The Washington times., 1917-04-21
ENGLISH HOSPITAL
WORK EXPANDING
Service Brought to High State
of Efficiency BY Gov ,
eminent.

LONDON, April 21.-war Is the
wasteful business in which men en-
gage; yet the system and method
which war requires teach some OF the
most useful lessons in practical
economy.
Necessarily, the hospital service OF
a country which has several million
men in armies and navy, undergoing
not only the risks of actual lighting
but also the privations, exposure, and
hardships OF the trenches, is a stu
pendous affair. Imagination fails tO
grasp the immensity of IL, and the
fgures that might visualize IL are SO
big that they leave one hopeless.
The British government has accom-
plished no more effective work In or
ganization than in the perfection OF
its hospital system.
Business organization has been
brought to a higher perfection here
than perhaps in any other part OF the
wars management. By dint of the ut
most care and economy the cost per
head of caring for sick and wounded
soldiers has actually been greatly re-
duced since the first months OF the
war, Notwithstanding the constant In
crease in the cost of practically every
thing needed for the conduct of hos
pital work.
Service II Expanding.
The hospital service has Deen q con-
stantly expanding one. Like every
thing else in the war. IT developed
with astonishing rapidity to proper
tions SO immense as to be hopelessly
beyond any anticipations. Hospital
service and medical service necessar-
fly have to keep step with the in
crease in the military forces, and the
soldiers have. to be constantly pro-
vided for. giving. every patient the
full benefit of improved methods as
fast as these are devised as the re-
suit of experience. This exchange in
dissemination of the results of actual
experience has been accomplished
with astonishing rapidity, and not
only without increasing the cost OF
the service, but simultaneously with
a great reduction in expense.
The plunge In the war was so sud
den that England was hardly able to
realize that all the horrors Of twen-
tieth century war were actually TAX
ing place few cannon shots distance
from its shores until the streams OF
wounded began to flow back. Hos
pitfalls at FIRST had to be improvised,
and then as fast as possible organized
and systematized on a permanent
basis; and all the time It was neces-
sary constantly to increase the mum
Der and capacity OF these establish
ments. At the beginning, the demand
for hospital supplies and accessories
was so great that IL was necessary to
60 back to first principles and az.
range for wholesale production OF
these on a scale that had never been
dreamed OF.
Tried to- Save Service.
In the beginning. the authorities in
charge of hospitals realized that II
no due regard were paid to the cost
of providing comforts and conven-
fences these would be afforded. in
many cases, at an expense that would
ultimately make proper service pro-
hibItive. The end might have been
obtained, but by methods of which
no administrator could approve
So the hospital service early insti-
tuted q system of rigid comparisons
of the methods, results and expenses
in different hospitals. Before the
war had entered upon its second
year these comparisons had been
carefully organized and studied, and
their application to the business Of
administration was promptly put
into effect
The first standard of comparison
consisted OF q monthly return show
ing the average daily cost OF, food
per patient in the hospitals OF each
command. Each hospital being in
receipt OF these data as to the other
hospitals was able to compare its
food cost with that of the others,
and whenever. a particular hospital
showed an apparently excessive cost
explanations were called for. Like
wise, when a given institution made
a showing OF impressively low costs
which seemed to testify to excellent
administration. Its methods were
studied and notified to other insti'
tutions. Thus there was established
a sort of competition for efficiency
ratings, and along with this con
tinuous exchange of experience, ideas