Articles: hospitals.
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The aim of the study is showing the results of the experience of "Hospital without pain" in the Lazio Region, in order to plan a specific regional project. This was a cross-sectional study conducted through the administration of a questionnaire during the month of October 2007, sent by the Social Department of the Regional Direction Health Planning to the General Directors of Local Health units, Hospital Trusts and Teaching Hospitals. 24 hospitals entered the study (response rate 80%). 37.5% of responders declare that pain level is routinely controlled by a trained health professional, mainly in smaller hospitals (50% vs. 20% in larger ones). In most hospitals (62.5%), pain monitoring is based on the use of the Visual analogue scale (VAS), whereas other scales are less frequently used (20.8%). ⋯ In the last case, these protocols are predominant in the roman (76.9%; p = 0.045), larger (80%; p = 0.069) and teaching hospitals (100%; p = 0.064). The management of pain in the Lazio Region shows a high heterogeneity, both in terms of geographical and dimensional issues. This study highlighted critical elements to be considered for the improvement of the situation at the regional level.
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Multicenter Study
Association between implementation of a medical team training program and surgical mortality.
There is insufficient information about the effectiveness of medical team training on surgical outcomes. The Veterans Health Administration (VHA) implemented a formalized medical team training program for operating room personnel on a national level. ⋯ Participation in the VHA Medical Team Training program was associated with lower surgical mortality.
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Multicenter Study Comparative Study
Hospital process compliance and surgical outcomes in medicare beneficiaries.
To determine whether high rates of compliance with perioperative processes of care used for public reporting and pay-for-performance are associated with lower rates of risk-adjusted mortality and high-risk surgical complications. ⋯ Currently available information on the Hospital Compare Web site will not help patients identify hospitals with better outcomes for high-risk surgery. The Centers for Medicare and Medicaid Services needs to identify higher leverage process measures and devote greater attention to profiling hospitals based on outcomes to improve public reporting and pay-for-performance efforts.
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Multicenter Study Comparative Study
Reduced access to care resulting from centers of excellence initiatives in bariatric surgery.
To determine the effect on travel distance for Medicare patients before and after Centers for Medicare & Medicaid Services required that bariatric procedures be performed at Centers of Excellence (COEs). ⋯ Center of Excellence requirements have increased the travel distance required for Medicare patients. Prior research has shown that outcomes at COEs are no different than those at non-COEs suggesting that the reduced access to care resulting from requiring COE status is not beneficial.
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Multicenter Study
Drug approval processes in Australian Paediatric Hospitals.
To describe and evaluate the decision-making processes for drug approval in Australian paediatric hospitals. ⋯ Most drug submissions in tertiary paediatric hospitals are approved; however, workload, drug expenditure and individual-patient use schemes vary considerably. Duplication of effort occurs, and few committees are resourced sufficiently given their terms of reference.