Advances in Health Care Management最新文献

{"title":"International benchmarking and best practice management: in search of health care and hospital excellence.","authors":"Wilfried von Eiff","doi":"10.1108/s1474-823120140000017014","DOIUrl":"https://doi.org/10.1108/s1474-823120140000017014","url":null,"abstract":"<p><strong>Purpose: </strong>Hospitals worldwide are facing the same opportunities and threats: the demographics of an aging population; steady increases in chronic diseases and severe illnesses; and a steadily increasing demand for medical services with more intensive treatment for multi-morbid patients. Additionally, patients are becoming more demanding. They expect high quality medicine within a dignity-driven and painless healing environment. The severe financial pressures that these developments entail oblige care providers to more and more cost-containment and to apply process reengineering, as well as continuous performance improvement measures, so as to achieve future financial sustainability. At the same time, regulators are calling for improved patient outcomes. Benchmarking and best practice management are successfully proven performance improvement tools for enabling hospitals to achieve a higher level of clinical output quality, enhanced patient satisfaction, and care delivery capability, while simultaneously containing and reducing costs.</p><p><strong>Approach: </strong>This chapter aims to clarify what benchmarking is and what it is not. Furthermore, it is stated that benchmarking is a powerful managerial tool for improving decision-making processes that can contribute to the above-mentioned improvement measures in health care delivery. The benchmarking approach described in this chapter is oriented toward the philosophy of an input-output model and is explained based on practical international examples from different industries in various countries.</p><p><strong>Findings: </strong>Benchmarking is not a project with a defined start and end point, but a continuous initiative of comparing key performance indicators, process structures, and best practices from best-in-class companies inside and outside industry. Benchmarking is an ongoing process of measuring and searching for best-in-class performance: Measure yourself with yourself over time against key performance indicators. Measure yourself against others. Identify best practices. Equal or exceed this best practice in your institution. Focus on simple and effective ways to implement solutions. Comparing only figures, such as average length of stay, costs of procedures, infection rates, or out-of-stock rates, can lead easily to wrong conclusions and decision making with often-disastrous consequences. Just looking at figures and ratios is not the basis for detecting potential excellence. It is necessary to look beyond the numbers to understand how processes work and contribute to best-in-class results. Best practices from even quite different industries can enable hospitals to leapfrog results in patient orientation, clinical excellence, and cost-effectiveness.</p><p><strong>Originality/value: </strong>Despite common benchmarking approaches, it is pointed out that a comparison without \"looking behind the figures\" (what it means to be familiar with the process structure, process d","PeriodicalId":35465,"journal":{"name":"Advances in Health Care Management","volume":"17 ","pages":"223-52"},"PeriodicalIF":0.0,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/s1474-823120140000017014","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33314027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Defining world-class care in academic medicine: enablers and challenges.","authors":"Andrew N Garman,&nbsp;Tricia J Johnson","doi":"10.1108/s1474-823120140000017002","DOIUrl":"https://doi.org/10.1108/s1474-823120140000017002","url":null,"abstract":"<p><strong>Purpose: </strong>Interest has grown among U.S. academic medical centers in developing international benchmarks for excellence in process and outcomes. Drivers behind this trend, as well as barriers to the development of useful benchmarks, are explored in this invited commentary.</p><p><strong>Design/methodology/approach: </strong>The commentary is based on the authors' conversations with members of the U.S. Cooperative for International Patient Programs as well as the University Healthsystem Consortium (UHC).</p><p><strong>Findings: </strong>Six key themes are summarized in this commentary, including four key drivers and two barriers.</p><p><strong>Originality/value: </strong>The practice-based perspectives this commentary summarizes provide a useful starting point for researchers and practitioners interested in establishing international comparison with the United States.</p>","PeriodicalId":35465,"journal":{"name":"Advances in Health Care Management","volume":"17 ","pages":"23-9"},"PeriodicalIF":0.0,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/s1474-823120140000017002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33314019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The link between health governance models and global health innovation: an exploration of OECD nations.","authors":"Karin Schnarr,&nbsp;Anne Snowdon,&nbsp;Heidi Cramm,&nbsp;Jason Cohen,&nbsp;Charles Alessi","doi":"10.1108/s1474-823120140000017004","DOIUrl":"https://doi.org/10.1108/s1474-823120140000017004","url":null,"abstract":"<p><strong>Purpose: </strong>While there is established research that explores individual innovations across countries or developments in a specific health area, there is less work that attempts to match national innovations to specific systems of health governance to uncover themes across nations.</p><p><strong>Design/methodology/approach: </strong>We used a cross-comparison design that employed content analysis of health governance models and innovation patterns in eight OECD nations (Australia, Britain, Canada, France, Germany, The Netherlands, Switzerland, and the United States).</p><p><strong>Findings: </strong>Country-level model of health governance may impact the focus of health innovation within the eight jurisdictions studied. Innovation across all governance models has targeted consumer engagement in health systems, the integration of health services across the continuum of care, access to care in the community, and financial models that drive competition.</p><p><strong>Originality/value: </strong>Improving our understanding of the linkage between health governance and innovation in health systems may heighten awareness of potential enablers and barriers to innovation success.</p>","PeriodicalId":35465,"journal":{"name":"Advances in Health Care Management","volume":"17 ","pages":"39-69"},"PeriodicalIF":0.0,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/s1474-823120140000017004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33314021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preface. Population health management in health care organizations.","authors":"Jennifer L Hefner,&nbsp;Timothy R Huerta,&nbsp;Ann Scheck McAlearney","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":35465,"journal":{"name":"Advances in Health Care Management","volume":"16 ","pages":"xvii-xxiv"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33337168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Invited letter: the evolving model of health care in the United States: system change is not enough.","authors":"Randell K Wexler","doi":"10.1108/s1474-823120140000016008","DOIUrl":"https://doi.org/10.1108/s1474-823120140000016008","url":null,"abstract":"","PeriodicalId":35465,"journal":{"name":"Advances in Health Care Management","volume":"16 ","pages":"173-6"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/s1474-823120140000016008","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33006865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Engaging the health care team through Operations Councils: strategies to improve population health from within.","authors":"Susan Moffatt-Bruce,&nbsp;Ann Scheck McAlearney,&nbsp;Alison Aldrich,&nbsp;Tina Latimer,&nbsp;Edmund Funai","doi":"10.1108/s1474-823120140000016003","DOIUrl":"https://doi.org/10.1108/s1474-823120140000016003","url":null,"abstract":"<p><strong>Purpose: </strong>Clinical front-line staff are best positioned within the organizations to identify patient safety problems and craft solutions. However, in traditional models, safety committees are led by senior executives who are not clinically responsible for patients. This top-down approach can result in missed opportunities to address patient-centered challenges and better manage the health of the defined populations served by these organizations.</p><p><strong>Design/methodology/approach: </strong>To foster teamwork, enhance empowerment, and improve the patient care environment, Operations Councils led by trained front-line staff were deployed in 15 clinical areas at the Ohio State University Wexner Medical Center (OSUWMC) as a performance improvement tool.</p><p><strong>Findings: </strong>Standardized training of Council facilitators was designed and implemented to guide the performance improvement process. Balanced scorecards were developed in each Council based on the risks and concerns of that particular clinical area. After initial implementation of the Operations Councils, patient safety events declined and team engagement improved by over 34% across the medical center; the highest changes were seen in areas where Operations Councils had been deployed. Additionally, outcome metrics including area-specific and system-wide mortality and readmissions improved after implementation.</p><p><strong>Originality/value: </strong>We suggest that this type of approach may be an appropriate strategy to consider in other health care organizations as such institutions are challenged to better manage the health of their defined patient populations.</p>","PeriodicalId":35465,"journal":{"name":"Advances in Health Care Management","volume":"16 ","pages":"51-67"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/s1474-823120140000016003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33006859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using teams to implement personalized health care across a multi-site breast cancer network.","authors":"Sarah Lewis,&nbsp;Joan Bloom,&nbsp;Jennifer Rice,&nbsp;Arash Naeim,&nbsp;Stephen Shortell","doi":"10.1108/s1474-823120140000016004","DOIUrl":"https://doi.org/10.1108/s1474-823120140000016004","url":null,"abstract":"<p><strong>Purpose: </strong>This study sought to identify the organizational factors associated with team and network effectiveness of the Athena Breast Health Network, a multi-site collaboration between five University of California health systems.</p><p><strong>Design/methodology/approach: </strong>Providers, managers, and support staff completed self-administered surveys over three years. Statistical analyses at the network and medical center levels tested hypotheses regarding the correlates of effective teams and perceived network effectiveness over time.</p><p><strong>Findings: </strong>Perceived team effectiveness was positively correlated with group culture and environments which support collaboration, negatively correlated with hierarchical culture, and negatively associated with professional tenure at year two. As measured by increasing team effectiveness scores over time and Athena's potential impact on patient care, perceived network effectiveness was positively associated with team effectiveness.</p><p><strong>Research limitations/implications: </strong>Results do not allow us to conclude that a certain type of culture \"causes\" team effectiveness or that team effectiveness \"causes\" greater perceptions of progress over time. Subsequent studies should examine these variables simultaneously. Further research is needed to examine the role of payment incentives, internal reward systems, the use of electronic health records, public disclosure of performance data, and depth of leadership within each organization and within the network overall.</p><p><strong>Practical implications: </strong>- Focusing on group affiliation and participation may improve team member perceptions regarding effectiveness and impact on patient care.</p><p><strong>Originality/value: </strong>Relatively little is known about the adaptive processes that occur within inter-organizational networks to achieve desired goals, and particularly the roles played by multi-disciplinary interprofessional teams. We studied a network comprising multiple campuses actively involved in better understanding, preventing, and treating a complex disease.</p>","PeriodicalId":35465,"journal":{"name":"Advances in Health Care Management","volume":"16 ","pages":"71-94"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/s1474-823120140000016004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33006860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Payment models to support population health management.","authors":"Timothy R Huerta,&nbsp;Jennifer L Hefner,&nbsp;Ann Scheck McAlearney","doi":"10.1108/s1474-823120140000016010","DOIUrl":"https://doi.org/10.1108/s1474-823120140000016010","url":null,"abstract":"<p><strong>Purpose: </strong>To survey the policy-driven financial controls currently being used to drive physician change in the care of populations.</p><p><strong>Design/methodology/approach: </strong>This paper offers a review of current health care payment models and discusses the impact of each on the potential success of PHM initiatives. We present the benefits of a multi-part model, combining visit-based fee-for-service reimbursement with a monthly \"care coordination payment\" and a performance-based payment system.</p><p><strong>Findings: </strong>A multi-part model removes volume-based incentives and promotes efficiency. However, it is predicated on a pay-for-performance framework that requires standardized measurement. Application of this model is limited due to the current lack of standardized measurement of quality goals that are linked to payment incentives.</p><p><strong>Practical implications: </strong>Financial models dictated by health system payers are inextricably linked to the organization and management of health care.</p><p><strong>Originality/value: </strong>There is a need for better measurements and realistic targets as part of a comprehensive system of measurement assessment that focuses on practice redesign, with the goal of standardizing measurement of the structure and process of redesign. Payment reform is a necessary component of an accurate measure of the associations between practice transformation and outcomes important to both patients and society.</p>","PeriodicalId":35465,"journal":{"name":"Advances in Health Care Management","volume":"16 ","pages":"177-83"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/s1474-823120140000016010","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33006804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A business planning model to identify new safety net clinic locations.","authors":"James Langabeer,&nbsp;Jeffrey Helton,&nbsp;Jami DelliFraine,&nbsp;Ebbin Dotson,&nbsp;Carolyn Watts,&nbsp;Karen Love","doi":"10.1108/s1474-823120140000016005","DOIUrl":"https://doi.org/10.1108/s1474-823120140000016005","url":null,"abstract":"<p><strong>Purpose: </strong>Community health clinics serving the poor and underserved are geographically expanding due to changes in U.S. health care policy. This paper describes the experience of a collaborative alliance of health care providers in a large metropolitan area who develop a conceptual and mathematical decision model to guide decisions on expanding its network of community health clinics.</p><p><strong>Design/methodology/approach: </strong>Community stakeholders participated in a collaborative process that defined constructs they deemed important in guiding decisions on the location of community health clinics. This collaboration also defined key variables within each construct. Scores for variables within each construct were then totaled and weighted into a community-specific optimal space planning equation. This analysis relied entirely on secondary data available from published sources.</p><p><strong>Findings: </strong>The model built from this collaboration revolved around the constructs of demand, sustainability, and competition. It used publicly available data defining variables within each construct to arrive at an optimal location that maximized demand and sustainability and minimized competition.</p><p><strong>Practical implications: </strong>This is a model that safety net clinic planners and community stakeholders can use to analyze demographic and utilization data to optimize capacity expansion to serve uninsured and Medicaid populations.</p><p><strong>Originality/value: </strong>Communities can use this innovative model to develop a locally relevant clinic location-planning framework.</p>","PeriodicalId":35465,"journal":{"name":"Advances in Health Care Management","volume":"16 ","pages":"95-112"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/s1474-823120140000016005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33006861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Strategic re-design of team-based patient-focused health care services.","authors":"Denise C Tahara,&nbsp;Richard P Green","doi":"10.1108/s1474-823120140000016000","DOIUrl":"https://doi.org/10.1108/s1474-823120140000016000","url":null,"abstract":"<p><strong>Purpose: </strong>This paper proposes an organizational change process to prepare physicians and other health professionals for their new roles in patient-centered medical homes (PCMHs). It provides physician-centered tools, models, concepts, and the language to implement transformational patient-centered medical care.</p><p><strong>Design/methodology/approach: </strong>To improve care delivery, quality, and patient engagement, a systems approach to care is required. This paper examines a systems approach to patient care where all inputs that influence patient interactions and participation are considered in the design of health care delivery and follow-up treatment plans. Applying systems thinking, organizational change models, and team-building, we have examined the continuum of this change process from ideation through the diffusion of new methods and behaviors.</p><p><strong>Findings: </strong>PCMHs make compelling business sense. Studies have shown that the PCMH improves patient satisfaction, clinical outcomes and reduces underuse and overuse of medical services. Patient-centered care necessitates transitioning from an adversarial to a collaborative culture. It is a transformation process predicated on strong leadership able to align an organization toward a vision of patient-centered care, creating a collaborative culture committed to health-goal achievement.</p><p><strong>Originality/value: </strong>This paper proposes that the PCMH is a rigorous team-building transformational organizational change, a radical departure from the current hierarchical, silo-oriented, medical practice model. It requires that participants within and across health care organizations learn new skills and behaviors to achieve the anticipated quality and efficiency improvements. It is an innovative health care organization model of the future whose success is premised on teams supplanting the individual as the building block and unit of health care performance.</p>","PeriodicalId":35465,"journal":{"name":"Advances in Health Care Management","volume":"16 ","pages":"3-22"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/s1474-823120140000016000","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33006857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}