Total quality management system: its application in a community hospital research department.

Lehigh Valley Hospital initiated a program of total quality management using the model taught by Philip Crosby Associates. When the training began in the Research Department, we used the application of this model to identify, define and chart the various processes that a research project or study moves through from conception to publication. The resulting charts and process outlines enabled the Research Department personnel to recognize problem areas in the processes, and to chart the progress of a study at any given time. This provided us with both a better understanding of input and output in the research processes, and an opportunity to improve efficiency by correcting problem areas.

Rapid assessment of human immunodeficiency virus seroprevalence in a community-based hospital.

BACKGROUND: To aid in development of patient testing policy, in-service education, and resource planning, it is necessary to have a useful and meaningful tool for determining the population-specific HIV seroprevalence rate for our hospital patients. We were offered by the Centers for Disease Control a newly developed survey tool: "Rapid Assessment of HIV Seroprevalence in Hospital Patients." We subsequently served as one pilot site for this tool. METHODS: A population-based sample of 1000 patients (500 inpatients, 500 outpatients) was stratified into age and sex groups on the basis of admission statistics from the previous year in a general community hospital system in southeastern Pennsylvania that consists of two clinical campuses: an urban site with 343 beds and a suburban site with 506 beds. The study was conducted as an anonymous, unlinked screening for HIV antibody in 1000 serum samples. RESULTS: We found our overall seroprevalence rate to be 2.60% (Poisson 95% confidence interval, 1.77% to 3.81%), or 1 in 38 patient specimens. The highest rates for both sexes were found in the age range 25 to 44 years. CONCLUSIONS: This protocol is a useful survey tool for community hospitals to determine the HIV seroprevalence rate in patient populations, a practical necessity for planning and education. Survey results would aid in implementation of current Centers for Disease Control guidelines for HIV testing of inpatients and outpatients in the acute care hospital setting.