Support team helps patients cope with stress.
Grant Hospital of Chicago recently adopted a new concept in psychiatric support of the physically ill patient. The medical staff believes it has improved hospital-patient relations.
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Grant Hospital of Chicago recently adopted a new concept in psychiatric support of the physically ill patient. The medical staff believes it has improved hospital-patient relations.
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The delivery of services in college health centers is improved through the use of relationship marketing and service quality advancement. Relationship marketing works to attract, maintain, and enhance customer or client relationships with the healthcare provider. The facets of relationship marketing are explored, with the greatest emphasis placed on internal marketing. Higher quality health services come from continuous improvement, a focus on process, and intensive staff development and participation, which build a service culture.
Nurses cannot always meet patients' expectations for nonclinical care. The authors describe the operational redesign of several hotel-related functions to enhance the provision of nonclinical care. This system enhances care delivery to better balance patients' perceptions of the clinical with the non-clinical components of care.
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As hospitals implement total quality management and CQI programs and experiment with patient-centered care initiatives, financial officers are moving away from their traditional "bean-counter" role toward a broader role as part of a leadership team crafting a vision of the future.
TQM/CQI and patient-centered care initiatives are also spurring changes in hospitals' employee payment and performance systems. The tricky part is that those systems have to change at the same time delivery systems are changing. "We feel we can't first develop new care delivery systems and then spend the next two years adjusting compensation systems," says one executive.
BACKGROUND: HCFA-sponsored Peer Review Organizations nationwide have been criticized by organized medicine, Medicare beneficiaries and interested Congressional parties for being punitive without exploiting educational opportunities garnered through their massive data collection capabilities. Until now this data has been poorly analyzed and has not been adequately utilized as a positive motivational tool. METHODS: HCFA has developed, with the cooperation of the medical community, six generic screens for Peer Review Organizations to utilize when evaluating quality care provided Medicare beneficiaries in an acute care setting. Through the sheer volume of cases seen, significant inpatient information can be obtained that cannot be duplicated in any other epidemiological endeavor. Line item discrepancies can be further studied through small-area-analysis to determine "who" as well as "what" may be the problem. RESULTS: By compiling and reviewing data in a systematic manner over two years (1990-1991), the Alabama Quality Assurance Foundation (AQAF) has singled out problems with patient medical stability at discharge as the predominant concern for care providers and reviewers alike. CONCLUSIONS: Having determined the primary problem in rendering quality care in a Prospective Payment System to Medicare beneficiaries lies in premature discharges, subsequent small-area-analysis further narrows the focus of concerned individuals. Hopefully, practitioners and providers alike will act on their own initiative in correcting this problem. Follow-up review will be utilized to assure this self-corrective action.
The Martin Luther King County General Hospital, Los Angeles, California, provides services for an equal number of Hispanics (most are recent immigrants from Mexico) and African Americans who have lived in the community since before the Watts riot in 1965. The hospital is staffed by a large percentage of foreign-trained doctors and other personnel who speak some English, but suffer from a lack of understanding of the Hispanic as well as the African-American patients. Very few trained interpreters are provided for the Spanish-speaking population, and no interpreters are provided for African Americans. A 100-question survey on common African-American expressions was conducted in the Department of Family Medicine, as well as an opinion poll to determine if adequate understanding existed between patients and providers. The data revealed that native African-American providers understood significantly more African-American expressions than foreign, white, and Hispanic providers. The opinion poll also revealed inadequate translation of medical complaints from patients through interpreters. In addition, the poll found that diagnoses and instructions were not adequately related to the patients. Furthermore, it was felt that trained interpreters should be provided for all patients who presented communication problems.
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Hospital billing and pricing practices are drawing increasing heat from lawmakers, employers and consumers. In a four-part package, we explore various aspects of this issue. First, an overview. With public dissatisfaction growing, leaders on Capitol Hill are delving into hospital administrative costs and practices as never before. Second, the pricing controversy. Hospitals have three antidotes to the problem: streamline their charge structures, keep prices closely tied to costs, and explain the complexities of cost-shifting to businesses. Many hospitals are already moving forward on this. On page 29, the consumer angle. While a number of lawsuits in Florida have alleged overcharging by hospitals, Nevada has begun operating a new commission charged specifically with arbitrating patient billing disputes. On page 31, the receivables management story. Hospitals must carefully examine the efficiency of all their business office functions to make billing and collection improvements, experts say; relying on automation alone will not work.