June 18, 2012
Abstract:
Background: Many academic medical centres have introduced strategies to assess the productivity of faculty as part of compensation schemes. We conducted a systematic review of the effects of such strategies on faculty productivity.
Posted in Journal Articles, READ Portal | Tagged with Canada, Efficiency, Health human resources, Hospital administration | No Comments
April 16, 2012
“Sustainability seeks to balance and simultaneously optimize environmental, social and financial concerns. Sustainability in healthcare represents a particularly challenging undertaking as it necessarily encompasses the wide variety of facilities, operations and activities in a typical healthcare organization. This exploratory study examines the organizational approaches of eight healthcare systems with relatively successful sustainability initiatives.
The organizations studied have embraced sustainability as a core organizational value, and consequently have committed significant resources and personnel to support their sustainability efforts. Nonetheless, they have realized significant financial benefits from the efforts. Environmental resource management — especially energy and waste — serves as the initial and often central focus of many sustainability initiatives. Improving energy efficiency is associated with reduced operating costs, as is increasing recycling and more carefully managing all waste streams. Managing energy and waste more sustainably was, for these health care organizations, critical for building organizational capabilities that could be applied to other areas, such as environmentally responsible purchasing and food management. Most of the organizations created new positions or hired new people to help manage and coordinate the sustainability initiatives. The sustainability coordinators are charged with identifying focus areas, developing sustainability-related goals, tracking performance, integrating environmental and social concerns into organizational processes, identifying significant external resources and helping to build important sustainability-related organizational capabilities.”
Posted in READ Portal, Reports & Papers | Tagged with Health care reform, Health planning, Hospital administration | No Comments
April 3, 2012
This article looks at the impact of hospital gardens on patient health. “Dismissed as peripheral to medical treatment for much of the 20th century, gardens are back in style, now featured in the design of most new hospitals, according to the American Society of Landscape Architects. In a recent survey of 100 directors and architects of assisted-living residences, 82 percent agreed that “the design of outdoor space should be one of the most important considerations in the design.” But can gardens, in fact, promote healing? It turns out that they often can. Scientists around the world are now digging into the data to find out which features of gardens account for the effect.”
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February 21, 2012
“Introduction: The role of ICU design and particularly single-patient rooms in decreasing bacterial transmission between ICU patients has been debated. A recent change in our ICU allowed further investigation.
Methods: Pre-move ICU-A and pre-move ICU-B were open-plan units. In March 2007, ICU-A moved to singlepatient rooms (post-move ICU-A). ICU-B remained unchanged (post-move ICU-B). The same physicians cover both ICUs. Cultures of specified resistant organisms in surveillance or clinical cultures from consecutive patients staying >48 hours were compared for the different ICUs and periods to assess the effect of ICU design on acquisition of resistant organisms.
Results: Data were collected for 62, 62, 44 and 39 patients from pre-move ICU-A, post-move ICU-A, pre-move ICUB and post-move ICU-B, respectively. Fewer post-move ICU-A patients acquired resistant organisms (3/62, 5%) compared with post-move ICU-B patients (7/39, 18%; P = 0.043, P = 0.011 using survival analysis) or pre-move ICUA patients (14/62, 23%; P = 0.004, P = 0.012 on survival analysis). Only the admission period was significant for acquisition of resistant organisms comparing pre-move ICU-A with post-move ICU-A (hazard ratio = 5.18, 95% confidence interval = 1.03 to 16.06; P = 0.025). More antibiotic-free days were recorded in post-move ICU-A (median = 3, interquartile range = 0 to 5) versus post-move ICU-B (median = 0, interquartile range = 0 to 4; P = 0.070) or pre-move ICU-A (median = 0, interquartile range = 0 to 4; P = 0.017). Adequate hand hygiene was observed on 140/242 (58%) occasions in post-move ICU-A versus 23/66 (35%) occasions in post-move ICU-B (P < 0.001).
Conclusions: Improved ICU design, and particularly use of single-patient rooms, decreases acquisition of resistant bacteria and antibiotic use. This observation should be considered in future ICU design.”
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February 15, 2012
“Patients need much more than just medication and skilled treatment in order to get well. Attentive care demonstrably accelerates people’s recovery. Hospital architecture and the design of workplaces and patients’ rooms also play an important role – for the patient’s wellbeing, but also an efficient workflow at the hospital.
At the beginning of the year, the staff at the St. Josef Hospital and Pediatric Clinic in Neunkirchen, Germany, faced the difficult task of moving their patients and all of the medical equipment to a new hospital building. Despite all of the cost pressures, this new beginning gave planners the rare opportunity to design and configure the hospital building and wards from the ground up. Upon entering the red-and-white painted hospital facility, visitors arrive in a foyer with a waiting area containing a piano. The corridors are painted in warm shades of yellow, and the patients’ rooms are much friendlier and more comfortable than those in the previous building. The impression of being in a living room is further enhanced by curtains and movable cupboards for the patients. Even such comparatively simple measures seem to have a big effect. “The patients say that they immediately feel as though they’re in a five-star hotel,” reports Dr. Ernst Konrad, Chief Physician of the Clinic for Anesthesiology and Intensive Care Medicine. In the intensive care units, doctors and nurses find it easier to do their work, and here too the rooms are more comfortable and colorful than those in the previous hospital building.”
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February 10, 2012
“Cultural competency in health care describes the ability of systems to provide care to patients with diverse values, beliefs and behaviors, including the tailoring of health care delivery to meet patients’ social, cultural and linguistic needs. A culturally competent health care system is one that acknowledges the importance of culture, incorporates the assessment of cross-cultural relations, recognizes the potential impact of cultural differences, expands cultural knowledge, and adapts services to meet culturally unique needs. Ultimately, cultural competency is recognized as an essential means of reducing racial and ethnic disparities in health care.
This guide explores the concept of cultural competency and builds the case for the enhancement of cultural competency in health care. It offers seven recommendations for improving cultural competency in health care organizations:
- Collect race, ethnicity and language preference (REAL) data.
- Identify and report disparities.
- Provide culturally and linguistically competent care.
- Develop culturally competent disease management programs.
- Increase diversity and minority workforce pipelines.
- Involve the community.
- Make cultural competency an institutional priority.”
Posted in READ Portal, Reports & Papers | Tagged with Hospital administration, Quality improvement | No Comments
February 9, 2012
“At a time when hospitals are under pressure to improve quality and make productivity savings, they need to find tools to support them. Service-line management (SLM) and service-line reporting (SLR) offer one approach. Service-line management is a system in which a hospital trust is divided into specialist clinical areas that are then managed, by clinicians, as distinct operational units. SLM enables clinicians and managers to plan service activities, set objectives and targets, monitor financial and operational activity and manage performance. Service-line reporting provides the necessary data on financial performance, activity, quality and staffing.
Service-line management: Can it improve quality and efficiency? presents the findings from a series of interviews with staff at seven NHS trusts that are using SLM or SLR, revealing how they are implementing this approach and identifying what helps and what hinders this way of working.
The paper outlines a number of important issues for trusts to consider when introducing SLM.
- The role of the board – including the need for both clear and consistent executive support for using SLM and for executives to be willing to relinquish control over decisions and budgets.
- Clinical engagement – especially the need to provide support and training to enable clinicians to take on leadership and management roles and to develop shared and realistic goals.
- Data – including identifying and evaluating existing sources of data and the need to accept that the time needed to implement SLM, the value of the information obtained, and the ease of data collection will vary between service lines because of external and clinical factors.
- Resources – including the challenge of finding the time and resources to dedicate to the introduction of SLR and SLM and the need for well-resourced and suitably skilled financial and informatics support.
The paper concludes that implementing SLR and SLM well is challenging, but it works best when it is part of the overall management approach of the trust and its day-to-day way of working.”
Posted in READ Portal, Reports & Papers | Tagged with Hospital administration, Quality assessment, Quality improvement | No Comments
January 26, 2012
“Four healthcare finance leaders share their strategies for creating a road map for change that leads to cost efficiencies and accountability as cornerstones of a new culture. (The main lesson is that) to drive the major organizational changes needed in a reform era, healthcare finance leaders should:
- Establish a vision of where the change in strategy affects their organizations’ direction and gain acceptance from staff about shared goals;
- Create partnerships with fellow executives to understand the metrics of the organization and promote a team approach for change:
- Define clear measures of success so staffers can understand business goals and their roles in organization:
- Communicate the progress that has been made in meeting goals and provide guidance when milestones have been missed.”
Posted in Journal Articles, READ Portal | Tagged with Decision making, Economics, Hospital administration | No Comments
December 7, 2011
“For hospital governance to be eff ective, it must incorporate two powerful and well-developed lines of health sector logic: on the one hand, national health policy and objectives; on the other, operational hospital management. One sphere is political, the other is technical. One is subjective and value based, the other is objective, with performance that can be measured both clinically and financially. Th e challenge for hospital-level governance is to integrate these two disparate logics into a coherent and eff ective institutional-level strategy.”
This study explores key developments in public hospital governance in Europe. In doing so, it highlights the central role of hospital-level decision-making and how it is shaped by the various participants and stakeholders. In particular, it examines the degree to which granting an individual hospital the ability to make its own strategic, financial and clinical decisions – to become semi-autonomous within the public sector – may improve institutional-level functioning and outcomes.
In the initial chapters of this study, we draw on a substantial body of literature in a number of related health policy, public management and institutional governance arenas. How these diff erent concepts might apply to public hospitals is the subject of considerable discussion here. It is in the interface of these diff ering conceptual approaches, with the evidence and experience seen in the eight country cases, that we catch a glimpse of the future of public hospital governance in Europe. We hope that this study can serve as a solid conceptual and practical contribution to future quantitative as well as qualitative research on this important subject.”
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Posted in READ Portal, Reports & Papers | Tagged with Health care reform, Health planning, Hospital administration | No Comments
December 6, 2011
“A new study has a message for doctors and nurses who fail to wash their hands: Don’t think about yourself. Think about your patients.
Getting health care professionals to comply with notices to wash their hands before and after dealing with patients has been something of a thorn in the side of many hospitals. Although this simple measure limits the spread of sickness — and could potentially reduce the nation’s hospital health care bill by billions of dollars — many doctors and nurses simply ignore it. Compliance rates for hand washing in American hospitals are only around 40 percent, and years of awareness programs urging doctors to wash up or use disinfectant gels have had little effect.
Part of the problem, according to a forthcoming study in the journal Psychological Science, are the actual signs posted in hospital washrooms urging health care workers to wash up. Changing the message from “Wash Your Hands to Protect Yourself” to “Wash Your Hands to Protect Your Patients,” the study found, could motivate some doctors and nurses to wash their hands more frequently.”
The full study, titled “It’s Not All About Me: Motivating Hand Hygiene Among Health Care Professionals by Focusing on Patients” by Adam M. Grant and David A. Hofmann is available as an online release through Psychological Science. Ask your institution’s library for information on accessing the article.
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