Calculating pneumatic systems' productivity.
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A two-unit study that evaluated the impact on cost, labor, and employee acceptance in relation to cost savings rather than revenues resulting from increased patient charges proved that an exchange cart system would be beneficial for the entire hospital.
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Since September 1992, attempts have been made at Kagoshima University Hospital to develop the Medical Material Distribution Management System which helps to realize optimal hospital management as a subsystem of the Total Hospital Information System of Kagoshima University (THINK). As this system has been established, it has become possible for us to have an accurate grasp of the flow and stock of medical materials at our hospital. Furthermore, since September 1993, the Medical Material Distribution Management System has been improved and the Total Medical Material Distribution Management System has been smoothly introduced into the site of clinical practice. This system enables automatic demands for fees for treatment with specific instruments and materials covered by health insurance. It was difficult to predict the effect of this system, because no similar system had been developed in Japan. However, more satisfactory results than expected have been obtained since its introduction.
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It is important for every materiel management employee to be trained to know the purpose, benefits and operations of the exchange cart system. This information can be shared in a simple, short inservice or during department orientation. It is vital to the success of the system. To summarize one expert's views on this training. "No system will work without people. The people must be trained to believe in the system, to understand the system, and to work within the system. Certainly the policies and procedures must be there to provide the guidelines for day-to-day operations. Certainly there should be some quantitative analysis in order to evaluate the daily results. However, the people will make most systems work or fail."
Our goal is to provide a framework for pharmacy in an evolving healthcare marketplace by identifying and discussing the three dimensions of pharmacy practice: (1) pharmacy practice across the continuum of care; (2) the major elements of pharmacy practice; and (3) the evolution of pharmacy during the five stages of the development of managed care. The framework was devised under the proposition that there is a substantial consistency in what patients need or should expect from pharmacists. As integrated health systems develop, pharmacists must apply their skills and knowledge across the continuum of care to ensure that they play an integral part in the systems. In a managed care environment characterized by change and the development of integrated health systems, pharmacists have opportunities to become involved directly in patient care in such areas as disease prevention, home healthcare, primary care, and subacute care. Information systems, hospital drug distribution, clinical pharmacy, and the fiscal environment comprise the major elements of pharmacy practice within an integrated health system, and the way in which each of these elements evolves as the healthcare market adapts to managed care is critical to pharmacy practice. If the pharmacy profession can demonstrate its ability to manage disease and health, improve outcomes, and reduce costs within the evolving healthcare system, pharmacists will play a vital role in the managed healthcare market in the approaching new millennium.
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This article analyses the water used at hospitals in Rio de Janeiro, Brazil. The research, based on microbiological and physical-chemical aspects, suggests subsidies for normalization of hospital potable water systems and makes recommendations for standardization of operational procedures for inspection for Legionella pneumophila. A total of 16 hospitals were inspected and positive results for the presence of L. pneumophila were found at five hospitals. These hospitals were integrated in a research project aiming at the detection and quantification of this pathogen. During 10 consecutive weeks, four collections representing a total of 200 analyses were done at the five researched hospitals. In this way seven physical-chemical parameters and three microbiological parameters were observed to evaluate the quality of water in each hospital. The results showed that routine surveillance for a hospital water distribution system is fundamental for public health and must include, as a priority, monitoring of L. pneumophila. The water quality varies in accordance with the hospital water system involved. It is important and necessary to implement environmental culturing in order to minimize hospital infection, in particular, pneumonia data and also to provide the basis for disinfection of the water system.
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