Thinking ahead on diesel storage

Hospital estates teams are no strangers to ensuring that they have a ready supply of diesel stored on site ready to fuel standby generators in the event of a power outage. However, new legislation now means that the formulation of red diesel is changing and, as Kenny Berrie, technical manager at generator specialist, Dieselec Thistle, explains, these changes will require a new approach to storing standby diesel supplies if hospitals are to avoid the costs and business continuity risks of stagnation.

Assertive or antiquated: ProMedica vows to appeal loss against FTC as questions loom over whether mergers lead to efficiencies or clout

ProMedica vows to fight the feds over the acquisition of St. Luke's Hospital. Here is what they have to say. "The cost of healthcare is a real problem for all Americans, and the commission seeks to address this national problem by using all the tools Congress gave to us, and by devoting significant resources so that competition will enable market participants to deliver on the promises of cost-containment and continued excellence and innovation," says the FTC's Jon Leibowitz.

State of change. As CIOs grapple with state government health IT legislation, technology requirements for payment reform are next on the states' agenda

State legislation poses an added layer of challenges for CIOs in meeting privacy and security, patient consent, technology, and payment reform that go beyond federal mandates.

The Care Quality Commission's end-of-year report

Annual reports of organizations are very useful, they portray the activities that have been carried out and also lay out plans for the future. Trends, challenges and opportunities for the organization and the sector are also identified. Annual reports are in many respects very similar to the end of year reports that we all received at school but perhaps not as blunt. The Care Quality Commission (CQC) annual report (the report) has just been published and it provides an illuminating picture of NHS care in England with many challenges, successes and failures clearly revealed. Key sections of the report that relate to NHS health care will be discussed in this article.

A systematic evaluation of the resource consumption of active pharmaceutical ingredient production at three different levels

In this paper, the development and the advantages of a methodology which allows the systematic assessment of the environmental impact on the resource side of specific pharmaceutical production processes with limited data entry is presented. The quantification of the process-specific mass and energy balances over three different system boundaries (process, gate-to-gate, and cradle-to-gate) is based on the methodology explained in Van der Vorst et al. (Ind. Eng. Chem. Res.2009, 48(11), 5344-5350). These mass and energy balances are now coupled with the thermodynamic term exergy allowing the quantification of the resource efficiency at the process and gate-to-gate level and the environmental impact at the cradle-to-gate level. The advantages of such a calculation tool for the resource evaluation are illustrated with five consecutive pharmaceutical production steps which are part of the galantamine (anti-Alzheimer medication) pathway. It is shown that such a quantitative and systematic evaluation tool allows a detailed and relatively fast evaluation of the resource efficiency of active pharmaceutical ingredient (API) production processes at the three different levels. Combining thermodynamics and the systematic data inventory methodology for the quantification of the resource efficiency first allows results to be merged into a single impact value (exergy loss/mol API or CEENE/mol API) for fast benchmarking and evaluation of different API production processes. Second, it also allows results to be divided over different categories depending on the users' interest and make thorough analysis of processes in order to pinpoint process improvements and quantitatively justify the introduction of second generation production processes or production techniques.

Feds refocus on fraud

Provisions in the reform law and a strengthened False Claims Act give the government new tools to fight fraud. Hospitals need to beef up their compliance programs.

New nuclear build and evolving radiation protection challenges

Radiological protection has continued to evolve in order to meet emerging challenges and will continue to do so. This paper will discuss the scientific and social challenges that will or may be faced by the radiological protection community in the coming 10 to 20 y and how these may affect what is expected to be a renewed interest in building and operating nuclear power plants for electricity generation.

Study on an agricultural environment monitoring server system using Wireless Sensor Networks

This paper proposes an agricultural environment monitoring server system for monitoring information concerning an outdoors agricultural production environment utilizing Wireless Sensor Network (WSN) technology. The proposed agricultural environment monitoring server system collects environmental and soil information on the outdoors through WSN-based environmental and soil sensors, collects image information through CCTVs, and collects location information using GPS modules. This collected information is converted into a database through the agricultural environment monitoring server consisting of a sensor manager, which manages information collected from the WSN sensors, an image information manager, which manages image information collected from CCTVs, and a GPS manager, which processes location information of the agricultural environment monitoring server system, and provides it to producers. In addition, a solar cell-based power supply is implemented for the server system so that it could be used in agricultural environments with insufficient power infrastructure. This agricultural environment monitoring server system could even monitor the environmental information on the outdoors remotely, and it could be expected that the use of such a system could contribute to increasing crop yields and improving quality in the agricultural field by supporting the decision making of crop producers through analysis of the collected information.

Obtaining compliance with occupational health and safety regulations: a multilevel study using self-determination theory

It was hypothesized that occupational health and safety (OHS) inspectors who prefer to use autonomy supportive tactics to resolve workplace conflicts (e.g. providing rationale, choices) would be more effective in resolving industry non-compliance with OHS regulations, compared to inspectors who prefer to use coercive tactics (e.g. deadlines, pressure). Preferences for resolving work conflicts were collected from 39 Canadian OHS inspectors and were linked to administrative records documenting 17,960 industry inspection episodes and 29,451 compliance orders issued by those inspectors from 2003-2006. Multilevel Poisson and negative binomial regression models examined associations between inspector autonomy-supportiveness and compliance outcomes, adjusting for covariates at the inspector level (e.g. job experience, number of inspection episodes) and at the worksite level (e.g. workplace safety record). Relative to coercive inspectors, autonomy-supportive inspectors issued fewer severe compliance orders and achieved compliance after fewer worksite visits. Use of autonomy-supportive approaches may reduce exposure to preventable injuries at non-compliant worksites.

Imperfect information in a quality-competitive hospital market

We examine the implications of policies to improve information about the qualities of profit-seeking duopoly hospitals which face the same regulated price and compete on quality. We show that if hospital costs of quality are similar then better information increases the quality of both hospitals. However, if the costs are sufficiently different improved information will reduce the quality of both hospitals. Moreover, even when quality increases, better information may increase or decrease patient welfare depending on whether an ex post or ex ante view of welfare is taken.