Health Services Administration Commons^™

What Are The Most Important Dimensions Of Quality For Addiction And Mental Health Services From The Perspective Of Its Users?, Priscilla Liu, Shawn Currie, Jassandre Adamyk-Simpson

Patient Experience Journal

There is a need to better engage service users in improving their experience with the care received in Addiction and Mental Health (A&MH). Dimensions of patient experience that are most salient to A&MH service users still remain to be properly defined from the patient perspective. This research focuses on identifying key domains of service experience important to patients of Addiction and Mental Health using patient focus groups. In addition, through a patient and family advisory committee, patients were also engaged as co-partners of the research team. The patient advisors had a major role in overseeing the research project, assisting with …

Exploring Workforce Confidence And Patient Experiences: A Quantitative Analysis, Katie M. Owens, Stephanie Keller

Patient Experience Journal

Confidence is recognized as one of the most influential factors to affect performance. Individual, leader, and team confidence play essential roles in achieving success and the absence of confidence has been connected with failure. While confidence is not a substitute for competency, it creates trusting relationships, empowerment, and resiliency to persevere when challenges arise. Objective: In this study, we examined workforce confidence in the patient experience and patient perceptions of their experience of care. Methods: We compared responses to the Patient-Centered Excellence Survey (PCES) from 41 United States hospitals, measuring workforce confidence in the patient experience provided, to patient’s ratings …

Nursing Transfer Of Accountability At The Bedside: Partnering With Patients To Pilot A New Initiative In Ontario Community Hospitals, Kristina Ba Miller, Aden Hamza, Kateryna Metersky, Dianne M. Gaffney

Patient Experience Journal

The transfer of accountability (TOA) for a patient from one nurse to another at change of shift is an important opportunity to exchange essential patient care information, as well as to enhance the safety and quality of patient care. This study was undertaken to explore nurses’, patients’ and family members’ perceptions associated with the implementation of bedside nurse to nurse TOA. Focus groups were conducted pre-implementation (two with nurses and two with patients and family members) and post-implementation (six with nurses and two with patients and family members). The focus groups were audio-recorded, transcribed and analysed using directed content analysis. …

Family-Centered Caregiving From Hospital To Home: Coping With Trauma And Building Capacity With The Hope For Families Model, Anna Newcomb, L Gordon Moore, Holly C. Matto

Patient Experience Journal

Informal caregivers and families play a significant role in the recovery process of trauma survivors. However, the needs and outcomes of orthopedic caregiving family members in the months following traumatic injury have received almost no attention in the literature. Our study sought to understand the factors impacting orthopedic trauma families’ experience and their ability to cope and provide care post-acute hospitalization. Based on these findings, we designed a hospital-based program to enhance family coping and adjustment post-discharge. Caregivers (N=12) of patients with orthopedic trauma injury engaged in three in-depth semi-structured face-to-face interviews to identify their most salient concerns. Once home, …

How Patients View Their Contribution As Partners In The Enhancement Of Patient Safety In Clinical Care, Marie-Pascale Pomey, Nathalie Clavel, Ursulla Aho-Glele, Noemie Ferré, Paloma Fernandez-Mcauley

Patient Experience Journal

Despite the call from the World Health Organization for more active involvement from patients in the prevention of health care-related risks, there is still insufficient evidence about how patients can be more proactive in the safety of their own care. This study helps understand the perspective of patients as partners regarding their roles, as well as their relatively untapped potential in detecting and limiting adverse events (AEs) for patient safety. 17 patients-as-partners were interviewed on five themes: 1) Behavior of patients/relatives for avoiding AEs; 2) Competencies sought in patients/relatives to play an active role in patient safety; 3) Factors limiting …

Barriers And Facilitators To Family Participation In The Care Of Their Hospitalized Loved Ones, Lynda Bélanger, Marie Desmartis, Martin Coulombe

Patient Experience Journal

This study’s objective was to better understand family members’ experiences in order to identify how healthcare organizations can facilitate their participation in the care of a hospitalized loved one. Eighteen individuals at the bedside of a hospitalized loved one were interviewed individually. Roles at the bedside and factors that facilitated their participation or represented barriers were examined. A qualitative analysis using a mixed inductive/deductive approach was performed. Reassurance and emotional support, as well as sharing information with the healthcare team emerged as main roles. Quality and timeliness of the information received about the patient’s condition, prognosis and changes in medical …

The Sherpa Meets Maslow: Medicine And The Hierarchy Of Needs, Rana Lee Adawi Awdish Md Fccp

Patient Experience Journal

A critical care physician returning to medicine after her own critical illness experiences a crisis of orientation. She finds she can no longer serve as the Voice of Medicine. She replaces the former construct with a more humble model, in which the physician serves as an intermediary. She equates this new role to that of the Sherpas of Nepal. Maslow’s hierarchy of needs forms the mountain, as she reimagines her role in her patients’ lives.

The Consumer Has Spoken: Patient Experience Is Now Healthcare’S Core Differentiator, Jason A. Wolf Phd

Patient Experience Journal

In just a few days we will celebrate Patient Experience Journal’s (PXJ) 4^th anniversary since our inaugural publication. In these 4 short and quick years we have seen 163 articles published in our first four volumes that have stirred a significant focus on building the evidence base in patient experience. Not only has PXJ served as the central clearing house for thoughtful research, measurable cases, and insightful narratives, but it also has reinforced the breadth and depth of what patient experience truly encompasses. This integrated view was reinforced by the very voices of healthcare’s consumers in The Beryl Institute’s …

Articulación Y Apoyo Del Programa De Los Agentes Sanitarios De Mendoza: De La Teoría A La Práctica / Coordination And Support In Mendoza’S Community Health Worker Program: From Theory To Practice, Kelly Mchugh

Independent Study Project (ISP) Collection

Información contextual: Desde que fue publicada la resolución de la Alma-Ata, varios sistemas de salud al nivel mundial han implementado programas de agentes sanitarios para ayudar en el cumplimiento de la estrategia de la Atención Primaria de la Salud (APS) y el aseguramiento de la salud como derecho humano. Sin embargo, en los últimos años, varios investigadores identificaron obstáculos comunes que enfrentan los agentes sanitarios en el alcance de sus tareas como resultado de la falta de apoyo que reciben por el sistema de salud. En forma sucesiva, dicha falta de apoyo ocasionó daño potencial para su capacidad de contribuir …

How Much Do We Spend? Creating Historical Estimates Of Public Health Expenditures In The United States At The Federal, State, And Local Levels, Jonathon P. Leider, Beth Resnick, David Bishai, F. Douglas Scutchfield

Health Management and Policy Faculty Publications

The United States has a complex governmental public health system. Agencies at the federal, state, and local levels all contribute to the protection and promotion of the population's health. Whether the modern public health system is well situated to deliver essential public health services, however, is an open question. In some part, its readiness relates to how agencies are funded and to what ends. A mix of Federalism, home rule, and happenstance has contributed to a siloed funding system in the United States, whereby health agencies are given particular dollars for particular tasks. Little discretionary funding remains. Furthermore, tracking how …

Inpatient Satisfaction At Different Public Sector Hospitals Of A Metropolitan City In Pakistan: A Comparative Cross-Sectional Study, Mehwish Hussain, Rehana Rehman, Zia Ikramuddin, Nava Asad, Ayesha Farooq

Department of Biological & Biomedical Sciences

Objective: To observe inpatient satisfaction at different public sector hospitals of Karachi, Pakistan.
Methods: A cross sectional study was carried out during 2010-2012 in four major public sector hospitals of Karachi. A total of 710 patients completed the study. Responses were gathered in a self-structured questionnaire that comprised of four dimensions of satisfaction with doctor, staff, administration and treatment. Average Score of each dimension was taken and compared using one way analysis of variance.
Result: Satisfaction with doctors, staff and administration of provincial and federal hospitals were comparatively similar (P > 0.05). However, satisfaction with treatment significantly differed in all four …

Family Impact Seminar 2018: The Kids Are Not All Right: Policy Options To Address Youth Trauma In Massachusetts, Denise Hines, Laurie Ross Ph.D, Marianne Sarkis Ph.D

Mosakowski Institute for Public Enterprise

Family Impact Seminars are a series of annual seminars, briefing reports, and discussion sessions that provide up-to-date, solution-oriented research on current issues for state legislators and their aides. The seminars provide objective, nonpartisan research on current issues and do not lobby for particular policies. Seminar participants discuss policy options and identify common ground where it exists.

The Kids are NOT All Right: Policy Options to Address Youth Trauma in Massachusetts is the ninth Massachusetts Family Impact Seminar. Today’s seminar is designed to emphasize a family perspective in policymaking on issues related to early intervention in childhood trauma, sex trafficking and …

A Longitudinal Analysis Of The Impact Of Child Custody Loss On Drug Use And Crime Among A Sample Of African American Mothers, Kathi L. H. Harp, Carrie B. Oser

Health Management and Policy Faculty Publications

This study examines the influence of child custody loss on drug use and crime among a sample of African American mothers. Two types of custody loss are examined: informal custody loss (child living apart from mother but courts not involved), and official loss (child removed from mother’s care by authorities).

Methods—Using data from 339 African American women, longitudinal random coefficient models analyzed the effects of each type of custody loss on subsequent drug use and crime.

Results—Results indicated that both informal and official custody loss predicted increased drug use, and informal loss predicted increased criminal involvement. Findings demonstrate …

Identifying Windows Of Opportunity For Active Living And Healthy Eating Policies In Connecticut, 2016, Anna E. Greer, Ann-Uriel Knausenberger

Public Health Faculty Publications

We examined the relative importance of 23 community issues among elected officials and health directors in Connecticut in 2016. For this cross-sectional study, 74 elected officials (40.7% response rate) and 47 health directors (62.7% response rate), who were purposively sampled, completed a questionnaire to rate their perceived importance of 23 community issues. Eight of these issues were related to active living, healthy eating, or obesity. We used χ2 tests to evaluate differences in responses. Compared with elected officials, health directors significantly more often perceived obesity, access to healthy groceries, poor nutrition, lack of pedestrian walkways, and pedestrian safety as important. …

Wellness And Multiple Sclerosis: The National Ms Society Establishes A Wellness Research Working Group And Research Priorities, Robert W. Motl, Ellen M. Mowry, Dawn M. Ehde, Nicholas G. Larocca, Kathy E. Smith, Kathleen Costello, Lynne Shinto, Alexander V. Ng, Amy B. Sullivan, Barbara Giesser, Kevin K. Mccully, Bo Fernhall, Malachy Bishop, Matthew Plow, Patrizia Casaccia, Nancy D. Chiaravalloti

Early Childhood, Special Education, and Counselor Education Faculty Publications

Background: People with multiple sclerosis (MS) have identified “wellness” and associated behaviors as a high priority based on “social media listening” undertaken by the National MS Society (i.e. the Society).

Objective: The Society recently convened a group that consisted of researchers with experience in MS and wellness-related research, Society staff members, and an individual with MS for developing recommendations regarding a wellness research agenda.

Method: The members of the group engaged in focal reviews and discussions involving the state of science within three approaches for promoting wellness in MS, namely diet, exercise, and emotional wellness.

Results: That process informed a …

Rural Family Physicians In Patient Centered Medical Homes Have A Broader Scope Of Practice, Lars E. Peterson, Bo Fang

Rural & Underserved Health Research Center Publications

Overview

• Rural family physicians often have a broader scope of practice, defined as the range of clinical and procedural services that they provide, than urban family physicians. The Patient Centered Medical Home (PCMH) model of care is intended to provide accessible and comprehensive care, but little is known about how practicing in a PCMH is associated with rural family physicians’ scope of practice.
• Using data from 18,846 family physicians nationally, we found that rural family physicians working in PCMH practices generally provide a wider scope of clinical and procedural services than those not working in PCMH practices.

Rural Family Physicians Have A Broader Scope Of Practice Than Urban Family Physicians, Lars E. Peterson, Bo Fang

Rural & Underserved Health Research Center Publications

Overview of Key Findings

• Little is known about whether rural family physicians provide a broader scope of practice, defined as the range of clinical and procedural services that they provide, than metropolitan family physicians.
• Using data from 18,846 family physicians, we examined variations in the provision of 21 clinical services (e.g., inpatient care, home visits, and obstetrics) and 18 procedural services (e.g., prenatal ultrasound, endoscopy, and office skin procedures) across metropolitan, large rural, small rural, and frontier areas.
• We found that the percentage of family physicians providing each type of clinical and procedural service rises with increasing rurality.

Rural/Urban Disparities In Pneumococcal Vaccine Service Delivery Among The Fee-For-Service Medicare Population, Jeffery C. Talbert, Aric Schadler, Patricia R. Freeman

Rural & Underserved Health Research Center Publications

Overview of Key Findings

• In 2014, the overall mean vaccination rate in urban areas was 4.66 compared to a mean vaccination rate of 2.81 in rural areas, indicating a 40% lower mean vaccination rate in rural communities.
• The majority of pneumococcal vaccine services delivered to fee-for-service Medicare beneficiaries were provided by primary care providers, although pharmacy providers delivered close to one-fourth (22.2%) of these services.
• The proportion of pneumococcal vaccine services delivered by pharmacy providers was significantly greater in rural versus urban counties (29.4% vs. 21.1%).
• Consistent with previous literature, county characteristics positively associated with pneumococcal vaccine service delivery include …

Wdph 2017 Summer Internship Report, Lauren Meininger

Mosakowski Institute for Public Enterprise

In the spring of 2014, the Worcester Division of Public Health, UMass Memorial Health Care, and Clark University’s Mosakowski Institute for Public Enterprise joined forces to begin developing a partnership that would combine academic resources, student input, and public health needs in the City of Worcester. Founders of this program were motivated to seek and implement innovative interventions for public health issues while simultaneously inspiring a new generation of public health professionals.

Each year, the Academic Health Collaborative of Worcester (AHCW) brings in student interns to work on the pressing public health issues of the moment. Interns work alongside epidemiologists, …

Policy Implementation Analysis On Exclusive Breastfeeding In Working Area Of Cicalengka Community Health Center In Bandung Regency West Java, Innana Mardhatillah, Yaslis Ilyas

Journal of Indonesian Health Policy and Administration

Data and information on the health profile of Indonesia in 2016 showed only 29.5% of infants receive exclusive breastfeeding until 6 months, the low level of exclusive breastfeeding made the government issue a regulation on exclusive breastfeeding in Government Regulation Number 33 of 2012. The study aimed to analyze the policy implementation of exclusive breastfeeding at Cicalengka Community Health Center. The study used qualitative analysis with in-depth interview method, focus group discussion and literature study. The result of this study shows that breastfeeding policy implementation in health centers is not optimal, as seen from the low coverage of exclusive breastfeeding. …

Analysis Of Factors Related To Employee Behavior In Implementing Patient Safety Program At Insan Permata Woman And Child Hospital Tangerang, Martha Fransisca, Ede Surya Darmawan

Journal of Indonesian Health Policy and Administration

Insan Permata Woman and Child Hospital was facing Patient Safety Incidence especially for periode of mid to late 2016 there were 12 incidents and 11 phlebitis cases. This indicated a gap between the conditions in the field and the ideal situation that should be achieved. This study aimed to see how the behavior of employees in implementing patient safety program and the factors that influence it. The sample of this study were 151 respondents as sample, consist of health and non health workers. The patient safety program focused on the accuracy of patient identification, reduction of risk of infection and …

Implementing A Mobile Health System To Integrate The Treatment Of Addiction Into Primary Care: A Hybrid Implementation-Effectiveness Study, Andrew Quanbeck, David H. Gustafson, Lisa A. Marsch, Ming-Yuan Chih, Rachel Kornfield, Fiona Mctavish, Roberta Johnson, Randall T. Brown, Marie-Louise Mares, Dhavan V. Shah

Health and Clinical Sciences Faculty Publications

Background: Despite the near ubiquity of mobile phones, little research has been conducted on the implementation of mobile health (mHealth) apps to treat patients in primary care. Although primary care clinicians routinely treat chronic conditions such as asthma and diabetes, they rarely treat addiction, a common chronic condition. Instead, addiction is most often treated in the US health care system, if it is treated at all, in a separate behavioral health system. mHealth could help integrate addiction treatment in primary care.

Objective: The objective of this paper was to report the effects of implementing an mHealth system for addiction in …

Analysis Of Policy Implementation For The Improvement Capability Of Internal Government Supervisory Apparatus (Apip) At Inspectorate General Of Ministry Of Health, Ajeng Hadiati Sarjono, Wachyu Sulistiadi

Journal of Indonesian Health Policy and Administration

The capability of the Internal Government Supervisory Apparatus (APIP) is the ability to carry out supervisory tasks consisting of three interrelated elements: capacity, authority, and competence. The objective of this research is to give policy recommendations for enhanced APIP capability in the Inspectorate General of the Ministry of Health. This research is a descriptive study with qualitative analysis method with in-depth interview and literature study. Results of this research indicate that there are some obstacles: the socialization done only to some employees of Itjen; no Special Team on the process of improving APIP capability; the time and task division is …

The Factors Of Management, Communication, Partnership, And Innovation In The Implementation Of Posbindu (Integrated Health Post) Ncd: A Study In Kelurahan Gunung Batu Bogor City, Siti Khodijah Parinduri, Pujiyanto Pujiyanto

Journal of Indonesian Health Policy and Administration

By 2015, 68% of deaths in Indonesia are due to non-communicable diseases (NCD) and are forecast to increase to 74% by 2030. Riskesdas data of 2013 show that 69.6% of cases of diabetes mellitus and 63.2% of cases of hypertension have not been diagnosed. The government has been trying to proactively make efforts to prevent NCD through the implementation of Posbindu (Integrated Health Post) NCD, but visit Posbindu NCD in the work area of Pasir Mulya Puskesmas, Bogor City is very diverse. The purpose of this study is to analyze the factors of management, communication, partnership, and innovation in the …

Analysis Of Partnership Of Private Practice Midwife In The National Health Insurance Program In District Bungo Jambi Province, Nurlie Azwar, Prastuti Soewondo

Journal of Indonesian Health Policy and Administration

On January 1, 2014, the government began to implement the National Health Insurance (NHI) program to realize social welfare for the whole community. Midwifery and neonatal care in the NHI program involves Puskesmas/family doctors and Private Practice Midwife (PPM) as its network. PPM participation in the NHI program in Bungo District was still lacking, only 12 (54.5%) PPM have cooperated with family doctors from 22 existing PPM. This study aimed to get an overview of PPM participation in the NHI program in Bungo District, Jambi Province. The study used qualitative research approach with Rapid Assessment Prosedur design, purposive sampling, and …

The Use Of External Change Agents To Promote Quality Improvement And Organizational Change In Healthcare Organizations: A Systematic Review, Esra Alagoz, Ming-Yuan Chih, Mary Hitchcock, Randall Brown, Andrew Quanbeck

Health and Clinical Sciences Faculty Publications

Background: External change agents can play an essential role in healthcare organizational change efforts. This systematic review examines the role that external change agents have played within the context of multifaceted interventions designed to promote organizational change in healthcare-specifically, in primary care settings.

Methods: We searched PubMed, CINAHL, Cochrane, Web of Science, and Academic Search Premier Databases in July 2016 for randomized trials published (in English) between January 1, 2005 and June 30, 2016 in which external agents were part of multifaceted organizational change strategies. The review was conducted according to PRISMA guidelines. A total of 477 abstracts were identified …

The Effectiveness Of Interventions And Bundles For Central Line-Associated Bloodstream Infections In The Neonatal Intensive Care Unit, Mohamad Alhamwi

Honors Undergraduate Theses

Introduction: Central Line-Associated Bloodstream Infections (CLABSIs) are a major cause of increased mortality, morbidity and healthcare costs in neonatal intensive care units (NICUs) patients. Despite CDC's efforts to reduce infection rates, patients often suffer consequences. The objective of this study is to perform a systematic review of strategies utilized in the neonatal population and evaluate them with the current CDC's guidelines to assess the effectiveness of bundles in preventing CLABSI in NICUs.

Methods: A systematic literature search was conducted using CINAHL Plus with Text, Cochrane Database of Systematic Reviews and MEDLINE from January 2008 up to 2018. There were multiple …

Perceived Treatment Need And Utilization For Illicit Drug And Opioid Use Disorders In Non-Metropolitan Areas, Tyrone F. Borders, Hefei Wen

Rural & Underserved Health Research Center Publications

The policy brief provides nationally representative estimates of perceived treatment need and utilization for illicit drug and prescription pain reliever use disorders among non-metropolitan and metropolitan adults ages 18-64.

Illicit Drug And Opioid Use Disorders Among Non-Metropolitan Residents, Tyrone F. Borders, Hefei Wen

Rural & Underserved Health Research Center Publications

Illicit drug use disorder rates are similar across metropolitan and non-metropolitan areas and did not decline from 2011-2013 to 2014-2015 despite the implementation of major substance use treatment policies over this time period.

Work And Family Conflict: A Comparative Analysis Among Staff Nurses, Nurse Managers, And Nurse Executives, Amanda Raffenaud

Electronic Theses and Dissertations

The nursing workforce increasingly faces issues that affect clinical and managerial practice. One such issue is work-family conflict (WFC) and family-work conflict (FWC). Nurses face role strain as they confront the pressures from often competing work-and-family roles. This study assessed WFC/FWC among varying nurse roles: staff nurses, managerial nurses, and nurse executives. A random sample of 5,000 nurses, generated from registered nurses practicing in the state of Florida, was surveyed for this research study. Nurses were surveyed on demographics, perceptions regarding the work environment, and perceptions of WFC/FWC. Descriptively, nurses experienced more work-family conflict than family-work conflict. Regression analyses and …