Today's hospitals face a difficult management task: they must change so that the goal of providing quality care to patients is combined with the demand of payors that care be provided at a lower cost. To successfully accomplish this, hospitals must understand the healthcare process, identifying the strengths of that process and focusing those strengths to simultaneously attain both goals. The healthcare process is characterized by a large amount of variability in the resources used for patients, even those patients with a common diagnosis. It is also characterized by customizing the care for an individual patient. As such, the provision of healthcare is difficult to standardize. A major strength of healthcare has been the ability to develop and to adopt new procedures and techniques which improve the quality of care; healthcare is flexible to change. The challenge is to use that strength--the flexibility of healthcare--to improve our performance relative to cost as well as quality.
A linear nondepressed skull fracture may be seen as two connecting lines because slight angulation of the beam of radiation results in separate visualization of the fracture as it crosses the outer table and then the inner table. These two lucent lines form an elliptical shape. A second projection can result in superimposition of the inner and outer table fractures, and the elliptical configuration is no longer seen. This disappearing ellipse is offered as an additional sign of a linear skull fracture which can help differentiate such fractures from vascular grooves.
