Health Services Research Commons^™

Tertiary Care Centres Must Do More For Patients With Unknown Conditions: Lessons Learned From A Child, Guido Filler, Lana Rothfels

Patient Experience Journal

Postural Orthostatic Tachycardia Syndrome (POTS) is a debilitating disease with a commonly non-uniform and unspecific presentation that makes diagnosis difficult. A twelve-year-old girl, recently diagnosed with Addison’s Disease, was referred to paediatric nephrology for Fludrocortisone-induced nocturnal hypertension. She had fallen off the growth curve for both height and weight from the 50th percentile at birth to below the 5th percentile at presentation. The severity and multitude of her symptoms, including muscle weakness, poor body control, dizziness, light headedness, persistent fatigue, excessive sweating, tachycardia, chronic constipation and recurrent infection hinted at the unusual nature of this case of Addison’s. At the …

Life With My Baby In A Neonatal Intensive Care Unit: Embracing The Family Integrated Care Model, Yasmin Lalani

Patient Experience Journal

This paper is a personal narrative that describes the components of the Family Integrated Care Model in a neonatal intensive care unit in Canada. I begin by introducing the reader with a brief story of how my son came to be admitted into a NICU. Next, I discuss three aspects of the Family Integrated Care Model that I found to be most striking: medical rounds, “do-ups” and skin-to-skin contact. I also discuss how my immersion in this healthcare setting for three months was a form of autoethnographic fieldwork, as I experienced the NICU both as a parent and a health …

What Medicine Can Learn From Pediatrics: A Mother's Perspective, Nancy Michaels

Patient Experience Journal

As a mother of a young adult child with Aspergers syndrome, as well as being a long-term patient myself (liver transplant in 2005), I have extensive experience in both camps. Recently my 20-year old son was admitted to a children’s hospital for a twisted colon that had to be surgically reduced. As the parent of a child with special needs and related physical health-related issues connected to him being on the autism spectrum, I was naturally very concerned about him entering a hospital (perhaps PTSD based on my own experience at moments). Surprising to me, the experience was a very …

Partners For Excellence: Committed To Meaningful Partnerships With Patients And Families In Pediatrics, Rachel Biblow, Msw, Sara Toomey Md, Mphil, Mph, Msc

Patient Experience Journal

Although the landscape in pediatrics continues to shift and change, one of the keys to our continued success remains the same… it’s about partnership. It’s clear the element of partnership is well woven through our organizations as illustrated by many of us having patient and family advisory councils, family consultants, and family partners. While this foundation is strong and essential, we must do more to truly listen, recognize the value of patient and family involvement, act upon the information shared, openly discuss issues, and strive for better together. True partnership with patients and families requires us to shift the paradigm …

Lessons For Patient Experience From The Voices Of Pediatrics And Children’S Hospitals, Jason A. Wolf Phd, Cpxp

Patient Experience Journal

This special issue on patient & family experience in children’s hospitals and pediatric care underlines pediatrics’ position as a leader in the experience journey. In pediatrics and children’s hospitals significant efforts are made to the ensure the environment is welcoming and comfortable, there is a commitment to communicating to patients – the children that are cared for – in a way they can understand, and there is a clear intention of engaging family members as an integral part of the care experience. In acknowledging that this is a special issue on pediatrics, we would miss a significant opportunity if we …

Cross Jurisdictional Boundaries To Build A Health Coalition: A Kentucky Case Study, Angela L. Carman, Margaret L. Mcgladrey

Health, Behavior & Society Faculty Publications

Cross-jurisdictional sharing is accomplished through collaboration across jurisdictional boundaries to deliver essential public health services and solve problems that cannot be easily addressed by single organizations or jurisdictions. Partners across 10 counties and three public health jurisdictions of the Barren River Area Development District (BRADD) convened as Barren River Initiative to Get Healthy Together (BRIGHT), a community health improvement coalition. Focus groups and interviews with BRIGHT members indicate that the use of effective strategies to focus collaborative health improvement efforts fosters a cohesive coalition even when the group is populated by individuals from across public health jurisdictional boundaries. Focusing strategies …

Rural Health Clinic Participation In The Merit-Based Incentive System And Other Quality Reporting Initiatives: Challenges And Opportunities, John A. Gale Ms, Zachariah T. Croll Mph, Andrew F. Coburn Phd

Rural Health Clinics

Rural Health Clinics (RHCs) are an important source of primary care in underserved rural communities with more than 4,200 RHCs providing primary care services to rural Medicare and Medicaid beneficiaries in 44 states. In light of the growing emphasis on quality reporting, it is important to understand factors influencing RHC readiness to participate in quality reporting including the Merit-Based Incentive Payment System (MIPS), Medicaid, and commercial payer quality reporting programs. The exclusion of RHCs from CMS’s quality reporting programs and value-based initiatives may potentially create a perception among consumers and policymakers that RHCs are unable to meet the requirements of …

Examining The Association Of Environmental Degradation And Poor Cardiovascular And/Or Respiratory Health Outcomes In A Disadvantaged Community, Khyati Niranjan Kantaria

Health Services Research Dissertations

Air pollution is associated with poor cardiovascular and/or respiratory health outcomes. The poor air quality in certain communities due to the emission of toxic air pollutants from industries and major roadways has been a growing concern. The main objective of this study was to examine whether residential proximity to environmental air pollution sources, individual-level risk factors (age, gender, and body mass index (BMI)) and number of years at same residence are associated with observed poor cardiovascular and/or respiratory health outcomes in the residents of Southeast community in Newport News, Virginia. Logistic regression was conducted to assess this association using the …

Surgical And Medical Applications Of Drones: A Comprehensive Review, Brent Terwilliger, James C. Rosser Jr., Vudatha Vignesh, Brett C. Parker

Publications

Drones have the ability to gather real time data cost effectively, to deliver payloads and have initiated the rapid evolution of many industrial, commercial, and recreational applications. Unfortunately, there has been a slower expansion in the field of medicine. This article provides a comprehensive review of current and future drone applications in medicine, in hopes of empowering and inspiring more aggressive investigation.

Sexual Violence Victimization, Mental Health, And University-Based Health Service Use Among College Females, Julie E. Stoner

Health Services Research Dissertations

Females between the ages of 18 and 24 consistently experience higher rates of sexual violence compared to females in any other age group (Sinozich & Langton, 2014). Approximately one in five college women experience sexual violence victimization (SVV; Krebs, Lindquist, Berzofsky, Shook-Sa & Peterson, 2016) during the academic year. Among undergraduate female students, 23.1% are victims of sexual violence due to physical force, violence or incapacitation (Cantor et al., 2015). Sexual victimization has been associated with several short- and long-term psychological health consequences, accounting for enhanced symptoms of depression, anxiety, PTSD, and suicide risk (Basile, Smith, Breiding, Black & Mahendra, …

Perspectives From The Society For Pediatric Research: Interventions Targeting Social Needs In Pediatric Clinical Care., Andrew F. Beck, Alicia J. Cohen, Jeffrey D. Colvin, Caroline M. Fichtenberg, Eric W. Fleegler, Arvin Garg, Laura M. Gottlieb, Matthew S S. Pantell, Megan T. Sandel, Adam Schickedanz, Robert S. Kahn

Manuscripts, Articles, Book Chapters and Other Papers

The social determinants of health (SDoH) are defined by the World Health Organization as the "conditions in which people are born, grow, live, work, and age." Within pediatrics, studies have highlighted links between these underlying social, economic, and environmental conditions, and a range of health outcomes related to both acute and chronic disease. Additionally, within the adult literature, multiple studies have shown significant links between social problems experienced during childhood and "adult diseases" such as diabetes mellitus and hypertension. A variety of potential mechanisms for such links have been explored including differential access to care, exposure to carcinogens and pathogens, …

Analisis Penerapan Prinsip Keselamatan Pasien Dalam Pemberian Obat Terhadap Terjadinya Medication Error Di Rawat Inap Rumah Sakit X Tahun 2018, Lediana Tampubolon, Pujianto Pujianto

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

Medication error is the incident of a drug provision that can inflicting injury to the patient with should be able to prevent as long as in control of a trained health professional, and of patients itself. From the 10 fact from World Health Organization on patient safety for the developing country in 2017 mentioned that 1 of 10 patients treated at hospital runs the risk against an onset of medical error and drug mistakes that may cause adverse effect. From the data of patient safety incident in hospital X performed from 2015 until 2016 there were 30 cases of patient …

The Potential Role Of Indonesia’S Universal Health Coverage In Management Of Severe-To-Profound Hearing Loss Through Cochlear Implantation, Trimartani Trimartani, Adik Wibowo

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

This study aimed to evaluate the role of Jaminan Kesehatan Nasional (JKN) in improving the quality of cochlear implant services using Strength, Weakness, Opportunity, and Threat (SWOT) analysis. The study identified the internal factors of the cochlear implant center in Cipto Mangunkusumo Hospital as a consideration for developing hospital policies and the external factors to determine strategies for future development. The role of JKN was highlighted on the SWOT analysis, showing that the cochlear implant center was strategically located, thus increased the quality and the competitive factor compared to other hospitals. Strength-Opportunity strategy was recommended in improving service quality and …

Analisis Faktor Yang Berhubungan Dengan Turnover Perawat Di Rumah Sakit Awal Bros Batam Tahun 2017, Luvi Christiani, Jaslis Ilyas

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

Hospitals as plenary health service providers have an obligation to maintain the quality of services provided. The nurse is one of the spearheads of service and is the largest part of the hospital's resources. The quality of nursing services with the main goal is to maintain patient safety by controlling the turnover rate. During 2015 to 2017 there were 15.4%, 14.3%, and 18.9% turnover rates for nurses at awal bros hospital batam. The method of research are quantitative and qualitative approach to determine factors related to nurse turnover. Quantitative research for all nurses who had left was 79 people. Qualitative …

Analisis Kebutuhan Tenaga Ahli Teknologi Laboratorium Medik Berdasarkan Beban Kerja Di Unit Laboratorium Klinik Rumah Sakit Santa Maria Pekanbaru, Arifin Arifin, Amal Chalik Sjaaf

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

The main challenge of the clinical laboratory unit in hospitals nowdays is making expenditures efficiency, especially human resources expenditures. On the other hand, patients and doctors normally request faster and more accurate laboratory checking results. The purpose of this study is to get proper number of medical laboratory technology experts needed based on workload in Santa Maria Pekanbaru Hospital Clinical Laboratory Unit. Research method applied is operational research with quantitative and qualitative analysis. Workload analysis was done toward the whole medical laboratory technology experts, which were 15 person, with the combination method of work sampling and daily log. The calculation …

Correlation Between Laboratory Turnaround Time In Pediatric Emergency Departement And Length Of Stay, Putu Diah Pratiwi, Dyah Kanya Wati, I Nyoman Budi Hartawan

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

A quick and precise diagnosis is essential in hospital services, especially in the emergency department. In condition with high volume patients, perfomance of laboratory usually decreases. Studies which identify directly the delay of laboratory examinations in emergency department in relation to length of stay in wards have not been conducted. We did correlative study using secondary data obtained from medical records. Inclusion criteria was child, age range from 29 days to 12 years old who needed supporting laboratory examinations, directly admitted to wards or PICU after getting treatments in emergency department. Exclusion criteria was child with growth and developmental problem, …

Pengaruh Pengetahuan, Sikap Dan Motivasi Terhadap Kepatuhan Dokter Dalam Penulisan Diagnosis Pada Resume Medis Di Rs Zahirah 2018, Muhammad Husni

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

The writing of a diagnosis on medical resume is the responsibility of the physician in charge of the patient (DPJP), for the benefit of BPJS claims. This relates to doctors' compliance in the diagnosis of medical resumes. Knowledge, attitudes, and motivations affect the physician's neck in writing the diagnosis on medical resume. This study aims to determine the influence of knowledge, attitudes, and motivation either partially or simultaneously to the doctor's compliance in the writing of the diagnosis on medical resume at Zahirah Hospital in 2018. This research is quantitative analytic, with cross sectional and prospective approach. The results showed …

Effect Of Febrile Neutropenia Guideline’S Implementation On Death Rate In Dharmais Cancer Center Hospital, Dody Ranuhardy

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

Febrile neutropenia may have a high morbidity and mortality impact for the patient. The death rate of febrile neutropenia in 2002 was 38.8%, while in 2009 was 27.3%. The difference in mortality rates could caused by several factors such as availability of the Neutropenic Fever Management Guidelines in 2006, in addition to infrastructure, human resources and equipment. This study aims to determine the effect of the availability of the guideline and other factors to cancer mortality rate in the compromised immune isolation room of Dharmais Hospital. This study is a cross-sectional retrospective study which investigate mortality rates and compare with …

Healthcare Utilization & Health Behaviors Among Older Adults: The Role Of Insurance, Jennifer Rose Geiger

LSU Doctoral Dissertations

As the population of older adults in the U.S. continues its exponential growth, so too will the need for high-quality health and preventive services. Despite the widely acknowledged need for proactive solutions to the coming public health challenges for this rapidly expanding age cohort, healthcare providers and social work practitioners continue to lack the proper education training to serve the needs of older adults. Furthermore, these allied health professionals also frequently engage in ageist behaviors across care settings that also often employ institutionally ageist policies and procedures. As a result, older adults may be particularly at risk of negative health …

Three Years In--Changing Plan Features In The U.S. Health Insurance Marketplace, Caitlin N. Mckillop, Teresa M. Waters, Cameron M. Kaplan, Erin K. Kaplan, Michael P. Thompson, Ilana Graetz

Health Management and Policy Faculty Publications

Background: A central objective of recent U.S. healthcare policy reform, most notably the Affordable Care Act's (ACA) Health Insurance Marketplace, has been to increase access to stable, affordable health insurance. However, changing market dynamics (rising premiums, changes in issuer participation and plan availability) raise significant concerns about the marketplaces' ability to provide a stable source of healthcare for Americans that rely on them. By looking at the effect of instability on changes in the consumer choice set, we can analyze potential incentives to switch plans among price-sensitive enrollees, which can then be used to inform policy going forward.

Methods: Data …