Sound management of hospital in Japan in general has become more and more difficult with frequent reductions in the fees officially paid to medical institutions for medical examinations and treatments, and this current situation obviously necessitates a more efficient way of hospital management and ardent efforts at improvement on the part of our hospital as well. The Division on Nursing has set the goals to implement thoroughgoing cost-management strategies and to strengthen cooperation with other divisions. For this purpose we visited the hospital wards jointly with other personnel from the Divisions of Medical Materials and Dispensary to check inventories of medical materials and to make them optimum. As a result, it was found that medical materials were often improperly placed, stored excessively, or returned inaccurately. The instructions for redefining the proper quota of the medical materials per ward, putting them in order and returning them properly in case of excess facilitated direct communication and cooperation between divisions, and resulted in inventory reduction and thus the annual costs of returning them. These efforts successfully inspired each staff member to participate voluntarily in the management of our hospital, which eventually led to reasonable inventory control of medical materials. It would be important for each division, while demonstrating its specialty, to realize the importance of cooperation to reach far greater achievements.
Hospitals ; Materials ; seconds ; cooperation ; Medical

Between February 1999 and November 1999, 33 patients (age 67.0±7.6 years old) underwent off-pump CABG using coronary shunt tubes. The number of graft anastomoses per patient was 2.8±0.8. The operative mortality was 0%. There was no incidence of on-pump conversion, low cardiac output syndrome, IABP insertion, mediastinitis or stroke. The maximum CPK-MB during the perioperative period was 25.9±18.8IU/l. One patient had perioperative myocardial infarction probably due to native coronary artery spasm. In patients with off-pump CABG, the intubation time, the ICU stay and the hospital stay were shorter. The number of patients who were extubated in the operating room was higher and the cost was lower than those with on-pump CABG. An early phase study revealed patency ratios of 85% (the previous term) and 97% (the latter term). Off-pump CABG is a safe and effective means of revascularization with no mortality, minimal morbidity and good short-term patency.