Medicine and Health Sciences Commons^™

Benefits And Barriers Of Implementation And Utilization Of Radio-Frequency Identification (Rfid) Systems In Transfusion Medicine, Alberto Coustasse, Brian Cunningham, Stacie Deslich, Eric Wison, Pamela Meadows

Pamela Meadows

Radio-frequency identification (RFID) technology is used by hospital supply chains to track medical products and monitor inventories. Hospitals have also begun incorporating RFID technology as part of their transfusion processes. The purpose of this review was to analyze how healthcare organization supply chains can benefit from the utilization of RFID systems in transfusion service departments. The methodology for this study was a literature review following the steps of a systematic review with a total of 52 sources referenced. RFID technology is used to manage and track blood products from the initial donor phlebotomy to final disposition or product transfusion. RFID-enabled …

Burnout Syndrome In Hospital Nurses, Priscilla Holdren, David P. Paul Iii, Alberto Coustasse

Alberto Coustasse, DrPH, MD, MBA, MPH

Burnout is a state of mental, physical and emotional stress resulting in a chronic state of pressure or stress at work and is associated with individuals who do “people work” (Aiken and Sloane, 1997), a category into which nurses obviously fall. The number of nurses suffering from burnout has increased over the years, possibly causing negative effects on patient care, working environments and staffing shortages. Hospitals should focus on creating a healthy work environment in which nurses feel supported by their coworkers and management. Hospitals should also make available stress management programs that address symptoms of burnout and assure safe …

Latino Access To Health Care: The Role Of Insurance, Managed Care, And Institutional Barriers, J. Emilio Carrillo, Fernando M. Trevino, Joseph R. Betancourt, Alberto Coustasse

Alberto Coustasse, DrPH, MD, MBA, MPH

The health care system in the United States is the most expensive and yet arguably among the least cost effective in the developed world (Anderson, 1998). Despite the highest per person health care spending among the Organization for Economic Cooperation and Development (OECD) nations, the United States still ranks below many along a variety of health indicators (Woolhandler & Himmelstein, 1991). In a complicated health care system where the rules are many and economic forces drive both structure and function, the needs of vulnerable populations inevitably suffer. This chapter explores the consequences of these market forces on a vulnerable population--Latinos …

Tweeting And Treating: How Hospitals Use Twitter To Improve Care, Christian Gomes, Alberto Coustasse

Alberto Coustasse, DrPH, MD, MBA, MPH

Introduction: Hospitals that have adopted Twitter primarily use it to share organizational news, provide general healthcare information, advertise upcoming community events, and foster networking. The purpose of this study was to explore the benefits that Twitter utilization has had in improving quality of care, access to care, patient satisfaction, and community footprint while assessing the barriers to its implementation. Methodology: The methodology used in this study was a qualitative study with a semi structure interview combined with a literature review which followed the basic principles of a systematic review. Results: The utilization of Twitter by hospitals suggest that it leads …

Benefits And Barriers Of Implementation And Utilization Of Radio-Frequency Identification (Rfid) Systems In Transfusion Medicine, Alberto Coustasse, Brian Cunningham, Stacie Deslich, Eric Wison, Pamela Meadows

Alberto Coustasse, DrPH, MD, MBA, MPH

Radio-frequency identification (RFID) technology is used by hospital supply chains to track medical products and monitor inventories. Hospitals have also begun incorporating RFID technology as part of their transfusion processes. The purpose of this review was to analyze how healthcare organization supply chains can benefit from the utilization of RFID systems in transfusion service departments. The methodology for this study was a literature review following the steps of a systematic review with a total of 52 sources referenced. RFID technology is used to manage and track blood products from the initial donor phlebotomy to final disposition or product transfusion. RFID-enabled …

How Does Market Making Affect Industrial Relations? Evidence From Eight German Hospitals, Ian Greer, Thorsten Schulten, Nils Böhlke

Ian Greer

The introduction of market mechanisms matters for industrial relations. In the German hospital sector, national liberalization policies have put immense pressure on local management and worker representatives and led to the growth of a low-wage sector. In case studies of eight hospitals, we find some locales where market making has led to union revitalization and mobilization, but this effect varies. Using an eight-way comparison, we infer a configuration of three aspects of the local political economy – labour markets, politics, and codetermination rules – that together provide a well fitting explanation for both variation and change.

Social Movement Unionism And Social Partnership In Germany: The Case Of Hamburg’S Hospitals, Ian Greer

Ian Greer

This paper traces the emergence of social movement unionism in Hamburg, Germany, as labor’s channels of influence have broken down and economic pressures have intensified. Trade unionists have responded to the privatization of the municipal hospitals by mobilizing members and building coalitions around issues beyond their members’ immediate interests, including democracy and public service quality. Although the loss of union influence has facilitated social movement unionism, in East Germany economic crisis has had a demobilizing effect.

When Does Marketisation Lead To Privatisation? Profit-Making In English Health Services After The 2012 Health And Social Care Act, Nick Krachler, Ian Greer

Ian Greer

Governments world-wide have attempted to use market mechanisms and privatisation to increase the quality and/or reduce the cost of healthcare. England’s Health and Social Care Act 2012 is an attempt to promote privatisation through marketisation in the National Health Service (NHS). While the health policy literature tends to assume that privatisation follows from private-sector entry points, we argue that this is more likely if firms expect to make a profit. This paper examines the link between privatisation and marketisation in England drawing on 32 semi-structured interviews with private-sector and public-sector respondents, campaigners, and other experts conducted 6-10 months after the …

Conventional Isolated Aortic Valve Replacement In Octogenarians: A 10-Year Single Center Experience, James K. Wu Md, Justin D. Roberts Do, Gregory S. Troutman Bs, Michael J. Weiss Mph, Sanjay M. Mehta Md, Theodore G. Phillips Md, Michael F. Szwerc Md, Gary W. Szydlowski Md, Tim S. Misselbeck Md, Raymond L. Singer Md

Raymond L Singer MD

No abstract provided.

Effects Of Unionization On Graduate Student Employees: Faculty-Student Relations, Academic Freedom, And Pay, Sean Rogers, Adrienne E. Eaton, Paula B. Voos

Sean Edmund Rogers

In cases involving unionization of graduate student research and teaching assistants at private U.S. universities, the National Labor Relations Board has, at times, denied collective bargaining rights on the presumption that unionization would harm faculty-student relations and academic freedom. Using survey data collected from PhD students in five academic disciplines across eight public U.S. universities, the authors compare represented and non-represented graduate student employees in terms of faculty-student relations, academic freedom, and pay. Unionization does not have the presumed negative effect on student outcomes, and in some cases has a positive effect. Union-represented graduate student employees report higher levels of …

Collaboration And Health Care Diagnostics: An Agent Based Model Simulation, Sebastian Linde, George K. Thiruvathukal

George K. Thiruvathukal

This paper presents a simple ABM simulation that seeks to provide insight into the public health benefits that derive from greater collaboration among health care professionals. In particular, the paper compares the efficiency, delivery and timeliness of health care diagnostics under two contrasting paradigms–one in which collaboration is encouraged, and an- other where it is not. The preliminary results of this study suggest that while the effect of cooperation on aggregate public health depends on the patient search algorithm employed, its effect on overall efficiency and timeliness of health care diagnostics and treatment is significant and pos- itive. Since the …

Hospitalist Involvement In Family Medicine Residency Training: A Cera Study, Robert A. Baldor, Judith A. Savageau, Navkiran Shokar, Stacy E. Potts, Joseph Gravel Jr., Kimberly Eisenstock, James Ledwith

Judith A. Savageau

BACKGROUND AND OBJECTIVES: Little is known about the impact of hospitalists on family medicine residencies. We surveyed family medicine residency directors to assess attitudes about hospitalists and their involvement in residency teaching.

METHODS: Questions were included in the 2012 Council of Academic Family Medicine Educational Research Alliance (CERA) survey of family medicine residency directors. Univariate statistics were used to describe programs, directors, and our questions on the use of hospitalists. Bivariate statistics were used to examine relationships between the use of hospitalists to teach and program characteristics.

RESULTS: Forty-one percent (n=175) of residency directors completed the hospitalist section of the …

Management Of Rfid Systems In Hospital Transfusion Services, Alberto Coustasse, Brian Cunningham, Stacie Deslich, Eric Wilson, Pamela Meadows

Pamela Meadows

Radio Frequency Identification Devices (RFID) technology is used by hospital supply chains to track various medical products and monitor inventories. To improve overall operations, hospitals have implemented RFID as part of their supply chain processes. Hospitals have also have begun incorporating RFID technology as part of their transfusion services processes. The purpose of this review was to analyze how healthcare organization supply chains can benefit from the utilization of RFID systems in transfusion services departments. The methodology for this study was a literature review following the steps of a systematic review with a total of 51 sources referenced. RFID technology …

Medical Tourism: Comparing Coronary Bypass Surgery In The U.S. And Abroad, William K. Willis, Alberto Coustasse

William K Willis

Rising health care costs have employers searching for remedies to the increasing rates they pay for employee health insurance. The development of U.S. health insurance policies, with the option of utilizing medical tourism as a low cost care provider for treatment of cardiac coronary bypass surgery provides a method for receiving treatment. The medical tourism approach to providing treatment for bypass surgery has prompted hospitals in India, Thailand, and Singapore to seek U.S. patients. A comparison of costs for bypass treatment between the U.S. and these countries illustrates some of the issues and concerns that arise when making such comparisons. …

The American Epidemic: The U.S. Nursing Shortage And Turnover Problem, Patrick Cox, William K. Willis, Alberto Coustasse

William K Willis

Introduction: Nursing shortages have been on the rise throughout the country which has continued to become a problem due to an aging baby-boomer population causing increased turnover through the United States (U.S.). With this need for nurses expected to rise, determining the root causes of this problem are essential for health care providers as costs continue to grow. Methods: The methodology for the qualitative study was a literature research review of case studies as well as a semi-structured interview. Five electronic databases were minded. Thirty-six articles were utilized in this study. Results: Through the use of a conceptual framework the …

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

William K Willis

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 …

Does Computerized Physician Order Entry Reduce Medical Errors?, Krista Charles, William K. Willis, Alberto Coustasse

William K Willis

Introduction: Computerized Physician Order Entry (CPOE) is a system that allows physicians to electronically order patient services. The services that can be ordered, but are not limited to include: prescriptions, labs, x-rays, and referrals. Adopting CPOE will eliminate the use of paper orders with illegible hand writing. The purpose of this research project was to examine the cause of medical errors and to determine if adopting a CPOE system would be an effective solution to this problem. Results: The results of this study show that CPOE can reduce medical errors and adverse drug events significantly. CPOE coupled with other systems …

Medical Tourism: Comparing Coronary Bypass Surgery In The U.S. And Abroad, William K. Willis, Alberto Coustasse

Alberto Coustasse, DrPH, MD, MBA, MPH

Rising health care costs have employers searching for remedies to the increasing rates they pay for employee health insurance. The development of U.S. health insurance policies, with the option of utilizing medical tourism as a low cost care provider for treatment of cardiac coronary bypass surgery provides a method for receiving treatment. The medical tourism approach to providing treatment for bypass surgery has prompted hospitals in India, Thailand, and Singapore to seek U.S. patients. A comparison of costs for bypass treatment between the U.S. and these countries illustrates some of the issues and concerns that arise when making such comparisons. …

The American Epidemic: The U.S. Nursing Shortage And Turnover Problem, Patrick Cox, William K. Willis, Alberto Coustasse

Alberto Coustasse, DrPH, MD, MBA, MPH

Introduction: Nursing shortages have been on the rise throughout the country which has continued to become a problem due to an aging baby-boomer population causing increased turnover through the United States (U.S.). With this need for nurses expected to rise, determining the root causes of this problem are essential for health care providers as costs continue to grow. Methods: The methodology for the qualitative study was a literature research review of case studies as well as a semi-structured interview. Five electronic databases were minded. Thirty-six articles were utilized in this study. Results: Through the use of a conceptual framework the …

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

Alberto Coustasse, DrPH, MD, MBA, MPH

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 …

Racial/Ethnic Differences In Exposure To Environmental Volatile Organic Compounds In The U.S. General Population: The National Health And Nutrition Examination Survey 1999–2000, Y. S. Lin, Alberto Coustasse, W. H. Ho, K. Singh, A. Arif

Alberto Coustasse, DrPH, MD, MBA, MPH

Background: Exposure to volatile organic compounds (VOCs) has been associated with many health disorders. A better understanding of unequal health risk from exposure to environmental VOCs is critical to the elimination of health disparities. Objective: The goal of this study was to investigate racial/ethnic differentials in exposure to airborne VOCs within a national sample of the U.S. population and assessed socio-demographic determinants that may contribute to these racial differences. Methods: We used data from a stratified sample of 576 participants (aged 20–59 years) who provided personal air samples for VOC measurements in the National Health and Nutrition Examination Survey (NHANES) …

Financial Advantages Of Hospitals’ Relationships With Accountable Care Organizations, David P. Paul Iii, Rodrigo Carmago, Thaisa Carmago, Stacie Deslich, Alberto Coustasse

Alberto Coustasse, DrPH, MD, MBA, MPH

Accountable care organizations are groups of providers who agree to accept the responsibility for elevating the health status of a defined group of patients, with the goal of enabling people to take charge of their health and enroll in shared decision-making with providers. The large initial investment required (estimated at $1.8 million) to develop an ACO implies that the participation of large health care organizations, especially hospitals and health systems, is required for success. Findings of the study suggest that ACOs based in a larger hospital organizations are more likely to meet CMS criteria for formation because of financial and …

Assisted Living: Trends In Cost And Staffing, Amy Kisling, David P. Paul, Alberto Coustasse

Alberto Coustasse, DrPH, MD, MBA, MPH

Assisted living communities (ALFs), which provide a community for residents who require assistance throughout their day, is an important part of the long-term care system in the US. Trained individuals assist residents with activities known as Activities of Daily Living (ADL). The costs of ALFs are paid either out of pocket, by Medicaid or by Long-Term Care Insurance (LTCI). Medicare does not pay for ALFs. Monthly costs of ALFs have increased over the past five years on an average of 4.1%. The major reason for this cost increase is probably the increased healthcare needs of the baby boomers generation, but …

Does Computerized Physician Order Entry Reduce Medical Errors?, Krista Charles, William K. Willis, Alberto Coustasse

Alberto Coustasse, DrPH, MD, MBA, MPH

Introduction: Computerized Physician Order Entry (CPOE) is a system that allows physicians to electronically order patient services. The services that can be ordered, but are not limited to include: prescriptions, labs, x-rays, and referrals. Adopting CPOE will eliminate the use of paper orders with illegible hand writing. The purpose of this research project was to examine the cause of medical errors and to determine if adopting a CPOE system would be an effective solution to this problem. Results: The results of this study show that CPOE can reduce medical errors and adverse drug events significantly. CPOE coupled with other systems …

Management Of Rfid Systems In Hospital Transfusion Services, Alberto Coustasse, Brian Cunningham, Stacie Deslich, Eric Wilson, Pamela Meadows

Alberto Coustasse, DrPH, MD, MBA, MPH

Radio Frequency Identification Devices (RFID) technology is used by hospital supply chains to track various medical products and monitor inventories. To improve overall operations, hospitals have implemented RFID as part of their supply chain processes. Hospitals have also have begun incorporating RFID technology as part of their transfusion services processes. The purpose of this review was to analyze how healthcare organization supply chains can benefit from the utilization of RFID systems in transfusion services departments. The methodology for this study was a literature review following the steps of a systematic review with a total of 51 sources referenced. RFID technology …

Medical Education, Pdas And Smartphones: Welcome To The 21st Century, David P. Paul, Nicole Moussa, Sara Asad, Brad Pershing, Alberto Coustasse

Alberto Coustasse, DrPH, MD, MBA, MPH

PDAs and Smartphones allow medical professionals to access medical information more easily than ever before. This literature review examines use of these devices and associated “apps” in medical education, finding widespread use by medical students, residents, and faculty. Surprisingly, little generational bias was noted.

The Business Case For The Efficiency And Effectiveness Of Tele-Intensive Care Units, David P. Paul, Deanna Bailey, Alesia Hairston, Stacie Deslich, Alberto Coustasse

Alberto Coustasse, DrPH, MD, MBA, MPH

A tele-Intensive Care Unit (tele-ICU) is the use of telemedicine in an Intensive Care Unit (ICU) setting, using technology to provide care to critically ill patients by off-site clinical resources. This literature review examined a large number of studies of the implementation of tele-ICU systems in hospitals. Generally, implementation of a tele-ICU system was associated with cost savings, shorter lengths of stay, and decreased mortality. Implementation of tele-ICUs is initially relatively expensive but result in cost savings and better clinical outcomes. Intensivists working these systems are used more effective providing better clinical outcomes for patients at lower costs for hospitals.

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

Alberto Coustasse, DrPH, MD, MBA, MPH

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 …

Benefits And Barriers For Adoption Of Personal Health Records, Brittany Vance, Brent Tomblin, Jena Studney, Alberto Coustasse

Alberto Coustasse, DrPH, MD, MBA, MPH

A Personal Health Record (PHR) is an electronic, universally available, lifelong resource of health information maintained by individuals. There are numerous potential benefits to PHRs, including improved patient-provider relationships, increased patient empowerment, and enhanced care safety, efficiency, coordination, and quality. However, privacy, security, cost, and adoption issues have been significant barriers to implementation. The purpose of this research was to determine how the use of PHRs affects patient outcomes, as well as to analyze benefits and barriers of adoption of PHRs. The methodology for the examination of the benefits and barriers to PHR implementation was conducted following the basic principles …

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

Alberto Coustasse, DrPH, MD, MBA, MPH

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.