- Published in print:
- 2010
- Published Online:
- January 2011
- ISBN:
- 9780199732586
- eISBN:
- 9780199894895
- Item type:
- book
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780199732586.001.0001
- Subject:
- Religion, History of Christianity
This book is a study and translation of the testimony given by witnesses at the canonization hearings of St. Elizabeth of Hungary, who died in 1231 at age 24 in Marburg, Germany. In January 1233 and ...
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This book is a study and translation of the testimony given by witnesses at the canonization hearings of St. Elizabeth of Hungary, who died in 1231 at age 24 in Marburg, Germany. In January 1233 and again in January 1235, papal commissioners interviewed hundreds of people as witnesses to the healing miracles associated with Elizabeth’s shrine. What these witnesses said about their maladies and their cures provides an unusually clear window into the workings of a nascent saint cult within the context of rural Germany. When the commission convened for the second time, it also heard from Elizabeth’s four closest associates, the so-called handmaids who had witnessed her transformation —under the guidance of her confessor Conrad of Marburg —from the powerful wife of the Thuringian landgrave (Ludwig IV) to a humble hospital worker in Marburg. Their statements, along with that of Conrad himself, allow for a better understanding of the effects of mendicant spirituality (normally associated with more urban environments) on a woman from the highest levels of German society.Less
This book is a study and translation of the testimony given by witnesses at the canonization hearings of St. Elizabeth of Hungary, who died in 1231 at age 24 in Marburg, Germany. In January 1233 and again in January 1235, papal commissioners interviewed hundreds of people as witnesses to the healing miracles associated with Elizabeth’s shrine. What these witnesses said about their maladies and their cures provides an unusually clear window into the workings of a nascent saint cult within the context of rural Germany. When the commission convened for the second time, it also heard from Elizabeth’s four closest associates, the so-called handmaids who had witnessed her transformation —under the guidance of her confessor Conrad of Marburg —from the powerful wife of the Thuringian landgrave (Ludwig IV) to a humble hospital worker in Marburg. Their statements, along with that of Conrad himself, allow for a better understanding of the effects of mendicant spirituality (normally associated with more urban environments) on a woman from the highest levels of German society.
Adam D. Reich
- Published in print:
- 2014
- Published Online:
- October 2017
- ISBN:
- 9780691160405
- eISBN:
- 9781400850372
- Item type:
- book
- Publisher:
- Princeton University Press
- DOI:
- 10.23943/princeton/9780691160405.001.0001
- Subject:
- Sociology, Health, Illness, and Medicine
This book explores the contradictions inherent in one particular health care market—hospital care. Based on extensive interviews and observations across the three hospitals of one California city, ...
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This book explores the contradictions inherent in one particular health care market—hospital care. Based on extensive interviews and observations across the three hospitals of one California city, the book examines the tensions embedded in the market for hospital care, how different hospitals manage these tensions, the historical trajectories driving disparities in contemporary hospital practice, and the perils and possibilities of various models of care. The book's three featured hospitals could not be more different in background or contemporary practice. PubliCare Hospital was founded in the late nineteenth century as an almshouse in order to address the needs of the destitute. HolyCare Hospital was founded by an order of nuns in the mid-twentieth century, offering spiritual comfort to the paying patient. And GroupCare Hospital was founded in the late twentieth century to rationalize and economize care for middle-class patients and their employers. The book explains how these legacies play out today in terms of the hospitals' different responses to similar market pressures, and the varieties of care that result. The book is an in-depth investigation into how hospital organizations and the people who work in them make sense of and respond to the modern health care market.Less
This book explores the contradictions inherent in one particular health care market—hospital care. Based on extensive interviews and observations across the three hospitals of one California city, the book examines the tensions embedded in the market for hospital care, how different hospitals manage these tensions, the historical trajectories driving disparities in contemporary hospital practice, and the perils and possibilities of various models of care. The book's three featured hospitals could not be more different in background or contemporary practice. PubliCare Hospital was founded in the late nineteenth century as an almshouse in order to address the needs of the destitute. HolyCare Hospital was founded by an order of nuns in the mid-twentieth century, offering spiritual comfort to the paying patient. And GroupCare Hospital was founded in the late twentieth century to rationalize and economize care for middle-class patients and their employers. The book explains how these legacies play out today in terms of the hospitals' different responses to similar market pressures, and the varieties of care that result. The book is an in-depth investigation into how hospital organizations and the people who work in them make sense of and respond to the modern health care market.
Adam D. Reich
- Published in print:
- 2014
- Published Online:
- October 2017
- ISBN:
- 9780691160405
- eISBN:
- 9781400850372
- Item type:
- chapter
- Publisher:
- Princeton University Press
- DOI:
- 10.23943/princeton/9780691160405.003.0010
- Subject:
- Sociology, Health, Illness, and Medicine
This book has examined the commodification of hospital care in the United States. It has looked at PubliCare Hospital, HolyCare Hospital, and GroupCare Hospital to highlight the contradictions ...
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This book has examined the commodification of hospital care in the United States. It has looked at PubliCare Hospital, HolyCare Hospital, and GroupCare Hospital to highlight the contradictions between the mission of hospital care and the market for it. If PubliCare is reminiscent of the hospital's past, and HolyCare is indicative of health care's present, then GroupCare seems to anticipate health care's future. This concluding chapter considers some of the changes in the U.S. health care market and cites the impact of the Patient Protection and Affordable Care Act (PPACA, 2010). For example, the law imposes important new regulations on the insurance industry and promotes and incentivizes “evidence-based” medicine. The chapter argues that while PPACA certainly changes the market for hospital care, it does not resolve the market's contradictions. It also reflects on future prospects for hospitals and hospital care.Less
This book has examined the commodification of hospital care in the United States. It has looked at PubliCare Hospital, HolyCare Hospital, and GroupCare Hospital to highlight the contradictions between the mission of hospital care and the market for it. If PubliCare is reminiscent of the hospital's past, and HolyCare is indicative of health care's present, then GroupCare seems to anticipate health care's future. This concluding chapter considers some of the changes in the U.S. health care market and cites the impact of the Patient Protection and Affordable Care Act (PPACA, 2010). For example, the law imposes important new regulations on the insurance industry and promotes and incentivizes “evidence-based” medicine. The chapter argues that while PPACA certainly changes the market for hospital care, it does not resolve the market's contradictions. It also reflects on future prospects for hospitals and hospital care.
Adam D. Reich
- Published in print:
- 2014
- Published Online:
- October 2017
- ISBN:
- 9780691160405
- eISBN:
- 9781400850372
- Item type:
- chapter
- Publisher:
- Princeton University Press
- DOI:
- 10.23943/princeton/9780691160405.003.0011
- Subject:
- Sociology, Health, Illness, and Medicine
This book explores the contradictions between the mission of hospital care and the market for it. It shows how market forces and market actors have become increasingly important to contemporary ...
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This book explores the contradictions between the mission of hospital care and the market for it. It shows how market forces and market actors have become increasingly important to contemporary hospital practice, and yet the commodification of hospital care in the United States remains uneven and incomplete. While they compete in a competitive marketplace, many hospitals—and the people within them—work to sustain social values that sit in uneasy tension with this market. In order to understand these contradictions, the book examines not only the broad sets of rules and regulations through which the market for hospital care is structured, but also the meanings, practices, and people that make up the hospital itself. The focus is on three hospitals located in Las Lomas, California—PubliCare Hospital, HolyCare Hospital, and GroupCare Hospital—and their ongoing struggle with the contradictory nature of the commodification of hospital care.Less
This book explores the contradictions between the mission of hospital care and the market for it. It shows how market forces and market actors have become increasingly important to contemporary hospital practice, and yet the commodification of hospital care in the United States remains uneven and incomplete. While they compete in a competitive marketplace, many hospitals—and the people within them—work to sustain social values that sit in uneasy tension with this market. In order to understand these contradictions, the book examines not only the broad sets of rules and regulations through which the market for hospital care is structured, but also the meanings, practices, and people that make up the hospital itself. The focus is on three hospitals located in Las Lomas, California—PubliCare Hospital, HolyCare Hospital, and GroupCare Hospital—and their ongoing struggle with the contradictory nature of the commodification of hospital care.
Rosalind Scott and Steven Howlett (eds)
- Published in print:
- 2009
- Published Online:
- November 2011
- ISBN:
- 9780199545827
- eISBN:
- 9780191730429
- Item type:
- book
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780199545827.001.0001
- Subject:
- Palliative Care, Patient Care and End-of-Life Decision Making, Palliative Medicine Research
This book provides practical guidelines on the responsibilities of those who lead, co-ordinate, and manage volunteers in small hospices, large specialist palliative care units, and in general ...
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This book provides practical guidelines on the responsibilities of those who lead, co-ordinate, and manage volunteers in small hospices, large specialist palliative care units, and in general hospitals with palliative care teams. Volunteers are key workers, who often perform difficult and important work. In the United Kingdom alone there are thousands of volunteers in hospice work, a small proportion doing work with patients, and the vast majority doing equally valuable work such as driving, sitting with relatives, and manning charity shops and telephones. As a result, Europe, Australia, the United States and Canada are very interested in the United Kingdom's use of volunteers. Aimed primarily at Voluntary Services Managers in small hospices, large specialist palliative care units, and in general hospitals with palliative care teams, this updated second edition covers volunteer selection, training, supervision and support, and legal and ethical considerations.Less
This book provides practical guidelines on the responsibilities of those who lead, co-ordinate, and manage volunteers in small hospices, large specialist palliative care units, and in general hospitals with palliative care teams. Volunteers are key workers, who often perform difficult and important work. In the United Kingdom alone there are thousands of volunteers in hospice work, a small proportion doing work with patients, and the vast majority doing equally valuable work such as driving, sitting with relatives, and manning charity shops and telephones. As a result, Europe, Australia, the United States and Canada are very interested in the United Kingdom's use of volunteers. Aimed primarily at Voluntary Services Managers in small hospices, large specialist palliative care units, and in general hospitals with palliative care teams, this updated second edition covers volunteer selection, training, supervision and support, and legal and ethical considerations.
John Ellershaw and Susie Wilkinson (eds)
- Published in print:
- 2003
- Published Online:
- November 2011
- ISBN:
- 9780198509332
- eISBN:
- 9780191730177
- Item type:
- book
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780198509332.001.0001
- Subject:
- Palliative Care, Patient Care and End-of-Life Decision Making, Pain Management and Palliative Pharmacology
Even for the most experienced healthcare professional, managing the last few days of life can be difficult. This book provides guidelines for the care of the dying based on the Liverpool Integrated ...
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Even for the most experienced healthcare professional, managing the last few days of life can be difficult. This book provides guidelines for the care of the dying based on the Liverpool Integrated Care Pathway for the Dying Patient (LCP). Developed at a hospice, the information can be disseminated and adapted to fit different settings such as hospitals and nursing homes. The LCP is a multiprofessional document that incorporates evidence-based practice and appropriate guidelines related to care of the dying. It provides a template that describes the process of care, which is generally delivered in a clinical situation and incorporates the expected outcome of care delivery. The LCP replaces all other documentation in this phase of care. Care pathways can provide a potentially powerful aid to professionals involved in palliative care. Basic principles of treatment are translated into daily practice, including bedside documentation systems, policies and procedures, standards of practice, continuing education, and quality improvement programmes. The book also includes chapters on symptom control, ethical issues, communication skills, and spiritual care.Less
Even for the most experienced healthcare professional, managing the last few days of life can be difficult. This book provides guidelines for the care of the dying based on the Liverpool Integrated Care Pathway for the Dying Patient (LCP). Developed at a hospice, the information can be disseminated and adapted to fit different settings such as hospitals and nursing homes. The LCP is a multiprofessional document that incorporates evidence-based practice and appropriate guidelines related to care of the dying. It provides a template that describes the process of care, which is generally delivered in a clinical situation and incorporates the expected outcome of care delivery. The LCP replaces all other documentation in this phase of care. Care pathways can provide a potentially powerful aid to professionals involved in palliative care. Basic principles of treatment are translated into daily practice, including bedside documentation systems, policies and procedures, standards of practice, continuing education, and quality improvement programmes. The book also includes chapters on symptom control, ethical issues, communication skills, and spiritual care.
John Ellershaw and Susie Wilkinson (eds)
- Published in print:
- 2010
- Published Online:
- November 2011
- ISBN:
- 9780199550838
- eISBN:
- 9780191730528
- Item type:
- book
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780199550838.001.0001
- Subject:
- Palliative Care, Patient Care and End-of-Life Decision Making, Pain Management and Palliative Pharmacology
Even for the most experienced healthcare professional, managing the last few days of life can be difficult. This book provides guidelines for the care of the dying based on the Liverpool Care Pathway ...
More
Even for the most experienced healthcare professional, managing the last few days of life can be difficult. This book provides guidelines for the care of the dying based on the Liverpool Care Pathway for the Dying Patient (LCP). Developed at a hospice, the information can be disseminated and adapted to fit different settings such as hospitals and nursing homes. The LCP is a multiprofessional document that incorporates evidence-based practice and appropriate guidelines related to care of the dying. It provides a template that describes the process of care which is generally delivered in a clinical situation and incorporates the expected outcome of care delivery. The LCP replaces all other documentation in this phase of care. Care pathways can provide a potentially powerful aid to professionals involved in palliative care. Basic principles of treatment are translated into daily practice, including bedside documentation systems, policies and procedures, standards of practice, continuing education, and quality-improvement programmes. This book includes chapters on symptom control, ethical issues, communication skills, and spiritual care, which underpin the use of the LCP.Less
Even for the most experienced healthcare professional, managing the last few days of life can be difficult. This book provides guidelines for the care of the dying based on the Liverpool Care Pathway for the Dying Patient (LCP). Developed at a hospice, the information can be disseminated and adapted to fit different settings such as hospitals and nursing homes. The LCP is a multiprofessional document that incorporates evidence-based practice and appropriate guidelines related to care of the dying. It provides a template that describes the process of care which is generally delivered in a clinical situation and incorporates the expected outcome of care delivery. The LCP replaces all other documentation in this phase of care. Care pathways can provide a potentially powerful aid to professionals involved in palliative care. Basic principles of treatment are translated into daily practice, including bedside documentation systems, policies and procedures, standards of practice, continuing education, and quality-improvement programmes. This book includes chapters on symptom control, ethical issues, communication skills, and spiritual care, which underpin the use of the LCP.
Ann Armstrong-Dailey and Sarah Zarbock (eds)
- Published in print:
- 2008
- Published Online:
- November 2011
- ISBN:
- 9780195340709
- eISBN:
- 9780199999927
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195340709.003.0001
- Subject:
- Palliative Care, Paediatric Palliative Medicine, Pain Management and Palliative Pharmacology
This introductory chapter explains the coverage of this book, which is about pediatric hospice care. The book provides specific information about providing for terminally ill children, including ...
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This introductory chapter explains the coverage of this book, which is about pediatric hospice care. The book provides specific information about providing for terminally ill children, including children's age-related understanding of death, the critical elements of pain and symptom control, and the psychosocial aspects of life-threatening illnesses in childhood and adolescence. It addresses the spiritual concerns of the family and sibling bereavement and describes inpatient palliative care practiced at St. Mary's Hospital for Children. The chapter also discusses the Children's Hospice International's (CHI) Program for All-Inclusive Care for Children and their Families (CHI PACC).Less
This introductory chapter explains the coverage of this book, which is about pediatric hospice care. The book provides specific information about providing for terminally ill children, including children's age-related understanding of death, the critical elements of pain and symptom control, and the psychosocial aspects of life-threatening illnesses in childhood and adolescence. It addresses the spiritual concerns of the family and sibling bereavement and describes inpatient palliative care practiced at St. Mary's Hospital for Children. The chapter also discusses the Children's Hospice International's (CHI) Program for All-Inclusive Care for Children and their Families (CHI PACC).
Sara Booth, Polly Edmonds, and Margaret Kendall
- Published in print:
- 2009
- Published Online:
- November 2011
- ISBN:
- 9780199238927
- eISBN:
- 9780191730092
- Item type:
- book
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780199238927.001.0001
- Subject:
- Palliative Care, Patient Care and End-of-Life Decision Making, Pain Management and Palliative Pharmacology
Hospital palliative care teams have been established in rapidly increasing numbers over the last twenty, as it has been recognised that hospices can never transfer the philosophy and practice of ...
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Hospital palliative care teams have been established in rapidly increasing numbers over the last twenty, as it has been recognised that hospices can never transfer the philosophy and practice of palliative care into the acute sector by simply existing; they often work as ‘stand alone units’ and remain outside mainstream medicine. However it has become apparent that improving access to palliative care for patients in acute hospitals is not as easy as employing external palliative care specialists as consultants. Even setting up a team of professionals who work solely in a hospital will often not improve the care of the great majority of patients being treated there. Based on the experience and knowledge of three clinicians in the area who have developed palliative care services in acute settings, this book provides those facing the same challenges with guidance and advice on a range of problems they might encounter. Using a problem focused and practical approach, this guide is filled with case-based problems to help with the identification of realistic, usable, everyday solutions. It also covers the skills and knowledge needed to help teams make progress in the hospital as well as outlining the best training to help professionals continue to flourish.Less
Hospital palliative care teams have been established in rapidly increasing numbers over the last twenty, as it has been recognised that hospices can never transfer the philosophy and practice of palliative care into the acute sector by simply existing; they often work as ‘stand alone units’ and remain outside mainstream medicine. However it has become apparent that improving access to palliative care for patients in acute hospitals is not as easy as employing external palliative care specialists as consultants. Even setting up a team of professionals who work solely in a hospital will often not improve the care of the great majority of patients being treated there. Based on the experience and knowledge of three clinicians in the area who have developed palliative care services in acute settings, this book provides those facing the same challenges with guidance and advice on a range of problems they might encounter. Using a problem focused and practical approach, this guide is filled with case-based problems to help with the identification of realistic, usable, everyday solutions. It also covers the skills and knowledge needed to help teams make progress in the hospital as well as outlining the best training to help professionals continue to flourish.
James F. Blumstein
- Published in print:
- 2010
- Published Online:
- May 2010
- ISBN:
- 9780195390131
- eISBN:
- 9780199775934
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195390131.003.007
- Subject:
- Law, Medical Law
This chapter considers the integration of (i) physician services and (ii) the institutional and economic interests of hospitals. These issues provide a vehicle for addressing the institutional ...
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This chapter considers the integration of (i) physician services and (ii) the institutional and economic interests of hospitals. These issues provide a vehicle for addressing the institutional fragmentation arising from existing hospital-governance regulation. How, and to what extent, should economic considerations factor into medical-care decision-making? What regulatory structure should govern physician–hospital interrelationships? Whereas hospitals once followed an “eBay” model, they now have their own institutional interests. Hospitals have independent duties to patients, and responsibilities to assure quality of care and manage costs. These realities call into question the traditional regulatory/governance structure of hospitals. The regulatory regime for integrated delivery networks (IDNs) is more flexible than the traditional JCAHO hospital model. The chapter concludes that (i) the legal/regulatory environment should not dictate how physician–hospital relationships should develop, nor the appropriate organizational form; and (ii) regulatory flexibility and “regulatory neutrality” should guide public policy in this arena.Less
This chapter considers the integration of (i) physician services and (ii) the institutional and economic interests of hospitals. These issues provide a vehicle for addressing the institutional fragmentation arising from existing hospital-governance regulation. How, and to what extent, should economic considerations factor into medical-care decision-making? What regulatory structure should govern physician–hospital interrelationships? Whereas hospitals once followed an “eBay” model, they now have their own institutional interests. Hospitals have independent duties to patients, and responsibilities to assure quality of care and manage costs. These realities call into question the traditional regulatory/governance structure of hospitals. The regulatory regime for integrated delivery networks (IDNs) is more flexible than the traditional JCAHO hospital model. The chapter concludes that (i) the legal/regulatory environment should not dictate how physician–hospital relationships should develop, nor the appropriate organizational form; and (ii) regulatory flexibility and “regulatory neutrality” should guide public policy in this arena.
Nick Bosanquet and Chris Salisbury
- Published in print:
- 1999
- Published Online:
- November 2011
- ISBN:
- 9780192629913
- eISBN:
- 9780191730153
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780192629913.003.0001
- Subject:
- Palliative Care, Patient Care and End-of-Life Decision Making, Palliative Medicine Research
This review aims to identify the most appropriate and cost-effective models of service delivery and level of provision for palliative care services. This includes the role of nurses in hospitals and ...
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This review aims to identify the most appropriate and cost-effective models of service delivery and level of provision for palliative care services. This includes the role of nurses in hospitals and the community, and the care of dying patients in acute hospitals. Ten key research questions were identified within this aim including the current need for and provision of services, proposed alternative models of provision, appropriate skill mix in nursing, the relationship between alternative models of care and patient satisfaction, carer satisfaction and patient's quality of life, and the impact of alternative models on other services. In this study a comprehensive review of literatures from the UK, North America, Europe, and Australia was conducted. Over 2,000 documents were identified, of which 673 were deemed to be relevant. Data extracted from these literatures were collated and synthesized in the sections of this study, along with tables of summary data derived from relevant papers.Less
This review aims to identify the most appropriate and cost-effective models of service delivery and level of provision for palliative care services. This includes the role of nurses in hospitals and the community, and the care of dying patients in acute hospitals. Ten key research questions were identified within this aim including the current need for and provision of services, proposed alternative models of provision, appropriate skill mix in nursing, the relationship between alternative models of care and patient satisfaction, carer satisfaction and patient's quality of life, and the impact of alternative models on other services. In this study a comprehensive review of literatures from the UK, North America, Europe, and Australia was conducted. Over 2,000 documents were identified, of which 673 were deemed to be relevant. Data extracted from these literatures were collated and synthesized in the sections of this study, along with tables of summary data derived from relevant papers.
Cicely Saunders
- Published in print:
- 2006
- Published Online:
- November 2011
- ISBN:
- 9780198570530
- eISBN:
- 9780191730412
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780198570530.003.0031
- Subject:
- Palliative Care, Palliative Medicine Research
In her later years, Cicely Saunders produced many forewords to the books of other writers. The first of these to be reproduced here was written for Norman Autton's Pain: An Exploration, first ...
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In her later years, Cicely Saunders produced many forewords to the books of other writers. The first of these to be reproduced here was written for Norman Autton's Pain: An Exploration, first published in 1986. She declares the book an admirable description of the search for an understanding of pain that draws on the author's long experience as a hospital chaplain. It is a book that has much to teach both professionals and those who are themselves experiencing pain.Less
In her later years, Cicely Saunders produced many forewords to the books of other writers. The first of these to be reproduced here was written for Norman Autton's Pain: An Exploration, first published in 1986. She declares the book an admirable description of the search for an understanding of pain that draws on the author's long experience as a hospital chaplain. It is a book that has much to teach both professionals and those who are themselves experiencing pain.
Dan Zuberi
- Published in print:
- 2013
- Published Online:
- August 2016
- ISBN:
- 9780801450723
- eISBN:
- 9780801469824
- Item type:
- book
- Publisher:
- Cornell University Press
- DOI:
- 10.7591/cornell/9780801450723.001.0001
- Subject:
- Sociology, Health, Illness, and Medicine
To cut costs and maximize profits, hospitals in the United States and many other countries are outsourcing such tasks as cleaning and food preparation to private contractors. To examine this ...
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To cut costs and maximize profits, hospitals in the United States and many other countries are outsourcing such tasks as cleaning and food preparation to private contractors. To examine this transformation in the healthcare industry, this book looks at the consequences of outsourcing from two perspectives: its impact on patient safety and its role in increasing socioeconomic inequality. The book argues that outsourcing has been disastrous for the cleanliness of hospitals—leading to an increased risk of hospital-acquired infections, a leading cause of severe illness and death—as well as for the effective delivery of other hospital services and the workers themselves. Interviews with the low-wage workers who keep hospitals running uncover claims of exposure to near-constant risk of injury and illness. Many report serious concerns about the quality of the work due to understaffing, high turnover, poor training and experience, inadequate cleaning supplies, and on-the-job injuries. The book also presents policy recommendations for improving patient safety by reducing the risk of hospital-acquired infection and ameliorating the work conditions and quality of life of hospital support workers. It makes the case that hospital outsourcing exemplifies the trend towards “low-road” service-sector jobs that threatens to undermine society's social health, as well as the physical health and well-being of patients in health care settings globally.Less
To cut costs and maximize profits, hospitals in the United States and many other countries are outsourcing such tasks as cleaning and food preparation to private contractors. To examine this transformation in the healthcare industry, this book looks at the consequences of outsourcing from two perspectives: its impact on patient safety and its role in increasing socioeconomic inequality. The book argues that outsourcing has been disastrous for the cleanliness of hospitals—leading to an increased risk of hospital-acquired infections, a leading cause of severe illness and death—as well as for the effective delivery of other hospital services and the workers themselves. Interviews with the low-wage workers who keep hospitals running uncover claims of exposure to near-constant risk of injury and illness. Many report serious concerns about the quality of the work due to understaffing, high turnover, poor training and experience, inadequate cleaning supplies, and on-the-job injuries. The book also presents policy recommendations for improving patient safety by reducing the risk of hospital-acquired infection and ameliorating the work conditions and quality of life of hospital support workers. It makes the case that hospital outsourcing exemplifies the trend towards “low-road” service-sector jobs that threatens to undermine society's social health, as well as the physical health and well-being of patients in health care settings globally.
Adam D. Reich
- Published in print:
- 2014
- Published Online:
- October 2017
- ISBN:
- 9780691160405
- eISBN:
- 9781400850372
- Item type:
- chapter
- Publisher:
- Princeton University Press
- DOI:
- 10.23943/princeton/9780691160405.003.0001
- Subject:
- Sociology, Health, Illness, and Medicine
This chapter examines both the promise and paradox of care at PubliCare Hospital. On the one hand, practitioners' deep commitment to the provision of care as a right gave the facility a special ...
More
This chapter examines both the promise and paradox of care at PubliCare Hospital. On the one hand, practitioners' deep commitment to the provision of care as a right gave the facility a special character. On the other hand, these same commitments seemed to go hand in hand with a lack of role differentiation or organizational structure that lef the organization in a constant state of disarray and financial peril. The chapter shows that, among practitioners across the three hospitals in Las Lomas, those at PubliCare struggled most with how to reconcile a right to health care with care as a commodity to be sold. It also considers PubliCare Hospital's “socialized medicine” for desperate and despairing patients, what is unique about PubliCare physicians and nurses, and vocational commitment and creativity at the hospital. Finally, the chapter explains how the mission of health care at PubliCare seemed to be at odds with the market for care.Less
This chapter examines both the promise and paradox of care at PubliCare Hospital. On the one hand, practitioners' deep commitment to the provision of care as a right gave the facility a special character. On the other hand, these same commitments seemed to go hand in hand with a lack of role differentiation or organizational structure that lef the organization in a constant state of disarray and financial peril. The chapter shows that, among practitioners across the three hospitals in Las Lomas, those at PubliCare struggled most with how to reconcile a right to health care with care as a commodity to be sold. It also considers PubliCare Hospital's “socialized medicine” for desperate and despairing patients, what is unique about PubliCare physicians and nurses, and vocational commitment and creativity at the hospital. Finally, the chapter explains how the mission of health care at PubliCare seemed to be at odds with the market for care.
Adam D. Reich
- Published in print:
- 2014
- Published Online:
- October 2017
- ISBN:
- 9780691160405
- eISBN:
- 9781400850372
- Item type:
- chapter
- Publisher:
- Princeton University Press
- DOI:
- 10.23943/princeton/9780691160405.003.0004
- Subject:
- Sociology, Health, Illness, and Medicine
This chapter examines the role played by chaplains at HolyCare Hospital's Department of Mission Integration and Spiritual Care. The Department of Mission Integration and Spiritual Care was ...
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This chapter examines the role played by chaplains at HolyCare Hospital's Department of Mission Integration and Spiritual Care. The Department of Mission Integration and Spiritual Care was responsible for maintaining the “emotional and spiritual well-being” of patients as well as for elevating the spiritual dimensions of the hospital as a whole. In the face of market pressures, Amanda Roberts, a chaplain at HolyCare Hospital, admitted that “it can feel as though the spirit or the heart of the place is getting dried out.” The market jeopardized those parts of hospital care that, in her mind, were most central to healing. The chapter considers how HolyCare Hospital wrestled with the relationship between the market for care and the meaning of care. It shows that the Catholic values at HolyCare Hospital had economic value, and that the hospital's marketing strategy merged seamlessly with its religious identity.Less
This chapter examines the role played by chaplains at HolyCare Hospital's Department of Mission Integration and Spiritual Care. The Department of Mission Integration and Spiritual Care was responsible for maintaining the “emotional and spiritual well-being” of patients as well as for elevating the spiritual dimensions of the hospital as a whole. In the face of market pressures, Amanda Roberts, a chaplain at HolyCare Hospital, admitted that “it can feel as though the spirit or the heart of the place is getting dried out.” The market jeopardized those parts of hospital care that, in her mind, were most central to healing. The chapter considers how HolyCare Hospital wrestled with the relationship between the market for care and the meaning of care. It shows that the Catholic values at HolyCare Hospital had economic value, and that the hospital's marketing strategy merged seamlessly with its religious identity.
Adam D. Reich
- Published in print:
- 2014
- Published Online:
- October 2017
- ISBN:
- 9780691160405
- eISBN:
- 9781400850372
- Item type:
- chapter
- Publisher:
- Princeton University Press
- DOI:
- 10.23943/princeton/9780691160405.003.0005
- Subject:
- Sociology, Health, Illness, and Medicine
This chapter examines the link between Emergency Medical Incorporated's financial success and the quality of hospital care it ultimately was able to provide. Emergency Medical Incorporated, one of ...
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This chapter examines the link between Emergency Medical Incorporated's financial success and the quality of hospital care it ultimately was able to provide. Emergency Medical Incorporated, one of the nation's largest contract management groups, held the contract for the emergency department at HolyCare Hospital. The company managed the scheduling, billing, and workflow of the emergency medicine physicians, who were technically “independent contractors” with the company. It also provided them with medical malpractice insurance and helped them minimize legal risk. The chapter considers the billing practices of HolyCare doctors and the effects of physicians' individualism on the quality of care at HolyCare. It shows that entrepreneurship was structured within larger organizations (from the physicians' group to the hospital itself) that also profited from doctors' profiteering.Less
This chapter examines the link between Emergency Medical Incorporated's financial success and the quality of hospital care it ultimately was able to provide. Emergency Medical Incorporated, one of the nation's largest contract management groups, held the contract for the emergency department at HolyCare Hospital. The company managed the scheduling, billing, and workflow of the emergency medicine physicians, who were technically “independent contractors” with the company. It also provided them with medical malpractice insurance and helped them minimize legal risk. The chapter considers the billing practices of HolyCare doctors and the effects of physicians' individualism on the quality of care at HolyCare. It shows that entrepreneurship was structured within larger organizations (from the physicians' group to the hospital itself) that also profited from doctors' profiteering.
Adam D. Reich
- Published in print:
- 2014
- Published Online:
- October 2017
- ISBN:
- 9780691160405
- eISBN:
- 9781400850372
- Item type:
- chapter
- Publisher:
- Princeton University Press
- DOI:
- 10.23943/princeton/9780691160405.003.0006
- Subject:
- Sociology, Health, Illness, and Medicine
This chapter examines the hierarchical relationships between nurses and physicians at HolyCare Hospital. If relationships at PubliCare were relatively egalitarian and informal, at HolyCare they were ...
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This chapter examines the hierarchical relationships between nurses and physicians at HolyCare Hospital. If relationships at PubliCare were relatively egalitarian and informal, at HolyCare they were hierarchical and codified. Paradoxically, in the name of the “patient experience,” most of the people working at HolyCare seemed relatively miserable. This was true across many different strata of hospital staff members. One physician administrator at PubliCare suggested that there was a “lack of collegiality” at HolyCare. Nurses and ancillary workers described the experience of working at HolyCare as one defined by fear and insecurity. The chapter considers how social values at HolyCare retained a degree of autonomy from exchange relations. It shows that the vocational values through which managers sought to secure an obedient workforce could be turned on their head and be used to advocate against management for the resources and power necessary to provide for themselves and their patients.Less
This chapter examines the hierarchical relationships between nurses and physicians at HolyCare Hospital. If relationships at PubliCare were relatively egalitarian and informal, at HolyCare they were hierarchical and codified. Paradoxically, in the name of the “patient experience,” most of the people working at HolyCare seemed relatively miserable. This was true across many different strata of hospital staff members. One physician administrator at PubliCare suggested that there was a “lack of collegiality” at HolyCare. Nurses and ancillary workers described the experience of working at HolyCare as one defined by fear and insecurity. The chapter considers how social values at HolyCare retained a degree of autonomy from exchange relations. It shows that the vocational values through which managers sought to secure an obedient workforce could be turned on their head and be used to advocate against management for the resources and power necessary to provide for themselves and their patients.
Adam D. Reich
- Published in print:
- 2014
- Published Online:
- October 2017
- ISBN:
- 9780691160405
- eISBN:
- 9781400850372
- Item type:
- chapter
- Publisher:
- Princeton University Press
- DOI:
- 10.23943/princeton/9780691160405.003.0007
- Subject:
- Sociology, Health, Illness, and Medicine
This chapter examines a paradox of GroupCare Hospital's palliative care program. On the one hand, GroupCare created a space for intimacy, honesty, and personal connection that has become exceedingly ...
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This chapter examines a paradox of GroupCare Hospital's palliative care program. On the one hand, GroupCare created a space for intimacy, honesty, and personal connection that has become exceedingly rare in the U.S. medical system. On the other hand, GroupCare considered the palliative care program to be consistent with its goal of “appropriate utilization” and likely would not have invested such resources in the program had it not been seen as economically efficient. This chapter shows that the staff at GroupCare tended to believe that through evidence-based medicine, technical savvy, and systems integration, it could make the mission of health care and the market for health care consistent with and supportive of one another. It also considers how GroupCare seemed to have succeeded in taming the market for hospital care and aligning the health of its membership with the economic interests of the organization and the practitioners within it.Less
This chapter examines a paradox of GroupCare Hospital's palliative care program. On the one hand, GroupCare created a space for intimacy, honesty, and personal connection that has become exceedingly rare in the U.S. medical system. On the other hand, GroupCare considered the palliative care program to be consistent with its goal of “appropriate utilization” and likely would not have invested such resources in the program had it not been seen as economically efficient. This chapter shows that the staff at GroupCare tended to believe that through evidence-based medicine, technical savvy, and systems integration, it could make the mission of health care and the market for health care consistent with and supportive of one another. It also considers how GroupCare seemed to have succeeded in taming the market for hospital care and aligning the health of its membership with the economic interests of the organization and the practitioners within it.
Patricia Crawford
- Published in print:
- 2010
- Published Online:
- May 2010
- ISBN:
- 9780199204809
- eISBN:
- 9780191709517
- Item type:
- book
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780199204809.001.0001
- Subject:
- History, British and Irish Early Modern History, Social History
This book studies the mothers and fathers of poor children in the England of the early modern and early industrial period. Although we know a good deal about the family life of monarchs in this ...
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This book studies the mothers and fathers of poor children in the England of the early modern and early industrial period. Although we know a good deal about the family life of monarchs in this period, much less is known about what life was like for poor single mothers, or for ordinary people who were trying to bring up their children. What were poor mothers and fathers trying to achieve, and what support did they have from their society, especially from the welfare system? This book attempts to answer these important questions, in order to illuminate the experience of parenting at this time from the perspective of the poor, a group who have naturally left little in the way of literary testimony. In doing this, it draws upon a wide range of archival material, including quarter session records, petitions for assistance, applications for places in the London Foundling Hospital, and evidence from criminal trials in London's Old Bailey. England in this period had a developing system of welfare, unique in Europe, by which parish rates were collected and administered to those deemed worthy of relief. The ‘civic fathers’ who administered this welfare drew upon a code of fatherhood framed in the Elizabethan period, by which a patriarch took responsibility for maintaining and exercising authority over wives and children. This code of family conduct was the product of a material world completely alien to that which the poor inhabited. Parents of the poor were different from those of middling and elite status. Poverty, not property, dictated their relationships with their children. Poor families were frequently broken by death. Fathers were frequently absent, and mothers had to rear their children with whatever forms of relief they could find.Less
This book studies the mothers and fathers of poor children in the England of the early modern and early industrial period. Although we know a good deal about the family life of monarchs in this period, much less is known about what life was like for poor single mothers, or for ordinary people who were trying to bring up their children. What were poor mothers and fathers trying to achieve, and what support did they have from their society, especially from the welfare system? This book attempts to answer these important questions, in order to illuminate the experience of parenting at this time from the perspective of the poor, a group who have naturally left little in the way of literary testimony. In doing this, it draws upon a wide range of archival material, including quarter session records, petitions for assistance, applications for places in the London Foundling Hospital, and evidence from criminal trials in London's Old Bailey. England in this period had a developing system of welfare, unique in Europe, by which parish rates were collected and administered to those deemed worthy of relief. The ‘civic fathers’ who administered this welfare drew upon a code of fatherhood framed in the Elizabethan period, by which a patriarch took responsibility for maintaining and exercising authority over wives and children. This code of family conduct was the product of a material world completely alien to that which the poor inhabited. Parents of the poor were different from those of middling and elite status. Poverty, not property, dictated their relationships with their children. Poor families were frequently broken by death. Fathers were frequently absent, and mothers had to rear their children with whatever forms of relief they could find.
Duana Fullwiley
- Published in print:
- 2011
- Published Online:
- October 2017
- ISBN:
- 9780691123165
- eISBN:
- 9781400840410
- Item type:
- chapter
- Publisher:
- Princeton University Press
- DOI:
- 10.23943/princeton/9780691123165.003.0004
- Subject:
- Anthropology, Social and Cultural Anthropology
This chapter examines how Senegalese French-trained research-physicians in Dakar have adopted similar low-tech strategies and health interventions within the biomedical realm. It focuses on how ...
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This chapter examines how Senegalese French-trained research-physicians in Dakar have adopted similar low-tech strategies and health interventions within the biomedical realm. It focuses on how doctors rationalize economically triaged care, while chronicling their methods for doing so in Dakar's principal sickle cell clinics. These are the pediatric care site at Albert Royer Children's Hospital and the Centre nationale de transfusion sanguine (CNTS), or the National Blood Transfusion Center, where most adult patients are followed. Although physicians often take cues from the social realities that define their patients' lived experiences with this disease, their own clinical limits and technological constraints also inform the alternative assemblages of care they construct.Less
This chapter examines how Senegalese French-trained research-physicians in Dakar have adopted similar low-tech strategies and health interventions within the biomedical realm. It focuses on how doctors rationalize economically triaged care, while chronicling their methods for doing so in Dakar's principal sickle cell clinics. These are the pediatric care site at Albert Royer Children's Hospital and the Centre nationale de transfusion sanguine (CNTS), or the National Blood Transfusion Center, where most adult patients are followed. Although physicians often take cues from the social realities that define their patients' lived experiences with this disease, their own clinical limits and technological constraints also inform the alternative assemblages of care they construct.
