Hospital & health services administration
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Pressures influencing the size and composition of medical staffs are increasing as hospitals and physicians respond to competition, market priorities, increasing numbers of physicians, and quality-of-care concerns. This article examines whether the quality of care provided by an applicant may be the primary criterion for admission to a hospital's medical staff. Methodological, legal, and organizational concerns that arise from this approach are reviewed. A quality criteria approach can assist in responding to increasing numbers of physicians, the transition to management care, and the marketing interests of a hospital.
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Hosp Health Serv Adm · Jan 1988
Universal precautions: employee resistance and strategies for planned organizational change.
Health care organizations have been strongly encouraged to design and implement procedures to prevent the spread of HIV/AIDS in the workplace. The procedures will have a dramatic impact on the work habits of health care workers and may even challenge some dominant health care values. ⋯ This article identifies some plausible causes for employee resistance to precautionary procedures. After describing the dilemma in terms of competing values and conflicting objectives, some practical managerial strategies for reconciling differences and securing broad-based commitment to preventive policies and procedures are proposed.
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Hosp Health Serv Adm · Jan 1988
Dodging the bullet: avoiding conspiracy claims in professional staff disputes.
Hospitals, because of their necessary reliance on medical staff physicians in making staff privilege decisions, are particularly susceptible to claims of conspiracy in restraint of trade in violation of the Sherman Antitrust Act. Physicians and other health care providers denied professional access to hospital facilities frequently initiate federal antitrust lawsuits against hospitals and their medical staffs asserting unlawful conspiracy in restraint of their practice. Regular, consistent, and timely preventive action by a hospital can avoid or limit the hospital's exposure to the expense and uncertainty of extended and cumbersome antitrust litigation.
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Hosp Health Serv Adm · Aug 1987
The integration of respiratory therapy into nursing: reorganization for improved productivity.
This article outlines a program, implemented by a 133-bed acute care facility, designed to provide more productive patient care delivery while maintaining the level of service delivered. This program required downsizing the respiratory therapy department, integrating a portion of its function into the nursing department, and reducing the annual salary budget by approximately $270,000 or 2 percent of total hospital salaries. The article describes the process and strategies that were used to implement this method of providing respiratory care to hospital patients.
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This article describes the Medicare pricing mechanism and explores potential responses to the reliance on the patient and related medical condition as the unit of payment. The analysis suggests that, although the provisions of PL 98-21 may benefit the Medicare program, the pricing system may jeopardize the financial viability of hospitals, increase inequities that emanate from differential pricing policies and, when viewed from the perspective of beneficiaries, reduce access to in-hospital care and the use of service once admitted.