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The integration of respiratory therapy into nursing: reorganization for improved productivity.

This article outlines a program, implemented by a 133-bed acute care facility, designed to provide more productive patient care delivery while maintaining the level of service delivered. This program required downsizing the respiratory therapy department, integrating a portion of its function into the nursing department, and reducing the annual salary budget by approximately $270,000 or 2 percent of total hospital salaries. The article describes the process and strategies that were used to implement this method of providing respiratory care to hospital patients.

Centralized Hospital Services↗

Hospital information systems.

The intention of this paper is to give an overall view of. (a) The part a computer-based hospital information system (HIS) might play in a hospital. (b) The consequences of this part as to requirements for the contents (components, structure) of a hospital information system. This intention takes shape as follows: (1) Characteristics of data and their use in a hospital are considered including sensitivity, poor standardisation, high availability and long term storage required, incompleteness. (2) An outline is given of which part a HIS might play in this context and how a HIS can achieve this. Quantitative as well as qualitative improvements are described to be realised by checking the input, fast accessibility, improved standardisation, improved exchange of data, improvement of coordination of activities in the hospital. The concept of integration is shortly described. The logical structure of most HISs is introduced: a central databank with a huge storage capacity, accessible for authorised users by means of various application-packages (software) and a large number of terminals (hardware). (3) As an example of an operational HIS, the Leiden University Hospital HIS is described. The following subjects are covered: technical form (hardware, availability for the users), organisation, the applications, the use of the system, costs and benefits.(ABSTRACT TRUNCATED AT 250 WORDS)

Centralized Hospital Services↗

Returning to work through job accommodation: a case study.

1. As more people live longer and more active lives the likelihood of experiencing a disability during one's career increases. Although the unemployment rate among people with disabilities is high, workers with disabilities are becoming more common. 2. Effective job accommodation costs only a small fraction of the hundreds of thousands of dollars that would otherwise be paid out in disability benefits and insurance premiums, or wasted in litigation. 3. Job accommodation planning should begin as early as possible in the disability process and include the active involvement of the individual with the disability and appropriate clinicians, as well as the supervisor and coworkers. 4. Successful accommodation is the result of teamwork, The occupational health professional is often the coordinator of a number of internal and external resources in the job accommodation process. Tools are available for sharing information among all those involved in the accommodation process, without compromise of confidential medical or business information.

Accidents, Occupational↗