hospital issues

Jefferson Using Shaped Beam Surgery to Sculpt Therapy for Hard-to-Treat Brain Tumors

In contrast to traditional surgical techniques, neurosurgeons and radiation oncologists at Thomas Jefferson University Hospital in Philadelphia are using a new type of advanced radiation technology to “surgically” treat a wide range of tumors in the brain and spine, curing tumors that they couldn’t treat before.

The new technology, called shaped beam surgery, can mold radiation beams to fit the exact size and shape of a tumor. It is available now only at Jefferson in the Delaware Valley and in a small number of medical centers in the nation.

“Shaped beam surgery is a major advance in treating both benign and malignant tumors in the brain and the spinal cord regions,” says neurosurgeon David Andrews, M.D., professor of neurosurgery at Jefferson Medical College of Thomas Jefferson University and director, division of Neuro-oncologic Neurosurgery and Stereotactic Radiosurgery, Thomas Jefferson University Hospital.


2.USA

Nearly 400 hospitals commit to safer needle devices

The American Nurse,November/December 1997
Lynda Arnold campaign has far-reaching effect on health care community
In less than a year and a half, Lynda Arnold, RN, has significantly impacted health care worker safety in the United States. Since she launched her Campaign for Health Care Worker Safety in February 1996, nearly 400 hospitals have signed written commitments to implement safety blood-drawing devices and IV catheters.

What has turned into a national movement started as a personal crusade for Arnold, who contracted HIV after sustaining a needlestick while removing a catheter needle from a patient's vein. Even though Arnold, 23 at the time, had worn latex gloves and complied with all the recommended precautions, she still became infected.

As of two years ago, when the Centers for Disease Control and Prevention (CDC) last released statistics on occupational HIV infection rates, Arnold was one of 133 health care workers who had been infected in this manner. The numbers today are believed to be much higher given that every year in the United States, more than 800,000 needlesticks occur.

Arnold and other occupational safety and health experts blame unsafe needle devices for this deadly trend. In the majority of cases, Arnold reports, health care workers contracted HIV from blood-drawing devices or intravenous catheter needles. She notes that safer needle devices are available and maintains that most of the needlesticks resulting in HIV infection are preventable if hospitals adopt safer needle devices.

To that end, the Campaign for Health Care Worker Safety has worked to contact every health care facility in the country to ask that they sign a commitment to implement protective blood drawing devices and IV catheters within one year of their sign-on date. Largely due to Arnold's tireless work over the past 18 months, nearly 400 hospitals have joined the campaign; 11 have declined. Making good on her promise to alert the public to the results of the campaign, she has published lists of both the hospitals signing the commitment and those who haven't.

3.Privatizing Public Hospitals

Community hospitals, many built during the Great Depression, are relics of a bygone era and should be privatized. That is the conclusion of a new study by Richard Tradewell, published by the Reason Public Policy Institute.

There are a number of benefits to be derived by going private -- among them less bureaucracy, increased accountability and better service at lower cost. Privatization agreements typically provide up to 25 percent more care for the indigent than their publicly funded counterparts.

There are several options open to governments exploring privatization of hospitals and health clinics.

Selling the facility could produce a large cash payment up front -- which could be used to retire debts and establish a trust fund for community health care.

Hospitals, clinics and their equipment could be leased to management firms.

A local government might decide to operate the facility jointly with a private firm, or it could sell a portion of the assets for cash -- retaining power to appoint a portion of board members.

Rather than operating a hospital, a government could purchase the number of bed days it needs for indigent care.
If a facility is not needed as a hospital at all, the community might just want to sell the land and buildings for other uses.

Tradewell warns that navigating the transition can be tricky. Citizens often start out with a skeptical view of the proposed change. But when examples are presented of the successful transitions other communities have made -- which are included in the study -- public opinion may shift to pro-privatization.