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Restructuring care: patient focus is key to innovation.

Hospitals across the country are busy reconfiguring their delivery systems to improve patient care delivery. In the process, they are overhauling their organizational structures, reaching out to other institutions for input and participation, and embracing local communities. Many hospital executives are also finding that the path itself is at least as interesting and valuable as the end result.

Community Health Services↗

Restructuring Canada's Blood System: what will be the impact on hospitals?

With the amount of publicity given to the Commission of Inquiry on the Blood System in Canada (Krever Commission), hospitals will be pressured to change policies and procedures regarding transfusions and the use of drug alternatives to surgical blood transfusions. Over the next year, hospital administrators will be forced to implement changes regarding allocation of resources, upgrades to information systems and revised patient care practices for patients requiring transfusions or blood alternatives. At a series of focus groups organized by the Canadian College of Health Service Executives and Janssen-Ortho Inc. in early 1996, 57 health care administrators from across Canada discussed their vision of how the Krever Commission has and will affect hospital policies and procedures over the next few years. This article summarizes the groups' findings relating to the changes that hospital administrators are likely to implement across Canada in the next two to three years as a result of the Commission's activities.

Blood Banks↗

[Contribution of psychiatric departments to restructuring inpatient management: the Saxony-Anhalt example].

In 1996, the available number of hospital beds for inpatients care in psychiatry, psychotherapy and psychogeriatrics in Sachsen-Anhalt amounted to approximately 0.4 beds per 1,000 inhabitants. As compared to 1992, when most beds were still concentrated in four large psychiatric hospitals, some decentralisation had been achieved. Now, 13 of 23 catchment areas have clinical facilities of their own, five of which were newly founded. About 800 of 1,346 beds and 245 of 299 day hospital places are now located outside the former large institutions. Some of the recently established facilities, however, are not yet sufficiently equipped to serve their catchment areas, with regard to appropriate size, room, staffing, internal specialisation and authorization to cope with compulsory admissions. Even in general hospitals, psychiatric departments are often separated from the main building, with the spatial distance providing some obstacle to the desired cooperation of psychiatry with other medical specialties.

Deinstitutionalization↗

The future of the pathologist in the hospital setting.

The future of the pathologist in the hospital setting can be speculated on in light of contemporary and predictable trends occurring in hospitals. From five of these trends--downsizing, restructuring, diversification, hospital-physician relations, and for-profit hospitals--eight implications for the practice of pathology are identified.

Financial Management, Hospital↗