Journal of Healthcare Management最新文献

{"title":"Building Community for Greater Well-Being.","authors":"Eric W Ford","doi":"10.1097/JHM-D-23-00214","DOIUrl":"10.1097/JHM-D-23-00214","url":null,"abstract":"","PeriodicalId":51633,"journal":{"name":"Journal of Healthcare Management","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72016139","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":"Wayne Young, FACHE, CEO, The Harris Center for Mental Health and IDD.","authors":"","doi":"10.1097/JHM-D-23-00213","DOIUrl":"10.1097/JHM-D-23-00213","url":null,"abstract":"","PeriodicalId":51633,"journal":{"name":"Journal of Healthcare Management","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72016143","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":"Behavior Intervention Response Team: Piloting an Effective Means to Manage Patient- and Family-Disruptive Behaviors.","authors":"Jennifer M Katzenstein, Sondra L Boatman, Kevin Newman, Kristin Maier","doi":"10.1097/JHM-D-23-00103","DOIUrl":"10.1097/JHM-D-23-00103","url":null,"abstract":"<p><strong>Goal: </strong>This article describes the development and implementation of a behavior intervention response team (BIRT). Pilot data indicate the successful implementation of BIRT interventions with patients and families and the positive staff response to these interventions.</p><p><strong>Methods: </strong>Patient- and family-disruptive behaviors are increasing in hospitals. Those behaviors arise from stress, financial burdens, and the mental weight of the patient's medical condition on the family. These distressed patients and their families tax an already overwhelmed staff, exacerbating the caregivers' exhaustion, depersonalization, and frustration. We recognized the need to proactively address these disruptions at our children's hospital with an interdisciplinary response. Disciplines engaged in the BIRT development included risk management, behavioral health, child life, service excellence, patient and family services, social work, and chaplaincy. Following multiple brainstorming sessions, we created a comprehensive, clear intervention strategy to engage with a disruptive patient or family. The BIRT was developed to work with both the family and their medical team to intervene at the first signs of potential disruption.</p><p><strong>Principal findings: </strong>With the BIRT, we were able to reduce disruptive behaviors and limit the subsequent removal of problematic individuals from the facility. Of the families who worked with the BIRT, 75.8% required no postintervention follow-up.</p><p><strong>Practical applications: </strong>The development of a BIRT can help head off disruptive behaviors and improve family-medical team relationships to support the highest quality and safest healthcare.</p>","PeriodicalId":51633,"journal":{"name":"Journal of Healthcare Management","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72016138","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-23-00206","DOIUrl":"10.1097/JHM-D-23-00206","url":null,"abstract":"<p><p>The following two abstracts are from presentations at the Forum on Advances in Healthcare Management Research that took place in March 2023 during the Congress on Healthcare Leadership of the American College of Healthcare Executives. An annual event, the Forum presents theoretical and empirical research with the potential for high impact on healthcare management. An abstract by Jennifer Ford of the Veterans Health Administration and Patricia MacTaggart of George Washington University titled \"Innovative Comprehensive Care Model: Pittsburgh VA Oncology\" also was presented at the Forum after publication in the November/December 2021 issue of the Journal of Healthcare Management.</p>","PeriodicalId":51633,"journal":{"name":"Journal of Healthcare Management","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72016136","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":"Providers' Perceptions of the Effectiveness of Electronic Health Records in Identifying Opioid Misuse.","authors":"Jeffrey Glenn, Danica Gibson, Heather F Thiesset","doi":"10.1097/JHM-D-22-00253","DOIUrl":"10.1097/JHM-D-22-00253","url":null,"abstract":"<p><strong>Goal: </strong>This study aimed to understand prescribing providers' perceptions of electronic health record (EHR) effectiveness in enabling them to identify and prevent opioid misuse and addiction.</p><p><strong>Methods: </strong>We used a cross-sectional survey designed and administered by KLAS Research to examine healthcare providers' perceptions of their experiences with EHR systems. Univariate analysis and mixed-effects logistic regression analysis with organization-level random effects were performed.</p><p><strong>Principal findings: </strong>A total of 17,790 prescribing providers responded to the survey question related to this article's primary outcome about opioid misuse prevention. Overall, 34% of respondents believed EHRs helped prevent opioid misuse and addiction. Advanced practice providers were more likely than attending physicians and trainees to believe EHRs were effective in reducing opioid misuse, as were providers with fewer than 5 years of experience.</p><p><strong>Practical applications: </strong>Understanding providers' perceptions of EHR effectiveness is critical as the health outcome of reducing opioid misuse depends upon their willingness to adopt and apply new technology to their standardized routines. Healthcare managers can enhance providers' use of EHRs to facilitate the prevention of opioid misuse with ongoing training related to advanced EHR system features.</p>","PeriodicalId":51633,"journal":{"name":"Journal of Healthcare Management","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10635334/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72016141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Evolution of Employee Assistance Programs to Best Support Healthcare Organizations.","authors":"Gregory P Couser, Jody L Nation, Dennis P Apker, Susan M Connaughty, Mark A Hyde","doi":"10.1097/JHM-D-23-00085","DOIUrl":"10.1097/JHM-D-23-00085","url":null,"abstract":"<p><strong>Goal: </strong>Employee assistance programs (EAPs) have been evolving since they first became prevalent in the 1970s. The important counseling component of EAPs is sometimes lost in discussions about what they do, with many EAPs marketing a broad portfolio of services such as childcare, elder care, legal referral, and other concierge services rather than counseling. The objective of this study was to examine outcomes for the EAP of one organization (Mayo Clinic), compare them to outcomes reported in the literature, and gain insights to help all healthcare organizations best support their employees.</p><p><strong>Methods: </strong>Consistent with customary EAP practice, data for this study was collected through an anonymous survey link distributed by e-mail to users of individual counseling as well as users of organizational consulting services such as advising leaders and supervisors and leading educational sessions.</p><p><strong>Principal findings: </strong>All (n = 82) individual counseling respondents indicated they would recommend the EAP, none reported worse symptoms, 90% decreased their stress levels, 92% reduced their feelings of anxiety, 88% enjoyed an overall improvement in mood, and 95% developed new skills. If their concern was work-related, 96% agreed the counselor understood the work culture and was able to provide helpful guidance; of the clients who were feeling burned out, 86% agreed they gained strategies to reduce its symptoms. Thematic analysis of individual counseling services indicated that participants highly valued their counselors. Regarding organizational consulting services, respondents (n = 50) indicated EAP services increased their confidence as leaders, supported their work, and provided tangible guidance. They appreciated having an internal EAP counselor. Thematic analysis of organizational consulting services indicated that EAP supported leaders by listening, coaching, and empowering them to normalize issues.</p><p><strong>Practical applications: </strong>EAPs have evolved into distinct internal, external, and hybrid internal-external models. Internal model counselors are company employees with inside knowledge of company culture, external EAP model counselors are contracted outside of the company, and hybrid models combine a small cadre of internal counselors with the support of outside contractors. Regardless of the model, EAP counselors must collaborate with internal stakeholders, notably the human resources department, to efficiently identify and troubleshoot employee relational issues and allow for customized initiatives to improve mental health. Based upon these findings and the authors' direct experiences with EAP providers, components of an ideal EAP are outlined to show how EAPs can best support employees. Healthcare leaders seeking to add EAP services are advised to focus on offerings that are custom fit to the organization.</p>","PeriodicalId":51633,"journal":{"name":"Journal of Healthcare Management","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72016142","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":"What Organizational Diagnostics Do You Use to Detect Management Issues?","authors":"Eric W Ford","doi":"10.1097/JHM-D-23-00153","DOIUrl":"10.1097/JHM-D-23-00153","url":null,"abstract":"","PeriodicalId":51633,"journal":{"name":"Journal of Healthcare Management","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10534737","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":"Impact of Clinical Pharmacy Surveillance on Pharmacy Services: A Quality Improvement Project.","authors":"Joan S Kramer,&nbsp;Cynthia Borum,&nbsp;Evan L Claxon,&nbsp;Kahari J Wines,&nbsp;Sarah Fraker,&nbsp;L Hayley Burgess","doi":"10.1097/JHM-D-22-00176","DOIUrl":"10.1097/JHM-D-22-00176","url":null,"abstract":"<p><strong>Goal: </strong>The purpose of this quality improvement project was to retrospectively evaluate pharmacist time to clinical surveillance alert intervention before and after implementing a pharmacy-directed alert priority category across a large for-profit United States health system with well-established clinical pharmacy surveillance software integrated into the clinical pharmacy workflow. The findings contributed to a financial evaluation of pharmacist productivity compared with drug spend for pharmacy-directed interventions that included intravenous (IV)-to-oral-conversion and renal dosing opportunities.</p><p><strong>Methods: </strong>A retrospective quality improvement pre-/postanalysis of deidentified, prepopulated clinical surveillance alert data for the preimplementation period of January 1, 2021, through September 30, 2021, was compared with that for the postimplementation period of November 1, 2021, to January 31, 2022, for 169 hospitals. Clinical pharmacist workflow was mapped pre- and postimplementation. The average time to alert intervention was calculated using the mean time in minutes between the alert firing within the software and when the pharmacist reviewed the alert, grouped by hospital, alert status, and priority category. Medications converted from IV to oral were assessed using the clinical surveillance software IV-to-oral calculator. Postimplementation renal dose cost savings were modeled using pharmacist-completed alerts by rule name that indicated a possible dose decrease based on the patient's renal function and current medication.</p><p><strong>Principal findings: </strong>Time to alert intervention for all completed pharmacist interventions was reduced for high-priority alerts by 32.6 min (p < .001) and routine-priority alerts by 65.1 min (p = .147). Alerts that moved to the pharmacy-directed alert priority category resulted in a reduced time to alert intervention of 38.7 min (p = .003). Normalized average wholesale price (AWP) cost savings from IV-to-oral conversion within 3 days of conversion eligibility were $1,693,600 in the preimplementation period and $1,867,400 in the postimplementation period, a $173,700 increase in cost savings. A total of 7,972 completed postimplementation renal dose adjustments resulted in a modeled AWP normalized cost savings of $1,076,700.</p><p><strong>Practical applications: </strong>Results indicated that optimizing clinical surveillance software alerts was effective and increased pharmacist productivity. Specifically, creating a pharmacy-directed alert category that pharmacists were able to complete by hospital policy or protocol improved workflow efficiency and increased IV-to-oral medication conversion cost savings. Further study is needed to validate the renal dose-modeled cost savings and address the financial benefits of quality measures to prevent acute kidney injury.</p>","PeriodicalId":51633,"journal":{"name":"Journal of Healthcare Management","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10552803","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":"Positive Leadership Behaviors Empower Teams and Effect Change.","authors":"Joshua A Wymer","doi":"10.1097/JHM-D-23-00146","DOIUrl":"10.1097/JHM-D-23-00146","url":null,"abstract":"Having the privilege to interact with and work alongside leaders from across the spectrum of healthcare, I am impressed by the similarity of challenges facing everyone who pursues and delivers on change. Various distinct attributes and behaviors seem to maximize the opportunity for successful change in healthcare organizations. However, the theme of these attributes always brings me back to one word, trust. Recognizing trust as a fundamental part of the human experience, we need to acknowledge its role in our practice as healthcare leaders. Years of strategic or operational leadership may guide us in maximizing the value of people, resources, and services, but change competencies and trust behaviors require a fresh evaluation. Transformational leaders recognize that reassessing and recalibrating trust behaviors are essential for continued success.","PeriodicalId":51633,"journal":{"name":"Journal of Healthcare Management","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10552802","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":"Annette M. Walker, President, City of Hope Orange County.","authors":"","doi":"10.1097/JHM-D-23-00160","DOIUrl":"10.1097/JHM-D-23-00160","url":null,"abstract":"","PeriodicalId":51633,"journal":{"name":"Journal of Healthcare Management","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10552804","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}