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Software for automating analysis of encoded combinatorial libraries.

This paper describes the applications which are used to automate the analysis of encoded combinatorial libraries. Commercial packages from MDL, Oracle and Agilent are linked with application software written in C/C++, in Microsoft Access and in ChemStation macro language. Encoding correspondence lists for each of up to three synthetic steps are conveniently associated with building block lists using the first application, CodeGen. The second application Decode allows the user to identify the individual beads picked onto a 96-well plate and the pool number for each bead. The decoding chromatography data for each well is then loaded into the program. The chromatography data is used to identify the tags used in the synthesis. Along with the building block information from ISIS/Host, the building block used in each step of the synthesis can be identified. A third routine, Code-to-Structure, takes the coded library building blocks and creates the connection table in ISIS for each structure found by the decode program. For quality control of encoded library synthesis, the decoded structures on a set of beads is compared to the LC/UV/MS data for the ligand cleaved from the same bead. CAPTURE, a GlaxoSmithKline proprietary application, is used to display and analyze the decoded structures and associated mass spectral data. This application uses simple isotopic composition and electrospray ionization rule sets to predict mass spectra and judge the concordance of a structure- mass spectrum data set. An ancillary program, EIC, is used to extract predicted single ion chromatograms from the full scan LC/MS data.

Combinatorial Chemistry Techniques↗

Constructing a coding compliance plan.

The government has turned its attention to coding compliance. Do you have an effective program in place? Use the steps in this article to build a coding compliance program that protects your organization.

Accounts Payable and Receivable↗

Housing and health. The role of the environmental health practitioner.

From a health standpoint, the residential environment is both the dwelling and its associated areas. The dwelling and related area are interrelated both in terms of sanitation problems affecting physical health and other problems affecting mental health. The residential environment certainly represents a complicated public health problem. The issue of inadequate shelter has been addressed throughout history, but the relationship of shelter and health brings it to our attention now. It is estimated that one out of every four persons in our nation lives with some kind of shelter deficiency. The Federal Housing Act of 1949 was instrumental in creating an awareness that the quality of shelter and the surrounding environment has a great influence upon the physical and mental health and well-being of each individual. When the Housing Act of 1949 was passed, the American Public Health Association Committee on the Hygiene of Housing acknowledged the role public health agencies would have in eliminating and preventing health hazards associated with substandard dwellings. It also recognized the need for a formal code to establish minimum standards for the condition and maintenance of dwellings.

Building Codes↗

Complying with current Joint Commission Statement of Conditions (SOC) requirements.

This Technical Document has been developed to provide the reader with insight into the Joint Commission on Accreditation of Healthcare Organizations' (JCAHO) Statement of Conditions (SOC) process and recent changes for completing the SOC for Business Occupancies. The intent of this document is not to replace the instructions in Part 1 of the SOC or to give a complete review of the National Fire Protection Agency's (NFPA) Life Safety Code for health care or business occupancies, but rather to complement them.

Accreditation↗

Alternative health care facilities: design reflects quality image.

To maintain high-quality services under increasing economic pressure, hospitals are turning to alternative health care delivery facilities with their lower overhead costs. The challenge for planners is twofold: to attract patients and to provide affordable services without sacrificing quality of care.

Architecture↗

Hospital generator sizing, testing, and exercising.

With the NFPA 99 and JCAHO requirements for minimum loads on generators during testing, hospital engineers are finding that oversized standby generators can mean operational problems. This document explains the oversized generator problem, including the code changes that gave birth to the problem. Some practical suggestions for sizing generators are then provided.

Building Codes↗

Medicaid program; fire safety standards for ICFs/MR--HCFA. Proposed rule.

This proposed rule would amend the fire safety standards for intermediate care facilities for the mentally retarded (ICFs/MR). It would incorporate the 1985 edition of the Life Safety Code of the National Fire Protection Association. Current regulations incorporate the 1981 edition. The incorporation of the current edition of the Life Safety Code is intended to ensure that Medicaid providers and recipients have the benefit of the most current fire protection standards.

Building Codes↗

Codes put greater emphasis on life safety.

To meet today's life-safety needs in modern facilities engineers must follow exact code parameters. This is the only way to ensure that maximum life-safety needs are met.

Accident Prevention↗

Medicaid program; fire safety standards for ICFs/MR--HCFA. Final rule.

This final rule amends the fire safety standards for intermediate care facilities for the mentally retarded. It updates the standards to incorporate the National Fire Protection Association's 1985 edition of the Life Safety Code, which will replace the 1981 edition currently required. The incorporation of the new edition of the Life Safety Code is intended to ensure that Medicaid providers and recipients have the benefit of the most current fire protection standards.

Accident Prevention↗

Facility redesign for your future laboratory requirements.

Laboratories must adapt to rapid changes in equipment technology and fundamental changes in the business of health care. A project begins with the creation of a project team representing the laboratory, administration, facilities, architects, and engineers. Each phase of the project works through the various issues affecting the facility, culminating in documents for the actual construction. Review of the codes, the existing physical facility, and the costs associated with the changes are all important in achieving an efficient laboratory.

Building Codes↗

Using faculty development to solve a problem of evaluation and management coding: a case study.

Compliance with billing and coding rules put forth by the Health Care Finance Administration (HCFA) is a challenge for practicing physicians, including those in academic settings. The authors, members of the academic practice at Wayne State University School of Medicine, Department of Family Medicine, designed and delivered a comprehensive curriculum as part of the practice's faculty development initiative surrounding the coding challenge. The authors defined outcomes expected on the way to achieving 100% compliance with HCFA's guidelines. Their curriculum covered topics of coding theory, chart auditing for coding, team building, effective meetings, and structured problem solving. The curriculum was delivered from January to May 1998. Chart audits of 251 charts (office notes) from before the intervention and 263 charts from after the intervention were performed to evaluate differences in coding accuracy. Errors were significantly reduced. The total error rate dropped from 50.2% to 31.1% (p < .05). Overcoding errors were reduced by one third (29.1% versus 19.7%), while undercoding errors were reduced by half (16.3% versus 8.4%). Other errors fell from 4.7% to 3%. The approach of defining and developing work teams and then using standard quality improvement tools may be an effective way to improve compliance with HCFA billing and coding rules. In addition, faculty development can be incorporated into the process of solving a problem that faces a faculty.

Centers for Medicare and Medicaid Services, U.S.↗