scholarly journals Benchmarking study of hospital libraries

Hypothesis ◽  
2019 ◽  
Vol 31 (1) ◽  
Author(s):  
Angela Spencer ◽  
Elizabeth Mamo ◽  
Brooke L. Billman
Keyword(s):  
Health System ◽  
Hospital System ◽  
Hospital Mergers ◽  
Document Delivery ◽  
Staffing Levels ◽  
Library Funding ◽  
Strategic Plans ◽  
Print Books ◽  
Hospital Systems ◽  
Effective Advocacy

Objectives: To assess the current landscape of hospital libraries by collecting benchmarking data from hospital librarians in the U.S. and other countries. Since the last MLA benchmarking survey in 2002 hospital libraries have faced significant changes including downsizing, position and library elimination, and hospital mergers. This survey will provides information to inform the development and implementation of effective advocacy for hospital libraries. Methods: A web-based, anonymous survey was designed to collect information from hospital librarians representing stand-alone hospitals and hospital systems. The 57-question survey was distributed via select list servs, targeting the US and Canada but open to any country. The topic areas covered hospital/health system, library, and library staff demographics; library characteristics and scope of service; interlibrary loan and document delivery; library funding; and library budget. Hospital library benchmarking surveys, including the previous MLA surveys, were reviewed and applicable questions were added. Results: There were a total of 180 respondents but the total number of responses for each question varied. Select results are as follows: of the responding libraries, 67.2% were part of a hospital system; 24.4% had merged with or were bought by another hospital or health system and, of those, 77.1% had acquired 1-5 hospitals in the last 10 years; 77.9% were not for profits; over half (55.2%) had <5,001 FTE in the organization; 56.9% had one library; 47.7% had 1 FTE librarian, 34.9% had 2-5; 82.1% did not or were not able to use social media; 60.7% didn’t have strategic plans; 66.1% belonged to a consortium; 48.2% provided up to 250 search requests a year; 66.3% did not receive funding outside of their organization; 32.5% had budgets for print books totaling less than $1,000; 30.1% had budgets, excluding salaries, of less than $100,000 and 9.7% had budgets over $1M. Conclusions: These findings contribute to the field’s knowledge of hospital library demographics as well as the services provided. The results suggest implications for hospital librarians regarding staffing levels and the depth of services within their unique settings, especially within the context of rapidly expanding health systems.

The Effects of Production Performance Model and Competitive Environment of Hospital Systems

2013 ◽  
Vol 300-301 ◽  
pp. 1623-1627
Author(s):  
Ching Kuo Wei
Keyword(s):  
Performance Model ◽  
Production Performance ◽  
Competitive Environment ◽  
Data Envelopment ◽  
Hospital System ◽  
Department Of Health ◽  
Competitive Environments ◽  
Significant Difference ◽  
Efficiency Performance ◽  
Hospital Systems

This study investigated the efficiency performance of the production technology of the Department of Health (DOH)-affiliated hospital system in Taiwan in different competitive environments. This study used Data Envelopment Analysis (DEA) to analyze a total of 396 hospitals of different systems in Taiwan. The results indicated that, in terms of the internal competitive environment, the production performance of hospital Q was the best, while that of hospital N was the worst. This study also analyzed the production performance and scale of DOH-affiliated hospitals and provided hospitals with a direction for scale development. Finally, this study proposed suggestions on improvement direction for hospitals with poor production performance. As for external competitive environment, there is no significant difference in the average efficiency among various hospital systems. However, there are a lot to be improved in DOH-affiliated hospitals, especially in the aspect of technology efficiency. The improvement of technology efficiency should be more beneficial to the overall efficiency.

scholarly journals Centralization of High-Risk Cancer Surgery Within Existing Hospital Systems

2019 ◽  
Vol 37 (34) ◽  
pp. 3234-3242 ◽  
Author(s):  
Kyle H. Sheetz ◽  
Justin B. Dimick ◽  
Hari Nathan
Keyword(s):  
High Risk ◽  
Postoperative Complications ◽  
Postoperative Mortality ◽  
Cancer Surgery ◽  
Independent Effect ◽  
Hospital System ◽  
American Hospital ◽  
Hospital Systems ◽  
High Risk Cancer

PURPOSE Centralization is often proposed as a strategy to improve the quality of certain high-risk health care services. We evaluated the extent to which existing hospital systems centralize high-risk cancer surgery and whether centralization is associated with short-term clinical outcomes. PATIENTS AND METHODS We merged data from the American Hospital Association’s annual survey on hospital system affiliation with Medicare claims to identify patients undergoing surgery for pancreatic, esophageal, colon, lung, or rectal cancer between 2005 and 2014. We calculated the degree to which systems centralized each procedure by calculating the annual proportion of surgeries performed at the highest-volume hospital within each system. We then estimated the independent effect of centralization on the incidence of postoperative complications, death, and readmissions after accounting for patient, hospital, and system characteristics. RESULTS The average degree of centralization varied from 25.2% (range, 6.6% to 100%) for colectomy to 71.2% (range, 8.3% to 100%) for pancreatectomy. Greater centralization was associated with lower rates of postoperative complications and death for lung resection, esophagectomy, and pancreatectomy. For example, there was a 1.1% (95% CI, 0.8% to 1.4%) absolute reduction in 30-day mortality after pancreatectomy for each 20% increase in the degree of centralization within systems. Independent of volume and hospital quality, postoperative mortality for pancreatectomy was two times higher in the least centralized systems than in the most centralized systems (8.9% v 3.7%, P < .01). Centralization was not associated with better outcomes for colectomy or proctectomy. CONCLUSION Greater centralization of complex cancer surgery within existing hospital systems was associated with better outcomes. As hospitals affiliate in response to broader financial and organization pressures, these systems may also present unique opportunities to improve the quality of high-risk cancer care.

scholarly journals 1144. Modern Problem, Medieval Cure-Resistant Aeromonas in Medicinal Leeches

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S344-S344
Author(s):  
Leighanne Olivia Parkes ◽  
Kevin Barker ◽  
Susan M Poutanen ◽  
Jennifer M Grant ◽  
Michael Libman ◽  
...  
Keyword(s):  
Preliminary Investigation ◽  
Pulse Field ◽  
Common Source ◽  
Modern Problem ◽  
Hospital System ◽  
Pulse Field Gel Electrophoresis ◽  
Hospital Systems ◽  
The Common ◽  
Reported Data ◽  
Medicinal Leeches

Abstract Background Medicinal leeches are used primarily in plastic and reconstructive surgery when venous congestion threatens tissue viability. The associated infection risk ranges from 4.1 to 20%. Prophylactic antimicrobials such as fluoroquinolones (FQ) or trimethoprim-sulfamethoxazole (SXT) are recommended and target commonly isolated pathogen and gut symbiont, Aeromonas. However, resistance to these agents has been reported and detected in leeches, including at hospital systems across Canada that acquire their stock from the same supplier. Our objective was to describe the local epidemiology of leech-related Aeromonas resistant to one or more commonly used prophylactic agents, and determine if such resistance originates from the common supplier. Methods Six hospital systems across Canada using leech therapy, purchased from the same supplier, were surveyed. A 5-year retrospective review of all antimicrobial resistant leech-related Aeromonas, derived from clinical, leech, and tank fluid specimens was performed. All Aeromonas resistant to either FQ or SXT were included, and retained frozen isolates from each system were analysed by pulse-field gel electrophoresis (PFGE) using a published Aeromonas protocol. Results All six hospital systems reported leech-related Aeromonas resistant to one or more antimicrobials, totalling 15 isolates. Three systems only reported data from the last year. Four systems used FQ and two used SXT as prophylaxis. Fifteen of 15 were either FQ resistant or intermediate, and four of 15 were SXT resistant. Three of 10 isolates tested for ceftriaxone (CRO) susceptibility were resistant. Five of 15 of the isolates were resistant to two or more agents. Of the two leech quality control isolates, 2/2 were FQ resistant and 1/2 was FQ, SXT and CRO resistant. Only three isolates, each from a different, geographically distinct hospital system, had been retained. PFGE analysis indicated 2/3 are closely related (Figure 1). Conclusion Our preliminary investigation suggests that the presence of FQ and SXT resistance in leech-related Aeromonas might be more common than previously suspected, and that such resistance might originate from a common source. A broader study of the molecular epidemiology of leech-related Aeromonas is warranted. Disclosures All authors: No reported disclosures.

scholarly journals Do All Hospital Systems Have Market Power? Association Between Hospital System Types and Cardiac Surgery Prices

2019 ◽  
Vol 6 ◽  
pp. 233339281988641
Author(s):  
Sung W. Choi ◽  
Avi Dor
Keyword(s):  
Cardiac Surgery ◽  
Linear Models ◽  
Artery Bypass ◽  
Private Insurance ◽  
Bypass Graft ◽  
Coronary Intervention ◽  
Claim Database ◽  
Hospital System ◽  
Hospital Systems ◽  
Antitrust Analysis

Objective: This study explores the price implications of hospital systems by analyzing the association of system characteristics with selected cardiac surgery pricing. Data Source: Using a large private insurance claim database, the authors identified 11 282 coronary artery bypass graft (CABG) cases and 49 866 percutaneous coronary intervention (PCI) cases from 2002 to 2007. Study Design: We conducted a retrospective observational study using generalized linear models. Principal Findings: We found that the CABG and PCI prices in centralized health and physician insurance systems were significantly lower than the prices in stand-alone hospitals by 4.4% and 6.4%, respectively. In addition, the CABG and PCI prices in independent health systems were significantly lower than in stand-alone hospitals, by 15.4% and 14.5%, respectively. Conclusion: The current antitrust guidelines tend to focus on the market share of merging parties and pay less attention to the characteristics of merging parties. The results of this study suggest that antitrust analysis could be more effective by considering characteristics of hospital systems.

The Growth of Corporate Private Hospitals in Malaysia: Policy Contradictions in Health System Pluralism

1997 ◽  
Vol 27 (4) ◽  
pp. 643-659 ◽  
Author(s):  
Simon Barraclough
Keyword(s):  
Health Care ◽  
Health System ◽  
Rapid Growth ◽  
Urban Areas ◽  
Private Hospital ◽  
Corporate Investment ◽  
Private Hospitals ◽  
Hospital System ◽  
Hospital Sector ◽  
The Government

The rapid growth of corporate investment in the Malaysian private hospital sector has had a considerable impact on the health care system. Sustained economic growth, the development of new urban areas, an enlarged middle class, and the inclusion of hospital insurance in salary packages have all contributed to a financially lucrative investment environment for hospital entrepreneurs. Many of Malaysia's most technologically advanced hospitals employing leading specialists are owned and operated as corporate business ventures. Corporate hospital investment has been actively encouraged by the government, which regards an expanded private sector as a vital complement to the public hospital system. Yet this rapid growth of corporately owned private hospitals has posed serious contradictions for health care policy in terms of issues such as equity, cost and quality, the effect on the wider health system, and the very role of the state in health care provision. This article describes the growth of corporate investment in Malaysia's private hospital sector and explores some of the attendant policy contradictions.

Benchmarking and pondering ASERL interlibrary loan operations, 2010 and 2013

2014 ◽  
Vol 42 (1) ◽  
pp. 16-25 ◽  
Author(s):  
David P. Atkins ◽  
Judy T. Greenwood ◽  
Pambanisha Whaley
Keyword(s):  
Mixed Methods ◽  
Resource Sharing ◽  
Interlibrary Loan ◽  
Content Type ◽  
Research Libraries ◽  
Document Delivery ◽  
Staffing Levels ◽  
Comparative Case Studies ◽  
Support Resource ◽  
Operational Metrics

Purpose – In 2010 and 2013, the libraries in the Association of Southeastern Research Libraries (ASERL) were surveyed to identify benchmarks and programs to support resource sharing. Benchmarks and challenges identified generate discussions regarding programming, networking, and other support to improve resource sharing operations. This paper seeks to address these issues. Design/methodology/approach – This study compares and contrasts the two surveys using mixed methods data analysis. This study assesses ILL performance and explores the challenges and trends interlibrary loan practitioners see today. Findings – The article identifies changes and trends in consortia-wide transaction volumes; staffing levels; campus document delivery; professional issues and challenges; and library organizational schemes. Research limitations/implications – The study did not include data from constituencies outside of interlibrary loan. It also did not include interview follow-ups with survey participants to discuss challenges and reorganizations in greater detail. Future interlibrary loan research could focus less on operational metrics and more on broader issues such as e-resources and change management. Mixed methods are effect tools for benchmarking and comparative case studies. Practical implications – Individual libraries can compare themselves to the operational benchmarks and use insights drawn from comment analysis to stimulate conversations regarding current and future roles for interlibrary loan. Consortia can duplicate the study to understand their operational benchmarks and their particular contexts. Originality/value – The study provides comparative benchmarks for research libraries and consortia spanning three years. It demonstrates substantial shifts in issues faced by libraries and librarians.

scholarly journals Del hospital de pobres a la cultura hospitalo-céntrica. Economía política y cambio cultural en el sistema hospitalario catalán / From the poor hospital to the hospital-centric culture. Political economy and cultural change in the Catalan hospital system

2017 ◽  
pp. 57
Author(s):  
Josep Maria Comelles Esteban ◽  
Elisa Alegre Agís ◽  
Josep Barceló Prats
Keyword(s):  
Mental Health ◽  
Health System ◽  
Cultural Change ◽  
Hospital System ◽  
Palabras Clave ◽  
El Sistema ◽  
Salud Mental ◽  
History Of ◽  
Hospital Institution

Resumen: En el presente artículo se describe la evolución del sistema sanitario catalán utilizando, para ello, el desarrollo de un concepto cultural –el hospitalo-centrismo– clave para entender la hegemonía de la institución hospitalaria en los dispositivos de salud actuales. A tales efectos y utilizando dos perspectivas complementarias como son la historia antropológica y la antropología médica, el artículo analiza un case study a partir de tres ejemplos: la demanda de urgencias hospitalarias asociadas a una concepción cultural de lo que es “grave” y al embodiment de su eficacia por los ciudadanos; la necesidad del rol de asilo en las enfermedades crónicas o terminales; y la conversión del cuidado doméstico como “hospitalización doméstica” en el caso de la salud mental. Palabras clave: hospital-centrismo, sistema sanitario, historia de hospitales, urgencias, cuidados crónicos, salud mental. Abstract: This article describes the evolution of the Catalan Health System, using the development of a key cultural concept –hospital-centrism– to understand the hegemony of the hospital institution in the current health devices. To this purpose, and using two complementary perspectives such as anthropological history and medical anthropology, the article analyzes a case study from three examples: the demand for hospital emergencies related with a cultural conception of what is “severe”, and with its effectiveness embodied by the citizens; the need of the asylum role in chronic or terminal diseases; and the transformation of domestic care to “domestic hospitalization” in mental health cases. Keywords: hospital-centrism, health system, history of hospitals, emergencies, chronic care, mental health.

scholarly journals Reduction in Emergency Department Presentations in a Regional Health System during the Covid-19 Pandemic

2021 ◽  
Vol 22 (4) ◽  
pp. 842-850
Author(s):  
Edana Mann ◽  
Daniel Swedien ◽  
Jonathan Hansen ◽  
Susan Peterson ◽  
Mustapha Saheed ◽  
...  
Keyword(s):  
Emergency Department ◽  
Health System ◽  
Mitigation Measures ◽  
Hospital System ◽  
Vein Thrombosis ◽  
Diagnosis Codes ◽  
Icd 10 ◽  
Ed Visits ◽  
Clinical Conditions ◽  
Deep Vein

Introduction: Nationally, there has been more than a 40% decrease in Emergency Department (ED) patient volume during the coronavirus disease 2019 (Covid-19) crisis, with reports of decreases in presentations of time-sensitive acute illnesses. We analyzed ED clinical presentations in a Maryland/District of Columbia regional hospital system while health mitigation measures were instituted. Methods: We conducted a retrospective observational cohort study of all adult ED patients presenting to five Johns Hopkins Health System (JHHS) hospitals comparing visits from March 16 through May 15, in 2019 and 2020. We analyzed de-identified demographic information, clinical conditions, and ICD-10 diagnosis codes for year-over-year comparisons. Results: There were 36.7% fewer JHHS ED visits in 2020 compared to 2019 (43,088 vs. 27,293, P<.001). Patients 75+ had the greatest decline in visits (-44.00%, P<.001). Both genders had significant decreases in volume (-41.9%, P<.001 females vs -30.6%, P<.001 males). Influenza like illness (ILI) symptoms increased year-over-year including fever (640 to 1253, 95.8%, P<.001) and shortness of breath (2504 to 2726, 8.9%, P=.002). ICD-10 diagnoses for a number of time-sensitive illnesses decreased including deep vein thrombosis (101 to 39, -61%, P<.001), acute myocardial infarction (157 to 105, -33%, P=.002), gastrointestinal bleeding (290 to 179, -38.3%, P<.001), and strokes (284 to 234, -17.6%, P=0.03). Conclusion: ED visits declined significantly among JHHS hospitals despite offsetting increases in ILI complaints. Decreases in presentations of time-sensitive illnesses were of particular concern. Efforts should be taken to inform patients that EDs are safe, otherwise preventable morbidity and mortality will remain a problem.

scholarly journals Stakeholders' Perception of the Introduction of Specialized Hospitals for Urologic Diseases: Qualitative Study

2021 ◽  
Vol 27 (2) ◽  
pp. 2-17
Author(s):  
Hye-Ran Jeong ◽  
Jee-Hee Pyo ◽  
Eun-Young Choi ◽  
Ju-Young Kim ◽  
Young-Kwon Park ◽  
...  
Keyword(s):  
Group Discussion ◽  
Healthcare Delivery ◽  
Government Support ◽  
Healthcare Delivery System ◽  
Hospital System ◽  
Urologic Diseases ◽  
Specialized Hospital ◽  
Depth Interview ◽  
Hospital Systems

Purpose: The purpose of this study is to seek in-depth perspectives of stakeholders on the necessity and specific criteria for designating a specialized hospital for urologic diseases.Methods: Eight participants experts in urology medicine and specialized hospital system were divided into four groups. Following the semi-structured guidelines, an in-depth interview was conducted twice and a focus group discussion was conducted three times. All the interviews were transcribed verbatim and analyzed.Results: The majority of participants predicted that there would be demand for specialized hospitals for urologic diseases. The criteria of designating a specialized hospital, such as the number of hospital beds and quality of health care, have to be modified in consideration of the specificity of urology. The introduction of a specialized hospital would improve the healthcare delivery system, positively affecting hospitals and patients. Furthermore, government support is essential for the maintenance of specialized hospital systems as urology hospitals experience difficulties in generating profits.Conclusion: This study is expected to be used as base data for introducing and operating a specialized hospital for urologic diseases. In addition, it is expected that the methodology and results of this study would encourage follow-up studies on specialized hospitals and provide guidelines to evaluate the effectiveness of such hospitals in other medical fields.

scholarly journals The effectiveness of early colchicine administration in patients over 60 years old with high risk of developing severe pulmonary complications associated with coronavirus pneumonia SARS-CoV-2 (COVID-19): study protocol for an investigator-driven randomized controlled clinical trial in primary health care—COLCHICOVID study

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Elena Bustamante Estebanez ◽  
Lucía Lavín Alconero ◽  
Beatriz Josa Fernández ◽  
Monica Gozalo Marguello ◽  
Juan Carlos López Caro ◽  
...  
Keyword(s):  
Primary Care ◽  
Clinical Trial ◽  
Health System ◽  
Pulmonary Complications ◽  
Phase Iii ◽  
Controlled Clinical Trial ◽  
Early Administration ◽  
Hospital System ◽  
Health Crisis ◽  
Link Type

Abstract Background There is no strong evidence that any drug is beneficial either for the treatment of SARS-CoV-2 disease or for post-exposure prophylaxis. Therefore, clinical research is crucial to generate results and evaluate strategies against COVID-19. Primary care (PC) centers, the first level of care in the health system, are in a favorable position to carry out clinical trials (CD), as they work with a large volume of patients with varied profiles (from acute to chronic pathologies). During the COVID-19 pandemic, the need for hospital admission and mortality is higher in people > 60 years. Therefore, this is a target population to try to reduce the serious complications and lethality of COVID pneumonia and to avoid overloading the hospital system. Given the pharmacological properties of colchicine (anti-inflammatory and anti-fibrotic, possible inhibition of viral replication, and inhibitory effect on coagulation activation), early treatment with colchicine may reduce the rate of death and serious pulmonary complications from COVID-19 in vulnerable patients. Methods The COLCHICOVID study is a randomized, multicenter, controlled, open-label parallel group (2:1 ratio), phase III clinical trial to investigate the efficacy of early administration of colchicine in reducing the development of severe pulmonary complications associated with COVID-19 infection in patients over 60 years of age with at-risk comorbidities. Discussion This is a pragmatic clinical trial, adapted to usual clinical practice. The demonstration that early administration of colchicine has clinical effectiveness in reducing the complications of SARS-CoV-2 infection in a population highly susceptible may mitigate the health crisis and prevent the collapse of the health system in the successive waves of the coronavirus pandemic. In addition, colchicine is a well-known medicine, simple to use in the primary care setting and with a low cost for the health system. Trial registration ClinicalTrials.govNCT04416334. Registered on 4 June 2020. Protocol version: v 3.0, dated 22 September 2020.

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