Improving levels of service through enhanced distribution techniques at Newark Beth Israel Medical Center

In an effort to reduce cost and improve service, Materiels Management Distribution Services, in cooperation with a prime vendor, created a distribution method unique to the needs of Newark Beth Israel Medical Center. The project combined the vendor's expertise and ability to "deliver direct" to an internal hospital location by product group with the distribution staff's ability to complete the process and deliver the merchandise to the final destination in an expedited manner. This article provides a contract template that can be adapted for other collaborative efforts and highlights the components of a successful program: electronic data interchange, verification of usage and par, reconfiguration of space, direct pallet delivery, and some basic indicators of success.     

Utilization management and data acquisition: a case study

The more a company knows about the source and nature of its health care costs, the more likely it is to make good cost-effective decisions. Three different companies, with the help of health care management vendors, were able to make significant health cost savings by organizing their data in creative ways. Combining different sources of cost data enabled them to answer questions they could not have answered through any single source.     

Endovascular treatment of carotid artery stenosis

Carotid artery stenting (CAS) was originally developed as an alternative to carotid endarterectomy (CEA) for high-risk patients. CAS is illustrated with before and after angiograms showing severe recurrent stenosis treated with a self-expanding stent. Indications and available outcome data for CEA and CAS are summarized. The future for CAS may well be bright, but the procedure is early in its development. Further trials are needed to demonstrate its long-term efficacy compared with CEA.     

Nursing home costs and quality of care outcomes

The relationship between cost and quality of care in nursing homes was examined using quality indicator measures of resident outcomes. While each individual quality measure makes only small contributions to costs, when considered across the facility, quality could have a substantial financial impact on the operations of the home.     

Race, ethnicity, and insurance as determinants of epidural use: analysis of a national sample survey

Despite widespread availability of pain interventions in childbirth, for most women, childbirth is associated with labor pain that exceeds expectations. Although epidural is superior to other medical interventions, the choice to use epidural still remains a matter of patient and doctor preference. Whether racial or ethnic characteristics influence preference of physician use or interact with insurance coverage is still unknown. This study used a large national sample of women to measure significant determinants of epidural use in order to discuss disparities in pain management. The findings suggest the need for nurse leaders to foster health policies that are sensitive to diversity and economics.     

Luxury for the masses

Increasingly wide income disparities, higher levels of education, and greater awareness of other cultures' ideas of the good life have given rise to a new class of American consumer. And a new category of products and services, including automobiles, apparel, food, wine, and spirits, has sprung into being to cater to it. That category is called new luxury. America's middle-market consumers are trading up to higher levels of quality and taste than ever before. Members of the middle market (those earning $50,000 and above annually) collectively have around $1 trillion of disposable income. And they will pay premiums of 20% to 200% for well-designed, well-engineered, and well-crafted goods that can't be found in the mass middle market and that have the artisanal touches of traditional luxury items. Most important, even when they address basic necessities, such goods evoke and engage consumers' emotions while feeding their aspirations for a better life. Supply-side forces are essential to the rise of new luxury. Like the consumers of their goods, entrepreneurs are better educated and more sophisticated about their customers than ever before. In addition, global sourcing, falling trade barriers and transportation costs, and rising offshore manufacturing standards are making possible the economical production of alluring products of high quality. Unlike old-luxury goods, new-luxury products can generate high sales volumes despite their relatively high prices. As a result, new-luxury companies are achieving levels of profitability and growth beyond the reach of their conventional competitors. Whether the item in question is a $6 Panera sandwich or a $30,000 Mercedes, new luxury is a formula that middle-market companies, facing erosion of their market share by high-end and low-end producers, can ill afford to ignore.