...Analysis about creating Adjustable Capacity for BWH: Adjustable capacity can be done by expanding capacity at the peak period by effective use of slack time or by making a portion of capacity is being made variable through design. Stretch existing capacity: People, Facilities and equipment can work longer to meet demand. This helps in concentrating on essentials tasks during emergency period. Align capacity with demand fluctuations: Use part time employees, outsource, rent or share facilities etc. Analysis of BWH Sharing Capacity: A service delivery system often requires a large investment in equipment and facilities. During periods of under utilization, it may be possible to find other uses for this capacity. BWH can also evaluate making some of underutilized wards can converted to ICU as demand arises and converted back to regular wards as demand reduces. Yield Management of BWH: Based on case, a comprehensive yield management system incorporating all strategies relating to demand for and supply of services was not incorporated to. Its not clear that how far their existing Yield management system has the ability to segment patient requirements into different service classes and helps for an efficient yield management. They should have implemented Yield management software applications which can be customized do this for them, which will same the time and energy. What strategies can be used to manage BWH capacity? Need for adjusting service capacity to match demand...
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...Specifically, women that intake synthetic gonadotrophin releasing hormone which controls the release of estrogen and progesterone, it has been shown that development of fibroids are decreased (Brigham and Women's Hospital, 2014, para. 7). In addition, oral contraceptives are helpful in treating abnormal bleeding during ovulation (Brigham and Women's Hospital, 2014, para. 9). A diet can be modified by eating less red meat and drinking less alcohol. Also a woman who has not given birth is at risk to develop uterine fibroids and...
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...Case #1: Brigham and Women’s/Faulkner Hospitals This case takes an in depth look into the evolving medical industry. Key aspects of this case focus on the benefits and drawbacks of a merger between large and community sized hospitals and the possible cost subsidizing that may occur and the impact the qualitative factors may play in such cases. Overview of Industry: Health Care costs began to rise while insurance reimbursements began to fall. This led to a larger amount of patients being treated on outpatient basis. This aided in temporarily curbing the costs associated with overnight patients. AMCs therefore focused on primary care as means of reducing operating costs. Thus a lot of emphasis was placed on cost control. Managed Care plans lead to capped fee for hospitals. As a result, BWH saw a drop in incoming patients. AMCs thus focused on primary care as means of reducing operating costs. Community doctors were reluctant to recommend AMC doctors, instead sent patients to less costly hospitals. The solution seemed to be pointing towards possible mergers. The mergers’ purpose was to achieve Economies of Scale and also get access to the patients and knowledge of community hospitals and fill the gap where the large hospitals lacked market penetration. OUTLINE OF BWH HOSPITAL: Largest hospital in New England. Often ranked as best in service. High end teaching hospital. Employs more than 12,000 people with 44,000 patients. Annual research budget of $400...
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...Professional Presence and Influence Julie Palmer Western Governors Professional Presence and Influence The profession of nursing can be looked at as having its own culture, complete with its own customs and rites. Nursing today is offered by practitioners with a bias for the rigors of science, the aesthetics of artistic expression, and the meaning of spiritual orientation (Koerner, 2011). As nurses it is important for us to understand who we are and how our behavior affects others. By focusing on our professional presence and mindfulness we can create a plan that will have both professional and personal applications. Models of Health and Healing Within the modern world of medicine, there are many different views and theories of nursing practice and nursing models. One such theorist is noted physician Larry Dossey, using his background as an internist Dr. Dossey noted the role of the mind in health and the role of spirituality in healthcare (Dossey, 2015). Using this knowledge, Dr. Dossey identified three eras that provide a framework for the medicine operational in the Western world today (Koerner, 2011). The three Eras are: Era I, mechanistic medicine, Era II, body/mind and Era III, Body/Mind/Spirit. Of the three theories, the biggest difference can be seen between the first and second Era. In Era I which began around the 1860’s the focus is on the physical being, health and illness are completely physical in nature, with a person’s consciousness being a by-product of the...
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...the identical because there were two people in my family that were diagnosed with this type of cancer and they were identical. Joe never had any children, so if the cancer is hereditary to the identical then the cancer gene stopped with him. Ewing’s Sarcoma is a very rare cancer in adults; it has usually spread to other parts of the body when it is detected. Ewing’s Sarcoma is a form of bone cancer and is typically found in teenagers when they undergo growth spurts, but it can occur at any age. Ewing’s Sarcoma is very rare in adults. Ewing’s Sarcoma accounts for about one to two percent of childhood cancers. There are about 225 children and adolescents diagnosed with Ewing’s Sarcoma in the United States each year (Brigham and Women's Hospital, 2010-2012). It is the second most common malignant bone tumor in children and adolescents. Adult patients with Ewing’s Sarcoma/PNET at highest risk for death are those older than 26 years and have metastatic disease or an extra osseous primary tumor. There are more males that are affected than females. Ewing’s...
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...basis of that analysis, to recommend both a size and a composition for the real-asset portfolio segment within that LTP. Background Partners Healthcare System was the largest health-care network in New England, providing a range of primary, secondary, and tertiary health-care services to millions of patients from throughout eastern Massachusetts. The Massachusetts General Hospital and the Brigham & Women’s Hospital, two world-famous acute-care hospitals in Boston, had joined together in 1994 to found the Partners network. Both Mass. General and Brigham not only provided acute clinical care but were also research and teaching hospitals affiliated with the Harvard Medical School. Over the next few years, four suburban hospitals had also joined the network, as had dozens of physician organizations (practices with multiple numbers of doctors) across eastern Massachusetts. A variety of important staff functions, including treasury functions like asset management, had been centralized at Partners headquarters in downtown Boston, but all the clinical care and research took place in the decentralized network of hospitals and physician offices (see Exhibit 1). Partners’ Treasury Department, headed by Manning, reported up through a senior vice president of Treasury to the chief executive officer and the board. Importantly, there was also an investment committee consisting of well-known and respected investment professionals who determined the investment policy for Partners’ pools of investments...
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...is a holistic process which heals the body and restores the mind. sickest neediest in community and our and around the world.” GARY GOTTLIEB, MD This is the story of Partners Healthcare who envisions a seamless world in the arena of medicine where one node is connected to any other node throughout the grid. They aim to provide affordable and quality medical healthcare through innovative programs that reach patients wherever they are. 1 QUICK FACTS ABOUT PARTNERS HEALTHCARE SYSTEM: - Partners HealthCare was founded in 1994 by Brigham and Women's Hospital and Massachusetts General Hospital - Now, Partners HealthCare, is a massive Boston-based non-profit hospital and physicians network - According to the Boston Globe, by 2008 Partners became Massachusetts's "largest private employer and its biggest healthcare provider, treating more than a third of hospital...
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...healthcare organization or component of one or on a healthcare strategy-related issue and/or challenge, or to develop a Strategic Plan for a healthcare organization or component of one. Each Research Project is presented in a final report of approximately 25 pages, the same length as each Strategic Plan. This spring, the students wrote research papers on: •The Changing Healthcare Environment and Accountable Care Organizations •Accountable Care Organizations: The Key to Transforming Healthcare •Electronic Health Records and Their Implementation •Reducing Unnecessary Medical Care Cost Using a Multidisciplinary Approach •Improving Patient Quality and Safety Through Strategic Initiatives at Brigham and Women’s Hospital, Children’s Hospital Boston, and Newton-Wellesley Hospital •A Strategic Approach to Quality and Safety at Tufts Medical Center •Chronic Disease Management Systems: A Strategic and Operational Analysis of How to Implement an Effective •Chronic Disease Management Service Line The strategic plans are on: •Successful Implementation of Quality and Performance Improvement Plans: Critical Areas to Address in Strategic Planning •Boston Pediatric Neurosurgical Foundation (BPNF) •Medical School Affiliation Strategy in the Boston Area •The field of renal medicine and the delivery of hemodialysis services at Beth Israel Deaconess Medical...
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...op yo rP os t NA0186 A Telemedicine Opportunity or a Distraction? Janis L. Gogan, Bentley University Monica J. Garfield, Bentley University S hawn Farrell, Executive Director of the Partners TeleStroke program, glanced at his smart phone while striding toward his office at Massachusetts General Hospital (MGH) in Boston; he nearly collided with Lee Schwamm, MD. Knowing that Dr. Schwamm’s overfull schedule as Vice Chairman of Neurology and Director of Acute Stroke and TeleStroke Services meant he had little time to chat, Farrell used the near-collision as an opportunity to quickly mention a recent conversation with a nurse from Falmouth Hospital on Cape Cod. An active participant in the TeleStroke service, Falmouth Hospital was regularly honored for its adherence to best practices in stroke care. “Recently some Falmouth nurses asked how we can convince other MGH departments—such as in critical-care pediatrics—to provide similar telemedicine consultation services,” Farrell stated, adding “Their nurse stroke coordinator, Jean Estes, is a huge cheerleader for TeleStroke.” Dr. Schwamm continued moving toward his office as he replied, No tC Shawn, don’t we already have too much to do? I need to see patients, complete the analysis for a study I am working on, submit a grant application. Next week I will speak at an international neurology conference. Telemedicine can certainly be invaluable in many clinical domains, but there just are not enough...
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...Massachusetts was an intense competitive environment. The two largest and most prestigious hospitals, Massachusetts General Hospital and the Brigham and Women’s Hospital, had agreed to a merger. The merger brought heavy pressures to many of the surrounding hospitals. The other hospitals realized that they needed strong negotiating power to push back against the health maintenance organizations to survive. Meanwhile, others were unable to fill the hospital beds which led to closures of many hospitals. Therefore, Massachusetts hospitals realized to keep afloat they would need a strong balance sheet in the perceived future price war. It was under these circumstances CareGroup was formed in 1996 through a three-way merger. The merger brought $1.6 billion of revenues to them and made it the second-largest group hospital in eastern Massachusetts. The Beth Israel Hospital and the Deaconess Hospital integrated into a single hospital, while the Mount Auburn Hospital reported to CareGroup as a separate entity. CareGroup consisted of health-care professionals who were devoted to provide high quality personalized health care to their patients. They offered community-based primary care and provided specialty services close to where their patients lived or worked. CareGoup’s mission was to develop integrated services across the hospitals, improve the quality of care, and cut down the cost. Their hospitals and physicians participated in nearly all managed care and health insurance plans...
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...Most fats are categorized two ways and that is saturated and unsaturated fats. Saturated fats are considered to be bad for the body while the other is called a healthy fat. The difference between the two is in their chemical composition. For example you have a group of people walking in a line, each carrying a bag full of hydrogen. They are saturated with hydrogen on their carbon chain. This results in fats that are solid at room temperature, like lard and butter. Unsaturated fats are missing a few hydrogen atoms on their carbon chain. The unsaturated hiker train has a few people whose bags have no hydrogen. This makes the fat unstable in its chemical composition, which accounts for their liquid state at room temperature. (www.fitday.com) Trans fat also known a s fatty acid that is commonly produced by the partial hydrogenation of vegetable oils and present in hardened vegetables oils, mostly margarines, commercial baked goods, and many fried foods. (www.freedictionarty.com) Food industries are striving to produce new products for consumers in order to stay in a positive profit margin. After all that is the point of a business? Yes, they are concerned about customers but a majority of businesses see the profit as their overall goal. There are companies that want to provide the best available products to consumers. But once again all of this cost money. And who want to be in the negative? The government ban on trans fat is a move to help those who have the...
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...MGT/230 Monica Frechette The selected organization for this topic is Massachusetts General Hospital (Mass General or MGH). MGH delivers excellence in patient care, which is advanced through innovative research and education of the diverse communities it serves. A description of MGH’s organizational structure will be provided. Two other organizational structures will be selected for the use of contrast and comparison to MGH. Lastly, the organizational functions of the various structures will be identified to determine influence on the organizational structure. MGH has most recently been ranked as the top hospital overall in the United States by U.S. News & World Report. It is ranked nationally in all adult specialties as well as for pediatric specialties. MGH was the original teaching affiliate of Harvard Medical School (HMS) and is currently one of over a dozen hospitals affiliated with HMS. MGH is owned by Partners HealthCare, which was formed by MGH and Brigham and Women's Hospital in 1994. With the opening of the Lunder Building in 2011, MGH is now the largest hospital in Massachusetts with 1,051 beds to service its community. Additionally, MGH has most recently been ranked as the top hospital overall in the United States by U.S. News & World Report 2012 – 2013 – a spot previously held by a different hospital. All these progressive decisions moving the hospital forward must begin somewhere. By establishing the organizational hierarchy and flow of managerial...
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...Mount Auburn Hospital: Physician Order Entry Introduction In September of 2002, Robert Todd, the head of information systems (IS) for Mount Auburn Hospital in Cambridge, Massachusetts, reviewed progress toward the launch of the hospital’s new computerized physician order entry (POE) system. The committee overseeing the project consisted of an across-the-board selection of hospital representation, including physicians, pharmacy staff, nurses, administrators, and IS operations staff. The POE system was scheduled to ‚go live‛ on a pilot basis in the middle of October in the hospital’s labor and delivery unit. It had not been difficult to mount support for the project. POE systems had been demonstrated to reduce error rates, and medical errors were widely recognized as a large and serious problem in health care. A landmark study published in 19911 estimated that 1.3 million injuries occurred annually in U.S. hospitals, 69% of which were at last partially due to errors in patient management. The study found that 13% of injuries resulted in patient death, ‚a rate that if extrapolated to the United States as a whole suggested that approximately 180,000 deaths a year were, at least partly, the result of injuries received during the course of care.‛2 This study also found that adverse drug events (ADEs) accounted for nearly 20% of total injuries (making them the largest injury category) and that 45% of ADEs were the result of errors. A later study at two Boston hospitals found that 6...
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...cancers are usually referred to as basal cell carcinoma and squamous cell carcinoma. These skin cancers are most often treated with surgery since they do not normally spread to other parts of the body. Melanoma is the most serious type of skin cancer. When Melanoma was first discovered people thought it was a joke. They didn’t pay any attention to what can cause melanoma skin cancer, or what to look for on their bodies to see if they should get checked by a doctor. No one believed in melanoma until they got it, or someone they knew had it. That’s when the all got their self-checked. They were all on alert. They never spent too much time in the sun, and If they did they had an umbrella. A prospective study by researchers at Brigham and Women's Hospital observed an association between risk of second primary cancer and history of non-melanoma skin cancer in white men and women. The researchers found that people with a history of non-melanoma skin cancer had a modestly increased risk of getting cancer in the future, specifically breast and lung cancer in women and melanoma in both men and women. Non-melanoma skin cancer, which includes basal cell and squamous cell carcinoma, is the most common form of cancer in the United States. People in my Community are on high alert over the talk about Melanoma skin cancer. People in my community are doing all they can to stay out of the sunlight. Also they are also avoiding ultraviolet lights. Ultraviolet lights are electromagnetic...
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...ENSEMBLE Case Study: Partners HealthCare System Partners HealthCare uses InterSystems Ensemble to integrate internal and external EMRs Partners HealthCare System Inc., based in Boston, Massachusetts, is an innovative integrated healthcare network that includes multiple major hospitals with more than 7,000 physicians attending to four million outpatient visits and 160,000 admissions per year. Partners’ institutions, including Massachusetts General Hospital and Brigham and Women’s Hospital, consistently rank among the best hospitals in the United States, according to U.S. News and World Report. To maintain its leadership status, Partners establishes enterprise-wide, CEO-supported corporate initiatives under the banner of “HighPerformance Medicine.” “Ensemble has given us tremendous flexibility with data transformations, and made us much more agile in delivering on this type of integration.” Steve Flammini, CTO One of these initiatives includes electronic medical record (EMR) adoption by all community physician practices in the Partners system. To achieve this goal, Partners offers these physicians full, Webbased access to its internal EMR. But first, Partners must rapidly create interfaces (programs that handle data translation and transmission between systems) to the community physicians’ practice management and scheduling systems, and integrate that data into its EMR. The initiative also gives participating physicians access to more than three...
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