Health and Medical Administration Commons^™

Randomized Clinical Trial Comparing Perioperative Care For Breast Cancer Patients At A Patient Hotel Versus A General Surgical Ward, Madleen Anna Camilla Huzell, Johan Frisack, Kristina Dalberg

Patient Experience Journal

Breast cancer is the most frequent cancer among women in Europe and the US. The aim of this study was to assess whether perioperative care, for breast cancer patients, provided at a patient hotel could be an alternative to the conventional care in an ordinary surgical ward. The study focuses solely on the patients’ experience of the provided care with a primary outcome that perioperative care at the patient hotel would be valued better than care in a general ward. Prospective, randomized single centre study. Between 2010 and 2012 a total of 151 patients < 80 years and without severe comorbidities were included in the trial, whereof 76 patients were randomised to the ward group and 75 patients to the hotel group. Five patients were excluded from each group. The validated IN2005-E questionnaire was used to evaluate the patients’ experiences of the care. The response rate was high with 65 patients answering the IN2005-E in each group. No difference could be found between the two groups regarding patient characteristics, type of surgery or tumour characteristics. The patients generally perceived the quality of the provided care as high. However, in the hotel group there was a better experience of care regarding issues such as coordination, privacy, some aspects of medical information, availability and the courtesy of the nurses. For selected patients, perioperative care at a patient hotel is an appreciated alternative to care at a surgical ward.

Patient Needs In Advanced Renal Cell Carcinoma: What Are Patients’ Priorities And How Well Are We Meeting Them?, Rick Harris, Kate Oake, Robert E. Hawkins, Robert J. Jones, Thomas Powles, David A. Montgomery

Patient Experience Journal

Treatment options and duration of therapy for patients with metastatic renal cell carcinoma (mRCC) have increased. Many patients now spend in excess of 2 years on active therapy. These patients’ needs, and the ability of health services to respond to them, are poorly understood. Ten patients living with mRCC for more than 2 years and treated with at least one targeted agent were selected at random from three hospitals in the United Kingdom (UK). One interviewer who was not involved in their care conducted in-depth interviews. Interview transcripts were analysed using Interpretative Phenomenological Analysis (IPA) to identify issues of greatest …

The Comparative Impact Of Different Patient-Centered Medical Home Domains On Satisfaction Among Individuals Living With Type Ii Diabetes, Jon Mills, Allyson Hall, Rebecca Tanner, Jeffrey Harman, David L. Wood, Charles Lorbeer

Patient Experience Journal

Chronic illnesses like type 2 diabetes are costly and difficult to treat. Patient-centered medical homes (PCMH) have the potential to improve patient satisfaction in this population. However, which domains have the most impact on patient satisfaction has not been established. The aim of this study was to assess the relative strength of association between seven PCMH domains and two measures of satisfaction. Cross-sectional data were used in this observational study collected from a random sample of adults aged 18-89 with type 2 diabetes (n=1301) seen at 4 PCMHs. The Ambulatory Care Experiences Survey instrument was used to assess all measures. …

A Vision For Using Online Portals For Surveillance Of Patient-Centered Communication In Cancer Care, Hardeep Singh, Neeraj K. Arora, Kathleen M. Mazor, Richard L. Street Jr

Patient Experience Journal

The Veterans Health Administration (VHA) is charged with providing high-quality health care, not only in terms of technical competence but also with regard to patient-centered care experiences. Patient-centered coordination of care and communication are especially important in cancer care, as deficiencies in these areas have been implicated in many cases of delayed cancer diagnosis and treatment. Additionally, because cancer care facilities are concentrated within the VHA system, geographical and system-level barriers may present prominent obstacles to quality care. Systematic assessment of patient-centered communication (PCC) may help identify both individual veterans who are at risk of suboptimal care and opportunities for …

Impact Of Hospital Characteristics On Patients’ Experience Of Hospital Care: Evidence From 14 States, 2009-2011, Emily M. Johnston, Kenton J. Johnston, Jaeyong Bae, Jason M. Hockenberry, Ariel C. Avgar, Arnold Milstein Md, Mph, Sandra S. Liu, Ira Wilson, Edmund Becker

Patient Experience Journal

This paper uses patient responses to the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey for three years (2009-2011) from 1,333 acute-care hospitals in fourteen states to analyze patterns in 10 hospital-reported patient experience-of-care scores by 29 characteristics classified as: patient characteristics, payer source, patient severity, hospital characteristics, hospital operations, and market characteristics. We also evaluate how scores have changed over the three-year period. We find significant differences in patient experience-of-care scores by hospital characteristics for 250 out of 290 HCAHPS-hospital characteristic combinations measured. We find fewer significant differences in changes in scores from 2009-2011 (135 out of …

Using A Process Improvement Tool To Improve Staff Skills & Enhance The Urgent Needs Patient Experience In A Women’S Health Center, Kenneth J. Feldman, Molly Lopez, Morris Gagliardi

Patient Experience Journal

NYC Health + Hospitals / Gouverneur serves more patients than any other diagnostic and treatment center in New York State. As part of the NYC Health + Hospitals public health care system, which serves 1.4 million patients and is the largest municipal health care delivery system in the United States, Gouverneur strives to serve the needs of both scheduled and unscheduled patients. Within Gouverneur, the Women’s Health department treats approximately 1,600 patients per month through approximately 2,100 visits. In September 2014, Gouverneur’s Women’s Health department launched a weeklong process improvement initiative known as a Rapid Improvement Event (RIE). Structured through …

Improving Process And Enhancing Parent And Therapist Satisfaction Through A Coordinated Intake Approach, Sharla Piecowye, Devona Gibson, Janis Carscadden, Kayla Ueland, Gregory Wells, Scott Oddie

Patient Experience Journal

Recent research indicates that, in Canada, approximately one in five children entering school are not meeting age appropriate milestones in physical, social, language, or cognitive development. Even where support services are available families often face barriers in accessing these. With the goals of improving access to programs, reducing barriers and increasing consistency and efficiency, a new Coordinated Intake Approach (CIA) was developed for families accessing Children’s Rehabilitation Services. It was expected that the CIA would result in 1) parents finding the intake process more satisfactory and easier to complete, 2) therapists feeling more supported and satisfied and 3) a decrease …

The Patient Patient: The Importance Of Knowing Your Navigator, Sarah M. Wheeler Phd, Julie E. Gilbert Phd, Melissa Kaan Mba, Eric Klonikowski, Claire Mb Holloway Md Phd Frcsc

Patient Experience Journal

In Ontario, Diagnostic Assessment Programs (DAPs) have been implemented to improve the quality of care patients receive during the diagnostic phase of the cancer journey. Patient navigators play a critical role in this model by coordinating care and providing information and support to patients and their families. The objectives of this study were 1) to determine whether patient navigation in DAPs is associated with a better patient experience and 2) to examine whether patient navigation in DAPs modifies the effect of wait times and patient volumes on patient experience. Data reflecting patients’ experience within the DAP were collected via survey …

Instruments To Measure The Inpatient Hospital Experience: A Literature Review, Kelly J. Edwards, Kim Walker, Jed Duff

Patient Experience Journal

Healthcare professionals worldwide are increasingly broadening their focus to include the experiences of patients and their family members as a means of assessing quality patient centered care. This paper seeks to identify and discuss instruments specifically designed to measure the inpatient hospital experience. A literature search focusing on pre-identified instruments as per the Health Foundation’s Helping Measuring Patient Centered Care database of measurement instruments (de Silva, 2014) and additional health databases (CINAHL, ERIC, EBSCO, HaPI, MEDLINE, PubMed and Psych INFO) was undertaken. Thirteen relevant instruments and seventeen associated studies (regarding instrument development and or validation) were identified. These instruments provide …

Managing Patient Expectations At Emergency Department Triage, Shital Shah, Anay Patel, Dino P. Rumoro, Samuel Hohmann, Francis Fullam

Patient Experience Journal

Emergency departments (ED) overcrowding, long wait, and uncomfortable waiting room conditions may lower perceived quality of the patient experience and satisfaction. This study investigates the relationship between patient satisfaction and communication of expected wait times, at the point of triage. A pre-post (11/4/ 2008 – 2/5/2009) group design with convenience sample (n=1,209) of all discharge adult ED patients was utilized for this study. A static expected wait time model (i.e., average wait time + one standard deviation) based on time of the day, day of the week and triage levels was employed to communicating expected wait time at triage while …

Bringing Patient Advisors To The Bedside: A Promising Avenue For Improving Partnership Between Patients And Their Care Team, Karine Vigneault, Johanne Higgins, Marie-Pascale Pomey, Josée Arsenault, Valérie Lahaie, Audrey-Maude Mercier, Olivier Fortin, Alain M. Danino

Patient Experience Journal

This paper presents an innovative model of care, which brings patients who have already been through a similar experience of illness (patient advisors) directly to the bedside of patients, where they are viewed as full-fledged members of the clinical team. As part of a pilot project, three patient advisors were recruited and met with patients who had sustained a traumatic amputation and were admitted to the only center of expertise in replantation of the upper limb in Canada. Several individual interviews and focus groups with patients and patient advisors have revealed very promising results. Indeed, patients have expressed …

Patient Leadership: Taking Patient Experience To The Next Level?, David Mcnally, Steve Sharples, Georgina Craig, Dr Anita Goraya, Frcgp

Patient Experience Journal

NHS England commissioned the project described in this article to explore how patients and carers can, acting as leaders, make a real difference in improving experience of care. The work was carried out on a collaborative basis, co-designing the scope of the research with patient leaders and commissioners. We gathered case examples across England that had involved patient leaders in using patient and carer feedback to improve experience of care. A Patient Leaders Expert Advisory Group selected four case examples that were visited to undertake a more detailed study and subsequently discussed and agreed the key learning points and conclusions. …

The Critical Role Of Family In Patient Experience, Brian Boyle

Patient Experience Journal

In this commentary Brian Boyle raises a simple, yet critical point about the value of family in the care experience. He offers, "When you are focusing on the goals for the patient's recovery, the doctors work with the nurses, specialists, and patient's family to decide on the appropriate care plan for the patient on both a short- and long-term basis. It is vital that this multi-disciplinary approach occurs during the formation of the care plan and is frequently updated as time goes on. The loved ones of a patient may not have a medical license or healthcare background, but their …

The State Of Patient Experience, Jason A. Wolf Phd

Patient Experience Journal

As the patient experience movement continues to flourish, there is greater alignment that experience encompasses all we do in healthcare – not simply a customer encounter, but how we engage people in mind, body and spirit, how we integrate the critical aspects of care from quality to safety to service and how we link the very complexities of our healthcare systems globally to provide for easy journeys for those receiving care. In sharing data from the latest study for The Beryl Institute on patient experience, the trends of this growing movement are seen as positive and a set of clear …

Irish Gms Cost Projections And Its Implications Between 2016 And 2026, Aisling Conway Lenihan, Noel Woods

Dept. of Management & Enterprise Publications

Introduction: Ireland had one of the highest pharmaceutical spends per capita in the EU in 2012. The General Medical Services (GMS) scheme is the largest community drug scheme in Ireland with approximately 40% of the population eligible for free drugs and appliances in 2012. The total cost of GMS prescriptions increased by 414% between 1998 and 2012. This paper projects Irish GMS cost from 2016 to 2026 and examines the implications of the estimated impact on GMS expenditure.

Method: Central Statistics Office (CSO) population projections (2013) and HSE-PCRS GMS population prescription data (2012) were used to develop four variables; population, …

Estimating Health & Economic Gains From Public Health Delivery System Transformation, Glen P. Mays

Health Management and Policy Presentations

Objectives: The Affordable Care Act created new resources and incentives for hospitals, insurers, public health agencies, and others to contribute to disease prevention and health promotion activities, potentially changing the structure of public health delivery systems and expanding the 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, which we use as indicators of public health system change; and (2) the effects of these changes on preventable mortality and resource use. Methods: …

Kentucky’S Public Health Strategic Plan: Strengthening Foundational Services & Improving Population Health, Glen P. Mays

Health Management and Policy Presentations

This session examines recent progress toward the 2012 Institute of Medicine recommendation to identify the components and costs of a "minimum package" of public health services and foundational capabilities to be available across the U.S. Research about the health and economic benefits of Foundational Public Health Services has begun to shape Kentucky's strategic plan for transforming the public health system.

Broadening Students’ Perceptions Of Conflict: The Challenge Of Metaphorical Change, Justin D. Walton

Administrative Issues Journal

This qualitative investigation examined the semester long effects of a critical transformative pedagogy on students’ metaphorical understandings of conflict interaction. The study included five university conflict management seminars taught over a four year period. Findings revealed that (a) while most students entered the course with predominantly negative and oppositional perceptions of conflict, the use of a critical transformative pedagogy did indeed (b) help support new metaphorical understandings of conflict interaction and (c) supported instances of personal empowerment and expanded self-knowledge. Implications and suggestions for future research are considered.

Graduate Students’ Evaluation Of The Character And Caring Of Their Instructors, Dan Shepherd

Administrative Issues Journal

Recent research concludes that student-teacher relationships are foundational for greater instructional effectiveness and its concomitant increase in overall student achievement or learning. Similarly, research seems to demonstrate conclusively that trust is a vital component in the development of strong relationships. Recently, 488 current participants and recent graduates of an online and blended Master of Education program were surveyed about their perceptions of their instructors’ character and concern for them as individuals. Survey respondents were public school teachers. Based on the survey’s results, the personal qualities and characteristics that graduate students most seem to prefer in their instructors when determining their …

Rethinking Professional Development Training Through Mentoring Relationships, Tania Marie-Cecile Benoiton

Administrative Issues Journal

This proposal looks at teacher mentorship and how it is manifested in different school environments. Grid and Group Theory provides the basis of discerning the cultural forces at play within the respective school environments. The theoretical framework will highlight the data collection process. Rather than being a secondary asset, mentorship should become a primary resource for the professional development of teachers, novice and veteran alike. Each school faces challenges that are unique to their environment which calls for the use of inhouse resources to engage the educator on multiple levels. The proposal reports preliminary findings and concludes on with a …

An Exploration Of The Validity Of Inferences Made From The Interpersonal And Social Empathy Index (Isei), Kateeka Harris, Celia M. Wilson

Administrative Issues Journal

Social empathy is the ability to understand other people by perceiving or experiencing their life situations, thus providing an opportunity to gain insight into social inequalities. Institutions of higher education have unique opportunities to engage students in socially just educational conversations that challenge negative social biases of others who are not like them. The current study investigated the validity of the inferences made from the Interpersonal and Social Empathy Index (ISEI), a common tool used to explore levels of empathy among college students. A comparison was then made between the original constructs described by the instrument developers (Segal et. al., …

The Challenge Of Organizational Change: Before, During, And After, Richard Parsells

Administrative Issues Journal

Aligning with the theme of this conference, this paper addresses actions, as reported in the literature, that are purported to assist organizations in successfully accomplishing change initiatives. This paper presents factors related to the development of a robust culture for the handling of change, actions to be taken during a change, and suggestions for action after a change. Implications for practice are explored.

Using Emergence Theory-Based Curriculum To Teach Compromise Skills To Students With Autistic Spectrum Disorders, Lance Fein, Don Jones

Administrative Issues Journal

This study addressed the compromise skills taught to students with autistic spectrum disorders (ASD) and related social and communication deficits. A private school in the southeastern United States implemented an emergence theory-based curriculum to address these skills, but no formal analysis was conducted to determine its effectiveness. Guided by cognitive development and constructivist theories, a concurrent, mixed-methods case study design was used to investigate the impact of this curriculum on teaching compromise skills to middle school students with ASD and related deficits. Teacher observations and compromise interventions were open coded and analyzed thematically using descriptive statistics. For the quantitative sequence, …

Performance Theory And Nonprofit Organizational Effectiveness, Jeffrey Aulgur

Administrative Issues Journal

This abridged article reports on a review of the literature of performance theory and its relationship to the effectiveness of nonprofit organizations. Specifically, the article explores the challenges in defining organizational effectiveness in the Third Sector due to the wide disparity in the size, scope and mission of nonprofit organizations. The following theoretical models, and their application to the Third Sector, are explored: Agency Theory, Resource Dependency Theory, Group/Decision Process Theory, Stakeholder Theory, Institutional Theory, Policy Governance Theory and Contingency Theory. The review indicates there is not a single theory or hypothesis capable of meeting the challenges of nonprofit governance. …

An Analysis Of Fertilizer Markets In Bric Countries, Robert Lloyd

Administrative Issues Journal

Over the previous decade the collection of countries known as the BRIC nations has worked together to advance social and economic agendas. These four nations represent unique challenges and immense opportunities for MNC’s searching to expand their business into these countries. This paper reviews these opportunities and challenges in the context of the fertilizer industry and provides an overall outlook for this international market. Recommendations are provided for how an international business might succeed in each of the BRIC nations.

An Investigation Of Factors Contributing To All But Dissertation Status: Doctor Of Education Students, Jacqueline M. Gaffner, Celia M. Wilson

Administrative Issues Journal

Literature regarding advanced degree completion illustrates multiple factors attributing to completion or abandonment of dissertation research. Contributing factors are typically linked to the environment associated with the institution in which a doctoral candidate is enrolled, or personality characteristics held by individual candidates. The purpose of this qualitative case study was to gather data from current doctoral candidates regarding factors that inhibited their completion of the doctor of education degree. Initial responses from participants appeared to confirm findings from similar research studies exploring dissertation non-completers. Most participants noted personal factors for non-completion, while a few mentioned institutional factors. In order to …

Leadership Opportunities In Education For Individuals With Disabilities, Sean Daniel Kinder

Administrative Issues Journal

This study examines the perceptions of individuals with disabilities concerning employment opportunities as administrative leaders in public school contexts. A discussion of the Americans with Disabilities Act of 1990, as well as the definition of what is considered a legal disability, as provided in Section 504 of the Rehabilitation Act of 1973. Additionally, this piece explains Critical Disability Theory as a theoretical lens that provides perspective and highlights the methods used in the data collection process. It reports preliminary findings and concludes with a discussion of why this educational issue is of significance.

Experiential Learning Approaches To Principles Of Management, Robert Lloyd

Administrative Issues Journal

This paper describes a lesson plan that can be used in an undergraduate course in principles of management. The lesson plan helps students learn the basic concepts of management and the functions performed by managers – planning, organizing, leading, and controlling. Through traditional lecture and classroom discussion, the students will better understand these concepts. This lesson plan also helps students recognize these functions through observation. Finally, to ensure that student’s have fully internalized each function of management, they will have the opportunity to apply the concepts through a group project. Upon completion of this lesson plan, the students should be …

Analytic Approaches For Causal Inference With Complex Multi-Component Interventions, Glen P. Mays, Arnold J. Stromberg, Jing Li, Mark V. Williams

Health Management and Policy Presentations

Estimating the causal effects of complex, multi-component health interventions is a task with many challenges in measurement and methodology. This presentation profiles the methods being used as part of the PCORI-funded Project Achieve, a national study to estimate the comparative effectiveness of heterogeneous care transition programs designed to help hospitalized patients and their caregivers navigate care delivery systems effectively and return back to the community with optimal health and wellbeing.

Administrative Issues Journal Conference Proceedings: Welcome And Table Of Contents

Administrative Issues Journal

No abstract provided.