Health Services Research Commons^™

Perubahan Status Kelembagaan Dan Kualitas Pelayanan Pasien Rumah Sakit, Dadang Kusnadi

Kesmas

Kenyamanan, keamanan, dan kepuasan pelayanan pasien merupakan fenomena pelayanan yang mencerminkan kualitas. Tujuan penelitian ini adalah untuk mengetahui pengaruh implementasi kebijakan perubahan status kelembagaan rumah sakit terhadap kualitas pelayanan pasien. Penelitian ini menggunakan desain kuantitatif dan metode explanatory survey. Metode analisis meliputi regresi linier multipel dengan uji validitas product moment pearson, uji reliabilitas teknik alpha cronbach, uji hipotesis path analysis dan uji statistik (t), serta transformasi data skala likert dengan alat ukur method of succesive interval. Populasi adalah pegawai rumah sakit sebanyak 1.072 orang dan sampel sebanyak 92 orang yang ditentukan dengan teknik stratified random sampling. Data dikumpulkan dengan wawancara …

Design Of A Prostate Cancer Patient Navigation Intervention For A Veterans Affairs Hospital, Narissa J. Nonzee, June M. Mckoy, Alfred W. Rademaker, Peter Byer, Thanh H. Luu, Dachao Liu, Elizabeth A. Richey

Dartmouth Scholarship

Patient navigation programs have been launched nationwide in an attempt to reduce racial/ethnic and socio-demographic disparities in cancer care, but few have evaluated outcomes in the prostate cancer setting. The National Cancer Institute-funded Chicago Patient Navigation Research Program (C-PNRP) aims to implement and evaluate the efficacy of a patient navigation intervention for predominantly low-income minority patients with an abnormal prostate cancer screening test at a Veterans Affairs (VA) hospital in Chicago.

Community Health Workers: A Front Line For Primary Care?, Lisa Sprague

National Health Policy Forum

Among the potential changes invoked in discussions on health system transformation, a need to revitalize primary care remains paramount. One way of doing this, most agree, is to move more in the direction of team-based care. Professionals such as physician assistants and nurse practitioners may be able to ease some of the physician’s clinical care load, but some populations also need help accessing services and basic health education in a familiar setting. Enter the community health worker (CHW), known by many titles and playing a variety of roles, who comes from the community he or she is serving and therefore …

Who Tended To Continue Smoking After Cancer Diagnosis: The National Health And Nutrition Examination Survey 1999-2008, Tung-Sung Tseng, Hui-Yi Lin, Sarah Moody-Thomas, Michelle Martin, Ted Chen

School of Public Health Faculty Publications

BACKGROUND: It has been estimated that there are approximately 12 million cancer survivors in the United States. Continued smoking after a cancer diagnosis is linked to adverse effects among cancer survivors on overall survival, treatment effectiveness, and quality of life. Little is known about who is more likely to quit smoking after his/her cancer diagnosis. The objective of this study is to evaluate factors associated with smoking cessation in cancer survivors, which to date has not been well studied. METHOD: The National Health and Nutrition Examination Survey (NHANES) 1999-2008 surveys were used in this study. A total of 2,374 cancer …

Bright Futures As-Is Assessment: How Child-Serving Practices, Health Systems, And The State Of Maine Use And Exchange Specific Clinical Data Related To Child Health Quality Measures, Kyra Chamberlain Ms, Rn, Martha Elbaum-Williamson Mpa, Jonathan Ives Mpm, Csm, Jin Liao M.Eng

Population Health & Health Policy

The purpose of the As Is assessment is to provide a description of Maine’s current HIT environment specifically pertaining to how EPSDT and other clinical data are entered, used, and exchanged electronically through information systems at pediatric practices, health systems, the State of Maine, and HIN. This information will inform plans currently under development by IHOC for electronic data exchange and child health measure calculation.

Faculty And Patient Evaluations Of Radiology Residents' Communication And Interpersonal Skills, Naila Nadeem, Abdul Mueed Zafar, Muhammad Nadeem Ahmad, Rukhsana Wamiq Zuberi

Department for Educational Development

Objective: To assess communication and interpersonal skills (CIS) of radiology residents through faculty and standardised patients (SP).

Methods: In this day-long objective structured clinical examination (OSCE) in January 2009, 42 radiology residents took part at six stations in Karachi, each with a standardised patient and a faculty evaluator. Each encounter lasted 15 minutes followed by independent assessments of the residents by both the evaluators.

Results: Based on rating-scale evaluations, all cases had satisfactory internal consistency (Cronbach\'s alpha 0.6 to 0.9). The alpha values were comparatively diminutive against the checklist scores. Correlation among faculty was 0.6 (p

Conclusion: Both checklists and …

Stubborn, Persistent, Dangerous C.Difficile Infections. Is Improvement Possible?, Sara Townsend

Master of Science in Healthcare Quality and Safety Capstone Presentations

C.difficile also known as C.diff or CDI has developed into a dangerous infection for the United States’ health care system. While much work has been done to improve C.diff rates, health care teams have not been successful in reducing C.difficile infections. Many studies have focused on the mode of transmission of C.difficle, yet there still is not consensus on understanding how this infection is spread. Bryn Mawr Hospital, a community hospital in the suburbs of Philadelphia, Pa, has struggled to improve their C.diff rates like their peers throughout the country. While their infection rates for C.diff are …

The Use Of Interpreters To Improve The Quality And Safety Of Healthcare Through Better Communication In Obstetric Patients: Effect On Primary Cesarean Delivery Rate, Stephen A. Pearlman, Md

Master of Science in Healthcare Quality and Safety Capstone Presentations

Patients with limited English proficiency have poorer healthcare outcomes. An assessment of the cultural and linguistic competency of Christiana Care Health Systems revealed that our language services were not sufficiently robust and this was affecting care. Therefore, the purpose of this quality improvement study was to improve healthcare outcomes, specifically the rate of primary cesarean delivery, through improved language assistance, to patients with limited English proficiency presenting to labor and delivery. The methods employed included use of the TeamSTEPPS program to educate the staff on how to improve safety for patients with limited English proficiency, adding a live Spanish interpreter …

Reinventing The 21st Century Public Health Workforce: Innovation, Evaluation & Practice-Based Research, Glen P. Mays

Health Management and Policy Presentations

Compelling opportunities exist for incorporating practice-based research to into the design, implementation, and evaluation of public health workforce training and development programs. Public Health Training Centers (PHTCs) can collaborate with practice-based research networks (PBRNs) to discover and disseminate evidence-based strategies for workforce development.

2011 Annual Report Of Child Deaths In Clark County, Nevada, Nevada Institute For Children’S Research And Policy, Tara Phebus

Nevada Institute for Children's Research and Policy Reports

The primary goal of all Child Death Review Teams is to prevent future child deaths. The child death review process enables jurisdictions to come together in a collaborative, multidisciplinary forum to openly discuss detailed circumstances in an effort to gain a better understanding of child deaths. The team provides a venue for representatives from a variety of both public and private agencies as well as community organizations to share information in a confidential and non-threatening environment. The National Center for Child Death Review (hereinafter, National Center), which is supported by the Maternal and Child Health Bureau of the U.S. Department …

Patterns Of Interaction Public Health Pbrns: Insight From Network Analysis, Rachel A. Hogg, Glen P. Mays

Health Management and Policy Reports

This report presents data from a network analysis survey conducted with public health practice-based research networks (PBRNs) to examine patterns of interaction among researchers and public health practitioners who participate in the networks. These data provide a baseline for tracking the types and frequencies of interaction that occur within networks, and reveal opportunities for promoting more productive patterns of engagement in applied public health research. Over time, these types of data can reveal how and under what circumstances PBRNs facilitate the production and application of research about public health services and delivery systems. The analysis includes data on more than …

Making The Case For Public Health: Estimating Roi And Value, Glen P. Mays

Health Management and Policy Presentations

This presentation describes recent progress and new directions for estimating the value of public health strategies and infrastructure.

Measurement Of A Model Of Implementation For Health Care: Toward A Testable Theory, Joan M. Cook, Casey O'Donnell, Stephanie Dinnen, James C. Coyne, Josef I. Ruzek, Paula P. Schnurr

Dartmouth Scholarship

Greenhalgh et al. used a considerable evidence-base to develop a comprehensive model of implementation of innovations in healthcare organizations [1]. However, these authors did not fully operationalize their model, making it difficult to test formally. The present paper represents a first step in operationalizing Greenhalgh et al.'s model by providing background, rationale, working definitions, and measurement of key constructs.A systematic review of the literature was conducted for key words representing 53 separate sub-constructs from six of the model's broad constructs. Using an iterative process, we reviewed existing measures and utilized or adapted items. Where no one measure was deemed appropriate, …

Nursing Science Research Consulting: A Multidisciplinary Framework, Thomas N. Templin

Nursing Faculty Research Publications

Nursing science research is at the intersection of the social and medical sciences and statistical developments in many different disciplines are relevant. A framework for nursing science statistics which recognizes and builds upon the statistical contributions from biostatistics, quantitative psychology, epidemiology, econometrics, survey research, computer science and statistics is presented. A broad eclectic framework is necessary to take advantage of new developments in statistical and research design methodology addressing specific problems common to a given area. This framework recognizes that awareness of differences in established expectations (conventions, guidelines, regulations, etc.) with regard to statistical methodology across different research areas is …

Quantifying The Value Of Public Health Investments, Glen P. Mays

Health Management and Policy Presentations

This session reviews recent findings from a series of studies that estimate the health and economic effects attributable to investments in public health services and delivery systems.

Developing Service Delivery Measures For Studies Of Practice Variation: The Mprove Study, Glen P. Mays

Health Management and Policy Presentations

OBJECTIVES: A growing body of evidence indicates that the delivery of public health activities varies widely across states and communities, creating missed opportunities for prevention as well as inequities in health protection. Consequently, HHS recently used a consensus-based process to develop a framework for improving quality in public health and to identify a set of nine priority areas for improvement. As next steps in operationalizing this framework, measures of quality in public health are needed to guide public health improvement initiatives and to support research on the comparative effectiveness of alternative public health strategies. This presentation profiles the methodology developed …

Scale And Scope Effects In Public Health Delivery: Estimating Gains From Regionalization, Glen P. Mays

Health Management and Policy Presentations

OBJECTIVES: Current approaches to health system reform under the Affordable Care Act include efforts to enhance the delivery of public health services that promote health and prevent disease and injury on a population-wide basis. The nation’s public health delivery system comprises nearly 3000 local public health agencies that vary widely in size, resources, and capabilities. Economic pressures, workforce shortages, and new national accreditation standards are leading these agencies to explore mechanisms for pooling resources and expertise across local jurisdictions to enhance delivery and improve population health. This analysis uses longitudinal observations on a national sample of local public health agencies …

Funding Public Health: A New Iom Report On Investing In A Healthier Future, George Isham, Robert Kaplan, Glen P. Mays

Health Management and Policy Presentations

A new Institute of Medicine report recommends establishing a national target for life expectancy and implementing new mechanisms for financing public health strategies to acheive this target.

Pengaruh Pengembangan Organisasi Kepemimpinan Jenjang Karir Terhadap Kepuasan Kerja Dan Kinerja Pegawai Puskesmas, I Gusti Gede Djestawana

Kesmas

Puskesmas harus mampu cepat tanggap terhadap kebutuhan pelanggan dengan konsekuensi organisasi memerlukan sumber daya manusia yang mempunyai keahlian dan kemampuan unik. Untuk mewujudkan hal tersebut, puskesmas harus berorientasi pada pembentukan kualitas sumber daya manusia yang mampu menjawab tuntutan perubahan. Tujuan dari penelitian adalah membuktikan pengaruh pengembangan organisasi, kepemimpinan, serta pengembangan karir secara parsial dan simultan terhadap kepuasan kerja dan kinerja pegawai Puskesmas Kota Denpasar. Penelitian dilakukan pada pegawai di 10 Puskesmas Kota Denpasar menggunakan 3 tahap teknis analisis multivariat dengan metode confirmatory factor analysis yang dilakukan dengan mengurangi satu demi satu indikator penyusun suatu variabel hingga tercapai suatu model pendugaan …

Emerging Disparities Among Self-Pay Trauma Patients, Michelle Chino Dr, Deborah A. Kuhls, Mark K. Markarian, Sam Holland, John J. Fildes

Journal of Health Disparities Research and Practice

Preliminary results from a study of trauma patients in Southern Nevada are yielding some unexpected findings with implications for both trauma centers and the growing Hispanic population. Hispanic patients are more likely to be self pay irrespective of income level and employment status when compared to non-Hispanic patient groups. Further, self pay Hispanics, unlike their non-Hispanic, self pay counterparts, tend to be employed, have families, and report stable living conditions. The implication is that the financial and social cost of traumatic injury may place a significant burden on trauma centers, patients, their families and the community.