Business Administration, Management, and Operations Commons^™

Evaluation Of The Care Manager Role In Primary Care, Malaika Stoll Md, Mpa, Lynn M. Deitrick Rn, Phd, Nancy Gratz Mpa, Pam Marcks, Kathleen Moser

Administration & Leadership

No abstract provided.

Cohorting Patients By Medical Groups Improves Throughput And Length Of Stay, Susan L. Lawrence Ms, Cmac

Administration & Leadership

No abstract provided.

Safety Culture As A Contemporary Healthcare Construct: Theoretical Review And Research Assessment, Patrick Albert Palmieri

Patrick Albert Palmieri

GOAL. To analyze the theoretical underpinnings of safety culture and to provide an assessment about the state of safety culture research in healthcare. METHODS. First, we reviewed the concept of safety culture, including its origination, disciplinary influences, and associated theoretical tenets. By describing the literature and discussing the interchangeable use of the terms “safety attitude,” “safety climate,” and “safety culture,” we are able to present the conceptual attributes associated with safety culture and present a definition of safety culture. Then, we discuss the psychometric properties for the most widely used instruments in healthcare. The article concludes with a discussion of …

Safety Culture As A Contemporary Healthcare Construct: Theoretical Review, Research Assessment, And Translation To Human Resource Management., Patrick Albert Palmieri

Patrick Albert Palmieri

Through a number of comprehensive reviews, the Institute of Medicine (IOM) has recommended that healthcare organizations develop safety cultures in order to align delivery system processes with the workforce requirements to improve patient outcomes. Until health systems can provide safer care environments, patients remain at risk for suboptimal care and adverse outcomes. Health science researchers have begun to explore how safety cultures might act as an essential system feature to improve organizational outcomes. Since safety cultures are established via modification in employee safety perspective and work behavior, human resource professionals need to contribute to this developing organizational domain. The IOM …

Complex Adaptive Systems As A Model For Evaluating Organisational Change Caused By The Introduction Of Health Information Systems, Kieren Diment Mr, Ping Yu, K. Garrety

Faculty of Informatics - Papers (Archive)

This paper documents the preliminary development of a framework for evaluating organisational change processes during the implementation of an electronic nursing documentation system in residential aged care facilities. It starts with a brief outline of organisational change processes. This is followed by a more detailed exposition of the principles underlying complex adaptive systems (CAS) theory, where we explain how mathematical concepts can be used to illuminate qualitative research approaches. Finally we present some preliminary findings on the facilitators and barriers for the introduction of the electronic documentation system, explained with reference to the CAS theory, based on analysis of interviews …

Uncompensated Care Cost: A Pilot Study Using Hospitals In A Texas County, Alberto Coustasse, Andrea L. Lorden, Vishal Nemarugommula, Karan P. Singh

Management Faculty Research

The financial ramifications of uncompensated care cost (UCC) on the healthcare industry have been difficult to quantify. With the lack of a standardized definition of uncompensated care and the need to account for the uninsured, indigent, and immigrant populations, the authors identified $190 million of UCC from Southwestern border hospitals for emergency room treatment of undocumented immigrants and $934 million of uncompensated care charges for 23 hospitals in a Texas county, which translated to $353 million of UCC. Although lawmakers passed the Medicare Prescription Drug Improvement and Modernization Act (2003) to address the growing imbalance, the shortfall of funds highlights …

Attribution Theory And Healthcare Culture: Translational Management Science Contributes A Framework To Identify The Etiology Of Punitive Clinical Environments, Patrick Albert Palmieri

Patrick Albert Palmieri

The Institute of Medicine’s seminal report, To err is human: Building a safer health system, established the national patient safety framework and initiated interest in changing the traditionally punitive healthcare culture. This paper reviews a multidisciplinary literature and offers an attribution framework to explicate the organizational processes that contribute to an industry-wide culture where clinicians are routinely blamed for adverse patient events. Attribution theory is concerned with the manner in which people explain the behaviors of others or themselves by assigning causality for events. To date, attribution theory, though well established in the management literature, has yet to be translated …

The Balanced Scorecard Framework-A Case Study Of Patient And Employee Satisfaction: What Happens When It Does Not Work As Planned?, Andrea Lorden, Alberto Coustasse, Karan P. Singh

Management Faculty Research

Background: The successful utilization of the balanced scorecard (BSC) framework in health care has been demonstrated in the literature. Given these successes, a financially struggling hospital implemented a BSC framework intervention which attempted a culture change centered upon patient satisfaction which it hoped would translate to improved financial stability. Despite the evidence of BSC successes, the intervention, entitled Route 99, did not succeed in this hospital.

Purpose: This case study was conducted to identify learnable lessons and confounding factors associated with the successes and failures of Route 99. Metrics for patient satisfaction and employee satisfaction were examined as reflections of …

Hospital Costs And Clinical Characteristics Of Continuous Renal Replacement Therapy Patients: A Continuous Ethical Dilemma, Alberto Coustasse

Management Faculty Research

This study describes the clinical characteristics and examines hospital costs involved in the care of 117 patients undergoing Continuous Renal Replacement Therapy (CRRT) between January 1999 and August 2002. The majority (70.9%) of the patients undergoing CRRT expired in the hospital. Statistically significant differences were found with respect to the length of stay for discharge status and gender; and with respect to costs for surgery versus no surgery and gender. Significant differences were also found between discharge status and gender, age, and cardiovascular surgery. The results of this study raise economic and ethical questions related to the cost/benefit of CRRT …

Organizational Culture In A Terminally Ill Hospital, Alberto Coustasse, Douglas A. Mains, Kristine Lykens, Sue G. Lurie, Fernando Trevino

Management Faculty Research

This study analyzed an organizational culture in a community hospital in Texas to measure organizational culture change and its impact on Patient Satisfaction (PS). The study employed primary and secondary data, combining quantitative and qualitative methods for a case study. Participant observation was used and archival data were collected to provide a better understanding of the organizational culture and the context in which change was taking place. This study also applied a “Shared Vision” of the organization as the central process in bringing forth the knowledge shared by members of the community hospital who were both subjects and research participants. …

Knowledge Integration: The Iaims Experience At Lvh., Donald L. Levick Md, Linda M. Schwartz Mde, Ahip, Cm, Bryan G. Kane Md

Administration & Leadership

No abstract provided.

Technological Iatrogenesis: New Risks Force Heightened Management Awareness, Patrick Albert Palmieri

Patrick Albert Palmieri

Iatrogenesis is a term typically reserved to express the state of ill health or the adverse outcome resulting from a medical intervention, or lack thereof. Three types of iatrogenesis are described in the literature: clinical, social and cultural. This paper introduces a fourth type, technological iatrogenesis, or emerging errors stimulated by the infusion of technological innovations into complex healthcare systems. While health information technologies (HIT) have helped to make healthcare safer, this has also produced contemporary varieties of iatrogenic errors and events. The potential pitfalls of technological innovations and risk management solutions to address these concerns are discussed. Specifically, failure …

Impact Of A Multifaceted Quality Improvement Initiative To Implement Jcaho Core Measures For Ami And Chf, Michael A. Rossi Md, Zubina M. Mawji Md, Mph, Patricia Parker Rn, Joshua B. Skibba Md, Katrina A. Fritz Bsn, Tamara Masiado Ma, Thomas E. Wasser Phd

Administration & Leadership

No abstract provided.

Effectiveness Of A Progress Note On Quality Care Indicators In A Get With The Guidelines Hospital, Michael A. Rossi Md, Zubina M. Mawji Md, Mph, Patricia Parker Rn, Joshua B. Skibba Md, Katrina A. Fritz Bsn, Tamara Masiado Ma, Thomas E. Wasser Phd

Administration & Leadership

No abstract provided.

Comparative Cost Analysis Of Crrt In Icu/Ccu Patients Undergoing Cardiovascular Surgery Vs. Other Procedures At A Texas Hospital, Tejaswi Belavadi, Alberto Coustasse, Douglas Mains, Antonio A. Rene

Management Faculty Research

The purpose of this study was to conduct a comparative analysis of hospital costs incurred by patients undergoing Cardiovascular Surgery (CVS) and patients undergoing other medical procedures who received Continuous Renal Replacement Therapy (CRRT) in a teaching hospital. A total of 117 patients were identified through review of medical charts for the period of January 1999 to August 2002. Twenty one percent of them were identified having CVS. Eighty-eight percent of the CVS patients admitted to the ICU for CRRT died compared to 67% for non-CVS patients (p=0.047). Average actual costs of hospitalization were $47,225 for CVS patients and $51,724 …

Gaining Compliance And Losing Weight: The Role Of The Service Provider In Health Care Services, Stephanie Dellande, Mary C. Gilly, John L. Graham

Business Faculty Articles and Research

This research provides and empirically tests a conceptualization of health care services in which customer compliance outside of the service organization is necessary for successful health outcomes. Using data from service providers and customers in a weight-loss clinic, the authors examine the provider's role in gaining customer compliance. They find that provider expertise and attitudinal homophily play a role in bringing about customer role clarity, ability, and motivation. This study demonstrates that compliance leads to goal attainment, which results in satisfaction. More important, compliance also leads to satisfaction directly; consumers who comply with program requirements have greater satisfaction with the …

Designing And Implementing A Balanced Scorecard: Lessons Learned In Nonprofit Implementation, Andra Gumbus, Tom Wilson

WCBT Faculty Publications

The balanced scorecard has been referred to as the management innovation of the century, and extensive articles have been written using case studies of organizations that use this performance measurement system. This article addresses the key issues of design and implementation with a step-by-step guide to how to design a balanced scorecard and lessons to avoid implementation problems in government and nonprofit settings.

Designing A Strategy To Effectively Communicate The Balanced Scorecard, Andra Gumbus, Bridget Lyons, Tom Wilson

WCBT Faculty Publications

As increasing numbers of organizations adopt the balanced scorecard (BSC) to align strategy with operations and measure progress toward meeting strategic goals, the importance of successful communication of the scorecard throughout the organization has become apparent. Successful implementation and effective use of the BSC occurs when organizational stakeholders recognize its role, use, and benefits. In the March/April 2003 issue of Cost Management, we detailed how Bridgeport Hospital, a member of Yale New Haven Health System (YNHHS), adopted the BSC and used the scorecard to align capital investment decisions with strategy.1 In this article, we will profile how the hospital designed …

Aligning Capital Investment Decisions With The Balanced Scorecard, Andra Gumbus, Bridget Lyons, Dorothy E. Bellhouse

WCBT Faculty Publications

The Balanced Scorecard (BSC) has evolved from a measurement tool to a strategic management tool used by thousands of organizations. The Balanced Scorecard has proven to be a powerful tool in translating strategy into action in the for-profit sector and has recently been adopted by increasing numbers of not-for-profit organizations as well.

University of Bridgeport Hospital, part of the Yale-New Haven Health System, has been using the BSC for over three years to effectively translate strategy into dayto-day operations. The hospital has also linked the capital budgeting process to the BSC to ensure that resource allocation is aligned with strategic …

Case Study On Costs And Efficiency Of Urgent Care Center Desert Valley Medical Group, Victorville, Hari Mallam Reddy

Theses Digitization Project

The purpose of this research project is to report on a comprehensive organizational audit of the Urgent Care Service of Desert Valley Medical Group in Victorville, California.

An International Cross-Cultural Study Of The Role Of Chief Informational Officers In Healthcare, Wallace Saunders

Faculty Dissertations

The introduction and utilization of Information Systems (IS) in the hospital environment has had a significant and lasting impact on the practice of medicine. The development of this dissertation will attempt to explore a widely overlooked area: The comparison of Chief Information Officers (CIOs) in the United States and the United Kingdom.

Aspects of CIO experiences relating to assumed roles, CIO challenges, skills, frustrations, success, failure, leadership, management, involvement and perceptions about the role of Information Technology (IT) in healthcare are discussed with a comparative global model. This study investigates the managerial roles of the Chief Information Officer based on …

Factors Associated With Emergency Room Choice Among Medicare Patients, Judith L. Mack, Karen M. File, Jeffrey E. Horwitz, Russ Alan Prince

WCBT Faculty Publications

Changing macroenvironmental factors have caused hospital administrators to reassess their positions across all service lines and market segments. This pilot study explores relationships among the service experience, satisfaction and future patronage decisions among 368 Medicare patients, an often overlooked segmaent, who were recent users of a hospital emergency room.

Productivity Measurement For Home Health Care Registered Nurses, Lazelle Emminizer Benefield

Theses and Dissertations in Urban Services - Urban Management

The purpose of this study is to develop a productivity measurement applicable to home health registered nurses (RNs) by identifying and quantifying the knowledge and ability variables that define productive nurse practice.

A preliminary set of knowledge and ability variables was identified based on content analysis of interviews with local nurse managers and round I of a three round Delphi procedure, using a purposive sample of nurse managers from nationally preeminent agencies. A randomized national sample of 337 nurse managers was then surveyed to determine the relative value and rank of the knowledge and ability variables. These variables were refined …

Ua35/11 Student Honors Research Bulletin, Wku Honors Program

WKU Archives Records

The WKU Student Honors Research Bulletin is dedicated to scholarly involvement and student research. These papers are representative of work done by students from throughout the university.

• Coates, Alan. Management's Attitude Toward Collective Bargaining
• Frew, Becky. The Effects of Personality Type and Social Support on Instances of Job Stress
• Green, Laura. Earth Sheltered Housing
• Gregory, Vicky. Fraud and Abuse by Medical Providers in Medicare and Medicaid
• Hignite, Susan. Japanese Students in Kentucky Classrooms
• Hodum, Martha. The Mathematically Gifted Child
• Jones, Rodney. Superman to Censorship: America's Romance with the Comic Book
• Marrs, Shawn. Romanticism and Unromanticism in Sir Gawain and the …