July 1, 2011
“…the purpose of this paper is to review and summarize the literature on the benefits and drawbacks of EHR systems. Much of the literature has focused on key EHR functionalities, including clinical decision support systems, computerized order entry systems, and health information exchange. Our paper describes the potential benefits of EHRs that include clinical outcomes (eg, improved quality, reduced medical errors), organizational outcomes (eg, financial and operational benefits), and societal outcomes (eg, improved ability to conduct research, improved population health, reduced costs). Despite these benefits, studies in the literature highlight drawbacks associated with EHRs, which include the high upfront acquisition costs, ongoing maintenance costs, and disruptions to workflows that contribute to temporary losses in productivity that are the result of learning a new system. Moreover, EHRs are associated with potential perceived privacy concerns among patients, which are further addressed legislatively in the HITECH Act. Overall, experts and policymakers believe that significant benefits to patients and society can be realized when EHRs are widely adopted and used in a “meaningful” way.”
Posted in Journal Articles, READ Portal | Tagged with e-health, Efficiency, Information technology | No Comments
June 27, 2011
“An interactive tool was developed for the ophthalmology department of the Academic Medical Center to quantitatively support management with strategic patient-mix decisions. The tool enables management to alter the number of patients in various patient groups and to see the consequences in terms of key performance indicators. In our case study, we focused on the bottleneck: the operating room. First, we performed a literature review to identify all factors that influence an operating room’s utilization rate. Next, we decided which factors were relevant to our study. For these relevant factors, two quantitative methods were applied to quantify the impact of an individual factor: regression analysis and computer simulation. Finally, the average duration of an operation, the number of cancellations due to overrun of previous surgeries, and the waiting time target for elective patients all turned out to have significant impact. Accordingly, for the case study, the interactive tool was shown to offer management quantitative decision support to act proactively to expected alterations in patient-mix. Hence, management can anticipate the future situation, and either alter the expected patient-mix or expand capacity to ensure that the key performance indicators will be met in the future.”
Posted in Journal Articles, READ Portal | Tagged with Efficiency, Operating rooms, Wait lists | No Comments
June 23, 2011
“Variability in admissions and lengths of stay inherently leads to variability in bed occupancy. The aim of this paper is to analyse the impact of these sources of variability on the required amount of capacity and to determine admission quota for scheduled admissions to regulate the occupancy pattern. For the impact of variability on the required number of beds, we use a heavy-traffic limit theorem for the G/G/∞ queue yielding an intuitively appealing approximation in case the arrival process is not Poisson. Also, given a structural weekly admission pattern, we apply a time-dependent analysis to determine the mean offered load per day. This time-dependent analysis is combined with a Quadratic Programming model to determine the optimal number of elective admissions per day, such that an average desired daily occupancy is achieved. From the mathematical results, practical scenarios and guidelines are derived that can be used by hospital managers and support the method of quota scheduling. In practice, the results can be implemented by providing admission quota prescribing the target number of admissions for each patient group.”
Posted in Journal Articles, READ Portal | Tagged with Efficiency, Health planning, Safety | No Comments
June 9, 2011
“Pfizer Inc. is conducting a drug trial in which patients participate from their homes using computers and smartphones rather than visiting a clinic.
The company plans to compare the results to those obtained from a previous, traditional trial of the same drug. The study involves the company’s overactive-bladder drug Detrol.
If successful, the methods used in the study might eventually be used to help drive down the high cost of bringing new medicines to market.”
Posted in Mass Media Articles, READ Portal | Tagged with e-health, Efficiency, Health technology, Telehealth | No Comments
June 1, 2011
This article from Modern Physician presents an overview of a 2011 study that examined the correlation between surgeon awareness of costs and number of blood tests administered. The study found that when surgeons knew the dollar value of tests, they preformed less blood tests. The decreasing number of test had no impact on mortality rates, length of hospital stay, transfer to ICU, etc. Additionally, the hospitals monitored in the study saw huge costs savings from the decrease in blood tests. The original study is available at the Archives of Surgery, though subscription is required to access the full text version.
Posted in Mass Media Articles, READ Portal | Tagged with Economics, Efficiency, Hospital administration | No Comments
May 6, 2011
“As part of a systemwide transformation, the VA formed its National Center for Patient Safety to foster an organizational culture of safety within its nationwide network of hospitals and outpatient clinics. A recent medical team training program designed to improve communication among operating room staff was associated with a reduction in surgical mortality and improvements in quality of care, on-time surgery starts, and staff morale. The program is now being expanded to other clinical units, along with a patient engagement program that prevents errors by facilitating communication relating to patients’ daily care plans. A recognition program stimulated facilities to conduct timelier and higher-quality root-cause analyses of reported safety events to identify stronger actions for preventing their recurrence. Other initiatives have reduced rates of health care–associated infections, patient mortality, and post-operative complications. Success factors include leadership accountability for performance and organizational support for testing, expanding, and adopting improvements.”
Posted in Journal Articles, READ Portal | Tagged with Benchmarking, Efficiency, Mortality rates, Quality control, Quality improvement, Safety | No Comments
May 2, 2011
Klein, S., & McCarthy, D. (2011). Sentara Healthcare: Making Patient Safety an Enduring Organizational Value. The Commonweatlh Fund. http://www.commonwealthfund.org/Content/Publications/Case-Studies/2011/Mar/Sentara-Healthcare.aspx. Sentara Healthcare, an integrated health care delivery system serving parts of Virginia and North Carolina, has developed a systematic program to foster a culture of safety throughout its member hospitals, with the aim of reducing the […]
Posted in Journal Articles, READ Portal | Tagged with Benchmarking, Efficiency, Policy, Quality assessment, Quality control, Quality improvement, Safety | No Comments
April 28, 2011
“What’s the key to staying above water in an environment of increasing demand and decreasing reimbursements? Patient throughput (is) key in mitigating potential financial risks…” The following lessons illustrate how one organization addressed its patient flow issues:
- Technology Brings Needed Momentum;
- Technology Can’t Be the Cure;
- Process Change and Culture Change Go Hand-in-Hand;
- Identifying Where You Can Create Capacity;
- Preparing for the Long-term Effects of Reform.
Posted in Journal Articles, READ Portal | Tagged with Decision making, Efficiency, Quality improvement, Technology | No Comments
April 22, 2011
This brief video provides one hospital’s approach to managing increasing costs while facing decreasing funding. The video presenter offers insight onto Lean implementation, performance management, and process improvement.
Watch the video..
Posted in Multimedia, READ Portal | Tagged with Efficiency, Funding, Process improvement | No Comments
April 21, 2011
“The report by van Walraven and colleagues on patient follow-up after an incidental finding of abdominal aortic aneuyrsm (AAA)—published today in Open Medicine—highlights an important conundrum in patient care: Who is responsible for monitoring and acting on test results when care is shared among different providers? Although it may seem convenient to place that accountability with the ordering physician or the patient’s family doctor, there are many points at which this approach can lead to ineffective and inadequate management. We suggest that one way to solve this problem might be to communicate test results directly to patients.”
Posted in Journal Articles, READ Portal | Tagged with Efficiency, Integrated care, Patient-centered care | No Comments
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