Hospital progress最新文献

Catholic health care ministry originates in and is shaped by the theme of call in the Old and New Testaments. To be specifically Catholic, health professionals and facilities must define their ministries according to the values expressed in this theological tradition. Sponsorship. The opportunity to provide health care enables religious communities to contribute to God's ongoing creation process and to reiterate Christ's call to minister to others. Although health care facility sponsorship thrusts religious communities into the arena of big business, the abandonment of the health care mission could be considered a betrayal of evangelical values. Quality of life. The implicit concern for human dignity that distinguishes Catholic health care facilities should be evident in personalized patient care, just working conditions, and a commitment to healing in the civic community. Stewardship in ethics. The development of business policies and procedures and institutional responses to social change should be carefully considered in light of the Catholic understanding of loving covenant and the Christian way of life. Shared ministry. Health care facilities have played a leading role in implementing the Second Vatican Council's vision of ministry. Sponsoring communities' continued willingness to share responsibilities with laity will be imperative in meeting the health care demands of the future.

The final rules for the first year of Medicare's prospective payment contain a number of crucial revisions of the interim rules: Payment standards. Because of a revised estimate of inflation, the adjusted federal standardized payment amounts have been reduced about $12. Update factors. Revised inflation updating factors will be applied to the hospital-specific portion of payment rates and will reflect a lower (0.1 percent) budget-neutrality adjustment. Outliers. For the three-year transitional period, additional payments for outlier patients will be based entirely on a smaller percentage of the federal payment amounts. Permissible charges to beneficiaries. Hospitals may charge beneficiaries for custodial care and medically unnecessary services before the day-outlier threshold is passed if the hospital or its utilization review committee determines that the beneficiary no longer needs inpatient care; this determination is confirmed by the attending physician or external medical review entity; and the patient is notified of the determination and potential charges. Periodic interim payment. This payment may be adjusted semiannually, or more frequently at a hospital's request. Biweekly payments will be made for items reimbursed on a reasonable-cost basis.

Though the concept of employee assistance programs (EAPs) is widely accepted throughout business and industry, few hospitals have established similar channels for dealing with workers whose personal problems cause work-related problems. Among the reasons for the health care profession's lack of involvement in this area are: lack of information about costs and benefits of EAPs; the hospital's multidisciplinary environment in which standards of employee competence and behavior are set by persons from many disciplines; hospital working hours; and health care workers' attitudes about their vulnerability to illness. St. Benedict's Hospital, Ogden, UT, however, has confronted the question of how to demonstrate Christian concern for its employees. St. Benedict's EAP, the Helping Hand, which was created in 1979, combines progressive disciplinary action with the opportunity for early intervention in and treatment of employees' personal problems. When a worker with personal problems is referred to the EAP coordinator, he or she is matched with the appropriate community or hospital resource for treatment. Supervisors are trained to identify employee problems and to focus on employee job performance rather than on attempting to diagnose the problem. St. Benedict's records during the program's first three years illustrate the human benefits as well as the cost savings of an EAP. Of 92 hospital employees who took part in the EAP, 72 improved their situations or resolved their problems. The hospital's turnover rates declined from 36 percent to 20 percent, and approximately $40,800 in turnover and replacement costs were saved.

Reconciliation is one way of caring. Our society fosters alienation among the elderly, and the result is that we are all losers as we miss the unique contributions that the aged can make. To bring about the reconciliation that God desires, health care institutions must join together in calling for public policies that protect the elderly's human rights; ensure that care systems and structures help to integrate the aged as a vital part of the community; and work to change attitudes (among both the young and the old) about old age's role, meaning, and purpose. Most important, those who care for the elderly must rely on God to strengthen them to make in their own lives whatever changes reconciliation requires.

The study of shared hospital services reported in this article was conducted to determine the magnitude of shared administrative and clinical programs, what institutions participate, and most frequently shared services. To ensure that hospitals with different characteristics and in various areas were represented, the investigators mailed questionnaires to 1,731 of the nation's 5,987 short-term, acute care general hospitals in nine census regions. Responses indicated the following trends: Not-for-profit hospitals outrank other types of hospitals in using shared services. About 90 percent of hospitals with 200 to 499 beds shared services. For almost all categories of services, a percentage increase occurred in the number of hospitals participating in shared programs. The three most shared services were purchasing, data processing, and insurance programs. Hospitals shared more administrative than clinical services. According to administrators' responses, cost containment was the most common reason for sharing services. As the pressures to control health care costs increase, the investigators predict that hospitals will share more clinical services. Shared services decrease unit cost, however, only when providers have an excess capacity.

When passage of the Social Security Amendments of 1983 required Holy Redeemer Hospital to return to the Social Security system on Jan. 1, 1984, the hospital examined alternatives to nonprofit hospitals' mandatory participation in the program. With a consortium of hospitals, it launched an unsuccessful lobbying effort to convince Congress to accept other options: deferring the return for several years, exempting hospitals that had left the system, or "grandfathering" nonprofit hospitals' employees. By Oct. 31, 1983, the hospital decided to forgo efforts to amend the legislation and made preparations for returning to the system. Employees were notified that they could continue to participate in the alternate plan (a tax-deferred annuity) or leave their account inactive until withdrawal at retirement. The plan's provisions that allowed withdrawals only under extraordinary circumstances were amended to permit withdrawals at any time. In addition, the administration introduced flexible benefits--a "cafeteria plan"--to allow participants to choose among certain taxable and nontaxable benefits that best fit each individual's life-style.