improvements in hospitals (/medical schools)

[tacojohn]

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hi all,

for the course im currently doing i have a very annoying assignment: i need to make a business plan for something in the hospital.
I thinked alot about this (day/night/while eating/in the toilet), but couldnt really find something good to improve.

So i started looking on internet for improvements other hospitals made. Even this is very hard to find 🙁

So i wanted to ask: do you know any business plan they made in your medical school/hospital and is worth to make this also in other hospitals? At least, this would point me in the right direction.
This isnt really medicine, but management...

 

[Law2Doc]

hi all,

for the course im currently doing i have a very annoying assignment: i need to pick something in the hospital (medical school), and make a brief report an how to improve it. The improvement can be something about the hospital making less waste (more profit) or something very beneficial for patients.
I thinked alot about this (day/night/while eating/in the toilet), but couldnt really find something good to improve.

So i started looking on internet for improvements other hospitals made. Even this is very hard to find 🙁

So i wanted to ask: do you know any (big) improvement they made in your medical school/hospital and is worth to make this also in other hospitals? At least, this would point me in the right direction.

The biggest thing some hospitals are trying to improve these days is how to limit the germs doctors are tracking from patient to patient. The hospital has become a dangerous place for sick people. Handwashing articles have appeared in the science section of the NY Times, and other publications, this past year. Better ways to disinfect medical staff would be a huge benefit. Is that the kind of thing you were going for?

 

[Critical Mass]

The biggest thing some hospitals are trying to improve these days is how to limit the germs doctors are tracking from patient to patient. The hospital has become a dangerous place for sick people. Handwashing articles have appeared in the science section of the NY Times, and other publications, this past year. Better ways to disinfect medical staff would be a huge benefit. Is that the kind of thing you were going for?

Yeah HCA has decided to screen all inpatients for MRSA upon admit at their facilities, much to my chagrin as the guy who does the testing (no billing for that one).

You might also look into electronic records. That's kind of a buzzword at my hospital.

 

[tacojohn]

This was one of my on-the-list items.

But the difficult part of it is that my hospital is a medical school (there arent many medical schools here) and i think they are doing enough with prevention.
But im going to look further in the annual report for some stats. 🙂

 

[colbgw02]

You might want to check out the 2007 JCAHO Guidelines. In addition to the infection control already mentioned, they're really big on patient identifiers, universal protocols, etc. In real life it's a huge pain in the butt, but I bet it would make good fodder for a report such as yours.

 

[JennyB]

You might want to check out the 2007 JCAHO Guidelines. In addition to the infection control already mentioned, they're really big on patient identifiers, universal protocols, etc. In real life it's a huge pain in the butt, but I bet it would make good fodder for a report such as yours.

I think you're talking about the National Patient Safety Goals from the Joint Commission. They also mention hand-off communication and medication reconciliation, two things that are pretty big where I work. Actually, medication reconciliation is huge during any Joint Commission survey.

 

[deleted77919]

Since health care delivery in this country has no regard for things like "reasonable" and "cost effective" I think to deliver the best care for everyone, anyone who walks in the door as a patient needs to be treated by the staff as biohazard level 4.

Have each patient isolated in a negative pressure sealed room with access only by full biohazard suit with self contained breathing apartus (again, different sets of suits for each room). This would really cut down on patient to patient spreading of disease. It also means when someone is coding it'll take you darn near 30 minutes just to enter their room. Guess that's just the cost of doing business.

In the future I envision a nurse version of a davinci to replace nurses as these machines can easily stay inside the biohazard room with the patient.

 

[Critical Mass]

Good points regarding the Joint Commission.

We are trying to ban certain abbreviations to prevent errors. DPT is one that comes to mind. We're also on the lookout for zeroes and decimal points that can cause confusion.

 

[tacojohn]

The assignement wasnt clear enough: i need to make a business plan for a hospital. This is even harder...

 

[Bubb Rubb]

step 1: hire a few anesthesiologists/open pain clinic/invite all low back pain sufferers from far and wide to come in
step 2: ????
step 3: profit

 

[Mardi-Bob]

Running a Hospital101:

Physician Viewpoint:

Step 1. Care for all patients regardless of ability to pay.
Step 2. ?????
Step 3. Something that feels good, but it sure as hell isn't profit.... only thing keeping it open is gov't subsidies.

Business Viewpoint:

Step 1. Increase profit margins and increase demand by any means for elective surgeries, require comprehensive health insurance or an organ, kidney will do, to enter hospital grounds, refer any uninsured patient to nearest "poor" hospital... i.e. county hospitals... if a caring physician tries to administer 'free' care use a taser on the physician.... then refer them both.
Step 2. ????
Step 3. Profit like theres not tomorrow.... flaunt new Ferrari by volunteering at a local soup kitchen.

I am also a proponent of using the "underpants gnomes" business philosophy.

 

[Law2Doc]

I think to deliver the best care for everyone, anyone who walks in the door as a patient needs to be treated by the staff as biohazard level 4.

They already do that -- why do you think they send in med students to take histories first, and a physician only comes in later, when it's deemed safe.

 

[Shredder]

need to make a business plan for something in the hospital.
I thinked alot about this (day/night/while eating/in the toilet), but couldnt really find something good to improve.

So i started looking on internet for improvements other hospitals made. Even this is very hard to find 🙁

So i wanted to ask: do you know any business plan they made in your medical school/hospital and is worth to make this also in other hospitals? At least, this would point me in the right direction.
This isnt really medicine, but management...

Oyy this is an amazing assignment, think of a grand moneymaking scheme. If it's incredible it could take you places! What course is it? It's far better than studying medicine itself--better to be a manager than a worker!

Mardi-Bob's plan is good. Get the poor ppl out STAT. Get docs out who sympathize with them. Make sure money grubbing is in the mindset of all in the hospital. Do something about the ER--not sure about specifics here. Play classical music everywhere, it will attract wealthy folk. Consider investing in fancy artwork, furniture and grand piano for ambience. Also give consideration to people suffering from chronic disease and draining dollars while they just wait to perish. Perhaps transfer them to death ward hospitals. If possible recruit lots of Lasik and lots of cosmetic surgery--offer to set up practices for them or something. Yes, get those margins up--find nonperforming sectors and shape them up, downsize them or eliminate them. Alternatively you can get volume up; depends on the context of the plan, what is it? Great thread!

Listen up, give some info on the course and professor. Some of these things could land you in hot water even if they are viable ideas. It takes a certain kind of person to consider only the bottom line.