Background: Management in healthcare industry has evolved over the years. There is increasing need for healthcare managers to acquire new skill sets particularly those related to strategic planning and business management. Aims: We sought to determine managerial competencies perceived as importsnt for healthcare managers in a tertiary healthcare institution in Calabar, Nigeria. Methods: A structured questionnaire (modeled after the Health Leadership Alliance competency questionnaire) was self-administered to 266 randomly selected managers comprising 5 strategic managers, 53 middle managers and 208 operational managers. Data were analyzed using SPSS version 20. Results: A total of 266 managers were included in this study with a M: F ratio of 1.3: 1. The findings of this study showed that operational, middle and strategic managers rated 27, 37 and 46 of the competencies as contributing significantly with a mean rating of ≥ 4. Important/essential competencies differed between the three tiers of management. Competencies related to financial/business management were not considered very important. The result from qualitative arm synchronized with the quantitative arm to some extent, and provided insight to the managers’ perspective. Conclusions: The findings of this study highlights the incongrous paradigm between managerial level and perceived important management competencies and supports the belief that there is inadequate managerial capacity especially those related to financial/business management.
背景:医疗保健行业的管理经历了多年的发展。医疗保健管理人员越来越需要获得新的技能，特别是与战略规划和业务管理相关的技能。目的:我们试图确定管理能力被认为是重要的医疗保健管理人员在卡拉巴，尼日利亚三级医疗机构。方法:采用结构化问卷(仿照健康领导联盟胜任力问卷)，随机抽取266名管理人员，其中战略管理人员5名，中层管理人员53名，业务管理人员208名。数据分析采用SPSS version 20。结果:本研究共纳入266名管理人员，M: F比为1.3:1。本研究结果显示，营运经理、中层经理和策略经理分别对27、37和46项胜任力作出显著贡献，平均评分≥4。重要/基本能力在三个管理层次之间有所不同。与财务/商业管理相关的能力被认为不是很重要。定性臂的结果与定量臂的结果在一定程度上是同步的，并为管理者的观点提供了洞见。结论:本研究的发现突出了管理水平与感知到的重要管理能力之间的不协调范式，并支持了管理能力不足的观点，特别是与财务/业务管理相关的管理能力。
{"title":"Perceived important managerial competencies for healthcare managers at a tertiary healthcare institution in Calabar, Cross River State, Nigeria","authors":"U. Okonkwo, Bernadine Ekpeyoung, A. Ndep","doi":"10.5430/jha.v9n1p18","DOIUrl":"https://doi.org/10.5430/jha.v9n1p18","url":null,"abstract":"Background: Management in healthcare industry has evolved over the years. There is increasing need for healthcare managers to acquire new skill sets particularly those related to strategic planning and business management. Aims: We sought to determine managerial competencies perceived as importsnt for healthcare managers in a tertiary healthcare institution in Calabar, Nigeria. Methods: A structured questionnaire (modeled after the Health Leadership Alliance competency questionnaire) was self-administered to 266 randomly selected managers comprising 5 strategic managers, 53 middle managers and 208 operational managers. Data were analyzed using SPSS version 20. Results: A total of 266 managers were included in this study with a M: F ratio of 1.3: 1. The findings of this study showed that operational, middle and strategic managers rated 27, 37 and 46 of the competencies as contributing significantly with a mean rating of ≥ 4. Important/essential competencies differed between the three tiers of management. Competencies related to financial/business management were not considered very important. The result from qualitative arm synchronized with the quantitative arm to some extent, and provided insight to the managers’ perspective. Conclusions: The findings of this study highlights the incongrous paradigm between managerial level and perceived important management competencies and supports the belief that there is inadequate managerial capacity especially those related to financial/business management.","PeriodicalId":15872,"journal":{"name":"Journal of Hospital Administration","volume":"4 1","pages":"18"},"PeriodicalIF":0.0,"publicationDate":"2019-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76028762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Asa B. Wilson, Zachary Wilkerson, L. Dickinson, Caitlin M. Young
Study provides an understanding of a hospital’s patient transportation department (PTD) and its essential function within a complex health care system. A participant-observer case study was accomplished using an intern’s extended exposure to first-hand interactions with managers, directors, and employees. The narrative delineates the importance of patient transportation in a large, expanding, fast-paced integrated delivery system; an environment requiring daily vigilance, continuous improvement, strategic positioning, innovation, and anticipation of future service needs. The departmental challenges and benefits of a facility-wide transition to a new electronic health information system are specified. The intern’s insights into the strategies and data sources that leadership uses to ensure departmental operating effectiveness are identified. Future PTD operations research opportunities are summarized.
{"title":"An intern’s case study analysis of the patient transport function","authors":"Asa B. Wilson, Zachary Wilkerson, L. Dickinson, Caitlin M. Young","doi":"10.5430/jha.v9n1p11","DOIUrl":"https://doi.org/10.5430/jha.v9n1p11","url":null,"abstract":"Study provides an understanding of a hospital’s patient transportation department (PTD) and its essential function within a complex health care system. A participant-observer case study was accomplished using an intern’s extended exposure to first-hand interactions with managers, directors, and employees. The narrative delineates the importance of patient transportation in a large, expanding, fast-paced integrated delivery system; an environment requiring daily vigilance, continuous improvement, strategic positioning, innovation, and anticipation of future service needs. The departmental challenges and benefits of a facility-wide transition to a new electronic health information system are specified. The intern’s insights into the strategies and data sources that leadership uses to ensure departmental operating effectiveness are identified. Future PTD operations research opportunities are summarized.","PeriodicalId":15872,"journal":{"name":"Journal of Hospital Administration","volume":"36 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91094364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Adeline Shuhan Koh, Zhixuan Zhang, G. Lim, B. Lim, W. Ng, Sze Joo Juan
Objective: Healthcare institutions have taken efforts to communicate to their healthcare workers (HCWs) about the concepts and importance of clinical quality and patient safety (CQPS). However, implementing interventions to promote pro CQPS behaviour without fully evaluating the factors that direct such behaviour may be costly and counter-productive. This study aimed to investigate HCWs’ perception of their competence and attitudes towards CQPS. It also looked into their perceived behaviour pattern to unsafe practices and usefulness of the different avenues to improve CQPS behavior in the hospital.Methods: A survey was conducted among doctors, nurses and allied health workers over two months in 2017. Paper surveys were distributed during departmental staff meetings. Participation was strictly voluntary, and responses were de-identified and kept confidential. Responses were measured using a five-point Likert scale. Data was analyzed using descriptive statistics.Results: The participation rate was 90.2% (541/600). Of the respondents, 88.0% and 85.6% agreed that CQPS was important and relevant to their work respectively. However, when asked if they execute a series of pro-CQPS behaviour, results showed a knowledge-behaviour disconnect. Only 36.2% will intervene when they see unsafe practice and 27.2% see the importance of reporting near miss events.Conclusions: While respondents are generally aware of the importance and relevance of CQPS, this is not reflected in their behaviour as they are unmotivated and show disinterest in practising pro-CQPS behaviour. Further studies are needed to address the factors associated with this knowledge-behaviour disconnect.
{"title":"Healthcare workers’ perception of their awareness, skills and attitudes towards clinical quality and patient safety in an acute care hospital in Singapore","authors":"Adeline Shuhan Koh, Zhixuan Zhang, G. Lim, B. Lim, W. Ng, Sze Joo Juan","doi":"10.5430/jha.v8n6p41","DOIUrl":"https://doi.org/10.5430/jha.v8n6p41","url":null,"abstract":"Objective: Healthcare institutions have taken efforts to communicate to their healthcare workers (HCWs) about the concepts and importance of clinical quality and patient safety (CQPS). However, implementing interventions to promote pro CQPS behaviour without fully evaluating the factors that direct such behaviour may be costly and counter-productive. This study aimed to investigate HCWs’ perception of their competence and attitudes towards CQPS. It also looked into their perceived behaviour pattern to unsafe practices and usefulness of the different avenues to improve CQPS behavior in the hospital.Methods: A survey was conducted among doctors, nurses and allied health workers over two months in 2017. Paper surveys were distributed during departmental staff meetings. Participation was strictly voluntary, and responses were de-identified and kept confidential. Responses were measured using a five-point Likert scale. Data was analyzed using descriptive statistics.Results: The participation rate was 90.2% (541/600). Of the respondents, 88.0% and 85.6% agreed that CQPS was important and relevant to their work respectively. However, when asked if they execute a series of pro-CQPS behaviour, results showed a knowledge-behaviour disconnect. Only 36.2% will intervene when they see unsafe practice and 27.2% see the importance of reporting near miss events.Conclusions: While respondents are generally aware of the importance and relevance of CQPS, this is not reflected in their behaviour as they are unmotivated and show disinterest in practising pro-CQPS behaviour. Further studies are needed to address the factors associated with this knowledge-behaviour disconnect.","PeriodicalId":15872,"journal":{"name":"Journal of Hospital Administration","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85633357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: The role of nurses’ shift-rotations in predicting adverse patient events has received little attention. The effect of fatigue on patient safety as a primary factor and the impact of shift-working on fatigue as a secondary factor in hospital-based nurses was investigated in the present study.Methods: In this cross-sectional study set in Iraqi Kurdistan in 2018, 71 nurses (Range: 20-44 years) were recruited purposively who worked in rotating shifts, in four multi-specialty hospitals.Results: The mean age of the nurses was 30.24 years (SD: 4.81; range: 20-44 years). The majority of nurses worked in the public sector (63.4%). The nurses worked in morning shift (26.8%) and shift-rotations (39.4%) for between 7.75 and 9.13 hours. In addition, 59.4% and 18.3% of nurses reported that they injured “sometimes” and “frequently” (respectively) patients in their care either directly or indirectly. Similarly, 19.7% of them reported that these were medication errors “sometimes” and “frequently.” Patient information was recorded incompletely or incorrectly sometimes by 18.3% and frequently by 35.2%. Also, 36.6% and 31.0% of them reported that they delayed care to patients frequently and sometimes, respectively. The mean values of physical and psychological fatigue were 8.77 of 21 and 3.42 of 12, respectively. The physical and psychological fatigue were escalated in case of lower total psychological well-being (p = .009 and p = .018, respectively). The study showed that single-shift working is a predictor of delayed patients care; 95.3% vs. 60.7%; p < .001).Conclusions: Hospital administrators must be aware that nurses are not able to work effectively on short roosters or extended shifts. Protocols for better nurse health surveillance and social support in respect to 24 hours shift work must be prioritized in order to avoid mental and physical significant impairment on nurses and adverse outcomes for their clients.
{"title":"Fatigue as a primary and secondary factor in relation to shift-rotating and patient safety in nurses","authors":"Deldar Morad Abdulah, K. Perot, E. Holroyd","doi":"10.5430/jha.v9n1p1","DOIUrl":"https://doi.org/10.5430/jha.v9n1p1","url":null,"abstract":"Objective: The role of nurses’ shift-rotations in predicting adverse patient events has received little attention. The effect of fatigue on patient safety as a primary factor and the impact of shift-working on fatigue as a secondary factor in hospital-based nurses was investigated in the present study.Methods: In this cross-sectional study set in Iraqi Kurdistan in 2018, 71 nurses (Range: 20-44 years) were recruited purposively who worked in rotating shifts, in four multi-specialty hospitals.Results: The mean age of the nurses was 30.24 years (SD: 4.81; range: 20-44 years). The majority of nurses worked in the public sector (63.4%). The nurses worked in morning shift (26.8%) and shift-rotations (39.4%) for between 7.75 and 9.13 hours. In addition, 59.4% and 18.3% of nurses reported that they injured “sometimes” and “frequently” (respectively) patients in their care either directly or indirectly. Similarly, 19.7% of them reported that these were medication errors “sometimes” and “frequently.” Patient information was recorded incompletely or incorrectly sometimes by 18.3% and frequently by 35.2%. Also, 36.6% and 31.0% of them reported that they delayed care to patients frequently and sometimes, respectively. The mean values of physical and psychological fatigue were 8.77 of 21 and 3.42 of 12, respectively. The physical and psychological fatigue were escalated in case of lower total psychological well-being (p = .009 and p = .018, respectively). The study showed that single-shift working is a predictor of delayed patients care; 95.3% vs. 60.7%; p < .001).Conclusions: Hospital administrators must be aware that nurses are not able to work effectively on short roosters or extended shifts. Protocols for better nurse health surveillance and social support in respect to 24 hours shift work must be prioritized in order to avoid mental and physical significant impairment on nurses and adverse outcomes for their clients.","PeriodicalId":15872,"journal":{"name":"Journal of Hospital Administration","volume":"34 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75075436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Healthcare associated infections are a leading cause of illness and death in the United States and across the world. Environmental surfaces are considered non-critical, although recent evidence suggests that the built environment may contribute to the transmission of pathogens. Ineffective cleaning and disinfecting of environmental non-critical surfaces may increase risk of transmitting nosocomial pathogens leading to hospital acquired infections among hospital patients.Objective: This systematic review identifies elements of cleaning and disinfecting protocols, synthesizing the evidence to evaluate cleaning protocols that effectively reduce surface contamination and minimize risk of hospital acquired illness.Methods: A systematic literature review was conducted with a clearly formulated research question and systematic approach to identify publications, select relevant studies, critically appraise the research through analysis of reported data, and reported the results according to the Cochrane methodology.Results: In total, 245 studies were initially identified with 19 studies meeting inclusion criteria. Emerging categories include chemical application methods, chemical application time, cleaning type and frequency, and interventions for training and monitoring.Conclusions: Establishing adequate cleaning protocols for hospital environments is a complex process which requires consideration of multiple components including mechanical action, chemical application materials, types of cleaning, chemical contact times, education and training of EVS staff, cleaning monitoring and feedback, no-contact cleaning methods, and self-disinfecting surfaces. Recommendations for protocol development based on the study results are provided.
{"title":"Cleaning and disinfecting protocols for hospital environmental surfaces: A systematic review of the literature","authors":"Keyanna P. Taylor, D. Harris","doi":"10.5430/jha.v8n6p27","DOIUrl":"https://doi.org/10.5430/jha.v8n6p27","url":null,"abstract":"Background: Healthcare associated infections are a leading cause of illness and death in the United States and across the world. Environmental surfaces are considered non-critical, although recent evidence suggests that the built environment may contribute to the transmission of pathogens. Ineffective cleaning and disinfecting of environmental non-critical surfaces may increase risk of transmitting nosocomial pathogens leading to hospital acquired infections among hospital patients.Objective: This systematic review identifies elements of cleaning and disinfecting protocols, synthesizing the evidence to evaluate cleaning protocols that effectively reduce surface contamination and minimize risk of hospital acquired illness.Methods: A systematic literature review was conducted with a clearly formulated research question and systematic approach to identify publications, select relevant studies, critically appraise the research through analysis of reported data, and reported the results according to the Cochrane methodology.Results: In total, 245 studies were initially identified with 19 studies meeting inclusion criteria. Emerging categories include chemical application methods, chemical application time, cleaning type and frequency, and interventions for training and monitoring.Conclusions: Establishing adequate cleaning protocols for hospital environments is a complex process which requires consideration of multiple components including mechanical action, chemical application materials, types of cleaning, chemical contact times, education and training of EVS staff, cleaning monitoring and feedback, no-contact cleaning methods, and self-disinfecting surfaces. Recommendations for protocol development based on the study results are provided.","PeriodicalId":15872,"journal":{"name":"Journal of Hospital Administration","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81237381","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Matthew D. Wilson, Kathleen B. Savoy, J. Dubin, Edward Floyd, M. Paik, Ira Rabin, D. Milzman
Objective: An evaluation of social factors associated with 30-day readmission was undertaken at our institution to determine which factors would be significantly associated with time to hospital readmission.Methods: Prospective observational study at an academic tertiary care hospital in the mid-Atlantic region of patients who were readmitted within 30 days of their last inpatient discharge. The electronic health record in conjunction with the regional hospital information system was used to generate a daily report to identify a convenience sample of readmitted patients. Using a standardized interview, data on 117 patients were collected for an exploratory analysis of social factors associated with readmission.Results: Regression modeling demonstrated poor correlation with prediction of time to readmission (R-squared = 0.2189). No individual social variables were found to be significant for influencing time to readmission (all p-values > .05). Common social factors were seen within the population affecting their utilization and access of healthcare. Poly-pharmacy was found in the majority of patients. Self-reported medication adherence was good, except with regards to mental health medication compliance. 97% of patients reported filling their prescriptions. 36% of the patients went to their follow-up appointment within 7 days although the vast majority of patients (92%) reported having a primary care doctor. 23% of patients expressed difficulty getting to their follow up appointments.Conclusions: At one single-center tertiary care hospital, there were some common underlying social determinants of health that may be related to readmission; however, no factors in isolation were predictive of hospital readmission. While there are common themes among readmitted populations, particularly in regard to factors driven by poverty, it is likely that the complex interaction of social factors with health continues to limit attempted administrative modeling of these data.
{"title":"Searching for underlying social determinants of health for thirty-day hospital readmissions","authors":"Matthew D. Wilson, Kathleen B. Savoy, J. Dubin, Edward Floyd, M. Paik, Ira Rabin, D. Milzman","doi":"10.5430/jha.v8n6p24","DOIUrl":"https://doi.org/10.5430/jha.v8n6p24","url":null,"abstract":"Objective: An evaluation of social factors associated with 30-day readmission was undertaken at our institution to determine which factors would be significantly associated with time to hospital readmission.Methods: Prospective observational study at an academic tertiary care hospital in the mid-Atlantic region of patients who were readmitted within 30 days of their last inpatient discharge. The electronic health record in conjunction with the regional hospital information system was used to generate a daily report to identify a convenience sample of readmitted patients. Using a standardized interview, data on 117 patients were collected for an exploratory analysis of social factors associated with readmission.Results: Regression modeling demonstrated poor correlation with prediction of time to readmission (R-squared = 0.2189). No individual social variables were found to be significant for influencing time to readmission (all p-values > .05). Common social factors were seen within the population affecting their utilization and access of healthcare. Poly-pharmacy was found in the majority of patients. Self-reported medication adherence was good, except with regards to mental health medication compliance. 97% of patients reported filling their prescriptions. 36% of the patients went to their follow-up appointment within 7 days although the vast majority of patients (92%) reported having a primary care doctor. 23% of patients expressed difficulty getting to their follow up appointments.Conclusions: At one single-center tertiary care hospital, there were some common underlying social determinants of health that may be related to readmission; however, no factors in isolation were predictive of hospital readmission. While there are common themes among readmitted populations, particularly in regard to factors driven by poverty, it is likely that the complex interaction of social factors with health continues to limit attempted administrative modeling of these data.","PeriodicalId":15872,"journal":{"name":"Journal of Hospital Administration","volume":"65 10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88841920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: The interaction between physicians and the pharmaceutical industry influences physicians’ attitudes and prescribing behaviors. In this regard, physicians’ attitudes towards pharmaceutical promotions and their trustworthiness towards pharmaceutical representatives’ information on new drugs were explored in this study.Methods: The present study was an analysis of a cross-sectional survey of 183 physicians with different job and education hierarchies and from various clinical settings in Erbil-Iraqi Kurdistan in July 2018. The physicians were invited from the public sector, comprising a general, emergency, and pediatric hospital. The information was collected through an anonymous, self-administered questionnaire. The questionnaire included exposure to marketing activities, motivations to contact pharmaceutical representatives, attitudes towards promotional activities, and trustworthiness of the pharmaceutical representatives’ information on new drugs.Results: Majority of the physicians reported that the information provided by pharmaceutical representatives assisted them in staying up to date or learning about new products (76.5%), but 55.7% of them trusted their medical information. In addition, most of them reported that pharmaceutical representatives prioritized the promotion of their products over patients’ benefits (70.5%). They reported that receiving promotional material and participating in promotional activities have an effect on doctors’ behaviors to prescribe a new drug, including promotional materials (55.2%); medical samples (67.8%); funding of registration costs to conferences (60.1%); participation in industry-funded researches (69.9%); and continuing medical education (69.4%). Receiving promotional materials and participation in promotional activities were considered to be ethical.Conclusions: The present study showed that most of the physicians reported the role of promotional materials and activities on physicians’ behaviors to prescribe new drugs.
{"title":"Pharmaceutical promotions and trustworthiness on new drug prescribing among physicians in public general hospitals","authors":"Deldar Morad Abdulah, K. Perot","doi":"10.5430/jha.v8n6p17","DOIUrl":"https://doi.org/10.5430/jha.v8n6p17","url":null,"abstract":"Objective: The interaction between physicians and the pharmaceutical industry influences physicians’ attitudes and prescribing behaviors. In this regard, physicians’ attitudes towards pharmaceutical promotions and their trustworthiness towards pharmaceutical representatives’ information on new drugs were explored in this study.Methods: The present study was an analysis of a cross-sectional survey of 183 physicians with different job and education hierarchies and from various clinical settings in Erbil-Iraqi Kurdistan in July 2018. The physicians were invited from the public sector, comprising a general, emergency, and pediatric hospital. The information was collected through an anonymous, self-administered questionnaire. The questionnaire included exposure to marketing activities, motivations to contact pharmaceutical representatives, attitudes towards promotional activities, and trustworthiness of the pharmaceutical representatives’ information on new drugs.Results: Majority of the physicians reported that the information provided by pharmaceutical representatives assisted them in staying up to date or learning about new products (76.5%), but 55.7% of them trusted their medical information. In addition, most of them reported that pharmaceutical representatives prioritized the promotion of their products over patients’ benefits (70.5%). They reported that receiving promotional material and participating in promotional activities have an effect on doctors’ behaviors to prescribe a new drug, including promotional materials (55.2%); medical samples (67.8%); funding of registration costs to conferences (60.1%); participation in industry-funded researches (69.9%); and continuing medical education (69.4%). Receiving promotional materials and participation in promotional activities were considered to be ethical.Conclusions: The present study showed that most of the physicians reported the role of promotional materials and activities on physicians’ behaviors to prescribe new drugs.","PeriodicalId":15872,"journal":{"name":"Journal of Hospital Administration","volume":"14 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76476596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Increasing attention has been given to price gouging by hospitals and physicians, a practice that is related to three forms of market pricing power: price setting, price negotiating, and price taking. This paper presents a discussion of healthcare pricing patterns and their relationship to charges, payments, costs, and cost shifting. Recommendations to address price gouging in a manner that is fair to all stakeholders are proposed.
{"title":"An analysis of price gouging in the US healthcare system","authors":"W. Riley, Natasha Coult, Kailey Love","doi":"10.5430/jha.v8n6p7","DOIUrl":"https://doi.org/10.5430/jha.v8n6p7","url":null,"abstract":"Increasing attention has been given to price gouging by hospitals and physicians, a practice that is related to three forms of market pricing power: price setting, price negotiating, and price taking. This paper presents a discussion of healthcare pricing patterns and their relationship to charges, payments, costs, and cost shifting. Recommendations to address price gouging in a manner that is fair to all stakeholders are proposed.","PeriodicalId":15872,"journal":{"name":"Journal of Hospital Administration","volume":"46 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85834163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
J. Gardner, J. Wolfe, W. Beck, K. Sexton, A. Bhavaraju, B. Davis, M. Kimbrough, H. Jensen, R. Robertson, R. Reif, Saleema A. Karim, John R Taylor
Objective: Communication in the hospital setting is an easy target for quality improvement. Capturing this change via communication between providers during hand-offs is necessary to reduce delays and errors. While this process has been more widely characterized in medical specialties, we designed this study to address the knowledge gap in surgical specialties.Methods: Our institution’s division of Acute Care Surgery (ACS) implemented Morning Report (MR) in October of 2015. At MR, all admissions and service transfers were discussed from Trauma, Emergency General Surgery (EGS), and Surgical Critical Care services from the previous 24 hours. This study compared patients who underwent a surgical procedure during their hospital stay before and after protocol implementation.Results: 974 patients were included in this study. The average patient was 50.3 years of age, 65.4% were white, and 51.7% were male. The average length of stay (LOS) was 8.3 days with 1.75 days to procedure. The post-MR cohort LOS was 2.7 shorter and had 0.85 fewer days to procedure. In an adjusted regression analysis, days to procedure and LOS decreased by 33% (p < .01) and 17% (p < .01) respectively.Conclusions: Implementation of MR led to a decrease in the overall LOS and days to procedure for operative patients. Our results advocate for the standard use of structured hand-offs in surgical units.
{"title":"Morning report decreases length of stay in emergency general surgery patients","authors":"J. Gardner, J. Wolfe, W. Beck, K. Sexton, A. Bhavaraju, B. Davis, M. Kimbrough, H. Jensen, R. Robertson, R. Reif, Saleema A. Karim, John R Taylor","doi":"10.5430/jha.v8n6p1","DOIUrl":"https://doi.org/10.5430/jha.v8n6p1","url":null,"abstract":"Objective: Communication in the hospital setting is an easy target for quality improvement. Capturing this change via communication between providers during hand-offs is necessary to reduce delays and errors. While this process has been more widely characterized in medical specialties, we designed this study to address the knowledge gap in surgical specialties.Methods: Our institution’s division of Acute Care Surgery (ACS) implemented Morning Report (MR) in October of 2015. At MR, all admissions and service transfers were discussed from Trauma, Emergency General Surgery (EGS), and Surgical Critical Care services from the previous 24 hours. This study compared patients who underwent a surgical procedure during their hospital stay before and after protocol implementation.Results: 974 patients were included in this study. The average patient was 50.3 years of age, 65.4% were white, and 51.7% were male. The average length of stay (LOS) was 8.3 days with 1.75 days to procedure. The post-MR cohort LOS was 2.7 shorter and had 0.85 fewer days to procedure. In an adjusted regression analysis, days to procedure and LOS decreased by 33% (p < .01) and 17% (p < .01) respectively.Conclusions: Implementation of MR led to a decrease in the overall LOS and days to procedure for operative patients. Our results advocate for the standard use of structured hand-offs in surgical units.","PeriodicalId":15872,"journal":{"name":"Journal of Hospital Administration","volume":"33 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83909755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
K. Hearld, Larry R. Hearld, H. Budhwani, D. McCaughey, L. Celaya, A. Hall
Objective: Our interest in patient attitudes and beliefs and how they contribute to health and health seeking behaviors is based on growing interest in fostering more patient-centered care. This is particularly relevant for cancer screening in women, where the procedures may be viewed as deeply personal and emotionally invasive. There is convincing evidence that health attitudes and beliefs are strong associates of cancer screening among women. The goal of this paper is to examine if accessibility and use of personal health information (PHI) is a positive predictive of cancer related health detection behaviors among United States women. This study is relevant and timely considering the growing focus on prevention in patient-centered care delivery.Methods: Using data from the 2017 Health Information National Trends Survey (HINTS), this paper employed multivariable path analysis to investigate whether PHI use is related to engaged women’s health detection behaviors, and if this relationship is mediated by self-perceived health status and patient attitudes regarding confidence in their self-care abilities.Results: This study found that PHI use worked directly on health detection behaviors for intermediate levels of health information only. Our findings also suggest that patient attitudes may only act as a mediator at low levels of information use and when both confidence in self-care abilities and self-assessed health status are considered simultaneously.Conclusions: As prevention continues to be a key focus of health care, efforts promoting enhanced population health are critically important. With greater expansion of patient portals, health systems and providers are expecting access to greater PHI will promote increased engagement by patients in their self-health. The results of our research suggest that PHI is positive for patients up until a point and that health care delivery professionals may wish to assess the amount and type of information made readily available to the patients they serve related to breast and cervical cancer screenings.
{"title":"Driving health behavior: The roles of personal health information use and attitudes towards health in women’s cancer screenings","authors":"K. Hearld, Larry R. Hearld, H. Budhwani, D. McCaughey, L. Celaya, A. Hall","doi":"10.5430/jha.v8n5p58","DOIUrl":"https://doi.org/10.5430/jha.v8n5p58","url":null,"abstract":"Objective: Our interest in patient attitudes and beliefs and how they contribute to health and health seeking behaviors is based on growing interest in fostering more patient-centered care. This is particularly relevant for cancer screening in women, where the procedures may be viewed as deeply personal and emotionally invasive. There is convincing evidence that health attitudes and beliefs are strong associates of cancer screening among women. The goal of this paper is to examine if accessibility and use of personal health information (PHI) is a positive predictive of cancer related health detection behaviors among United States women. This study is relevant and timely considering the growing focus on prevention in patient-centered care delivery.Methods: Using data from the 2017 Health Information National Trends Survey (HINTS), this paper employed multivariable path analysis to investigate whether PHI use is related to engaged women’s health detection behaviors, and if this relationship is mediated by self-perceived health status and patient attitudes regarding confidence in their self-care abilities.Results: This study found that PHI use worked directly on health detection behaviors for intermediate levels of health information only. Our findings also suggest that patient attitudes may only act as a mediator at low levels of information use and when both confidence in self-care abilities and self-assessed health status are considered simultaneously.Conclusions: As prevention continues to be a key focus of health care, efforts promoting enhanced population health are critically important. With greater expansion of patient portals, health systems and providers are expecting access to greater PHI will promote increased engagement by patients in their self-health. The results of our research suggest that PHI is positive for patients up until a point and that health care delivery professionals may wish to assess the amount and type of information made readily available to the patients they serve related to breast and cervical cancer screenings.","PeriodicalId":15872,"journal":{"name":"Journal of Hospital Administration","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84326770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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