{"title":"Quality assurance and medical information processing.","authors":"H K Selbmann","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Quality assurance of medical care is a process designed to improve quality of health care delivery by eliminating deficiencies. Since every quality assurance process starts with the assessment of quality and the recognition of deficiencies, quality assurance is in the first place a problem of information: if one does not know the inadequacy of the own care, one has no idea that it should be improved. Therefore, appropriate quality indicators differentiating between good and bad medical care and functioning information systems with or without computers are basic prerequisites for the assurance of quality. Additionally, external comparisons of the hospital's own data with the data of other hospitals stimulate the efforts of quality assurance committees. Computer based hospital information systems may be valuable tools to support quality assurance processes. However, further research and development of quality monitoring systems, practicable medical and economical quality indicators, and decision supporting techniques will be necessary to meet all requests of the quality assurance professionals.</p>","PeriodicalId":79547,"journal":{"name":"Acta hospitalia","volume":"31 2","pages":"5-10"},"PeriodicalIF":0.0,"publicationDate":"1991-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20983743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A report of the main aspects and problems of the Greek National Health System.","authors":"S Konstantinou","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":79547,"journal":{"name":"Acta hospitalia","volume":"Spec No ","pages":"65-8"},"PeriodicalIF":0.0,"publicationDate":"1991-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20985437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Proposed changes in the UK health-care system.","authors":"G N Green","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":79547,"journal":{"name":"Acta hospitalia","volume":"Spec No ","pages":"57-63"},"PeriodicalIF":0.0,"publicationDate":"1991-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20985436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A review of nursing manpower issues.","authors":"D McKenzie","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This paper, presented by the E.C. Hospital Committee's Sub-Committee on Economics and Planning, reviews what is regarded by many as a crisis in hospital nurse manpower in the 1990's. Indeed, there are signs that the problem of recruiting sufficient qualified staff had already arrived in some places in the latter part of the 1980's. So what is the nature and extent of the problem? Information has been gathered about population, as it affects demands on health care and as a source of potential health service employees. The current position of nurse staffing has been investigated and is discussed together with indications from member states of ways of tackling the problem to safeguard the quality of patient care to which the member states are committed.</p>","PeriodicalId":79547,"journal":{"name":"Acta hospitalia","volume":"31 2","pages":"51-5"},"PeriodicalIF":0.0,"publicationDate":"1991-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20983744","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Hospital services in Ireland and how they have evolved.","authors":"D J Doherty","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":79547,"journal":{"name":"Acta hospitalia","volume":"Spec No ","pages":"73-8"},"PeriodicalIF":0.0,"publicationDate":"1991-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20985439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Hospital financing by self administrated institutions. Proposals for a new form of organization and financing of hospital care in West-Germany.","authors":"J Baumgarten","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Acta Hospitalia publishes this summary as an illustration of the difficult process most Western countries experience in reorienting their hospital financing systems. The case of West-Germany is of particular interest. It is the leading economic power in the European Economic Community and its sickness funds (the Krankenkassen) play a very important role in hospital financing. The article reports on the conclusions of a five year study by the R. Bosch Stiftung. We draw attention to the following: The article illustrates that each hospital financing system implies a particul balance of power between the hospitals, on the one hand, and the sickness funds on the other hand, under the auspices of the government. The final balance of power is not so much determined by the general principles but by the detailed operational procedures on which the financing system will eventually be based. This may explain why the conclusions of the Commission are rather vague. The option of the price as the main control instrument immediately demands some 'state committee' to lay down the guidelines for the provision of hospital care including the regional conditions and minimum service quantity and quality standards.</p>","PeriodicalId":79547,"journal":{"name":"Acta hospitalia","volume":"28 3","pages":"67-73"},"PeriodicalIF":0.0,"publicationDate":"1988-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21167555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Current policy issues in the Irish Health Services.","authors":"J O'Dwyer","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The article provides a general outline of current policy issues in the Irish health services. Referring to a demographic and epidemiological background and taking into account the recent trends in health expenditure, the author deals with six main issues: selection and clarification of objectives, funding, resource allocation, organisation, managing for change, the public/private mix. Comparing Ireland to other European countries, the author concludes that, because of limited resources, Ireland must be clearer and cleverer. The meeting of the expectations of the population will continue to provide a stirring challenge.</p>","PeriodicalId":79547,"journal":{"name":"Acta hospitalia","volume":"28 4","pages":"59-68"},"PeriodicalIF":0.0,"publicationDate":"1988-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21182580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The impact of the new hospital concept on the doctor's education: the place for physician-executives.","authors":"W D'Hoore","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Health care cost containment and the involvement of physicians in the hospital management are features spreading throughout the Western nations. In fact, physician-executives are needed to preserve an optimal level of care while achieving the aims of the cost containment policies. Belgium is no exception: the new hospital law outlines the physician's status in relation to the hospital management and provides for the implementation of a prospective payment system. An important point is examined in this paper: the problem of the physician's management skills. In order to solve this problem, two methods were used to collect data. First, an analysis of the tasks provided in the law and its commentary was helpful to determine the main skills needed if physicians want to act as hospital managers. Second, market research in management education was carried out to discern the number and the characteristics of physicians who could be interested in receiving management training. A physician-dedicated curriculum was developed from the first approach. The second approach revealed that half the hospital doctors are willing to train as managers, providing they are actually involved in hospital management. Therefore, universities and their Schools of Medicine should develop such curricula. Nonetheless, studies should be conducted to clarify the relationship between physician-executives and other physicians and to assess the impact of the presence of physician-executives on the hospital organization and on the quality of care.</p>","PeriodicalId":79547,"journal":{"name":"Acta hospitalia","volume":"28 4","pages":"33-43"},"PeriodicalIF":0.0,"publicationDate":"1988-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21185363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A study on absenteeism among hospital personnel.","authors":"S Al Sanie, J J Haxhe","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This is a retrospective study on absenteeism in a large teaching hospital covering the calender years 1982 and 1983. The number of personnel under study is 2.700 divided in six professional categories: administrative employees, qualified nurses, non-qualified nurses, laboratory technicians, caterers, cleaners. A 30% sample was chosen by the method of stratified sampling. Data were collected for each person on personal and professional factors. Absence data were collected for each person and were analysed by computer techniques. Females form the majority of the sample (82%). The overall absence rate was 9%; on excluding maternity leave it was around 6%. Female workers have double the pregnancy rate of employees and double their absence rate (maternity leave excluded). Both younger age groups have a high frequency of absence. A consistantly higher absenteeism was observed in females than in males even after the exclusion of pregnancy. Nationality had only a slight influence. The effects of seasonal variations was observed: increase in the winter and decrease in the summer. The factor education showed a direct relationship with absenteeism, the higher the education, the lower the absenteeism and vice versa. In order to detect which factors significantly influence absenteeism, each isolated factor was first considered. 'Marital status' appeared to be the most significant. On the multifactorial analysis, only education was found to be highly significant. Profession appeared also significant but is correlated to education. From these data, the probability of absenteeism can be determined. Propositions are made for an effective registration of absences and some approaches to reduce absenteeism are discussed.</p>","PeriodicalId":79547,"journal":{"name":"Acta hospitalia","volume":"27 3","pages":"31-9"},"PeriodicalIF":0.0,"publicationDate":"1987-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21154650","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The development of the clinical nurse specialist in the United Kingdom.","authors":"G Castledine","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The phenomenon of the Clinical Specialist has been known in the USA since the 1960s. Interest in involving nurses with advanced (university) training in patient care has also developed in Europe. This is partially the result of the evolution that nursing has undergone in Europe. Specialisation in nursing has been expanding in many different ways in the United Kingdom. Some of these nurses have been criticised for following the medical model, where as others have been developing their nursing role and expertise. Much confusion and controversy still arises as to what should be the correct criteria for a Clinical Nurse Specialist and in which direction the role should progress. This article describes the situation in the United Kingdom. The changes that have taken place in recent years in British nursing are presented and the role of pressure groups and the reform attempts in specialist hospitals are sketched. Finally the author puts forward eleven key factors that have been identified as crucial to the development of Clinical Nurse Specialists. At present not many nurses in the United Kingdom meet all of these criteria and many lack the educational qualifications, and advanced training required to develop their role. Proposed new legislation and the continuing growth of university and higher education for nurses in the United Kingdom are seen as possible ways forward for improving the specialist nursing skills and care given by these experienced nurses.</p>","PeriodicalId":79547,"journal":{"name":"Acta hospitalia","volume":"27 3","pages":"67-79"},"PeriodicalIF":0.0,"publicationDate":"1987-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21154653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}