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At least 811 records · Page 45Linked to original sources
PubMed1983

A comparison of the practices used for distribution of controlled substances in Massachusetts hospitals with those reported nationally.

A survey questionnaire concerning the procedures used to distribute controlled substances was mailed to 100 randomly selected Massachusetts hospital pharmacies. The tabulated results were compared to a similar study surveying 285 short-term medical and surgical hospitals nationwide. Of the 58 responding hospitals, 47 (81%) reported controlling either all or some Schedule III Controlled Substances in a manner similar to that used for the distribution and accountability of Schedule II drugs. A total of 42 (72%) reported maintaining the same systems for Schedule IV agents. In contrast, only 24 (42%) of those respondents reported controlling Schedule V drugs in a manner similar to Schedule II Controlled Substances. Similar to the findings of a nationwide study, many of the responding Massachusetts hospitals reported selective inclusion of those Schedule III, IV, and V drugs possessing an increased risk of illicit diversion into a more controlled distribution system. In conclusion, many Massachusetts hospitals distribute and account for controlled substances in a manner similar to that used nationwide.

Drug and Narcotic Control↗
PubMed1983

The hospital financing system of the Federal Republic of Germany.

This paper deals with the present hospital financing system of the Federal Republic of Germany. The structure of the financing system is treated as well as the actual financing process, and, as far as possible, both are also quantitatively described. The first section contains a description of the structure, and is concerned with the major institutions participating in the hospital financing system:--the hospitals are described according to ownership, number of beds, specialization, personnel, regional distribution and utilization;--the health insurance system is illustrated by the two major institutions, i.e. statutory and private health insurance agencies, and its effect on hospital financing is explained;--the regulation of the hospital financing system by the federal political system is discussed;--finally, the major economic functions of the institutions involved are summarized; the interrelations of hospital care and the ambulatory sector are also mentioned. The second section contains a detailed description of the actual financing process, which can be classified according to the sections of financing:--the basic system of the German hospital financing law is introduced;--in the section on investment costs, public grants and their allocation, which are closely related to hospital planning, are discussed;--in the section on operating costs, full cost reimbursement as the basic principle, the structure of costs, the elements and the mechanism of operating cost financing, the actual prices, the financing of private patients' care and special services are described;--a short view of accounting balances, i.e. the differences between costs and financing of hospital services which result in profits or deficits, is given. A few considerations on the evaluation of the financing system conclude the paper.

Costs and Cost Analysis↗
PubMed1995

Trends of strategic importance for the future information landscape in the hospital.

Hospitals are complex enterprises with, at the time being, evolving organizational structures. In the 80s innovative system concepts for the computer support of such complex organizations were developed, based on a controlled distribution of the components of multi-functional information systems (IS). More recently several R&D initiatives promoted these issues in general and for hospital information and communication systems (HICS) in particular. Three leading strategic ideas have in the meantime attained fundamental importance and will be considered in more detail: distribution, integration, and evolution. Strong interdependencies exist however between those three concepts, mainly expressed by the notions of interoperability and coupling of system components. In the context of a distributed IS, the notion of integration has to be extended since the centralization of all dp resources is replaced by a cooperative system concept with centralized control functions for information of hospital-wide interest, based on global models for data and processes, and distributed dp resources with a powerful central component, which is especially true for most HICS. In view of the broad scope of requirements, it is not feasible to construct these comprehensive multi-functional systems as closed and complete products. Therefore a concept of evolutionary system development is indispensable. Finally, the overall functionality of commercially available software products for integrated HICS is analyzed. With regard to the present German market for HICS of the new generation, the patient administration and hospital management functions of the care system are covered rather well; the medical/clinical functions however are not at all complete.

Germany↗
PubMed1999

Stop the carts.

Nurses and pharmacists at the University of Utah Hospitals & Clinics successfully implement an automated medication distribution system to cut costs, and find they also create measurable process improvements.

Clinical Pharmacy Information Systems↗
PubMed1977

Integration of pharmacy into the computerized problem-oriented medical information system (PROMIS)--a demonstration project.

The integration of pharmacy into the computerized problem-oriented medical information system (PROMIS) at the Medical Center Hospital of Vermont is discussed. Practioners who generate and retrieve information communicate directly with the computer without intermediary personnel. Touch-screen cathode-ray tube terminals are used for data input. Under PROMIS, the pharmacist has two new resources which better integrate his services into total patient care: (1) the ability to directly access online patient data in the pharmacy, and (2) the ability to directly couple online current drug information to a specific patient's computerized medical record in the pharmacy. The PROMIS solutions to pharmacy problems in drug ordering, drug distribution and drug therapy audit are discussed; In a demonstration project on a 20-bed unit, PROMIS made the medical record readily available to all health care providers, reduced reliance on memory, preserved the logic of medical action, and provided feedback loops for corrective action in everyday medical practice. Also discussed are user acceptance of the system, effect on pharmacy staffing, and implications for pharmacy.

Computers↗
PubMed1997

Benefits of distributed HIS/RIS-PACS integration and a proposed architecture.

The tight integration of the Hospital Information System/Radiology Information System (HIS/RIS) and the Picture Archive Communication System (PACS) has become a priority in modern healthcare delivery systems. Traditional paper-based systems are being replaced by gateway style interface engines. Gateways provide a tightly integrated link between the HIS/RIS and the PACS, increasing productivity by automating many mundane clerical tasks associated with paper-based systems. A centralized gateway, however, represents a processing bottleneck and single point of failure. A self-monitoring distributed gateway architecture that replicates essential services increases the fault tolerance and the overall availability of the gateway, while providing reduced, consistent transaction times. A possible distributed architecture is proposed as a means to realize the advantages of a distributed architecture.

Computer Systems↗
PubMed1995

Computerized pharmacokinetics on an institutional clinical information system.

Computer-based hospital information systems (HISs) are an integral part of the current hospital environment. Traditionally, the HIS hospital information system has performed drug distribution-related activities for the pharmacy. Clinical applications have been limited to monitoring for drug interactions, duplication of therapy, drug allergies, and dosage range checking. Personal computers have been used for more clinical applications and individualized dosing. At Hamot Medical Center, the integration of the pharmacokinetics consultation service with the HIS has been accomplished. The pharmacokinetic equations were programmed into the HIS. Data needed for the equations were extracted from information in the database, thereby eliminating the need to enter the majority of the data. The program was designed to print the pharmacokinetic consultation for the chart. The integration of the pharmacokinetic consultation service with the HIS has saved time and increased efficiency.

Clinical Pharmacy Information Systems↗
PubMed2005

[Hospitalization and mortality from mansoni schistosomiasis in the state of Pernambuco, Brazil, 1992/2000].

In order to investigate the historical trends, epidemiological profile, and spatial distribution of hospital admissions and deaths from schistosomiasis in the State of Pernambuco, Brazil, an analysis was conducted of data from the Hospital Information System and Mortality Information System from 1992 to 2000. The results showed a reduction in hospital admissions and mortality, while identifying more admissions and deaths among males. There was a lower percentage of deaths and admissions from schistosomiasis in individuals under 30 years of age. However, schistosomiasis is still of relevant magnitude, as evidenced by the number of deaths from this cause and the number of patients admitted to the hospital system in Pernambuco. A spatial analysis of the endemic's distribution in the State showed that although from 1995 to 1999 there was a greater spread of admissions due to schistosomiasis in the municipalities (counties) of the Sertão (backlands) and São Francisco river valley, the number of municipalities with hospitalizations due to schistosomiasis decreased from 1995 to 1998, followed by an increase in 1999 and 2000.

Brazil↗
PubMed1998

Protecting patient confidentiality in hospitals.

As new methods of electronic data storage and distribution appear in hospitals, new challenges in protecting confidentiality have emerged. At the same time, demands for 'seamless' care and the desire to share information between clinicians are motivating hospitals to relax barriers to the transfer of patient information. Increasing numbers of users at multiple sites compound the difficulty of ensuring information systems security. Hospital policy may demand that requests by patients to restrict the distribution of personal information be respected, while existing electronic systems are not able to deliver on this promise. Compliance with the Information Privacy Principles of the Commonwealth Privacy Act 1988 and the Australian Standard 4400-1995 'Personal privacy protection in health care information systems' will provide a useful framework for managing these challenges. However, their implementation will require some forethought.

Australia↗
PubMed1975

Potential economic effets of a brand standardization policy in a 1000-bed hospital.

The potential economic effects of a brand standardization policy on 50 multiple source, nonproprietary drugs in a 1000-bed hospital which uses a unit dose drug distribution system were studied. Inpatient drug usage cost and inpatient drug inventory cost for the year 1974 were compared under the existing nonformulary system and a simulated formulary system of brand standardization. Drug usage cost was defined as expenditures made by the study hospital for drugs which were administered. Drug inventory cost was defined as the dollar value of drug inventory being stored for use in the hospital. Potential saving in excess of $35,000 for drug usage cost and $9,000 for drug inventory cost could have been realized with a brand standardization policy on 50 nonprietary drugs. The differences in costs were significant at the 0.005 level. It is concluded that a brand standardization policy can be effective means of reducing drug usage cost and drug inventory cost in a large hospital.

Costs and Cost Analysis↗
PubMed1990

The challenge of health care developments for hospital pharmacy.

The traditional role of hospital pharmacists in drug analysis and drug compounding broadened to a patient-oriented approach during the sixties and seventies. The clinical pharmacy concept was adopted. This practice includes daily-prepared total parenteral nutrition and chemotherapy, sophisticated analgesic systems, individualized drug distribution and specific information. The hospital pharmacy provides aseptic procedures as well as specialized logistics. Clinical pharmacy practice concentrates on tailor-made pharmaceutical care. As home health care usually deals with therapeutic modalities, this approach offers great possibilities for highly skilled out-patient care. Financial and legal interferences and the traditional gap between in-patient care and out-patient care must be removed. Home health care challenges the hospital pharmacists to place his knowledge and abilities at the disposal of this new type of patient care.

Delivery of Health Care↗
PubMed1980

A simple work measurement system that can aid in effective production planning.

With the advent of increased controls in the hospital field has come the mandate for more efficient use of available resources. Production planning is the mechanism by which these efficiencies can be gained. Ongoing measurement of various work components must be conducted and retrospectively compared to make meaningful use of production planning techniques. The pharmacy department at Brokaw Hospital, which utilizes a unit dose drug distribution system combined with intravenous admixture and monitoring services, has developed an internal measurement system based on key variable weighted units of service. Each component is assigned a value depending on time needed (in minutes) for completion. The units are tabulated daily, with the monthly sum being divided by departmental manhours to yield a monthly productivity ratio. This ratio is used as an aid in making decisions related to work assignments and staff scheduling. Compared against the productivity ratio of a benchmark month of known departmental efficiency (derived by measuring all activities for the month divided by man-hours consumed), projections can be made for future manpower requirements.

Efficiency↗
PubMed1984

Cost effective method of implementing decentralized unit dose pharmacy services in a Friesen setting.

A limited decentralized drug distribution system was implemented at the Graduate Hospital, a 310-bed Friesen Concept teaching hospital. This mobile system services 252 medical/surgical beds on three floors of the hospital. Operation was limited to hours of peak demand for pharmacy services and to initial doses. The system was able to reduce turnaround time from 217 minutes to 90 minutes for 80-85% of newly written orders. Further, the systems was found to increase the availability of the pharmacist as a reference source and to clarify unclear or inappropriate orders. This approach required no increase in full-time equivalents and minimal capital expenditure.

Centralized Hospital Services↗