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The hygienic importance of barrier zoning in hospitals has been evaluated on the basis of the relevant international literature between 1970 and 1989. There have been only a very few pertinent publications and in none has there been any pointer which would support the hypothesis of barriers having an infection-preventing effect. Using four University Hospitals in Baden-Würtemberg as paradigms, a model was prepared for calculating what space and cost savings were possible, if a simpler system could be installed, instead of the one demanded under federal regulations and already planned for the four hospitals. It was found that it would save a realizable area of 319,5 m2 at a potential cost saving of DM 1,138,335. By dispensing with hygienically not justifiable building work at the planning stage of new hospitals considerable greater costs could be avoided.

Dorothea Lynde Dix, 19th century defender of the rights of the mentally ill to hospital care, holds a significant place in the history of Nova Scotia. Her two major accomplishments in this province include laying the groundwork for its first psychiatric hospital and the outfitting of treacherous Sable Island with rescue equipment to aid ships stranded off its shore. The techniques that Miss Dix employed in these missions parallel those she successfully used in the establishment of psychiatric hospitals in a number of American states. It will be argued that her influence has been a positive one on the treatment of the mentally ill particularly in light of the failures of the deinstitutionalization movement.

Architects restore a 57-year-old hospital facility without destroying its traditional and unusual characteristics.

To cope with the impact of codes, design, and attitudes in a renovation project, a hospital may have to make compromises and consider many alternatives to its plan.

This paper explores the political and bureaucratic determinants of grant allocations within the Hospital Survey and Construction Act of 1946 (the Hill-Burton Act), which established the major hospital construction subsidy program in the United States. Resource allocation within the Hill-Burton Program was neither purely a function of external political forces impinging on the state nor purely a result of internal organizational factors. Instead, as shown in the analysis which follows, external political forces shaped program structure, operating routines, and rules and regulations at the time of the Program's formation. Rules and regulations depoliticized the grant allocation process while institutionalizing the interests of hospitals and other producers into the program structure. Consumer interests and influence are excluded from program decision making. Once established, the rules and regulations and a set of bureaucratic behaviors play a critical role in determining resource allocation. Rules and regulations facilitate distributing divisible benefits to producer interests in a politically predi-table way. Yet rules and regulations must also regulate the supply of hospital beds in accordance with local and national market conditions. The mode of operations required for distributing benefits in a politically predictable way limited the Program's ability to regulate hospital bed supply. This was a critical factor which led the Hill-Burton Program to subsidize excess capacity in the U.S. hospital system and is a useful way of explaning many similar dysfunctions within allocative programs such as Hill-Burton.

This rule amends Title 42 of the Code of Federal Regulations by reinstating the provision at Section 53.134 concerning notification of the Department of the transfer of a medical facility assisted under Title VI of the Public Health Service Act (the Hill-Burton Act) or termination of services provided in the facility. The provision was incorrectly deleted in a rule published on August 6, 1979, 44 FR 45946.

New and more flexible design alternatives result when architects use the planning/program/design model for reuse/reconfiguration projects.

With proper planning and use of successful techniques of claims avoidance, recognition, and resolution from the initial stages of the project, a hospital can prevent or minimize construction delays and claims and can complete its new construction in a reasonable atmosphere with a minimum of cost.