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PubMed1994

Special report on reimbursement. Medicare and Medicaid false claims prosecutions: your clerk's mistake can subject you to criminal penalties!

A number of steps are available to individual and institutional providers to minimize exposure under the new wave of enforcement activity. The first is education: learn what rules apply in your setting and share that knowledge with management and line employees. Second, undertake an independent compliance review to identify and resolve any existing exposure, including voluntary disclosure to the authorities, if appropriate. Third, institute an ongoing program to communicate to all employees not only the content of applicable rules, but also the genuine commitment of management to ensure continuing compliance above other concerns.

Fraud↗
PubMed1995

Renaissance CFO emerges in response to market pressures.

A 1995 survey of chief financial officers (CFOs) in healthcare organizations finds that as the healthcare industry reshapes itself through mergers, acquisitions, and downsizing, the CFOs of the mid-1990s also are reshaping themselves into "Renaissance CFOs." They are acquiring new skills and expertise beyond the traditional area of finance. About one-third of the CFOs who took part in the February 1995 survey, which updates similar surveys in 1992 and 1990, said they are working to enhance their knowledge of managed care because they expect to assume responsibility for managed care as part of their expanding CFO responsibilities. Other new areas survey respondents said they expect to oversee before the decade's end are financial costing and pricing and physician relations. The 1995 CFO survey was commissioned by HFMA and Executive Risk Management Associates, Inc., and was conducted by Elrick & Lavidge, Inc. Previous CFO profile surveys have included analysis of CFO compensation data. This year, however, a separate, more indepth survey of CFO compensation was commissioned by HFMA; the findings of this survey will be presented in the October issue of HFM.

Attitude of Health Personnel↗
PubMed1994

Elected medical staff leaders: who needs 'em?

Authority, influence, and power are not synonyms. In working with elected medical staff leaders, a physician executive who chooses to exert authority may soon find him- or herself relatively powerless. But one who chooses to downplay authority, to influence through persuasion, and to coach leaders to lead effectively soon generates support for his or her ideas. The need to coax, cajole, explain, persuade, and "seek input" frustrates many leaders in all kinds of organizations. It would be much easier just to order people about. It's so tempting to think: "Who needs 'em? I'm the 'chief physician.' I know what needs to be done. Let's weigh anchor, take her out, and do what it takes to sail those rough, uncharted seas." If you really enjoy sailing a large ship in rough seas without a crew, go right ahead. Or if you think it makes sense to run an organization with only an executive staff and no knowledgeable middle managers, by all means let clinician leaders know that, now that you're aboard, they're just window-dressing. If you can make this approach work, well and good. Your life will be much less complicated, each day will have far fewer frustrations, and progress toward established goals will be much faster. However, given the reality of traditionally thinking physicians, it would be best to keep an up-dated resume in the locked lower left-hand drawer of your desk.

Decision Making, Organizational↗
PubMedDate not supplied

Encouraging women and minorities to enter medical management.

Women and minorities are underrepresented in medical management. If we use our personal knowledge of physician managers we know, it should be clear that the profession is dominated by white males, mainly middle-aged. But the evidence is more conclusive.

Female↗
PubMed1999

Developing a reliable medical informatics network.

As medical informatics increasingly places demands on computer resources, healthcare organizations need to plan for and develop fully integrated, enterprisewide communications networks. Healthcare systems should invest in upgradable equipment that is compatible with industry standards and select specialized contractors familiar with the infrastructure required for healthcare networks. The potential for downtime should be minimized through remote diagnostics that assist repair capabilities. The fully integrated network should be supported by staff who are provided with ongoing training and overseen by a knowledgeable network manager.

Computer Communication Networks↗
PubMedDate not supplied

Radiotherapy in Italy: state of the art and possible developments.

The major role of radiotherapy and its outcomes in the treatment of cancer are now supported by a 100-year experience. To cover the cost of the equipment needed for an effective application of RT in Italy, the allocation decided according to the Census of 1995 is definitely inadequate. The Italian radiotherapists to cope with this situation should acquire a sound professional preparation as well as be familiar with the organizational management. The knowledge of the National and European regulations and the programs of Quality Control and Quality Assurance, the use of guidelines agreed on with other specialists, the application of standardized procedures controllable on inspection and audit, the plan of the budget, the appraisal of costs are all indispensable to safeguard the personal professional dignity and to improve the quality of life of the patients.

Forecasting↗
PubMed2000

WebDietAID: an interactive Web-based nutritional counselor.

WebDietAID is a Web-based system aimed at assisting individuals affected by high serum cholesterol. The system tries to reproduce the types of intervention performed by a nutritional counselor. It is structured as a set of advisors, each of which handles a different side of the counseling process. The tasks of the advisors range from monitoring weight, to teaching about healthy nutrition, to assessing motivation and psychological obstacles to behavior change. WebDietAID is based on a development environment for Web-based applications that includes a dynamical Web server, a knowledge base management system, and an interface to a relational database. We describe the architecture of the system, and several of the implemented advisors. Finally, we discuss how the architecture could be generalized to other counseling domains.

Computer-Assisted Instruction↗
PubMedDate not supplied

Current status and changing trends of antimicrobial resistance in Lebanon.

Antimicrobial resistance among microorganisms has been on the rise worldwide including Lebanon. Several surveillance programs have been initiated to monitor the patterns of resistance due to the deleterious consequences on patients management. Thus, knowledge about the local antimicrobial resistance patterns is essential for epidemiologic aspects as well as clinical practice. In this context, the current status and changing trends of antimicrobial resistance in Lebanon are addressed covering the most relevant bacterial, mycobacterial and fungal pathogens.

Bacterial Infections↗
PubMed2001

[The evaluation of complications caused by insertion of Veres needle and trocars placement based on analysis of 4211 laparoscopic operations].

The retrospective analysis of 4211 laparoscopic operations was performed. The complications caused by insertion of Veres needle and trocars placement were found in 66 cases (1.6%). There were: retropneumoperitoneum--in 33 cases (8@1000), vascular injuries--22 cases (5@1000), injuries of the gastrointestinal organs--9 cases (2@1000). In 2 cases (0.4@1000) perforation of the wall of urinary bladder occurred. The accurate preparation of patients to laparoscopy, knowledge of management with complications, ability to laying sutures through all of abdominal layers, using of Foley's catheter for haemostasis enabled to cure both the main disease and complications.

Female↗
PubMed2002

Primary health care in complex humanitarian emergencies: Rwanda and Kosovo experiences and their implications for public health training.

In a complex humanitarian emergency, a catastrophic breakdown of political, economic, and social systems, often accompanied by violence, contributes to a long-lasting dependency of the affected communities on external service. Relief systems, such as the Emergency Response Units of the International Federation of Red Cross and Red Crescent Societies, have served as a sound foundation for fieldwork in humanitarian emergencies. The experience in emergencies gained in Rwanda in 1994 and Kosovo in 1999 clearly points to the need for individual adjustments of therapeutic standards to preexisting morbidity and health care levels within the affected population. In complex emergencies, public health activities have been shown to promote peace, prevent violence, and reconcile enemies. A truly democratic and multi-professional approach in all public health training for domestic or foreign service serves as good pattern for fieldwork. Beyond the technical and scientific skills required in the profession, political, ethical, and communicative competencies are critical in humanitarian assistance. Because of the manifold imperatives of further public health education for emergency assistance, a humanitarian assistance competence training center should be established. Competence training centers focus on the core competencies required to meet future needs, are client-oriented, connect regional and international networks, rely on their own system of quality control, and maintain a cooperative management of knowledge. Public health focusing on complex humanitarian emergencies will have to act in prevention not only of diseases and impairments but also of political tension and hatred.

Altruism↗
PubMed2002

Clinical features of community-acquired pneumonia treated at Srinagarind Hospital, Khon Kaen, Thailand.

Pneumonia is a serious illness associated with significant morbidity and mortality. The interpretation guidelines for pneumonia management requires knowledge of both the clinical presentation of the disease and local epidemiology. We studied the clinical features, initial laboratory results, antibiotic sensitivities, and outcomes of patients diagnosed with acute community-acquired pneumonia between January 1999 and December 2000 at Srinagarind Hospital. The causative organisms were identified in only 52.2% patients; Streptococcus pneumoniae accounted for 23.1% of infections. Other common causes included Klebsiellapneumoniae (19.2%), Burkholderia pseudomallei (15.4%), Hemophilus influenzae (11.5%), Mycoplasma pneumoniae (6.2%), and Staphylococcus aureus (4.6%). Younger patients were more likely to be infected with M. pneumoniae, while the mean age of those with other types of infections was 50. Healthy adults were infected with M. pneumoniae and S. pneumoniae; specific pathogens attacked patients with certain co-morbidity : i) diabetes mellitus and ageing, ii) diabetes mellitus and renal disease, iii) cardiovascular diseases, and iv) connective tissue diseases and steroid-use; these patients were vulnerable to i) K. pneumoniae, ii) B. pseudomallei, iii) H. influenzae, and iv) S. aureus respectively. White blood cell counts were normal in M. pneumoniae infection. Gram-stained sputum had some limitations, especially when determining Gram-negative infections; chest x-rays could not differentiate pathogens. Bactermia was found in one half of patients infected with B. pseudomallei and S. aureus. Antibiotic-resistant organisms were not common in our study. Because morbidity and mortality were high among patients infected with S. aureus and B. pseudomallei, empirical antibiotic treatment should be considered in suspected cases, especially when patients present with acute severe community-acquired pneumonia.

Adult↗
PubMed1988

Migration Amendment Act 1987 (No. 133 of 1987), 16 December 1987.

This Act does the following, among other things: 1) requires that certain requests relating to entry permits, visas, and return endorsements are not considered to have been made unless in writing in accordance with the relevant approved forms and unless any fee payable has been made; 2) makes "operators," as well as charterers, liable for the carriage of persons to Australia without documentation; and 3) provides that international air operators shall pay immigration clearance fees payable by passengers whether or not the operator has collected the fees from the passengers.

Australia↗