Health Care Management Review最新文献

{"title":"Social determinants of health data reporting and hospitals' 30-day readmissions.","authors":"Hanadi Hamadi, D Rob Haley, Sinyoung Park, Aurora Tafili, Mei Zhao, Aaron Spaulding","doi":"10.1097/HMR.0000000000000469","DOIUrl":"10.1097/HMR.0000000000000469","url":null,"abstract":"<p><strong>Background: </strong>Hospitals' utilization of social determinants of health data represents an important strategy for improving patient outcomes and reducing 30-day readmissions.</p><p><strong>Purpose: </strong>Using a contingency theory lens, this study investigated the relationship between hospitals' use of social needs data (SND) and 30-day readmission rates for conditions targeted by the Centers for Medicare and Medicaid Services' Hospital Readmission Reduction Program.</p><p><strong>Methodology/approach: </strong>A cross-sectional retrospective study was conducted using data from general and surgical acute care hospitals ( n =1,350). Regression models were used to examine associations between SND usage and 30-day readmission rates.</p><p><strong>Findings: </strong>Hospitals using SND for referrals to social service organizations experienced a 0.46-point decrease in heart failure readmissions ( p <.001). Population health analytics use was associated with a 0.13-point decrease in hospital-wide readmissions ( p <.05). Complete utilization of SND use was associated with a 0.30-point decrease in COPD ( p <.05) and a 0.33-point decrease in pneumonia readmissions ( p <.05).</p><p><strong>Conclusions: </strong>The effectiveness of SND strategies varies significantly based on hospital characteristics, regional factors, and clinical conditions, supporting contingency theory's premise that performance depends on alignment between strategies and contextual factors.</p><p><strong>Practice implications: </strong>Rather than advocating for uniform activities, our results suggest that hospital administrators should seek to achieve an optimal fit between the social needs identified in their communities and their specific organizational and environmental circumstances.</p>","PeriodicalId":47778,"journal":{"name":"Health Care Management Review","volume":" ","pages":"121-128"},"PeriodicalIF":2.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146144031","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":"COVID-19 and breast cancer care: How multidisciplinary teams managed the quality of care.","authors":"Roberta Laurita, Federica Morandi, Americo Cicchetti","doi":"10.1097/HMR.0000000000000468","DOIUrl":"10.1097/HMR.0000000000000468","url":null,"abstract":"<p><strong>Background: </strong>Organizations worldwide have faced many challenges due to the COVID-19 pandemic. In the health care sector, including breast cancer, multidisciplinary teams have suffered disruptions due to changes in the organization of work and in membership composition. Moreover, the entire health care workforce has been impacted by significant stress.</p><p><strong>Purpose: </strong>This study aimed to understand how these challenges affected the probability of observing changes in breast unit (BU) patients' perceptions of the quality of care received.</p><p><strong>Methodology/approach: </strong>We tested three research hypotheses using a sample of 366 patients nested in 68 BUs, performing logistic regression using STATA 14.</p><p><strong>Results: </strong>The stress experienced by BU team leaders had a positive impact on the perceived stability of quality of care, whereas changes in team composition and social distancing among members had a negative impact on it.</p><p><strong>Practice implications: </strong>Health care managers should develop new training paths to help professionals adapt to new ways of working using appropriate technologies. Organizations should make teams able to share knowledge and practices through specific instruments, such as repository tools that can support teams even in cases of membership changes. Policymakers should pay greater attention to the mental health of health care workers, especially in emergencies.</p><p><strong>Conclusions: </strong>This paper highlights the key factors that enable multidisciplinary teams to succeed, even under emergency conditions.</p>","PeriodicalId":47778,"journal":{"name":"Health Care Management Review","volume":" ","pages":"99-107"},"PeriodicalIF":2.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146151046","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":"Patient and clinician perspectives of high-reliability organizing in practice: A qualitative study of cancer teams.","authors":"Megan Salwei, Leigh Anne Tang, Timothy J Vogus, Matthew B Weinger, Daniel J France, Shilo Anders, Carrie Reale, Joyce Harris, Jason M Slagle, Kim M Unertl, Laurie L Novak","doi":"10.1097/HMR.0000000000000474","DOIUrl":"10.1097/HMR.0000000000000474","url":null,"abstract":"<p><strong>Background: </strong>Health care organizations have failed to replicate the performance of high-reliability organizations (HROs), systems that operate nearly error-free despite inherently complex, interdependent, and time-pressured environments.</p><p><strong>Purposes: </strong>We sought to better understand conditions that facilitate and inhibit HRO in health care by expanding the conceptualization of who contributes to high reliability to include patients. We also examine how cancer care teams and patients describe jointly enacting (or failing to enact) each of the five HRO principles.</p><p><strong>Methodology/approach: </strong>We conducted a qualitative field study, interviewing 25 oncology clinicians from diverse roles (e.g., surgery, nursing, dentistry) (17 interviews) and eight cancer patients. Interviews were audio-recorded, transcribed, and deductively coded for barriers and facilitators to the five HRO principles.</p><p><strong>Findings: </strong>We identified conditions that supported and hindered high-reliability cancer care. HRO principles commonly overlapped to support or hinder system resilience. A common barrier was insufficient processes to proactively identify clinical deterioration. Patients and their family caregiver(s) were primarily responsible for monitoring their health and identifying and communicating any signs of deterioration. Cancer patients and caregivers were routinely engaged as team members, and patients developed expertise throughout treatment, thereby supporting system safety.</p><p><strong>Conclusions: </strong>These findings expand the conceptualization of how high reliability is produced. Specifically, we highlight the key role that patients play in preventing errors and monitoring care.</p><p><strong>Practice implications: </strong>Our findings expand our understanding of how HRO principles interact to promote cancer care system safety and elucidate how patients and their family caregivers contribute to system resilience. This work can inform the redesign of care processes to optimize patient safety.</p>","PeriodicalId":47778,"journal":{"name":"Health Care Management Review","volume":" ","pages":"108-120"},"PeriodicalIF":2.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13505956/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146151087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Team creativity as a catalyst for care effectiveness and well-being in primary care teams.","authors":"Yuna S H Lee, Nancy LaVine, Cheryl Rathert, Yulia Kogan, Lusine Poghosyan","doi":"10.1097/HMR.0000000000000465","DOIUrl":"10.1097/HMR.0000000000000465","url":null,"abstract":"<p><strong>Background: </strong>Primary care teams play a critical role in delivering high-quality, patient-centered care, yet they face mounting challenges, including high rates of burnout and job dissatisfaction. Creativity within teams may serve as a key resource for fostering continuous improvement and innovation while simultaneously enhancing team members' well-being.</p><p><strong>Purpose: </strong>This study introduces team creativity as a novel and actionable teamwork construct, assessing its relationship with burnout, job satisfaction, and perceived effectiveness of care delivery. We validate a new multidimensional measure of team creativity tailored to the primary care context.</p><p><strong>Methodology/approach: </strong>Using survey data from 648 primary care team members across a large health system, we conducted confirmatory factor analysis to validate the Primary Care Team Creativity tool. We then tested hypotheses to assess associations between primary care team creativity, perceived effectiveness of care delivery, and well-being.</p><p><strong>Results: </strong>Findings confirm the validity of the Primary Care Team Creativity tool. Primary care team creativity was positively associated with job satisfaction and negatively associated with burnout. Perceived effectiveness of care delivery mediated these relationships, indicating that creativity enhances well-being by improving team members' perceptions of the quality of care they provide.</p><p><strong>Conclusion: </strong>This study establishes team creativity as a validated, actionable construct in primary care and demonstrates its potential for enhancing care effectiveness, reducing burnout and enhancing job satisfaction for primary care professionals.</p><p><strong>Practice implications: </strong>Health care leaders can foster team creativity by embedding structured opportunities for idea generation, encouraging interdisciplinary collaboration, and leveraging creativity to enhance care processes-ultimately supporting both innovation and provider well-being in primary care.</p>","PeriodicalId":47778,"journal":{"name":"Health Care Management Review","volume":" ","pages":"68-77"},"PeriodicalIF":2.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12922685/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146167341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A value chain analysis of digitalizing hospital-at-home services in Finland.","authors":"Fan Wang, Henna Härkönen, Gillian Vesty, Terhi-Maija Isakov, Petri Ahokangas, Irina Atkova, Miia Jansson","doi":"10.1097/HMR.0000000000000467","DOIUrl":"10.1097/HMR.0000000000000467","url":null,"abstract":"<p><strong>Background: </strong>In recent years, increasing numbers of elderly people and cuts to the health budget have led health care providers to search for alternative plans to balance the quality of care and the health budget. HaH is growing as an alternative model for hospital wards, with the emergence of its own value chain activities and digitalization as a differentiated strategy to provide cost-effective services.</p><p><strong>Purposes: </strong>The aim of this study is to explore the value of digitalization in the hospital-at-home (HaH) value chain in Finland. This qualitative study used both deductive and inductive methods to map the HaH value chain and find out how digitalization can help improve value-added activities.</p><p><strong>Methodology/approach: </strong>In total, 25 semistructured single and paired interviews from all well-being service counties in Finland were carried out in September to October 2023.</p><p><strong>Findings: </strong>This study highlights the value of data interoperability, remote and real-time digital solutions, data analytics in enhancing coordination and efficiency, optimizing service delivery, improving patient experience, and supporting cost-effectiveness across the HaH value chain.</p><p><strong>Practical implications: </strong>This study provides HaH leaders with an overview of what, where, and how digitalization can improve the quality of care and highlights the strategic importance of investing in digital infrastructure and leveraging digitalization to restructure costs. It also offers ICT companies actionable insights into the specific digital care needs within HaH service delivery, guiding the development of digital health solutions that align with frontline requirements and fostering cocreation in digital health and communication technologies.</p>","PeriodicalId":47778,"journal":{"name":"Health Care Management Review","volume":" ","pages":"87-98"},"PeriodicalIF":2.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12922686/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146776885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Leading responsibly in the digital age: A framework for health care digital workplace transformation.","authors":"Samuel Gyamerah, Leila Afshari, Karen Hallam, Jennifer Cook","doi":"10.1097/HMR.0000000000000471","DOIUrl":"10.1097/HMR.0000000000000471","url":null,"abstract":"<p><strong>Issue: </strong>Digital workplace transformation (DWT) in health care promises improved efficiency and care delivery; however, it also generates new leadership challenges. Leaders must navigate ethical dilemmas, workforce strain, and fragmented coordination across stakeholder groups. Existing leadership models often fall short in addressing these multidimensional pressures, particularly with respect to clinician well-being, responsible innovation, and the legitimacy of technological change.</p><p><strong>Critical theoretical analysis: </strong>This article synthesizes transformational, responsible, and digital leadership theories to propose a Responsible Digital Transformational Leadership (RDTL) framework for health care DWT. RDTL framework is grounded in leadership literature and aligned with emerging health care realities, such as the strategic role of health care leaders and the need for team-based leadership configurations. RDTL is underpinned by five testable, interrelated principles: ethical stewardship, inclusive engagement, navigating complexity with agility, empowering digital confidence, and visionary digital stewardship.</p><p><strong>Insight/advance: </strong>The RDTL model advances leadership theory by integrating ethical responsibility, technological competence, and human-centered change in a unified framework. It offers testable propositions linking leadership behaviors to key outcomes such as staff well-being, patient care quality, and the ethical legitimacy of digital transformation initiatives. Unlike leader-centric models, RDTL also foregrounds team-based dynamics and stakeholder inclusivity as essential drivers of responsible innovation.</p><p><strong>Practice implications: </strong>RDTL provides health care leaders with a values-driven roadmap for guiding digital transformation while safeguarding employee well-being and ethical standards. It emphasizes participatory decision-making, psychological safety, and long-term stewardship as essential components of trustworthy and sustainable change.</p>","PeriodicalId":47778,"journal":{"name":"Health Care Management Review","volume":" ","pages":"141-150"},"PeriodicalIF":2.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145835095","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 influence of physician-hospital integration on physician communication and patient experience: Evidence from U.S. private acute care hospitals.","authors":"Xiao Li, Jae Man Park, Geoffrey A Silvera","doi":"10.1097/HMR.0000000000000475","DOIUrl":"10.1097/HMR.0000000000000475","url":null,"abstract":"<p><strong>Background: </strong>Various forms of Physician-Hospital Integration (PHI) have occurred across the U.S. health care delivery system, and research has shown that the structure and characteristics of PHI models may influence various aspects of hospital performance.</p><p><strong>Purpose: </strong>This study explores the relationship between different PHI types and patient experience (PX), with a specific interest in the influence of these structures on physician communication and overall hospital ratings.</p><p><strong>Methodology: </strong>Using a Generalized Estimating Equations model, we analyzed data from 2,716 U.S. acute care hospitals (n=2,716) to explore how \"tight,\" \"loose,\" and \"multimodal\" PHI types influence PX during the COVID-19 pandemic, utilizing data from two time points: 2019 (prepandemic) and 2022 (post-peak pandemic).</p><p><strong>Results: </strong>Our results reveal that hospitals with \"tight\" PHI type, characterized by greater control over physicians, were associated with lower physician communication ratings and overall hospital ratings.</p><p><strong>Conclusions: </strong>Our findings suggest that rigid organizational structures may hinder effective physician-patient interactions and hospital performance during crises. Conversely, hospitals with \"loose\" PHI type demonstrated better resilience in maintaining PX, likely due to increased physician autonomy and flexibility in care delivery.</p><p><strong>Practice implications: </strong>These findings highlight the importance of adaptable strategies in health care management, emphasizing the need for balance between physician oversight and autonomy to improve PX.</p>","PeriodicalId":47778,"journal":{"name":"Health Care Management Review","volume":" ","pages":"162-170"},"PeriodicalIF":2.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146151011","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":"Dust in the wind? How leadership transitions unfold in purpose-oriented networks.","authors":"Robin Peeters, Daan Westra, Rachel Gifford, Dirk Ruwaard","doi":"10.1097/HMR.0000000000000470","DOIUrl":"10.1097/HMR.0000000000000470","url":null,"abstract":"<p><strong>Background: </strong>Health care is increasingly organized in networks in which organizations collaborate to address health care's grand challenges. While leadership is key to network effectiveness but can be disrupted by turnovers, little is known about how leadership transitions unfold.</p><p><strong>Purpose: </strong>This study aimed to understand how such leadership transitions unfold in purpose-oriented networks.</p><p><strong>Methodology/approach: </strong>We explored this through an in-depth case study of a network prior and during a leadership transition (5 years), performing 34 interviews, 46 hours of observations, and collecting documents.</p><p><strong>Results: </strong>Our results show that an unexpected leadership transition can take time and affect dynamics such as trust and the network's composition. A lead organization can be established based on either its organizational characteristics or the characteristics of its individuals. In the latter case, the network's governance structure may be less stable. Covert conversations and decision-making occurred outside formal network meetings, showing that the influence of formal leaders, though lacking formal hierarchy, may be larger than previous research suggests.</p><p><strong>Findings: </strong>Leadership transitions can affect dynamics in networks negatively and the influence of formal leaders, though they lack formal hierarchy, may be larger than previously suggested. Lead organization can emerge through different ways, including personal characteristics, organizational resources, and organizational-network goal alignment.</p><p><strong>Practice implications: </strong>Networks benefit from consciously designing their governance and leadership structure in a way that diminishes the effects of an unexpected transition, such as dual leadership from two organizations. Furthermore, networks should consider the three pathways for lead organizations to emerge in choosing their lead organization during each life-cycle phase.</p>","PeriodicalId":47778,"journal":{"name":"Health Care Management Review","volume":" ","pages":"129-140"},"PeriodicalIF":2.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12922687/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145985897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Resilience in care: An integrative negotiation perspective on the behavioral dynamics of resource exchanges in responding to setbacks.","authors":"Kim Johanna Petronella Maria Van Erp, Ludo M Glimmerveen, Bianca Beersma, Henk L G R Nies","doi":"10.1097/HMR.0000000000000462","DOIUrl":"10.1097/HMR.0000000000000462","url":null,"abstract":"<p><strong>Issue: </strong>Caring is inextricably intertwined with resilience: the ability of individuals and collectives to deal with setbacks. To respond resiliently, actors draw on resources that may lie beyond their direct reach, requiring the engagement of others within the care system. The complex, hierarchical, and fragmented nature of care systems both necessitates and complicates cooperation and coordination between actors as they pursue or support resilient responses.</p><p><strong>Critical theoretical analysis: </strong>Relational perspectives on resilience provide a starting point for understanding the relational processes determining whether and how resources are exchanged. However, they do not provide insight into the behavioral dynamics that help explain how interdependent actors negotiate their relationships as they pursue or support resilience.</p><p><strong>Advance: </strong>Drawing on the integrative negotiation theory, we extend resource-based and relational perspectives on resilience by elucidating the interactional specifics of how actors can collaborate to effectively deal with setbacks-even when they pursue seemingly conflicting outcomes. Highlighting the importance of voice, epistemic motivation, and prosocial motivation, we capture the interpersonal dynamics that shape (a) awareness of resource needs and others' ability to provide these; (b) interactions informing decisions on whether and how resources are exchanged; and (c) the ability to find integrative solutions that go beyond zero-sum exchanges, serving all actors' interests and needs.</p><p><strong>Practice implications: </strong>Our framework informs the collective development of resilient solutions. We highlight the behavioral repertoires (i.e., the interactions through which resources are pursued, negotiated, and/or shared), enabling actors within care systems to build on their interdependencies as they pursue or support resilient responses to setbacks.</p>","PeriodicalId":47778,"journal":{"name":"Health Care Management Review","volume":" ","pages":"22-31"},"PeriodicalIF":2.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145543176","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":"Integrating family and caregiver voices in health care management research.","authors":"Timothy J Vogus","doi":"10.1097/HMR.0000000000000464","DOIUrl":"10.1097/HMR.0000000000000464","url":null,"abstract":"","PeriodicalId":47778,"journal":{"name":"Health Care Management Review","volume":" ","pages":"1"},"PeriodicalIF":2.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145543114","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}