HOSPITAL EFFICIENCY

Evening Post, Volume CXI, Issue 3, 5 January 1926, Page 6

HOSPITAL EFFICIENCY

A GREAT MOVEMENT.

HOW AMERICA HAS BENEFITED BY STANDARDISATION

STATEMENT BY DB. M. MacEACHEEN.

Dr. Malcolm MaeEaehsrn, Associate Director of the American College of Surgeons, will visit New Zealand in the course of a few weeks, and after inspecting a number of the principal hospitals of the Dominion, will offer some advice as to how, in his opinion, improvement* may be made in our existing hospital system. Dr. MacEachern, as a director of the great national movement in America, has been loaned to the Government of Victoria for the purpose of investigation and reporting on the system there. Dr. MacEachern is an enthusiastic > worker. He laboured right through the Christmas holidays in I Melbourne. Out of the 24 hours, Dr. MacEachern remains quiet during four, when he sleeps, the rest of the time he is electrio. Some few years ago doctors practising in America felt the need for some form of hospital inspection. Surgeons and physicians alike realised that under existing conditions they could not work efficiently. Hospitals varied considerably, and it was felt that many were quite unworthy of the name they bore. Yet there was no competent body that could settle the question. Ultimately several wellknown and highly-Kspected members of the medical profession privately investigated the subject of hospital management, with the result, that the American College Qf. Surgeons was founded. Pr. M. T. MacEachern," states the Melbourne "Age,'/is one of the main forces in this international movement, which aims at bettering hospital management ana facilities. PRACTICAL PRINCIPLES. What was known as hospital standardisation was now in its ninth year of development and progress, and it was becoming world-wide in its influence. That did not, in the opinion of Dr. MacEachern, mean that all hospitals should be built, operated, and maintained alike. Hospital standardisation meant the advocating of certain practical principles, adaptable with modifications. to every institution caring for the sick. Those principles had to be worked out by each institution in such a manner as would euaure the highest degree of efficiency and service to the sick patients. The principles, as applied to hospitals con-cerned—-(I) the proper organisation of the institutions, so as to set forth the duties, responsibilities, and functions, without overlapping or omissions. (2) The providing of adequate facilities for diagnosis and treatment, as well as the safety and care of the patient. That was based on the principle that every man, woman, and child, regardless of social status, race, colour, or creed; was entitled to the. best and most accurate diagnosis and ! efficient treatment known 1 to medical i aeionce. Those hospitals must have laboratories, X-ray and all such means of increasing efficiency of treatment and hastening of recovery. (3) The necessity of having a competent and trained personnel to do the work, whether it be physical or scientific. Each hospital to-day required a staff with certain qualifications, such as interest, industry, honesty, and love for the work. (4) Arrangements for the periodic check-up or medical audit of the work of the hospitals by the medical staff who accounted for all results of, treatment, with a. careful investigation into all deaths, complications, improvements, and all conditions or results not up to 100 per cent, efficiency. The hospital was no longer a come-stay-go institution, where patients passed through it as if it were a machine. Each patient needed individual consideration, with provision of such procedures in diagnosis and treatment as were necessary.

Complete ease records, and competent supervision and many other measures, were' laid down in standardisation, and a careful medical audit of the hospital was thus provided. A definite scheme of standardisation had .been worked out for hospitals after years of study and investigation. Its broadest interpretation was allowed by each hospital in working out the principles so as not to interfere with the individuality of the institute. It had been proved after years of experience that those principles were applicable to hundreds of hospitals- There were instances of hospitals with under twenty beds carrying out the scheme as consistently as the larger institutions. . ; HOSPITAL A PART OF SOCIAL LIFE. What was known popularly as the minimum standard 'or the American hospital was the measuring stick of efficiency, and it drew the distinction betwcea two types of institutions. Ou the one hand, the one which could rightfully be termed a hospital having not only bed, board, nursing, and al] the domestic and other services, but also laboratories, X-ray, and other scientific adjuncts, so that the patient and the doctor might have at their fingers' tips every facility necessary for the best that sciance could provide. On the other hand, there were such institutions as could be regarded as hotels for patients that provided 'bed, board, ana nursing, but lacking the scientific facilities which were the earmark of a real hospital. While the doctor and the nurse had many Godgiven natural means of doing great things for the patients, thoy must also have the scientific facilities to help them work out their problems rapidly and accurately, and thus where thousands of persons died formerly through lack of those modern adjuncts to medicine in the years gone by, now thousands are saved. The hospital had become a part of the social life of our people, and a great national economy, for every life saved was worth much to the nation, and every day of sickness saved meant much to industry, not to say anything concerning the great minimising of suffering and sorrow.