Business Administration, Management, and Operations Commons^™

The Effect Of Magnet Hospitals On Nursing Burnout, Jonathan Settle, Michael Davis, Eric Pulice, Alberto Coustasse

Management Faculty Research

Introduction:

The World Health Organization [2019] defined burnout as a syndrome caused by chronic job stressors that are not successfully managed, characterized by exhaustion, depersonalization, job detachment, and feelings of inadequacy (WHO, 2019). According to Murthy [2022], the nursing burnout crisis was underway before COVID-19. Nurse burnout recognized pre-COVID-19 was due to systemic organizational problems such as inadequate organizational support and underinvestment in public health (Murthy, 2022).

A 2022 survey of 2500 nurses exhibited increased rates of burnout during the pandemic, with 75% of respondents experiencing burnout, while 65% of those surveyed expressed their desire to leave the healthcare field …

Magnet Hospitals: An Update On The Impact On Nursing Burnout, Jonathan Settle, Michael Davis, Alberto Coustasse

Management Faculty Research

Nurse burnout has been associated with worsened outcomes for nurses, such as increased turnover or quitting and lower job satisfaction. The purpose of this research was to examine Magnet-designation status in U.S. hospitals, specifically shared governance and structural empowerment, and its effects on nurse burnout, nurse turnover, and job satisfaction of nurses. This study utilized a literature review complemented by two semi-structured interviews. The results showed that Magnet hospitals kept lower levels of burnout, better job satisfaction, and less turnover than non-Magnet hospitals, but this was only the case for some studies of Magnet hospitals. Some outcomes could be attributed …

Relationship Between The Hospital Readmission Reduction Program And Readmissions, Postoperative Complications, And Cost, Cary A. Blick, Blake P. Williams, Drake T. Myers, Joshua Pomranke, Sarah M. Clemente, Alberto Coustasse

Management Faculty Research

Hospital readmissions have contributed significantly to rising healthcare costs in the United States. To curb rising costs, the Centers for Medicare and Medicaid Services introduced the Hospital Readmissions Reduction Program (HRRP), a penalty-based program designed to decrease healthcare costs. This research aims to determine if the HRRP has successfully reduced healthcare costs and increased quality outcomes associated with total knee arthroplasty (TKA) or total hip arthroplasty (THA) as defined by a reduction in readmission rates, postoperative complications, and overall costs. Although a positive correlation has been shown between outcomes and costs post-HRRP, more research is needed to tease out the …

Landscaping Wellness At Work: A Participatory Model For Worker-Centered Health, Anya Helena Piotrowski

Antioch University Full-Text Dissertations & Theses

This study contributes to a body of scholarship that demonstrates the benefits and need of employee-driven and defined wellness at work processes. This participatory action research study brought together a team of employees within a remote-work, start-up organization to define and design a process for implementing wellness at work for their organization. Through a participatory process that allowed outcomes to emerge from the group, employees identified opportunities to foster embodied wellness in their organization in three core areas: organizational, personal, and cross-boundary initiatives. Through a reflective collaboration, employees generated ideas and developed a plan to address employee-identified priorities that will …

Egypt’S Pediatric Oncology Hospital 57357: A Case Study Analysis, Ashley A. Clegg

Honors Theses

Hospital 57357 is the foremost pediatric oncology hospital in Egypt and provides treatment free of charge to children with cancer. Since its establishment in 2007, the hospital has grown to a capacity of 380 patient beds across three locations. Its quest for continuous improvement led to the development of a new performance management system emphasizing the tracking and measurement of a multitude of Key Performance Indicators across all departments. While this new system enables objective and perpetual monitoring of key patient care metrics, its integration into the existing structure introduces challenges that must be addressed. To analyze the external environment …

Profit Or Purpose: What Increases Medical Doctors’ Job Satisfaction?, Young Kyun Chang, Won-Yong Oh, Sanghee Han

Management, Entrepreneurship and Technology Faculty Publications

This study integrates two competing views to examine whether medical doctors are satisfied with their jobs when they perceive their hospitals as being oriented toward profit (i.e., rational choice theory) or purpose (i.e., public service motivation). Using a sample of 127 doctors from 70 hospitals, this study tests these competing views. The results show that doctors who perceive their hospitals as purpose-driven are likely to experience job satisfaction, and this pattern still holds even if they also perceive their hospitals to be emphasizing profits. However, only the purpose-driven orientation results in job satisfaction via a sense of meaningfulness. Thus, this …

Association Of Electronic Medical Records And Opioid Prescription, Archana Suwal, Jemimah Okonjo, Stacie Deslich, Alberto Coustasse

Management Faculty Research

A Prescription Drug Monitoring Program (PDMP) is an electronic database that tracks controlled substance prescriptions in a state. PDMPs can provide health authorities timely information about prescribing and patient behaviors that contribute to the epidemic and facilitate an agile and directed response. Electronic Prescribing for Controlled Substances (EPCS) aimed to eliminate paper prescriptions by allowing clinical prescribers to write prescriptions electronically, making them digital and trackable for both the prescriber and the pharmacist and has been an essential part of any health information technology system, as well as a requirement for 'meaningful use' (Blumenthal & Tavenner, 2010). However, one of …

Evaluation Of House Staff Candidates For Program Fit: A Cohort-Based Controlled Study, Soo-Hoon Lee, Phillip H. Phan, Sanjay V. Desai

Management Faculty Publications

Background: Medical school academic achievements do not necessarily predict house staff job performance. This study explores a selection mechanism that improves house staff-program fit that enhances the Accreditation Council for Graduate Medical Education Milestones performance ratings.

Objective: Traditionally, house staff were selected primarily on medical school academic performance. To improve residency performance outcomes, the Program designed a theory-driven selection tool to assess house staff candidates on their personal values and goals fit with Program values and goals. It was hypothesized cohort performance ratings will improve because of the intervention.

Methods: Prospective quasi-experimental cohort design with data from two house staff …

Competencies For Successful Middle Managers In Healthcare And Medical Education, Ahmed Al Ansari

Antioch University Full-Text Dissertations & Theses

The Kingdom of Saudi Arabia (KSA) and the Kingdom of Bahrain (KB) are currently in the process of the rapid transformation of health care to a self-sustained autonomous system. Middle managers play a pivotal role in achieving this goal. The aim of this study is to develop a feasible, reliable, and valid scale for measuring the leadership and managerial competencies of MM in KSA and KB. Zhou’s (2019) conceptual framework using a mixed-method approach was followed. After procuring ethical clearance from concerned authorities and informed consent from all the participants (n = 27), semi-structured interviews were conducted across three groups: …

Integrating Interpersonal Neurobiology In Healthcare Leadership And Organizations, Lynn Redenbach

Antioch University Full-Text Dissertations & Theses

Interpersonal Neurobiology (IPNB) is an interdisciplinary, science-based field that seeks to understand human reality including the nature of mind, brain, and relationships. IPNB has been used extensively by mental health practitioners as well as child development and parenting experts. While practitioners and scholars have described ways that IPNB can be used in leadership and organizations, there has been no systematic inquiry into the practical and phenomenological experience of this application. IPNB offers an alternative to dominant models of care and leading in healthcare settings and fields, which are characterized by disconnection, objectification, and separation. It offers a relationally centered approach …

Potential Savings From Consumer-Driven Health Plans, William Ferguson, Brittany Smith, Jessica Mcnair, Sarah Miller, Bojing Wang, Alberto Coustasse

Management Faculty Research

Consumer Driven Health Plans (CDHPs) have been identified as a high-deductible insurance option that has increased consumer responsibility while healthcare expenditures have decreased. There has been an increasing need of these plans because they can help to control healthcare costs, and the increasing healthcare utilization. As the use of these plans have expanded, educated consumers have become more engaged in their healthcare services and have increased demands for transparency of healthcare costs. The methodology for this study was a literature review using 36 sources. The purpose of this study was to determine if CDHPs have created financial savings by increasing …

Bear River Health Department: Covid-19 Contact Tracing, Mike Dixon, Zach Rusk

Huntsman School of Business Teaching Scholarship Series

This case introduces students to a highly variable process that has uncertain demand and processing times. It describes the contact tracing efforts as a response to positive Covid-19 cases in a rural health district in the state of Utah during the first 9 months of the pandemic of 2020. The case puts students in the shoes of the managing director of a health department trying to decide how to best manage a team of contact tracers who are increasingly unable to timely complete their work that is vital to stopping the spread of the disease.

Sustainability Of Rural Hospitals In The United States, Stephanie Cole, Kathleen Lanhan, Alberto Coustasse

Management Faculty Research

Introduction: Rural hospitals experienced both challenges and opportunities in providing healthcare to the community. As these facilities were one of the largest employers in the area, their impact was significant. The purpose of this study was to determine the sustainability of rural hospitals in the U.S. by examining variables that affect these institutions such as accessibility, availability of services, quality outcomes, and effective administrative practices.

Methodology: This qualitative study utilized a literature review and open-ended survey of an expert in Hospital Administration within or collaborating with rural areas. Five databases were used to collect 48 total sources. These sources were …

The Experience Of Children's Mental Health Leaders During Times Of Constraint: A Narrative Study, Jody Levison-Johnson

Antioch University Full-Text Dissertations & Theses

Across the United States, each state has a public mental health system that is designed to support children and youth with emotional and behavioral challenges. This is critically important as recent estimates show that one in six children in the United States has a diagnosed mental health condition (Whitney & Peterson, 2019). The design and structure of these systems vary by state, but consistent across them is the presence of a state-designated leader who is faced with an array of constraining factors that influence their behavior and shape the resulting system. This study describes the experience of leaders in children’s …

Managing Clinic Variability With Same-Day Scheduling, Intervention For No-Shows, And Seasonal Capacity Adjustments, Kum Khiong Yang, Tugba Cayirli

Research Collection Lee Kong Chian School Of Business

This study investigates demand and capacity strategiesfor managing clinic variability. These include (i) same-day scheduling tocontrol random walk-ins, (ii) no-show intervention, where the clinic callsadvance-booked patients a day before to identify and release canceled slots tosame-day patients, and (iii) adjustments to daily number of appointments foradvance-booked patients to match seasonal variations in same-day demand. Thesestrategies are tested over the individual-block/fixed-interval (IBFI) and theDome appointment rules. The resulting appointment systems are tested underscenarios with different levels of same-day demand, demand seasonality,no-shows and cost ratios. The goal is to minimize the weighted sum of patients’wait time and physician’s idle-time and overtime. Our …

Implications Of Upcoding On Medicare, Katrina Cremeans, Samantha Marcum, Carli Followay, Jessica Oldaker, Alberto Coustasse

Management Faculty Research

The complexity of and amount of funds involved in Medicare has led to a significant increase in the incidence of Medicare fraud. A type of Medicare fraud, upcoding, has contributed to excessive and unnecessary health care spending. Upcoding has been an illegal strategy that some providers have used to increase their Medicare reimbursement for certain conditions. This is accomplished by coding a provided service as a more expensive service than what was actually performed. With the proliferation of upcoding, there has been an astonishing $12.5 billion in fraudulent Medicare charges since 2007. The fraudulent strategy of upcoding to increase Medicare …

Potential Savings From Consumer-Driven Health Plans, Jessica Mcnair, Brittany White, Christopher Miller, William Ferguson, Alberto Coustasse

Management Faculty Research

Consumer Driven Health Plans (CDHPs) have been identified as a high-deductible insurance option that has increased consumer responsibility while health care expenditures have decreased. Anticipated savings through the use of CDHPs have drawn increased interest of employers and policymakers. The increased need to control healthcare costs as well as healthcare utilization have also fostered the development of increased use of CDHPs. As the use of CDHPs have expanded, educated consumers have become more engaged in their healthcare services and have increased demands for transparency of healthcare costs. Healthcare costs, utilization, and moral hazard of this study are further discussed.

The Use Of Big Data By Managed Care Organizations, Bojing Wang, Xiaoying Liu, Alberto Coustasse

Management Faculty Research

Big data have become available in all kinds of healthcare organizations. The application of big data analytics in Managed Care Organizations (MCOs) has the potential to improve health care, lower costs, save lives, and help to make better-informed decisions. The study illustrated the implication of big data in MCOs. Big data can help MCOs reduce patients’ relevance, analyze specific diseases such as asthma and diabetes. Big data also could help MCOs to reduce cost after collecting data and determined the specific patients’ situation. The implication of big data has benefited MCOs in reducing costs, improving the quality of healthcare care. …

The Continuing Epidemic Of Hepatitis C In The United States: The Case Of West Virginia, David P. Paul Iii, Neha Botre, Maggie Phillips, Jumana Abboud, Alberto Coustasse

Management Faculty Research

Hepatitis C virus (HCV) is one of the most significant public health problems currently facing the U.S. If it is left untreated, the likelihood of sustaining a treatment response decreases. While early identification has been identified as a critical focus in trying to obtain better health outcomes, new drug treatments appear quite promising.

Coordination Of Inpatient And Outpatient Care For Neurology Patients Undergoing Epilepsy Monitoring, Sara Schrock, Michelle Beane, Kathryn Cope, Mark Parker, Suneela Nayak, Ruth Hanselman, Stephen Tyzik, Amy Sparks, Brendan Lilley

Operational Transformation

ORGANIZING A SYSTEM TO CONSOLIDATE EPILEPSY REFERRALS TO AN OUTPATIENT NEUROLOGY PRACTICE

An outpatient neurology practice was experiencing delayed or lost referrals for epilepsy monitoring. This delay was leading many patients to suffer unnecessary and unmanaged seizures and, in some cases, frequent trips to the emergency department.

As a result, a team consisting of the neurology practice and neuro-navigators used baseline metrics to demonstrate the current state of the problem and conducted a root cause analysis that outlined several causes. A number of countermeasures were initiated with the goal of decreasing referral misses.

Post the initiation of two KPIs, a …

Mmc Fall With Injury Prevention Project, M. Wiggins, Joanne Chapman, Laurie Wilson, Rhonda Babine, Jennifer Laflamme, Melissa Vanmeter, Erica Weightman, Natalie Talbot, Kristine Hykras, Marie Hodge, Angela Smith

Maine Medical Center

Problem/Impact Statement:

Patients falls with injury remains an elusive problem at MMC. Over the past 8 quarter, (2016 and 2017) MMC has outperformed 3 of the last 8 Quarters of data. The average rate for the past 8 quarters is .57/1000 patient days with the mean benchmark of .54/per 1000 patient days. MH has determined a focus goal for all the MH hospitals to be below .70/MH 100 patient days as a goal for falls with injury. MMC having the largest volume must be below NDNQI mean to drive this change as the .70 is the average of all MH …

Hospital Nurse Burnout: A Continuing Problem, David P. Paul Iii, Lama Bakhamis, Harlan M. Smith Ii, Alberto Coustasse

Management Faculty Research

RNs are a critically important component of the U.S. healthcare system. RN burnout – the feeling of exhaustion from working long hours without rest – is a real concern, having been reported in many hospitals. We examine the background, causes and consequences of burnout among RNs in U.S. hospitals, in order to identify solutions to this problem. Findings indicate that Burnout Syndrome in RNs can be analyzed in terms of four clusters of characteristics: individual, management, organizational, and work. The consequences of burnout include increased RN turnover rates, poor job performance, and threats to patient safety. RN burnout in hospitals …

Macra And Rural Hospitals, Erica Kelley, Rhea Lipscomb, Jennifer Valdez, Alberto Coustasse

Management Faculty Research

The purpose of this research was to study MACRA (Medicare Access & CHIP Reauthorization Act) and to determine how its implementation would financially impact rural hospitals. Although the long-term effects of MACRA have not been able to be studied, MACRA has the prospective to negatively impact rural hospitals financially. MACRA has potential risks and benefits for physicians associated with its two reimbursement payment methods. The estimated negative reimbursements and set reductions to hospital reimbursement have supported the idea that physicians and all healthcare organizations need to be aware and prepared for MACRA.

The Opioid Epidemic In West Virginia, Nicholas Bowden, Rachel Merino, Sruthi Katamneni, Alberto Coustasse

Management Faculty Research

The rate of overdose-related to the use of licit and illicit opioids has drastically increased over the last decade in the U.S. The epicenter being West Virginia the highest rates of overdoses accounting for 41.5 deaths for 100,000 people among the 33,091 deaths in 2015. The number of people injecting drugs has increased from 36% in 2005 to 54% in 2015. The total U.S cost of prescription opioid abuse in 2011 has been estimated at $25 billion, and criminal-justice-system costs to $5.1 billion. The reasons for this opioid epidemic incidence in WV have been a combination of sociocultural factors, a …

A Multi-Method Scheduling Framework For Medical Staff, Wael Rashwan, John Fowler, Amr Arisha

Conference Papers

Hospital planning teams are always concerned with optimizing staffing and scheduling decisions in order to improve hospital performance, patient experience, and staff satisfaction. A multi-method approach including data analytics, modeling and simulation, machine learning, and optimization is proposed to provide a framework for smart and applicable solutions for staffing and shift scheduling. Factors regarding patients, staff, and hospitals are considered in the decision. This framework is piloted using the Emergency Department(ED) of a leading university hospital in Dublin. The optimized base staffing patterns and shift schedules actively contributed to solving ED overcrowding problem and reduced the average waiting time for …

Informing Quality In Emergency Care: Understanding Patient Experiences, Esmat Swallmeh, Vivienne Byers, Amr Arisha

Articles

Purpose: Assessing performance and quality in healthcare organisations is moving from focussing solely on clinical care measurement to considering the patient experience as critical. Much patient experience research is quantitative and survey based. The purpose of this paper is to report a qualitative study gathering in-depth data in an emergency department (ED).

Design/methodology/approach: The authors used empirical data from seven focus groups to understand patient experience as participants progressed through a major teaching hospital in an Ireland ED. A convenience sampling technique was used, and 42 participants were invited to share their perceptions and outline key factors affecting their journey. …

The Impact Of Big Data On Chronic Disease Management, Niharika Bhardwaj, Bezawit Wadajo, Anthony Spano, Alberto Coustasse

Management Faculty Research

Introduction: Population health management – and specifically chronic disease management – depend on the ability of providers to identify patients at high risk of developing costly and harmful conditions such as diabetes, heart failure, and chronic kidney disease (CKD). The advent of big data analytics could help identify high-risk patients which is really beneficial to healthcare practitioners and patients to make informed decisions in a timelier manner with much more evidence in hand. It would allow doctors to extend effective treatment but also reduces the costs of extending improved care to patients.

Purpose: The purpose of this study was to …

An Integrated Lean Supply Chain Framework For U.S. Hospitals, Subhajit Chakraborty, Jorge A. Gonzalez

Management Faculty Publications and Presentations

We apply a lean supply chain framework to the healthcare industry in the U.S., drawing support from lean systems philosophy. We conceptualize a view of the U.S. healthcare ecosystem that places a hospital and its admitted patients at the center and describes how all entities inside and outside the hospital work can implement lean principles to improve patients' quality care. This application depicts how a holistic consideration of hospital resources available in both the internal and external supply chain would increase the optimal use of such resources and ultimately serve patients. We offer propositions suggesting that an integrated supply chain …

Burnout Syndrome In Hospital's Nurses: Causes And Consequences, Lama Bakhamis, Harlan M. Smith Ii, Alberto Coustasse, David P. Paul Iii

Management Faculty Research

PURPOSE: The purpose of this research was to examine the causes and consequences of Burnout Syndrome among RNs in U.S. hospitals to identify solutions to this problem.

METHODS: The methodology was the review of the literature and a semi-structured interview. There were seven primary databases and two websites used in this research, and 35 articles were used for this literature review.

RESULTS: Causes and risk factors of burnout syndrome among RNs have been categorized into four major areas: individual, management, organizational, and work characteristics. Burnout syndrome rate among RNs with age under 30 years was 43.6% higher …

Evaluating Patient Preferences For Different Incentive Programs To Optimize Pharmacist-Provided Patient Care Program Enrollment, Daniel M. Tomaszewski, Tim Cernohaus, Rajiv Vaidyanathan

Pharmacy Faculty Articles and Research

BACKGROUND: Employers have increased efforts to engage employees in health and wellness programs. Providing employees with incentives to participate in these programs has been shown to improve overall enrollment and engagement. One program that has had challenges with enrollment and engagement is medication therapy management (MTM).

OBJECTIVES: To (a) determine how individuals evaluate different financial incentives to improve participation in an MTM program and (b) measure the effect of participant characteristics on incentive preference.

METHODS: This study was composed of a paper-based survey administered to participants after focus group sessions. Participants included MTMeligible beneficiaries from 2 employer groups and included …