Promoting productivity in the National Health Service, 1950 to 1966

In the 1950s, the Ministry of Health, supported by interested groups outside government, recognised the political importance of productive efficiency. For leadership, organisational models and techniques the Ministry looked to the movement for industrial productivity. The NHS was receptive, but private-sector approaches were modified and dampened as they were imported. NHS management was to be the provider of technical expertise, but the deployment of this expertise was limited by clinical autonomy and de-coupling from financial incentives. This article casts new light on the history of productivity policy, NHS management and the moving frontier between state and civil society.     

Preaching in thirteenth-century hospitals

This article uses thirteenth-century hospital sermons as a window into the moral and religious environment of these charitable institutions, large numbers of which were founded during the twelfth and thirteenth centuries. What emerges from the reportationes of sermons preached in the hôtel-dieu of Paris and ad status sermons directed at hospitals' personnel and inmates by Jacques de Vitry, Humbert of Romans and Guibert de Tournai is a spirituality that stressed the penitential (and potentially salvific) power of doing works of mercy (in the case of hospital workers) and bodily suffering (in the case of hospital inmates). The particular social context of hospital preaching is also evident in preachers' anxieties about the quality of hospital administration. The sermons that were preached in thirteenth-century hospitals reflect the heightened value placed on caring for the sick and poor, a historical development more often associated with the later middle ages.     

Seismic Performance to Emergency Centers,Communication and Hospital Facilities Subjected to Nepal Earthquakes, 2015

Emergency centers, communication systems, and hospitals are essential infrastructures for emergency rescue and subsequent reconstruction activities. An investigation into the Nepal 2015 earthquake sequences found that the visited government offices were functioning normally 40 days after the main shock; that the local media failed to coordinate with the entire society at the beginning, but mobile phone-based communication recovered quickly; and that the hospitals in high-intensity areas were badly damaged as a result of improper design and adverse site configuration. Recommendations are proposed to enhance the aseismic capacity of structural and non-structural components using earthquake early warning and base isolation.     

Preaching in thirteenth-century hospitals

This article uses thirteenth-century hospital sermons as a window into the moral and religious environment of these charitable institutions, large numbers of which were founded during the twelfth and thirteenth centuries. What emerges from the reportationes of sermons preached in the hôtel-dieu of Paris and ad status sermons directed at hospitals' personnel and inmates by Jacques de Vitry, Humbert of Romans and Guibert de Tournai is a spirituality that stressed the penitential (and potentially salvific) power of doing works of mercy (in the case of hospital workers) and bodily suffering (in the case of hospital inmates). The particular social context of hospital preaching is also evident in preachers' anxieties about the quality of hospital administration. The sermons that were preached in thirteenth-century hospitals reflect the heightened value placed on caring for the sick and poor, a historical development more often associated with the later middle ages.     

Using Discrete Event Simulation Models to Evaluate Resilience of an Emergency Department

Hospitals are critical infrastructures which are vulnerable to natural disasters, such as earthquakes, man-made disasters and mass causalities events. During the emergency, the hospital might also incur in structural and non-structural damage, have limited communication and resources, so they might not be able to treat the large number of incoming patients. For this reason, the majority of medium- and large-size hospitals have an emergency plan that expands their services quickly beyond normal operating conditions to meet an increased demand for medical care, but it is impossible for them to test it before an emergency occurs. The objective of this article is to develop a simplified model that could describe the ability of the Hospital Emergency Department to provide service to all patients after a natural disaster or any other emergency. The waiting time is the main response parameter used to measure hospital resilience to disasters. The analytical model has been built using the following steps. First, a discrete event simulation model of the Emergency Department in a hospital located in Italy is developed taking into account the hospital resources, the emergency rooms, the circulation patterns and the patient codes. The results of the Monte Carlo simulations show that the waiting time for yellow codes, when the emergency plan is applied, are reduced by 96%, while for green codes by 75%. Then, using the results obtained from the simulations, a general metamodel has been developed, which provides the waiting times of patients as function of the seismic input and the number of the available emergency rooms. The proposed metamodel is general and it can be applied to any type of hospital.     

医院档案管理中存在的问题及应对策略

随着医疗制度改革的不断深入,医院档案管理工作如何更好地服务于医疗、教学、科研等工作,是新时期所要面对的新任务、新课题。由于医院档案工作具有广泛性的特点,它涉及医院的各个部门,融入了医院全方位的信息,因此,良好的档案管理是医院科学管理的基础。对此,笔者对医院档案管理中存在的问题及应对策略进行了初步的分析和阐述。     

Neurognostics Answer

William S. Halsted was the founding chief of surgery at the Johns Hopkins Hospital. Among his basic principles were (1) the use of the experimental laboratory to solve intraoperative surgical problems, (2) gentle handling of all tissues, and (3) full-time surgical subspecialization. Halsted trained Harvey Cushing, who used Halsted's principles to reinvent neurosurgery to make it successful by lowering mortality and morbidity rates.     

Making the Lancastrian capital at Leicester: the battle of Boroughbridge,civic diplomacy and seigneurial building projects in fourteenth-century England

Though a community of some note throughout the Middle Ages, Leicester really came to the forefront of England's consciousness following a series of political and economic crises in the first decades of the fourteenth century. Thereafter the relationship between the town and its Lancastrian lords was forced to shift from one of sometimes indifferent, sometimes overwhelming, clientage to a more balanced and mutually beneficial association. This increasingly positive relationship found physical expression in two projects in particular: the renovation of Leicester Castle and the foundation of the Newarke Hospital and College. This building programme gave the Lancastrian dynasty not only a place to stay, entertain and pray in southern England, but also a solid base from which to face the political and economic turmoil of the fourteenth century. This fact, along with Leicester's growing connection to the English royal family, would distinguish the town, and bequeath it an importance even once its Lancastrian lords had become kings of England. Leicester exemplifies important themes in later-medieval urban history. The town not only derived concord out of conflict with its lords in the face of difficult economic circumstances; it also brought some of the most potent aspects of both the English and continental traditions of urban-seigneurial relations together, especially in terms of the lord's political and physical connections with the town under his control.     

A Review of: “Michael Hagner,Geniale Gehirne. Zur Geschichte der Elitegehirnforschung”

Charcot and Pasteur were scientific contemporaries, but their relationship has not been extensively studied. We analyzed available source documents from the Charcot Library, Bibliothèque Nationale, Institute Pasteur, and Pasteur Library. These documents demonstrate that in spite of geographical proximity, international and local recognition, Charcot and Pasteur largely pursued their careers independent of one another. Although the Paris scientific climate was one of active debate, Pasteur's and Charcot's interactions remained distanced but mutually respectful and did not descend into rivalry or contention. With different primary interests and different etiological views, side by side, they exemplified two models of French medicine at the close of the nineteenth century: medical scientist and scientific physician.     

How to Carefully Construct a Hospital over a Roman Boat in Central London,UK

This paper examines the Roman boat, buried beneath Guys Hospital in London, UK. A small part was discovered in 1958, and has been carefully left free of disturbance since that date. In 2009, a proposal was made to construct a 14-storey building above the boat; clearly raising challenges for preservation, not to mention the philosophy of burying or excavating and entire ancient monument. A trial pit was opened to see if any remains of the boat survived and uncovered well-preserved timber planks and nails preserved five metres below ground level. Consequently, archaeologists worked closely with the entire design team, determined that more was required than the usual scheme of preserving and monitoring the boat. A legal agreement was secured, making this one of the few projects in the world to have a clearly structured and enforceable plan, if the monitoring data show demonstrable deterioration.