Health Services Research Commons^™

Patient Safety: Just Ask. Patients As Reporters Of Real-Time Safety Data; A Pilot Project To Improve Patient Safety In Secondary Care, Thomas A. Cairns Dr, Iain Mccallum Mr

Patient Experience Journal

The Berwick review into patient safety recommended ‘involving patients in the healthcare organisation and seeking out the patient voice as an essential asset to monitor safety.’ (1) However routine data collection from patients in our institution is retrospective and doesn't focus on safety. Our objective was to create a patient-centred mechanism to monitor patient-perceived safety concerns and provide immediate resolution of highlighted issues. A pragmatic 6-question questionnaire was developed containing 4 scored and 2 free text questions. This questionnaire was piloted and adjusted before being administered to all inpatients meeting the inclusion criteria in our institution on one day. Safety …

Patient And Provider Experiences With Relationship, Information, And Management Continuity, Jeanette Jackson, Gail Mackean, Tim Cooke, Markus Lahtinen

Patient Experience Journal

From 2003 to 2014, the Health Quality Council of Alberta (HQCA) monitored patient experiences with healthcare services through a biennial Satisfaction and Experience with Healthcare Services (SEHCS) survey. The findings consistently showed a direct link between coordination of care, an aspect of continuity of care, and healthcare outcomes. Specifically, it showed that better coordination is linked to positive outcomes; the reverse is also true. Given the critical role continuity of care plays in the healthcare system, the HQCA conducted in-depth interviews, interactive feedback sessions and focus groups with patients and providers to explore factors that influence both seamless and fragmented …

Healthcare Providers Versus Patients' Understanding Of Health Beliefs And Values, Betty M. Kennedy, Matloob Rehman, William D. Johnson, Michelle B. Magee, Robert Leonard, Peter T. Katzmarzyk

Patient Experience Journal

This study examined how well healthcare providers perceive and understand their patients’ health beliefs and values compared to patients’ actual beliefs, and to determine if communication relationships maybe improved as a result of healthcare providers’ understanding of their patients’ illness from their perspective. A total of 61 participants (7 healthcare providers and 54 patients) were enrolled in the study. Healthcare providers and patients individually completed survey instruments and each participated in a structured focus group. Healthcare provider and patient differences revealed that patients perceived greater meaning of their illness (p = 0.038), and a greater preference for partnership (p = …

Rebalancing The Patient Experience: 20 Years Of A Pendulum Swing, Tiffany Christensen

Patient Experience Journal

This essay looks back at two decades of the patient experience movement. The evolution of patient experience includes moving from a belief system in which patients and families are solely the recipients of care to a model in which patients and families are co-designing treatment plans, systems and policies. This evolution has taken time and continues to evolve to this day. As the pendulum swings, we see that we have made great progress and, simultaneously, found ourselves with all new challenges to overcome.

Accelerating Patient Experience Performance: Collaboration And Engagement As Drivers For Success, Sidney Klajner

Patient Experience Journal

The efforts at Albert Einstein Jewish Hospital in São Paulo, Brazil have been focused on principles of excellence for many years as realized in engagement in and commitment to some of the leading global healthcare practices over the last decade. In reinforcing a commitment to excellence and continuous improvement, the patient experience efforts at Einstein have evolved from an operating structure for patient experience efforts to a truly integrated program for action in address all elements in the organization impacting and ultimately driving patient experience outcomes. By grounded efforts in core evidence-based practice, while engaging the hearts and minds of …

The Patchwork Perspective: A New View For Patient Experience, Jason A. Wolf Phd

Patient Experience Journal

As Patient Experience Journal has continued to contribute to the expanding patient experience conversation, we too recognize this has been a significant year of progress for the patient experience movement. This progress has emerged in a number of ways in research, practice and programs that reveal a comprehensive and integrated approach is now more than ever a central consideration in a commitment to experience. This idea of interwoven efforts, begins to frame an image – a patchwork of clear, critical and comprehensive pieces that while operating distinctly each have value, yet when bringing them together have an exponential opportunity to …

Leadership For Public Health 3.0: A Preliminary Assessment Of Competencies For Local Health Department Leaders, Emmanuel D. Jadhav, James W. Holsinger Jr., Billie W. Anderson, Nicholas Homant

Health Management and Policy Faculty Publications

Background: The foundational public health services model V1.0, developed in response to the Institute of Medicine report For the Public’s Health: Investing in a Healthier Future identified important capabilities for leading local health departments (LHDs). The recommended capabilities include the organizational competencies of leadership and governance, which are described as consensus building among internal and external stakeholders. Leadership through consensus building is the main characteristic of Democratic Leadership. This style of leadership works best within the context of a competent team. Not much is known about the competency structure of LHD leadership teams. The objectives of this study characterize …

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."

Ambulance Services For Medicare Beneficiaries: State Differences In Usage, 2012-2014, Suzanne Troske, Alison Davis

Rural & Underserved Health Research Center Publications

Ambulance services are at risk of scaling back or dissolving in some places. We analyzed Medicare beneficiaries’ use of ambulance services across the U.S. Improved understanding of how beneficiaries, most of whom are elderly, use these services provides vital information for policymakers who set rules and regulations about access to the services.

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 …

Opening A Student-Run Pro Bono Occupational Therapy Pediatric Clinic, Anne H. Zachry

Faculty Presentations

This presentation described the opening of a student-run pro bono pediatric therapy clinic that provides services to children/families who are economically disadvantaged. The benefits of participation for students and clients were reviewed, and fund-raising and the development of a mission statement were discussed.

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 …

Evaluating Mental Health In Cuban Refugees: The Role Of The Refugee Health Screener-15, Rahel Bosson, Victoria A. Schlaudt, Monnica T. Williams, Ruth M. Carrico, Adriana Peña, Julio A. Ramirez, Jonathan Kanter

Journal of Refugee & Global Health

The Refugee Health Screener-15 (RHS-15) is widely used in refugee populations, but the psychometric properties and clinical utility have not been evaluated in Cuban refugees and entrants. The current study explored results from the Spanish version of the RHS-15 in a sample of 53 Cuban entrants and refugees, and of these, 17.6% screened positive for a mental health concern. Analyses suggested that a positive screening was significantly related to symptoms of anxiety, depression, and posttraumatic stress disorder; however, it was not associated with demographic variables such as gender, mode of transport, or the number of countries through which a refugee …

Patient-Centered Medical Home Adoption In School-Based Health Centers, Abbey Gregg

Theses & Dissertations

The patient-centered medical home (PCMH) is promoted as a primary care delivery design that can improve health care quality and patient outcomes while controlling health care costs. To achieve PCMH recognition, primary care providers must implement practice-level changes in order to deliver care that is comprehensive, coordinated, accessible, high quality, and whole-person oriented. This practice transformation requires advanced use of health information technology, staff investment in quality improvement and care coordination, and significant investments of both financial and human resources to support these activities. As a safety-net provider, school-based health centers (SBHCs) serve vulnerable children that typically experience barriers to …

Advancing Learning Health Systems Through Embedded Research: The 23rd Annual Conference Of The Health Care Systems Research Network, Harold S. Luft, Ming Tai-Seale, Sarah M. Greene

Journal of Patient-Centered Research and Reviews

The 23rd annual conference of the Health Care Systems Research Network (HCSRN, formerly the HMO Research Network) was held in San Diego, California, March 21–23, 2017, attracting 387 attendees. As a consortium of 20 research organizations embedded in or affiliated with large health care delivery organizations, the HCSRN has held annual research conferences since 1994. The overall aim of the conferences is to bring researchers, project staff, research funders and other stakeholders together to share latest scientific findings and foster new research ideas and collaborations. The 2017 conference was hosted by the Palo Alto Medical Foundation Research Institute.

Each host …

Effectiveness Of Failure Modes Effect Analysis (Fmea) To Reduce Medical Error, Putri Ingen Setiasih, Purnawan Junadi

Journal of Indonesian Health Policy and Administration

One of the prevention efforts of medical errors that occur in health services is by identifying the potential failure of the service before the failure occurs. FMEA is one way to identify the risks of failure. Therefore, the authors wanted to find out whether FMEA was effective for reducing medical error based on previous studies. This article was a literature review using references in an online database such as EBSCOhost. The author found 280 articles while searching by using the keyword “FMEA”. After filtered by publication period from 2012 to 2017, full text and language, finally got 7 articles. Finally, …

Analysis Of Policy Making Factors On The Prohibition Of Hormones And Antibiotics Use For Feed As A Public Health Protection, Zaima Amalia, Wiku Adisasmito

Journal of Indonesian Health Policy and Administration

Food safety is one of the current international emerging issues. The danger of using antibiotics in animal husbandry is one of the contributors to human resistance. In Indonesia, antibiotics are commonly used as growth promoters in animal husbandry. Prohibition on the use of hormones and antibiotics mixed into animal feed written in Law No. 18 of 2009 on Animal Husbandry and Health which is then clarified by the Minister of Agriculture Regulation No. 14/Permentan/PK.350/5/2017 on the Classification of Animal Drugs. The purpose of this study is to determine the factors which influence the formation of policy on the prohibition of …

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 …

A Trip To Healthcare, David E. Matz

Patient Experience Journal

This narrative shares how my experience with two colonoscopies and three surgeries in one year taught me that I am not so good at engaging in treatment decisions. I thought I was. This essay sets out where I made my mistakes, why I believe I made those mistakes, and how the hospitals, intentionally or not, made good decision-making harder. I offer two suggestions for enhancing the role of the patient in decision-making including 1) Every doctor in a diagnostic-decision-making interview should use the sentence “You have some choices here.” The doctor will have preferences, of course, but the patient needs …

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 …

Greater Involvement Of Hiv-Infected Peer-Mothers In Provision Of Reproductive Health Services As "Family Planning Champions" Increases Referrals And Uptake Of Family Planning Among Hiv-Infected Mothers., Peter Mudiope, Ezra Musingye, Carolyne Onyango Makumbi, Danstan Bagenda, Jaco Homsy, Mai Nakitende, Mike Mubiru, Linda Barlow Mosha, Mike Kagawa, Zikulah Namukwaya, Mary Glenn Fowler

Journal Articles: Health Services Research & Administration

BACKGROUND: In 2012, Makerere University Johns - Hopkins University, and Mulago National Referral Hospital, with support from the National Institute of Health (under Grant number: NOT AI-01-023) undertook operational research at Mulago National Hospital PMTCT/PNC clinics. The study employed Peer Family Planning Champions to offer health education, counselling, and triage aimed at increasing the identification, referral and family planning (FP) uptake among HIV positive mothers attending the clinic.

METHODS: The Peer Champion Intervention to improve FP uptake was introduced into Mulago Hospital PMTCT/PNC clinic, Kampala Uganda. During the intervention period, peers provided additional FP counselling and education; assisted in identification …

Greater Involvement Of Hiv-Infected Peer-Mothers In Provision Of Reproductive Health Services As "Family Planning Champions" Increases Referrals And Uptake Of Family Planning Among Hiv-Infected Mothers., Peter Mudiope, Ezra Musingye, Carolyne Onyango Makumbi, Danstan Bagenda, Jaco Homsy, Mai Nakitende, Mike Mubiru, Linda Barlow Mosha, Mike Kagawa, Zikulah Namukwaya, Mary Glenn Fowler

Journal Articles: Health Services Research & Administration

BACKGROUND: In 2012, Makerere University Johns - Hopkins University, and Mulago National Referral Hospital, with support from the National Institute of Health (under Grant number: NOT AI-01-023) undertook operational research at Mulago National Hospital PMTCT/PNC clinics. The study employed Peer Family Planning Champions to offer health education, counselling, and triage aimed at increasing the identification, referral and family planning (FP) uptake among HIV positive mothers attending the clinic.

METHODS: The Peer Champion Intervention to improve FP uptake was introduced into Mulago Hospital PMTCT/PNC clinic, Kampala Uganda. During the intervention period, peers provided additional FP counselling and education; assisted in identification …

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 …