Business Administration, Management, and Operations Commons^™

Utilization Of A Resource Algorithm To Enhance Departmental Communications, Diane Horoski, Kenneth Miller Med, Rrt-Nps, Angela Lutz Bs, Rrt-Nps

Administration & Leadership

No abstract provided.

Managed Care And Accountable Care Organizations, David P. Paul, Diego Arroyo, Bethany Daniel, Heather Graves, Krisitn Neal, Alberto Coustasse

Management Faculty Research

Managed care generally, and more specifically, accountable care organizations (ACOs) have attempted to provide coordination of patient care in order to eliminate or reduce unnecessary procedures and or test redundancy. The purpose of this research was to study the effects of managed care in accountable care organizations by decreasing health care costs by increasing efficiency in health care.

Practicing Anthropology In An Academic Community Hospital: Lessons From The Field, Lynn Deitrick, Terry Capuano, Debbie Salas-Lopez

Debbie Salas-Lopez MD, MPH

No abstract provided.

Physician Clinical Alignment And Integration: A Community Academic Hospital Approach, Debbie Salas-Lopez Md, Mph, Sandra Jarva-Weiss Jd, Brian A. Nestor Do, Mba, Thomas V. Whalen Md

Debbie Salas-Lopez MD, MPH, FACP

An overwhelming need for change in the U.S. healthcare delivery system, coupled with the need to improve clinical and financial outcomes, has prompted hospitals to direct renewed efforts toward achieving high quality and cost-effectiveness. Additionally, with the dawn of accountable care organizations and increasing focus on patient expectations, hospitals have begun to seek physician partners through clinical alignment. Contrary to the unsuccessful alignment strategies of the 1990s, today's efforts are more mutually beneficial, driven by the need to achieve better care coordination, increased access to infrastructure, improved quality, and lower costs. In this article, we describe a large, academic, tertiary …

Alignment Of Lean Management Process To Quality And Safety In A Academic Community Hospital: Psychiatry For The Twenty First Century., Ronald Swinfard, Michael Kaufmann, Ralph Primelo, Laurence Karper, Muhamad Rifai, Edward Norris, Debbie Salas-Lopez, David Burmeister, Gail Stern, David Dylewski, D Ezrow, Rosanne Teders, Courtney Vose

Debbie Salas-Lopez MD, MPH

No abstract provided.

An Ecological Approach To Organizational Transformation: The Growth Of Cross-Cultural Health Care Delivery In An Academic Community Health Network, James Geiger, Judith Sabino, Eric Gertner, Jarret Patton, Llewellyn Cornelius, Debbie Salas-Lopez

Debbie Salas-Lopez MD, MPH

No abstract provided.

An Ecological Approach To Organizational Cultural Competence, Judith Sabino, Jarret Patton, Erica Mahady, Lynn Deitrick, James Geiger, Marykay Grim, Debbie Salas-Lopez

Debbie Salas-Lopez MD, MPH

No abstract provided.

The Neighborhood Cancer Center, Gregory R. Harper Md, Phd, Debbie Salas-Lopez Md, Mph, Keith J. Weinhold Mha, Elliot J. Sussman Md, Mba

Debbie Salas-Lopez MD, MPH

No abstract provided.

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

Alberto Coustasse, DrPH, MD, MBA, MPH

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 …

Patient Safety Culture And High Reliability Organizations, Jared D. Padgett

Walden Dissertations and Doctoral Studies

A 1999 evaluation of case studies performed by staff from the Institute of Medicine found that between 40,000 and 98,000 patients died from preventable errors, while 43,598 individuals died in car accidents that year. A 2011 report increased that estimate nearly 10 times. Widespread preventable patient harm still occurs despite an increase in healthcare regulations. High-reliability organization theory has contributed to improved safety and may potentially reverse this trend. This explorative single case study explored how the perceptions and experiences of nursing and respiratory staff affected the successful transition of a healthcare organization into a reliability-seeking organization. Fourteen participants from …

The Changing Role Of Ancillary Health Care Service Providers: An Evaluation Of Health Diagnostic Laboratory, Inc., Steven M. Thompson, Stephen Varvel, Szilard Voros, Dawn Thiselton, Shahrzad Grami, Ralph M. Turner, John Barron

Management Faculty Publications

In an effort to reduce cost and improve quality, health care payers have enacted a number of incentives to motivate providers to focus their efforts on achieving better clinical outcomes and reducing the prevalence and progression of disease. In response to these incentives, providers are entering into new arrangements such as accountable care organizations and patient-centered medical homes to redesign delivery processes and achieve quality and cost objectives. This article reports the results of a study designed to evaluate the impact on cost and quality of care resulting from services provided by Health Diagnostic Laboratory, Inc., a clinical laboratory with …

Information Flow And Clinical Outcomes In A Fully Functional Perinatal Continuum Of Care, Donald Levick Md, Michael Sheinberg Md, Chad Meyerhoefer Phd, Mary Deily, Shin-Yi Chou Phd, Susan Sherer Phd

Donald Levick MD

No abstract provided.

Achieving Succession Planning And Implementation: One Healthcare Network's Story, Terry Capuano, Richard Mackenzie

Terry A Capuano MBA, MSN, RN, FACHE, NE-BC

Frequent transitions in leadership can cause inefficiency, inconsistency, and lack of alignment with priorities and strategy. Retaining management talent and collaboratively planning their succession can help ensure organizational survival. Succession planning, in healthcare and other industries, addresses some of these concerns; however, there is a dearth of descriptive articles emphasizing "how to." This article demonstrates one healthcare network's comprehensive system for succession planning and implementation. Leaders looking to plan their human resource processes for organizational sustainability would be able to emulate and adapt practices for their networks.

An Indian Healthcare Company’S Foray Onto The World Stage, Singapore Management University

Perspectives@SMU

Fortis Healthcare expanded from one hospital to over 70 in a dozen years. It is now consolidating to focus on what it does best: saving lives.

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

Alberto Coustasse, DrPH, MD, MBA, MPH

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 …

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

Alberto Coustasse, DrPH, MD, MBA, MPH

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 …

A Mixed Method Study Of Information Availability On Pregnancy Outcomes, Donald Levick Md

Donald Levick MD

No abstract provided.

An Analysis Of The Effects Of The 2003 And 2011 Acgme Work Hour Rules On Medical Resident Satisfaction At An Independent Academic Medical Center, Rachael E. Trout

Theses, Dissertations and Capstones

The purpose of this research was to determine what effects, if any, the 2003 and 2011 ACGME work hour rules had on medical resident satisfaction at an independent academic medical center in the United States. This research analyzed results of a survey administered by an independent academic medical center utilizing its own instrument of measure. Items reviewed to determine self-perceived satisfaction included questions related to program director effectiveness, resident input, quality of life, and satisfaction with program. Four comparisons were reviewed and analyzed for statistical significance utilizing the Mann-Whitney U non-parametric test for independent samples. The results indicated neither the …

Direct-To-Consumer Advertising Of Drugs And Patients' Health Care Seeking Behaviors, Patricia Elaine Kennedy-Tucker

Walden Dissertations and Doctoral Studies

Known as direct-to-consumer advertising (DTCA), pharmaceutical companies in the United States are permitted to advertise prescription drugs directly to consumers. The purpose of this quantitative study was to determine if an association exists between DTCA and health care-seeking behaviors. The theoretical framework for this study involved social learning theory, information integration theory, and prospect theory. The research questions identified if exposure to DTCA (a) is associated with physician office visits, (b) influences a patient/physician conversation regarding a prescription, (c) influences requesting a prescription, and (d) has an impact on patients' ratings of the overall interaction with the physician. Data were …

A Correlational Analysis Of Empowerment And Experience With Resistance To Change, Rita Elizabeth Burgess

Walden Dissertations and Doctoral Studies

Despite more than 60 years of research about the nature of change, resistance to change remains a problem across industries. Health care leaders have limited knowledge of how health care managers' perceptions of empowerment, years of experience, and resistance to change (RTC) relate. The purpose for this nonexperimental correlational study was to examine the relationship between empowerment, years of experience, and RTC among managers via an online survey. The theoretical framework incorporated Kanter's structural empowerment theory and Kotter's change theory. The sample included 245 out of 1,181 health care managers from Veterans Administration (VA) hospitals in the New York metropolitan …

Early Mobilization In Icu Patients, Alex Hunter, Leslie Johnson, William Willis, Alberto Coustasse

Management Faculty Research

Introduction: Bed rest or immobilization is frequently part of treatment for patients in the intensive care unit with critical illness. The average intensive care unit length of stay was 3.3 days and for every day spent in an intensive care unit bed, the average patient spent an additional 1.5 days in a non-intensive care unit bed. Daily costs have increased more than 30% from 2000-2005 with an average daily cost of $3518. Weaning from mechanical ventilation has been correlated with increased intensive care unit and hospital length of stay. Mechanical ventilation has been correlated with the development of intensive care …

Factors That Promote Perceived Usefulness Of And Clinical Outcomes From Sign-Outs At The National University Hospital, Soo-Hoon Lee, Wei-Ping Goh, Dale A. Fisher, Phillip H. Phan

Management Faculty Publications

IMPORTANCE OF THE STUDY. Currently, there is a paucity of evidence in the literature to show that handoff strategies improve the quality of handoff outcomes. Studies that show the usefulness and outcomes obtained from sign-outs may motivate junior clinicians, who have limited time to perform their clinical responsibilities, to support sign-out improvement efforts.

OBJECTIVE. To test a research model that embeds the Technology Acceptance Model and the Theory of Planned Behavior to explore factors that enhance the perceived (a) usefulness of and (b) clinical outcomes from sign-outs among junior medical officers.

DESIGN, SETTING, AND PARTICIPANTS.

A retrospective study was conducted …

A Pilot Study On Nurse-Led Rounds: Preliminary Data On Patient Contact Time, Soo-Hoon Lee, Alice Lee, Siang-Ngim Lim, Mei-Jiao Koh, Benjamin Tan, Phillip H. Phan, Reshma A. Merchant, Aisha Lateef, Dale A. Fisher

Management Faculty Publications

IMPORTANCE OF THE STUDY. Ward rounding has been a historical clinical method of inter-professional collaboration to support inpatient care through the sharing of mental models by exchanging information and discussing plans of care, treatment goals, and discharge plans for the patient. The extant literature reports that rounds are frequently led by doctors with infrequent nurse-physician collaboration and patients’ interactions with doctors during ward rounds tend to be brief.

OBJECTIVE. To explore the effects of nurse-led morning ward rounds on patient contact time.

DESIGN. An ethnographic prospective observational study comparing nurse-led and physician-led rounds. SETTING. A General Medicine ward at the …

Electronic Prescribing And Its Implementation In The United States, Kate Englebert, Amber Porterfield, William K. Willis, Alberto Coustasse

Management Faculty Research

Introduction: Electronic prescribing (e-prescribing) is an important part of the nation’s push to create an electronically accessible national health system. E-prescribing allows providers to send prescriptions electronically to the pharmacy and can be stand-alone systems or part of an integrated electronic health record system.

Methodology: The methodology for this study was a literature review. Electronic databases accessed include EBSCOhost, PubMED, and Google Scholar. Additionally, government websites and a semi-structured interview were used. A total of 39 sources were referenced for the review.

Results: The results of the literature review demonstrated that e-prescribing reduces prescribing errors, increases efficiency, and helps save …

Diffusion Of Social Network Technology And Overuse Among Health Industry Knowledge Workers, Abdel Rahman Toure

Walden Dissertations and Doctoral Studies

Many organizations now realize the important role of social network technology (SNT) in building social capital and hence broadening their customer base. However, observations have indicated that, while working, many knowledge workers use SNT to engage in non-job related activities, potentially leading to a decrease in productivity. The purpose of this study was to examine the relationship between the usage of SNT and productivity in the health sector. The theoretical foundation of this study emanated from Rogers's theory of diffusion of innovations and Campbell, Rodney, Scott, and Christopher's theory of performance. Collection of data involved a self-administered survey designed with …