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PubMed1992

Ownership and organizational performance. A comparison of technical efficiency across hospital types.

Using a national data base of urban hospitals, the effect of ownership (government, nonprofit, and for-profit) on the technical efficiency of hospitals was examined. Efficiency scores were computed using a method called data envelopment analysis. Controlling for environmental and hospital characteristics, for-profit hospitals were found somewhat less frequently and government hospitals consistently more frequently in the efficient category. When examining highly inefficient hospitals as a percentage of those receiving inefficient scores, for-profit hospitals appeared to be highly inefficient relative to the other ownership forms. Government and nonprofit hospitals were somewhat indistinguishable from one another regarding their percentages of highly inefficient scores. For-profit hospitals also tended to use supply and capital asset (hospital size) inputs less efficiently, and service and labor inputs more efficiently than hospitals in the other ownership categories.

Efficiency↗
PubMed2006

Soprano Specialty Forms Project--A solution that empowers clinicians in the management of research and audit data.

Throughout the world, clinicians (including nurses) create ad-hoc stand-alone databases in order to meet their individual research and audit requirements. These databases often exist in large numbers within an institution. They meet individual requirements and capture a large quantity of valuable clinical information, but it is not possible to pool or share that information because of a lack of common data structures and coding. The Soprano Specialty Forms solution developed by Orion Health in collaboration with Auckland District Health Board resolves this problem. The solution provides a common data storage and coding infrastructure within which clinicians can create their own forms for data collection, enter data through an integrated portal used as part of their everyday clinical practice, and easily query the data collected regardless of its source.

Databases as Topic↗
PubMed2003

Acute contrast reaction management by radiologists: a local audit study.

Consultant radiologists and trainees must possess knowledge of optimal acute management of anaphylactic/anaphylactoid contrast reactions because patient survival depends upon prompt initial management. The aim of the present study is to assess the knowledge of first-line management of these reactions among radiologists. Within one working day, and without prior knowledge, radiology consultants and trainees within four teaching hospitals in a major Australian capital city were asked to complete a confidential questionnaire regarding acute resuscitation management. Scenarios were presented of an adult who developed life-threatening symptoms of anaphylaxis immediately after intravenous contrast administration, ventricular fibrillation and profound bradycardia. Questions were asked with regards to adrenaline, corticosteroid, antihistamines, intravenous volume expansion, cardio-pulmonary rescuscitation and knowledge of the emergency telephone number. Sites were assessed for presence of an anaphylaxis management chart and also when each participant last completed a resuscitation course. Forty-two participants were recruited. Overall, 53% of questions were answered correctly. Only 43% knew the adrenaline dose and if an incorrect dose was administered it was more likely to be an overdose. Notable inadequacies were also discovered with corticosteroid, atropine, antihistamine doses and intravenous fluid use. Only 26% had completed a resuscitation course in the past 2 years. Forty-five percent knew the emergency telephone number and 55% of rooms using intravenous contrast contained an immediately visible chart for contrast reaction management. Radiologist and trainee knowledge of immediate life-threatening contrast reaction management is deficient. Severe contrast reactions are uncommon with today's use of non-ionic contrast, but they still occur. Experience in the management of anaphylaxis can only come from regular, compulsory training.

Acute Disease↗
PubMed2001

Cardiac diseases during pregnancy: who will manage?

This study on 408 pregnant women with heart disease tried to audit the management of these women in a well equipped highrisk pregnancy unit. The outcome was nearly comparable to that obtained in series where the management was done in cardiology units.

Journal Article↗
PubMed1993

Notes: a suitable case for audit.

The increasing emphasis on management responsibilities and audit led us to investigate the state of surgical notes in our hospital. Twelve criteria were evaluated regarding information that should be contained in the notes and the absence of this important information was documented. Deficiencies were revealed in all criteria selected. Until hospital patients files are well kept and maintained, retrospective audit whether financial or medical will not be valid. A significant injection of resources is required to redress the situation. Hospitals which have not carried out detailed studies into the contents of their notes need to do so as a matter of urgency.

Humans↗