Health and Medical Administration Commons^™

Improving Chronic Pain Management Processes In Primary Care Using Practice Facilitation And Quality Improvement: The Central Appalachia Inter-Professional Pain Education Collaborative, Roberto Cardarelli, Sarah Weatherford, Jennifer Schilling, Dana King, Sue Workman, Wade Rankin, Juanita Hughes, Jonathan Piercy, Amy Conley-Sallaz, Melissa Zook, Kendra Unger, Emma White, Barbara Astuto, Bobbi Stover

Journal of Patient-Centered Research and Reviews

Purpose: With the increasing burden of chronic pain and opioid use, provider shortages in Eastern Kentucky and West Virginia have experienced many challenges related to chronic pain management. This study tested a practice facilitator model in both academic and community clinics that selected and implemented best practice processes to better assist patients with chronic pain and increase the use of interdisciplinary health care services.

Methods: Using a quasi-experimental design, a practice facilitator was assigned to each state’s clinics and trained clinic teams in quality improvement methods to implement chronic pain tool(s) and workflow processes. Charts for 695 patients with chronic …

Challenges In Delivering Refugee Health Services, Thy Vo, Fabiana Kotovicz

Journal of Patient-Centered Research and Reviews

Background: Aurora Health Care is the major health care system providing care to refugees in Milwaukee, where half of Wisconsin’s refugee population resides. Like many other institutions caring for refugee patients, Aurora faces significant challenges when trying to address refugee health needs. Even with the assistance of medical interpreters, cultural differences, language barriers and limited patient health literacy, as well as lack of knowledge of refugee patients’ backgrounds, are major obstacles encountered by health care providers in this setting.

Purpose: This quality improvement study aims to assess Aurora providers’ perceptions of the benefits and barriers to working with refugee …

Evaluating Patient Preferences For Different Incentive Programs To Optimize Pharmacist-Provided Patient Care Program Enrollment, Daniel M. Tomaszewski, Tim Cernohaus, Rajiv Vaidyanathan

Pharmacy Faculty Articles and Research

BACKGROUND: Employers have increased efforts to engage employees in health and wellness programs. Providing employees with incentives to participate in these programs has been shown to improve overall enrollment and engagement. One program that has had challenges with enrollment and engagement is medication therapy management (MTM).

OBJECTIVES: To (a) determine how individuals evaluate different financial incentives to improve participation in an MTM program and (b) measure the effect of participant characteristics on incentive preference.

METHODS: This study was composed of a paper-based survey administered to participants after focus group sessions. Participants included MTMeligible beneficiaries from 2 employer groups and included …

Strategi Pemasaran Poli Bedah Estetik Bali Royal Hospital (Bros) Denpasar, Deity Indrayati Nugraha

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

This study aims to create a good marketing strategy to determine the problems faced so it is expected that in the end the number of visits to the aesthetic surgery surgery BROS Denpasar has increased. This research uses qualitative method with observation, and in-depth interview. From the product-price mix, there are several strategies, namely by providing variations of products or additional services, buying aesthetic surgical instruments with the latest technology, and can also lower the rates of aesthetic surgery services. For the price place mix, the strategy is to move the esthetic surgical poly to a more private room. The …

Analisis Kesiapan Sistem Remunerasi Berdasarkan Peraturan Gubernur Provinsi Dki Jakarta Nomor 222 Tahun 2016 Di Rsud Pesanggrahan Tahun 2017, Endah Kartika Dewi

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

RSUD Pesanggrahan as a Health Service Unit of Special Capital Region of Jakarta which has applied financial pattern of Regional Public Service Board (BLUD). This research uses quantitative with simulation of system calculation to be applied and qualitative with explore stakeholder perception readiness with indepth interview. From the result of research it is known that in general the informant is satisfied with the income received now. And from the simulate conducted, RSUD Pesanggrahan has not been able to apply the system based on Governor Regulation No. 222/2016 yet. Suggestion to the Health Department as a regulator is to give the …

Analisis Standar Kompetensi Tenaga Kesehatan Di Rumah Sakit Bhakti Yudha Depok Tahun 2017, Syifa Silviana

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

Competency of healthcare provider has significant impact on performance of the hospital. Measuring competency of healthcare provider are essential to improve better quality of service provisioned. The study evaluates competency of healthcare provider at Bhakti Yudha Hospital by using the competency standards established by multiple organizations of Indonesian national healthcare provider association mapped against eight units of health provider. The result stated that competency level of healthcare providers at Bhakti Yudha Hospital have had not met the expectations. It is concluded that working experiences and number of relevant training received has significant impact on competency level of healthcare provider.

Analisis Elemen Bauran Pemasaran Yang Mempengaruhi Loyalitas Pelanggan Rumah Sakit: Systematic Review, Elisabeth Dewi Agustine

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

Increasing the number of hospitals improves the competitive of medical services. Hospitals must have the right marketing strategy to retain old customers and attract new customers. To increase of the hospital customer loyalty, the marketing mix can be use as tool. Aim: To know the marketing mix elements that influence the loyalty of hospital customers. Preferred report items for systematic reviews and meta-analyzes (PRISMA) are evidence based methods for performing systematic reviews. There are 33.33% of the 9 studies that mention 7 elements (product, price, place, people, process, physical evidence, promotion) in the marketing mix, all of which affect the …

Analisis Penerapan Program Pencegahan Dan Pengendalian Infeksi Di Ruang Rawat Inap Rsud Tebet Tahun 2017, Tetyana Madjid

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

The focus of this research is indentifying infection prevention and control program in Tebet hospital through observation of nursing action on infusion, bandage, injecting and waste management, and indentifying nurse’s characteristics, policies, facilities, monitoring and reporting of infection. This research using qualitative and quantitative approach. Unit analysis of this research is 105 of actions mentioned above by all nurses in the inpatient room. The results of this study show that most of the actions performed by the nurses were good, analysis with univariat, bivariat and logistic regression of multivariat. The most affecting variables is the reporting of infection. Suggestions for …

Penerapan Lean Thinking Untuk Mereduksi Waktu Boarding Pasien Igd Ke Rawat Inap Di Rsud Koja Tahun 2017, Theryoto Theryoto

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

The implementation of the National Health Insurance Program (Program JKN) affects the increased number of patients to emergency unit and boarding patients that resulting crowding in the emergency unit. Koja Hospital has implemented bed management in order to reduce the boarding time of emergency unit patients but has not succeeded, so an effort to help reducing the boarding time of emergency unit patients to inpatient in order to continuous improvement was done using the lean thinking principle. This research uses operational research method and intervention with PDCA (Plan, Do, Check, Action) cycle. The study revealed that lean thinking approach could …

Analisis Kesiapan Rumah Sakit Umum Daerah Kramat Jati Menjadi Health Promoting Hospital Tahun 2017, Winarto Winarto

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

The readiness of Regional General Hospital (RSUD) of Kramat Jati to become Health Promoting Hospital (HPH) is very important based on Health Promotion Standard of Ministry of Health Republic of Indonesia Year 2011. Therefore, the purpose of this research is to know the preparedness of RSUD Kramat Jati become Health Promoting Hospital, done by qualitative approach. The results showed that from six (6) standard of hospital health promotion, one (1) standard of hospital health promotion has been fulfilled by RSUD Kramat Jati, while five (5) standard of health promotion of hospital have not been fulfilled. Preparation of technical policies for …

Managing The Cost Of Diabetes, Laressa Bethishou

Pharmacy Faculty Articles and Research

"This is of concern to health care providers because inadequate management of diabetes results in short- and long-term complications. Patients with diabetes and no health insurance have fewer physician visits and are prescribed fewer medications for management of their diabetes. Patients with diabetes make up 11.9% of all emergency department visits in the United States.Hispanic and non-Hispanic blacks are at greater risk for developing diabetes and serious associated health complications, including chronic kidney disease. This may be attributed to a combination of genetics, diet, and exercise. However, access to health care resources may also play an important role."

Gender Differences In Virologic Response After Antiretroviral Therapy In Treatment-Naïve Hiv-Infected Individuals: Results From The 550 Clinic Hiv Cohort Study., Andrea Reyes-Vega, Alejandra Loban, Kavitha Srinivasan, Stephen P. Furmanek, Conner English, Mary Bishop, Cathy Spencer, Daniel Truelove, Julio A. Ramirez, Anupama Raghuram, Paula Peyrani

Faculty and Staff Scholarship

Background

Controversy still exists regarding gender differences in virologic response between treatment-na•ve HIV-infected individuals. The objective of this study was to evaluate gender difference in virologic and immunologic response to antiretroviral therapy in treatment-na•ve HIV-infected individuals. Methods

This was a retrospective, observational study of treatment-na•ve HIV-infected individuals managed at the 550 clinic who started antiretroviral therapy (ART) between January 1st, 2010 and December 31, 2015. Patients with available viral load and CD4 counts before and one year after initiating ART were included in this study. Virologic suppression was defined as < 48 HIV-1 RNA copies/mL, and mmunologic recovery was defined as a CD4 count increase of at least 150 cells/mm3. Dichotomous variables were reported in number and percentages and analyzed using Chi-squared tests and Fisher’s exact (whichever was appropriate). Continuous variables were reported as median and interquartile range (IQR) and analyzed using Wilcox rank-sum tests. Multivariate analyses performed were logistic regressions with adjustment for other covariates. P value <0.05 was considered statistically significant. R version 3.3.2 was used for the statistical analysis. Results

A total of 70 women and 90 men were included …

Las Condiciones De Vida De Los Usuarios Adultos Mayores Del Hospital Makewe / The Living Conditions Of Elderly Users Of Makewe Hospital, Taylor Selembo

Independent Study Project (ISP) Collection

Life conditions are a fundamental aspect of the health of senior citizens, as these are the factors that determine their quality of life and capacity to satisfy their needs. Life conditions are dependent on the particular social, political, economic, and geographic context of the region. This study intends to answer the following question: How are the life conditions of senior citizens belonging to Hospital Makewe, located in the IX region of Chile? This quali-quantitative study utilized observation, surveys (n = 40) and interviews (n = 15) in order to accomplish the main objective. The main objective was to describe senior …

Nonprofit Hospital Community Benefit Requirements: An Exploration Of National Health Policy Models, Justin P. Swearingen

Dissertations and Theses

Introduction: Nonprofit hospital organizations are public charities with complete tax immunity. Such exemptions are worth $24.6 billion and impact the health of hundreds of millions of people, yet what these charities must do to meet the current “community benefit standard” to maintain their tax-exempt status remains a policy debate. To help inform policymaking, an evaluation of four national requirement models was performed: Tax Value Requirement (at least the value of the tax exemptions must be spent on community benefit), Grassley Requirement (at least 5% of revenue must be spent on community benefit), Expense Requirement (at least 3% of expenses must …

Analyzing The Effectiviness Of A Prescription Drug Monitoring Program Targeting At-Risk Opioid Abuse Patients, Treadway Childs

Public Administration ETDs

The effectiveness of a prescription drug monitoring program in coordination with a prescription opioid recidivism program was examined at a semi-rural community hospital. Patients were identified by a multi-disciplinary committee to be at-risk for opioid misuse or abuse, and were denied prescription opioids. Patients were considered eligible for the program if they had over 12 emergency department visits in the previous 12 months, or 6 visits in the previous 6 months, depending on how long the hospital had records on a patient. Patients who were placed in the prescription opioid recidivism program could not receive opioids at this hospital. The …

Refugee-Centered Medical Home:A New Approach To Care At The University Of Louisville Global Health Center, Rahel Bosson, Ruth M. Carrico, Anupama Raghuram, Paula Peyrani, William A. Mattingly, Rebecca Ford, Stephen P. Furmanek, Julio A. Ramirez

Journal of Refugee & Global Health

Refugees arrive to the United States with a full spectrum of health conditions, many of which involve intense case management requiring significant financial investments and use of healthcare resources. Kentucky receives more than 3,000 new refugees each year and ranked 10th in the nation for numbers of new arrivals resettled during 2015. These refugees arrive from diverse countries representing different cultures and speaking different languages. In addition, they arrive with diverse health conditions and medical needs. The aims of this paper are to share experiences from the University of Louisville Global Health Center regarding conceptualization, implementation and evaluation of a …

Abstracts From The 23rd Annual Health Care Systems Research Network Conference, March 21–23, 2017, San Diego, California

Journal of Patient-Centered Research and Reviews

This proceedings supplement includes selected abstracts presented at the 23rd annual conference of the Health Care Systems Research Network (HCSRN), held March 21–23, 2017, in San Diego, California. Formerly called the HMO Research Network, HCSRN aims to improve individual and population health through research that connects the resources and capabilities of its member health care systems.

Call For Submissions. Special Issue – July 2018: Patient & Family Experience In Children’S Hospitals And Pediatric Care, Patient Experience Journal

Patient Experience Journal

Patient Experience Journal (PXJ) is excited to announce a call for submission for its special issue scheduled for July 2018 on the topic of patient & family experience in children’s hospitals and pediatric care. This special issue is open to all authors conducting cutting-edge research, implementing innovative practices or with powerful experiences to share around efforts in either children’s hospitals or pediatric care. It is encouraged that articles submitted deal directly with efforts in those care settings. The issue will look for pieces that address evidence-based efforts at improvement, practices that have impact on outcomes or stories that reflect …

Experience-Based Co-Design: A Method For Patient And Family Engagement In System-Level Quality Improvement, Bianca Fucile, Erica Bridge, Charlene Duliban, Madelyn P. Law Dr.

Patient Experience Journal

Integrating patient and family member needs, wants and preferences in healthcare is of utmost importance. However, a standardized patient and family engagement model to understand these needs, wants and preferences in order to translate into high quality improvement activities is lacking. Experience based co-design (EBCD) is an approach that enables patients, family members and healthcare providers to co-design improvement initiatives together. In this study, EBCD was employed to: 1) assess the current state of information and educational resources at a local oncology center and 2) partner with patients, family members, and healthcare providers to create quality improvement initiatives targeting identified …

Integrating Person Directed Care Into The Client Experience, Tammy L. Marshall Ms., Joann P. Reinhardt, Orah Burack, Audrey S. Weiner

Patient Experience Journal

Culture Change leaders in long term care have identified creative ways to implement a model of Person Directed Care to improve the client experience by providing choice, instilling dignity, and fostering deep relationships among its community members. One organization created an environment of care called ”The Small House” and educated its’ workforce using the Green House® Project Legacy Alignment program to redesign the organizational structure, experience and environment. Interviews were conducted with elders, staff, and family members (N=20) about their experiences living, working or visiting a Small House as compared to experiences in their previous dwelling, a traditional nursing home. …

Understanding The Role Of Patient And Public Involvement In Renal Dietetic Research, Andrew Morris Mr, Deborah Biggerstaff, Nithya Krishnan, Deborah Lycett

Patient Experience Journal

The objective was to consult patients on a proposed recruitment strategy to a patient and public involvement exercise. We wanted to explore the reasoning and willingness of patients to become co-researchers within a grant application. Eighteen people using the renal health service informed the consultation by action research so that their experiences could be used to guide the overall methodology. Twelve people took part in semi-structured interviews. NVIVO 10 and Framework Analysis were used to interpret emerging themes from the data. The recruitment strategy, informed by research expertise, became an experience-based expert design. The design took into account the limitations …

Lack Of Patient Involvement In Care Decisions And Not Receiving Written Discharge Instructions Are Associated With Unplanned Readmissions Up To One Year, Kyle A. Kemp, Hude Quan, Maria J. Santana

Patient Experience Journal

This retrospective, cross-sectional study examined the relationship between aspects of inpatient communication and discharge instructions and unplanned, all-cause readmissions using individual-level data up to one-year post-discharge. Patients completed the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) telephone survey within 6 weeks of hospital discharge in Alberta, Canada. Survey data were linked to corresponding inpatient records. Independent variables included selected demographic characteristics, clinical variables, and five survey questions: a) patient involvement in care decisions, b) receiving written information at discharge, c) understanding the purpose of taking medications, d) understanding responsibility for one’s health, and e) discussing help needed when …

The Paradigm Of Patient Must Evolve: Why A False Sense Of Limited Capacity Can Subvert All Attempts At Patient Involvement, Dave Debronkart

Patient Experience Journal

This essay reviews the role of paradigms in molding the thoughts of a scientific field and looks rigorously at what two key terms mean – empowered and engaged – and how their interaction points to a new way forward, requiring a re-examination of our “paradigm of patient.” Five years ago, the Institute of Medicine’s Best Care at Lower Cost declared that patient-clinician partnerships are a cornerstone of a learning health system, a declaration that’s foundational to the era of involvement. How can we engineer that era correctly if our conception of “patient” is out of date? And how can we …

Pushing The Boundaries Of Patient Experience, Jason A. Wolf Phd

Patient Experience Journal

This special issue is designed to push the boundaries of patient experience a little farther. Beyond just examples of applying the critical principles of patient and family centered care or even practices of patient engagement, we have been pushed to move further down the perspective of partnership, to the era of “doing with” in which healthcare now finds itself. The idea of involvement as the descriptor selected to frame this issue, was due to its broad and representative nature. It reflects all the words on involving patients mentioned above, but gets further along to participation and ownership (or activation as …

Faktor-Faktor Yang Mempengaruhi Net Death Rate (Ndr) Stroke Di Rsud Dr. Kanujoso Djatiwibowo Balikpapan Tahun 2014, Rosjidah Rahmawati

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

This study is seeking the impact of structure and process as the quality aspect according to Donabedian's theory that affecting to the Net Death Rate (NDR) Stroke disease. Selected data source are Stroke patients, consisting of Intracerebral Haemorrhage and Cerebral Infarction at Dr Kanujoso Djatiwibowo Balikpapan Hospital in the year 2014. This study is a qualitative research using descriptive analytic retrospective method. Structure and Process Factors that are influencing each other. It reveals that Structure Factors in hospitalization that are affecting sequentially are the condition of the patient, facilities, policies and human resource. On the other hand it reveals that …

Intervensi Continuous Improvement Rawat Jalan Rumah Sakit Haji Jakarta, Teguh Ariotejo

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

The process of general patient care in the outpatient installation of Haji Hospital Jakarta when viewed from the outpatient mobility flow since registration until the patient came home seen the flow that makes the patient walk back and forth to the cashier or to the supporting room service (laboratory and radiology). This is of course a waste of time and the movement of patients. Therefore, continuous improvement is needed in the effort to improve the quality and efficiency of service to the patient in the outpatient installation of Jakarta Hajj Hospital.

Penerapan Lean Manajemen Pada Pelayanan Rawat Jalan Pasien Bpjs Rumah Sakit Hermina Depok Tahun 2017, Elisabeth Dyah Noviani

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

The length of waiting time in the hospital outpatient service is important for efficient hospital service. Long waiting time leads to accumulating queue and inefficient service. This study was aimed to analyze the application of lean method on outpatient BPJS services at Hermina Depok Hospital in 2017. This qualitative research method investigated the time spent by BPJS outpatient patient by applying lean method and observing the outpatient service flow condition. The results showed that 90% service time was a non-value added activities and only 10% of value-added activities. After conducting future state analysis with the proposed improvement with simulative lean …

Review Sistematik: Elemen-Elemen Utama Dalam Membangun Budaya Keselamatan Pasien Di Rumah Sakit, Adik Wibowo

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

Patient safety culture in a hospital setting is the foundation for all health care activities,with the aim to provide safe and comfortable environment throughout the healing process of the patients. This systematic review aims to describe:1) the relationship between hospital as an organization and patient safety culture,2) the traditional and the modern concepts on patient safety, 3)the seven basic elements as founda tion of hospital patient safety culture and 4) the instrument to analyse hospital patient safety culture. The paradigm has changed from traditional way of punishing hospital staff when doing medical error to the just culture, with the philosophy …

Analisis Biaya Dan Faktor-Faktor Penentu Inefisiensi Layanan Hemodialisis Pada Pasien Gagal Ginjal Kronik Rumah Sakit Rk Charitas Palembang Tahun 2016, Noer Triyanto Rusli

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

Enactment of JKN in hospital changes the payment system from retrospective payment (fee for service) into prospective payment (INA-CBG's). As a healthcare facility, RK Charitas Hospital has a role to provide not only quality but also to consider cost effective of services. This study aimed to analyze costs and identify the determinants of the inefficiency of hemodialysis services in patients with chronic renal failure at RK Charitas Hospital. This is a descriptive analysis research using primary and secondary data. Approach of cost analysis is Activity Based Costing (ABC) with "Bottom Up" method. ABC method is used to allocate costs by …

Analisia Kinerja Rumah Sakit Umum Daerah Dr. H. Abdul Moeloek Provinsi Lampung Tahun 2011- 2013 Berdasarkan Balanced Scorecard, Laisa Muliati

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

RSUDAM as public sector organizations BLUD status, health services should be held responsible, effective and efficient. It required comprehensive tools as a form of accountability to the community or the owner. Balanced scorecard by many nonprofits regarded as a comprehensive measuring tool. Namely the customer perspective, financial, internal business process perspective and the perspective of growth and learn. to analyze the performance of RSUDAM years 2011-2013 based balanced scorecard.The data analysis univariate analysis (descriptive). Data processing with methods of qualitative and quantitative studies of secondary data research activities in 2011-2013 show that: 1) The performance of the customer's perspective: Patient …