Background/Aims: Various surgical treatments are indicated for early gastric cancers in upper third of the stomach (U-EGC) because of its anatomical property and favorable prognosis. Methodology: Five hundred and eighty six cases of U-EGCs were collected for 9 years from 19 hospitals in Japan. Surgical procedures were classified as total ...

What is already known about this subject: Variations in hospital drug formularies have been reported in Germany and the Netherlands for competitive classes. Since a spill-over effect on the community may be expected, assessment of hospital formularies is needed. No study has already explored French hospitals' drug formularies. What this ...

The study aimed to assess 75% of drug utilization (DU75%) in participating hospitals and identify quality indicators which should be used to monitor performance within the hospitals. In the European Surveillance of Antimicrobial Consumption (ESAC; http://www.esac.ua.ac.be) project anatomic therapeutic chemical (ATC), defined daily dose (DDD) and route of administration (RoA) ...

The purpose of this study was to investigate the physicians' perceptions, and expectations of their experiences with the pharmacists at Hamad Medical Corporation (HMC) in Qatar. A cross-sectional study was conducted at HMC between January and March 2006 using a validated questionnaire. The self-administered questionnaire was distributed to 500 physicians ...

WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT: Women are more at risk for developing adverse drug reactions (ADRs) due to differences in pharmacokinetics, pharmacodynamics and drug use. ADRs regularly lead to hospital admissions. There are differences between the sexes in hospital admissions attributed to ADRs. The risk of being hospitalized ...

This study was conducted to evaluate treatment outcome, mortality, and predictors of both in patients with multidrug-resistant tuberculosis (MDR-TB) at 3 TB referral hospitals in the public sector of Korea. We included MDR-TB patients treated at 3 TB referral hospitals in 2004 and reviewed retrospectively their medical records and mortality ...

Ronan Quinn, managing director of interior construction specialist Ardmac, describes the challenges of building and fitting out a new cleanroom laboratory for blood and bone marrow therapeutic treatment at Our Lady's Children's Hospital Crumlin in Dublin. The "state-of-the-art" facility, which fully complies with the recent EU Directive concerning human tissues ...

In April 2009, media reports indicated an outbreak of swine flu (H1N1) resulting from several students from a local high school having been in Mexico. Over the next 6 weeks, the demand for the services of the children's hospital strained available resources, requiring innovative measures to care for more than ...

This article explores the practice of false patient out-referral by medical students in Iranian teaching hospital emergency departments. Drawing on participant-observations and interviews during eight months in six hospitals in Tehran, we investigate how discourse is appropriated to construct and legitimate out-referrals through four general strategies of sympathy, mystification, intimidation, ...

Reform legislation links payment to quality, and hospitals will be challenged to keep up with ever-changing measures.

Our conversation was interrupted with a woman shouting at her husband, 'I told you that you had selective deafness, you only hear what you want to and when you want to'. The innocent remark was bellowed across the hospital restaurant as I sat discussing practice issues with four perioperative colleagues. ...

Hospital-acquired pneumonia and ventilator-associated pneumonia are associated with high rates of morbidity and mortality and are often caused by drug-resistant pathogens. Trials of potential new agents to treat these serious infections are complicated by various factors associated with their design and conduct and the complex underlying conditions of the patients ...

Bruce Johnson, senior vice-president at the Houston, Texas offices of internationally-recognised HKS Architects, examines the considerable physical challenge of accommodating sizeable proton external beam radiation therapy equipment into hospitals, drawing on work undertaken by the practice to date in designing hospitals to cater for such sizeable machinery.

Three big risks for hospitals under healthcare reform are: The inevitable deficit reduction initiatives beginning in FFY12. The estimated one-third increase in Medicaid enrollment. The dramatic increase in regulation of private health insurance.

Critically ill elderly patients facing crucial decisions about their future medical treatment routinely come under the care of hospital physicians who may have no previous relationship with them or their families. The majority of patients for whom this sort of decision must be made are unable to participate in decision ...

Some of the nation's most fiscally fit hospitals were bruised but survived the Great Recession. Now they're ready to take on the challenges of reform.

There are several special issues that confront the physician when dealing with the older male. Physicians need to pay attention to these issues and recognize their importance to their patients. This article briefly reviews these unique challenges.

Shortages of both generalist and specialist physicians are intensifying as the US healthcare system confronts an unprecedented confluence of demographic pressures, including an aging population, the retirement of thousands of baby-boomer physicians, the growth of nonpractice opportunities for MDs, and physician demands for greater work-life balance. This work posits that ...

Smaller and rural hospitals face particular challenges in terms of matching the needed financial and human resources to the task of achieving meaningful use. Nonetheless, some smaller and rural hospitals have made surprising progress towards meeting the 2011 meaningful use criteria. Data reporting requirements under meaningful use will be particularly ...

For more than 30 years, a negative "off-peak effect" on patient outcomes has been associated with weekend and/or nighttime hospitalization in more than 25 diagnostic groups. Descriptive studies have verified the presence of this off-peak effect on patient outcomes but have done little to explain its cause. Institutional ethnography is ...

Kiosks are expected to become more interactive in terms of the revenue cycle. Consent forms and way-finding are the more traditional uses of kiosks. The emergency room is an ideal place to use kiosk or tablet technology because of the long waits. Using tablets before a full kiosk implementation is ...

Healthcare disparities are a major challenge for hospital and healthcare system leadership. Leaders must possess vision, visibility, and ability to drive organizational change toward an environment that fosters diversity and cultural competence. As challenging economic conditions force management to make difficult budgetary decisions, the integration of equity into the organization's ...

As you can see from a review of the physician interface, there are many exciting potentials that exist for the future of the EMR. None of these will happen unless we change the focus of the system design process and start by making the physician a key and primary player ...

A severe shortage of IT professionals who can help implement EMR, CPOE, and other core clinical technologies could soon emerge across hospitals nationwide. CIOs could face staffing challenges both within their organizations, and with regard to the vendors and consulting firms they might engage to facilitate implementation. Keys to retaining ...

The United States is facing serious physician workforce challenges. This article reviews the current status of the US physician workforce and the challenges facing the nation over the next 20 years and compares the national situation with prevailing and future conditions in Texas.

CONTEXT: Although there is a wealth of information for patients and physicians on the Medicare Prescription Drug, Improvement, and Modernization Act, little research exists related to its impact on osteopathic physicians (DOs). OBJECTIVE: To examine the impact of Medicare's prescription drug benefit-or Part D-on DOs and their practices. METHODS: Two ...

As one of the UK's largest builders of healthcare facilities, construction company Morgan Ashurst is accustomed to delivering complex, challenging hospital projects. The construction of a new oncology centre at Musgrove Park Hospital, Taunton for Taunton and Somerset NHS Foundation Trust-- said to be the first new stand-alone radiotherapy centre ...

Market forces may lead to increased consolidation in the healthcare industry, creating both opportunities and challenges. Opportunities for small hospitals and health systems include partnering with stronger organizations, while for larger organizations, acquiring potentially undervalued hospitals can yield the benefits associated with increased size and scale. Potential barriers to success ...

Dealing sensitively with local wildlife, necessitating a phased demolition of an existing 1930s-built hospital to avoid disturbing bats and badgers in and around the construction site, was among the challenges successfully overcome by Mansell in completing the new Brentwood Community Hospital in Essex to a standard which has both delighted ...

The number of female physicians all over the world has grown considerably, yet little is known about these women. This study was conducted to explore challenges faced by Egyptian female physicians as they pursue their careers and find different ways of coping with these challenges. The mean age of participants ...

Healthcare continues to face many significant challenges in its quest to provide optimal patient care. Many hospitals have instituted various process improvement methodologies to address these challenges. The outcome of these efforts still produces a large volume of manual tasks that must be addressed by the caregiver. The Chester County ...

Healthcare security advancement in recent years in Australia has not kept pace with clinical staff advancement, the author points out. This failure to recognize the need for professionalism in healthcare security and provide the unique skills and training that hospital security officers require is severely hampering the industry's capability of ...

The treatment of war wounds poses many unique challenges to all healthcare providers (surgeons, flight medics, nurses, etc.), whether they are located at the far forward trauma hospitals located in or near areas of conflict, at regional hospitals such as Landstuhl Medical Center in Germany, or the larger military hospitals ...

Ian Hinitt, deputy estates director at Bradford Teaching Hospitals NHS Foundation Trust, and project director of an ambitious "ultra fast-track" modular ward development at Bradford Royal Infirmary, describes the numerous challenges in getting the building completed in just six months, extolling the virtues of Partnering and Framework Agreements and a ...

Every major mass disaster challenges the health care services, especially in the third world. These challenges include the expected situations mainly pertaining to the overload of patients and the stretching of hospital facilities. We report our experiences about several unforseen challenges faced by our hospital in the 2005 earthquake that ...

We invited you to share your thoughts on the practice and career challenges that confront you today. You responded emphatically to our questionnaire, and two issues--maintaining physician compensation as reimbursement declines, and operating costs that are escalating faster than revenues--essentially tied for first place. The threat of further cuts in ...

In 2003 a new type of provider organisation, the Foundation Trust (FT), was introduced in England, and the best performing NHS hospitals were able to apply for 'Foundation status'. FTs enjoy greater financial flexibility and are subject to less central monitoring and control. The phased introduction of FTs represents an ...

RATIONALE: In this article, the difference between team and group is tested empirically. The research question posed is How are teams formed? Three theoretical concepts that distinguish groups from teams are presented: sequentiality, parallelism and synchronicity. The presumption is that groups cooperate sequentially and teams synchronously, while parallel cooperation is ...

Pneumonia with associated complex pleural disease is a cause of significant morbidity among hospitalized children. The management of this patient population continues to be a challenge and varies even among single institutions. The article presented here reviews the management goals for pediatric patients hospitalized with complex parapneumonic effusions and provides ...

In health care, most gainsharing arrangements have focused on aligning economic incentives between hospitals and physicians. At one time, the Office of Inspector General had declared such arrangements flatly illegal, but recent advisory opinions suggest that the OIG is taking a more lenient stance. Today, in addition to hospital-physician arrangements, ...

The vast majority of hospitals in the United States today are led by nonphysicians. This is in sharp contrast to the turn of the 20th century, when over a third of the hospitals in the United States were physician led. As the pendulum swings back from lay leader to clinician ...

OBJECTIVE: To review the common roles that physicians pursue away from work and identify related challenges and potential solutions, so that individuals can develop a personalized plan for success in each of the areas. DESIGN: Literature review. SETTING: University-based and university-affiliated medical centers. PATIENT(S): No subjects were involved in this ...

Veterinary teaching hospitals (VTHs) are facing more and greater challenges than at any time in the past. Changes in demand, expanding information, improving technology, an evolving workforce, declining state support, and an increasingly diverse consumer base have combined to render many traditional VTH modes of operation obsolete. In pursuit of ...

OBJECTIVE: To describe the dermoscopic features, including vascular structures and patterns associated with dermatofibromas in a large series of cases. DESIGN: Digital dermoscopic images of the prospectively collected dermatofibromas were evaluated for the presence of multiple structures and patterns. SETTINGS: Dermatofibromas were collected in the Departments of Dermatology of the ...

The pathologic distinction of atypical fibroxanthomas (AFXs) from cutaneous spindle cell/sarcomatoid squamous cell carcinomas (SCSCCs) may occasionally pose a significant diagnostic challenge, given the substantial clinicopathologic overlap between these lesions. Recent studies indicate that p63 and CD10 are expressed in significant proportions of SCSCC and AFX, respectively. The purpose of ...

The purpose of this paper is to examine the activity of a purpose-built elective surgery unit in a busy district general hospital and the patient journey associated with same day admission to the elective surgery unit. This paper describes the layout of the elective surgery unit in a busy district ...

The adoption of new technology within healthcare has been promoted as a way to reduce costs and increase efficiencies as well as improve quality. The literature has documented a significant number of implementation failures by large groups and hospitals with access to IT skills and resources. Given the low adoption ...

The history of healthcare is complex, confusing and contested. In Walking London's medical history the story of how health services developed from medieval times to the present day is told through seven walks. The book also aims to help preserve our legacy, as increasingly former healthcare buildings are converted to ...

Clinical Directorates (CDs), in the sense of "intermediate organizational arrangements through which defined parts of larger hospitals health services are managed", were introduced in the Italian National Health Service (INHS) by law after the major reform of 1992. By means of such reform, accountability chains within INHS hospitals were streamlined. ...

In 1912, the Hospital for the Ruptured and Crippled (R & C) moved to its third location since its founding in 1863. It was a newly constructed six-story building on 42nd Street between Second Avenue and First Avenue. At the time Dr. Virgil Gibney, the second Surgeon-in-Chief, was 65 years ...