Health and Medical Administration Commons^™

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 …

After Closure: Options For Pursuing A High Performance Rural Health System, Andrew F. Coburn Phd

Rural Hospitals (Flex Program)

Presented at the 2017 National Rural Health Association Annual Meeting. Coburn, a member of the Rural Policy Research Institute Panel, discussed the following key questions: What kind of rural health system is possible in places that cannot support a full-service hospital? How does a rural community navigate the transition from hospital-centric care toward new models that deliver high performance? What implementation support will be needed? Coburn noted that there is no single model for re-configuring the rural health system after hospital closure; local assets, affiliations and partnerships, financial and delivery flexibility and capacities must be critically assessed to determine the …

An American Epidemic: Burnout Syndrome In Hospital Nurses, David P. Paul Iii, Lama Bakhamis, Harlan Smith, Alberto Coustasse

Management Faculty Research

The number of Registered Nurses (RNs) in the United States (U.S.) is roughly three times that of physicians and surgeons, making RNs a critically important component of the U.S. healthcare system. RN Burnout – defined as the feeling of exhaustion from working long hours without rest – is a real concern, having been reported in many hospitals. The purpose of this research is to examine the causes and consequences of Burnout Syndrome among RNs in U.S. hospitals, in order to identify solutions to this problem. The methodology involves a review of the literature and semi-structured interviews. Seven primary databases, two …

Dimensions Of Nurse-Physician Communication, Rachel Malek Hamdan

Walden Dissertations and Doctoral Studies

Hospital leaders set quality and safety as high priorities in their strategic goals. Improving the quality and safety of patient care requires improving internal processes that have direct implications for patient care. Hospital leaders need to improve health care providers' communication as part of improving quality and safety. The problem addressed in this study was the lack of strategies health care administrators use to guide nurse-physician communication patterns in a university medical center in the Middle East. The purpose of this qualitative case study was to explore communication strategies that health care administrators use to guide nurse-physician communication. Relational coordination …

Dr. William Randolph Sims Papers - Accession 1582, William Randolph Sims

Manuscript Collection

The William Randolph Sims Papers consists of records primarily relating to the York County Hospital. Dr. William Randolph Sims, Sr. (1886-1972) was a longtime Chairman of the York County Hospital as well as the former Vice-President and Manager of J.P. Phillips Drugs Inc. The York County Hospital (also known as York General Hospital) opened on May 15, 1940 in the corporate limits of the Town of Ebenezer (now part of Rock Hill, SC) and included a nursing school and a home for nursing students. It was approved by the American College of Surgeons on February 2, 1944. It was later …

Handoffs, Safety Culture, And Practices: Evidence From The Hospital Survey On Patient Safety Culture, Soo-Hoon Lee, Phillip H. Phan, Todd Dorman, Sallie J. Weaver, Peter J. Pronovost

Management Faculty Publications

Background: The context of the study is the Agency for Healthcare Research and Quality’s Hospital Survey on Patient Safety Culture (HSOPSC). The purpose of the study is to analyze how different elements of patient safety culture are associated with clinical handoffs and perceptions of patient safety.

Methods: The study was performed with hierarchical multiple linear regression on data from the 2010 Survey. We examine the statistical relationships between perceptions of handoffs and transitions practices, patient safety culture, and patient safety. We statistically controlled for the systematic effects of hospital size, type, ownership, and staffing levels on perceptions of patient safety. …

Use Of Smartphones In Hospitals, N. A. Thomairy, M. Mummaneni, S. Alsalamah, N. Moussa, Alberto Coustasse

Management Faculty Research

Mobile technology has begun to change the landscape of the medical profession with more than two-thirds of physicians regularly using smart phones. Smartphones have allowed healthcare professionals and the general public to communicate more efficiently, collect data and facilitate the clinical decision making. The methodology for this study was a qualitative literature review following a systematic approach of the smartphone usage among physicians in hospitals. Fifty-one articles were selected for this study based on inclusion criteria. The findings were classified and described into seven categories: use of smartphone in obstetrics, pediatrics, surgery, internal medicine, radiology, and dermatology which were chosen …

The New Era Of Health Care: Catholic Health Initiatives Journey With Bundled Payment For Care Improvement In Total Joint Replacements, Tamara Cull

MUSC Theses and Dissertations

This study examined the relationships between total costs of care and total readmission rates for Medicare patients undergoing major joint replacement of the lower extremity (knee/hip arthroplasty) at one of four Catholic Health Initiatives (CHI) facilities participating in both Phase 1 and Phase 2 of the BPCI program by using complete Medicare claims data for beneficiaries. Both univariate and multivariate models were utilized to examine the impact of the BPCI initiative on costs and readmissions. Findings from this study suggest a relationship between Phase 2 BPCI participation and decreased costs. Hospitals participating in the Phase 2 BPCI program had total …

Differences Between For-Profit And Nonprofit Hospitals: Perceived Quality And Access, Michael Ray Eiland

Walden Dissertations and Doctoral Studies

Despite a large body of literature addressing the issue, questions remain about whether nonprofit hospitals provide more community benefit than do for-profit hospitals. This lack of information impacts governments, hospitals, and the healthcare industry, as stakeholders attempt to generate requirements to which hospitals should adhere to maintain nonprofit status, and thus tax exemption. This study addressed this lack of information by examining U.S. hospitals through the lens of stewardship theory to determine whether nonprofits are better stewards of the public good than for-profits, and thus likely to provide higher quality and access. The study applied logistic regression to Centers for …

Multiple Regression Analysis Of Factors Concerning Cardiovascular Profitability Under Health Care Reform, Gordon Brian Wesley

Walden Dissertations and Doctoral Studies

Cardiovascular (CV) patients receive one-third of the care and account for $444 billion of the health care costs in the United States. The cardiovascular service line (CVSL) in hospitals contributes to the profitability influenced by elements of resource dependence theory (RDT). The purpose of this study was to understand whether the regression model of hospital characteristics and outcomes would predict profitability in a CVSL through the cost-to-charge ratio (CCR). The use of a general linear model and multiple regression analysis to examine the 2012 National Inpatient Sample from the Healthcare Cost and Utilization Project allowed estimates from a weighted sample …

Factors That Promote Perceived Usefulness Of And Clinical Outcomes From Sign-Outs At The National University Hospital, Soo-Hoon Lee, Wei-Ping Goh, Dale A. Fisher, Phillip H. Phan

Management Faculty Publications

IMPORTANCE OF THE STUDY. Currently, there is a paucity of evidence in the literature to show that handoff strategies improve the quality of handoff outcomes. Studies that show the usefulness and outcomes obtained from sign-outs may motivate junior clinicians, who have limited time to perform their clinical responsibilities, to support sign-out improvement efforts.

OBJECTIVE. To test a research model that embeds the Technology Acceptance Model and the Theory of Planned Behavior to explore factors that enhance the perceived (a) usefulness of and (b) clinical outcomes from sign-outs among junior medical officers.

DESIGN, SETTING, AND PARTICIPANTS.

A retrospective study was conducted …

A Pilot Study On Nurse-Led Rounds: Preliminary Data On Patient Contact Time, Soo-Hoon Lee, Alice Lee, Siang-Ngim Lim, Mei-Jiao Koh, Benjamin Tan, Phillip H. Phan, Reshma A. Merchant, Aisha Lateef, Dale A. Fisher

Management Faculty Publications

IMPORTANCE OF THE STUDY. Ward rounding has been a historical clinical method of inter-professional collaboration to support inpatient care through the sharing of mental models by exchanging information and discussing plans of care, treatment goals, and discharge plans for the patient. The extant literature reports that rounds are frequently led by doctors with infrequent nurse-physician collaboration and patients’ interactions with doctors during ward rounds tend to be brief.

OBJECTIVE. To explore the effects of nurse-led morning ward rounds on patient contact time.

DESIGN. An ethnographic prospective observational study comparing nurse-led and physician-led rounds. SETTING. A General Medicine ward at the …

Examining Universal Primary Healthcare Through Community-Based Initiatives, Donald E. Warden

Oglethorpe Journal of Undergraduate Research

This paper examines enacting community-based primary healthcare programs and initiatives. It looks at the weaknesses of past attempts, the successes of current attempts, and gives insight into ways everyday citizens can change the way the world does healthcare. There are social, economic, and political barriers as to why these programs are not enacted. Since 1978, Member states of the United Nations strive towards healthcare for all. The original 1978 Declaration of Alma-Ata sets the bar at achieving this goal by the year 2000. Now in the 21^st century, the world still battles inadequate healthcare. Nations continue to strive towards …

The Role Of Is Infrastructure And Organizational Context On Implementation Of Electronic Health Records Systems, Pilar Pazos, Anjee Gorkhali, Rolando Delaguila

Engineering Management & Systems Engineering Faculty Publications

This research explores the role that Information System (IS) infrastructure and organizational context play on the implementation of Electronic Health Records (EHR) Systems. A number of indicators can be used as a proxy for IS infrastructure such as: Information System (IS) Department Budget allocation, percentage of full time IS staff and the number of technical trainings provided by the IS department to the clinical staff. Data was obtained from the Healthcare Information and Management Systems Society (HIMSS) database, a non-for profit organization that evaluates the use of information technology in the health care industry. This paper reports on the development …

Evaluation Of Patient Room Furniture In An Impatient Rehabilitation Hospital, Stanley L. Healy

MUSC Theses and Dissertations

Investigating the contents of nightstands and over-the-bed tables (OBTs) located in post-acute settings is a first step towards understanding how patients use hospital furniture to allow for user-centered design. This study provides an inventory of items located on the over-the-bed table and nightstand of patients in a rehabilitation hospital. This research agenda is to improve the usability and effectiveness of patient room furniture; this study's findings have added to the current body of knowledge and have some significant implications. This study suggests that by discovering what furnishings are realistically needed or can be utilized in the patient room, hospital expenses …

Advancing Leadership In Public Healthcare: Beyond Crowded Hospitals And Labour Shortfalls, Singapore Management University

Perspectives@SMU

Features a panel discussion on the Singapore ageing population and the expanding demand for healthcare by four public healthcare leaders, at the SMU-Singhealth Graduate Diploma in Healthcare Management and Leadership graduation ceremony.

The Impact Of Minority And Women Leaders On Health Care Employee Satisfaction, Kinneil Coltman

MUSC Theses and Dissertations

A preponderance of research suggests that the presence of minorities on the front lines of health care can improve access, satisfaction, and quality of care for minority patients, in addition to mitigating health care disparities. Yet, there is little evidence of the utility of diversity efforts focused on the upper echelons of health care. By examining employee satisfaction scores from 58 hospitals across the United States, this study explored the relationship between the presence of women and minority managers and executives and two key indicators-representation of minority employees and employee satisfaction. Quantitative analyses showed that gender and racial diversity in …

Facilitating Emergence: Complex, Adaptive Systems Theory And The Shape Of Change, Peter Martin Dickens

Antioch University Dissertations & Theses

This study used Principal Component Analysis to examine factors that facilitate emergent change in an organization. As organizational life becomes more complex, today’s dominant management paradigms no longer suffice. This is particularly true in a health care setting where multiple sources of disease interacting with each other meet with often-competing organizational priorities and accountabilities in a highly complex world. This study identifies new ways of approaching complexity by embracing the capacity of complex systems to find their own form of order and coherence. Based on a review of the literature, interviews with hospital CEOs, and my organization development practice experience …

Trends Of Increase In Western Medical Services In Traditional Medicine Hospitals In China, Jay J. Shen, Ying Wang, Fang Lin, Jun Lu, Charles B. Moseley, Mei Sun, Mo Hao

School of Public Health Faculty Research

Background:

Compare changes in types of hospital service revenues between traditional Chinese medicine (TCM) hospitals and Western-medicine based general hospitals.

Methods:

97 TCM hospitals and 103 general hospitals were surveyed in years of 2000 and 2004. Six types of medical service revenue between the two types of hospitals were compared overtime. The national statistics from 1999 to 2008 were also used as complementary evidence.

Results:

For TCM hospitals, the percentage of service revenue from Western medicine increased from 44.3% to 47.4% while the percentage of service revenue from TCM declined from 26.4% to 18.8% from 1999 to 2004. Percentages of …

Adoption Of Electronic Health Records By Admitting Physicians: A Heuristic Model, John Sharon Hudson

Health Services Research Dissertations

Background: Although hospital electronic health records (EHRs) are generally perceived to improve care, physician resistance may hinder EHR adoption.

Purpose: This study uses constructs from diffusion of innovations and resource dependence theories to predict adoption and rate of adoption of an EHR by admitting physicians from three of ten hospitals in a highly integrated health system in Virginia. Functions evaluated: computerized physician order entry (CPOE), electronic history and physical (EH&P) and electronic discharge summary (EDS). The study tested hypotheses that adoption would be associated with: working at larger, academic hospitals; financial alignment; larger physician groups; office EHR; youth; males; medical …

Potential Benefits And Perceived Need For Health Promoting Hospitals In Pakistan: A Healthcare Stakeholder's Perspective, Asif Raza Khowaja, Rozina Mistry, Ajmal Agha, Rozina Karmaliani

Community Health Sciences

OBJECTIVES: To explore perceptions of healthcare stakeholders' about health promoting hospitals, potential benefits and need in Pakistan.METHODOLOGY: A qualitative exploratory study was conducted between July-August 2007. The data was collected through key-informant (KI) interviews and focus group discussions (FGD) with purposively selected hospital administrators, healthcare providers, health policy makers, and UN-donor agency representatives. The thematic analysis was done using QSR NVivo 2.0; and nodes representing themes were generated.RESULTS: The study participants perceived health promotion, a concept synonymous to health education. Those participants with public health background were better able to relate their perceptions to a more holistic view of health …

Or Practice—Efficient Short-Term Allocation And Reallocation Of Patients To Floors Of A Hospital During Demand Surges, Steven M. Thompson, Manuel Nunez, Robert Garfinkel, Matthew D. Dean

Management Faculty Publications

Many hospitals face the problem of insufficient capacity to meet demand for inpatient beds, especially during demand surges. This results in quality degradation of patient care due to large delays from admission time to the hospital until arrival at a floor. In addition, there is loss of revenue because of the inability to provide service to potential patients. A solution to the problem is to proactively transfer patients between floors in anticipation of a demand surge. Optimal reallocation poses an extraordinarily complex problem that can be modeled as a finite-horizon Markov decision process. Based on the optimization model, a decision-support …

Uncompensated Care Cost: A Pilot Study Using Hospitals In A Texas County, Alberto Coustasse, Andrea L. Lorden, Vishal Nemarugommula, Karan P. Singh

Management Faculty Research

The financial ramifications of uncompensated care cost (UCC) on the healthcare industry have been difficult to quantify. With the lack of a standardized definition of uncompensated care and the need to account for the uninsured, indigent, and immigrant populations, the authors identified $190 million of UCC from Southwestern border hospitals for emergency room treatment of undocumented immigrants and $934 million of uncompensated care charges for 23 hospitals in a Texas county, which translated to $353 million of UCC. Although lawmakers passed the Medicare Prescription Drug Improvement and Modernization Act (2003) to address the growing imbalance, the shortfall of funds highlights …

The Relationship Of Patient Falls To Prevention Policies In Hospitals: A Case Study, Cornelia Branzan

Master in Public Administration Theses

There have been a lot of studies over the past decade on patient falls, risk factors, and strategies for preventing the falls. However, these studies provide answers for long term care; acute care and community hospitals need more specific interventions. Falls and their consequences are important for patients and families, health care providers, insurance companies, state agencies, hospital accreditation, and others. Furthermore, they are causing psychological and physiological injuries among the patients, take a greater time to recover, prolong hospitalization [15 days in Switzerland, Sweden, USA, Western Australia, Province of British Columbia and Quebec in Canada www.stopfalls.com )] and increase …

Cost Of Medical Detoxification Among Drug And Alcohol Users In A Private Texas Hospital, Alberto Coustasse

Management Faculty Research

Purpose – The purpose of this paper is to estimate the costs of medical detoxification among patients with alcohol and substance abuse disorders.

Design/methodology/approach – The study data was drawn from a medical detoxification program in a community hospital in Texas. Secondary data analysis of 1337 cases from three years was reviewed. Age, gender, race, alcohol, cocaine, cannabis, amphetamines, sedatives, opioids, financial classification, cost, length of stay (LOS) and cost by LOS were analyzed using Kruskal-Wallis test and Mann-Whitney U-test.

Findings – The sample comprised of 42.8 percent women and 57.2 percent males. The mean cost and cost by LOS …

Application Of Queuing Theory And Procedure Time Estimation In A Local Healthcare System, Galina Tsoy

Engineering Management & Systems Engineering Theses & Dissertations

People in the United States pay more for their basic healthcare needs than do people in any other nation in the world. When we consider that the United States is the wealthiest nation in the world, controlling the majority of the world's resources, it seems only reasonable to ask: Why should it be this way?

In an effort to address this problem, this thesis examines two possible methods of improving health care efficiency in hospitals. The thesis is thus in two parts: the first part examines resource allocation in medical units using Queuing Theory, and the second part examines a …

Healthcare Strategic Management: The Impact Of State And Federal Funding Levels On The Implementation Of Strategic Plans At Tennessee Hospitals., Randy Lee Byington

Electronic Theses and Dissertations

The purpose of this study was to determine hospital executive management’s perceptions of how turbulence in the politico-legal sector of the macroenvironment impacted the strategic management systems of Tennessee hospitals. In particular, how did Federal and State funding restrictions (Medicare and TennCare) impact the strategic planning and implementation process of their hospitals? The study was also designed to gain insight regarding specific changes to strategic management systems that may have resulted from these funding restrictions.

The research was conducted during April and May of 2003. Data were gathered by surveying the Chief Executive Officers (CEOs) of acute care hospitals in …

The Role Of Institutional And Market Forces In Divergent Organizational Change, Thomas D'Aunno, Melissa Succi, Jeffrey A. Alexander

Business Faculty Articles and Research

This paper focuses on a radical change, in which organizations abandon an institutionalized template for arranging their core activities, that is likely to occur in organizational fields that have strong, local market forces and strong but heterogeneous institutional forces. We examine the role of market forces and heterogeneous institutional elements in promoting divergent change in core activities among all U.S. rural hospitals from 1984 to 1991. Results support the view that divergent change depends on both market forces (proximity to competitors, disadvantages in service mix) and institutional forces (state regulation, ownership and governance norms, and mimicry of models of divergent …

Health Care Marketing And The Internet, C. David Shepherd, Daniel Fell

Faculty Articles

This article presents research on the growing number of health care providers using the Internet as a health care marketing tool in the U.S. The author notes that the Internet is changing the way consumers seek healthcare related information as well as the way it can be provided to them. The results of the study suggest that consumers will increasingly rely on sources like the Internet for information, that health information will be a commodity on the Internet, that the Internet will help build relationships between providers and consumers and that marketers will be expected to develop and manage Internet-related …

Labor's Response To Hospital And Workplace Transformation, Enid Eckstein

New England Journal of Public Policy

The health care industry and the nation's hospitals are in the throes of revolutionary change. The shift to managed care resulted in fundamental changes in the delivery of care and the structure of health care, For the past ten years, hospitals have actively been merging and creating large-scale integrated delivery systems. Employers, eager to expand market share and reduce costs, are engaged in radical reorganization of the hospital and the structure of work from which no group is immune. Physicians, nurses, technicians, and housekeepers are all affected by these changes. Hospitals are reducing their personnel, shifting work outside the hospital, …