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Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

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PubMed2005

Medication Safety Issue Brief. Small and rural hospitals--unique challenges, unique solutions.

Small rural hospital pharmacies face ths same quality challenges as their large, urban counterparts. Yes, they often lack access to the necessary resources to address these issues. That's no minor problem. AHA Hospital Statistics 2006 reports that 2,003 (41 percent) of the nation's 4,919 community hospitals in 2004 were rural. And, as of Aug. 31, 2005, 1,141 hospitals in the United States are designated as critical access hospitals. People living in rural areas are less likely to have insurance and are by and large poorer than those who live in urban areas, according to the National Rural Health Association. The rural population is also older and tends to suffer from more chronic diseases than residents of urban areas. That adds to the challenge for small and rural hospitals. These facilities must treat complex medical cases with limited resources, often with minimal on-site pharmacy coverage.

Clinical Pharmacy Information Systems↗
PubMed1989

Analysis of the market driven nursing shortage.

Donley and Flaherty look anew at the nursing shortage; they explain why the supply-side orientation cannot explain or resolve the problem. The mere increase in our numbers is not a solution in today's complex care environment. The authors explain the market-driven shortage and the changes in the work environment essential for ameliorating the shortage.

Allied Health Personnel↗
PubMed2002

Statement of net worth. As executive salaries keep growing bigger, some healthcare industry experts question whether associations are getting value for money.

Healthcare associations are paying their executives a little more every year--and officials say it's worth it for their hard work, clout and connections. In 2000, the chief executives of major healthcare associations earned an average annual base compensation of nearly $400,000. But are the associations really getting value for their money?

Administrative Personnel↗
PubMed1990

The field's evaluation of proposed clinical indicators for social work services in the acute care hospital.

Evolving approaches to quality assurance emphasize ongoing measurement and uniformity of data collection across settings. To meet new requirements, a work group established by the National Association of Social Workers and the Society for Hospital Social Work Directors of the American Hospital Association is developing clinical indicators for monitoring and evaluating the quality of social work services in the acute care medical hospital. The work group sought systematic feedback from practitioners in the field to evaluate and further refine the work to date. In a mail survey, a random sample of the Society for Hospital Social Work Directors' membership was asked to evaluate nine proposed indicators along four dimensions: (1) clarity, (2) relevance for practice, (3) meaningfulness in relation to quality of care, and (4) feasibility of implementation. Results of the survey indicated high levels of favorability for six of the nine indicators, suggesting their utility as a uniform data set for further empirical validation efforts. Uncertainty about the feasibility of specific indicators was widespread.

Hospital Departments↗
PubMed2001

Geriatric services offered by hospitals: predicting services by internal and external community characteristics.

This article explores the role of hospitals in providing geriatric services and identifies associated community and hospital characteristics. The sample is 4571 community hospitals responding to the 1995 American Hospital Association (AHA) Annual Survey. Most hospitals offer some geriatric services; the mean is 3.3. The dependent variable is an index of 13 geriatric services created from the AHA data. Independent variables are taken from the AHA survey, Area Resource File, and census data. Regression analysis explains fifteen percent of the variance. Hospital characteristics predicting provision of geriatric services are non-profit tax status, hospital bed size and system membership. Community characteristics predicting provision of geriatric services included higher population density, high percentage of county aged, and county nursing facility beds. Hospital characteristics yielded slightly higher predictive ability than did community characteristics. The findings suggest policies to increase hospital leadership in providing access to senior services require a multi-dimensional approach.

Aged↗
PubMedDate not supplied

The uneven landscape of newborn intensive care services: variation in the neonatology workforce.

CONTEXT: In the past 30 years, the number of neonatologists has increased while total births have remained nearly constant. It is not known how equitably this expanded workforce is distributed. OBJECTIVE: To determine the geographic distribution of neonatologists in the United States. DATA SOURCES: 1996 American Medical Association physician masterfiles; 1999 survey of all U.S. neonatal intensive care units; 1995 American Hospital Association hospital survey; and 1995 U.S. vital records. MEASURES: The number of neonatologists and neonatal mid-level providers per live birth within 246 market-based regions. RESULTS: The neonatology workforce varied substantially across neonatal intensive care regions. The number of neonatologists per 10,000 live births ranged from 1.2 to 25.6 with an interquintile range of 3.5 to 8.5. The weakly positive correlation between neonatologists and neonatal mid-level providers per live birth is not consistent with substitution of neonatal mid-level providers for neonatologists (Spearman rank-correlation coefficient, 0.17; P < 0.01). There was no difference in the percentage of neonatal fellows in the lowest and highest workforce quintile (14% vs. 16%) or in the percentage of neonatologists engaged predominantly in research, teaching, or administration (14% in lowest and highest quintiles). CONCLUSIONS: The regional supply of neonatologists varies dramatically and cannot be explained by the substitution of neonatal mid-level providers or by the presence of academic medical centers. Further research is warranted to understand whether neonatal intensive care resources are located in accordance with risk and whether more resources improve newborn outcomes.

Age Distribution↗
PubMedDate not supplied

Storm warning. Insurance regulation.

Pressure is mounting on state insurance commissioners to treat provider-run health networks like insurers. Like a distant tropical depression, this potential threat to collaborative networks hasn't shown up on the radar screens of most hospitals. But it will. Put on your galoshes.

American Hospital Association↗
PubMed1978

The voluntary effort.

Explore the source record for details and available documents.

American Hospital Association↗
PubMed2001

Medication safety issue brief. Using automation to reduce errors. Part 2.

The medication-use system in hospitals is inherently complex. There can be more than 100 steps from the time a prescription is written to the time a patient receives the medication. Technology has the potential to reduce medication errors by reducing complexity, avoiding over-reliance on memory, simplifying key processes, and, if designed and implemented properly, increasing efficiency. It can also be a cost-effective tool for improving quality. This briefing examines issues in selection and implementation automation.

Clinical Pharmacy Information Systems↗
PubMed2001

Medication safety issue brief. Using a system-wide approach. Part 4.

The meat and potatoes of error reduction is in the root cause analysis of mistakes and near-misses, and the identification of new, safer ways to carry out tasks. This is also the most technical part of patient safety. But hospital leaders find that their staffs can learn from mistakes using home-grown expertise and wisdom, and that it works best if everyone is willing to open up their daily work lives to some well-intentioned scrutiny.

Humans↗
PubMed2003

Medication safety issue brief. Change your culture forever. Series II, Part 3.

What is it they say about the best-laid plans? They often go awry. It's the same with initiatives to make drug delivery in hospitals safer. An organization can analyze its procedures with the most sophisticated methods and squeeze out every possible chance for error, but the new design will mold with disuse if momentum is lost. There are many ways for an innovation to get derailed: lost enthusiasm, personnel changes, budget cuts. As they mature in the safety process, organizations have to be flexible but also stay firm in maintaining medication safety as a top priority. Keep safety initiatives alive by involving staff, "hardwiring" changes into the system and monitoring their progress well into the future.

Humans↗