People and Technology in the Workplace (1991) / Chapter Skim
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Managing the Ambulatory Care Unit
Managing the Ambulatory Care Unit
Pages 159-170
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From page 159... ...
Now the payment system for health care is a major national issue. The efforts to control health care costs, led by the purchasers of health care— insurers, consumers, and employers who pay for health insurancehave resulted in revolutionary changes in the way physicians and hospitals use technology to perform their work more costeffectively.
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From page 160... ...
Consumers are also more conscious of prices for health care because, depending on their insurance plan, they are held responsible for higher premiums, deductibles, and sometimes copayments. Employers are acutely aware of cost control the single largest expense for General Motors in manufacturing a car is paying for the employees' health benefits.
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From page 161... ...
The ensuing surgery involves! opening up the knee while the patient was under anesthesia and then using normal surgical instruments to remove foreign Doilies or repair damaged ligaments.
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From page 162... ...
all the equipment necessary for surgery, including anesthesia and radiological equipment, and a staff of perioperative nurses, scrub technicians, unit assistants, and clerical staff. By establishing this Short Procedure Unit ESPY, the hospital was able to use all 12 rooms in one building for inpatient surgical cases and to centralize the entire outpatient program in an adjacent building.
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From page 163... ...
For example, patients have to pay attention to what medications they take and the food they eat in the clays before the operation, and often may be required to take nothing by mouth the night before. After the surgery, they must be aware of their own healing processes, paying attention to their incision scars and reactions to any meclication, as well as keeping up with any postoperative exercises or precautions delineated by the physician.
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From page 164... ...
The nurses in the SPU have an important eclucational role with the patients and their families, answering questions and clarifying issues for them. After the requisite recovery period, the nurses ensure that the patients leave the SPU safely.
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From page 165... ...
that leacis to a much quicker heating process. As in arthroscopic knee surgery, a video camera is attached to the scope so assistants, nurses, and observers can view the work on a television screen.
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From page 166... ...
where a blood sample is taken from the fetal umbilical blood vessel. Using PUBS, doctors can administer medication, monitor medication levels that reach the fetus, and perform fetal blood transfusions.
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From page 167... ...
Since 1982 a pulmonary disease specialist at Pennsylvania Hospital has been using lasers successfully to open the airway passages of people suffering from lung cancer and other bronchial obstructions. In 1987 he and the chief of racliation oncology began to follow the clearing of the obstructions with the temporary implantation of a wire laden with radioactive material.
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From page 168... ...
For example, diagnosis of tumors of the breast can now be done on an outpatient basis because of fine needle aspiration and the technology to study very small biopsies. Surgeons can take the biopsies uncler local anesthesia in the Short Procedure Unit, and the women often avoid inpatient surgery altogether if laboratory examination shows that the tumor is benign.
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From page 169... ...
This positive attitude toward technological advancements and medical education continues today. The past 10 years have seen revolutionary changes in the health care system coming about because of the redefinition of medical insurance and payment systems.
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From page 170... ...
The cost of the research and development affects the price of the pacemaker but also results in better prognosis for the patient. It is highly likely that as health care costs continue to rise, even more new technologies will develop, and the rate of change will continue through the l990s.
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