Rationalizing Acute Care Services 1st Edition by Pauline Mistry ISBN 1857751256 978-1857751253

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ISBN 10: 1857751256
ISBN 13: 978-1857751253
Author: Pauline Mistry

Rationalization is concerned with making the most effective use of the resources available. In many places where this process is taking place it is plagued with public opposition and misunderstanding. Hitherto rationalization in the acute care sector has primarily been concerned with closing sites closing beds moving beds between services and moving beds from one site to another. This book discusses the need for rationalization in the context of health service reforms and future strategy. It considers recent changes in the health service the case for rationalization health care needs the role of public relations the future of the acute care hospital site and facilities appraisal and the costs of rationalization. The text is essential reading for managers and clinicians involved in acute care services non-executive members of boards and trusts and students of health services management.

Rationalizing Acute Care Services 1st Table of contents:

1 Summary of changes in the NHS over the past decade

Introduction

The 1990 NHS reforms

The allocation of resources

The impact of contracting for services

The development of competition

The move towards care in the community

The Health Authorities Act of 1995

Towards a primary care-led NHS

Other government initiatives

The trend towards mergers

Summary

References

2 The case for rationalization of acute care beds

Introduction

The international scene

The history of hospital growth and building in the UK

Major reasons for the rationalization of acute care beds

The increase in emergency admissions

The increase in hospitalization

References

3 The future of the acute care hospital and the importance of strategic thinking

Introduction

NHS priorities and planning guidance

The future organization and structure of acute care

The Calman Report on cancer services

Responsibility for implementing the future structure

The role of the acute care manager

The case for strategic thinking

Obstacles to strategic thinking

The information required to support strategic thinking

References

4 Understanding the catchment population

Introduction

Defining the catchment area

Verifying the catchment area

Reviewing the population of the catchment area

Health characteristics of the population

Health care needs assessment

Planned changes in the area

Targeting populations outside of the catchment area

Reference

5 Analysis of current patient activity

Introduction

Contracts with purchasers

Total patient activity

Ward analysis

Specialty analysis

Bed census

Audit Commission indicators for monitoring the use of beds

Review of competition

Summary of patient activity

Reference

6 Projecting bed needs

Introduction

Building a hospitalization model

Comparison of beds required with beds available

Projecting bed needs

Scenario planning

Other major factors to consider

Determining beds by the number of patient episodes

Summary

Reference

7 Site and facilities appraisal

Introduction

Single versus multiple sites

Estates’ functional content and space utilization

Site constraints

Condition appraisal

Site services appraisal

Statutory requirements

Location and accessibility

Patient focused care

Future implications for acute care health facilities

Consideration of options

Reference

8 The costs of rationalization

Introduction

The analysis of options

Costing the options

The private finance initiative

9 Public relations, communications, and consultation

Introduction

The role of public relations in hospitals

Internal communications

Openness and clarity

The public consultation process

The need for less but better consultation

The confusion between consultation and patient involvement

References

10 Future uncertainties

Introduction

Alternative health policies

The private sector

Priorities and rationing

Evidence-based medicine

The era of cooperation between competing providers

Conclusion

References

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