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PubMed1985

ABC analysis of the relationship between pharmacy charges and DRGs.

DRGs and pharmacy charges were analyzed using the ABC analysis for a cross section of hospitals represented in the Blue Cross of Central Ohio (BCCO) region and for Riverside Methodist Hospital (RMH). A total of 43,969 patients were discharged from the 43 BCCO hospitals and 6,121 patients from RMH in the one-year study period. They were retrospectively assigned to 465 and 371 DRG categories, respectively. The ABC analysis of pharmacy charges and DRGs showed that 10 major diagnostic categories (MDCs) accounted for 80.4% and 80.1% of all pharmacy and i.v. charges for the BCCO hospitals and RMH, respectively. Hospital charges were found to be strongly related to pharmacy charges, and length of stay was found to be moderately related to pharmacy charges. In the absence of pharmacy cost data per DRG, the ABC analysis can be used to categorize DRGs on the basis of pharmacy charges. Before using pharmacy or hospital charges data per DRG for resource monitoring, hospital pharmacy directors should investigate the causes of high pharmacy charges for the high-cost DRGs and MDCs.

Blue Cross Blue Shield Insurance Plans↗
PubMed1994

Collaborative partnerships involving the community.

Riverside Methodist Hospitals in Columbus, OH, is the 1,063-bed flagship hospital of the U.S. Health Corporation. Riverside depends on collaborative activities to carry out its mission to improve the health status of the community, and credits the collaborative spirit to a top-down leadership philosophy. To strengthen the concept of collaboration, education and experiential training are provided to board members, medical and executive staff, and employees to demonstrate the interrelatedness between the hospital and other systems in the community. Collaboration is a process which can be learned by any individual or organization. As Riverside's experience demonstrates, choosing collaborative partners carefully and using several key strategies facilitate successful collaborative efforts.

Community Health Services↗
PubMed1995

Process redesign: making your film library work for you.

When Riverside Methodist Hospitals in Columbus, Ohio, experienced serious problems in its radiology film library, administrators recognized that poor processes were to blame and used quality management techniques to create a new system. A radiology information system was part of Riverside's long-range plan, but an effective manual process was implemented first. Riverside had decided that closing the library to referring physician access would result in more successful operations. An Operational Changes Planning Committee composed of file clerks, technologists, managers, radiologists and referring physicians planned the redesign. The committee identified four goals: Reduce unmet requests. Improve response time. Benchmark operations of comparable organizations. Implement an effective manual process prior to automation. Steps in the redesign process included identifying the problem, applying statistical tools to the situation and understanding customer requirements. Flow charts, benchmarking, data collection within the department and focus groups provided important quantitative information. Creating an improved process included the following actions: Work simplification. Work elimination (especially non-value-added work). Uncovering and removing causes of delay. Automation of repetitive tasks via the RIS. Reduction and elimination of any rework steps. One important change was to close the library to physician access. There were moderate gains in effectiveness as a result of redesign of the manual process. Results have continued to improve, and the redesign process provided greater commitment and cooperation for the more significant improvements that followed the RIS introduction.

Efficiency, Organizational↗
PubMed2004

Challenges associated with the integration of endovascular repair of abdominal aortic aneurysms in a community hospital.

PURPOSE: There has been considerable debate regarding the proper place for endovascular repair (ER) of abdominal aortic aneurysms (AAAs) versus traditional open repair (OR). Our study compared preoperative patient demographics and outcomes for elective, asymptomatic AAA repairs performed at our center over a 33-month period. METHODS: For this study, we selected 342 consecutive elective infrarenal AAA repairs performed between July 1, 2000, and March 31, 2003, at Riverside Methodist Hospital. The patients underwent either ER or OR, depending on patient and surgeon collaborative determinations. Ruptured and symptomatic AAAs were excluded from our study. Preoperative demographics, anesthesia, complications, and discharge status for the 2 groups were analyzed, and statistical analysis was done to determine statistically significant differences. RESULTS: The preoperative status of the ER and OR patient groups were essentially similar. There were only 3 significant differences between the 2 groups: alcohol use was higher for the OR group than for the ER group (12.0% versus 5.2%; P = .04), and the incidence of type II diabetes mellitus and peripheral vascular disease were lower for the OR group compared with the ER group (6.7% versus 13.4% [P = .04] and 18.3% versus 30.6% [P = .008], respectively). The OR group used more general anesthesia than the ER group (99% versus 86%; P < .001) and had more complications, including dysrhythmia (8.65% versus 1.59%; P = .005), ileus (13.94% versus 0.79%; P < .0001), infection (8.17% versus 0.0%; P = .0007), respiratory complications (12.50% versus 1.59%; P = .0003), and renal complications (5.29% versus 0.79%; P = .032). The ER group had a higher rate of wound hematoma (4.76% versus 0.48%; P = .007). ER patients also had significantly less blood loss (379 mL versus 1930 mL; P < .001), a better independent discharge status (P < .0001), a shorter length of stay (1.8 days versus 8.2 days; P < .001), and a lower mortality rate (0.75% versus 3.85%; P = .0954). CONCLUSIONS: From our study we cautiously continue to encourage the consideration of the ER of AAAs in our patient population while being mindful of its limitations.

Adult↗
PubMedDate not supplied

The QA program evaluation: a powerful punch.

Even the best quality assurance program requires periodic review in order to attain or regain maximum efficiency and effectiveness. The JCAHO standard for annual QA program evaluation adds impetus to this obligation. Riverside Methodist Hospitals' QA program evaluation is constructed in a three year cycle. Internal evaluation in year one and external expert evaluation in year three are balanced in year two with a combined internal/external program review. The year one internal evaluation discussed in the article outlines a framework for evaluation which includes positioning the evaluation for maximum influence, identifying key QA program components and designing meaningful, comprehensive evaluation inputs. The informed judgments of professionals, as well as traditional documentation review, provide powerful evaluative insights. Evaluation outputs include a program rating, an identification of program strengths and weaknesses, and targeted recommendations for QA program improvements.

Forms and Records Control↗
PubMed1994

The healing process of presence.

Therapeutic relationships help provide the milieu for the nurse and the patient to gain insights into the essence of disease and the nature of healing. In building a foundation on which to be in optimally responsive relationships, nurses at Riverside Methodist Hospitals in Columbus, Ohio, participate in a 2-day course that explores and names how we bring ourselves as gifts to others as well as to ourselves in the dynamic of therapeutic presence. The following article reviews the literature on presence, provides a course description and contents on presence, and assists nurses in incorporating principles of presence into nursing practice.

Empathy↗
PubMed1994

Climbing the ladder: evolution of a clinical advancement program.

Clinical advancement programs have been popular in nursing for years and have only recently permeated allied health disciplines, including radiography. In this article, the author explores the evolution of a clinical advancement program at his institution, involving radiographers of all disciplines and sonographers. The evolution of the program at Riverside Methodist Hospitals over the last three-and-a-half years is explored as a follow-up to the article "Approaching Clinical Advancement in Radiology," published in Radiology Management 13.4, fall 1991.

Career Mobility↗
PubMed1989

Service, training key to information center's success.

Three years ago, an Information Center was put in place at Riverside Methodist Hospitals. The PC-based system supports hundreds of users and communicates with a wide variety of ancillary departments. In addition, ongoing training and support helps ensure that users can maximize the benefits of the available technology.

Computer Systems↗
PubMed1999

Merger, they wrote.

When senior executives at Grant and Riverside Methodist Hospitals in Columbus, OH, decided to merge their institutions into one healthcare system, the two security forces suddenly were faced with the need for major changes. The directors of the two security departments decided to work together to plot a successful integration strategy and to protect the security staff in the bargain. By involving staff in organization decisions, they made integration easier.

Decision Making, Organizational↗
PubMed1990

CEO walkabouts get firsthand look at employee problems.

"The CEO doesn't take care of patients; the CEO takes care of the people who take care of patients," says Eire "Chip" Chapman, the president of 869-bed Riverside Methodist Hospitals. This philosophy is endorsed by other top administrators who have made a point to leave their desks to investigate first-hand employee concerns and work situations.

Hospital Administrators↗
PubMed1984

A day rehabilitation stroke program.

An innovative approach to the rehabilitation of the stroke patient was initiated at Riverside Methodist Hospital to accommodate an increasing number of patients. Patients spend six hours a day several days a week attending a day rehabilitation program at which all necessary therapies are provided. A year-end analysis of the program substantiates the original hypothesis that stroke patients would show significant improvement with treatment in a specialized day rehabilitation facility.

Adolescent↗