Small Community Hospitals. Henry J. South-Mayd , Geddes Smith

1945 ◽  
Vol 19 (2) ◽  
pp. 278-279
Author(s):  
Dora Goldstine
Keyword(s):  
Small Community ◽  
Community Hospitals

Multicenter study to evaluate the benefits of technology-assisted workflow on i.v. room efficiency, costs, and safety in small community hospitals

2019 ◽  
Vol 76 (13) ◽  
pp. 964-969 ◽  
Author(s):  
Jordyn P Higgins ◽  
Sarah Hardt ◽  
Debby Cowan ◽  
Eula Beasley ◽  
Stephen F Eckel
Keyword(s):  
United States ◽  
Multicenter Study ◽  
The United States ◽  
Turnaround Time ◽  
Error Reporting ◽  
Small Community ◽  
Community Hospitals ◽  
Error Type ◽  
Average Turnaround Time ◽  
Sterile Product

Abstract Purpose To evaluate the benefits of technology-assisted workflow (TAWF) compared to manual workflow (non-TAWF) on i.v. room efficiency, costs, and safety at community hospitals with less than 200 beds. Methods Four hospitals in the United States (2 with and 2 without TAWF) were evaluated, and characteristics of medication errors and frequency of each error type were measured across the institutions. The average turnaround time per workflow step and cost to prepare each compounded sterile product (CSP) were also calculated. The results were evaluated using descriptive and inferential statistics. Results The TAWF hospital sites detected errors at a significantly higher rate (3.78%) compared to the non-TAWF hospital sites (0.13%) (p < 0.05). The top error-reporting category for the TAWF sites was incorrect medication (71.66%), whereas the top error-reporting category for the non-TAWF sites could not be determined because of the small number of errors detected. Use of TAWF may be associated with a decrease in turnaround time and a decrease in overall cost to prepare a CSP. Conclusion Significantly more errors were detected in small community hospitals that use TAWF in the i.v. room compared to those not using it. There were differences in error types observed between technology and nontechnology groups. The use of TAWF was associated with faster preparation times and lower costs of preparation per CSP.

Optimal Resources for Rural Surgery

2020 ◽  
Vol 86 (9) ◽  
pp. 1057-1061
Author(s):  
Kelsey A. Musgrove ◽  
Jad M. Abdelsattar ◽  
Stephanie J. LeMaster ◽  
Marguerite C. Ballou ◽  
David A. Kappel ◽  
...  
Keyword(s):  
Life Support ◽  
Surgical Care ◽  
Synthetic Mesh ◽  
Further Education ◽  
Advanced Trauma Life Support ◽  
Small Community ◽  
Ct Scanner ◽  
Community Hospitals ◽  
Emergency General Surgery ◽  
Packed Red Blood Cells

Background Timely access to emergency general surgery services, including trauma, is a critical aspect of patient care. This study looks to identify resource availability at small rural hospitals in order to improve the quality of surgical care. Methods Forty-five nonteaching hospitals in West Virginia were divided into large community hospitals with multiple specialties (LCHs), small community hospitals with fewer specialties (SCHs), and critical access hospitals (CAHs). A 58-question survey on optimal resources for surgery was completed by 1 representative surgeon at each hospital. There were 8 LCHs, 18 SCHs, and 19 CAHs with survey response rates of 100%, 83%, and 89%, respectively. Results One hundred percent of hospitals surveyed had respiratory therapy and ventilator support, computerized tomography (CT) scanner and ultrasound, certified operating rooms, lab support, packed red blood cells (PRBC), and FFP accessible 24/7. Availability of cryoprecipitate, platelets, tranexamic acid (TXA), and prothrombin complex concentrate (PCC) decreased from LCHs to CAHs. The majority had board-certified general surgeons; however, only 86% LCHs, 53% SCHs, and 50% CAHs had advanced trauma life support (ATLS) certification. One hundred percent of LCHs had operating room (OR) crew on call within 30 minutes, emergency cardiovascular equipment, critical care nursing, on-site pathologist, and biologic/synthetic mesh, whereas fewer SCHs and CAHs had these resources. One hundred percent of LCHs and SCHs had anesthesia availability 24/7 compared to 78% of CAHs. Discussion Improving access to the aforementioned resources is of utmost importance to patient outcomes. This will enhance rural surgical care and decrease emergency surgical transfers. Further education and research are necessary to support and improve rural trauma systems.

Antimicrobial Stewardship Knowledge, Attitudes, and Practices among Health Care Professionals at Small Community Hospitals

2016 ◽  
Vol 51 (2) ◽  
pp. 149-157 ◽  
Author(s):  
Whitney R. Buckel ◽  
Adam L. Hersh ◽  
Andy T. Pavia ◽  
Peter S. Jones ◽  
Ashli A. Owen-Smith ◽  
...  
Keyword(s):  
Health Care ◽  
Antimicrobial Stewardship ◽  
Health Care Professionals ◽  
Small Community ◽  
Community Hospitals ◽  
Attitudes And Practices ◽  
Knowledge Attitudes And Practices

scholarly journals 889. Impact of an Infectious Disease Telehealth (IDt) Service on S. aureus Bacteremia (SAB) Outcomes in 15 Small Community Hospitals

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S22-S22
Author(s):  
Alithea D Gabrellas ◽  
John J Veillette ◽  
Brandon J Webb ◽  
Edward A Stenehjem ◽  
Nancy A Grisel ◽  
...  
Keyword(s):  
Hospital Mortality ◽  
Health Department ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Categorical Variables ◽  
Small Community ◽  
Community Hospitals ◽  
Post Discharge ◽  
Exact Test ◽  
The Impact

Abstract Background Infectious diseases (ID) consultation improves SAB readmission rates, compliance with care bundles and mortality. Small community hospitals (SCHs) (which comprise 70% of US hospitals) often lack access to on-site ID physicians. IDt is one way to overcome this barrier, but it is unknown if IDt provides similar clinical benefits to traditional ID consultation. Our study aims to evaluate the impact of IDt on patient outcomes at 15 SCHs (bed range: 16–146) within the Intermountain Healthcare system in Utah. Methods Baseline demographics, Charlson Comorbidity Index (CCI), hospital length of stay (LOS), and mortality (in-hospital, 30- and 90-day) were collected using an electronic health record database and health department vital records on all patients with a positive S. aureus blood culture from January 1, 2009 through December 31, 2018. Data from January 2014 through Sep 2016 were excluded to avoid potential influence of a concurrent antimicrobial stewardship study. Starting in October 2016 an IDt program (staffed by an ID physician and pharmacist) provided consultation for SCH providers and patients using electronic consultation and encrypted two-way audiovisual communication.Statistical analyses were performed using Fisher’s exact test or χ 2 test for categorical variables and Mann–Whitney U test for nonparametric continuous data. Results In total, 625 patients with SAB were identified: 127 (20%) received IDt and 498 (80%) did not (non-IDt). The two groups (IDt vs. non-IDt) were similar in median age (66 vs. 62 years; P = 0.76), percent male (62% vs. 58%; P = 0.35), and median baseline CCI (4 vs. 4; P = 0.54). There were no statistically significant differences in median LOS (5 vs. 5 days; P = 0.93) or in-hospital mortality (2% in both groups). The IDt group had a lower 30-day (9% vs. 15%; P = 0.049) and 90-day mortality (13% vs. 21%; P = 0.034). Conclusion IDt consultation was associated with a decrease in 30- and 90-day mortality for SCH SAB cases. Early transfer of critically ill patients might have affected LOS and in-hospital mortality. Post-discharge care factors might also contribute to 30- and 90-day mortality. While more work is needed to identify other factors associated with the effect of IDt on SAB, these data support the use of IDt to increase access to care and improve SAB outcomes in SCHs. Disclosures All Authors: No reported Disclosures.

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