Healthcare Executives Research Articles

ANALYSIS OF MANAGEMENT EFFORTS IN SHAPING SAFETY CULTURE IN X HOSPITAL SEMARANG

Patient safety is the essence of health service quality. Hospitals are a combination of several elements that together produce a high-risk situation. Safety culture should be the core in hospital organization. From the data obtained there are still incidents of safety of patients in hospital X Semarang and there has been no trend decrease in the incidence of meaningful incidents over time. This research aims to determine the cultural overview of safety and how the management efforts influence in shaping the safety culture of hospital X Semarang. This type of research is quantitative analytic with survey method that analyzes management efforts in shaping safety culture in hospital X Semarang. Research conducted in January-March 2020. Data collection techniques using a questionnaire adapted from the American College of Healthcare Executives in 2017 and a description of safety culture were acquired by collecting data from a Patient safety culture questionnaire adopted from the Hospital Survey on Patient Safety Culture questionnaire published by The Agency for Healthcare Research and Quality (AHRQ) in 2004. Number of respondents as many as 220 people selected in proportionate stratified random sampling. The results showed that the safety culture at hospital X showed a positive response in the organizational learning dimension and continuous improvement (90.15%), the dimension of cooperation in units (81.82%) and dimension of management support to patient safety efforts (80.45%). The other dimension of safety culture has a negative response (< 75%). Management efforts that include the determination of vision, trust values, respect and inclusion, selection, development and management engagement, leadership development that prioritizes safety, just culture, expectations of organizational behaviour as well as assumptions, values and artifacts related to safety culture have an influence in the establishment of safety culture in hospital X Semarang. Keyword: Safety Culture, management efforts

COVID-19, reviewing the organization of the units

The coronavirus disease 2019 epidemic affected severely and rapidly the Oise department. The care of patients infected with this virus required a review of the organization of the units. The healthcare executive has been a key player in the management of this health crisis. Example in a follow-up care and rehabilitation service.

Health Care Leadership: Educating the Future Health Care Executives: Editor-in-Chief Welcome

Health Care Leadership: Educating the Future Health Care Executives: Editor-in-Chief Welcome

Quality and Safety in Healthcare, Part LXXIX: Chief Nursing Officer Development, Assessment, and Turnover: An Example for Many Other Healthcare Executives.

Most executives new to a health care organization should have introductory and development programs during their first year, which should include networking opportunities, special projects to improve skills, independent or assigned course work, multiple types of assessments, and periodic discussions regarding expectations about their work and their progress in achieving them. It is preferable for the organization and the new executive to have information from outside sources about how a person in that position can achieve success and the reasons for turnover in the position. This is discussed in this article, using the chief nursing officer as the example.

A mixed-methods sequential explanatory design comparison between COVID-19 infection control guidelines\u2019 applicability and their protective value as perceived by Israeli healthcare workers, and healthcare executives\u2019 response

BackgroundHealthcare workers (HCWs) are on the front line of the COVID-19 outbreak, and their constant exposure to infected patients and contaminated surfaces puts them at risk of acquiring and transmitting the infection. Therefore, they must employ protective measures. In practice, HCWs in Israel were not fully prepared for this sudden COVID-19 outbreak. This research aimed to identify and compare: (1) Israeli HCWs’ perceptions regarding the official COVID-19 guidelines’ applicability and their protective value, and (2) HCWs executives’ response to HWCs’ concern regarding personal protective equipment (PPE) shortage.MethodsA mixed-methods sequential explanatory design consists of: (1) An online survey of 242 HCWs about the application of the guidelines and PPE, and (2) Personal interviews of 15 HCWs executives regarding PPE shortage and the measures they are taking to address it.ResultsA significant difference between the perceived applicability and protective value was found for most of the guidelines. Some of the guidelines were perceived as more applicable than protective (hand hygiene, signage at entrance, alcohol rub sanitizers at entrance, and mask for contact with symptomatic patients). Other were perceived as less applicable than protective (prohibited gathering of over 10 people, maintaining a distance of 2 m’, and remote services).ConclusionsHCWs need the support of the healthcare authorities not only to provide missing equipment, but also to communicate the risk to them. Conveying the information with full transparency, while addressing the uncertainty element and engaging the HCWs in evaluating the guidelines, are critical for establishing trust.

Https://ecancer.org/en/journal/article/1096-cancer-treatment-during-the-covid-19-pandemic-in-the-kurdistan-region-of-northern-iraq

With major parts of the United States in lockdown, parts of Europe and the UK possibly going back on lockdown or expecting a second COVID-19 wave and rapidly rising rates elsewhere other than Asia, many people are forgoing regular cancer screenings and prevention services. More worrisome, some may be experiencing early signs or symptoms, yet they are not seeking evaluation, treatment or surveillance examinations. The long-term impact of this on patients, families and health care providers will be substantial. Not only will this strain sophisticated health systems in developed countries, but it will also overwhelm the health care infrastructure in developing countries.Health-care executives, cancer center directors, oncologists and policy experts should focus now on serving this potential “third wave” of sick patients who have delayed treatment. Stopping COVID-19 is critical. However, it’s also essential to plan for the coming wave of patients who have delayed seeking care or don’t have access.

Quality and Safety in Healthcare, Part LXXVIII: Expected Competencies of the Chief Nursing Officer and Most Other Healthcare Executives.

Numerous expected competencies of a chief nursing officer are outlined in this article including communication, ability to build relationships, expertise about the environment of healthcare and its future directions, leadership, expertise in business matters, combating bullying, encouraging shared decision making, and optimizing interdisciplinary teams and the use of advanced practice providers. These skills are also expected of most other healthcare executives, whether or not they are nurses, because using these competencies increases quality, safety, and value for the patients and improves conditions for the healthcare organization and those who work there.

The impact of knowledge on e-health: a systematic literature review of the advanced systems

Purpose Economists have recognized knowledge management as a promising tool regarding all aspects of the economy, including health care. The volume of biomedical literature is currently growing at an exponential rate, and the vast number of studies makes it extremely difficult for researchers to keep up with new developments in their research areas. Therefore, the efficient management of huge amounts of data and the accuracy of the knowledge thus obtained are vital concerns. Electronic health (e-health) has emerged as a useful concept to provide data for solo self-care management. Although health care is a common topic on the internet, patients rarely share their health care-related knowledge on social media. This study aims to examine the impact of knowledge on e-health. Design/methodology/approach This paper complies with the methodological requirements of systematic literature reviews. The present paper has investigated the newest systems and studied their practical techniques in detail. The effects of knowledge on e-health have been categorized into major groups. Findings The outcomes indicate that the capabilities of information and communication technology certainly promote the exchange of knowledge within clinics. The results also show that institutional architectures have significant impacts on knowledge-sharing exercises, significantly improving patient safety. Practical implications These findings will be essential in the understanding of the interplay among various signals in theory and in the understanding of patients’ choice in the e-health community in practice. The results have implications for existing health management and e-health literature. The present paper will help policymakers, health-care executives and project managers to effectively set their operations and make them maintainable, prevent unpredicted obstacles and better allocate their resources. Overall, the results of this paper will guide researchers who are working in the field of e-health. Originality/value E-health attempts have mostly focused on answering questions using context-specific technical answers, regardless of the key role of knowledge resources. The present paper has provided an innovative viewpoint on how knowledge resources and knowledge-sharing initiatives may have a role in the innovative work behaviors shown by health-care employees. As noted before, there have been only a few studies regarding the effects of knowledge on health care, so the present paper contributes to the previous literature, particularly about e-health.

Optimising implementation of European guidelines on cardiovascular disease prevention in clinical practice: what is needed?

Cardiovascular disease is a model example of a preventable condition for which practice guidelines are particularly important. In 2016, the joint task force created by the European Society of Cardiology (ESC) together with 10 other societies released the new version of the European guidelines on cardiovascular disease prevention. To facilitate the implementation of the ESC guidelines, a dedicated prevention implementation committee has been established within the European Association of Preventive Cardiology. The paper will first explore potential barriers to the guidelines' implementation. It then develops a discussion that seeks to inform the future development of the committee's work, including a new definition of the guidelines' stakeholders (health policy-makers, healthcare professionals and health educators, patient organisations, entrepreneurs and the general public), future activities within four specific areas: strengthening awareness of the guidelines among stakeholders; supporting organisational changes to facilitate the guidelines' implementation; motivating stakeholders to utilise the guidelines; and present ideas on new implementation strategies. Providing multifaceted cooperation between healthcare professionals, healthcare management executives and health policy-makers, the novel approach proposed in this paper should contribute to a wider use of the 2016 ESC guidelines and produce desired effects of less cardiovascular disease morbidity and mortality. Furthermore, the solutions presented within the paper may constitute a benchmark for the implementation of practice guidelines in other medical disciplines.

The prevalence of social care in US health care settings depends on how and whom you ask

BackgroundDespite unprecedented enthusiasm for integrating social risk screening and related interventions into US health care settings, we know relatively little about the extent to which these activities occur. We reviewed results from multiple national surveys that reported on the prevalence of social care activities.MethodsWe used snowball sampling to solicit input from 29 expert informants who were asked to share any knowledge about survey instruments that included questions on the prevalence of social care-related activities conducted in health care settings. We subsequently ran web searches on recommended surveys to identify those fielded with a national sample and conducted between Jan 1, 2007 and May 31, 2019. Finally, we analyzed and compared results across surveys.ResultsWe reviewed 23 total survey events (19 individual surveys and 4 that had been re-administered) that included questions on the extent of social care activities across health care disciplines and settings. Samples included a wide range of health care stakeholders (including payers, health care executives, providers, and patients.) Sample sizes ranged across the types of respondents: 95–120 respondents in surveys of payers; 44–757 in surveys of health care delivery leaders; 484–2333 in surveys of clinicians; and 500–7002 in surveys of patients. In eight cases, survey reports did not include response rates; another four reports described response rates under 25%. Fifteen of the 23 surveys incorporated questions on the prevalence of social risk screening; 17 included questions on social care intervention activities. Responses about the prevalence of both screening and interventions varied widely: between 15 and 100% of respondents reported their organization conducts screening for at least one social risk; 18–100% of respondents reported providing social care interventions. Between 3 and 22% of surveyed patients reported being screened or assisted with a social risk. In the four surveys that were administered in different years, we found no significant differences in results between survey administrations.ConclusionsFindings suggest that caution is warranted in interpreting survey findings from any single survey since existing surveys report a wide range of prevalence estimates for social risk screening and interventions.

Coordination between hospitals and insurers in developing economies: an interpretive structural modeling approach

PurposeThe purpose of this paper is to identify the factors that influence hospitals’ selection by health-care insurers in India and to establish a hierarchical model representing the relationship among different factors and their influence on the entire scenario.Design/methodology/approachA survey with a set of questionnaires was conducted with different health-care insurer executives of reputed health insurance companies. The data has been gathered by using a five-point Likert scale. Their opinions were converted into a reachability matrix and an interpretive structural modeling was constructed. The final results obtained were verified by using fuzzy Matriced Impacts Croises-Multiplication Applique and Classement analysis.FindingsThe results suggested three key driving factors, National Accreditation Board for Hospitals & Healthcare Providers accreditation of the hospital, purchasing power of people in the region and national and international recognition of the hospital among the eleven factors selected for the study.Research limitations/implicationsThe research mainly focuses on the health insurance benefits provided by privately owned insurance companies and do not comment on any government’s mass health insurance scheme.Practical implicationsWith a small proportion of people under the umbrella of health insurance in India, these factors will assist and expedite insurer’s effort to penetrate deep into rural and urban areas enhancing availability and escalating affordability.Originality/valueThis paper presents key factors responsible for better coordination between health-care systems and insurance companies.

Health Care Executive Perceptions of Hiring and Retention Practices of People With Disabilities: Results From Executive Focus Groups

The supply-side approach to providing services without taking into account employer practices has not been effective in achieving meaningful, competitive, and integrated employment outcomes for people with disabilities. This focus neglects the fact that disability and employment is a two-way process with businesses being accountable for such demand-side factors as establishing better hiring, retention, and advancement practices. To initiate the identification of effective employer practices, this article shares the results of two executive focus groups that were conducted in a large health care organization, across four individual hospitals, with a documented success rate of hiring and retaining people with disabilities (PWDs). The purpose of the focus groups was to explore executive perceptions of their organization’s success at integrating PWDs throughout their work force. Results are explored through five identified themes: (a) organizational mission guided decision-making concerning the employment of PWDs, (b) executives living the mission through their daily inclusive behaviors led to employing PWDs, (c) organizational values were important to employing PWDs, (d) the organization benefited from employment of PWDs, and (e) employing PWDs benefited organization staff and the surrounding community. The results of these executive focus groups provide an initial glimpse into the culture and practices of a highly effective organization.

The mental health of doctors during the COVID-19 pandemic.

Doctors experience high levels of work stress even under normal circumstances, but many would be reluctant to disclose mental health difficulties or seek help for them, with stigma an often-cited reason. The coronavirus disease 2019 (COVID-19) crisis places additional pressure on doctors and on the healthcare system in general and research shows that such pressure brings a greater risk of psychological distress for doctors. For this reason, we argue that the authorities and healthcare executives must show strong leadership and support for doctors and their families during the COVID-19 outbreak and call for efforts to reduce mental health stigma in clinical workplaces. This can be facilitated by deliberately adding 'healthcare staff mental health support process' as an ongoing agenda item to high-level management planning meetings.

Artificial intelligence: future impacts, challenges and recommendations on healthcare services

In this report, we review the market impact of artificial intelligence (AI) in healthcare and future predictions. AI is a rapidly advancing technology in healthcare. It provides rich and relevant information to patients and healthcare providers with on-demand medical and clinical confidence, AI can greatly advance healthcare professional and patient communications. Interest and investment in artificial intelligence continues to grow. At the same time there exists some practical challenges that will determine the course of this market trend. We will discuss the macroeconomic, ethical and legal challenges that pertain to this industry and make recommendations to the healthcare executives.

Master of Healthcare Administration program's journey to competency‐based education

AbstractWinston‐Salem State University's (WSSU), Master of Healthcare Administration (MHA) program, answered the call of the University of North Carolina system to offer education at an equal or higher quality than currently provided at a cost that is consistent with the state's constitution. As such, WSSU converted its MHA program to a competency‐based education (CBE) platform. The American College of Healthcare Executives (2017) states that this is an exciting time for healthcare management. The field requires talented people to help introduce and manage the changes taking place in health care. Implementation of the CBE program resulted in increased enrollment, increased student satisfaction through more flexibility to complete an advanced degree, and greater ease in balancing work–life student demands. WSSU's CBE program is designed to ensure that graduates have training and expertise they need to promote career readiness. This article will discuss the journey of transforming a hybrid MHA program to CBE.

Evidence-Based Community Health Worker Program Addresses Unmet Social Needs And Generates Positive Return On Investment.

Interventions that address socioeconomic determinants of health are receiving considerable attention from policy makers and health care executives. The interest is fueled in part by expected returns on investment. However, many current estimates of returns on investment are likely overestimated, because they are based on pre-post study designs that are susceptible to regression to the mean. We present a return-on-investment analysis that is based on a randomized controlled trial of Individualized Management for Patient-Centered Targets (IMPaCT), a standardized community health worker intervention that addresses unmet social needs for disadvantaged people. We found that every dollar invested in the intervention would return $2.47 to an average Medicaid payer within the fiscal year.

Let’s Get Serious About Caring for People With Serious Mental Illness

Back to table of contents Previous article Next article From the PresidentFull AccessLet’s Get Serious About Caring for People With Serious Mental IllnessBruce Schwartz, M.D.Bruce SchwartzSearch for more papers by this author, M.D.Published Online:31 Dec 2019https://doi.org/10.1176/appi.pn.2020.1a18I have been writing over the past several months in this column about the barriers to accessing mental health care in our country. We all know that members of minorities and low-income families have a particularly hard time getting the treatment they need, but well-insured, middle-income families are often unable to get timely and affordable care as well.The access problem is rooted in discrimination against mental illness, which has led to the underinvestment in research and treatment resources. We know that patients don’t go away unless, tragically and needlessly, they die by suicide. Many people end up in our jails and prisons or are homeless on the streets or in shelters. The loss of human potential is staggering. Mental illness is the leading cause of disability from the second to the seventh decade of life in the United States. Making the problem even worse is that the current shortage of psychiatrists is expected to increase over the next several years.Overcoming this complex and multifactorial access problem requires concerted dedication by APA and the psychiatric community. But let’s be realistic—that’s not enough: The entire mental health provider community—including psychologists, social workers, nurse practitioners, mental health counselors, advocates, and peer counselors—are needed to succeed at convincing our politicians, insurance companies, health care executives, and the public that the costs are worth the benefits to our society and culture.To this end, as an outcome of the presidential retreat that I led last summer, I appointed a task force to produce joint principles of effective collaboration to promote access to high-quality treatment for people with serious mental illness (SMI). Your APA secretary, Dr. Sandra DeJong, has agreed to serve as chair. Invitations to join the task force were accepted by the National Association of Social Workers, Association of Psychiatric Nurse Practitioners, American Association of Nurse Practitioners, American Mental Health Counselors Association, American Academy of Physician Assistants, Association for Behavioral and Cognitive Therapies, NAMI, American Psychological Association, College of Psychiatric and Neurologic Pharmacists, and International Association of Peer Supporters.It is time for APA to demonstrate leadership in bringing together other mental health organizations to identify ways we can collaborate effectively to care for people with SMI. It will not be easy to put aside some of our guild concerns, but I believe everyone who chooses to become a mental health professional is motivated to help people with mental illness lead healthy, functional, and fulfilling lives.Some of our skills are different and some overlap, but all of our skills are needed in the care of SMI patients. A colleague I have known for many years and highly respect responded to one of my earlier columns regarding the problems of treating SMI patients in a private office. As he correctly noted, most psychiatrists do not have the required resources in their offices to care for this challenging population. Perhaps this task force will help identify clinicians throughout the country who want to collaborate with psychiatrists in providing the range of services that SMI patients need.This is my vision: There is strength in numbers. As we join our voices and organizational efforts to break through the institutionalized discrimination that prevents people from getting the care they need and deserve, we will not only be able to help more people, but also bring an end to the view that mental illness is less of a priority than other medical illnesses and not worthy of the research funding accorded just about every other category of major illness. ■ ISSUES NewArchived

Evaluation of skill gaps of health-care leaders in Indian public and private sectors

Background: Indian health care is experiencing a significant shift in terms of requirement of resources and changing demographic pattern. The customer-oriented and quality conscious competitive environment has intensified the need for healthcare organizations to attain higher levels of organizational performance. Competencies of health-care leaders play a pivotal role in deciding the organizational development and strategic growth. A cross-sectional study of select health-care leaders� of India was done from various hospitals and other health delivery agencies to identify and analyze the gaps in competencies. Objectives: The study objectives were to identify the existing leadership competencies of private and public health-care executives, assess and compare these competencies against standardized leadership models, and recommend key competencies for Indian leaders. Materials and Methods: A cross-sectional study was carried out amidst health-care leaders of India so as to assess their leadership competencies. Health-care leaders of India were identified after focused group discussion and senior health-care leaders such as Directors, Deans, CEOs, and Principals were shortlisted for this study. Two structured questionnaires were administered to health-care leaders of various hospitals in India. The ratings in the questionnaire were on a Likert scale ranging from very poor to excellent. Respondents were asked to self-evaluate various competencies and the same was analyzed using the SPSS statistical software. Interpretation of results of data analysis was done. Ethics Committee Clearance was taken from the institute where the study was done. Results: A total of 300 questionnaires were sent of which 106 questionnaires were completed and returned back by select health-care leaders, 78 were doctors and 28 were nursing executives. The study has been able to identify deficiencies in the perceived �existing competency� and �required competency� levels in the selected competencies amidst public and private sector health executives. Conclusion: The findings of this study suggest that there is deficiency in perceived �existing competency� and �required competency� levels in the selected competencies of health-care leaders both from private and public sectors. Indian health-care leaders are operating at operational level and have not graded themselves highly in transformational roles. There is a need for training to bridge the competency gap of Indian health-care leaders both in public and private sectors.

Recovering Patient Trust We Lost in the Pandemic

The question of how to engender patient trust in a pandemic is not easy to answer, and yet it is a critical question that requires a convincing response. On March 14, 2020, the surgeon general of the United States called for a stop to elective procedures. Ultimately, that led us at Scripps Health to close some clinics to protect personal protective equipment supplies and then furlough staff because of the decrease in patient visits. It soon became evident, however, that patients needed our care more than ever, and we had to pivot to provide the services they needed-but in a very different way. Our team rose to the challenge and quickly redesigned the entire organizational approach to accelerate telehealth services for the convenience of our patients. In the process, we also targeted a patient outreach program to our high-risk patients, which turned out to be an important aspect of our COVID-19 patient care initiative.

Weathering the Storm: How Superstorm Sandy Shaped the Response to COVID-19.

Catastrophic weather, like a pandemic, can wreak havoc on hospital operations. NYU Langone Health in New York City has experienced the extremes of both phenomena. In 2012, Superstorm Sandy severely damaged the system's core facilities, disabled operations, and forced the evacuation of more than 220 patients to other health systems. In 2020, the arrival of the novel coronavirus severely disrupted operations again-but this time, we were better prepared. Our experience in dealing with Superstorm Sandy taught us critical lessons that supported our readiness for COVID-19. Those lessons can be summed up as preparation, organization, and innovation.