Health and Medical Administration Commons^™

Complex Adaptive Systems As A Model For Evaluating Organisational Change Caused By The Introduction Of Health Information Systems, Kieren Diment Mr, Ping Yu, K. Garrety

Dr Ping Yu

This paper documents the preliminary development of a framework for evaluating organisational change processes during the implementation of an electronic nursing documentation system in residential aged care facilities. It starts with a brief outline of organisational change processes. This is followed by a more detailed exposition of the principles underlying complex adaptive systems (CAS) theory, where we explain how mathematical concepts can be used to illuminate qualitative research approaches. Finally we present some preliminary findings on the facilitators and barriers for the introduction of the electronic documentation system, explained with reference to the CAS theory, based on analysis of interviews …

Leadership And Organisational Effectiveness – Lessons To Be Drawn From Education?, Pauline Joyce

Pauline Joyce

Aim  The aim of this paper is to present findings of a case study on organisational effectiveness in an education setting and draw similarities with a healthcare setting, focusing on the school principal and nurse leader. Background  The study was carried out in a primary school setting and focuses on a principal (as leader). The school, which will be named St Senan’s for the case study, is a typical tall structure has a staff of 30 (teachers and special needs’ assistants) and a student number of 117. Methods  A case study methodology was used. Data was collected by interviewing the …

Crossing The Threshold Into Reflective Practice., Pauline Joyce

Pauline Joyce

Encouraging reflective practice across postgraduate programmes for health professionals is challenging. Assessing reflections and determining the level of reflective practice reached can be difficult. Understanding reflection as a threshold concept may be useful to help meet the pedagogical challenges of such a valuable skill.

Virtual Community Health Promotion, Richard Crespo

Richard Crespo

The “wiki” and open-source phenomena are transforming the way knowledge is generated and shared around the world. The word wiki is from the Hawaiian term wiki-wiki, which means to do something quickly (1). The term became prominent because of the online encyclopedia Wikipedia (www.wikipedia.org), which now has more than 2 million articles contributed by tens of thousands of people. People in so many fields are using Internet communities that the term wiki has come to refer to an online group that collectively works on a project. In the business world, the wiki concept is called wikinomics (1). Even U.S. spy …

The University Of Massachusetts Medical School, A History: Integrating Primary Care And Biomedical Research, Ellen S. More

Ellen S. More

The University of Massachusetts Medical School was chartered in 1962 and opened in 1970, one of the cohort of medical schools founded in response to fears of a physician shortage. In Massachusetts, this translated into a call for more opportunities for the state’s students to attend an affordable school where, it was hoped, they would deliver primary care to the people of their home state. Yet, the original dean and faculty, most of whom were recruited from Boston medical schools, were equally devoted to basic research and tertiary care medicine. This book tells the story of the school’s successful efforts …

Medical Malpractice Reform: A Societal Crisis Or Fear Marketing?, Phil Rutsohn, Andrew Sikula Sr.

Andrew Sikula, Sr.

This paper explores the primary issues surrounding the malpractice crisis currently facing the healthcare system and asks the question ‘is it truly a crisis or is it an effective marketing campaign waged by interested parties?’ The authors discuss the primary issues presented by both the supporters of tort reform and the opposition to tort reform. As is true for many issues in healthcare, final analysis suggests that tort reform is needed or not needed depends on the analysts' role in the system. The authors argue that the evidence suggests malpractice reform will produce desired results if the goal is to …

Contrasting Views Of Physicians And Nurses About An Inpatient Computer-Based Provider Order-Entry System, Todd W. Gress, Michael Weiner, David R. Thiemann, Mollie Jenckes, Stephanie L. Reel, Steven F. Mandell, Eric B. Bass

Todd W. Gress

Objective: Many hospitals are investing in computer-based provider order-entry (POE) systems, and providers’ evaluations have proved important for the success of the systems. The authors assessed how physicians and nurses viewed the effects of one modified commercial POE system on time spent patients, resource utilization, errors with orders, and overall quality of care. Design: Survey. Measurements: Opinions of 271 POE users on medicine wards of an urban teaching hospital: 96 medical house officers, 49 attending physicians, 19 clinical fellows with heavy inpatient loads, and 107 nurses. Results: Responses were received from 85 percent of the sample. Most physicians and nurses …

Factors Associated With Ordering Laboratory Monitoring Of High-Risk Medications, Shira H. Fischer, Terry S. Field, Daniel J. Peterson, George Reed, Jerry H. Gurwitz, Jennifer Tjia

Jennifer Tjia

Background

Knowledge about factors associated with provider ordering of appropriate testing is limited.

Objective

To determine physician factors correlated with ordering of recommended laboratory monitoring tests for high-risk medications, accounting for patient characteristics.

Methods

Analysis of the administrative claims and electronic medical records of patients prescribed a high-risk medication requiring laboratory monitoring in a large multispecialty group practice between January 1, 2008 and December 31, 2008. The outcome is a physician order for each recommended laboratory test for each prescribed medication. Key predictor variables include physician characteristics, including age, gender, specialty training, years since completing training, and prescribing volume. We …

Standardized Query Formatting, Joyce K. Kutin

Joyce K Kutin RN, MSN, MOL

Evolving more than thirty years ago, the Diagnosis Related Groups (DRGs) covers a wide variety of applications that impact all health care segments throughout the United States. The DRGs are a patient classification scheme originally developed as a means of relating the type of patients a hospital treats (i.e., casemix) to the costs incurred by the hospitals.

The DRG terminology has experienced evolutionary growth through later generations: Major Comorbidities and Complications (MCC), Comorbidities and Complications (CC) and All Patient Refined Diagnosis Related Groups (APR DRG). This process directly impacts the reimbursement or payment re-distribution by Medicare and Medicaid.

Medicare continues …

Altruism Trumping Privacy Hipaa, Privacy, Big Data Set Benefits, Douglas J. Henderson

DOUGLAS J HENDERSON

The United States Government must administer a publicly held cloud networked Big Data Set of Private Health Information (PHI) in order to utilize Big Data Analytics and allow free data mining of such PHI so that the health care industry can operate most cost effectively while also meeting the health care needs of the aging United States populace with the highest quality of care.

Complex Adaptive Systems As A Model For Evaluating Organisational Change Caused By The Introduction Of Health Information Systems, Kieren Diment Mr, Ping Yu, K. Garrety

Karin Garrety

This paper documents the preliminary development of a framework for evaluating organisational change processes during the implementation of an electronic nursing documentation system in residential aged care facilities. It starts with a brief outline of organisational change processes. This is followed by a more detailed exposition of the principles underlying complex adaptive systems (CAS) theory, where we explain how mathematical concepts can be used to illuminate qualitative research approaches. Finally we present some preliminary findings on the facilitators and barriers for the introduction of the electronic documentation system, explained with reference to the CAS theory, based on analysis of interviews …