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An Effective Response to Healthcare Disparities Begins With a Strategic Plan. 有效应对医疗保健差距始于战略计划。
Q4 Medicine Pub Date : 2022-12-01 DOI: 10.1097/HAP.0000000000000153
Denise Brooks-Williams

For too long, healthcare disparities have negatively affected underrepresented groups in urban areas throughout the United States. Disparities in care and outcomes related to social determinants were known, and efforts were made to address them. Effective change for all moved up to top priority in the wake of COVID-19's arrival, police brutality, social unrest, and the murders of Black Americans, including George Floyd. Henry Ford Health (HFH), working with leading local community organizations, immediately pledged to address social and racial injustices. Unfortunately, many neighborhoods still suffer disproportionately from maternal and infant mortality, food insecurity, and other social vulnerabilities. HFH's commitment to equity includes creatively meeting the needs of the underserved. HFH has developed innovative ways to address the social, economic, and educational challenges to the health of Metro Detroit. Through thoughtful consideration and passionate leadership, HFH is strategically creating authentic and scalable social change to address racism and discrimination in healthcare.

长期以来,医疗保健差距对美国城市地区代表性不足的群体产生了负面影响。与社会决定因素有关的护理和结果方面的差异是已知的,并作出了努力来解决这些差异。在2019冠状病毒病到来、警察暴行、社会动荡以及包括乔治·弗洛伊德在内的美国黑人被谋杀之后,为所有人提供有效的变革成为当务之急。亨利·福特健康公司与当地主要社区组织合作,立即承诺解决社会和种族不公正问题。不幸的是,许多社区仍然不成比例地遭受孕产妇和婴儿死亡率、粮食不安全以及其他社会脆弱性的影响。HFH对公平的承诺包括创造性地满足服务不足人群的需求。HFH开发了创新的方法来解决底特律地铁健康面临的社会、经济和教育挑战。通过深思熟虑的考虑和充满激情的领导,HFH正在战略性地创造真实和可扩展的社会变革,以解决医疗保健中的种族主义和歧视问题。
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引用次数: 0
Climate Change and Healthcare: A Complicated Relationship. 气候变化和医疗保健:一个复杂的关系。
Q4 Medicine Pub Date : 2022-10-01 DOI: 10.1097/HAP.0000000000000148
Kathy Gerwig

Climate change is a crisis with a devastating impact on health. The warming atmosphere is increasing the tolls of deaths and illnesses from heat waves, extreme weather, poor air quality, insect-borne diseases, and other conditions. Healthcare is connected to climate change in a way that is not fully appreciated by many healthcare leaders-in fact, the sector generates a significant share of greenhouse gas emissions that cause climate change. As additional costs, healthcare providers' margins are put at risk from treating more climate-related disease and illness, supply chain disruptions, and damage from severe storms and wildfires. These connections provide a compelling rationale for healthcare executives to create more resilience in operations, lead efforts toward decarbonization, and catalyze for climate action.

气候变化是一场对健康造成毁灭性影响的危机。大气变暖正在增加热浪、极端天气、空气质量差、虫媒疾病和其他疾病造成的死亡和疾病的人数。医疗保健与气候变化之间的联系是许多医疗保健领导者没有充分认识到的——事实上,该行业产生了导致气候变化的温室气体排放的很大一部分。作为额外成本,医疗保健提供商的利润率面临着治疗更多与气候有关的疾病、供应链中断以及严重风暴和野火造成的破坏的风险。这些联系为医疗保健管理人员提供了一个令人信服的理由,使他们能够在运营中建立更强的弹性,领导努力实现脱碳,并促进气候行动。
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引用次数: 1
How a Faith-Based Healthcare Organization Is Turning the Tide of Environmental Impact. 一个以信仰为基础的医疗保健组织如何扭转环境影响的趋势。
Q4 Medicine Pub Date : 2022-10-01 DOI: 10.1097/HAP.0000000000000145
Craig Cordola

The healthcare sector's role in every community is inextricably linked to the health of those it serves. As research and media reports point to the significant impact of people on our planet's ecosystems, Ascension has responded by setting several environmental sustainability goals. Our work is defined by three pillars: Net Zero Places focuses on carbon sources associated with Ascension's physical environments-carbon footprint, operational efficiency of facilities, and sustainable transportation.Responsible Supply Chain focuses on the flow of goods from procurement to disposition-responsible purchasing, product usage management, recycling, and waste management.Healthy Communities focuses on the relationship between sustainability and social determinants of health (SDOH)-linking determinants to Ascension's mission to sustain and improve the health of those we serve, especially the poor and vulnerable. When we think about future generations, we realize that this work cannot wait. That is why we are reimagining today what environmental impact and sustainability could look like through the next decade and beyond. We are setting our corporate sights on net zero carbon and zero waste by 2040 and encourage other healthcare organizations to join us in these efforts. Working together, we can make a difference.

卫生保健部门在每个社区的作用与它所服务的人的健康有着不可分割的联系。随着研究和媒体报道指出人类对地球生态系统的重大影响,阿森松岛已经制定了几个环境可持续性目标作为回应。我们的工作有三大支柱:净零场所关注与阿森松岛物理环境相关的碳源——碳足迹、设施运营效率和可持续交通。负责任的供应链侧重于货物从采购到处置的流动-负责任的采购,产品使用管理,回收和废物管理。健康社区侧重于可持续性与健康的社会决定因素之间的关系,将决定因素与阿森松的使命联系起来,即维持和改善我们所服务的人,特别是穷人和弱势群体的健康。当我们考虑子孙后代时,我们意识到这项工作刻不容缓。这就是为什么我们今天正在重新设想未来十年乃至更长时间内环境影响和可持续性的样子。我们的企业目标是到2040年实现净零碳排放和零浪费,并鼓励其他医疗机构加入我们的行列。通过共同努力,我们可以有所作为。
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引用次数: 0
ESG and Healthcare's Leading Role in Saving Our Planet. ESG和医疗保健在拯救地球方面的主导作用。
Q4 Medicine Pub Date : 2022-10-01 DOI: 10.1097/HAP.0000000000000151
Carla J Sampson
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引用次数: 1
The Value of Sound Environmental Practices in Healthcare Facilities Management. 健全的环境实践在医疗设施管理中的价值。
Q4 Medicine Pub Date : 2022-10-01 DOI: 10.1097/HAP.0000000000000147
Jonathan J Flannery

The time has come for healthcare organizations to improve their efforts regarding their impact on the environment, particularly on the communities they serve. For years, healthcare has been at the forefront in addressing social needs with public health initiatives but has lagged on environmental concerns. By carefully reviewing their energy usage and aging infrastructures, healthcare leaders and their facility managers can do a better job of controlling healthcare's environmental impact. Green practices are key indicators of an organization's ethically focused sustainability efforts. So, while healthcare has traditionally focused on its social impact-providing healthcare services is, after all, inherently social-it must expand its community engagement by considering the environmental impact of hospitals and health systems on their communities in the context of climate change.

现在是医疗保健组织改进其对环境影响的努力的时候了,特别是对他们所服务的社区的影响。多年来,医疗保健一直处于通过公共卫生倡议解决社会需求的前沿,但在环境问题上却落后了。通过仔细检查他们的能源使用和老化的基础设施,医疗保健领导者和他们的设施管理人员可以更好地控制医疗保健的环境影响。绿色实践是一个组织以道德为中心的可持续发展努力的关键指标。因此,虽然医疗保健传统上侧重于其社会影响——毕竟,提供医疗保健服务本质上是社会性的——但它必须通过考虑医院和卫生系统在气候变化背景下对社区的环境影响来扩大其社区参与。
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引用次数: 0
Stony Brook University Hospital: Working Cleaner, Smarter. 石溪大学医院:工作更干净,更聪明。
Q4 Medicine Pub Date : 2022-10-01 DOI: 10.1097/HAP.0000000000000152
Carol A Gomes

To protect the well-being of their communities and the planet, healthcare organizations must take the lead in correcting the negative impacts of their business on the environment by finding new ways to work cleaner and smarter. Stony Brook University Hospital has been recognized for making the commitment to develop and maintain sustainable practices-from the elimination of mercury to the efficient design of new facilities-that are good for the environment and good for business. With the participation of the entire organization, from the C-suites to the front lines, the results are measurably impressive.

为了保护社区和地球的福祉,医疗保健组织必须通过寻找更清洁、更智能的新工作方式,带头纠正其业务对环境的负面影响。石溪大学医院因致力于发展和维护可持续实践而受到认可——从消除汞到新设施的高效设计——这对环境和商业都有好处。在整个组织的参与下,从最高管理层到第一线,结果令人印象深刻。
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引用次数: 0
The Impact of Environmental Factors on Credit Ratings in Healthcare. 环境因素对医疗行业信用评级的影响
Q4 Medicine Pub Date : 2022-10-01 DOI: 10.1097/HAP.0000000000000146
Emily E Wadhwani

At their core, credit ratings are holistic assessments of relative credit risk, inclusive of both quantitative and qualitative factors. Environmental, social, and governance (ESG) considerations have always been implicitly incorporated in credit rating methodology as components of a hospital or health system's wider performance. More recently, however, ESG effects have been explicitly identified. While social and governance considerations are important to credit ratings, the impact of environmental factors on rating outcomes in the healthcare sector continues to expand exponentially. This movement reflects the varied ways in which climate change, resource and materials management, energy management, and water management can affect credit profiles. The shift to a lower carbon-dependent economy also presents opportunities for issuers that make meaningful transitions toward renewable energy sources.

信用评级的核心是对相对信用风险的整体评估,包括定量和定性因素。环境、社会和治理(ESG)考虑因素一直隐含地纳入信用评级方法,作为医院或卫生系统更广泛绩效的组成部分。然而,最近ESG的影响已经被明确地识别出来。虽然社会和治理因素对信用评级很重要,但环境因素对医疗保健行业评级结果的影响继续呈指数级增长。这一变化反映了气候变化、资源和材料管理、能源管理和水资源管理对信用状况的不同影响。向低碳经济转型也为发行人提供了向可再生能源转型的机会。
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引用次数: 0
Moving Past Business as Usual to Meet Future Hospital Staffing Needs 改变以往的业务模式,以满足未来医院人员的需求
Q4 Medicine Pub Date : 2022-07-01 DOI: 10.1097/HAP.0000000000000143
Darlene Stromstad
Summary Workforce shortages, a dark reality for healthcare organizations even before the arrival of COVID-19, are being exacerbated by the persistent side effects of the pandemic. Burnout, more retirements, opposition to vaccination mandates, and intense competition from other industries are adding to the challenge. Those factors are keenly felt by hospitals and healthcare systems that are located beyond better-resourced major metropolitan areas. Many years will be required to resolve staffing shortfalls, and that work must begin now. Mohawk Valley Health System (MVHS) is making some noteworthy responses to the healthcare workforce crisis in the Utica, New York, area. Employing a mix of deep appreciation for workers' personal and professional needs—backed by additional financial investment and development of a diverse talent pipeline— MVHS leadership is working to ensure that it will be able to safely deliver care to patients in its communities now and for years to come.
即使在COVID-19到来之前,劳动力短缺就已经是医疗机构的一个黑暗现实,而大流行的持续副作用正在加剧这一现实。职业倦怠、退休人数增加、反对接种疫苗以及来自其他行业的激烈竞争都加剧了挑战。那些位于资源较好的大都市地区以外的医院和医疗保健系统对这些因素有着敏锐的感受。解决人员短缺问题需要许多年的时间,这项工作必须从现在开始。莫霍克谷卫生系统(MVHS)正在做出一些值得注意的反应,以医疗保健人力危机在尤蒂卡,纽约,地区。通过对员工个人和专业需求的深刻理解,加上额外的财务投资和多元化人才管道的发展,MVHS领导层正在努力确保它能够在现在和未来几年安全地为其社区的患者提供护理。
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引用次数: 1
Deploying Advanced Practice Practitioners in Response to the Healthcare Workforce Crisis in the Ambulatory Setting. 部署先进的实践从业者,以应对医疗人力危机在门诊设置。
Q4 Medicine Pub Date : 2022-07-01 DOI: 10.1097/HAP.0000000000000142
Paul E Neagle

Summary: The clinical staffing shortages that the US healthcare sector is experiencing are sure to become even more profound as the general population continues to grow and age. With more people living well beyond age 65, more physicians will be needed to provide care.A solution to help fill the gaps in physician coverage is centered on the use of advanced practice practitioners, especially in the ambulatory setting. The growing shortage of primary care physicians could be significantly reduced or eliminated if the appropriate contributions of advanced practice practitioners-including physician assistants/physician associates (PAs) and nurse practitioners (NPs)-are considered when calculating financial costs.My organization uses a model in the ambulatory setting that emphasizes the use of PAs and NPs who are supported by physician oversight in their clinical practice. Throughout the critical challenges of the recent past, the model has served us well. Other organizations may also see important benefits with this strategy.

摘要:随着人口的不断增长和老龄化,美国医疗保健部门正在经历的临床人员短缺肯定会变得更加严重。随着越来越多的人活到65岁以上,将需要更多的医生来提供护理。一个解决方案,以帮助填补空白的医生覆盖是集中在使用高级执业医师,特别是在门诊设置。如果在计算财务成本时考虑到高级执业医师(包括医师助理/医师助理(PAs)和执业护士(NPs))的适当贡献,初级保健医生的日益短缺可以显著减少或消除。我的组织在门诊环境中使用一个模型,强调在临床实践中由医生监督支持的PAs和NPs的使用。在最近的重大挑战中,这一模式对我们很有帮助。其他组织也可能看到这种策略的重要好处。
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引用次数: 1
Ethical Challenges in Staffing: The Importance of Building Moral Muscle. 人员配备中的道德挑战:建立道德力量的重要性。
Q4 Medicine Pub Date : 2022-07-01 DOI: 10.1097/HAP.0000000000000140
Jason Lesandrini, David Reis

Summary: Addressing ethics issues in healthcare is essential to living out an organization's mission, vision, and values. In addition to exacerbating existing ethical dilemmas, the COVID-19 pandemic raised many new and complex questions for leaders and their organizations. Ethical issues related to the workforce require a deliberate and comprehensive consideration of values. The case study scenarios presented here demonstrate examples of common ethical staffing challenges that healthcare leaders have faced, notably the allocation of care providers among COVID-19 patients and the balancing of care quality with staff and patient safety. With access to expert resources and a decision-making framework, leaders can build the moral muscle to meet these challenges and reach ethically justifiable resolutions. These staffing issues highlight the need for increased access to ethics resources for organizational leaders, including moral development support and assistance from experts to resolve complex ethical matters.

总结:解决医疗保健中的道德问题对于实现组织的使命、愿景和价值观至关重要。除了加剧现有的道德困境外,2019冠状病毒病大流行还给领导者及其组织带来了许多新的复杂问题。与劳动力相关的道德问题需要对价值观进行深思熟虑和全面的考虑。本文提供的案例研究场景展示了医疗保健领导者面临的常见道德人员配置挑战,特别是在COVID-19患者中分配护理提供者以及在护理质量与员工和患者安全之间取得平衡。通过获得专家资源和决策框架,领导者可以建立道德力量来应对这些挑战,并达成道德上合理的解决方案。这些人员配备问题突出表明,需要为组织领导人提供更多的道德资源,包括道德发展支持和专家协助,以解决复杂的道德问题。
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引用次数: 0
期刊
Frontiers of Health Services Management
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