample of general hospitals (i.e., hospitals in one domain). The results of my investigation point to the advisability of including hospitals with religious affiliations in studies of this type. Some of the methodological issues pertinent to hospital-organization studies are relevant to other organization research.


Ageism.

Ageism.


Equal pay for equal work? Of course. But how about equal pay for comparable work? Should housepainters make more than nurses?


Armenian Women's Welfare Association Nursing Home.


Systematic measures of ideal nursing homes: planning and research prospects.


The nursing manpower issue--an initial inquiry.


Mental wellness programs in industry: a survey report.


Altruism and economic behavior: II--private charity and public policy. The relative advantages of private charitable organizations as against government agencies in achieving efficient redistribution of income and supply of services are examined. Central to this discussion is the elasticity of private giving to tax concessions and the proportion of donor dollars being absorbed in overhead. Recent estimates of these magnitudes are summarized. Of parallel concern is to what extent can reliance on altruism by sellers of goods and services serve as a substitute for government regulations to enforce standards, prices or product disclosures. Finally, the ways in which government can use and encourage private charitable impulse to maximize social welfare are examined; of particular interest here is the literature surrounding Richard Titmuss' work on blood donorship which raises the issue of whether or not extension of markets reduces, rather than extends, individual choice. The growing technological complexities of society, it is concluded, render the altruistic virtues of trust and consideration increasingly valuable-if increasingly rare.


Hospital chiefs' pay averages $63,058.

Hospital chiefs' pay averages $63,058.


Nation's radiologists at the front in battle between technology and cost controls.


The general surgeon's role in an age of specialization.


Hospitals should get involved in primary health care.


The challenge of cost containment.

The challenge of cost containment.


The changing role of HSAs in surgical practice.


Good news and bad about the Federal Trade Commission.


The President's reflections on the American College of Surgeons.


Report of the Chairman of the Board of Governors.


Annual reports from nine surgical specialty boards.


Apples and oranges: salary review and performance review.


Report of the Chairman of the Board of Regents.


Medical devices; procedures for investigational device exemptions--Food and Drug Administration. Final rule. This rule sets forth the procedures and conditions under which investigations of medical devices involving human subjects may be exempt from certain requirements of the Federal Food, Drug, and Cosmetic Act, in accordance with the Medical Device Amendments of 1976. The rule sets out the procedures to obtain an investigational device exemption (IDE); it delineates the responsibilities of sponsors, institutional review boards, and clinical investigators with respect to clinical investigations of medical devices; and the rule also prescribes informed consent requirements and specifies recordkeeping and reporting requirements.


Department of Health and Human Services Public Health Services. Notification of a new system of records: Three Mile Island mental health survey, respondent records. In accordance with the requirements of the Privacy Act, the Public Health Service (PHS) is publishing notice of a proposal to establish a new system of records entitled "Three Mile Island Mental Health Survey, Respondent Records, HHS/ADAMHA/NIMH." The Disaster Assistance and Emergency Mental Health Section, Division of Special Mental Health Programs, National Institute of Mental Health, is responsible for the system. The purpose of the system is to enable the Government to arrange followup study to the currently-funded research project entitled "The Mental Health of Residents Near the Three Mile Island Reactor: A Comparative Study of Selected Groups." PHS invites interested persons to submit comments on the proposed routine uses on or before November 3, 1980.


Public Health Service; National Institutes of Health; statement of organization, functions, and delegations of authority.


Public Health Service--Health maintenance organizations; employees' health benefits plans. Final regulations. This rule amends the Public Health Service regulations by setting forth revised requirements for certain employers, States, and political subdivisions of States to include in any health benefits plans offered to their employees the option of membership in qualified health maintenance organizations (HMOs). These changes are made as a result of public comments received on the notice of proposed rulemaking (NPRM) published on July 18, 1979. Certain minor technical and editorial changes have also been made.


A mini-college for the aging.

A mini-college for the aging.


Public Health Service--Grants for traineeships in health administration, hospital administration, or health policy analysis and planning at public or nonprofit private educational institutions other than schools of public health. Final rule. This rule sets forth requirements for programs for Grants for Traineeships in Health Administration, Hospital Administration, or Health Policy Analysis and Planning at Public or Nonprofit Private Educational Institutions Other Than Schools of Public Health under Section 749 of the Public Health Service Act (42 U.S.C 294s).


Public Health Service--Health maintenance organizations; requirements for a health maintenance organization. Final regulations. This rule amends the Public Health Service regulations by setting forth revised requirements for the organization and operation of federally qualified health maintenance organizations (HMOs). These amendments are made as a result of (1) public comments on the interim regulations published on July 18, 1979, and (2) public comments on the notice of proposed rulemaking (NPRM) governing relationships between federally qualified HMOs and other parties, also published on July 18, 1979.


Employee relations for the '80s.

Employee relations for the '80s.


Public Health Service-Criteria for designation of health manpower shortage areas. Final regulations. These regulations set forth the criteria for designation of health manpower shortage areas under section 332 of the Public Health Services Act. Entities in these areas are eligible to apply for assignment of National Health Service Corps Personnel. These areas are also eligible areas for certain loan repayment, scholarship, and other Public Health Service programs.


National guidelines for health planning: Public Health Service, HHS. Notice of proposed rulemaking. This Notice proposes to add national health planning goals to the National Guidelines for Health Planning under section 1501 of the Public Health Service Act. These goals concern health status outcomes, disease prevention and health promotion and personnel resources and systems of care. They supplement Subparts A and C of the Guidelines published as final regulations on March 28, 1978, which addressed standards for nine types of health services and facilities. Later issuances will provide additional goals and standards.


Protection of human subjects--Department of Energy. Proposed rule. Executive Order 12044 sets forth a program of regulatory reform to be followed by all executive departments. One element of that program is periodic review of existing regulations. The Department of Energy is committed to review all of its existing regulations within five years, on schedule set forth in the Federal Register for May 8, 1980, 45 FR 30448. As part of that commitment, the Department has reexmained the regulations contained in 10 CFR Part 745. These regulations deal with the protection of human subjects in research activities supported by the Department. In this notice, we are proposing regulations that will supersede the existing requirements. These proposed regulations are intended substantially to duplicate the policies and procedures proposed by the Department of Health and Human Services on August 14, 1979 (44 FR 47688). The primary responsibility for adequate review and approval to protect human subjects of research activities sponsored by the Department of Energy is placed on the institution that receives, or is accountable to the Department, for the funds awarded.


Government's nursing home rules--better care or more bureaucracy? The government has proposed revised regulations for nursing homes that receive medicaid and medicare funds, and the nursing home industry is howling. The new rules, they say, are impractical and will cost at least seven times as much as the government estimates.


Reagan's cure for health care ills--keep the government's hands off. The trouble with the medical care system, Republicans complain, is too much government interference. Beginning next month, the GOP will have a chance to put its ideas into practice--to remove "the straitjacket of federal programs," as the party's platform put it. That means, among other things, attempts to cut back on federal spending, dismantle some programs and encourage competition as a way of controlling costs.


Hospital chains continue to gain strength, but some see significant pullback shaping up.


Workers get cash for high deductible.

Workers get cash for high deductible.


Employers balk at HMO debts.

Employers balk at HMO debts.


Forgiving our debts.

Forgiving our debts.


Pullout threatens N.Y. plan.

Pullout threatens N.Y. plan.


Conversion to SI units in a regional 300 bed hospital and ten associated hospitals.


Safety in electron microscopy and protective glove hazards.


Muriel Driver Memorial Lecture 1980--Directions for the decade. Following an introductory summary of role theory, this paper examines one element of professional development -- that of ROLE NEGOTIATION. Research findings as outlined which provide evidence of the need for developing role negotiation skills within the occupational therapy profession in Canada. The paper describes four role strategies which can be used to professional advantage, as therapists negotiate their roles. The final emphasis is on the positive professional implications of effective role negotiations in the 80's.


Medical care insurance vs a national health service: impact on the patterns of medical practice.


Pastoral health care in Canada: some issues.


Shared purchasing: 'demand and supply.'.


New X-ray machine: the CAT scanner's successor?


Continuing education for employed clinical engineers: skills required for clinical engineering practice.


Traffic control in central service.

Traffic control in central service.


OR/CS supervisor: a new breed.

OR/CS supervisor: a new breed.


An update: training CS workers.

An update: training CS workers.


Foothills Hospital special services: 20 years of planning.


A multifarious hospital board.

A multifarious hospital board.


Submission to the Health Services Review '79.


An effective method for health-care decision making.


Politics and patient care.

Politics and patient care.


Quality assurance for the small hospital.


The St. Thomas solarium: a unique approach to relieving hospital stress.


Confidentiality: a comparison of state statues.


The dilemma of professional associations.


Hospital nurse pool: a three-year analysis.


The 10 commandments: a prescription for progress in 1981.


So, who cares? Pre-testing hospital brochures.


BAD news...for hospital costs.

BAD news...for hospital costs.


Medical staff impact on cost containment.


Use of PRN medications in skilled nursing facilities. Many elderly individuals in skilled nursing facilities (SNFs), afflicted with an array of acute and chronic diseases, may have as many as 20 different prescribed medications administered on a pro re nata (PRN) basis. In this study, 20 SNFs in Indiana were inspected. Data on PRN medications were taken from medical charts to determine the extent of PRN medication use by the patients. From one to 10 PRN medication were prescribed per patient; 47% of the patients had not used any of their PRN medications. Further data are needed to justify PRN medication prescribing and usage and to decrease the potential for hidden medical costs, adverse drug effects, and drug interactions.


Clinical pharmacy services in a hospital-based home care program. The Hospital-Based Home Care (HBHC) Program at the Veterans Administration Medical Center in San Francisco, California, is a specialized medical service designed to provide comprehensive continuity of care to the veteran patient in his or her own home through the use of a multidisciplinary team approach. Professional health care services are provided by nurses, dieticians, physical therapists, pharmacists, physicians, and social workers. Professional services provided by the clinical pharmacists include: the evaluation of prescribed medication regimen; product identification; patient counseling and education; drug therapy consultant to the HBHC team; and liaison between the HBHC team and outpatient pharmacy services.


Patient behaviors that promote high blood pressure control. The most important issue in hypertension control currently is treatment maintenance. This is important to the pharmacist since he or she may have the most patient contact. The decision to adhere to a drug regimen ultimately must be made by the patient. The patient must make the decision to control blood pressure, take the medication as prescribed, monitor his or her progress toward blood pressure control, and resolve the problems that block blood pressure control. The pharmacist can supply information about high blood pressure and emphasize the need for continuing treatment.


Project management, construction management and the consultant.


Protecting the hospital with risk management.


Identification of potentially noncompliant patients with a mailed medication refill reminder system. A medication refill reminder system was evaluated as a tool for identifying noncompliant patients. The system anticipates the date that a fully compliant patient would be expected to exhaust his or her medication supply and sends postcard reminders to all who have not obtained refills by the anticipated date. This refill reminder system has been in operation at the Pioneer Medical Center since 1973. During a 1-month study period, responses to the postcard reminders were monitored closely. Patients failing to respond within 5 days were contacted by telephone. The status of each patient's medication supply at the time of the pharmacy visit or telephone call was determined. Of 121 anticipated medication refill visits, 49 patients were found to have refilled their medications on or before the anticipated date. Reminder postcards were mailed to 72 patients. Within 5 days, 46 patients responded. Telephone calls were placed to 24 out of 25 patients. Two types of noncompliant behavior were identified; 34 out of 70 patients exhausted their medication supply before returning for a refill and 25 out of 70 patients accumulated a 1- to 30-day excess medication supply because of omitted doses. The postcard medication refill reminder system was found to be an effective tool for identifying patients who may benefit from compliance counseling with the pharmacist.


The pharmacist in the HMO environment.

The pharmacist in the HMO environment. Community pharmacists can provide pharmaceutical services to the health maintenance organization (HMO) patient on a cost-effective, competitive basis. Reimbursement based on usual and customary fees has proven to be an attractive method of payment not only to the participating pharmacists, but to the HMO administration as well. State pharmaceutical associations can play an integral role in developing, administering, and monitoring the pharmaceutical component of an HMO. A sharing of the financial risk encourages pharmacists to act as prudent purchasers of the drug product to be dispensed to HMO patients.


Twin cities HMO offers three different plans.


ECG system's remote access capability is added step toward technology sharing.


Flying ED ready for any kind of disaster.


Government and private groups compromise to control cost of French health care benefits.


Cal. EMs drilling against earthquake day.


"Free-standing emergency clinics"--is there a responsibility?


Controlling the trauma scene.

Controlling the trauma scene.


Immediate care of patients after a radiation accident.


Stress as related to EMT-P.

Stress as related to EMT-P.


Basic life support skills and a cardiopulmonary resuscitation control system.


Organizing medical services for large groups in field situations.


Aspects of paramedic education sties in postsecondary institutions.


The 16th EMSS component--money: where and how to raise nongovernmental funding.


EMS systems, records, and protocols: keeping score.


Emergency medical services in industry.

Emergency medical services in industry.


EMT training: roles, responsibilities, and performance outcomes.


Mental health needs assessment of children and adolescents.


Evaluating a private foundation's health program.


Fundamental issues in the practice of dental public health.


Challenges to the adoption of community water fluoridation.


Managing the aftermath of rapid EMS growth: what happens when the federal funds dry up?


Consumer influence on the quality of dental care.


Influencing federal, state, and local oral health policies.


Alternative oral health service delivery systems.


500 safely evacuated in Montreal hospital fire.


Cash management.

Cash management.


Effective public education for achieving oral health.


Proven: the value of an emergency preplan.


Marketing research in a competitive health care environment.


Make giving meaningful: key to development success. Interview by Larry Kofsky. Starting virtually from scratch in 1975, Berkshire Medical Center has built a fund raising success story. In this, the second part of a two-part interview, Mr. Davis discusses the hospital's employee giving program, planned gifts, foundation and corporate grants and special events.


The 1980-81 contract foodservice report: hospitals and nursing homes.


Health care.

Health care.


Fallacies and pitfalls of hospital cost containment.


Interview: Renee Fox.

Interview: Renee Fox.


New Britain Emergency Medical Services Foundation, Inc.


Controversy still reigns over USFMGs.

Controversy still reigns over USFMGs.


Perspectives on patients' rights.

Perspectives on patients' rights.


Medical ethics: assessing the dialogue between medicine and philosophy.


How Mount Sinai saved $7.5 million in manpower costs.


Management training for nurses: will we ever have it?


Training the supervisor as systems analyst is easy.


The health activation program: encouraging self care in college students.


Product standardization--or how to save nearly $500,000.


Texas Panhandle EMS system.

Texas Panhandle EMS system.


Healthful health management.

Healthful health management.


Making doctors cost-conscious.

Making doctors cost-conscious.


The Student Wellness Resource Center: a holistic approach to student health.


Dealing with nurse dissatisfaction: a management tool that works.


Hospital building: throwing bricks at design. It's no comfort to patients and staff at the Dukeries Centre in Central Nottinghamshire to know that the spring and early summer of 1980 were the wettest for 30 years. The roof of this seven year old maternity unit leaked and the local CHC said in its 1980 annual report: 'Rain water started to leak slowly into patient areas and has gradually increased into what can only be described as a flood. In nursing areas within the unit plastic dustbins and other large containers have had to be used to collect large amounts of water coming through the roof during rainy weather. This has obviously caused considerable inconvenience to both staff and patients and has made the unit more difficult to keep clean.' Repairs to the roof, totalling 150,000 pounds, are being carried out by the district but not soon enough to stop the water causing deterioration to the fabric of wards. The report says: 'It seems to the CHC that something has gone wrong with either the design or construction of the roof.' To find out how often this sort of problem has occurred in new hospitals over recent years, the Journal's Pauline Drummond conducted a survey of structural defects.


Toilet hygiene: clean round the bend.

Toilet hygiene: clean round the bend. Toilet cleaning is now so complex, writes Geoff Farrell, that it seems a graduate in chemistry and biology is the only person likely to make an efficient toilet cleaner. Mr. Farrell stresses the need to get in to all the nooks and crannies and discusses the dangers of mixing cleaning compounds as though you were pouring a Bacardi and Coke.


Educational outreach: an experimental evaluation of wellness center involvement in classes.


Goods handling: tugs, trailers and tractors. Ease of handling ought to be a priority in any supply and disposal system. Hazel Grayson, senior research officer at the Medical Architecture Research Unit, Polytechnic of North London, suggests that even where driver-operated electric tow tractors cannot be used, other types of electric pulling device should be considered.


Marketing goes to work: how a group leads its program development with occupational health.


Sources of funding for EMS in rural settings.


Health and safety--3: Hazards on hospital roads. Problems of road transport in hospitals and health premises are discussed by Mr A. Smith, safety liaison officer, Haringey HD, in his continuing series on health and safety problems.


Personnel management: commissioning in Oxford. In July this year, the closure of Cowley Road Hospital marked the completion of the biggest organisational change in Oxford's hospitals since the Radcliffe Infirmary first opened 200 years ago on St Luke's Day in 1770. The staff and geriatric patients from Cowley Road moved to the partly vacated infirmary and the Churchill Hospital for the purposes of rehabilitation and continuing care. Some of the acute beds had already moved to the John Radcliffe for the integration of general medicine and geriatric admissions, writes David Charles-Edwards, personnel officer, Oxford AHA.


Lewisham bereavement project: death and the life that's left. Coping with bereaved relatives is a problem, both emotional and practical, for nursing staff. At Lewisham Hospital a scheme was set up bringing in the existing volunteer system to support the bereaved. Here, Janet Keyte, sector administrator; Bette Meade, voluntary services organiser; and Philip Nye, senior nursing officer, give the history of the Lewisham Volunteer Bereavement Project.


The lifestyling program: moving toward high level wellness.


Management: carrying their own cans.

Management: carrying their own cans. The NHS is being urged to collaborate with the private health sector. In spite of the presence of many ex-NHS administrators, the approach to management is rather different, as Stanley Hill found when he talked to the people concerned with the embryonic Cromwell Hospital in London. This brings to a close this first series of three articles, but in a few months' time Stanley Hill will be looking at three more organizations outside the NHS, and how they are managed.


Health and safety--4: don't play with fire. Continuing his autumn series of health and safety Mr A. Smith turns his attention to fire precautions. He talks about organisation and arrangements which exist in hospitals to ensure that all precautions are taken, that staff are trained and that the Health and Safety at work Act is observed.


Prestel: flaws in the indexing tree.

Prestel: flaws in the indexing tree. Viewdata is a generic name for a system that links people to computer-based data through an adapted TV set and the telephone. It is expensive; information providers can spend hundreds of thousands of pounds a year on information frames that still have limited use. In Britain the main system is called Prestel. Pauline Drummond examines its relevance for the health service, particularly in the light of recent experiments.


Health and safety--8: offices--new laws for old. Who actually remembers anything about the Offices, Shops and Railway Premises Act? It came into operation in 1964 and was introduced to the NHS by Circular HM(64)46. The Health and Safety at Work Act is intended eventually to replace the OSRPA together with other earlier safety legislation. A. Smith jogs our memories.


Joint finance--1: ripping the Lambeth canvas. Jef Smith, director of social services for Kingston-upon-Thames, has been visiting various parts of the country to talk about joint finance with a range of local authority and health service practitioners. In the first of three articles he reports on issues posed in the London Borough of Lewisham.


Health and safety--9. foam--the critical two minutes. The recently published Home Office report on the Woolworth's fire in Manchester, in May 1979, which involved furniture containing polyurethane (PU) foam, must inevitably re-open the debate on whether this material should be used for hospital mattresses. A. Smith outlines the arguments.


Companion animals: patients' best friends.


Light bulbs: list price doesn't really count.


Regional group purchasing helps Maine hospitals save food dollars.


Clinics for occupational medicine help Sweden work safely.


Community health care in the USA: some aspects in South Western Ohio.


Sharing fairly in the NHS: the effect of imperfect cost data on RAWP.


Cross boundary flows of patients.

Cross boundary flows of patients.


RAWP: the need for further discussion.

RAWP: the need for further discussion.


How GPs are paid.

How GPs are paid.


National and political aspects of closures: can we manage things better?


Hospitals upgrade management training program after they merge.


Developing a hospital malpractice fund.

Developing a hospital malpractice fund.


Training; the key to an effective risk management program.


Whittingham Hospital power house scheme.


A new role for the hospital engineer: the technical administrator.


Microprocessor techniques in energy conservation.


Heating control systems for small buildings.


Medico-technical devices--reporting of accidents.


Acoustic power measurement of medical ultrasonic probes using a strain gauge technique.


Finding alternatives to regulation.

Finding alternatives to regulation.


Annual report 1979-80: Association of Western Hospitals and AWH Educational & Research Foundation.


The Institute of Hospital Engineering: Code and rules of conduct and disciplinary regulations.


Access to engineering services for maintenance.


Model for a successful governmental affairs program.


Air filtration.

Air filtration.


How to overhaul your physician credentialing process.


Health care manager's notebook: effective presentations.


Futurism in health care.

Futurism in health care.


Patient-based audit relates condition and drug.


Deregulation update: Colorado launches initiative program.


Limited criteria, follow-up common to successful audits.


Regulation vs. competition.

Regulation vs. competition.


Improved hospital productivity dependent on revised incentives.


Pope John Paul II: On medical ethics.

Pope John Paul II: On medical ethics.


Casa de los Niños, Tuscon, AZ. Crisis nursery treats abuse victims.


The sleeping giant stirs: growth in multihospital systems. Because their future is interwoven with the Church's broader role, Catholic multihospital systems must not grow solely for efficiency's sake. On the following pages the authors analyze data showing a direct shift toward a new form of health care delivery and suggest that system types, organization structures, and objectives should reflect and enhance Gospel values.


Trustees called to reexamine governance, sponsorship roles. The role of Catholic health care trustees includes certain responsibilities that arise from the sponsor's nature and relationship to the Church. Sponsors, boards, and management must clarify and communicate their expectations of trusteeship.


Competency and commitment: key to lay CEO's success. Because lay administrators will either strengthen or weaken how the sponsoring group's philosophy is interpreted, careful recruitment is essential. The effective lay CEO is a competent administrator and committed to the sponsoring group's goals and objectives.


Survey indicates increased shared services in Ohio Catholic hospitals. Short-term, general hospitals in Ohio report an increase in shared services and multiinstitutional arrangements. Cost-saving agreements for shared administrative services tend to be more popular than those for clinical services.


Commitment to family-oriented care demands innovation, sensitivity. During the Decade of the Family, Catholic health care facilities should reexamine their commitment to family-oriented care. Do admission, treatment, and discharge procedures take into account that the patient is one member of a unit? Or do they focus solely on the patient as a physically sick individual?


St. Margaret's Hospital for Women and St. Mary's Home, Boston. Maternity hospital's care supports parents, child. Family-centered maternity and perinatal care for high-risk mothers and infants is a special mission demanding firm commitment from health care personnel. Support services in the form of education, social service, psychiatric consultation, recreation, and nutrition supplement the full range of maternity-cycle care.


St. Joseph's Hospital, Milwaukee, WI. Four-day work week improves purchasing efficiency.


Hospital suspends physician in patients' interests.


Proceedings instituted to withdraw respirator.


Patient alleged lack of informed consent.


St. Joseph Medical Center, Wichita, KS. Hospital's alternative to Social Security boosts employees' pay, local economy.


Current trends in nutritional care of inpatients.


The role of human service professionals in executive decision making in third party organizations.


Changing expectations for third sector executives.


New Jersey high court rules attorney retained by malpractice insurer breached duty to client physician by settling suit: inherent conflict of interest.


FDA NPRM would standardize blood labeling to permit inventory automation.


NRC's new enforcement policy could cost hospitals up to $100,000 for non-compliance: medical community criticizes regulations' lack of clarity.


Formulating meaningful standards: a contemporary approach.


Cost savings in hospital planning using computer simulation.


What games do people play in your hospital?


Transfer of Hill-Burton facilities subject to right of recovery: HHS developing interim procedures manual.


Strict employer liability for sex harassment affirmed in final EEOC guidelines.


Personnel practices and human rights commissions.


Expiration dates, sterile or unsterile? That is the question.


Special feature: Hospitals can diminish potential liability by clarifying patients' rights vis-a-vis house staff and students.


Ethylene oxide environmental monitoring--an evaluation of a new and novel ETO monitor.


ART to RRA: a career path.

ART to RRA: a career path.


Hospital planning: the contemporary challenge.


Dual challenge: medical record continuity and availability.


Pharmacy Q's and A's: effective programs for adverse drug reaction and medication error reporting.


On the homogeneity of diagnostic related groups (DRGs).


A research methodology course for senior medical record administration students at St. Louis University.


A hospital-wide qualimetry program.

A hospital-wide qualimetry program.


Word processing eliminates use of outside transcription service.


Auditing nutritional services for hospitalized patients--an example of peer review.


Contract transcription services--cost containment decision.


When is a leader also a follower?

When is a leader also a follower?


MRA graduates respond to survey: careers and college preparation.


The radiation therapy chart: a clinical chart for a radiation therapy center.


Psychiatric records: confidentiality as it relates to release of health information.


About nurses--some fantasies laid to rest.


I quit--your rights.

I quit--your rights.


New DHC to dispel local skepticism.

New DHC to dispel local skepticism.


Join nursing homes to hospitals?

Join nursing homes to hospitals?


OR technicians--who, what, where?

OR technicians--who, what, where?


Emergency care--the state of the art.

Emergency care--the state of the art.


Sharing cuts foodservice costs.

Sharing cuts foodservice costs.


How and why to use consultants.

How and why to use consultants.


Team care: behavioral science meets medicine.


Team care: learning to pull together.

Team care: learning to pull together.


Let's not carry team care too far.

Let's not carry team care too far.


FCIM defines the internist.

FCIM defines the internist.


Recall of health education display materials.


The emergence of self-help groups.

The emergence of self-help groups.


Hospice and health policy.

Hospice and health policy. This article gives a review of the hospice concept of care. The importance of caring for the patient and family as one unit for the purpose of addressing needs of each, and the specific needs of the dying patient and of his/her family are discussed. The alleviation of symptoms and control of pain are of primary importance in terminal cases. Throughout the dying process the patient should be treated as a unique individual and his fear of isolation and abandonment must be overcome by the availability of personal attention. Although the patient receives a great deal of attention it is of vital importance to him/her that he/she is just as involved in giving as receiving. The family is both an agency and a recipient of care. It is the task of hospice care to allow the family to go on living. Feelings of anticipatory grief--of which a definition is given--have to be reduced; the most difficult time for the family is however when the patient is very close to death. It is stressed that real exchange of feelings between family and the dying person is of utmost importance for both, and should be encouraged by hospice care. The hospice staff should maintain contact with the family and close friends after the death of their loved one, to allow them ventilation of their feelings.


Influences of a future corporate health system on medical education. Corporate attention to problems in health care delivery has grown over the last decade. As this focus by the "purchasers" of medical care increases business and industry influence on health policy decisions, significant changes may come about in the delivery system, and eventually in medical education. Whether the evolving corporate design for health care best serves consumer interests is less clear than how the medical profession and medical educators will fare in the next twenty years.


Regional physician supply and graduate medical education. This paper examines the relationship between medical students' practice plans and residency plans. The paper concludes that most students surveyed knew where they wanted to practice and that, unless otherwise constrained, students who knew where they wanted to practice tended to apply to programs there. This finding suggests that the Weiskotten literature and its apparent policy implications should be evaluated critically. In particular, the results call into question the rationale for unrestricted subsidies of undergraduate and graduate medical education by the states.


Consumer agendas and health planning priorities: one consumer's perspective.


Is consumer choice and competition in health care the wave of the future?


Tax-exempt hospital revenue bonds--first-half financing up despite high interest rates.


Five misconceptions about hospital finance.


An approach to cost containment: short-term patient census forecasting models.


Developing patient charge structures--an eight-step formula.


Touch endorsement protects patients' money, valuables.


Colorado develops innovative master's degree.


Meeting the challenges involves some risks.


Cooperative planning.

Cooperative planning.


Payment patterns: charging patients for a late discharge.


Part I--hospital security: a joint endeavor.


Answers to questions about management development programs.


Hospital security and nursing--a cooperative relationship.


Hospital x-ray film: a higher priority for thievery.


Getting things done--in a simple way.

Getting things done--in a simple way.


Regionalization among children's hospitals.


Sharing services: the dynamics of institutional and administrative behavior.


How to keep up with the literature.

How to keep up with the literature.


Part II--hospital security: a joint endeavor.


Use liability experience to focus RM, QA efforts.


Biohazards control: tips from consultants.


A blueprint for hospitalwide quality assurance. Hospital medical staffs currently are faced with the task of writing a quality assurance plan that will meet the requirements of JCAH's new standard for integrating quality assurance activities on a hospitalwide basis. The following article details the essential components of a written quality assurance plan and the special procedural requirements that must be spelled out in the written statement.


Point of law: fathers in the delivery room.


How self-insurance can offer more for the money. The author examines the three services that conventional liability insurance carriers offer to hospitals and shows how self-insurance combined with a good risk management program may provide these services better and more cost-effectively.


Evaluation of antibiotic usage in a pediatric hospital.


Development of competency standards for quality assurance in clinical pharmacokinetics. In response to an editorial in Hospital Pharmacy which called for "in-house credentialling" of pharmacists engaged in the application of clinical pharmacokinetics, a method of introducing quality assurance in pharmacokinetics is presented. The evolution of a pharmacokinetic dosing service in which each pharmacist is responsible for the provision of dosage recommendations on his/her patient care area is discussed, along with the difficulties which had to be overcome in order to establish uniform guidelines for our clinical pharmacy staff to follow when providing this service. Finally, the establishment of acceptable levels of competence, means of obtaining those levels, and methods for the determination of competence are presented.


Comprehensive pharmacy services and their impact on nursing services in a 40-bed hospital.


An automated graphics system.

An automated graphics system.


'Heartifacts': a pilot project in nutrition and cardiovascular disease education.


A regional evaluation of citizen mental health boards. This is a report of an evaluation of citizen board functioning in an eighty-county region. Included in the study were seven county mental health boards, four state hospital boards, one community mental health center and four metropolitan catchment area boards. Board effectiveness criteria (knowledge of mental health legislation, policy-making effectiveness, knowledge of the community and agency procedures, organizational effectiveness) are related to demographic and ideological profiles for each board. Board effectiveness was measured by the Self-Diagnosis Guidelines (Institute for Voluntary Organizations, 1977). Board ideology was assessed with the Community Mental Health Ideology Scale (Baker & Schulberg, 1969). Results indicated that: (1) boards were generally not representative of their communities; (2) most boards saw themselves as only marginally effective; (3) the low self-ratings of boards were due to deficiencies in crucial areas of board responsibility; (4) there were significant differences in effectiveness among boards; and (5) board members reported less support for community mental health philosophy than some professional groups. Implications of the findings for mental health policy and legislation were drawn.


A statewide assessment of mental health governing board training needs. This paper describes a statewide survey assessment of the training needs of governing board members and presents a demographic profile of governing board presidents. Presidents of the 55 governing boards in a consortium of state-funded, community-based mental health agencies were mailed questionnaires. They were asked to respond in terms of board rather than individual priorities. Forty-four questionnaires were returned representing 80% of the sample and 57% of all governing boards in the state. Seventy-one percent of the respondents were male and 55% were executives or managers. Their mean age was 45. Of the 10 needs assessment items, the two highest rated pertained to the financing of centers and knowledge of mental health legislation. Three areas of need emerged from a factor analysis: a board mandate factor, a board organization factor, and a planning and evaluation factor. The perceived training needs of the Chicago Metropolitan Area and Downstate Illinois were similar. The issue of effective citizen involvement vis-à-vis valid representation and appropriate training was discussed.


Use of consumer feedback in planned change and evaluation activities. Consumer feedback about services can be used to reward staff, stimulate improved performance, and make the service organization more responsive to consumer needs. Carefully collected consumer feedback can be used in a process of organizational planned change involving a cycle of problem perception and documentation, followed by the choice, implementation, and evaluation of solutions to these problems. Presently, consumer feedback is often poorly collected or inadequately utilized. Through preparation of concrete items related to manipulable aspects of service delivery, use of precoded response categories for items, and use of computers for data analysis, high quality consumer feedback can be obtained and used to pinpoint service delivery problems, evaluate solutions to problems, and evaluate the impact of other service changes and innovations.