Journal of Healthcare Management最新文献

{"title":"Assessing the Performance Value of the Baldrige Journey: A Comparison of Baldrige Applicants and Nonapplicants.","authors":"Jennifer O Strahan,&nbsp;Larry R Hearld,&nbsp;Nathan W Carroll,&nbsp;John McWhorter,&nbsp;Jeff M Szychowski","doi":"10.1097/JHM-D-21-00045","DOIUrl":"https://doi.org/10.1097/JHM-D-21-00045","url":null,"abstract":"<p><strong>Goal: </strong>The national Baldrige program has supported performance excellence in healthcare since 1999. Previous studies have compared the performance of Baldrige hospital recipients to nonrecipients. This study, however, sought to address the question of whether the mere pursuit of the Baldrige award provides value.</p><p><strong>Methods: </strong>This study used propensity score matching with linear and quantile regression techniques to understand the impact of hospitals applying the Baldrige Excellence Framework across a comprehensive set of standardized industry performance measures, regardless of award recognition.</p><p><strong>Principal findings: </strong>The analysis demonstrated that Baldrige applicants outperformed non-Baldrige applicants in select operational measures of efficiency (such as inpatient average length of stay), patient experience, and financial measures (including return on net assets, days in accounts receivable, and expenses as a percentage of patient revenues). However, there was no statistically significant difference in clinical performance between Baldrige applicants and nonapplicants.</p><p><strong>Practical applications: </strong>The findings from this study suggest that hospital leaders can realize significant gains with select operational and financial measures without compromising clinical outcomes when applying the Baldrige Excellence Framework to their organizations.</p>","PeriodicalId":51633,"journal":{"name":"Journal of Healthcare Management","volume":"67 4","pages":"266-282"},"PeriodicalIF":1.8,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40595806","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":"Organizational Factors That Promote Error Reporting in Healthcare: A Scoping Review.","authors":"Dawn Wawersik,&nbsp;Janice Palaganas","doi":"10.1097/JHM-D-21-00166","DOIUrl":"https://doi.org/10.1097/JHM-D-21-00166","url":null,"abstract":"<p><strong>Goal: </strong>The overarching aim of this systematic review was to offer guidelines for organizations and healthcare providers to create psychological safety in error reporting. The authors wanted to identify organizational factors that promote psychological safety for error reporting and identify gaps in the literature to explore innovative avenues for future research.</p><p><strong>Methods: </strong>The authors conducted an online search of peer-reviewed articles that contain organizational processes promoting or preventing error reporting. The search yielded 420 articles published from 2015 to 2021. From this set, 52 full-text articles were assessed for eligibility. Data from 29 articles were evaluated for quality using Joanna Briggs Institute critical appraisal tools.</p><p><strong>Principal findings: </strong>We present a narrative review of the 29 studies that reported factors either promoting error reporting or serving as barriers. We also present our findings in tables to highlight the most frequently reported themes. Our findings reveal that many healthcare organizations work at opposite ends of the process continuum to achieve the same goals. Finally, our results highlight the need to explore cultural differences and personal biases among both healthcare leaders and clinicians.</p><p><strong>Applications to practice: </strong>The findings underscore the need for a deeper dive into understanding error reporting from the perspective of individual characteristics and organizational interests toward increasing psychological safety in healthcare teams and the workplace to strengthen patient safety.</p>","PeriodicalId":51633,"journal":{"name":"Journal of Healthcare Management","volume":"67 4","pages":"283-301"},"PeriodicalIF":1.8,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40595807","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":"Jonathan B. Perlin, MD, PhD, President and CEO, The Joint Commission.","authors":"","doi":"10.1097/JHM-D-22-00124","DOIUrl":"https://doi.org/10.1097/JHM-D-22-00124","url":null,"abstract":"","PeriodicalId":51633,"journal":{"name":"Journal of Healthcare Management","volume":"67 4","pages":"223-229"},"PeriodicalIF":1.8,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40595801","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":"Blockchain Technology in Healthcare: An Analysis of Strengths, Weaknesses, Opportunities, and Threats.","authors":"Warren A Poquiz","doi":"10.1097/JHM-D-22-00106","DOIUrl":"https://doi.org/10.1097/JHM-D-22-00106","url":null,"abstract":"<p><strong>Summary: </strong>The dawn of the crypto age has highlighted the potential of blockchain technology in an array of functions for multiple industries. Blockchain technology disrupts existing architecture by offering an efficient and decentralized data management platform. It provides a potential solution to current health information technology problems. The strengths of blockchain are interoperability, data accuracy, security, and transparency. Its weaknesses include a lack of standardization, accessibility, ownership, and change management. Applications in healthcare include revenue cycle management, physician credentialing, electronic health records, and supply chain management, although potential government regulation and internal attacks pose threats to its wider adoption.</p>","PeriodicalId":51633,"journal":{"name":"Journal of Healthcare Management","volume":"67 4","pages":"244-253"},"PeriodicalIF":1.8,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40595804","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":"Establishing a Sustainable Healthcare Delivery Workforce in the Wake of COVID-19.","authors":"Allison J Weidman","doi":"10.1097/JHM-D-22-00100","DOIUrl":"https://doi.org/10.1097/JHM-D-22-00100","url":null,"abstract":"<p><strong>Summary: </strong>Prior to the COVID-19 pandemic, the U.S. healthcare sector was facing challenges that threatened the sustainability of its workforce. These challenges included changing demographics, competition from other employers, and burnout. Now in the wake of the pandemic, the labor market is seeing more disruption with the exacerbation of these issues. Healthcare organizations have a responsibility to prevent further labor shortages so that they can continue to deliver high quality care and achieve positive health outcomes. Given the changes in people's values and behaviors, healthcare leaders can consider four innovative strategies to meet the needs of their current and future employees: flexible work arrangements, alternative benefits packages, career pathways, and mental health services. Organizations need to take into account their employee populations and the ability to invest in these changes when considering how to move forward.</p>","PeriodicalId":51633,"journal":{"name":"Journal of Healthcare Management","volume":"67 4","pages":"234-243"},"PeriodicalIF":1.8,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40595803","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":"Engaging Physicians in Leadership: Motivations, Challenges, and Identity-Based Considerations.","authors":"Erin E Sullivan,&nbsp;Amber L Stephenson,&nbsp;Aaron R Hoffman","doi":"10.1097/JHM-D-21-00224","DOIUrl":"https://doi.org/10.1097/JHM-D-21-00224","url":null,"abstract":"<p><strong>Goal: </strong>Physician leadership has been associated with improved patient outcomes, increased provider satisfaction, and decreased physician burnout as well as more profitable, higher-quality healthcare delivery. However, physicians frequently struggle when assuming leadership positions, given the dissonance between their administrative and clinical roles. Informed by social identity theory, we aimed to identify why physicians lead, how they experience leadership roles, and the challenges they face during the transition into those roles.</p><p><strong>Methods: </strong>We conducted 27 semistructured interviews with primary care physician leaders between January and April 2020. Interviews were transcribed and analyzed using the constant comparative method.</p><p><strong>Principal findings: </strong>Four themes were developed from the analysis, including (1) desire for change, (2) desire for growth, (3) challenges experienced during the transition to a leadership role, and (4) changes to professional identity. The results of this study identified aspects of leadership perceived by physicians as attractive and motivating. The study also revealed challenges that occur during the transition into leadership as well as shifts in professional identity experienced by physicians.</p><p><strong>Applications to practice: </strong>The results can be used by healthcare managers and executives to empower more physicians to take on leadership roles and implement changes that alleviate stresses associated with physicians transitioning into leadership roles.</p>","PeriodicalId":51633,"journal":{"name":"Journal of Healthcare Management","volume":"67 4","pages":"254-265"},"PeriodicalIF":1.8,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40595805","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":"DEI in the Healthcare Workforce: Advancing Equity Systemwide to Improve Service, Care, and Innovation.","authors":"Brenda Battle","doi":"10.1097/JHM-D-22-00105","DOIUrl":"https://doi.org/10.1097/JHM-D-22-00105","url":null,"abstract":"","PeriodicalId":51633,"journal":{"name":"Journal of Healthcare Management","volume":"67 4","pages":"230-233"},"PeriodicalIF":1.8,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40595802","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":"Systematic Outcomes Measurement Can Lead to Performance Excellence","authors":"Christine Pitocco","doi":"10.1097/JHM-D-22-00056","DOIUrl":"https://doi.org/10.1097/JHM-D-22-00056","url":null,"abstract":"Category 7 of the Baldrige criteria puts performance results into five areas: (1) product and process;(2) customer-focused;(3) workforce-focused;(4) leadership and governance;and (5) financial, market, and strategy (National Institute of Standards and Technology, n.d.). [...]it’s all about the results. According to Rosenkranz and colleagues, “The most critical value of diversity in healthcare is improving patient outcomes” (2021, p. 1058). To identify counterproductive tasks, healthcare leaders should again take a team-based approach—for example, information technology staff working alongside clinicians to identify ways to streamline the electronic health record entry.","PeriodicalId":51633,"journal":{"name":"Journal of Healthcare Management","volume":"67 1","pages":"145 - 148"},"PeriodicalIF":1.8,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49254170","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":"Effects of Healthcare Organization Actions and Policies Related to COVID-19 on Perceived Organizational Support Among U.S. Internists: A National Study","authors":"J. Sonis, D. Pathman, S. Read, B. Gaynes, Courtney Canter, P. Curran, Cheryl B. Jones, Thomas Miller","doi":"10.1097/JHM-D-21-00208","DOIUrl":"https://doi.org/10.1097/JHM-D-21-00208","url":null,"abstract":"SUMMARY Goal: Perceived organizational support (POS) may promote healthcare worker mental health, but organizational factors that foster POS during the COVID-19 pandemic are unknown. The goals of this study were to identify actions and policies regarding COVID-19 that healthcare organizations can implement to promote POS and to evaluate the impact of POS on physicians’ mental health, burnout, and intention to leave patient care. Methods: We conducted a cross-sectional national survey with an online panel of internal medicine physicians from the American College of Physicians in September and October of 2020. POS was measured with a 4-item scale, based on items from Eisenberger’s Perceived Organizational Support Scale that were adapted for the pandemic. Mental health outcomes and burnout were measured with short screening scales. Principal Findings: The response rate was 37.8% (N = 810). Three healthcare organization actions and policies were independently associated with higher levels of POS in a multiple linear regression model that included all actions and policies as well as potential confounding factors: opportunities to discuss ethical issues related to COVID-19 (β (regression coefficient) = 0.74, p = .001), adequate access to personal protective equipment (β = 1.00, p = .005), and leadership that listens to healthcare worker concerns regarding COVID-19 (β = 3.58, p < .001). Sanctioning workers who speak out on COVID-19 safety issues or refuse pandemic deployment was associated with lower POS (β = –2.06, p < .001). In multivariable logistic regression models, high POS was associated with approximately half the odds of screening positive for generalized anxiety, depression, post-traumatic stress disorder, burnout, and intention to leave patient care within 5 years. Applications to Practice: Our results suggest that healthcare organizations may be able to increase POS among physicians during the COVID-19 pandemic by guaranteeing adequate personal protective equipment, making sure that leaders listen to concerns about COVID-19, and offering opportunities to discuss ethical concerns related to caring for patients with COVID-19. Other policies and actions such as rapid COVID-19 tests may be implemented for the safety of staff and patients, but the policies and actions associated with POS in multivariable models in this study are likely to have the largest positive impact on POS. Warning or sanctioning workers who refuse pandemic deployment or speak up about worker and patient safety is associated with lower POS and should be avoided. We also found that high degrees of POS are associated with lower rates of adverse outcomes. So, by implementing the tangible support policies positively associated with POS and avoiding punitive ones, healthcare organizations may be able to reduce adverse mental health outcomes and attrition among their physicians.","PeriodicalId":51633,"journal":{"name":"Journal of Healthcare Management","volume":"67 1","pages":"192 - 205"},"PeriodicalIF":1.8,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44745092","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":"Hospital Cultural Competency Leadership and Training is Associated with Better Financial Performance","authors":"Soumya Upadhyay, R. Weech-Maldonado, William Opoku-Agyeman","doi":"10.1097/JHM-D-20-00351","DOIUrl":"https://doi.org/10.1097/JHM-D-20-00351","url":null,"abstract":"SUMMARY Goal: An organization’s cultural competency reflects its ongoing capacity to provide high-quality, equitable, safe, and patient-centered care. Cultural competency leadership and training (CCLT) influences organizational cultural competency, which could affect organizational performance. Policies regarding health disparities point to the need for hospitals to become culturally competent. This study aimed to explore if CCLT practices are associated with better financial performance. Methods: Using secondary data from three sources—the American Hospital Association Annual Survey, the Health Care Cost Information System, and the Area Health Resource File—a longitudinal panel study design reviewed 3,594 hospital-year observations for acute care hospitals across the United States from 2011 to 2012. CCLT, the independent variable, was measured as a summated scale of strategy, execution, implementation, and training in diversity practices. For financial performance, the operating and total margins of hospitals were measured as dependent variables. Two random-effects regression models with year- and state-fixed effects were used to examine the relationship, with hospital being the unit of analysis. Principal Findings: The descriptive statistics showed that hospitals had an average CCLT score of approximately 2 (the range was 0–4). Regression analysis indicated that an increase in the CCLT score was associated with a 0.3% and 0.4% increase in total and operating margins, respectively (p < .05). Also, with each 10 additional staffed beds, hospitals on average experienced a 0.1% increase in both total and operating margins. Overall, for-profit hospitals experienced a 2.4% higher total margin and a 4.9% higher operating margin, as compared to not-for-profit hospitals. On the contrary, government hospitals showed 1% and 5.8% lower total and operating margins, respectively. Applications to Practice: Results of our study support a business case for CCLT practices. Cultural competency makes good economic sense by helping to improve cost savings, increase market share, and enhance the efficiency of care. Therefore, healthcare leaders should consider investing in CCLT. With the growing emphasis on value-based purchasing related to patient outcomes and experience, hospitals that develop a high degree of cultural competency through CCLT can benefit from the changes in reimbursement. CCLT also affects financial performance through avoidance of costs related to employee absenteeism and turnover and improves team cohesiveness by reducing cultural conflicts. Other mechanisms by which CCLT assists in saving costs and affecting financial performance include avoidance of unnecessary readmissions and expensive hospitalizations through the proper screening of patients from diverse backgrounds. CCLT improves cultural competency and diversity management, thus creating a unique competitive advantage for hospitals.","PeriodicalId":51633,"journal":{"name":"Journal of Healthcare Management","volume":"67 1","pages":"149 - 161"},"PeriodicalIF":1.8,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46319416","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}