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Planning and cost analysis of digital radiography services for a network of hospitals (the Veterans Integrated Service Network)

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JOURNAL OF TELEMEDICINE AND TELECARE 1998年第3期4卷 172-178页

作者： Duerinckx, AJ Kenagy, JJ Grant, EG Univ Calif Los Angeles Serv Radiol W Los Angeles Vet Affairs Med Ctr Ctr Med Los Angeles CA 90073 USA Univ Calif Los Angeles Med Ctr Dept Radiol Los Angeles CA 90024 USA Vet Integrated Serv Network Desert Pacific Healthcare Network Long Beach CA USA

This study analysed the design and cost of a picture archiving and communications system (PACS), computerized radiography (CR) and a wide-area network for teleradiology. The Desert Pacific Healthcare Network comprises 10 facilities, including four tertiary medical centres and one small hospital. Data were collected on radiologists' workloads, and patient and image flow within and between these medical centres. These were used to estimate the size and cash flows associated with a system-wide implementation of PACS, CR and teleradiology services. A cost analysis model was used to estimate the potential cost savings in a filmless radiology environment. ATM technology was selected as the communications medium between the medical centres. A strategic plan and business plan were successfully developed. The cost model predicted the cost-effectiveness of the proposed PACS/CR configuration within four to six years, if the base costs were kept low. The experience gained in design and cost analysis of a PACS/teleradiology network will serve as a model for similar projects.

关键词：加利福尼亚费用效益分析医院费用医院间共用服务医院退伍军人/组织和管理洛杉矶规划技术放射科医院/经济学放射科医院/组织和管理放射学信息系统/经济学放射学信息系统/组织和管理远程放射学/经济学远程放射学/组织和管理工作负荷量人类

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A TOTAL INFECTION CONTROL PROGRAM - 6 ELEMENTS MAKE IT WORK

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AMERICAN JOURNAL OF INFECTION CONTROL 1980年第2期8卷 51-57页

作者： PAPPAS, SA KRAUSE, SL Hines Ill.

The infection control program at Veterans Administration Edward Hines Jr. Hospital has evolved from one of predominantly surveillance and education to the multifaceted one that exists today. This program is composed of six elements: surveillance, education, consultation/liaison, epidemiologic (special) investigations, research, and evaluation. Since these elements were identified and formalized in 1976, we have found that any of our activities are easily incorporated into one of these categories. We believe that the integration of these six elements is necessary and provides the framework for a total, effective infection control program which will provide improvement in the quality of health care. The establishment and implementation of an effective infection control program requires persistence, creativity, a good educational preparation, an inquisitive mind, diplomacy, tact, and, most important, a commitment to the delivery of quality health care.

关键词：交叉感染/预防和控制医院病床数 500张以上医院退伍军人/组织和管理伊利诺伊在职培训人员医院/教育卫生保健质量人类

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EXCHANGE OF VETERANS AFFAIRS MEDICAL DATA USING NATIONAL AND LOCAL NETWORKS

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ANNALS OF THE NEW YORK ACADEMY OF SCIENCES-SERIES 1992年第1期670卷 50-66页

作者： DAYHOFF, RE MALONEY, DL Washington Information Systems Center Department of Veterans Affairs 8403 Colesville Road Suite 200 Silver Spring Maryland 20910

Remote data exchange is extremely useful to a number of medical applications. It requires an infrastructure including systems, network and software tools. With such an infrastructure, existing local applications can be extended to serve national needs. There are many approaches to providing remote data exchange. Selection of an approach for an application requires balancing of various factors, including the need for rapid interactive access to data and ad hoc queries, the adequacy of access to predefined data sets, the need for an integrated view of the data, the ability to provide adequate security protection, the amount of data required, and the time frame in which data is required. The applications described here demonstrate new ways that the VA is reaping benefits from its infrastructure and its compatible integrated hospital information systems located at its facilities. The needs that have been met are also needs of private hospitals. However, in many cases the infrastructure to allow data exchange is not present. The VA's experiences may serve to establish the benefits that can be obtained by all hospitals.

关键词： CD-ROM 临床药学信息系统/组织和管理计算机通信网络/组织和管理诊断显像卫生服务需求医院信息系统/组织和管理医院退伍军人/组织和管理机构间关系病案连锁病案系统计算机化多机构系统/组织和管理办公室自动化病人转诊人群监测转诊和会诊登记软件远程医学美国

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STRATEGIC-PLANNING IN PATIENT EDUCATION - A KEY ELEMENT OF SUCCESSFUL MANAGEMENT

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PATIENT EDUCATION AND COUNSELING 1988年第1期11卷 65-73页

作者： CORDELL, BJ LINNELL, KE PRICE, JL VET ADM INTERWEST REG MED EDUC CTR NW FIELD OFFPORTLANDOR VIRGINIA MASON CLIN SEATTLEWA

Strategic Planning is a useful technique for patient education planning in health care facilities. The consultants to the planning process at a Veterans Administration Medical Center outline the lessons of strategic planning in an effort to guide and encourage newcomers. The Seattle VA Medical Center planning outcomes are described to emphasize the benefits. The authors enthusiastically recommend strategic planning as a management tool for patient education committees.

关键词：医院病床数 300至499张医院退伍军人/组织和管理病人教育(主题)/组织和管理规划技术专家委员会/组织和管理华盛顿

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AN ANALYSIS OF DECISION-MAKING IN DISCHARGE PLANNING

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EVALUATION & THE HEALTH PROFESSIONS 1990年第1期13卷 121-142页

作者： WEAVER, FM BRYANT, FB LOYOLA UNIV CHICAGOIL 60611

A repeated-measures design was used to examine medicalprofessionals'discharge planning strategies. Physicians, residents,nurses, and social workers were presented with 16 hypothetical case scenarios and asked to: (1) rate the appropriateness offour discharge options (nursing home, community nursing, adult day, and outpatient clinic care), and (2) select the most appropriatedischarge plan for each case. Four within-group variables were included in the scenarios: physical impairment, caregiver availability,follow-up required, and patient compliance. Decisions were greatly influenced by caregiver availability. When a caregiverwas available, respondents preferred community-based options (i.e., community nursing care or outpatient clinic); if the caseinvolved complications (i.e., severe physical impairment, heavy follow-up, noncompliant patient), they considered communitynursing care more appropriate than outpatient clinic. When a caregiver was unavailable, respondents preferred institution-basedoptions (i.e., nursing home or adult daycare); if there were complications, they considered nursing home more appropriatethat adult daycare.

关键词：出院后医疗/统计学和数值数据方差分析决策评价研究医院退伍军人/组织和管理医务人员医院模型理论多元分析护理人员医院病人出院问卷调查美国人类

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Performance improvement through self-paced learning.

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Journal for healthcare quality : official publication of the National Association for Healthcare Quality 1997年第4期19卷 26-28,33页

作者： Wehlander, T. Overton Brooks VA Medical Center Shreveport LA United States

Organizations are facing the economic challenges of managed care while employees are facing the domino effect. Both are having an arduous time with changes in healthcare delivery. Employees don't automatically fall into line with strategic plans for organizational change. They need current information and assistance into obtaining the necessary training related to their jobs. How does a medical center help employees to integrate the organization's mission, vision, and values into all work processes in ways that meet their needs? Adult learners need to know why they need to grasp the concept of managed care and how they can apply it on the job.

关键词：效率组织医院退伍军人/组织和管理医院退伍军人/标准在职培训/组织和管理路易斯安那管理医疗规划组织文化组织改革人员医院/教育职业病人关系规划制订质量保证卫生保健/组织和管理人员开发/组织和管理

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Reorganization and quality management of psychiatric and substance abuse patients.

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Journal for healthcare quality : official publication of the National Association for Healthcare Quality 1998年第6期20卷 21-23,32页

作者： Mozdzierz, G.J. Greenblatt, R.L. Snodgrass, R. Sladen, B. Jameson, D. Hines VA Hospital USA.

We conducted a study in the mental health and behavioral sciences program at Hines Veterans Administration Hospital to determine if a recent reorganization of the mental health services had resulted in the efficient use of treatment resources according to patients' needs. The Brief Symptom Inventory was used to assess symptomatology when patients were admitted to the inpatient psychiatry, dual diagnosis, or substance abuse lodger units. The results indicated that the groups differ significantly from one another on eight of nine symptom dimensions and on all three global indices of psychopathology. The results also reinforced the supposition that patients are receiving appropriate treatment and that resources are being used efficiently.

关键词：行为医学/组织和管理行为医学/标准诊断双重(精神病学) 效率组织医院改组医院退伍军人/组织和管理医院退伍军人/标准伊利诺伊管理审计精神障碍/病理生理学精神障碍/治疗方案评价精神病科医院/组织和管理精神病科医院/标准心理学试验物质相关性障碍/病理生理学物质相关性障碍/治疗全面质量管理/组织和管理人类

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Complying with Joint Commission nursing standards: practical documentation tools.

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Journal for healthcare quality : official publication of the National Association for Healthcare Quality 1992年第1期14卷 24-29页

作者： Miller, D.H. Carl T. Hayden VA Medical Center Phoenix AZ United States

The need for accurate and complete documentation of nursing care has grown as hospitals seek to comply with the new requirements of the Joint Commission on Accreditation of Healthcare Organizations. As of January 1991, the Joint Commission implemented standards for nursing services that include documentation of the planning and delivery of nursing care. While the new JCAHO standards do not call for a separate nursing care plan, they nevertheless involve enough changes to require modification of most currently used documentation forms. This article describes the methods used to design new forms at the Carl T. Hayden Veterans Affairs Medical Center in Phoenix, AZ. The newly developed forms are reviewed and compared with the Joint Commission's new standards and scoring guidelines.

关键词：亚利桑那文献工作/标准表格和记录管理/标准医院病床数 300至499张医院退伍军人/组织和管理医院退伍军人/标准卫生保健组织鉴定联合委员会病案/标准护理估计护理记录/标准护理部医院/标准病人入院病人医疗护理计划/标准病人出院/标准质量保证卫生保健/组织和管理美国

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Development of a social work case management guideline and model.

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Journal for healthcare quality : official publication of the National Association for Healthcare Quality 1997年第5期19卷 37-42页

作者： Bialk, B.S. Van Horn, E. Department of Veterans Affairs National Center for Cost Containment Milwaukee WI United States

This article describes the process that a team of Department of Veterans Affairs social work service department heads went through as they developed national guidelines for social work case management. Many of the con... 详细信息

关键词：算法病例管理/组织和管理病例管理/标准病人医护连续性医院退伍军人/组织和管理医院退伍军人/标准管理医疗规划/标准模型组织管理质量指标卫生保健社会工作科医院/标准美国美国退伍军人事务部人类

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Using beepers to keep family members involved in the patient's care.

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Journal for healthcare quality : official publication of the National Association for Healthcare Quality 1997年第3期19卷 32-36,39页

作者： Morehead, K.A. Hunt, D.M. Oklahoma City Veterans Affairs Medical Center United States

The 1994 Veterans Health Administration (VHA) National Customer Feedback Survey of 43,594 recently discharged inpatients revealed that problems relating to emotional support were reported two to three more frequently by VHA patients than by patients in the private sector. The scores related to emotional support that were reported by 130 Oklahoma City Veterans Affairs Medical Center surgery respondents were the facility's least favorable scores in benchmark comparisons with all VHA surgery patients and with surgery patients at Picker Institute, a nonprofit, private sector research and education organization. These scores prompted the initiation of a successful program to loan radio and digital beepers to patients' family members.

关键词：觉知效率组织家庭/心理学卫生保健调查医院通信系统医院退伍军人/组织和管理医院退伍军人/标准俄克拉何马病人医疗小组病人满意度职业家庭关系规划制订全面质量管理人类

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