新视野大学英语读写教程听力 第三册 te-unit07-c

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[00:04.32]1  Open-heart surgery at the Medical Center Hospital of Vermont
[00:11.30]used to cost patients an average of $26,300.
[00:18.07]Today it's $3,000 less.
[00:22.82]2  Also saved: patients' discomfort.
[00:28.26]They used to suffer for about 37 hours
[00:33.23]after surgery on average with a plastic tube
[00:37.30]as thick as a thumb running through their mouth or nose
[00:40.82]and down 11 inches of their throat.
[00:44.24]The tube assists breathing,
[00:48.60]but patients say it feels like a fire running through their throat and hurts
[00:54.14]more than having their chest cut open.
[00:57.53]3  Two years ago, a 15-member team at the 115-year-old teaching hospital,
[01:06.46]under pressure to cut costs from a health maintenance organization (HMO),
[01:09.70]was given permission by the hospital's top manager
[01:13.40]to find a way to get the tube removed sooner.
[01:17.62]That would ease the pain and help the hospital
[01:21.36]transfer patients from the intensive care area — an area
[01:26.54]that charges patients or their insurance company $1,600 a day — sooner.
[01:34.54]The hospital was facing an expensive expansion to the building
[01:39.83]because of a continual shortage of beds in intensive care.
[01:44.58]Transferring patients sooner
[01:48.47]would eliminate the need for additional rooms and beds.
[01:53.11]4  Until recently, many hospitals would have resisted steps
[01:59.27]that moved patients out of intensive care and into a room
[02:03.55]that costs $800 a day.
[02:06.43]But the national effort to reduce health care costs
[02:11.80]has resulted in dramatic changes in the way hospitals think.
[02:16.48]Insurance companies and HMOs increasingly are paying
[02:23.42]hospitals a set amount for each patient,
[02:26.84]regardless of how long they say.
[02:30.62]One HMO was threatening to move its heart-surgery patients
[02:36.89]from Medical Center Hospital to a different hospital,
[02:40.96]if the Medical Center Hospital didn't get its costs down.
[02:46.10]5  The team — six doctors, three nurses,three breathing specialists,
[02:52.69]two drug experts and a manager
[02:55.64] — studied the situation and camp up with improvements
[02:59.86]that earned the team a special award for quality improvement.
[03:05.11]6  Thanks to the team,
[03:07.67]the hospital stay of an open-heart surgery patient
[03:12.02]dropped from an average of nine days to seven days.
[03:17.50]Some leave in just five days.
[03:21.85]Patients typically have the tubes in their throats about 29 hours.
[03:29.84]And death rates have gone down slightly,
[03:34.02]possibly because fewer infections set in once any foreign object is removed.
[03:40.75]7  Early on, the team used the quality-improvement concept
[03:46.33]known as benchmarking
[03:48.56]— adopting the best methods or processes used by other companies.
[03:54.07]The members borrowed a seven-step
[03:57.71]problem-solving process from an electric company.
[04:01.88]Each meeting focused on one step.
[04:06.35]First, they tried to understand what was wrong with the process
[04:12.61](the treatment of heart patients after surgery).
[04:16.18]At the second meeting, they set a target for improvement.
[04:22.33]8 Team members also studied the medical literature
[04:27.52]and interviewed new employees who had worked at other hospitals.
[04:32.92]They discovered some hospitals were removing the tube much faster.
[04:40.22]The hospitals had cut way back on the large amounts of pain-killing drugs
[04:47.21]usually given during and after surgery that were used primarily
[04:52.54]to control blood pressure, not pain.
[04:56.35]9  "This was a story about results," says the judge
[05:01.93]who gave the team the quality award.
[05:05.50]"With their new post-surgery process,
[05:09.24]they have given themselves a greater ability to respond to health care reform."
[05:08.24]By using pain-killing drugs that wear off quickly and a simple pain medicine,