Medicine and Health Sciences Commons^™

Impact Of Radio-Frequency Identification (Rfid) Technologies On The Hospital Supply Chain: A Literature Review, Alberto Coustasse, Shane Tomblin, Chelsea Slack

Management Faculty Research

Supply costs account for more than one-third of the average operating budget and constitute the second largest expenditure in hospitals. As hospitals have sought to reduce these costs, radio-frequency identification (RFID) technology has emerged as a solution. This study reviews existing literature to gauge the recent and potential impact and direction of the implementation of RFID in the hospital supply chain to determine current benefits and barriers of adoption. Findings show that the application of RFID to medical equipment and supplies tracking has resulted in efficiency increases in hospitals with lower costs and increased service quality. RFID technology can reduce …

Generating Hypotheses About Care Needs Of High Utilizers: Lessons From Patient Interviews., Dawn B Mautner, Hauchie Pang, Jeffrey C Brenner, Judy A Shea, Kennen S Gross, Rosemary Frasso, Carolyn C Cannuscio

Department of Family & Community Medicine Faculty Papers

Informed by a largely secondary and quantitative literature, efforts to improve care and outcomes for complex patients with high levels of emergency and hospital-based health care utilization have offered mixed results. This qualitative study identifies psychosocial factors and life experiences described by these patients that may be important to their care needs. Semi-structured interviews were conducted with 19 patients of the Camden Coalition of Healthcare Providers' Care Management Team. Investigators coded transcripts using a priori and inductively-derived codes, then identified 3 key themes: (1) Early-life instability and traumas, including parental loss, unstable or violent relationships, and transiency, informed many participants' …

The Effect Of Heart Failure Education On Reducing Readmissions, Mayola Lara Villarruel

Evidence-Based Practice Project Reports

Management of heart failure is a significant financial challenge for the health care industry, costing approximately $33.2 billion annually. Common reasons for preventable heart failure readmissions include inadequate discharge education and lack of self-care and health management activities. Education at discharge is a vital component of improving heart failure outcomes. Following a review of the literature, high quality evidence supports that heart failure education should focus on medication adherence, sodium and fluid restriction, daily weights, activity tolerance, identification of deteriorating signs and symptoms of heart failure, and smoking cessation. The purpose of this EBP project was to reduce heart failure …

Organizational Culture In A Terminally Ill Hospital, Alberto Coustasse, Douglas A. Mains, Kristine Lykens, Sue G. Lurie, Fernando Trevino

Alberto Coustasse, DrPH, MD, MBA, MPH

This study analyzed an organizational culture in a community hospital in Texas to measure organizational culture change and its impact on Patient Satisfaction (PS). The study employed primary and secondary data, combining quantitative and qualitative methods for a case study. Participant observation was used and archival data were collected to provide a better understanding of the organizational culture and the context in which change was taking place. This study also applied a “Shared Vision” of the organization as the central process in bringing forth the knowledge shared by members of the community hospital who were both subjects and research participants. …

Education And Referral Criteria: Impact On Oncology Referrals To Palliative Care., Barbara Reville, Joanne Reifsnyder, Deborah B Mcguire, Karen Kaiser, Abbie Santana

Department of Family & Community Medicine Faculty Papers

OBJECTIVE: To describe a quality improvement project involving education and referral criteria to influence oncology provider referrals to a palliative care service.

METHODS: A single group post-test only quasi-experimental design was used to evaluate palliative care service (PCS) referrals following an intervention consisting of a didactic presentation, education outreach visits (EOV) to key providers, and referral criteria. Data on patient demographics, cancer types, consult volume, reasons for referral, pre-consult length of stay, overall hospital stay, and discharge disposition were collected pre-intervention, then post-intervention for 7.5 months and compared.

SETTING AND SAMPLE: Attending oncologists, nurse practitioner, and house staff from the …

Needle Stick Injuries--Risk And Preventive Factors: A Study Among Health Care Workers In Tertiary Care Hospitals In Pakistan., Asad Ali Khan Afridi, Ameet Kumar, Raza Sayani

Community Health Sciences

BACKGROUND:

Health care workers (HCWs) are at substantial risk of acquiring blood borne infections such as HIV, Hepatitis-B and Hepatitis-C through needle stick injuries (NSIs). This study aimed to assess the proportion of NSIs and their associated factors among HCWs and also to identify the areas in which preventive efforts might be directed to protect against this occupational hazard.

METHODOLOGY:

A cross-sectional study was conducted in two tertiary care hospitals of Pakistan representing both private and public health sector. A total of 497 HCWs (doctors and nurses) were interviewed using a structured questionnaire. Data was collected from January to May …

The Association Between Hospital Obstetrical Volume And Maternal Postpartum Complications., Kathy L Kyser, Xin Lu, Donna Santillan, Mark Santillan, Stephen Hunter, Alison G Cahill, Peter Cram

Donna A. Santillan

OBJECTIVE: The purpose of this study was to examine the relationship between delivery volume and maternal complications.

STUDY DESIGN: We used administrative data to identify women who had been admitted for childbirth in 2006. Hospitals were stratified into deciles that were based on delivery volume. We compared composite complication rates across deciles.

RESULTS: We evaluated 1,683,754 childbirths in 1045 hospitals. Decile 1 and 2 hospitals had significantly higher rates of composite complications than decile 10 (11.8% and 10.1% vs 8.5%, respectively; P < .0001). Decile 9 and 10 hospitals had modestly higher composite complications as compared with decile 6 (8.8% and 8.5% vs 7.6%, respectively; P < .0001). Sixty percent of decile 1 and 2 hospitals were located within 25 miles of the nearest greater volume hospital.

CONCLUSION: Women who deliver at very low-volume hospitals have higher complication rates, as do women who deliver at …

Hospital Contributions To Public Health Activities Before And After Aca: Incentives, Constraints & Crowd-Out, Glen P. Mays

Health Management and Policy Presentations

Research Objective: The Affordable Care Act created enhanced IRS requirements for not-for-profit hospitals regarding the provision of community benefits, potentially stimulating new approaches to community health needs assessment, priority setting, and engagement with public health agencies and other community stakeholders. Yet the economic downturn has constrained hospital earnings and increased demand for uncompensated care, potentially crowding out hospital contributions to public health activities. This study uses data from 1998-2012 on a national cohort of communities to examine: (1) the extent and nature of change in hospital contributions to public health activities; and (2) the economic, institutional, and policy-related factors that …

The Effect Of Electronic Medical Record Sophistication On U.S. Hospital Emergency Department Efficiency, Imran Chaudhri

Honors Theses

A key concern in emergency departments (EDs) is their overall efficiency, One proposed solution to making EDs more efficient is the use of electronic medical records (EMRs). This paper seeks to determine if varying levels of EMR sophistication have an effect on measures of emergency department efficiency. Furukawa (2011) found that EMR sophistication had varying effects on ED efficiency. Fully functional EMRs significantly improved ED efficiency in multiple measures, while basic EMR varied on its effects on efficiency. Since Furukawa’s results are somewhat inconclusive, this study aims to see if these effects are longstanding. I hypothesize that as EMR became …

Electronic Medical Records: Is It Working In Long Term Health Care?, Krista Phillips, Chris Wheeler, Josh Campbell, Alberto Coustasse

Alberto Coustasse, DrPH, MD, MBA, MPH

Long-term care (LTC) facilities possess unique characteristics in terms of implementation and utilization of electronic medical records (EMRs). The focus of LTC is on a population requiring care encompassing all aspects associated with quality of life rather than simply acute treatment. Because this focus is of a larger scale than traditional medical facilities, the priorities in the implementation and utilization of EMRs are higher in accessing patient history information. The purpose of this study was to determine the EMR utilization in the chronic care settings. In conclusion, the literature review performed does not support the fact that EMRs are currently …

Electronic Medical Records In Long-Term Care, Krista Phillips, Chris Wheeler, Josh Campbell, Alberto Coustasse

Alberto Coustasse, DrPH, MD, MBA, MPH

Long-term care (LTC) facilities possess unique characteristics in terms of implementation and utilization of electronic medical records (EMRs). The focus of LTC is on a population requiring care encompassing all aspects associated with quality of life rather than simply acute treatment. Because this focus is of a larger scale than traditional medical facilities, the priorities in the implementation and utilization of EMRs are higher in accessing patient history information. The purpose of this study was to determine the EMR utilization in the chronic care settings. In conclusion, the literature review performed does not support the fact that EMRs are currently …

The Association Between Hospital Obstetrical Volume And Maternal Postpartum Complications., Kathy L Kyser, Xin Lu, Donna Santillan, Mark Santillan, Stephen Hunter, Alison G Cahill, Peter Cram

Stephen K. Hunter

OBJECTIVE: The purpose of this study was to examine the relationship between delivery volume and maternal complications.

STUDY DESIGN: We used administrative data to identify women who had been admitted for childbirth in 2006. Hospitals were stratified into deciles that were based on delivery volume. We compared composite complication rates across deciles.

RESULTS: We evaluated 1,683,754 childbirths in 1045 hospitals. Decile 1 and 2 hospitals had significantly higher rates of composite complications than decile 10 (11.8% and 10.1% vs 8.5%, respectively; P < .0001). Decile 9 and 10 hospitals had modestly higher composite complications as compared with decile 6 (8.8% and 8.5% vs 7.6%, respectively; P < .0001). Sixty percent of decile 1 and 2 hospitals were located within 25 miles of the nearest greater volume hospital.

CONCLUSION: Women who deliver at very low-volume hospitals have higher complication rates, as do women who deliver at …

A Theory-Driven, Longitudinal Evaluation Of The Impact Of Team Training On Safety Culture In 24 Hospitals, Katherine J. Jones, Anne M. Skinner, Robin High, Roni Reiter-Palmon

Psychology Faculty Publications

Effective teamwork facilitates collective learning, which is integral to safety culture. There are no rigorous evaluations of the impact of team training on the four components of safety culture—reporting, just, flexible and learning cultures. We evaluated the impact of a year-long team training programme on safety culture in 24 hospitals using two theoretical frameworks.

Perceptions Of Hospital Patient Safety Culture In Department Of Veterans Affairs Station 593 Southern Nevada, Kimberly Falco

UNLV Theses, Dissertations, Professional Papers, and Capstones

Opportunities for error exist, adverse events occur, and challenges endure. However, patients will continue to experience preventable adverse events unless steps are taken. Efforts to improve patient safety are critical to today's healthcare environment. The Department of Veterans Affairs (VA) believes that the identification of adverse events allows for creation of system improvements to increase patient safety.

Implementing safety culture requires a proper assessment of existing barriers and potential challenges. Patient safety culture assessments start by evaluating the current patient care environment. This assists the organization in identifying barriers to patient safety and in working toward creating a culture of …

Impacting The Tdap Acceptance Rate Among Postpartum Women, Amie Burns-Scharnke

Evidence-Based Practice Project Reports

Pertussis, also known as Whooping Cough, is a contagious disease that affects children more than adults, especially children under the age of 12 months. In the United States in 2009, there were more than 16,000 cases of pertussis in infants less than 6 month of age (National Network for Immunizations and Information, 2011). At a local Midwestern community hospital, a revised Tdap policy that consisted of an education component and standardization of when the vaccine was administered was implemented to increase the acceptance rate of Tdap vaccines among postpartum mothers due to their significantly low Tdap acceptance rate. The purpose …

The Costly Skeleton In Hospital Closets, Karen Charlton

Karen E. Charlton

No abstract provided.

The Effects Of A Violence Assessment Checklist On The Incidence Of Violence For Emergency Department Nurses, Sarah Knapp

Evidence-Based Practice Project Reports

Workplace violence (WV) is commonplace in American culture, and nurses working in emergency departments (ED) are not immune to its effects. Violence against emergency department nurses is prominent in current nursing literature, and a cause for major concern. Regrettably there is no consistent tool being used to assess for potential patient violence specific to the emergency department. Current assessment tools have been developed and are commonly used in the mental health arena. This evidence-based practice project concentrated on answering the clinical question of whether or not a violence risk assessment checklist reduced the incidence of violence and increased perception of …

Hospital-Based Nurse Practitioner Practice: An Exploration Of Interprofessional Teams., Christina J. Hurlock-Chorostecki

Electronic Thesis and Dissertation Repository

Nurse practitioner (NP) roles within hospital teams are evolving worldwide. However, understanding of their practice within the context of interprofessional (IP) teamwork remains limited. This two-phase study undertaken within Ontario, Canada provides a new multi-perspective understanding of the value of NP practice within IP hospital teams. Constructivist grounded theory, a modification of the classic methodology, guided an interpretive approach based in exploration of process and meaning construction, privilege and power exposure, and juxtaposition with extant theory. A conceptual rendering of NP practice was determined through supplemental analysis of 30 team member focus groups. This new perspective emerged as three practice …

A Review Of Radio Frequency Identification Technologies And Impacts On The Hospital Supply Chain: 2002–2012, Alberto Coustasse, Shane Tomblin, Chelsea Slack

Management Faculty Research

Supply costs are the second largest expenditure in hospitals, accounting for more than one third of the average operating budget. RFID technology can reduce these costs, improve patient safety, and supply chain management by increasing the ability to track and locate equipment, as well as monitoring theft prevention, distribution management, and patient billing. Findings of this study have shown that the application of RFID on medical equipment and supplies have resulted in efficiency increase in healthcare with lower costs and increased quality services. Even though the cost of RFID implementation is decreasing, the total expenditures are still significant and the …

Using Computer Simulation To Study Hospital Admission And Discharge Processes, Edwin S. Kim

Masters Theses 1911 - February 2014

Hospitals around the country are struggling to provide timely access to inpatient beds. We use discrete event simulation to study the inpatient admission and discharge processes in US hospitals. Demand for inpatient beds comes from two sources: the Emergency Department (ED) and elective surgeries (NonED). Bed request and discharge rates vary from hour to hour; furthermore, weekday demand is different from weekend demand. We use empirically collected data from national and local (Massachusetts) sources on different-sized community and referral hospitals, demand rates for ED and NonED patients, patient length of stay (LOS), and bed turnover times to calibrate our discrete …

The Late Preterm Infant: How Much Transition Time Is Needed To Prevent Hypothermia?, Sandi Lane

Nursing Theses and Capstone Projects

Late preterm infants are those infants born between 34 weeks and 36 and 6/7 weeks gestation. They are generally the same weight and appearance of full term infants and are treated in level 1 or well baby nurseries the same as full term infants. Late preterm infants are not as physiologically mature as full term infants and have problems that may go overlooked. Late preterm infants experience complications such as hypothermia, hypoglycemia, respiratory difficulties, and feeding problems that lead to hyperbilirubinemia. These complications can lead to longer hospital stays or readmissions and higher healthcare costs. It is the purpose of …

Home-Based Dietetic Intervention Improves Nutritional Status Post Hospital Discharge In Older People, A H. Hamirudin, A Carrie, K Charlton, K Walton, L Tapsell, Marianna Milosavljevic, G Pang, J Potter

Faculty of Science, Medicine and Health - Papers: part A

Abstract of poster that presented at 20th International Congress of Nutrition, Granada, September 2013.

Lying Down On The Job- Does Posture Affect Grip Strength And Opening Hospital Food And Beverage Packaging?, Alison Bell, Jacqueline Chevis, Nicola Westblade, Kate Morson, Karen Walton

Faculty of Science, Medicine and Health - Papers: part A

Abstract of paper that presented at the Occupational Therapy Australia, 25th National Conference and Exhibition, 24-26 July 2013, Adelaide Convention Centre.

Observations Of Mealtimes In Hospital Aged Care Rehabilitation Wards, Karen Walton, Peter Williams, Linda Tapsell, Matthew Hoyle, Zhi Wei Shen, Lauren Gladman, Martin Nurka

Faculty of Science, Medicine and Health - Papers: part A

Malnutrition is common in long-stay elderly hospitalized patients and their dietary intakes are often poor, despite the provision of adequate quantities of food to meet patient needs. The aim of this study was to identify environmental factors that were associated with achieving adequate food consumption in a hospital context. This study observed the daily routines of 30 elderly patients over 2 days in rehabilitation wards in three Australian hospitals. All activities associated with mealtimes were recorded, from the commencement of breakfast to the conclusion of supper at the end of the day. Four key themes emerged: the eating location; assistance …

Cost Effectiveness Of Patient Education For The Prevention Of Falls In Hospital: Economic Evaluation From A Randomized Controlled Trial, Terry P. Haines, Anne-Marie Hill, Keith D. Hill, Sandra G. Brauer, Tammy Hoffmann, Christopher Etherton-Beer, Steven M. Mcphail

Physiotherapy Papers and Journal Articles

Background

Falls are one of the most frequently occurring adverse events that impact upon the recovery of older hospital inpatients. Falls can threaten both immediate and longer-term health and independence. There is need to identify cost-effective means for preventing falls in hospitals. Hospital-based falls prevention interventions tested in randomized trials have not yet been subjected to economic evaluation.

Methods

Incremental cost-effectiveness analysis was undertaken from the health service provider perspective, over the period of hospitalization (time horizon) using the Australian Dollar (A$) at 2008 values. Analyses were based on data from a randomized trial among n = 1,206 acute and …

Impact Of Quality Performance On Financial Risk And Cost Of Capital In Hospitals, James D. Byrd Jr

All ETDs from UAB

This study evaluated the relationship of hospital quality of care as measured by mortality scores to hospital cost of capital as represented by average cost of debt. A composite mortality score (weighted average of Hospital Compare's risk adjusted mortality rate for each hospital) was regressed against the hospitals' average cost of debt using OLS and the Stata 11 robust clustering function to adjust for repeated occurrences of hospitals across years. The data base consisted of acute care hospitals with interest expense observed over the three year period 2008 - 2010 (n=3420). Control variables included a number of hospital characteristic (e.g., …

Optimizing Atraumatic Emergency Care In Child Sexual Abuse, Kristen A. Morris

Evidence-Based Practice Project Reports

Child sexual abuse has been identified as a common problem. According to the United States Department of Health and Human Services, in 2010 it was estimated that child victims of sexual abuse accounted for 9.2% (69,368) of the 573,794 children under the age of 12 years who were the victims of maltreatment. The emergency department (ED) is often the point of entry into the healthcare system for child sexual abuse victims, which adds to the resource burden of this department nationwide. The purpose of this evidence-based project was to develop a best-practice screening tool for medical providers to guide the …

Conocimiento Del Personal De Salud Del Hospital San Rafael De Leticia Sobre El Sistema Obligatorio De Garantía De La Calidad En La Atención En Salud, Yulima González Hernández, Maryori Quiñones, Wilson Giovanni Jiménez

Ciencia y Tecnología para la Salud Visual y Ocular

Este artículo surgió del trabajo llevado a cabo en la Universidad Jorge Tadeo Lozano para obtener el título de especialista en Gerencia y Auditoría de la Calidad de la Salud, durante el 2012. Está basado en la normatividad que se encuentra establecida en el Decreto 1011 del 2006, a partir de la cual se crean los estándares del Sistema Obligatorio de Garantía de la Calidad en la Atención en Salud (SOGCS). Objetivo: conocer el grado de conocimiento que tiene el personal de salud que labora en el Hospital San Rafael, en Leticia, Amazonas, sobre este decreto. Materiales y métodos: se …

High-Tech Services And Hospital Performance In The United States, Ferhat Devrim Zengul

All ETDs from UAB

This dissertation examined the relationship between high-technology medical services and hospital performance by focusing on financial and quality performance dimensions. An initial systematic review disclosed the paucity of research and mixed findings about the technology-performance relationship. The review indicated the need for further analyses by emphasizing some limitations of existing studies. The resource-based view (RBV) of a firm was used as a conceptual framework in examining the relationship between high-tech medical services and hospital financial performance. It was hypothesized that large breadth (number) of high-tech services and the use of rare high-tech services would be positively associated with hospitals' financial …