Nurse practitioner–physician comanagement of primary care patients: The promise of a new delivery care model to improve quality of care
Background:
The U.S. primary care system is under tremendous strain to deliver care to an increased volume of patients with a concurrent primary care physician shortage. Nurse practitioner (NP)–physician comanagement of primary care patients has been proposed by some policy makers to help alleviate this strain. To date, no collective evidence demonstrates the effects of NP–physician comanagement in primary care.
Purpose:
This is the first review to synthesize all available studies that compare the effects of NP–physician comanagement to an individual physician managing primary care.
Methods:
The PRISMA (Prefe...
Source: Health Care Management Review - May 31, 2019 Category: American Health Tags: Features Source Type: research
The role of collective labor contracts and individual characteristics on job satisfaction in Tuscan nursing homes
Conclusion:
Although working conditions play a relevant role in the job satisfaction of aides, labor contracts do not seem to affect it. Interestingly, aides of the NHs with the contract having the best conditions register a significantly lower level of satisfaction compared to the NHs with the worst contract conditions. This suggests that organizational factors such as culture, team work, and other characteristics, which were not explicitly considered in this study, may be more powerful sources of worker satisfaction than labor contracts.
Practice Implications:
Our analysis has value as a management tool to consider ...
Source: Health Care Management Review - May 31, 2019 Category: American Health Tags: Features Source Type: research
Clinicians’ ability, motivation, and opportunity to acquire and transfer knowledge: An age-driven perspective
Conclusion:
This study contributes to existing research by offering a set of testable propositions for future research. These propositions will hopefully encourage empirical research into this important topic and lead to guidelines for reducing the risks of organizational knowledge loss due to aging.
Practice Implications:
We suggest several ways that health care organizations can tailor managerial practices in order to help capitalize on the knowledge-based resources held by their younger and older clinicians. Such initiatives may affect employees’ ability (e.g., by providing specific training programs), motivation...
Source: Health Care Management Review - May 31, 2019 Category: American Health Tags: Features Source Type: research
Employee organizational commitment and hospital performance
Conclusion:
The findings highlight the importance of providing adequate facilities and EOC within hospitals and suggest that CEOs and general managers should try to enhance the provision of such resources in an attempt to elicit EOC within their hospitals.
Practice Implications:
The findings suggest that managers should try to enhance their provision of adequate facilities in order to elicit EOC and enhance hospital performance. With regard to medical facilities, they should consider and incorporate the latest technology and up-to-date equipment. They should also provide adequate staff resources, including appropriate...
Source: Health Care Management Review - May 31, 2019 Category: American Health Tags: Features Source Type: research
Let’s be civil: Elaborating the link between civility climate and hospital performance
Background:
The importance of interpersonal behavior at the workplace is increasingly recognized in the health care industry and related literature. An unresolved issue in the existing health care research is how a climate of courteous interpersonal behavior may form the foundation for strong hospital care performance.
Purpose:
The aim of this study was to test the link between a climate of courteous interpersonal behavior, termed “civility climate,” and hospital care performance. We conceptualize a multidimensional model of care performance by contrasting two dimensions: performance as perceived by employees and ...
Source: Health Care Management Review - May 31, 2019 Category: American Health Tags: Features Source Type: research
Managing the Internet of Things in Health Care Organizations
No abstract available (Source: Health Care Management Review)
Source: Health Care Management Review - May 31, 2019 Category: American Health Tags: Department: Editorial Source Type: research
Sustaining multistakeholder alliances
This study addresses the question: “Under what conditions do participants in alliances consider that their alliances are well positioned for the future, will perform well over time, and will be able to deal effectively with future challenges?”
Methods:
We draw on cross-sectional survey data collected in the summer of 2015 from a total number of 638 participants in 15 alliances that participated in the Robert Wood Johnson Foundation’s Aligning Forces for Quality program.
Results:
Results from regression analyses indicate that alliance participants are more likely to view their alliances as sustainable when they ...
Source: Health Care Management Review - March 7, 2019 Category: American Health Tags: Features Source Type: research
Market and organizational factors associated with hospital vertical integration into sub-acute care
Background:
Changes in payment models incentivize hospitals to vertically integrate into sub-acute care (SAC) services. Through vertical integration into SAC, hospitals have the potential to reduce the transaction costs associated with moving patients throughout the care continuum and reduce the likelihood that patients will be readmitted.
Purpose:
The purpose of this study is to examine the correlates of hospital vertical integration into SAC.
Methodology/Approach:
Using panel data of U.S. acute care hospitals (2008–2012), we conducted logit regression models to examine environmental and organizational factors a...
Source: Health Care Management Review - March 7, 2019 Category: American Health Tags: Features Source Type: research
Sustaining multistakeholder alliances
This study addresses the question: “Under what conditions do participants in alliances consider that their alliances are well positioned for the future, will perform well over time, and will be able to deal effectively with future challenges?”
Methods:
We draw on cross-sectional survey data collected in the summer of 2015 from a total number of 638 participants in 15 alliances that participated in the Robert Wood Johnson Foundation’s Aligning Forces for Quality program.
Results:
Results from regression analyses indicate that alliance participants are more likely to view their alliances as sustainable when they ...
Source: Health Care Management Review - March 5, 2019 Category: American Health Tags: Features Source Type: research
The role of accountable care organization affiliation and ownership in promoting physician practice participation in quality improvement collaboratives
Background:
Quality improvement collaboratives (QICs) have emerged as an important strategy to improve processes and outcomes of clinical care through interorganizational learning. Little is known about the organizational factors that support or deter physician practice participation in QICs.
Purpose:
The aim of this study was to examine organizational influences on physician practices' propensity to participate in QICs. We hypothesized that practice affiliation with an accountable care organization (ACO) and practice ownership by a system or community health center (CHC) would increase the propensity of physician pra...
Source: Health Care Management Review - March 5, 2019 Category: American Health Tags: Features Source Type: research
A systematic review of vertical integration and quality of care, efficiency, and patient-centered outcomes
Background:
Small independent practices are increasingly giving way to more complex affiliations between provider organizations and hospital systems. There are several ways in which vertically integrated health systems could improve quality and lower the costs of care. But there are also concerns that integrated systems may increase the price and costs of care without commensurate improvements in quality and outcomes.
Purpose:
Despite a growing body of research on vertically integrated health systems, no systematic review that we know of compares vertically integrated health systems (defined as shared ownership or joi...
Source: Health Care Management Review - March 5, 2019 Category: American Health Tags: Features Source Type: research
The impact of accountable care organization participation on hospital patient experience
Conclusion:
ACO participation improved some aspects of patient experience among hospitals with prior good performance. However, hospitals with historically poor performance did not benefit from ACO participation.
Practice Implications:
Prior care coordination and quality improvement experience position Medicare ACOs for greater success in terms of patient experience. Hospital leaders need to consider the potential negative consequences of ACO participation and the hospital’s preparedness for care coordination. (Source: Health Care Management Review)
Source: Health Care Management Review - March 5, 2019 Category: American Health Tags: Features Source Type: research
Market and organizational factors associated with hospital vertical integration into sub-acute care
Background:
Changes in payment models incentivize hospitals to vertically integrate into sub-acute care (SAC) services. Through vertical integration into SAC, hospitals have the potential to reduce the transaction costs associated with moving patients throughout the care continuum and reduce the likelihood that patients will be readmitted.
Purpose:
The purpose of this study is to examine the correlates of hospital vertical integration into SAC.
Methodology/Approach:
Using panel data of U.S. acute care hospitals (2008–2012), we conducted logit regression models to examine environmental and organizational factors a...
Source: Health Care Management Review - March 5, 2019 Category: American Health Tags: Features Source Type: research
Clinical coordination in accountable care organizations: A qualitative study
Background:
Accountable care organizations (ACOs) are becoming a common payment and delivery model. Despite widespread interest, little empirical research has examined what efforts or strategies ACOs are using to change care and reduce costs. Knowledge of ACOs' clinical efforts can provide important context for understanding ACO performance, particularly to distinguish arenas where ACOs have and have not attempted care transformation.
Purpose:
The aim of the study was to understand ACOs' efforts to change clinical care during the first 18 months of ACO contracts.
Methods:
We conducted semistructured interviews betw...
Source: Health Care Management Review - March 5, 2019 Category: American Health Tags: Features Source Type: research
Coping with interdependencies related to patient choice: Boundary-spanning at four accountable care organizations
Background:
Accountable care organizations (ACOs) are responsible for outcomes that are only partially under their control because patients may choose to self-refer outside the ACO, overuse resource-intensive services, or underuse evidence-based care. ACOs must devise boundary-spanning practices to manage these interdependencies related to patient choice.
Purpose:
The aim of this study was to identify, conceptualize, and categorize ACO efforts to cope with interdependencies related to patient choice.
Approach:
We conducted qualitative organizational case studies of four ACOs. We interviewed 89 executives, mid-level...
Source: Health Care Management Review - March 5, 2019 Category: American Health Tags: Features Source Type: research
