Public hospitals and health care reform: choices and challenges.
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Community Health Services↗
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Results for “Hospital Restructuring”
Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.
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The "corporatization" of U.S. hospitals: what can we learn from the nineteenth century industrial experience?
While broad parallels have been noted between the current "corporatization" of health care and developments in U.S. manufacturing in the late 19th century, there has been little in-depth analysis of these parallels. This article explores trends in the industrial organization of the hospital industry from the perspective of the manufacturing experience. Efforts to use corporate managerial techniques to rationalize hospitals have played an important role in the development of the modern structure of the hospital industry since the 1920s. But the emergence of multihospital systems is a new phenomenon. Some significant similarities exist between current conditions in the hospital industry and conditions in manufacturing at the time of the great industrial merger boom at the turn of the century. The subsequent experience of multiplant manufacturing firms created during the great industrial merger boom varied considerably. The characteristics of successful industrial consolidations are not present in the hospital industry; but motives for consolidation exist that were not present in manufacturing, while changes in the organization of production loom in the future.
Commerce↗
Inquiries at Lakeside and Aradale Hospitals: lessons and advances?
The release of reports of inquiries into two related psychiatric hospitals (Lakeside and Aradale) in Victoria occurred in 1991. These inquiries identified deficiencies in patient care standards and organisational dynamics. Knowledge of institutional dysfunction was available from similar Australian and overseas inquiries but nonetheless this knowledge had not prevented organisational inertia and decline in these two psychiatric hospitals. This paper examines the possible contribution of a failed medical hegemony model to organisational dysfunction and discusses organisational life-cycles. It reaches the conclusions that politically motivated inquiries do not achieve long term positive outcomes and that there is a need for academic research into the organisation of psychiatric services and staff productivity and morale.
Burnout, Professional↗
The experiences and perceptions of nursing service managers regarding transformation of health services in selected provincial academic health complexes.
Nursing service managers are challenged with enormous transformations within the new political dispensation in South Africa. The objective of the study was to explore and describe the experiences and perceptions of the nursing service managers regarding transformation of health services in selected Provincial Academic Health Complexes. A qualitative, exploratory, descriptive and phenomenological design was employed utilising focus group interviews and narratives as methods of data collection. After content analysis was performed, results were grouped into management of health service transformation and quality of patient care in relation to the levels of the organisation. The levels in the organisation are individual level, group level, departmental level and organisational level. Positive and negative experiences and perceptions were identified.
Academic Medical Centers↗
The commercialisation of public teaching hospitals is a fundamental error.
The new funding system for Australia's public hospitals has not been shown to be effective and is likely to fragment and undermine services that require cooperation rather than competition.
Australia↗
The public hospital of the future.
Public hospitals designed for the past are not changing rapidly enough to meet the needs of the future. Changing work practices, increased pressure on bed occupancy, and greater numbers of patients with complex diseases and comorbidities will determine the functions of future hospitals. To maximise the use of resources, hospital "down times" on weekends and public holidays will be a distant memory. Elective surgery will increase in the traditionally "quiet times", such as summer, and decrease in the busy winter period. The patient will be the focus of an efficient information flow, streamlining patient care in hospital and enhancing communication between hospitals and community-based health providers. General and specialty units will need to work more efficiently together, as general physicians take on the role of patient case managers for an increasing proportion of patients. Funding needs to be adequate, and system management should involve clinicians. Safety will be enshrined in hospital systems and procedures, as well as in the minds of hospital staff. If these changes are not implemented successfully, public hospitals will not survive in the future.
Australia↗
[The implementation process of a new model of intensive rehabilitation in a hospital setting: the development of an innovative practice within the context of integration of settings, services and treatment models].
This article describes the process of implementation of an internal intensive rehabilitation program at Douglas hospital for people with severe mental disorders. A discussion of contemporary paradigms of rehabilitation implies the integration of biological and psychosocial perspectives in the characterization and treatment of the pathology. The discussion of the reorganization of the entire rehabilitation services of the Program for severe mental disorders leads to specifying the organizational and regional context of the implementation. The axes of implementation in priority are the following : analysis of needs, training, reorganization of work and modification of the setting of care. These activities are implemented in reference to scientific developments that are empirically relevant and assessed regularly. Future challenges include the pursuit of integration of treatment models, of settings and services within the context of the hierarchy of mental health care in Québec.
Hospital Restructuring↗
Partnership between a Veterans Affairs medical center and a podiatric medical college.
The health care academic delivery system is dramatically changing in today's economy. In order to survive, the delivery system must decrease its costs and increase productivity. Integration of academic affiliates and community health care facilities has produced a more efficient health care system and improved medical education. The formation and methodology of the mutual benefits and responsibilities between a health care system and a college of podiatric medicine are examined in detail. Developing unique sharing partnerships can mutually improve medical student experiences, reduce financial burdens, combine joint research projects, and ultimately improve patient care.
Academic Medical Centers↗
Strong foundations.
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Attitude of Health Personnel↗
Developing nurse endoscopy through re-engineering.
Innovative developments in nursing roles have been one of the benefits of re-engineering at The Leicester Royal Infirmary NHS Trust. In the third in a series of four reports, the author describes nursing innovation in endoscopy.
Clinical Protocols↗
[Social change in the hospital during the 19th century. The example of the Munich General Hospital].
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Female↗
Learning from a merger opportunity.
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Centralized Hospital Services↗
Informatics & process improvement in real life. The clinical design unit.
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Diffusion of Innovation↗
AHM names new top officer.
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Hospital Administration↗
Two hospitals may reopen in Chicago's strained system.
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Chicago↗
For-profit chains look beyond the bottom line.
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Health Facility Merger↗