The Need for Hybrid Cars

Since the very conception of the automobile, engineers and designers have been searching for was to make them more efficient and save on fuel consumption. Petrol fuels the majority of vehicles and diesel fuel is used in heavier automotive equipment. The internal combustion engine is considered to be a major if not the biggest source of environmental pollution and the cost of fuel is increasing every day.

With a constant rise in fuel costs and the environmental concerns regarding automobiles, vehicle engineers have had to develop more economical and environmentally safer alternatives to the internal combustion engine that powers most cars. This has led to the birth of the hybrid automobile. These hybrid automobiles offer a number of benefits. The hybrid automobile is a car that is powered by both an electric motor and a gasoline engine. Compared to non hybrid vehicles, the hybrid car saves on the cost of fuel by being more fuel efficient and has a lower rate of fuel consumption.

Hybrid cars operate on a dual mode where the electric motor, powered by batteries, takes over once the gasoline engine has gotten the vehicle up to speed. Braking and deceleration generates energy that is used to charge the electric motor’s batteries. This system allows the hybrid car to provide better fuel efficiency. This also means that the engine of a hybrid vehicle is shut the moment the car is stopped. Considered the biggest advantage to the hybrid car is the reduction of environmental pollution due to fewer emissions of carbon dioxide and other harmful gases in to our atmosphere. Automobile manufactures such as Honda, Toyota, and Ford have already introduced hybrid car models to the commercial market and several others are in development.

Currently there are two types of hybrid vehicles on the market. The first is the “Series” hybrid. A battery powered electric motor powers the Series hybrid car. It also has a gasoline powered engine but it does not singularly power the vehicle. The gasoline engine powers a generator which is used in turn to charge the batteries of the electric motor. The electric motor is left on during the vehicles entire operation however the gasoline engine can be switched on or off depending on the needs of the vehicle. This type of hybrid automobile provides better mileage in city traffic.

The second type of hybrid vehicle on the market is called the “Parallel” hybrid. The Parallel hybrid car, like the Series type, has a gasoline engine and an electric motor. The electric motor and the electric motor can both be used to turn the transmission and power the vehicle. The major difference between the two types of hybrid cars is that the Parallel hybrid uses its electric motor to boost the vehicles power when required to increase the car’s speed. The Parallel hybrid car is considered better suited for the open highway.

Hybrid automobiles provide several benefits due to some very unique features. The construction of the hybrid vehicle uses more lightweight materials than traditional automobile. This saves energy by using less to propel the hybrid car. Hybrid cars also increase energy efficiency because of their more aerodynamic shapes. Tires used by hybrid vehicles run on a higher pressure and are made of a more rigid material than general car tires. The higher pressure helps to increase the vehicles gas mileage per gallon of gasoline used. The overall efficiency of the vehicle is increased by these tires because they reduce friction on road surfaces and provided a grip. The braking system provided an energy transfer from the electric motor to the vehicles batteries when ever the brakes are applied. The overall gas mileage of a hybrid varies from model to model. The EPA test numbers report that the Lexus RX400h receives 31 MPG in the city and 27 MPG the highway while the Honda Insight receives 61 MPG in the city and 68 MPG on the highway.

In conclusion, the future of automobiles is currently the hybrid car and purchasing a hybrid vehicle will not only save you money but will also allow you to take responsibility and do you part in creating a safer, cleaner and greener environment.

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Mobile POS Usage in Hospital Retail Operations

As consumers, most of us have had some exposure to a mobile POS system while either shopping at a retail store, or dining at a restaurant or quick serve establishment. Many restaurant servers now come to the table equipped with a mobile or hand-held device for order taking instead of the traditional order pad and pencil, with the completed table order automatically going to the kitchen, and the server quickly moving on to the next table. In many retail stores, clerks now walk the sales floor with a mobile POS device for line busting to quickly check out customers standing in long lines and get them on their way faster. This not only speeds check out time and increases customer satisfaction, but also reduces the potential for losing a customer.

Healthcare retail offers many opportunities where a mobile POS solution can provide added convenience to employees and guests, expand the functionality already present in a traditional POS system, and greatly improve operational efficiency with cost saving results.

The Cafeteria and Coffee Cart

Take for example the hospital cafeteria with traditional POS terminals situated in the check-out lanes, and additional outdoor seating that opens when the weather permits. Rather than routing patrons through the check-out lanes to pay for food and beverages before seating themselves outside, mobility allows the transaction to be performed at table side giving the employee or guest more time to enjoy their meal and dining experience, or possibly prevent the loss of a customer. With a traditional POS system in place, the cafeteria menu may be broadcasted to the mobile device with detailed sales data rolling into a central data base for reporting and informed decision-making. Mobile solutions are also ideally suited for mobile coffee carts, or mobile food carts where a POS system is needed, but space and portability rules out a large cash register with all its peripheral devices.

Patient Guest Services

A lot of hospitals now offer patient guests the convenience of ordering food and beverages from the cafeteria menu presented on an iPad or Android device, and paying either by cash or credit card on the same device. Just image visiting a friend or family member in their hospital room as patient dining is either taking or delivering their meal. It’s a great comfort and convenience to be able to order and enjoy your meals together.

The Gift Shop and Fundraisers

Usually run by the hospital gift shop, fundraisers are a vital revenue generator for the hospital retail area. Generally held in the hospital lobby, the fundraising event may sell anything from uniforms to jewelry, and are usually geared to the hospital employees. The use of a mobile POS system is ideal for this temporary event, especially when the capability to accept credit card or employee payroll deductions as payment types is enabled.

Tell us about how you’re using a Mobil POS solution in your hospital, or where your operation has a need for it.

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Things To Consider When Selecting An Animal Hospital For Your Pet

It is not wrong to say that after home, an animal hospital is the next important thing for your lovely pet. It is essential to select the one for your pet so that in case of an emergency you can take your pet without any delay. You need to see that the hospital you are selecting has a specialized team of doctors and the trained staff. It is important to note that the animal hospitals aren’t just offering treatment of domestic animals and pets rather wild animals that are ill or injured in any accident.

Selecting a veterinary hospital may seem like a simple task, however there are a number of factors associated with selecting the best hospital for your needs. It is not only the location of the hospital that matters a lot, the hospital must have the hours of operation that match your work schedule.

A special bond is developed between the pets and their owners. It is for this reason; they become your very close friend or family member is a very short duration of time. When you adopt a pet, there come my responsibilities. One of these responsibilities is arranging a suitable animal hospital where general checkups as well as complicated operations in time of need are possible.

In addition to the location, it is also important to consider the services that are available with the hospital. For instance, many animal hospitals offer special appointments or programs to the new clients. They offer expert advice and treatment for elderly animals or those with serious ailments. In the very first meeting, it is important to discuss with your veterinarian what exactly are your expectations and how you want to proceed further.

In addition to above, there are a few other aspects you need to consider while selecting a suitable animal hospital for your pet. For instance you should inquire about the license of the veterinarian and find out if the hospital has a registered veterinary staff or not. There are a number of tests a registered veterinary personnel have to pass. These include the regulated state tests for treating all vets. It is important to go to a registered technician because he will have the skills and experience that are considered must for the examinations and proper treatment of the vets.

You should not allow a non-registered technician to administer pills and shots or to treat your pet as this can prove to be very dangerous. It is also important to first tour any animal hospital to interview the veterinarian. While doing so, you should observe if proper hygiene is maintained in the hospital or not; especially in the surgical rooms and examination rooms.

So, the above mentioned are a few important aspects you need to consider while selecting an animal hospital for your lovely pet.

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Santiago, Chile’s Best Hospitals

Santiago is the capital of Chile and also the largest city of the country. Santiago is the center of finance and trade in Chile and the headquarters of many multinational companies in the country are located here. The city has many well-known shopping centers and high-rise architecture and has become one of the most modern metropolitan areas of Latin America.

Santiago has many good hospitals in both public and private sectors. Many of the leading private hospitals offer world-class health care service, which is affordable too. These hospitals are well equipped and accept all major health insurance companies.

This is a brief description of some of the major hospitals in Santiago.

Clinica Las Condes located at Lo Fontecilla 441 – Las Condes, Santiago is a reputed private hospital in Chile and Latin America that has all modern medical facilities to deliver excellent health care. The hospital founded in 1978 by a famous doctor has now achieved the prestigious Joint Commission International accreditation and has affiliation with Johns Hopkins Medicine International for training. This 220-bedded modern hospital has well equipped specialties in every branches of medicine. The hospital’s surgery department is well known and performs most modern laparoscopic surgery for digestive endocrine tumors, breast surgery using advanced technique like mammography, stereotactic biopsy equipment, and trauma surgery. CLC has facilities in blood bank, clinical laboratory, diagnostic imaging, nuclear medicine and physiotherapy. The hospital has many special centers like anti smoking center, kidney stone, travel medicine, advanced center for epilepsy and spine center. Its new emergency service with separate laboratory system was built under the guidance of Johns Hopkins Hospital,US. This favorite hospital among the foreign patients offers luxurious accommodation and has agreements with all major insurance companies. Phone: (56-2 ) 210 4000

Clínica Alemana is one of the leading private hospitals in Chile and is situated at Av. Vitacura 5951 – Vitacura – Santiago. This hospital was founded by a well-reputed nonprofit foundation-“Sociedad de Beneficencia Hospital Alemán”- that has established many modern hospitals across the country. This 350-bedded hospital with 18 operating rooms offers best medical service to over 35, 000 patients annually by employing more than 700 eminent doctors and 3000 dedicated staff. This multidisciplinary healthcare facility has full-fledged departments in cardiology, ENT, neurology, pediatrics, gynecology, gastroenterology, psychology, bronchopulmonology, physical therapy and many more. Clínica Alemana has many special centers like comprehensive adolescent care unit, breast care center, center for oral and maxillofacial surgery, round the clock blood bank, radiation therapy center, maternity ward, and five well-equipped ICUs. This hospital possesses an outstanding diagnostic imaging department with service in radiology, ultrasound, nuclear medicine, mammography, MRIs, Computed Tomography and angiography. The hospital staffs some of the best surgeons in the country and its surgery department has five different kinds of operating rooms (OR) including main operating room, cardiology OR, obstetrics/ gyn OR. The hospital has well equipped emergency department with separate general emergency room and pediatric emergency room. Clínica Alemana offers comfortable accommodation in various rooms and suites including rooms for non-paying patients and provides all modern facilities. Phones: (56-2) 210 1111

Hospital San Juan De Dios situated at Huérfanos 3255, Santiago, is another major hospital in the city that offers complete and cost effective medical service. The Western Metropolitan Health Service manages this service-oriented polyclinic, founded in 1954.This is also a premier teaching hospital and has affiliation with the University of Chile. Hospital San Juan De Dios has four large buildings and staffs 332 doctors and 17 dental practitioners. The hospital has lounges and restrooms for users, well-equipped coronary care unit, new custom delivery rooms and modern Surgical ICU. The hospital has adult and children sub specialties in all major departments. The hospital has an emergency sector featuring 3 focus rooms of 19 beds, an observation room, a modern recovery room and a procedures room. Hospital San Juan De Dios has implemented AUGE system to improve care for the sick and included more than 50health problems in this like chronic renal failure, cancer, rheumatoid arthritis, advanced palliative care and congenital heart diseases in children. Phone: (0)2 360 1053

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Storing Linens in a Hospital

Clean and sterile linens, changed frequently, can create the baseline of infection control at any major health care facility, but creating a proper linen care policy does not happen by accident. A hospital administrator needs to establish and enforce strict policies for storing bedding and other cloth in the hospital, whether soiled or clean.

Soiled Linens

Staff members tasked with the removal of soiled linens should be trained in the proper removal and handling of dirty sheets, towels and washcloths. While at home it may be no big deal to shake sheets out to find wayward socks, hospital staff need to be reminded that virtually every patient is a potential source of infection. Staff members should wear gloves whenever handling soiled bedding, and it should be folded toward the middle so that any contaminants in the sheets remain there.

Once the soiled bedding is collected, it should be placed in clearly marked carts or in bags which can then be closed, preventing infectious material and odors from the linens from permeating the area.

Soiled linens should then be pretreated with stain remover as necessary and placed in a loosely loaded washing machine. Stuffing as many sheets as possible into the washer is a good way to prevent cleanliness. They should be washed in hot water and detergent for a minimum of 10 minutes at 105 degrees Fahrenheit before being dried in dryers that reach a minimum of 160 degrees.

Clean Linens

Clean linens should be handled by staff members also wearing gloves to prevent them from transferring contaminants. Clean linens should be folded in an area separate from the handling area for soiled linens. Once folded, the bedding must be placed in clean laundry bags or on covered laundry carts for transporting to proper storage areas.

Unlike a home linen closet which typically gets cleaned during spring and fall cleaning or when things start tumbling down, hospital linen storage areas should be sanitized and sterilized often, preferably at least once a week. Clean linens should be kept in orderly stacks in the linen storage facility and removed only as needed. For transport between the linen storage area and the site where they are needed, clean linens should be kept on a linen cart which is sterilized daily. The cart should be kept covered.

The recommendations for hospital linen storage help prevent the spread of infectious disease and can easily be met by a professional linen service. A professional linen service can be contracted to maintain the cleanliness of the hospital’s linen storage area as well as providing clean and sanitized linens. Professional linen services can provide proper storage and delivery of hospital linens as well as inventory and linen maintenance.

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Things To Keep In Mind While Designing A Hospital Logo

Hospital services are increasing and becoming like any other corporate business day by day therefore a hospital logo should be managed like any other corporate identity.

Hospital logo design is the best way to represent the healthcare services you intend to provide to your target audience.

It is the graphic representation of your hospitals identity. By looking at the logo your target audience gets an idea of your professionalism and expertise. What things should be kept in mind while designing a hospital logo?

• What’s the hospital mission and for whom are you designing the logo for?

The first thing you should be very clear is what is the mission of the hospital? Is it providing services to the under privileged or is targeting the elites of the society.

For instance if you are targeting the underprivileged class of the society logo should reflect a warm feeling, use of soft colors with images people easily relate conveys your message to your audience in a much effective way.

A more businesslike approach is required for targeting the elite using sharp colors and images with bold outlook attracts the elites and educated class.

• Appropriate Choice for hospital logo design

Color

Color choice is very important while creating a hospital logo. It should be designed to grab the attention of the audience while giving them a sense of security and trust. Colors play an effective role in conveying what your hospital services stands for, usually red, blue, green or any bright color is used in hospital logo mainly to grab the attention.

Graphic

Most people hold the misconception that a logo should always suggest what a company does. This is not true for instance it is not always necessary to show a dry cleaning machine in a cleaning logo. Hospital logos should show the specialties that you offer, the graphics and symbols used in the logo should convey the sense of comfort and professionalism. Use of relevant medical symbols or images of the areas of specialty like orthopedics or gynecology change the entire look of the logo giving it a feel of geniuses and effectiveness.

Font

Font is yet another important part of your logo design. Using a stylish perky font for a hospital design is appropriate?? Always use a simple straight font that is readable and understandable by all audience.

Like any other business a hospital also has its own personality but most often we see almost similar logos presenting different hospitals using identical images, fonts and colors.

The most important thing for a hospital is to build trust and reliability among the audience therefore hospital logos should be designed while keeping in the mind the individuality, trust, responsibility as well as it should be compelling.

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Three Good Hospitals in Baku

The Republic of Azerbaijan is one of the previous constituent republics that made up the United Soviet Socialist Republic or the USSR. The country is located in Transcaucasia, on the shores of the Caspian Sea. It has Russia, Georgia, Armenia and Iran, as its neighbors. Azerbaijan underwent a lot of political assaults and disputes. However, as of late, it has come out of its past and is gradually developing an independent economy, by banking on its oil and gas resources. The healthcare industry is not very well developed, but it has come a long way from the past.

The country has Baku as its capital city. Baku is a top tourist spot and draws huge numbers of visitors, from all corners of the world. The medical facilities are among the best available in all of Azerbaijan. There are both public hospitals as well as privately run clinics in Baku. The public hospitals house ample beds but suffer from lack of adequate practitioners or related staff. However, for basic treatment tourists can seek the aid of these public hospitals.

The private clinics are a better option for more specialized treatment and complications. These clinics along with few international hospitals offer up to date, quality treatment to their visitors. There are separate wards for accidents and emergencies as well. The doctors are well qualified. The hospitals have labs attached that give accurate test results. The nurses are well trained and extremely caring as well. The hospitals have a sufficient number of beds. However, patients are recommended to bring their own basic toiletries as Baku clinics often fall short in that area.

Language seems to be the main concern of foreign patients of Baku hospitals. As of late it has been observed that many Baku doctor are comfortable conversing with their patients in English. It is, however, always safe to get in touch with your respective embassies, in order to obtain a list of doctors who speak your language.

The most popular hospitals and clinics among tourists visiting Baku are Western Medical, Turkish-American Medical Centre, Oil Workers Hospital, Mediclub Centre, Mediclub Paedriatic, German Medical Hospital, and Central Clinical Hospital.

MediClub Centre:

More than a traditional Hospital, the MediClub Centre can be branded as a complete medical assistance organization. Tourists can receive excellent treatment at MediClub Centre. The doctors and staff are very conversant in English, the wards are clean and there are specialized departments to treat various types of illnesses. The food served at this center is of great quality and the help lines to the clinics are open round the clock. The ambulance service is very active and will be able to provide emergency transportation easily. The doctors and nurses take proper care to ensure the satisfaction of all of their patients. All that expats need to receive care from this center is a card that allows them to access the quality services on offer by the MediClub group.

German Medical Hospital:

Set up under German authority, the German Medical hospital is one of the leading medical service providers in Baku. The staff members are well qualified and trained in the western methods of medicine. The facilities are up to date as is the equipment which is state of art. Tourists may also come across staff who possess a working knowledge of English.

Turkish-American Medical Centre:

Dating back to 1998, the Turkish-American Medical Centre is one of the most modernized medical centers that caters to tourists and residents alike. The treatment methods, labs and facilities are all at the latest standards. The staff and doctors are committed and well qualified. The hospital has departments for almost all aspects of medicine and diseases.

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Jerusalem's Best Hospitals

Jerusalem, the capital of Israel, lies in the Judean Mountains nestled between the Mediterranean Sea and the Dead Sea. Together with East Jerusalem it forms the largest city of the country. It is a great tourist attraction for religious and cultural reasons.

Bikur Cholim Hospital is situated in the heart of the city at the junction of Strauss and Hanevi'im, Jerusalem, 492. It was set up in 1826 and over the years it has emerged as one of the largest and most important hospitals of Israel. The branches of medicine for which the hospital offers treatment are surgery, pediatrics, ENT, internal medicine, obstetrics and gynecology, nephrology, neurology and urology. The hospital also has an Alternative Medicine Clinic, Neonatal Intensive Care Unit, Baby Welfare Clinic and a Women's Clinic. The emergency department at the hospital offers quality services to its patients and is also the largest emergency department in Israel.

The Shaare Zedek Medical Center located at Jaffa Road is a century old hospital that provides high quality medical care. The hospital started as a modest healthcare center with 20 beds and is now a modern hospital with state of art infrastructure. It is a multidisciplinary hospital of international repute which specializes in the following fields: cardiology, cardiothoracic surgery, women's health, medical genetics, neonatology, pediatric neurology, oncology and palliative medicine, laparoscopic surgery and Gaucher's Disease. The Emergency Department at the hospital is well equipped and this department includes the Kennedy Leigh Trauma & Resuscitation.

The ALYN Pediatric and Adolescent Rehabilitation Center was set up as a voluntary organization by Dr. Henry Keller, an American orthopedist in 1932. The multidisciplinary hospital is dedicated to providing modern and advanced care to children. The hospital provides an array of medical and paramedical services that include physiotherapy, speech therapy, rehabilitation, cerebral palsy, acquired brain damage, respiratory disorders, and psychosocial problems. It is also is the leading pediatric orthopedic clinic in the country treating both simple and highly complex cases.

The St John of Jerusalem Eye Hospital Group is part of the Foundation of The Order of St John which is the oldest charity in the world. This hospital is known for its high level of services and specialization in eye related ailments throughout the West Bank, Gaza and East Jerusalem. The hospital has an ISO accreditation and is staffed by well trained doctors and paramedical staff from within the country and from offshore countries as well. This modern hospital runs a 24 hours emergency room and also runs an outpatient department and treats patients regardless of their ability to pay. The hospital specializes in Retinal, Corneal and Pediatric services. The address and telephone number for the hospital are; Nashashibi Street, Sheikh Jarrah, Jerusalem 97200; Tel: 00 972 (0) 2 5828325

Hadassah's Medical Organization has two medical centers at Jerusalem; one is at Ein-Karen and the other is at Mount Scopus. Both the hospitals have a large team of doctors and support staff which makes them ready to deal with all kinds of medical emergencies and routine procedures and care. The Hadassah is known for its proficient services and contemporary infrastructure. Both the centers are multidisciplinary and the medical branches for which they provide services are orthopedic surgery, neurosurgery, oncology, rehabilitation, dermatology, ENT, endocrinology, hematology, genetics and metabolic disease, bone marrow transplant and psychiatry. The hospitals are also outfitted with Emergency Rooms, Trauma Units, Pain Clinics and Blood Banks. The Emergency Department at Ein-Karen provides comprehensive and quick care to patients for a large range of medical problems and is supported by modern technology. The Mount Scopus Emergency Department receives a large number of patients each year owing to its highly specialized care especially in the neurological and cardiac surgery field.

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Survey Shows US Families Who Can’t Pay Hospital Bills Still High

A study by the The Commonwealth Fund, a private institution in the United States which seeks to promote a better health system, showed that a third of American adults forgo a visit to the hospital because they either have no insurance or a plan that is inadequate for their true needs. Those who seek medical care and pay their hospital bills did not end up any better anyway because they have no money to purchase medicines. Contrast that with some areas in Europe such as United Kingdom and the Netherlands, for example, which boast of just 5-6 percent slippage in the number of patients in population who failed to seek medical care due to insurance concerns.

The same survey showed that one in five adults or about 20% in the US could not pay hospital bills. You know what’s the second developed country in the list? France, with a measly nine percent. The issues don’t stop there because the U.S. also has one of the highest out-of-pocket expenses-meaning the amount patients pay before insurance kicks in-for medical bills in the world, right up there (or to be more specific, right down there) with other third world countries with poor government allocation for health service.

The study compared the health care systems in 11 countries like Canada, Australia, U.K., Switzerland, Sweden, Norway, the Netherlands, Australia, France, U.S. and Germany. The gap between the rich and the poor has more impact on the capacity of the patient to pay hospital bills compared to other countries where the “haves” usually foot the bill for the “have-nots.”

The report result is nothing new, of course, because it only confirms what most of us already knows: there’s a need to reform the U.S. health system.

The study analyzes findings from the Commonwealth Fund 2010 International Health Policy Survey in Eleven Countries, focusing on insurance and access to health care experiences reported by 19,700 adults from Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, the United Kingdom and the United States. The study reveals widespread disparities by income within the United States. Lower income U.S. adults were far more likely than those with above average incomes to report difficulty with medical bills and timely access to health care.

“We spend far more on health care than any of these countries, but this study highlights pervasive gaps in U.S. health insurance that put families’ health and budgets at risk,” said Commonwealth Fund Senior Vice President Cathy Schoen, lead author of the article. “In fact, the U.S. is the only country in the study where having health insurance doesn’t guarantee you access to health care or financial protection when you’re sick. This is avoidable – other countries have designed their insurance systems to value access and limit out-of-pocket costs.”

A new 11-country survey from The Commonwealth Fund finds that adults in the United States are far more likely than those in 10 other industrialized nations to go without health care because of costs, have trouble paying medical bills, encounter high medical bills even when insured, and have disputes with their insurers or discover insurance wouldn’t pay as they expected. According to the report, the findings highlight the need for Affordable Care Act reforms that will ensure access to health care, protect people from medical debt, and simplify health insurance.

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Giving Birth in Shaarei Zedek Hospital of Jerusalem, Israel

More pregnant women choose to give birth in Shaarei Zedek hospital, Jerusalem, than any other hospital in Israel. They must be doing something mothers like.

In 2012, there were more than 15,000 births in Shaarei Zedek. This figure does not include any births related to their taking over the management of Bikur Cholim hospital in late December 2012.

In 2013, the combined total of the two locations under their management was over 20,000 births! On average, there were 41 births a day in Shaarei Zedek alone, not including Bikur Cholim.

Shaarei Zedek’s magazine reports that the cesarean rate in 2013 was 11%. Professor Samuelov, the director of the department of obstetrics and gynecology, emphasized that “This is one of the lowest cesarean rates in the country, and the reason for it is that Jerusalem is a very supportive environment for normal birth. We provide assistance and ideal treatment for women who desire to give birth normally, and ensure ways to do it safely. We have a lot of experience, and we have the knowledge and ability to prevent cesareans in certain cases. We make it possible to have a normal birth even after two cesareans, for breech presentations and for twins, something that isn’t accepted in most places.”

As Professor Samuelov notes, “Jerusalem is a very supportive environment for normal birth” because many pregnant women in Jerusalem “desire to give birth normally”. Why is this desire stronger and more common in Jerusalem than it is in other parts of the country? Apparently, the reason is that more women in this locality belong to ethnic groups with a high birth rate. Simply, avoiding an unnecessary cesarean is much more important to mothers who intend to have many children than it is to women who don’t, because of the increased rate of complications in subsequent pregnancies for women with a previous cesarean.

Professor Samuelov explains that his department tries hard to keep the cesarean rate down in order to give pregnant women what they want most. In order to do this safely, Shaarei Zedek provides top-quality medical care, including a carefully supervised trial of labor after two cesareans, and breech births in selected cases.

Supplying what women want means that more pregnant women choose to give birth in Shaarei Zedek hospital, which increases its income, since Israel’s National Insurance Institute pays hospitals very well for births. The fact that Shaarei Zedek officially observes the Sabbath also helps the hospital to attract religious women who have a high birth rate. Two out of three pregnant women in Jerusalem choose one of the hospitals under their management, and only one in three choose one of the Hadassah hospitals. Attracting a greater market share of births is what keeps Shaarei Zedek’s finances in good condition, while the two Hadassah hospitals are having great financial difficulties. As a childbearing woman, you are likely to benefit from choosing a hospital that doesn’t have to cut back on services to patients.

The high birth rate itself provides an incentive to the hospital to keep the cesarean rate down, because the more cesareans a women had, the greater the risk of complications in subsequent pregnancies and deliveries, even if they are delivered by repeat cesarean. Obstetricians in Jerusalem have seen more of these complications than doctors in other places because they serve a population with a high birth rate. Providing the option of regular birth after one or two cesareans for women who want large families prevents a lot of risky high-order repeat cesareans, the kind of surgery that doctors in Jerusalem would rather avoid having to perform.

Presumably, the director of obstetrics in Shaarei Zedek terms Jerusalem “a very supportive atmosphere for normal birth” due to the combination of its high birth rate and competition between the local hospitals.

If it is important to you to participate in decision-making, Shaarei Zedek is very amenable to this. On a recent tour of the delivery suite, without being asked, the midwife leading the tour mentioned the importance of involving the mother in decision-making.

Dr. Abulafia, a retired obstetrician who worked in Shaarei Zedek, in an interview for Shaarei Zedek’s magazine, described the differences between the mother’s participation nowadays and in the past: “The involvement of the childbearing woman has changed noticeably. The accessibility of information, the calculators in the internet, the great variety of medical tests and the modern equipment for imaging and surveillance, have all made the mother into a real partner. In the past it was the doctor who knew and understood, and the patient put herself in his hands. Today, pregnant women come to us with a great deal of knowledge, and this obligates the doctor to keep updated in order to be able to answer any question.”

Shaarei Zedek’s magazine also interviewed the head midwife, Chava Chacham. She too addressed the topic of the mother’s participation: “In the course of the pregnancy, the couple is exposed to a lot of information. In many cases, they ask to be participants in planning the course of the birth and make special requests. We advise mothers to share her desires with us when she arrives at the delivery suite so we can coordinate expectations together. Some women are interested in delayed cutting of the umbilical cord, others request not to bathe the baby immediately. We respect every request. Our staff believes in the autonomy of the childbearing woman’s decisions, and we will do whatever is possible to answer her requests openly and in cooperation. As long as the birth proceeds safely and there is no medical problem, the decision is in the hands of the woman giving birth. There are some women interested in an epidural, others prefer that we decide for them. Many women choose to give birth naturally, and in order to help them to carry out their wishes, some of our midwives took continuing education courses in yoga and relaxation – techniques that help reduce both tension and pain.”

What this means for you as a childbearing woman is that on any given shift, there are likely to be some midwives who enjoy supporting natural birth, and you can probably get one if you request this. If you don’t say anything about your preferences, your midwife may presume that you would like her to recommend when she thinks you would benefit from an epidural. The head midwife of Shaarei Tzedek advises you to tell the staff in the examining room what approach you prefer, natural birth or epidural. If you follow her advice, they will be able to assign a midwife who is most appropriate for you. This will enable both you and the midwife will find the experience as rewarding as it can be.

Only 55% of all women giving birth in Shaarei Zedek request an epidural, but 80% of all first-time mothers get an epidural. In comparison, in hospitals in the center of the country, 80 to 90% receive epidural. One of the reasons for the low rate of epidural usage is that Shaarei Zedek serves a population with a high birth rate, meaning a high percentage of the births there are not first births.

Shaarei Zedek has its own nursing school. Of all departments in a hospital, the quality of the nursing staff is most important in the delivery suite, because medical care during normal uncomplicated childbirth is provided by midwives, not doctors. Having a staff of top midwives means a higher likelihood that childbirth will remain normal and uncomplicated.

You can choose to give birth on their birth stool, which makes the birth more modest and faster and may also be more comfortable for you.

Until recently, Sharei Zedek had three maternity wards with 134 beds. In early 2014, they opened a fourth maternity ward in their new building, with an additional 40 beds. The new ward offers full rooming-in, in which the baby is next to his/her mother almost all hours of the day, including at night. Babies in full rooming-in are taken to the newborn nursery for examinations four times a day. Every mother receives instructions how to care for her baby on her own, but if she wants a short break, she can bring him to the nursery. All three pre-existing maternity wards have partial rooming-in.

Shaarei Zedek also moved its neonatal special care unit to the new building in early 2014. The new unit has 70 beds, enough to handle expected growth in the next few years, as well as the most advanced equipment available today, including things that no other hospital in the country has. Although the old unit had only about 35 beds, almost immediately, the new unit began to care for an average of 50 babies at a time! Two reasons could be contributing to this sudden increase: more mothers whose babies were likely to need special care decided to give birth in Shaare Zedek and/or more babies born elsewhere were transferred here to get the best neonatal special care available in Israel, and among the best in the world.

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