Hospital Readmissions

Hospital Readmissions
Policy makers created the Medicare Hospital Readmissions Reduction Program (HRRP) in an
attempt to improve quality of patient care and lower costs (James, 2013). In order to avoid these
penalties, healthcare leaders must recognize that CMS has identified a correlation between
readmissions and a lack of quality care. Therefore, the aim is not to focus solely on hospital
readmissions, but to seek clinical excellence by investing in quality improvement (Silow–Carrol,
Edwards & Lashbrook, 2011). However, reducing readmissions is a complex undertaking, because
not all readmissions can or should be prevented. Indeed, some readmissions are planned as part of
sound clinical care. Furthermore, while hospitals work to reduce readmissions caused
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Shouldice Hospital
© 2007–2008 Richard E Murphy
Even Swaps – Shouldice Hospital
18 November 2007
1. How Successful is Shouldice Hospital?
Shouldice Hospital is a highly successful business that maintains a focused service delivery system
due to the success rate of its surgeries, its low employee turnover, its ability to maintain high quality
standards, its ability to keep costs low and to remain profitable, and most especially the positive
evaluations of its patients.
Its strengths can be attributed to stringent policies of staff
training in the Shouldice surgical method; the preservation of a communal atmosphere amongst both
the staff and with the patients; the implementation of efficient and cost–effective facility operations;
and ... Show more content on Helpwriting.net ...
(b) See "The Market" section of the case.
(c) See "The Market" section of the case.
(d) Assuming the operations were performed near the patient's home.
(e) The shortest stay mentioned in "The Patient's Experience" section.
(f) Assuming the patient is engaged in a job involving "light" work, as described in
"The Patient's Experience" section of the case.
Assumption:
(1) All monetary calculations based on Canadian dollars @ 1983 exchange rate
$.8CA = $1.US
c. Target Market
The target market for Shouldice Hospital is primarily healthy persons who require low risk inguinal
hernia operations.
The advantage of admitting only
healthy persons is that the percentage of successful procedures is high, while the duration in the
hospital is low, which is important given that the hospital is a nonprofit organization and only the
clinic generates profits. So, by cutting down on the stay of the patient, customer turnover is higher

and costs are substantially reduced. Further, since most patients are ambulatory, linens need not be
changed
3
© 2007–2008 Richard E Murphy
Even Swaps – Shouldice Hospital
18 November 2007
daily and bed pans are not required, so nurses can better utilize their time conducting orientation
programs counseling patients.
d. Staff Considerations
The hospital focuses not only on the

Hospital Budget
Problem Analysis and Budget Impact Financial issues in the healthcare industry are a significant
problem, and there is a need for organizations to take the appropriate approach in resolving their
financial status. One problem that smaller organizations face is the limitation in the budget, which
restricts their ability to invest in a large range of resources. Additionally, the problem further
enhances by the preference of patients to visit bigger institutions that have different benefits,
numerous services, and higher quality services. In essence, larger organizations have an advantage
of a larger budget that allows investment in the service provision. Hence, there is a need for an
accounting department that analyzes the expenditure of the ... Show more content on
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The initial investment will be an expense for the hospital, and there is a need to sacrifice some of the
profits to establish these features. Studies done in a hospital in West China illustrate that TDABC is
efficient in determining the effectiveness of different procedures. Furthermore, numerous
organizations that show that the process is efficient in resource allocation. Firstly, the program will
allow the identification of the most effective procedures and beneficial services. The organization
can invest more money in these activities. Additionally, there will also be an illustration of non–
essential services, which will assist the organization in the reduction of unnecessary expenditure.
The article Implementing Change in a Hospital Management by Padovani et al. (2014),
acknowledges that the Management Accounting System (MAS) is the central possibility of a
healthcare institution reducing its costs. Low–cost information technology allows the organization
to improve the quality of its services at lower prices. This will have a positive impact on the budget
of the organization, and will increase the clientele and improve on customer satisfaction. In essence,
MAS is similar to TDABC and is ideal in the capitalization of beneficial services and reduction of
unnecessary

Acute Hospital Care
Topic: Acute Hospital Care
Course: Health Care and Insurance
Date: November 28th, 2012
Acute Hospital Care
Acute care is medical treatment at a hospital which is short–term. Acute care is a level of health care
in which a patient is treated for a brief but severe episode of illness, for conditions that are the result
of disease or trauma, and during recovery from surgery. Acute care is generally provided in a
hospital by a variety of clinical personnel using technical equipment, pharmaceuticals, and medical
supplies. According to Connecticut public health code that regulates hospitals, an acute care hospital
is defined as a short–term hospital that has facilities, medical staff and all necessary personnel to
provide diagnosis, ... Show more content on Helpwriting.net ...
However, the breakup of acute care services (eg stroke, acute myocardial infarction, respiratory
failure) has removed many consultants from the general medical admitting role and certain
specialties (eg neurology, dermatology) effectively provide no junior– or consultant–level staffing
for this activity in the majority of hospitals. Only 19% of consultants reported having a formalized
acute team in their hospital.
There have been are strain on the increase number of patients who are acutely sick patients. This is
due to more people surviving cancer, heart attacks and stroke and lives on into old age. Nearly two–
thirds of the patients now being admitted to hospital are over the age of 65 and many are much
older. At night or over the weekend acute hospitals mostly have a junior doctor who may be in their
first two years of training as cover. Studies show patient deaths rise by 10% over weekends. In a
survey a third of the respondents said their hospital was "average" at delivering high quality of care
24 hours a day, seven days a week and over 10% said it was "poor".
At the acute hospital all patients deserve to receive safe, high–quality, sustainable care centered
around their needs and delivered in an appropriate setting by respectful, compassionate, expert
health professionals. Yet it is increasingly clear that our hospitals are struggling to cope with the
challenge of an ageing population and increasing

Not-For-Profit Hospital: Lancaster General Hospital
Lancaster General Hospital, founded in 1893 is a not–for–profit hospital. They are a part of
Lancaster General Health and a member of Penn Medicine. This hospital has been recognized
regionally and nationally for clinical excellence and patient safety. LGH offers patients some of the
most advanced health care technology available. The hospital also has the county's only trauma
center and provides a wide range services that are normally found in large urban setting. Their
mission is to "advance the health and well–being of the communities we serve" (Health, 16). They
use a system called EPIC to record patient medical records.
Description of "Lancaster General Hospital"
Lancaster General Hospital is located in downtown Lancaster County. They ... Show more content
on Helpwriting.net ...
One external user includes Center for Medicare and Medicaid Services (CMS). In order for
Medicaid and Medicare to cover a patient's bill, they need to have access to their health information
so they know what care or treatments the patient received. Private insurers need access as well to
cover the patient's bill. The Joint Commission is another external user who has access to this
information. They have "standards" and all hospitals and providers are to abide by these standards.
"The Joint Commission's hospital standards address important functions relating to the care of
patients and the management of hospitals" (Health, 16). They also have unannounced "on site
surveys" to evaluate how well hospitals are managed and review medical reports to see how patient
quality and safety is performed in order to renew or give the hospital's accreditation. "However, to
ensure compliance with all health information–related standards, review of all sections and
monitoring of all pertinent standards that are found is important" (Sayles, 2013). The Electronic
Medical Record Adoption Model (EMRAM) also has access to LGH's health system. It is needed to
track EMR progress used at this hospital. With the advancing technology, LGH has completely
transitioned from the use of paper records to Electronic Records. They

Hospital Restraining
Today started off with caring for all hospital patients and preparing the surgeries for the doctor. To
prepare for the surgeries I clipped the hair on the leg and put in catheters. Then we sedated and
monitored the patient while preparing the surgical site for the doctor. We had two
ovariohysterectomies and a neuter today. Once they were done and the clinic opened we
immediately had to kick it into high gear when a hit by a car came in. We had to give him some
pretty heavy sedatives once he was stabilized so we could do several x–rays which I assisted on
restraining and positioning. Once the x–rays were taken, they asked me to develop them by myself.
It was difficult to maneuver in that dark room and getting the label in the right spot,

Psychiatric Hospitals
The results of the study by Rosenhan were that many of the pseudopatients didn't enjoy being in the
psychiatric hospitals. When the pseudo patients were in the psychiatric hospitals, although they had
no real mental disorders, all of them, except for one, were admitted as patients with schizophrenia,
and discharged with a diagnosis of schizophrenia in remission. Due to the fact that they were
admitted to the hospital so easily, some of the pseudo patients experienced mild anxiety and
nervousness. They also feared that they would be figured out by either the hospital staff, or their
fellow patients. Many of the pseudo patients only stayed in the hospitals for 19 days, and went
completely unnoticed. And the regular actions the sane pseudo patients ... Show more content on
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In the study Rosenhan pointed out that during hospitalization, patients experienced
depersonalization and powerlessness. Hospital staff didn't care enough to know whether or not
paitents swallowd their medication, which they didn't, since there were many pills found in the
bathrooms around the toilets. And many staffs yelled at, mocked, and beat patients who were unable
to speak up for themselves. An explanation for the staffs behavior may have been that they weren't
under the proper surveillance and didn't face any consequences for their behavior. Something that
Rosehan mentioned was the fact that, "staff were credible witnesses, but patients were not" because
the patients were not seen as sane.
The pros of diagnostic labels, as shown in this study, are that they helped the hospitals put the
pseudopatients under a certain category. Since the pseudo patients reported that they were
experiencing certain symptoms and feelings, the hospitals were able to take them in, label them as
schizophrenic and treat them for that mental illness. The cons of diagnostic labeling, as shown in
this study, are that even though the pseudo patients were considered to be sane by the hospitals, they
were still labeled as schizophrenic when discharged,

Shouldice Hospital
Decision Case #13
Shouldice hospital offers an enriched and comfortable experience for patients accepted into the
program for hernia operations. As soon as they arrive at the hospital they are interacted with very
closely. Administrators and surgeons spend time with their patients prior to the operation to ensure
that their needs are met and that their stay at Shouldice is a comfortable and successful one. After a
normal hernia operation at a hospital or another institution, patients are encouraged to check out,
whereas Shouldice recommends a resting period for up to four days to recover fully, with the help of
on–site nurses. This four day period is also a small vacation for patients, which after any surgery is
important in the ... Show more content on Helpwriting.net ...
On the fourth morning, patients were ready for discharge. During the stay, patients were encouraged
to take advantage of exploring the premises and make new friends. Patient's attitudes were the most
important element of the Shouldice program. On many occasions, patients tend to request to stay an
extra day because it is so relaxing. The process in which the patient goes through, the end result
defiantly matches the value and benefits in why people choose Shouldice for this specific operation.
* Tangibles: The Shouldice Hospital contains two facilities in one building–the hospital and the
clinic. On the first level, the hospital contains the kitchen and dining rooms. The second level
contains a large, open lounge area, the admissions offices, patient rooms, and a spacious glass–
covered Florida room. The third level has additional patient rooms and recreational areas. The
recreational rooms range simply from pool tables to an exercise gym. All patients' rooms have no
telephone or television, which is to promote exercising. Patients will then be forced to walk in and
out of their rooms if they would like to use other facilities, with the added bonus of exercising to
help with a quick recovery. The whole hospital is also floored with carpet to offer a comfortable
environment, compared to a hospital where there is a disinfectant tile smell.
* Reliability: Shouldices' reliability has a very good track record from patients who

Healing Hospital
A Healing Hospital
Yashate Manning
GCU
Spirituality in Health Care
HLT–310V
Pauline King
January 27, 2013
A Healing Hospital
Love and compassion, along with providing services to others is just a few components of a healing
hospital. Often time the hospital is where patients are at their weakest state, both mentally and
physically. This environment is a place where diagnosis and treatment of illnesses are implemented
with the use of pharmacologic and technical means. It's vital that the focus remains on the patient as
a whole; therefore the physical and spiritual issues must be equally addressed. Patients could be
placed in a defenseless circumstance upon admission to the hospital; therefore they may feel a sense
loss of their ... Show more content on Helpwriting.net ...
The scripture James 5:14–15: "Is any among you sick? Let him call for the elders of the church; and
let them pray over him, anointing him with oil in the name of the Lord: and prayer of faith shall
save him that is sick, and the Lord shall rise him up; and if he have committed sins, it shall be
forgiven him."5:14–15 (King James Version). It's apparent there is a need for the elders or faithful
people of God to carry out an essential duty of physical and spiritual healing for the sick among
them. Not only will the sick be healed but their sins forgiven; therefore the body and mind both are
addressed and the person would be made whole. A healthy life is a direct result of a thriving
physical, mental, and spiritual state of being. Many people face challenges and illness they have no
control over, but this passage should remind us that prayer and faith does change things. A healing
hospital is the gateway to holistic healing such as, spiritual, mental, physical, and emotional, which
would all be achieved in a healing environment. God did not leave us comfortless; he left his holy
word the Bible to help guide our footsteps along the road of life.
In conclusion a healing environment isn't the building in which persons are enclosed, it's the love
and compassion that fills the air in which makes a healing atmosphere. When patients are sick and at
their weakest point, it's essential that loving staff is there to embrace

The Pain At The Hospital
The pain in my side was excruciating! I had never felt a pain like this before; it would come and go
in waves like something was squeezing at some unknown organ. This had happened twice before,
but the pain had never been as unbearable as this third time. Because of the severity of this "attack,"
I finally decided to go see a professional. We first visited a small clinic, but they were not able to
assist me because they did not have any machines needed for deep body scans. The staff suggested
that we go to the emergency room. When we arrived at the hospital, it did not take long before I was
admitted and taken back to a room. Very soon afterward, I met my primary nurse, who was not very
compassionate, and she took some notes of my ... Show more content on Helpwriting.net ...
Though I was not fully aware of things, I was aware of the doctor and the nurse kicking many of my
family members out of the room so that they could ask me some "personal" questions. After asking
many questions (about things that he did not need to know) about my personal business, he finally
gave up his belief that I was pregnant, and moved on the more likely idea that I had a kidney stone.
The long wait had finally paid off. Soon afterwards, two radiology techs came to my room, and
brought me to have a CT scan done. By this time, I had begun to tremble uncontrollably, and for the
CT scan I had to lay down on a freezing table while the machine passed over me. This did not take
long, and I was soon wheeled back to my room. But before I had been pushed out of the room, one
the techs gave me a blanket to put over the thin sheet I had been using. This was the one act of
kindness that was shown to me during my hospital experience. Hour after painful hour ticked by as
we waited to hear back from the doctor about the test. I could not help but to cry. I was in pain, I
was cold, I was hungry, and it seemed that these people were the exact opposite of urgency. I
realized that it was an emergency room, and the nurses had to also look after other people who were
severely injured. But I could not help but question, "How long does it take to read

Misdiagnosed In Hospital
Things to Consider When You Are Misdiagnosed in Hospital No wise person ever likes to be
himself in a hospital emergency room. When you see yourself in such condition, possibilities are
you have been badly injured or are seriously ill and have big pain. An emergency room remains
filled with patients and inadequate in number of medical staff. This type of challenging atmosphere
can some time contribute to mistakes. When you imagine that your urgent treatment in emergency
room really made you health worse than good, in that case you may be the suffered one of medical
lack of care and should talk with a medical negligence lawyer in an instant. Taking a dynamic role
in your personal health care can help you avoid being a suffered one of medical ... Show more
content on Helpwriting.net ...
This does not imply they are treating negligibly. A patient must be able to confirm that one more
reasonably competent doctor under the similar condition would not have overlooked the right
analysis. It can be not easy when the defendant is a contributing factor in an active patient work.
Wrong or late diagnosis by its own is not a base for any personal injury case. The patient would
need to be able to provide evidence that by not perfectly diagnosing a disease, the situation goes on
and harmfully impacted the way of treatment. An excellent example of this condition would be a
person who sounds off of pain in upper body, is given antiacids and subsequently later gets a heart
failure. Had they been determined the nature of disease correctly, protective measures would have
been considered. As an alternative, they now may get surgical treatment to heart damage. There are
quite a few variables in a health care negligence claim. The most excellent alternative for the patient
is to hire a medical negligence lawyer. A reasonable working example is that of a Missouri teen who
admitted to the emergency room following an auto accident. An infection to a body part could not
be found during treatment and contributed to long lasting brain injury. The court rewarded the
claimant nearly 5 million dollars in compensations. The teen now has long term motor skills and
cognitive skills loss. The money for his upcoming medical expenses was a reason for the court when
setting the amount for

Hospital Diabetes
The role of a hospital diabetes specialist in New Zealand is very important in helping to treat and
manage those with type 2 diabetes. Specifically, diabetes specialists often examine and diagnose
diabetics, recommend medical treatments and work with families or caregivers of those affected,
provide the necessary treatment to patients and follow them up with progress checks, keep patients
diabetes records and coordinate with their family doctor and will often be involved in the research
of the diabetes mellitus disease (Physicians, 2017). Diabetes specialists work may involve caring for
a child with diabetes, which usually involves working closely with families and is therefore
important that the specialists understand the developmental stages ... Show more content on
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Diabetes specialists are specialists for a reason – they are familiar with the nature of the disease and
how to combat or manage diabetes with each individual case. Their responsibility within the
hospital environment is to effect cure and therefore their involvement in the patient's experience in
hospital is very intermittent, intervening with patients in small chunks, leaving most of the care to
the nurses (Gloubermann & Mintzberg, 2001). Their perspective is less centred around caring for
patients or working collectively but more independent in their decision making, following the
direction of the physician profession and working for the interest of the patient. Although diabetes
specialists do talk to patients and offer advice on the management of diabetes, most of their time and
energy goes into administering cure, and the perspective they therefore hold regarding type 2
diabetes services is that what is most important is improving the health of the individual diabetics
they treat, and having the freedom to make the decisions surrounding treatment and management
they feel is in the best interests of the patient (Gloubermann & Mintzberg,

Hospital Failure
Each year between 210,000 and 440,000 patients go to the hospital for care suffers some type of
preventable harm that contributes to their death (Allen). Knowing that so many patients go into a
hospital and never leave due to mistakes made by a physician or nurse is extremely sickening.
Physician and nurses have to sometimes slow down and double or even triple check information that
have entered into patients chart or doses they are about to administer to an patient. I know it is hard
sometimes to slow down because there are so many patients that needed to be attended to at any
given moment. Hospitals now are becoming very crowded and sometimes the patients are in pain as
well as inpatient. Nurses and physician are trying to do their best to ensure that they touch bases
with ... Show more content on Helpwriting.net ...
No certain dollar amount will make the grieving easier. It may help with burial expenses and any
other debts that the love one may have left behind, but it will not fix the emotional pain associated
with losing a love one. As for who should pay for these mistakes, it should be the attending
physician(s) and the hospital. The physician should pay because the care of the patient was in their
hands. It was their duty to care for the patient and provide a standard of care. Their lack of providing
a standard of care leads to patients losing their lives and leaving their families to grieve. The
hospital is responsible because their have to be a way to make sure all the staff are following all
proper guidelines and procedures when it comes to providing patients with proper care. If it takes
assigning people to drop in on surgeries to make sure everyone is scrubbed properly, or double
checking random records to make sure the dosage that are given to patients is correct. Medical
errors are the third–leading cause of death in America, behind heart disease, which is first, and
cancer, which is second

Kaysen In The Hospital
I found this quote to be very accurate, Kaysen being in the hospital she was free for the price of no
privacy, no liberty, and no dignity. For example on page 94, "as long as we were willing to be upset,
we didn't have to get jobs or got to school." In the ward, they had more privileges than I even have
today, no school, no jobs, and no homework. They didn't have to do anything that provided for their
futures. Would life be so bad in a mental hospital after all? All you would have to do is act like your
crazy or pretend you're depressed. If I had this choice I don't think I ever would though, but some
people might. In the hospital you would be stress–free, but all of this has a price. Kaysen was able to
get out of everything except eating and taking medication. ... Show more content on Helpwriting.net
...
In the hospital, Kaysen was free to make any choices as she pleased. Being in there however, meant
being watched 24/7 which is not much freedom in my opinion. In the hospital you were allowed to
wear a belt, have a shaver, and even long fingernails after being there awhile. In the hospital you
had a choice, to recover or spend the rest of your life there. When Kaysen recovered and was let out
of the institution finding a job was very difficult. Where ever she applied to they looked at her past
and saw that she was admitted to the hospital so she often had to try many places. Where ever you
are either in a mental hospital or in the real world you are never really "free" no matter what there
are prices to pay for your considered

Hospital
Hospice
General Purpose of the Department:
As we have learned, the hospice idea is not new. Literally meaning "given to hospitality," hospices
provided comfort, kindness, and nourishment to people in need hundreds of years ago. Today,
hospices offer comfort to people as they near the end of life's journey.
Hospice is a special way of caring for people with terminal illnesses and their families. It is a
multidisciplinary health care program that is responsible for palliative and supportive care with
consideration of the patient's and families wishes. Hospice focuses on care, not cure.
Hospice care is important because it provides many benefits that aren't possible in a traditional acute
or long–term health care setting. Within ... Show more content on Helpwriting.net ...
Special Requirements:
Staff needs to be oriented in the special situations that arise in dealing with a patient in their own
home. Respect for the patient and their surroundings is of utmost importance. Being empathetic to
even the smallest of concerns is the mark of a well–trained care–giver. There must be an emphasis
on maintaining a quality of life that the patient as well as the family feel comfortable with.
Since the patient is treated by such a wide variety of workers, there are weekly case management
meetings which are mandated by Medicare, but often also influenced by hospital policy to ensure
quality of care. It is at this time that information is shared by all who have had contact with the
patient and any concerns are addressed. This helps for the staff to work out their feelings as well –
because in hospice care where you may treat a patient for a year or more, bonds begin to form.
Reports, Statistics, and Records:
I would like to spend a bit of time on this subject in consideration of the nature of our program. As
director of the hospice program, one duty that would fall on you is the compilation of statistics, the
submitting of reports, and the overseeing of the legal medical record.
Since hospice keeps it's own legal medical record on their patients, their relationship with the

medical record department is very limited. If a hospice patient checks in to the hospital, there must
be a release of information from hospice to the hospital

Shouldice Hospital
Shouldice Hospital Case Analysis
Question 1. How successful is the Shouldice Hospital? Generate a P&L statement using available
information from the case. Treat each of the two operations – hospital and the surgery – separately
Compared to other medical institutions that provide a wide array of medical procedures, Shouldice
Hospital specializes in one procedure for patients that suffer from abdominal hernias. This
specialization allows each doctor at Shouldice Hospital to perform approximately 600 hernia
surgeries per year, while doctors at other institutions only perform 25–50 hernia surgeries per year.
As a result, the "Shouldice Method" has been perfected to an unparalleled level for the well–being
of the patient. The ... Show more content on Helpwriting.net ...
Lastly, the doctors experience low turnover, as do the nurses, because they are given opportunities to
learn and improve on their skills via training in the Shouldice technique. In addition to the benefit of
low turnover, proper training and continuous improvement allows for standardization of the method
of operation and minimizes flaws or defects.
Lastly, the success of the hospital is attributed to the facility and the culture it fosters. The hospital
encourages interaction between staff members and patients. Hospital staff is encouraged to eat
together in the dining room and pick up their meals from the kitchen; hospital administrator is
trained to be multi–functional and can pitch in to help one and other during peak times. To
encourage interaction and activity among the patients, the hospital offers acres of gardens, uses
carpeting to avoid the typical smell of disinfectant, modifies the stairways to allow the patients to be
able to climb up after operations, and places entertainment in a common room to encourage patients
to walk around and socialize. These factors help provide an uplifting, supportive environment that
leads to happy staff and healthier patients.
Question 3. Prepare a Process Flow Diagram from arrival through surgery and determine the
capacities at each stage. For this diagram, only indicate major points in the process, e.g., admitting,
examination,

Hospital Falls
Falls among Hospitalized Adults There's an increased rate at which patients fall in hospital settings
are affecting the healthcare industries, patients and family members. According to studies
performed, it is evident that those who are mainly affected are the adults that are over 60 years of
age. Some of the factors that lead to these falls are; visual impairments, wrong footwear and tripping
are some of the external causes of falls among these hospitalized patients. Because this has become
a major concern, research has embarked on how these factors have led to increased falls in these
patients. Adult patients falls are major threat to patients safety and cost management in hospitals
making prevention measures a key area of concern and ... Show more content on Helpwriting.net ...
One patient pays about $30,000 and the price rises because over 810,000 are hospitalized on an
annual basis. The costs are calculated regarding the amount spent in hospitals as well as that which
will be spent at home after discharge to ensure a full recovery. Other expenses are on drugs,
processing insurance covers, and other medical equipment required in treating the patients. The John
Hopkins Fall Risk Assessment has played an integral role in reducing the number of falls. The
toolkit has reduced the number of falls to 20% since it was introduced. The license fees have also
been reduced to $600 thus not hard for anyone to afford (Carrol, Slattum, & Cox, 2005). Clinical
Practice Guideline These falls can be fatal as they have led to many deaths especially when it has to
do with older patients. Because of this, the American Medical Directors Association (AMDA) is a
clinical practice that has been introduced to provide guidelines and principles as well as the role of
nurses in fall prevention (Vance, 2011). The clinical practice has been formulated in a manner that
gives both the nurses involved and the long–term care staff to have a clear comprehension of the
risk factors that are associated with falls among older patients. The systematic approach provided by
AMDA ensures patient assessment and choosing of the best interventions and strategies that will see
to it that the patients receive the

Barclay Memorial Hospital: District Hospital
Barclay Memorial Hospital (BMH) has served its community since 1947 offering the best in health
care and gaining the trust of the citizens in the community. A district board was set up to govern the
hospital and direct it in a way that would allow the hospital to achieve their goals by bringing
quality health care to the neighborhood. The district board was made up of five members who were
elected by residents in the district to serve 3–year terms. Around 10 years ago, the board and the
CEO decided that the best course of action for the hospital in order to remain competitive was to
join a medical group, Valley Physician Group. This made BMH a private, not–for–profit hospital.
However, the physician–hospital organization eventually ... Show more content on Helpwriting.net
...
A good way to communicate this to the surgeons would be to develop a financial plan with the
board to show the surgeons how much more profitable more surgeons would be. While Carson is
developing a financial plan, she should also look to develop a completely new strategic plan for the
company that sets the tone for how the company is going to direct itself for the next 3–5 years. This
is another good opportunity to get the board involved and to make them a part of the conversation of
what direction they want to move the company toward in the coming years. Carson should stress the
companies market position with them and what they could do to improve on that position. Barclay
Memorial is licensed for 400 beds but last year operated only 275 beds with an average daily census
of 249 patients. Despite these low numbers, the number of deliveries last year was at an all time
high with 3,216 and this number is likely to increase the following year. Surgeries also totaled
6,201, which has the potential to increase, if Carson can get the hospital on board with expanding
the number of surgeons at the hospital to handle increasing patient volumes. Orthopedics should
also be a topic of conversation as it is in a position to grow in the future. By looking to improve on
these services, Barclay Memorial can expect to improve on their position in the market. I feel that
involving the board in devising a new strategic plan and allowing them to communicate with the

Hospital Benefits Of Hospital Acquired Infection Essay
Hospital–acquired infection can be devastating not only to the patient, but also to the hospital. This
also impacts how much the facility receives as payment or reimbursement from healthcare insurance
and/or Medicare. Curlej (2016) wrote a quantitative descriptive study about implementing the
guidelines to decrease central line infections. Curlej (2016) conducted the study at a 486–bed rural,
level 1 trauma, teaching hospital in Pennsylvania. This hospital has a 486 bed occupancy, which
means that at a certain time the hospital has this particular number of bed that is "set up, equipped,
staffed, and available for patient care" (Oachs, LaTour, and American Health Information
Management, 2014, p. 488). The patients included in their study were patients with central line–
associated bloodstream infection (CLABSI) admitted to the hospital from July 2007 to June 2010.
The total number of patients included in the study was 76. The author utilized the database of CDC
National Healthcare and Safety Network to obtain the CLABSI rate (p. 291). However, in order to
determine the CLABSI rate of the facility, the researcher has to use observation strategy such as
compliance with specific SHEA guidelines surrounding central line insertion, maintenance, and
education of the personnel. Nurses' documentation were analyzed.
If I were the Director of Health Information, I have to ensure that best practices are used in order to
improve patient care outcomes in the hospital. There are different

Hospital Trips
5.3. The total distance traveled by Nurse Thomas Smith in miles
Nurse Thomas Smith's day includes 6 trips from the nursing station to each of the 12 patient rooms
(back and forth), 20 trips to the medical supply room, 5 trips to the break room, and 12 trips to the
linen supply room.
Nurse Walking Distance = ∑ Distance x Frequency
Distance traveled to the 12 patient's rooms:
6 Trips x 2 (back and forth) x2 x (20+30+40+50+60+70) = 3240
+ Distance traveled to the medical supply room: 20x50 = 1000
+ Distance traveled to the break room: 5x40 = 200
+ Distance traveled to the linen supply room: 12x30 = 360
4800 x 2 = 9600 feet
5280 foot = 1 mile
9600 = X
9600/5280 x 1 = 1,818181818
Therefore 1.82 miles were traveled by Nurse Thomas Smith per day at the Traditional Hospital
layout.
5.4. Miles walked by Nurse Susan Jones during her shift
Nurse Susan Jones's day includes 7 trips from the nursing pod to each of the 12 ... Show more
(b) Signs, symbols and artifacts – Painting some of the hospital walls with common mother and
child artifacts (e.g. cartoon characters or flowers), using children's furniture, having a play area, and
having semi–private rooms for tiny babies with customized pull–down Murphy beds for family
members, will allow patients and visitors to feel at ease and comfortable which will enhance a
positive customer experience of the facility.
(c) Ambient conditions – Using warm colours, having 14–foot ceilings and natural lighting with
over emphasized windows in patient rooms, playing soothing music in the background creates a
positive hospital experience for patients and visitors. Research shows that babies improve and
develop much more quickly with this layout design (Heizer and Render

Healing Hospitals
Healing Hospital's
Every hospital posts their mission statement where the public can read the promising words
describing a caring compassionate health care team that is there for you. But when people show up
looking for that compassionate caring help during their time of need they often find that the medical
staff is sometimes rude, condescending or nowhere to be found. And if that doesn't make you
already feel helpless and scared, toss in some loud overhead messages such as "Code Blue to
emergency". Then you see someone being wheeled around on a gurney looking scared and sick
sometimes with body parts hanging out that should not be because no one took the time to care
about the patients' modesty. If you are not aware that there is a ... Show more content on
Helpwriting.net ...
Therapy programs would need to be evaluated and holistic components need to be added that ensure
overall healing of mind, body and soul. Peaceful, comforting care from staff along with
surroundings designed to focus on stress reduction and healing can begin changes that are necessary
to attain a Healing hospital. Creating healing environments that follows Mission Statement every
day through a holistic, loving and compassionate way of working from the management down can
take up to six months Spirituality and prayer is brought back into health care as an important factor
in the healing process (Geimer–Flanders, 2009).
While health care workers such as myself wait for the rest of the health care population to realize
that healing the overall person is not a new theory, but rather one of the first ways to be healed
according to The Bible, Proverbs 17:22, "A joyful heart is good medicine, but a crushed spirit dries
up the bones" (The Holy Bible, 2001). This is still true in health care today because anyone involved
in health care today can testify to the fact that patients who have some kind of spiritual belief always
feel better even under dire circumstances. And many of us working in an environment that does not
have the words "Healing" attached, can still make a difference by being in a spirituality good place
and by taking care of ourselves so that we may help others in their healing process.
References
Dunn, L., (n.d.) Creating Healing Environments: A

Healing Hospital
Healing hospital: A Daring Paradigm
Thania Arellano
Grand Canyon University: HLT 302
"A healing hospital is a place characterized by thousands of small and wonderful things and a few
big ones. At the center is love. More than anything else, supports a strong culture of caring. It
expresses the deep passion of both patients and caregivers" (Chapman, 2003). Healing hospitals
focus on patient–centered care. Healing hospitals focus on patients on a holistic manner. To build
this type of care for a healing hospital starts with something as simple as the hospital design. The
design of the hospital is very important. Weather there will be a lot of light or not, spacing, and how
that space it utilized. "Historically, healthcare ... Show more content on Helpwriting.net ...
Although the hiring process is though, many employees can be fake and dishonest with their level of
radical loving care, or not even demonstrate radical loving care at all. Since a healing hospital is
filled with spirituality, I believe that having a bible handy is important for the medical staff. If asked
a question about life or healing or any other aspect, the doctor or nurse can reference a bible verse to
make the patient feel more peaceful or tranquil about the stay at the hospital. Proverbs 24:14 Know
that wisdom is such to your soul; if you find it, there will be a future, and your hope will not be cut
off; this specific verse I believe is a good verse to recite to a person who is losing hope, because it is
saying to look within yourself and find the wisdom, which I also think can mean strength, therefore
finding the hope the person needs to continue fighting. In Jeremiah 29:11, which states, for I know
the plans I have for you, declares the LORD, plans for welfare and not for evil, to give you a future
and a hope. This verse is good to give to a patient who is feeling let down by the lord. This is stating
that God has his own plans for each person and in those plans there is no evil. God will not let
anything bad happen to the person, instead he will do anything for the specific person to have hope
for the future and look ahead to a healthy and better life. An example that hope and faith are two
things that

The People's Hospital
The People's Hospital applies corporate governance in the management of the company. The
management and employees of The People's Hospital are guided by set values that determine the
ethics and integrity of each employee. Moreover, the values of the hospital are used in the
determination of the corporate governance in recognizing the responsibilities of patients, employees,
shareholders and the community at large. Excellent corporate governance results from the cohesive
coordination of resources and responsibilities among all entities of an organization. Commitment of
the Chief Executive Officer of the hospital to this objective, in support of all
directors/administrators, shareholders of the hospital results in good governance. However, my
father's health was compromised at People's Hospital, a factor that questioned the adherence to
corporate governance. My father was given wrong medication that worsened his health state and
complicated his recovery process.
More specifically in my fathers case he had to be transferred to the ICU from a medical surge unit in
which he remained for nearly a week. The change in my fathers condition occurred after
administration of a dose of medication that was 3 times the maximum dose authorized by the FDA
and 10 times stronger than the dose he took at home. I was informed at the time of the event that a ...
Show more content on Helpwriting.net ...
The order, or prescription, that was written for the medication had been given by a resident by
phone. A more seasoned nurse had taken the order and imputed it in to the computer. The attending
physician never reviewed the order for accuracy. Furthermore, the pharmacy approved the
medication order at this toxic dose. The system failed my father in every way. There were plenty of
opportunities at every step in the process to prevent this error, but no action was

Memorial Hospital
CASE
MEMORIAL HOSPITAL
The nurses at Memorial Hospital work a regular schedule of four 10–hour days per week. The
average regulartime pay across all nursing grades is $12.00 per hour. Overtime may be scheduled
when necessary. However, because of the intensity of the demands placed on nurses, only a limited
amount of overtime is permitted per week. Nurses may be scheduled for as many as 12 hours per
day for a maximum of five days per week. Overtime is compensated at a rate of $18.00 per hour. In
periods of extremely high demand, temporary part–time nurses may be hired for a limited period of
time. Temporary nurses are paid $15.00 per hour. Memorial Hospital has a policy that limits the
proportion of temporary nurses to 15 percent of the ... Show more content on Helpwriting.net ...
Emergency surgery is scheduled as needed. ‡ Daily equivalents are used to schedule nurses because
patients flow through these wards in relatively short periods of time. A daily equivalent of 5
indicates that, throughout a typical day, an average of five patients are treated in the ward.
continued
continued
TABLE C11.2 Average Daily Patient Census per Month
MONTH WARD J F M A M J J A S O N D
Intensive care Cardiac Maternity Pediatric Surgery* Post op† Emergency† General
13 18 8 22 20 10 6 110
10 16 8 23 18 8 4 108
8 15 12 24 18 7 4 100
7 13 13 24 17 7 7 98
7 14 10 25 16 6 8 95
6 12 8 21 16 6 5 90

11 13 13 22 22 10 5 88
13 12 13 20 21 10 4 92
9 13 14 18 17 7 4 98
10 15 10 20 18 8 3 102
12 18 8 21 20 9 4 107
14 20 7 19 22 10 6 94
* Average surgeries per day. † Daily equivalents.
After looking over the information that she has collected, Darlene Fry decides that it is time to roll
up her sleeves and get started. She wants to consider staffing changes in all areas except the surgery
ward, which is already correctly staffed. Questions 1. Explain the alternatives available to Darlene
Fry as she develops a nurse staffing plan for Memorial Hospital. How does each meet the objectives
stated by the CEO?
2. Based on the data presented, develop a nurse staffing plan for Memorial Hospital. Explain your
rationale for this plan.

Healing Hospital
Healing Hospital: A Daring Paradigm Sandra Mays Grand Canyon University HLT310V Patricia
Mullen September 12, 2010
Healing Hospital: A Daring Paradigm
The spirituality in a healing hospital starts with the Chief Executive Officer and spirals downward
toward management, and then the frontline employees. Healing hospitals must have a form of
culture that serves the community. This includes the building, its contents, the CEO, the managers,
and caregivers. This is what leads to the care that entails the spiritual mixture that takes into account
a person's whole body, which includes the mind and spirit. Healing and spirituality should be at the
forefront of each patient's ... Show more content on Helpwriting.net ...
Patients are sometimes placed on medications that cause variations in their temperatures. Does the
staffing limits allow for the staff to provide spiritual time for the nurse– patient load? Many nurses
cite increased patient loads as a hindrance to providing spiritual care to their patients. (Healthcare
staff). The benefits of creating a healing environment are improved patient satisfaction, Better
patient outcomes, a decrease in employee turnover, increased scores from JACHO (Joint
Commission on Accreditation of Hospital Organizations) and improved financial stability. One can
also reap the benefit of working in an environment filled with a compassionate staff (Chapman,
2010). Without CEO support the iniative of a healing hospital would be impossible. This iniative
has to have deep leadership commitment. The idea of a healing hospital is different for some CEO's
due to the required rethinking of the hospital's fundamental mission. Most CEO's spend a
tremendous amount of time hearing financial reports and business plans, and reviewing minutes
from previous meetings. Clearly all these activities have their places, but CEO's have to start to
think of their frontline staff members and not their financial reports. The medical staff is a harder
task to encourage starting the use the art of loving care. Most doctors already believe they are
engaged in

Hospital Mergers
There has been an increase of mergers between hospitals throughout the nation. Two hundred and
nine transactions of mergers and acquisitions were conducted just between 2010 and 2013. (Budryk,
2014) It is controversial weather mergers in healthcare are of benefit to the community.
Some may argue that the mergers are in fact good for hospitals and patients alike. The expansion of
the hospitals and their services lead not only to the increase of the bottom line for the hospitals but
also improves healthcare services for the patients. (Pear, 2014) On the other hand, the Federal Trade
Commission Act of 1975 Section 5 of the Federal Trade Commission Act (15 U.S.C.A. § 45),
prohibits "unfair methods of competition" and gives the Federal Trade Commission ... Show more
One patient's evaluation may vary greatly from another, which makes it even harder for the
healthcare providers to determine the cost of treatment. The insured population has dramatically
increased since Affordable Care Act (ACA) came in effect, now there are even more healthcare
systems mergers and private practice acquisitions. Hospitals and physician practices creating
Accountable Care Organizations (ACO) where they are working together for more coordinated care.
However, the patients themselves have little to none access to the quality and price information for
comparison when it comes to choosing

Preventing Hospital-Acquired Infections In Hospitals
ealth care. Without all hospitals rigorously following the procedures needed to prevent hospital–
acquired infections, this problem continues to affect a great amount of Americans. Due to the spread
of infection in hospitals, it has contributed to an overuse of antibiotics leading to antibiotic
resistance and an increase in deaths among patients, consequentially decreasing the effectiveness of
health care in America.
The overuse and misuse of antibiotics contributes to antibiotic resistance, which persists as a
problem because it can further result in a patient's death. Inpatients are frequently affected by
infections in hospitals and antibiotics are given to treat these patients. However, due to the overuse
and misuse of antibiotics in ... Show more content on Helpwriting.net ...
This problem creates a vicious cycle for Americans because infections among patients lead to the
overuse of antibiotics, in turn creating more antibiotic resistance, which can lead to death among
Americans. Infection cannot only physically kill patients, but can kill them financially as well.
Overall, this problem needs to be addressed more closely by Americans in order to make a slight
difference in changing the health care

Healing Hospital
The Healing Hospital Paradigm The inception of the "Healing Hospital" is not new. Healing
hospitals in various forms have been around throughout history. As hospitals were slowly taken over
by religious orders they became more holistic concentrating on all aspects of healing including
physical, mental, and spiritual. Instead of focusing on the patient as a carrier of disease and death
they began to look at them as a person that has certain fundamental needs for existence. One of
these needs as fore mentioned is spirituality. Spirituality simply defined "is that which relates to or
affects the human spirit or soul as opposed to material or physical things. Spirituality touches that
part of you that is not dependent on material things or ... Show more content on Helpwriting.net ...
In a healing hospital these three components and taken very seriously from the CEO down to the
newest person in training. In a Healing Hospital everything depends upon giving love
unconditionally. Loving care means helping other people no matter what. (Chapman, 2007, p. 56)
This may all sound easy to do but the reality are that we are used to a task oriented environment
with only 5 minutes to do a job that if done properly actually takes 10 minutes. We are so
concentrated on getting as much done as possible in the shortest time possible to complete our tasks
in the allotted shift time that we take shortcuts such as yelling down the hall to the CNA that you
need help in 506, Cutting across the lobby with a patient instead of using the patient elevator. These
along with a multitude of what we consider minor inconveniences to our patients actually begin to
add up very rapidly in their eyes. Things like drawing blood in the middle of the night for routine
labs, passing out trays a little late, being told your MRI will be at 10:00 am and still waiting at
17:00. These inconveniences increase the patients stress levels and hinders proper healing while
disrupting their sense of spiritualty. Jesus went throughout Galilee, teaching in their synagogues,
proclaiming the good news of the kingdom, and healing every disease and sickness among the
people. News about him spread all over

Hospital Management : Hospitals And Hospitals
Hospitals are health care institutions that offer varying rages of acute, convalescent and terminal
inpatient care as a result of acute and chronic conditions arising from diseases and injuries 24 hours
a day 7 days a week. Hospitals of yesteryear originated as an institution for the poor, mentally ill
and the homeless. They really didn't provide elaborate care or treatment because of the limited
amount of true medical knowledge that was available. The middle class avoided hospitals and chose
to receive their care at home. The 1900's brought about scientific method in medical practice which
was the beginning of the hospital environment that we know today. Currently, most hospitals are on
the forefront of technology and clinical medicine and often provide the most complex of care to the
most critically ill patients. Many hospitals provide a wide variety of outpatient services to help them
compete. Hospitals can be for–profit or not–for–profit entities. Some hospitals are owned and
operated by local or state government while others are owned by one entity while operated under
contract by another entity such as a hospital management company. Some hospitals provide
specialty services while others continue to offer a broad range of generalized services. Hospitals
come in all sizes, however, the larger institutions are typically associated with medical schools and
are deemed as teaching hospitals. Smaller hospitals are usually found in more rural areas and are
often threatened

Hospital Volunteering
In my community many people do not understand the struggles of kids with serious illnesses and the
financial and mental toll it has in the parents. To have more understanding of the problem I
encourage people to volunteer at hospitals to gain more knowledge about the problem.
Visiting a hospital and seeing what the children need or playing with them makes them very happy.
Volunteering at a hospital lets me see the hospital from an insider's perspective. I am considering a
career in a health–related field, volunteering at a hospital provides me with the chance to work with
medical professionals and see what their jobs are like in the real world. My first day at the children's
hospital was very warm and accepting. I was very anxious to meet the

Hospital Scenarios
Maggie Solis (approaching both Officer Myers and Officer Ramirez): Both children seem to be Ok,
but we'll need to transport them to the Hospital for a full medical evaluation. Will Child Protective
Service be at the Hospital?
Officer Myers: Yes, they will be dispatched to the Hospital in fact, CPS will be there by the time
you arrive.
Maggie Solis: Great, then were on our way.
Scene 2: Maggie Solis and Lucinda Doe arrived at the Hospital with the children. Maria Moreno
from the CPS department was waiting for them at the main Hospital entrance along with two
Special Victim's Investigators, Raul Ponce and Simon De la Fuente who were assigned to
investigate the case. The investigators will go back to the house to investigate and the children are
taken to a private room where they will be ... Show more content on Helpwriting.net ...
Rodriguez (addressing to Maria Moreno): Before I can let you question the children, I have to do a
series of testing to make sure they are stable and healthy.
Maria Moreno: That's fine with me, I understand Dr.
Dr. Rodriguez went in the examining room along with a lab technician to examine the children. The
Dr. examine them from head to toe and concluded there were no broken bones, bruises, or any
visible trauma inflicted on the children. The lab technician then took some hair, saliva and blood
samples from the children and a couple of hours later all test were done, the results left everyone
puzzled.
Maria Moreno: What's wrong Dr. Rodriguez? What is it? Can you please for god's sake tell me
what's wrong?
Dr. Rodriguez (puzzled and scratching his head, turns to Maria): The tests can't be wrong, we ran
them again and again.
Maria Moreno: What do you mean the test are wrong?
Dr. Rodriguez: I can't explain it, we took blood samples from the children and ran the tests, but the
results came back from a dead person and not just a dead person, but someone who has been dead

for some time.
Maria Moreno: What do you mean a dead person? You must of have ran the wrong

Analysis Of The Hospitals
From analysis over 200 hospitals in Southern California from 2010–2014, I have found that the
varying sizes of the hospitals have a significant impact of the facilities' expense composition. There
were three primary expenses that seemed to have a strong correlation with each other and hospital
size: Salaries expense, Purchased Services, and Other General expenses. Taking note of these
factors have not only show their impact, but will help hospitals realign their financial objectives to
ensure they have continuing success.
II. Salaries
Salaries expense is a larger proportion of overall expenses for larger hospitals relative to small and
medium–sized ones. Keeping factors such as teaching status and hospital location constant, large ...
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Teaching hospitals have a higher demand for PhD's, which also comes with a higher pay grade. For
teaching hospitals, larger hospitals had a smaller proportion of salaries expenses relative to smaller
hospitals. However, larger hospitals have a slightly higher overall salaries expense for non–teaching
hospitals. This may indicate that large non–teaching hospitals are not as efficient with their salaries
expenses as large teaching hospitals.
III. Purchased Services
Analysis of the sampled hospitals' purchased services showed that smaller hospitals spend more
money on these services than larger hospitals. Holding all other factors equal, smaller hospitals
spend on average 2% more on purchased services than larger hospitals. The gap between the two is
possibly due to the fact that smaller hospitals do not have as much technology and equipment as
larger hospitals, which gives them more limitations. For example, larger hospitals may have access
to their own HR services or facility support services such as a food cafeteria. Conversely, smaller
hospitals not have this privilege, and are forced to outsource these services out to a HR company or
food caterer. Another factor that impacted the salaries expense was teaching status. Non–teaching
hospitals purchased services expense averaged nearly 2% more than teaching hospitals. There are
two potential factors that are driving this statistic. The size of the hospital has a strong correlation
with its teaching status.

My Reflection Of A Hospital Admissions To Mercy Hospital
1/3/2017 at 1:30, I arrived at the structure in question but the door was locked. I then headed to
Mercy Hospital which was across the street. I asked personnel in hospital admissions to please assist
me in contacting someone that was in charge of building and grounds at the hospital. They contacted
Mr. Lloyd McFerran (Director of Facility Services) who was out to lunch but asked that I wait for
his return.
After about 35 minutes Mr. McFerran returned to the hospital and stated that the building was built
in the 90's and had no asbestos. I asked Mr. McFerran if an asbestos survey had been completed on
that building he said that he would have to check. He stated that the building had been surveyed for
mold recently (but not asbestos)

Closure Of Hospital
I was surprised to see how beautiful the hospitals are. They look gothic and solid. The mental
institutions look really expensive to build and the size is incredible. Even though the hospitals
housed many patients, they were forgotten because patients were out of society's view. They did not
live in the larger society. It is shocking that some psychiatrists think they were helping patients get
care. Some of the psychiatrist' attempts were barbaric. Patients were even being mistreated by some
hospital staff. Watching the documentary, I was surprised because the patients' experiences at the
mental hospitals were traumatic. Additionally, something that stood out to me was that drugs may
have played a role in keeping mental institutions open. ... Show more content on Helpwriting.net ...
Treatments in the past have been unsuccessful in curing patients' mental illness. The terrible
conditions in the hospitals led to the search for more humane approach to help patients get better.
The justification for mental institutions were questioned. As both the American and British mental
institutions utilized drugs to help patients get better, they still live behind bars. As described in the
textbook, the United States' mental healthcare system is very dependent on government budget.
When the government cut the funding, many hospitals struggle to keep the facilities running. The
same is true with the British mental healthcare system, as discussed in the video. Many patients
were misfits of society. They were neglected and the hospitals seem to be the only place to get care.
But, they ended up being dirty and the patients were mistreated by staff of the hospitals. Most of the
psychiatric care in both countries are similar. Mental health became the general hospitals'
responsibility as the asylums were being closed and patients went back into society. The British
asylums and the United States' mental hospitals did share many commonalities. The Americans had
a moral movement that focused on legal rights and protection for the patients. In the 1950s, the
British had a similar movement. Also, the British had the user movement, where patients can have
more input about the treatments they receive, as is discussed in the video. In Britain, grassroots
efforts sprang up for patients to have more say in the treatment options, the way it is in modern day

Hospital Admissions
Hospital admissions account for the largest component of health care expenditures (Centers for
Medicare and Medicaid Services (2011). In the past several decades, the critical decisions for
determining need for hospitalization have been increasingly made by emergency medicine (EM)
physicians (Schuur & Venkatesh, 2012). In view of the impact of hospital admissions, both hospitals
and physicians are increasingly encouraged to find alternatives that are less costly. Nevertheless,
perhaps wary that non–clinical factors may adversely influence EM physician decisions, in October
2015, the American College of Emergency Physicians (ACEP) published a policy statement
regarding Emergency Physician Rights and Responsibilities. An important stated ... Show more
After adjusting for patient and clinical characteristics, the hospital–level admission rate varied from
27% to 41% and the physician level, admission rates varied from 21% to 49% (Abualenain, et al.,
2013). Similarly, Gutterman, J.J., Lundberg, S.R., Scheib, G.P., Richman, M.J., Wang, C–J., &
Talan, D.A. (2016) found highly variable admission rates (15.2–32%). Although these correlated to
Medicaid denied payment day rates, the variance was unexplained by known confounding clinical
variables and unrelated to the quality of care. Interestingly, attending physician estimates of their
admission rate ranged from 7–33% with 71% overestimating and 24 % under estimating their own
admission rate and there was no significant correlation between actual and self–described admission

Shouldice Hospital
OPERATIONS MANAGEMENT
CASE 1 – Shouldice Hospital
Introduction Shouldice Hospital, set up in 1945 by Dr. Earl Shouldice, is located near Toronto. It
follows the business model of focus on a single standardised service for a narrow target of
consumers, rather than to provide customised solution (as in a general clinic or hospital). It focuses
on providing quick, convenient, and reliable cure for external types of abdominal hernias. The
Hospital uses its own technique, called the Shouldice Method. It is famous for a relatively short
post–operative recovery period.
Description
1. Shouldice Hospital provides low–cost medical service in its area of specialization. Use of the
Shouldice Method allows patients to recuperate fast ... Show more content on Helpwriting.net ...
Free Service to clergy and family members
13. Out–of–town patients were diagnosed online using the medical information questionnaire,
saving $200–$400
14. Recovery time for patients is 1–4 weeks, as compared to 2–8 weeks in other hospitals
Process Flow Diagram
Process Analysis using Cost and Capacity
A: Cost Analysis
Budget for the Hospital: $ 2.8 million
Budget for the clinic: $2 million
Therefore, Total Budget = Budget for the Hospital+ Budget for the clinic = $2.8 million + $2
million = $ 4.8 million
Number of operations per year = 6850 (considering the same as for the year, 1982)
Therefore average cost per operation = $4.8 million/6850 = $701
Total charge to the patient = Hospital stay + Surgical fee + Assistant surgeon fee + Anesthetic fee =
111*4 + 450 + 60 +75 = $1029
Net profit per patient = $(1029–701) = $328

B: Capacity Analysis
The critical resources in this case are:
• Number of operation theatres
• Number of hospital beds
• Number of staff (including surgeons, assistant surgeons and nurses)
These resources are tabulated as under:
Resource name Availability Max. capacity per week
Operation Theatre 5 185
Number of beds 117 152
Number of surgeons 12 357
For details of calculation of the maximum capacity, please refer to points 1, 2 and 3 below.
1. Average number of operations per day = 27(See Appendix A above)
Number of critical operations performed = 18% of total

Hospital Vs Non-Profit Hospital
I chose to compare the operation management between the for–profit hospitals to non–profit
hospitals. I chose this topic because I have worked for both. My degree is going to be Associates of
Occupation Health for Medical Billing and Coding. I am also a License Practical Nurse. In Fort
Smith were I last worked we had a private owned hospital, Non–profit hospital and a community
owned hospital. People had a choice on where to go. Around here in Tulsa there are multi hospitals
to choose from.
When you go to a hospital it is very important to pick the right one for your family. Unless you have
a HMO plan that tells you which one to choose, you can go to any hospital in the area. It is best to
check with your insurance company to see which one is in your network. It is always best to go with
you're the hospital in your network. The difference between these hospitals are that Community
based hospital is financial supported by the community. The one in the Fort Smith area was Summit.
The county was the one to start it to help with the low income families in the northern area close to
Van Buren. It was not big and had bare minimum medical services. The taxes in the area help start
and continue to support the hospital. We don't have a lot of community based hospital in the United
States ... Show more content on Helpwriting.net ...
The ambulance took them to Sparks. Because Sparks Regional is known for their Heart Center.
Sparks emergency physician stabilized the patient then put back into ambulance to send to Mercy.
The patient did not have a great insurance plan. It was one of those plans that had $5000.00
deductible. The patient had another heart ache in the ambulance on the ride over. He almost did not
make it. It was just a 30 minute drive. The EMT was working on him pretty much the whole way
over. The patient lived but nothing happen to that doctor or Sparks. They still have the same

The Difference Between Hospital And Hospital
Payal Otia
Professor Della Corna
English M02
4 October 2017
Live or Die
Hospital and clinic are two types of health care system that are undeniably different from each other.
However, both institutes, differ due to the differences in their nature. Clinic is health center
consulting private room beginning with a physician. A hospital is place where the sick and injured
are taken for treatment. The doctors and nurses are readily available there for attending on their
patients. They are employed by the hospitals to nurse the sick back to health.
Both hospital and clinical have big differences between each, some examples include: Size–
clinicals are smaller than hospitals and hospitals are larger than clinicals and, Staffs– clinicals are
always runned by few practitioners and hospital has many doctors, nurses and other medical techs.
However, clinical mainly treats outpatients and, are not open twenty four hour a day. Whereas
hospitals treats both inpatients and outpatients with open service of twenty four hour a day. Clinicals
are not provided with more departments whereas hospitals concludes of different departments with
different treatments.Deaths take place in the hospitals. On the other hand, deaths do not take place in
the clinics. "Even if a patient comes in a serious condition, the doctor at the clinic quickly transfers
him to the nearby hospital" (Difference between). Clinics normally do not have emergency kits. On
the other hand, all hospitals have emergency kits

Hospital Readmissions

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