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Biomedical subjects

P Whitman

Publications and source records attributed to P Whitman.

5 recordsLinked to original sources
PubMed1993

Achieving empowerment through information.

Despite the problems we encountered, which are not uncommon with the development and implementation of any data system, we are confident that our success in achieving our goals is due to the following: establishing a reliable information database connecting several related departments; interfacing with registration and billing systems to avoid duplication of data and chance for error; appointing a qualified Systems Manager devoted to the project; developing superusers to include intensive training in the operating system (UNIX), parameters of the information system, and the report writer. We achieved what we set out to accomplish: the development of a reliable database and reports on which to base a variety of hospital decisions; improved hospital utilization; reliable clinical data for reimbursement, quality management, and credentialing; enhanced communication and collaboration among departments; and an increased profile of the departments and staff. Data quality specialists, Utilization Management and Quality Management coordinators, and the Medical Staff Credentialing Supervisor and their managers are relied upon by physicians and administrators to provide timely information. The staff are recognized for their knowledge and expertise in their department-specific information. The most significant reward is the potential for innovation. Users are no longer restricted to narrow information corridors. UNIX programming encourages creativity without demanding a degree in computer science. The capability to reach and use diverse hospital database information is no longer a dream.

Academic Medical Centers↗
PubMed1991

Financial and operational impact of a transfer center.

A tertiary care hospital established a transfer center to manage the large number of transfer requests from other hospitals in its catchment region. Motivating factors included occurrence of economic transfers, medically inappropriate transfers, poor interfacility communication, and a bed shortage. An interdisciplinary task force was convened to design and implement the transfer center, requiring two months from conception to implementation. Non-recurring direct costs were $3000. At the time of implementation, written transfer agreements were promoted and signed with many transferring hospitals. A retrospective audit covering 28 weeks of operation indicates that 1141 inpatient days were avoided for an average of 21.5 days per back-transferred patient. (Back-transfer refers to the return of a patient to the original hospital.) An additional 140 admissions were possible as a result of these avoided days. Approximately $550,000 in variable costs were saved on an annualized basis. Moreover, substantial improvements in communications and interfacility cooperation were realized. No cases of inappropriate denials or delays in transfer were identified. We conclude that a transfer center can be a highly cost-effective mechanism to manage the large number of patients transferred to a tertiary care center.

Admitting Department, Hospital↗
PubMed1981

Urodynamic studies in female patients with multiple sclerosis.

Patients with multiple sclerosis may have two fundamental, related problems in the lower urinary tract, i.e., urinary retention and/or urinary incontinence. Forty-six patients were assessed by urodynamic testing. Evidence of detrusor overactivity was seen in 40 patients (86.9%), elevated resting urethral pressures in 39 patients (84.8%), a positive bethanechol chloride (Urecholine) stress test in 24 patients (63.2%), and a significant residual urine in 26 patients (56.5%). Data were analyzed in an attempt to explain retention and incontinence in these patients.

Female↗
PubMed1978

Transport of organic anions through the erythrocyte membrane as K+-valinomycin complexes.

K+, Rb+, or Cs+ complexes of valinomycin form ion pair complexes with picric acid and trinitrobenzenesulfonate (TNBS). The formation of a picrate-K+-valinomycin complex is supported by spectral evidence. These complexes have zero net charge and readily permeate the intact erythrocyte membrane. The K+-valinomycin complex has been used to convert the nonpenetrating TNBS into a penetrating covalent probe, making it as useful vectorial probe to measure accessible amino groups of proteins and phospholipids on both sites of the erythrocyte membrane. The enhanced transport of TNBS into the cell by valinomycin is dependent on external K+ in the medium. The entry of TNBS into the cell is manifested by an increased labeling of hemoglobin and membrane phosphatidylethanolamine (PE). Stilbeneisothiocyanatedisulfonate (SITS) and anilinonaphthalenesulfonate (ANS) inhibit both the basal and K+-valinomycin stimulated labeling of PE and hemoglobin by TNBS. The data suggest two independent effects of ANS and SITS, one mediated by an inhibition of the anion transport protein and another by the incorporation of these hydrobic anions into the cell membrane with an increase in negative charge on the membrane which leads to an inhibition of TNBS permeation into the cell by electrostatic repulsion.

Anilino Naphthalenesulfonates↗