A multistage model of hospital bed requirements. (17/29)

This article presents a model for projecting future hospital bed requirements, based on clinical judgment and basic probability theory. Clinical judgment is used to define various categories of care, including a category for patients who are inappropriately hospitalized, for a large teaching hospital with a heavy indigent and psychiatric workload. Survey results and discharge abstract data are then used to calculate expected discharges and patient days for each clinical category. These expected discharges and patient days are converted into estimated bed requirements using a simple deterministic equation. Results of this multistage model are compared with the results obtained from exercising the simple deterministic equation alone. Because the multistage model removes patients from the hospital if they are deemed inappropriately placed, this model results in the projection of 5.1 percent fewer hospital beds than the simple deterministic equation alone.  (+info)

Making hospital geriatrics work. (18/29)

The first year's work at a new geriatric department at Northwick Park Hospital shows that active policies revolutionize the geriatric service and result in high turnover of patients and no waiting list. Comparison with low turnover/waiting list departments shows the effects of a waiting list in terms of diminished therapeutic benefit and less favourable outcome for patients admitted. The requirements for elimination of the waiting list appear to be well directed policies and adequate and enthusiastic staff. Active geriatrics results in high morale and could be widely applicable within the present hospital bed resources given the necessary improvements in staffing.  (+info)

Scottish automated follow-up register for thyroid disease: four years' experience in Glasgow. (19/29)

Four years of experience in Glasgow with an automated follow-up system for thyroid disease developed initially in a low-density population area has confirmed that the approach is a successful, practical, and exportable method of sharing long-term patient management between general practitioners and a hospital specialist clinic.  (+info)

Computer model simulating medical care in hospital. (20/29)

A computer model has been constructed to simulate the activities and events concerned in the care of patients in hospital. After validation of the model it has been used to examine the consequences of certain changes in the mode of working in the hospital, including the scheduling of items of service and a system of progressive care. It is concluded that computer models of this kind are likely to prove of value in the management of hospital resources.  (+info)

Experiment in progressive patient care. (21/29)

A successful experiment is described in providing total progressive patient care in a small hospital. This was based on dividing ward services into nursing and "hotel" services, the latter being provided by a housekeeping team. Patients were divided into three categories according to the amount of nursing care needed, and two wards were converted, one into an intensive care unit, the other into a homeward bound unit, with high and low nurse/patient ratios respectively.  (+info)

The anaesthetist and intensive care. (22/29)

Intensive care and its development is part of an evolutionary process in the general organization of hospital medical practice. No new disease process is involved, and this alone should be sufficient to support our view that intensive care does not call for the creation of a new specialty. The experience, skill, and knowledge of anaesthetists qualify them to fill vital roles in intensive care, but it is of paramount importance that in doing so they should neither neglect nor abdicate from their own special field of medical work from which their unique expertise derives.  (+info)

Domiciliary treatment of tuberculosis. (23/29)

In the present therapy of tuberculosis with antimicrobial agents, most patients receive the major part of their treatment at home, and a significant proportion of active cases never enter sanatorium or stop working during their treatment.Domiciliary treatment in Canada, with and without sanatorium admission, has been reviewed. At present, approximately 7500 patients are being treated on an outpatient basis. Most have had a period of sanatorium treatment for investigation and institution of antimicrobial therapy, but in one province up to 30% of new active cases of tuberculosis, and in another 12%, are treated entirely on an outpatient basis.The indications are that domiciliary treatment is successful and that the practice is expanding. This practice will probably continue to expand as more and better outpatient clinic facilities are developed to provide the necessary supervision and follow-up of tuberculous patients.  (+info)

An approach to patient care classification. (24/29)

Employing the principles of progressive patient care and using data obtained from charts, nurses and resident physicians, 265 patients on the wards of a teaching hospital were classified into one of six optimal levels of care by the resident physicians and also by an outside observer. It was assumed that facilities for the three alternatives to general hospital care, i.e. long-term hospital care, nursing care and sheltered care, were available in the community. It was also assumed that socio-economic factors presented no barrier to hospital discharge.The outside observer allocated 96 patients, approximately one-third, to the alternative facilities outside the general hospital. Those factors found to have statistically significant effects on assigned levels of care were the diagnoses, length of stay, region of residence, bed status, extent of nursing care, hospital service and discharge status. The residents allocated 60 patients, approximately one-fifth, to alternative facilities.The extent of agreement between the residents and the outside observer reached 81% for those to alternate versus general hospital care.This method could be used by nurses and residents to screen out those most suitable for care in alternate facilities.  (+info)