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At least 343 records · Page 19Linked to original sources
PubMed2005

Results of a survey of hospital coagulation laboratories in the United States, 2001.

CONTEXT: Coagulation and bleeding problems are associated with substantial morbidity and mortality, and inappropriate testing practices may lead to bleeding or thrombotic complications. OBJECTIVE: To evaluate practices reported by hospital coagulation laboratories in the United States and to determine if the number of beds in a hospital was associated with different practices. DESIGN: From a sampling frame of institutions listed in the 1999 directory of the American Hospital Association, stratified into hospitals with 200 or more beds ("large hospitals") and those with fewer than 200 beds ("small hospitals"), we randomly selected 425 large hospitals (sampling rate, 25.6%) and 375 small hospitals (sampling rate, 8.8%) and sent a survey to them between June and October 2001. Of these, 321 large hospitals (75.5%) and 311 small hospitals (82.9%) responded. RESULTS: An estimated 97.1% of respondents reported performing some coagulation laboratory tests. Of these, 71.6% reported using 3.2% sodium citrate as the specimen anticoagulant to determine prothrombin time (81.3% of large vs 67.7% of small hospitals, P < .001). Of the same respondents, 45.3% reported selecting thromboplastins insensitive to heparin in the therapeutic range when measuring prothrombin time (59.4% of large vs 39.8% of small hospitals, P < .001), and 58.8% reported having a therapeutic range for heparin (72.9% of large vs 53.2% of small hospitals, P < .001). An estimated 96.3% of respondents assayed specimens for activated partial thromboplastin time within 4 hours after phlebotomy, and 89.4% of respondents centrifuged specimens within 1 hour of collection. An estimated 12.1% reported monitoring low-molecular-weight heparin therapy, and to do so, 79% used an assay for activated partial thromboplastin time (58% of large vs 96% of small hospitals, P = .001), whereas 38% used an antifactor Xa assay (65% of large vs 18% of small hospitals, P = .001). CONCLUSIONS: Substantial variability in certain laboratory practices was evident. Where significant differences existed between the hospital groups, usually large hospitals adhered to accepted practice guidelines to a greater extent. Some reported practices are not consistent with current recommendations, showing a need to understand the reasons for noncompliance so that better adherence to accepted standards of laboratory practice can be promoted.

Anticoagulants↗
PubMed1989

Changes in nutrition support services between 1984 and 1986.

Reports of the economic impact of diagnosis-related group funding on staffing and patient care in hospitals have varied from optimistic to bleak. The Dietitians in Nutrition Support Practice Group of The American Dietetic Association developed a questionnaire to evaluate changes in nutrition support services provided to inpatients and home patients between 1984 and 1986. The written survey instrument was mailed to clinical nutrition managers at a nationwide random selection of 1,000 hospital members of the American Hospital Association. Two hundred thirty-six responses were received. Respondents reported an increase in the use of enteral nutrition support for inpatients between 1984 and 1986. In 1986, tertiary-care hospitals also reported greater use of parenteral nutrition support and tube feeding for inpatients and home patients than did primary-care hospitals. Tertiary-care hospitals also reported higher staffing in 1986 than did primary-care hospitals in the following areas: clinical, nutrition support, and outpatient dietitians and dietetic technicians. Greater use of enteral and parenteral support for inpatients was noted by large hospitals as well as greater staffing in the following areas: clinical managers; nutrition support, clinical, outpatient, and home care dietitians; and dietetic technicians. However, the ratio of patients to RDs was greater in large than in small hospitals. There was no significant difference in patients:RD ratio between tertiary-care and primary-care hospitals. The only difference between responses from for-profit and nonprofit hospitals was in the number of nutrition support RD positions, which was larger in the nonprofit hospitals. Utilization of nutrition support for inpatients or home patients was not different for hospitals in different profit categories.

Diagnosis-Related Groups↗
PubMed1989

Duty calls: hospitals' responsibility for controlling the tobacco epidemic.

Growing public awareness of the health hazards associated with smoking and the growing social unacceptability of the smoking habit constitute one of the major public health revolutions of our time. In recent years, almost all of the country's major medical and health professional organizations have become actively involved in the tobacco control movement. Unfortunately, hospitals and their professional associations have been conspicuously absent from the ranks of those leading this effort. The authors argue that the American Hospital Association and individual hospitals have an opportunity and a duty to become leaders in the effort to reduce tobacco addiction in this country and around the world. Specific suggestions are provided for individual hospitals and for their professional associations to work toward protecting the health of nonsmokers by eliminating cigarette smoking in hospitals, to work for political solutions to eliminate efforts by tobacco companies to promote smoking, and to reduce the incidence of smoking initiation among young people.

Advertising↗
PubMed2005

The growth of palliative care programs in United States hospitals.

BACKGROUND: Palliative care programs are becoming increasingly common in U.S. hospitals. OBJECTIVE: To quantify the growth of hospital based palliative care programs from 2000-2003 and identify hospital characteristics associated with the development of a palliative care program. DESIGN AND MEASUREMENTS: Data were obtained from the 2001-2004 American Hospital Association Annual Surveys which covered calendar years 2000-2003. We identified all programs that self-reported the presence of a hospital-owned palliative care program and acute medical and surgical beds. Multivariate logistic regression was used to identify characteristics significantly associated with the presence of a palliative care program in the 2003 survey data. RESULTS: Overall, the number of programs increased linearly from 632 (15% of hospitals) in 2000 to 1027 (25% of hospitals) in 2003. Significant predictors associated with an increased likelihood of having a palliative care program included greater numbers of hospital beds and critical care beds, geographic region, and being an academic medical center. Compared to notfor- profit hospitals, VA hospitals were significantly more likely to have a palliative care program and city, county or state and for-profit hospitals were significantly less likely to have a program. Hospitals operated by the Catholic Church, and hospitals that owned their own hospice program were significantly more likely to have a palliative care program than non- Catholic Church-operated hospitals and hospitals without hospice programs respectively. CONCLUSIONS: Our data suggest that although growth in palliative care programs has occurred throughout the nation's hospitals, larger hospitals, academic medical centers, not-for-profit hospitals, and VA hospitals are significantly more likely to develop a program compared to other hospitals.

Data Collection↗
PubMed1979

The Voluntary Effort gears up for a tough year.

The success of the Voluntary Effort can be credited to the movement's broad-based coalition and the commitment shown at the grass roots level. But, much remains to be done, and the VE is gearing up to meet the challenge. In 1979 emphasis will be placed on: a greater role and involvement for hospital trustees, increased efforts by hospitals to develop better ways to inform physicians about the costs of tests and services, and the need to create an even greater awareness and commitment to the VE at the grass roots level.

American Hospital Association↗
PubMedDate not supplied

Organizing for strategic planning in smaller not-for-profit community hospitals.

It is generally assumed that conventional strategic planning techniques can be applied to all complex organizations. However, the approach used to organize for the strategic planning function may vary to accommodate institutional differences. While health administration literature addresses the issue of strategic planning, there is little research to validate prescriptive theory, particularly for smaller and rural hospitals. To shrink the "research gap," a survey questionnaire developed in cooperation with the Hospital Association of Pennsylvania was mailed to 101 hospitals registered by the American Hospital Association; of these, 66 usable responses were received. The scope of the study was limited to smaller (100 to 299 beds) not-for-profit community hospitals in Pennsylvania. The results discussed in this article focus on the creation of an appropriate organizational framework to support strategic planning efforts. The findings shed light on the proper role for board members, staff specialists, and outside consultants as participants in the planning process.

Hospital Bed Capacity, 100 to 299↗
PubMed1978

Alternative birth centers offer family-centered care.

With the endorsement of the five major health care associations involved in maternity/newborn care and the support of the American Hospital Association, hospitals throughout the country are beginning to offer alternatives to traditional maternity care. Alternative birth centers (ABCs) have sprung up throughout the country and are providing one-room, homelike environments for labor, delivery and recovery; Leboyer atmosphere; natural childbirth techniques; rooming in; and early discharge. Consumer demand has greatly influenced the changes, and hospital costs have been cut in half.

Family↗
PubMed2005

Medication safety issue brief, Look-alike, sound-alike drugs.

Confusing drugs with similar names accounts for about 10 percent of all medication errors, according to the Food and Drug Administration. Last year, the American Pharmacists Association reported that there are more than 33,000 trademarked medication names in the United States and more than 9,000 generic names. The large number of medications--added to clinicians' heavy workloads, job stress, unfamiliarity with drug names and confusing, unclear orders, among other things--creates ample opportunity for confusion. A Joint Commission on Accreditation of Healthcare Organizations' National Patient Safety Goal requires that hospitals identify and annually review a list of look-alike and sound-alike drugs, at minimum, and take action to prevent errors involving the interchange of these drugs.

Clinical Pharmacy Information Systems↗
PubMed2005

Medication Safety Issue Brief. Small and rural hospitals--unique challenges, unique solutions.

Small rural hospital pharmacies face ths same quality challenges as their large, urban counterparts. Yes, they often lack access to the necessary resources to address these issues. That's no minor problem. AHA Hospital Statistics 2006 reports that 2,003 (41 percent) of the nation's 4,919 community hospitals in 2004 were rural. And, as of Aug. 31, 2005, 1,141 hospitals in the United States are designated as critical access hospitals. People living in rural areas are less likely to have insurance and are by and large poorer than those who live in urban areas, according to the National Rural Health Association. The rural population is also older and tends to suffer from more chronic diseases than residents of urban areas. That adds to the challenge for small and rural hospitals. These facilities must treat complex medical cases with limited resources, often with minimal on-site pharmacy coverage.

Clinical Pharmacy Information Systems↗