Health Services Administration Commons^™

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 …

Teen, Parent, And Clinician Expectations About Obesity And Related Conditions During The Annual Well-Child Visit, Andrew S. Bossick, Charles Barone, Gwen L. Alexander, Heather A. Olden, Tanya Troy, Andrea E. Cassidy-Bushrow

Journal of Patient-Centered Research and Reviews

Purpose: This study aimed to examine family (patient, parent/guardian) and clinician preferences for identification and management of obesity and obesity-related conditions during the well-child visit.

Methods: Four focus groups with teen patients (n = 16), four focus groups with parents (n = 15) and one focus group with providers (n = 12) were conducted using a structured moderator guide tailored to each population. Eligible patients had a well-child visit during the past 12 months and a diagnosis of overweight, obesity, hyperlipidemia or elevated blood pressure. Parents who attended their child’s well-child visit and whose child met the diagnostic …

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 …

Merging Cultures: Organizational Behavior, Leadership, And Differentiation In A Health System Merger, Colin G. Chesley

Electronic Theses and Dissertations

Health system mergers and acquisitions (M&As) have increased exponentially in recent years as a result of the Affordable Care Act (Brown, Werling, Walker, Burgdorfer & Shields, 2012). M&As are consummated as a way to control for interdependencies within the market, control costs and leverage debt, and negotiate better rates among health insurers (Bolman & Deal, 2013; Cooper & Finkelstein, 2010; Mirc, 2013). Regardless of the impetus for a merger, the largest predictor of the success or failure of a M&A lies within the organizational culture (Brown, et al., 2012; Cooper & Finkelstein, 2010; Kastor, 2010; Ovseiko, Melham, Fowler & Buchan, …

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 …

Level Of Adherence And Its Determinants Of Prolanis Attendance In Type 2 Diabetes Mellitus Participants At Five Bpjs Primary Health Care In Bekasi 2016, Ledy Visna Asfiani, Yaslis Ilyas

Journal of Indonesian Health Policy and Administration

The continuity of the participation in Prolanis is one of the primary health care services indicators of commitment, so finding out the level of adherence and the factors influencing it is very important. The aim of the study is to investigate the adherence level of Prolanis participanst and its determinants in type 2 diabetes patients at five BPJS primary health care in Bekasi. This is a cross sectional study, using questionnare to 220 participants with type 2 diabetes by simple random sampling method proportionally. Adherence level of the participants is 3.59 out of 6 times. Length of illness, perceived benefits, …

Inpatient Readmission Insidence Of National Health Insurance Patients At Partner Hospitals Of Bpjs-Health In Sukabumi 2015, Atmiroseva Atmiroseva, Atik Nurwahyuni

Journal of Indonesian Health Policy and Administration

The INA-CBG payment system in the JKN program allegedly increasing the incidence of readmission. This study aims to map the incidence of readmission in JKN participants admitted to thirteen partner hospitals of BPJS-Health in Sukabumi. The research design is a descriptive study with the unit of analysis is patient. The study used secondary data from inpatient claims in thirteen partner hospitals BPJS-Health Sukabumi which has been verified during 2015. The study found that the number of readmission is 8.81% with the most readmission incidence occurs in the equal CMG category and at the least in the equal severity level category. …

Analysis Of Policy Change Relating To Presidential Regulation No.19 Year 2016 On Health Insurance Became Presidential Regulation No.28 Year 2016 On Health Insurance, Julian Simanjuntak, Amal Chalik Sjaaf

Journal of Indonesian Health Policy and Administration

The rapid change from presidential regulation no.19 year 2016 on health insurance into presidential regulation no.28 year 2016 on health insurance get a big attention. This research was purposed to analyze about health insurance policy which changed very quickly. It changed from presidential regulation no.19 year 2016 into presidential regulation no.28 year 2016 on health insurance. The researcher used qualitative methods. The analysis from the input processing and output showed that the change of presidential regulation is a responsive form from president when he looked public rejection response for the increase of fee. The president extended it through the department …

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, …

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 …

Supporting And Retaining Village Health Teams: An Assessment Of A Community Health Worker Program In Two Ugandan Districts., Daniel C Mays, Edward J O'Neil, Edison A Mworozi, Benjamin J Lough, Zachary J Tabb, Ashlyn E Whitlock, Edward M Mutimba, Zohray M Talib

Health Policy and Management Faculty Publications

Background

Uganda’s national community health worker program involves volunteer Village Health Teams (VHTs) delivering basic health services and education. Evidence demonstrates their positive impact on health outcomes, particularly for Ugandans who would otherwise lack access to health services. Despite their impact, VHTs are not optimally supported and attrition is a growing problem. In this study, we examined the support needs and existing challenges of VHTs in two Ugandan districts and evaluated specific factors associated with long-term retention. We report on findings from a standardized survey of VHTs and exploratory interviews with key stakeholders and draw conclusions that inform efforts to …