Health Services Research Commons^™

How Does Patient Experience Fit Into The Overall Healthcare Picture?, Karen Luxford Bsc(Hons), Phd, Faim, Faaqhc, Sue Sutton Rn, Phd, Fhimss

Patient Experience Journal

Understanding the experience of patients provides insight into health care as well as being a crucial first step towards partnering with patients to drive improvement. Increasingly, health care organizations gain feedback from patients about their experience through surveys. Patients are also turning to other avenues, including the internet, to document their experiences.

Although long recognised as a domain of quality, evidence of the link between patient experience and clinical outcomes has emerged more recently. Organizations that succeed in improving patient experience have adopted a strategic approach to patient focus that incorporates both patient feedback and consumer engagement.

Adopting a patient …

Defining Patient Experience, Jason A. Wolf Phd, Cpxp, Victoria Niederhauser Drph, Rn, Dianne Marshburn Phd, Rn, Ne-Bc, Sherri L. Lavela Phd, Mph, Mba

Patient Experience Journal

In recent years, perceptions of performance and quality of healthcare organizations have begun to move beyond examining the provision of excellent clinical care, alone, and to consider and embrace the patient experience as an important indicator. There is a need to determine the extent to which clear and formal definitions exist, have common overarching themes, and/or have unique, but important constructs that should be considered more widely. In this article, we provide a 14-year synthesis of existing literature and other sources (2000-2014) that have been used to define patient experience. A total of 18 sources (articles or organizational websites) were …

Concern For The Patient’S Experience Comes Of Age, Irwin Press Phd

Patient Experience Journal

In this special guest editorial for the inaugural issue of Patient Experience Journal. Dr. Press reflects on how the focus on patient experience has evolved. He starts with a reflection, "A journal devoted exclusively to the patient’s experience? A patient satisfaction survey mandated by CMS for all hospitals and a portion of reimbursement dependent upon the scores? An Institute and an “Association” addressing Patient Experience? A new hospital administrative position labeled “Chief Experience Officer”? Some 30 years ago no one would have predicted any of these."

Dr. Press helps us explore and review how the patient experience movement has …

Expanding The Dialogue On Patient Experience, Jason A. Wolf Phd

Patient Experience Journal

It is with great excitement that I welcome you to the inaugural issue of Patient Experience Journal (PXJ). This publication in so many ways epitomizes all that is right and good about the patient experience movement itself. That being: no one individual or organization owns this conversation or can claim to have every answer, but rather it is a true effort of a community of voices from research to practice, from caregivers to patients and family members, across the care continuum and into the reaches of resources provided and concepts yet unknown.

This journal is a product of and …

Editorial Comment: Changing The Rules In Vaccine Coverage For Vulnerable Populations, Nancy L. Winterbauer

Frontiers in Public Health Services and Systems Research

Increasing life expectancy through decreasing vaccine preventable deaths is a hallmark of modern public health in the United States (1). Two federal vaccine programs help insure coverage for vulnerable populations. The Vaccines for Children (VFC) Program provides vaccines to eligible children[1] at no cost, removing financial barriers to vaccinations. Close to half of US children and 30 percent of adolescents are vaccinated through the VFC program yearly (2). The federal Section 317 Immunization Grant Program (Section 317) complements VFC by supporting the national immunization infrastructure, primarily immunization workforce, delivery systems, and emergency response, as well as by providing vaccines …

The Effects Of The Changes In Section 317 Rules For Administration Of Federally Purchased Vaccines, Margaret A. Knight, Anne D. Kershenbaum, Martha Buchanan, Janet Ridley, Paul C. Erwin

Frontiers in Public Health Services and Systems Research

Section 317 of the Public Health Services Act is a federal program that provides funds for the purchase of vaccines. These annual Congressional allocations fluctuate from year to year as Congress responds to changes in national needs for immunizations. The Affordable Care Act requires first dollar coverage of immunizations and other preventive care, allowing a reduction in federal funding for vaccine purchase and a reallocation of funds to other uses such as infrastructure development. In fiscal year 2013, Section 317 rules redefined the population eligible for immunization with Section 317 purchased vaccines. In Tennessee, the response was a policy change …

Editorial Comment: A Method For Identifying Positive Deviant Local Health Departments In Maternal And Child Health, Sharla A. Smith, Michael A. Preston, Marylou Wallace

Frontiers in Public Health Services and Systems Research

Improving the well-being of mothers, infants, and children is a vital public health initiative in the United States. Local health departments are designated agents for addressing maternal and child health outcomes. Klaiman and colleagues used a positive deviant (PD) framework in identifying the modifiable activities and approaches for LHDs that contribute to better MCH outcomes.

Editorial Comment: Cost-Effectiveness Analysis For Prioritization Of Limited Public Health Resources - Tuberculosis Interventions In Texas, Kaja M. Abbas

Frontiers in Public Health Services and Systems Research

Public health departments have limited evidence to understand and analyze the costs and benefits of different health programs, including tuberculosis control and prevention programs. The study by Miller et. al addresses this challenge to estimate costs and benefits of tuberculosis prevention programs in Texas and identify cost-effective diagnostic and treatment combinations, thereby improving the evidence-based decision making power of the public health departments.

Playing To Our Strengths: An Academic/Health Department Collaboration To Facilitate Public Protections Against Tuberculosis, Thaddeus L. Miller, Erin K. Carlson, Nuha A. Lackan

Frontiers in Public Health Services and Systems Research

Background:

Economic modeling and analysis can facilitate evidence-based policy and practice. Such analyses may exceed the technical capacity and mission of public health agencies, yet may be critical to sustain health protections such as tuberculosis (TB) control. The net effect of TB prevention is incompletely understood, hampering objective value judgments of national TB elimination policies. This may promote inefficiencies and threaten individual and public health protections.

We describe how a HRSA-funded Texas Public Health Training Center (TPHTC) coordinated specialized analytical skills with the needs of a state public health department to create a user-friendly tool to inform planning and resource …

Editorial Comment: Differences In Definitions Of Ebph And Evidence: Implications For Communication With Practitioners, Paul C. Erwin

Frontiers in Public Health Services and Systems Research

Through interviews of 12 members of an expert panel – importantly, involving both practitioners and researchers/academicians – Aronson and colleagues sought to understand how evidence-based public health (EBPH) is defined, what counts as “evidence”, and what EBPH actually looks like when operationalized in a local health department. What Aronson and colleagues have shown us is how critical it is that in both creating and implementing EBPH, especially in practice-based research, practitioner and researcher/academician develop a shared understanding of EBPH before the dance begins, especially for practice-based research.

Differences In Definitions Of Ebph And Evidence: Implications For Communication With Practitioners., Robert E. Aronson, Kay Lovelace, Mark Smith, Gulzar H. Shah

Frontiers in Public Health Services and Systems Research

In this study, we interviewed twelve members of an expert panel to elicit their views on Evidence-based Public Health (EBPH), including how they define EBPH, what constitutes “evidence”, and what LHDs do that can be described as EBPH. Telephone interviews lasting 60 minutes were recorded and transcribed for basic content analysis. Experts differed in their definitions of EBPH and their views of what constitutes evidence. Definitions of EBPH ranged from the adoption and implementation of rigorously tested interventions to the application of evidence to decision making for population health improvement. Views on what constitutes evidence also varied, from strict “evidence …

Understanding Hiv Care Delays In The Us South And The Role Of The Social-Level In Hiv Care Engagement/Retention: A Qualitative Study, Courtenay Sprague, Sara E. Simon

Center for Peace, Democracy and Development Publications

Introduction: In a significant geographical shift in the distribution of HIV infection, the US South - comprising 17 states - now has the greatest number of adults and adolescents with HIV (PLHIV) in the nation. More than 60% of PLHIV are not in HIV care in Alabama and Mississippi, contrasted with a national figure of 25%. Poorer HIV outcomes raise concerns about HIV-related inequities for southern PLHIV, which warrant further study. This qualitative study sought to understand experiences of low-income PLHIV on the AIDS Drug Assistance Program in engagement and retention in continuous HIV care in two sites in Alabama. …

Quality Of Emergency Departments In Amman Evaluated By The Availability Of Essential Emergency Equipment, Seif Laeth Sari Nasir

Independent Study Project (ISP) Collection

The present study aims to determine the quality of emergency health care in Jordan by assessing the availability of essential emergency equipment in emergency departments in Amman. This study uses a cross-­‐sectional questionnaire assessing the accessibility of equipment and medication in emergency departments, as well as eliciting the opinions of the participants regarding the future development of the emergency medical sector in Jordan. The questionnaires were distributed to the physician directors of every participating hospital emergency department in Amman, and completed by the physician director excepting two cases, one of which was completed by the head staff nurse, and the …

Citizenship Documentation Requirement For Medical Eligibility: Effects On Oregon Children, Brigit A. Hatch, Jennifer E. Devoe, Jodi A. Lapidus, Matthew J. Carlson, Bill J. Wright

Sociology Faculty Publications and Presentations

BACKGROUND AND OBJECTIVES: The Deficit Reduction Act (DRA) of 2005 mandated Medicaid beneficiaries to document citizenship. Using a prospective cohort (n=104,375), we aimed to (1) determine characteristics of affected children, (2) describe effects on health insurance coverage and access to needed health care, and (3) model the causal relationship between this new policy, known determinants of health care access, and receipt of needed health care.

METHODS: We identified a stratified random sample of children shortly after the DRA was implemented and used state records and surveys to compare three groups: children denied Medicaid for inability to document citizenship, children denied …

Exploring The Association Between Long-Term Hpsa Designation And County Population-To-Physician Ratio, Christopher Duffrin, Natalie A. Jackson

Frontiers in Public Health Services and Systems Research

Federal, state, local and public health officials utilize Health Professional Shortage Area (HPSA) designations to manage health and physician workforce development in underserved regions. HPSA designation length by county was examined to determine if there is significant association with population-to-primary care physician ratio since the inception of HPSA designations in 1978. Counties were grouped in 5 categories based on consecutive designation length and analyzed with demographic variables. This report examines the relationship of long-term HPSA status and changes in primary care physician workforce.

The Effects Of The State Of Tennessee Immunization Policy Change Of 2011 - 2012 On Vaccination Uptake In East Tennessee, Margaret A. Knight, Anne D. Kershenbaum, Martha Buchanan, Janet Ridley, Paul C. Erwin

Frontiers in Public Health Services and Systems Research

In the United States, funding for the purchase of vaccines depend on annual Congressional allocations. These allocations fluctuate from year to year as Congress responds to changes in national needs for immunizations. The Affordable Care Act requires first dollar coverage of immunizations and other preventive care, allowing a reduction in federal funding for vaccine purchase and a reallocation of funds to other uses such as infrastructure development. In fiscal year 2012, the loss of funds allocated from the American Recovery and Reinvestment Act required action by states to ensure appropriate use of remaining funds. In Tennessee, the response was a …

Diffusion Theory And Knowledge Dissemination, Utilization And Integration, Lawrence W. Green, Judith M. Ottoson, César García, Robert A. Hiatt, Maria L. Roditis

Frontiers in Public Health Services and Systems Research

Part of the Community Health and Preventive Medicine Commons, Health and Medical Administration Commons, Health Policy Commons, Health Services Administration Commons, Health Services Research Commons, and the Public Health Education and Promotion Commons

Many accomplishments of public health have been distributed unevenly among populations. This article reviews the concepts of applying evidence-based practice in public health in the face of the varied cultures and circumstances of practice in these varied populations. Key components of EBPH include: making decisions based on the best available scientific evidence, using data and information systems systematically, applying program planning frameworks, engaging the community and practitioners …

Public Health Services Most Commonly Provided By Local Health Departments In The United States, Gulzar H. Shah, Huabin Luo, Sergey Sotnikov

Frontiers in Public Health Services and Systems Research

The primary purpose of this research is to identify the most commonly performed public health services by local health departments (LHDs) and highlight variation by LHD characteristics. Data were drawn from the 2008 and 2010 National Profile of LHDs, conducted by the National Association of County and City Health Officials (NACCHO). The descriptive analysis aims to further the essential dialogue triggered by a recent Institute of Medicine (IOM) report about the standard minimum set of services that all LHDs should provide. This study identified a set of 22 activities performed by LHDs that are common in jurisdictions of all sizes. …

Community Health Assessment By Local Health Departments: Future Questions, Kay Lovelace

Frontiers in Public Health Services and Systems Research

This "Letter to the Editor" is a response to the article "Community Health Assessment by Local Health Departments: Presence of Epidemiologist, Governance, and Federal and State Funds are Critical" published in volume 2, issue 6 of this journal. It considers how LHDs develop CHAs in complex jurisdictions, the roles of other professionals in the development of CHAs, and the conduct, quality, and use of CHAs.

Diffusion Theory And Knowledge Dissemination, Utilization And Integration, Lawrence W. Green, Judith M. Ottoson, César García, Robert A. Hiatt, Maria L. Roditis

All Faculty Scholarship for the College of the Sciences

Many accomplishments of public health have been distributed unevenly among populations. This article reviews the concepts of applying evidence-based practice in public health in the face of the varied cultures and circumstances of practice in these varied populations. Key components of EBPH include: making decisions based on the best available scientific evidence, using data and information systems systematically, applying program planning frameworks, engaging the community and practitioners in decision making, conducting sound evaluation, and disseminating what is learned. The usual application of these principles has overemphasized the scientific evidence as the starting point, whereas this review suggests engaging the community …

Expanding Women’S Healthcare Access In The United States: The Patchwork “Universalism” Of The Affordable Care Act, Randy Albelda, Diana Salas Coronado

Center for Social Policy Publications

This paper explores the promise of the Patient Protection and Affordable Care Act, commonly called “Obamacare” (referred to here as the ACA), with attention to the ways gender matter by tracing the development and implementation of key US social protection systems, an examination of the current health system with particular attention to women’s coverage, and the potential impacts of the ACA, including how it conforms to international human rights norms for health care. The ACA promises to vastly improve the key dimensions of health coverage in the US, but it conforms with other US social policy by relying on market-based …

Evaluation Of The Jewish Community Housing For The Elderly Memory Support Initiative, Joan Hyde

Gerontology Institute Publications

Jewish Community Housing for the Elderly (JCHE) is a large, multi-campus organization that houses and serves 1,500 residents (80 market rate and 1,420 low income). The average age is 80 years old, with one-third of residents 85 and older. Three quarters of the residents are not native English speakers. Through HUD and other funding, JCHE offers a range of supports to these residents, including translators, interpreters and staff with language and cultural competence, meals, transportation and, through their Service Coordinators, facilitation of resident access to government benefits, home care and other services.

According to the Alzheimer’s Association’s 2012 special report …

Navigating The Health Care Labyrinth: Portraits Of The Socioeconomically Disadvantaged, Thomas C. Crawford Phd

Antioch University Dissertations & Theses

In 2010, an estimated population of the 311,212,863 Americans generated approximately 1,014,688,290 physician office encounters (Moore, 2010). The frequency and number of professional interactions between caregivers and patients/family members in medical office settings equated to a staggering 1,931 visits per minute. Based on the massive volume of interactions that occurred between patients of different races, ethnicities, genders, sexual orientations, and socioeconomic standings that generated an average household income of $49,445 in 2010 (United States Census Bureau, 2010a) with a physician workforce that the Association of American Medical Colleges (2010) captured as being 75% White that earned (primary care specialties) in …

Evaluating Quality Improvement To Improve Hiv Reporting, Nandi A. Marshall, William C. Livingood, Angela Peden, Gulzar H. Shah, Russ Toal, Dayna Alexander, Alesha Wright, Sandra Jump, Shelby Freeman, Kay Davis, Lynn Woodhouse, Kellie Penix

Frontiers in Public Health Services and Systems Research

The incorporation and evaluation of Quality Improvement into Georgia’s public health systems continues to be a focus of the Georgia Public Health Practice Based Research Network. This report describes the process, preliminary results and lessons learned from incorporating Quality Improvement into one of Georgia’s public health districts.

Commentary: Moving Beyond The Numbers, Effectively Using Research To Influence Policy, F. Douglas Scutchfield, Marylou Wallace

Frontiers in Public Health Services and Systems Research

This seventh issue of Frontiers reflects the variety of PHSSR. One emerging theme, however, is the notion of public health and its role in policy and policy development. PHSSR focuses on several potential users, researchers, practitioners and policy makers. As it concerns policy makers, PHSSR delivers research that allows them to make decisions about policy change that not only influences public health status, but creates healthy conditions. In this way, PHSSR essentially influences decisions about support for public health services.

The National Longitudinal Survey Of Public Health Systems: Selected Findings And Applications, Glen P. Mays

Health Management and Policy Presentations

This presentation reviews the National Longitudinal Survey of Public Health Systems and its applicability for monitoring the effects of the Affordable Care Act on public health delivery within the U.S.

A Profile Of Community Health Center Patients: Implications For Policy, Peter Shin, Carmen Alvarez, Jessica Sharac, Sara J. Rosenbaum, Amanda Van Vleet, Julia Paradise, Rachel Garfield

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

Community health centers are a key source of comprehensive primary care in medically underserved communities across the country, and their role is expected to grow as health coverage expands under the Affordable Care Act (ACA). To sharpen understanding of the health center patient population, this brief compares it to the overall low-income population, using data from the Health Center Patient Survey and the National Health Interview Survey,respectively. The pre-ACA profile of health center patients that emerges sets the stage for measuring change following implementation of the reform law and can inform health center policy, planning, and assessment moving forward.

Preliminary Findings From An Interventional Study Using Network Analysis To Support Management In Local Health Departments In Florida, Chin S. Park, Hado Byon, Jonathan W. Keeling, Leslie M. Beitsch, Jacqueline A. Merrill

Frontiers in Public Health Services and Systems Research

Management is the core service that integrates and coordinates essential public health services. Managers of local health departments (LHDs) are experts in practice but may not have expertise in organizational management. We conducted an evidence-based training intervention in 10 LHDs in Florida to support managers’ decision-making on organizational integration and coordination. We deployed a standard survey to collect organizational network measurements pre and post intervention. We presented results as evidence-based performance feedback and interviewed managers to document how they used the results in the context of each organization. Post intervention we found unexpected, significantly higher network centralization in daily work. …

Characteristics Of A Local Health Department Associated With The Use Of The Health Equity Index, Moira A. Lawson, Sharon Mierzwa, Michael Knapp

Frontiers in Public Health Services and Systems Research

Local health departments are tasked with understanding and addressing health inequities in the populations they serve. To meaningfully address health inequities, local health departments have identified the need for credible local data to better understand the relationship between community conditions and health outcomes. Yet, when given access to these data, we observe a very large variation in the level of interest between local health departments.

In this study, we offered Connecticut’s Local health departments access to the Health Equity Index, a web based tool that provides data on health outcomes and community conditions at the state, municipal or neighborhood levels. …

Evaluating Use Of Custom Survey Reports By Local Health Departments, Nadya M. Belenky, Christine A. Bevc, Elizabeth Mahanna, Carol Gunther-Mohr, Mary V. Davis

Frontiers in Public Health Services and Systems Research

This report demonstrates how providing survey feedback, like comparative reports, to survey respondents can result in improvement activities. For each of the past three years (2010-2013), the North Carolina Institute for Public Health (NCIPH) has invited local health departments (LHDs) from 40 states to participate in a preparedness capacities survey. In addition, NCIPH fielded a six-question evaluation survey to a subset of LHDs (n=70) to determine how LHDs use these reports. LHDs that reported using their custom reports compared their preparedness capacities to other LHDs, conducted strategic planning (e.g., benchmarking, setting preparedness goals), planned staff trainings, and disseminated the report …