Journal of Healthcare Management最新文献

{"title":"PRACTITIONER APPLICATION: Strategies for Delivering Value-Based Care: Do Care Management Practices Improve Hospital Performance?","authors":"Kimberly J Miller","doi":"10.1097/JHM-D-19-00193","DOIUrl":"https://doi.org/10.1097/JHM-D-19-00193","url":null,"abstract":"Jain, Thorpe, Hockenberry, and Saltman address a critically important strategy for delivering value-based care: the relationship of care management processes with hospital performance. The value-based care payment structure affects not only the delivery and quality of care but also the future viability of healthcare organizations. As delivery and payment models continue to make the transition from a volume-driven structure to a more patient-centric care management model, organizations and individual care providers must raise the bar on their performance. The authors state that a hospital’s ability to perform well in value-based care has more to do with its internal organizational processes than the structure of the organization. As a hospital leader, I have also found this to be true. Yes, there are significant initial costs associated with implementation of foundational changes in care management and coordination. Over time, however, these changes can yield increasingly positive results for the patients’ well-being and the organization’s value-based care metrics. The initial, incremental changes accelerate as providers gain a deeper understanding of the new model of care delivery and their individual and team roles in the outcomes. Central to our successful implementation and positive outcomes was transparent and frequent communication among all team members in the organization. We achieved this success via multiple avenues of communication, and one of the most effective channels was the use of clear, concise dashboards that outlined results as compared to benchmarks and best performers. Healthcare providers are driven by evidence-based data, and information that is prominently displayed and shared across the organization advances adoption of the new strategies to better serve the patients. In addition, communication of vision and objectives for care delivery must be fully aligned throughout the organization, starting with the CEO and continuing through the chief medical officer and chief nursing officer. I further believe that focusing on financial metrics alone will not improve quality and lower costs to any meaningful degree. Internal processes also must be restructured, and the voices of the patient and providers must be considered. When value-based care initially began to make an impact on financial performance, the dollars at risk for any given organization were low. As the value-based care model has evolved, the dollars at risk have increased. My experience supports a slow start to learn","PeriodicalId":51633,"journal":{"name":"Journal of Healthcare Management","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/JHM-D-19-00193","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43641761","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":"Kenneth L. Johnson, PhD, FACHE, Associate Dean and Professor, Weber State University.","authors":"","doi":"10.1097/JHM-D-19-00195","DOIUrl":"https://doi.org/10.1097/JHM-D-19-00195","url":null,"abstract":"","PeriodicalId":51633,"journal":{"name":"Journal of Healthcare Management","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/JHM-D-19-00195","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46443920","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":"Patient Engagement Functionalities in U.S. Hospitals: Is Early Adoption Associated With Financial Performance?","authors":"O. Asagbra, F. Zengul, Darrell Burke","doi":"10.1097/JHM-D-18-00095","DOIUrl":"https://doi.org/10.1097/JHM-D-18-00095","url":null,"abstract":"EXECUTIVE SUMMARY\u0000U.S. hospitals are in various stages in their adoption of health information technology (HIT) with patient engagement functionalities. The Health Information Technology for Economic and Clinical Health Act of 2009 allocated $30 billion to incentivize the adoption and use of HIT. This study aims to identify hospital characteristics of early patient engagement functionality adoption and compare the financial performance of groups of hospitals that offer these functionalities according to Rogers' adopter categories. The combined data from the American Hospital Association Annual Survey and Information Technology Supplement, Centers for Medicare & Medicaid cost reports, and Health Resources & Services Administration Area Health Resource Files from 2008 to 2013 yielded a sample of 696 unique acute care hospitals. Three adopter categories-early adopters, early majority, and late majority-were created. Generalized estimating equations were used to examine the financial performance (operating margin, return on assets, total margin, operating expenses, revenue per inpatient day) across the adopter types. Compared to early adopter hospitals, operating margins were lower for early majority hospitals (β = -.407, p < .05) and late majority hospitals (β = -.608, p < .05). Moreover, compared to early adopter hospitals, late majority hospitals exhibited significantly lower operating revenue (β = -.087, p < .01) and operating expenses (β = -.064, p < .01) per inpatient day. No significant relationships were observed when comparing these groups based on total margin and return on assets. Hospital administrators should consider the positive financial outcomes associated with early adoption of patient engagement functionalities in the decision-making process.","PeriodicalId":51633,"journal":{"name":"Journal of Healthcare Management","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/JHM-D-18-00095","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49335854","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":"ABSTRACTS FROM THE FORUM ON ADVANCES IN HEALTHCARE MANAGEMENT RESEARCH","authors":"","doi":"10.1097/jhm-d-19-00183","DOIUrl":"https://doi.org/10.1097/jhm-d-19-00183","url":null,"abstract":"","PeriodicalId":51633,"journal":{"name":"Journal of Healthcare Management","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/jhm-d-19-00183","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48711073","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":"PRACTITIONER APPLICATION: Lean Management and U.S. Public Hospital Performance: Results From a National Survey.","authors":"Tracy A Comer","doi":"10.1097/JHM-D-19-00198","DOIUrl":"https://doi.org/10.1097/JHM-D-19-00198","url":null,"abstract":"www.ache.org/journals 379 JHM-D-19-00198 Shortell, S. M., Blodgett, J. C., Rundall, T. G., & Kralovec, P. (2018). Use of Lean and related transformational performance improvement systems in hospitals in the United States: Results from a national survey. Joint Commission Journal on Quality and Patient Safety, 44(10), 574–582. doi.org/10.1016/j.jcjq.2018.03.002 Spear, S. J. (2004). Learning to lead at Toyota. Harvard Business Review, 82(5), 78–86. Taher, D., Landry, S., & Toussaint, J. (2016). Breadth vs. depth: How to start deploying the daily management system for your Lean transformation. Journal of Hospital Administration, 5(6), 90–96. doi: 10.5430/jha.v5n6p90 Toussaint, J., & Gerard, R. A. (2010). On the mend: Revolutionizing healthcare to save lives and transform the industry. Cambridge, MA: Lean Enterprise Institute. Vest, J. R., & Gamm, L. D. (2009). A critical review of the research literature on Six Sigma, Lean and Studer Group’s Hardwiring Excellence in the United States: The need to demonstrate and communicate the effectiveness of transformation strategies in healthcare. Implementation Science, 4(1), 35. doi.org/10.1186/1748-5908-4-35","PeriodicalId":51633,"journal":{"name":"Journal of Healthcare Management","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/JHM-D-19-00198","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49530445","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":"Process Improvement in Patient Pathways: A Case Study Applying Accelerated Longitudinal Design With Decomposition Method.","authors":"Aske Skouboe, Z. Hansen, Jan Kloppenborg MØller","doi":"10.1097/JHM-D-18-00224","DOIUrl":"https://doi.org/10.1097/JHM-D-18-00224","url":null,"abstract":"EXECUTIVE SUMMARY\u0000Evaluations of improvements in long chronic-patient pathways must include both short- and long-term effects on patients; that is, effects on the full patient pathway. Otherwise, costs might be cut without considering the long-term effects and, consequently, the overall cost of the pathway could increase. Unfortunately, current methods of evaluation present several issues: (1) they do not provide valid insights regarding the effects of a given improvement effort until several years later, (2) they provide imprecise and biased results, and (3) the aggregated results are not useful for identifying and disseminating the best practices that lead to an improvement. In this article, the accelerated longitudinal design with decomposition of total costs (ALDD) method is applied to evaluate the effects of improvement efforts on inpatient utilization for long cardiac pathways at a Danish hospital. The results show that the ALDD method can deliver valid results much faster than traditional methods and can uncover hidden improvements in the local work processes of clinical teams. Application of the ALDD method at a hospital in Denmark identified a significant reduction (15.4%) in the mean total bed utilization per cardiac pathway and revealed that this reduction was caused by improvements in the work processes.","PeriodicalId":51633,"journal":{"name":"Journal of Healthcare Management","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/JHM-D-18-00224","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48510976","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":"The Value and Imperative of Diversity Leadership Development and Mentoring in Healthcare.","authors":"R. Zambrano","doi":"10.1097/JHM-D-19-00209","DOIUrl":"https://doi.org/10.1097/JHM-D-19-00209","url":null,"abstract":"","PeriodicalId":51633,"journal":{"name":"Journal of Healthcare Management","volume":"1 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/JHM-D-19-00209","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42733183","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":"Can Organizational Leaders Sustain Compassionate, Patient-Centered Care and Mitigate Burnout?","authors":"B. Lown, Andrew Shin, Richard N. Jones","doi":"10.1097/JHM-D-18-00023","DOIUrl":"https://doi.org/10.1097/JHM-D-18-00023","url":null,"abstract":"EXECUTIVE SUMMARY\u0000Organizational leaders are recognizing the urgent need to mitigate clinician burnout. They face difficult choices, knowing that burnout threatens the quality and safety of care and the sustainability of their organizations. Creating cultures and system improvements that support the workforce and diminish burnout are vital leadership skills. The motivation to heal draws many health professionals to their chosen work. Further, research suggests that compassion creates a sense of personal reward and professional satisfaction. Although many organizations stress compassion in mission and vision statements, their strategies to enhance well-being largely ignore compassion as a source of joy and connection to purpose.Passage of the HITECH (Health Information Technology for Economic and Clinical Health) Act in 2009 and the Affordable Care Act in 2010 ushered in a new era in healthcare. Little is known about how changes in the healthcare delivery system related to these legislative milestones have influenced health professionals' capacity to offer compassionate care. Further, advances such as artificial intelligence and virtual care modalities brought more attention to the elements that form the clinician-patient relationship.This study analyzed the views of U.S. healthcare providers on the status of compassionate healthcare compared with 2010. Postulating that compassion is inversely correlated with burnout, we studied this relationship and contributing factors. Our review of evidence-based initiatives suggests that leaders must define the organizational conditions and implement processes that support professionals' innate compassion and contribute to their well-being rather than address burnout later through remedial strategies.","PeriodicalId":51633,"journal":{"name":"Journal of Healthcare Management","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/JHM-D-18-00023","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43766943","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":"Strategies for Delivering Value-Based Care: Do Care Management Practices Improve Hospital Performance?","authors":"Sanjula Jain, K. Thorpe, J. Hockenberry, R. Saltman","doi":"10.1097/JHM-D-18-00049","DOIUrl":"https://doi.org/10.1097/JHM-D-18-00049","url":null,"abstract":"EXECUTIVE SUMMARY\u0000Value-based payment has the potential to rein in the volume incentive inherent in fee-for-service payment by holding providers accountable for the quality of patient care they deliver. Success under the new payment structure will depend on how effectively key organizational reforms are embraced by providers in the implementation of quality improvement processes for care delivery. This study examined the relationship between implementation of care management processes (CMPs, the specific tactics that enable the practice of value-based care) and hospital performance under value-based payment. Using the American Hospital Association's Survey of Care Systems and Payment and the Centers for Medicare & Medicaid Services' Hospital Compare, we estimated the relationship between hospital implementation of CMPs and performance as it relates to spending, patient satisfaction, readmission reduction, value-based purchasing, and clinical care outcomes. We found that hospitals increased implementation of CMPs from 2013 to 2014, which has led to modest changes in performance. We concluded that care coordination is associated with greater improvements in hospital performance. However, the long-term effects of resulting changes in care delivery may differ from the short-term effects. Thus, study findings underscore the importance of continued evaluation of care management practice as a strategy for optimizing delivery of high-quality, efficient patient care.","PeriodicalId":51633,"journal":{"name":"Journal of Healthcare Management","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/JHM-D-18-00049","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46362136","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":"The Butterfly Effect in Healthcare: What Happens When an Organization Tackles Unconscious Bias and Promotes Diversity of Thought?","authors":"Ernie W Sadau, Tiffany Capeles","doi":"10.1097/JHM-D-19-00152","DOIUrl":"https://doi.org/10.1097/JHM-D-19-00152","url":null,"abstract":"","PeriodicalId":51633,"journal":{"name":"Journal of Healthcare Management","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/JHM-D-19-00152","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46451647","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}