Hospitals systems

Texas Poison Center System Parkland Health Hospital System 5201 HaiTy Hines Blvd. 

Some of these measures are part of larger, semistructured interviews administered by the therapist. The most commonly used assessments in this category are a family of instruments developed mainly in the Veterans Administration (VA) hospital system. The first instrument in this family is known as the Addiction Severity Index (ASI McLellan et al., 1985). The ASI assesses for a wide variety of biographical data, so it has the advantage of potentially being used as part of an intake interview. The ASI asks about consequences in a wide variety of life domains, and determines recent and lifetime patterns of drug and alcohol use. The ASI also detects recent and lifetime occurrence of problems in these different life domains (e.g., work). Each domain can be scored for the severity of the problems based upon the responses of the client and the clinical judgment of the interviewer. The ASI can be administered by computer to provide for rapid interpretation of answers. 

With the notable exception of the Veteran s Administration (VA) hospital system, health care providers, both in primary care and mental health care, do a relatively poor job of identifying PTSD. There are two basic steps to diagnosing PTSD (1) determining that the patient has been exposed to a traumatic event, and (2) determining that the trauma-exposed patient is experiencing symptoms that fulfill diagnostic criteria for the disorder. 

Farber MS, Palwlicki KS, Tims PM, et al. 2002. Proactive root cause analysis in a multi-hospital system. ASHP Summer Meeting, Baltimore, MD. 

There was an interesting study published in 1975 titled "Achieving the Optimal Information System for the Laboratory" (published by J. Lloyd Johnson Associates, Northbrook 111.). Their study is primarily concerned with hospital systems, but as far as we are going, there is no difference in the applicability of the results to general laboratory automation. 

A mass casualty incident occurs as the result of events in which sudden and high patient volume exceeds an emergency department s resources. An emergency department s resources can be significantly challenged by many factors. A mass casualty incident commonly occurs with bus or train crashes, high-occupancy structural fires, or incidents from natural or intentional causes. The emergency department is the entry point into the hospital system and the initial facility-based patient care area for victims of a mass casualty incident. 

It does not take a nationally publicized event to seriously impact a health care system even a local apartment fire can cause a regional hospital system to exceed its surge capacity. A bum center s capacity is determined by available burn beds, burn surgeons, burn nurses, support staff, operating rooms, equipment, supplies, and related resources it is a dynamic number. Surge capacity is the ability to handle up to 50% more than the normal maximum burn patient census when there is an emergency. 

Chief surgeon for Pickett s division of the Army of Northern Virginia, despite praise for Moore s accomplishments in building from scratch a pavilion hospital system and boards of examination for physicians, noted that Moore could be inflexible and excessively stern. See Charles W. Chancellor, A Memoir of the Late Samuel Preston Moore, M.D., Surgeon General of the Confederate States Army, Southern Practitioner 25 (1903) 634-643. 

The professional practice of medicine and pharmacy and the public hospital system are controlled by the respective States and Territories. Other areas of healthcare, including registration of pharmaceutical products and licensing of manufacturers, are the responsibility of the Federal government. 

Moeller FG, Chen YW, Steinberg JL, et al Risk factors for clozapine discontinuation among 805 patients in the VA hospital system. Ann Clin Psychiatry 7 167-173,1995... 

Drug information practitioners in institutional and academic environments may work within a single institution or may be involved in a hospital system that requires services to multiple institutions, perhaps over a wide geographic region. 

Parkland Health and Hospital System, Dallas, Texas, U.S.A. 

The Health Industry Business Communications Council (HIBCC) code was originally developed in the USA to establish its own codification structure for the full range of health sectors, but has come to be used mainly within the US hospital system. In the UK, HIBCC is also called the Health Industry Bar Code Convention by the Article Numbering Association (ANA), and also the Health Industry Business Code Council. In the Netherlands it is known as the Health Industry Bar Code (HIBC). The code is composed of five elements ... 

These practices prove that dejure the mental hospital system functions as an arm of the medical profession, but de facto it functions as arm of the states law-enforcement system. Accordingly, I maintain that standard psychiatric practices do not represent the abuses of psychiatry on the contrary, they represent its "proper uses, sanctioned by tradition, science, medicine, law, custom, and common sense. The very definition of the word certifiable supports this interpretation of the psychiatrists role formerly called alienist, his job was, and is, to alienate, that is, remove, the subject from society Webster s defines certifiable as fit to be certified as insane, befitting an insane person. ... 

The decree of Louis XIII was not a solitary occurrence. It has been repeated time and again through the history of psychiatry. The German mental hospital system, for example, was inaugurated in 1805 with the following declaration by Prince Karl August von Hardenberg ... 

The idea that the mental hospital is harmful for the inmates, serving primarily the Interests of the patient s relatives or those of society, is more easily traced to specific individuals in the history of psychiatry than is the idea that mental illness is not a disease. This is because the mental hospital system is only about three hundred years old, whereas man s views on madness are as old as recorded history. 

I cite these reports not as examples of the unfortunate abuses of the mental hospital system in need of correction by an enlightened citizenry, but rather as characteristic examples of a pervasive psychiatric pattern of harassment, intimidation, and degradation, authenticating the right of certain social authorities to cast individuals, especially from the lower socioeconomic classes, into the role of mental patient. To maintain that a social institution suffers from certain abuses is to imply that it has certain other desirable or good uses. This, in my opinion, has been the fatal weakness of... 

For more than 20 years at the Regenstrief Institute at the University of Indiana, Clement McDonald has been using a medical record system that now holds more than 480 million distinct laboratory and clinical measurements, 40 million radiology images, and a variety of other kinds of data. Since 1994, five major hospital systems in Indianapolis participate in this program along with public health departments, physician offices, laboratories, and other care providers. 

The Veterans Administration (VA), convinced that clinical engineers were vital to the overall operation of the VA hospital system, divided the country into biomedical engineering districts, with a chief biomedical engineer overseeing all engineering activities in the hospitals in that district. 

Acknowledgement We thank Amy L. Wyatt, R.D., L.D., affiliated with the University Hospital System in San Antonio, TX, for information provided on the content of thiamine in foods, as fisted in Table 14.6. We gratefully acknowledge the excellent reviews by Drs. Roger Butterworth and colleagues (Hazell, 1998 Desjardins and Butterworth, 2005) and W.J. McEntee (1997), which served as valuable source material for this review. 

Patient and family participation. Through the hospital system s family advisory council, families were invited to each minicourse. One early minicourse included family as faculty. "It was an illustration that the families are viewed as equal partners in creating safety," said the organizer. 

These changes enabled by the hospital system s information technology investments are immense, but they are being phased in slowly over several years. 

Analysis of near misses is an investment in prevention. Experience is the best teacher, but in our case the tuition is paid for by the patients. With close calls, tuition is free (Bagian, 2002). Bagian s words challenge us to mine the rich sources of information we currently have and thereby prevent or reduce the probability of harmful or fatal medical accidents. Content analyses of more than 4,000 safety reports from a hospital system in the Midwest identified patterns predictive of medical accidents. Analysts in the hospital system found that near misses that had not been dealt with were characterized by error-prone conditions, which later reassembled to create medical accidents. This discovery jolted the organization. A question now asked on all safety reports and in aU analyses of critical events analyses is Has this event or a similar event ever occurred before Have you seen this before ... 

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