Supervision of Suicidal Patients in Adult Inpatient Psychiatric Units in General Hospitals.

OBJECTIVE: The safety of suicidal patients is expected to be maintained during hospitalization. This study surveyed a sample of adult inpatient psychiatric units in general hospitals across the United States about their use of various levels of supervision for suicidal patients, the advantages and disadvantages of these interventions, and issues of cost and reimbursement for the services. METHODS: A 33-item questionnaire was sent to a nationwide random sample of hospital-based adult inpatient psychiatric units. A total of 105 surveys from all regions of the country were used in the analysis. RESULTS: Although 98 hospitals reported that they used one-to-one continuous observation of suicidal patients, observation of the suicidal patient every 15 minutes was the most frequently used type of supervision, ranked first or second in frequency by 69 hospitals. Patients\u27 safety was the most frequently cited advantage of supervision, and increased staffing the most frequently cited disadvantage. In most cases, the cost of supervision for suicidal patients was absorbed by the hospital, and hospitals were not reimbursed for care based on the severity of patients\u27 illness. CONCLUSIONS: Future research on the effectiveness of various strategies for supervision of suicidal patients should include cost-benefit analyses. Policies for reimbursement for care of suicidal patients should be based on the patient\u27s severity of illness

Mission, Staffing, and Budget Data of Flight Programs in the United States.

INTRODUCTION: Manage care and other health care reform initiatives have forced all hospitals to evaluate their work processes. In this era of cost containment, many flight programs are examining the structure of their programs to determined whether they are functioning in an efficient, cost-effective fashion. METHODS: A survey was sent to the chief flight nurse of 240 flight programs in the United States. RESULTS: Eighty-five programs (35.4%) responded. Data were collected on demographics, management structure, mission information, staffing issues, and budgets. Results in each program varied widely. CONCLUSION: Benchmark data are available against which programs can compare themselves. Such comparisons may allow the discovery of opportunities to enhance program efficiency and cost-effectiveness