Health Services Management Research最新文献_第3页

A framework for lean implementation in preoperative assessment: Evidence from a high complexity hospital in Italy. 术前评估中的精益实施框架：来自意大利一家高复杂性医院的证据。

IF 1.6

Health Services Management Research Pub Date : 2024-11-01 Epub Date: 2023-08-23 DOI: 10.1177/09514848231194853

Giulia Goretti, Martina Pisarra, Maria Rosaria Capogreco, Patrizia Meroni

{"title":"A framework for lean implementation in preoperative assessment: Evidence from a high complexity hospital in Italy.","authors":"Giulia Goretti, Martina Pisarra, Maria Rosaria Capogreco, Patrizia Meroni","doi":"10.1177/09514848231194853","DOIUrl":"10.1177/09514848231194853","url":null,"abstract":"Purpose: A routine preoperative assessment is considered both ineffective and inefficient. Despite the widespread application of lean thinking in healthcare, there is little evidence of successful experiences in preoperative admissions in order to reduce \"No value added\" activities. A conceptual framework reporting the drivers (clinic, tools, innovation, organization, and governance) and impacts (patient, efficiency, sustainability, time, learning and growth) was developed. Methodology: Drawing on the experience of an Italian high complexity hospital, this paper analyzes the case study by reporting evidence on how to implement lean in preoperative assessment and how to evaluate the positive results obtained. Results: Applying lean principles, the identification of value improved the appropriateness of care by creating 40 personalized pathways; the value stream resulted in a reduction of \"No Value Added Time\" from 37% to 28%, chest X-rays from 41% to 14% and cardiac visits from 49% to 37%; the pursuit of continuous flow through innovation contributed to increase the use of digitalization; the new pull organization helped to reduce the average time spent per year by 1.5 h; the continuous improvement was ensured through the governance of results. Conclusion: The proposed framework should be used to improve the quality of care in preoperative admissions by adopting the lean drivers for successful implementation and reporting the impacts.","PeriodicalId":45801,"journal":{"name":"Health Services Management Research","volume":" ","pages":"236-244"},"PeriodicalIF":1.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11545146/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10283163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

"A different sense of what we do here, who we are and what we deliver": Provider perspectives on the effects of a change in governance of healthcare services in correctional facilities in British Columbia. "对我们在这里做什么、我们是谁以及我们提供什么有不同的认识":提供者对不列颠哥伦比亚省惩教设施保健服务治理变化的影响的看法。

IF 1.6

Health Services Management Research Pub Date : 2024-11-01 Epub Date: 2023-11-29 DOI: 10.1177/09514848231218626

Katherine E McLeod, Jane A Buxton, Ruth Elwood Martin

{"title":"\"A different sense of what we do here, who we are and what we deliver\": Provider perspectives on the effects of a change in governance of healthcare services in correctional facilities in British Columbia.","authors":"Katherine E McLeod, Jane A Buxton, Ruth Elwood Martin","doi":"10.1177/09514848231218626","DOIUrl":"10.1177/09514848231218626","url":null,"abstract":"In 2017, British Columbia (BC) transferred responsibility for healthcare services in provincial correctional facilities from the Ministry of Public Safety and Solicitor General to the Ministry of Health. This study explored how healthcare leadership perceived the impact of the transfer on services, work-life, and job satisfaction. We conducted one-on-one interviews (n = 8) with healthcare managers and medical and administrative leadership within Correctional Health Services. Using the Two-Factor theory of job satisfaction as a framework, we applied Interpretive Description methodology to analyse interview data. Participants identified changes to four areas of the working environment: (1) staffing, equipment, and resources (2) systems of supervision and support (3) standards, policies, and quality improvement and (4) culture and orientation. These changes predominantly affected motivational factors of job satisfaction and were described as enriching the roles of managers and staff. Participants described improved autonomy and recognition of providers, increased quality of services delivered, and a shift toward patient-centred care. The perspectives of healthcare leaders provide new insight into the potential impact of transferring healthcare services in custody to a public healthcare system. Discussion of changes and their affects also provide practical learning for jurisdictions seeking to improve healthcare under a variety of governance and service-delivery models.","PeriodicalId":45801,"journal":{"name":"Health Services Management Research","volume":" ","pages":"219-226"},"PeriodicalIF":1.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11545118/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138452822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The (very real) risk of irrelevance, and the great opportunity. 无关紧要的风险（非常现实）和巨大的机遇。

IF 1.6

Health Services Management Research Pub Date : 2024-11-01 Epub Date: 2024-10-18 DOI: 10.1177/09514848241295480

Federico Lega

引用次数: 0

Strategies to convert hospital beds for COVID-19 patients to minimize emergency department overcrowding. 为COVID-19患者转换医院床位以尽量减少急诊科过度拥挤的策略。

IF 1.6

Health Services Management Research Pub Date : 2024-11-01 Epub Date: 2023-12-07 DOI: 10.1177/09514848231218648

Giovanni Nattino, Marco Maria Paganuzzi, Giulia Irene Ghilardi, Giorgio Costantino, Carlotta Rossi, Francesca Cortellaro, Roberto Cosentini, Stefano Paglia, Maurizio Migliori, Guido Bertolini

{"title":"Strategies to convert hospital beds for COVID-19 patients to minimize emergency department overcrowding.","authors":"Giovanni Nattino, Marco Maria Paganuzzi, Giulia Irene Ghilardi, Giorgio Costantino, Carlotta Rossi, Francesca Cortellaro, Roberto Cosentini, Stefano Paglia, Maurizio Migliori, Guido Bertolini","doi":"10.1177/09514848231218648","DOIUrl":"10.1177/09514848231218648","url":null,"abstract":"Background: The shortage of hospital beds for COVID-19 patients has been one critical cause of Emergency Department (ED) overcrowding. Purpose: We aimed at elaborating a strategy of conversion of hospital beds, from non-COVID-19 to COVID-19 care, minimizing both ED overcrowding and the number of beds eventually converted. Research Design: Observational retrospective study. Study Sample: We considered the centralized database of all ED admissions in the Lombardy region of Italy during the second \"COVID-19 wave\" (October to December 2020). Data collection and Analysis: We analyzed all admissions to 82 EDs. We devised a family of Monte Carlo simulations to evaluate the performance of hospital beds' conversion strategies triggered by ED crowding of COVID-19 patients, determining a critical number of beds to be converted when passing an ED-specific crowding threshold. Results: Our results suggest that the maximum number of patients waiting for hospitalization could have been decreased by 70% with the proposed strategy. Such a reduction would have been achieved by converting 30% more hospital beds than the total number converted in the region. Conclusions: The disproportion between reduction in ED crowding and additionally converted beds suggests that a wide margin to improve the efficiency of the conversions exists. The proposed simulation apparatus can be easily generalized to study management policies synchronizing ED output and in-hospital bed availability.","PeriodicalId":45801,"journal":{"name":"Health Services Management Research","volume":" ","pages":"209-218"},"PeriodicalIF":1.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11545217/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138499710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Delphi Plus: A novel methodology for identifying evidence-based data standards for health service decision-making. Delphi Plus:一种用于确定卫生服务决策的循证数据标准的新方法。

IF 1.6

Health Services Management Research Pub Date : 2024-11-01 Epub Date: 2023-11-28 DOI: 10.1177/09514848231218637

Peter W Clark, Lauren T Williams, Jessica Lee, Lauren Ball

{"title":"Delphi Plus: A novel methodology for identifying evidence-based data standards for health service decision-making.","authors":"Peter W Clark, Lauren T Williams, Jessica Lee, Lauren Ball","doi":"10.1177/09514848231218637","DOIUrl":"10.1177/09514848231218637","url":null,"abstract":"The underlying tenet of evidence-based decision-making in health services is assessing all the relevant evidence. Using the traditional qualitative and quantitative approaches to identifying evidence may not capture the full spectrum of factors that need to be addressed. A selective mixed-method approach may provide a comprehensive assessment of the relevant knowledge. This paper adds to the methodological literature by outlining a novel sequential, mixed-method, exploratory process for identifying evidence-based data standards that may be used for health service decision-making. The three-phase process, entitled Delphi Plus, engages peer-nominated topic-specific experts to assess all publicly available and practice-based items and, through a series of reviews, reach an evidence-based consensus on standards for decision-making. Each process phase is outlined in-depth and supplemented by practical learnings gained through its implementation. The Delphi Plus methodology provides the first comprehensive process for combining the published and practised data to develop evidence-based data standards. The routine use of Delphi Plus would provide a framework for benchmarking in health services, enabling greater monitoring and evaluation of client outcomes and improving quality care. This manuscript describes the process of implementing Delphi Plus and provides an example of data standards generated from its use, which directly inform the Australian Government's Primary Health Care 10 Year Plan.","PeriodicalId":45801,"journal":{"name":"Health Services Management Research","volume":" ","pages":"227-235"},"PeriodicalIF":1.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138452823","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}

引用次数: 0

A multi-dimensional study of organisational boundaries and silos in the healthcare sector. 组织边界和孤岛在医疗保健部门的多维研究。

IF 1.6

Health Services Management Research Pub Date : 2024-11-01 Epub Date: 2023-11-27 DOI: 10.1177/09514848231218617

Esben Rahbek Gjerdrum Pedersen, Frantisek Sudzina, Francesco Rosati

引用次数: 0

An exploration of factors leading to readiness for organizational health literacy change in community-based health organizations. 探讨导致社区医疗机构做好组织健康知识变革准备的因素。

IF 1.6

Health Services Management Research Pub Date : 2024-10-24 DOI: 10.1177/09514848241295655

Melanie Stone, Ricardo Wray, Jason Rosenfeld, Melissa Valerio-Shewmaker, Teresa Wagner

{"title":"An exploration of factors leading to readiness for organizational health literacy change in community-based health organizations.","authors":"Melanie Stone, Ricardo Wray, Jason Rosenfeld, Melissa Valerio-Shewmaker, Teresa Wagner","doi":"10.1177/09514848241295655","DOIUrl":"https://doi.org/10.1177/09514848241295655","url":null,"abstract":"Introduction: Healthcare systems have a responsibility to improve organizational health literacy (OHL) to increase health equity. This study explored two organizational cultural factors, leadership support and staff buy-in, for organizations planning OHL change.Methods: Ten community-based health organizations participated in an OHL program. The study design was mixed methods. The qualitative inquiry was interviews with senior leaders to explore awareness of OHL and: impetus to transform, leadership commitment, staff engagement, alignment to organizational goals, and integration of health literacy change with current practices. The quantitative assessment was the Organizational Readiness for Implementing Change (ORIC) questionnaire to assess staff's perceptions about OHL change readiness.Results: Senior leaders articulated the effects of low health literacy in their patient and client population. Support for OHL change was seen at both leadership and staff levels. Impetus for change was primarily a response to a community need or for quality improvement. Most of the non-clinical organizations had higher ORIC scores than the clinical organizations, indicating a perceived higher level of readiness for OHL change.Conclusion: Leadership commitment and staff buy-in are important factors of readiness for OHL change. A novel finding is that community-based health organizations are able and willing to engage in OHL change.","PeriodicalId":45801,"journal":{"name":"Health Services Management Research","volume":" ","pages":"9514848241295655"},"PeriodicalIF":1.6,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142510135","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}

引用次数: 0

The impact of policy and technology infrastructure on telehealth utilization. 政策和技术基础设施对远程医疗使用的影响。

IF 1.6

Health Services Management Research Pub Date : 2024-08-28 DOI: 10.1177/09514848241276471

Ying-Chih Sun, Ozlem Cosgun, Raj Sharman

{"title":"The impact of policy and technology infrastructure on telehealth utilization.","authors":"Ying-Chih Sun, Ozlem Cosgun, Raj Sharman","doi":"10.1177/09514848241276471","DOIUrl":"https://doi.org/10.1177/09514848241276471","url":null,"abstract":"The COVID-19 outbreak resulted in an unprecedented surge in telehealth utilization. However, the effects of policy enactment on utilization remain understudied in the literature. Our research examines the impact of policy mandates relating to federal incentive programs on telehealth utilization across states during the pandemic by considering technology infrastructure, such as broadband penetration and equipment possession. This study also considers the impact of political orientation and control factors, including income attributes, on telehealth utilization. Considering telehealth utilization in the Medicare program as a test case, this study employed the partial least square and structural equation model to analyze data from the Centers for Medicare & Medicaid Services, the American Community Survey, and the Microsoft Airband Project to draw inferences. Our study finds that telehealth legislation, broadband penetration, political orientation, and control factors have a direct significant impact on telehealth utilization, whereas incentive programs and equipment possession have an indirect impact through broadband penetration.","PeriodicalId":45801,"journal":{"name":"Health Services Management Research","volume":" ","pages":"9514848241276471"},"PeriodicalIF":1.6,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142093952","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}

引用次数: 0

Hospital process performance and the adoption of medical devices: An organization-based view. 医院流程绩效与医疗设备的采用：基于组织的观点。

IF 1.6

Health Services Management Research Pub Date : 2024-08-05 DOI: 10.1177/09514848241270874

Francesca De Domenico, Guido Noto, Maria Cristina Cinici

{"title":"Hospital process performance and the adoption of medical devices: An organization-based view.","authors":"Francesca De Domenico, Guido Noto, Maria Cristina Cinici","doi":"10.1177/09514848241270874","DOIUrl":"https://doi.org/10.1177/09514848241270874","url":null,"abstract":"Over the past two decades, there has been a growing scholarly interest in the adoption of technology in healthcare. While numerous studies have delved into the effects of specific technologies on the performance of different organizational units and medical specialties, the findings have often been divergent. Unlike the established literature, our approach focuses on the organization's perspective to analyze how technology impacts process performance in hospital settings. More precisely, we compiled a tailored dataset from 56 healthcare organizations in Italy and conducted a comprehensive analysis of panel data from 2016 to 2019, utilizing Ordinary Least Squares (OLS) regression as our main analytical tool. The data shows a clear relationship between an organization's use of medical devices and its overall process performance. Our research highlights the importance of achieving substantial improvements in process performance by strategically integrating new technologies and devices. Policymakers are encouraged to consider introducing incentives to drive hospitals to invest in innovative technologies. Furthermore, monitoring expenditures on new devices could serve as a valuable metric for assessing the extent of technology adoption within clinical practices.","PeriodicalId":45801,"journal":{"name":"Health Services Management Research","volume":" ","pages":"9514848241270874"},"PeriodicalIF":1.6,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141890434","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}

引用次数: 0

Insights into how universal, tax-funded, single payer health systems manage their waiting lists: A review of the literature. 洞察由税收资助的全民单一支付医疗系统如何管理候诊名单：文献综述。

IF 1.6

Health Services Management Research Pub Date : 2024-08-01 Epub Date: 2023-07-02 DOI: 10.1177/09514848231186773

Francesco Amigoni, Federico Lega, Elena Maggioni

{"title":"Insights into how universal, tax-funded, single payer health systems manage their waiting lists: A review of the literature.","authors":"Francesco Amigoni, Federico Lega, Elena Maggioni","doi":"10.1177/09514848231186773","DOIUrl":"10.1177/09514848231186773","url":null,"abstract":"Background: A conspicuous consequence of gatekeeping arrangements in universal, tax-funded, single-payer health care systems is the long waiting times. Besides limiting equal access to care, long waiting times can have a negative impact on health outcomes. Long waiting times can create obstacles in a patient's care pathway. Organization for Economic Co-operation and Development (OECD) countries have implemented various strategies to tackle this issue, but there is little evidence for which approach is the most effective. This literature review examined waiting times for ambulatory care. Objective: The aim was to identify the main policies or combinations of policies universal, tax-funded, and single-payer healthcare systems have implemented to improve the governance of outpatient waiting times. Methods: Starting from 1040 potentially eligible articles, a total of 41 studies were identified via a 2-step selection process. Findings: Despite the relevance of the issue, the literature is limited. A set of 15 policies for the governance of ambulatory waiting time was identified and categorized by the type of intervention: generation of supply capacity, control of demand, and mixed interventions. Even if a primary intervention was always identifiable, rarely a policy was implemented solo. The most frequent primary strategies were: guidelines implementation and/or clinical pathways, including triage, guidelines for referral and maxim waiting times (14 studies), task shifting (9 studies), and telemedicine (6 studies). Most studies were observational, with no data on costs of intervention and impact on clinical outcomes.","PeriodicalId":45801,"journal":{"name":"Health Services Management Research","volume":" ","pages":"160-173"},"PeriodicalIF":1.6,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9740002","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}

引用次数: 0