Dan Zuberi
- Published in print:
- 2013
- Published Online:
- August 2016
- ISBN:
- 9780801450723
- eISBN:
- 9780801469824
- Item type:
- chapter
- Publisher:
- Cornell University Press
- DOI:
- 10.7591/cornell/9780801450723.003.0001
- Subject:
- Sociology, Health, Illness, and Medicine
This introductory chapter describes the increasing prevalence of hospital-acquired infections (HAIs) plaguing hospitals across the United States, Canada, and Europe. It outlines the dangers of ...
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This introductory chapter describes the increasing prevalence of hospital-acquired infections (HAIs) plaguing hospitals across the United States, Canada, and Europe. It outlines the dangers of hospital infections and the tolls this takes on both patients and hospitals alike. Though steps have been taken to minimize the risk of infection in hospital environments and to promote hospital cleanliness, the problem perseveres. There are many complex factors that contribute to this problem, though this chapter focuses on the rise of outsourcing as one possible cause. The chapter delves into an in-depth study of the consequences of outsourcing in hospitals, for both the patients and the outsourced hospital workers—who are themselves victims in a larger trend of franchise capitalism.Less
This introductory chapter describes the increasing prevalence of hospital-acquired infections (HAIs) plaguing hospitals across the United States, Canada, and Europe. It outlines the dangers of hospital infections and the tolls this takes on both patients and hospitals alike. Though steps have been taken to minimize the risk of infection in hospital environments and to promote hospital cleanliness, the problem perseveres. There are many complex factors that contribute to this problem, though this chapter focuses on the rise of outsourcing as one possible cause. The chapter delves into an in-depth study of the consequences of outsourcing in hospitals, for both the patients and the outsourced hospital workers—who are themselves victims in a larger trend of franchise capitalism.
Dan Zuberi
- Published in print:
- 2013
- Published Online:
- August 2016
- ISBN:
- 9780801450723
- eISBN:
- 9780801469824
- Item type:
- chapter
- Publisher:
- Cornell University Press
- DOI:
- 10.7591/cornell/9780801450723.003.0007
- Subject:
- Sociology, Health, Illness, and Medicine
This concluding chapter suggests measures for hospitals to reduce infection, as well as provide better economic opportunities for the working poor. Countries such as the Netherlands and Norway have ...
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This concluding chapter suggests measures for hospitals to reduce infection, as well as provide better economic opportunities for the working poor. Countries such as the Netherlands and Norway have done an extraordinary job of keeping rates of hospital-acquired infections extremely low. They have been proactive about hospital hygiene and other infection-control approaches and have largely avoided outsourcing hospital support services. From their example the chapter argues that focusing on preventive health care and public welfare are far more efficient ways of obtaining better health outcomes. Moreover, better health care is also dependent on the well-being of health support staff—in short, a new movement dedicated to fighting germs must also, on a fundamental level, uplift its workers.Less
This concluding chapter suggests measures for hospitals to reduce infection, as well as provide better economic opportunities for the working poor. Countries such as the Netherlands and Norway have done an extraordinary job of keeping rates of hospital-acquired infections extremely low. They have been proactive about hospital hygiene and other infection-control approaches and have largely avoided outsourcing hospital support services. From their example the chapter argues that focusing on preventive health care and public welfare are far more efficient ways of obtaining better health outcomes. Moreover, better health care is also dependent on the well-being of health support staff—in short, a new movement dedicated to fighting germs must also, on a fundamental level, uplift its workers.
Carl T. Bergstrom and Michael Feldgarden
- Published in print:
- 2007
- Published Online:
- April 2010
- ISBN:
- 9780199207466
- eISBN:
- 9780191728167
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780199207466.003.0010
- Subject:
- Biology, Evolutionary Biology / Genetics
Bacteria evolve resistance to antibiotics with near certainty after several years of widespread use. Resistance can evolve via several genetic mechanisms and spread through and between species via ...
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Bacteria evolve resistance to antibiotics with near certainty after several years of widespread use. Resistance can evolve via several genetic mechanisms and spread through and between species via gene transfer. Resistance that evolves in agricultural settings can transfer into human populations. Associations among resistance genes, and the process of compensatory evolution, can cause retention of resistance genes, even in the absence of selection favoring resistance. Novel approaches to antimicrobial therapy may provide alternatives to traditional broad-spectrum antibiotics for which resistance is less quick to evolve. To eradicate antibiotic resistance from a hospital setting, researchers need a thorough understanding of the underlying ecology. For example, antibiotic cycling, the hospital equivalent of crop rotation, does not necessarily reduce the environmental heterogeneity at the scale relevant to bacterial clones spreading through the hospital and thus may be ineffective at reducing the frequency of resistant strains in a hospital setting.Less
Bacteria evolve resistance to antibiotics with near certainty after several years of widespread use. Resistance can evolve via several genetic mechanisms and spread through and between species via gene transfer. Resistance that evolves in agricultural settings can transfer into human populations. Associations among resistance genes, and the process of compensatory evolution, can cause retention of resistance genes, even in the absence of selection favoring resistance. Novel approaches to antimicrobial therapy may provide alternatives to traditional broad-spectrum antibiotics for which resistance is less quick to evolve. To eradicate antibiotic resistance from a hospital setting, researchers need a thorough understanding of the underlying ecology. For example, antibiotic cycling, the hospital equivalent of crop rotation, does not necessarily reduce the environmental heterogeneity at the scale relevant to bacterial clones spreading through the hospital and thus may be ineffective at reducing the frequency of resistant strains in a hospital setting.
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.
Paul W. Ewald
- Published in print:
- 2018
- Published Online:
- August 2018
- ISBN:
- 9780198789833
- eISBN:
- 9780191831508
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/oso/9780198789833.003.0009
- Subject:
- Biology, Disease Ecology / Epidemiology, Evolutionary Biology / Genetics
An evolutionary suggests that health interventions can reduce not only the frequency of infectious disease but also the harmfulness of the causal organisms. Interventions that may accomplish this ...
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An evolutionary suggests that health interventions can reduce not only the frequency of infectious disease but also the harmfulness of the causal organisms. Interventions that may accomplish this dual goal include hygienic investments such as vector proofing of housing, provisioning of safe water supplies, infrastructure that blocks transmission of durable propagules, the prevention of attendant-borne transmission in hospitals and reductions in the potential for sexual transmission. Vaccines can also reduce the frequency of infection and the harmfulness of the target organisms if they are designed to inhibit selectively the harmful variants in the target population. These approaches should help suppress the evolution of antimicrobial resistance because benign variants causing mild or asymptomatic infections will be less exposed to antimicrobial treatment, reducing the strength of selection for antimicrobial resistance. The interventions should improve health at low cost, which would be especially important for low-income populations.Less
An evolutionary suggests that health interventions can reduce not only the frequency of infectious disease but also the harmfulness of the causal organisms. Interventions that may accomplish this dual goal include hygienic investments such as vector proofing of housing, provisioning of safe water supplies, infrastructure that blocks transmission of durable propagules, the prevention of attendant-borne transmission in hospitals and reductions in the potential for sexual transmission. Vaccines can also reduce the frequency of infection and the harmfulness of the target organisms if they are designed to inhibit selectively the harmful variants in the target population. These approaches should help suppress the evolution of antimicrobial resistance because benign variants causing mild or asymptomatic infections will be less exposed to antimicrobial treatment, reducing the strength of selection for antimicrobial resistance. The interventions should improve health at low cost, which would be especially important for low-income populations.
Robert L. Wears and Kathleen M. Sutcliffe
- Published in print:
- 2019
- Published Online:
- November 2019
- ISBN:
- 9780190271268
- eISBN:
- 9780190271299
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/oso/9780190271268.003.0009
- Subject:
- Public Health and Epidemiology, Public Health
Unbridled optimism and a flurry of organizational activity followed the publication of To Err is Human. As patient safety became corporatized into new institutions and programs; it became ...
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Unbridled optimism and a flurry of organizational activity followed the publication of To Err is Human. As patient safety became corporatized into new institutions and programs; it became mainstreamed and adopted by organized healthcare. Patient safety became dominated by a measure and manage approach. US hospitals added patient safety to existing quality, risk management and regulatory compliance bureaucracy. This internalization and incorporation led to a closing off of patient safety from influences outside of healthcare. Infection control and health information technology began to dominate safety efforts. Safety culture became a popular topic but in a narrow and instrumental way.Less
Unbridled optimism and a flurry of organizational activity followed the publication of To Err is Human. As patient safety became corporatized into new institutions and programs; it became mainstreamed and adopted by organized healthcare. Patient safety became dominated by a measure and manage approach. US hospitals added patient safety to existing quality, risk management and regulatory compliance bureaucracy. This internalization and incorporation led to a closing off of patient safety from influences outside of healthcare. Infection control and health information technology began to dominate safety efforts. Safety culture became a popular topic but in a narrow and instrumental way.