Health Services Administration Commons^™

Health Policy & Management News, Georgia Southern University

Health Policy & Community Health: News & Publications (2011-2018)

• Georgia Southern Examines Legal Space for Syringe Exchange Programs
• Georgia Southern Examines Emerging Trends and Pathogens in Healthcare

Did A Physician-Targeted Intervention That Reduced Potentially Inappropriate Prescribing To Elderly Patients Also Reduce Related Hospitalizations?, Jacquelyn Mcrae, Pharmd, Sarah E. Hegarty, Pharmd, M. Alcusky, A. Vegesna, S. Varga, S. W. Keith, S. Del Canale, M. Lombardi, Vittorio Maio, Pharmd, Msph

College of Population Health Posters

Objectives:

To determine whether a general practitioner focused intervention aimed at decreasing PIM prescribing in the elderly can decrease the risk of PIM-related hospitalizations.

Poster presented at 2016 ISPOR conference in Washington DC.

Health Policy & Management News, Georgia Southern University

Health Policy & Community Health: News & Publications (2011-2018)

• Georgia Southern Examines Healthcare-Associated Infections

Health Policy & Management News, Georgia Southern University

Health Policy & Community Health: News & Publications (2011-2018)

• Georgia Southern Receives $510,000 Grant from the Georgia Department of Community Health

Making An Employee Wellness Program Work For You, Ryan Schneck

BU Well

This paper attempts to look at the problems with employee wellness programs and why they're not achieving the results many hoped they would. In addition to looking at why employee wellness programs do not succeed, it attempts to give solutions and tips for better health care outcomes. This paper focuses on the economics of employee wellness programs, the benefits they can provide, and the future of employee wellness.

This paper has no additional disclosures or conflicts of interests with outside sources.

Why Not Fix It?, William H. Lane

English Faculty Publications

Have you felt the pinch of rising health care costs this year? If not, maybe you haven't actually needed to see a doctor or pay for a prescription. Even those of us who are lucky enough to be "covered" at work have noticed rapidly rising deductibles and copays - and shrinking networks of providers. Employers, facing a big, one-year increase in insurance costs, naturally enough go shopping for a new plan. But the big savings with a new plan often mean a big effective pay cut for everyone who's covered under it when employee contributions, deductibles and copays all rise …

Hospital Mortality In The United States Following Acute Kidney Injury, Jeremiah. R. Brown, Michael E. Rezaee, Emily J. Marshall, Michael E. Matheny

Dartmouth Scholarship

Acute kidney injury (AKI) is a common reason for hospital admission and complication of many inpatient procedures. The temporal incidence of AKI and the association of AKI admissions with in-hospital mortality are a growing problem in the world today. In this review, we discuss the epidemiology of AKI and its association with in-hospital mortality in the United States. AKI has been growing at a rate of 14% per year since 2001. However, the in-hospital mortality associated with AKI has been on the decline starting with 21.9% in 2001 to 9.1 in 2011, even though the number of AKI-related in-hospital deaths …

Patient Satisfaction As A Reflection Of Quality Health Care And Outcomes, Ian C. Brown, Taylor M. Piatkowski

Physician Assistant Capstones, 2016 to 2019

Background: In 2006 the Centers of Medicaid and Medicare Services mandated that acute care centers begin submitting HCAHPS survey data for financial reimbursement for Medicare patients. The national shift to a patient centered focus and the financial incentive to improve patient satisfaction scores has stimulated debate regarding the relationship between patient satisfaction and quality healthcare.

Clinical Question: Does improvement in patient satisfaction with their healthcare and its providers, as measured by the HCAHPS survey, improve healthcare quality and outcomes?

Design: Systematic literature review.

Methods: Searches were performed using PubMed and Scopus databases.The terms used for the PubMed search were “patient …

Health Policy & Management News, Georgia Southern University

Health Policy & Community Health: News & Publications (2011-2018)

• Georgia Southern Estimates the Effects of Smoking Bans on Neonatal Health

Chhs May 2016 Icymi, Dr. John Bonaguro, Dean, Vashon S. Wells, Editor, Wku College Of Health & Human Services

College of Health & Human Services Publications

No abstract provided.

Healthcare Facility Location: A Breast Cancer Alliance Case Study, Alexandra Knopf

Sustainability and Social Justice

Community health is impacted by the location of a health advocacy agency. This commissioned report for the Breast Cancer Alliance of Greenwich, CT, consists of a location analysis to review potential cities in which they might locate expansion efforts. Such cities include Boston, MA, Chicago, IL, Greenwich, CT, Los Angeles, CA, San Francisco, CA, and Washington, D.C. This report will look at five ways (4 mathematical and one spatial) of conducting a location analysis that require specialized knowledge for interpretation. For this study, a Spatial Geographic Information System methodology is preferred because of the visualization component, which can ensure that …

Health Information Exchange: A Strategy For Improving Access For Rural Veterans In The Maine Flex Rural Veterans Health Access, Karen B. Pearson Mlis, Ma, Amanda Burgess Mppm, John A. Gale Ms, Andrew F. Coburn Phd, Anush Yousefian Hansen Ms, Ma

Access / Insurance

This paper reports on the design and implementation of a first-in-the nation project to expand rural veterans’ access to healthcare by establishing a bi-directional connection between Maine’s statewide health information exchange (HIE) and Veterans Administration facilities and centers. The paper reviews key factors that have contributed to implementation challenges and successes and lessons relevant to efforts to create interoperable health IT systems across multiple, complex organizational settings.

Enhancing Access To Alcohol Use Disorder Pharmacotherapy And Treatment In Primary Care Settings: Adapt-Pc, Hildi J. Hagedorn, Randall Brown, Michael Dawes, Eric Diepernick, Donald Myrick, Elizabeth M. Oliva, Todd H. Wagner, Jennifer P. Wisdom, Alex Harris

Health Policy and Management Faculty Publications

Background: Only 7.8% of individuals meeting diagnostic criteria for alcohol use disorder (AUD) receive treatment in a given year. Most individuals with AUDs are identified in primary care (PC) settings and referred to substance use disorders (SUD) clinics; however, only a minority of those referred attend treatment services. Safe and effective pharmacological treatments for AUD exist, but they are rarely prescribed by PC providers. The objective of this study is to refine, implement, and evaluate an intervention to integrate pharmacological AUD treatment options into PC settings. This paper provides a detailed description of the intervention design and the evaluation components. …

Super-Utilization: The New Perfect Storm Of Health Reform, Jill Diane Nault

Theses and Dissertations (ETD)

This three-essay dissertation was focused on geographic variation of super-utilization, or the disproportionately high healthcare utilization and costs attributed to a small sub-set of the inpatient population. For purposes of this research, super-utilization was operationalized as high repeat utilization (HRU) and referred to inpatient utilization and inpatient readmission expenditures attributed to beneficiaries with four or more 30-day readmissions per year. The overall purpose of the research was to identify geographic areas at increased risk for HRU. These areas corresponded to where beneficiaries live and were aligned with the geographically-bound healthcare delivery systems. Each essay employed an observational study design using …

Population Health Improvement Through Coordination Of Care, Trevey Davis

Muskie School Capstones and Dissertations

The objective of this Capstone Project is to work with the Mercy Gap in Care Coordinators (GCCs) to document the value of the care coordination at Mercy Health System. A key element of this project was to develop a workflow diagram alongside the GCC in order to track patient outcomes. Additionally, the team developed a system for documenting patient outcomes that is crucial to measuring the impact of care coordination. From the data collected there are a number of outcomes that can be measured. The number of patients who are contacted for screening is measurement of patient experience. Following initial …

Implementing A Good Catch Program In Nursing Homes, Leigh Raposo

Muskie School Capstones and Dissertations

Rationale and processes for reporting near misses and evidence-based tools were collected by a literature search, seminal works by Sidney Dekker and James Reason, and websites for the Agency for Healthcare Research and Quality (AHRQ), the Institute for Healthcare Improvement (IHI), and the Centers for Medicare and Medicaid Services (CMS). Tools, information, and strategies found in this research were evaluated for implementation in Maine nursing homes. The tools provide a communication vehicle for nursing home staff to safely report to management near misses, or mistakes that do not harm residents. To emphasize a positive approach, the project replaces the term …

Assessing The Role Of Faith-Based Organizations In Health Promotion, Troylyn Braud Francis

Theses and Dissertations (ETD)

Objective: The objective of this analysis was to evaluate the relationship between organizational readiness (OR) and weight loss and physical activity outcomes among faith-based organizations (FBOs).

Methods: Data for this study were collected in two phases. Phase I data were based on a feasibility study and targeted African-American individuals (N = 55) who participated in an obesity prevention program. The intervention was accomplished in two stages, which included a 10-week core period followed by a 6-month maintenance period. Phase II data were based on key informant interviews that were conducted with community health leaders (CHLs) (N=6) from participating …

The Story Of Emily, Lori L. Jennings Ms, Barb O'Neil, Kim Bossy, Denise Dodman, Jill Campbell

Patient Experience Journal

This case study describes Bluewater Health’s quest to weave the philosophy and practice of patient and family-centered care from the boardroom to the bedside by introducing Emily. Emily’s image is a composite of photographs of staff, physicians, volunteers, patients and families exemplifying that each has a role in Emily’s care. Emily represents every patient and family of the past, present, and future. Emily’s journey started with the launch of Bluewater Health‘s 2013-2015 strategic plan and moved throughout the organization as patient councils were established and the organization embedded three foundational patient and family-centered RNAO Best Practice Guidelines into daily practice …

Applying Experience-Based Co-Design With Vulnerable Populations: Lessons From A Systematic Review Of Methods To Involve Patients, Families And Service Providers In Child And Youth Mental Health Service Improvement, Alison Mulvale, Ashleigh Miatello, Christina Hackett, Gillian Mulvale

Patient Experience Journal

The objective was to identify methods used to involve patients, family and service providers in child and youth mental health service improvement research. We analyzed the alignment of methods used with Experience-Based Co-Design (EBCD) methodology, and how power imbalances among participants were addressed. A systematic review of the English-language peer review literature since 2004 was carried out. The EMBASE, Scholar’s Portal, PubMed, Web of Science databases and the Ontario College of Art and Design University libraries were searched electronically for variations of ‘child’, ‘mental health’, ‘experience-based co-design’, ‘participatory research’ and ‘health care services’. Textual data was systematically extracted and analyzed. …

Impact Of Logo Wear On Provider Perception Of Patient, Bill R. Gombeski Jr

Patient Experience Journal

Patient’s appearance affects provider perception of patients and subsequent provider behavior. Based on anecdotal information, it was hypothesized that wearing a health organization’s brand would result in a more positive perception of a patient by providers and subsequently a better patient experience. A study of 121 individuals with patient contact was conducted. Using photos of patients with and without a health care brand on their shirts, study subjects rated the attractiveness and willingness to engage with photos of patients. Patients with a Mayo brand and UK HealthCare brand showed some significant positive attractiveness over the same patient without the brand. …

Patient Evaluations Of The Interpersonal Care Experience (Ice) In U.S. Hospitals: A Factor Analysis Of The Hcahps Survey, Geoffrey A. Silvera, Jonathan R. Clark

Patient Experience Journal

The Hospital Consumer Assessment of Healthcare Providers and Systems survey (HCAHPS) is widely used to evaluate patients’ perceptions of their inpatient healthcare experiences. The HCAHPS is organized into 10 measures: six composite measures, two individual measures, and two global measures.¹ In prior research on the link between patients’ care experiences and hospital’s quality and cost outcomes, scholars have grouped these measures in a variety of ways. The evident lack of consistency in these groupings along with the persistent lack of empirical justification for these groupings suggests a need to empirically examine the relational structure of HCAHPS measures. …

Developing Approaches To The Collection And Use Of Evidence Of Patient Experience Below The Level Of National Surveys, Elizabeth J. Gibbons, Chris Graham, Jenny King, Kelsey Flott, Crispin Jenkinson Professor, Raymond Fitzpatrick Professor

Patient Experience Journal

National approaches to collecting patient feedback provide trust level information which although can provide a benchmark for trusts often doesn’t provide information about specific services or patients experiences of pathways of care. This more granular level of data could be more informative for local service development and improvement. This research explored the feasibility and usefulness of such approaches. A conceptual model and standard questionnaire of patient experience was developed that might work across a range of services and pathways of care. Seven trusts were recruited as collaborating sites in which the model and survey instrument was tested. These were from …

Impact Of Hospital Diagnosis-Specific Quality Measures On Patients’ Experience Of Hospital Care: Evidence From 14 States, 2009-2011, Emily M. Johnston, Kenton J. Johnston, Jaeyong Bae, Jason M. Hockenberry, Arnold Milstein, Edmund Becker

Patient Experience Journal

In order to assess consistency across quality measures for Untied States hospitals, this paper uses patient responses to the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey for three years (2009-2011) from 1,333 acute-care hospitals in fourteen states to analyze patterns in hospital-reported patient experience-of-care scores by diagnosis-specific process and outcome measures for acute myocardial infarction, heart failure, and pneumonia. We also evaluate how scores have changed over the three-year period. We find significant differences in patient experience-of-care scores for 195 out of 230 relationships between HCAHPS patient experience-of-care scores and 23 diagnosis-specific process and outcomes measures. We …

Patient Perceptions Of An Aidet And Hourly Rounding Program In A Community Hospital: Results Of A Qualitative Study, Tosha Allen, Tyne Rieck, Stacie Salsbury

Patient Experience Journal

Quantitative evidence links patient satisfaction scores to the use of communication strategies such as AIDET (Acknowledge, Introduce, Duration, Explanation, and Thank you) and Hourly Rounding. However, little is known about patient perceptions of these tools in regards to their hospital experience. Qualitative interviews were conducted with a convenience sample of 14 adult medical/surgical inpatients in one mid-sized, community hospital, following hospital discharge. The interview data was transcribed and opened coded, utilizing constant comparison to identify common themes. Themes emerged in four topical areas: (a) patient experience of hospitalization, (b) AIDET, (c) Hourly Rounding, and (d) unexpected findings. Patients placed significant …

Does She Think She’S Supported? Maternal Perceptions Of Their Experiences In The Neonatal Intensive Care Unit, Emily A. Lilo, Richard J. Shaw, Julia Corcoran, Amy Storfer-Isser, Sarah M. Horwitz

Patient Experience Journal

Parents’ involvement in the care of their infants in the neonatal intensive care unit (NICU) is critically important, leading many NICUs to implement policies and practices of family-centered care (FCC). Analyzing narrative interviews, we examined whether mothers of premature infants who participated in an intervention to help reduce anxiety, stress, and depression felt that their NICU experience reflected four key nursing behaviors previously identified as being necessary to achieving FCC. Fifty-six narratives derived from semi-structured interviews with the mothers were analyzed qualitatively and quantitatively to examine whether the women experienced emotional support, parent empowerment, welcoming environment, and parent education, as …

A Call To Excellence In Patient Experience, Geoffrey A. Silvera

Patient Experience Journal

In this address, the incoming associate editor describes his early experience with the Patient Experience Journal (PXJ) and issues a call to action to the PXJ community. In the call to action, the PXJ community is asked to build upon our collective history of scholastic and practical excellence. The combination of practical relevance and methodological rigor in our contributions will help to ensure a future in which patient experience is paramount in health service delivery conversations. In addition, gaps in the patient experience literature and emergent opportunities for theoretical and practical contributions are recommended.

Patient Experience: Driving Outcomes At The Heart Of Healthcare, Jason A. Wolf Phd

Patient Experience Journal

There is no longer a question that patient experience matters in healthcare today. It matters for those that are cared for and served and matters to all those working each and every day to provide the best in care at all touch points across the healthcare continuum. With this recognition, there too needs to be a change in mindset about patient experience itself. When addressing the topic of patient experience, the conversation is about something much broader than the “experience of care”, as identified in the triple aim. The idea of experience reflects our biggest opportunity in healthcare, where experience …

Trends In Clinical Billing By Local Health Departments, J. Mac Mccullough

Frontiers in Public Health Services and Systems Research

Background: Billing for clinical services is perceived to be increasingly important for local health departments (LHDs). Yet very little evidence exists regarding the frequency and relative financial importance of clinical billing revenues.

Purpose: The purpose of this study is to report on trends in the frequency and financial scope of clinical billing by LHDs from 2008 to 2013.

Methods: The study used data from the 2008, 2010, and 2013 National Association of City and County Health Officials Profile report surveys. Per capita revenues from clinical billing and percent of total LHD revenues from clinical billing were calculated. …

Summary Of Results From The 2016 National Health Security Preparedness Index, Glen P. Mays, Michael T. Childress, Pierre Martin Dominique Zephyr, Anna Goodman Hoover

Health Management and Policy Reports

The National Health Security Preparedness Index tracks the nation’s progress in preparing for, responding to, and recovering from disasters and other large-scale emergencies that pose risks to health and well-being in the United States. Because health security is a responsibility shared by many different stakeholders in government and society, the Index combines measures from multiple sources and perspectives to offer a broad view of the health protections in place for nation as a whole and for each U.S. state. The Index identifies strengths as well as gaps in the protections needed to keep people safe and healthy in the face …

The Evolution Of The U.S. Catholic Hospital: From Sisters In Habits To Men In Suits, Michael Greenstein

Celebrating Scholarship & Creativity Day (2011-2017)

In today’s ever-changing healthcare landscape, Catholic U.S. hospitals have undergone a change in their mission and thus their identity. This paper argues that Catholic hospitals need to rediscover the origins of their ministry. This can be accomplished by refocusing their efforts away from mergers with secular entities that deal strictly with life and death issues to mergers that more fully engage the care for the poor and vulnerable. To provide the context for this paper, Part One will present an overview of Jesus’ ministry, which is the foundation for Catholic health care. Part Two will address the history of the …