Financial performance, employee well-being, and client well-being in for-profit and not-for-profit nursing homes: A systematic review
Background: Expanding the opportunities for for-profit nursing home care is a central theme in the debate on the sustainable organization of the growing nursing home sector in Western countries.
Purposes: We conducted a systematic review of the literature over the last 10 years in order to determine the broad impact of nursing home ownership in the United States. Our review has two main goals: (a) to find out which topics have been studied with regard to financial performance, employee well-being, and client well-being in relation to nursing home ownership and (b) to assess the conclusions related to these topics. The rev...
Source: Health Care Management Review - September 11, 2017 Category: American Health Tags: Features Source Type: research
Hospital safety climate and safety behavior: A social exchange perspective
This article uses the theoretical lens of Social Exchange Theory to study the joint impact of leader–member exchange in the safety sphere and coworker support for safety on safety-related behavior at the hospital ward level. Social exchange constructs are further related to the existence of a shame-/blame-free environment, seen as a potential antecedent of safety behavior.
Research Design: A cross-sectional study including 166 inpatients in hospital wards belonging to 10 public hospitals in Italy was undertaken to test the hypotheses developed.
Methodology: Hypothesized relations have been analyzed through a fully medi...
Source: Health Care Management Review - September 11, 2017 Category: American Health Tags: Features Source Type: research
Nursing Home Administrator Quality Improvement Self-Efficacy Scale
This article presents the development and preliminary validation of an instrument to measure NH administrator self-efficacy in QI.
Methodology/Approach: We used a mixed-methods cross-sectional design to develop and test the measure. For item generation, 39 NH leaders participated in qualitative interviews. Item reduction and content validity were established with a sample of eight subject matter experts. A random sample of 211 administrators from NHs with the lowest and highest Centers for Medicare and Medicaid Services Five-Star Quality ratings completed the measure. We conducted exploratory and confirmatory factor analy...
Source: Health Care Management Review - September 11, 2017 Category: American Health Tags: Features Source Type: research
Does size matter in aged care facilities? A literature review of the relationship between the number of facility beds and quality
Discussion: The theory that aged care facility size (bed numbers) will influence service quality was supported by 26 of the 30 studies reviewed.
Practice Implications: The review findings indicate that aged care facility size (number of beds) may be one important factor related to service quality. Smaller facilities are more likely to result in higher quality and better outcomes for residents than larger facilities. This has implications for those who make investment decisions concerning aged care facilities. The findings also raise implications for funders and policy makers to ensure that regulations and policies do not ...
Source: Health Care Management Review - September 11, 2017 Category: American Health Tags: Features Source Type: research
Health care multidisciplinary teams: The sociotechnical approach for an integrated system-wide perspective
Background: The current literature on the enabling conditions of multidisciplinary teams focuses on the singular dimensions of the organizations (i.e., human resources, clinical pathways, objects) without shedding light on to the way in which these organizational factors interact and mutually influence one another.
Purpose: Drawing on a system perspective of organizations, the authors analyze the organizational patterns that promote and support multidisciplinary teams and how they interrelate and interact to enforce the organization work system.
Methodology/Approach: The authors develop a modified sociotechnical system (...
Source: Health Care Management Review - September 11, 2017 Category: American Health Tags: Features Source Type: research
An intraorganizational model for developing and spreading quality improvement innovations
Background: Recent policy reforms encourage quality improvement (QI) innovations in primary care, but practitioners lack clear guidance regarding spread inside organizations.
Purpose: We designed this study to identify how large organizations can facilitate intraorganizational spread of QI innovations.
Methodology/Approach: We conducted ethnographic observation and interviews in a large, multispecialty, community-based medical group that implemented three QI innovations across 10 primary care sites using a new method for intraorganizational process development and spread. We compared quantitative outcomes achieved throug...
Source: Health Care Management Review - September 11, 2017 Category: American Health Tags: Features Source Type: research
The role of health information technology in advancing care management and coordination in accountable care organizations
Background: To be successful, accountable care organizations (ACOs) must effectively manage patient care. Health information technology (HIT) can support care delivery by providing various degrees of coordination. Few studies have examined the role of HIT functionalities or the role of different levels of coordination enabled by HIT on care management processes.
Purposes: We examine HIT functionalities in ACOs, categorized by the level of coordination they enable in terms of information and work flow, to determine which specific HIT functionalities and levels of coordination are most strongly associated with care manageme...
Source: Health Care Management Review - September 11, 2017 Category: American Health Tags: Features Source Type: research
Community, population health, and health care organizations
No abstract available (Source: Health Care Management Review)
Source: Health Care Management Review - September 11, 2017 Category: American Health Tags: Department: Editorial Source Type: research
Contextual factors associated with hospitals’ decision to operate freestanding emergency departments
Background: Freestanding emergency departments (FSEDs) are fast growing entities in health care, delivering emergency care outside of hospitals. Hospitals may benefit in several ways by opening FSEDs.
Purpose: The study used the resource dependence theory as a means to analyze the relationship between market and organizational factors and the likelihood of hospitals to operate FSEDs.
Methodology: All acute care hospitals in 14 states with FSEDs present during the study period from 2002 to 2011. Data on FSEDs were merged with American Hospital Association Annual Survey, Centers for Medicare and Medicaid Services’ Cost R...
Source: Health Care Management Review - June 2, 2017 Category: American Health Tags: Features Source Type: research
Evidence that electronic health records can promote physician counseling for healthy behaviors
This study estimates the impact of select EHR functionalities on the rate of health behavior counseling provided during primary care visits.
Methodology: Multivariable regression analyses of the 2007–2010 National Ambulatory Medical Care Survey were conducted to examine whether eight EHR components representing four core functionalities of EHR systems were correlated with the rate of health behavior counseling services. Propensity score matching was used to control for confounding factors given the use of observational data. To address concerns that EHR may only lead to improved documentation of counseling services and ...
Source: Health Care Management Review - June 2, 2017 Category: American Health Tags: Features Source Type: research
Patient experience and hospital profitability: Is there a link?
Background: Patient experience has had a direct financial impact on hospitals since value-based purchasing was instituted by the Centers for Medicare & Medicaid Services in 2013 as a method to reward or punish hospitals based on performance on various measures, including patient experience. Although other industries have shown an indirect impact of customer experience on overall profitability, that link has not been well established in the health care industry. Return-to-provider rate and perceptions of health quality have been associated with profitability in the health care industry.
Purpose: Our aims were to assess whe...
Source: Health Care Management Review - June 2, 2017 Category: American Health Tags: Features Source Type: research
The work-based predictors of job engagement and job satisfaction experienced by community health professionals
This study drew on the demand–control model, in addition to stressors that are more specific to community health services (e.g., unrewarding management practices), to identify conditions that are closely associated with the engagement experienced by a community health workforce. Job satisfaction was also included as a way of assessing how the predictors of job engagement differ from those associated with other job attitudes.
Methodology/Approach: Health and allied health care professionals (n = 516) from two Australian community health services took part in the current investigation. Responses from the two organizations...
Source: Health Care Management Review - June 2, 2017 Category: American Health Tags: Features Source Type: research
The strategic nature of individual change behavior: How physicians and their staff implement medical home care
Conclusions: The findings show that particular forms of PCMH work not only advance patient care in favorable ways but also enhance individual and organizational capacity for adapting to this innovative model and its demands. This knowledge adds to our understanding of how to implement PCMH care in ways that are good for workers, primary care organizations, and patients and offers practical guidance as to which forms of PCMH work should be encouraged, incented, and rewarded. (Source: Health Care Management Review)
Source: Health Care Management Review - June 2, 2017 Category: American Health Tags: Features Source Type: research
Integrating: A managerial practice that enables implementation in fragmented health care environments
Background: How some organizations improve while others remain stagnant is a key question in health care research. Studies identifying how organizations can implement improvement despite barriers are needed, particularly in primary care.
Purposes: This inductive qualitative study examines primary care clinics implementing improvement efforts in order to identify mechanisms that enable implementation despite common barriers, such as lack of time and fragmentation across stakeholder groups.
Methodology: Using an embedded multiple case study design, we leverage a longitudinal data set of field notes, meeting minutes, and in...
Source: Health Care Management Review - June 2, 2017 Category: American Health Tags: Features Source Type: research
Acceptance of lean redesigns in primary care: A contextual analysis
This study underscores the need for change leaders to consider the contextual factors that surround efforts to implement Lean in primary care. As Lean redesigns are scaled across a system, special attention is warranted with respect to the implementation approach, internal clinic setting, and implications for professional roles and identities of physicians and staff. (Source: Health Care Management Review)
Source: Health Care Management Review - June 2, 2017 Category: American Health Tags: Features Source Type: research
