Change is not an option. Spurred by health care reform, boards revamp their roles.
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Biomedical subjects
Publications and source records attributed to T Hudson.
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Thirty-five consecutive odontoid views were taken using a standardized technique. A 10-mm radiographic marker was positioned lateral to the tip of the C-1 transverse process. Data from three independent readers showed an 18% magnification error inherent to anteroposterior open-mouth odontoid radiographs. Integrity of the transverse ligament after Jefferson fractures has been inferred from the separation of the lateral masses measured on the odontoid view. Spence's anatomic study showed that lateral mass separation of > 6.9 mm implied rupture, but radiograph magnification was not taken into account. Transverse ligament rupture should not be inferred with lateral mass separation of < 8.1 mm.
Despite a large and rapidly growing body of knowledge concerning the human immunodeficiency virus and treatment of the acquired immune deficiency syndrome (AIDS) cases in general hospital settings, there is a dearth of information about the care of those psychiatric patients who might be at high risk for exposure to the virus and, hence, at high risk for contracting the illness. This article deals with the approach taken by a large Canadian psychiatric hospital in educating staff and clients about AIDS, and to the development of a comprehensive Universal Precautions system to supplement existing infection control protocols.
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The 1992 presidential election was about a lot of things, from the economy to taxes to education. Health care reform played a major role in the public policy debate, and the different approaches taken by the candidates on that issue helped define them. A look at the result and what it may mean for the health care field.
With operating costs ever rising and reimbursements ever tightening, hospitals are looking for ways to cut costs at every turn. The good news is that there are a lot of innovative, imaginative approaches being tried in every area of hospital operations--approaches that don't require massive financial investment, organizational restructuring, or teams of outside consultants. The examples we've found through talking with hospitals across the country are a fair sample of the types of opportunities out there. They range across the entire hospital, from the laboratory to the pharmacy to nursing to waste management to the medical staff to the operating suite. In other words, something for everyone.
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National attention to the tax-exempt status issue is not as acute as it has been in the last few years, but the challenges are continuing in a number of states. Hospital administrators and legal experts in Pennsylvania, the nation's flashpoint state on the issue, discuss what's going on and why.
Hospitals that have successfully integrated the risk-management function with other hospital departments say that the process requires both education and teamwork. Among the major challenges: overcoming physician reluctance to participate in risk-management activities, and linking risk management to quality assurance.
As states struggle to forge health care reform plans that meet the opposing objectives of cutting costs and improving access, one thing is certain: Their initiatives will create profound changes to health care and to hospital operations. In fact, five factors emerging from the state reform debate could drastically transform hospitals: reregulation, explosive managed care growth, uncertain state funding mechanisms, new insurance measures, and greater hospital accountability for cost and quality. "This is a wake-up call for hospitals to get very realistic about the cost concerns that are out there," says one hospital executive. Especially since these state efforts are a precursor to national reform.
Hospitals are entering a complex new era. As they strive to work fairly with their HIV-positive workers, they are encountering a range of legal and operational challenges. Beginning on page 24, we look at the legal hurdles facing hospitals as they balance the right of HIV-positive workers to work, while ensuring co-worker and patient safety. On page 28, we look at the pioneering human resources policies being employed by one hospital in the infection control area. And on page 30, we look at the ongoing search for safer needle devices.
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