Implementation science as an organizational process
No abstract available (Source: Health Care Management Review)
Source: Health Care Management Review - June 1, 2018 Category: American Health Tags: Department: Editorial Source Type: research
Fostering evidence-based quality improvement for patient-centered medical homes: Initiating local quality councils to transform primary care
Conclusions:
Overall, quality councils successfully cultivated interdisciplinary, multilevel primary care quality improvement leadership with accountability mechanisms and generated frontline innovations suitable for spread. Practice level performance data and quality improvement project management support were critical.
Practice Implications:
In order to successfully facilitate systematic, sustainable primary care quality improvement, regional and executive health care system leaders should engage interdisciplinary practice level leadership in a priority-setting process that encourages frontline innovation and establ...
Source: Health Care Management Review - February 28, 2018 Category: American Health Tags: Features Source Type: research
The quality perception gap between employees and patients in hospitals
Conclusion:
Hospital employees score hospital quality consistently lower than patients and are also more heterogeneous in their assessments. This makes it from a managerial point of view relevant to subdivide employees in more homogeneous subgroups. Hospital size has no clear effect on the perception gap. Doctors compared to patients and other employee groups have substantially different perceptions on hospital quality.
Practice Implications:
Our findings fuel the practical and ethical debate on the extent that perception gaps could and should be allowed in the context of high-quality and transparent hospital performa...
Source: Health Care Management Review - February 28, 2018 Category: American Health Tags: Features Source Type: research
Hybrid practices as a means to implement quality improvement: A comparative qualitative study in a Dutch and Swedish hospital
Background:
Managers and scholars commonly perceive resistance from professionals as hampering the implementation of quality improvement (QI) and refer to the incompatibility of clinical and managerial approaches to QI as a reason. Yet a growing body of research indicates that, in practice, these two approaches rather blend into hybrid practices that embody different types of QI-related knowledge and values. This opens up a new perspective on implementation challenges that moves attention away from resistance against managerial QI toward difficulties for clinicians to draw together different types of knowledge and values...
Source: Health Care Management Review - February 28, 2018 Category: American Health Tags: Features Source Type: research
Differences in work environment for staff as an explanation for variation in central line bundle compliance in intensive care units
Background:
Central line-associated bloodstream infections (CLABSIs) are a common and costly quality problem, and their prevention is a national priority. A decade ago, researchers identified an evidence-based bundle of practices that reduce CLABSIs. Compliance with this bundle remains low in many hospitals.
Purpose:
The aim of this study was to assess whether differences in core aspects of work environments—workload, quality of relationships, and prioritization of quality—are associated with variation in maximal CLABSI bundle compliance, that is, compliance 95%–100% of the time in intensive care units (ICUs).
...
Source: Health Care Management Review - February 28, 2018 Category: American Health Tags: Features Source Type: research
Giving voice to all patients: On patients at the margins and their intention and perceived ability to complain
We examined the extent to which patients’ social (being elderly or poorly educated), physical (having a permanent impairment such as deafness, blindness, or a chronic physical condition), and mental marginality (having a mental illness or learning disability) is associated with their intention and perceived ability to complain.
Methodology:
We matched survey and patient record data for hospital inpatients treated in the English National Health Service in 2007. We then computed two-stage probit selection models to estimate the cross-sectional association between patients’ social, physical, and mental marginality and ...
Source: Health Care Management Review - February 28, 2018 Category: American Health Tags: Features Source Type: research
Team-based primary care: The medical assistant perspective
Conclusion:
Team-based care can provide low-status health care workers with more fulfilling work and strengthen relationships across status lines. The extent of this positive impact may depend on supporting factors at the organization, team, and individual worker levels.
Practice Implications:
To maximize the benefits of team-based care, primary care leaders should recognize the larger role that MAs play under this model and support them as increasingly valuable team members. Contingent on organizational conditions, practices may find MAs who are willing to manage the increased workload that often accompanies team-bas...
Source: Health Care Management Review - February 28, 2018 Category: American Health Tags: Features Source Type: research
Determinants of knowledge-sharing networks in primary care
Background:
Around the world, health reforms are increasingly fostering collaboration and integration among primary care physicians with the aim of facilitating knowledge sharing and evidence-informed decision-making. Although extant research on this topic is abundant, the evidence and results regarding social and organizational factors affecting the formation of knowledge-sharing networks in this setting are inconclusive.
Purpose:
The aim of this article is to explore multiple theoretical mechanisms explaining the formation of knowledge-sharing networks among primary care physicians across relevant clinical areas.
M...
Source: Health Care Management Review - February 28, 2018 Category: American Health Tags: Features Source Type: research
Professional networks and the alignment of individual perceptions about medical innovation
This study investigated the role of professionals’ social networks and social capital in the formation of similar individual perceptions about a highly innovative robotic surgical system.
Methodology:
We collected data from a sample of 50 professionals, including both physicians and nurses, working in three hospital wards belonging to an Italian hospital organization. Using a survey, we gathered data on professionals’ demographic characteristics, the adoption and impact of the new technology, and social networks. We tested our hypotheses using a dyadic perspective and logistic regression quadratic assignment procedu...
Source: Health Care Management Review - February 28, 2018 Category: American Health Tags: Features Source Type: research
Theory for advances in health care management research
No abstract available (Source: Health Care Management Review)
Source: Health Care Management Review - February 28, 2018 Category: American Health Tags: Department: Editorial Source Type: research
Leadership development programs for health care middle managers: An exploration of the top management team member perspective
Background:
Hospitals throughout the United States establish leadership and management programs for their middle managers. Despite their pervasiveness and an increased emphasis on physician leadership, there is limited research regarding the development programs designed for clinical and nonclinical health care middle managers.
Purpose:
Using two theoretical lenses, signaling and institutional theory, this exploratory study investigates mid-sized hospital development programs from the perspective of top management team (TMT) members. Our objective is to find out what types of programs hospitals have, how they are deve...
Source: Health Care Management Review - January 1, 2018 Category: American Health Tags: Features Source Type: research
Building trust: The influence of mentoring behaviors on perceptions of health care managers’ trustworthiness
Background:
In health care organizations, trust is critical for effective workplace relationships that ensure patient-centered outcomes. Although research has focused on trust in the relationship between patients and clinicians, less is known about what influences workers to trust their managers. An understanding is needed of the specific behaviors that influence health care workers’ evaluations of their managers’ trustworthiness. Mentoring research focuses on the developmental assistance that a more experienced worker provides to a less experienced worker. Building upon Kram’s (1988) seminal research on mentoring ...
Source: Health Care Management Review - January 1, 2018 Category: American Health Tags: Features Source Type: research
Insider versus outsider executive succession: The relationship to hospital efficiency
Background:
The relationship between Chief Executive Officer (CEO) succession and hospitals’ competitive performance is an area of interest for health services researchers. Of particular interest is the impact on overall strategic direction and health system performance that results from selecting a CEO from inside the firm as opposed to seeking outside leadership. Empirical work-to-date has yielded mixed results. Much of this variability has been attributed to design flaws; however, in the absence of a clear message from the evidence, the preference for hiring “outsiders” continues to grow.
Purpose:
This paper ...
Source: Health Care Management Review - January 1, 2018 Category: American Health Tags: Features Source Type: research
Do learning collaboratives strengthen communication? A comparison of organizational team communication networks over time
This study highlights key future research directions that can disentangle the relationship between learning collaboratives and team networks. (Source: Health Care Management Review)
Source: Health Care Management Review - January 1, 2018 Category: American Health Tags: Features Source Type: research
Targeted implementation of the Comprehensive Unit-Based Safety Program through an assessment of safety culture to minimize central line-associated bloodstream infections
Background:
Approximately 250,000 central line-associated bloodstream infections (CLABSIs) occur annually in the United States, with 30,000 related deaths. CLABSIs are largely preventable, and the Comprehensive Unit-Based Safety Program (CUSP) is a proven sustainable model that can be used to reduce CLABSIs. CUSP is a resource intensive program that, although widely used, has not been universally adopted.
Purpose:
The purpose of this study is to identify the significant factors of safety culture prior to CUSP implementation associated with a reduction or elimination of CLABSIs. By identifying these factors, hospitals ...
Source: Health Care Management Review - January 1, 2018 Category: American Health Tags: Features Source Type: research
