Quality assurance in psychiatric treatment.


A private mental hospital model.

A private mental hospital model.


Developmental concepts in the quality care of adolescents.


Alternative solution methods for the inventory replenishment problem under increasing demand.


Treatment aspects of inpatient care.

Treatment aspects of inpatient care.


Follow-up study on residential treatment of children, ages six through twelve.


High level wellness and the HSAs: the failure to move from advocacy to action.


Health systems agencies: performance and prospects--a symposium.


Practical inventory replenishment policies for a linear trend in demand followed by a period of steady demand.


Evaluating health systems agency performance.


Dealing with the conflict of loyalties: the continuing seminar and action research.


Resolving state-local differences among plans under the 1974 Health Planning Act.


The national government's role in health planning: a political analysis.


What we need to know about performance appraisals.


How to make a business decision: an analysis of theory and practice.


Preventing medical malpractice in hospitals: perspectives from law and policy.


Laundry manager offers advice on how to control linen usage.


Laundry workers should be part of linen conservation programs.


I.P.A.--the initials that may mean your future.


How pressure is building for negotiated fees.


Grayzoning: does it protect patients--or bad doctors?


The human face of records.

The human face of records.


An analysis of an innovative curriculum in medical record technology.


The medical record scientist as a health care computer user: an emerging role for the future.


Development of a medical record management control system through a work sampling study.


Improving medical record completion at a university hospital.


A risk management primer for medical record practitioners.


Federal Privacy of Medical Information Act: update.


Students' efficient management of the registration examination.


Cincinnati Technical College's "co-opportunity" plan.


Medical records manpower.

Medical records manpower.


Bed use statistics.

Bed use statistics.


Procedures for disclosure of a Health Authority's case notes relating to a patient involved in or contemplating civil proceedings.


Inflation, unpredictable money costs complicate CEO's job.


Hospitals may need product liability immunity for therapeutic x-rays.


Harris signs notice of CON rules.

Harris signs notice of CON rules.


Fire brigade insures fast response.

Fire brigade insures fast response.


Wanted: more innovation in nurse recruiting ads, use of new media.


Bill helps city hospitals pull U.S. medical grads.


Financing healthcare: survival depends on profit boost.


Design innovations improve laboratories.


Pump $300 million into Kaiser growth.

Pump $300 million into Kaiser growth.


Multihospital system survey: multiunit systems grow 11% in '79.


Chains continue HUG despite pullout.

Chains continue HUG despite pullout.


Regulators will force unit mergers.

Regulators will force unit mergers.


Nonprofits raise share of contracts.

Nonprofits raise share of contracts.


Investor-owned systems: for-profits target smaller hospitals.


VA units undergo $1 billion facelift to meet increasing service demands.


International multihospital systems.

International multihospital systems.


Multiunits threaten regulators' clout.

Multiunits threaten regulators' clout.


Multihospital systems' goals and structures change as they mature.


PHS uses DRGs to determine costs.

PHS uses DRGs to determine costs.


Nursing administration: what does it take to stem turnover, flight from field?


Inefficient buying may spur controls.

Inefficient buying may spur controls.


DRG modifications, cost data needed.

DRG modifications, cost data needed.


Hospitals commit to IV contracts.

Hospitals commit to IV contracts.


Capital markets recover slightly but long-term bond market lags.


Highly diversified National Medical Enterprises shows it's able to do it all.


Economics of private rooms change.

Economics of private rooms change.


Hospitals' computer costs will rise dramatically during next five years.


More than low salaries deter data processing staff from hospitals.


Phoenix hospitals merge emergency medical services.


Consultants see shift from shared services toward in-house systems.


Data base: new management power.

Data base: new management power.


Trustee involvement in managing hospital data processing rises.


Smooth implementation depends on planning input from system's users.


Office building can be part taxable and part tax-exempt, court decides.


GE buys EMI CT scanner business.

GE buys EMI CT scanner business.


HHS begins enforcing equal access to healthcare; threatens fund cuts.


Information systems: shaking their inferiority complexes, hospitals prepare for new advances.


Multihospital systems are becoming opportunistic planners, marketers.


Purchasing: feds' committed volume wields clout.


Competition in, regulation out in healthcare reform proposal.


HMOs' federal mandate may face legal challenge.


Hospitals resume feasibility studies as many gear up for bond market.


Seattle prepaid group plan cuts hospital stays.


Planning dilemma of '80s may be to protect, enhance access to capital.


Bond markets restrict borrowing; may force new financing strategies.


Multiunits increasing municipal bond issues.


Hospitals scramble to issue bonds as crippled municipal market rallies.


Secondary market activity picks up.

Secondary market activity picks up.


Sloppy bookkeeping, California's Proposition 9 may hurt credit ratings.


Insurance for tax-exempt hospital bonds dries up; no relief in sight.


More hospitals will resume leasing as prime interest rate decreases.


Alternative construction contracts save hospitals thousands of dollars.


Tight money, higher interest rates slow nursing home systems growth.


Dividing up markets might violate antitrust laws, Justice Dept. says.


Read laws as are, not as might be.

Read laws as are, not as might be.


Blues test capitation payment plan.

Blues test capitation payment plan.


Management must meet nurses' changing needs.


Trustees must decide to whom they owe allegiance: hospital or employer.


Running an E.R. with staggered shifts.

Running an E.R. with staggered shifts.


Suggestion systems, an answer to perennial problems. Suggestion systems, as one of our five panelists puts it, are no longer just the "complaint box" on the wall, but a formal communication vehicle which taps employee creativity, improves morale, and saves your company time and money. This comprehensive report is for those organizations who are interested in setting up a suggestion system program and for those whose present programs could be bettered.


The annual employee earnings and benefits letter. Considering the investment that companies make in establishing and improving fringe benefits, it appears that many of these same companies do very little to translate benefits into a value dimension that employees will understand and appreciate. One answer to the problem is a simple, easily customized form letter that can be given to employees along with their W-2 forms.


Managing professionals: the quiet conflict. The dichotomy between managers and professionals is usually seen as a matter of incompatible values and false perceptions. Consultant Lebell supports this basic viewpoint, but enriches it through theoretical discussion, practical recommendations and some revealing interviews with both parties to the conflict.


Commonly overlooked dimensions of employee selection. Most failures on the job are not due to lack of skills or ability. Therefore, according to psychologist Witkin, the employee selection process must also consider such factors as employee motivation, past performance, potential for failure, the emotional demands of the job, and the proper use of testing tools.


Performance appraisal: the legal implications of Title VII. Since the enactment of the Civil Rights Act of 1964 and specifically Title VII of the Act, the federal government has increasingly involved itself with personnel policies and practices of employers in both the public and the private sector. While Title VII was initially directed toward discriminatory employee selection practices, the development of case law in this area suggests that the courts are now interpreting the Act much more broadly. In light of this, human resources managers would be wise to reevaluate the adequacy of existing performance appraisal systems to make them defensible against charges of discriminatory employment practices. After examining significant cases brought before the courts involving performance appraisal systems, authors Gary L. Lubben, Duane E. Thompson, and Charles R. Klasson draw conclusions as to what would constitute a defensible appraisal system. Chief among these is to make the overall appraisal process as formal, standard, and objective as possible and to consider subjective supervisory ratings as only one component of the overall evaluation process.


Evaluating the personnel department's internal functioning. Much has been written of late about auditing the personnel department--particularly in terms of its cost effectiveness, the time allocated to its various functions, and the extent and nature of expanding services. R. Bruce McAfee, assistant professor of management at Old Dominion University, takes up a different kind of audit--one that evaluates the effectiveness of personnel staff members in delivering and implementing personnel policies and procedures. Logically enough, he points to those who avail themselves of such services--the other employees in the organization--as being in the best position to perform such an evaluation. Thus the first step in his "personnel internal functioning audit" is to design a questionnaire for the purpose, and he takes it from there--citing along the way the experiences of a large midwestern hospital that conducted this kind of simple, inexpensive audit.


Measurement systems in physical therapy. Many physical therapists lack an understanding of the prociples and applications of objective measurement methods in the clinical environment. This paper presents a working definition of the parameters of motor performance (analyzed in terms of outcome or process) as well as an explanation of measurement systems, particularly those related to measurements of position and motion (goniometers and photography), force (dynamometers and force gauges), and muscle activity (electromyography).


Evaluation of quality of patient care in physiotherapy. Government control over health spending and public demands for improved services have increasingly stimulated professional activity in methods of evaluating the quality of patient care. This paper discusses three distinct approaches to evaluation: evaluation of structure, process and outcome. A well-rounded system of quality appraisal should probably include concurrent or co-ordinated assessments of all three methods, to the extent that each of these is observable and measurable under the constraints inherent in any given setting. The greatest value of developmental and methodological tasks in this area may be that they channel creative activity into a critical appraisal of the content and effect of professional practice. Nonetheless, the challenge ahead is our ability to demonstrate experimentally that these activities do indeed improve the quality of care.


Infection control in hydrotherapy.

Infection control in hydrotherapy. Bacteria which flourish in untreated whirlpool and hubbard tank water may cause disease in people who are elderly, debilitated, or on antibiotics. This study compared various bactericidal agents in order to find the most economical, convenient and effective way to prevent infection occurring in patients undergoing hydrotherapy. Samples of water from a hubbard tank and two whirlpool baths were tested for colony count and culture before, during and after use, while regular patient loads and cleaning procedures were in effect. A germicidal detergent, an iodophor, and two chlorine agents were tried in succession. Acceptability to patients, effectiveness against bacteria, cost, and ease of handling were compared. The germicidal detergent only killed some bacteria and was very foamy. The iodophor was expensive and stained the tanks. Household bleach was unreliable in its effect hard to handle, and produced many complaints of "chlorine" smell. Stabilized granular chlorine treatment of the water provided an excellent infection control method for the physiotherapy department in this study.


Continuing education: avoiding professional obsolescence. The purpose of this paper is to describe how professional excellence can be maintained by participation in continuing education, thus avoiding professional obsolescence, and to describe essential factors in planning programs. Health professionals must recognize that lifetime licensure in a health care field is no longer a viable method of operation. Mandatory recertification requiring continuing educational experiences seems to present a possible alternative. Factors that contribute to professional obsolescence are reviewed and a rationale supporting continuing educational experience is developed. It is argued that health care professionals must participate in lifelong educational experience to maintain professional competence. Processes for planning continuing education programs for health professionals are reviewed. Seven steps necessary for program planning are outlined: set the philosophy, goals, objectives, obstacles, scope and the control and evaluation guidelines. The factors that reduce resistance to change and facilitate planning are discussed. The author concludes by noting that the health professional will become incompetent and a danger to the health care delivery system if he or she ignores the need for continuing education.


A physiotherapist in China.

A physiotherapist in China.


Reflections on designing special devices for the disabled: towards a holistic approach. This paper proposes a holistic systems approach to the prescription, development and provision of devices and environments aimed at supplementing the abilities of the disabled so that they might achieve independent living at an optimal level. The study of man-environment phenomena and the adoption of an ecosystemic view of these phenomena are proposed as essential elements, providing the 'attitudinal' context from which a comprehensive approach to problem identification and solution might be derived. The design and development of devices and environments for the disabled is presented within a proposed model of rehabilitation design. A model of the design process is also presented and both seek to establish a general systemic understanding of this field of intervention.


Wellness...and what's in it for the hospital.


Stand by...you're on! Physiotherapy on community television. A 12-month trial of a community television series entitled Physiotherapy and Your Health has been completed. The evolution and philosophy of the series are described. Mechanics of production, limitations, and potential scope for other television series on physiotherapy, in areas served by community television outlets, are presented.


What's in a name? A lot, wellness center experience shows.


A step-by-step guide to fund raising.

A step-by-step guide to fund raising.


Focus groups save centers one year's worth of time, money, and staff morale.


Court orders hearings in hospital transfers.


Privileged communication in social work.


Medical equipment/Germany.

Medical equipment/Germany.


Groups decry refugees in VA hospitals.

Groups decry refugees in VA hospitals.


CHAMPUS peer review questioned.

CHAMPUS peer review questioned.


M.P.H. training in native American alcohol phenomena.


Attitudes of health professional students toward selected social issues in health care.


Professional review in Quebec includes office inspections.


Perspectives on aging and dying.

Perspectives on aging and dying.


CT scanners' image is improving.

CT scanners' image is improving.


Louisville central to serve four hospitals.


Making good health pay off--in cash.

Making good health pay off--in cash.


Why annual health checkups may not really help.


Quality decisions start with good questions.


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


Department of Defense--Implementation of the Civilian Health and Medical Program of the Uniformed Services; Amendment No. 4. Final rule. This amendment extends benefits under the Civilian Health and Medical Program of the Uniformed Services (CHAMPUS) for abortion services, and adds an exclusion in the provisions for cosmetic, reconstructive, and/or plastic surgery procedures. This amendment also implements language contained in Public Law 96-154, Department of Defense Appropriations Act of 1980, and Public Law 96-173, effective October 1, 1979, which deletes the CHAMPUS exclusion of benefits for Military Service-connected disabilities.


The relationship of admissions criteria to student performance.


Office of Human Development Services--Grants to Indian tribes for social and nutrition services. Final rule. The Administration on Aging (AoA), in the Office of Human Development Services, is issuing final regulations for a new program for older Indians authorized by Title VI of the Older Americans Act, as amended. The purpose of this program is to promote the delivery of social and nutrition services for older Indians comparable to the services provided through the State and Community Programs on Aging, under Title III of the Act. Eligible tribal organizations will be able to apply for direct funding to pay the costs of providing social and nutrition services to Indians at 60 and older, including the acquisition, alteration, or renovation of multipurpose senior centers.


Showcase displays hospitals' promotion program, forges closer links with city's business community.


Long-standing hospital seeks new look, new life in health and fitness center.


Public Health Service--Grants for community mental health centers; Final rule. This rule establishes requirements for grants and applications for grants under the Community Mental Helath Centers Act (42 U.S.C. 2689 et seq.), excluding Part D thereof ("Rape Prevention and Control"), as amended by the Community Mental Health Centers Amendments of 1975 (Title III of the Act of July 29, 1975; Pub L. 94-63), section 308 of the Health Services Extension Act of 1977 (in Title III of the Act of August 1, 1977; Pub. L. 95-83), the Community Mental Health Centers Extension Act of 1978 (Title I of the Act of November 9, 1978; Pub. L 95-622), and section 8 of the Act of July 10, 1979 (Pub. L. 96-32). Also included are requirements for the development, submission, and approval of State  plans.


Public Health Service--Grants for allied health projects. Final rule. These regulations set forth requirements for grants to: (a) Establish regional or State systems to assure that allied health and nursing personnel needs in the area are met by coordinating and managing allied health professions and nursing education and training within and among educational institutions and their clinical affiliates; (b) Establish or improve recruitment, training, and retraining programs for allied health personnel; and (c) Establish career ladders and advancement programs for practicing allied health personnel. These regulations implement section 796 of the Public Health Service Act.


Public Health Service--Grants for graduate programs in health administration. Final rule. This rule sets forth requirements for Programs for Grants for Graduate Programs in Health Administration under section 791 of the Public Health Service Act (42 U.S.C. 295h), as amended by the Health Professions Educational Assistance Act of 1976 (Pub. L. 94-484).


Health Care Financing Administration--Adoption of the National Bureau of Standards fire safety evaluation system for health care facilities. Final notice. The Department of Health, Education, and Welfare proposed extending the new Fire Safety Evaluation sSystem (FSES) to all hospitals participating in the Medicare and Medicaid programs in a Notice of comment period publishedon June 28, 1979 in the Federal Register (44 FR 37818). The Department also sought public comment on whether to apply the FSES to skilled nursing facilities (SNFs) and intermediate care facilities (ICFs) in this same Notice. After a careful review and analysis of the public comments received, the Department has decided to adopt the FSES as a means of evaluating alternative arrangements used to achieve compliance with the provisions of the Life Safety Code for hospitals, skilled nursing facilities, and intermediate care facilities participating in the Medicare and Medicaid programs.


Hospitals find hidden benefits in evaluating health promotion programs.


Remarks presented at the conference on certification of long-term care administrators.


Abridged report of the context, content, and levels of education and training programs in health services management/administration needed in developing countries and possible U.S. involvement in this field.


'Thermometer' illustrates importance of dietary restrictions.


Issues: Washington's view--federal health promotion effort.


Ft. Lauderdale hospital offers 'cuisine a la cart'.


Primary nursing: trend or tradition?

Primary nursing: trend or tradition?


Taking the mystery out of evaluation.

Taking the mystery out of evaluation.


Innovative approach can turn coffee shops into profit centers.


Public Health Service--Special project grants for graduate programs in public health. Final rule. This rule sets forth requirements for programs for Special Project Grants for Graduate Programs in Public Health under section 792 of the Public Health Service Act (42 U.S.C. 295h-1).


New congressional health leaders--the emphasis is on competition.


Health care and inflation: social compassion and efficient choice.


Competition coming on.

Competition coming on. Even the proponents of national health insurance have come around to the view that private insurers, not the government, should be in charge of its administration. Just listen to Rep. Henry A. Waxman, who complains that government-run programs leave consumers with no choices.


Retrofitting fire safety systems.

Retrofitting fire safety systems.


After 70,000 malpractice actions in five years, physicians strike back with suits of their own.


Seamen health guides may cut costs.

Seamen health guides may cut costs.


Follow-up self care assessment.

Follow-up self care assessment. The following study was undertaken to evaluate the level of slef-care activities of severely disabled patients discharged from the G. F. Strong Rehabilitation Centre to extended care units (FCU). The results may offer significant information with regard to the ongoing rehabilitation program at the Centre, and could have implications in terms of total management for severely disabled patients in the future.


Can Saskatchewan save its Catholic hospitals?


Canada's health care insurance programs (Medicare) today.


West coast hospitals cope with volcanic aftermath.


Interview: Reverend Norman Andries of Saskatchewan.


Chicoutimi: an initiative toward further humanizing a hospital environment.


The role of central service in infection control.


Catholic health services today.

Catholic health services today.


Associations: keys to competence.

Associations: keys to competence.


Western hospital saves $50,000 with geothermal heating.


The chemistry and microbiology of disinfectants.


Hospital obsolescence: do non-code compliant hospitals have to be closed?


National health insurance.

National health insurance.


Consumers' impact on the diffusion of medical technology.


Keepers of the environment.

Keepers of the environment.


Moral leadership in a socialized health care system (Part II).


Canada/Required staffing levels.

Canada/Required staffing levels.


Life begins at Swiss Village.

Life begins at Swiss Village.


Averting dietary complaints.

Averting dietary complaints.


New Jersey hospital complex offers 'money-back' guarantee on services.


The prima facie case and remedies in Title VI hospital relocation cases.


In-house registry for part-time nurses saves hospital $190,000 in agency fees.


On death and human existence.

On death and human existence.


NJ Hospital Association initiates computerized food buying for members.


A death that is worthy and Christian.

A death that is worthy and Christian.


Multihospital systems: weighing the pros and cons of joining together.


Interview: Dr. Leo Klug, Catholic Health Care Conference of Alberta.


The CHAC's presentation to the Hall Inquiry: health services review 1979-1980.


Contributory dental plan option introduced.


Activity of antibiotic admixtures subjected to different freeze-thaw treatments. The freezing of antibiotic admixtures has been proposed as a potentially useful method by which the efficiency of admixture services might be improved. The time involved in thawing, however, has discouraged the implementation of this practice. This study describes a technique of thawing frozen antibiotic admixtures contained in minibags in commercially available microwave ovens. A quantitative microbiological agar gel diffusion assay was employed to determine the effect of such treatment on the antibiotic activity of the admixture. Admixtures containing cephalothin sodium, cefazolin sodium, cefamandole nafate, cefoxitin sodium, penicillin G potassium, ampicillin sodium, oxacillin sodium, carbenicillin disodium, and gentamicin sulfate in dextrose 5% solution were frozen at -20 degrees C for 30 days. The admixtures were assayed immediately before freezing, and again after either thawing technique: that is, upon exposure of the minibags to room temperature air or to microwave radiation. Assays were also performed 8 and 24 hours after thawing in order to assess antibiotic stability following each freeze-thaw treatment. It was discovered that, with the exception of ampicillin sodium, each of the antibiotics studied could be frozen and thawed as described without significant loss of activity, and were stable for 24 hours after thawing. The application of a freeze microwave-thaw technique to central admixture services can be seen as a cost-effective method of circumventing many of the problems associated with existing programs.


FHP celebrates anniversary with 6,100 members.


Education of independent elderly in the responsible use of prescription medications. A pilot study to test the effectiveness of medication instruction was carried out using 61 voluntary participants age 65 and older. They were interviewed regarding their medication taking, and instruction was individualized using one of four teaching modes: oral; written; oral and written; and oral and written combined with memory aids. Postinstruction interviews revealed no significant difference in compliance among all groups. The preinstruction mean compliance score of all subjects was 98.8 percent. Although compliance, judged specifically on the basis of the prescription label instructions, was extremely high both before and after instruction, drug-taking behavior and knowledge did change. The preinstruction compliance score does not necessarily reflect safe or desirable drug-taking behavior. There was no specific information given to clients with their prescriptions and prescription medications, indicating, for drug-therapy decision makers, a much broader problem than non-compliance.


Chicago employer's program: communications spark high enrollment in HMOs.


HIAA reviews state cost control regulation.


No aid snarl for casualties at Olympics.


Emergency dept. standards debated at meeting.


Regional concept overcoming state boundary arguments.


Physician must get involved to help make the law comfortable.


New ED closings in NYC smooth out EMS service.


Disaster plan works for volcano eruption victims.


Seattle paramedic training impresses British observer.


Phone screen effective in reducing ED pediatric visits.


Employees identify work unit's learning needs. The modified critical incident technique described in this article is a diagnostic tool that takes advantage of employees' insight into the everyday problems facing a work unit. Through group needs assessment, a training program can be devised that directly addresses the deficiencies in a particular work environment.


Why Syosset Hospital is sick.

Why Syosset Hospital is sick.


A new voice in the hospital.

A new voice in the hospital.


Top management meets line employees face to face. The communication gap between a hospital's top management and the line employees need not be an ever-widening chasm. St. Luke's Hospital of Kansas City, MO, has established a system that allows administrators and employees to meet face to face every month without destroying the hospital's essential chain of command.


Family practice physicians: their impact on improving family and community health.


Entering the 1980s: the health care system and primary care.


Nurse practitioners in primary care.

Nurse practitioners in primary care.


An approach to the organization of primary care.


The Alaskan health aide: a successful model of family and community health.


Stress and holistic medicine.

Stress and holistic medicine.


EMS communications: a coordinated approach.


The physician's own type A behavior pattern.


On the meta-physical aspect of health care: attitudes, values, and other thoughts we use to think.


The role of a hospital-based emergency helicopter service in a rural state.


Clinical research--advantages for group practice.


Clinical research--advantages for delivery.


Trauma center utilization in Illinois: a report from the Illinois trauma study.


Managing the conflicts of change--communication is the key.


Fire preparedness--studies show survival linked to leadership. This article takes a look at fire prevention in group practice settings from several different vantage points: through an examination of data gathered on fire incidents in group practice-type settings, reported on a national level; from the perspective of an informal inspection at an AAAHC-accredited AGPA member group practice; via an appeal to member groups to become concerned with life and fire safety.


Experimental use of mobile satellite communications technology in rural EMS systems.


Tap all sources in search for major gifts. To launch a deferred giving program in the midst of spiraling inflation, growth of competition and the changing attitudes of individuals, it is necessary to look towards all sources for major gifts. A planned giving program which incorporates this concept along with dedication on the part of the staff and sound plan of action will bring about success.


Get down to basics key in hospital development.


Identify super donors through direct mail. Landing donors who are willing to make a planned gift is a difficult task if not all of the avenues of fund raising are uncovered. One of the most effective means to target your "super donors" is through an adequate program in direct mail.


Mandatory continuing medical education.

Mandatory continuing medical education.


Telemedicine Project.

Telemedicine Project.


Survival of the medical internship.

Survival of the medical internship.


Medical ethics--its role in medical care.


A comment on specialty board examinations: they don't use multiple-choice tests to license airline pilots.


Marketplace medicine--no bargain.

Marketplace medicine--no bargain.


A time of transition.

A time of transition.


Health planning will continue but road may be rocky, Cain predicts.


Communication: the indispensable tool for managerial success.


Bringing the upper echelons into MBO.

Bringing the upper echelons into MBO.


Accident and emergency: a hospital under siege. There is often little or no warning of a major accident or emergency; the receiving hospital may have to prepare very hurriedly. Howard Lyons, house governor of St Stephen's in Chelsea, London, describes how his hospital fared when faced with the aftermath of the Iranian Embassy siege earlier this month.


Perinatal mortality: is home a safer place? An immediate reduction in perinatal mortality could be achieved by reversing the policy which seeks to ensure that all births take place in consultant obstetric units. This is the logical consequence of the argument presented by Marjorie Tew, research associate in the department of surgery, Nottingham University Medical School, which is based on a statistical study of the various risk factors sometimes assumed to account for the higher crude perinatal mortality rates found in these units.


Declaratory judgments: revamping tax law for charities.


Keep the official flag flying over birth control services. The Family Planning Association celebrates its fiftieth anniversary this year. However, the celebrations are marred by the current problems of NHS family planning clinic services. Audrey Leathard, a lecturer in social policy and administration, comments.


Prescriptions for reducing hospital drug expenditures.


Hospital building: sizing up the size problem. Political dogma or an attempt to bring hospital services closer to the people? The Government's policy on hospital size as expressed in a new consultation paper is sure to be controversial; Stephen Halpern looks at the proposals and their implications for hospital staff, patients and the NHS.


NHS finance: exploring the way ahead.

NHS finance: exploring the way ahead. The DHSS has made West Midlands RHA responsible for developing new financial information systems for the NHS. Gordon Greenshields, area treasurer, Lambeth, Southwark and Lewisham AHA(T), has been looking at two documents outlining the project's objectives and the results of initial consultations with NHS officers of varying disciplines and levels.


Physiotherapy: the roots of a profession. Sixty years after their Royal Charter was granted by King George V, physiotherapists are proud to acknowledge their heritage and traditions. Bob Bryant, secretary of the Chartered Society of Physiotherapy takes us through its history to the present, to a vigorous and expanding profession already looking forward to its centenary.


Cottage hospitals: beautiful isles with an air of fiction. Continuing our series on cottage hospitals Nick Davidson visited St Mary's Hospital in the Isles of Scilly and found himself surrounded by breathtaking beauty. The hospital, which is practically self-sufficient in vegetables, is run by a nursing officer who believes in 'people not machines', and most casualties are treated for sunburn or the removal of fish hooks.


Distribution of knowledge is the distribution of power. Earlier this year the Journal published an article by Brian Watkin in which he criticised the contribution made to the NHS by many health authority members. Now Charlotte Williamson, a member of the North Yorkshire AHA, takes the debate a stage further. The specific remit of members, she argues, is to protect the interests of patients by ensuring resources are allocated in accordance with need, and proper standards of care are achieved.


Staffing levels: choosing the right use for the formula. There is increasing interest in the use of the Aberdeen formula to establish appropriate nurse staffing levels. Len Goldstone, of the Department of Management Sciences, University of Manchester Institute of Science and Technology, suggests that if it is to be used it is more useful for region-wide planning than for day-to-day management at local level.


Group purchasing: why & how.

Group purchasing: why & how.


Health education: the community as an agent of its own change. Health education has often proceeded on the assumption that when a health problem is identified, efforts should be made to make the public more aware of it. Dr Ina Simnet, area health education officer for Northumberland, suggests this approach may be counterproductive.


Estate management: a dynamic approach to restructuring. Proper estate management can improve the environment for patients and make substantial capital and revenue savings. Cyril Battye, of the Centre for Health Services Management, Leicester Polytechnic, describes some of the work being done to improve the status and effectiveness of estate management in the NHS.


IHF tour: efficiency with humanity.

IHF tour: efficiency with humanity. For all its current concern about high health service and hospital building costs, West Germany has for many years been content to spend far more than Britain. One result is hospitals where finishes and fittings put British hospitals to shame, and an adventurousness in design which is difficult to achieve under the stricter controls of the UK.


Contract services: patients and the profit motive. As pressure grows within the health service for more effective use of ever-scarcer resources, Jack Broadley, managing director of Crothall Limited, a hospital domestic and housekeeping services company, looks at the contractor's role and discusses the benefits that companies like his can provide.


Group purchasing: it's only as good as members make it.


Centralized inventory: the key to decreasing space needs and material movement.


Fact sheet: health hazard notification report.


Orientation introduces new employees to safety policies.


Smoking restrictions help reduce hospital fire hazards.


Morale, job satisfaction and turnover--part 1.


A salaried service for general practitioners: a scheme for the Shetlands.


The Secretary of State's address.

The Secretary of State's address.


Manpower for the 1980s.

Manpower for the 1980s.


The planning of central store.

The planning of central store.


Isolation infringes on rights of nursing home patients.


IC officer quells alarm about high C-section infection rates.


Bacteremia tied to overcrowding, overtime and decreased handwashing.


Identifying and discarding the myths of infection control.


HMOs and health delivery reform.

HMOs and health delivery reform.


Iowa association markets infection report system.


Maley study suggests need to wash forearms and hands.


The proper care of whirlpools.

The proper care of whirlpools.


Legionnaires' disease haunts Wadsworth VAMC since opening.


Plastics--the energy savers.

Plastics--the energy savers.


New switchboard at Glasgow Royal Infirmary.


ECG criteria for employees.

ECG criteria for employees.


What is hospital marketing? And how did it get a bad name?


Marketing in the real world: 4 views.

Marketing in the real world: 4 views.


VA hospital modernization: humanitarian and economical.


Is death chart review feasible?

Is death chart review feasible?


Chaplaincy in the hospital.

Chaplaincy in the hospital.


Fallout from Mount St. Helens.

Fallout from Mount St. Helens.


NCCB issues statement on tubal ligation.


Vatican declaration on euthanasia: declaration synthesizes Church teaching, stresses conscience.


Marketing basics for hospital managers.

Marketing basics for hospital managers.


Calvary Hospital, New York CITY. Internship program facilitates Sisters' career change decisions.


An interview with Sr. Mary Brooks, CSC: Sisters respond to CRS call for volunteers to Thailand.


Health care: an apostolate to the family. Family life and a definition of the family are frequent topics of discussion in 1980. Catholic health care institutions have a special opportunity and obligation to advocate a sense of family on three levels: among their own staffs, between patients and their families, and in outreach to the global community.


A child's rights to his own parents: a look at two value systems. Christians and humanists accept an evolutionary world view and respect those fundamental relations underlying evolutionary development. Both value systems should be able to discuss seriously the risks of altering one of the most fundamental of all relations: that of child to parent.


Bioethics guides medical-moral decisions that affect families. Advanced medical technology has complicated moral decisions affecting health care by increasing costs and by holding out heroic measures that may be contrary to an individual's self-actualization. Bioethics guides the family, society's principal institution for nurturing, as it grapples with issues of life generation, prolongation, and termination.


Family-centered health care recognizes needs of patients, families, employees. Total patient care includes care for the needs of the patient's family who, up until hospitalization, have been the care-givers. A family-centered hospital attends to needs of patients, employees, and their families.


Government-financed health care two-edged sword in recession.


Centralized transcription reduced costs, increases productivity. By centralizing transcription services, a 340-bed hospital stabilized personnel turnover and absenteeism, eliminated equipment duplication, and improved output. A well-planned implementation and a financial incentive program contributed to increased productivity.


Bad writing wastes time, raises costs.

Bad writing wastes time, raises costs. Pompous phrasing, grammatical errors, and incorrect usage plague business. Hospital administrators cannot afford to tolerate unclear writing, which fails to communicate, wastes time, and causes errors.


Hospital sues anesthesiologist in malpractice case.


NY Court refuses to review medical privileges.


Supply warehousing by hospitals: sensible or senseless?


Effect of governmental regulation on the vendor.


Hospital supply representatives replaced by technical experts.


Vendors: a product inservice goldmine.

Vendors: a product inservice goldmine.


The future of the prime vendor concept.

The future of the prime vendor concept.


Your ethics: how do they look?

Your ethics: how do they look?


Simplifying the purchase procedure.

Simplifying the purchase procedure.


Will shared materiel management services work?


Equipment selling and hospital materiel management.


The effects of the prudent buyer concept on the supplier.


Expanded hospital role for family physicians.


Hospital topical law: breach of an oral contract for life-time employment.


Material management in nursing service.

Material management in nursing service.


That expensive hideaway.

That expensive hideaway.


Alternative birth center for cesarean delivery opens.


The challenge of infection control.

The challenge of infection control.


Successful planning and implementation of a hospital-based community self-help group for patient and community cardiac education.


Trial retrospective drug audits using the PAS system.


Department of nursing implementation of JCAH standards: a quality assurance program applied.


HCFA sends final draft on PRRB regulations to Secretary Harris...


The planning stages of building a new or remodeled hospital library.


Bureau of Health Planning clarifies definition of provider: new interpretation will benefit hospitals as HSAs fill board vacancies.


EPA issues hazardous waste regulations; infectious waste regulations expected in fall.


Spreading word on infection to hospitals in Virginia.


. . . Hospital associations submit PRRB reform bill to Congress.


Federal Appeals Court affirms National Gerimedical ruling of antitrust exemption for health planning.


Million dollar annual savings in material management operations.


Two U.S. Appeals Courts deny tax-exempt status to shared laundry services: AHA will file Amicus brief in appeal to U.S. Supreme Court.


Internal control procedures in the department of material management.


Hospital topical law: dismissal.

Hospital topical law: dismissal.


Legal aid organizations investigate hospital compliance with Hill-Burton; answering extra-regulatory requests is at hospital's discretion.


Antitrust ruling touches on health care and insurance; requires Blue Shield reimbursement to psychologists.


National Governors' Association recommendations for low-level radioactive waste disposal will impact on hospitals.


California High Court rules on ability to work with others as criterion for medical staff privileges: must be related to patient care.


Community Services Administration revised poverty income guidelines effective immediately.


Hospital marketing communications.

Hospital marketing communications.


AHA's CON regulation testimony focuses on effective date, access, and procedures.


New ruling touches health care-antitrust relationship.


The effect of microcomputer based medical equipment on hospital cost containment.


An on-going internal audit of nursing care.


Delineating privileges for clinical nurses.


The Pygmalion effect in management.

The Pygmalion effect in management.


New York Court outlines procedures for ending life support.


DOE's proposed Federal Emergency Energy Conservation Plan regulations prompt AHA's hospital-specific comments.


FDA chief says demand by patients for more drug information is genuine.


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


How Utah Valley Hospital put their CPD on wheels!


Selected national economic indicators.

Selected national economic indicators.


Selected community hospital statistics from the National Hospital Panel Survey.


Modified diet prescriptions in medical school affiliated hospitals.


Consultant's corner: European health systems.


Productivity: it's every supervisor's business.


How to build pride with positive image.

How to build pride with positive image.


Achieving growth through HMO.

Achieving growth through HMO.


A suggested process for selecting a forecasting model.


Arguments for and against MBO.

Arguments for and against MBO.


Strategic planning: reality versus literature.


Promoting health and fitness--a new role for hospitals.


Need satisfaction among health care managers.


Coping with your HSA.

Coping with your HSA.


Computer system streamlines variance reporting for Iowa hospitals.


Uniform approach to safety reduces incidents, director says.


Patient confusion on consent forms can pose legal liability.


Employee evaluation: it's a dirty job, but somebody's got to do it.


Risk managers request IC practitioners' cooperation.


Antibiotic review is part of integrated quality assurance activities.


Local water supply: a risk to dialysis units?


Expert details risk areas for mental health care.


Implied consent to drunk driving tests: how hospitals can help. An attorney explains the state laws designed to remove intoxicated drivers from the road by suspending their driving privilege. He describes the role the hospital emergency department plays in performing tests to determine blood alcohol level, and suggests that hospitals establish procedures for administration of such tests.


Surgeons face cost containment issues.

Surgeons face cost containment issues. Surgeons who attended the annual convention of the American College of Surgeons heard strong arguments on what surgeons can--and cannot--do to lower the cost of health care. Although reducing the number of laboratory and x-ray tests will help, others contended that a more complete approach taking into account health care as part of the national economic picture is needed.


Medical education faces a no-growth decade. The nation's medical colleges are coming out of a decade of growth and expansion into what some perceive as a steady-state decade that will see a decline in financial support and an increase in regulation. Physicians and administrators gathered at the annual convention of the Association of American Medical Colleges discussed the effects of such a restricted environment on medical education and health care in general.


Tax-exempt status can boost group practice benefits. Although organizing a group practice as a professional corporation has some advantages, operating such a plan as a tax-exempt organization has greater advantages.


Committee generates year-round interest in accreditation process. During the usual two-year period between JCAH surveys, staff members' interest in the accreditation process often dwindles. Forming an in-house hospital accreditation committee is one method for generating year-round staff involvement in the process and awareness of the standards.


Auditing neomycin irrigating solution in orthopedic surgery.


Adverse drug reactions and the P & T committee.


Compounding and repackaging--a need for complete records. The necessity for adequate record systems is discussed in relation to repackaging and compounding activities. Sample forms are presented. Basic requirements associated with governmental and professional regulations and guidelines are detailed. Specific governmental regulatory agencies do not now directly monitor hospital pharmacy in terms of Good Manufacturing Practices; however, professional and legal criteria should be appraised to account for what may be construed as the "state of the art." An example of one type of record system is presented for review.


Unit dose prepackaging: a guide for development of policies and procedures.


Development of a multihospital pharmacy quality assurance program. Seven community hospitals have worked cooperatively for 18 months to develop an initial hospital pharmacy quality assurance program. Auditing criteria were developed for nine service areas corresponding to the model program developed by the American Society of Hospital Pharmacists. Current plans are to implement and modify this program as required at each participating hospital. Follow-up programs will also be essential to a functional, ongoing program, and these will be developed in the future.


Volunteer paraprofessional mental health workers' participation in an inner city early intervention program: a dose of reality. Specification of the personal impact of participating as a paraprofessional in mental health programs has become increasingly important. The present study compared seven paraprofessional participants in a school-based program with seven matched controls, pre and post participation. Paraprofessionals, relative to controls, became significantly: (a) warmer, (b) more positive in attitudes about mental health and children, and (c) less optimistic about social systems in general and more negative toward "elementary schools" in particular.


Characteristics of clients, staff interventions, and the continuum of care. In two samples of over 200 consecutive referrals each from a psychiatric hospital to community agencies, client characteristics were generally unrelated to referral success but three staff interventions were related to completing referrals. It was concluded that known interventions are stronger predictors of successful referrals than patient characteristics. Staff telephone contacts with ethnic minorities were more successful in effecting referrals than with majority patients.


Reducing missed initial appointments in a community mental health center. Budget cutbacks and cost accountability are currently key issues for community mental health centers. Consequently, maximizing the available resources is important to the staff and to the community. Clients who fail to attend the initial appointment represent a significant loss of staff time and resources. Many studies have looked at variables related to missed initial appointments. However, the current study looked at means of reducing missed initial appointments. Eighty-eight subjects were assigned to one of four groups. Group A received a letter three days prior to initial appointment; Group B received a telephone call three days prior to initial appointment; Group C received a telephone call one day prior to initial appointment; Group D was a non-intervention control. The results showed a significant reduction in the rate of missed initial appointments in the group receiving a telephone call one day prior to the initial appointment. This group had a 9% nonattendance rate. Groups receiving either a letter or telephone call three days prior to the initial appointment had a 32% nonattendance rate. The nonintervention control group had a 55% nonattendance rate. The effectiveness of these interventions in reducing the nonattendance rate and thereby enhancing the resources of CMHCs was discussed. Unexpected effects of the study upon the homeostasis of the CMHC were looked at as well as other areas of application.


Patients' satisfaction with an Army family practice setting. Using the Patient Satisfaction Questionnaire to assess consumer satisfaction, patients were very satisfied with the quality of the health care received. The care received by patients who visited the family practice clinics was rated as significantly more satisfying than the care received at either the non-family practice clinics or at the General Medical clinic.


Will multi-institutional systems serve as change agents to improve the management of ambulatory care?


Ambulatory care opportunities: linking the private and public sectors.


The federal initiative in primary care.

The federal initiative in primary care.


Multi-institutional system enhances access to care: Samaritan Health Service.


A regional concept in ambulatory care services.


The Memorial General Hospital Association experience.


The emergicare center.

The emergicare center.


Wichita tornado paralyzes laundry.

Wichita tornado paralyzes laundry.


Hospital consultant tells how to get the most for your linen dollars.


How does a laundry consultant view an institutional laundry?


How HMOs are refining their hard-sell tactics.


Are you robbing patients of the will to live?


Mt. St. Helens fallout causes run on surgical masks.


'Birthing centers' being born across country.


Advertise? You'll need a thick skin.

Advertise? You'll need a thick skin.


Products for the 1980s: technology in the medical equipment and devices industry.


Environmental health and safety concerns in the health care setting. Increasing attention to the physical, chemical, and biological aspects of the health care environment is evidenced by the actions of consumer groups, as well as state and federal regulatory bodies, and private accreditation and insurance agencies. This paper reviews the major areas of environmental concern within the health care industry and encourages active participation by environmental health professionals in evaluating environmental risk and impacting positive change.


How to "price" X rays.

How to "price" X rays. With the escalating cost of x-ray production, it has become necessary to look at some alternatives for setting prices.


Will the Twin Cities experience be duplicated? A study of HMO development in Denver, Colorado.


Rural health care: a case study in Maine. Experience recommends a dual financial strategy--"hard" practice money and "soft" grant and contract money--as a flexible approach to rural healthcare problems.


Competition and regulation: the consumer choice health plan alternative.


Use of computers in medicine.

Use of computers in medicine.


Pharmaceutical services: XIII Olympic Winter Games.


Controlling rental equipment.

Controlling rental equipment.


Financing distributor chargebacks to manufacturers.


The nurse's role in pharmaceutical therapy.


Patient labeling regulations.

Patient labeling regulations.


AMA council finds HMOs high in quality, low in cost.


Employee separation.

Employee separation. The second of a two-part article dealing with an effective employee separation process and its maximization as a management tool through interview feedback.


Health planning and the law: an update on the statute.


The goals of informed consent.

The goals of informed consent.


Authority hospitals helped. How P.A. 104 became law.


Disaster strikes.

Disaster strikes.


American Medical Intl. acquires Hyatt Medical for about $60 million.


Private sector hospitals beat feds on prices for high volume supplies.


Albumin contract prompts vendor attempts to break purchasing group.


Election-year federal bailout for financially distressed hospitals?


Interest rates are creeping up, but bond market can withstand pressure.


Conversion plans infuriate Harlem.

Conversion plans infuriate Harlem.


Do your employee understand all they are getting in addition to paychecks?


Contract management: department contract management up to 14%.


Trustees hire management firms and ease financial, recruiting pressures.


The changing group insurance marketplace.


Industry protests reimbursement cutback on management services.


Management firms hike psych, alcohol profits.


Straightforward annual reports keep trustees and public informed.


Multihospital chains add services.

Multihospital chains add services.


Do administrative residencies fit the needs of the 'me' generation?


Carter's NHI bill gets a boost...

Carter's NHI bill gets a boost...


The service stranglehold.

The service stranglehold.


What is productivity?

What is productivity? Effective laboratory management and planning requires an evaluation of current levels of activity, review of past experience, and projection of future trends. This need can be met in large part by measuring workload, and if the method of measurement is codified into a system, comparative studies among cooperating laboratories can be made. In this article, the authors describe and compare three such systems for measuring workload, and review standards for productivity which various authors have provided in the past.


Quality control revisited.

Quality control revisited. Quality Control is a way of life for today's clinical laboratory and the direct responsibility of its director. While individual laboratory sections require quality control procedures of ever-growing complexity, there also is need for an overview and the statement of policies that concern the laboratory as a whole. In the August 1977 issue of Pathologist (I & A Center, pp. 442-444), Dr. Diamond, regional commissioner for the northeast, described a guide for a comprehensive quality control statement. The following article is an expansion and development of that statement.


SAMA/PMA position: safe disposal of laboratory wastes containing sodium azide. While it is well established that the disposal of laboratory wastes containing sodium azide might be hazardous, evidence proving such a risk when the wastes are disposed of properly remains inconclusive. The Scientific Apparatus Makers Association and the Pharmaceutical Manufacturers Association oppose any general policy requiring the elimination of the preservative from laboratory reagents. Rather, they endorse the concept of alerting users to its presence and advising them of proper handling procedures. The following position paper, prepared by the SAMA/PMA Task Force, explains these suggestions.


Cost containment: stay independent and compete with HMOs?


Cost containment: what's it really like to be in an IPA?. Interview by Rick B. Honey.


An interview with Sen. James McClure: regulating the regulators. Interview by Rick B. Honey.


A riled community attacks HSA plans.

A riled community attacks HSA plans.


Given Center--Part III: making team care serve patient wants and needs.


An HSA planner defends his goals.

An HSA planner defends his goals.


Taking action to contain health care costs: Part 1. Health care is one company expenditure that can definitely be cut and controlled. Part I of this two-part study focuses on what major corporations have been doing to keep their costs down and their employees healthy--practices which will work within most existing corporate structures.


Measuring human resources effectiveness.


The 10 most common mistakes in developing computer-based personnel systems. Computers are a boon to personnel record-keeping, but the author warns us not to fall prey to these too-common errors in judgment which can prove fatal to an effective personnel data system.


Personnel budgets and staffs: how big should they be? Different situations, of course, can dictate the size of a personnel department in any given company, but here are some methods of justifying that needed staff addition.


Ethnicity and clinical care: American blacks.


The future of private practice in the USA.


Defining 'informed consent'.

Defining 'informed consent'.


Is your department ready for a union?

Is your department ready for a union?


Results of the Third National Conference on Mental Health Administration.


The role of health administration programs in training administrators for mental health and mental retardation services.


Training the mental health administrator of the twenty-first century.


The graduate education program for mental health manpower specialists at the Johns Hopkins University.


The legal forum: should a radiology administrator discharge an employee who fails to carry out an order because the employee feels incompetent, or not legally qualified to perform the procedure?


Cost containment, CT scanning and the future of health care technologies.


Mental retardation, the education of administrators: comments on the report of the National Task Force on Mental Health/Mental Retardation Administration.


Resources in radiologic physics and radiation safety for the radiology administrator.


Diagnostic radiology guidelines: the Commonwealth of Massachusetts Department of Public Health.


Processor quality control science.

Processor quality control science.


Mental health administration for the practicing administrator: a unique program.


Perspectives on mental health administration education.


Medical device regulations: the Bureau of Medical Devices and the Bureau of Radiological Health.


The voluntary effort: how to put $ lid on.


Who is liable if a student from an affiliating college or university negligently injures a patient while conducting their clinical practicum at a hospital?


Administrative medicine: education of clinician-executives at the University of Wisconsin-Madison.


An integrated educational program in mental health administration at the University of Missouri-Columbia.


'Competition' legislation: cure for health care woes?


Study results of the AUPHA nationwide investigation of the education and experience requirements and job responsibilities of senior-level mental health administrators.


Spinal cord injuries.

Spinal cord injuries.


A specialization in mental health policy and program management at the University of North Carolina-Chapel Hill.


Casework and the medical metaphor.

Casework and the medical metaphor. After discussing metaphors in general, the author describes the medical metaphor--or medical model--that was for many years the basis of casework. The author suggests that the medical model has had a detrimental influence on the profession of social work, and he offers alternative models.


Recognizing the mental health needs of developmentally disabled people. Many developmentally disabled persons and their families are being denied adequate mental health services. This problem exists because of the attitudes of mental health professionals and the structure of major agencies that serve the disabled. The author presents brief case histories that illustrate the types of stress experienced by the developmentally disabled and makes suggestions for therapeutic intervention.


A model automated resource file for an information and referral center.


Will the sun set on occupational licensing?


Perceived control and responsibility as mediators of the effects of therapeutic recreation on the institutionalized aged.


Death rates from cervical cancer by health service area, 1968-72.


M. D. Anderson: treating cancer on an outpatient basis.


Dealing with childhood cancer.

Dealing with childhood cancer.


Isolation techniques.

Isolation techniques.


The art of caring.

The art of caring.


Quality assurance anecdotes: committee canons.


Allied health education: recommendations and comments.


Hospice: a concept of care for the terminally ill.


Competition and health care: planning for deregulation.


Psychiatric liability: abuse of the therapist-patient relationship.


Utilizing the total hospital case care system.


Drug liability litigation: toward better dental care. Seattle attorney Ann Pearl Owen reviews the proliferation of litigation involving dental anesthesia and drug liability, ties it to trends in dentistry and pharmaceutical manufacturing, and finds a positive role for trial lawyers.


Effective initial screening.

Effective initial screening.


Emergency room negligence.

Emergency room negligence.


How directors can meet their responsibility of patient care quality. The Joint Commission on Accreditation of Hospitals and the courts have laid on the governing board ultimate responsibility for quality of care and the competence of medical staff appointees. This article describes the steps one board has taken to comply with these directives.


The CEO: finding the right one...

The CEO: finding the right one... Recruiting a hospital administrator is perhaps the single most important task of the board of trustees. This article offers guidelines for making the search process more productive, from choosing a search committee through locating and interviewing candidates to making an offer.


The CEO: ...paying him what he's worth.

The CEO: ...paying him what he's worth. With competent hospital executives in increasing demand, boards of trustees can no longer base executive compensation levels on the traditional view of the market. This article reviews the changing forces affecting executive compensation in hospitals and the elements that make up a sound executive compensation program.


Trustee Week: education for trustees, by trustees. Trustee Week, an in-depth educational program designed and conducted by the University of Washington's Graduate Program in Health Administration and Planning under a grant from the W. K. Kellogg Foundation to the Western Network for Education in Health Administration, uses a graduated workshop format to allow trustees to select the level best suited to their needs.


As I see it: the job of a hospital president.


Anatomy of a merger.

Anatomy of a merger. Last November, two neighboring New York City hospitals merged to become the first full-service hospital in lower Manhattan. This article describes how the merger came about as well as the role played by the new hospital's board chairman in carrying out the merger.


Designing for hospital growth.

Designing for hospital growth. This article describes and illustrates a planning methodology for accommodating the unpredictable pattern of hospital growth. The methodology is based on four concepts: overstated planning targets for every department; a circulation skeleton; a zoning pattern providing separate zones for major hospital functions; and a deliberate effort to design flexible, expandable physical space.


Trustee development program: the hospital auxiliary.


As I see it: being the chairman of the board of a hospital in the 80's.


The hospital board chairmanship: living in a fishbowl.


Five rules to help trustees avoid liability. Although the legal duties and obligations of hospital trustees are substantial, the threat of personal liability should not cause trustees undue concern. Simple honesty and sound business judgment will enable trustees to avoid most liability issues.


The HMO board chairmanship: a pleasant disposition helps.


The hospital board in an investor-owned chain.


Why occupancy isn't the best measure of hospital performance. Occupancy is a time-honored measure of hospital efficiency and bed need, but it is a measure whose chief virtue is its ease of calculation. Specific indicators of cost, quality, and access are more difficult to develop and interpret, but they are far more accurate and important measures of the appropriateness of a hospital's capacity and use.


Federal hospital plan drops provision for HSA reviews.


Contingency plan details approach to wartime civilian hospital use.


Disposal reservation restrictions pose problem for some hospitals.


Health information series draws community audiences.


Eyes right for glaucoma detection.

Eyes right for glaucoma detection.


Local artists on display.

Local artists on display.


Museum pieces: treasures for the finding.


Service before salaries: volunteers test job skills.


The education connection.

The education connection.


Self-help groups offer new service options.


Where villains are booed and heroes cheered.


Volunteers who've been there support recovering alcoholics.


For newborns in crisis, parents help parents cope.


The Stockholm County health care information system.


Why does Stockholm have eight times as many hospital beds for the elderly as Bristol?


Health planning in the United States.

Health planning in the United States.


Hospitals and primary health care.

Hospitals and primary health care.


HECLINET--specialised international documentation for hospital care.


Health care planning in urban areas: a progress report on an IHF project.


New programs and careers for the rehabilitation specialist.


Creative arts therapies.

Creative arts therapies.


The transitional volunteer: paradigm of community mental health in action.


Hard times ahead for physicians?

Hard times ahead for physicians?


Administration vs. medical staff: how to squelch the squabbles.


Health planning: its strengths and weaknesses.


Canada's doctors take off the gloves.

Canada's doctors take off the gloves.


Essential drugs.

Essential drugs.


A race we're winning: the United States and the Union of Soviet Socialist Republics: infant mortality and age-adjusted death rates.


Britain's NHS: how one physician would update it.


The challenge for community medicine.

The challenge for community medicine.


Stranded and sick.

Stranded and sick.


Ten years of American medicine.

Ten years of American medicine.


Kenya--Flying Doctor Service.

Kenya--Flying Doctor Service.


The role of the family doctor in the health care service.


Laundries clean up after volcanic ash covering.


Alta Bates' program: trainable retarded work in laundry.


P.R. and the department head.

P.R. and the department head.


Clinician's task made easier.

Clinician's task made easier.


HCA opens 10th Australian unit.

HCA opens 10th Australian unit.


Making your meetings count.

Making your meetings count. In the article, the author outlines and discusses techniques that he has found useful in planning productive meetings. To be successful, a meeting has to be planned around a specific objective. A goal should be set before the meeting, a related plan should be formulated, and feedback should be provided to ensure the achievement of this goal. Tombari classifies meetings as educational, informational, or decisional, and applies his broad principles to these specific settings. In meetings called to educate participants, it is recommended that the leader: (1) prepare brief remarks about a well defined topic supplemented by audio or visual aids; (2) open the meeting up for discussion; and (3) comment on the learning experience following general discussion. In an informal "action" meeting, the leader is acting as a monitor or disseminator and must be well versed on the topic. The author recommends that general participation be limited. When the purpose of the meeting is to reach a decision, the leader's tasks are to: (1) articulate the problem facing the group; (2) demonstrate the urgency; (3) clarify the need for a group decision; (4) seek as many suggestions as possible; (5) help formulate alternative solutions; and (6) try to bring about a consensus. Despite the differences in the types of meetings and the approaches required, it is concluded that a successful meeting is dependent on careful planning and management.


How MDs would improve emergency medical care in flight.


Private health care in Britain.

Private health care in Britain. Private medicine has been growing rapidly in Great Britian, a trend the author says indicates dissatisfaction with the National Health Service (NHS). Spivak notes that even when free medical treatment is available, citizens will pay for a private room, quicker treatment, and the chance to choose their own physicians and hospitals. Membership in private health plans has increased 15 fold since the inception of NHS 30 years ago. These plans are adding over 100,000 members a year so that the private sector now accounts for about $550 million, or 2-3% of Britian's annual outlay on medical care. The author attributes this trend to three factors: (1) private medicine is now generating enough capital to finance a substantial expansion of its own facilities; (2) deterioration in NHS; and (3) the low price of private health plans. Critics of private health care have described it as an alternative restricted to the affluent; the author counters that private plans are beginning to enroll blue-collar workers for the first time. He cites the opinions of experts who foresee the private sector covering for NHS shortcomings in non-emergency care until a full-fledged partnership develops. Spivak concludes by pointing to a conservative plan, now in its early stages, to promote a move in this direction. Whether or not this scheme comes to fruition, he adds, private medicine is beginning to flourish in a socialized system.


A unique nonprofit, hospital-based faculty group practice.


Why the FTC has declared war on doctors. In this article, the Washington editor of MEDICAL ECONOMICS reviews the salient actions taken by the Federal Trade Commission (FTC) against medical societies, physician directors of Blue Shield organizations, Health Systems Agencies, and Professional Services Review Organizations. When interviewed, top-ranking FTC staff officers responded to specific questions regarding the concerns of the agency. The FTC regards the practice of medicine as an activity in which competition must be protected. Thus, the restriction of advertising, setting of free schedules, limitation on the number of physicians, and exclusion of other health-care providers or organizations is regarded as anti-competitive and merits intervention by the FTC. The staff members acknowledge that the Congress may enact laws to control health care costs which would permit practices that the FTC would oppose in the absence of such legislation.


Physicians and collective bargaining.

Physicians and collective bargaining. This article discusses both the history of physician collective bargaining and the applicability of the 1974 health amendments of the National Labor Relations Act to this subject. Gordon outlines the issues for housestaff programs as well as for hospital-based professionals. The scope of physician bargaining includes: wages, hours, working conditions and issues related to the quality of patient care. Housestaff collective bargaining often addresses the issues of on-duty meals, free laundry and uniforms, subsidized housing, parking facilities, and on-call rooms. The concerns of staff physicians include tenure, pensions, and insurance benefits. Gordon suggests that the difficulty and novelty of physician/ hospital collective bargaining will frequently result in an impasse. He states that the propriety or impropriety of a doctors' strike depends upon: (l) the patient-care implications of the grievance causing the strike; (2) the gravity of the grievance leading to work stoppage; (3) the consequences of the strike for patient care; and (4) the other alternatives available. In the view of the author, a doctors' strike may be justified when it arises from a grievance relating to patient care as well as to self-aggrandizement. He states,"...if the strike is the only effective method of making known conditions prejudicial to patient care, including conditions which regularly and systematically cause loss of health and life, the physician may be obliged to engage in such a strike, rather than desist from such action." He concludes that as professionals shift from being private entrepreneurs to salaried employees, they will be compelled to use a collective bargaining approach for professional as well as economic concerns.


Let's talk: effectively communicating praise.


Why a new malpractice crisis is coming.

Why a new malpractice crisis is coming. This article predicts escalating premiums and a greater risk of malpractice suits based on the increasing frequency and cost of claim payouts. The number of insurance claims increased by 12% in 1978 after a decrease of 11% in 1976 and by 2% in 1977. The percentage of premium income paid out has followed the same pattern. It was a high of 66.5% in 1975 and then fell into the 40% range in the next two years. Last year it bounced back to 60.6%. Some insurance authorities view the 1976-77 drop in claims as artificial and attribute it to a reluctance to file suits during the period immediately following new malpractice laws. The reluctance to sue has apparently relaxed. About 16% of the cases actually go to court. Out of those, 90% of the verdicts favor doctors. The rise in cases going to court shows that reform! legislation passed in several states to reduce malpractice litigation is not yet working. The average payout was up 20% between 1976 and 1978 with the greatest rise in large awards; million-dollar settlements are not uncommon. Escalating payouts are attributed to general inflation anf rising medical costs. In addition, the public has become better medically informed and been taught that for every wrong ther is a remedy.


An acute shortage of nurses.

An acute shortage of nurses.


Blood and blood components; error and accident reports--Food and Drug Administration. Proposed rule. The Food and Drug Administration (FDA) is proposing to amend the biologics regulations concerning blood and blood components to require the submission of certain error and accident reports to the agency by licensed and unlicensed blood etablishments. These reports of error and accidents are being limited to those related to the issue of hepatitis-reactive blood and blood components and the accidental infusion of the wrong red blood cells to a donor during plasmapheresis. Certain other reports of error and accidents would no longer be required to be submitted to the Director, Bureau of Biologics, by these blood establishments. The agency is also proposing to amend the current good manufacturing practice (GMP) regulations for blood and blood components to provide a uniform procedure for reporting and maintaining these records.


Public Health Service--National Health Service Corps Scholarship Program. Final regulations. These regulations set forth the requirements for the award of scholarships under the National Health Service Corps Scholarship Program to students receiving academic training in medicine, osteopathy, dentistry, and other health professions in order to assure an adequate supply of trained health professionals for the National Health Service Corps.


Public Health Service, Health Resources Administration--list of health manpower shortage areas designated under section 332 of the Public Health Service Act.


Public Health Service--financial distress grants to health profession schools. Final regulations. The Public Health Service is issuing regulations to implement the program of financial distress grants to health professions schools to assist them in meeting their costs of operation, if they are in serious financial distress, or in meeting accreditation requirements, if they have a special need for assistance in meeting these requirements, and to carry out appropriate operational, managerial, and financial reforms. These grants are authorized under the Public Health Service Act.


Public Health Service--health maintenance organizations: final regulations. These rules amend the Public Health Service (PHS) regulations by implementing certain changes made by the HMO Amendments of 1978 with respect to grants and loan guarantees for planning and initial development costs (Subpart D) and to loans and loan guarantees for initial costs of operation (Subpart E). These regulations change Subpart D by including projects for the "expansion of services" of an HMO among the projects eligible for initial development assistance. In addition, they change the limits on the amount of assistance permitted for initial development projects. These regulations also change Subpart E by substituting the words "costs of operation" for the words "operating costs," thereby expanding the scope of assistance for initial operations (1) to include costs of certain small capital expenditures for equipment and alterations and renovations of facilities and (2) to incorporate into the regulations a longstanding policy which specifies the amount of preaward balance sheet liabilities which may be paid for with funds under operating loans (whether made directly or guaranteed by the Secretary).


Federal Emergency Management Agency--emergency health and medical occupations: final rule. This rule lists skills which would be needed to provide public health services during and after an emergency in which the survival of the population is the primary consideration. It is issued with the agreement of the Secretary of Labor and the Secretary of Health, Education and Welfare.


Department of Energy--appropriate technology small grants program: final rule. This rule prescribes amendments to the Program Guidelines for the Appropriate Technology Small Grants Program which were issued pursuant to the Energy Research and Development Administration Appropriation Authorization of 1977. The full text of Part 470, as amended, is set forth in this final rule.


Department of the Air Force--Obtaining medical, dental and veterinary care from civilian sources. Final rule. The Department of the Air Force is amending its regulations by revising Subpart A of Part 880, Subchapter I, 32 CFR. The revision tells how Air Force and NATO personnel may obtain essential medical, dental, and veterinary care from cilivian sources when care from a government facility is unavailable, and tells how to authorize and provide reimbursement at Air Force expense. This revision also changes the policy on active duty maternity episode. The internal effect of this revision is to keep current those rules published in 32 CFR, Chapter VII.


Hospitals adopting the old axiom--in numbers there is strength. Almost a third of the nation's hospitals are owned, leased or managed by hospital corporations, and the trend toward professional group management is expected to continue. It is partly a response to the growing complexities of the federal laws that govern reimbursements for medicare and medicaid services and that dictate conformity to state plans for hospital expansion. Group ownership is also a way of pooling resources to make it easier to obtain the capital for expansion.


Severe nurse shortage forces some hospitals to close beds or units.


Right-to-die groups seek another right: to aid in suicide.


The overburdened manager and decision making. This article discusses three methods managers can use to make decisions: intuition, management analysis, and Type 1 and Type 2 error analysis. Olson identifies studies that have shown that top managers work at an unrelenting pace and jump from one activity to another. He claims that managers do not have time to plan in a reflective, systematic manner. In fact, in his view, decision makers  usually react intuitively to situations that can no longer be ignored. The author presents evidence that top managers prefer verbal media such as telephone calls and meeting for decision making because of their timeliness. He points out that the strategic data bank of the organization is largely in the mind of the manager. As a consequence, he states, an effective analysis requires that the manager communicate to the analyst the relevant data stored in his head. This process often makes it easier for the manager to solve the problem himself rather than delegate it to others. Olson identifies five organizational conditions that enable a top manager to effectively delegate problem solving tasks to management analysts: (1) the analyst must have the confidence of the same people who influence the manager; (2) the analyst must be able to adapt the techniques to the specific needs of the manager; (3) there must be sufficient time for the analyst to structure the problem and evaluate the alternatives; (4) the analyst must share in information gathered by the manager from verbal contacts; and (5) the manager must be part of an organization large enough to make it profitable for him to seek assistance from an analyst. When the above organizational conditions are not met, the author suggests Type 1 and Type 2 error analysis. He promotes this form of analysis as a method for using logic and intuition to consider various forms of information. This management tool is named for Type 1 error (accepting a proposal that should have been rejected) and Type 2 error (rejecting a proposal that should have been accepted). The author advocates the use of this methodology because, in his view, it focuses the attention of the manager on the facts when a decision needs to be made. In this process, the manager must identify and evaluate the likelihood and consequences of each alternative strategy. Olson sees Type 1 and Type 2 error analysis as providing explicit logic to strengthen the intuitive decision making process.


Hospitals organize group property plan.

Hospitals organize group property plan.


Health reform act encourages competition.


Wellness epidemic sweeps companies.

Wellness epidemic sweeps companies.


Hospital cost control test backfires; tune-up helps.


Health care costs: saving in the private sector. Robeson offers a number of options to employers to help reduce the impact of increasing health care costs. He points out that large organizations which employ hundreds of people have considerable market power which can be exerted to contain costs. It is suggested that the risk management departments assume the responsibility for managing the effort to reduce the costs of medical care and of the health insurance programs of these organizations since that staff is experienced at evaluating premiums and negotiating with third-party payors. The article examines a number of short-run strategies for firms to pursue to contain health care costs: (1) use alternative delivery systems such as health maintenance  organizations (HMOs) which have cost-cutting potential but require marketing efforts to persuade employees of their desirability; (2) contracts with third-party payors which require a second opinion (peer review), a practice which saved one labor union over $2 million from 1972 to 1976; (3) implementation of insurance coverage for less expensive outpatient care; and (4) the use of claims review. These strategies are compared in terms of four criteria: supply of demand for health services; management effort; cost; and time necessary for realized savings. Robeson concludes that development of a management plan for containing health care costs requires an extensive analysis of alternatives, organizational objectives, existing policies, and resources, and offers a table summarizing the cost-containment strategies that a firm should consider.


When in doubt, act: Law Reform Survey--Part 2.


Take care of yourself in the hospital.

Take care of yourself in the hospital.


The denominational hospital within a socialized health care system.


Systems analysis: the need for automation in health care.


Automated management in a nursing home.

Automated management in a nursing home.


Day programs for the elderly.

Day programs for the elderly.


FTC investigation: long-term care industry has valid complaints.


An ethical basis for nursing in Canada.

An ethical basis for nursing in Canada.


Wellness across Tennessee.

Wellness across Tennessee.


Meetings in small homes: do they help?

Meetings in small homes: do they help?


Wellness--what does it mean for hospitals?


Health care ethics--living-will legislation opposed: Massachusetts.


Prescription medication practices of the elderly. The prescription medication practices of 30 subjects, 65 years or older, were surveyed and compared to the actual physician's instructions indicated on the prescription label. The study identified reasons for errors in administration and compliance or noncompliance with the prescribed regimen. The subjects were interviewed with a questionnaire developed by the author. The study revealed that more errors were made by subjects who were 65 to 69 years old, Protestant, and female. The error-prone individuals also lived alone and had less than 12 grades of education. Teaching about medications is typically a nursing or pharmacy function; a professional nurse or pharmacist could be employed to present instructional sessions periodically.


'Giving to get' breeds success.

'Giving to get' breeds success.


Human serum albumin usage in a comprehensive cancer center. During 1977, M.D. Anderson Hospital and Tumor Institute used 270,575 g of human serum albumin (HSA) at a patient cost of $1.1 million. For a 1-month period in early 1978, a survey of HSA usage was conducted in the 440-bed hospital. Patients who were started on albumin during the study period were included and monitored for the duration of their therapy. The largest groups of patients receiving albumin were those with gynecological tumors (30%) and gastrointestinal tumors (16%). Two-thirds of all patients receiving HSA were also receiving intravenous hyperalimentation (IVH); 80% of all HSA used was given to IVH patients. Although the IVH patients received a smaller daily dose of HSA, the average length of their therapy was about three times longer than that of the non-IVH patients. The mean total dose for the IVH patients was 344 g as compared to 180 g for non-IVH patients. For all patients, the mean total dose of HSA was 289 g at a patient cost of $1212. Of the patients, 66% had an initial serum albumin level determined before therapy was begun, 43% had a serum albumin level run at the termination of therapy, 16% had neither, and 28% had only one serum albumin level during their HSA therapy. Ninety percent of the patients had at least one period of 4 days or longer without a serum albumin level being obtained.


Pharmacy services for diabetic patients in South Carolina: a survey of physician and patient attitudes. Diabetic patients and physicians in South Carolina were surveyed to gauge their attitudes to 13 potential pharmacy services. Approximately 33% of the physician sample and 42% of the patient sample responded to a self-administered, mailed questionnaire. The results indicated that both groups held favorable attitudes toward services aimed at improving the patient's knowledge of diabetes but reacted negatively to services in which the pharmacist would be involved in the collection of information relating to diabetic control. Although the attitudes of patients and physicians were highly congruent, patients typically held more favorable attitudes than physicians when significant differences were found. It also was found that patient and physician characteristics were incapable of segregating respondents into groups with varying attitudes.


Cardiac rehab gains momentum: a nuts & bolts program outline.


Attitudes of pharmacists and physicians toward Florida's drug product selection law. Pharmacist and physician attitudes were surveyed approximately 1 year after the implementation of Florida's drug product selection legislation. It was not possible to identify a consistent relationship between the attitudes of prescribers and pharmacists and subsequent drug product selection behavior, even though pharmacists were generally in favor of the law and physicians opposed it. However, neither saw the law as weakening their professional relationships. Both groups seemed to overestimate the degree of drug product selection activity actually occurring. From a methodological perspective, this suggests that a survey questionnaire approach to estimating these rates may not be valid.


Hospitals as future houses of well repute.


Teaching because we care.

Teaching because we care.


Engineering in medicine.

Engineering in medicine. The Canadian Medical and Biological Engineering Society has produced an outline of activities to clarify categories of engineering in medical care. The outline is intended to provide health care personnel with a better understanding of the role of rapidly growing disciplines. CLINICAL ENGINEERING believes these description to be of great value and is reprinting them with permission. It appears to us that the three areas designate a beginning, broad field (BME), much like biology is to medicine, followed by a clinical unit (CE), much like medicine itself, and finally a subspecialty (rehabilitation or physical therapy, for example).


A Talk with Nathan Stark.

A Talk with Nathan Stark.


Discharge planning: a wellness mechanism.


Potential and actual drug product selection rates in Florida. A systematic review of new prescriptions conducted 1 year after the enactment of Florida's drug product selection law showed that 36.3% were potentially subject to product interchange. Product interchange actually occurred in only 6.2% of these potentially eligible prescriptions. Positive formularies established by the pharmacies reduced the eligible population to 8.1% of all new prescriptions and the product selection rate relative to these formularies was 14.7%. Twenty drugs accounted for nearly three-fourths of all drug product selection activity.


Cardiac rehab gains momentum: Heart Beat at Gibson General.


Two-way communications--is anybody there?


Hospitals and the recession.

Hospitals and the recession.


X-ray "miniaturization" program boosts income from used film.


'Megahertz' education brings variety of program to Ohio hospital.


Making patient education a reality.

Making patient education a reality.


How to cope with a small budget.

How to cope with a small budget.


The effective committee chair: a primer. The author summarizes his past work on committees with special emphasis on the Chair as leader, administrator, meeting head, and spokesperson. Articulating principles of agenda and temporal integrity, the "rule of halves," the "rule of three-fourths," and the "rule of thirds," Dr. Tropman provides a procedural checklist to help the new--and not-so-new--committee Chair evaluate committee performance.


Continuing education for the improvement of professional intervention in patient care. Continuing education has a vital and unique role to play in enabling the practitioner to maintain professional competence. The contributions of continuing education supplement formal preparatory education and practice experience. The future for pharmacy continuing education is tied to the transition currently underway as pharmacy emphasizes involvement in patient care. The Pharm.D.'s affect on the pharmacist, acceptance of the pharmacist in a new role, preparation of pharmacists to deal with an aging population, and capitalizing on the movement toward health promotion are all challenges that face continuing pharmacy educators.


Self-monitoring of blood pressures in hypertensive subjects and its effects on patient compliance. This study investigated the effects, if any, that teaching hypertensive patients to take their own blood pressures, as well as education and counseling, would have on compliance. Prior to the initiation of the study, the pharmacist-investigator collected data on the hypertension clinic as it traditionally functioned. This preliminary investigation included studying the work flow of the clinic and reviewing medical records to determine who among the clinic registrants met the criteria set up for inclusion in this study. During the study phase, 12 patients were educated about their disease state, counseled, and taught to take their own blood pressures, using a home blood pressure measuring device. Upon each return visit, they were evaluated by the pharmacist using such parameters as pill counts, blood pressure readings, fluctuations in body weight, and disease symptomatology. All these data were analyzed and compared to those of the 12 patients in the control group who were educated and counseled, but not taught to take their blood pressures. An overall improvement in any or all of these monitored parameters was the criterion for determining effectiveness in promoting better compliance. At the end of the five-month study, the frequency of prescription refill had increased from 38 to 72.56 percent for the treatment group and from 31.6 to 59.26 percent for the control group. There were no significant changes in the other parameters monitored during this period.


In my opinion...pressures for cost containment.


Group evaluation of programs unites educators. The Northwestern Washington Chapter of the American Society for Health Manpower Education and Training focused on alternative methods of educational programming to create a forum for planned constructive sharing of ideas and problem solving. This project served not only to enhance the existing program, which consists of a quarterly business meeting and educational events, but also to strengthen the cohesiveness of the membership


Take a systematic approach to patient education programming.


School management and contingency theory: an emerging perspective. In an article written for educational administrators, Hanson  explains the assumptions, framework, and application of contingency theory. The author sees contingency theory as a way for organizations to adapt to uncertainty by developing a strategic plan with alternative scenarios. He urges school administrators to join businessmen and public managers in using a technique described as "the most powerful current sweeping over the organizational field." The theory assumes that: (1) a maze of goals govern the development of events; (2) different management approaches may be appropriate within the same organization; and (3) different leadership styles suit different situations. Contingency planning helps the organization to respond to uncertainty in the external environment by identifying possible events that may occur and by preparing alternative stratgies to deal with them. Hanson describes the purpose of this process as providing "a more effective match between an organization and its environment." He explains that contingency theory analyzes the internal adjustments of the organization (e.g., decision making process, structure, technology, instructional techniques) as it seeks to meet the shifting demands of its external or internal environments. According to the author, the intent of contingency theory is to establish an optimal "match" between environmental demands (and support) and the response capabilities of the organization including its structure, planning process, and leadership style.


Evaluating EMS devices: FDA vs. private sector.