Objective: To explore the capacity and responsiveness of the Home Care Package (HCP) Program to deliver the promise of a meaningful life for rural residents. Methods: In-depth interviews utilising appreciative enquiry in two local government areas in rural/outer regional Tasmania (MM2-6). Participants: Rural staff and residents who were either receiving, seeking or delivering support through the HCP Program. Results: Interviews revealed that positive impacts of being assisted to stay at home resulted when staff were able to provide support that was appropriate to need, and enabled the continuation of rural community engagement, individual autonomy and control. When the HCP did not provide these, or even hindered them, there were negative consequences, and feelings of confusion, mistrust, and disappointment for staff and residents. The rural context creates specific challenges for the HCP Program in its current form, related to service availability and choice, staff recruitment, training and availability, and client/provider needs mismatch. Conclusions: Older rural people are variously impacted upon by the HCP Program. Factors of rurality, including workforce issues, hamper the Program’s potential to positively contribute to a meaningful life. As demand grows, changes are needed. There is a need to examine the Program design for urban-centrisms, and gain a greater awareness of older rural people’s needs and rural
{"title":"Can a Home Care Package deliver a meaningful life? Challenges for rural home care delivery","authors":"P. Marsh, Amelie Fuller, Judith Anderson","doi":"10.5430/JHA.V10N2P12","DOIUrl":"https://doi.org/10.5430/JHA.V10N2P12","url":null,"abstract":"Objective: To explore the capacity and responsiveness of the Home Care Package (HCP) Program to deliver the promise of a meaningful life for rural residents. Methods: In-depth interviews utilising appreciative enquiry in two local government areas in rural/outer regional Tasmania (MM2-6). Participants: Rural staff and residents who were either receiving, seeking or delivering support through the HCP Program. Results: Interviews revealed that positive impacts of being assisted to stay at home resulted when staff were able to provide support that was appropriate to need, and enabled the continuation of rural community engagement, individual autonomy and control. When the HCP did not provide these, or even hindered them, there were negative consequences, and feelings of confusion, mistrust, and disappointment for staff and residents. The rural context creates specific challenges for the HCP Program in its current form, related to service availability and choice, staff recruitment, training and availability, and client/provider needs mismatch. Conclusions: Older rural people are variously impacted upon by the HCP Program. Factors of rurality, including workforce issues, hamper the Program’s potential to positively contribute to a meaningful life. As demand grows, changes are needed. There is a need to examine the Program design for urban-centrisms, and gain a greater awareness of older rural people’s needs and rural","PeriodicalId":15872,"journal":{"name":"Journal of Hospital Administration","volume":"21 1","pages":"12"},"PeriodicalIF":0.0,"publicationDate":"2021-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87904320","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}
Hisahiro Ishijima, Shuichi Suzuki, Fares Masaule, V. Mlay, R. John
In Tanzania, regional referral hospitals (RRHs) play a major role in providing curative and diagnostic services and influence the performance of the entire health system. The results of a baseline survey conducted in 2015 to determine the status of RRHs in Tanzania indicated that there were many supportive supervisory and assessment tools for RRHs but none of them specifically focused on the performance of hospitals. In an endeavor to enhance the performance of RRHs, the Ministry of Health, Community Development, Gender, Elderly and Children (MoHCDGEC) and the President Office – Regional Administration and Local Government (PO-RALG) developed an external hospital performance assessment (EHPA) tool to analyze all aspects of the performance of RRHs. EHPA was started in 2017 to assess the performance of 28 RRHs in the country. This study examines the changes to the performance of the RRHs based on the introduction of the EHPA and the supportive interventions by the Ministry of Health. It is also studying the factors that influence the assessment of EHPA. As the results of this study, there is a great indication of the overall performance of RRHs being improved as observed from an upward gradient of average EHPA scores from 2017 to 2019 in all RRHs. This improvement is exemplified by the decrease in the standard deviation gap amongst RRHs. The three years (2017–2019) of consecutive assessment has also observed implicit competition in improving hospital services among Regional Referral Hospital Management Teams (RRHMTs) using the findings from the EHPA.
{"title":"Measuring hospital performances of regional referral hospitals in Tanzania","authors":"Hisahiro Ishijima, Shuichi Suzuki, Fares Masaule, V. Mlay, R. John","doi":"10.5430/JHA.V10N2P1","DOIUrl":"https://doi.org/10.5430/JHA.V10N2P1","url":null,"abstract":"In Tanzania, regional referral hospitals (RRHs) play a major role in providing curative and diagnostic services and influence the performance of the entire health system. The results of a baseline survey conducted in 2015 to determine the status of RRHs in Tanzania indicated that there were many supportive supervisory and assessment tools for RRHs but none of them specifically focused on the performance of hospitals. In an endeavor to enhance the performance of RRHs, the Ministry of Health, Community Development, Gender, Elderly and Children (MoHCDGEC) and the President Office – Regional Administration and Local Government (PO-RALG) developed an external hospital performance assessment (EHPA) tool to analyze all aspects of the performance of RRHs. EHPA was started in 2017 to assess the performance of 28 RRHs in the country. This study examines the changes to the performance of the RRHs based on the introduction of the EHPA and the supportive interventions by the Ministry of Health. It is also studying the factors that influence the assessment of EHPA. As the results of this study, there is a great indication of the overall performance of RRHs being improved as observed from an upward gradient of average EHPA scores from 2017 to 2019 in all RRHs. This improvement is exemplified by the decrease in the standard deviation gap amongst RRHs. The three years (2017–2019) of consecutive assessment has also observed implicit competition in improving hospital services among Regional Referral Hospital Management Teams (RRHMTs) using the findings from the EHPA.","PeriodicalId":15872,"journal":{"name":"Journal of Hospital Administration","volume":"18 1","pages":"1"},"PeriodicalIF":0.0,"publicationDate":"2021-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81721293","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: This quality improvement (QI) project’s aim was to lower 30-day healthcare reutilization for patients aged 50 or older with hip fracture using an evidence-based discharge process method, the Re-Engineered Discharge (RED) Toolkit.Methods: The QI project of a revised patient discharge process to lower healthcare reutilization of Baton Rouge Rehabilitation Hospital (BRRH) hip fracture patients was implemented as an evidence-based quality improvement initiative. Inpatient and outpatient discharge process revisions were implemented at an inpatient rehabilitation facility (IRF) based on Re-Engineered Discharge (RED) Toolkit recommendations. Inpatient revisions included patient barrier identification with associated documentation changes to the IRF interdisciplinary team form. Outpatient modifications consisted of an After-Hospital Care Plan (AHCP), and two post-discharge Telephone Follow-Up (TFU) calls.Results: Healthcare reutilization and thirty-day hospital readmission for this project were measured at 8.5% and 5.7%, respectively. A decrease in healthcare reutilization of at least 1.6% was observed for the IRF. Most participants scored at a high level (88.6%) of “patient knowledge of self-management” post intervention. Out of participants who did not attend their first Primary Care Provider (PCP) appointment, 33.3% experienced healthcare reutilization. This result emphasized the importance of seeing one’s PCP post-discharge. Patient satisfaction increased by 5% and 6.73%, measured by Hospital Consumer Assessment of HealthCare Providers and Systems (HCAHP) scores for nursing care and physician care, respectively.Conclusions: Implementation of a RED Toolkit-based discharge process at an IRF positively impacted all three study outcomes and associated healthcare costs in lowering preventable readmissions.
{"title":"Care transition from rehabilitation to home: A QI project using the RED Toolkit to decrease readmission rates","authors":"J. Bernard, E. Creel, Rhonda K. Pecoraro","doi":"10.5430/JHA.V10N1P46","DOIUrl":"https://doi.org/10.5430/JHA.V10N1P46","url":null,"abstract":"Objective: This quality improvement (QI) project’s aim was to lower 30-day healthcare reutilization for patients aged 50 or older with hip fracture using an evidence-based discharge process method, the Re-Engineered Discharge (RED) Toolkit.Methods: The QI project of a revised patient discharge process to lower healthcare reutilization of Baton Rouge Rehabilitation Hospital (BRRH) hip fracture patients was implemented as an evidence-based quality improvement initiative. Inpatient and outpatient discharge process revisions were implemented at an inpatient rehabilitation facility (IRF) based on Re-Engineered Discharge (RED) Toolkit recommendations. Inpatient revisions included patient barrier identification with associated documentation changes to the IRF interdisciplinary team form. Outpatient modifications consisted of an After-Hospital Care Plan (AHCP), and two post-discharge Telephone Follow-Up (TFU) calls.Results: Healthcare reutilization and thirty-day hospital readmission for this project were measured at 8.5% and 5.7%, respectively. A decrease in healthcare reutilization of at least 1.6% was observed for the IRF. Most participants scored at a high level (88.6%) of “patient knowledge of self-management” post intervention. Out of participants who did not attend their first Primary Care Provider (PCP) appointment, 33.3% experienced healthcare reutilization. This result emphasized the importance of seeing one’s PCP post-discharge. Patient satisfaction increased by 5% and 6.73%, measured by Hospital Consumer Assessment of HealthCare Providers and Systems (HCAHP) scores for nursing care and physician care, respectively.Conclusions: Implementation of a RED Toolkit-based discharge process at an IRF positively impacted all three study outcomes and associated healthcare costs in lowering preventable readmissions.","PeriodicalId":15872,"journal":{"name":"Journal of Hospital Administration","volume":"246 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87492045","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: Many healthcare workers (HCWs) have been subjected to additional workplace and personal stressors during the COVID-19 pandemic. Some stressors may be more likely to contribute to career choice regret and the decision to leave the healthcare profession. Loss of critical numbers of personnel could leave healthcare systems without a ready, capable workforce. The purpose of this research was to determine which personal and professional characteristics increased frequency of career choice regret. Methods: An international, cross-sectional survey was conducted to determine if specific personal and professional characteristics were associated with career choice regret and intent to leave. One short-answer item was included in the 20-item survey. The sample consisted of 874 English-speaking HCWs from 18 countries with representation of various practice settings, disciplines, ages, and years in healthcare. Results: Significant correlations between preand intra-pandemic frequency of thoughts about leaving the healthcare profession were observed. Ordinal regression analyses were conducted, finding significant relationships between career regret thoughts and female gender, age, and death of a family member or friend. Death of a coworker was not associated with increased thoughts of leaving the healthcare profession. Themes from the short-answer item included fatigue, anger, doubt, fulfillment, and the pandemic as a journey. Conclusions: Healthcare systems may be vulnerable to a loss of HCWs due to the effects of working during the COVID-19 pandemic. Hospital and health system executives need to understand the current threats to the stability of the workforce and develop strategies to prevent attrition of skilled, capable professionals.
{"title":"Personal and professional factors influencing career choice regret during the COVID-19 pandemic","authors":"M. Gaffney","doi":"10.5430/JHA.V10N1P40","DOIUrl":"https://doi.org/10.5430/JHA.V10N1P40","url":null,"abstract":"Objective: Many healthcare workers (HCWs) have been subjected to additional workplace and personal stressors during the COVID-19 pandemic. Some stressors may be more likely to contribute to career choice regret and the decision to leave the healthcare profession. Loss of critical numbers of personnel could leave healthcare systems without a ready, capable workforce. The purpose of this research was to determine which personal and professional characteristics increased frequency of career choice regret. Methods: An international, cross-sectional survey was conducted to determine if specific personal and professional characteristics were associated with career choice regret and intent to leave. One short-answer item was included in the 20-item survey. The sample consisted of 874 English-speaking HCWs from 18 countries with representation of various practice settings, disciplines, ages, and years in healthcare. Results: Significant correlations between preand intra-pandemic frequency of thoughts about leaving the healthcare profession were observed. Ordinal regression analyses were conducted, finding significant relationships between career regret thoughts and female gender, age, and death of a family member or friend. Death of a coworker was not associated with increased thoughts of leaving the healthcare profession. Themes from the short-answer item included fatigue, anger, doubt, fulfillment, and the pandemic as a journey. Conclusions: Healthcare systems may be vulnerable to a loss of HCWs due to the effects of working during the COVID-19 pandemic. Hospital and health system executives need to understand the current threats to the stability of the workforce and develop strategies to prevent attrition of skilled, capable professionals.","PeriodicalId":15872,"journal":{"name":"Journal of Hospital Administration","volume":"10 1","pages":"40"},"PeriodicalIF":0.0,"publicationDate":"2021-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78925628","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}
Ged Williams, Nawal A. Awad, D. Roloff, C. Daniels
Objective: We describe the practical aspects of planning for and executing the safe movement of patients and care teams from an existing tertiary hospital (Mafraq Hospital) to a new hospital (Sheikh Shakhbout Medical City) in Abu Dhabi, United Arab Emirates. Methods: Field notes and measures taken during the planning and execution of this event were prospectively collated by the authors to inform the final manuscript. Results: A central command structure similar to that used for major disaster management helped to guide the move of all inpatients, staff and support services from one hospital to the other. Five patient tracks (clinical teams) were established to move patients to the new facility concurrently along set and separate routes. Five additional support tracks were established to provide logistical support for the movement of essential non-patient resources. A total of 142 acutely ill general care and critically ill hospital patients were moved during a five-hour period with zero patient harm events. Conclusions: The tools, processes used, and lessons learned in this exercise are shared in the hope that others who are required to move hospitals can learn from and use our experience.
{"title":"Relocation and transfer of patients to a new hospital: Practical lessons","authors":"Ged Williams, Nawal A. Awad, D. Roloff, C. Daniels","doi":"10.5430/JHA.V10N1P23","DOIUrl":"https://doi.org/10.5430/JHA.V10N1P23","url":null,"abstract":"Objective: We describe the practical aspects of planning for and executing the safe movement of patients and care teams from an existing tertiary hospital (Mafraq Hospital) to a new hospital (Sheikh Shakhbout Medical City) in Abu Dhabi, United Arab Emirates. Methods: Field notes and measures taken during the planning and execution of this event were prospectively collated by the authors to inform the final manuscript. Results: A central command structure similar to that used for major disaster management helped to guide the move of all inpatients, staff and support services from one hospital to the other. Five patient tracks (clinical teams) were established to move patients to the new facility concurrently along set and separate routes. Five additional support tracks were established to provide logistical support for the movement of essential non-patient resources. A total of 142 acutely ill general care and critically ill hospital patients were moved during a five-hour period with zero patient harm events. Conclusions: The tools, processes used, and lessons learned in this exercise are shared in the hope that others who are required to move hospitals can learn from and use our experience.","PeriodicalId":15872,"journal":{"name":"Journal of Hospital Administration","volume":"1 1","pages":"23"},"PeriodicalIF":0.0,"publicationDate":"2021-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73278529","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}
Kyung Hun Nam, D. Kim, W. Baek, H. Lee, Joo Hyung Kim
A substantial number of Korean patients who require tracheostomy or oral suctioning are admitted to long-term care hospitals. However, under the Korea’s current daily fixed-rate reimbursement system, the cost of suction catheters is a considerable financial burden. To further discuss proper reimbursement policies for suction catheters in South Korean long-term care system, we examined the number and cost of suction catheters used in a long-term care hospital. This study is a single-center prospective cohort observational study that was conducted on patients admitted to the step-down unit at Ajou University Intermediate Care Hospital. Data of 47 patients were collected for this study. The average amount of suction catheter use per person was 529 during the 62 days of the study period. Daily suction catheter usage showed a statistically significant difference between patients with and without tracheostomy (10.5 ± 6.9 vs 2.1 ± 3.3, p-value < .001). It also showed a significant difference between patients who were diagnosed with or without pneumonia during hospitalization (12.3 ± 4.2 vs 5.5 ± 4.2, p-value < .001). The estimated cost of suction catheter usage for 30 days on a single patient who has tracheostomy was about 160,000 Korean won ($160), which was about 7.3% of the total monthly reimbursement. With the current reimbursement system, there is a potential risk of improper reuse and underuse of suction catheters. To improve respiratory care and prevent pneumonia, we suggest a separate reimbursement system for suction catheters for patients with tracheostomy in South Korean long-term care hospitals.
需要气管切开术或口腔吸痰的韩国患者中，有相当一部分被送往长期护理医院。然而，在韩国目前的每日固定费率报销制度下，吸引管的费用是相当大的财政负担。为了进一步探讨韩国长期护理系统中吸引管的合理报销政策，我们调查了一家长期护理医院中使用的吸引管的数量和成本。本研究是一项单中心前瞻性队列观察性研究，研究对象为亚洲大学中级护理医院降压病房住院患者。本研究收集了47例患者的资料。在62天的研究期间，每人平均使用529次吸管。气管切开术患者与未切开术患者每日吸管使用率差异有统计学意义(10.5±6.9 vs 2.1±3.3,p值< 0.001)。住院期间诊断为肺炎或未诊断为肺炎的患者之间也存在显著差异(12.3±4.2 vs 5.5±4.2,p值< 0.001)。一名气管切开术患者使用30天的吸管费用估计约为16万韩圆(合160美元)，约占每月总报销额的7.3%。在目前的报销制度下，有潜在的不适当的重复使用和使用不足的吸引导管的风险。为了改善呼吸系统护理和预防肺炎，我们建议韩国长期护理医院气管切开术患者的吸痰导管单独报销制度。
{"title":"Suction catheter usage and cost at long-term care hospitals in Republic of Korea","authors":"Kyung Hun Nam, D. Kim, W. Baek, H. Lee, Joo Hyung Kim","doi":"10.5430/JHA.V10N1P1","DOIUrl":"https://doi.org/10.5430/JHA.V10N1P1","url":null,"abstract":"A substantial number of Korean patients who require tracheostomy or oral suctioning are admitted to long-term care hospitals. However, under the Korea’s current daily fixed-rate reimbursement system, the cost of suction catheters is a considerable financial burden. To further discuss proper reimbursement policies for suction catheters in South Korean long-term care system, we examined the number and cost of suction catheters used in a long-term care hospital. This study is a single-center prospective cohort observational study that was conducted on patients admitted to the step-down unit at Ajou University Intermediate Care Hospital. Data of 47 patients were collected for this study. The average amount of suction catheter use per person was 529 during the 62 days of the study period. Daily suction catheter usage showed a statistically significant difference between patients with and without tracheostomy (10.5 ± 6.9 vs 2.1 ± 3.3, p-value < .001). It also showed a significant difference between patients who were diagnosed with or without pneumonia during hospitalization (12.3 ± 4.2 vs 5.5 ± 4.2, p-value < .001). The estimated cost of suction catheter usage for 30 days on a single patient who has tracheostomy was about 160,000 Korean won ($160), which was about 7.3% of the total monthly reimbursement. With the current reimbursement system, there is a potential risk of improper reuse and underuse of suction catheters. To improve respiratory care and prevent pneumonia, we suggest a separate reimbursement system for suction catheters for patients with tracheostomy in South Korean long-term care hospitals.","PeriodicalId":15872,"journal":{"name":"Journal of Hospital Administration","volume":"6 1","pages":"1"},"PeriodicalIF":0.0,"publicationDate":"2021-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82095183","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}
E. Guérin, E. M. Bouattane, J. Joanisse, D. Prud'homme
Objective: Documenting multimorbidity profiles and resource use across hospital sectors can help inform and improve healthcare delivery. The purpose of this cohort study (2013-2017) was to describe profiles of multimorbidity among patients at an acute care hospital in Ontario, Canada. Methods: This was a retrospective cohort study over five fiscal years. Data from patients who were admitted as inpatients, visited the emergency department (ED), or received day surgeries at an acute care hospital in Ottawa, Canada between 2013 and 2017 were obtained from two individual-level administrative databases. Diagnoses for 13 chronic diseases and clusters of multimorbidity were identified using validated methods. The analysis sample was comprised of 22,932 patients with multimorbidity aged 18 years or over. Demographic (e.g., age) and clinical (e.g., ED visit count) characteristics of chronic disease clusters were examined across inpatient, ED, and day surgery services, and between language groups. Results: The most common disease profiles encompassed hypertension, diabetes, and arthritis. Mental health and mood conditions were highly concomitant among ED patients. Degree of multimorbidity was significantly associated with length of stay (LOS) and frequency of ED visits. Compared to Anglophone inpatients, hospitalized Francophone patients had significantly more comorbid conditions. Conclusions: Treatment plans should be tailored for different types of hospital services and will need to be patient-centered to account for variability in disease clusters, sociodemographic factors, and acuity levels. More studies are needed to understand the impacts of multimorbidity on healthcare systems.
{"title":"Clusters of multimorbidity across hospital services and by language groups","authors":"E. Guérin, E. M. Bouattane, J. Joanisse, D. Prud'homme","doi":"10.5430/JHA.V10N1P6","DOIUrl":"https://doi.org/10.5430/JHA.V10N1P6","url":null,"abstract":"Objective: Documenting multimorbidity profiles and resource use across hospital sectors can help inform and improve healthcare delivery. The purpose of this cohort study (2013-2017) was to describe profiles of multimorbidity among patients at an acute care hospital in Ontario, Canada. Methods: This was a retrospective cohort study over five fiscal years. Data from patients who were admitted as inpatients, visited the emergency department (ED), or received day surgeries at an acute care hospital in Ottawa, Canada between 2013 and 2017 were obtained from two individual-level administrative databases. Diagnoses for 13 chronic diseases and clusters of multimorbidity were identified using validated methods. The analysis sample was comprised of 22,932 patients with multimorbidity aged 18 years or over. Demographic (e.g., age) and clinical (e.g., ED visit count) characteristics of chronic disease clusters were examined across inpatient, ED, and day surgery services, and between language groups. Results: The most common disease profiles encompassed hypertension, diabetes, and arthritis. Mental health and mood conditions were highly concomitant among ED patients. Degree of multimorbidity was significantly associated with length of stay (LOS) and frequency of ED visits. Compared to Anglophone inpatients, hospitalized Francophone patients had significantly more comorbid conditions. Conclusions: Treatment plans should be tailored for different types of hospital services and will need to be patient-centered to account for variability in disease clusters, sociodemographic factors, and acuity levels. More studies are needed to understand the impacts of multimorbidity on healthcare systems.","PeriodicalId":15872,"journal":{"name":"Journal of Hospital Administration","volume":"39 1","pages":"6"},"PeriodicalIF":0.0,"publicationDate":"2021-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74111297","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}
B. Ashar, B. Bigelow, R. Demski, Clarence K Lam, Jennifer K Parks, Saira Huggins, Jill Barbaro, Kimberly S Peairs
Coronavirus disease 2019 placed unprecedented challenges on the modern healthcare system. In addition to caring for patients directly affected by the virus, hospitals and clinics had to quickly mobilize forces in order to protect and manage employees with symptoms and/or exposures to COVID-19. Interventions are needed to efficiently diagnose and quarantine healthcare workers with disease while returning those without disease expediently in order to maintain a workforce capable of dealing with the pandemic surge. This article describes the Johns Hopkins system-wide occupational health response to the coronavirus outbreak. Specifically, the steps taken to develop and implement an employee covid call center that fielded 9,000 calls during the 2 2 month initial surge of the virus are outlined. The 24/7 availability and rapid triage of healthcare workers led to an ultimate decline in call volume despite increasing exposure to the virus and rising hospitalizations.
{"title":"Development of an employee call center for healthcare workers with symptoms and exposures to COVID-19","authors":"B. Ashar, B. Bigelow, R. Demski, Clarence K Lam, Jennifer K Parks, Saira Huggins, Jill Barbaro, Kimberly S Peairs","doi":"10.5430/JHA.V10N1P18","DOIUrl":"https://doi.org/10.5430/JHA.V10N1P18","url":null,"abstract":"Coronavirus disease 2019 placed unprecedented challenges on the modern healthcare system. In addition to caring for patients directly affected by the virus, hospitals and clinics had to quickly mobilize forces in order to protect and manage employees with symptoms and/or exposures to COVID-19. Interventions are needed to efficiently diagnose and quarantine healthcare workers with disease while returning those without disease expediently in order to maintain a workforce capable of dealing with the pandemic surge. This article describes the Johns Hopkins system-wide occupational health response to the coronavirus outbreak. Specifically, the steps taken to develop and implement an employee covid call center that fielded 9,000 calls during the 2 2 month initial surge of the virus are outlined. The 24/7 availability and rapid triage of healthcare workers led to an ultimate decline in call volume despite increasing exposure to the virus and rising hospitalizations.","PeriodicalId":15872,"journal":{"name":"Journal of Hospital Administration","volume":"19 1","pages":"18"},"PeriodicalIF":0.0,"publicationDate":"2021-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74546822","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}
A. Fuher, J. Pathoulas, Nathan Rubin, Lisa M. Hursin, Molly A. Wyman, R. Farah
Objective: The novel coronavirus 2019 (COVID-19) pandemic led to a shortage of personal protective equipment (PPE) early in the pandemic. Healthcare systems asked for public donations of PPE and established community drop-off sites. Herein, we aim to profile community PPE donors at one large academic medical center including evaluation of donor industry, public messaging, and psychosocial aspects of donation.Methods: A survey was created and distributed to donors at two urban PPE drop-off sites between March and April 2020. Targeted donors and drop-off sites were located in the Twin Cities metropolitan area (approximate population of 3.5 million people).Results: A total of 486 surveys were completed. Nearly half (47.3%) of PPE donated was initially intended for personal use. Donors primarily learned of PPE collection efforts through word of mouth (23.2%) and social media (22.7%). The most frequently reported barrier to donation included distance between donors and drop off sites or location (27.8%). Donors rated the severity of the PPE shortage in the state as a 7.8 ± 1.7 out of 10. There was a slight correlation between donors assessment of COVID-19 severity and feeling that their donation was a meaningful contribution against COVID-19 (r = 0.21, p = .00).Conclusions: Future community collection campaigns during widespread disasters should prioritize mobilizing privately held goods from individuals rather than small businesses. Public messaging around donation should utilize simple narratives that are easily shareable via social media and evoke donation as a means of building community.
目的:新型冠状病毒2019 (COVID-19)大流行导致个人防护装备(PPE)早期短缺。卫生保健系统要求公众捐赠个人防护装备并建立社区落货点。在此，我们的目标是在一个大型学术医疗中心对社区个人防护装备捐赠者进行分析，包括对捐赠行业、公共信息和捐赠的社会心理方面的评估。方法:于2020年3月至4月在两个城市个人防护装备投递点进行调查并向捐赠者分发。目标捐助者和投递点位于双子城大都市区(约有350万人口)。结果:共完成问卷调查486份。捐赠的个人防护装备近一半(47.3%)最初用于个人使用。捐助方主要通过口耳相传(23.2%)和社交媒体(22.7%)了解个人防护装备收集工作。最常见的捐赠障碍包括捐赠者与捐赠地点或地点之间的距离(27.8%)。捐助者将该州个人防护装备短缺的严重程度评为7.8±1.7分(满分为10分)。献血者对COVID-19严重程度的评估与他们认为自己的捐赠对COVID-19有意义的贡献之间存在轻微的相关性(r = 0.21, p = 0.00)。结论:未来在大范围灾害期间的社区收集活动应优先从个人而不是小企业中动员私人持有的物品。有关捐赠的公共信息应该使用易于通过社交媒体分享的简单叙述，并将捐赠作为建立社区的一种手段。
{"title":"Characterization of community-based donation of personal protective equipment to an academic health center during the COVID-19 pandemic","authors":"A. Fuher, J. Pathoulas, Nathan Rubin, Lisa M. Hursin, Molly A. Wyman, R. Farah","doi":"10.5430/JHA.V9N6P34","DOIUrl":"https://doi.org/10.5430/JHA.V9N6P34","url":null,"abstract":"Objective: The novel coronavirus 2019 (COVID-19) pandemic led to a shortage of personal protective equipment (PPE) early in the pandemic. Healthcare systems asked for public donations of PPE and established community drop-off sites. Herein, we aim to profile community PPE donors at one large academic medical center including evaluation of donor industry, public messaging, and psychosocial aspects of donation.Methods: A survey was created and distributed to donors at two urban PPE drop-off sites between March and April 2020. Targeted donors and drop-off sites were located in the Twin Cities metropolitan area (approximate population of 3.5 million people).Results: A total of 486 surveys were completed. Nearly half (47.3%) of PPE donated was initially intended for personal use. Donors primarily learned of PPE collection efforts through word of mouth (23.2%) and social media (22.7%). The most frequently reported barrier to donation included distance between donors and drop off sites or location (27.8%). Donors rated the severity of the PPE shortage in the state as a 7.8 ± 1.7 out of 10. There was a slight correlation between donors assessment of COVID-19 severity and feeling that their donation was a meaningful contribution against COVID-19 (r = 0.21, p = .00).Conclusions: Future community collection campaigns during widespread disasters should prioritize mobilizing privately held goods from individuals rather than small businesses. Public messaging around donation should utilize simple narratives that are easily shareable via social media and evoke donation as a means of building community.","PeriodicalId":15872,"journal":{"name":"Journal of Hospital Administration","volume":"79 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88689072","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}
A. Litvintchouk, L. Bilello, C. Smotherman, Katryne Lukens Bull
Objective: As the opioid addiction epidemic continues to grow, other serious health issues regarding drug use has also increased. This study examines the trends in admissions and population characteristics of those who experience infective endocarditis with opioid drug dependence.Methods: We used ICD-9-CM and ICD-10-CM codes to identify patients admitted to a hospital with infective endocarditis and with a secondary diagnosis of opioid use related disorders using data released by the Florida Agency for Health Care Administration (AHCA). Data included age, gender, ethnicity, race, discharge disposition, admission type, payer status, total charges, and zip code of patients’ residence.Results: During the four-year period, the percent of patients diagnosed with infective endocarditis and a diagnosis code associated with opioid abuse or dependence doubled (4.48% to 8.52%). Of the patients dually diagnosed, the mean age was 37.47 and the majority were white (90.78%), non-Hispanic (91.96%), and female (58.55%). Nearly 47% of the patients did not have health insurance. The percentage of patients with both diagnosis codes living in urban counties was 91.37%. Median length of stay was 10 days and median total charges for patients was $101,604.Conclusions: With the increasing incidence of opioid dependence and addiction within the United States, there is a rise in infective endocarditis, a costly and debilitating disease. Our analysis provides the framework for hospital systems to identify patients who may benefit from addiction services, which through downstream effects will cause less of a health and financial burden.
{"title":"Hospitalized patients co-diagnosed with infective endocarditis and opioid drug dependence in Florida, 2015-2018","authors":"A. Litvintchouk, L. Bilello, C. Smotherman, Katryne Lukens Bull","doi":"10.5430/jha.v10n4p26","DOIUrl":"https://doi.org/10.5430/jha.v10n4p26","url":null,"abstract":"Objective: As the opioid addiction epidemic continues to grow, other serious health issues regarding drug use has also increased. This study examines the trends in admissions and population characteristics of those who experience infective endocarditis with opioid drug dependence.Methods: We used ICD-9-CM and ICD-10-CM codes to identify patients admitted to a hospital with infective endocarditis and with a secondary diagnosis of opioid use related disorders using data released by the Florida Agency for Health Care Administration (AHCA). Data included age, gender, ethnicity, race, discharge disposition, admission type, payer status, total charges, and zip code of patients’ residence.Results: During the four-year period, the percent of patients diagnosed with infective endocarditis and a diagnosis code associated with opioid abuse or dependence doubled (4.48% to 8.52%). Of the patients dually diagnosed, the mean age was 37.47 and the majority were white (90.78%), non-Hispanic (91.96%), and female (58.55%). Nearly 47% of the patients did not have health insurance. The percentage of patients with both diagnosis codes living in urban counties was 91.37%. Median length of stay was 10 days and median total charges for patients was $101,604.Conclusions: With the increasing incidence of opioid dependence and addiction within the United States, there is a rise in infective endocarditis, a costly and debilitating disease. Our analysis provides the framework for hospital systems to identify patients who may benefit from addiction services, which through downstream effects will cause less of a health and financial burden.","PeriodicalId":15872,"journal":{"name":"Journal of Hospital Administration","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88493835","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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