Aligning for accountable care: Strategic practices for change in accountable care organizations
Background: Alignment within accountable care organizations (ACOs) is crucial if these new entities are to achieve their lofty goals. However, the concept of alignment remains underexamined, and we know little about the work entailed in creating alignment.
Purpose: The aim of this study was to develop the concept of aligning by identifying and describing the strategic practices administrators use to align the structures, processes, and behaviors of their organizations and individual providers in pursuit of accountable care.
Approach: We conducted 2-year qualitative case studies of four ACOs that have assumed full risk fo...
Source: Health Care Management Review - June 2, 2017 Category: American Health Tags: Features Source Type: research
Time for more creativity in health care management research and practice
No abstract available (Source: Health Care Management Review)
Source: Health Care Management Review - June 2, 2017 Category: American Health Tags: Department: Editorial Source Type: research
The proliferation of elective services in U.S. urban hospitals
Background: Although adding convenience for both patients and providers, the proliferation of elective services and equipment in U.S. general hospitals contributes to higher costs and raises concerns about quality and overuse.
Purposes: We assess the relationship of two forces—health system membership and market competition—with the diffusion of elective services and equipment.
Methodology/Approach: The sample consists of all urban U.S. nonfederal general acute hospitals in 2010 (n = 2,467). Elective equipment and services are defined by 25 services offered by less than 33% of urban general hospitals. We relate the n...
Source: Health Care Management Review - March 4, 2017 Category: American Health Tags: Features Source Type: research
Determinants of job satisfaction for novice nurse managers employed in hospitals
We examined factors associated with job satisfaction of novice frontline nurse managers.
Methodology/Approach: We used a cross-sectional, correlational survey design. The sample consisted of responders to the fifth wave of a multiyear study of new nurses in 2013 (N = 1,392; response rate of 69%) who reported working as managers (n = 209). The parent study sample consisted of registered nurses who were licensed for the first time by exam 6–18 months prior in 1 of 51 selected metropolitan statistical areas and 9 rural areas across 34 U.S. states and the District of Columbia. We examined bivariate correlations between job ...
Source: Health Care Management Review - March 4, 2017 Category: American Health Tags: Features Source Type: research
Practice environments and job satisfaction and turnover intentions of nurse practitioners: Implications for primary care workforce capacity
We examined NP practice environments in primary care organizations and the extent to which they were associated with NP retention measures.
Methodology: Data were collected through mail survey of NPs practicing in 163 primary care organizations in Massachusetts in 2012. NP practice environment was measured by the Nurse Practitioner Primary Care Organizational Climate Questionnaire, which has four subscales: Professional Visibility, NP–Administration Relations, NP–Physician Relations, and Independent Practice and Support. Two global items measured job satisfaction and NPs’ intent to leave their job. We aggregated NP ...
Source: Health Care Management Review - March 4, 2017 Category: American Health Tags: Features Source Type: research
Organizational capacity for change in health care: Development and validation of a scale
Background: We do not have a strong understanding of a health care organization’s capacity for attempting and completing multiple and sometimes competing change initiatives. Capacity for change implementation is a critical success factor as the health care industry is faced with ongoing demands for change and transformation because of technological advances, market forces, and regulatory environment.
Purpose: The aim of this study was to develop and validate a tool to measure health care organizations’ capacity to change by building upon previous conceptualizations of absorptive capacity and organizational readiness f...
Source: Health Care Management Review - March 4, 2017 Category: American Health Tags: Features Source Type: research
Use of comparative performance indicators in rehabilitation
Background: The development of performance indicators that enable benchmarking between organizations is an important mechanism for accountability, organizational learning, and performance improvement. In the province of Quebec (Canada), 21 rehabilitation organizations developed a common set of performance indicators through interorganizational collaboration.
Purpose: The aims of this study were to describe the rehabilitation organizations’ use of a common set of performance indicators and to identify the factors influencing such use.
Approach: A qualitative survey was performed. Individual semistructured interviews wer...
Source: Health Care Management Review - March 4, 2017 Category: American Health Tags: Features Source Type: research
Geography of community health information organization activity in the United States: Implications for the effectiveness of health information exchange
This study describes the extent of reported community HIO coverage in the United States and explores the practical and policy implications of overlaps and gaps in HIO service areas. Furthermore, because self-reported service areas may not accurately reflect the true extent of HIOs activities, this study maps the actual markets for health services included in each HIO.
Methodology: An inventory of operational community HIOs that included self-reported geographic markets and participating organizations was face-validated using a crowd-sourcing approach. Aggregation of the participating hospitals’ individual health care ma...
Source: Health Care Management Review - March 4, 2017 Category: American Health Tags: Features Source Type: research
The relationship between the external environment and physician e-mail communication: The mediating role of health information technology availability
Background: Physician e-mail communication, with patients and other providers, is one of the cornerstones of effective care coordination but varies significantly across physicians. A physician’s external environment may contribute to such variations by enabling or constraining a physician’s ability to adopt innovations such as health information technology (HIT) that can be used to support e-mail communication.
Purpose: The aim of the study was to examine whether the relationship of the external environment and physician e-mail communication with patients and other providers is mediated by the practice’s HIT availab...
Source: Health Care Management Review - March 4, 2017 Category: American Health Tags: Features Source Type: research
Implementing the patient-centered medical home in complex adaptive systems: Becoming a relationship-centered patient-centered medical home
This study explores the implementation experience of nine primary care practices becoming patient-centered medical homes (PCMH) as part of the New Hampshire Citizens Health Initiative Multi-Stakeholder Medical Home Pilot.
Purpose: The purpose of this study is to apply complex adaptive systems theory and relationship-centered organizations theory to explore how nine diverse primary care practices in New Hampshire implemented the PCMH model and to offer insights for how primary care practices can move from a structural PCMH to a relationship-centered PCMH.
Methodology/Approach: Eighty-three interviews were conducted with a...
Source: Health Care Management Review - March 4, 2017 Category: American Health Tags: Features Source Type: research
Creating value for participants in multistakeholder alliances: The shifting importance of leadership and collaborative decision-making over time
Background: Multistakeholder alliances that bring together diverse organizations to work on health-related issues are playing an increasingly prominent role in the U.S. health care system. Prior research shows that collaborative decision-making and effective leadership are related to members’ perceptions of value for their participation in alliances. Yet, we know little about how collaborative decision-making and leadership might matter over time in multistakeholder alliances.
Purpose: The aim of this study was to advance understanding of the role of collaborative decision-making and leadership in individuals’ assessm...
Source: Health Care Management Review - March 4, 2017 Category: American Health Tags: Features Source Type: research
Defending science for our health, safety, and well-being
No abstract available (Source: Health Care Management Review)
Source: Health Care Management Review - March 4, 2017 Category: American Health Tags: Department: Editorial Source Type: research
Work-related factors influencing home care nurse intent to remain employed
Background: Health care is shifting out of hospitals into community settings. In Ontario, Canada, home care organizations continue to experience challenges recruiting and retaining nurses. However, factors influencing home care nurse retention that can be modified remain largely unexplored. Several groups of factors have been identified as influencing home care nurse intent to remain employed including job characteristics, work structures, relationships and communication, work environment, responses to work, and conditions of employment.
Purpose: The aim of this study was to test and refine a model that identifies which f...
Source: Health Care Management Review - December 2, 2016 Category: American Health Tags: Features Source Type: research
Integrated versus fragmented implementation of complex innovations in acute health care
Background: Increased demand and escalating costs necessitate innovation in health care. The challenge is to implement complex innovations—those that require coordinated use across the adopting organization to have the intended benefits.
Purpose: We wanted to understand why and how two of five similar hospitals associated with the same health care authority made more progress with implementing a complex inpatient discharge innovation whereas the other three experienced more difficulties in doing so.
Methodology: We conducted a qualitative comparative case study of the implementation process at five comparable urban hos...
Source: Health Care Management Review - December 2, 2016 Category: American Health Tags: Features Source Type: research
Organizational responses to accountability requirements: Do we get what we expect?
Background: In health care, accountability is being championed as a promising approach to meeting the dual imperatives of improving care quality while managing constrained budgets.
Purposes: Few studies focus on public sector organizations' responsiveness to government imperatives for accountability. We applied and adapted a theory of organizational responsiveness to community care agencies operating in Ontario, Canada, asking the question: What is the array of realized organizational responses to government-imposed accountability requirements among community agencies that receive public funds to provide home and communit...
Source: Health Care Management Review - December 2, 2016 Category: American Health Tags: Features Source Type: research
