An in-hospital thin client network system was constructed for access to the Internet, and its usefulness and advantages were assessed.
The thin client system comprised a server-based centralized computing system containing centralized computers on modular circuit cards （so-called blade PCs） placed in a secure server rack. The terminal units did not contain central processing units or storage devices and were equipped only with a graphic display and input mechanisms such as a keyboard and mouse. These units comprised a local area network with several types of servers and resources that were connected to the Internet service provider outside the hospital.
The thin client system offered many advantages including reduced cost, ease of maintenance and use, and security. The number of blade PCs and software required was only the number actually in use at one time, which was less than the number of terminal computers used in a standard decentralized system. Total cost of equipment acquisition was reduced due to centralization, consolidation, and standardization. Running costs were also reduced because of minimized power consumption and ease of maintenance. If one blade PC failed, the user could simply access another blade PC and log in again, and all of their files would still be accessible. This system also offered greater security over that of a decentralized system because all of the processing was controlled at a central location. All data could be maintained in the datacenter and easily saved to a mass storage device, so if the access device were stolen or destroyed, the data would not be compromised.
In summary, in terms of economy, security, and convenience, we found the thin client system to be a useful tool for in-hospital network system access to the Internet.

View full abstract

A questionnaire survey of public general hospitals was conducted to determine how the nursing assistants working at those hospitals are treated (number of responses:499 hospitals;response rate: 51.4%). Due to various problems, including increasing employment costs and limitation in the number of full-time employees, regardless of the increasing demand for labor at hospitals, the mean percentages of full-time employees, part-time employees, temporary workers, and vendor and contingent workers at the responder hospitals were 14.3%, 45.6%, 37.5%, and 2.7%, respectively. The work hours of temporary employees were the same as those of full-time employees at 74.9% of the hospitals, indicating that many of the responder hospitals use a large number of temporary workers who have no limitations on work hours, without setting a duty-free period between contracts. Regarding the basic pay table for full-time employees, 34.4% of the hospitals use the basic pay table for laborers set by the National Personnel Authority, followed by 29.3% of the hospitals which create their own. As for pay raise, 50.8% of the hospitals have no pay raise system, and the monthly pay of the employees does not change at 96.7% of the hospitals, even after the hospitals start receiving surcharges for having an acceptable acute-phase nursing assistant system. Furthermore, statistically significant differences were observed in several items among different management styles and locations of the hospitals, including in those related to the position of nursing assistant.

View full abstract