Quality Assurance, Health Care: Activities and programs intended to assure or improve the quality of care in either a defined medical setting or a program. The concept includes the assessment or evaluation of the quality of care; identification of problems or shortcomings in the delivery of care; designing activities to overcome these deficiencies; and follow-up monitoring to ensure effectiveness of corrective steps.Quality Control: A system for verifying and maintaining a desired level of quality in a product or process by careful planning, use of proper equipment, continued inspection, and corrective action as required. (Random House Unabridged Dictionary, 2d ed)Lot Quality Assurance Sampling: A sampling methodology using small sample sizes when conducting surveys in small geographical or population-based areas or lots.Quality of Life: A generic concept reflecting concern with the modification and enhancement of life attributes, e.g., physical, political, moral and social environment; the overall condition of a human life.Quality of Health Care: The levels of excellence which characterize the health service or health care provided based on accepted standards of quality.Health Status: The level of health of the individual, group, or population as subjectively assessed by the individual or by more objective measures.Laboratories: Facilities equipped to carry out investigative procedures.Public Health: Branch of medicine concerned with the prevention and control of disease and disability, and the promotion of physical and mental health of the population on the international, national, state, or municipal level.Delivery of Health Care: The concept concerned with all aspects of providing and distributing health services to a patient population.Quality Indicators, Health Care: Norms, criteria, standards, and other direct qualitative and quantitative measures used in determining the quality of health care.Health Policy: Decisions, usually developed by government policymakers, for determining present and future objectives pertaining to the health care system.Health Care Reform: Innovation and improvement of the health care system by reappraisal, amendment of services, and removal of faults and abuses in providing and distributing health services to patients. It includes a re-alignment of health services and health insurance to maximum demographic elements (the unemployed, indigent, uninsured, elderly, inner cities, rural areas) with reference to coverage, hospitalization, pricing and cost containment, insurers' and employers' costs, pre-existing medical conditions, prescribed drugs, equipment, and services.Film Dosimetry: Use of a device (film badge) for measuring exposure of individuals to radiation. It is usually made of metal, plastic, or paper and loaded with one or more pieces of x-ray film.Accreditation: Certification as complying with a standard set by non-governmental organizations, applied for by institutions, programs, and facilities on a voluntary basis.Health Surveys: A systematic collection of factual data pertaining to health and disease in a human population within a given geographic area.Health Promotion: Encouraging consumer behaviors most likely to optimize health potentials (physical and psychosocial) through health information, preventive programs, and access to medical care.Andrology: A scientific or medical discipline concerning the study of male reproductive biology, diseases of the male genital organs, and male infertility. Major areas of interest include ENDOCRINOLOGY; SPERMATOGENESIS; semen analysis; FERTILIZATION; CONTRACEPTION; and CRYOPRESERVATION.Health Care Surveys: Statistical measures of utilization and other aspects of the provision of health care services including hospitalization and ambulatory care.Pathology, Surgical: A field of anatomical pathology in which living tissue is surgically removed for the purpose of diagnosis and treatment.Mental Health: The state wherein the person is well adjusted.Health Services Research: The integration of epidemiologic, sociological, economic, and other analytic sciences in the study of health services. Health services research is usually concerned with relationships between need, demand, supply, use, and outcome of health services. The aim of the research is evaluation, particularly in terms of structure, process, output, and outcome. (From Last, Dictionary of Epidemiology, 2d ed)Primary Health Care: Care which provides integrated, accessible health care services by clinicians who are accountable for addressing a large majority of personal health care needs, developing a sustained partnership with patients, and practicing in the context of family and community. (JAMA 1995;273(3):192)Pathology Department, Hospital: Hospital department which administers and provides pathology services.Health Physics: The science concerned with problems of radiation protection relevant to reducing or preventing radiation exposure, and the effects of ionizing radiation on humans and their environment.Clinical Laboratory Techniques: Techniques used to carry out clinical investigative procedures in the diagnosis and therapy of disease.Total Quality Management: The application of industrial management practice to systematically maintain and improve organization-wide performance. Effectiveness and success are determined and assessed by quantitative quality measures.Health Services Accessibility: The degree to which individuals are inhibited or facilitated in their ability to gain entry to and to receive care and services from the health care system. Factors influencing this ability include geographic, architectural, transportational, and financial considerations, among others.Credentialing: The recognition of professional or technical competence through registration, certification, licensure, admission to association membership, the award of a diploma or degree, etc.Health: The state of the organism when it functions optimally without evidence of disease.Attitude to Health: Public attitudes toward health, disease, and the medical care system.Reproducibility of Results: The statistical reproducibility of measurements (often in a clinical context), including the testing of instrumentation or techniques to obtain reproducible results. The concept includes reproducibility of physiological measurements, which may be used to develop rules to assess probability or prognosis, or response to a stimulus; reproducibility of occurrence of a condition; and reproducibility of experimental results.Laboratories, Hospital: Hospital facilities equipped to carry out investigative procedures.Health Planning: Planning for needed health and/or welfare services and facilities.Peer Review: An organized procedure carried out by a select committee of professionals in evaluating the performance of other professionals in meeting the standards of their specialty. Review by peers is used by editors in the evaluation of articles and other papers submitted for publication. Peer review is used also in the evaluation of grant applications. It is applied also in evaluating the quality of health care provided to patients.Pathology, Clinical: A subspecialty of pathology applied to the solution of clinical problems, especially the use of laboratory methods in clinical diagnosis. (Dorland, 28th ed.)National Health Programs: Components of a national health care system which administer specific services, e.g., national health insurance.European Union: The collective designation of three organizations with common membership: the European Economic Community (Common Market), the European Coal and Steel Community, and the European Atomic Energy Community (Euratom). It was known as the European Community until 1994. It is primarily an economic union with the principal objectives of free movement of goods, capital, and labor. Professional services, social, medical and paramedical, are subsumed under labor. The constituent countries are Austria, Belgium, Denmark, Finland, France, Germany, Greece, Ireland, Italy, Luxembourg, Netherlands, Portugal, Spain, Sweden, and the United Kingdom. (The World Almanac and Book of Facts 1997, p842)Quality Improvement: The attainment or process of attaining a new level of performance or quality.Health Behavior: Behaviors expressed by individuals to protect, maintain or promote their health status. For example, proper diet, and appropriate exercise are activities perceived to influence health status. Life style is closely associated with health behavior and factors influencing life style are socioeconomic, educational, and cultural.Radiometry: The measurement of radiation by photography, as in x-ray film and film badge, by Geiger-Mueller tube, and by SCINTILLATION COUNTING.Program Evaluation: Studies designed to assess the efficacy of programs. They may include the evaluation of cost-effectiveness, the extent to which objectives are met, or impact.Insurance, Health: Insurance providing coverage of medical, surgical, or hospital care in general or for which there is no specific heading.Medical Audit: A detailed review and evaluation of selected clinical records by qualified professional personnel for evaluating quality of medical care.Organization and Administration: The planning and managing of programs, services, and resources.Peer Review, Health Care: The concurrent or retrospective review by practicing physicians or other health professionals of the quality and efficiency of patient care practices or services ordered or performed by other physicians or other health professionals (From The Facts On File Dictionary of Health Care Management, 1988).Health Services: Services for the diagnosis and treatment of disease and the maintenance of health.Radiation Oncology: A subspecialty of medical oncology and radiology concerned with the radiotherapy of cancer.Health Personnel: Men and women working in the provision of health services, whether as individual practitioners or employees of health institutions and programs, whether or not professionally trained, and whether or not subject to public regulation. (From A Discursive Dictionary of Health Care, 1976)Outcome Assessment (Health Care): Research aimed at assessing the quality and effectiveness of health care as measured by the attainment of a specified end result or outcome. Measures include parameters such as improved health, lowered morbidity or mortality, and improvement of abnormal states (such as elevated blood pressure).Health Facilities: Institutions which provide medical or health-related services.World Health Organization: A specialized agency of the United Nations designed as a coordinating authority on international health work; its aim is to promote the attainment of the highest possible level of health by all peoples.World Health: The concept pertaining to the health status of inhabitants of the world.Medical Laboratory Personnel: Health care professionals, technicians, and assistants staffing LABORATORIES in research or health care facilities.Health Education: Education that increases the awareness and favorably influences the attitudes and knowledge relating to the improvement of health on a personal or community basis.Questionnaires: Predetermined sets of questions used to collect data - clinical data, social status, occupational group, etc. The term is often applied to a self-completed survey instrument.Health Services Needs and Demand: Health services required by a population or community as well as the health services that the population or community is able and willing to pay for.Radiotherapy Planning, Computer-Assisted: Computer-assisted mathematical calculations of beam angles, intensities of radiation, and duration of irradiation in radiotherapy.Health Knowledge, Attitudes, Practice: Knowledge, attitudes, and associated behaviors which pertain to health-related topics such as PATHOLOGIC PROCESSES or diseases, their prevention, and treatment. This term refers to non-health workers and health workers (HEALTH PERSONNEL).Guidelines as Topic: A systematic statement of policy rules or principles. Guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by convening expert panels. The text may be cursive or in outline form but is generally a comprehensive guide to problems and approaches in any field of activity. For guidelines in the field of health care and clinical medicine, PRACTICE GUIDELINES AS TOPIC is available.Public Health Administration: Management of public health organizations or agencies.International Cooperation: The interaction of persons or groups of persons representing various nations in the pursuit of a common goal or interest.Community Health Services: Diagnostic, therapeutic and preventive health services provided for individuals in the community.Benchmarking: Method of measuring performance against established standards of best practice.Attitude of Health Personnel: Attitudes of personnel toward their patients, other professionals, toward the medical care system, etc.Oral Health: The optimal state of the mouth and normal functioning of the organs of the mouth without evidence of disease.Professional Review Organizations: Organizations representing designated geographic areas which have contracts under the PRO program to review the medical necessity, appropriateness, quality, and cost-effectiveness of care received by Medicare beneficiaries. Peer Review Improvement Act, PL 97-248, 1982.Child Health Services: Organized services to provide health care for children.United StatesHealth Expenditures: The amounts spent by individuals, groups, nations, or private or public organizations for total health care and/or its various components. These amounts may or may not be equivalent to the actual costs (HEALTH CARE COSTS) and may or may not be shared among the patient, insurers, and/or employers.Management Quality Circles: Participation of employees with management as a labor-management team, in decisions pertaining to the operational activities of the organization or industry.Health Plan Implementation: Those actions designed to carry out recommendations pertaining to health plans or programs.Mass Screening: Organized periodic procedures performed on large groups of people for the purpose of detecting disease.Allied Health Personnel: Health care workers specially trained and licensed to assist and support the work of health professionals. Often used synonymously with paramedical personnel, the term generally refers to all health care workers who perform tasks which must otherwise be performed by a physician or other health professional.Genetic Services: Organized services to provide diagnosis, treatment, and prevention of genetic disorders.Environmental Health: The science of controlling or modifying those conditions, influences, or forces surrounding man which relate to promoting, establishing, and maintaining health.Health Status Disparities: Variation in rates of disease occurrence and disabilities between population groups defined by socioeconomic characteristics such as age, ethnicity, economic resources, or gender and populations identified geographically or similar measures.Occupational Health: The promotion and maintenance of physical and mental health in the work environment.Patient Acceptance of Health Care: The seeking and acceptance by patients of health service.Cross-Sectional Studies: Studies in which the presence or absence of disease or other health-related variables are determined in each member of the study population or in a representative sample at one particular time. This contrasts with LONGITUDINAL STUDIES which are followed over a period of time.EuropeDiagnostic Errors: Incorrect diagnoses after clinical examination or technical diagnostic procedures.GermanySpecimen Handling: Procedures for collecting, preserving, and transporting of specimens sufficiently stable to provide accurate and precise results suitable for clinical interpretation.Practice Guidelines as Topic: Directions or principles presenting current or future rules of policy for assisting health care practitioners in patient care decisions regarding diagnosis, therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery.Equipment Safety: Freedom of equipment from actual or potential hazards.Health Care Rationing: Planning for the equitable allocation, apportionment, or distribution of available health resources.Facility Regulation and Control: Formal voluntary or governmental procedures and standards required of hospitals and health or other facilities to improve operating efficiency, and for the protection of the consumer.Sampling Studies: Studies in which a number of subjects are selected from all subjects in a defined population. Conclusions based on sample results may be attributed only to the population sampled.Delivery of Health Care, Integrated: A health care system which combines physicians, hospitals, and other medical services with a health plan to provide the complete spectrum of medical care for its customers. In a fully integrated system, the three key elements - physicians, hospital, and health plan membership - are in balance in terms of matching medical resources with the needs of purchasers and patients. (Coddington et al., Integrated Health Care: Reorganizing the Physician, Hospital and Health Plan Relationship, 1994, p7)Mental Health Services: Organized services to provide mental health care.Health Priorities: Preferentially rated health-related activities or functions to be used in establishing health planning goals. This may refer specifically to PL93-641.Great BritainSystematized Nomenclature of Medicine: Controlled vocabulary of clinical terms produced by the International Health Terminology Standards Development Organisation (IHTSDO).Public Health Practice: The activities and endeavors of the public health services in a community on any level.Reference Standards: A basis of value established for the measure of quantity, weight, extent or quality, e.g. weight standards, standard solutions, methods, techniques, and procedures used in diagnosis and therapy.Sensitivity and Specificity: Binary classification measures to assess test results. Sensitivity or recall rate is the proportion of true positives. Specificity is the probability of correctly determining the absence of a condition. (From Last, Dictionary of Epidemiology, 2d ed)Outcome and Process Assessment (Health Care): Evaluation procedures that focus on both the outcome or status (OUTCOMES ASSESSMENT) of the patient at the end of an episode of care - presence of symptoms, level of activity, and mortality; and the process (ASSESSMENT, PROCESS) - what is done for the patient diagnostically and therapeutically.Certification: Compliance with a set of standards defined by non-governmental organizations. Certification is applied for by individuals on a voluntary basis and represents a professional status when achieved, e.g., certification for a medical specialty.Health Care Sector: Economic sector concerned with the provision, distribution, and consumption of health care services and related products.Women's Health: The concept covering the physical and mental conditions of women.Radiotherapy, Intensity-Modulated: CONFORMAL RADIOTHERAPY that combines several intensity-modulated beams to provide improved dose homogeneity and highly conformal dose distributions.Multicenter Studies as Topic: Works about controlled studies which are planned and carried out by several cooperating institutions to assess certain variables and outcomes in specific patient populations, for example, a multicenter study of congenital anomalies in children.Rural Health: The status of health in rural populations.Research Design: A plan for collecting and utilizing data so that desired information can be obtained with sufficient precision or so that an hypothesis can be tested properly.Program Development: The process of formulating, improving, and expanding educational, managerial, or service-oriented work plans (excluding computer program development).Management Audit: Management review designed to evaluate efficiency and to identify areas in need of management improvement within the institution in order to ensure effectiveness in meeting organizational goals.Dental Records: Data collected during dental examination for the purpose of study, diagnosis, or treatment planning.Laboratory Proficiency Testing: Assessments aimed at determining agreement in diagnostic test results among laboratories. Identical survey samples are distributed to participating laboratories, with results stratified according to testing methodologies.Private Sector: That distinct portion of the institutional, industrial, or economic structure of a country that is controlled or owned by non-governmental, private interests.Urban Health: The status of health in urban populations.Radiotherapy Dosage: The total amount of radiation absorbed by tissues as a result of radiotherapy.Guideline Adherence: Conformity in fulfilling or following official, recognized, or institutional requirements, guidelines, recommendations, protocols, pathways, or other standards.Health Literacy: Degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions.Managed Care Programs: Health insurance plans intended to reduce unnecessary health care costs through a variety of mechanisms, including: economic incentives for physicians and patients to select less costly forms of care; programs for reviewing the medical necessity of specific services; increased beneficiary cost sharing; controls on inpatient admissions and lengths of stay; the establishment of cost-sharing incentives for outpatient surgery; selective contracting with health care providers; and the intensive management of high-cost health care cases. The programs may be provided in a variety of settings, such as HEALTH MAINTENANCE ORGANIZATIONS and PREFERRED PROVIDER ORGANIZATIONS.Patient Satisfaction: The degree to which the individual regards the health care service or product or the manner in which it is delivered by the provider as useful, effective, or beneficial.Pilot Projects: Small-scale tests of methods and procedures to be used on a larger scale if the pilot study demonstrates that these methods and procedures can work.Device Approval: Process that is gone through in order for a device to receive approval by a government regulatory agency. This includes any required preclinical or clinical testing, review, submission, and evaluation of the applications and test results, and post-marketing surveillance. It is not restricted to FDA.Rural Health Services: Health services, public or private, in rural areas. The services include the promotion of health and the delivery of health care.Health Maintenance Organizations: Organized systems for providing comprehensive prepaid health care that have five basic attributes: (1) provide care in a defined geographic area; (2) provide or ensure delivery of an agreed-upon set of basic and supplemental health maintenance and treatment services; (3) provide care to a voluntarily enrolled group of persons; (4) require their enrollees to use the services of designated providers; and (5) receive reimbursement through a predetermined, fixed, periodic prepayment made by the enrollee without regard to the degree of services provided. (From Facts on File Dictionary of Health Care Management, 1988)Professional Staff Committees: Committees of professional personnel who have responsibility for determining policies, procedures, and controls related to professional matters in health facilities.Socioeconomic Factors: Social and economic factors that characterize the individual or group within the social structure.Cost-Benefit Analysis: A method of comparing the cost of a program with its expected benefits in dollars (or other currency). The benefit-to-cost ratio is a measure of total return expected per unit of money spent. This analysis generally excludes consideration of factors that are not measured ultimately in economic terms. Cost effectiveness compares alternative ways to achieve a specific set of results.Niger: A republic in western Africa, north of NIGERIA and west of CHAD. Its capital is Niamey.Terminology as Topic: The terms, expressions, designations, or symbols used in a particular science, discipline, or specialized subject area.Phantoms, Imaging: Devices or objects in various imaging techniques used to visualize or enhance visualization by simulating conditions encountered in the procedure. Phantoms are used very often in procedures employing or measuring x-irradiation or radioactive material to evaluate performance. Phantoms often have properties similar to human tissue. Water demonstrates absorbing properties similar to normal tissue, hence water-filled phantoms are used to map radiation levels. Phantoms are used also as teaching aids to simulate real conditions with x-ray or ultrasonic machines. (From Iturralde, Dictionary and Handbook of Nuclear Medicine and Clinical Imaging, 1990)Organizational Objectives: The purposes, missions, and goals of an individual organization or its units, established through administrative processes. It includes an organization's long-range plans and administrative philosophy.Early Detection of Cancer: Methods to identify and characterize cancer in the early stages of disease and predict tumor behavior.Clinical Audit: A detailed review and evaluation of selected clinical records by qualified professional personnel to improve the quality of patient care and outcomes. The clinical audit was formally introduced in 1993 into the United Kingdom's National Health Service.National Institutes of Health (U.S.): An operating division of the US Department of Health and Human Services. It is concerned with the overall planning, promoting, and administering of programs pertaining to health and medical research. Until 1995, it was an agency of the United States PUBLIC HEALTH SERVICE.Efficiency, Organizational: The capacity of an organization, institution, or business to produce desired results with a minimum expenditure of energy, time, money, personnel, materiel, etc.Medical Laboratory Science: The specialty related to the performance of techniques in clinical pathology such as those in hematology, microbiology, and other general clinical laboratory applications.Time Factors: Elements of limited time intervals, contributing to particular results or situations.Medical Informatics Applications: Automated systems applied to the patient care process including diagnosis, therapy, and systems of communicating medical data within the health care setting.Community Health Planning: Planning that has the goals of improving health, improving accessibility to health services, and promoting efficiency in the provision of services and resources on a comprehensive basis for a whole community. (From Facts on File Dictionary of Health Care Management, 1988, p299)Population Surveillance: Ongoing scrutiny of a population (general population, study population, target population, etc.), generally using methods distinguished by their practicability, uniformity, and frequently their rapidity, rather than by complete accuracy.Particle Accelerators: Devices which accelerate electrically charged atomic or subatomic particles, such as electrons, protons or ions, to high velocities so they have high kinetic energy.Radiation Monitoring: The observation, either continuously or at intervals, of the levels of radiation in a given area, generally for the purpose of assuring that they have not exceeded prescribed amounts or, in case of radiation already present in the area, assuring that the levels have returned to those meeting acceptable safety standards.Patient Care Team: Care of patients by a multidisciplinary team usually organized under the leadership of a physician; each member of the team has specific responsibilities and the whole team contributes to the care of the patient.Documentation: Systematic organization, storage, retrieval, and dissemination of specialized information, especially of a scientific or technical nature (From ALA Glossary of Library and Information Science, 1983). It often involves authenticating or validating information.Data Collection: Systematic gathering of data for a particular purpose from various sources, including questionnaires, interviews, observation, existing records, and electronic devices. The process is usually preliminary to statistical analysis of the data.Histocytological Preparation Techniques: Methods of preparing cells or tissues for examination and study of their origin, structure, function, or pathology. The methods include preservation, fixation, sectioning, staining, replica, or other technique to allow for viewing using a microscope.Respiratory Therapy Department, Hospital: Hospital department which is responsible for the administration of diagnostic pulmonary function tests and of procedures to restore optimum pulmonary ventilation.Chemistry, Clinical: The specialty of ANALYTIC CHEMISTRY applied to assays of physiologically important substances found in blood, urine, tissues, and other biological fluids for the purpose of aiding the physician in making a diagnosis or following therapy.Consumer Satisfaction: Customer satisfaction or dissatisfaction with a benefit or service received.Hospital Bed Capacity, 500 and overDecision Making, Organizational: The process by which decisions are made in an institution or other organization.Physical Therapy Department, Hospital: Hospital department which is responsible for the administration and provision of diagnostic and medical rehabilitation services to restore or improve the functional capacity of the patient.Hospital Administration: Management of the internal organization of the hospital.Regional Health Planning: Planning for health resources at a regional or multi-state level.Cooperative Behavior: The interaction of two or more persons or organizations directed toward a common goal which is mutually beneficial. An act or instance of working or acting together for a common purpose or benefit, i.e., joint action. (From Random House Dictionary Unabridged, 2d ed)Australia: The smallest continent and an independent country, comprising six states and two territories. Its capital is Canberra.Prospective Studies: Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group.Radiotherapy, Computer-Assisted: Computer systems or programs used in accurate computations for providing radiation dosage treatment to patients.Prevalence: The total number of cases of a given disease in a specified population at a designated time. It is differentiated from INCIDENCE, which refers to the number of new cases in the population at a given time.International Educational Exchange: The exchange of students or professional personnel between countries done under the auspices of an organization for the purpose of further education.Health Manpower: The availability of HEALTH PERSONNEL. It includes the demand and recruitment of both professional and allied health personnel, their present and future supply and distribution, and their assignment and utilization.Interviews as Topic: Conversations with an individual or individuals held in order to obtain information about their background and other personal biographical data, their attitudes and opinions, etc. It includes school admission or job interviews.Models, Organizational: Theoretical representations and constructs that describe or explain the structure and hierarchy of relationships and interactions within or between formal organizational entities or informal social groups.Clinical Laboratory Information Systems: Information systems, usually computer-assisted, designed to store, manipulate, and retrieve information for planning, organizing, directing, and controlling administrative and clinical activities associated with the provision and utilization of clinical laboratory services.Health Resources: Available manpower, facilities, revenue, equipment, and supplies to produce requisite health care and services.International Agencies: International organizations which provide health-related or other cooperative services.Treatment Outcome: Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series.Community Health Centers: Facilities which administer the delivery of health care services to people living in a community or neighborhood.Patient-Centered Care: Design of patient care wherein institutional resources and personnel are organized around patients rather than around specialized departments. (From Hospitals 1993 Feb 5;67(3):14)Medical Records: Recording of pertinent information concerning patient's illness or illnesses.Patient Safety: Efforts to reduce risk, to address and reduce incidents and accidents that may negatively impact healthcare consumers.Risk Management: The process of minimizing risk to an organization by developing systems to identify and analyze potential hazards to prevent accidents, injuries, and other adverse occurrences, and by attempting to handle events and incidents which do occur in such a manner that their effect and cost are minimized. Effective risk management has its greatest benefits in application to insurance in order to avert or minimize financial liability. (From Slee & Slee: Health care terms, 2d ed)Telecommunications: Transmission of information over distances via electronic means.Societies, Hospital: Societies having institutional membership limited to hospitals and other health care institutions.Retrospective Studies: Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons.Point-of-Care Systems: Laboratory and other services provided to patients at the bedside. These include diagnostic and laboratory testing using automated information entry.Calibration: Determination, by measurement or comparison with a standard, of the correct value of each scale reading on a meter or other measuring instrument; or determination of the settings of a control device that correspond to particular values of voltage, current, frequency or other output.Societies, Medical: Societies whose membership is limited to physicians.Inservice Training: On the job training programs for personnel carried out within an institution or agency. It includes orientation programs.Jurisprudence: The science or philosophy of law. Also, the application of the principles of law and justice to health and medicine.Forensic Pathology: The application of pathology to questions of law.Equipment Design: Methods of creating machines and devices.Qualitative Research: Any type of research that employs nonnumeric information to explore individual or group characteristics, producing findings not arrived at by statistical procedures or other quantitative means. (Qualitative Inquiry: A Dictionary of Terms Thousand Oaks, CA: Sage Publications, 1997)Preventive Health Services: Services designed for HEALTH PROMOTION and prevention of disease.Electronic Health Records: Media that facilitate transportability of pertinent information concerning patient's illness across varied providers and geographic locations. Some versions include direct linkages to online consumer health information that is relevant to the health conditions and treatments related to a specific patient.Evidence-Based Medicine: An approach of practicing medicine with the goal to improve and evaluate patient care. It requires the judicious integration of best research evidence with the patient's values to make decisions about medical care. This method is to help physicians make proper diagnosis, devise best testing plan, choose best treatment and methods of disease prevention, as well as develop guidelines for large groups of patients with the same disease. (from JAMA 296 (9), 2006)Infant, Newborn: An infant during the first month after birth.Water Quality: A rating of a body of water based on measurable physical, chemical, and biological characteristics.Maintenance: The upkeep of property or equipment.Education, Medical, Continuing: Educational programs designed to inform physicians of recent advances in their field.Databases, Factual: Extensive collections, reputedly complete, of facts and data garnered from material of a specialized subject area and made available for analysis and application. The collection can be automated by various contemporary methods for retrieval. The concept should be differentiated from DATABASES, BIBLIOGRAPHIC which is restricted to collections of bibliographic references.Cesium Radioisotopes: Unstable isotopes of cesium that decay or disintegrate emitting radiation. Cs atoms with atomic weights of 123, 125-132, and 134-145 are radioactive cesium isotopes.Radiology Information Systems: Information systems, usually computer-assisted, designed to store, manipulate, and retrieve information for planning, organizing, directing, and controlling administrative activities associated with the provision and utilization of radiology services and facilities.Pathology: A specialty concerned with the nature and cause of disease as expressed by changes in cellular or tissue structure and function caused by the disease process.Cancer Care Facilities: Institutions specializing in the care of cancer patients.Neoplasms: New abnormal growth of tissue. Malignant neoplasms show a greater degree of anaplasia and have the properties of invasion and metastasis, compared to benign neoplasms.Research Report: Detailed account or statement or formal record of data resulting from empirical inquiry.IndiaPhysician's Practice Patterns: Patterns of practice related to diagnosis and treatment as especially influenced by cost of the service requested and provided.Pregnancy: The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH.Maternal Health Services: Organized services to provide health care to expectant and nursing mothers.Pain Clinics: Facilities providing diagnostic, therapeutic, and palliative services for patients with severe chronic pain. These may be free-standing clinics or hospital-based and serve ambulatory or inpatient populations. The approach is usually multidisciplinary. These clinics are often referred to as "acute pain services". (From Br Med Bull 1991 Jul;47(3):762-85)Clinical Protocols: Precise and detailed plans for the study of a medical or biomedical problem and/or plans for a regimen of therapy.Family Practice: A medical specialty concerned with the provision of continuing, comprehensive primary health care for the entire family.Software: Sequential operating programs and data which instruct the functioning of a digital computer.Netherlands: Country located in EUROPE. It is bordered by the NORTH SEA, BELGIUM, and GERMANY. Constituent areas are Aruba, Curacao, Sint Maarten, formerly included in the NETHERLANDS ANTILLES.

A comparative analysis of six audit systems for mental health nursing. (1/3566)

PURPOSE: To devise an analytical framework to help identify strengths and weaknesses in the audit process as specified by existing psychiatric nursing audit systems, in order to analyse current audit practice and identify improvements for incorporation in the Newcastle Clinical Audit Toolkit for Mental Health. DATA SOURCES: Published material relating to the following six systems: the Central Nottinghamshire Psychiatric Nursing Audit; Psychiatric Nursing Monitor; Standards of Care and Practice; Achievable Standards of Care; Quartz; and Quest. DATA EXTRACTION: Comparison of the six systems according to an analytical framework derived from detailed empirical study (structures, processes and outcomes) of one of them in use and the educational evaluation literature. Examination of the extent to which guidance is provided for operating the systems and for wider process-related aspects of audit. RESULTS OF DATA SYNTHESIS: Five of the systems failed to specify some important elements of the audit process. Conceptually, the six systems can be divided into two main types: 'instrument-like' systems designed along psychometric lines and which emphasize the distance between the subjects of audit and the operators of the systems, and 'tool-like' systems which exploit opportunities for care setting staff to engage in the audit process. A third type of system is the locally-developed system which is offered to a wider audience but which does not make the same level of claim to universal applicability. CONCLUSION: The analytical framework allows different approaches to audit to be compared and contrasted not only according to the techniques used, but also according to process issues. The analysis of six systems revealed a variety of different techniques and procedures which can facilitate, in a methodologically rigorous manner, practitioner and other stakeholder involvement in audit processes.  (+info)

Why and how is soft copy reading possible in clinical practice? (2/3566)

The properties of the human visual system (HVS) relevant to the diagnostic process are described after a brief introduction on the general problems and advantages of using soft copy for primary radiology interpretations. At various spatial and temporal frequencies the contrast sensitivity defines the spatial resolution of the eye-brain system and the sensitivity to flicker. The adaptation to the displayed radiological scene and the ambient illumination determine the dynamic range for the operation of the HVS. Although image display devices are determined mainly by state-of-the-art technology, analysis of the HVS may suggest technical characteristics for electronic displays that will help to optimize the display to the operation of the HVS. These include display size, spatial resolution, contrast resolution, luminance range, and noise, from which further consequences for the technical components of a monitor follow. It is emphasized that routine monitor quality control must be available in clinical practice. These image quality measures must be simple enough to be applied as part of the daily routine. These test instructions might also serve as elements of technical acceptance and constancy tests.  (+info)

Image processing strategies in picture archiving and communication systems. (3/3566)

An image processing strategy is presented that assures very similar soft-copy presentation on diagnostic workstations of a picture archiving and communication system (PACS) over the lifetime of an image file and simultaneously provides efficient work-flow. The strategy is based on rigid partitioning of image processing into application- and display-device-specific processing. Application-specific processing is optimized for a reference display system. A description of this system is attached to the file header of the application-specifically processed image which is stored in the PACS. Every diagnostic display system automatically reproduces the image quality for which the application-specific processing was optimized by adjusting its properties by display-system-specific processing so that the system becomes effectively equal to the reference display system.  (+info)

A critical appraisal of the quality of the management of infective endocarditis. (4/3566)

OBJECTIVES: The purpose of this study was to assess the quality of the management of infective endocarditis. BACKGROUND: Although many guidelines on the management of infective endocarditis exist, the quality of this management has not been evaluated. METHODS: We collected data on all patients (116) hospitalized with infective endocarditis over 1 year in all hospitals in the Rhone-Alpes region (France). RESULTS: Prophylactic antibiotics were not given before infective endocarditis to 8/11 cardiac patients at risk and who underwent an at risk procedure. Among the 55 cardiac patients at risk and with fever and who consulted a physician, blood cultures were not performed before antibiotic therapy was initiated for 32 patients. In-hospital antibiotic therapy was incorrect for 23 patients. The portal of entry was not treated for 16/61 patients with an accessible portal of entry. Among the 19 patients who had severe heart failure or fever persisting more than 2 weeks in spite of antibiotic therapy and who could have undergone early surgery, surgery was delayed for five, and not performed for three. Overall, the average score was 15/20. CONCLUSIONS: More information on the management of infective endocarditis should be widely disseminated to the physicians' and the dentists' communities and to the patients at risk.  (+info)

Evaluation of the quality of an injury surveillance system. (5/3566)

The sensitivity, positive predictive value, and representativeness of the Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP) were assessed. Sensitivity was estimated at four centers in June through August 1992, by matching independently identified injuries with those in the CHIRPP database. The positive predictive value was determined by reviewing all "injuries" in the database (at Montreal Children's Hospital) that could not be matched. Representativeness was assessed by comparing missed with captured injuries (at Montreal Children's Hospital) on demographic, social, and clinical factors. Sensitivity ranged from 30% to 91%, and the positive predictive value was 99.9% (i.e., the frequency of false-positive capture was negligible). The representativeness study compared 277 missed injuries with 2,746 captured injuries. The groups were similar on age, sex, socioeconomic status, delay before presentation, month, and day of presentation. Injuries resulting in admissions, poisonings, and those presenting overnight were, however, more likely to be missed. The adjusted odds ratio of being missed by CHIRPP for admitted injuries (compared with those treated and released) was 13.07 (95% confidence interval 7.82-21.82); for poisonings (compared with all other injuries), it was 9.91 (95% confidence interval 5.39-18.20); and for injuries presenting overnight (compared with those presenting during the day or evening), it was 4.11 (95% confidence interval 3.11-5.44). These injuries were probably missed because of inadequate education of participants in the system. The authors conclude that CHIRPP data are of relatively high quality and may be used, with caution, for research and public health policy.  (+info)

Lot quality assurance sampling for monitoring immunization programmes: cost-efficient or quick and dirty? (6/3566)

In recent years Lot quality assurance sampling (LQAS), a method derived from production-line industry, has been advocated as an efficient means to evaluate the coverage rates achieved by child immunization programmes. This paper examines the assumptions on which LQAS is based and the effect that these assumptions have on its utility as a management tool. It shows that the attractively low sample sizes used in LQAS are achieved at the expense of specificity unless unrealistic assumptions are made about the distribution of coverage rates amongst the immunization programmes to which the method is applied. Although it is a very sensitive test and its negative predictive value is probably high in most settings, its specificity and positive predictive value are likely to be low. The implications of these strengths and weaknesses with regard to management decision-making are discussed.  (+info)

The potential of health sector non-governmental organizations: policy options. (7/3566)

Non-governmental organizations (NGOs) have increasingly been promoted as alternative health care providers to the state, furthering the same goals but less hampered by government inefficiencies and resource constraints. However, the reality of NGO health care provision is more complex. Not only is the distinction between government and NGO providers sometimes difficult to determine because of their operational integration, but NGOs may also suffer from resource constraionts and management inefficiencies similar to those of government providers. Some registered NGOs operate as for-profit providers in practice. Policy development must reflect the strengths and weaknesses of NGOs in particular settings and should be built on NGO advantages over government in terms of resource mobilization, efficiency and/or quality. Policy development will always require a strong government presence in co-ordinating and regulating health care provision, and an NGO sector responsive to the policy goals of government.  (+info)

Comparative hospital databases: value for management and quality. (8/3566)

OBJECTIVES: To establish an accurate and reliable comparative database of discharge abstracts and to appraise its value for assessments of quality of care. DESIGN: Retrospective review of case notes by trained research abstractors and comparison with matched information as routinely collected by the hospitals' own information systems. SETTING: Three district general hospitals and two major London teaching hospitals. PATIENTS: The database included 3905 medical and surgical cases and 2082 obstetric cases from 1990 and 1991. MAIN MEASURES: Accessibility of case notes; measures of reliability between reviewers and of validity of case note content; application of high level quality indicators. RESULTS: The existing hospital systems extracted insufficient detail from case notes to conduct clinical comparative analyses for medical and surgical cases. The research abstractors at least doubled the diagnostic codes extracted. Interabstractor agreement of about 70% was obtained for primary diagnosis and assignment to diagnosis related group. These data were sufficient to create a comparative database and apply high level quality indicators designed to flag topics for further study. For obstetric-specific indicators the rates were comparable for abstractors and the hospital information systems, which in each case was a departmentally based system (SMMIS) producing more detailed and accessible data. CONCLUSIONS: Current methods of extracting and coding diagnostic and procedural data from case notes in this sample of hospitals is unsatisfactory: notes were difficult to access and recording is unacceptably incomplete. IMPLICATIONS: Improvements as piloted in this project, are readily available should the NHS, hospital managers, and clinicians see the value of these data in their clinical and managerial activities.  (+info)

  • However, such trials require patients and healthcare providers who are willing to participate in clinical research. (beds.ac.uk)
  • In the last years another relevant aspect of participation in clinical trials has emerged: "Do healthcare institutions or service providers who are active in research deliver better care and outcomes than those who do not participate in clinical research? (beds.ac.uk)
  • 5 ], especially from the healthcare policy perspective, this question should be the main focus of future research because benefit from a research-active institution will affect many more patients than just the small proportion of participants in clinical trials. (beds.ac.uk)
  • The authors concluded that research activity might result in better health care outcomes, although the reason for this effect remains unclear. (beds.ac.uk)
  • To respond to the global need for adequate quality assurance of pharmaceuticals, WHO's Expert Committee on Specifications for Pharmaceutical Preparations has over the years made numerous recommendations to establish standards and guidelines and to promote the effective functioning of national regulatory and control systems and the implementation of internationally agreed standards by trained personnel. (google.com)
  • An member's tier is assigned based upon the results of the member's Supports Intensity Scale (SIS) assessment related to home living skills, community living activities, health and safety activities, social activities, and the identification of exceptional medical and behavioral support needs. (iowa.gov)
  • The tiered rate methodology will not be used for HCBS ID waiver services paid in shorter time units such as: SCL 15-minutes (H2015), Day Habilitation 15-minutes (T2021), Adult Day Care 1/2 day (S5101), or Adult Day Care Hourly (S5100) services. (iowa.gov)
  • Page 17 - Practice is that part of Quality Assurance which ensures that products are consistently produced and controlled to the quality standards appropriate to their intended use and as required by the Marketing Authorisation or product specification. (google.com)
  • All those planned and systematic actions necessary to provide adequate confidence that a product or service will satisfy given requirements for quality. (google.com)
  • Page 104 - Establishing documented evidence which provides a high degree of assurance that a specific process will consistently produce a product meeting its predetermined specifications and quality attributes. (google.com)
  • Despite efforts made around the world to ensure a supply of quality and effective medicines, substandard, spurious and counterfeit products still compromise health care delivery in many countries. (google.com)
  • Responsibilities Work closely with QA mgr to assist in development and execution of SQF plans to achieve/maintain SQF (Safe Quality Foods) Certification at the facility and to meet all Bay Valley Foods requirements related to quality and food safety progr. (careerbuilder.com)
  • Along with their physician or nurse practitioner, patients assist in creating a personalized care plan with Grandview Health Care Clinic as their primary care "home. (beltonregionalmedicalcenter.com)
  • Welcome Coordinators are an integral part of Primary Care of. (simplyhired.com)
  • These changes included the following: a validated hypertension population registry, a simple drug treatment algorithm based on a combination antihypertensive medication, regular performance feedback, alerts to providers that the patient has an elevated blood pressure measure, improved staff competency in blood pressure monitoring, expansion of patient access to primary care by using medical assistants to check blood pressure, and strong leadership support for health care delivery changes to improve hypertension control. (cdc.gov)
  • Call your primary care office for a phone or video visit. (ecommunity.com)
  • Primary care physicians, nurse practitioners, and physician assistants, as well as medical subspecialists, are encouraged to adopt these materials and make this process specific to their settings and populations. (aappublications.org)
  • In addition, the model of shifting payment promotes healthcare providers to form accountable care organizations (ACOs) that coordinate care among primary care physicians, hospitals, pharmacists, and other healthcare providers so as to improve quality of care while reducing costs. (grandviewresearch.com)
  • The U.S. Centers for Disease Control and Prevention in South Africa (CDC South Africa), through its Global AIDS Program (GAP), works hand-in-hand with the National Department of Health (NDOH) to strengthen quality HIV and AIDS palliative care service delivery and implement standards of care. (cdc.gov)
  • The programme is aligned to the standards specified by Skills for Health (the Skills Council for the NHS) and on completion of the course you'll be able to demonstrate to prospective employers that your advanced skills conform to the National Occupational Standards (NOS). (londonmet.ac.uk)
  • We conduct simulation studies in order to investigate alarm characteristics of the Bernoulli log-likelihood CUSUM chart for crude and risk-adjusted performance indicators, and illustrate CUSUM charts on performance data from the external quality assurance of hospitals in Bavaria, Germany. (biomedcentral.com)
  • It provides ongoing community relations and outreach to encourage members to become active participants in their health care. (businesswire.com)
  • All survey participants 1 year and older were eligible for the oral health examination. (cdc.gov)
  • Participants aged 30 years and older were eligible for the periodontal evaluation if they had at least one tooth (excluding third molars) and did not meet any of the health exclusion criteria. (cdc.gov)
  • Present well-prepared, organized, and clear content that follows CEO s course syllabus to participants enthusiastically and with deep care . (indeed.com)
  • When using SPM to monitor inpatient care, in particular the hospital risk profile, hospital volume and properties of each monitored performance indicator (e.g. baseline failure probability) influence the results and must be taken into account to ensure a fair process evaluation. (biomedcentral.com)
  • There are a number of CRFs located within the Royal Cornhill hospital and Foresterhill sites (Health Sciences Building, oncology, diabetes, stroke, cardiovascular, haematology, opthalmology, paediatrics) which are overseen by the CRF manager. (abdn.ac.uk)
  • The Medicare Payment Advisory Committee (MedPAC), an independent federal body created to advise Congress on issues affecting the Medicare Program, has highlighted heart failure as one of seven conditions that account for nearly 30% of potentially preventable readmissions in the 15-day period following initial hospital discharge (National Quality Measures Clearinghouse, 2015). (consultgeri.org)
  • Fifty-one percent of programs reported that a credentialing/privileging plan was in place at their hospital, and 71% of programs had a quality assurance/image review procedure in place. (nih.gov)
  • As part of an on-going quality control practice, all data are reviewed systematically for logical inconsistencies and examiner error. (cdc.gov)
  • Internal quality control data review indicates that data quality is acceptable. (cdc.gov)
  • Reviews of quality system documentation and quality control programs. (intertek.com)
  • ARL places strong emphasis on quality control, proficiency testing and other quality assurance initiatives. (aspirus.org)
  • ARL participates in a number of external quality control programs. (aspirus.org)
  • Although the Defense Health Agency may or may not use these sites as additional distribution channels for Department of Defense information, it does not exercise editorial control over all of the information that you may find at these locations. (health.mil)
  • The Kaiser Permanente Southern California (Kaiser) health care system succeeded in improving hypertension control in a multiethnic population by adopting a series of changes in health care delivery. (cdc.gov)
  • Hypertension control increased overall from 54% to 86% during that period, and 80% or more in every subgroup, regardless of race/ethnicity, preferred language, or type of health insurance plan. (cdc.gov)
  • Million Hearts has a goal of 70% for blood pressure control in health care settings, which is achievable through changes in health care delivery (5). (cdc.gov)
  • The objective of this study was to describe how health care delivery changes improved hypertension control in a multiethnic population. (cdc.gov)
  • Since 2004, Kaiser has implemented a series of changes in health care delivery to improve identification and treatment of patients with hypertension and to increase hypertension control. (cdc.gov)
  • As a result of sequential and concurrent changes in health care delivery from 2003 through 2010, blood pressure control increased to about 86% in the Kaiser patient population as measured by the HEDIS CBP measure. (cdc.gov)
  • Amerigroup Tennessee helps improve health care access and quality for approximately 436,000 Tennessee residents who participate in the state's various Medicaid programs. (businesswire.com)
  • Anthem is one of 10 health insurance companies in Wisconsin offering Medicaid SSI. (businesswire.com)
  • Medicaid SSI is for Wisconsin residents who receive Supplemental Security Income (SSI) and offers extra support to adults with special health care needs or a disability. (businesswire.com)
  • When a state has mandated participation in Medicaid managed care plans, it must implement rigorous regulatory oversight to ensure the quality and financial viability of participating managed care plans. (aappublications.org)
  • Building on the foundation of Medicare and Medicaid, enacted in 1965, four successive presidents-Lyndon Johnson, Richard Nixon, Gerald Ford, and Jimmy Carter-paid such significant attention to national health care issues that many believed broad-scale reform was imminent. (nap.edu)
  • The Trump administration's effort to remake Medicaid by requiring low-income people to work for health care suffered a serious setback when a federal appeals court ruled it goes beyond what's allowed by law. (journalrecord.com)
  • For instance, the Affordable Care Act (ACA) implemented in the U.S., focuses on expanding health insurance coverage to individuals with low income. (grandviewresearch.com)
  • The Affordable Care Act or Patient Protection and Affordable Care Act (PPACA) is effective since 2014 in the U.S. Health care reform legislations intend to increase the affordability, availability, and use of health insurance. (grandviewresearch.com)
  • Several provisions in the Affordable Care Act involve an expansion of the private insurance market. (grandviewresearch.com)
  • Ever since the Patient Protection and Affordable Care Act powered their creation, ACOs have been expanding their reach across the country and gaining traction among employers. (shrm.org)
  • Marys Manor, a department of Community HealthCare System, is seeking a Registered Nurse to join our Team of Excellence. (healthcarecrossing.com)
  • Midwest Physicians is also part of HCA Midwest Health System. (beltonregionalmedicalcenter.com)
  • Not since the 1970s has there been such interest in restructuring the health care system. (nap.edu)
  • Instead, the intervening years have been characterized by incremental, marginal changes in health care policies rather than by fundamental realignment of the public-private system now in place. (nap.edu)
  • In rapid succession over the last several years, however, many important national organizations and public policy leaders have introduced blueprints for reforming the health care system, some radically, some less so. (nap.edu)
  • and, finally, the steady erosion of the public health care system because of chronic underfinancing and the seriousness and intensity of problems brought to its doorstep, including AIDS, drug addiction, and violence. (nap.edu)
  • In addition to following these policies, Principal Recipients must ensure that all pharmaceutical products are procured in accordance with the principles set out in the Model Quality Assurance System for Procurement Agencies interagency guidelines, available below for download. (theglobalfund.org)
  • Successful participation in a QA program, provides assurance to your customers that your products are manufactured and controlled under an established quality system, are consistently manufactured to the specifications set forth in quality system documentation, and are faithful reproductions of those which were originally independently tested and rated. (intertek.com)
  • Training opportunities in the Military Health System. (health.mil)
  • 1) To implement the recommendations made by the Department of Veterans Affairs - Department of Defense Joint Executive Committee with respect to health care resources, as well as to carry out other health care contracts and agreements for coordination and sharing initiatives as they consider appropriate, the two Secretaries shall jointly issue guidelines and policy directives. (cornell.edu)