Public Health Commons^™

Patient Partnership In Quality Improvement Of Healthcare Services: Patients’ Inputs And Challenges Faced, Marie-Pascale Pomey, Hassiba Hihat, May Khalifa, Paule Lebel, André Néron, Vincent Dumez

Patient Experience Journal

This research focuses on the perception of patients who participated in Continuous Quality Improvement Committees (CIC) regarding their contribution, lessons learned, and challenges encountered. The committees are engaged in a care partnership approach where patients are recognized for their experiential knowledge and treated as full members of the clinical team. Based on patient interviews, we conclude that they bring a structured and thoughtful vision of their experience. They identify themselves as real partners in the care process and are grateful for the opportunity to improve the care provided to other patients by using their own experience and by bringing changes …

Meaningful And Effective Patient Engagement: What Matters Most To Stakeholders, Mandy Bellows, Katharina Kovacs Burns, Karen Jackson, Brae Surgeoner, Jennifer Gallivan

Patient Experience Journal

To determine what resources, preparation, and support are needed for patients, providers, and leaders to meaningfully and appropriately engage in patient-centred health system redesign, researchers sought to learn what really matters to these three stakeholder groups. A qualitative descriptive design was selected using purposive participant sampling, focusing on ‘who’, ‘what’ and ‘why’ questions pertaining to stakeholder perceptions about patient engagement in their specific context as patients, providers or leaders. Four project groups were selected; each group was responsible for a strategic initiative within Alberta Health Services and represented one of three different levels of the healthcare system (i.e. program, site …

The Power Of Patient Ownership: The Path From Engagement To Equity, Zal Press, Dawn Richards

Patient Experience Journal

Understanding patient engagement from the lens of a person who is suffering, who is in pain and anguish, who is wracked with fear of the impact of this pain on their body, their family, their career, and their mortality, is a complex undertaking. The authors provide an important patient perspective in acknowledging and highlighting efforts to shift the conversation on experience from one about patients and families to one with patients and families. They challenge us to consider the power that can be found in creating ownership for patients and suggest it may be the one true path to moving …

Reframing The Work On Patient Experience Improvement, Jocelyn Cornwell

Patient Experience Journal

In reframing the work on patient experience improvement Dr. Jocelyn Cornwell, chief executive of The Point of Care Foundation, challenges us to broaden our view on what is necessary to impact patient experience efforts. From a defined need to reduce avoidable suffering associated with health care delivery dysfunction, she suggests we extend the discussion in two ways: First, to include a concern for staff engagement, experience and well-being, and second, to position patient experience improvement as one type of quality improvement (QI) in healthcare, and urge practitioners to pay more attention to the lessons from QI in other domains. High …

Patient Experience Established: One Year Later, Geoffrey A. Silvera, Jason A. Wolf Phd

Patient Experience Journal

Scholars and administrators have long dedicated themselves to centering healthcare conversations and debates on the experiences of patients and their families. Patient experience advocates view these experiences as critical to evaluations of healthcare quality. There have been a great multitude of important contributions, yet, for decades, these calls for patient-centric care experiences and healthcare systems have been confined to the fringes of disparate health policy and reform debates. This bygone reality created a diaspora of scholars and administrators dedicated to understanding, evaluating, and improving the patient experience. This article begins to explore a coalescing around patient experience research efforts citing …

The Patient Experience Movement Moves On, Jason A. Wolf Phd

Patient Experience Journal

As we present Volume 2 of Patient Experience Journal (PXJ) we both recognize the contributions that helped launch this publication and acknowledge the work that helped build the foundation of the broader research exploration in the emerging field of patient experience. On this base of knowledge we have worked to establish a new home for expanding the exploration of new ideas and practices through this publication. The importance of building, supporting and sustaining an outlet for research in patient experience is grounded in the belief that positive patient experience is good for healthcare, it is good for the people who …

Assessing Changes In Safety Net Providers Since The Passage Of The Affordable Care Act, Arlesia Mathis, Julia Burke, Gulzar H. Shah

Health Policy & Management: Faculty Presentations (2008-2022)

The passage of the Affordable Care Act presented opportunities and challenges for safety net providers. Significant investments in provider capacity promised much needed expansion of services; and in 2014, the law extended coverage to millions of previously uninsured Americans. However, safety net providers are concerned that changes to financing brought about by changes in the ACA may threaten their ability to provide services to millions more who still lack insurance. This is a preliminary study of changes occurring with maternal and child health services among safety-net providers.

Use Of Facebook By Local Health Departments: Activity And Focus Areas, Rakhi Trivedi, Gulzar H. Shah

Health Policy & Management: Faculty Presentations (2008-2022)

This presentation was given at the Keeneland Conference for Public Health Systems and Services Research.

Can Electronic Health Records Systems Support New Payment Methods For Health Centers?, Peter Shin, Feygele Jacobs, Jeffrey Barnes, James B. Welsh, Lisa Perry, Scott D. Morgan

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

This study assessed the feasibility and usefulness of combining electronic health record (EHR) data with federal cost report data for the purposes of: 1) quantifying the provision of enabling services; and 2) for use as the basis of community health center payment rate-setting. The study used EHR data derived from the Center for Primary Care Informatics to isolate enabling services and perform the end-to-end analysis that might be required to develop or evaluate reimbursement rates. The study revealed that data extracted from federal cost reports combined with data from the EHR fall short of providing the information required to reasonably …

Investigating Barriers To Early Cancer Detection For Rural Indian Women: A Qualitative Analysis Of Cancer Outreach In Dehradun, Uttarakhand, Blair Burnett

Independent Study Project (ISP) Collection

This study examines barriers to early detection for women’s specific cancers in rural India in and around Dehradun, Uttarakhand, within the framework of existing health outreach programs from tertiary hospitals in the state. The burden of cancer mortality within India is disproportionately affecting women living in rural populations considering the current health education and health care infrastructure in place. Barriers of knowledge, access to knowledge, economic condition, geography, and cultural norms are all examined within this study in the context of early cancer detection. National Indian health policy is currently framed to address the burden of cancer within India; however, …

Geographic Variation In The Delivery Of Public Health Services: Understanding Causes And Consequences, Glen P. Mays

Health Management and Policy Presentations

The implementation and reach of evidence-based prevention and public health programs varies widely across the U.S., as does the availability of cross-cutting infrastructure and foundational capabilities required to support these interventions. This talk profiles ongoing research to uncover the causes and consequences of variation in public health delivery. This research points to policy and administrative strategies that can reduce inequities and inefficiencies in public health protections.

Deconstructing Unmade Examining The Capacity Of Ayurveda To Address India’S Mental Health Crisis, Cassie Sutten Coats

Independent Study Project (ISP) Collection

Though India does not have a credible, widespread system in place to recognize and focus on issues of mental health, especially in allopathic treatments, it is imperative to evaluate the existing practices and approaches in regards to mental health alongside the impact that these approaches may have on Indian society. In contrast to Westernized systems of medicine, the traditional Indian system of Ayurveda inherently addresses issues in mental health due to the holistic approach through mind-body medicine. This study evaluates the enormous potential that exists within Ayurvedic philosophy to provide adequate, culturally congruent, treatments and care in mental health, and …

Characteristics Of Local Health Departments Associated With Their Implementation Of Electronic Health Records And Other Informatics System, Gulzar H. Shah, Jonathon P. Leider, Brian C. Castrucci, Karmen S. Williams, Huabin Luo

Health Policy & Management: Faculty Presentations (2008-2022)

Background: Information technology and information systems (IT/IS) play a critical role in the daily operation of local health departments (LHDs). Assessing LHDs’ informatics capacities is important, especially within the context of broader, system-level health reform efforts.

Research Objective: This study assesses a nationally representative sample of LHDs’ level of adoption of information systems, technology, and the factors associated with adoption/implementation. Specifically, five areas of public health informatics were examined: electronic health records (EHRs), health information exchange (HIE), immunization registry (IR), electronic disease reporting system (EDRS), and electronic lab reporting (ELR).

Data Sets and Sources: Data from NACCHO’s 2013 National Profile …

Levels And Predictors Of Lhds' Engagement In Community Health Assessment, 2002-2013, Gulzar H. Shah, Kay Lovelace, Daniel F. Linder

Health Policy & Management: Faculty Presentations (2008-2022)

This presentation was given at the Keeneland Conference for Public Health Systems and Services Research.

Factors Driving Local Health Department’S Collaboration With Other Organizations In The Provision Of Personal Healthcare Services, Huabin Luo, Nancy L. Winterbauer, Ashley Tucker, Gulzar H. Shah

Health Policy & Management: Faculty Presentations (2008-2022)

Background: Recent work has highlighted the necessity of integrating primary care services and public health to improve quality and reduce the cost of healthcare.

Research Objectives: To describe levels of partnership between local health departments (LHD) and other organizations in the community in the provision of personal healthcare services; and to assess LHD organizational characteristics and community factors that contribute to partnerships.

Data Sets and Sources: Data were drawn from the 2013 NACCHO Profile Study (Module 1) and the Area Health Resource File. A total of 490 LHDs responded to Module 1, where LHDs were asked to describe the level …

Confronting Cultural Challenges For Migrant Healthcare In Switzerland, Rebecca Weiss

Independent Study Project (ISP) Collection

Switzerland is home to many migrants, and migration exacerbates health risks. In addition to physical health problems, migrants are more likely than Swiss nationals to face mental health challenges and cultural barriers, which complicate their experiences seeking healthcare. Similarly, clinicians encounter numerous challenges related to the special circumstances of migrant patients. As a response to the specific health needs of migrants, hospital networks and migrant support organizations promote the migrant health situation. However, these services are not ubiquitous in Switzerland, partly due to the partial freedoms of each canton to create its own health policy. This paper explores the barriers …

Answering The Call To Integrate: Simple Strategies From Public Health And Healthcare Executives In One Urban County, Erik L. Carlton, Paul C. Erwin

Frontiers in Public Health Services and Systems Research

Background: As the Affordable Care Act transforms the practice of both public health and health care, it also provides opportunity for both to become more closely linked through improved integration and collaboration. Yet, while public health agencies are increasingly called to work with healthcare partners to address population health needs, both public health leaders and their healthcare counterparts may not be well equipped to answer that call. Although recent studies have begun exploring the collaborative strategies and capacity of public health system partners, there is still much to learn. The purpose of this study was to identify, through the perspective …

Accreditation Intent, Community Health Assessments, And Local Health Department–Hospital Collaboration, Erik L. Carlton, Simone Singh

Frontiers in Public Health Services and Systems Research

Background: Community health assessments (CHAs) are among the most core of activities conducted by local health departments (LHDs), and many LHDs have been conducting CHAs on a regular basis for years. More recently, completing a CHA has also become a prerequisite for LHDs seeking accreditation by the Public Health Accreditation Board (PHAB). Similarly, under the Affordable Care Act, tax-exempt hospitals are required to conduct periodic community health needs assessments. Opportunities thus exist for LHDs and tax-exempt hospitals to engage in collaborations related to CHAs. Yet, it remains unclear whether interest in PHAB accreditation provides incentive to LHDs to engage in …

Alternate Payment Models For Ryan White Hiv/Aids Program Funded Services: Strategies Used By Nine Grantees, Naomi Seiler, Scott Dafflitto, Rosalind Fennell, Julia Hidalgo, Katie Horton, Mary-Beth Malcarney

Health Policy and Management Faculty Publications

The Health Resources and Services Administration (HRSA) HIV/AIDS Bureau (HAB) offers Ryan White HIV/AIDS Program (RWHAP) Part A and Part B grantees some flexibility in determining the method used for paying subgrantees for core medical and support services. Many Part A and Part B grantees use a traditional “cost-based reimbursement” approach, in which subgrantees submit budgets that include personnel costs, other direct costs related to the provision of funded services, and capped indirect costs (IDCs). Some grantees, however, have developed alternative reimbursement models for core medical and/or support services. This report summarizes the reimbursement approaches taken by nine RWHAP grantees. …

Strengthening The Detection Of And Early Response To Public Health Emergencies: Lessons From The West African Ebola Epidemic, Mark J. Siedner, Lawrence O. Gostin, Hilarie H. Cranmer, John D. Kraemer

Georgetown Law Faculty Publications and Other Works

Background

In the year since the World Health Organization (WHO) notified of an Ebola outbreak in West Africa, more than 24,000 cases have been reported and over 10,000 individuals have died. Moreover, countless non-Ebola deaths have occurred as a result of health system closings and an international aid effort in the $USD billions has been invested in control efforts. While the international response to the West African Ebola virus disease epidemic eventually exemplified the great potential of the global public health community, the protracted early response also revealed critical gaps, which likely resulted in exacerbation of the epidemic. It is …

The Impact Of Emotional Intelligence On Conditions Of Trust Among Leaders At The Kentucky Department For Public Health, Jennifer Redmond Knight, Heather M. Bush, William A. Mase, Martha Cornwell Riddell, Meng Liu, James W. Holsinger

Health Policy & Management: Faculty Publications (2006-2018)

There has been limited leadership research on emotional intelligence and trust in governmental public health settings. The purpose of this study was to identify and seek to understand the relationship between trust and elements of emotional intelligence, including stress management, at the Kentucky Department for Public Health (KDPH). The KDPH serves as Kentucky’s state governmental health department. KDPH is led by a Commissioner and composed of seven primary divisions and 25 branches within those divisions. The study was a non-randomized cross-sectional study utilizing electronic surveys that evaluated conditions of trust among staff members and emotional intelligence among supervisors. Pearson correlation …

Teaching Health Centers: A Promising Approach For Building Primary Care Work Force For The 21 St Century, Leighton Ku, Fitzhugh Mullan, Christine Cerrano, Zoe Barber, Peter Shin

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

No abstract provided.

Refining And Improving The Methodology For The National Health Security Preparedness Index, Glen P. Mays

Health Management and Policy Presentations

This first meeting of two newly reconstituted Working Groups for the National Health Security Preparedness Index Program examined opportunities for improving and refining the Index's measurement, scaling, weighting, and aggregation methodologies. Methodological improvements will enhance the Index's utility for education, planning, policy development, and quality improvement efforts focused on improving national preparedness and resiliency for large-scale health threats.

Community Health Centers: A 2013 Profile And Prospects As Aca Implementation Proceeds, Peter Shin, Jessica Sharac, Zoe Barber, Sara J. Rosenbaum, Julia Paradise

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

In 2013, more than 1,200 federally funded community health centers provided access to care for low-income populations living in medically underserved communities throughout the country. The Affordable Care Act made expansion of health centers a key part of its strategy for ensuring that these communities would realize the benefits of increased health insurance coverage for their residents. As health insurance coverage expands under the Affordable Care Act (ACA) and the demand for primary care increases, the role of health centers is likely to increase. A key question going forward is whether health centers’ expanded capacity, developed over the past five …

Determinan Perilaku Tes Hiv Pada Ibu Hamil, Nanik Setiyawati, Niken Meilani

Kesmas

Human immunodeficiency virus (HIV) dan Acquired immune deficiency syndrome (AIDS) merupakan salah satu sorotan dalam pencapaian target Millenium Development Goals (MDGs). Ibu hamil dengan HIV akan berisiko menularkan kepada bayinya. Tes HIV merupakan gerbang pembuka status HIV yang sangat penting dilakukan pada ibu hamil. Penelitian ini bertujuan untuk menentukan determinan perilaku tes HIV pada ibu hamil yaitu tingkat pendidikan, tingkat pengetahuan, persepsi kerentanan diri tertular HIV, sikap, Provider-Initiated Testing and Counselling (PITC) dan ketersediaan sumber informasi (keluarga dan kader kesehatan). Jenis penelitian adalah potong lintang dengan metode survei. Penelitian ini dilakukan di Puskesmas Mantrijeron dan Puskesmas Sleman yang telah memiliki …

Pengaruh Faktor Personal Berpengaruh Terhadap Perilaku Seksual Pranikah Pada Remaja Di Kota Kendari Provinsi Sulawesi Tenggara, Rosdarni Rosdarni, Djaswadi Dasuki, Sumarni Djoko Waluyo

Kesmas

Perilaku seksual pranikah yang tinggi pada remaja disebabkan oleh faktor personal seperti pengetahuan kesehatan seksual, Infeksi Menular Seksual (IMS) dan HIV / AIDS, sikap terhadap seksualitas, harga diri dan efikasi diri. Penelitian ini bertujuan untuk mengetahui pengaruh faktor personal seperti pengetahuan tentang kesehatan seksual, IMS dan HIV / AIDS, sikap, harga diri dan efikasi diri terhadap perilaku seksual pranikah pada remaja di Kota Kendari yang diukur melalui kuesioner dan wawancara mendalam. Desain penelitian adalah studi potong lintang dengan jumlah sampel 200 remaja yang berasal dari empat sekolah negeri di Kota Kendari mulai dari Agustus sampai dengan Oktober 2014. Analisis regresi …

Mekanisme Hubungan Sosial Ekonomi, Pemanfaatan Pelayanan Kesehatan Dan Kehamilan Risiko Tinggi Terhadap Prevalensi Panjang Badan Lahir Pendek, Demsa Simbolon, Wahyu Dwi Astuti, Lusi Andriani

Kesmas

Prevalensi panjang badan lahir pendek di Indonesia masih tinggi dan menjadi masalah kesehatan masyarakat yang disebabkan oleh pelbagai faktor secara langsung dan tidak langsung serta berdampak luas dan berkelanjutan dalam siklus kehidupan. Penelitian menggunakan data Riset Kesehatan Dasar (Riskesdas) 2013 dengan pendekatan potong lintang bertujuan mengetahui mekanisme hubungan berbagai variabel laten terhadap prevalensi panjang badan lahir pendek. Sampel adalah 497 kabupaten yang diagregat dari data individu, yaitu anak lahir dari ibu berusia 15 hingga 49 tahun dengan kriteria anak kandung dan lahir tunggal. Pemodelan menggunakan Structural Equation Modelling. Kehamilan berisiko tinggi berhubungan positif langsung dengan prevalensi panjang badan lahir pendek …

Risiko Ergonomi Ketidaksesuaian Desain Dan Ukuran Tempat Duduk Sepeda Motor Terhadap Antropometri Pada Mahasiswa, Zulkifli Djunaidi, Rahmadani Arnur

Kesmas

Transportasi merupakan hal yang sangat dibutuhkan dalam menunjang pembangunan nasional. Belum baiknya sistem transportasi massal di Indonesia, membuat masyarakat lebih memilih menggunakan kendaraan pribadi, seperti sepeda motor yang praktis dan ekonomis untuk digunakan. Namun, dalam menggunakan sepeda motor, aspek ergonomi dan kenyamanan bagi pengendara perlu untuk diperhatikan. Desain dan ukuran tempat duduk sepeda motor yang tidak sesuai dengan antropometri duduk statis pengendara dapat menimbulkan kelelahan pada pengendara dan mengakibatkan terjadinya kecelakaan. Tujuan dari penelitian ini adalah untuk mengetahui risiko ergonomi dari ketidaksesuaian antara desain dan ukuran tempat duduk sepeda motor dengan antropometri duduk statis. Untuk menganalisis risiko ergonomi, dilakukan penelitian …

Model Pengendalian Faktor Risiko Stunting Pada Anak Bawah Tiga Tahun, Erna Kusumawati, Setiyowati Rahardjo, Hesti Permata Sari

Kesmas

Stunting merupakan masalah gizi, terbukti data pemantauan status gizi Kabupaten Banyumas 2012 prevalensi stunting sebesar 28,37% dan prevalensi tertinggi (41,6%) di Puskesmas Kedungbanteng. Tujuan penelitian untuk menganalisis faktor risiko terkait faktor anak, ibu, lingkungan terhadap stunting bawah tiga tahun (batita) agar dapat dikembangkan model pengendaliannya. Penelitian menggunakan desain kasus kontrol, populasi adalah seluruh anak usia 6 sampai 36 bulan di Puskesmas Kedungbanteng Kabupaten Banyumas selama enam bulan tahun 2013. Sampel kasus adalah 50 batita stunting, sampel kontrol adalah 50 batita status normal. Teknik pengambilan sampel kasus diambil dari tujuh desa yang terbanyak stuntingnya, sedangkan kontrol adalah batita normal tetangga terdekat …

Lama Merokok Dan Jumlah Konsumsi Rokok Terhadap Trombosit Pada Laki-Laki Perokok Aktif, Rini Sundari, Dinyar Supiadi Widjaya, Aditya Nugraha

Kesmas

Jumlah perokok dan jumlah rokok yang dikonsumsi mengalami peningkatan dari waktu ke waktu. Rokok dapat memengaruhi trombosit yang dapat menyebabkan gangguan kardiovaskular. Penelitian ini merupakan penelitian potong lintang yang bertujuan untuk menganalisis lama merokok dan jumlah rokok yang dikonsumsi terhadap jumlah trombosit, mean platelet volume (MPV), platelet distribution width (PDW), platelet crit (PCT), dan platelet large cell ratio (PLCR). Penelitian dilakukan di Pabrik Garmen Cimahi pada tahun 2014 yang diikuti oleh 31 laki-laki perokok aktif berusia 19 - 50 (32,97 + 10,28) tahun, 70,9% di antaranya sebagai perokok sedang. Analisis data dilakukan secara deskriptif, uji normalitas Shapiro-Wilk, dan uji korelasi …