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This paper describes the development and validation of two software tools to explore the relationship between prognostics and health management (PHM) technologies and servitization in the machine tool industry. The software tools are based on software tools that were originally developed to analyse the costs and benefits of PHM technology in the aerospace industry. The development was initiated following an extensive review of relevant literature on both servitization and PHM technology. This review revealed the fact that the servitization literature makes almost no mention of the use of PHM technology to support servitization and the PHM literature makes almost no mention of the servitization business model that might justify expenditure on this technology. The tools model the life cycles of two sets of machine tools, with and without PHM technology, before calculating the net present value of the costs and benefits of PHM in the context of a servitization business model. Although the data used in the tools are hypothetical, the approach taken in the models was validated through interviews with a major machine tool vendor. This research extends existing knowledge on servitization as published in the management literature by linking it to research into PHM as published in the systems engineering literature. The paper concludes by indicating the need for more empirical data on the reliability of machine tool subsystems in order to increase confidence in the value of PHM technology to support machine tool servitization. [ABSTRACT FROM AUTHOR]

The American Psychological Association's Presidential Task Force on Evidence-Based Practice articulates a decision-making process based on the integration of the best available research, clinical expertise, and patient characteristics. The treatment method, the individual psychotherapist, the treatment relationship, and the patient are all vital contributors to successful psychotherapy. Several studies have shown that the variation in treatment effect among psychotherapists using the same method is greater than the variation in treatment effect among different methods. This outcome pleads for a comprehensive psychotherapist-related 'g-factor' of psychotherapy. In terms of decision-making for health-care institutions and clinical practices, it would seem wise not to separate the psychotherapist, the patient, or the relationship from the method as there seem to be extensive effects relative to the interaction among these parameters. Parallel to a growing knowledge of evidence-based methods, there is still a decisive lack of scientific knowledge about these interactions. [ABSTRACT FROM AUTHOR]

The article discusses the results of the study on the possible factors that contributed to the nurses' decision to venture into independent life care planning. It states that the study interviewed seven independent life care planners who shared their experiences, the challenges they faced, and the effects the transition had on their lives. Factors include the changes in the management of health care facilities and the subordinate or paternalistic relationship between nurses and institutions.

The article focuses on the Institute for Safe Medication Practices' (ISMP) reported medication errors that occurred in health care facilities. It states that a reported case to ISMP Canada shows that a physician interchanged the patient's height and weight into the electronic chemotherapy prescribing system, which led to dosing error. It adds a report on misinterpretation of null sign as number four by two nurses that caused a patient's cardiac arrest due to basal infusion of morphine 4mg/hour.

The article offers information on Dr. Arthur L. Kellerman's view on the ethics in boarding of patients and emergency medicine. It reports on the Kellerman's emphasis on the innovations in emergency medicine which has also been compromised because of the mismanagement of the healthcare system. Boarding of patients as well as delays in admission and the treatment of patients in waiting rooms are discussed.

Copyright of Saúde e Sociedade is the property of Universidade de Sao Paulo, Faculdade de Saude Publica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Targeting, acquiring and retaining the right customers are at the core of many successful service organizations. Research has been consistent within the business world where it has been shown that competitors are always seeking innovative ways to allure customers away from where consumers currently conduct their business. Retaining a customer has become equally important to recruiting a customer since it is increasingly difficult for organizations to assume that there exists an unlimited customer base. Many organizations spend large sums of money in search of new markets and under-spend on retaining existing customers. Hence, the purpose of the study is to identify salient strategies that are applied at commercial health and fitness organizations in customer retention. The methodology involved gathering data through a questionnaire using a sample of commercial health and fitness centres managers and administrators in South, Central and Northern Gauteng. Data from 124 usable questionnaires were captured and analysed for the study. Factor analysis revealed seven strategies used by health and fitness organizations in retaining customers. Health and fitness centre managers can leverage these seven retention strategies in order to retain customers. A well documented complaints handling process is essential which can be used by managements of health and fitness centres to identify and act on problems which may motivate customers to stay within organizations. Future research on a comprehensive examination of satisfaction, loyalty, switching behaviour and retention is warranted. [ABSTRACT FROM AUTHOR]

Background. Patients hospitalized in resource-poor health care settings are at increased risk for hospital-acquired respiratory infections due to inadequate infrastructure. Methods. From 1 April 2007 through 31 March 2008, we used a low-cost surveillance strategy to identify new onset of respiratory symptoms in patients hospitalized for 172 h and in health care workers in medicine and pediatric wards at 3 public tertiary care hospitals in Bangladesh. Results. During 46,273 patient-days of observation, we recorded 136 episodes of hospital-acquired respiratory disease, representing 1.7% of all patient hospital admissions; rates by ward ranged from 0.8 to 15.8 cases per 1000 patient-days at risk. We identified 22 clusters of respiratory disease, 3 of which included both patients and health care workers. Of 226 of heath care workers who worked on our surveillance wards, 61 (27%) experienced a respiratory illness during the study period. The cost of surveillance was US$43 per month per ward plus 30 min per day in data collection. Conclusions. Patients on these study wards frequently experienced hospital-acquired respiratory infections, including 1 in every 20 patients hospitalized for 172 h on 1 ward. The surveillance method was useful in calculating rates of hospital-acquired respiratory illness and could be used to enhance capacity to quickly detect outbreaks of respiratory disease in health care facilities where systems for outbreak detection are currently limited and to test interventions to reduce transmission of respiratory pathogens in resource-poor settings. [ABSTRACT FROM AUTHOR]

The Department of Health in England released a new health research strategy in 2006 with far-reaching implications for both health research and research management. The explicit policy shift is towards centres of excellence and away from historical block allocations of funding to National Health Service (NHS) healthcare organisations-with these replaced by new nationally competitive funding streams. Academic researchers wishing to access these new and rich funding sources need to work more closely with healthcare providers, as grants money will be paid [ABSTRACT FROM AUTHOR]

The article offers tips on how to manage nursing policies in a nursing facility. It emphasizes the importance for facility leaders to recognize the growing edges of its policies, the employment of the concept of collaborative governance, and the value of setting up a solidly representative governance. It projects that leaders should understand the reason behind the existence of various policies and that they should not assume that their policies have already been examined. It also underlines the need to conduct a rapid review and inventory of policies and remove policy excesses. Further, it suggests the leaders to be receptive to comments and reviews with regards to their policies.

Copyright of International Journal of InformaticsTechnologies is the property of Institute of Informatics, Gazi University and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

An essay is presented on combating the Ebola virus epidemic. It offers the history of ebola epidemic in West Africa, which is caused by the deadliest species of the ebolavirus and has a 50% fatality rate. The author suggests that in order to prevent the virus from spreading to South Africa, it is crucial to improve health care infrastructure as well as screen all entrants into the country.

This paper explores how the passage of Saskatchewan's Health Facilities Licensing Act in 1996 created both a legal framework for private health facilities in the province as well as erecting significant barriers to virtually insure that no such facilities could effectively operate. This is done within the context of discovering how placing barriers to privatization has contributed to reform of the health care system and the conditions in which reform will be permitted. Data for the study were collected from a series of eleven key informant interviews including elected officials, civil servants, health care professionals, academics, members of key stakeholder organizations which both supported and opposed the legislation. [ABSTRACT FROM AUTHOR]

The purpose of the research was to show how lean asset thinking can be applied to UK health-care facilities using different measures to compare the estates contribution to the business of health-care providers. The challenge to conventional wisdom matches that posed by 'Lean Production' to 'Mass Manufacturing'. Data envelope analysis examined the income generated and patient-occupied area as outputs from the gross area of a NHS Trust's estate. The approach yielded strategic comparisons that conventional facilities management measures of cost per square metre hide. The annual cost of an excess estate is conservatively estimated at £600,000,000 (in England alone). Further research to understand the causes of the excess is needed. Meanwhile the research illustrates the power of an alternative way of assessing facilities performance. The authors are not aware of the lean asset perspective previously being applied to health-care facilities. The research shows the underlying fallacy of relying on cost per square metre as the primary measure of asset performance. The results and discussion will be particularly useful to senior estates and facilities managers wishing to use new measures to define strategic estates targets. [ABSTRACT FROM AUTHOR]

Falls clinics are a newer model for falls management among the elderly. Few studies have addressed the impact of the strategy on falls prevention in the healthcare system. The aim of the present study was to describe the social processes that affect the implementation of new strategies in falls management. A newly established falls clinic was chosen as an instrumental case to describe the systematic and comprehensive approach to falls prevention among the elderly. The investigation had a qualitative case study research design with triangulation of sources and methods, including interviews, participant observation and analysis of documents. The study was conducted from January 2006 to June 2007 at a newly established falls clinic at a Danish hospital. Data were analysed qualitatively according to four main themes: The concept of falls, success/failure, competition and expertise. The study showed that the falls clinic was embedded in a context where interests varied at different levels of the organizational hierarchy. In contrast to the political agenda for falls prevention, patients and professionals did not associate falls with chronological age. The biomedical structure of the falls clinic and the hegemonic mode of handling falls prevention may have facilitated falls prevention services and patient trajectories across sectors, but if falls are associated with chronic disease secondary to an unhealthy lifestyle, the individual patient becomes responsible for the falls problem. This may subsequently prevent the patients from seeking timely help from the healthcare system, or patients may drop out of the existing programmes. Future research needs to look at sustainability and dropping out in relation to falls prevention programmes. [ABSTRACT FROM AUTHOR]

Background: Interpretive performance of screening mammography varies substantially by facility, but performance of diagnostic interpretation has not been studied. Methods: Facilities performing diagnostic mammography within three registries of the Breast Cancer Surveillance Consortium were surveyed about their structure, organization, and interpretive processes. Performance measurements (false-positive rate, sensitivity, and likelihood of cancer among women referred for biopsy [positive predictive value of biopsy recommendation (PPV2)]) from January 1, 1998, through December 31, 2005, were prospectively measured. Logistic regression and receiver operating characteristic (ROC) curve analyses, adjusted for patient and radiologist characteristics, were used to assess the association between facility characteristics and interpretive performance. All statistical tests were two-sided. Results: Forty-five of the 53 facilities completed a facility survey (85% response rate), and 32 of the 45 facilities performed diagnostic mammography. The analyses included 28100 diagnostic mammograms performed as an evaluation of a breast problem, and data were available for 118 radiologists who interpreted diagnostic mammograms at the facilities. Performance measurements demonstrated statistically significant interpretive variability among facilities (sensitivity, P = .006; false-positive rate, P < .001; and PPV2, P < .001) in unadjusted analyses. However, after adjustment for patient and radiologist characteristics, only false-positive rate variation remained statistically significant and facility traits associated with performance measures changed (false-positive rate = 6.5%, 95% confidence interval [Cl] = 5.5% to 7.4%; sensitivity = 73.5%, 95% Cl = 67.1% to 79.9%; and PPV2 = 33.8%, 95% Cl = 29.1% to 38.5%). Facilities reporting that concern about malpractice had moderately or greatly increased diagnostic examination recommendations at the facility had a higher false-positive rate (odds ratio [OR] = 1.48, 95% Cl = 1.09 to 2.01) and a non- statistically significantly higher sensitivity (OR = 1.74, 95% Cl = 0.94 to 3.23). Facilities offering specialized interventional services had a non-statistically significantly higher false-positive rate (OR = 1.97, 95% Cl = 0.94 to 4.1). No characteristics were associated with overall accuracy by ROC curve analyses. Conclusions: Variation in diagnostic mammography interpretation exists across facilities. Failure to adjust for patient characteristics when comparing facility performance could lead to erroneous conclusions. Malpractice concerns are associated with interpretive performance. [ABSTRACT FROM AUTHOR]

Copyright of Socijalna Ekologija is the property of Croatian Sociological Association and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract: Objectives: Effective and timely communication of information is essential for quality patient care. Information and communication technology tools have the potential to transform and enable health care processes to be more accurate, timely, and integrated. This study describes the development, implementation, and evaluation of an electronic whiteboard in a General Internal Medicine (GIM) inpatient unit of an acute care hospital. Methods: The development, implementation, and evaluation of the inpatient whiteboard included scope discussions, workflow analyses, communication and training, and issues and enhancement reporting, all managed through a central project team. Evaluation of the whiteboard was two-fold: a survey given to allied health, nursing and physician disciplines (n =120), and an audit performed on whiteboard usage. Results: The whiteboard displays relevant, real-time patient information, in a single, highly visible, user-friendly display. With a quick glance at the whiteboard, one can get an accurate snapshot view of the current patient activity in the unit. Approximately 71% of survey participants believed that the whiteboard improves and standardizes communication within the care team. Further, approximately 62% of the participants agreed that the whiteboard saves them time when searching for information on a patient and their care plan. In addition, the whiteboard has had an impact on the work practices of many GIM care providers, and it along with its users has acted together as agents for positive change. Whiteboard utilization has significantly increased since its implementation. Conclusions: The success of the whiteboard is in part due to overall change management methodologies through collaborative development throughout the project development lifecycle and subsequent continuous improvement initiatives. The multidisciplinary care team embraced the tool, took ownership of it, and tailored it to meet their needs. [Copyright &y& Elsevier]

The article provides information on how freestanding home health agencies can survive the competition against hospital-based agencies. It notes that even the health care field is not immune to the seismic change in social and economic expectations. Hospitals are struggling to attract patients and become the one-stop shop hospital for the aged and the sick There are some hospitals who are expanding the scope of services being offered such as adding multispecialty clinics and mobile health vans, as their strategies in leveling up with big hospital agencies. Moreover, it identifies three steps in order to develop a good strategy which includes pursuing referrals from everyone like attorneys and religious leaders, finding a best niche for the agency, and taking the message to the people.

In Germany, recommendations on dealing with patients who are colonised with methicillin-resistant S. aureus (MRSA) for the inpatient sector have been published in 1999 by the Commission for Hospital Hygiene and Infection Prevention (KRINKO). Some challenges arise with regard to the practical implementation of the KRINKO recommendations. These challenges do not principally question the benefit of the recommendations but have come into criticism from users. In this commentary the German Society for Hospital Hygiene (DGKH) discusses some controversial issues and adds suggestions for unresolved problems regarding the infection control management of MRSA in healthcare settings. [ABSTRACT FROM AUTHOR]

The article focuses on the things which must be considered in the management of hospitals. Topics discussed include the meaning of the word hospital which is coming from the Latin hospes, the continued development of hospitals in Europe, and the vital role played by hospitals in healthcare management.

Over 60% of the recurrent budget of the Ministry of Health (MoH) in Angola is spent on the operations of the fixed health care facilities (health centres plus hospitals). However, to date, no study has been attempted to investigate how efficiently those resources are used to produce health services. Therefore the objectives of this study were to assess the technical efficiency of public municipal hospitals in Angola; assess changes in productivity over time with a view to analyzing changes in efficiency and technology; and demonstrate how the results can be used in the pursuit of the public health objective of promoting efficiency in the use of health resources. The analysis was based on a 3-year panel data from all the 28 public municipal hospitals in Angola. Data Envelopment Analysis (DEA), a non-parametric linear programming approach, was employed to assess the technical and scale efficiency and productivity change over time using Malmquist index.The results show that on average, productivity of municipal hospitals in Angola increased by 4.5% over the period 2000–2002; that growth was due to improvements in efficiency rather than innovation. [ABSTRACT FROM AUTHOR]

The article reports on the impact of organizational characteristics on quality-related activities in health centers. A mailed questionnaire was used for a cross-sectional assessment of quality-related activities in Health Resources and Services Administration-funded health centers. Moreover, the study indicates that accreditation presents a greater likelihood that health centers have integrated specific quality-related activities into their daily operations.

The article discusses the roles of managers in health care industry. It mentions that manager's responsibility grows and extends as time passes by. It also examines the impact of uniting affiliations to the functions of managers. According to the author, health care managers need to be flexible and adaptive.

Objectives.— To analyze the demographics, diagnosis, and treatment patterns in patients with headache-seeking treatment in one of the busiest emergency rooms (ER) of an academic medical center in the USA. Background.— The past decade has seen tremendous improvement in acute and preventive management of headaches. However, there are very few data on how headache patients are managed by ER doctors. Methods.— Retrospective analysis of 100 charts chosen at random for patients with a discharge diagnosis of headache (according to ICD-9 codes) from the University of Southern California + Los Angeles County Hospital ER. Results.— The majority of patients were female (74%) and Hispanic (76%) with an age range of 15-68 years. The most common ER diagnoses were migraine (42%) and headache not otherwise specified (headache NOS – 42%). Fifty-one percent of patients received a head computerized tomography; 9% received a lumbar puncture. Medications most frequently used for acute treatment, whether migraine or headache NOS, were narcotics (25%), followed by antiemetics (24%), nonsteroidal anti-inflammatory drugs (19%), and acetaminophen (17%). Only 5% of migraine patients received migraine-specific triptans in the ER (2% overall). Thirty-one percent of migraineurs were given a prescription for a triptan upon discharge from the ER (17% of all patients). Eighteen percent of patients were admitted to the hospital with secondary headache. The final diagnosis in the ER matched the diagnosis of the neurologist in 79% of cases with a moderate degree of agreement. Conclusion.— Narcotics remain the medications most often chosen for treatment of all acute headaches (including migraine) in the ER. There is very little use of migraine-specific medications in the ER. In addition, neurology consults are underutilized even in an academic setting in the ER. The data suggest a lack of clear standards of care for diagnosis and treatment of headache, especially migraines. Specific guidelines for headache management should be established keeping in mind the unique setting of the ER. [ABSTRACT FROM AUTHOR]

Abstract: Objective: Numerous studies have demonstrated the robustness of the framing effect in a variety of contexts. The present study investigated the effects of a debiasing procedure designed to prevent the framing effect for young adults who made decisions based on hypothetical medical decision-making vignettes. Methods: The debiasing technique involved participants listing advantages and disadvantages of each treatment prior to making a choice. One hundred and two undergraduate students read a set of three medical treatment vignettes that presented information in terms of different outcome probabilities under either debiasing or control conditions. Results: The framing effect was demonstrated by the control group in two of the three vignettes. The debiasing group successfully avoided the framing effect for both of these vignettes. Conclusion: These results further support previous findings of the framing effect as well as an effective debiasing technique. This study improved upon previous framing debiasing studies by including a control group and personal medical scenarios, as well as demonstrating debiasing in a framing condition in which the framing effect was demonstrated without a debiasing procedure. Practice implications: The findings suggest a relatively simple manipulation may circumvent the use of decision-making heuristics in patients. [Copyright &y& Elsevier]

Objective To quantify staff requirements in primary health care facilities in South Africa through an adaptation of the WHO workload indicator of staff needs tool. Methods We use a model to estimate staffing requirements at primary health care facilities. The model integrates several empirically-based assumptions including time and type of health worker required for each type of consultation, amount of management time required, amount of clinical support required and minimum staff requirements per type of facility. We also calculate the number of HIV-related consultations per district. The model incorporates type of facility, monthly travelling time for mobile clinics, opening hours per week, yearly activity and current staffing and calculates the expected staffing per category of staff per facility and compares it to the actual staffing. Findings Across all the districts there is either an absence of doctors visiting clinics or too few doctors to cover the opening times of community health centres. Overall the number of doctors is only 7% of the required amount. There is 94% of the required number of professional nurses but with wide variations between districts, with a few districts having excesses while most have shortages. The number of enrolled nurses is 60% of what it should be. There are 17% too few enrolled nurse assistants. Across all districts there is wide variation in staffing levels between facilities leading to inefficient use of professional staff. Conclusion The application of an adapted WHO workload tool identified important human resource planning issues. [ABSTRACT FROM AUTHOR]

The growing costs of healthcare as a percentage of GDP in the industrial countries are causing considerable problems for these economies, but any attempt to change the existing healthcare system in any given country is usually accompanied by hefty political debate. A system needs to be found that rations healthcare efficiently and effectively, and which is also politically acceptable. The following article examines recent changes in the healthcare systems in the UK and USA and discusses the extent to which they meet these criteria. [ABSTRACT FROM AUTHOR]

Following increases in national demands on healthcare facilities and services, healthcare facilities management (FM) has gradually matured to become an established research and development topic. This paper reviews the state of the art in the main domains related to healthcare FM and defines the central themes in the development of a healthcare FM model. FM, maintenance management and performance management are reviewed in a wider context, and the main domains of healthcare FM are discussed. The five salient topics included in healthcare FM are maintenance management, performance management, risk management, supply services management, and development. These five core domains are interrelated, and can be integrated using information and communications technology, which provides the desired environment required for the challenging decision making and development prevalent in healthcare FM. [ABSTRACT FROM AUTHOR]

Focuses on the problems in the development and organization of pain clinics and palliative care in the developing countries. Discussion on specific problems in organizing a pain clinic like conceptual acceptance and paucity of funding; Need for more number of pain management clinics in India; Evaluation of the performance of pain clinics and fulfillment of essential requirements of clinical governance; Efforts of palliative care experts in organizing palliative home care in India; Scarcity of Morphine in the Indian domestic market, despite a large amount of it being manufactured here.

Presents guidelines for emergency preparedness for water treatment systems of dialysis facilities. Approach in knowing water suppliers; Alternative sources of water supply; Reasons for drawing water samples; How to maintain water treatment systems.

Discusses the need for disaster preparedness by individual dialysis units in the United States. Background information on disasters; Principles for disaster planning; Details on basic services needed to operate dialysis facilities; Conclusion.

Describes the disaster management undertaken by dialysis centers in North Carolina in preparation for a flood in the aftermath of two hurricanes on September 1999. Details on the outpatient and inpatient hemodialysis unit stories; Support services utilized during the disaster; Problems encountered; Conclusion.

Assesses several marketing strategies for health care systems. Details on how to position the business; Opportunity in the growing markets; Missionary work.

Discusses a way of reducing risk in health care organizations by promoting safety culture and shared sense of accountability among personnel. Elements of organizational learning; Details of a program implemented by the Children's Hospitals and Clinics in Minneapolis, Minnesota; Views on leadership and accountability.

The article discusses the role of risk assessments and risk management procedures in understanding Ebola virus disease (EVD) in the developed countries. Topics covered include a background on the outbreak of EBD, questions regarding the application of tools of risk analysis, and appropriate waste management protocols in medical facilities.