Hospitals in Latin America and the Caribbean

Health service provided by public or private institutions at the primary and hospital referral levels should be coordinated so that the available resources are distributed equitably to meet the needs and aspirations of the population. The challenge is to improve the quality of hospital care and the existing pattern of public and private services in Latin America and the Caribbean.(AU)

Issues in Resource Management: A model hospital

This paper seeks to present the issues in resource management facing Health Administrators in the English Speaking Caribbean against a service delivery backdrop. Using a model 150 bed acute care general hospital, the authors would try to demonstrate the benefits and value of accountability management change and paradigm shifts in the management of hospitals. The model hospital is characterised by high quality, efficiency and effective delivery of service, continuous improvement and value added to the community. All aspects of the organization will be considered. * Financial Resources - Adequacy and Control; * Human Resources - Staffing, Development and Planning; * Technology - Appropriateness use and Relevance; * Information - Decision support Services, Decision Making; * Quality - Service standards, Continuous improvement; * Organizational Design and Development; * Management Systems Development; * Policies and Procedures; * Physical Plant and Equipment; * Aesthetics; * Public and Community Relations (AU)

Clinical aspects of blood transfusion in adults

The transfusion of blood or blood products may be life-saving or may reduce morbidity but also carries risks. Therefore, it should be prescribed only when it is clearly indicated, after a careful assessment of the benefits and risks for the patient. The pattern of blood usage in developing countries differs from that in developed countries. This reflects the better infrastructure (e.g. availability of safe water and adequate sanitation), public health services and more sophisticated health systems in developed countries, and the prevalence of some hereditary haematological disorders in developing countries. There are also differences in usage among developing countries, with the pattern in a small group similar to that of developed countries. In this paper we discuss the indications and the precedures for transfusion of blood and blood products, and outline the complications of haemotherapy and methods for avoiding or correcting them at the time of transfusion or afterwards (AU)

Five year health sector plan

Presents a plan aimed at guiding the development of the infrastructure, manpower, management and the delivery and provision of health services on the islands of Grenada, Carriacou and Petit Martinique. Objectives include decreasing mortality and morbidity and strengthening the initiatives of health for all by the year 2000. Details on the current health services; priority programmes for health development; health infrastucture and facilities; and details of legislation pertaining to health are given. Also outlines health policy statements of the Government. The general objectives of the plan are outlined and the strategies that should be used to achieve these goals are included

Ministry of Health: management review

Presents a review of five areas of the health services infrastructure, viz. General Hospital, Richmond Hill institutions, Princess Alice Hospital. Princess Royal Hospital and community health services. Details of the organizational structure and proposals for improved administrative practices and working conditions are given. Includes statistical data on medical, nursing and administrative personnel

The supply of oxygen to the Queen Elizabeth Hospital - abstract

The Queen Elizabeth Hospital gets its oxygen supplies as compressed gas in cylinders from the sole producer in Barbados. Expenditure on oxygen will have risen to B$500,000 per annum in 1988. The rising use and cost of oxygen, stimulated the Queen Elizabeth Hospital Administration to consider generation of its oxygen. A cost analysis revealed that by doing this, it may be possible to save B$250,000 in expenditure on oxygen annually. An oxygen concentrator was installed at the Hospital and put into use in November, 1988 (AU)

Analysis of the incentive systems used at the University of the West Indies

Reviews the history of the University Hospital, its organization, administration and financing. Discusses the open system of the University Hospital, its emphasis on service, the goals and objectives of the organization and of individuals, the economic and external constraints and the need for adequate incentive systems for workers. Discusses the present hospital-wide incentive systems: medical care, long service awards, contributory pension and life assurance schemes, staff training programmes and other schemes, vacation, sick and departmental leave, and employer's liability. Analyses the utilization, costs and problems involved with these. Presents the individual incentive schemes as applied to nurses and drivers in respect of absenteeism, staff-shortage, and accidents respectively. Contends that while incentives are not directly related to the productive affort of the workers, mangement expects to improve the stability and strength of the hospital. Suggests specific measures to improve the incentive system and the introduction of new schemes to encourage and reward group effort. Recommends also greater involvement of employees in the decision making process and proper vertical and horizontal lines of communication. Concludes that poor finances, poor remuneration of staff and changing societal human behaviour problems have contributed to present low staff morale and staff relations and that the hospital-wide incentive schemes must be complemented by group and incentive schemes. (AU)

Hospital restoration project

The hospital restoration project seeks to assist the government in the rationalisation and development process of the secondary care services and establishing strong linkages between the primary and secondary levels in order to create a comprehensive care system. Constraints occasioned by recent structural adjustment programmes together with concentration of capital development projects in the public health sector on primary health care have contributed to the erosion of the secondary care service. Funding agencies will assist the government. Specific objectives of the project are to: upgrade physical facilities and equipment, develop and strengthen management systems, improve training capabilities, establish norms and standards and improve the maintenance of facilities and equipment by strengthening the maintenance system. (AU)