Medicine and Health Sciences Commons^™

What's Happening: September, 2008, Maine Medical Center

What's Happening

No abstract provided.

Shea/Apic Guideline: Infection Prevention And Control In The Long-Term Care Facility, Philip W. Smith, Gail Bennett, Suzanne Bradley, Paul Drinka, Ebbing Lautenbach, James Marx, Lona Mody, Lindsay Nicolle, Kurt Stevenson

United States Department of Veterans Affairs: Publications

Long-term care facilities (LTCFs) may be defined as institutions that provide health care to people who are unable to manage independently in the community.¹ This care may be chronic care management or short-term rehabilitative services. The term nursing home is defined as a facility licensed with an organized professional staff and inpatient beds that provides continuous nursing and other services to patients who are not in the acute phase of an illness. There is considerable overlap between the 2 terms.

More than 1.5 million residents reside in United States (US) nursing homes. In recent years, the acuity of illness …

Community-Based Long-Term Care In Milwaukee: Wisconsin Still Ahead, Judith D. Moore, Carol O'Shaughnessy, Lisa Sprague

National Health Policy Forum

The National Health Policy Forum has made two site visits to Wisconsin in two years. The first, in August 2007, focused on an overview of Family Care, the state's managed long-term care program, and looking at service delivery in a rural setting. The August 2008 site visit focused on the operations of MCOs and Family Care service providers in the urban environment of Milwaukee. Issues examined included the link between housing and social services, care management, capitation and rate-setting, measuring quality, and integrating people with disabilities into a program that initially targeted the elderly.

Strong As The Weakest Link: Medical Response To A Catastrophic Event, Eileen Salinsky

National Health Policy Forum

Natural disasters and acts of terrorism have placed a spotlight on the ability of health care providers to surge in response to catastrophic conditions. This paper reviews the status of efforts to develop the capacity and capabilities of the health care system to respond to disasters and other mass casualty events. Strategies for adapting routine medical practices and protocols to the demands posed by extraordinary circumstances and scarce resources are summarized. Existing federal roles, responsibilities, and assets relative to the contributions of state and local government and the private sector are described, including specific programmatic activities such as the Strategic …

What's Happening: August, 2008, Maine Medical Center

What's Happening

No abstract provided.

Medicare Demonstrations, Amanda Cassidy

National Health Policy Forum

This publication provides an overview of Medicare demonstration projects, including what they are, how and by whom they are initiated, and how they differ from research projects. This document highlights several significant demonstrations in Medicare history and outlines several current demonstration projects. Key considerations in designing, implementing and evaluating demonstrations are mentioned.

Medicaid And Schip Waivers, Cynthia Shirk

National Health Policy Forum

No abstract provided.

The Fundamentals Of Medicare Demonstrations, Amanda Cassidy

National Health Policy Forum

Demonstrations are experiments that test Medicare policy changes without permanently changing the Medicare program. They allow policymakers to learn about the potential impact and operational challenges of a proposed modification to Medicare, but in a more controlled environment and on a limited basis. Since demonstrations can affect hundreds of thousands of beneficiaries and providers and involve millions of dollars, they are often controversial. This paper describes the basics of Medicare demonstrations, including what they are, how they are initiated, and why they are undertaken. The paper also explores the relationship between demonstrations and other research projects. The primary challenges in …

Shaping Medicaid And Schip Through Waivers: The Fundamentals, Cynthia Shirk

National Health Policy Forum

The use of waivers has become one of the key vehicles for innovation in Medicaid and the State Children’s Health Insurance Program (SCHIP). This background paper examines the use of research, demonstration, and program waiver authorities to test new approaches to the delivery of and payment for health care and long-term care services. The paper reviews the statutory basis and mechanics of demonstrations and program waivers, as well as their history and political context in shaping Medicaid and SCHIP. It also explores the ways the changing state-federal relationship and the ever-growing demand for state flexibility have driven waiver policy. Finally, …

The Relationship Of Patient Falls To Prevention Policies In Hospitals: A Case Study, Cornelia Branzan

Master in Public Administration Theses

There have been a lot of studies over the past decade on patient falls, risk factors, and strategies for preventing the falls. However, these studies provide answers for long term care; acute care and community hospitals need more specific interventions. Falls and their consequences are important for patients and families, health care providers, insurance companies, state agencies, hospital accreditation, and others. Furthermore, they are causing psychological and physiological injuries among the patients, take a greater time to recover, prolong hospitalization [15 days in Switzerland, Sweden, USA, Western Australia, Province of British Columbia and Quebec in Canada www.stopfalls.com )] and increase …

What's Happening: Spring, 2008, Maine Medical Center

What's Happening

No abstract provided.

An All Time Low Budget For Healthcare In Pakistan, Jamil Ahmed, Babar T Shaikh

Community Health Sciences

No abstract provided.

The Changing Role Of Physicians In Disaster Management And Hospital Incident Command, F. Matthew Mihelic, M. David Stockton, Stephen A. Cole, Gregory H. Blake

Faculty Publications

Recent changes in governmental policy toward disaster medicine and hospital incident command foreshadow a significant change in the role that physicians will play in disaster preparedness and response. The distinct discipline of Disaster Medicine has received authoritative recognition and promotion in the recent Homeland Security Presidential Directive 21, and recently established guidelines for incident command within hospitals have included a new position designated as “Medical/Technical Specialist(s)” that will assist the Incident Commander in disaster-related decision-making. This is a multidisciplinary position, and its functions can be filled by one or more individuals. As physician training and competency in Disaster Medicine increases, …

An Analysis Of The Differences In Preemptive Kidney Transplantation Between Blacks And Whites, Kennard D. Brown

Theses and Dissertations (ETD)

Background. This cohort study investigates whether there are inequities in the allocation of cadaver kidneys for preemptive kidney transplants (PKT) between blacks and whites.

Methods. This analysis uses descriptive statistics and univariate and multivariate analyses to identify factors associated with the determination of whether a patient receives a PKT or a conventional, post dialysis kidney transplant. The sample includes patients identified by the Centers for Medicare and Medicaid Services (CMS) as having end stage renal disease (ESRD), >19 years of age, either black or white, and receiving either a PKT (0-<6 months dialysis) or conventional transplant between January 1, 2000 and December 31, 2003 (n = 10,067) from any of the 11 organ procurement regions in the United States.

Results. Whites were more likely to receive a PKT …

Why Pharmacists Choose To Seek Or Not Seek Board Certification In Pharmacy Practice: A Comparison Of Motivation And Motivating Factors, Mark Tankersley

Theses and Dissertations (ETD)

The stated mission of the Board of Pharmaceutical Specialties (BPS) with regard to specialization is, via board certification, to recognize specialty areas, define skill standards for those specialty areas, and evaluate the knowledge and skills of individual Pharmacy specialists. The perceived or real benefits to the pharmacist of pursuing board certification are unknown. These benefits can be evaluated by separating into values (valences) and instrumentalities, the latter of which is the perceived or known probability that a performance will lead to an outcome. The primary purpose of this study was to determine the differences in values and instrumentalities perceived by …

The Aging Services Network: Accomplishments And Challenges In Serving A Growing Elderly Population, Carol O'Shaughnessy

National Health Policy Forum

In 1965, Congress enacted the Older Americans Act, establishing a federal agency and state agencies to address the social services needs of the aging population. The mission of the Older Americans Act is broad: to help older people maintain maximum independence in their homes and communities and to promote a continuum of care for the vulnerable elderly. In successive amendments, the Act created area agencies on aging and a host of service programs. The “aging services network,” broadly described, refers to the agencies, programs, and activities that are sponsored by the Older Americans Act. The Act’s funding for services is …

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 …

Pediatric Safety And Quality, Susan R. Lacey, Janis B. Smith, Karen Cox

Manuscripts, Articles, Book Chapters and Other Papers

Excerpt

Pediatric care is complex due to developmental and dependency issues associated with children. How these factors impact the specific processes of care is an area of science in which little is known. We are only beginning to understand the relationship between nurse staffing and adverse events in hospitalized children; effects that may be compounded by inadequate numbers of pediatric nurses. Throughout health care providing safe and high quality patient care continues to provide significant challenges. Efforts to improve the safety and quality of care are resource intensive and take continued commitment not only by those who deliver care, but …

A Delphi Study Assessing Long-Term Access To Electronic Medical Records (Emr), Byron D. Nicholson

Theses and Dissertations

This research effort addressed the issue of long-term access to electronic medical records as technological generations become obsolete, thereby preventing the access to patient health information. Using the Delphi methodology, experts with experience in electronic medical records and applicable systems provided insight based on their years of hands-on experience managing and/or using records and these systems. The end result of this research was a collection of ideas that medical institutions and medical informaticians must consider to ensure that patients and hospitals do not lose long-term access to electronic medical records as electronic medical records and technology continually evolves. Results of …

Competition And Collaboration, Chicago-Style, Laura A. Dummit, Lisa Sprague

National Health Policy Forum

The National Health Policy Forum sponsored a site visit to Chicago, Illinois, March 16-18, 2008 to consider how competition and collaboration have shaped Chicago?s health care market. Chicago is a study of contrasts between wealth and poverty and between large, internationally known facilities and struggling community hospitals. The stressed state of the county health system concerned all of the stakeholders and may be an impetus for increased cooperation among the haves and the have nots. No longer waiting for state health reform efforts, key players were working to shore up needed providers and develop a more equitable distribution of resources, …

Completing The Recipe For Children's Health: New Variations On Key Ingredients: A Report From The Workshop On June 28, 2007, Jennifer Ryan

National Health Policy Forum

This paper offers a broad overview of the issues surrounding the social and environmental determinants of children’s health. These issues were explored during a discussion convened by the National Health Policy Forum on June 28, 2007, among a group of individuals concerned about the influences beyond medical care on the health of children. The paper considers the policy and financing tensions that exist across programs and populations that make addressing the full range of influences challenging. It also highlights some of the community-based initiatives that have been successful in providing services to children and families, as described during the workshop. …

The Walmart Effect: Retailing Of Health Care, William Martin

College of Business Faculty and Staff Works

No abstract provided.

What's Happening: February, 2008, Maine Medical Center

What's Happening

No abstract provided.

Complying With The National Institutes Of Health Public Access Policy: Copyright Considerations And Options, Michael Carroll

Scholarly Articles in Law Reviews & Journals

This White Paper is written primarily for policymaking staff in universities and other institutional recipients of NIH support responsible for ensuring compliance with the Public Access Policy. The January 11, 2008, Public Access Policy imposes two new compliance mandates. First, the grantee must ensure proper manuscript submission. The version of the article to be submitted is the final version over which the author has control, which must include all revisions made after peer review. The statutory command directs that the manuscript be submitted to PMC “upon acceptance for publication.” That is, the author’s final manuscript should be submitted to PMC …

Pharmacogenomics: A Primer For Policymakers, Leslie Tucker

National Health Policy Forum

Researchers are exploring how genetic variations among individuals may help explain why a drug can work well in some people and poorly (or not at all) in others, including those who appear to have the same disease. Pharmacogenomics, as this new field is called, aims to help physicians make use of genetic tests to distinguish among patients whose genetic characteristics predispose them to respond in certain ways to certain medicines. If physicians can use this information to quickly and reliably choose the appropriate drug at the most effective dose for each patient, they may produce better patient outcomes and save …

Resuscitating A Healthcare Charity, R Akhileswaran, Seet Ai Mee

Social Space

When government funding policies change, voluntary welfare organisations that depend largely on subsidies to run their services can find their survival at stake. Dr R Akhileswaran and Dr Seet Ai Mee present the case study of HCA Hospice Care.

Listening To The Stars: The Constellation Model Of Collaborative Social Change, Tonya Surman, Mark Surman

Social Space

There has been much talk about social sector partnerships and networks. Tonya Surman and Mark Surman explain how the ‘constellation model’, developed for the Canadian Partnership for Children’s Health and the Environment, offers an innovative approach to organising such collaborative efforts.

Understanding Leadership Skills Of Hospice Executives, Paul D. Longenecker

Health and Sport Sciences Faculty Scholarship

The healthcare industry is a rapidly changing environment requiring leaders to possess a high level , of leadership skills. leaders in the hospice industry have experienced the same level of change, but over the brief span of 25 years.With the aging of hospice executives and the dynamic environment of the hospice industry, the need for strong leadership is more important than ever. This research study reports on the perceived leadership skills of hospice executives and is a replication of an earlier study (longenecker, 2006). All study participants were executives of organizations that participated in clinical and operational benchmarking activities at …

Cost Of Medical Detoxification Among Drug And Alcohol Users In A Private Texas Hospital, Alberto Coustasse

Management Faculty Research

Purpose – The purpose of this paper is to estimate the costs of medical detoxification among patients with alcohol and substance abuse disorders.

Design/methodology/approach – The study data was drawn from a medical detoxification program in a community hospital in Texas. Secondary data analysis of 1337 cases from three years was reviewed. Age, gender, race, alcohol, cocaine, cannabis, amphetamines, sedatives, opioids, financial classification, cost, length of stay (LOS) and cost by LOS were analyzed using Kruskal-Wallis test and Mann-Whitney U-test.

Findings – The sample comprised of 42.8 percent women and 57.2 percent males. The mean cost and cost by LOS …

To The Bitter End: Disparities In End-Of-Life Care, Alberto Coustasse, Theresa Quiroz, Sue G. Lurie

Management Faculty Research

Although technological advancements have provided the means to sustain life and provide care regardless of whether the treatment is appropriate and compassionate given the condition of the patient, bioethical, legal, and moral concerns related to disparities in care still arise in the United States. These concerns call into question the necessity to continue life-sustaining or palliative care treatments when patients and/or families are faced with end-of-life decisions. This study will focus on various historical, clinical cultural, and ethical issues that have placed this dilemma into a controversial public spectrum, by using case studies retrieved from referenced literature, which illustrate disparities …