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Stated in the article on the basis of the author's personal experience and summarized materials of the study of the "Medical Institution Regulations" are main principles and sections of this document that is the chief state-paper regulating activities of a medical institution. The importance is shown of the "Regulations" for a medical institution to function properly under new social-and-economic conditions.
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A year ago HEW published guidelines regulating hospital beds and occupancy rates. Reluctant to close their doors, administrators have sought conversion alternatives, most of them impractical and economically impossible. A go-slow attitude is recommended, as population increases will dictate hospitals' proper response.
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In the face of decreasing federal spending for health care services despite an increased demand for services, hospitals would be well advised to work with, rather than against, government in attempting to control hospital spending.
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Developing and implementing an effective program to reduce excess hospital capacity is an extremely difficult and complex task. But it is clearly a logical means to contain health care costs and to develope a cost-effective health system.
Seven hospitals that closed between 1974 and 1977 were forced to shut down by a variety of factors. Several of the closings were accomplished in a relatively painless fashion. Others were difficult and created many problems. The individuals involved in the closings and their aftermath learned many lessons, the chief among which is the critical need for communication among all parties involved.
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This paper describes a framework for compliance the regulatory agency requirements and internal service standards in response to service decentralization and institution of a multi-task environmental worker role. Initiation and maintenance of the compliance system and the coordination of institutionally specific service standards are described. Five keys for success are detailed.
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