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 …

A Human Centered Geovisualization Framework To Facilitate Visual Exploration Of Telehealth Data: A Case Study, Ashish Joshi, Chiehwen Ed Hsu

Chiehwen Ed Hsu

Background: Public health data is typically organized by geospatial units. Routine geographic monitoring of health data enables an understanding of the spatial patterns of events in terms of causes and controls. GeoVisualization (GeoVis) allows users to see information hidden both visually and explicitly on a map. Despite the applicability of GeoVis in public health, it is still underused for visualizing public health data. Objective: The objective of this study is to conduct user analysis by examining the various kinds of users that are involved with the telehealth program, their expertise and skills and their perception towards the utilization of GeoVis …

Developing A Nursing Management Degree Programme To Meet The Needs Of Irish Nurse Managers, Pauline Joyce

Pauline Joyce

Background The study is placed within the context of the Irish health care system, which has undergone tremendous change, at the dawn of the new millennium, in particular from the nursing management and leadership viewpoint. Aim of the study The aim of this study is to explore nurses' expectations of the content and delivery of nursing management degree programme. Methods This is an on-going action research study. Data has been collected using a focus group interview, questionnaire, document analysis and a reflective diary. Data was analysed using thematic analysis and SPSS as appropriate to qualitative and quantitative data respectively. To …

Leading And Leadership: Reflections On A Case Study., Pauline Joyce

Pauline Joyce

Aim: The aim of this case study was to explore if observing leaders in the context of their day-to-day work can provide an insight into how they lead in particular circumstances. Background: The study was carried out in small organisation which was set up five years ago. Methods: A case study methodology was used. Data was collected by field notes of non-participant and participant observations. Follow-up interviews were transcribed and analysed to contextualise the observations. A reflective diary was used by the researcher to add to the richness of the data. Results: The data demonstrates how the leader responded in …

Evaluation Of Postgraduate Healthcare Professionals' Learning In An Outcomes-Based Curriculum., Pauline Joyce

Pauline Joyce

This study evaluated learning of postgraduate healthcare professionals. Their experiences, as insider stakeholders, are placed within the perspectives of their lecturers and external examiner, as external stakeholders.

Shaping The Future Of Nursing Education In Ireland, Pauline Joyce

Pauline Joyce

This paper presents core principles of curriculum design. These principles were used as categories following analysis of submissions made to the Nursing Education Forum in Ireland between 1999/2000. This forum was established following a Commission on Nursing, set up to examine the future of nursing in Ireland. The transition from curriculum design to curriculum development is considered and a summary of curriculum activities is outlined. The paper concludes by presenting questions to focus further discussion.

Action Learning- A Process Which Supports Organisational Change Initiatives, Pauline Joyce

Pauline Joyce

This poster outlines how action learning sets were used to support organisational change initiatives as part of a Master’s programme. Evaluations were carried out from the students’ perspectives (n= 102) via the ALSE tool1. Focus groups (two) were held with thirteen facilitators, who were all healthcare professionals at a senior level in their own organisations. Data was analysed by Microsoft Excel for the survey and via content analysis for the focus group meetings. Students communicated with their facilitators and members by email or chat rooms at least once between meetings. They were focused on progressing their change projects and came …

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 …

Factors Associated With The Process Of Adaptation Among Pakistani Adolescent Females Living In United States., Salma Khuwaja, Chiehwen Ed Hsu

Chiehwen Ed Hsu

This study explored post-migration experiences of recently migrated Pakistani Muslim adolescent females residing in the United States. In-depth, semi-structured interviews were conducted with thirty Pakistani Muslim adolescent females between the ages of 15 and 18 years living with their families in Houston, Texas. Data obtained from the interviews were evaluated using discourse analysis to identify major reoccurring themes. Participants discussed factors associated with the process of adaptation to the American culture. The results revealed that the main factors associated with adaptation process included positive motivation for migration, family bonding, social support networks, inter-familial communication, aspiration of adolescents to learn other …

Many Schools Unprepared For Next Pandemic, Chiehwen Ed Hsu

Chiehwen Ed Hsu

Worked with the media to evaluate a school-based pandemic preparedness study. Take home message: Not much, really. However, the CDC should carefully review its promotion of yet-to-be-proven effective syndromic surveillance systems - and the mega $ associated with the investment - until they are proven otherwise effective.

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 …

Communicating H1n1 Risk To College Students: A Cross-Sectional Survey Study, Francisco G. Soto Mas, Chiehwen Ed Hsu

Chiehwen Ed Hsu

Objective: To assess the H1N1 risk communication needs of college students. Participants: Students at a major university in the southwestern U.S. Method: Data were collected in early spring 2010 through a 24-item, self-administered survey. Outcome variables included knowledge, behavior and intention. Results: A total of 483 students participated. Most reported trying to prevent H1N1 influenza though specific behaviors. Many lacked knowledge about symptoms and treatment, a few (10%) had been vaccinated, and half had no intention to get vaccinated or practice self-isolation. Gender and age were significantly associated with the three outcome variables. Intention was the most significant contributor of …

Designing Human Centered Geovisualization Application - The Sanaviz - For Telehealth Users: A Case Study., Ashish Joshi, Chiehwen Ed Hsu

Chiehwen Ed Hsu

No abstract provided.

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 …

Stereotactic Ablative Radiotherapy For Comprehensive Treatment Of Oligometastatic Tumors (Sabr-Comet): Study Protocol For A Randomized Phase Ii Trial., Michael Lock

Michael Lock

No abstract provided.

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.

Health Care Decision Means More Work For Irs, David Gamage

David Gamage

No abstract provided.

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 …

Knowledge And Perceived Barriers About Diabetic Retinopathy And Dilated Eye Exam In Patients With Diabetes, Manisha Verma, Md, Mph, Mona Sarfaty, Robert Simmons, Drph, Mph, Albert Crawford

Mona Sarfaty

Conclusions:

• The results of this study suggest that 68% of the population from this primary care practice got a dilated eye exam within a year. Facilitators were awareness/knowledge about the DR and DFE, eye problems and information from their doctors.
• Almost 20% of the patients did not get an eye exam as recommended. Various barriers included cost, transportation issues, time constraint issues, lack of symptoms of the disease, and fear of the exam.
• There is a significance difference in getting an eye exam by the type of insurance with a smaller percentage of Medicaid recipients (60%) meeting the guidelines compared …

Alternatives In Health Care Financing, Francis Koh, Chin Lim

Francis Koh

No abstract provided.

Do Ehr Investments Lead To Lower Staffing Levels?, Jeff Helton, Chiehwen Ed Hsu

Chiehwen Ed Hsu

No abstract provided.

Facing The Fear Factor In Taiwan Election, Chiehwen Ed Hsu

Chiehwen Ed Hsu

After observing recent legislative and presidential elections in Taiwan, members of the independent International Election Observation Mission have concluded that the elections were largely “free, yet partially unfair” (“Elections ‘free, partly unfair,’ watchdog says,” Jan. 16, page 1), citing several structural problems (eg, vote-buying, misuse of government power, and substantial disparities in party wealth) and extraneous fear factors (ie, undue influence exerted by the US and China under the myth of arguably fictional stability) that posed concerns for and pressures on Taiwan’s democracy, particularly on the freedom and fairness of the choices that Taiwanese voters must take. A case in …

Learning From Other Industries: Lessons And Challenges For Healthcare Organizations, Amer Kaissi

Amer A Kaissi

No abstract provided.

Dialysis Rationing And The Just Allocation Of Resources: A Historical Primer., Teri Browne

Teri Browne

No abstract provided.

A Roadmap For Trust: Enhancing Physician Engagement, Amer Kaissi

Amer A Kaissi

No abstract provided.