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Is cost-awareness really improving?

The findings of a comparative study of cost awareness amongst particular groups of health service staff are reported. The study is a repeat of that undertaken in 1987 by Fairbrass and Chaffe. The findings are compared to assess how awareness of the cost of anaesthetic drugs, fluids and disposables has changed as a result of the publicity since 1987. Without prior warning, the study group were asked to estimate the cost of twenty-eight items. The results show that their degree of accuracy remains poor. Overall the tendency was to overestimate costs, whilst a small number of expensive items such as volatile agents were consistently underpriced. The results show that, over the last three years, there has been no significant change in the knowledge of cost awareness. At a time when the effective use of scarce resources is being emphasised, a staff programme of continuing cost awareness training is recommended.

Anesthesiology↗

The training of non-medical theatre personnel.

Highly trained, dedicated assistants with relevant occupational skills are essential for safe medical practice. A vocational qualification has been introduced as a potential common training for non-medical personnel wishing to pursue a career in operating department practice. Approval of extended role options gives an opportunity for specialist support, and may also be of use in relieving some of the problems associated with the reduction of the hours of trainee doctors. This paper briefly traces the evolution of theatre training and reviews current developments.

Accreditation↗

HHS circulating regulations finalized on June 17.

On June 17, 1986, the US Department of Health and Human Services (HHS) published its final regulations in the Federal Register governing the hospital Conditions of Participation in Medicare and Medicaid programs. The final regulations state that "In accordance with applicable State laws and approved medical staff policies and procedures, ...surgical technologists may assist in circulatory duties under the supervision of a qualified registered nurse who is immediately available to respond to emergencies". Coming after a dozen years of exhaustive research and debate on the conditions, HHS deleted the work "direct" as it applies to the degree of supervision required for circulating surgical technologists because, HHS states, "it will give hospitals maximum flexibility to manage their internal procedures...and will recognize appropriately the special qualifications of surgical technologists". The following article will provide you with the historical background and development of this regulation, scheduled to take effect on September 15.

Facility Regulation and Control↗