Health and Medical Administration Commons^™

Learning From Covid-19: Clinical Trials, Health Information Technology, And Patient Mortality, Christos Nicolaides, Avinash Collis, Seth Benzell, Indranil Bardhan

Economics Faculty Articles and Research

During the COVID-19 pandemic, deaths per case in the United States decreased from 7.46% in April 2020 to 1.76% in April 2021. One mechanism that could explain this decline is a learning effect associated with testing of new treatments by hospitals. Hospitals that participated in clinical trials developed better organizational capabilities to diagnose and treat COVID-19 patients. Simultaneously, hospitals used health information technologies (IT) that integrated health information across healthcare providers to facilitate greater learning and sharing of best practices. Using US county-level data on clinical trial participation, use of health IT, and COVID-19 cases and deaths, we show that …

Towards The Four-Hour Rule: Impact Of Observation Units And Emergency Medicine Specialists In An Indonesian Tertiary Hospital, Septo Sulistio, Ascobat Gani

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

Emergency Department (ED) overcrowding is a global challenge. In response, the government of Indonesia mandates an ED Length of Stay (LOS) of ≤4 hours. This study aims to evaluate the impact of implementing an Emergency Department Observation Unit (EDOU) combined with an Emergency Medicine (EM) specialist-led disposition process on ED LOS at a national referral hospital in Indonesia. This was a retrospective, pre-post analysis comparing all ED visits in 2023 (pre-intervention, n = 26,282) with all visits in 2024 (post-intervention, n = 31,483). The primary outcome was the proportion of patients with an ED LOS ≤4 hours. Secondary outcomes included …

Analisis Implementasi Rekam Medis Elektronik Terhadap Kelengkapan Dokumentasi Rekam Medis, Novita Purnamasari, Adang Bachtiar

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

Completeness of medical records is one of the important factors in improving the quality of health services. Despite its importance, incomplete documentation remains a prevalent issue, and the adoption of Electronic Medical Records (EMRs) is anticipated to address this challenge. This study is a narrative review and utilized the PRISMA 2020 flow diagram for literature selection. Articles were sourced from the ProQuest and Scopus databases for articles published in 2019-2024. From an initial selection of 431 articles, eight articles met the inclusion criteria for this study. The analysis of these studies shows that the implementation of electronic medical records positively …

Effect Of Establishing A Separate Outpatient Pharmacy Counter On Reducing Waiting Time In Mayapada Hospital, Hanifan Irham, Masyitoh Basabih

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

Pharmacy waiting time is one of the quality indicators that affects patient satisfaction in hospitals. One of the various efforts to reduce drug waiting times is adding outpatient pharmacies. This study aims to see whether the addition of pharmacies based on guarantors can reduce drug waiting times for outpatients. This is an observational study with a cross-sectional design. The sample included 11,703 patients who received prescriptions at Mayapada Hospital Bogor outpatient with insurance and private coverage. Data were collected over four months, two months before and two months after the separation of pharmacies. Waiting time data were obtained from the …

The Role Of The Triage Nurse Deployment In Reducing Triage Time In Emergency Department, Ristanti Karina, Masyitoh Basabih

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

Emergency Departments (ED) operate under high-pressure conditions where rapid and accurate triage is essential to ensure optimal patient outcomes. This study aimed to evaluate whether the assignment of dedicated triage nurses could reduce triage procedure time in the ED. The study employed an observational cross-sectional design using secondary data extracted from the Hospital Information System (HIS) at XYZ Private Hospital, Bogor. The intervention involved assigning trained triage nurses for each shift starting in June 2024, replacing the previous practice of ad hoc triage by available nurses. The results showed a significant reduction in median triage time from 4 minutes and …

Determinant Factors Of Completeness Of Medical Resume Filling By Doctors At Pesawaran Regional General Hospital, Achmad Deza Farista, Aila Karyus, Abikusno Djamaluddin

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

A medical resume serves as a vital document that compiles essential information related to a patient’s clinical management. In 2019, the completeness rate of medical resume documentation at Pesawaran Regional General Hospital was only 37.4%. This study aimed to identify factors influencing the completeness of medical resume documentation by doctors through a quantitative, cross-sectional design involving 37 inpatient care doctors. Data were collected via questionnaires and direct observation, then analyzed using univariate, bivariate (Chi-Square), and multivariate (Logistic Regression) methods. Observation showed that 56.8% of medical resumes were incomplete. Questionnaire results indicated that 54.1% of respondents had negative perceptions of Standard …

Orthostatic Hypotension In Older Adults And Its Economic Impact On The Healthcare System: A Systematic Literature Review, Olushola E. Ilogho, Jennifer Broyles, Viet Le, Denise Rizzolo

Lynchburg Journal of Medical Science

ABSTRACT

Orthostatic Hypotension (OH) has been shown to lead to poor quality of life, falls, and death. Literature suggests that falls from OH may be preventable, therefore opportunities to reduce its associated cost to the healthcare system exist. This literature review aims to evaluate the importance of diagnosing and treating OH in older adult patients. OH is the drop in blood pressure upon changing to an upright position. This acute hemodynamic drop in blood pressure causes hypoperfusion in the brain, leading to dizziness, syncope, and falls. An extensive literature search for publications in PubMed and Cumulative Index in Nursing and …

The Home Visiting Referral Quality Improvement Initiative (Thrive) Change Package, Elizabeth Yakes Jimenez, Theresa Cruz, Rebecca Craig, Ivan De La Rosa

Population Health Research and Scholarship

Early childhood home visiting programs improve maternal and child health outcomes but remain underutilized. Healthcare providers are well-positioned to connect families to home visiting services; however, structural barriers in clinical settings limit consistent and effective referral practices. The Home Visiting Referral Quality Improvement Initiative (THRIVE) change package was developed to provide a starting point for addressing these challenges. The THRIVE change package outlines actionable improvement strategies to test, such as standardizing referral workflows, training clinical teams, and establishing relationships and feedback loops with home visiting programs. It offers a scalable approach to strengthening clinical–community linkages and improving family engagement with …

Dermatological Primary Health Care Services For Older Adults In Thailand, Chinmanat Lekhavat, Jiruth Sriratanaban

Journal of Health Research

Background: The increasing population aging worldwide poses challenges to accessibility to dermatological care, especially in rural areas with limited dermatologist availability. Establishing dermatological primary health care (PHC) services for older adults is crucial for improving access, efficiency, and equity. However, no study has systematically explored such a system.

Method: This mixed-methods study employed a participatory action research (PAR) model to identify structural and procedural requirements, patient journeys, health needs, and expectations. Data were collected through focus groups, in-depth interviews, and surveys. Design thinking workshops, guided by PAR principles, were used to develop dermatological PHC services. A survey was conducted across …

Glucometer Cleanliness On A Neuro-Medical Intensive Care Unit, Abbey Camire

Operations Transformation

Glucometers on the Neuro-Medical ICU are being docked with visible reddish/brown residue, indicating they are not properly cleaned beforehand. This poses a risk of transmitting pathogens, endangering patient and staff safety, and violates hospital policy and regulatory standards. Proper disinfection of mobile medical equipment is essential for infection control and hospital accreditation.

Investigation Of The Optimal Length Of Discharge Summaries In Care Transitions: A Cross-Sectional Study, Taku Harada, Shintaro Kosaka, Aki Morishima, Seitaro Iguchi

Journal of Community Hospital Internal Medicine Perspectives

Introduction

Discharge summaries are essential documents that support continuity of care during patient transitions between inpatient and outpatient settings. They help ensure that crucial clinical information is conveyed accurately and completely. However, while their clinical significance is well established, there is little consensus on the optimal format, particularly in terms of length and structural clarity. Excessively brief summaries may omit key details, while overly lengthy ones can hinder efficient information transfer. Despite varied suggestions in the literature—ranging from half a page to four pages—empirical data on physician preferences are limited.

Methods

We conducted a cross-sectional, web-based survey among physicians who …

Enhancing Patient Outcomes: Developing A Comprehensive Database For Tracking Post- Dural Puncture Headache Incidence And Contributing Factors, Meredith B. Auge, Brittany Bogonovich

Doctor of Nurse Anesthesia Practice (DNAP) Manuscripts

Post-dural puncture headache (PDPH) is a debilitating complication following labor analgesia, often resulting from unintentional dural puncture (UDP). While national incidence is approximately 1.5%, institutional rates may vary due to provider experience, documentation practices, and patient factors. This Doctor of Nurse Anesthesia Practice (DNAP) quality improvement project aimed to improve identification and monitoring of UDP and PDPH through a revised tracking tool, retrospective review of 2024 data, and planning for an electronic registry. A multidisciplinary team of anesthesiologists, Certified Registered Nurse Anesthetists (CRNAs), Student Registered Nurse Anesthetists (SRNAs), and IT and quality specialists revised an existing tracking tool to better …

Vitamin B12 Deficiency: Confidence, Perspectives, And Practices Among Registered Dietitian Nutritionists, Avery Miller Adams

Master's Theses

Vitamin B12 deficiency is common in the United States, occurring in 20% of adults aged 60 and above (Andres et al., 2004). Veterans are susceptible to B12 deficiency due to tobacco product usage, alcohol consumption, and poor diet quality. Megaloblastic anemia is the second most prevalent vitamin deficiency disorder recorded in military personnel from 1997 to 2015 (Knapik et al., 2021). This exploratory, analytic research aims to assess registered dietitian RDN nutritionists’ (RDN) knowledge, perceptions, and intentions regarding treating vitamin B12 deficiency in a clinical setting. Due to population prevalence differences, responses from VA and non-VA practicing registered dietitian-nutritionists (RDNs) …

Enhancing Cataract Surgery Outcomes: Optimal Use Of Pre- And Post-Operative Eye Drops, Keith Skolnick M.D., Anu Valiaveedu

Mako: NSU Undergraduate Student Journal

Many preoperative and postoperative cataract patients struggle with comprehending the use of prescription medication as directed. Language barriers and low health literacy levels are major factors contributing to improper use of prescriptions. To increase patients comprehension, the Fort Lauderdale Eye Institute employed an educational intervention consisting of a live presentation and an instructional video. Results found that 44% of patients were hesitant to ask questions to clinical staff, 32% felt overwhelmed, and nearly 70% lacked confidence in using their prescribed eye drops. Following the intervention, 91% of patients reported increased confidence in their medications, and most indicated that the video …

The Impact Of Physician Precepting On Medical Education And Healthcare Delivery: A Qualitative Secondary Analysis, Hannah E. Gutjahr, Steven A. Fasko

SIU Journal of Medical Science Scholarly Works

This qualitative study investigates the impact of physician precepting on medical education and healthcare delivery, prompted by the need for consistency in precepting practices across various institutions and specialties. Physician preceptors, who bridge the gap between theoretical learning and practical application, play a critical role in shaping competent and compassionate healthcare professionals. However, inconsistencies in precepting quality and challenges such as time constraints, inadequate training, and balancing clinical duties with teaching responsibilities necessitate a comprehensive evaluation of precepting's effectiveness.

A systematic literature review was conducted to explore these issues, focusing on secondary data from peer-reviewed journals, case studies, and policy …

The Silent Epidemic: Equipment Maintenance Failures And Patient Outcomes In Ghana's Healthcare System, Ramseyer Adekorang Asamoah, Celene Dzreke, Evans Dzreke, David Kanzin

Health & Biomedical Sciences Faculty Publications

Broken tools indicate a broken system. This new study reveals how medical equipment failures destroy Ghana's public hospitals, turning life-saving technologies into silent murderers that disproportionately affect rural areas. Moving beyond technical diagnostics, we study the cascading systemic failures, chronic underfunding, critical staff shortages, and fragmented supply chains that leave 40% of vital equipment, such as ventilators, MRI scanners, and dialysis machines, inoperable at any given time. We quantify the devastating human toll through rigorous mixed-methods analysis of equipment downtime records across ten regional hospitals (2018-2023) and profound narratives from 50 frontline stakeholders, doctors forced to improvise without working incubators, …

A Qualitative Analysis Of The Lived Experience Of Active-Duty Servicewomen Receiving Perinatal Care Within The Military Health System., Caitlin Russell, Emily Balog, Anne Teitelman, Rosemary Polomano

Rowan-Virtua School of Osteopathic Medicine Departmental Research

OBJECTIVES: We explored the lived experiences of active-duty servicewomen (ADSW) accessing and receiving care during the perinatal period (from discovery of pregnancy to 1 year postpartum) within the Military Health System.

STUDY DESIGN: Using qualitative methods, we conducted semi-structured interviews between September 2022 and February 2023 with 23 ADSW participants who were pregnant or within their first year postpartum. Data were analyzed using inductive coding and thematic analysis techniques.

RESULTS: Participants reported bureaucratic hurdles and long wait times for accessing care, too little choice in providers, and inadequate coordination between civilian and military care providers. Those who experienced perinatal complications …

Partnership, Collaboration, And Co-Production To Improve Patient Experience Beyond Conducting Surveys – Lessons From The Quebec Model, Canada, Marie-Pascale Pomey, Catherine Wilhelmy, Myriam Fournier-Tombs, Vincent Dumez, Cécile Vialaron, Monica Nelea Iliescu, Karina Prevost, Simon Courtemanche, Louise Normandin, Geneviève David

Patient Experience Journal

Objective: The objectives of this article are to present how, in the province of Quebec (Canada), healthcare and service partnerships have been implemented, to take stock of the current situation and to suggest ways to continue strengthening the model over the coming years, in Quebec and elsewhere in the world. Methods: Three methods were mobilized: (1) a review of the literature and reports published in recent years on implementations of partnerships in Quebec; (2) a survey sent to the persons responsible for partnerships in Quebec’s health and social services establishments; and (3) a working committee comprised of patient experts, partnership …

Peer Mentoring, Camaraderie, And Support (Pmcs) Of Southern New Jersey: Suicide Prevention Using Human Experience And Social Determinants Of Health, Ali A. Poorani, Matthew Jacobs, Patrick Carney, Jaclyn Tomasetti

Patient Experience Journal

Suicide prevention is a high priority for Veterans Health Administration (VHA). Recent data show an increase in suicide rates, especially among Veterans that had not used VHA health services and nor had received any VHA benefits. Meanwhile, data collected for the past two decades reveals a decline in suicide rates among Veterans who were recent VHA users with mental health or substance use disorders. The objective of the Peer Mentoring, Camaraderie, and Support (PMCS) Program was to explore novel ways to reengage and reintegrate Veterans into their earned VA healthcare benefits, and examine the effectiveness of this new initiative by …

“All Together”: A Case Study Demystifying Patient And Public Involvement (Ppi) In Brief Psychological Interventions Within A Community Mental Health Service For Adults In The Uk, Molly H. Nadel, Katherine Parkin, Stephanie Casey, Rachel Maciag, Alice Xie, Mu-Yin Chang, Youngsuk Kim

Patient Experience Journal

The importance and value of involving patients and the public in the decision-making processes within services designed to support them, and research projects aimed at understanding and improving those services, have long been established. This is often referred to as Patient and Public Involvement (PPI). However, establishing good quality involvement work in practical terms is often less well understood and therefore, the uncertainty surrounding this can lead to hesitation by clinicians in practice. In this paper, we will share our lessons learned and the practical outcomes of PPI when applied in an NHS community mental health service for adults. We …

The Implementation Of A Telehealth Patient Advisory Council In A Network Of Federally Qualified Health Centers, Jessica Korins, Lisa Schaffer, Nandini Shroff

Patient Experience Journal

Patient input is recognized across the healthcare field as essential for tailoring innovations and quality improvement initiatives to meet the needs of intended patient populations. This paper describes the implementation of a patient advisory council (PAC) established to provide feedback on telehealth innovations and quality improvement initiatives at a network of federally qualified health centers (FQHCs) in New York State (NYS). We report on the implementation process, success and challenges, and reflections shared by PAC members regarding their experiences.

Understanding Online Reviews Of Geriatricians: Correlations Within A Dataset Of 53,210 Physician Reviews, Yizhong Wu, Eric Reuben Smith, Nick Shaffer, Hanh Dieu Trinh, Becky Powers

Patient Experience Journal

Introduction: Online reviews are increasingly influential in how patients find and choose physicians. Patients appreciate the transparency of online reviews, and they offer an avenue for physicians to receive feedback. This cross-sectional study aims to provide insight into correlations between provider level information such as wait times or physician demographics, and the reviews patients submit online for geriatricians.

Methods: ParseHub software was used to extract and pool data from 6,631 provider profiles categorized under “geriatric medicine” on the popular open-source physician review website Healthgrades.com. Physician race or ethnicity was modeled by profile last name based on 2010 US census data. …

Family-Centered Care In Pediatric And Neonatal Intensive Care Units: A Systematic Review Of Effects On Parental Satisfaction And Length Of Stay, Vincenzo Andretta, Valentina Cerrone, Veronica Strini, Angela Prendin

Patient Experience Journal

Background: Family-centered care (FCC) is essential in pediatric and neonatal intensive care units (PICUs), potentially increasing parent satisfaction and reducing length of hospital stay, but evidence of its effectiveness is inconsistent. Objective: To assess the effects of FCC interventions on parent satisfaction and length of hospital stay in PICUs. Methods: A systematic review was conducted, with 17 studies meeting the established inclusion criteria. The McMaster tool was used to assess the methodological quality of studies, along with an assessment of risk of bias. Results: The review identified a wide range of FCC interventions, including promoting parental …

I Felt More Confident That It Would Work For Me: A Grounded Theory Of Person-Centered Interprofessional Collaboration Based On Patients’ Lived Experiences, Katherine Hope Morgan, Cristina S. Barroso, Kathleen Conroy Brown, Michael R. Bleich, Soghra Jarvandi, Elizabeth B. Strand, Shaun Rowe

Patient Experience Journal

Interprofessional collaboration (IPC) is considered the highest standard of practice for delivering care to patients with multiple, complex, and chronic conditions. Despite reported benefits of IPC, the voice of the care receiver and how or whether they experience IPC is underexplored. Our objective was to examine patients’ experiences with IPC in two rural primary care settings in the U.S., where the burden of multiple chronic conditions (MCCs) is coupled with lower life expectancies and reduced access to care. We used a semi-structured interview to assess patients’ experiences within 72 hours after an IPC healthcare visit. This study, conducted in two …

Role Of Patient-Reported Measures (Prms) In Addressing Ethical Challenges During Telemedicine Consultation: A Narrative Review, Asiya Attar, Kasturi Shukla

Patient Experience Journal

Introduction: Telemedicine has revolutionized medical care delivery by emphasizing on Patient-Centred Care (PCC). Patient Reported Measures (PRMs) can assist in providing PCC since it assesses the treatment outcomes and patient experience. However, using PRMs is not just limited to gauging clinical efficiency; it can also play a role in addressing the ethical challenges in telemedicine. Yet this aspect of PRMs remains underexplored. Method: Literature search was conducted using a combination of keywords from the Google Scholar, Scopus, and Web of Science databases. 126 peer-reviewed journal articles in English from 2015 to 2024 were screened, and 34 relevant full-text …

Understanding Patient Experiences: A Qualitative Study On Communication And Cultural Competence In Multiple Sclerosis Care, Vaishnavi Sridharan, Charee Thompson, Rola Mahmoud, Minnatallah N. E. Eltinay, Chungyi Chiu

Patient Experience Journal

Objective: Effective communication is crucial in multiple sclerosis (MS) care, influencing patient satisfaction, self-management, and health outcomes. This study explores the experiences of people with MS (PwMS) regarding communication with healthcare providers and between providers within healthcare systems. Methods: This qualitative study analyzed open-ended responses from 590 participants in a national cross-sectional survey. Thematic content analysis was conducted to explore MS patients’ experiences with healthcare communication and care delivery. Results: Three major themes emerged: (1) Patient-provider communication, where 62.9% of participants reported positive experiences, citing responsiveness and empathy, while 37.1% noted issues such as inattentiveness and rushed consultations. (2) …

“Why Should Anyone Want To Make Things Better For Me Particularly?” – A Qualitative Exploration Of Care Opinion And Nhs Care Improvements, Emma Berry, Zoe Skea, Marion K. Campbell, Louise Locock

Patient Experience Journal

Care Opinion is an online platform which enables people to share anonymous feedback (known as “stories”) about their experiences of UK healthcare. In Scotland, this platform has official government backing, though healthcare organisations are not obliged to use it. Care Opinion staff review and edit these stories, acting as moderators. Healthcare staff are invited to respond to stories and are encouraged to use it for healthcare improvement. However, the number of changes made and registered on the platform is relatively small. This paper brings together findings from interviews with story authors (those sharing experiences), NHS staff and Care Opinion moderators …

Psychosocial Dimensions Of Living With Hep B: Notes From The Field: The Lived Experience Of A Mother Raising A Daughter With Hepatitis B, Julie Gerhardt

Patient Experience Journal

What follows is based on the interweaving of three points of view each of which contributes to an understanding of the experience of living with Hepatitis B: (i) as the mother of a daughter who was diagnosed with HBV at 5 months and who still, at age 22, carries traces of the surface antigen in her blood; (ii) as a participant in the Hepatitis B Foundation’s (HBF) “Storytellers” program in which those impacted by the disease meet with others to share experiences and narrate a short video posted on the HBF website; and (iii) as a PhD research psychologist-turned-psychoanalyst interested …

My Husband Didn’T Have To Die: A Doctor Reflects On All That Went Wrong With Her Husband’S Care In One Of The Nation’S Top Medical Centers, Joanna A. Cooper

Patient Experience Journal

The outcomes of complex care are never predictable. Despite this, reflecting on my husband’s care and his untimely death, I am certain that his fate would have been different with better communication, attention to detail, collaboration, and measures of curiosity, humility, and compassion.

Holding Space: An Effective Intervention For When Hope Wanes, Annette Lane, Marlette Reed, Rose Schroeder

Patient Experience Journal

Holding space is a person-centered, non-judgmental approach to working with clients. This approach goes beyond listening to client concerns; it entails deep listening and being present, developing trust with clients, and helping them connect goals with values. Within this brief account, the concept of holding space is described. What it is and is not is explained. Examples of holding space are woven throughout in order illustrate this concept. Finally, implications for professionals are provided.