Shivani Gupta, Ferhat D Zengul, Justin Blackburn, Larry R Hearld, Rita Jablonski, Bisakha Sen, Robert Weech-Maldonado
{"title":"Hospital-based skilled nursing facility survival: Organizational and market-level predictors.","authors":"Shivani Gupta, Ferhat D Zengul, Justin Blackburn, Larry R Hearld, Rita Jablonski, Bisakha Sen, Robert Weech-Maldonado","doi":"10.1097/HMR.0000000000000411","DOIUrl":"10.1097/HMR.0000000000000411","url":null,"abstract":"<p><strong>Background: </strong>Rising health care costs and consequent increases in Medicare reimbursements have led to many payment reforms over the years. Implementation of the prospective payment system (PPS) for hospitals in 1983 incentivized hospitals to either purchase skilled nursing facilities (SNFs) or utilize their excess capacity to establish one within the hospital. With PPS reimbursement being applied to SNFs in 1998, prior monetary incentives for hospitals to own an SNF disappeared. However, despite the reduction in numbers, many hospitals continued to operate their hospital-based skilled nursing facilities (HBSNFs).</p><p><strong>Purpose: </strong>This study examines the organizational and market-level factors associated with the survival of HBSNFs using the population ecology of organizations framework.</p><p><strong>Methodology: </strong>Using American Hospital Association survey data, event histories of all U.S. acute care hospitals with an open HBSNF in 1998 were plotted to examine if a hospital closed its HBSNF during a 22-year period (1998-2020). The primary independent variables included hospital size, ownership, total margin, market competition, and Medicare Advantage penetration. The independent and control variables were lagged by 1 year. Cox regressions were conducted to estimate the hazard ratios capturing the risk of HBSNF closure.</p><p><strong>Results: </strong>The results showed that HBSNFs located in large, not-for-profit hospitals and those operating in less competitive markets had greater odds of surviving.</p><p><strong>Practice implications: </strong>The HBSNF administrators of small, for-profit hospitals and those operating in highly competitive markets could utilize the findings of this study to judiciously allocate slack resources to their HBSNFs to keep those open given the current emphasis on continuity of care by regulatory bodies.</p>","PeriodicalId":47778,"journal":{"name":"Health Care Management Review","volume":" ","pages":"254-262"},"PeriodicalIF":1.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141894551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Karin Kee, Henk Nies, Marieke van Wieringen, Bianca Beersma
{"title":"Exploring barriers to employee voice among certified nursing assistants: A qualitative study.","authors":"Karin Kee, Henk Nies, Marieke van Wieringen, Bianca Beersma","doi":"10.1097/HMR.0000000000000415","DOIUrl":"10.1097/HMR.0000000000000415","url":null,"abstract":"<p><strong>Background: </strong>Research shows that voice-the communication of ideas, concerns, and perspectives by employees to those in positions to instigate changes-is related to job satisfaction, retention, and organizational improvement. Nevertheless, health care professionals often do not exercise voice. Although researchers have explored the barriers registered nurses working in hospitals experience in expressing their voices, there has been a notable lack of attention in research and practice to the voice of certified nursing assistants working in long-term care settings.</p><p><strong>Purposes: </strong>Ensuring that certified nursing assistants can exercise voice is essential for the welfare and well-being of this occupational group and critical for the success of their organizations. Therefore, we explore the barriers certified nursing assistants encounter that hinder them from exercising voice.</p><p><strong>Methodology: </strong>We conducted seven focus groups in which 24 Dutch certified nursing assistants participated.</p><p><strong>Results: </strong>The results show that respondents were not always willing to exercise voice, which stemmed primarily from negative prior experiences with exercising voice. Respondents were further not always able to exercise voice, as the conditions under which they had to do so were unfavorable. Finally, respondents sometimes lacked the necessary skills to convey their ideas, concerns, and perspectives effectively.</p><p><strong>Practice implications: </strong>Our findings indicate that health care managers must address multiple factors if they wish to enhance the voice of certified nursing assistants.</p>","PeriodicalId":47778,"journal":{"name":"Health Care Management Review","volume":" ","pages":"291-300"},"PeriodicalIF":1.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141749277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pejmon Noghrehchi, Jennifer L Hefner, Daniel M Walker
{"title":"The relationship between hospital patient safety culture and performance on Centers for Medicare & Medicaid Services value-based purchasing metrics.","authors":"Pejmon Noghrehchi, Jennifer L Hefner, Daniel M Walker","doi":"10.1097/HMR.0000000000000414","DOIUrl":"10.1097/HMR.0000000000000414","url":null,"abstract":"<p><strong>Background: </strong>Despite the intense policy focus on reducing health-care-associated conditions, adverse events in health care settings persist. Therefore, evaluating patient safety efforts and related health policy initiatives remains critical.</p><p><strong>Purpose: </strong>The aim of this study was to explore the relationship between hospital patient safety culture and hospital performance on Centers for Medicare & Medicaid Services (CMS) Hospital Value-Based Purchasing (HVBP) metrics.</p><p><strong>Methodology/approach: </strong>A pooled cross-sectional study design was used utilizing three secondary datasets from 2018 and 2021: the Hospital Survey on Patient Safety Culture, the American Hospital Association annual survey, and the Hospital Compare data from CMS. We used two multivariable linear regression models to examine the relationship between organizational patient safety culture and hospital performance. The dependent variables included the overall CMS total performance score (TPS) and the four individual TPS domain scores. Hospital patient safety culture, the independent variable, was operationalized using two measures from the Hospital Survey on Patient Safety Culture: (a) the domain score of overall perceptions of patient safety and (b) the patient safety grade.</p><p><strong>Results: </strong>We observed positive and significant associations between hospital patient safety culture and a hospital's overall TPS and the \"patient and community engagement\" and \"safety\" domains.</p><p><strong>Conclusion: </strong>Findings suggest that building a strong patient safety culture has the potential to lead health care organizations to achieve high performance on HVBP metrics.</p><p><strong>Practice implications: </strong>Our findings have important policy implications for both the future of CMS HVBP as a motivator of patient safety and how health care managers integrate culture change into programs to meet external quality metrics.</p>","PeriodicalId":47778,"journal":{"name":"Health Care Management Review","volume":" ","pages":"281-290"},"PeriodicalIF":1.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141894552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Larry R Hearld, J'Aime Jennings, Demetria Hubbard, Seung-Yup Lee, Kristine R Hearld
{"title":"The role of patient and family advisory boards in promoting greater attention to patient social needs by U.S. acute care hospitals.","authors":"Larry R Hearld, J'Aime Jennings, Demetria Hubbard, Seung-Yup Lee, Kristine R Hearld","doi":"10.1097/HMR.0000000000000417","DOIUrl":"10.1097/HMR.0000000000000417","url":null,"abstract":"<p><strong>Background: </strong>There is growing attention to individual-level patient social needs such as unstable housing and food insecurity. Such considerations, however, have historically been the purview of public health and have not been a priority of more traditional health care delivery organizations, such as acute care hospitals.</p><p><strong>Purpose: </strong>The purpose of this study was to examine whether the presence of patient and family advisory boards (PFABs) among acute care community hospitals was associated with screening for and programs to address patient social needs.</p><p><strong>Methods: </strong>We used a secondary data set derived from the American Hospital Association's 2020 and 2021 annual surveys, along with multinomial and negative binomial regression models to assess the relationship between the presence/absence of a PFAB and the likelihood of offering and the number of areas addressed by social needs screening programs.</p><p><strong>Results: </strong>More than half (55.9%) of all responding hospitals reported having a PFAB in 2020 (55.9%) and 2021 (52.7%). The presence of a PFAB among hospitals was significantly associated with patient social needs screening, more areas addressed by programs, and more types of partners to address these needs.</p><p><strong>Conclusions: </strong>Community hospitals with a PFAB have more robust programs and partnerships to address patient social needs.</p><p><strong>Practice implications: </strong>Hospital leaders should consider going beyond simply establishing programs to address social needs but also consider comprehensiveness of these programs to recognize the intersectionality of social needs. One way to do this is to formally establish a PFAB to help hospitals better identify and prioritize the needs in local communities and design social needs programs/solutions that are patient- and family-centric.</p>","PeriodicalId":47778,"journal":{"name":"Health Care Management Review","volume":" ","pages":"311-322"},"PeriodicalIF":1.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141894570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Conservation of resources perspective on authentic leadership and employee well-being: The influence of job stress and emotional intelligence.","authors":"Fang-Chi Shih, Shu-Chuan Jennifer Yeh","doi":"10.1097/HMR.0000000000000418","DOIUrl":"10.1097/HMR.0000000000000418","url":null,"abstract":"<p><strong>Background: </strong>Health care industries must consider their sustainable development, and employee well-being is a crucial environmental, social, and governance indicator that should be prioritized. During events such as the COVID-19 pandemic, information transparency is a concern for health care workers. Authentic leaders can build trust by openly sharing their thoughts and feelings. Understanding how authentic leadership affects employee well-being through job stress and how emotional intelligence reduces job stress is essential for health care workers.</p><p><strong>Purposes: </strong>This study investigated the effect of authentic leadership on employee well-being and considered the mediating role of job stress and moderating role of emotional intelligence in this effect.</p><p><strong>Methodology/approach: </strong>A time-lagged survey of 452 full-time health care workers (comprising nurses, allied health professionals, and administrative workers) from a general hospital in Taiwan was conducted.</p><p><strong>Findings: </strong>Authentic leadership was positively associated with employee well-being, and job stress mediated the effects of authentic leadership on employee well-being. Among the employees who perceived leadership to be authentic, those with higher emotional intelligence felt less job stress.</p><p><strong>Conclusion: </strong>From the perspective of conservation of resources theory, authentic leadership was identified as a crucial factor influencing how health care workers reduce job stress and improve their well-being. Emotional intelligence was identified as essential in enhancing the effects of authentic leadership on reducing the job stress of health care workers.</p><p><strong>Practice implications: </strong>Organizations should promote authentic interactions between leaders and followers and provide training for developing authentic leadership. They should also provide training to improve their employees' emotional intelligence.</p>","PeriodicalId":47778,"journal":{"name":"Health Care Management Review","volume":" ","pages":"323-330"},"PeriodicalIF":1.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141894550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ashlyn Burns, Valerie A Yeager, Joshua R Vest, Christopher A Harle, Emilie R Madsen, Cory E Cronin, Simone Singh, Berkeley Franz
{"title":"New insights about community benefit evaluation: Using the Community Health Implementation Evaluation Framework to assess what hospitals are measuring.","authors":"Ashlyn Burns, Valerie A Yeager, Joshua R Vest, Christopher A Harle, Emilie R Madsen, Cory E Cronin, Simone Singh, Berkeley Franz","doi":"10.1097/HMR.0000000000000408","DOIUrl":"10.1097/HMR.0000000000000408","url":null,"abstract":"<p><strong>Background: </strong>Nonprofit hospitals are required to conduct community health needs assessments (CHNA) every 3 years and develop corresponding implementation plans. Implemented strategies must address the identified community needs and be evaluated for impact.</p><p><strong>Purpose: </strong>Using the Community Health Implementation Evaluation Framework (CHIEF), we assessed whether and how nonprofit hospitals are evaluating the impact of their CHNA-informed community benefit initiatives.</p><p><strong>Methodology: </strong>We conducted a content analysis of 83 hospital CHNAs that reported evaluation outcomes drawn from a previously identified 20% random sample ( n = 613) of nonprofit hospitals in the United States. Through qualitative review guided by the CHIEF, we identified and categorized the most common evaluation outcomes reported.</p><p><strong>Results: </strong>A total of 485 strategies were identified from the 83 hospitals' CHNAs. Evaluated strategies most frequently targeted behavioral health ( n = 124, 26%), access ( n = 83, 17%), and obesity/nutrition/inactivity ( n = 68, 14%). The most common type of evaluation outcomes reported by CHIEF category included system utilization ( n = 342, 71%), system implementation ( n = 170, 35%), project management ( n = 164, 34%), and social outcomes ( n = 163, 34%).</p><p><strong>Practice implications: </strong>CHNA evaluation strategies focus on utilization (the number of individuals served), with few focusing on social or health outcomes. This represents a missed opportunity to (a) assess the social and health impacts across individual strategies and (b) provide insight that can be used to inform the allocation of limited resources to maximize the impact of community benefit strategies.</p>","PeriodicalId":47778,"journal":{"name":"Health Care Management Review","volume":" ","pages":"229-238"},"PeriodicalIF":1.7,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141077142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Nurse practitioners, physician assistants, and trust: A systematic review.","authors":"Tracy H Porter, Jessica A Peck, Gina Thoebes","doi":"10.1097/HMR.0000000000000405","DOIUrl":"10.1097/HMR.0000000000000405","url":null,"abstract":"<p><strong>Background: </strong>The use of physician extenders (e.g., nurse practitioners [NPs] and physician assistants [PAs]) has risen in recent years in the U.S. health care domain, yet some scholars have questioned if physician extenders are being fully utilized in the health care field.</p><p><strong>Purposes: </strong>The purpose of this research was to conduct a systematic review to determine if trust in the NP/PA might be influential in the ways these professionals are utilized. We view trust through the lens of Mayer et al. and their model of organizational trust, and we seek to examine how patients, physicians, and NPs/PAs themselves view one another.</p><p><strong>Methods: </strong>This systematic review spanned from 1996 to 2022 and applied the Preferred Reporting Items for Systematic Reviews and Meta-Analyses strategy. The final sample consisted of 29 articles.</p><p><strong>Results: </strong>The findings point to how the antecedents of trust according to Mayer et al.; i.e., trustee's ability, benevolence, and integrity) influence the trusting relationships between patients and NPs/PAs and between physicians and NPs/PAs. Consequences and outcomes of trust are also discussed. Importantly, a trustor's propensity to trust and repeat interactions over time (e.g., feedback loop) is influential to trusting relationships.</p><p><strong>Practice implications: </strong>These findings offer health care organizations insight into the mechanisms for building trust as physician extenders become more prominent in the health care field.</p>","PeriodicalId":47778,"journal":{"name":"Health Care Management Review","volume":" ","pages":"198-209"},"PeriodicalIF":1.7,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141077144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Tago L Mharapara, Katherine Ravenswood, Janine H Clemons, Gill Kirton, James Greenslade-Yeats
{"title":"Enhancing midwives' occupational well-being: Lessons from New Zealand's COVID-19 experience.","authors":"Tago L Mharapara, Katherine Ravenswood, Janine H Clemons, Gill Kirton, James Greenslade-Yeats","doi":"10.1097/HMR.0000000000000406","DOIUrl":"10.1097/HMR.0000000000000406","url":null,"abstract":"<p><strong>Background: </strong>The World Health Organization posits that adequate maternity health is possible if midwives are supported, respected, protected, motivated, and equipped to work safely and optimally within interdisciplinary health care teams. Based on qualitative survey data, we argue that the COVID-19 pandemic amplified job demands and resources, professional invisibility, and gender norms to negatively impact midwives' well-being.</p><p><strong>Purposes: </strong>We aim to develop a refined understanding of the antecedents of well-being in midwifery to equip policymakers, administrators, and professional associations with the knowledge to enhance midwives' well-being postpandemic.</p><p><strong>Methodology/approach: </strong>Drawing on the Job Demands-Resources model, we thematically analyzed qualitative survey data ( N = 215) from New Zealand midwives to reveal how job demands, resources, and structural factors impacted midwives' well-being.</p><p><strong>Results: </strong>We identified fear of contracting and spreading COVID-19, financial and legal imperatives (job demands), work-related hypervigilance, sense of professional duty, practical and social support, and appreciation and recognition (job resources) as key antecedents of midwives' well-being. These job demands and resources were influenced by professional invisibility and gender norms.</p><p><strong>Conclusion: </strong>Policy and practice solutions must address job demands, resources, and structural factors to meaningfully enhance midwives' well-being postpandemic.</p><p><strong>Practice implications: </strong>We recommend that policymakers, administrators, and professional associations monitor for signs of overcommitment and perfectionistic strivings and then take appropriate remedial action. We also suggest that midwives receive equitable pay, sick leave, and other related benefits.</p>","PeriodicalId":47778,"journal":{"name":"Health Care Management Review","volume":" ","pages":"210-219"},"PeriodicalIF":1.7,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140959729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The crisis of primary care and the case for more primary care management research.","authors":"Larry R Hearld, Cheryl Rathert","doi":"10.1097/HMR.0000000000000410","DOIUrl":"10.1097/HMR.0000000000000410","url":null,"abstract":"","PeriodicalId":47778,"journal":{"name":"Health Care Management Review","volume":"49 3","pages":"159-160"},"PeriodicalIF":1.7,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141088889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Alden Yuanhong Lai, Kenneth Z Wee, Jemima A Frimpong
{"title":"Proactive behaviors and health care workers: A systematic review.","authors":"Alden Yuanhong Lai, Kenneth Z Wee, Jemima A Frimpong","doi":"10.1097/HMR.0000000000000409","DOIUrl":"10.1097/HMR.0000000000000409","url":null,"abstract":"<p><strong>Background: </strong>Proactive behaviors at work refer to discretionary actions among workers that are self-starting, change oriented, and future focused. Proactive behaviors reflect the idiosyncratic actions by individual workers that shape the delivery and experience of professional services, highlight a bottom-up perspective on workers' agency and motivation that can influence organizational practices, and are associated with a variety of employee and organizational outcomes.</p><p><strong>Purpose: </strong>This systematic review aims to understand the various forms of proactive behaviors in health care workers that have been studied, and how these proactive behaviors are associated with employee-level outcomes and quality of care.</p><p><strong>Methods: </strong>Systematic review of articles published to date on proactive behaviors in health care workers.</p><p><strong>Results: </strong>Based on the identification of 40 articles, we find that job crafting, active problem solving, voice, extra-role behaviors, and idiosyncratic deals have been investigated as proactive behaviors among health care workers. Among these, job crafting is the most commonly studied (35% of articles), and it has been conceptualized and measured in the most consistent way, including as individual- and group-level phenomena, and as organizational interventions. Studies on active problem solving, which refers to workers accepting responsibility, exercising control, and taking action around anticipated or experienced problems at work, have not been consistently investigated as a form of proactive behavior but represent 25% of the articles identified in this review. Overall, this review finds that proactive behaviors in health care is a burgeoning area of research, with the majority of studies being cross-sectional in design and published after 2010, and focused on workers' job satisfaction as the outcome.</p><p><strong>Practice implications: </strong>Health care workers and managers should consider the distinct influences and contributions of proactive behaviors as ways to improve employee-level outcomes and quality of care.</p>","PeriodicalId":47778,"journal":{"name":"Health Care Management Review","volume":" ","pages":"239-251"},"PeriodicalIF":2.5,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140959733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}