Medical waste management: implications for plastic surgery offices and surgicenters.

This article focuses on how current rules and regulations impact on waste management in plastic surgery offices, and outpatient surgicenters. The suggestions provided are based on federal and state laws, OSHA requirements, JCAHO and AORN standards, and experience provided by members of ASPRSN.

The impact of computer usage on the perceptions of hospital secretaries.

This study explored the perceptions of hospital unit secretaries regarding computer usage. Specifically, six attitudinal variables: performance, resistance, interpersonal relations, satisfaction, challenge, and work overload were examined. The study had two major findings: (1) hospital unit secretaries have positive perceptions of job performance, satisfaction, and challenge as a result of using the PHAMIS computer system and (2) hospital unit secretaries do not feel resistant to the system, overloaded with work, or inclined to increase their interpersonal interaction with coworkers. These two findings might appear contradictory on the surface, but in fact are consistent with overall positive perceptions about the PHAMIS system. The study also considered the impact of two independent variables--age and number of years at work--on the responses of subjects. The analysis indicated that together these two variables explained some variations in the values of at least two of the dependent variables--resistance and challenge. The authors therefore concluded that the installation of the hospital computer system has established a favorable working environment for those whose work is affected by it. The dramatic expansion of computer systems in nonprofit institutions as well as in profit-oriented institutions has made people more familiar with computer technology. This trend can account for the overall positive perception of the unit secretaries toward the new computer system. Moreover, training programs and the support of top management for the system may also have enhanced the positive attitude of the users.

[Empirical study of the market orientation of veterinarians in The Netherlands]. / Empirisch onderzoek naar de marktgerichtheid van dierenartsen in Nederland.

Linked to the theoretical framework of marketing in the veterinary practice, as explained in Schuurmans and Smidts (1) pp. 1-10 and Schuurmans and Smidts (2), an empirical research project has been undertaken. This research gives insight into the extent to which practices base their services on a marketing orientation. By means of telephone inquiries among a sample of 166 veterinarians, this was investigated. The research shows that veterinarians think more in a product-oriented way than in a market-oriented way, and they do not use all the opportunities a marketing orientation could bring to their services. This expresses itself, among others by not using market segmentation, by the inadequate use of the marketing mix elements communication and distribution, and by the fact that the opportunities of the marketing information system are hardly applied. By means of further research in individual practices it might be possible to give concrete advise fit for that practice. Research among the clients of the veterinarians might, beside many other kinds of research, also give valuable insights.

Triplicate prescription: an idea whose time has yet to come.

A coalition of Maryland state officials and agencies is considering the introduction of legislation that would enact a triplication prescription program, a concept that dates back almost a half century. To date, only eight states have adopted such legislation, and since 1964, at least sixteen other states have thoroughly examined the concept and rejected it.

Radiology film-management systems at Los Angeles County-University of Southern California Medical Center.

An accurate and efficient x-ray film-retrieval service was needed in the radiology department at Los Angeles County-University of Southern California Medical Center. In July 1986, the radiology department implemented the radiology film-management system in concert with the surgery department. The centralized radiology film files were replaced by service bins, each containing all inpatient films for a specified surgical service. Physician waiting time, clerical work load, and the number of lost and misplaced films have been reduced, and cost savings to date is $840,000. By mid-1988, the system had been expanded to accommodate more than 90% of radiology users.

A record-keeping format for training systemic therapists.

Training in systemic therapy necessitates a structured approach to teaching systemic thinking. The Systemic Therapy Sessions Summary Form, a record-keeping method, is presented as a tool for enhancing training in systemic therapy. The purpose of this form is to provide the structure for the trainee to develop circular hypotheses, to connect reflexively the assessment and intervention components of therapy, and to maintain a sense of the evolving nature of therapy across sessions. A case example illustrates the use of this record-keeping format.

A hospital-wide forms management program: doing more for less.

The day-to-day management of the hospital forms business can be time-consuming, frustrating, and expensive. In many cases, the official inventory represents only a fraction of the total number of forms used throughout an institution. Since the responsibility for inventory and quality control becomes diffuse, forms users experience frequent stockouts and poorly designed forms. Without a centralized program, it is difficult to determine the costs associated with forms. An effective forms management program can be designed to fulfill most everyone's needs. The program described in this article incorporates the concept of stockless purchasing to gain better quality forms at significant cost savings.

A simple approach to quality assurance in a complex ambulatory care setting.

In an effort to implement ongoing and continuous monitoring and evaluation of the quality of care in its unusually complex ambulatory care setting, the University of Chicago Hospitals developed a system of clinic-based activity. All 60 of its clinics use the same procedure, involving indicators that address both servicewide and clinic-specific concerns and a single, adaptable tool for data collection and reporting that makes it easier for centralized bodies to review and act on reports. Specific examples show how the system has improved care and encouraged multidisciplinary involvement in the quality assurance effort.