The spiraling costs of healthcare is a paramount issue in the healthcare arena. Today cost containment programs and budgetary costs affect all hospital departments, especially nursing. The purpose of this study was to identify the current and planned mechanisms in which selected hospitals cost out nursing care. The utilization of patient classification systems and patient care hours has also explored in relation to costing out nursing care. The significance of the study was to establish an information base for hospitals regarding methodologies to cost out nursing care and to describe current methodologies of costing out nursing care in select hospitals. The sample was a convenience sample of 30 hospitals identified as charging for nursing services and utilizing variable billing for nursing services. Thirty questionnaires were mailed. Procedures for the protection of human subject rights were followed. Thirteen questionnaires (43%) were returned with eleven (36%) questionnaires fully completed. The results indicated that approximately one-half (50%) of the hospitals currently bill patients for care actually received based on a patient acuity level. Nursing was primarily responsible for costing out nursing care once the program had been implemented. The costs of nursing care included a variety of items and varied across institutions. The majority (45.5%) included salary, benefits, indirect administrative costs and indirect overhead costs. Almost all the respondents stated the hospital used a patient classification system (91%) and the concept "hours of care" (100%). The majority (54.5%) of the hospitals had patient class systems adopted from another hospital. The time included in hours of care varied greatly between the institutions. Despite the variance, all the facilities related hours of care to acuity levels of the patient classification system either a pre-determined hour of care requirement or an acuity level generated by hours of care determined. Findings from this study concluded that costing out nursing care is a viable method in which the nursing profession can charge for nursing care rendered. The data concerning methodologies to cost out nursing care demonstrated several of the limitations defined in nursing literature, e.g. variations in patient classification systems and variations of items included in hours of care. Therefore the conclusion was that although the majority of respondent hospitals cost out nursing care, the charges vary due to the variation in methodologies. The profession of nursing must work to overcome these variations and make the concept of costing out nursing care a commonly performed practice. / School of Nursing

Call number: LD2668 .T4 1979 M26 / Master of Science

Thesis. 1975. M.C.P.--Massachusetts Institute of Technology. Dept. of Urban Studies and Planning. / Bibliography: leaves 137-139. / M.C.P.

Not available / text

This study has presented a history of the early development, design, and construction of the Marion, Indiana Branch of the National Home for Disabled Volunteer Soldiers. A general history of the institution of the National Home for Disabled Volunteer Soldiers provides the context for the establishment of the Marion Home. A historical review of the selection of the Marion site, its layout plan, design and construction of buildings, and landscape design between 1888 and 1900 was then provided. The development of the Marion Home is next compared with the 1890's developmental history of the Central Branch in Dayton, Ohio and the first ten years of the Danville, Illinois Branch in order to assess commonalities and differences in construction among three homes during the same period. In the conclusion, the evidence suggests that the layout and architectural design of three homes had many similarities during the 1890s and the turn of twentieth century. / Department of Architecture

American tuberculosis sanitarium architecture developed largely from trends set by European health spas and sanitarium design. The first American tuberculosis sanitariums largely resembled European health spas and resorts and catered to rich clientele. The spread of the White Plague, however, urged American states to develop sanitarium institutions that could provide for all classes. These first sanitariums melded nineteenth century resort architecture with radial prison designs and Kirkbride insane asylums to create large hospital complexes devoted exclusively to tuberculosis treatment and research. By the 1920s and 1930s, the European modernist movement had created modern tuberculosis sanitariums that inspired American sanitarium design. Despite the important role these institutions played in curing consumptives and limiting the spread of the White Plague, the increased use of drug therapy made sanitariums obsolete by the 1970s. Today, many of these sanitariums have been abandoned, demolished, or rehabilitated for new uses. / History of the disease -- The European and American health spa movements -- The development of the European sanitarium movement -- The development of the American sanitarium movement -- The American sanitarium movement : borrowing from European modernist innovation. / Department of Architecture

Bedside terminals are an approach to data entry that is maximally effective, due to capture at the point of care, to meet the challenges facing nursing today in relation to information documentation. The purpose of this evaluation research study was to determine if bedside terminals are justifiable though a cost-benefit analysis.The General Systems Theory, which was formulated by Ludwig von Bertalanffy in the late 1920's, was the theoretical framework used for this study (Putt, 1978).A non-standardized checklist of factors was developed by the researcher to evaluate the associated costs. related to bedside terminals. The factors included patient census, acuity, lost charges, reimbursement denials, and medication errors.A convenience sample of one surgical nursing unit from a large midwestern metropolitan hospital was chosen for data collection. Based on the literature, monetary values werearbitrarily assigned to the factors. Costs were assigned based on projected figures for bedside terminal implementation in 1993 obtained from the literature. All participants were notified of rights as human subjects and the confidentiality of this study.This study was significant because the results will be added to the limited information on the justification of bedside terminals using a cost-benefit analysis available in the current literature.Projections of bedside terminal costs were limited due to the unwillingness of bedside terminal vendors to provide current costs to compare against the quantitative benefits collected in this study. Reimbursement denials were not obtained due to the accounting practices of the institution. Due to these limitations, a prospective rather than the retrospective approach used in this study for data collection would be recommended to ensure obtaining information on all data elements. The results of this study should be considered when contemplating purchase of bedside terminals. Based on the results of this cost-benefit analysis study, the purchase of bedside terminals is cost-justified. A favorable return on investment of a one year payback was obtained. / School of Nursing

Bedside computer terminals are an approach to data entry that is maximally effective to meet the challenges facing nursing today and process hospital information. The purpose of this evaluation research study was to determine if bedside computers are justifiable through a cost-benefit analysis. Costbenefit analysis was done to determine whether the benefits outweigh the costs involved in implementing a bedside computer system.The General Systems Theory formulated by Ludwig von Betalanaffy was the theoretical framework utilized for this project. A non-standardized checklist of factors was developed from the literature review. The factors included were patient census, acuity, lost charges, reimbursement denials, and medicine errors. Interrater reliability was established by a panel ofthree experts on cost-benefit analysis.A convenience sample of one 42 bed nursing unit from a large metropolitan Midwestern hospital was chosen for data retrieval. One month of financial data was analyzed for this study. The procedures for the protection of human subjects were followed.The study showed that bedside computers are costjustified.-based on the results of the cost-benefit analysis. The projection of cost versus benefits realized from the bedside terminals was limited due to the unwillingness of vendors to share actual cost information. Reimbursement denials were unable to be retrieved because of the financial accounting practices of the institution chosen.A prospective approach rather than the retrospective approach utilized in this study may produce the data necessary for reimbursement denials. Recognizing its limitations, the results of this study should be considered when contemplating the purchase of bedside terminals or the increasingly more advanced technology of hand-held and voice activated computers. / School of Nursing

The Catholic Church is one of the largest providers of medical care in the US, with 1 in 6 acute-care beds residing in a Catholic hospital. One third of these hospitals are in rural or underserved areas in the US, and advocacy for the vulnerable is a central platform of the Catholic Healthcare Association. Despite this, the Church has been under attack for allegedly putting women at risk of injury or death due to the care restrictions concerning reproductive health stipulated in the Ethical and Religious Directives (ERDs). Additionally, scholars are questioning the distinctiveness of the Catholic healthcare mission in practice, pointing to the increased homogenization of Catholic and non-Catholic hospitals. For these reasons, it is necessary to assess if and how women are being harmed in Catholic hospitals and, if there is harm being done, if there is a way to prevent these harms while preserving the Catholic Social Tradition in medicine. In carrying out this assessment, I read the current literature closely to explore both the origins and the practical consequences of these ethical conflicts. Subsequently, I use Chris Durante's "pragmatic perspectivism" to formulate a proposal that considers both Catholic medical ethics and secular medical ethics on the same plane. The proposal suggests the adoption of an alternative and complementary lens for Catholic health care. Using this framework would allow the Church to pursue its health care mission in a fuller sense, unencumbered by the inertia of the medical industry towards homogenization due to legal and economic pressures. It also provides the potential for Catholics to more easily receive Catholic care in all hospitals, not just those under Catholic sponsorship. Importantly, it would also prevent any American woman from being practically forced to receive Catholic care, circumventing many of the ethical conflicts present in the current system.