Prenatal care: a strategic first step toward EMR acceptance

Rather than turn a practice upside-down with a "big bang" implementation or replace old workflows with entirely new ones, executives must survey and understand those clinical areas where the needs are real and the value of an electronic medical record to clinicians is immediate and obvious. For these and other reasons, obstetrics may be the best place to test an electronic medical record.     

Short-stay hospitalization of elderly persons: first step toward institutionalization?

One month outcome after hospitalization was studied in 1695 persons aged 75 and over, living in the community and admitted to acute care medical units: only 9.6% of them were then institutionalized. Returning home requires a high level of independence for feeding, mental status and continence. The level of dependence of institutionalized patients was particularly high for dressing or bathing, technical care, mental status and security. A multivariate analysis showed that the only independent predictors of institutionalization were: sex, living alone, mental status and hospital type. The role played by physical disability must be counterbalanced by the effective physical assistance, brought to the elderly by institutional or informal home care after hospitalization. These results allow early identification of persons at high risk of institutionalization.     

Assessing access as a first step toward improving the quality of care for very old adults

Understanding the barriers to obtaining care that the population of people age 80 and older (80+) experiences is one of the first steps toward developing organizational and clinical strategies aimed at improving care. This article reviews the data from the 80+ Project's survey to assess the prevalence of barriers to care and identify the characteristics that place the 80+ population at risk. Barriers to access for older adults occur on many levels. Ultimately, the ability to improve health outcomes through reducing barriers to care is dependent on the effectiveness and quality of care received. By recognizing the barriers to care that limit access, health care professionals can begin to develop strategies to eliminate these barriers and improve the health care of older adult patients.     

Taking steps toward integration

If patients are to be at the center of health care, then providers should work diligently to better organize the delivery system. In this Perspective, two Mayo Clinic leaders provide their views on why it is necessary for physicians and hospitals to set aside their differences and work together for the good of their patients. They cite successful enterprises nationwide that combine hospital and physician control. Many of them have been recognized as examples.     

加快卫生人事制度改革 优化卫生人力资源配置

多年来,我县医疗单位存在着人浮于事、效率低下等弊端,长期困扰着各级领导,成为改革的"瓶颈".为认真贯彻落实<中共中央、国务院关于卫生改革与发展的决定>,促进人事制度改革,优化卫生人力资源配置,努力提高卫生服务质量,增强医疗卫生单位活力,近年来,我们积极探索,大胆实践,勇于改革,率先在全市进行人事制度改革,为卫生事业单位走向市场经济迈出了关键性的一步.