HISTORY AND PHYSICAL
Patient Name: Marilyn Sue Stone
Patient ID: 116588 DOB: 01/24 Age: 50 Sex: F
Room No.: 181A
Date of Admission: 02/07/2012
Admitting Physician: Jessie D. Smith, MD of Orthopedics
Admitting Diagnosis: Chronic Hip Pain
HISTORY OF PRESENT ILLNESS: Patient is a candidate for a total right hip revision. She has 2 units of directed packed red blood cells. It is not autologous. She does had Hepatitis B. She has arthrogryposis. She had a right total hip replacement many years ago by Dr. Dodd at the University of Miami. She has had multiple other surgical procedures as follows. A: She had bilateral foot surgery In the remote past. B: She had left hip surgery a year ago. C: She had right foot
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Postoperative Diagnosis: Same.
Operative Procedures: 1. Reversion of total hip replacement, right hip. 2. Allograft bone graft, right hip.
Specimen Removed: Prosthesis.
IV Fluids: See Anesthesia records.
Estimated Blood Loss: 300 mL.
Urine Output: Not recorded.
Complications: None.
PROCEDURE IN DETAIL: The patient was brought into the operating room, after satisfactory anesthesia, was placed in the left lateral dicubitis position. The right hip was prepped and draped. A previous made incision was reopened over the greater trochanter and carried down to Illiotibial (IT) band. The IT band was opened in the direction of the skin incision. The anterior 1/3 of the gluteus medius/minimus group was reflected off the trochanter over to the anterior brim of the pelvis. The hip was dislocated. The femoral component was easily removed. It was loose in the cement. The polyethylene was loose and easily removed. There was a lot of cement in and around the acetabulum. We debridement most of this. There was a wired mesh plug that went medially into the pelvis that was left in place. There was also one in the ishium that was quite stable and it was left in place. There was a large defect in the medial wall of the acetabulum about the size of a silver dollar.
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There did not to appear to be a pelvic disassociation. Due to the shape of the
Shortly the incision made off the weight bearing surface of the posterior heel. Guide wire from the 70 cannulated
1.) What is the marginal cost estimate of the Phase 4 hospital services, assuming that 60 percent of the designated costs are fixed and the remaining costs are variable?
The acquisition and post-acquisition period for Mt. Mercy Hospital/Sister Mary Theresa’s purchase of Abbott Hospital experienced several organizational change issues. Within Dr. Belasen’s corporate communications model “CVFCC,” several quadrants became compromised. During the acquisition period, conflict arose within the realm of Investor Relations and Government Relations. Conflict continued to arise after the acquisition – specifically within the quadrant of Employee Relations.
Dr. Gary Kaplan was trying to achieve change at Virginia Mason. He envisioned the transformation of Virginia Mason Medical Center into the quality leader in health care and sought to lead the organization toward this vision. When Dr. Kaplan joined VMMC what attracted him to the medical field was a collaborative team approach and Virginia Masons’ unique culture that was created in the early 1900’s. With time VMMC started to face challenges, competition was fierce and VMMC soon began to experience financial troubles. In addition, its employees were unhappy and the staff morale around the hospital was declining. Kaplan noticed that
#1 With no change in volume (utilization), is the clinic projected to make a profit?
How would Ed’s blood help protect him from a foreign invader such as the one now in his system?
Big Bend Medical Center is a full-service, not-for-profit, acute care hospital with 325 beds located in Big Bend, Texas. The bulk of the hospital’s facilities are devoted to inpatient care and emergency services. (Gapenski, pg. 27) The outpatient services section of the hospital is used by the Outpatient Clinic, as well as the Dialysis Center. The Outpatient Clinic, which makes up about 80 percent of the outpatient services section, has recently grown in volume and has created a need for 25 percent more space than it currently has. Moving the Dialysis Center to a new building was decide to allow expansion of the Outpatient Clinic. A change and focus on the allocation of costs has some department heads angry and claiming of
from the doctor. The health information technician has to track down that doctor. Also, the Billing department may receive requests from unknown insurance companies. When this happens, the Billing department gets Medical Records to act on their behalf. The Medical Records then has to obtain an authorization form from the patient in order to fulfill the unknown insurance company needs.
Table of Contents Situational Analysis Appendices External Analysis Appendix A: S.W.O.T. Analysis Appendix B: External Trend/Issue Analysis Appendix C: Environmental Trends/Issues Plot Appendix D: Stakeholder Map Appendix E: Service Area Profile Appendix F: Service Area Structural Analysis Appendix G: Service Area Competitor Analysis Appendix H: Critical Success Factor Analysis Appendix I: Mapping Competitors Appendix J: Synthesizing the Analysis Internal Analysis Appendix K: Financial Analysis Appendix L: Value Chain Strengths and Weaknesses Appendix M: Value Chain Competitive Advantages Relative to Strengths
Indications: The patient is a 69 year old black female who fell landing on her right hip. She was seen in the Emergency Room where physical exam and x-ray revealed an intertrochanteric right femoral fracture. She was admitted to Dr. Loyd’s service .
An incision will be made in your hip. Your surgeon will take out any damaged cartilage and bone.
Medical errors are avoidable mistakes in the health care. These errors can take place in any type of health care institution. Medical errors can happen during medical tests and diagnosis, administration of medications, during surgery, and even lab reports, such as the mixing of two patients’ blood samples. These errors are usually caused by the lack of communication between doctors, nurses and other staff. A medical error could cause a severe consequence to the patient in cases consisting of severe injuries or cause/effect any health conditions, and even death. According to recent studies medical errors are not the third leading cause of death in the United States. (Walerius. 2016)
• The leg on the side of the dislocated hip appearing shorter than the other leg.
This surgery was performed three days following the accident, due to swelling of the affected limb.
Subject line: Describe what went right and what went wrong with this venture. Add in how you would fix the identified problems, if this was your company.