Journal of Healthcare Management最新文献

{"title":"How Hospitals Can Respond to Declining Support for Public Health.","authors":"Eric W Ford","doi":"10.1097/JHM-D-25-00199","DOIUrl":"https://doi.org/10.1097/JHM-D-25-00199","url":null,"abstract":"","PeriodicalId":51633,"journal":{"name":"Journal of Healthcare Management","volume":"70 5","pages":"303-306"},"PeriodicalIF":2.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144994110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Redefining Mental Health Care Through Innovative, Personalized Support.","authors":"Andrea Walsh","doi":"10.1097/JHM-D-25-00175","DOIUrl":"https://doi.org/10.1097/JHM-D-25-00175","url":null,"abstract":"","PeriodicalId":51633,"journal":{"name":"Journal of Healthcare Management","volume":"70 5","pages":"312-316"},"PeriodicalIF":2.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144994148","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vulnerable Patient Intensified Protocol to Reduce Readmission Disparities After Coronary Artery Bypass Grafting: Design, Implementation, and Lessons Learned from a Quality Initiative.","authors":"Ralph Mosca, Brenda Aydin, Rosio Ynfante, Ming Liao, Rhett Tanselle, Eugene Grossi","doi":"10.1097/JHM-D-24-00153","DOIUrl":"https://doi.org/10.1097/JHM-D-24-00153","url":null,"abstract":"<p><strong>Goal: </strong>In 2024, the Centers for Medicare & Medicaid Services (CMS) introduced equity metrics for healthcare systems to document social determinants of health (SDOH). Payment determinations were also linked to readmission performance measures. Readmission prevention programs for vulnerable patients, defined by CMS as dually eligible (DE) for Medicare and Medicaid, racial/ethnic minorities, and those with disabling conditions, have the potential to reduce readmission disparities. Our goal was to develop a systematic and pragmatic approach to collect, analyze, and utilize SDOH and insurance status to assign patients to an intensified protocol for reducing readmission disparities after coronary artery bypass grafting (CABG).</p><p><strong>Methods: </strong>Patients admitted to a major urban medical center for isolated CABG from October 2023 to October 2024 (N = 286) completed a standardized clinician-assisted SDOH questionnaire. SDOH risk was adapted from ICD-10 Z codes that targeted social risk factors within the scope of healthcare providers' practices (i.e., language barriers, health literacy, access to a heart-healthy diet, lack of transportation to postoperative appointments, financial difficulties impeding access to prescription medications or medical care, and lack of a caregiver/social support). Project managers reviewed electronic health records and documented racial/ethnic categories using current CMS recommendations. SDOH+ (positive) and Medicaid or DE patients were assigned to a vulnerable patient intensified protocol (VPIP) readmission prevention program focused on education, deployment of hospital and community-based resources, transportation assistance, and increased frequency of postoperative follow-up. Non-VPIP patients continued their surgeons' usual care protocols.</p><p><strong>Principal findings: </strong>Of the 286 isolated CABG patients, 55% were ≥65 years old, 80% were male, 47% were White, 24% had Medicaid, and 14% were DE. The most prevalent SDOH+ responses were the need for an interpreter (31%), low health literacy or less than a high-school education (23%), and transportation issues (17%). White patients were significantly (p < .05) less likely to qualify for VPIP than non-White patients, as were patients with Medicare compared to those with self-pay, commercial, or military insurance. Overall, 27% of patients had ≥2 SDOH risk factors. The need for an interpreter was 6.6 times more likely to be associated with having Medicaid or being DE than not. Low health literacy or less than a high school education, transportation issues, and the lack of access to a heart-healthy diet were all significantly associated with Medicaid or DE patients. White patients, compared to non-White patients or unknown or declined responses, were significantly less likely to be SDOH+ (13% vs. 39%, p < .0001). Asian patients were at a higher risk for SDOH+ compared to White patients (49% vs.13%, p < .0001), and among Asian patients","PeriodicalId":51633,"journal":{"name":"Journal of Healthcare Management","volume":"70 5","pages":"369-383"},"PeriodicalIF":2.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144994153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chad T. Lefteris, FACHE, President and CEO, UCI Health, Orange County, California.","authors":"","doi":"10.1097/JHM-D-25-00179","DOIUrl":"https://doi.org/10.1097/JHM-D-25-00179","url":null,"abstract":"","PeriodicalId":51633,"journal":{"name":"Journal of Healthcare Management","volume":"70 5","pages":"307-311"},"PeriodicalIF":2.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144994093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Who's Not Talking? Nonresponse Bias in Healthcare Employee Well-Being Surveys.","authors":"C Aubrey Rhodes, Xi Hu, Richard B Freeman, Ridhika Agrawal, Elizabeth Cherot, Thomas S Dardarian, Stephanie Rouse, Tiffany Chan, Bart Blackburn","doi":"10.1097/JHM-D-24-00166","DOIUrl":"https://doi.org/10.1097/JHM-D-24-00166","url":null,"abstract":"<p><strong>Goal: </strong>Employee well-being surveys are essential tools used by healthcare leaders to assess workforce functioning, such as burnout, team dynamics, and perceptions of support, but surveys frequently have low response rates, which may skew results. Research on nonresponse bias is limited because of the difficulty in sourcing data on outcomes of interest from nonrespondents. This study aimed to examine whether nonrespondents and respondents differed on key outcomes of interest to healthcare leaders to understand whether results of an employee well-being survey were valid. Specifically, we examined differences between respondents and nonrespondents in terms of demographics, turnover over one-year postsurvey, and employee functioning such as productivity and work outside of regular work hours. By using objective data as a proxy for physician functioning, our innovative approach allowed us to study nonresponse bias without relying on a follow-up survey of nonrespondents. The goal was to inform leaders about potential biases that impact survey conclusions and, therefore, better interpret the survey results in decision-making.</p><p><strong>Methods: </strong>The longitudinal study included physicians (N = 348) and advanced practitioners (APs) (i.e., physician assistants, nurse practitioners, and certified nurse midwives; N = 143) from obstetrics and gynecology clinics in the Midwest and Northwest United States, who were invited to complete an employee well-being survey in 2021. Data on demographics, turnover, and other workplace environment indicators-i.e., productivity measured by relative value units (RVUs), work outside of regular work hours, duration of encounters, and appointment cancellations-were collected from electronic health records (EHRs) and human resources information systems (HRIS). Employment status was tracked for 1.25 years post-survey. The study examined demographic differences (i.e., age, gender, race/ethnicity, marital status), assessed the relative risk of turnover at each quarter over 1.25 years, and evaluated differences in productivity and workplace variables between respondents and nonrespondents. For relative risk, we observed turnover differences between retirement age and below retirement age subgroups.</p><p><strong>Principal findings: </strong>AP nonrespondents had a nearly 10 times higher risk in the full sample and a 12 times risk in the below-retirement age sample of turnover in the quarter after the survey was deployed. Physician nonrespondents below retirement age had a 5 times relative risk of turnover in the two quarters postsurvey. Among APs, nonrespondents were significantly older and more likely to be married; no differences existed for physicians.</p><p><strong>Practical applications: </strong>Results demonstrate that individuals at higher risk within an organization, as indicated by higher turnover risk and lower productivity, are less likely to fill out employee surveys. This suggests that em","PeriodicalId":51633,"journal":{"name":"Journal of Healthcare Management","volume":"70 5","pages":"337-353"},"PeriodicalIF":2.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144994337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Volunteers Needed: Understanding African Americans' Perceptions of Clinical Trials and Intentions to Participate.","authors":"Joe M Ricks, McDowell Porter Iii, Elyria Kemp","doi":"10.1097/JHM-D-24-00137","DOIUrl":"https://doi.org/10.1097/JHM-D-24-00137","url":null,"abstract":"<p><strong>Goal: </strong>African Americans lack participation in clinical trials, and therefore, are underrepresented in medical initiatives that can provide life-saving treatment. This research examines the attitudes, beliefs, and perceptions of African Americans toward participation in clinical trials.</p><p><strong>Methods: </strong>Researchers conducted a survey using a representative sample of African Americans in the United States (n = 1,260). Structural equation modeling was used to analyze the data.</p><p><strong>Principal findings: </strong>Findings indicate that behavioral beliefs about clinical trials are positively related to attitudes about participating in clinical trials. Furthermore, attitudes are positively related to intentions to participate in clinical trials. Participation in clinical trials is also dictated by social influence. Results indicate that what \"important others\" think about participation in clinical trials is positively related to trial participation; however, risk perceptions are negatively related to trial participation. Findings reveal that gender and educational attainment moderate risk perceptions. African American women and those with less educational attainment possess risk perceptions, which negatively influence their intention to participate in clinical trials.</p><p><strong>Practical applications: </strong>This research highlights how behavioral beliefs and attitudes are positively linked to participation intentions, while subjective norms further reinforce the influence of social pressures on decision-making. Importantly, risk perceptions serve as a significant barrier to participation, particularly among African American women and individuals with lower educational attainment. These findings point to the need for targeted interventions that address specific concerns and build trust through culturally informed, accessible communication. By developing communication strategies that enhance positive beliefs, leverage community influence, and reduce perceived risks, research and healthcare communities can take meaningful steps toward fostering inclusion and trust.</p>","PeriodicalId":51633,"journal":{"name":"Journal of Healthcare Management","volume":"70 5","pages":"317-336"},"PeriodicalIF":2.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144994141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How Stakeholder Perceptions of Quality Shape Healthcare Transactions: Insights from Key Decision-Makers Across the Ecosystem.","authors":"Melissa Culhane Maravic, Suepattra G May, Elizabeth Oyekan, Jocelyn Vanderbrink, Meaghan Roach, Kassidy Shumaker, Irina Kolobova, Esther Renee Smith-Howell, Dennis Scanlon","doi":"10.1097/JHM-D-24-00078","DOIUrl":"https://doi.org/10.1097/JHM-D-24-00078","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Goal: &lt;/strong&gt;In today's healthcare ecosystem, quality measures are theorized to inform the spectrum of healthcare delivery and evaluation, including specific functional areas such as quality improvement, regulation, accreditation, and value-based payment. Yet, the ways in which expectations about quality-real or perceived-shape and inform transactional relationships between healthcare stakeholders have not been well elucidated. We elicited the perspectives of healthcare decision-makers to understand their experiences with quality and how they may influence transactions and strategic alliances.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A qualitative study incorporating semistructured in-depth interviews conducted with C-suite and D-suite decision-makers in the United States representing a mix of different types of healthcare organizations. Interviewees were asked about organizational culture and strategic priorities, qualities sought in potential business partners, and factors that drive decisions to transact with external partners. Interviews were audio-recorded and transcribed verbatim, and data were analyzed to identify key themes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Principal findings: &lt;/strong&gt;Quality, as an objective measure (e.g., the Healthcare Effectiveness Data and Information Set [HEDIS] or the Consumer Assessment of Healthcare Providers and Systems [CAHPS]), or a subjective assessment, was only one of many considerations that shaped transactional relationships with external healthcare stakeholders. Key informants described a range of factors considered, including partner reputation, alignment of culture and mission, and ability to achieve strategic priorities. While the term quality was broadly used and defined among the key informants, participants often incorporated the term value into their lexicography of quality and felt that value played a more significant role in decision-making. Standardized quality measures can be useful both for prompting investment within organizations and for deciding when to seek the assistance of external parties to help improve commonly collected and reported quality measures. Ultimately, the manner in which quality manifests in real-world practice and operations is not as simple or straightforward as policymakers or quality metrics developers may believe.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Practical applications: &lt;/strong&gt;Although there has been significant public and private investment in quality initiatives, including their use in payment and regulatory models, this study elucidates how stakeholders across the healthcare ecosystem assess quality from a strategic operating perspective. We identified a number of key drivers that underpin transactional relationships and that ultimately impact the results of standardized and publicly reported quality measures captured for payment, regulation, and public accountability purposes. While decisions regarding these relationships are internal matters and thus fall outside the scope of regulators, poli","PeriodicalId":51633,"journal":{"name":"Journal of Healthcare Management","volume":"70 5","pages":"354-368"},"PeriodicalIF":2.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144994113","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Leading-Edge Care: Where High Tech Meets High Touch.","authors":"Scott Rissmiller","doi":"10.1097/JHM-D-25-00116","DOIUrl":"10.1097/JHM-D-25-00116","url":null,"abstract":"","PeriodicalId":51633,"journal":{"name":"Journal of Healthcare Management","volume":"70 4","pages":"244-247"},"PeriodicalIF":1.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144585595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"MEND the Divide: A Pathway to Equitable Maternal Care in the United States.","authors":"Tanéha Fincher","doi":"10.1097/JHM-D-25-00137","DOIUrl":"10.1097/JHM-D-25-00137","url":null,"abstract":"<p><strong>Summary: </strong>Maternal mortality rates in the United States are far exceeding those of other developed nations. This healthcare crisis is disproportionately affecting marginalized populations, including Black women and women living in rural communities. The MEND framework-developed through extensive research and informed by real-world case studies-offers a comprehensive and equity-driven solution to address existing disparities and improve maternal health outcomes nationwide. This framework emphasizes four objectives (or pillars), named after the first letter of each pillar: (1) Maternal care integration, (2) Equity-driven policies, (3) Navigated support, and (4) Driving collaboration. Each pillar presents actionable strategies to reduce maternal mortality and morbidity in the United States. The MEND framework offers a comprehensive, scalable roadmap for systemic change to help ensure equitable, high-quality care for all mothers.</p>","PeriodicalId":51633,"journal":{"name":"Journal of Healthcare Management","volume":"70 4","pages":"248-260"},"PeriodicalIF":1.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144585597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characteristics of High-Performing Administrative Leaders in a Physician-Administrator Dyad in an Academic Medical Center.","authors":"Ji Yun Kang, Yu-Li Huang, Minji Lee, Petrine Cerri, Eric Klavetter","doi":"10.1097/JHM-D-24-00157","DOIUrl":"10.1097/JHM-D-24-00157","url":null,"abstract":"<p><strong>Goal: </strong>The purpose of the research is to explore, through the lens of organizational performance and staff satisfaction, the characteristics of administrative leaders working as dyad partners with physician leaders.</p><p><strong>Methods: </strong>All 54 administrative leaders from 71 clinical departments at the three US Mayo Clinic sites were invited to participate in the study. We used an unsupervised cluster analysis machine learning method to group the leaders based on their characteristics, as measured by the 32-dimension Occupational Personality Questionnaire (OPQ 32r), and we used a three-cluster model to explore the relationships between the clusters and the performance outcome. We took the department performance data from the previous year and compared the percentage of departments with the upward changes among the clusters. For staff survey data, we calculated the percentage of departments with scores that were above average among the three clusters for both physician and administrative staff responses.</p><p><strong>Principal findings: </strong>Analysis of personality data revealed three different clusters. Cluster 1 leaders were caring and democratic, forward-thinking, strategic, optimistic, and trusting of others. Cluster 2 leaders were extremely hardworking and authoritative. Cluster 3 leaders were caring, modest, and rule-following. Cluster 1 leaders showed the best financial performance and sense of belonging among their followers, cluster 2 leaders elicited high engagement from their departments, and cluster 3 leaders encouraged lower burnout among staff members.</p><p><strong>Practical applications: </strong>From this study, we obtained empirical evidence of administrative leaders' characteristics that showed positive relationships with financial and staff-satisfaction metrics. The results showed that distinct types of leaders influence administrative staff and physician staff differently and that different situations require different styles of leadership. We can also conclude that implementing robust, scientifically validated tools to assess leadership traits and tendencies can positively affect leadership and organizational performance for healthcare organizations.</p>","PeriodicalId":51633,"journal":{"name":"Journal of Healthcare Management","volume":"70 4","pages":"288-302"},"PeriodicalIF":1.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144585594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}