Medicine and Health Sciences Commons^™

Inter-Organizational Network Effects On The Implementation Of Public Health Services, Glen P. Mays

Health Management and Policy Presentations

Background: The Affordable Care Act created new incentives for hospitals, insurers, public health agencies, and others to contribute to disease prevention and health promotion activities, potentially changing inter-organizational relationships and expanding implementation of strategies that improve population health. This study uses data from the 1998-2014 National Longitudinal Survey of Public Health Systems to examine: (1) the extent and nature of change in inter-organizational contributions to public health activities; (2) whether network changes attenuate or exacerbate disparities in public health implementation across communities; and (3) how network changes affect preventable mortality and resource use.

Methods: We follow a longitudinal cohort of …

Implementing Ipe In An Academic Health Science Center: Changing Attitudes, Beliefs, & Knowledge, Kerry Proctor-Williams, Elizabeth Alley

ETSU Faculty Works

Completion of 3-year pilot Interprofessional Education Program involving graduate students in an Academic Health Science Center yielded pre- and post-program evaluations of attitudes, beliefs, and knowledge of students and faculty. This session offers a description of a program without curricular level changes, presentation of research outcomes, and resulting planned modifications.

Implementing Shared Decision-Making: Consider All The Consequences, Glyn Elwyn, Dominick L. Frosch, Sarah Kobrin

Dartmouth Scholarship

The ethical argument that shared decision-making is “the right” thing to do, however laudable, is unlikely to change how healthcare is organized, just as evidence alone will be an insufficient factor: practice change is governed by factors such as cost, profit margin, quality, and efficiency. It is helpful, therefore, when evaluating new approaches such as shared decision-making to conceptualize potential consequences in a way that is broad, long-term, and as relevant as possible to multiple stakeholders. Yet, so far, evaluation metrics for shared decision-making have been mostly focused on short-term outcomes, such as cognitive or affective consequences in patients. The …

Analisis Implementasi Kebijakan Dokter Spesialis Jaga On Site Di Instalasi Gawat Darurat Rumah Sakit Dr. Mohammad Hoesin Palembang, Kms Anhar

Jurnal ARSI (Administrasi Rumah Sakit Indonesia)

Since the introduction of the National Health Insurance Program January 1, 2014 has been an increase in patients visit to hospital-government hospitals. Emergency Department (ED) Hospital is a unit leader in the provision of hospital services. The increasing amount of patients visit especially in dr. Moh. Hoesin Palembang (RSMH) raises complex issues which experienced by other hospitals both at world, national and regional. Although the problems in the ED is complex they still expected to provide a certifiable quality service in accordance with the Decree of the Minister of Health no. 856 in 2009 about ED service standards. The problems …

An Application Of The Socio-Technical Systems Approach To Implementation Of Electronic Evidence Into Practice: The Clinical Practice Model Framework, Kathleen Abrahamson, Priscilla Arling, Bonnie Wesorick, James Anderson

Priscilla Arling

Implementation of electronic evidence into the practice environments of clinical staff is an ongoing challenge in health care organizations. Despite localized efforts to integrate point-of-care technology with clinical practice, system-wide transformation across multiple clinical settings has not commonly occurred. This paper examines a framework designed to guide the implementation of evidence-based practice using technology in health care settings from the theoretical lens of the Socio-Technical Systems (STS) approach. The framework under study is called the CPM Framework™, developed by the Clinical Practice Model Resource Center (CPMRC). The CPMRC is a collaborative consortium of health care providers representing over 300 rural, …

Does Self-Efficacy Influence The Application Of Evidence-Based Practice?, Kathleen Abrahamson, Priscilla Arling, Jenna Gillette

Priscilla Arling

Background: Implementation of Evidence-Based Practice (EBP) is complex and consequently, even within organizations that have made efforts to promote EBP use, EBP is often underutilized by individual clinicians. Purpose: The aim of our study was to better understand the relationship between self-efficacy and EBP implementation in clinical environments that have undergone efforts to increase EBP utilization. We suggest that EBP is a set of behaviors that result from individuals acquiring, applying, and sharing new knowledge with others in the organization. We hypothesize, based upon a social cognitive theoretical approach, that these behaviors are influenced by clinician perception of self-efficacy. Methods: …

Nutrition Support Nursing Handoff: A Computerized Template, Suzanne L. Bundrick

Theses and Graduate Projects

At a large Midwest private nutrition support practice, a manual reporting tool has been the communication practice used in daily handoff practices. For patients who require consultation from the Nutrition Support Consulting Service, accurate communication of the nutrition plan of care among members of the health care team is a critical element of patient care and safety. Because communication errors are a leading cause of sentinel events for patients, having a safe transfer of care from nurse to nurse each day is imperative. A nutrition support computerized handoff template not only creates continuity of care among team members, it also …

Evidence-Based Practice: A Lack Of Confidence, Knowledge, And Implications In Athletic Training, Joseph R. Brown

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

No abstract provided.

Supporting Practices To Adopt Registry-Based Care (Sparc): Protocol For A Randomized Controlled Trial, Rebeccar S. Etz, Rosalind E. Keith, Anna M. Matemick, Karen L. Stein, Roy T. Sabo, Melissa S. Hayes, Purvi Sevak, John Holland, Jesse C. Crosson

Publications and Research

Background: Diabetes is predicted to increase in incidence by 42% from 1995 to 2025. Although most adults with diabetes seek care from primary care practices, adherence to treatment guidelines in these settings is not optimal. Many practices lack the infrastructure to monitor patient adherence to recommended treatment and are slow to implement changes critical for effective management of patients with chronic conditions. Supporting Practices to Adopt Registry-Based Care (SPARC) will evaluate effectiveness and sustainability of a low-cost intervention designed to support work process change in primary care practices and enhance focus on population-based care through implementation of a diabetes …

Implementation Of Motivational Interviewing In A Multidisciplinary Hiv Clinic In An Academic Medical Setting, Lucy Ledesma

Doctoral Dissertations

Purpose: People living with HIV (PLWH) struggle with medication adherence. Antiretroviral therapy (ART) requires greater than 95% adherence to prevent HIV drug resistance and treatment failure. Motivational interviewing (MI) is an effective counseling method designed to enhance health behavior change. This project determined the effectiveness of a two-day introductory MI training course on participant MI knowledge, perception of MI effectiveness, perception of client behavior change, and likelihood of MI use in a Midwest outpatient HIV clinic.

Participants: Seven clinical and non-clinical members of the multidisciplinary care team completed the two-day MI training course. Approximately 82% of the participants had never …

Characteristics Of Local Health Departments Associated With Their Implementation Of Electronic Health Records And Other Informatics System, Gulzar H. Shah, Jonathon P. Leider, Brian C. Castrucci, Karmen S. Williams, Huabin Luo

Health Policy and Management Faculty Presentations

Background: Information technology and information systems (IT/IS) play a critical role in the daily operation of local health departments (LHDs). Assessing LHDs’ informatics capacities is important, especially within the context of broader, system-level health reform efforts.

Research Objective: This study assesses a nationally representative sample of LHDs’ level of adoption of information systems, technology, and the factors associated with adoption/implementation. Specifically, five areas of public health informatics were examined: electronic health records (EHRs), health information exchange (HIE), immunization registry (IR), electronic disease reporting system (EDRS), and electronic lab reporting (ELR).

Data Sets and Sources: Data from NACCHO’s 2013 National Profile …

Pubh 4133 - Health Promotion Program Planning Ii, Raymona H. Lawrence

Jiann-Ping Hsu College of Public Health Syllabi

Introduces students to additional theory and application of community-based program planning and evaluation. The second of a two-course sequence, the focus will be on program implementation, evaluation, and reporting of the health promotion plan developed during the prior semester. Students will gain first-hand experience in conducting an evaluation of community health education program.

The Role Of Leadership In Creating A Strategic Climate For Evidence-Based Practice Implementation And Sustainment In Systems And Organizations, Gregory Aarons, Mark Ehrhart, Lauren Farahnak, Marisa Sklar

G A Aarons

There is a growing impetus to effectively implement evidence-based practices (EBPs) in health and allied health settings in order to improve the public health impact of such practices. To support implementation and sustainment of EBPs, it is important to consider that health care is delivered within the outer context of public health systems and the inner context of health care organizations and work groups (3). This article identifies two relevant types of leadership for implementation and recommends steps that leaders can take in developing a strategic climate for EBP implementation and sustainment within the outer and inner contexts of health …

Assessments Of The Extent To Which Health‐Care Providers Involve Patients In Decision Making: A Systematic Review Of Studies Using The Option Instrument, Nicolas Couët, Sophie Desroches, Hubert Robitaille, Hugues Vaillancourt, Annie Leblanc, Stéphane Turcotte, Glyn Elwyn, France Légaré

Dartmouth Scholarship

Background: We have no clear overview of the extent to which health-care providers involve patients in the decision-making process during consultations. The Observing Patient Involvement in Decision Making instrument (OPTION) was designed to assess this. Objective: To systematically review studies that used the OPTION instrument to observe the extent to which health-care providers involve patients in decision making across a range of clinical contexts, including different health professions and lengths of consultation. We conducted online literature searches in multiple databases (2001-12) and gathered further data through networking.

Aca Implementation In The South: The Political Economy Of Full Participation In Kentucky, Glen P. Mays

Health Management and Policy Presentations

This analysis, conducted as part of the ACA Implementation Research Network, examines economic and political forces shaping Kentucky's early experience with implementation of the Patient Protection and Affordable Care Act.

Supporting Practices To Adopt Registry-Based Care (Sparc): Protocol For A Randomized Controlled Trial, Rebecca S. Etz, Rosalind E. Keith, Anna M. Maternick, Karen L. Stein, Roy T. Sabo, Melissa S. Hayes, Purvi Sevak, John Holland, Jesse C. Crosson

Family Medicine and Population Health Publications

Background

Diabetes is predicted to increase in incidence by 42% from 1995 to 2025. Although most adults with diabetes seek care from primary care practices, adherence to treatment guidelines in these settings is not optimal. Many practices lack the infrastructure to monitor patient adherence to recommended treatment and are slow to implement changes critical for effective management of patients with chronic conditions. Supporting Practices to Adopt Registry-Based Care (SPARC) will evaluate effectiveness and sustainability of a low-cost intervention designed to support work process change in primary care practices and enhance focus on population-based care through implementation of a diabetes registry. …

Examining Barriers With Implementing Augmentative And Alternative Communication In A Midwest School, Ashley Renee Fields

Walden Dissertations and Doctoral Studies

Many speech-language pathologists (SLPs) in a Midwest urban public school system have experienced barriers that prohibit the effective use of augmentative and alternative communication (AAC). The result has left some students with speech language impairments (SLI) without the communication skills for meaningful relationships and success in and out of school. The purpose of this exploratory case study was to determine the perceived barriers of 8 local school SLPs regarding the successful implementation of AAC and their suggestions for addressing the problem. Data were collected from semi-structured interviews with the SLPs. Data collection and analysis were grounded by Ely's conditions of …