Management concepts in clinical engineering. The social and economic environment surrounding health care delivery is forcing improved financial management. The resulting responsibilities within health care institutions create the need for Clinical Engineers to develop improved management skills. Along with more traditional evaluation of technologies, these skills must be developed in the areas of Personnel and Data Management. The primary tool is a P.M./Repair Documentation System that can provide the data necessary for adequate manpower management, especially such factors as productivity and effectiveness. In addition, concepts previously foreign to engineers, such as group and human behavior, policy and program analysis, and organizational structure, must become part of the Clinical Engineers' working knowledge.


Increasing complexities of personnel management in the '80's.


Rehospitalization rates and function levels of patients discharged to a comprehensive community support system.


The executive director's contract and evaluation: its role in board governance and quality management.


Mental health systems and services in the United States.


Integration of physical and mental health services: can we meet the challenge?


The integration of the delivery of mental health and general medical services.


Administrative approach to the problem of violence.


The market surrogate obligation of the public sector boards.


A review of legal challenges to personnel testing.


Level of functioning: a behaviorally-oriented approach to client assessment, treatment, systems planning, and research.


Influence tree model for the purchase of mental health services.


Need assessment for organizational development and systems change within mental health organizations.


Employee health and safety rights under the LMRA and federal safety laws.


Calculating cost figures: a vital part of a linen manager's responsibilities.


Linen management: is everything under control in your hospital?


Senior retirees run the machines at Gaston Memorial Hospital plant.


Contour sheets boost handling costs of institutional laundries, says expert.


Funding cuts and the nation's health--an interview with the government's top doctor.


What you should know about stress.

What you should know about stress.


Antitrust and health planning.

Antitrust and health planning.


Construction picketing notices to health care institutions: the National Labor Relations Board alters its approach.


Nursing management must be strengthened.


Businesses may be steady buyers of hospitals' wellness programs.


Retirement centers are in strong demand; require careful planning.


Urge trustees to lead coalitions.

Urge trustees to lead coalitions.


Extravagant atrium cuts energy use yet costs nothing more.


Famous, rich, powerful people play major role in facility's development.


Court shares burden with doctors of making life-and-death decisions.


It's no joke--health care exec needs sense of humor to be good manager.


Personal scorecards for the overloaded financial officer.


Hospital Bureau drops many shared services.


HMOs will be high risk investments through '80s; need 7% profit margins.


Competition woes await successor to retiring BC-BS chief McNerney.


United Healthcare Systems build 'All-Star team' of large hospitals.


Health costs don't concern business.

Health costs don't concern business.


Union hits facility with public relations bomb during violent strike.


Health planners search for jobs as feds prod local HSAs to wind down.


California hospitals tackle working conditions causing nurse turnover.


Healthcare industry fights to keep industrial development bonds alive.


The future and healthy people: political and social implications.


Decision suggests High Court will scrutinize repeal of antitrust laws.


Reagan's 'New Federalism' divides hospital industry.


Toward a new national health policy for the elderly.


Myths about continuing education.

Myths about continuing education.


The "periodic physical examination" as a strategy for prevention in clinical practice.


American Medical Supply bought by Glasrock.


Teleconferences save time, money; expand inservice opportunities.


Voluntary x-ray guidelines could change demand.


Establishing target levels for hospital accounts receivable.


A BASIC data management program for clinical laboratory audits. Presented in this article is a simple computer program written in BASIC for audit purposes. Although it is developed with a DEC PDP-11 microcomputer, the program can be modified for other microcomputers. Shorter and less versatile than most commercially available data management programs, it is suitable for the type of audit functions likely to be encountered in clinical laboratories.


Business coalitions for health.

Business coalitions for health.


How to manage employee job performance.

How to manage employee job performance.


Do they really work? Formal grievance procedures in non-union plants.


Toward a continuum of care for the elderly: a note of caution. The search for better ways to care for the chronically ill elderly has led to "alternatives to institutional care." A study fo geriatric day care and homemaker services finds that they were used as an add-on to existing care, few patients benefited, and costs were 60-71% higher than costs of a control group. Four more studies have confirmed the lack of substitution effects. Services could be targeted on those who need them even though it is very difficult to do so, and efficacy should be demonstrated before benefits are expended to new services.


Discipline: a management tool.

Discipline: a management tool. An effective discipline system is both a management tool and a learning experience for our employees. The system defines and protects the rights of 95 percent of our employees, who will never require disciplinary action. At the same time, the system must provide appropriate constructive action on penalties for the 5 percent of our employees who do not comply with the rules. In essence, a good discipline system administered uniformly and consistently can be a learning experience, resulting in a mutual benefit to both the employee and administration.


Overview of word processing.

Overview of word processing.


Digital radiography: a look inside and down the road.


The management process.

The management process.


The competitive scenario for health care reform.


Why have an employee rating system?

Why have an employee rating system?


Performance appraisals: a feasible and unbiased approach.


'Restaurants' in nursing homes liven up meals.


Remodeled cafeteria eliminates hospital's food service headaches.


The Hawaii Prepaid Health Care Act: legislating health insurance in the Islands.


Shock trauma!

Shock trauma!


Regionalization of trauma care.

Regionalization of trauma care.


Informed consent in critical and emergency care research.


Resuscitation research and human rights.


Taking a dose of drug-free weekends.

Taking a dose of drug-free weekends.


Seminars, classes emphasize holistic approach to aging.


Games people play.

Games people play.


Staff sees life from patients' eyes during Fla. home's sensitivity day.


Garden project unites community, residents.


Teaching self-care to COPD patients and families.


Wanted: respiratory therapists. Recruitment in a expanding field.


The health care industry: facing the realities of the eighties.


Health insurance coverage for alcoholism: a review of costs and utilization.


The role of federal, state, local, and voluntary sectors in expanding health insurance coverage for alcoholism.


Quality assurance and cost containment in alcoholism services.


Health insurance coverage for alcoholism treatment: policy issues.


The role of alcoholism services providers in health insurance coverage for alcoholism.


Occupational programs and their relation to health insurance coverage for alcoholism.


Health insurance coverage for underserved populations.


Health insurance issues for the 1980s.

Health insurance issues for the 1980s.


Women, health insurance and alcoholism.

Women, health insurance and alcoholism.


A review of progress in development of health insurance coverage for alcoholism treatment.


Alcoholism detoxification services in a rural community: a formal development approach.


Nature and scope of benefit packages in health insurance coverage for alcoholism treatment.


LMs slightly favor cost per patient day.


Psychiatric day treatment clerkship for undergraduate pharmacy students.


Us vs. them: Part II.

Us vs. them: Part II.


Skillful interviewing: more than conversation.


The closed circuit connection: how to set up, operate and maintain a CCTV system in your hospital.


Winning administrative support: the department you save may be your own.


Dental insurance: product for the 1980s.


The role of federal legislation.

The role of federal legislation.


CanSur: modern data management for improved cancer patient care.


The College's Commission on Cancer: evolving to meet the needs of the times.


Progress in cancer patient management in community hospitals.


An assessment of surgical training.

An assessment of surgical training.


Quality circles in the service sector.

Quality circles in the service sector.


Management guidelines: understanding needs.


Taking the pain out of performance appraisal interviews.


Making MBO work: matching management style to MBO program.


Florence Nightingale wants you! To recruit nurses, hospitals are boosting pay and perks.


The quaalude scam.

The quaalude scam.


Veterans Administration: schedule of reviews for "contracting out"; initiative of Veterans Administration's Department and Surgery.


When doctors play God.

When doctors play God.


Public Health Service--Privacy Act of 1974. Notification of establishment of a new Privacy Act System of Records 09-25-0148. In accordance with the requirements of the Privacy Act, the Public Health Service (PHS) is publishing notice of a proposal to establish a new Privacy Act System of Records 09-25-0148. Contracted and Contract-Related Research: Records of Subjects in Clinical, Epidemiological and Biomedical Studies of the National Institute of Neurological and Communicative Disorders and Stroke, HHS/NIH/NINCDS. We are also proposing routine uses for this system. This system will be used to support (1) epidemiological, clinical and biometric investigations into the causes, nature, outcome, therapy, prevention and cost of neurological and communicative disorders and stroke, and (2) review and evaluation of the progress of these research projects, and identification and planning for improvements or for additional research.


Measurement of the activity of radiopharmaceutical dosages: Nuclear Regulatory Commission. Proposed rule. The Nuclear Regulatory Commission (NRC) is proposing to amend its regulations on human uses of byproduct material, to require specific medical licensees to (1) Measure the total activity of each radiopharmaceutical dosage, except those containing less than 10 microcuries or a pure beta-emitting radionuclide, before it is administered to a patient; (2) verify that smaller dosages contain less than 10 microcuries; and (3) keep a record of the measurements. The assary of each radiopharmaceutical dosage before it is administered to a patient is currently required as a condition for a specific license. Measurement of the total activity of radiopharmaceutical dosage helps to protect patients from unnecessary radiation resulting from errors in labeling, calculating or dispensing dosages. The purpose of this rulemaking is: (1) To simplify licensing by replacing a condition that appears in all medical licenses with one regulation, and (2) To enhance patient radiation safety by minimizing potential misadministrations caused by not measuring the patient dosage.


Hospital fire protection using the unit concept.


Profile of an occupational therapist revisited.


Measurement and management of stress in health professionals working with advanced cancer patients.


Spiritual care for the dying.

Spiritual care for the dying.


Firefighters and hospital personnel join forces to treat burn patients.


Could your community cope in an accident with 50 burn patients?


Planning mental health services on the basis of need: a clinician's point of view.


Teleconferences help maintain in-service training programs.


Adequate staffing.

Adequate staffing.


Medical & Surgical Purchasing Guide proves a boon to purchasers.


Computer bits ... in purchasing.

Computer bits ... in purchasing.


Vending machines show profit at Greenwich Hospital.


A communication system for stockouts and backorders.


Career development related to radiography.


Buy back clause clinches van purchase agreement.


Hospital-purchased physician supplies: a violation of antitrust statutes?


Drug therapy review in nursing homes: proposed standards and guidelines. In 1974, the Department of Health, Education, and Welfare mandated monthly drug regimen reviews by pharmacists for all Medicaid-financed residents in skilled nursing facilities. In 1980, proposed federal regulations were developed to extend the benefit of that type of review to residents of intermediate care facilities. The Government Accounting Office, in the meantime, found that a definition of the scope of medication review is still lacking, as is a single source of information on drug monitoring. As the proposed regulations and the corresponding guidelines appear to have severe shortcomings, the authors developed new standards and guidelines for the Baltimore City PSRO. Foremost in these is the statement that drug regimen review is not complete until the physician has responded in writing in the patient's chart to any recommendation the pharmacist-consultant has made.


Comparison of patient acceptance of pharmacists and physicians as measured by appointment compliance.


Readability formulas: are they enough?

Readability formulas: are they enough? Because of FDA requirements concerning patient package inserts and growing awareness of the need for patient education, pharmacists and other health care practitioners have become interested in assessing the readability of written information intended for patients. Readability formulas have seemingly furnished a quick and easy answer. However, users of readability formulas should be aware of their limitations. Several of these limitations are presented, along with suggestions for overcoming them. This approach will enable pharmacists and other health care practitioners to become more sophisticated in assessing the readability of various documents and ultimately to produce readable documents.


Effect of label format on information recall in patients receiving prescription medications. Many patients receive their filled prescriptions without verbal instructions and must rely on the label as their only source of information. A two-phase study was designed to measure differences in recall information when two common variations in label format were employed. Phase I: Does the patient comprehend label directions better if numbers are typed as words or as numerals? Phase II: Does the addition of preprinted auxiliary labels affect recall of directions? In Phase I, 100 patients were asked to read a label expressing three numbers as words and an additional 100 read the same label using numerals. In Phase II, patients saw the label using numerals with either zero, one, two, or three auxiliary labels attached. Each label was seen by 50 patients. Patients were scored on a point system based on their ability to repeat label directions. There was no significant difference in information recall between label format groups (p greater than 0.05). Only 44% of the patients could remember all directions, 13% could remember no information, and 63% failed to read the auxiliary labels. These results suggest that pharmacists should place less reliance on label format and the use of auxiliary labels to communicate information and spend more time verbally counseling their patients on the proper use of their medications.


Analysis of the change in work patterns following installation of an inpatient pharmacy computer system. An experiment was designed to determine if the installation of a pharmacy computer produced a significant change in the distribution of routine inpatient dispensing activities for pharmacy personnel. Data were obtained using time lapse motion picture photography and work sampling procedures. Cameras were placed in three different locations for 6 days over a 2-week period before and after installation of the computer. A sample of approximately 2000 observations was reduced to machine readable format and analyzed using nonparametric statistical procedures. Results indicated a shift in work patterns of pharmacy personnel. It was concluded that the installation of a pharmacy computer had a significant effect on the distribution of routine inpatient dispensing activities. Pharmacy management should consider this information in anticipating efficient use of personnel and proper placement of computer hardware.


New models in ambulatory care.

New models in ambulatory care.


Pharmacist involvement in emergency room services. Emergency rooms providing primary health care services continue to expand, especially in community hospitals, where practicing hospital pharmacists are finding opportunities for growth such as administrative planning, provision of drug and poison information to the emergency room staff, and direct involvement in "codes". Coordination with the community pharmacist can assure proper dispensing of "emergency room take-home meds" and counseling of patients. Funding sources to expand pharmacy services may exist in traditional dispensing, administration of injectable drugs, qualitative drug screens, and grant or educational monies.


Pharmacy manpower--a roundtable discussion.


Let's program lab tests.

Let's program lab tests.


Humanizing hospital design.

Humanizing hospital design.


Hospital trusteeship: somebody has to do it.


Continuing education: the pros and cons.


A statement on the status of interns and residents.


The politics of health care in Canada.

The politics of health care in Canada.


A health care editor tells how it feels to be a patient.


Avoidance of copayment feature in dental plan subverts plan design and adds to premium costs.


The administrative costs of non-profit health insurers. Interest in the efficiency or inefficiency of non-profit firms has spawned research on the administrative costs of Blue Cross and Blue Shield plans. Relying on plausible implications of the property rights theory of the firm, both Blair, Ginsburg, and Vogel (1975) and Vogel (1977) noted some evidence of inefficiency in these firms. Our analysis, however, utilizing their models and more recent data, reveals little convincing evidence for the view that Blue Shield plans are inefficient.


Employers work hard to promote HMOs but get poor employee response, administrative problems.


Cafeteria benefits: a commentary on process.


Old myths and new realities: wide and sudden dissemination of radioactive materials.


Health premium increases due to utilization? History, corporate experience indicate otherwise.


Hyatt carnage a shocker..even to veteran EP's.


Cause of EP burnout: workplace and motivation.


The concept of a total EMS system.

The concept of a total EMS system.


Impact of the repeal of the Kansas Mandatory Motorcycle Helmet Law, 1975 to 1978: an executive summary.


Radiation primer.

Radiation primer.


Programmed patients: a method of improving field performance.


Liability for the unsafe driver.

Liability for the unsafe driver.


Mental health and mental retardation institutional housekeeping.


Mobility and the family in hospital medicine.


Doctors in government.

Doctors in government.


What happens when the patient goes home?


Health care trends and issues in the 1980s.


The timing of and reasons for doctor's career decisions.


Specialty budgeting: a pilot study carried out in East Cumbria Health District.


New roles for educators.

New roles for educators.


The challenge of the '80's.

The challenge of the '80's.


Trends in microbiology work-loads in the National Health Service: England and Wales (1968-79).


2,000 Michigan LPNs affiliate with 1199.


Contract gains for 12,500 members.

Contract gains for 12,500 members.


A hospital director recalls 22 years with 1199. Interview by Nancy Stiefel.


An ecological orientation toward human abuse.


Child neglect and abuse.

Child neglect and abuse.


The battered elderly: physical and psychological abuse.


Home is where the hell is.

Home is where the hell is.


Delivering human services for abused clients: a system and individual approach.


Training counts: Scott & White educates support staff in patient relations.


Foreign health market: expanding frontier for American hospital management firms.


Group practice, now--and then.

Group practice, now--and then.


U.S. trade official sees services as great opportunity for export growth.


Eurodollar market is major source to borrow capital for projects abroad.


Budget reconciliation -- legislative speedwriting.


Export disincentives handicap U.S. business expansion in foreign market.


The elders speak... Dorothy Killian, ASHFSA. Interview by B. Allen.


The choice: computers in foodservice.

The choice: computers in foodservice.


The test: computers in University of Kansas Medical Center.


Business of insurance and antitrust: some case history.


Study indicates slower rise in costs in non-rate setting states.


Band-Aids by the boxcar.

Band-Aids by the boxcar.


Third party coverage is a key obstacle facing U.S. psychiatry, APA chief says.


Why capital campaigns fail to achieve full potential.


Health care marketing in the Middle East: a mixture of challenges and opportunities.


NAPPH leader foresees continued growth of private psychiatric in '80s.


Strategic plans increase capital campaign success.


The National Board of Medical Examiners--responding to the needs of the licensure community.


Multi-unit systems loom large in future of health care.


Psychiatric hospitals beset by unusual problems in regulation and reimbursement.


Shift in mental health emphasis provides new opportunities for private sector.


What it means to make a merger.

What it means to make a merger.


Studies in energy management: institutional.


Doing something about boosting clerical productivity in hospitals.


Patients in waiting.

Patients in waiting.


Safety hazards: figuring out fire facts.


Special legislative sessions likely on state fund crises.


Dwindling public funds for psychiatric care pose challenges to private sector.


Organ donorship: all donations welcome.

Organ donorship: all donations welcome.


Enterprise, planning help companies handle nurse shortage.


Medical photography: picture of health.

Medical photography: picture of health.


Utilization of selected drug information resources by nurses.


A warning to hospitals.

A warning to hospitals.


Alcoholism and the increasing role of the hospital.


Supplies service: ethics and inducements.


Group purchasing trends in USA.

Group purchasing trends in USA.


Health and safety: pollution precautions.


Fund raising: support your local hospital.


First aid fire fighting.

First aid fire fighting.


Computers in hospital: the first ten years.


Mobile health unit: nursing education brings health screening and health teaching to the community.


Antitrust developments and the planning process: an overview.


The library literature retrieval system.


Ethics for patient educators.

Ethics for patient educators.


Controlling inventory with an automated ordering system.


Should a registered pharmacist sign P.O. for a controlled drug?


Materials control practices in the pharmacy.


Cost-plus buying takes mystery out of pricing.


Estimating damages in requirements contract.


Pharmacy/purchasing cooperation saves time and money.


Telephone sales of "distressed" merchandise: caveat emptor.


Does your hospital have a purchasing manual?


Joint Purchasing Corp. helps members buy food.


Disciplining our procedures: an analysis of the disciplinary and grievance procedures in the NHS--1.


Plop! There goes another decision.

Plop! There goes another decision.


Can teams manage?

Can teams manage?


Team development in the NHS.

Team development in the NHS.


Suggestions and complaints procedure in Scotland.


Big hat, no cattle: managing human resources. When faced with business problems, managers naturally make identifying the trouble their priority. Once that is done, at least half the job is over; finding solutions is just a matter of time. This hasn't been so, however, with the human resources problem: how to motivate employees. Sixty years ago, the Hawthorne experiments revealed the issue, and ever since, managers, researchers, and consultants have been searching for the answer to the human resources problem. Why aren't employees as productive, loyal, and dedicated to their companies as their managers know they can be? The author of this article proposes four reasons why actuality has fallen so far below expectation in personnel management, namely, that managers' expectations have been too high in the first place, that the concepts staff professionals offer managers are frequently contradictory, that the corporate role of personnel has always been problematic, and finally, that managers hold assumptions concerning their employees that undermine efforts to motivate them.


Outlook for hospitals: systems are the solution. Interview by Jeff C. Goldsmith. Like all industries, the health care industry undergoes change. A fragmented system of isolated, free-standing community hospitals is undergoing rapid consolidation into large multihospital corporations and systems. If the history of other industries is any guide, this consolidation will accelerate as the nation instills greater economic competition in the health marketplace. In the future, say the managers of two very different hospital networks, large multihospital systems will predominate. Two big questions, then, are: Should these systems be proprietary or voluntary? And how should they go about meeting people's changing health care needs? These interviews with the physician founders of two multihospital organizations, Hospital Corporation of America in Nashville and Rush-Presbyterian-St. Luke's Medical Center in Chicago, focus on these organizations' contrasting corporate strategies and on the mechanisms that will enable them to survive a shakeout in the industry. The differences between the two systems are linked to the philosophies of their founders, who disagree about how and where patients will get the best treatment.


Patient education on videotape.

Patient education on videotape.


Unit concept pulls together critical fire safety factors.


Using an executive search consultant to find the right executives.


Special report: are biological indicators the 'ultimate' sterilizer test?


Chickenpox exposures cost hospital $20,000.


Mallison describes methods of solid waste disposal.


Productivity: "a dirty word in the voluntary non-profit agency"?


DHSS and the NHS: can the elephant turn white?


Future developments in the care of the mentally handicapped.


The management challenge after reorganisation.


A comparison of home health care for the elderly in the United States and Japan: report of a cross-national project.


Business/Industry alliance: the untapped health market.


Marketing to expand a home care service.


Your present home health information system: is it in need of improvement?


Disciplining our procedures: an analysis of the disciplinary and grievance procedures in the NHS--2.


Health care in China: hospitals relegated to secondary role in People's Republic.


Marketplace competition: California Hospital Association task force examines impact, makes recommendations.


Job applications--the state of the art.

Job applications--the state of the art.


Health services in the 1980s.

Health services in the 1980s.


Comparing staff attitudes and patient satisfactions in a home health agency. Patient and staff perceptions of Home Health care delivery were examined in the present study. Opinions from the two groups were surveyed then compared on five perceptual areas. The five areas rated were (a) feelings of ease at home, (b) learning and understanding self-care, (c) trust, (d) quality of care received, and (e) severity of illness. Staff characteristics and patient idiosyncracies were also considered. Overall, patient satisfaction with the Home Health care system was explored. The results indicated a high degree of satisfaction with the amount and appropriateness of Home Health care, confidence about self-care, and feelings of ease at home. All patients returning questionnaires would recommend Home Health services to a friend who may need them. Perhaps more importantly, the provider's opinions exhibited both accordance and discordance with those of the patients surveyed. Accordance was detected in ratings of ease, learning and understanding self-care, trust, and quality of care received at home. Discordance was noted regarding severity-of-illness ratings. As a whole, staff rated the severity of patients' illnesses or injuries as being less severe than did the patients themselves. Independent of primary diagnostic grouping, older patients' illnesses were rated by the staff less severe in nature than those of the younger patients. It was concluded that the Home Health practitioner must guard against legitimizing the illnesses of patients at any age.


Hospital quality circles improve quality and productivity.


A management-information system can assure a successful OA program.


U.S. hospitals: what does the public want?


Communication encouraged to ensure quality in hospitals.


Health care manager's notebook: utilizing support staff.


Major superiors roundtable.

Major superiors roundtable.


Trustees: shepherds of wholeness.

Trustees: shepherds of wholeness.


Options for America: international hospital literature offers insight, possible approaches to American problems.


Adolescent health facilities: focus on wholistic care.


John Bigelow. Interview by Al Dieffenbach.


Nurse retention, recruitment: opposite poles in staffing strategy.


Board obligated to monitor quality of medical service.


Pastoral care certification recognizes competent ministry.


"Alternatives to Social Security".

"Alternatives to Social Security".


Congress slashes HMO support, administration's stance remains unclear.


Home care program serves three hospitals' discharged patients.


CHA survey report: selected data and issues of religious congregations' involvement in acute health care.


Lay sponsorship: a right, a trust.

Lay sponsorship: a right, a trust.


Mission accountability: an agency for congregations.


A congregation's ministry and multiinstitutional systems.


St. Joseph Hospital of Kirkwood (MO). Congregation's charism: focus of an education program.


The IRS, "family religious orders," and traditional congregations.


Court ruling casts doubt on shared services' tax status.


Priorities for CHA research: survey report.


AMA guideline on defective newborns raises ethical, legal questions.


Physical injury not necessary in emotional distress claim.


Right to refuse extraordinary treatment upheld.


Ethnicity and clinical care: selected issues in treating Puerto Rican patients.


FTC judge rules Michigan Medical Society conspired to restrain physician competition.


Eight PHS hospitals threatened with early closure.


Budget reconciliation conference reaches final agreement.


As Social Security reform debate continues, hospitals examine options.


Tax reform: another piece in the economic puzzle for hospitals.


Participation agreements between providers and third-party insurers withstand antitrust challenges in two recent federal district court cases.


Executive Order 12291 -- questions of legality arise.


Omnibus Reconciliation Act requires HHS to set minimum standards for radiology technicians; rural hospitals will be most affected.


Federal district court dismisses alleged antitrust and civil rights violations in Florida hospitals' denial of staff privileges.


Allegheny General Hospital wins landmark staff privileges antitrust suit.


Energy management--developments and trends: Part 4.


Baylor "no solicitation" ruling lands before NLRB for third time: Board finds no distinction between working time and working hours.


Atmospherics--an important element in the hospital promotion mix.


Public relations handbook.

Public relations handbook.


The strategic use of information in health care management.


Code of ethics and a guide to the interpretation of the code.


Strategic marketing and hospital medical record departments.


Getting involved in the legislative process.


Marketing the medical record indices.

Marketing the medical record indices.


One state's experience with public relations and marketing the medical record profession.


Clementine Churchill Hospital, Harrow.

Clementine Churchill Hospital, Harrow.


Pipeline to success.

Pipeline to success.


Public relations: the used 'care' salesman.


Hospital-at-home: the United Kingdom.

Hospital-at-home: the United Kingdom.


Who won the medical record marathon?

Who won the medical record marathon?


The time has come for assessment.

The time has come for assessment.


Health education after reorganisation in 1982: a model for the Oxford Region.


Sickle cell anaemia: a challenge for health education.


The Western Domiciliary Care Service: a report on the development and activities of a home care scheme associated with a teaching hospital. This article reports the development and first five years experience of the Western Domiciliary Care Service, Adelaide, South Australia. This service began accepting referrals in July 1971. Referrals are accepted without regard to age or degree of disability. Assessments are made in the patients' homes by social workers and therapists, who maintain close contact with the general practitioners. Liaison with The Queen Elizabeth Hospital has been a tremendous advantage. Of the 1,800 active patients, about 700 would be in nursing homes if this service did not exist, and many referrals to The Queen Elizabeth Hospital have been avoided. The scheme has proved very economical.


Evaluating a decision-oriented approach to smoking education.


The use of marketing for disease prevention and health promotion.


Diversification: a survival strategy for rural hospitals.


Estimating the market for physician services.


HCPM interview: Joseph P. Peters--planning and marketing around the country.


Health care prices.

Health care prices.


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


Getting the most out of your facility.

Getting the most out of your facility.


Community hospital statistics.

Community hospital statistics.


Is national health insurance the best we can do?


Putting nonprofits on the academic map.

Putting nonprofits on the academic map.


Contract management: a viable alternative.


The twenty years Kaiser-Permanente experience with psychotherapy and medical utilization: implications for national health policy and national health insurance.


An examination of the association of "shortage" and "medical access" indicators.


The market as Messiah: the invisible hand strikes again.


Health care providers face critical choices.


The family and the health care system.

The family and the health care system.


Second quarter: record-high rates continue.


Capital management: funding strategy among multi-hospital systems.


What's a hospital feasibility study and who needs it?


Short- and intermediate-term funding in a volatile market.


Healthcare financial problems are international.


Charity care--who will pay?

Charity care--who will pay?


Forecasting accuracy: a valuable key to financial feasibility studies for hospitals.


Credit worthiness assessment: hospital revenue bonds--how they're rated.


Management techniques.

Management techniques.


Forms management trims inventory and costs.


Cesarean birth: the politics of consensus development.


Managing the 'big three' and other health hazards.


Assertiveness training for hospital supervisors.


Police physicians' handwriting to cut medication errors.


Quality in admitting.

Quality in admitting.


Move over Jack, here comes Doc-in-the-Box.


Space age ailment.

Space age ailment.


Insulating your hospital from asbestos risk.


Corporate management model eroding physician influence in hospitals.


Medicolegal review: nosocomial infections next target for malpractice suits.


How to participate in career promotion.

How to participate in career promotion.


Peer group committee tackles physician behavior problems.


Physician input in technology acquisition proves invaluable.


Recommendations for control of rubella in hospitals. The following recommendations for the control of rubella within hospitals have been prepared by members of the American Hospital Association (AHA) Advisory Committee on Infections in response to a need to reduce the risk of costly rubella (three-day or German measles) infections among hospital patients and personnel. Although this common childhood disease is often thought to be relatively harmless, serious consequences may result from it. The most important of these consequences are the fetal anomalies that may occur from infection in early pregnancy, especially in the first trimester.


Mock survey leads to more successful JCAH evaluation.


Evaluating a hospital quality assurance plan.


Measurement of formulary inclusion costs.


The MAC program and advisors to the government.


Physicians' perceptions of clinical pharmacy service.


Survival of the fittest: the 'competition' model for health care.


Implementation of a modified decentralized drug distribution system with the use of master medication carts. A decentralized drug distribution system with the use of master medication carts was implemented. This system was designed so that roving pharmacists could dispense new medication orders quickly and develop a more personal means of nurse-pharmacist interaction for the benefit of better patient care. The key to the system using roving pharmacists is a master medication cart, a pharmacy dispensing unit on wheels, which travels to each nursing unit. The pharmacy medication profiles are kept with the cart, and at each nursing unit patient medication profiles are reviewed, new drug orders are filled, missing medications and discrepancies are resolved, and nurse-pharmacist consultations can take place. There are two roving pharmacists who make simultaneous rounds of all nursing units in the hospital with two similarly stocked master medication carts from 9 A.M. to 9 P.M., seven days a week. All unit dose drawers are filled in the central pharmacy and are exchanged once daily at 2 A.M. by the night pharmacy technician. Each master medication cart carries about 300 different medications, which comprise nearly 95% of the drug needs of the 340 patients served by the two medication carts. The pharmacy department has added 1.4 Full-Time Equivalent (FTE) registered pharmacists and eliminated 2.8 FTE pharmacy messengers in implementing the decentralized drug distribution system. Currently, three registered pharmacists per day are assigned to the inpatient unit dose drug distribution system (two roving pharmacists and one unit dose filling pharmacist). Our roving pharmacists play a vital role in improving patient care. The overwhelming support by the nursing and medical staff represents an attempt by the hospital to continue to provide an optimal health care delivery system.


Unreported adverse drug reactions determined by screening physician orders for diphenhydramine. According to the standards developed by the Joint Commission on the Accreditation of Hospitals, all adverse drug reactions should be reported following written procedures. An Adverse Drug Reaction Reporting Program is conducted by the Department of Pharmacy Services under the direction of the Pharmacy and Therapeutics Committee. However, many of the adverse drug reactions that occur go unreported. The purpose of the study was to determine whether patients can be screened for particular adverse drug reactions by reviewing the charts of patients having medication orders for diphenhydramine. While 48% of the patients included in the study had received diphenhydramine for treatment of an allergic reaction to a medication, none of the cases involving these reactions were reported according to the written procedures governing the Adverse Drug Reaction Reporting Program. The results of the study indicate that by auditing the prescribing of certain medications one can identify patients having complications due to their drug therapy. A more comprehensive study program could be developed which would screen for many types of adverse drug reactions and audit all of the drugs used to treat these drug-induced illnesses.


Hospital pharmacy practice in the state of Kansas.


Review of the justification for pharmacy parenteral admixture preparation. Pharmacy-based intravenous admixture programs are still not present in many hospitals today, despite the length of time these programs have been advocated. This paper reviews the scientific, legal, and administrative basis for pharmacy-based centralized intravenous admixture programs. Key elements in developing admixture programs based on these points are reviewed.


The organization and use of information: contributions of information science, computational linguistics and artificial intelligence.


Can nursing home personnel be taught how to "sell"?


The Wichita Minor Surgery Center: perspective of the independent, free-standing surgery center.


Air lift to Washington.

Air lift to Washington.


The role of profit in a reimbursement plan.


Bouquets from the President.

Bouquets from the President.


Activity coordinator registration: route signs and recognition.


Policy issues: AHCA's views.

Policy issues: AHCA's views.


Staff's morale.

Staff's morale.


Nutritional assessment and care.

Nutritional assessment and care.


Elements of staff development.

Elements of staff development.


On being a smart activity coordinator.

On being a smart activity coordinator.


Long term care review in Iowa: a success story.


Our nursing dilemma: "nurses are leaving the profession in great numbers and are heading into more lucrative fields.".


ACHA policy paper: patients' rights.

ACHA policy paper: patients' rights.


New Zealand's South Island.

New Zealand's South Island.


Clinical applications of sociology in health care.


A lift for you: working with helicopters.


Truth well told: public relations the Acadian way.


A permanent cardiac life support center: an economical and efficient way to provide basic and advanced training.


Australia's EMS.

Australia's EMS.


Nightmare in Kansas City.

Nightmare in Kansas City.


Guest editorial: professional burnout.

Guest editorial: professional burnout.


A client-centered model of therapeutic intervention.


The psychiatric hospital treatment of alcoholism: a multidisciplinary approach.


Microfiche: an answer to a medical records paper problem.


Implementation of computer simulation projects in health care.


A method of determining production load and size of inventories when demand is variable.


The structured use of music in pastoral psychotherapy.


On asking the right question.

On asking the right question.


Areawide planning and administration: overcoming conflicting frames of reference.


Beyond annual planning in human services: the new situation in aging.


Dilemmas of program implementation: California's pilot multipurpose senior services project.


Working in aging services: job satisfaction, regulation, and turnover.


The quest for human services integration as reflected in HEW.


Child life workers: who are they and what are they doing? The survey responses from 152 U.S. and Canadian Child Life Programs are presented to describe the backgrounds of Child Life workers and the services they are currently offering to pediatric patients and their families. The majority of Child Life workers tend to be females with training in Child Development, Education, or Recreation Therapy. Although there is variation between Child Life Programs versus those with other titles, the "core" activities of Child Life workers tend to be supervising the activity room, preparing patients/families for medical and surgical procedures, and attending interdisciplinary meetings. The survey findings are used to raise questions for consideration in the further development of the Child Life profession.


Canadian child life/non-medical programs in hospitals. Child Life, Play Therapy, and Recreational Therapy Programs in Canadian hospitals were surveyed to determine: (1) the nature of the programs (goals and philosophy), (2) the children involved, (3) the staff resources (roles and qualifications), and (4) perceived training needs. Results are discussed in terms of pertinent issues relating to the acceptance of the concept of Child Life and the need for structured educational programs in the field.


A care-by-parent unit: its planning, implementation and patient satisfaction. Influenced by a shortage of nurses, the high cost of hospitalization, and a belief that parents can give adequate care to certain hospitalized children, a care-by-parent unit (CBPU) was developed. Patient care is provided by parents. No nurses are on the unit; a unit coordinator is the only hospital personnel. A care-by-parent committee composed of representatives from several disciplines gives direction to the unit. Unit success has been measured by several criteria. Cost-per-patient day has been lowered, physicians have expressed satisfaction, and a survey of children and their parents indicates that both are highly supportive of the unit.


Showing them what you can do: a practical guide for evaluating child life programming. To successfully compete with other services for scarce hospital funds, Child Life professionals must be able to demonstrate accountability through competent program evaluation. In addition to the function of assessing the achievement of programs goals, evaluation offers an opportunity to educate supervisory personnel by indicating: (1) the value of the services offered, (2) the competence of Child Life personnel and their concern for quality, and (3) the need for additional hospital support. Guidelines for conducting and submitting an evaluation and the relationship between evaluation and the promotion of Child Life goals are discussed.


A children's fair.

A children's fair. As outdoor, free, public Children's Fair for Multicultural Health Activities provided appropriate participatory exhibits, experiences, materials, and conversations for predominantly non-Anglo children and families. The purpose was to reduce fears, create greater understanding of the role of parents, and increase awareness of the family's emotional needs when the child is in health care.


Microfiche readers.

Microfiche readers.


Word processing in libraries.

Word processing in libraries.


Photocopiers.

Photocopiers.


The library catalog: com and on-line options.


Printer terminals for libraries.

Printer terminals for libraries.


Managing employee stress: reducing the costs, increasing the benefits.


Education: a vital tool in achieving the objectives of your department.


Hospital liability for professional negligence.


Laundry plays a crucial role in efforts to combat infection.


Expectations of administrators: demands continue to increase.


New on-premise laundry facility opens at Ohio's Doctors Hospital.


Portable microfiche readers.

Portable microfiche readers.


Survey of word processing equipment.

Survey of word processing equipment.


How you can get burned taking HMO referrals.


Doctor-owned malpractice insurers: growing pains or death throes?


"Paying patients to stay well" gets a boost from doctors.


One kind of cost-containment that everybody likes.


My battle with the nursing home that barred me.


Two clinics of New Orleans.

Two clinics of New Orleans.


The administrator as teacher.

The administrator as teacher. The medical group administrator plays more than just a single role. He is a leader, a financial advisor, a manager, a physician liaison, and a personnel manager. He is given many opportunities to reflect on and appreciate these roles and the complexity of them both in day-to-day life at the clinic and in management literature. The administrator also may serve as an educator, and in this role he provides a means for the clinic to actively participate in the professional enrichment of its employees, and a means for himself to become a more organized, effective manager.


The growing interest of hospital pharmacies in ambulatory care.


Shared services: a viable concept for the 80s?


Rehabilitation literature: a guide to selection materials. The rehabilitation of physically disabled persons is an expanding and interdisciplinary field, and the literature on this topic has grown rapidly in recent years. Bibliographic control of rehabilitation literature is poor, and selection of materials about physically disabled persons can be a difficult undertaking. The present article describes and evaluates various selection tools on the basis of their coverage of rehabilitation literature and their usefulness to academic, public, and special librarians.


Malpractice prevention that pays off immediately.


Employee recognition award--it pays.

Employee recognition award--it pays. Industrial psychologists agree that reasons for motivation are difficult to pinpoint. Two basic schools of thought prevail. One theory is that individuals must have built-in motivation factors, while another contends that people can be motivated by positive stimuli. Either way, both sides generally agree that an open, positive working environment encourages workers to fulfill their potential. It makes sense. Employees are apt to be more motivated and, therefore, more productive in a pleasant work environment where praise, encouragement, and support exists. By developing an employee recognition award program in your clinic, you will help create a work environment that is conductive to maximizing employee performance.


Cost accounting--curse or cure-all?

Cost accounting--curse or cure-all?


What is the payoff in computerized appointment scheduling? Is your group experiencing difficulty in the area of patient appointment scheduling? By changing from a manual method to a system of on-line computerized appointment scheduling, you will not only realize the value of consistent scheduling, but also the benefits of credit control and a reduction of time-consuming error correction. The process that this group went through in developing a computerized system to meet their specific needs is especially relevant to larger group practices. However, there are systems available that can fulfill the needs of any size group.


Substitution--the relevant market.

Substitution--the relevant market.


The role of the pharmaceutical industry in the health market.


The smallest patients: technology's successes and failures heighten poignant medical dilemmas.


Managing for placebo effects.

Managing for placebo effects.


Management by objectives: does it work for hospitals?


The Myers-Briggs test: a role definition tool.


Confronting problem performance: the art of preserving human resources.


Starting a development program.

Starting a development program.


The center for research.

The center for research.


Let's stop alienating prospective employees.


Santa Cruz Medical Clinic.

Santa Cruz Medical Clinic.


The development officer from the CEO's point of view.


Videodisc technology: equipment, software, and educational applications.


Group/hospital affiliation: possible barriers to medical staff integration. Group practice administrators are understandably concerned about the drawbacks and the benefits of formal affiliation of their groups with hospitals or other healthcare institutions. An administrator may wonder: "Should we align ourselves with this particular institution at this time?" or "What kinds of formal arrangements should we enter into?" A good administrator is also a good negotiator, and as such, will try to consider and include the opinions of the other participants in actions involving his group. When considering affiliation with an organization, the administrator will try to understand the drawbacks and the benefits as seen from the other side of the fence.


Development and health promotion: a happy marriage.


Health care in China -- a magnificent public effort.


Positive staff/auxilian relationships keep hospital volunteers on board.


Development: an effective institutional role.


PROS and CONS of campaigns vs. fund programs.


Professional may be held to higher advertising standards, court rules.


Hospital execs may turn to hedging to better control bond sales timing.


Changes might cripple some small, rural HSAs.


Nurse shortage spurs trend-setting contracts.


Make doctors aware of problems with R.N.s.


For-profit and public hospitals get best I.V. prices.


Hospitals and HMOs play hardball.

Hospitals and HMOs play hardball.


Large firms will invest $250 million in HMOs during the next five years.


Follow 'gut feelings' and interview protocol when hiring key manager.


Tax cuts make fund raising harder.

Tax cuts make fund raising harder.


Quality circles may substantially improve hospital employees' morale.


Quality circles put workers in charge of their productivity.


Old loft feeling makes replacement psychiatric hospital seem spacious.


Equipment will cut costs and close some hospitals.


Look for 1 more CT generation.

Look for 1 more CT generation.


A new generation of patient monitors is coming to market.


Computer assisted management of occupational health programs.


Medical services for construction projects.


Hospital fire safety program.

Hospital fire safety program.


Health vacuum being filled by nonmedical sector.


'Wellness' can save lives--and dollars.

'Wellness' can save lives--and dollars.


Pricing health policies in an uncertain time: Part I.


Advantages and limitations of hospital foundations.


Phone system cuts energy use, emergency response time.


The retainer fee contract.

The retainer fee contract.


Selecting and evaluating a collection agency.


Request for proposal for a laboratory computer system--a proposed outline.


Misguided surveillance: public actions and medical care assessment. The public has accused physicians of overusing or misusing ancillary services and clinical laboratory tests, and government agencies have been entrusted to help eliminate performance of these so-called unnecessary services. Here, the author documents the confused and contrary evidence that became the basis of established public policies toward monitoring physician performance or behavior. In next month's issue, the author will examine physicians' roles in medical care assessment.


Misguided surveillance: physicians' roles in medical care assessment. Part II. In his article last month, Mr. Gliebe showed that no consensus has been reached on what the indicators of quality of medical care are actually measuring. In this article, he emphasizes that judgments of overuse or misuse of ancillary services and laboratory tests cannot be made without first judging quality of care, yet quality measurement capabilities are minimal. He maintains that since medical care review is mandated, it should be based on valid data obtained from the clinician involved in the patient's treatment. Thus, he suggests as a possible solution focusing on the individual clinical case.


Retaliation: a misunderstood form of employment discrimination.


Operations planning with VERT.

Operations planning with VERT. The Venture Evaluation and Review Technique (VERT) is a computerized, mathematically oriented network-based simulation technique designed to analyze risk existing in three parameters of most concern to managers in new projects or ventures--time, cost, and performance. As such, the VERT technique is more powerful than techniques such as GERT, which are basically time and cost oriented. VERT has been successfully utilized to assess the risks involved in new ventures and projects, in the estimation of future capital requirements, in control monitoring, and in the overall evaluation of ongoing projects, programs, and systems. It has been helpful to management in cases where there is a requirement to make decisions with incomplete or inadequate information about the alternatives. An example describing the application of VERT to an operational planning problem--the evaluation of electric power generating methods--is illustrated.


Quality control in employee selection.

Quality control in employee selection.


Incentive programs: pros and cons.

Incentive programs: pros and cons.


Eliminating HSAs.

Eliminating HSAs.


HMOs: regulations, problems and outlook.


Documentation: a tool for effective management.


Contracting for EAP services.

Contracting for EAP services.


Teaching the patient with ischemic heart disease: a systemic approach to instructional design. Does a systematic approach to the design of instruction for patients with ischemic heart disease (IHD) produce an effective educational product? One hundred patients, 67 men and 33 women with an average age of 57 years, who were hospitalized with IHD (myocardial infarction or unstable angina), were randomly assigned to an experimental or control condition and pretested to determine their knowledge of the disease and its treatment. Experimental subjects received a linear self-instructional program on the nature and treatment of IHD. Control subjects did not receive the program. Two days later a posttest was administered to experimental and control subjects; an average of 14 days after discharge a retention test was given to both groups. Individual test scores revealed that (allowing for a subject effect) patients who completed the program achieved significantly (P less than 0.001) higher posttest and retention test scores than those who did not. Also, patients who completed the program retained the information during the two weeks between the posttest and the retention test. Results of this study indicate that the instructional framework that was effective in the design of a health-education program for pregnant women can be applied to the design of instruction for patients with IHD.


Informed consent: legal, behavioral, and educational issues. The doctrine of informed consent is examined from legal, behavioral, and educational perspectives. A brief legal history of the doctrine is presented along with a discussion of contemporary standards of disclosure and the emerging right of the patient to understand informed consent disclosures. Behavioral and educational issues include the relationship between disclosure and patient anxiety, patient recall of disclosures, readability of consent forms, and alternatives to the traditional doctor-patient disclosure model. A role for the patient-health educator in strategies to improve both the consenting and informing processes of the informed consent requirement is suggested.


Effect of counselling rejected blood donors to seek health care. The appropriate public health role of a blood bank has not been completely defined. An evaluation of verbal counselling as an incentive for rejected blood donors to seek follow-up medical care was undertaken. Two groups, deferred from donating blood because of low hematocrits, were compared in terms of compliance rate (percentage seeking medical care). The first group, comprising 60 individuals deferred in a traditional manner with either a brief written or verbal statement, had a compliance rate of 25%. In the second group, comprising 61 individuals to whom additional counselling was offered, 79% requested such counselling. A compliance of 60% was found among those counselled, and an overall compliance rate of 54% was noted in the group as a whole. The more than doubling of the compliance rate indicates that a blood bank can effectively encourage deferred donors, most of whom are asymptomatic, to seek health care.


Income differences between male and female physicians.


Relative changes in medical care prices: the Consumer Price Index.


Outpatient educational program for rheumatoid arthritis patients. A patient-education program was designed to meet the expressed needs of clinic rheumatoid arthritis patients. This program consisted of six educational seminars involving various health professionals. A quasi-experimental control group design was employed to evaluate the patients' cognitive and behavioral responses to this program. Responses were assessed through the administration of pretests, posttests, and three-month follow-up tests to treatment and control groups. The treatment group increased its cognitive score 22.5% from initial pretest to long-term follow-up, whereas the control group improved only 5.1% on these questions. The treatment group improved its behavioral score between the administration of the pretest and the posttest and maintained this improvement on the long-term follow-up. Although the control group initially scored somewhat higher on the behavioral measures, it reported a decrease in the performance of self-care activities on the posttest and follow-up.


The relationship of health locus of control to patients with end-stage renal disease. Twenty-eight patients with end-stage renal disease receiving dialysis at the University of Utah Medical Center were the subjects of a nonequivalent control group study. This study was designed to measure the impact of a preventive aerobic exercise/educational intervention on the patients' locus of control. A creative incentive plan was utilized to motivate patients to accept responsibility for acquire cardiovascular fitness. There were no statistically significant differences before and after the intervention, as measured by the Multidimensional Locus of Control scale. The absence of change was partly attributed to an unusual internal orientation at the pretest level. Of the four factors examined that might account for this finding, the one that emerged with a statistically significantly high correlation was the duration on dialysis.


How to estimate employee turnover costs.


Sources of information about cancer as perceived by adolescent patients, parents, and physicians. As survival time has been extended for young cancer patients, their informational needs have also increased. Using written questionnaires, we surveyed 63 adolescent patients, 60 parents, and 53 physicians to compare their perceptions of patient-communication patterns and current and preferred information sources. Physicians were the main current and preferred information sources noted by all three groups. Group discussions with patients the same age, films and television programs, and books were ranked as acceptable but less preferable sources by more than half of each group. More than 90% of the patients were usually accompanied by a parent. Patients most frequently sought their parents to discuss general concerns and cited parents as their second most frequently used source of disease-related information. Adolescents qualified their parental discussions more than was perceived by their parents (P less than 0.01) and viewed themselves as discussion initiators more frequently than did their parents (P less than 0.05). Parents were more likely than patients to prefer physicians as their child's information source (P less than 0.05). Physicians consistently underestimated their own and the parents' importance, believing instead that the patients relied more on peers. Fewer physicians than patients or parents favored including parents in discussion with health professionals (P less than 0.001).


Female physicians in the 1970s: their changing roles in medicine.


Trends in physicians' incomes, expenses, and fees: 1970-1979.


Geographic mobility of physicians: 1971-1975.


Regulation of hospital costs, volume and prices.


Modified abduction board for the adult burn patient.


Competition in health care: cure or chaos?


Recertification: what physicians think now.


Home health care: cost cutter or another expense?


Functional staffing.

Functional staffing.


Refusal of consent: what the doctor must do.


"Taste' marketing rounds out hospital's image.


Developing an employee cardiovascular fitness program. Employee fitness programs, which have become increasingly popular in industrial settings, particularly over the past decade, are now also gaining favour in the hospital environment. Whereas employers are interested in the positive relationships between physical fitness, absenteeism and work performance, employees, as a result of participation in fitness activities, enjoy a more positive outlook on life. This paper discusses several points which might be considered during the development of a fitness program for employees, such as: persuading administrators of the need; generating employee interest; pre-testing participants; and actual program planning. The organization of the program -- it frequency and duration, and the warm-up, training and cool-down periods -- is also outlined.


A chest rehabilitation program that emphasizes the rural patient. This paper describes the multifaceted chest rehabilitation program at a referral-teaching hospital in Saskatchewan. The program was developed following recognition of the special needs of rural patients undergoing treatment for chronic obstructive pulmonary disease (COPD). It has evolved to include three aspects. The first is concerned with the rural patient as an inpatient who participates in chest, exercise and education classes, in conjunction with medical treatment, and whose discharge needs are recognized and acted upon while in hospital. The second aspect is that of the one-day educational workshop aimed at outpatients not yet requiring hospitalization. The third aspect pertains to the educational seminars organized to help the rural health professional in fulfilling a role in his or her community, whether assisting patients with COPD at home or in hospital. In the future, in order to assess the efficacy of this multifaceted program, a formal research study devised according to the data obtained through a preliminary survey of 101 of the program's inpatients should be undertaken.


Sunnybrook Hospital, American Cafe, lead the way with electronics to cut costs, ease workloads.


Developing an effective housekeeping training program.


Director offers step-by-step guide for independent units.


Common staffing questions answered by manager.


Decade of the 1970s -- window on the 1980s: a review of health care policy.


Abstractive and observational methods of educational evaluation in a dietetic clinic.


Background, attitudinal and behavioural patterns of individuals occupying eight discrete health states.


How lasers save sight.

How lasers save sight.


The Buffalo System: an example of remediation as a method of social control.


Viewpoint: resurrecting the arena.

Viewpoint: resurrecting the arena.


A look at how some hospitals are maximizing income, minimizing expenses in response to the financial dilemma.


Third-party payment for health promotion? An insurance leader weighs the prospects.


Communication training for undergraduate students in health planning and administration.


Who's paying what for health promotion services -- and why.


Competency-based education: implications for health administration education and accreditation.


Can accreditation serve health planning/policy programs? Report of the health planning/policy task force of ACEHSA.


Cutting the cost of RT supplies: a group purchasing plan.


Voluntary accreditation and the public intent: implications for graduate education for health services administration.


Intervention with the elderly in information and referral agencies.


A reappraisal of confidentiality.

A reappraisal of confidentiality.


Self-help groups for families of the mentally ill.


The rural hospice: integrating formal and informal helping systems.


Towards a theory of perceived and medically defined need.


Facility report: Memorial Hospital, Sarasota, Fla.


Participant observation: some notes on the applicability of organization theory to the administrative residency process.


A treatment bed for immobilized patients.


Softball league for day treatment programs.


A queueing network approach to health care planning with an application to burn care in New York State.


Estimating the economic impacts of public spending in a sub-region: an econometric approach.


Factors affecting variations in health services utilization in Quebec, Canada.


Recreation therapy: a prescriptive approach.


Recreational therapy: a model for consideration.


Attitudes of institutionalized, elderly Iowans toward physical activity.


The patient and the medical record.

The patient and the medical record.


Issues and problems in ambulatory care medical record practice.


Evaluation of ambulatory care delivery systems.


Ronald McDonald houses--homes away from home.


Florida hospital develops a hurricane preparedness plan.


The uniform ambulatory medical care data set.


Home health record systems: a challenge to the medical record profession.


Data base system relieves hospital cost headaches.


Reorganization of the medical record department in an ambulatory care facility.


Clinical information systems in small primary care settings.


A controlled-decentralized file system for outpatient medical records.


Retention of medical records: legal requirements and practical constraints.


Discoverability and admissibility of medical staff committee records: a state-by-state analysis.


Consent authorization--not a form.

Consent authorization--not a form.


Self-funding for employee health plans.

Self-funding for employee health plans. In today's environment of increasing pressures to contain costs, hospital management is faced with the need to identify all potential areas of cost savings. Self-funding of employee health care benefits appears to be one such area: this approach should enable the hospital to control its health plan and allow cash flow to work to its advantage. Further advantages may accrue to the hospital which elects to self-fund its employee health plan should a group of hospitals purchase reinsurance together. SCHA members have enjoyed similar advantages through pooled arrangements in purchasing other employee benefit plans. A series of regional meetings conducted during the fall of 1980 provided a forum for discussion of self-funding alternatives by administrators, chief financial officers, and personnel directors. As a result of these meetings, hospital management is better equipped to monitor, evaluate, and consider alternatives to their present employee health plans. And SCHA, through its committee structure, is continuing to explore self-funding of employee health care benefits as a potential area of cost savings.


Access to medical records, Part 2: liability for improper disclosure of medical records.


Hospital liability, risk management, and the medical record.


The importance of proper medical record entries.


Rational planning and responsiveness: the case of the HSAs. American government in the twentieth century has been faced with a serious value conflict between the need for rational allocation of scarce resources through planning, and the need to be responsive to a diverse society. Two ideal types of planning correspond to these two values. Rational planning emphasizes the importance of the planner's expertise in achieving the "best" path to socially defined goals. Advocacy planning emphasizes the importance of responsiveness to group interests since all planning decisions are basically a matter of value choice. Citizen participation in planning often combines elements of these two models, embodying the value conflict in planning agency procedures. Health systems agencies are examined as a typical case of such planning. Their failure to build a constituency is viewed as a consequence of role conflict reduction strategies by representatives who did not know whether to play the planner or the advocate role, and how to play either.


The case abstract: a legal reference tool for medical record practitioners.


Legal issues concerning peer review documents.


Right to die issues.

Right to die issues.


Treating alcohol-related problems: a specialized service within social service.


The hospital pharmacy: cost containment offers real challenges.


Quality assurance: implementing a management information system for nursing.


Quality assurance: patient care coordinators fill varied roles.


Wellness: coming of age in hospitals.

Wellness: coming of age in hospitals.


So you want to start a wellness program.


Professionalism and the smaller hospital administrator.


Education in infection control important in preventing illness.


TDH: an activist for health people.

TDH: an activist for health people.


The hospital's role in health promotion.


Health education: replacing myths with facts.


Health promotion: a personal and institutional investment.


IRS softens position on taxability of lab services.


The Chinese Hospital: a board faces tradition and change in an old community.


What financial information should the board receive?


Taking the mystery out of financial information.


Blueprint for a successful building program. The primary role of the board in developing a health care facility is to establish decisive policy regarding the building program. This article describes what is entailed in the development process; the makeup of the external consulting team; the hospital's internal review and decision-making process; and the issues and decisions the board must face.


Do's and dont's for a successful construction project.


Remodel or replace? Deciding what to do with an aging facility. The decision whether to remodel or replace an aging facility turns on such factors as whether the existing building was designed for expansion and how well it has been maintained. The possibility of relocation should be considered with an expansion program even if a move isn't seriously contemplated. To avoid obsolescence, the goal of original hospital design should be a physical plant with built-in flexibility that is able systematically to accommodate changes in medical technology and patient care delivery.


Seeing double: how multihospital systems develop their facilities.


Coping with the codes explosion.

Coping with the codes explosion.


Investment bankers advise on financing a construction project.


GAO urges delaying VA care until eligibility claim verified.


Quality control for volunteer services.

Quality control for volunteer services.


Leprosy report: hospital closures pose uncertain future for ambulatory patients.


Hospital and community set up parenting sessions.


Pastoral associates contribute to patient care.


The value of an internship in volunteer administration.


Studies in linguistic ambiguity and insecurity. This article focuses on problems of cross-culture communication between patients and psychiatrists of varying socio-linguistic and foreign language backgrounds, in an in-patient psychiatric community facility. Issues of diagnosis, integration into the ward treatment program, and progress in the course of treatment can in some cases be traced to specific socio-linguistic problems, which have previously gone undiagnosed. The clinical impact of three types of communication breakdowns are evaluated: (1) overt language differences; (2) linguistic ambiguity; and (3) linguistic insecurity. A need exists for further research in identification and assessment of language insecurity, and for modification of therapeutic procedures to deal with inter-dialectic communication difficulties.


El asesino silencioso: a methodology for alerting the Spanish-speaking community. Information describing the health status of the Spanish-speaking population, the nation's second largest minority, is extremely scarce. In particular, few studies have attempted to document the prevalence or ascertain the extent of treatment or the level of public awareness of hypertension or other cardiovascular diseases in this minority population. However, before any large scale effort to determine the prevalence or to determine the treatment and awareness needs related to hypertension is initiated, preliminary questions concerning how to reach and motivate the Spanish-speaking population to adopt cardiovascular health risk-reducing behaviors must be answered.


A causal model for turnover for nurses.

A causal model for turnover for nurses. Longitudinal data on 1,091 registered nurses in seven hospitals were used to estimate a causal model of turnover in organizations. Total effects on turnover were found to be the greatest for four determinants: intent to stay, opportunity, general training, and job satisfaction. The relative importance of the determinants of turnover and the explanatory power of the model are presented and discussed.


The influence of task and personality characteristics on employee turnover and absenteeism incidents.


Problems with contingency theory: testing assumptions hidden within the language of contingency "theory.". This paper suggests that there are five problems with contingency theory, ranging from a simple lack of clarity in its theoretical statements to more subtle issues such as the embedding of symmetrical and nonmonotonic assumptions in the theoretical arguments. Starting from Galbraith's (1973) contingency theory about organizing for effectiveness, several traditional contingency hypothesis were tested along with more precise hypotheses developed from knowledge of the five problems with contingency theory. Data were drawn from a study of organizational effectiveness in acute care hospital operating room suites. Although traditional contingency notions were not supported by the data, the more precise hypotheses received stronger empirical support. The study data suggest that relationships between technology, structure, and organizational effectiveness are more complicated than contingency theory now assumes. The paper concludes by suggesting formulation of a contingency theory of organizational effectiveness that includes interactive, nonmonotonic, and symmetrical arguments.


Treatment and research of the chronic schizophrenic patient.


Can arbitration work?

Can arbitration work?


Physician burnout: when the healer is wounded.


Nothing fails like success.

Nothing fails like success.


How to deal with the fears of dying.

How to deal with the fears of dying.


Texas nurses take aim at profession's shortage.


Costs worrying hospitals: Florida perinatal program a mixed success.


Poison control battle erupts.

Poison control battle erupts.


Hale Pulama Mau: meeting the needs of Hawaii's elderly.


Hospital 'guarantee' plans spreading.

Hospital 'guarantee' plans spreading.


In-service training for linen users.

In-service training for linen users.


New linen system helps central cut poundage.


On Lok Senior Health Services: community-based long term care.


Linen utilization: Part 1.

Linen utilization: Part 1.


A famous Army institution builds a technological showcase.


Dyeing stained linen makes it usable again.


Towards a more humane health care.

Towards a more humane health care.


A one-story medical complex blossoms in the desert.


A mental health center infills a tight urban site.


Experiment in Texas: nursing home group practice results mixed.


Family services for an inner city neighborhood.


A hospital bridges a transitional urban site.


It's not impossible to get free air time, just a lot of work.


The politics of constraint: inequities in health policy.


Foreign ownership: is it really that bad after all?


The biggest private hospital in Australia: St John of God enters a new era.


Energy conservation--hospital engineering services.


In re Sharon Siebert: decision regarding a brain-damaged adult.


A pastoral walk with the fearful.

A pastoral walk with the fearful.


Spiritual needs of terminally ill patients.


Siebert commentary: medical-legal issues.


Decision-making for the incompetent: exemplars and questions from Siebert.


The role of the chaplain in a changing institutional setting.


Meditations from a hospital bed: making sense out of the nonsense of hospitalization.


The employee stressor: violence on the job.


Standards for wholistic health care.

Standards for wholistic health care.


Visiting on the pediatric unit.

Visiting on the pediatric unit.


Your pastor--saint or schloop?

Your pastor--saint or schloop?


Reduction of standards and discontinuation of funding for chaplaincy in state institutions.


Starting a community hospice: "holding an elephant by the tail".


A healthy hospital (system) encourages health; the role of the chaplain as a management consultant.


Triage on the Big Thompson.

Triage on the Big Thompson.


The recruitment, orientation, and involvement of volunteer chaplains in a non-sectarian hospitals.


Orchestrating patient care: a chaplain's involvement in a cancer adaptation team.


Physician-clergy cooperation.

Physician-clergy cooperation.


The chaplain's role in stress management of hospice nurses.


Closed circuit television as a religious ministry.


Importance of being frank.

Importance of being frank.


New substitutes for skin.

New substitutes for skin.


The impact of questionnaire research on clinical populations: a dilemma in review of human subjects research resolved by a study of a study.


Guidelines for development and implementation of state solid waste management plans and criteria for classification of solid waste disposal facilities and practices--Environmental Protection Agency. Final rule. This rule modifies the Environmental Protection Agency's Guidelines for the Development and Implementation of State Solid Waste Management Plans (40 CFR Part 256) and the Criteria for the Classification of Solid Waste Disposal Facilities and Practices (40 CFR Part 257). The Guidelines are being amended to expand public participation opportunities in the planning process and provide for expedited approval of certain portions of the State plans. The Criteria are being amended to modify the groundwater, surface water and air protection criteria. EPA is taking this action as part of a settlement agreement reached with industrial groups which have challenged these regulations in Federal Court.


Benefit programs for the elderly--off limits to federal budget cutters?


Hospitals and houses are consuming America.


Communal resources, community responsibilities.


Emergency room physicians and the law.

Emergency room physicians and the law.


Position statement on federal funding of biomedical research training and investigator-initiated research grants: American Federation for Clinical Research.


Involvement--the bottom line for this hospital CCTV channel.


Keys to cost containment: executive involvement, useful data, and a consistent health care policy.


Health care labor relations law--understanding the issues. The 1974 amendments to the Labor Management Relations Act have created new problems of statutory interpretation in the rapidly evolving area of health care labor law. By including nonprofit hospitals under the auspices of the Act, the amendments have opened up a new area for unionization and have given rise to questions concerning the types of bargaining units that are appropriate in health care facilities. In the following article, the authors discuss these questions and other current issues in health care labor relations law. The issues include the determination of relevant bargaining units, the status of state nursing associations as labor organizations, and the ten-day strike notice requirement of the Labor Management Relations Act.


Limitations and legal implications of employers' security procedures.


Growing old: a developmental crisis for society.


Auditing dietetic services in a psychiatric facility.


The hospital's responsibility for the negligent actions of its doctors.


The development of a Canadian hospital pharmacy workload measurement system. The aim of the proposed study is to establish a national workload measurement system for hospital pharmacy in Canada. No reliable method presently exists to determine staffing requirements for hospital pharmacy. In order to establish staffing guidelines, a method of scientifically assessing and measuring hospital pharmacy workloads is needed. It is proposed to develop worlkload measurement data for hospital pharmacy according to the Canadian Workload Recording Method of Statistics Canada. The Canadian Workload Recording Method was developed to provide a scientific basis for measuring clinical laboratory workload, thus promoting effective laboratory management. This method is now being applied to other health professions. Data for hospital pharmacy will be collected from various hospital pharmacy departments across Canada based on standardized definitions of modern hospital pharmacy practice. The proposed study will be carried out over a period of two years by a research group located at the College of Pharmacy, University of Saskatchewan, Saskatoon, in cooperation with the Canadian Society of Hospital Pharmacists. Workload measurement data of pharmacy services in Canadian hospitals will serve as a valuable management tool for hospital pharmacy directors, hospital administrators and federal-provincial funding agencies in the determination of total manpower needs and resources for hospital pharmacy. Also, information obtained will be of administrative assistance in the areas of: (a) development of standardized methods of recording hospital pharmacy management information; (b) generation of valid and reliable data to allow comparative studies of hospital pharmacy departments in terms of productivity and utilization of manpower; (c) determination of the proper staffing ratio between pharmacists and supportive personnel; and (d) development of short and long-term planning goals for the hospital pharmacy department. The Canadian Workload Recording Method was designed to reflect current practice by a system of continuous monitoring and review by the user. As new pharmaceutical services develop, additional workload studies can be conducted to establish new standards demonstrating the impact of future programs on manpower requirements.


Fulfillment for the aged--a change in perspectives.


The Lilly Lecture 1981: professional practice and managing a hospital service.


Cooperative negotiations: the key to getting what you need in EMS management.


Labor turnover in the ambulance service: a case study of the Sacramento Valley.


Professional liability coverage: is it necessary?


Travel in good health.

Travel in good health.


Monitoring system lowers absenteeism, improves morale.


An in-house uniform store.

An in-house uniform store.


Horizontal synthetic estimation: a strategy for estimating small area health related characteristics.


Client satisfaction in a health maintenance organization: providers' perceptions compared to clients' reports. This study seeks to compare clients' reports of satisfaction/dissatisfaction with an HMO and its medical care program to providers' perceptions of client satisfaction. The main conclusion is that providers are fairly aware of medical care system attributes with which clients are highly satisfied and dissatisfied. Those with direct patient contact, especially physicians and nurses, are most accurate in their perceptions. Personnel without direct patient contact are about equally accurate in their perceptions of client satisfaction, though personnel without patient contact perceive relatively more dissatisfaction than clients report. Most approaches to medical care evaluation examine costs and efficiency and, more recently, the technical quality of care. Less attention has been given to the assessment of client satisfaction, and almost no attention has been given to what providers perceive as the assessment of clients. Clearly, HMOs' viability is determined largely by their ability to identify and correct major problems affecting their enrollments.


Evaluation of a hospice program: effects on terminally ill patients and their families. Hospice care in the United States has grown rapidly since its introduction here from England in the mid-1970s. Surprisingly little evaluation of services has been made public, particularly with regard not merely to demographics but also the actual effect of hospice caregiving on patients and families. This article describes an attempt to identify the life dimensions that hospice addresses and the levels of discomfort or well-being of patients and families achieved in a hospice home care program. After assessing the changes in medical, psychosocial, and spiritual status for each of a group of hospice home care patients, the trend toward greater wellbeing of patients in the program can be delineated.


Handling problems of ecological fallacy in program planning and evaluation.


The health demographic profile system: current and longitudinal data base for social area analysis.


How do you measure up? Dietitians vs. nurses.


Feedback to the ambulance team.

Feedback to the ambulance team.


Marketing the prepaid group practice: an empirical assessment.


Aiming for "detached concern"--how EMTs and paramedics cope.


Problem: how to reduce purchasing costs. Solution: implement a prime vending system.


Communications: making a good thing better.


Issues in the evaluation of an HMO media campaign: results of a case study.


Some issues in HMO private sector financing: approaches to generating development capital.


My brother and his keepers.

My brother and his keepers.


Burnout: everybody's problem.

Burnout: everybody's problem.


Self-help groups provide cost-efficient image building.


Monitoring staff safety.

Monitoring staff safety.


Management logo competition: management as a serpent in a bowler hat.


Spinal injuries: collecting information to promote research in USA.


A little Irish rejig.

A little Irish rejig.


Underwater health service: flying doctors and sea dogs.


Protecting the EMT by law.

Protecting the EMT by law.


Reorganisation: doctors' perceptions.

Reorganisation: doctors' perceptions.


Hong Kong health service: all for 50p a day.


Setting safer standards.

Setting safer standards.


Doctors in management--a missed opportunity.


The district administrator's job: its demands, constraints and choices.


Who is liable for equipment failure?

Who is liable for equipment failure?


Life after the fed: a user fee provides regional funding.


Buy your supplies in bulk and increase your savings.


Price monitor: measuring up with mattresses and underpads.


Time management: a survival guide for EMS managers.


Computer system at U. of Minnesota makes possible total M. M.


Toxic shock syndrome recognized as postoperative risk.


Antibiotic usage review needed to control resistant organisms.


What's available from the manufacturers? Educational resources for infection control--1981.


Installation and use of clinical anaesthetics: safety precautions.


Biomedical engineering department in a US 500-bed acute care hospital: staffing and operations.


Equipment for the disabled: a works contribution.


Boiler fuels: their applications.

Boiler fuels: their applications.


Legionnaires' disease.

Legionnaires' disease.


Technology and health care.

Technology and health care.


The technical department in a large hospital.


Inter-organizational survival strategies: options for the voluntary non-profit home health agency.


Innovative home care programs: one alternative for nutrition services.


Selecting a home health care management information system: common pitfalls and how to avoid them.


Health care for the aging: United States.


Audits ensure QA at three hospitals.

Audits ensure QA at three hospitals.


Hospital charges determined by level of nursing care.


Part-time nurse pool eases night, weekend staffing.


Will competition affect quality in health care?


Discharge program maintains quality in and out of hospital.


Nurses use peer review to monitor quality care.


Organizing an effective quality assurance program.


Precompetition health care model contradicts antiregulation bias.


Christian values, the Catholic health ministry, and Vatican II's themes.


Franciscans' understanding of sponorship: a movement.


Social pressures, not legislation, prompt ambulatory services' growth.


Discussion series sensitizes nurses to patients' spiritual needs.


Redefining professional nursing: solution to the chronic shortage?


Urban voluntary hospitals: predictable closure/relocation pattern?


Natural family planning study validates treatment's success.


Sheppey General Hospital: boiler conversion from steam to MTHW.


Physicians required to act responsibly in labor dispute.


Consortium mortgage, capital campaign enable hospital to remain in inner city.


Social Security financing problem: no reason to withdraw.


Ethnicity and clinical care: Indians.

Ethnicity and clinical care: Indians.


Material management: product substitutes.


How to evaluate the finance function--a do it yourself hospital audit.


How to develop a CSR quality assurance program.


Hospital services in terms of the market mix.


Genetic screening: new challenge for human resource management?


Negotiation: a tool for cost containment.


New operating room record system.

New operating room record system.


Practices and beliefs of the traditional Dinka healer in relation to provision of modern medical and veterinary services for the Southern Sudan. One class of traditional Dinka healers is a practical surgeon-bonesetter-obstetrician who practices (all but obstetrics) on both people and animals. His anatomical, physiological, and pathological knowledge and surmises, derived almost entirely from observations on cattle, are in some respects remarkable, especially those on the function of the kidney and nature of the circulatory system. He shares with ancient Egyptian healers the belief that sperm originate in the spinal cord and brain and performs a unique surgical operation on the horns of bulls that has been known in the Nile valley since the Egyptian 5th dynasty. With minimum training he might function effectively within the governmental health and veterinary services of the southern Sudan, an area populated mostly by transhumant cattle-culture peoples not easily reached through conventional health services. Although it has been recommended that traditional healers be incorporated as grassroots workers in community health programs in the southern Sudan, there is little knowledge of their medical or veterinary beliefs and practices.  Taped interviews were used to elicit information on these topics from influential men of the Amothnhom clan of the Agar Dinka.  The medical activities and knowledge of anatomy, diseases, and epidemiology of the class of healers known as atet, or specialists, are discussed.  Most atet practice on cattle, goats, and people, and the range and effectiveness of their skills vary.  Demand for their services arises mainly because of their surgical skills and obstetrical skills with animals.  Medical atet usually learn their skills by observing their fathers or uncles.  Their beliefs about human internal anatomy and physiology are apparently derived entirely by analogy from sacrificial dissection of cattle and goats.  The Agar medical atet performs a range of useful manual skills on animals and people based on considerable practical knowledge of bovine anatomy and physiology and may also employ medicines to treat cattle diseases.  It is concluded that their intelligence and willingness to acknowledge personal limitations of knowledge and skill equip them to be of great potential help in the delivery of primary health services to people and livestock in the Dinka areas of southern Sudan.  Partial integration of the medical atet within the official veterinary and medical services could enhance their effectiveness and help solve the difficult problem of rural health care among pastoralist peoples.


An effective information system for ambulatory surgery centers.


U.S. Appellate Permian decision suggests caution in voluntarily releasing confidential attorney communications.


Managing problem employees.

Managing problem employees.


Will the next round of budget cuts affect hospital capital financing?


Packaging.

Packaging.


Ipswich Hospital.

Ipswich Hospital.


A case for factory-built laboratory structures.


Design standards: Part 2.

Design standards: Part 2.


A micro computer productivity management system. How the Johns Hopkins Hospital developed a systematic approach to setting staffing levels.


Boiler replacement.

Boiler replacement.


Teaching guidelines make learning easier.


It pays to control silver recovery.

It pays to control silver recovery.


Work-related daycare has proven benefits.


Gatekeeper: guard or guardian? An idea whose time has come?


Volunteering as therapy.

Volunteering as therapy.


Gatekeeper: guard or guardian? Don't regulate--educate.


New statement on geriatrics: American Society of Internal Medicine.