ABSTRACT
Inova Mount Vernon Hospital, a part of the Inova Health System in northern Virginia, has developed a plan to redesign its joint replacement service to better coordinate patient care across the entire continuum. The redesign incorporates services, such as presurgery therapy and patient education, registration and insurance activities, rehabilitation, and home care, into an existing acute care joint replacement clinical pathway to create a continuum of care. To encourage the provider partners to integrate the joint replacement service, Inova Mount Vernon Hospital developed new types of clinical, economic, and service outcome measurements to view episodes of care from a system perspective. These measurements will be used to assess the success of the functional integration effort.
Subject(s)
Continuity of Patient Care/organization & administration , Critical Pathways , Delivery of Health Care, Integrated/standards , Joint Prosthesis/standards , Critical Pathways/economics , Episode of Care , Hospitals, Proprietary/organization & administration , Humans , Joint Prosthesis/economics , Marketing of Health Services , Models, Organizational , Outcome Assessment, Health Care/organization & administration , Quality Assurance, Health Care/organization & administration , VirginiaABSTRACT
Healthcare operating managers understand that capitation has inverted the financial incentives that existed in the fee-for-service environment. However, cost-structure implications of the managed care environment also must be understood if organizations are to prosper as markets evolve into capitation.
Subject(s)
Capitation Fee , Financial Management/methods , Managed Care Programs/economics , Data Interpretation, Statistical , Fee-for-Service Plans , Income/statistics & numerical data , Reimbursement, Incentive , United StatesABSTRACT
45 patients with oral cancer preoperatively received regional intraarterial chemotherapy (RIAC). All patients developed stomatitis or glossitis limited to the region of cytostatic perfusion. Between 1 and 19 days (median 4 days) after RIAC the tumor was removed by hemiglossectomy, partial resection of the floor of the mouth etc. The tissue alterations induced by chemotherapy in these surgical specimens were analyzed histomorphologically. Stomatitis due to RIAC was characterized by necrosis, ulceration and severe epithelial dysplasia of mucous membranes. Approximately 2 weeks after chemotherapy both the inflammatory changes and the dysplasia had disappeared completely. The differences between spontaneous premalignant dysplasia of the oral cavity and dysplasia induced by RIAC are discussed.
Subject(s)
Antineoplastic Combined Chemotherapy Protocols/adverse effects , Glossitis/chemically induced , Stomatitis/chemically induced , Adult , Aged , Antineoplastic Combined Chemotherapy Protocols/administration & dosage , Carcinoma, Squamous Cell/drug therapy , Cisplatin/administration & dosage , Cisplatin/adverse effects , Epirubicin/administration & dosage , Epirubicin/adverse effects , Female , Fluorouracil/administration & dosage , Fluorouracil/adverse effects , Humans , Infusions, Intra-Arterial , Male , Middle Aged , Mouth Neoplasms/drug therapy , Sialadenitis/chemically inducedABSTRACT
Recent moves by the National Labor Relations Board could accelerate union growth among healthcare organizations, making employee strikes a new concern for many of them. An urban hospital that recently faced potential strikes by two unions developed a strike contingency plan to cope with the situation. The plan, enacted before strike notices were received, reviewed staffing concerns, addressed strategic areas of operation, and helped managers set priorities.
Subject(s)
Hospital Planning/methods , Hospitals, Teaching/organization & administration , Strikes, Employee , Financial Management, Hospital , Hospital Bed Capacity, 500 and over , Interdepartmental Relations , Personnel Staffing and Scheduling , Planning Techniques , United StatesABSTRACT
Flexible budgeting is a relatively simple way to introduce department heads to the complex world of cost management. Managers use a flexible budget system to set financial targets for their department and track progress towards those goals. This system gives instant feedback on a department's performance in terms of staffing hours and dollars. Full cooperation is key to a flexible budgeting system's success. Department managers must be involved in every step of the process--from educating and training staff members to determining cost variables.
Subject(s)
Budgets/methods , Financial Management, Hospital/methods , Financial Management/methods , Hospital Departments/economics , Costs and Cost Analysis , District of Columbia , Hospital Bed Capacity, 500 and over , Personnel Staffing and Scheduling/economics , Software , United StatesABSTRACT
For the past few years, The Washington Hospital Center has had a prepaid obstetric clinic program for uninsured patients. Although the program was satisfactory, some deficiencies had developed. For example, research had shown a high correlation between a mother's lack of prenatal care and high healthcare expenditures. By implementing a new program that included financial incentives for various prenatal care programs, the hospital was able to financially break even with the old program, have a more predictable financial performance evaluation, and have healthier mothers and babies.
