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With the goals of decreasing acute care length of stay and maintaining quality and patient satisfaction, an alliance took place between a physician's office, an acute care provider, and a home care provider. This model illustrates success in the shift from hospital to home care.
The expansion of managed care into the home care industry necessitates change to prepare for different systems of payment and cost containment. One home care provider learned from what hospitals were doing how it could improve its own day-to-day workings and outcomes.
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Defining, analyzing, and changing macro- and micro-processes has become almost a routine part of the TQM efforts of many laboratories as they strive to improve service and reduce costs. Scrutinizing each part of a process can reveal unnecessary steps that, if eliminated, would generate improvements with desired outcomes. This laboratory reviewed the processes associated with phlebotomy, especially for STAT tests, at the same time its administration was planning to establish 11 patient care centers where there previously had been three traditionally operated hospitals. Through process analysis, this laboratory transferred the entire function of in-patient phlebotomy from the laboratory to nursing. The results of an 8-month follow-up study show a significant favorable effect on laboratory turnaround time and related costs but not without some problems.
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WHERE: The emergency department of Parkview Memorial Hospital, a 519-bed, VHA-affiliated acute care facility in Ft. Wayne, IN. PROBLEM: The need to shorten waiting time, improve patient satisfaction, and reduce costs while maximizing the potential of a $9 million renovation. Also, the need to address emergent and urgent care with different processes and operations. SOLUTIONS: Through benchmarking, staff initiated bedside registration on laptop computers; cross-trained and restructured to drastically reduce overtime and salary expenses while adding FTEs; and provided tools for training physicians and nurses to handle patients. RESULTS: Wait time to see a doctor has declined by two-thirds. Cost per visit has dropped 12%, saving the department more than $422,000 in 1996. Satisfaction scores have almost doubled to 86%.
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The premise of this article is that, until recently, health promotion for people with disabilities has been a neglected area of interest on the part of the general health community. Today, researchers, funding agencies, and health care providers and consumers are leading an effort to establish higher-quality health care for the millions of Americans with disabilities. The aims of a health promotion program for people with disabilities are to reduce secondary conditions (eg, obesity, hypertension, pressure sores), to maintain functional independence, to provide an opportunity for leisure and enjoyment, and to enhance the overall quality of life by reducing environmental barriers to good health. A greater emphasis must be placed on community-based health promotion initiatives for people with disabilities in order to achieve these objectives.
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The implementation of nontraditional healthcare delivery increases the need for information technology innovation, not only in use of computer-based patient records, but also in enabling infrastructures to support health information exchange. This is very apparent in mobile health clinics where care is provided to vulnerable community populations at locations far removed from academic and tertiary care settings. Several challenges of designing a computerized system for the University of Maryland School of Nursing's Wellmobile will be addressed in this article, as well as possible solutions to these challenges. It is the authors' belief that implications for further study will become apparent as these constraints and challenges are described.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.