Good Business

2014 ◽  
Author(s):  
Adam D. Reich
Keyword(s):  
Hospital Care ◽  
Contract Management ◽  
Financial Success ◽  
Independent Contractors ◽  
Legal Risk ◽  
Emergency Medical ◽  
Malpractice Insurance ◽  
Medical Malpractice Insurance ◽  
Management Groups

This chapter examines the link between Emergency Medical Incorporated's financial success and the quality of hospital care it ultimately was able to provide. Emergency Medical Incorporated, one of the nation's largest contract management groups, held the contract for the emergency department at HolyCare Hospital. The company managed the scheduling, billing, and workflow of the emergency medicine physicians, who were technically “independent contractors” with the company. It also provided them with medical malpractice insurance and helped them minimize legal risk. The chapter considers the billing practices of HolyCare doctors and the effects of physicians' individualism on the quality of care at HolyCare. It shows that entrepreneurship was structured within larger organizations (from the physicians' group to the hospital itself) that also profited from doctors' profiteering.

scholarly journals Changes in weekend and weekday care quality of emergency medical admissions to 20 hospitals in England during implementation of the 7-day services national health policy

2020 ◽  
pp. bmjqs-2020-011165
Author(s):  
Julian Bion ◽  
Cassie Aldridge ◽  
Alan J Girling ◽  
Gavin Rudge ◽  
Jianxia Sun ◽  
...  
Keyword(s):  
Adverse Event ◽  
Quality Of Care ◽  
National Health ◽  
Hospital Care ◽  
Care Quality ◽  
Weekend Effect ◽  
Early Warning Score ◽  
Emergency Medical ◽  
Day Services

BackgroundIn 2013, the English National Health Service launched the policy of 7-day services to improve care quality and outcomes for weekend emergency admissions.AimsTo determine whether the quality of care of emergency medical admissions is worse at weekends, and whether this has changed during implementation of 7-day services.MethodsUsing data from 20 acute hospital Trusts in England, we performed randomly selected structured case record reviews of patients admitted to hospital as emergencies at weekends and on weekdays between financial years 2012–2013 and 2016–2017. Senior doctor (‘specialist’) involvement was determined from annual point prevalence surveys. The primary outcome was the rate of clinical errors. Secondary outcomes included error-related adverse event rates, global quality of care and four indicators of good practice.ResultsSeventy-nine clinical reviewers reviewed 4000 admissions, 800 in duplicate. Errors, adverse events and care quality were not significantly different between weekend and weekday admissions, but all improved significantly between epochs, particularly errors most likely influenced by doctors (clinical assessment, diagnosis, treatment, prescribing and communication): error rate OR 0.78; 95% CI 0.70 to 0.87; adverse event OR 0.48, 95% CI 0.33 to 0.69; care quality OR 0.78, 95% CI 0.70 to 0.87; all adjusted for age, sex and ethnicity. Postadmission in-hospital care processes improved between epochs and were better for weekend admissions (vital signs with National Early Warning Score and timely specialist review). Preadmission processes in the community were suboptimal at weekends and deteriorated between epochs (fewer family doctor referrals, more patients with chronic disease or palliative care designation).Conclusions and implicationsHospital care quality of emergency medical admissions is not worse at weekends and has improved during implementation of the 7-day services policy. Causal pathways for the weekend effect may extend into the prehospital setting.

The objective assessment of the quality of hospital care: dream or reality?

2007 ◽  
Vol 148 (43) ◽  
pp. 2033-2041
Author(s):  
Éva Belicza ◽  
Erika Takács
Keyword(s):  
Hospital Care ◽  
Objective Assessment

A nemzetközi szakirodalom egyre gyakrabban foglalkozik azzal a kérdéssel, hogy a minőségi indikátorokra támaszkodó nyilvános minőségértékelésnek mi a hatása az ellátás minőségére és az érintettek döntésére vonatkozóan, illetve melyek azok a kritériumok, amelyek mentén nyilvános minőségértékelési rendszereket célszerű kialakítani. A nemzetközi szakirodalom alapján a dolgozat hat témakört mutat be: (1) az indikátorok képessége a szolgáltatók megkülönböztetésére; (2) az eredményindikátorok alkalmassága a szolgáltatók megítélésére; (3) a bajnoki tabellák képessége a szolgáltatók rangsorolására; (4) a lakosság viselkedése a szolgáltatók választása során; (5) az indikátorokra támaszkodó nyilvános minősítések hatásai; (6) ajánlások minősítési rendszerek kidolgozására. A szakirodalmi kutatások szerint elsősorban a kockázatkiegyenlítési problémák miatt az indikátorok képessége a szolgáltatók megkülönböztetésére a nyújtott ellátás minősége szempontjából kérdéses; az elért ellátási eredmények nem feltétlenül utalnak vissza az ellátási folyamatok minőségére; a több indikátorból komponált intézményi sorrendek (bajnoki tabellák) nem megbízhatóak; a lakosság a szolgáltatók kiválasztásakor elsősorban a környezet véleményét és a távolságot veszi figyelembe; és a nyilvános közlések hatására igazoltan romlik az ellátás átfogó minősége. A szolgáltatók értékelésében alkalmazott mérési eredmények közzétételét eszköznek kell tekinteni. A lakosság intézményválasztásának elősegítésére az ő preferenciáik mentén végzett betegelégedettségi vizsgálatok nyilvánossá tétele hozhatja meg a kívánt eredményt. A minőségfejlesztési célokat igazoltan segítik a szolgáltatói körben végzett közvetlen visszajelzések az indikátorok mért értékeiről, illetve pontosabb kép kapható az ellátási és szervezési folyamatok, standardok egységes felülvizsgálatára alapozott eljárások külső értékelési rendszerekbe történő beemelésével.

Training Package for Emergency Medical Teams Deployed to Disaster Stricken Areas: Has ‘TEAMS’ Achieved its Goals?

2021 ◽  
pp. 1-7
Author(s):  
Moran Bodas ◽  
Kobi Peleg ◽  
Bruria Adini ◽  
Luca Ragazzoni
Keyword(s):  
Self Efficacy ◽  
Training Programs ◽  
Team Work ◽  
Pilot Training ◽  
Perceived Needs ◽  
Training Package ◽  
Emergency Medical ◽  
Field Team ◽  
Medical Teams

Abstract In spite of their good intentions, Emergency Medical Teams (EMTs) were relatively disorganized for many years. To enhance the efficient provision of EMT’s field team work, the Training for Emergency Medical Teams and European Medical Corps (TEAMS) project was established. The purpose of this study was to assess the effectiveness and quality of the TEAMS training package in 2 pilot training programs in Germany and Turkey. A total of 19 German and 29 Turkish participants completed the TEAMS training package. Participants were asked to complete a set of questionnaires designed to assess self-efficacy, team work, and quality of training. The results suggest an improvement for both teams’ self-efficacy and team work. The self-efficacy scale improved from 3.912 (± 0.655 SD) prior to training to 4.580 (± 0.369 SD) after training (out of 5). Team work improved from 3.085 (± 0.591 SD) to 3.556 (± 0.339 SD) (out of 4). The overall mean score of the quality of the training scale was 4.443 (± 0.671 SD) (out of 5). In conclusion, The TEAMS Training Package for Emergency Medical Teams has been demonstrated to be effective in promoting EMT team work capacities, and it is considered by its users to be a useful and appropriate tool for addressing their perceived needs.

Using Assessing Care of Vulnerable Elders Quality Indicators to Measure Quality of Hospital Care for Vulnerable Elders

2007 ◽  
Vol 55 (11) ◽  
pp. 1705-1711 ◽  
Author(s):  
Vineet M. Arora ◽  
Martha Johnson ◽  
Jared Olson ◽  
Paula M. Podrazik ◽  
Stacie Levine ◽  
...  
Keyword(s):  
Quality Indicators ◽  
Hospital Care
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