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2015

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Articles 1 - 30 of 231

Full-Text Articles in Health Policy

Health Care Service Disparity: Factors Associated With The Distribution Of Primary Care Physicians, Robert L. Morgan Dec 2015

Health Care Service Disparity: Factors Associated With The Distribution Of Primary Care Physicians, Robert L. Morgan

Senior Honors Projects, 2010-2019

Primary care physicians operate on the front lines of health care. Although primary care physicians play a critical role in improving health outcomes, workforce trends in the United States show a growing shortage of primary care physicians as demand for primary care rises. In conveying the importance of primary care physicians, the worsening physician shortage, the inequitable distribution of providers, and the lackluster institutional response thus far, this paper calls into question the effectiveness of current indicators used to identify underserved areas and provide appropriate government assistance. Through the use of data from the 2010 census and American Medical Association …


Advocacy In Action: A Framework For Implementation Of The American Counselors Association Advocacy Competencies On A Local Level, Jeffrey M. Lown Dec 2015

Advocacy In Action: A Framework For Implementation Of The American Counselors Association Advocacy Competencies On A Local Level, Jeffrey M. Lown

Educational Specialist, 2009-2019

Despite calls from within the professional field and external forces, counselors have faced ongoing challenges in their efforts to be effective advocates for their clients and themselves. A review of the literature reveals that throughout the history of the profession, prominent figures have called on counselors to assume advocacy roles, and that some initiatives have been successful in fostering lasting change. However, as counselors and their clients’ needs continue to evolve, so too must strategies to address these needs be reevaluated and new initiatives put into place.

In this paper, I have outlined a committee structure and agenda that seeks …


Inter-Organizational Network Effects On The Implementation Of Public Health Services, Glen P. Mays Dec 2015

Inter-Organizational Network Effects On The Implementation Of Public Health Services, Glen P. Mays

Health Management and Policy Presentations

Background: The Affordable Care Act created new incentives for hospitals, insurers, public health agencies, and others to contribute to disease prevention and health promotion activities, potentially changing inter-organizational relationships and expanding implementation of strategies that improve population health. This study uses data from the 1998-2014 National Longitudinal Survey of Public Health Systems to examine: (1) the extent and nature of change in inter-organizational contributions to public health activities; (2) whether network changes attenuate or exacerbate disparities in public health implementation across communities; and (3) how network changes affect preventable mortality and resource use.

Methods: We follow a longitudinal cohort of …


Puerto Rico’S Community Health Centers In A Time Of Crisis, Peter Shin, Jessica Sharac, Marie Nina Luis, Sara J. Rosenbaum Dec 2015

Puerto Rico’S Community Health Centers In A Time Of Crisis, Peter Shin, Jessica Sharac, Marie Nina Luis, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

In 2014, Puerto Rico’s twenty federally funded community health centers, operating in 71 sites located throughout the Commonwealth, served 330,736 patients, approximately one in ten Commonwealth residents. Compared to other Puerto Rico residents, health center patients are less likely to be insured. Despite considerable growth in Medicaid as a result of the supplemental funding provided under the Affordable Care Act, in 2014, 12.2% of health center patients remained uninsured.

Compared to health centers outside Puerto Rico, Puerto Rico’s health centers show a greater proportion of Medicaid patients served (69% compared to 46% outside Puerto Rico), a greater dependence on physician …


Workforce Innovations In Oral Health, Jean Moore, Margaret Langelier, Bridget Baker Dec 2015

Workforce Innovations In Oral Health, Jean Moore, Margaret Langelier, Bridget Baker

Health Workforce Speaker Series

No abstract provided.


The Challenges Of Leading Change In Health-Care Delivery From The Frontline, Vivienne Byers Dec 2015

The Challenges Of Leading Change In Health-Care Delivery From The Frontline, Vivienne Byers

Articles

Aim: The public sector is facing turbulent times and this challenges nurses, who are expected to serve both patient interests and the efficiency drives of their organisations. In the context of implementing person-centred health policy, this paper explores the evolving role of front-line nurses as leaders and champions of change.

Background: Nurses can be seen to have some autonomy in health-care delivery. However, they are subject to systems of social control. In implementing person- centred policy, nurses can be seen to be doing the best they can within a constrained environment.

Method: A survey of nursing practice in person-centred health-policy …


Health Center Trends: Recent Experience In Medicaid Expansion And Non-Expansion States., Peter Shin, Jessica Sharac, Julia Zur, Sara J. Rosenbaum, Julia Paradise Dec 2015

Health Center Trends: Recent Experience In Medicaid Expansion And Non-Expansion States., Peter Shin, Jessica Sharac, Julia Zur, Sara J. Rosenbaum, Julia Paradise

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

In thousands of medically underserved communities across the U.S., community health centers enroll lowincome people in health coverage and provide care to millions of patients. Against the backdrop of significant health center expansion over several years and a full year of expanded health coverage under the Affordable Care Act (ACA), this brief examines change between 2013 and 2014 in the volume and health coverage profile of health center patients, and health center enrollment activities and service capacity, comparing states that implemented the ACA Medicaid expansion in 2014 and states that did not expand Medicaid in 2014. The study is based …


Capstone Revival, Mary Mesele, Ruochen Lu, Quilin Jiang Dec 2015

Capstone Revival, Mary Mesele, Ruochen Lu, Quilin Jiang

School of Professional Studies

The capstone project is a culminating experience whereby students choose to research a topic that is relevant in their field of study and have been highly regarded as important learning activities. The capstone allows students to use research, analytical, problem solving and evaluation skills they have learned in the course of the graduate program. McGill indicates the benefit of the completion of a capstone project not only in gaining knowledge in capstone but also in learning how to apply the knowledge gained in other courses in the major (McGill, 2012). Currently, COPACE (College of Professional and Continuing Education) has three …


Bridging The Divide White Paper On Medication Abortion: Overview Of Research & Policy In The United States, Liz Borkowski, Julia Strasser, Amy Allina, Susan Wood Dec 2015

Bridging The Divide White Paper On Medication Abortion: Overview Of Research & Policy In The United States, Liz Borkowski, Julia Strasser, Amy Allina, Susan Wood

Jacobs Institute of Women's Health

Medication abortion (also called medical abortion) is a safe method of abortion available for the past 15 years in the US. The Bridging the Divide white paper summarizes the scientific evidence related to the current medication abortion process and potential changes to the process that could make it even safer and more accessible for patients, as well as policy considerations and directions for future research.

In the fall of 2000, the US Food & Drug Administration (FDA) approved the drug Mifeprex© (generic: mifepristone) for use in medication abortions. That approval included requirements that affect both patients and providers and that …


Quality And Cost Of Diabetes Mellitus Care In Community Health Centers In The United States., Patrick Richard, Peter Shin, Tishra Beeson, Laura S. Burke, Susan F. Wood, Sara Rosenbaum Dec 2015

Quality And Cost Of Diabetes Mellitus Care In Community Health Centers In The United States., Patrick Richard, Peter Shin, Tishra Beeson, Laura S. Burke, Susan F. Wood, Sara Rosenbaum

Health Policy and Management Faculty Publications

OBJECTIVE: To examine variations in the quality and cost of care provided to patients with diabetes mellitus by Community Health Centers (CHCs) compared to other primary care settings.

RESEARCH DESIGN AND METHODS: We used data from the 2005-2008 Medical Expenditure Panel Survey (N = 2,108). We used two dependent variables: quality of care and ambulatory care expenditures. Our primary independent variable was whether the respondent received care in a Community Health Centers (CHCs) or not. We estimated logistic regression models to determine the probability of quality of care, and used generalized linear models with log link and gamma distribution to …


A Phenomenological Study Of Anticipated Intimacy And Sexual Expression Needs Of Aging Male And Female Baby Boomers., Charles Shawn Oak Dec 2015

A Phenomenological Study Of Anticipated Intimacy And Sexual Expression Needs Of Aging Male And Female Baby Boomers., Charles Shawn Oak

Electronic Theses and Dissertations

The purpose of this study was to understand the phenomenon of how heterosexual Baby Boomers define and understand intimacy, sexual expression, along expectations and desires relating to their respective expressions across the lifespan through their individual experiences and reflections. A set of guiding questions were used in a hermeneutic phenomenological qualitative research design. Data was gathered from thirteen subjects (n=13) using the Rappaport Time Line (RTL) that was used to develop individualized semi-structured interviews and follow-up interviews that were professionally transcribed. These were coded to identify emergent themes. Results of the study provided insight into the phenomenon of how heterosexual …


Hospital Practices Related To Breastfeeding In Mississippi: A Socio-Ecological Approach, Amir Alakaam Dec 2015

Hospital Practices Related To Breastfeeding In Mississippi: A Socio-Ecological Approach, Amir Alakaam

Dissertations

Mississippi continues to have one of the lowest rates and the weakest support in respect to breastfeeding in the nation (Centers for Disease Control and Prevention, 2014a). Hospital practices supporting breastfeeding such as the Ten Steps to Successful Breastfeeding (TSSB) can dramatically increase breastfeeding rates and duration (Rosenberg, Stull, Adler, Kasehagen, & Crivelli-Kovach, 2008). The aim of this study was to explore breastfeeding practices in Mississippi hospitals based on two levels of the Socio-Ecological Model: the organizational level (phase I) examined the hospital practices based on the level of implementation of the TSSB; the individual level (phase II) examined knowledge …


Using A New Evidence-Based Health Workforce Innovation Research Framework To Compare Innovations In Community Health Center And Other Ambulatory Care Settings, Leah E. Masselink, Patricia Pittman, Claire Houterman Nov 2015

Using A New Evidence-Based Health Workforce Innovation Research Framework To Compare Innovations In Community Health Center And Other Ambulatory Care Settings, Leah E. Masselink, Patricia Pittman, Claire Houterman

Health Workforce Research Center Publications

In the United States, changing demographics, rising costs, and the impact of new regulations and payment models arising from the Affordable Care Act have placed unprecedented pressures on healthcare providers to increase access to care, improve quality and to control costs. To meet these challenges, some providers are forming accountable care organizations (ACOs) while others are pursuing medical homes or other novel payment and care delivery models designed to help meet these challenges. Within established organizations such as federally funded community health centers (CHCs), healthcare leaders are exercising significant latitude in developing innovative solutions for meeting their patients’ needs more …


Pesticide Exposure, Behavior Of Farmer, And Activity Of Cholinesterase Enzyme In Blood Of Fertile Women Farmers, Deni Abdul Rahman, Zakianis Zakianis, Laila Fitria Nov 2015

Pesticide Exposure, Behavior Of Farmer, And Activity Of Cholinesterase Enzyme In Blood Of Fertile Women Farmers, Deni Abdul Rahman, Zakianis Zakianis, Laila Fitria

Kesmas

Petani perempuan usia subur berisiko mengalami penurunan aktivitas kolinesterase akibat pajanan pestisida. Penelitian ini bertujuan untuk menganalisis hubungan antara pajanan pestisida dan perilaku pemajan terhadap aktivitas kolinesterase petani perempuan usia subur di Desa Kedunguter. Penelitian ini menggunakan desain potong lintang pada 94 petani perempuan usia subur tahun 2015. Pengumpulan data dilakukan secara observasi, wawancara, dan uji kolinesterase. Analisis data menggunakan uji kai kuadrat dan hasil analisis menunjukkan hubungan signifikan antara jenis pestisida, waktu kerja, penggunaan sarung tangan, perilaku mencuci tangan terhadap aktivitas kolinesterase petani perempuan usia subur. Hasil analisis pada penelitian ini menunjukkan bahwa variabel waktu kerja memiliki nilai odds …


The Use Of Earthworms And Household Organic Waste Composting Length Of Time, Abdul Khair, Lucky Herawati, Noraida Noraida, Munawar Raharja Nov 2015

The Use Of Earthworms And Household Organic Waste Composting Length Of Time, Abdul Khair, Lucky Herawati, Noraida Noraida, Munawar Raharja

Kesmas

Pengomposan dengan cacing tanah merupakan proses pembuatan kompos dengan melibatkan organisme makro cacing tanah. Kerja sama antara cacing tanah dengan mikroorganisme dapat memberi dampak pada proses penguraian yang dilakukan oleh mikroorganisme tersebut dibantu dengan keberadaan cacing tanah. Oleh karena bahan-bahan yang akan diurai oleh mikroorganisme telah diurai lebih dahulu oleh cacing, maka kerja mikroorganisme lebih efektif dan lebih cepat. Penelitian ini bertujuan untuk mengetahui pengaruh penggunaan cacing tanah terhadap lama waktu pengomposan sampah organik dari rumah tangga dengan menggunakan desain penelitian eksperimen. Objek penelitian adalah seluruh sampah organik dari rumah tangga yang diambil secara acak pada satu rumah tangga. Variabel …


Riwayat Berat Badan Lahir Dengan Kejadian Stunting Pada Anak Usia Bawah Dua Tahun, Atikah Rahayu, Fahrini Yulidasari, Andini Octaviana Putri, Fauzie Rahman Nov 2015

Riwayat Berat Badan Lahir Dengan Kejadian Stunting Pada Anak Usia Bawah Dua Tahun, Atikah Rahayu, Fahrini Yulidasari, Andini Octaviana Putri, Fauzie Rahman

Kesmas

Kabupaten Hulu Sungai Utara masih dihadapkan dengan permasalahan gizi pada anak bawah dua tahun (baduta). Salah satu masalah gizi hingga saat ini adalah stunting. Anak dengan riwayat berat badan lahir rendah (BBLR) merupakan salah satu faktor yang potensial memengaruhi pertumbuhan anak. Penelitian ini bertujuan untuk mengkaji risiko riwayat berat badan lahir dengan kejadian stunting pada anak baduta. Desain penelitian adalah potong lintang. Populasi penelitian ini merupakan ibu-ibu yang memiliki anak baduta dan besar sampel sejumlah 117 terdiri dari anak baduta. Pelaksanaan penelitian dilakukan selama tiga bulan pada bulan September – November 2014. Kategori BBLR jika riwayat berat badan lahir < 2.500 gram. Analisis data bivariat menggunakan uji kai kuadrat dan data multivariat menggunakan uji regresi logistik. Hasil analisis bivariat menunjukkan bahwa terdapat hubungan yang signifikan antara riwayat status BBLR (nilai p = 0,015) dengan stunting pada anak baduta. Berdasarkan hasil analisis multivariat, diperoleh bahwa BBLR merupakan faktor risiko yang paling dominan berhubungan dengan kejadian stunting. Anak dengan BBLR memiliki risiko 5,87 kali untuk mengalami stunting. Riwayat BBLR memiliki peranan penting dalam kejadian stunting anak baduta di wilayah Puskesmas Sungai Karias, Hulu Sungai Utara. North Hulu Sungai District is still facing nutrition problems among children under two years old. One of nutrition problems up to now is stunting. Child with low birthweight (LBW) record is one of potential factors influencing the growth of a child. This study aimed to assess any risk of LBW records with stunting incidence among children under two years old. This study used cross-sectional design. The population was mothers having children under two years old and samples amounted to 117 consisted of children under two years old. This study was conducted within three months on September – November 2014. Category of LBW was if birth weight records < 2,500 gram. Bivariate data analysis used chi-square test and multivariate data analysis used logistic regression test. The result of bivariate analysis showed a significant relation between LBW status records (p value = 0.015) with stunting incidence among children under two years old. Based on the result of multivariate analysis, LBW was the most dominating risk factor related to stunting incidence. Children with LBW had 5.87 times risk of suffering from stunting. LBW records take an important role in stunting incidence among children under two years old around Sungai Karias Primary Health Care area in North Hulu Sungai.


Penemuan Kasus Infeksi Kusta Subklinis Pada Anak Melalui Deteksi Kadar Antibodi (Igm) Anti Pgl-1, Arif Sujagat, Fardhiasih Dwi Astuti, Eva Muslimawati Saputri, Annisa Sani, Agil Dwi Prasetya Nov 2015

Penemuan Kasus Infeksi Kusta Subklinis Pada Anak Melalui Deteksi Kadar Antibodi (Igm) Anti Pgl-1, Arif Sujagat, Fardhiasih Dwi Astuti, Eva Muslimawati Saputri, Annisa Sani, Agil Dwi Prasetya

Kesmas

]Kusta merupakan penyakit menular kronis yang disebabkan Mycobacterium leprae. Indonesia menempati peringkat ketiga penyumbang kasus kusta terbanyak di dunia pada tahun 2012 – 2014. Kota Surabaya merupakan daerah endemis kusta. Penelitian ini bertujuan untuk deteksi dini kusta subklinis berdasarkan pengukuran kadar antibodi (IgM) anti PGL-1 dan mengetahui faktor-faktor yang berhubungan dengan kusta subklinis pada anak di Kota Surabaya. Penelitian analitik menggunakan desain potong lintang pada bulan April - Mei 2015. Populasi dilakukan penelitian adalah keluarga yang memiliki anggota penderita kusta. Sampel dipilih dengan teknik simple random sampling dan sebanyak 30 kepala keluarga terpilih melalui rapid school and village survey pada …


Pre-Eklampsia Berat Dan Kematian Ibu, Nova Muhani, Besral Besral Nov 2015

Pre-Eklampsia Berat Dan Kematian Ibu, Nova Muhani, Besral Besral

Kesmas

Pre-eklampsia berat, salah satu penyebab utama kematian ibu di Indonesia dan di RSUD Dr. H. Abdul Moeloek Lampung, merupakan penyebab kematian ibu nomor satu (47,25%). Penelitian ini bertujuan untuk mengetahui hubungan prediktor pre-eklampsi berat (PEB) yang dinilai dari tekanan darah sistolik, tekanan darah diastolik, proteiunuria, eklampsia, sindrom hemolysis, elevated liver enzymes, low platelets count (HELLP) dengan kematian ibu di RSUD Dr. H. Abdul Moeloek. Penelitian ini menggunakan desain kasus kontrol dengan jumlah sampel 60 kasus dan 120 kontrol. Data diolah dari rekam medis rumah sakit selama periode lima tahun (2010 – 2014). Hasil penelitian ini memperlihatkan bahwa sindrom HELLP memiliki …


Peran Tenaga Kesehatan Dan Keluarga Dalam Kehamilan Usia Remaja, Mery Ramadani, Dien Gusta Anggraini Nursal, Livia Ramli Nov 2015

Peran Tenaga Kesehatan Dan Keluarga Dalam Kehamilan Usia Remaja, Mery Ramadani, Dien Gusta Anggraini Nursal, Livia Ramli

Kesmas

Sebanyak 10,3% kematian tidak langsung pada ibu disebabkan kehamilan usia remaja (< 20 tahun). Di Kabupaten Tanah Datar, masih terjadi peningkatan kehamilan usia remaja dalam tiga tahun terakhir. Penelitian ini bertujuan untuk mengetahui peran tenaga kesehatan, dukungan keluarga, dan pengetahuan remaja dengan kehamilan usia remaja di wilayah kerja Puskesmas Singgalang, Kabupaten Tanah Datar tahun 2014. Penelitian dilaksanakan pada bulan Mei – Juni 2014 menggunakan desain potong lintang. Populasi adalah seluruh remaja putri berusia < 20 tahun yang telah menikah berjumlah 215 orang. Sampel berjumlah 68 orang dan pengambilan sampel dilakukan secara proporsional di delapan jorong/desa. Data dikumpulkan melalui wawancara menggunakan kuesioner. Kemudian, analisis bivariat dilakukan dengan uji kai kuadrat dan analisis multivariat dengan uji regresi logistik ganda. Hasil penelitian mendapatkan sebanyak 55,9% responden hamil di usia remaja. Sebanyak 52,9% responden kurang merasakan peran dari tenaga kesehatan, 66,2% kurang mendapat dukungan keluarga, dan 58,8% memiliki pengetahuan rendah. Didapatkan hubungan peran tenaga kesehatan (nilai p = 0,032), dukungan keluarga (nilai p = 0,025), dan tingkat pengetahuan (nilai p = 0,002) dengan kehamilan usia remaja. Dapat disimpulkan bahwa tenaga kesehatan, keluarga dan tingkat pengetahuan berperan dalam kehamilan remaja. Tenaga kesehatan perlu memberikan penyuluhan mengenai risiko kehamilan remaja kepada remaja serta keluarga. Worth 10.3% of indirect maternal death is due to teenage pregnancy (< 20 years old). In Tanah Datar District, the increase of teenage pregnancy has occured in the last three years. This study aimed to determine health worker's role, family's support and teenagers' knowledge with teenage pregnancy in work area of Singgalang Primary Health Care, Tanah Datar District in 2014. This study was conducted on May – June 2014 using cross-sectional design. Population was 215 married teenage girls < 20 years old. A total of sample was 68 selected proportionally in eight villages. Data were collected through interview using questionnaire. Then bivariate analysis was conducted using chi-square test and multivariate analysis using multiple logistic regression test. Results of study found 55.9% of respondents were pregnant in teen age. Respondents worth 52.9% got less health worker’s role, 66.2% got less family’s support and 58.8% had low level of knowledge. There was a relation found between health worker’s role (p value = 0.032), family’s support (p value = 0.025) and knowledge level (p value = 0.002) with teenage pregnancy. In conclusion, health workers, family and knowledge level play a role in teenage pregnancy. Health workers need to provide counseling concerning teenage pregnancy risks for both teenagers and families.


Pengaruh Musik Keroncong Selama Pelaksanaan Kangaroo Mother Care Terhadap Respons Fisiologis Dan Lama Rawat Bayi Dengan Berat Badan Lahir Rendah, Anita Rahmawati, Endah Marianingsih Theresia, Yuliasti Eka Purnamaningrum Nov 2015

Pengaruh Musik Keroncong Selama Pelaksanaan Kangaroo Mother Care Terhadap Respons Fisiologis Dan Lama Rawat Bayi Dengan Berat Badan Lahir Rendah, Anita Rahmawati, Endah Marianingsih Theresia, Yuliasti Eka Purnamaningrum

Kesmas

Kangaroo mother care (KMC) merupakan metode merawat bayi berat badan lahir rendah (BBLR). Beberapa intervensi perawatan di neonatal intensive care unit seperti pijat bayi, KMC, dan mendengarkan musik bermanfaat untuk pertumbuhan bayi berupa respons fisiologis BBLR dan mengurangi lama rawat. Penelitian ini bertujuan untuk mengetahui manfaat musik keroncong terhadap respons BBLR selama KMC dan lama rawat. Rancangan penelitian adalah quasi eksperimental dengan pretest dan posttest dengan desain grup kontrol. Pada Juli - September 2014 populasi penelitian adalah ibu dan bayi BBLR yang melaksanakan KMC. Pengambilan sampel dengan purposive sampling sebanyak 60 bayi. Kriteria inklusi bayi BBLR yang ditetapkan adalah berat …


Disability Prevention Programs For Older People: Factors Associated With Medical And Nursing Care Costs, Takaaki Ikeda, Susumu Yanagawa, Kenichi Murakami, Toshiyuki Inoue, Takamasa Tsurumi Nov 2015

Disability Prevention Programs For Older People: Factors Associated With Medical And Nursing Care Costs, Takaaki Ikeda, Susumu Yanagawa, Kenichi Murakami, Toshiyuki Inoue, Takamasa Tsurumi

Kesmas

Penelitian ini bertujuan untuk mengklarifikasi faktor-faktor yang terkait dengan biaya medis dan perawatan lanjut usia (lansia) yang tinggal di panti sosial serta menyarankan program pencegahan disabilitas yang efektif. Total partisipan dalam penelitian ini adalah 83 orang (29 laki-laki dan 54 perempuan; usia rata-rata 81,2 ± 6,3 tahun) pada 1 November – 28 Desember 2014. Penelitian ini membandingkan biaya medis dan perawatan rata-rata per bulan dengan rata-rata nasional bagi yang berusia ≥ 65 tahun. Uji regresi logistik dilakukan untuk memeriksa keterkaitannya dengan biaya medis dan perawatan. Mereka yang pergi ke luar rumah ≥ 3 kali seminggu tiga kali lebih kecil kemungkinannya …


Vision, Mission, And Values: From Concept To Execution At Mayo Clinic, Sandhya Pruthi, Dawn Marie R. Davis, Dawn L. Hucke, Francesca B. Ripple, Barbara S. Tatzel, James A. Dilling, Paula J. Santrach, Jeffrey W. Bolton, John H. Noseworthy Nov 2015

Vision, Mission, And Values: From Concept To Execution At Mayo Clinic, Sandhya Pruthi, Dawn Marie R. Davis, Dawn L. Hucke, Francesca B. Ripple, Barbara S. Tatzel, James A. Dilling, Paula J. Santrach, Jeffrey W. Bolton, John H. Noseworthy

Patient Experience Journal

Mayo Clinic displays steadfast commitment to patient care, referral relations, and health care quality through institutional examples of unique, value-add endeavors that are under way with the Mayo Clinic Patient Experience Subcommittee and the Referring Physician Office. In this article, we share the Mayo Model of Care and patient stories that embody the 8 Mayo Clinic values of respect, compassion, integrity, healing, teamwork, excellence, innovation, and stewardship. The Mayo founders imparted to their staff the passion for patient care by encouraging a fair and just culture for its employees. This culture allows the creation, maintenance, and improvement of clinical care, …


Randomized Clinical Trial Comparing Perioperative Care For Breast Cancer Patients At A Patient Hotel Versus A General Surgical Ward, Madleen Anna Camilla Huzell, Johan Frisack, Kristina Dalberg Nov 2015

Randomized Clinical Trial Comparing Perioperative Care For Breast Cancer Patients At A Patient Hotel Versus A General Surgical Ward, Madleen Anna Camilla Huzell, Johan Frisack, Kristina Dalberg

Patient Experience Journal

Breast cancer is the most frequent cancer among women in Europe and the US. The aim of this study was to assess whether perioperative care, for breast cancer patients, provided at a patient hotel could be an alternative to the conventional care in an ordinary surgical ward. The study focuses solely on the patients’ experience of the provided care with a primary outcome that perioperative care at the patient hotel would be valued better than care in a general ward. Prospective, randomized single centre study. Between 2010 and 2012 a total of 151 patients < 80 years and without severe comorbidities were included in the trial, whereof 76 patients were randomised to the ward group and 75 patients to the hotel group. Five patients were excluded from each group. The validated IN2005-E questionnaire was used to evaluate the patients’ experiences of the care. The response rate was high with 65 patients answering the IN2005-E in each group. No difference could be found between the two groups regarding patient characteristics, type of surgery or tumour characteristics. The patients generally perceived the quality of the provided care as high. However, in the hotel group there was a better experience of care regarding issues such as coordination, privacy, some aspects of medical information, availability and the courtesy of the nurses. For selected patients, perioperative care at a patient hotel is an appreciated alternative to care at a surgical ward.


Patient Needs In Advanced Renal Cell Carcinoma: What Are Patients’ Priorities And How Well Are We Meeting Them?, Rick Harris, Kate Oake, Robert E. Hawkins, Robert J. Jones, Thomas Powles, David A. Montgomery Nov 2015

Patient Needs In Advanced Renal Cell Carcinoma: What Are Patients’ Priorities And How Well Are We Meeting Them?, Rick Harris, Kate Oake, Robert E. Hawkins, Robert J. Jones, Thomas Powles, David A. Montgomery

Patient Experience Journal

Treatment options and duration of therapy for patients with metastatic renal cell carcinoma (mRCC) have increased. Many patients now spend in excess of 2 years on active therapy. These patients’ needs, and the ability of health services to respond to them, are poorly understood. Ten patients living with mRCC for more than 2 years and treated with at least one targeted agent were selected at random from three hospitals in the United Kingdom (UK). One interviewer who was not involved in their care conducted in-depth interviews. Interview transcripts were analysed using Interpretative Phenomenological Analysis (IPA) to identify issues of greatest …


The Comparative Impact Of Different Patient-Centered Medical Home Domains On Satisfaction Among Individuals Living With Type Ii Diabetes, Jon Mills, Allyson Hall, Rebecca Tanner, Jeffrey Harman, David L. Wood, Charles Lorbeer Nov 2015

The Comparative Impact Of Different Patient-Centered Medical Home Domains On Satisfaction Among Individuals Living With Type Ii Diabetes, Jon Mills, Allyson Hall, Rebecca Tanner, Jeffrey Harman, David L. Wood, Charles Lorbeer

Patient Experience Journal

Chronic illnesses like type 2 diabetes are costly and difficult to treat. Patient-centered medical homes (PCMH) have the potential to improve patient satisfaction in this population. However, which domains have the most impact on patient satisfaction has not been established. The aim of this study was to assess the relative strength of association between seven PCMH domains and two measures of satisfaction. Cross-sectional data were used in this observational study collected from a random sample of adults aged 18-89 with type 2 diabetes (n=1301) seen at 4 PCMHs. The Ambulatory Care Experiences Survey instrument was used to assess all measures. …


A Vision For Using Online Portals For Surveillance Of Patient-Centered Communication In Cancer Care, Hardeep Singh, Neeraj K. Arora, Kathleen M. Mazor, Richard L. Street Jr Nov 2015

A Vision For Using Online Portals For Surveillance Of Patient-Centered Communication In Cancer Care, Hardeep Singh, Neeraj K. Arora, Kathleen M. Mazor, Richard L. Street Jr

Patient Experience Journal

The Veterans Health Administration (VHA) is charged with providing high-quality health care, not only in terms of technical competence but also with regard to patient-centered care experiences. Patient-centered coordination of care and communication are especially important in cancer care, as deficiencies in these areas have been implicated in many cases of delayed cancer diagnosis and treatment. Additionally, because cancer care facilities are concentrated within the VHA system, geographical and system-level barriers may present prominent obstacles to quality care. Systematic assessment of patient-centered communication (PCC) may help identify both individual veterans who are at risk of suboptimal care and opportunities for …


Impact Of Hospital Characteristics On Patients’ Experience Of Hospital Care: Evidence From 14 States, 2009-2011, Emily M. Johnston, Kenton J. Johnston, Jaeyong Bae, Jason M. Hockenberry, Ariel C. Avgar, Arnold Milstein Md, Mph, Sandra S. Liu, Ira Wilson, Edmund Becker Nov 2015

Impact Of Hospital Characteristics On Patients’ Experience Of Hospital Care: Evidence From 14 States, 2009-2011, Emily M. Johnston, Kenton J. Johnston, Jaeyong Bae, Jason M. Hockenberry, Ariel C. Avgar, Arnold Milstein Md, Mph, Sandra S. Liu, Ira Wilson, Edmund Becker

Patient Experience Journal

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 10 hospital-reported patient experience-of-care scores by 29 characteristics classified as: patient characteristics, payer source, patient severity, hospital characteristics, hospital operations, and market characteristics. We also evaluate how scores have changed over the three-year period. We find significant differences in patient experience-of-care scores by hospital characteristics for 250 out of 290 HCAHPS-hospital characteristic combinations measured. We find fewer significant differences in changes in scores from 2009-2011 (135 out of …


Using A Process Improvement Tool To Improve Staff Skills & Enhance The Urgent Needs Patient Experience In A Women’S Health Center, Kenneth J. Feldman, Molly Lopez, Morris Gagliardi Nov 2015

Using A Process Improvement Tool To Improve Staff Skills & Enhance The Urgent Needs Patient Experience In A Women’S Health Center, Kenneth J. Feldman, Molly Lopez, Morris Gagliardi

Patient Experience Journal

NYC Health + Hospitals / Gouverneur serves more patients than any other diagnostic and treatment center in New York State. As part of the NYC Health + Hospitals public health care system, which serves 1.4 million patients and is the largest municipal health care delivery system in the United States, Gouverneur strives to serve the needs of both scheduled and unscheduled patients. Within Gouverneur, the Women’s Health department treats approximately 1,600 patients per month through approximately 2,100 visits. In September 2014, Gouverneur’s Women’s Health department launched a weeklong process improvement initiative known as a Rapid Improvement Event (RIE). Structured through …


Improving Process And Enhancing Parent And Therapist Satisfaction Through A Coordinated Intake Approach, Sharla Piecowye, Devona Gibson, Janis Carscadden, Kayla Ueland, Gregory Wells, Scott Oddie Nov 2015

Improving Process And Enhancing Parent And Therapist Satisfaction Through A Coordinated Intake Approach, Sharla Piecowye, Devona Gibson, Janis Carscadden, Kayla Ueland, Gregory Wells, Scott Oddie

Patient Experience Journal

Recent research indicates that, in Canada, approximately one in five children entering school are not meeting age appropriate milestones in physical, social, language, or cognitive development. Even where support services are available families often face barriers in accessing these. With the goals of improving access to programs, reducing barriers and increasing consistency and efficiency, a new Coordinated Intake Approach (CIA) was developed for families accessing Children’s Rehabilitation Services. It was expected that the CIA would result in 1) parents finding the intake process more satisfactory and easier to complete, 2) therapists feeling more supported and satisfied and 3) a decrease …


The Patient Patient: The Importance Of Knowing Your Navigator, Sarah M. Wheeler Phd, Julie E. Gilbert Phd, Melissa Kaan Mba, Eric Klonikowski, Claire Mb Holloway Md Phd Frcsc Nov 2015

The Patient Patient: The Importance Of Knowing Your Navigator, Sarah M. Wheeler Phd, Julie E. Gilbert Phd, Melissa Kaan Mba, Eric Klonikowski, Claire Mb Holloway Md Phd Frcsc

Patient Experience Journal

In Ontario, Diagnostic Assessment Programs (DAPs) have been implemented to improve the quality of care patients receive during the diagnostic phase of the cancer journey. Patient navigators play a critical role in this model by coordinating care and providing information and support to patients and their families. The objectives of this study were 1) to determine whether patient navigation in DAPs is associated with a better patient experience and 2) to examine whether patient navigation in DAPs modifies the effect of wait times and patient volumes on patient experience. Data reflecting patients’ experience within the DAP were collected via survey …