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Portable ultrasound examinations in intensive care units.

The portability of modern real-time ultrasound units has led to a marked increase in the demand for examinations in medical, surgical, and pediatric intensive care units, the pediatric nursery, and the operating room. The results of all portable ultrasound examinations in the medical and surgical intensive care units at the Massachusetts General Hospital over a four-month period were analyzed to determine the efficacy of such studies. Of 48 examinations, portable sonograms were useful in 90 per cent, found new, clinically important information in 17 per cent, and led to misleading information in 4 per cent. Portable ultrasound examinations are valuable clinically and are probably cost effective.

Boston↗

An open, modular, distributed and redundant computer system for hospitals.

Based on his experience at the University of Würzburg in Germany, Dr. Schuller shows how a successful MUMPS-based hospital information system can be developed, including goals and requirements, networking, software hierarchies, programming in MUMPS, medical applications, data security/privacy and international standards.

Confidentiality↗

Steam sterilization costs: a guide for the central service manager.

The Nassau County Medical Center CS department, East Meadow, New York, was faced with a staff layoff and an increased workload. With some hard thinking and strong staff support, new processes/systems were designed to save time and money. These included outsourcing the sterilization of "easy" trays, instituting a case cart program and developing custom packs. In order to determine where savings could be had, it was first important to examine current costs. By breaking the costs of sterilization processing down into an average cost per load, a formula was developed that helped determine many additional cost comparisons for the department. For example, the cost analysis formula could be used by CS departments to determine the cost-effectiveness of off-site sterilization, to compare using disposable vs. reusable items and to determine costs for EtO sterilization and aeration.

Central Supply, Hospital↗

Improving the case cart process at Abbott Northwestern Hospital.

UNLABELLED: An interdepartmental team at Abbott Northwestern Hospital, in Minneapolis, audited surgical case carts for three months to determine why a large percentage were incomplete or incorrectly filled. After discovering a shortage of specific supplies and instruments and an unavailability of staff at times when case carts needed to be filled, the team designed specific interventions that almost doubled the number of completed carts. RESULTS: Case cart completeness increased from 50 percent to 93 percent. The number of trips staff made to case carts to add missing items was reduced by 20 percent, saving more than $40,000 per year in labor costs. The level of physician and staff frustration decreased, and communication and cooperation among the operating, central processing, and instrument departments greatly improved.

Efficiency, Organizational↗