PAPERS OX MEDICINE AND PUBLIC HEALTH 433 



lu expressing his opiuion on the rapidity of this move- 

 ment, President Henry S. Pritchett of the Carnegie 

 Foundation said: ''From coast to coast the idea is 

 changing the conditions in hospitals. Every^vhere there 

 is the ferment of development, the activity of improve- 

 ment. In great centers of medical affairs the changes 

 have been startling. In Baltimore, there is not a hospital 

 of 100 beds or more that has not put into eft'ective opera- 

 tion the "Minimmn Standard", and in Xctt York and 

 other cities the hospitals have made almost as great an 

 advance. The world of the hospital is changing. An ad- 

 vance normally to be expected in twenty years has come 

 in three." The change in Canada has been just as rapid. 

 In five provinces not a single large hospital remains un- 

 classified. 



No movement is destined to contribute more to the con- 

 seiwation of the public health of the country than the 

 hospital standardization movement. 



In 1917, the records kept in lo'^c of the hospitals of this 

 country were practically valueless. Xo examinations 

 were made of the patients on admission. Xo diagnosis, 

 no family history and no physical examination were re- 

 corded. 



Figures from two prominent hospitals prepared on 

 similar cases before and after standardization show that 

 the percentage of operative cases was reduced from -l-l 

 to 30^: in one hospital, and in another from 62 to 47/o, 

 and the mortality was reduced about l^c This repre- 

 sents the prevention of 15% of unnecessary operations 

 and the saving of one in a hundred of all patients ad- 

 mitted. 



Again, a comjDarison of a standardized and a non-stand- 

 ardized hospital in which 100 appendectomies were done 

 showed the following: 



s N. s. 



Complete physical examination and blood count 100 — 14. 



Consultations held 41 — 2. 



Working diagnosis reported 100 — 0. 



Progress notes recorded 100 — 0. 



Infections following operation 3 — 12. 



Incorrect diagnosis 4 — 14. 



Patients relieved 94 — 77. 



Deaths 2 — 9. 



