Hospital
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{{for|other uses|Hospital (disambiguation)}}
[[Image:Universitary Hospital.jpg|right|thumb|The University Hospital of [[UFPE]] in [[Recife]], [[Brazil]].]]
[[Image:AIIMS central lawn.jpg|thumb|right|[[All India Institute of Medical Sciences]] in [[Delhi]], [[India]].]]
A '''hospital''' is an institution for [[health care]] providing treatment by specialised staff and equipment, and often but not always providing for longer-term patient stays.
Today, hospitals are usually funded by the state, health organizations ([[For-profit hospital|for profit]] or [[Non-profit organization|non-profit]]), [[health insurance]]s or [[Charitable organization|charities]], including direct charitable donations. In history, however, they were often founded and funded by religious orders or charitable individuals and leaders. Similarly, modern-day hospitals are largely staffed by professional [[physician]]s, [[surgeon]]s and [[nurse]]s, whereas in history, this work was usually done by the founding religious orders or by volunteers.
==Etymology==
During the [[Middle Ages]] the hospital could serve other functions, such as [[almshouse]] for the poor, hostel for [[pilgrims]], or [[hospital school]]. The name comes from [[Latin language|Latin]] ''hospes'' (host), which is also the root for the English words ''[[hotel]]'', ''[[hostel]]'', and ''[[hospitality]]''. The modern word ''hotel'' derives from the French word ''hostel'', which featured a silent ''s'', which was eventually removed from the word. (The [[circumflex]] on modern French ''hôtel'' hints at the vanished ''s'')
[[Grammar]] of the word [[American and British English differences|differs]] slightly depending on the dialect. In the U.S., ''hospital'' usually requires an article; in Britain and elsewhere, the word is normally used without an article when it is the object of a preposition and when referring to a patient ("in/to the hospital" vs. "in/to hospital"); in Canada, both usages are found.
==Types==<!-- This section is linked from [[Runcorn]] -->
Some [[patient]]s in a hospital come just for [[diagnosis]] and/or therapy and then leave ('outpatients'); while others are 'admitted' and stay overnight or for several weeks or months ('inpatients'). Hospitals are usually distinguished from other types of medical facilities by their ability to admit and care for inpatients.
===General ===
The best-known type of hospital is the general hospital, which is set up to deal with many kinds of [[disease]] and [[injury]], and typically has an [[emergency ward]] to deal with immediate threats to [[health]] and the capacity to dispatch [[emergency medical services]]. A general hospital is typically the major health care facility in its region, with large numbers of beds for [[intensive care]] and long-term care; and specialized facilities for [[surgery]], [[plastic surgery]], [[childbirth]], bioassay laboratories, and so forth. Larger cities may have many different hospitals of varying sizes and facilities.
===Specialized ===
Types of specialized hospitals include [[trauma center]]s, rehabilitation hospitals, [[Children's Hospital|children's hospitals]], seniors' ([[geriatric]]) hospitals, and hospitals for dealing with specific medical needs such as [[psychiatry|psychiatric]] problems (see [[psychiatric hospital]]), certain disease categories, and so forth.
A hospital may be a single building or a [[campus]]. (Many hospitals with pre-20th-century origins began as one building and evolved into campuses.) Some hospitals are affiliated with [[universities]] for [[medical research]] and the training of medical personnel. Worldwide, most hospitals are run on a [[non-profit]] basis by governments or charities. Within the [[United States]], most hospitals are not-for-profit.
===Teaching===
A [[teaching hospital]] (or university hospital) is that who combines assistance to patients with teaching to medical students.
===Clinics===
A medical facility smaller than a hospital is called a [[clinic]], and is often run by a [[government agency]] for health services or a private [[partnership]] of physicians (in nations where private practice is allowed). Clinics generally provide only [[outpatient]] services.
==Departments==
[[Image:ER room after a trauma.jpg|thumb|Resuscitation room bed after a [[physical trauma|trauma]] intervention, showing the highly technical equipment of modern hospitals.]]
[[Image:Hospital beds.jpg|thumb|Empty Chamber and the [[iron]] bed in a hospital the city of [[Kharkov]], [[Ukraine]].]]
{{Seealso|:Category:Hospital departments}}
Hospitals may have any of the following departments or units:
* [[Behavioral health|Behavioral Health]] Services
* [[Burn (injury)|Burn unit]]
* [[Cancer|Cancer Center]]
* [[Coronary care unit]]
* [[Dispensary]]
* [[Emergency department]]
* [[Intensive Care Unit]]
** [[Neonatal intensive care unit]]
** [[Trauma center]]
* [[Labor and Delivery]]
* [[Laboratory|Laboratory Services]]
* [[Nursing unit]]
* [[Orthopedic|Orthopedic Services]]
* [[Outpatient Department]]
* [[Pharmacy]]
* [[Psychiatric ward]]
* [[Physical medicine and rehabilitation|Rehabilitation Services]]
* [[Physical Therapy]]
* [[Post anesthesia care unit]]
* [[Radiology]]
* [[Respiratory Therapy]]
* [[Surgery]]
* [[Urgent care]]
Non-medical departments include:
*[[Medical records department]]
*[[Release of Information department]]
== History ==
[[Image:Physician in hospital sickroom printed 1682.jpg|thumb|A physician visiting the [[sick]] in a hospital. German [[engraving]] from 1682.]]
In ancient cultures, religion and medicine were linked. The earliest known institutions aiming to provide cure were [[Ancient Egypt|Egyptian]] temples. [[Greek temple]]s dedicated to the healer-god [[Asclepius]] might admit the sick, who would wait for guidance from the god in a dream. The [[Ancient Rome|Romans]] adopted his worship. Under his Roman name Æsculapius, he was provided with a temple ([[291 BC]]) on an island in the [[Tiber]] in [[Rome]], where similar rites were performed.<ref>Roderick E. McGrew, ''Encyclopedia of Medical History'' (Macmillan 1985), pp.134-5.</ref>
===Ancient Asia ===
The [[Sinhalese people|Sinhalese]] ([[Sri Lanka]]ns) are perhaps responsible for introducing the concept of dedicated hospitals to the world. According to the [[Mahavamsa]], the ancient chronicle of Sinhalese royalty written in the 6th century A.D., King Pandukabhaya (4th century BC) had lying-in-homes and hospitals (Sivikasotthi-Sala) built in various parts of the country. This is the earliest documentary evidence we have of institutions specifically dedicated to the care of the sick anywhere in the world.<ref>Prof. Arjuna Aluvihare, "Rohal Kramaya Lovata Dhayadha Kale Sri Lankikayo" ''Vidhusara Science Magazine'', Nov. 1993.</ref><ref>''[http://www.hsph.harvard.edu/ihsg/publications/pdf/No-42.PDF Resource Mobilization in Sri Lanka's Health Sector]'' - Rannan-Eliya, Ravi P. & De Mel, Nishan, [[Harvard School of Public Health]] & Health Policy Programme, [[Institute of Policy Studies]], February 1997, Page 19. Accessed 2008-02-22.</ref> [[Mihintale]] Hospital is perhaps the oldest in the world.<ref>Heinz E Müller-Dietz, ''Historia Hospitalium'' (1975).</ref>
Institutions created specifically to care for the ill also appeared early in [[India]]. King [[Ashoka]] is said to have founded at least 18 hospitals ca. 230 BC, with physicians and nursing staff, the expense being borne by the royal treasury.<ref>''Encyclopedia of Medical History'' - McGrew, Roderick E. (Macmillan 1985), p.135.</ref> However, there are historians who strictly dispute the claim that Ashoka built any hospitals at all, and argue that it is based on a mistranslation, with references to 'rest houses' being mistaken for hospitals. The error is thought to have occurred because similar edicts and records talk of Ashoka importing medicinal supplies.<ref>''[http://www.ucl.ac.uk/~ucgadkw/papers/HistoryOfHospitalsInIndia.pdf The Nurses should be able to Sing and Play Instruments]'' - Wujastyk, Dominik; [[University College London]]. Accessed 2008-02-22.)</ref>
State-supported hospitals later appeared in [[China]] during the first millennium A.D.{{Fact|date=February 2008}} The first [[teaching hospital]] where students were authorized to methodically practice on patients under the supervision of physicians as part of their education, was the [[Academy of Gundishapur]] in the [[Persian Empire]]. One expert has argued that "to a very large extent, the credit for the whole hospital system must be given to Persia".<ref>C. Elgood, ''A Medical History of Persia'', (Cambridge Univ. Press), p. 173.</ref>
=== Roman Empire ===
The Romans created ''valetudinaria'' for the care of sick slaves, gladiators and soldiers around [[100 BC]], and many were identified by later archeology. While their existence is considered proven, there is some doubt as to whether they were as widespread as was once thought, as many were identified only according to the layout of building remains, and not by means of surviving records or finds of medical tools.<ref>''[http://www.novaesium.de/news/1998-1220-valetudinaria.htm The Roman military Valetudinaria: fact or fiction]'' - [[Patricia Anne Baker|Baker, Patricia Anne]], [[University of Newcastle upon Tyne]], Sunday [[20 December]] [[1998]]</ref>
The adoption of [[Christianity]] as the state religion of the empire drove an expansion of the provision of care. The [[First Council of Nicaea]] in [[325]] A.D. urged the Church to provide for the poor, sick, widows and strangers. It ordered the construction of a hospital in every cathedral town. Among the earliest were those built by the physician [[Saint Sampson]] in [[Constantinople]] and by [[Basil of Caesarea|Basil, bishop of Caesarea]]. The latter was attached to a [[monastery]] and provided lodgings for poor and travelers, as well as treating the sick and infirm. There was a separate section for lepers.<ref>Roderick E. McGrew, ''Encyclopedia of Medical History'' (Macmillan 1985), p.135. </ref>
===Medieval Islam===
{{main|Bimaristan}}
{{see|Islamic medicine}}
The earliest recorded hospitals in the [[Islamic Golden Age|medieval Islamic world]] refer to the hopital of [[Al-Walid I|al-Walid ibn 'Abdul Malik]] (ruled 705-715 CE) which he built in 86 AH (706-707 CE). It somewhat resembled the Byzantine nosocomia, but was more general as it extended its services to the [[Leprosy|lepers]] and the invalid and destitute people. All treatment and care was free of charge and there was more than one physician employed in this hospital.<ref>al-Hassani, Woodcock and Saoud (2007), 'Muslim heritage in Our World', FSTC Publishing, pp.154-156</ref>
In the [[Islamic Golden Age|medieval Islamic world]], the word "[[Bimaristan]]" was used to indicate a hospital in the modern sense, an establishment where the ill were welcomed and cared for by qualified staff. In this way, [[Islamic medicine|Muslim physicians]] were the first to make a distinction between a hospital and other different forms of [[healing temple]]s, [[sleep temple]]s, [[hospice]]s, [[assylum]]s, [[lazaret]]s and [[leper]]-houses, all of which in [[Ancient history|ancient times]] were more concerned with isolating the [[sick]] and the [[mad]] from society "rather than to offer them any way to a true cure." Some thus consider the medieval Bimaristan hospitals as "the first hospitals" in the modern sense of the word.<ref>{{citation|last=Micheau|first=Francoise|contribution=The Scientific Institutions in the Medieval Near East|pages=991-2}}, in {{Harv|Morelon|Rashed|1996|pp=985-1007}}</ref> The first [[public hospital]]s,<ref name=Barrett>[[Peter Barrett]] (2004), ''Science and Theology Since Copernicus: The Search for Understanding'', p. 18, [[Continuum International Publishing Group]], ISBN 056708969X.</ref> [[psychiatric hospital]]s<ref>Ibrahim B. Syed PhD, "Islamic Medicine: 1000 years ahead of its times", ''[[The Islamic Medical Association of North America|Journal of the Islamic Medical Association]]'', 2002 (2), p. 2-9 [7-8].</ref> and [[Medical school|medical]] [[University|universities]]<ref name=Glubb/> were also introduced by medieval Muslim physicians.
Between the eighth and twelfth centuries CE [[Muslim]] hospitals developed a high standard of care. Hospitals built in [[Baghdad]] in the ninth and tenth centuries employed up to twenty-five staff physicians and had separate wards for different conditions. Al-Qairawan hospital and mosque, in [[Tunisia]], were built under the [[Aghlabid]] rule in 830 CE and was simple but adequately equipped with halls organized into waiting rooms, a [[mosque]], and a special bath. The hospital employed female [[nurse]]s, including nurses from [[Sudan]], a sign of great breakthrough. In addition to regular physicians who attended the sick, there were ''Fuqaha al-Badan'', a kind of religious [[Physical therapy|physio-therapists]], group of religious scholars whose medical services included bloodletting, bone setting, and cauterisation. During [[Ottoman Empire|Ottoman]] rule, when hospitals reached a particular distinction, Sultan [[Bayazid II]] built a [[Psychiatric hospital|mental hospital]] and medical [[madrasa]] in [[Edirne]], and a number of other early hospitals were also built in Turkey. Unlike in Greek temples to healing gods, the clerics working in these facilities employed [[scientific method]]ology far beyond that of their contemporaries in their treatment of patients.<ref>''[http://www.muslimheritage.com/uploads/TurkishScience.pdf Turkish Contributions to Scientific Work in Islam]'' - [[Aydin Sayili]], ''Foundation For Science, Technology and Civilisation'', Septermber 2004, Page 9</ref>
According to Sir [[John Bagot Glubb]]:
{{quote|"By [[Al-Mamun|Mamun]]'s time [[medical school]]s were extremely active in Baghdad. The first free [[public hospital]] was opened in Baghdad during the [[Caliphate]] of [[Harun al-Rashid|Haroon-ar-Rashid]]. As the system developed, physicians and surgeons were appointed who gave lectures to [[Medical school|medical students]] and issued [[diploma]]s to those who were considered qualified to practice. The first hospital in Egypt was opened in 872 AD and thereafter public hospitals sprang up all over the empire from [[Al-Andalus|Spain]] and the [[Maghrib]] to [[History of Iran|Persia]]."<ref name=Glubb>{{citation|last=Sir Glubb|first=John Bagot|author-link=John Bagot Glubb|year=1969|title=A Short History of the Arab Peoples|url=http://www.cyberistan.org/islamic/quote2.html#glubb|accessdate=2008-01-25}}</ref>}}
===Medieval Europe===
[[Image:Hospicio Cabañas.JPG|thumb|[[Hospicio Cabañas]] was the largest hospital in colonial America.]]
[[Image:LesInvalidesFull.JPG|thumb|The church at [[Les Invalides]] in France showing the often close connection between historical hospitals and churches.]]
Medieval hospitals in [[Europe]] followed a similar pattern. They were religious communities, with care provided by [[monk]]s and [[nun]]s. (An old French term for hospital is ''[[hôtel-Dieu]]'', "hostel of God.") Some were attached to monasteries; others were independent and had their own endowments, usually of property, which provided income for their support. Some hospitals were multi-function while others were founded for specific purposes such as leper hospitals, or as refuges for the poor or for [[pilgrim]]s: not all cared for the sick. Not until later where most hospitals multi-functional, though the first Spanish hospital, founded by the Catholic [[Visigoth]] bishop [[Masona]] in 580 at [[Mérida]], was a ''xenodochium'' designed as an inn for travellers (mostly pilgrims to the shrine of [[Eulalia of Mérida]]) as well as a hospital for citizens and local farmers. The hospital's endowment consisted of farms to feed its patients and guests.
===Colonial America===
It is believed that the first Spanish style hospital founded in the Americas [Western Hemisphere] following Columbus arrival to the island now known as Hispaniola was the Hospital San Nicolás de Bari [Calle Hostos] in Santo Domingo, [Distrito Nacional] Dominican Republic.
Fray Nicolas de Ovando, Spanish governor and colonial administrator from 1502-1509, authorized its construction in or after 1504. It is believed that this hospital also served as a church during its lifetime. The first phase of its construction was completed in 1519. Erwin Walter Palm, [former author and professor of Spanish American art, culture, and history] wrote that "the Brotherhood of Our Lady of the Conception continued the construction of the hospital in 1533, adding modern elements, including additional buildings." Abandoned in the mid-18th century the hospital now lies in ruins near the Cathedral in the colonial zone in Santo Domingo, DR, amid additional historical New World sights.
The [[Hospital de Jesús Nazareno]] in [[Mexico City]] is the oldest hospital in [[North America]]. It was founded in 1524 with the economic support of [[conquistador]] [[Hernán Cortés]] to care for poor Spanish soldiers and the native inhabitants.
The first hospital in North America north of Mexico is the [[Hôtel-Dieu de Québec]]. It was established in [[New France]] in [[1639]] by three [[Augustinians]] from l'Hôtel-Dieu de Dieppe in France. The project of the niece of [[Cardinal de Richelieu]] was granted a royal charter by King [[Louis XIII]] and staffed by colonial physician [[Robert Giffard de Moncel]].
=== Modern era ===
In Europe the medieval concept of Christian care evolved during the sixteenth and seventeenth centuries into a secular one, but it was in the eighteenth century that the modern hospital began to appear, serving only medical needs and staffed with physicians and surgeons. The [[Charité]] (founded in [[Berlin]] in 1710) is an early example.
[[Guy's Hospital]] was founded in [[London]] in 1724 from a bequest by wealthy merchant [[Thomas Guy]]. Other hospitals sprang up in London and other British cities over the century, many paid for by private subscriptions. In the British American colonies the [[Pennsylvania Hospital|Pennsylvania General Hospital]] was chartered in [[Philadelphia]] in 1751, after £2,000 from private subscription was matched by funds from the Assembly.<ref>Roderick E. McGrew, ''Encyclopedia of Medical History'' (Macmillan 1985), p.139. </ref>
When the Viennese General Hospital ([[Allgemeines Krankenhaus]]) opened in 1784 (instantly becoming the world's largest hospital), physicians acquired a new facility that gradually developed into the most important research center. During the 19th century, the Second Viennese Medical School emerged with the contributions of physicians such as [[Carl Freiherr von Rokitansky]], [[Josef Škoda]], [[Ferdinand Ritter von Hebra]] and [[Ignaz Philipp Semmelweis]]. Basic medical science expanded and specialization advanced. Furthermore, the first dermatology, eye, as well as ear, nose and throat clinics in the world were founded in [[Vienna]], being considered was the birth of specialized medicine.{{Fact|date=April 2008}}
By the mid-[[nineteenth century]] most of Europe and the United States had established a variety of public and private hospital systems. In Continental Europe the new hospitals were generally built and run from public funds. The [[National Health Service]], the principle provider of healthcare in the United Kingdom, was founded in 1948.
In the [[United States]] the traditional hospital is a [[non-profit hospital]], usually sponsored by a religious denomination. One of the earliest of these "almshouses" in what would become the United States was started by [[William Penn]] in [[Philadelphia]] in 1713. These hospitals are tax-exempt due to their charitable purpose, but provide only a minimum of charitable medical care. They are supplemented by large [[public hospital]]s in major cities and research hospitals often affiliated with a medical school. In the late twentieth century, chains of [[for-profit hospital]]s arose in the USA.
== Criticism ==
While hospitals, by concentrating equipment, skilled staff and other resources in one place, clearly provide important help to patients with serious or rare health problems, hospitals are also criticised for a number of faults, some of which are endemic to the system, others which develop from what some consider wrong approaches to health care.
One criticism often voiced is the 'industrialised' nature of care, with constantly shifting treatment staff, which dehumanises the patient and prevents more effective care as doctors and nurses are rarely intimately familiar with the patient. The high working pressures often put on the staff exacerbates such rushed and impersonal treatment. The architecture and setup of modern hospitals is often voiced as a contributing factor to the feelings of faceless treatment many people complain about.<ref>''References provided in [[Hospital#Architecture|this same article]].''</ref>
Another criticism is that hospitals are in themselves a dangerous place for patients, who are often suffering from weakened [[immune system]]s - either due to their body having to undergo substantial surgery or because of the illness which placed them in the hospital itself. As an example, it is estimated that as much as 10% of all patients in the United States contract a [[nosocomial infection|nosocomical (hospital-caused) infection]].<ref>''References provided in the linked article.''</ref> Due to the environment in which [[antibiotics]] are used in large quantities, the infections are also often multi-resistant to various treatment methods, such as the relatively common [[Methicillin-resistant Staphylococcus aureus|MRSA]] infection.
==Funding==
In the modern era, hospitals are, broadly, either funded by the government of the country in which they are situated, or survive financially by competing in the private sector (a number of hospitals are also still supported by the historical type of charitable or religious associations).
In the United Kingdom for example, a relatively comprehensive, "free at the point of delivery" healthcare system exists, funded by the state. Hospital care is thus relatively easily available to all legal residents (although as hospitals prioritize their limited resources, there is a tendency for 'waiting lists' to be generated for non-emergency treatment, and those who can afford it may take out private healthcare to get treatment faster).<ref name="GROW">''[http://www.nzherald.co.nz/organisation/story.cfm?o_id=366&objectid=10487870 Surgery worries create insurance boom]'' – ''[[The New Zealand Herald]]'', Monday [[21 January]] [[2008]]</ref> On the other hand, many countries, including for example the USA, have in the 20th Century followed a largely private-based, [[Business|for-profit]]-approach to providing hospital care, with few state-money supported "charity" hospitals remaining today.<ref name="USATODAY"/> Where for-profit hospitals in such countries admit uninsured patients in emergency situations (such as during and after the [[Hurricane Katrina]] in the USA), they incur direct financial losses,<ref name="USATODAY">''[http://www.usatoday.com/money/industries/health/2006-04-25-new-orleans-hospitals-usat_x.htm Hospitals in New Orleans see surge in uninsured patients but not public funds]'' – ''[[USA Today]]'', Wednesday [[26 April]] [[2006]]</ref> ensuring that there is a clear disincentive to admit such patients.
While for-profit-based systems have produced some of the best hospitals in the world, a proportion of the populace may have little or no access to healthcare services of adequate quality.{{Fact|date=March 2008}}
As quality of healthcare has increasingly become an issue around the world, hospitals have increasingly had to pay serious attention to this. Independent external assessment of quality is one of the most powerful ways of assessing the quality of healthcare, and [[hospital accreditation]] is one means by which this is achieved. In many parts of the world such accreditation is sourced from other countries, a phenomenon known as [[international healthcare accreditation]], by groups such as the [[Joint Commission]] from the USA and the [[Trent Accreditation Scheme]] from [[Great Britain]].
==Buildings==
[[Image:NHS NNUH entrance.jpg|thumb|right|The [[National Health Service]] [[Norfolk and Norwich University Hospital]] in the [[United Kingdom|UK]], showing the utilitarian architecture of many modern hospitals.]]
===Architecture===
Modern hospital buildings are designed to minimize the effort of medical personnel and the possibility of contamination while maximizing the efficiency of the whole system. Travel time for personnel within the hospital and the transportation of patients between units is facilitated and minimized. The building also should be built to accommodate heavy departments such as radiology and operating rooms while space for special wiring, plumbing, and waste disposal must be allowed for in the design.
However, the reality is that many hospitals, even those considered 'modern', are the product of continual and often badly managed growth over decades or even centuries, with utilitarian new sections added on as needs and finances dictate. As a result, Dutch architectural historian [[Cor Wagenaar]] has called many hospitals:
:''"... built catastrophes, anonymous institutional complexes run by vast bureaucracies, and totally unfit for the purpose they have been designed for ... They are hardly ever functional, and instead of making patients feel at home, they produce stress and anxiety."<ref name="ODE">''[http://www.odemagazine.com/doc/35/healing_by_design Healing by design]'' – ''Ode Magazine'', July/August 2006 issue. Accessed 2008-02-10.</ref>
Some newer hospital designs now try to reestablish design that takes the patient's psychological needs into account, such as providing for more air, better views, and more pleasant color schemes. These ideas harken back to the late 18th century, when the concept of providing fresh air and access to the 'healing powers of nature' were first employed by hospital architects in improving their buildings.<ref name="ODE"/>
Another major change which is still ongoing in many parts of the world is the change from a ward-based system (where patients are treated and accommodated in communal rooms, separated at best by movable partitions) to a room-based environment, where patients are accommodated in private rooms. The ward-based system has been described as very efficient, especially for the medical staff, but is considered to be more stressful for patients and detrimental to their privacy. A major constraint on providing all patients with their own rooms is however found in the higher cost of building and operating such a hospital, which causes some hospitals to charge for the privilege of private rooms.<ref>''[http://www.nationalreviewofmedicine.com/issue/2004/11_15/feature05_21.html Health administrators go shopping for new hospital designs]'' – ''[[National Review of Medicine]]'', Monday [[15 November]] [[2004]], Volume 1 NO. 21 </ref>
===Infrastructure===
The surgical, special procedures, radiological, [[intensive care unit]], and patient rooms typically have medical gases, emergency and normal electrical power; and heating, air conditioning and ventilation systems.
===Electrical===
The reliability of the electrical power systems that serve a hospital is important. In order to provide higher electrical reliability, the [[National Institutes of Health]], NIH, requires that all secondary [[electrical substation|substations]] > 500 kVA at their Bethesda, [[MD]] campus be the spot network type. The [[spot network substation]]s cost more than other arrangements.
===Information===
[[Pneumatic tube]] conveying systems are often used to move the actual paper prescriptions for medicines to the Pharmacies, and to move medicines, especially intra-venous, IV, bags to the patient care rooms. Tissue samples can be sent to the Laboratory. Medical notes can be transcribed, printed, and then transported via a Pneumatic Tube Conveying System.
As measured by the weight of the item be transferred, the 15 cm (6”) diameter tube systems have about 225% of the lifting and moving capacity of a 10 cm (4”) system. When the seals are new, the 10 cm tube carriers will move a 1 kg (2+ pound) IV bag. But when the seals on the tube carriers are worn, the tubes can stop moving in the piping, and require a trained technician to recover the tube carrier.
Modern hospitals have information infrastructure such as secured patient information system and [[PACS]].
==References & Notes==
{{reflist}}
*{{Harvard reference
|last1=Morelon
|first1=Régis
|last2=Rashed
|first2=Roshdi
|year=1996
|title=[[Encyclopedia of the History of Arabic Science]]
|volume=3
|publisher=[[Routledge]]
|isbn=0415124107
}}
== External links ==
{{commons|Hospital}}
*[http://www.buildinghistory.org/Articles/Heritage.htm Jean Manco, The Heritage of Mercy] (medieval hospitals in Britain)
*[http://www.musee-mccord.qc.ca/en/keys/webtours/VQ_P2_10_EN.html Last Resort: Hospital Care in Canada] (an illustrated historical essay)
*[http://www.historyfish.net/clay/clay_hospitals.html Medieval Hospitals of England, by Rotha Mary Clay] (1909 book, now in the public domain)
* [http://www.dashboardzone.com/hospital-dashboard-metrics-and-scorecard-for-hospital-managment-dashboards Hospital Metrics and Scorecard]
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