Reduction in inappropriate hospital use based on analysis of the causes

<p>Abstract</p> <p>Background</p> <p>To reduce inappropriate admissions and stays with the application of an improvement cycle in patients admitted to a University Hospital. The secondary objective is to analyze the hospital cost saved by reducing inadequacy after the implementation of measures proposed by the group for improvement.</p> <p>Methods</p> <p>Pre- and post-analysis of a sample of clinical histories studied retrospectively, in which the Appropriateness Evaluation Protocol (AEP) was applied to a representative hospital sample of 1350 clinical histories in two phases. In the first phase the AEP was applied retrospectively to 725 admissions and 1350 stays. The factors associated with inappropriateness were analysed together with the causes, and specific measures were implemented in a bid to reduce inappropriateness. In the second phase the AEP was reapplied to a similar group of clinical histories and the results of the two groups were compared. The cost of inappropriate stays was calculated by cost accounting. Setting: General University Hospital with 426 beds serving a population of 320,000 inhabitants in the centre of Murcia, a city in south-eastern Spain.</p> <p>Results</p> <p>Inappropriate admissions were reduced significantly: 7.4% in the control group and 3.2% in the intervention group. Likewise, inappropriate stays decreased significantly from 24.6% to 10.4%. The cost of inappropriateness in the study sample fell from 147,044 euros to 66,642 euros. The causes of inappropriateness for which corrective measures were adopted were those that showed the most significant decrease.</p> <p>Conclusions</p> <p>It is possible to reduce inadequacy by applying measures based on prior analysis of the situation in each hospital.</p

Positive Psychology and LGBTQ Populations

Extant research suggests that there are benefits and positive aspects of LGBTQ identities and relationships. For example, many sexual minorities report increased confidence, more positive self-regard, and greater empathy for others as a result of publicly and openly identifying as LGBTQ. Despite limited conceptualizations of LGBTQ issues within a positive psychological framework to date, exploring strengths and positive psychology can be useful for understanding many of the facets of LGBTQ identity that may have psychological benefit: freedom from socially restrictive views of gender expression and sexual identity; multiple psychological benefits from same-sex relationships and families including the emphasis on relationship equality and shared labor division, as well as expansive gender roles among children of LGB couples; and strengths gained through forming LGBTQ communities of support and participation in social justice movements

LGBTQ-Parent families and schools

Children are influenced by multiple contexts, including their families and schools. Yet research on children with LGBTQ parents has rarely attended to their school experiences. The lack of research on the family-school interface of LGBTQ-parent families is troubling, in that these families are vulnerable to marginalization and stigma in their broader communities, which may extend to the school environment. This chapter reviews research on children with LGBTQ parents, with particular attention to those domains that are most relevant to teachers, administrators, and other school personnel. We address research on the academic achievement, social functioning, and bullying of children with LGBTQ parents. We also discuss research on LGBTQ parents themselves, including their experiences selecting and interacting with their children’s schools. Where relevant, we emphasize race/ethnicity, social class, and other social locations with respect to their role in shaping LGBTQ-parent families. We end with practical recommendations for educators for creating an inclusive environment for these families