Journal of Healthcare Management最新文献

{"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":"68 6","pages":"380-383"},"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":"68 6","pages":"420-426"},"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":"68 6","pages":"452-454"},"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":"68 6","pages":"390-403"},"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":"68 6","pages":"404-419"},"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":"African Traditional Medicine: Its Potential, Limitations and Challenges","authors":"Sifuna Nixon","doi":"10.36959/569/475","DOIUrl":"https://doi.org/10.36959/569/475","url":null,"abstract":"","PeriodicalId":51633,"journal":{"name":"Journal of Healthcare Management","volume":"189 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75006385","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}

{"title":"Gearing Up for a Vaccine Requirement: A Mixed Methods Study of COVID-19 Vaccine Confidence Among Workers at an Academic Medical Center","authors":"M. Mahoney, M. Winget, C. Brown-Johnson, Lindsay de Borba, D. Veruttipong, J. Luu, David Jones, Bryan D. Bohman, S. Vilendrer","doi":"10.1097/JHM-D-21-00226","DOIUrl":"https://doi.org/10.1097/JHM-D-21-00226","url":null,"abstract":"SUMMARY Goal: Assessing barriers to vaccination among healthcare workers may be particularly important given their roles in their respective communities. We conducted a mixed methods study to explore healthcare worker perspectives on receiving COVID-19 vaccines at a large multisite academic medical center. Methods: A total of 5,917 employees completed the COVID-19 vaccine confidence survey (20% response rate). Most participants were vaccinated (93%). Compared to vaccinated participants, unvaccinated participants were younger (60% < 44 years), more likely to be from a non-Asian minority group (48%), and more likely to be nonclinical employees (57% vs. 46%). Among the unvaccinated respondents, 53% indicated they would be influenced by their healthcare provider, while 19% reported that nothing would influence them to get vaccinated. Key perceived barriers to vaccination from the qualitative analysis included the need for more long-term safety and efficacy data, a belief in the right to make an individual choice, mistrust, a desire for greater public health information, personal health concerns, circumstances such as prior COVID-19 infection, and access issues. Principal Findings: Strategies endorsed by some participants to address their concerns about safety and access included a communication campaign, personalized medicine approaches (e.g., individual appointments to discuss how the vaccine might interact with personal health conditions), and days off to recover. Mistrust and a belief in the right to make an individual choice may be harder barriers to overcome; further dialogue is needed. Applications to Practice: These findings reflect potential strategies for vaccine requirements that healthcare organizations can implement to enhance vaccine confidence. In addition, organizations can ask respected health professionals to serve as spokespeople, which may help shift the perspectives of unvaccinated healthcare workers.","PeriodicalId":51633,"journal":{"name":"Journal of Healthcare Management","volume":"67 1","pages":"206 - 220"},"PeriodicalIF":1.8,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46866638","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}