Medicine and Health Sciences Commons^™

How Liability Insurers Protect Patients And Improve Safety, Tom Baker, Charles Silver

All Faculty Scholarship

Forty years after the publication of the first systematic study of adverse medical events, there is greater access to information about adverse medical events and increasingly widespread acceptance of the view that patient safety requires more than vigilance by well-intentioned medical professionals. In this essay, we describe some of the ways that medical liability insurance organizations contributed to this transformation, and we catalog the roles that those organizations play in promoting patient safety today. Whether liability insurance in fact discourages providers from improving safety or encourages them to protect patients from avoidable harms is an empirical question that a survey …

Servant Leadership Characteristics And Empathic Care: Developing A Culture Of Empathy In The Healthcare Setting, Mark Anthony Martin

Antioch University Full-Text Dissertations & Theses

The purpose of this study was to assess the degree to which servant leadership characteristics are exhibited in medical group practices, and the degree to which servant leadership characteristics correlated with measures of empathic care. This study featured an explanatory mixed methods research design embedded in appreciative inquiry. A total of 189 mid-level practitioners consisting of nurse practitioners, physician assistants, and practice mangers responded to a 32-item scale survey that featured a six-point Likert scale to measure servant leadership items and a 10-point continuous scale to assess measures of empathic care. The servant leadership items were based on the seven …

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 …

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 …

An American Epidemic: Burnout Syndrome In Hospital Nurses, David P. Paul Iii, Lama Bakhamis, Harlan Smith, Alberto Coustasse

Management Faculty Research

The number of Registered Nurses (RNs) in the United States (U.S.) is roughly three times that of physicians and surgeons, making RNs a critically important component of the U.S. healthcare system. RN Burnout – defined as the feeling of exhaustion from working long hours without rest – is a real concern, having been reported in many hospitals. The purpose of this research is to examine the causes and consequences of Burnout Syndrome among RNs in U.S. hospitals, in order to identify solutions to this problem. The methodology involves a review of the literature and semi-structured interviews. Seven primary databases, two …

Handoffs, Safety Culture, And Practices: Evidence From The Hospital Survey On Patient Safety Culture, Soo-Hoon Lee, Phillip H. Phan, Todd Dorman, Sallie J. Weaver, Peter J. Pronovost

Management Faculty Publications

Background: The context of the study is the Agency for Healthcare Research and Quality’s Hospital Survey on Patient Safety Culture (HSOPSC). The purpose of the study is to analyze how different elements of patient safety culture are associated with clinical handoffs and perceptions of patient safety.

Methods: The study was performed with hierarchical multiple linear regression on data from the 2010 Survey. We examine the statistical relationships between perceptions of handoffs and transitions practices, patient safety culture, and patient safety. We statistically controlled for the systematic effects of hospital size, type, ownership, and staffing levels on perceptions of patient safety. …

Use Of Smartphones In Hospitals, N. A. Thomairy, M. Mummaneni, S. Alsalamah, N. Moussa, Alberto Coustasse

Management Faculty Research

Mobile technology has begun to change the landscape of the medical profession with more than two-thirds of physicians regularly using smart phones. Smartphones have allowed healthcare professionals and the general public to communicate more efficiently, collect data and facilitate the clinical decision making. The methodology for this study was a qualitative literature review following a systematic approach of the smartphone usage among physicians in hospitals. Fifty-one articles were selected for this study based on inclusion criteria. The findings were classified and described into seven categories: use of smartphone in obstetrics, pediatrics, surgery, internal medicine, radiology, and dermatology which were chosen …

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 …

Facilitating Emergence: Complex, Adaptive Systems Theory And The Shape Of Change, Peter Martin Dickens

Antioch University Full-Text Dissertations & Theses

This study used Principal Component Analysis to examine factors that facilitate emergent change in an organization. As organizational life becomes more complex, today’s dominant management paradigms no longer suffice. This is particularly true in a health care setting where multiple sources of disease interacting with each other meet with often-competing organizational priorities and accountabilities in a highly complex world. This study identifies new ways of approaching complexity by embracing the capacity of complex systems to find their own form of order and coherence. Based on a review of the literature, interviews with hospital CEOs, and my organization development practice experience …

Or Practice—Efficient Short-Term Allocation And Reallocation Of Patients To Floors Of A Hospital During Demand Surges, Steven M. Thompson, Manuel Nunez, Robert Garfinkel, Matthew D. Dean

Management Faculty Publications

Many hospitals face the problem of insufficient capacity to meet demand for inpatient beds, especially during demand surges. This results in quality degradation of patient care due to large delays from admission time to the hospital until arrival at a floor. In addition, there is loss of revenue because of the inability to provide service to potential patients. A solution to the problem is to proactively transfer patients between floors in anticipation of a demand surge. Optimal reallocation poses an extraordinarily complex problem that can be modeled as a finite-horizon Markov decision process. Based on the optimization model, a decision-support …

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 …

Journey To Destination 2005, Andra Gumbus, Bridget M. Lyons, Dorothy E. Bellhouse

WCBT Faculty Publications

Bridgeport Hospital and Healthcare Services (BHHS) in Bridgeport, Conn., a part of the Yale New Haven Health System (YNHHS), embraced the balanced scorecard because it had been experiencing a loss in revenue and income due to managed care penetration in the local marketplace. This hospital is not alone in facing financial pressures. The balanced scorecard provides the framework for measuring performance in a complex and changing medical environment. Still retaining financial measures, the following drivers of financial success are incorporated into Bridgeport's scorecard: quality clinical outcomes; expert clinical care providers; satisfied patients, doctors, and staff; and volume and market-share growth. …

The Role Of Institutional And Market Forces In Divergent Organizational Change, Thomas D'Aunno, Melissa Succi, Jeffrey A. Alexander

Business Faculty Articles and Research

This paper focuses on a radical change, in which organizations abandon an institutionalized template for arranging their core activities, that is likely to occur in organizational fields that have strong, local market forces and strong but heterogeneous institutional forces. We examine the role of market forces and heterogeneous institutional elements in promoting divergent change in core activities among all U.S. rural hospitals from 1984 to 1991. Results support the view that divergent change depends on both market forces (proximity to competitors, disadvantages in service mix) and institutional forces (state regulation, ownership and governance norms, and mimicry of models of divergent …

Developing A Hospital Web Site As A Marketing Tool: A Case Study, Thomas G. Widmer, C. David Shepherd

Faculty and Research Publications

This article presents a case study which described the efforts of Siskin Hospital to develop a Web site as its marketing tool in 1999. Several years ago. Siskin Hospital, a rehabilitation facility in the southeastern U.S., began the process of developing a hospital Web site. It was agreed that a multidisciplinary team was needed. Then, the next step was to determine target audiences for the site based on the objectives. Fourteen distinct targets were identified. The type of information each would require was brainstormed and detailed. The information types were then prioritized using a matrix developed by the team.

Health Care Marketing And The Internet, C. David Shepherd, Daniel Fell

Faculty and Research Publications

This article presents research on the growing number of health care providers using the Internet as a health care marketing tool in the U.S. The author notes that the Internet is changing the way consumers seek healthcare related information as well as the way it can be provided to them. The results of the study suggest that consumers will increasingly rely on sources like the Internet for information, that health information will be a commodity on the Internet, that the Internet will help build relationships between providers and consumers and that marketers will be expected to develop and manage Internet-related …

A Pilot Study: Result Of Menu Presentation System Change, Stella Manikas Copulos

FIU Electronic Theses and Dissertations

Attempts to modify dietary habits of individuals in order to improve their nutrition do not seem to have met with success. Patterns established by individuals appear to continue throughout their lifetime. Diet patterns are influenced by society, families, and peer groups.

From pre-school through adolescence environmental factors of influence are ever present. Influences may be the result of hereditary attitudes passed from generation to generation. However, the need for diet improvement seems primary. Research to discover methods or systems to affect such habits is needed from the science of nutrition.

The continued failure of man to produce food for the …