Public Health Commons^™

Penerapan Lean Thinking Untuk Mereduksi Waktu Boarding Pasien Igd Ke Rawat Inap Di Rsud Koja Tahun 2017, Theryoto Theryoto

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

The implementation of the National Health Insurance Program (Program JKN) affects the increased number of patients to emergency unit and boarding patients that resulting crowding in the emergency unit. Koja Hospital has implemented bed management in order to reduce the boarding time of emergency unit patients but has not succeeded, so an effort to help reducing the boarding time of emergency unit patients to inpatient in order to continuous improvement was done using the lean thinking principle. This research uses operational research method and intervention with PDCA (Plan, Do, Check, Action) cycle. The study revealed that lean thinking approach could …

Analisis Kesiapan Sistem Remunerasi Berdasarkan Peraturan Gubernur Provinsi Dki Jakarta Nomor 222 Tahun 2016 Di Rsud Pesanggrahan Tahun 2017, Endah Kartika Dewi

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

RSUD Pesanggrahan as a Health Service Unit of Special Capital Region of Jakarta which has applied financial pattern of Regional Public Service Board (BLUD). This research uses quantitative with simulation of system calculation to be applied and qualitative with explore stakeholder perception readiness with indepth interview. From the result of research it is known that in general the informant is satisfied with the income received now. And from the simulate conducted, RSUD Pesanggrahan has not been able to apply the system based on Governor Regulation No. 222/2016 yet. Suggestion to the Health Department as a regulator is to give the …

Managing The Cost Of Diabetes, Laressa Bethishou

Pharmacy Faculty Articles and Research

"This is of concern to health care providers because inadequate management of diabetes results in short- and long-term complications. Patients with diabetes and no health insurance have fewer physician visits and are prescribed fewer medications for management of their diabetes. Patients with diabetes make up 11.9% of all emergency department visits in the United States.Hispanic and non-Hispanic blacks are at greater risk for developing diabetes and serious associated health complications, including chronic kidney disease. This may be attributed to a combination of genetics, diet, and exercise. However, access to health care resources may also play an important role."

Gender Differences In Virologic Response After Antiretroviral Therapy In Treatment-Naïve Hiv-Infected Individuals: Results From The 550 Clinic Hiv Cohort Study., Andrea Reyes-Vega, Alejandra Loban, Kavitha Srinivasan, Stephen P. Furmanek, Conner English, Mary Bishop, Cathy Spencer, Daniel Truelove, Julio A. Ramirez, Anupama Raghuram, Paula Peyrani

Faculty and Staff Scholarship

Background

Controversy still exists regarding gender differences in virologic response between treatment-na•ve HIV-infected individuals. The objective of this study was to evaluate gender difference in virologic and immunologic response to antiretroviral therapy in treatment-na•ve HIV-infected individuals. Methods

This was a retrospective, observational study of treatment-na•ve HIV-infected individuals managed at the 550 clinic who started antiretroviral therapy (ART) between January 1st, 2010 and December 31, 2015. Patients with available viral load and CD4 counts before and one year after initiating ART were included in this study. Virologic suppression was defined as < 48 HIV-1 RNA copies/mL, and mmunologic recovery was defined as a CD4 count increase of at least 150 cells/mm3. Dichotomous variables were reported in number and percentages and analyzed using Chi-squared tests and Fisher’s exact (whichever was appropriate). Continuous variables were reported as median and interquartile range (IQR) and analyzed using Wilcox rank-sum tests. Multivariate analyses performed were logistic regressions with adjustment for other covariates. P value <0.05 was considered statistically significant. R version 3.3.2 was used for the statistical analysis. Results

A total of 70 women and 90 men were included …

Las Condiciones De Vida De Los Usuarios Adultos Mayores Del Hospital Makewe / The Living Conditions Of Elderly Users Of Makewe Hospital, Taylor Selembo

Independent Study Project (ISP) Collection

Life conditions are a fundamental aspect of the health of senior citizens, as these are the factors that determine their quality of life and capacity to satisfy their needs. Life conditions are dependent on the particular social, political, economic, and geographic context of the region. This study intends to answer the following question: How are the life conditions of senior citizens belonging to Hospital Makewe, located in the IX region of Chile? This quali-quantitative study utilized observation, surveys (n = 40) and interviews (n = 15) in order to accomplish the main objective. The main objective was to describe senior …

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 …

Analyzing The Effectiviness Of A Prescription Drug Monitoring Program Targeting At-Risk Opioid Abuse Patients, Treadway Childs

Public Administration ETDs

The effectiveness of a prescription drug monitoring program in coordination with a prescription opioid recidivism program was examined at a semi-rural community hospital. Patients were identified by a multi-disciplinary committee to be at-risk for opioid misuse or abuse, and were denied prescription opioids. Patients were considered eligible for the program if they had over 12 emergency department visits in the previous 12 months, or 6 visits in the previous 6 months, depending on how long the hospital had records on a patient. Patients who were placed in the prescription opioid recidivism program could not receive opioids at this hospital. The …

Refugee-Centered Medical Home:A New Approach To Care At The University Of Louisville Global Health Center, Rahel Bosson, Ruth M. Carrico, Anupama Raghuram, Paula Peyrani, William A. Mattingly, Rebecca Ford, Stephen P. Furmanek, Julio A. Ramirez

Journal of Refugee & Global Health

Refugees arrive to the United States with a full spectrum of health conditions, many of which involve intense case management requiring significant financial investments and use of healthcare resources. Kentucky receives more than 3,000 new refugees each year and ranked 10th in the nation for numbers of new arrivals resettled during 2015. These refugees arrive from diverse countries representing different cultures and speaking different languages. In addition, they arrive with diverse health conditions and medical needs. The aims of this paper are to share experiences from the University of Louisville Global Health Center regarding conceptualization, implementation and evaluation of a …

Abstracts From The 23rd Annual Health Care Systems Research Network Conference, March 21–23, 2017, San Diego, California

Journal of Patient-Centered Research and Reviews

This proceedings supplement includes selected abstracts presented at the 23rd annual conference of the Health Care Systems Research Network (HCSRN), held March 21–23, 2017, in San Diego, California. Formerly called the HMO Research Network, HCSRN aims to improve individual and population health through research that connects the resources and capabilities of its member health care systems.

Call For Submissions. Special Issue – July 2018: Patient & Family Experience In Children’S Hospitals And Pediatric Care, Patient Experience Journal

Patient Experience Journal

Patient Experience Journal (PXJ) is excited to announce a call for submission for its special issue scheduled for July 2018 on the topic of patient & family experience in children’s hospitals and pediatric care. This special issue is open to all authors conducting cutting-edge research, implementing innovative practices or with powerful experiences to share around efforts in either children’s hospitals or pediatric care. It is encouraged that articles submitted deal directly with efforts in those care settings. The issue will look for pieces that address evidence-based efforts at improvement, practices that have impact on outcomes or stories that reflect …

Experience-Based Co-Design: A Method For Patient And Family Engagement In System-Level Quality Improvement, Bianca Fucile, Erica Bridge, Charlene Duliban, Madelyn P. Law Dr.

Patient Experience Journal

Integrating patient and family member needs, wants and preferences in healthcare is of utmost importance. However, a standardized patient and family engagement model to understand these needs, wants and preferences in order to translate into high quality improvement activities is lacking. Experience based co-design (EBCD) is an approach that enables patients, family members and healthcare providers to co-design improvement initiatives together. In this study, EBCD was employed to: 1) assess the current state of information and educational resources at a local oncology center and 2) partner with patients, family members, and healthcare providers to create quality improvement initiatives targeting identified …

Integrating Person Directed Care Into The Client Experience, Tammy L. Marshall Ms., Joann P. Reinhardt, Orah Burack, Audrey S. Weiner

Patient Experience Journal

Culture Change leaders in long term care have identified creative ways to implement a model of Person Directed Care to improve the client experience by providing choice, instilling dignity, and fostering deep relationships among its community members. One organization created an environment of care called ”The Small House” and educated its’ workforce using the Green House® Project Legacy Alignment program to redesign the organizational structure, experience and environment. Interviews were conducted with elders, staff, and family members (N=20) about their experiences living, working or visiting a Small House as compared to experiences in their previous dwelling, a traditional nursing home. …

Understanding The Role Of Patient And Public Involvement In Renal Dietetic Research, Andrew Morris Mr, Deborah Biggerstaff, Nithya Krishnan, Deborah Lycett

Patient Experience Journal

The objective was to consult patients on a proposed recruitment strategy to a patient and public involvement exercise. We wanted to explore the reasoning and willingness of patients to become co-researchers within a grant application. Eighteen people using the renal health service informed the consultation by action research so that their experiences could be used to guide the overall methodology. Twelve people took part in semi-structured interviews. NVIVO 10 and Framework Analysis were used to interpret emerging themes from the data. The recruitment strategy, informed by research expertise, became an experience-based expert design. The design took into account the limitations …

Lack Of Patient Involvement In Care Decisions And Not Receiving Written Discharge Instructions Are Associated With Unplanned Readmissions Up To One Year, Kyle A. Kemp, Hude Quan, Maria J. Santana

Patient Experience Journal

This retrospective, cross-sectional study examined the relationship between aspects of inpatient communication and discharge instructions and unplanned, all-cause readmissions using individual-level data up to one-year post-discharge. Patients completed the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) telephone survey within 6 weeks of hospital discharge in Alberta, Canada. Survey data were linked to corresponding inpatient records. Independent variables included selected demographic characteristics, clinical variables, and five survey questions: a) patient involvement in care decisions, b) receiving written information at discharge, c) understanding the purpose of taking medications, d) understanding responsibility for one’s health, and e) discussing help needed when …

The Paradigm Of Patient Must Evolve: Why A False Sense Of Limited Capacity Can Subvert All Attempts At Patient Involvement, Dave Debronkart

Patient Experience Journal

This essay reviews the role of paradigms in molding the thoughts of a scientific field and looks rigorously at what two key terms mean – empowered and engaged – and how their interaction points to a new way forward, requiring a re-examination of our “paradigm of patient.” Five years ago, the Institute of Medicine’s Best Care at Lower Cost declared that patient-clinician partnerships are a cornerstone of a learning health system, a declaration that’s foundational to the era of involvement. How can we engineer that era correctly if our conception of “patient” is out of date? And how can we …

Pushing The Boundaries Of Patient Experience, Jason A. Wolf Phd

Patient Experience Journal

This special issue is designed to push the boundaries of patient experience a little farther. Beyond just examples of applying the critical principles of patient and family centered care or even practices of patient engagement, we have been pushed to move further down the perspective of partnership, to the era of “doing with” in which healthcare now finds itself. The idea of involvement as the descriptor selected to frame this issue, was due to its broad and representative nature. It reflects all the words on involving patients mentioned above, but gets further along to participation and ownership (or activation as …

Analisis Biaya Dan Faktor-Faktor Penentu Inefisiensi Layanan Hemodialisis Pada Pasien Gagal Ginjal Kronik Rumah Sakit Rk Charitas Palembang Tahun 2016, Noer Triyanto Rusli

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

Enactment of JKN in hospital changes the payment system from retrospective payment (fee for service) into prospective payment (INA-CBG's). As a healthcare facility, RK Charitas Hospital has a role to provide not only quality but also to consider cost effective of services. This study aimed to analyze costs and identify the determinants of the inefficiency of hemodialysis services in patients with chronic renal failure at RK Charitas Hospital. This is a descriptive analysis research using primary and secondary data. Approach of cost analysis is Activity Based Costing (ABC) with "Bottom Up" method. ABC method is used to allocate costs by …

Analisia Kinerja Rumah Sakit Umum Daerah Dr. H. Abdul Moeloek Provinsi Lampung Tahun 2011- 2013 Berdasarkan Balanced Scorecard, Laisa Muliati

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

RSUDAM as public sector organizations BLUD status, health services should be held responsible, effective and efficient. It required comprehensive tools as a form of accountability to the community or the owner. Balanced scorecard by many nonprofits regarded as a comprehensive measuring tool. Namely the customer perspective, financial, internal business process perspective and the perspective of growth and learn. to analyze the performance of RSUDAM years 2011-2013 based balanced scorecard.The data analysis univariate analysis (descriptive). Data processing with methods of qualitative and quantitative studies of secondary data research activities in 2011-2013 show that: 1) The performance of the customer's perspective: Patient …

Intervensi Continuous Improvement Rawat Jalan Rumah Sakit Haji Jakarta, Teguh Ariotejo

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

The process of general patient care in the outpatient installation of Haji Hospital Jakarta when viewed from the outpatient mobility flow since registration until the patient came home seen the flow that makes the patient walk back and forth to the cashier or to the supporting room service (laboratory and radiology). This is of course a waste of time and the movement of patients. Therefore, continuous improvement is needed in the effort to improve the quality and efficiency of service to the patient in the outpatient installation of Jakarta Hajj Hospital.

Penerapan Lean Manajemen Pada Pelayanan Rawat Jalan Pasien Bpjs Rumah Sakit Hermina Depok Tahun 2017, Elisabeth Dyah Noviani

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

The length of waiting time in the hospital outpatient service is important for efficient hospital service. Long waiting time leads to accumulating queue and inefficient service. This study was aimed to analyze the application of lean method on outpatient BPJS services at Hermina Depok Hospital in 2017. This qualitative research method investigated the time spent by BPJS outpatient patient by applying lean method and observing the outpatient service flow condition. The results showed that 90% service time was a non-value added activities and only 10% of value-added activities. After conducting future state analysis with the proposed improvement with simulative lean …

Review Sistematik: Elemen-Elemen Utama Dalam Membangun Budaya Keselamatan Pasien Di Rumah Sakit, Adik Wibowo

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

Patient safety culture in a hospital setting is the foundation for all health care activities,with the aim to provide safe and comfortable environment throughout the healing process of the patients. This systematic review aims to describe:1) the relationship between hospital as an organization and patient safety culture,2) the traditional and the modern concepts on patient safety, 3)the seven basic elements as founda tion of hospital patient safety culture and 4) the instrument to analyse hospital patient safety culture. The paradigm has changed from traditional way of punishing hospital staff when doing medical error to the just culture, with the philosophy …

Faktor-Faktor Yang Mempengaruhi Net Death Rate (Ndr) Stroke Di Rsud Dr. Kanujoso Djatiwibowo Balikpapan Tahun 2014, Rosjidah Rahmawati

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

This study is seeking the impact of structure and process as the quality aspect according to Donabedian's theory that affecting to the Net Death Rate (NDR) Stroke disease. Selected data source are Stroke patients, consisting of Intracerebral Haemorrhage and Cerebral Infarction at Dr Kanujoso Djatiwibowo Balikpapan Hospital in the year 2014. This study is a qualitative research using descriptive analytic retrospective method. Structure and Process Factors that are influencing each other. It reveals that Structure Factors in hospitalization that are affecting sequentially are the condition of the patient, facilities, policies and human resource. On the other hand it reveals that …

Cancer Center Regional Benchmarks For Psychosocial Care, Desiree R. Azizoddin

Loma Linda University Electronic Theses, Dissertations & Projects

The American College of Surgeons (ACoS) Commissions on Cancer (CoC) formulated and implemented standard 3.2 for Psychosocial Distress Screening. This standard requires that all accredited cancer centers evaluate psychosocial distress and provide appropriate triage and intervention for all cancer patients. Over the past decade, Loma Linda University Medical Oncology Center (LLUMOC) administration, physicians, nurses, psychosocial care staff, and chaplaincy collaborated to implement a psychosocial screening and referral program throughout cancer patient services. This current research includes qualitative analysis assessing strengths and barriers of the psychosocial program at LLUMOC from the perspective of LLUMOC providers and two directors of Supportive Care …

The Effect Of Bundled Interventions On Prevention Of Hospital Acquired Clostridium Difficile Infection, Kaitlin Kendys

Evidence-Based Practice Project Reports

Clostridium difficile infection (CDI) rates have steadily increased in hospitalized patients due to the change in epidemiology. Approximately 13 of every 1,000 inpatients are either infected or colonized with C. difficile (CDC, 2013). CDI rates continue to rise due to the hyper-virulent strain of C. difficile and length of therapy needed to treat CDI. The average cost for a single inpatient CDI is more than $35,000, and the estimated annual cost burden for the healthcare system exceeds $3 billion (Walsh, 2012). The purpose of this evidence-based project (EBP) was to reduce hospital-acquired CDI rates over a 3-month period-oftime from November …

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 …

Text Messaging Appointment Reminders To Increase Patient Appointment Adherence Within A Prevention And Wellness Program, Janel Willingham

Graduate Theses, Dissertations, and Capstones

Abstract

Healthcare organizations want to provide quality care, decrease costs, and promote preventative services for the communities they service. Mobile health units have become an extension of many healthcare organizations and provide different types of services, such as mammography. Providing mammography and wellness exams on a mobile unit presents several challenges; appointment adherence is one of them. Mobile units typically travel to underserved areas to serve people at risk for various health conditions such as breast cancer. Breast cancer is estimated to affect over 250,000 women in the United States during 2017; women have a 1:8 lifetime risk of being …

Not So Affordable Healthcare, Ashlee Charles

Honors College Theses

Rising healthcare cost in the United States has created a need to understand how a lack of healthcare coverage is decreasing women’s quality of life and leading to negative health outcomes. Though the goal of the 2010 Affordable Care Act is to give more Americans access to affordable health insurance and to reduce the growth in health care spending, it still remains unaffordable for many Americans. The purpose of this study was to identify what ecological factors impede and/or promote the quality of life for medically uninsured women. Through a focus group, participants shared information on how living without health …

Long-Term Sustainment Of Rapid Improvement Events: A Case Study In “Room Readiness”, Gabriela V. Coronel

Undergraduate Honors Theses

Shifting payment models from fee for service (FFS) to pay for performance (P4P) have fundamentally changed the environment of healthcare administration in the United States (Center for Medicaid and Medicare Services (CMS), 2011). Due to this shift, there has been an increase in demand for tracking and improving quality measures to ensure not only patient safety, but optimization of utilization. Constraints on resources and capacity, coupled with increasing safety measures has developed a new study of patient flow (Miró, Sánchez, Espinosa, et al., 2003). Decreasing patient room turnover times has the potential to maximize utilization while ensuring patient safety and …

Poster: Communication Strategies For The School Nurse Mentor: A Pilot Training Program, Amy Hotler Dnp, Rn, Lsn, Aphn-Bc

Doctor of Nursing Practice Scholarly Projects

Mentorship has widespread support among many disciplines for the impact on improved job satisfaction, decreased job turnover and decreased costs to organizations. Ongoing support through mentorship is critical to nurses transitioning to a new role and nurse mentors must be prepared for the role with relevant education tailored to their needs . Though literature describing training programs for mentors is limited, some studies have reported an increase in confidence among mentors after training. In addition, improved mentoring skills (that includes communication) is in literature.

In one large urban school district in Ohio, a school nurse, mentorship program was developed and …

How Safe Is Healthcare? Perceptions Within The Healthcare Community And The General Public., Rodhan A. Khthir, Shahed Elhamdani, Ibrahim Hatab, Felyn Espina, Gerry Asuncion, Sutoidem Akpanudo

Marshall Journal of Medicine

Objectives: Complexity of health care is progressively increasing and with that the number of medical errors and adverse events are increasing to an alarming level. The purpose of this study is to assess the perception of healthcare safety within the healthcare community and the general public and examine the association between the perception regarding healthcare safety and the prior exposure to medical errors.

Methods: The study is a cross-sectional online survey. The online survey included basic demographics and a series of questions related to the knowledge and perception about healthcare safety and personal healthcare experience.

Results: 504 respondent …