What Practices Does John Hopkins Medical Center Seem to Use to Help Employees Minimize Stress
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Considering his wealth a trust, Johns Hopkins used it for the benefit of humanity. By 1873, the year of his death, Johns Hopkins had outlined his wishes: to create a university that was dedicated to advanced learning and scientific research, and to establish a hospital that would administer the finest patient care, train superior physicians and seek new knowledge for the advancement of medicine. In appointing a Board of Trustees to carry out his vision, Johns Hopkins selected the intellectuals of his town. They, in turn, created an environment that attracted top educators and medical professionals to direct the university and hospital. Hopkins never married, never had children who might inherit his wealth, and some people with a taste for romantic tragedy suggest that if Hopkins’ family and his religion had not pressured him out of marrying the one woman he truly loved, neither The Johns Hopkins Hospital nor The Johns Hopkins University would ever have been established.
The health care sector in the United States consists of an array of clinicians, hospitals and other health care facilities, insurance plans, and purchasers of health care services, all operating in various configurations of groups, networks, and independent practices. Some are based in the public sector; others operate in the private sector as either for-profit or not-for-profit entities. The health care sector also includes regulators, some voluntary and others governmental. Although these various individuals and organizations are generally referred to collectively as “the health care delivery system,” the phrase suggests an order, integration, and accountability that do not exist. Communication, collaboration, or systems planning among these various entities is limited and is almost incidental to their operations. For convenience, however, the committee uses the common terminology of health care delivery system. However, even when the uninsured receive care, they fare less well than the insured. The IOM Committee on the Consequences of Uninsurance found that “[u]ninsured adults receive health services that are less adequate and appropriate than those received by patients who have either public or private health insurance, and they have poorer clinical outcomes and poorer overall health than do adults with private health insurance” (IOM, 2002a: 87). For example, Hadley and colleagues (1991) found that uninsured adult hospital inpatients had a significantly higher risk of dying in the hospital than their privately insured counterparts. Emergency and trauma care were also found to vary for insured and uninsured patients. Uninsured persons with traumatic injuries were less likely to be admitted to the hospital, received fewer services when admitted, and were more likely to die than insured trauma victims (Hadley et al., 1991).
To summarize, six years before his death, Johns Hopkins organized two corporations, one for a hospital and one for a university, and his will (1870) divided $7,000,000 equally between them. He also endowed an orphanage for black children. Johns Hopkins University opened its doors in 1876, the hospital in 1889; and a medical school utilizing the facilities of both held its first class—admitting women on the same basis as men—in 1893.
Haas JS, Adler NE. 2001. The causes of vulnerability: disentangling the effects of race, socioeconomic status and insurance coverage on health. Background paper prepared for the Institute of Medicine Committee on the Consequences of Uninsurance.
Hadley J, Steinberg EP, Feder J. 1991. Comparison of uninsured and privately insured hospital patients: condition on admission, resource use, and outcome. Journal of the American Medical Association 265(3):374–379
IOM. 2002. c. Setting the Course: A Strategic Vision for Immunization Part 1: Summary of the Chicago Workshop. Committee on the Immunization Finance Dissemination Workshops, Division of Health Care Services, Institute of Medicine. Washington, DC: The National Academies Press.