Academic literature on the topic 'Discharge calls'
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Journal articles on the topic "Discharge calls"
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Schuller, Kristin A., Szu-Hsuan Lin, Larry D. Gamm, and Nicholas Edwardson. "Discharge Phone Calls." Journal for Healthcare Quality 37, no. 3 (2015): 163–72. http://dx.doi.org/10.1111/jhq.12051.
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Cave, Lucinda A. "Follow-up Phone Calls after Discharge." American Journal of Nursing 89, no. 7 (July 1989): 942. http://dx.doi.org/10.2307/3426370.
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CAVE, LUCINDA A. "FOLLOW–UP PHONE CALLS AFTER DISCHARGE." AJN, American Journal of Nursing 89, no. 7 (July 1989): 942–43. http://dx.doi.org/10.1097/00000446-198907000-00015.
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O’Neill, S. E., and J. Newman. "Discharge follow-up phone calls for BMT patients." Biology of Blood and Marrow Transplantation 12, no. 2 (February 2006): 150. http://dx.doi.org/10.1016/j.bbmt.2005.11.464.
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Morse, Lucy, Linda Xiong, Vanessa Ramirez-Zohfeld, Scott Dresden, and Lee Lindquist. "Tele-Follow-Up of Older Adult Patients from the Geriatric Emergency Department Innovation (GEDI) Program." Geriatrics 4, no. 1 (January 29, 2019): 18. http://dx.doi.org/10.3390/geriatrics4010018.
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The objective of this study was to characterize the content and interventions performed during follow-up phone calls made to patients discharged from the Geriatrics Emergency Department Innovation (GEDI) Program and to demonstrate the benefit of these calls in the care of older adults discharged from the emergency department (ED). This study utilizes retrospective chart review with qualitative analysis. It was set in a large, urban, academic hospital emergency department utilizing the Geriatric Emergency Department Innovations (GEDI) Program. The subjects were adults aged 65 and over who visited the emergency department for acute care. Follow-up telephone calls were made by geriatric nurse liaisons (GNLs) at 24–72 h and 10–14 days post-discharge from the ED. The GNLs documented the content of the phone calls, and these notes were analyzed through a constant comparative method to identify emergent themes. The results showed that the most commonly arising themes in the patients’ questions and nurses’ responses across time-points included symptom management, medications, and care coordination (physician appointments, social services, therapy, and medical equipment). Early follow-up presented the opportunity for nurses to address needs in symptom management and care coordination that directly related to the ED admission; later follow-up presented a unique opportunity to resolve sub-acute issues that were not addressed by the initial discharge plan and to manage newly arising symptoms and patient needs. Thus, telephone follow-up after emergency department discharge presents an opportunity to better connect older adults with appropriate outpatient care and to address needs arising shortly after discharge that may not have otherwise been detected. By following up at two discrete time-points, this intervention identifies and addresses distinct patient needs.
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Ng, Y. H., D. V. Pilcher, M. Bailey, C. A. Bain, C. MacManus, and T. K. Bucknall. "Predicting Medical Emergency Team Calls, Cardiac Arrest Calls and Re-Admission after Intensive Care Discharge: Creation of a Tool to Identify At-Risk Patients." Anaesthesia and Intensive Care 46, no. 1 (January 2018): 88–96. http://dx.doi.org/10.1177/0310057x1804600113.
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We aimed to develop a predictive model for intensive care unit (ICU)–discharged patients at risk of post-ICU deterioration. We performed a retrospective, single-centre cohort observational study by linking the hospital admission, patient pathology, ICU, and medical emergency team (MET) databases. All patients discharged from the Alfred Hospital ICU to wards between July 2012 and June 2014 were included. The primary outcome was a composite endpoint of any MET call, cardiac arrest call or ICU re-admission. Multivariable logistic regression analysis was used to identify predictors of outcome and develop a risk-stratification model. Four thousand, six hundred and thirty-two patients were included in the study. Of these, 878 (19%) patients had a MET call, 51 (1.1%) patients had cardiac arrest calls, 304 (6.5%) were re-admitted to ICU during the same hospital stay, and 964 (21%) had MET calls, cardiac arrest calls or ICU re-admission. A discriminatory predictive model was developed (area under the receiver operating characteristic curve 0.72 [95% confidence intervals {CI} 0.70 to 0.73]) which identified the following factors: increasing age (odds ratio [OR] 1.012 [95% CI 1.007 to 1.017] P <0.001), ICU admission with subarachnoid haemorrhage (OR 2.26 [95% CI 1.22 to 4.16] P=0.009), admission to ICU from a ward (OR 1.67 [95% CI 1.31 to 2.13] P <0.001), Acute Physiology and Chronic Health Evaluation (APACHE) III score without the age component (OR 1.005 [95% CI 1.001 to 1.010] P=0.025), tracheostomy on ICU discharge (OR 4.32 [95% CI 2.9 to 6.42] P <0.001) and discharge to cardiothoracic (OR 2.43 [95%CI 1.49 to 3.96] P <0.001) or oncology wards (OR 2.27 [95% CI 1.05 to 4.89] P=0.036). Over the two-year period, 361 patients were identified as having a greater than 50% chance of having post-ICU deterioration. Factors are identifiable to predict patients at risk of post-ICU deterioration. This knowledge could be used to guide patient follow-up after ICU discharge, optimise healthcare resources, and improve patient outcomes and service delivery.
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Plakogiannis, Roda, Ana Mola, Shreya Sinha, Abraham Stefanidis, Hannah Oh, and Stuart Katz. "Impact of Pharmacy Student–Driven Postdischarge Telephone Calls on Heart Failure Hospital Readmission Rates: A Pilot Program." Hospital Pharmacy 54, no. 2 (April 18, 2018): 100–104. http://dx.doi.org/10.1177/0018578718769243.
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Background: Heart failure (HF) hospitalization rates have remained high in the past 10 years. Numerous studies have shown significant improvement in HF readmission rates when pharmacists or pharmacy residents conduct postdischarge telephone calls. Objective: The purpose of this retrospective review of a pilot program was to evaluate the impact of pharmacy student–driven postdischarge phone calls on 30- and 90-day hospital readmission rates in patients recently discharged with HF. Methods: A retrospective manual chart review was conducted for all patients who received a telephone call from the pharmacy students. The primary endpoint compared historical readmissions, 30 and 90 days prior to hospital discharge, with 30 and 90 days post discharge readmissions. For the secondary endpoints, historical and postdischarge 30-day and 90-day readmission rates were compared for patients with a primary diagnosis of HF and for patients with a secondary diagnosis of HF. Descriptive statistics were calculated in the form of means and standard deviations for continuous variables and frequencies and percentages for categorical variables. Results: Statistically significant decrease was observed for both the 30-day ( P = .006) and 90-day ( P = .007) readmission periods. Prior to the pharmacy students’ phone calls, the overall group of 131 patients had historical readmission rates of 24.43% within 30 days and 38.17% within 90 days after hospital discharge. After the postdischarge phone calls, the readmission rates decreased to 11.45%, for 30 days, and 22.90%, for 90 days. Conclusion: Postdischarge phone calls, specifically made by pharmacy students, demonstrated a positive impact on reducing HF-associated hospital readmissions, adding to the growing body of evidence of different methods of pharmacy interventions and highlighting the clinical impact pharmacy students may have in transition of care services.
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Bauer, Eric E., Achim Klug, and George D. Pollak. "Spectral Determination of Responses to Species-Specific Calls in the Dorsal Nucleus of the Lateral Lemniscus." Journal of Neurophysiology 88, no. 4 (October 1, 2002): 1955–67. http://dx.doi.org/10.1152/jn.2002.88.4.1955.
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This study evaluated how neurons in the dorsal nucleus of the lateral lemniscus (DNLL) in Mexican free-tailed bats respond to both tone bursts and species-specific calls. Up to 20 calls were presented to each neuron, of which 18 were social communication and 2 were echolocation calls. We also measured excitatory response regions (ERRs): the range of tone burst frequencies that evoked discharges at a fixed intensity. Neurons were unselective for one or another call in that each neuron responded to any call so long as the call had energy that encroached on its ERR. Additionally, responses were evoked by the same set of calls, and with similar spike counts, when they were presented normally or reversed. By convolving activity in the ERRs with the spectrogram of each call, we showed that responses to tones accurately predicted discharge patterns evoked by species-specific calls. DNLL cells are remarkably homogeneous in that neurons having similar BFs responded to each of the species-specific calls with similar response profiles. The homogeneity was further illustrated by the ability to accurately predict the response profiles of a particular DNLL cell to species-specific calls from the ERR of another similarly tuned DNLL cell. Thus DNLL neurons tuned to the same or similar frequencies responded to species-specific calls with latencies and temporal discharge patterns that were so similar as to be virtually interchangeable. What this suggests is that DNLL responses evoked by complex sounds can be largely explained by a simple summation of the excitation in each neuron's ERR. Finally, superimposing the spectrograms of each call on the responses evoked by that call revealed that the DNLL population response re-creates both the spectral and the temporal features of each signal.
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Darcy, Ann Marie, Gina A. Murphy, and Susan DeSanto-Madeya. "Evaluation of Discharge Telephone Calls Following Total Joint Replacement Surgery." Orthopaedic Nursing 33, no. 4 (2014): 188–95. http://dx.doi.org/10.1097/nor.0000000000000062.
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&NA;. "Evaluation of Discharge Telephone Calls Following Total Joint Replacement Surgery." Orthopaedic Nursing 33, no. 4 (2014): 196–97. http://dx.doi.org/10.1097/nor.0000000000000070.
Full textDissertations / Theses on the topic "Discharge calls"
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Cassavettes, Wanda Lee. "Discharge Calls and Avoiding Hospital Readmissions." ScholarWorks, 2018. https://scholarworks.waldenu.edu/dissertations/4842.
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Hospital readmissions are disruptive and costly for patients and hospitals. As hospital discharge instructions are a key nursing responsibility, this project implemented a nurse follow-up phone call intervention within 12-48 hours of patient discharge from an indigent care facility in the Great Lakes region of the United States. The project was designed to understand whether follow-up phone calls from nurses that clarified discharge instructions, symptom management, and medications would be associated with decreased readmission rates within 30 days post-discharge among chronic care patients. The theoretical framework was the health belief model, which proposes that the patient's knowledge of illness severity, susceptibility, and benefits of care predicts his/her health-related behaviors, including self-care. A comparison of the hospital readmission rate prior to 30 days of discharge in the baseline (pretest) group was 77.87%, and 22% in the Post-intervention group within the same facility. Chi-square results showed a significant association between the follow-up calls and decreased hospital 30-day readmission rates, X2(1)- =- 6.605, p- =- 0.010, This low-cost intervention can and should be replicated in other indigent care hospital facilities. Similar results may suggest a causal relationship that can later be explored in large scale research studies. This study may contribute to social change by demonstrating a practice that provides reduction in 30-day patient readmissions, which benefits patients' and families', economic and health outcomes.
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Fyfe, Kristen, Tiffany Lee-Chan, Heather Marrow, Janet Cooley, and Terri Warholak. "The Effect of Follow-Up Phone Calls After Patient Discharge on 30-day Hospital Readmission Rates." The University of Arizona, 2014. http://hdl.handle.net/10150/614153.
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Class of 2014 AbstractSpecific Aims: The objective of this study was to perform follow-up phone calls to patients after discharge to determine if it had a significant effect in lowering 30- day readmission rates. Methods: Men and women aged 18 years and older who provided informed consent participated in this prospective, pre-post study. The intervention consisted of a scripted follow-up phone call to each patient after discharge. At three to seven days post-discharge, a pharmacy student on an advanced pharmacy practice experience rotation at a teaching hospital called each patient discharged from a designated ward (Med/Surg I), which admits patients with a variety of conditions, such as liver cirrhosis, pneumonia, osteomyelitis, those who are uninsured, or those who require placement after discharge. Information was collected regarding prescription filling, understanding of medication(s), concerns regarding medications, and the community pharmacy he/she used to fill the discharge medications. The specified community pharmacy was then called to verify that the patient filled discharge medications at that pharmacy. The results were compared to the readmission rate in the same ward over the same time period one year prior to implementation of the intervention. Chi-square and descriptive analysis was used and the alpha a priori is 0.05. The institutional review board approved this study. Main Results: Of the 315 people contacted, a total of 89 people completed the survey (28% response rate) and 11 of these participants were readmitted at least once. There was no statistically significant difference between the participant readmission rate and the readmission rates of the total unique admission population of Med/Surg I in 2013 (χ2 = 1.206; p = 0.272). Conclusion: Follow-up phone calls did not significantly impact 30-day readmission rates; however, a downward trend was observed in the participant group.
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Forsman, Berit. "Sköra äldre patienters erfarenheter av akut återinläggning på sjukhus : Webbkollen - återinskrivna." Thesis, Högskolan Väst, Avdelningen för omvårdnad - avancerad nivå, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:hv:diva-10017.
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Background: Frail elderly is described as multi diseased, vulnerable, in need of medication and hospital care. The group of patients is a growing part of the population in the western world. Theories of patient centered care, health literacy and hand over problems are also described in the background. Aim: to describe a group of frail elderly patients experiences of hospital readmission and identify possible organizational flaws. Method: Qualitative data was collected from 20 patients during their second visit at the hospital and a content analysis was performed. Results: Findings were; experiences of ill being ever since the first hospitalization period due to not being well enough, being sent home to quickly or relatives not being strong enough to handle the situation. Experiences of not being informed or being informed in a noisy surrounding about the given care, and how to rehab when returning home. Findings also described situations of misunderstanding related to informant´s present medication and finally a need for appropriate discharge calls for the frail elderly patient. Conclusion: The results highlight a need to act according to the patient´s legal rights to be informed and participate in the decision-making. An implementation of patient centered care can make it possible. An increased number of nursing specialists in the elderly care might also lead to improved continuity and give support to the frail elderly.
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Prudencio, Denise Angelo Moreno. "Discharge Phone Call on Unplanned Readmission Due to Chemotherapy Among Cancer Patients." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/7060.
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The transition after hospitalization is a vulnerable period when adverse events like unplanned readmissions may occur. Unplanned readmissions with patients undergoing chemotherapy that are the result of gaps in communicating the discharge plan may be preventable. Several transitional care interventions have been explored, and one of these is the nurse discharge phone call. This project explored the effect of a nurse-led transitional discharge phone call within 30-days after hospital discharge on unplanned readmission due to chemotherapy among patients in the medical-oncology compared to patients without a nurse-led transitional discharge phone call. A nurse-led transitional discharge phone call was implemented within 48 to 72 hours after discharge from the medical-oncology unit of a hospital in the northeastern region of United States to determine its effectiveness in reducing the number of unplanned readmissions due to chemotherapy. The Donabedian model, the Iowa model of evidence-based practice to promote quality care, the diffusion of innovation theory, and the health belief model served as the theoretical underpinnings of the project. Seven patients undergoing chemotherapy received the discharge phone call, and none were readmitted due to cancer-related complications. The unplanned hospital readmission rate was 0% compared to the 14.17% in 2017. The findings of this project might contribute to positive social change by helping the community of patients on chemotherapy to have a better transition process through acquiring necessary information for their postdischarge care and thus mitigating the possible causes of unplanned hospital readmission.
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Pangallo, Georgianne. "Effect of a supportive and informational telephone call on threat appraisal in the newly discharged surgical cardiac patient." Virtual Press, 1990. http://liblink.bsu.edu/uhtbin/catkey/722461.
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The purpose of the present study was to test the theoretical relationship of the concepts of informational support and threat appraisal with a sample of surgical cardiac patients twenty-four hours after discharge from the hospital. These discharged patients were adjusting to the transition of hospital to home environment while still recovering from a life threatening illness. They may need varying informational supports to reduce their threat perception of the magnitude of the illness. A convenience sample of thirty-six surgical cardiac patients was assigned to three groups. The groups received the standard discharge preparation as stated by the hospitals' policy and procedure manual. The experimental group received a supportive and informational telephone call approximately twenty-four hours after discharge. The second group was the placebo group, these participants were given a telephone call at the end of the twenty-four hours to remind them to return the questionnaire. The third group was the control group, received no telephone call and were instructed to complete the questionnaire at the specified time. All groups were instructed at the time of initial contact to complete the questionnaire at approximately the end of the first twenty-four hours after discharge. The placebo group and control group were then pooled for data analysis due to the low return rate of the two groups. The two groups were compared with a t-test. The demographic data compared age and educational level to the perceived level of threat. Reliability of the tool was determined using a Cronbach's Alpha.School of Nursing
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Asheela, Ndatega Victoria. "The advantage requirement in sequestration applications : a call for relaxation." Diss., University of Pretoria, 2012. http://hdl.handle.net/2263/26556.
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In South African insolvency law, in as much as debt relief measures are contained in three pieces of legislation, a discharge from debt is only available to an insolvent debtor whose estate has been sequestrated and he is eventually rehabilitated. The history of South African insolvency law indicates a developmental change from a ‘harsh creditor-orientated’ approach to a ‘debtor-friendly’ approach. However, the advantage for creditors’ requirement is now firmly embedded in the Insolvency Act 24 of 1936. This requirement is not defined in the Insolvency Act but has been largely interpreted by the courts and stringently applied. It is only once the applicant for the sequestration order has extinguished the burden of proving this requirement, amongst others, will the court exercise its judicial discretion to grant or refuse the order. Consequently, this requirement creates a stumbling block for debtors wishing to use the sequestration process as a debt relief measure and force discharge of their debts on their creditors. The sequestration process is aimed at the advantage of creditors and not the relief of debtors. Overburdened debtors seeking debt relief who cannot prove advantage of creditors are therefore not considered in sequestration applications. However, although debt relief is not a primary object of the Insolvency Act, it is an indirect consequence of the sequestration process when the insolvent debtor is rehabilitated. The Insolvency Act almost deals with every aspect of the different classes of creditors while there is no provision of the different classes of debtors who can and those who cannot prove an advantage to creditors. This serves as an indication that there is an imbalance between creditors’ and debtors’ interests. The study seeks to analyse the effect of the advantage requirement on sequestration applications from a debtor’s perspective. The alternative debt relief measures available to debtors when pursued by their creditors as contained in the Magistrates` Court Act 32 of 1944 and the National Credit Act 34 of 2005 are examined. It is submitted that South Africa does not provide the required sufficient debt relief because the administration orders and debt review in addition to other deficiencies, do not provide debtors with a statutory discharge from debts. The South African Law Reform Commission in the 2000 Insolvency Bill has recommended that the advantage for creditors’ requirement be retained in the new Insolvency Act. In a comparative survey, various legal systems are considered to investigate how the issue of finding a balance between debtors’ and creditors’ interests in insolvency law is dealt with. To accommodate all debtors, it is then submitted that the advantage requirement should not be retained in the Insolvency Act.Dissertation (LLM)--University of Pretoria, 2012.
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Books on the topic "Discharge calls"
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1950-, Petch Alison, Caplan Richard, and Scotland Social Research, eds. 'Don't they call it seamless care?': A study of acute psychiatric discharge. Edinburgh: Scottish Executive, Social Research, 2002.
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Record, Isaac, and Boaz Miller. Taking iPhone Seriously. Oxford University Press, 2018. http://dx.doi.org/10.1093/oso/9780198769811.003.0007.
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David Chalmers thinks his iPhone exemplifies the extended-mind thesis by meeting the criteria that he and Andy Clark established in their well-known paper (1998). Andy Clark agrees. This chapter takes this proposal seriously, evaluating the case of the GPS-enabled smartphone as a potential mind extender. It is argued here that the “trust and glue” criteria enumerated by Clark and Chalmers are incompatible with both the epistemic responsibilities that accompany everyday activities and the practices of trust that enable users to discharge them. Prospects for revision of the original criteria are dim. The chapter therefore calls for a rejection of the trust criterion and a reevaluation of the extended-mind thesis. It also addresses the extended mind, extended knowledge, digital technology and devices, varying stakes and GESs.
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Shiffrin, Seana Valentine. A Thinker-Based Approach to Freedom of Speech. Princeton University Press, 2017. http://dx.doi.org/10.23943/princeton/9780691157023.003.0004.
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This chapter examines the foundational connection between the grounds for the moral prohibition on lying and the moral and political protection of freedom of speech. Both the prohibition on lying and the prohibition on wrongful deception work aim to protect the ability of listeners to rely on speech to develop understandings of one another and of the world. These understandings are essential for our mutual flourishing, for the apprehension and discharge of our moral obligations to one another as individuals, and to enable us to pursue our collective moral ends. The chapter draws some connections between these values and freedom of speech. It argues that the connection between discursive communication and moral agency also provides the foundations for what it calls a “thinker-based approach” to freedom of speech, which affords free speech theory a more natural way to represent the unity between freedom of thought and freedom of communication.
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Eisenberg, Melvin A. The Parol Evidence Rule. Oxford University Press, 2018. http://dx.doi.org/10.1093/oso/9780199731404.003.0038.
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Assume that A and B make a contract. Call this the first contract or the parol agreement. Later, A and B make a second contract, in writing, which does not contradict, but relates to the same subject matter, as the first contract. Later still, A sues B for breach of the first contract and B defends on the ground that the second written agreement superseded or discharged the first contract, although it did not explicitly so provide. Under the parol evidence rule B will prevail unless an exception to the rule applies. Chapter 38 examines that rule.
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Jakobsson, Jan. Anaesthesia for day-stay surgery. Edited by Philip M. Hopkins. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199642045.003.0068.
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Day-stay surgery is becoming increasingly common the world over. There are several benefits of avoiding in-hospital care. Early ambulation reduces the risk for thromboembolic events, facilitates wound healing, and avoiding admission reduces the risk for hospital-related infection. Additionally, the risk of neurocognitive side-effects can be avoided by returning the elderly patient to their home environment. Day-stay anaesthesia calls for adequate and structured preoperative assessment and patient evaluation, and the potential risk associated with surgery and anaesthesia should be assessed on an individual basis. Need for preoperative testing should be based on functional status of the patient and preoperative medical history but even the surgical procedure should be taken into account. Preoperative fasting should be in accordance with modern guidelines, refraining from food for 6 hours and fluids for 2 hours prior to induction in low-risk patients. Preventive analgesia and prophylaxis of postoperative nausea and vomiting (PONV) should be administered preoperatively. Local anaesthesia should be administered prior to incision, constituting part of multimodal analgesia. The multimodal analgesia strategy should also include paracetamol and a non-steroidal anti-inflammatory drug in order to reduce the noxious stimulus from the surgical field. Third-generation inhaled anaesthetics or a propofol-based maintenance are both feasible alternatives. Titrating depth of anaesthesia by using an EEG-based depth of anaesthesia monitor may facilitate the recovery process. The laryngeal mask airway has become commonly used and has several advantages. Ultrasound-guided peripheral blocks may facilitate the early postoperative course by reducing pain and avoiding the use of opiates. Perineural catheters may be an option for prolongation of the block following painful orthopaedic procedures but a strict protocol and follow-up must be secured. Not only pain but even nausea and vomiting should be prevented, and therefore risk stratification, for example by the Apfel score, and PONV prophylaxis in accordance with the risk score is strongly recommended. Early ambulation should be encouraged postoperatively. Safe discharge should include an escort who also remains at home during the first postoperative night. Analgesics should be provided and be readily available for self-care when the patient comes home. Pain medication should include an opioid; however, the benefit versus risk must be assessed on an individual basis. Patients should also be instructed about a rescue return-to-hospital plan. Quality of care should include follow-up and analysis of clinical practice, and institution of methods to improve quality should be enforced for the benefit of the ambulatory surgical patient.
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The authority and transmission of the ministry in Christ's church with some of the qualifications for its due discharge: A sermon, preached at an ordination in St. Paul's Church Halifax, Nova Scotia, on the 19th March, 1848. [Halifax, N.S.?: s.n.], 1987.
Find full textBook chapters on the topic "Discharge calls"
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"Case 11: Discharge Phone Calls (En Español)." In Healthcare Quality Management. New York, NY: Springer Publishing Company, 2020. http://dx.doi.org/10.1891/9780826145147.0017.
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Brian C, Kalt. "Part III Section 4 in “Practice”, 9 Tough Calls." In Unable. Oxford University Press, 2019. http://dx.doi.org/10.1093/law/9780190083199.003.0010.
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The hypothetical situations in this chapter raise more difficult issues. Here, the President might suffer from dementia or a stroke but be unaware of her lost faculties. Mental illness might cause a president to become unable to discharge his powers and duties, but could be difficult to diagnose. If the President is able to contest a Section 4 action, he will find it easy to retake power unless his disability is substantial. Other cases covered in this chapter include a traveling President out of communication with the White House may necessitate giving power to the Vice President if decisive action is needed; and a President under criminal prosecution. Finally, the Vice President and Cabinet may worry that a possibly disabled President is on the verge of creating an imminent catastrophe. Even if Congress does not uphold the Vice President’s decision, invoking Section 4 would provide time to remove the nuclear button from the President’s hands.
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Odd Petersen, Lars. "Balancing the Capacity in Health Care." In Encyclopedia of Healthcare Information Systems, 141–48. IGI Global, 2008. http://dx.doi.org/10.4018/978-1-59904-889-5.ch020.
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Diagnostics and treatment of patients often involve several different clinics. When improving quality and efficiency in health care we therefore need to consider the entire pathway from the patient’s first contact with a health institution until the final discharge from the hospital and rehabilitation after the end of treatment. A system view is needed to consider the stochastic nature of acute patient arrivals, the variety of pathways through the clinics, and the stochastic time needed for diagnostics and treatment. A balancing of the capacity at the different clinics, in order to deliver health care services in due time, to improve the overall productivity or use of capacity, calls for a reallocation of resources. A successful accomplishment of such a process requires a common insight and agreement by the clinics and therefore representatives from the clinics participating in the analytical process. The clinician participation enables elucidation and use of information on organizational behaviour of importance for the daily operations. This type of information does not appear from the registered patient data and implies analytical tools, which are both simple and intuitive and capable of handling and displaying the type and amount of information needed in a trustworthy and consistent way.
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"Propagated Fish in Resource Management." In Propagated Fish in Resource Management, edited by BRIAN BRAZIL, BRIAN VINCI, and STEVE SUMMERFELT. American Fisheries Society, 2004. http://dx.doi.org/10.47886/9781888569698.ch52.
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<em>Abstract.</em>—Concerns for long-term water supply, public calls for environmental compatibility, potential pathogen contamination from influent and effluent waters, and increasingly restrictive water discharge regulations have led to the application of advanced water treatment technologies at various aquaculture facilities. As a result, novel management strategies and innovative facility designs have been developed for culturing fish in controlled or semicontrolled environments. However, questions surrounding the quality of the product obtained from such facilities suggest that greater attention should be given to end use requirements during the design, engineering, and operation of facilities culturing food fish or facilities culturing fish intended for wild release. The optimal “wild” fish that is to be produced for recovery or supplementation purposes is profoundly different than the optimal “domesticated” fish that is produced for food or for put-andtake stocking. Facility design considerations will be presented, which include the intended use of the fish and physical/chemical limitations of water sources. The various design and operating parameters that must be considered include differences in culture density, photoperiod, time to harvest/stocking, feed formulation, culture system scale and replications, tank surface properties, hydrodynamics, water quality, and physical/chemical limitations of water sources. However, assorted design parameters and culture conditions can be addressed with similar culture system unit processes. Finally, this paper will provide design examples of innovative fish culture strategies applying state-of-the-art technologies.
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Schickler, Eric. "Beyond the Roll Call." In Racial Realignment. Princeton University Press, 2016. http://dx.doi.org/10.23943/princeton/9780691153872.003.0008.
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This chapter argues that rank- and-file northern Democrats in the House of Representatives also responded to activist and constituent pressure for civil rights by the late 1930s and early 1940s. These locally rooted politicians proved willing to take on southern Democrats and party leaders by signing discharge petitions that extricated civil rights bills from obstructionist committees, forcing the measures to the House floor. Prior to the late 1930s, northern Republicans had outpaced northern Democrats in their civil rights support. Northern Democrats showed increased civil rights support by the end of the 1930s, displacing northern Republicans as the leading advocates of civil rights during World War II. The Democrats most supportive of civil rights came from the highly urban, unionized areas that were most associated with New Deal liberalism, while the smaller number of GOP supporters tended to come from atypical districts for the party. The gap between the parties was substantial from the mid-1940s onward.
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Raine, Tim, George Collins, Catriona Hall, Nina Hjelde, James Dawson, Stephan Sanders, and Simon Eccles. "Life on the wards." In Oxford Handbook for the Foundation Programme, 67–124. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198813538.003.0002.
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This chapter discusses life on the wards. It includes the medical team, the multidisciplinary team, daily ward duties, ward rounds, being on-call, night shifts, writing and common symbols in the notes, anatomical terms and planes, discharge summaries (TTOs/TTAs), fitness to work notes, referrals, referral letters, investigation requests, radiology, common ward dilemmas, pain, thinking about death, palliative care, the dying patient, death, nutrition, nutritional requirements, difficult patients, aggression and violence, needle-stick injuries, surgery, pre-op assessment, bowel preparation, surgical terminology, preparing in-patients for surgery, booking theatre lists, surgical instruments, the operating theatre, post-op care, post-op problems, wound management, common elective operations, and stomas.
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Reilly, Lorie. "Follow-up." In The Pediatric Procedural Sedation Handbook, edited by Cheryl K. Gooden, Lia H. Lowrie, and Benjamin F. Jackson, 132–34. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190659110.003.0020.
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Follow-up is an important part of the pediatric sedation process. Follow-up may be performed in several different ways, such as a telephone call, direct contact with the patient and family, a mailed questionnaire, or an in-person visit (e.g., inpatient). Adverse events that occur after the postsedation discharge and are reported during the follow-up process should be documented in the medical record, because this is important and useful information for future sedation encounters. During follow-up some of the topics for discussion with the parent may include any change in the child’s activity level, appetite, sleep pattern, or behavior. An evaluation of patient/family satisfaction may be incorporated into the follow-up.
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Zaidi, Sara R., and Jeremy R. Simon. "The Reluctant Consultant." In Legal and Ethical Issues in Emergency Medicine, 97–104. Oxford University Press, 2020. http://dx.doi.org/10.1093/med/9780190066420.003.0013.
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This chapter discusses the obligations under the Emergency Medical Treatment and Active Labor Act (EMTALA) of both emergency physicians and on-call consultants to patients who present to the emergency department with a medical complaint. Whereas emergency physicians, by the nature of their work, cannot avoid being present to treat patients when they arrive, consultants may be reluctant to fulfill their obligation and come to the emergency department to treat an unstable patient who cannot be discharged without their services. Techniques for avoiding and resolving such impasses are discussed, as well as what to do in the case of true intransigence.
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Metcalfe, David, and Harveer Dev. "Effective Communication." In Oxford Assess and Progress: Situational Judgement Test. Oxford University Press, 2018. http://dx.doi.org/10.1093/oso/9780198805809.003.0022.
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Communication is fundamental to the role of the doctor. It includes routine verbal communication (e.g. history taking, updating relatives, handovers, and requesting investigations from specialists), written communication (e.g. prescriptions, updating the clinical notes, and discharge summaries), breaking bad news, and ‘challenging’ interactions such as dealing with an angry relative. Questions within this section assess your ability to communicate effectively with patients and colleagues. Effective communication requires understanding and being understood. You will need to demonstrate an ability to negotiate with colleagues, to document information within the medical notes clearly and concisely, to gather information from patients, and to listen to angry relatives. As always, your responses must adapt to the needs and context of each situation, while always remembering to demonstrate empathy and compassion. ● Listen to patients, relatives, and colleagues. They are trying to tell you something. ● Explain your position carefully after listening to the other side. ● Adapt your style as far as possible to the person with whom you are communicating. ● However strongly you feel, poor manners will never get the job done faster. Foundation doctors should not usually be left to ‘break bad news’ in the classical sense of a new cancer diagnosis in clinic. However, bad news can take many forms and it is likely that you will find yourself going through the ‘breaking bad news’ sequence many times during the foundation programme. For example, the following scenarios are all bad news to varying degrees. Some patients will take such developments in their stride and others will rank them amongst other significant life events. ● An incidental ‘nodule’ found on a CT chest that might be benign but will require a follow- up scan in three months. ● An elderly man who has become very unwell and is unlikely to survive while you are on call. You have been assigned the task of calling his wife, providing an update, and suggesting she come to the hospital urgently. ● The fact that investigations have all been normal and they are being discharged without a diagnosis for their persistent debilitating abdominal pain.
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Shahid, Mohd, Hridesh Mishra, Hemant Kumar Mishra, Trivendra Tripathi, Haris M. Khan, Farrukh Sobia, and Anuradha Singh. "Pharmaco-EcoMicrobiology and Its Potential Role in Medical and Environmental Sciences." In Pharmacoinformatics and Drug Discovery Technologies, 291–302. IGI Global, 2012. http://dx.doi.org/10.4018/978-1-4666-0309-7.ch018.
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Despite the call of the World Health Organization (WHO) for “Pharmacovigilance,” i.e. the monitoring, detection, assessment, and prevention of any adverse reactions, poor attention has been given to identify the long term and short term Adverse Effects (ADEs) of antimicrobial agents on the environment. It is obvious that most of the health sectors across the globe are occupied by infectious diseases (e.g. tuberculosis, HIV, and hepatitis), and to combat such threats, the pharmaceutical industries are pouring tons of drugs and reagents into a market worth billions of dollars. The discharge of these products into the ecosystem is potentially a threat to the environment and human health. In this chapter, the authors depicted a recently described terminology, “Pharmaco-EcoMicrobiology” (PEcM), that could cover these problems and their possible solutions on medical and environmental aspects. In this regard, the role of pharmacoinformatics could also be crucial, since it can provide swift information for implementation and use of information technologies for the discovery and development of drugs as well as in pharmacy education and also the detection and combat of adverse drug effects.
Conference papers on the topic "Discharge calls"
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"Call for papers." In 2004 Electrical Overstress/Electrostatic Discharge Symposium (EOS/ESD). IEEE, 2004. http://dx.doi.org/10.1109/eosesd.2004.5272574.
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Sun, Li-Ning, Bing Shao, and Dong-Sheng Qu. "Structure Design, Dynamic Analysis and Test of FPSM of APT System in Free Space Laser Communication." In 2007 First International Conference on Integration and Commercialization of Micro and Nanosystems. ASMEDC, 2007. http://dx.doi.org/10.1115/mnc2007-21054.
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As one of the best solutions for future space communication, free space optical communication possesses such advantages as high data rate, large capacity and high secrecy as compared with microwave communication. However, the extremely narrow beam width calls for severe acquisition, pointing and tracking requirements. As a key component of laser beam Acquisition, Pointing, and Tracking (APT) system for free space optical communication, the compact Fine Pointing Steering Mirror (FPSM) determines the performances of the communication system. This paper presents a new type structural design of FPSM — a piezoelectrically-driven micro-positioning deflective mechanism where the tilt movements are implemented by the elastic deformation of flexible rings. It provides fast and precise control in tilt movements around X-axis and Y-axis. The mechanism is machined from one solid alloy steel block cut by wire-EDM (electric discharge machining). The flexure rings promise zero friction, zero clearance and excellent guiding accuracy. The mirror, 36mm in diameter, is driven by four piezoelectric actuators (two pairs) spaced at 90° intervals. Each actuator pair works as a unit in push/pull mode. The differential design exhibits excellent angular stability over a wide temperature range. The stiffness model of the flexible ring was setup through the analysis of structural mechanics. The FSPM has been simplified to springs-particle system. A dynamic model was then presented based on Lagrange Equation, and modal analysis and experiments were then performed. Dynamic calculation demonstrates that the first order, the second order and the natural frequency of the FSPM is 1.278 KHz, 1.653 KHz and 1.653 KHz. Modal analysis shows that the first, second and third order natural frequency is 1.308 KHz, 1.525 KHz and 1.530 KHz. The experimental test displays that the first, second and third order natural frequency of the FPSM is 1.28 KHz, 1.56 KHz and 1.58 KHz. The error between three of methods is less than 10%. It demonstrates that the novel FSPM has excellent performance and can meet the dynamic requirements for establishing optical communication link.
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Koosha, Rasool, and Luis San Andrés. "A Model for Tilting Pad Thrust Bearings Operating With Reduced Flow Rate – Do Benefits Outweigh Risks?" In ASME Turbo Expo 2021: Turbomachinery Technical Conference and Exposition. American Society of Mechanical Engineers, 2021. http://dx.doi.org/10.1115/gt2021-60396.
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Abstract The literature on tilting pad thrust bearings (TPTB) calls for flow reduction as an effective means to reduce drag power losses as well as oil pumping costs. However, the highest level of flow reduction a bearing can undergo while maintaining reliable operation is a key question that demands comprehensive analysis. This paper implements a model into an existing thermoelasto-hydrodynamic (TEHD) computational analysis tool to deliver load performance predictions for TPTBs operating with reduced flow rates. For bearings supplied with either a reduced flow or an over flow conditions, a sound model for the flow and thermal energy mixing in a feed groove determines the temperature of the lubricant entering a thrust pad. Under a reduced flow condition, the analysis reduces the effective arc length of a wetted pad until matching the available flow. Predicted discharge flow temperature rise and pad subsurface temperature rise from the present model match measurements in the archival literature for an eight-pad bearing supplied with 150% to 25% of the nominal flow rate, i.e., the minimum flow that fully lubricates the bearing pads. A supply flow above nominal rate increases the bearing drag power because the lubricant enters a pad at a lower temperature, and yet has little effect on a thrust pad peak temperature rise or its minimum film thickness. A reduced flow below nominal produces areas lubricant starvation zones, and thus the minimum film thickness substantially decreases while the film and pad’s surface temperature rapidly increase to produce significant thermal crowning of the pad surface. Compared to the bearing lubricated with a nominal rate, a starved flow bearing produces a larger axial stiffness and a lesser damping coefficient. A reduction in drag power with less lubricant supplied brings an immediate energy efficiency improvement to bearing operation. However, sustained long-term operation with overly warm pad temperatures could reduce the reliability of the mechanical element and its ultimate failure.
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Koralewska, Ralf. "Resource Recovery: The Contribution of Energy-From-Waste Plants." In 20th Annual North American Waste-to-Energy Conference. American Society of Mechanical Engineers, 2012. http://dx.doi.org/10.1115/nawtec20-7023.
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Energy-from-Waste plants using grate-based systems have gained world-wide acceptance as the preferred method for the sustainable treatment of waste. Key factors are not only the reduction of waste volume and mass and the destruction or separation of pollutants but also the efficient production and use of energy (electricity, district heating/cooling, process steam), compliant disposal and the recovery of resources from combustion residues (e.g. metals, rare earths). International requirements relating to energy efficiency and materials recovery by means of thermo-recycling in Energy-from-Waste plants call for the continuing development and optimization of existing technologies and concepts. The technologies and processes for the recovery of reusable materials from dry-discharged bottom ash and from filter ash point to the key role that Energy-from-Waste plants are able to play in the efficient conservation of resources. It is primarily thermal treatment with dry discharge and subsequent processing of the bottom ash fractions that enables Energy-from-Waste plants to justify their status as universal recyclers. In addition to recovery of the energy inherent in the waste, the treatment of dry-discharged bottom ash is an important contribution to compliance with raw material and climate policies and to the promotion of closing the material cycle in general. Furthermore, dry bottom ash discharge represents a further step towards waste-free operation and “after-care-free” landfills. This paper documents the potential of Energy-from-Waste plants for the recovery of resources and provides examples of recent developments and large-scale implementations of innovative recovery technologies in Europe.
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Portella, Ricardo B., Luiza F. Andrade, Tomazo Garzia Neto, and Nelson Coelho. "Single-Pour/Single Pass Loading: An Innovative Concept for a New Generation of Ore Carriers." In ASME 2011 30th International Conference on Ocean, Offshore and Arctic Engineering. ASMEDC, 2011. http://dx.doi.org/10.1115/omae2011-49589.
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Bulk Carriers have been developed since 1950 to carry large quantities of non-packed commodities such as grains, coal and iron ore. Nowadays, there are some 5,000 bulk carriers around the world and this number points to some concerns that affect owners of these types of ship and ports. One of these problems is the big waiting time at the ports that reaches 12% of the global fleet around the world at any given moment. At Brazilian iron ore ports the time waiting average was of 6–8 days during 2006–2008. A concrete example is the VALE operation that responds from mineral resources exploration to mineral resources delivery, passing through mines, railroads, seaport terminals and shipping business, forming a logistic chain that can not be interrupted by the expected growth in trade and consequent port congestion. In view of this, PROJEMAR and VALE faced the challenge of designing ore carriers in such a way that it would not interfere with the logistics chain by delaying other ships at the loading or discharge terminal. As the cargo operation is taken as the initial point of the design conception, the expected final product is a ship able to safely take loading rates as high as 16,000 tons of ore per hour, with each hold loaded in one pour and the ship fully loaded in one pass, resulting in fewer pours into the holds of the ore carrier, faster loading operations and, consequently, a significant economy for the ship owner and for the port. The amount of extra steel needed over conventional designs: less than one percent. The fundamental idea of this new concept, which PROJEMAR calls “single-pour, single-pass” design, is a method of ballast control that is synchronized with the cargo loading, scientifically deballasting the ship during loading in a way that balances the forces induced by the incoming cargo. Potential hull loading stress problems can occur due to the manner in which ore cargoes are loaded and due to the amount of cargo which is loaded in an individual hold. To avoid the creation of any unacceptable stresses in the ship’s structure, loading studies considering the planning of cargo loading and discharging operations, maximum allowable and minimum required mass of cargo for each hold and for adjacent holds as a function of the draught at mid-hold position in form of hold mass curves, calculations of still water shear forces and still water bending moments for each port loading condition and structural analysis are required to be developed on the early design stages. This ship loading concept is creating a new generation of ore carriers in such a way that the main class societies are nowadays developing new specific class notation dedicated to these ships. The purpose of this paper is to present the “single-pour, single pass” concept development and how it has been applied to the design of the new 400,000 DWT ore carriers that are being built for VALE in Chinese and Korean shipyards, and to the 80,100 DWT Bauxite Carrier that are being built for LOG-IN in Brazil. The “single-pour, single pass” concept was also partially considered on the design of 12 VLCCs that are being converted to VLOCs for VALE in China with PROJEMAR’s design.
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Rahardjo, Johan, Socorro Miller, Leo Lopez, and Steve L. Williams. "Developing a More Inclusive System Level ESD Characterization Methodology." In ISTFA 2005. ASM International, 2005. http://dx.doi.org/10.31399/asm.cp.istfa2005p0151.
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Abstract ESD (Electrostatic Discharge) has become an increasing problem on electronic devices. The electronics industry is always looking for ways to improve the reliability of electronic devices by enhancing their test methods. The industry has found that the current ESD test methods do not encompass all possible scenarios to which electronic devices are exposed at the customer site. This paper describes a novel method to bridge the gap between current system level ESD specifications and customer real world situations. Field failure investigations led us to discover a new customer situation where ESD is induced on a computer system through a peripheral/cable that is already attached (different than hot-plug event). To simulate this scenario, ESD was injected directly into the signal pins of the bus being tested, creating what we call the DCD (Direct Contact Discharge) test methodology. This paper compares DCD against the current ESD standards and demonstrates that introducing DCD into the current ESD testing methodology will significantly lower the system field failures. DCD is not a replacement for current ESD testing practices in the industry; DCD is a complement that allows a more inclusive ESD test coverage
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Kattegollahalli Shivakumar, Darshan, Ganesan Sabbani, Gursharanjit Singh, and Purushothama Harthi Revanasiddappa. "Prediction of Gas Turbine Afterburner Performance Using CFD for Different Operating Conditions and Reheat Strength." In ASME 2017 Gas Turbine India Conference. American Society of Mechanical Engineers, 2017. http://dx.doi.org/10.1115/gtindia2017-4631.
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A gas turbine afterburner is required to operate under severe conditions of pressure and temperature to meet the design requirements of next generation gas turbine engines. This fact, coupled with the current trends towards higher turbine discharge temperature and the requirement for satisfactory operation over extended fuel/air ratios and flight maps call for greater understanding of the internal aerodynamics for improving thrust developed by the afterburner. The present work focuses on prediction of performance of a practical afterburner for different altitude conditions and reheat strengths (i.e., fuel-air ratios) using Computational Fluid Dynamics (CFD) simulations. Combustion efficiency and thrust boost at these conditions have been predicted. The reacting flow field has been analyzed and changes suggested for improving thrust at low performance points.
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San Andrés, Luis, Bonjin Koo, and Sung-Hwa Jeung. "Experimental Force Coefficients for Two Sealed Ends Squeeze Film Dampers (Piston Rings and O-Rings): An Assessment of Their Similarities and Differences." In ASME Turbo Expo 2018: Turbomachinery Technical Conference and Exposition. American Society of Mechanical Engineers, 2018. http://dx.doi.org/10.1115/gt2018-76224.
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Squeeze film dampers (SFDs) in aircraft engines effectively aid to reduce rotor motion amplitudes, in particular when traversing a critical speed, and help to alleviate rotor whirl instabilities. The current work is a long term endeavor focused on quantifying the dynamic force performance of practical SFDs, exploring novel design damper configurations, and producing physically sound predictive SFD models validated by experimental data. Piston rings (PRs) and O-rings (ORs), commonly used as end seals in SFDs for commercial and military gas turbine engines, respectively, amplify viscous damping in a short physical length and while operating with a modicum of lubricant flow. This paper presents experimental force coefficients (damping and inertia) for two identical geometry SFDs with end seals, one configuration hosts PRs, and the other one ORs. The test rig comprises a stationary journal and bearing cartridge (BC) hosting the SFD and supported on four elastic rods to emulate a squirrel cage. The damper film land length, diameter and clearance are L = 25.4 mm, D = 5L, and c = 0.373 mm (D/c = 340), respectively. A supply feeds ISO VG 2 oil to the film land at its middle plane through either one hole or three holes, 2.5 mm in diameter, 120° apart. In the PR-SFD, the lubricant exits thru the slit opening at the ring butted ends. The O-rings suppress oil leakage; hence, lubricant evacuates through a 1 mm hole at ¼ L near one journal end. The O-rings when installed add significant stiffness and damping to the test structure. The ORSFD produces 20% more damping than the PR-SFD, whereas both sealed ends SFDs show similar size added mass. For oil supplied at 0.69 bar(g) through a single orifice produces larger damping, 60% to 80% more than when the damper operates with three oil feedholes. A computational model reproducing the test conditions delivers force coefficients in agreement with the test data. Archival literature calls for measurement of a single pressure signal to estimate SFD reaction forces. For circular centered orbits, the dynamic pressure field, in the absence of any geometrical asymmetry or feed/discharge oil condition, “rotates” around the bearing with a speed equal to the whirl frequency. The paper presents force coefficients estimated from (a) measurements of the applied forces and ensuing displacements, and (b) the dynamic pressure recorded at a fixed angular location and “integrated” over the journal surface. The first method delivers a damping coefficient that is large even with lubricant supplied at a low oil supply pressure whereas the inertia coefficient increases steadily with feed pressure. Predictions show good agreement with the test results, in particular the added mass. On the other hand, identified damping and inertia coefficients from dynamic pressures show a marked difference from one pressure sensor to another, and vastly disagreeing with test results from the first method or predictions. The rationale for the discrepancy relies on local distortions in the dynamic pressure fields that show zones of oil vapor cavitation at a near zero absolute pressure and/or with air ingestion producing high frequency spikes from bubble collapsing; both phenomena depend on the magnitude of the oil supply pressure. An increase in lubricant supply pressure suppresses both oil vapor cavitation and air ingestion which produces an increase of both damping and inertia force coefficients. No prior art compares the performance of a PR-SFD vis-à-vis that of an OR-SFD. Supplying lubricant with a large enough pressure (flow rate) is crucial to avoid the pervasiveness of air ingestion. Lastly, the discussion on force coefficients obtained from two distinct methods questions the use of an oversimplifying assumption; the dynamic pressure field is not invariant in a rotating coordinate frame.
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Garg, Pardeep, Sriram Hebbalguppe Krishna, Pramod Kumar, Thomas Conboy, and Clifford Ho. "Advanced Low Pressure Cycle for Concentrated Solar Power Generation." In ASME 2014 8th International Conference on Energy Sustainability collocated with the ASME 2014 12th International Conference on Fuel Cell Science, Engineering and Technology. American Society of Mechanical Engineers, 2014. http://dx.doi.org/10.1115/es2014-6545.
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Turbine inlet pressures of ∼ 300 bar in case of CO2 based cycles call for redesigning the cycle in such a way that the optimum high side pressures are restricted to the discharge pressure limits imposed by currently available commercial compressors (∼150 bar) for distributed power generation. This leads to a cycle which is a combination of a transcritical condensing and a subcritical cycle with an intercooler and a bifurcation system in it. Using a realistic thermodynamic model, it is predicted that the cycle with the working fluid as a non-flammable mixture of 48.5 % propane and rest CO2 delivers ∼37.2 % efficiency at 873 K with a high and a low side pressure of 150 and 26 bar respectively. This is in contrast to the best efficiency of ∼36.1 % offered by a transcritical condensing cycle with the same working fluid at a high side pressure of ∼ 300 bar.
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Tucker, David, Larry Lawson, Randy Gemmen, and Richard Dennis. "Evaluation of Hybrid Fuel Cell Turbine System Startup With Compressor Bleed." In ASME Turbo Expo 2005: Power for Land, Sea, and Air. ASMEDC, 2005. http://dx.doi.org/10.1115/gt2005-68784.
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Current design concepts for hybrid systems call for the use of presently available turbine systems. Simply stated, the combustor of a turbine system is replaced with a high temperature fuel cell whose excess heat is used to drive the turbine. However, the startup of a turbine in such a direct fired fuel cell turbine hybrid system is made problematic through the increased pressure losses introduced by heat recuperation, and the relatively large cathode volume now present between the compressor discharge and the turbine inlet. This work evaluates the use of compressor bleed air to avoid stall and surge during the startup of a fuel cell turbine hybrid power system using the Hybrid Performance (Hyper) project hardware simulation facility at the National Energy Technology Laboratory (NETL), U.S. Department of Energy. Because integration of a fuel cell and often multiple recuperators into the compressed air stream results in a higher required pressure ratio for any given compressor inlet mass flow, a strategy must be developed to avoid compressor stall during startup. Turbine starts were attempted using the NETL Hyper project facility over a range of compressor bleed mass flows. The experimental facility at NETL makes use of a natural gas burner controlled by a real time fuel cell model to simulate the thermal output of a solid oxide fuel cell. Pressure vessels, used for simulating the cathode and post combustion volumes, and exhaust gas recuperators are integrated into the system with a modified turbine and compressor on a single shaft. The startup profiles are compared to the stall line of the compressor map to quantitatively evaluate the efficacy of the applied method in avoiding stall and surge during startup events.