A hospital is an institution for health care providing patient treatment by specialised staff and equipment, and often but not always providing for longer-term patient stays. A hospital today is a centre for professional health care provided by physicians and nurses. During the Middle Ages it could serve other functions, such as almshouse for the poor, or hostel for pilgrims. The name comes from Latin hospes (host), which is also the root for the words hotel and hospitality. Hospital-acquired infections (HAIs), also known as health-care-associated infections, encompass almost all clinically evident infections that do not originate from a patient’s original admitting diagnosis.
Within hours after admission, a patient’s flora begins to acquire characteristics of the surrounding bacterial pool. Most infections that become clinically evident after 48 hours of hospitalization are considered hospital-acquired. Infections that occur after the patient’s discharge from the hospital can be considered to have a nonsocial origin if the organisms were acquired during the hospital stay. Today, hospitals are usually funded by the state, health organizations (for profit or non-profit), health insurances or charities, including direct charitable donations. In history, however, they were often founded and funded by religious orders or charitable individuals and leaders.
Similarly, modern-day hospitals are largely staffed by professional physicians, surgeons and nurses, whereas in history, this work was usually done by the founding religious orders or by volunteers. There are several kinds of hospital. The best-known is the general hospital, which is set up to deal with many kinds of disease and injury, and typically has an emergency ward to deal with immediate threats to health and the capacity to dispatch emergency medical services. A general hospital is typically the major health care facility in its region, with large numbers of beds for intensive care and long-term care, facilities for surgery and childbirth, bio assay laboratories, and so forth. Larger cities may have many different hospitals of varying sizes and facilities. One plum wall says it all: Hospital services are separate and distinct from boarding and grooming services-yet both are easily accessible to pet owners and team members.
During a candid conversation with his architect, Dr. David Gordon, medical director of VCA Arroyo Animal Hospital (formerly Arroyo Pet Care Center) in Lake Forest, Calif., mentioned he’d like to distinctly separate the hospital and medical functions and the boarding and grooming functions. Yet his idea of using a scalpel handle and blade on the outside of the building to depict that separation didn’t quite seem appropriate. Some patients just come just for diagnosis and/or therapy and then leave (outpatients), others stay the nights (inpatients). Putting the patient first is a challenge that requires not just a huge change in the mindset of all the stakeholders in health care provision, but also the means by which to measure the levels of satisfaction of patients, and to discover what matters to them before, during and after their visit to any hospital. Patient quality initiatives, with their softer, experiential focus than clinical audit, with its precise and scientific methods of measurement, demand different measurement techniques.
Often, the most effective means is to adapt from the survey techniques widely practiced in social research and market research by using surveys and objective self-completion questioning techniques. Yet, without careful management, the measurement teams can drown in a sea of questionnaires. Surveys are labor intensive, so it makes sense to use software developed to handle surveys in this context too, and make the process into something that can be managed by the small teams usually given this responsibility within the hospital.
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