Hospital Administrative Staff Research Articles

Effect of Knowledge Management and Job Satisfaction on Organizational Loyalty of the Hospital Administrative Staffs

With rapid changes in hi-tech information and the flourishing development of the internet, knowledge management seems to constitute a rather large challenge to the medical industry, and becomes a main topic of debate for their present and future success. In order to examine the effect of the knowledge management infrastructure, knowledge management capability and job satisfaction on organizational loyalty, this study conducted Structural Equation Modeling (SEM) to test the hypotheses with 399 questionnaires of hospital administrative staffs in Taiwan. In exploration of the model of this study, it was found that the factors greatly influencing organizational loyalty of hospital administrative staffs, in turn, were knowledge management infrastructure, job satisfaction, and knowledge management capability. The results of this research can help the authorities of hospitals to understand their staffs' job satisfaction and organizational loyalty, which will allow authorities to take the steps necessary to increase job satisfaction and organizational loyalty. Research implications and directions are discussed.

Health care satisfaction among foreign residents in Taiwan--an assessment and improvement.

In 2012, almost half-million foreigners (2.3% of the total population) from 160 countries were estimated to live in Taiwan. In 2010, approximately eighty-seven percent of the population expressed high satisfaction in the national health care system of Taiwan. However, satisfaction level among foreign residents towards the Taiwanese health care system has not been clearly documented in the literature. In this study, we assessed satisfaction level among foreign residents for receiving healthcare facility in Taiwanese hospital. In addition, the study came out with some potential solutions to improve health care received by them. Human-Centered Design (HCD) approach was deployed, which included three phases: observation, pattern recognition, and ideation and delivery. Each phase involved various steps. Techniques, such as ethnography, interview, discussion, and survey were used in accomplishing various steps within each phase. Four participants and two facilitators from Taiwan took part in the study. The study revealed various stories, insights, and themes about the health care received by the foreigners in Taiwan. In addition, some potential solutions and immediate available opportunities were recommended to improve their health care. The results provided a deeper understanding into the satisfaction level among foreign residents in Taiwan. For instance, this study pointed out the need to improve English proficiency of hospital's administrative staffs because a lack of English language proficiencies was found to be a major barrier in delivering quality health care to foreign residents. Therefore, adoption of various training modalities, such as English training using mobile device based games, role-play, and hospital's workflow depiction using English posters were recommended.

Features of High Quality Discharge Planning for Patients Following Acute Myocardial Infarction

Hospital discharge planning is required as a Medicare Condition of Participation (CoP), and is essential to the health and safety for all patients. However, there have been no studies examining specific hospital discharge processes, such as patient education and communication with primary care providers, in relation to hospital 30-day risk standardized mortality rates (RSMRs) for patients with acute myocardial infarction (AMI). To identify hospital discharge processes that may be associated with better performance in hospital AMI care as measured by RSMR. We conducted a qualitative study of U.S. Hospitals, which were selected based on their RSMR reported by the Centers for Medicare & Medicaid Services (CMS) Hospital Compare website for the most recent data available (January 1, 2005 - December 31, 2007). We selected hospitals that ranked in the top 5% and the bottom 5% of RSMR for the two consecutive years. We focused on hospitals at the extreme ends of the range in RSMR, known as deviant case sampling. We excluded hospitals that did not have the ability to perform percutaneous coronary intervention in order to decrease the heterogeneity in our sample. Participants included key hospital clinical and administrative staff most involved in discharge planning for patients admitted with AMI. We conducted 14 site visits and 57 in-depth interviews using a standard discussion guide. We employed a grounded theory approach and used the constant comparative method to generate recurrent and unifying themes. We identified five broad discharge processes that distinguished higher and lower performing hospitals: 1) initiating discharge planning upon patient admission; 2) using multidisciplinary case management services; 3) ensuring that a follow-up plan is in place prior to discharge; 4) providing focused education sessions for both the patient and family; and 5) contacting the primary care physician regarding the patient's hospitalization and follow-up care plan. Comprehensive and more intense discharge processes that start on admission continue during the patient's hospital stay, and follow up with the primary care physician within 2days post-discharge, may be critical in reducing hospital RSMR for patients with AMI.

System-Level Factors Affecting Clinicians’ Perceptions and Use of Interpreter Services in California Public Hospitals

Professional language interpreters are skilled in the nuances of interpretation and are less likely to make errors of clinical significance but clinicians infrequently use them. We examine system-level factors that may shape clinicians' perceptions and use of professional interpreters. Exploratory qualitative study in 12 California public hospitals. We conducted in-person key informant interviews with hospital leadership, clinical staff, and administrative staff. Five emergent themes highlight system-level factors that may influence clinicians' perceptions and use of professional interpreters in hospitals: (1) organization-wide commitment to improving language access for LEP patients; (2) organizational investment in remote interpreter technologies to increase language access; (3)training clinicians on how to access and work with interpreters; (4) hospital supports the training and certification of bilingual staff to serve as interpreters to expand in-person, on-site, interpreter capacity; and (5)organizational investment in readily accessible telephonic interpretation. Multiple system-level factors underlie clinicians' use of professional interpreters. Interventions that target these factors could improve language services for patients with limited English proficiency.

Health Promoting Behaviors and the Expectations for the Environment of the Hospital Administrative Staff

Health Promoting Behaviors and the Expectations for the Environment of the Hospital Administrative Staff

Prevalence and risk factors for tuberculosis infection among personnel in two hospitals in Viet Nam

Two general hospitals in Viet Nam. To assess the risk of tuberculosis (TB) infection associated with hospital employment. During October-December 2009, we performed a cross-sectional study of hospital personnel and, for community comparison groups, staff from nearby schools. We tested for TB infection using the tuberculin skin test; an induration ≥ 10 mm indicated TB infection. Of 956 hospital personnel, 380 (40%) had TB infection compared to 40 (26%) of 155 school personnel. Hospital personnel had twice the odds of TB infection compared with school personnel (OR 2.0, 95%CI 1.3-3.0) after adjustment for age and sex. Compared to hospital administrative staff, the odds of TB infection were similar among clinical staff (OR 1.0, 95%CI 0.6- 1.3), clinical support staff (OR 0.9, 95%CI 0.5-1.6) and auxiliary staff (OR 1.1, 95%CI 0.6-2.0) at the hospitals. No additional infection risk was detected in high-risk departments (OR 1.1, 95%CI 0.6-2.0). Hospital personnel are at increased risk of TB infection. Among hospital personnel, risk was independent of job or department, suggesting that personnel are commonly at risk and that improvements in infection control are needed throughout hospitals.

Hospital administration team development and support in a children's cancer service

The administration team in the Queensland Children's Cancer Centre at the Royal Children's Hospital, Brisbane, included a team of 16 administration staff supporting the service and the state-wide clinical network. Shortly after the creation of a new expanded service, issues became apparent in administration team morale, relationships, communication, processes, leadership, support and training. The analysis of these issues included team interviews and surveys, consultation with senior administration staff and monthly sick leave monitoring. Strategies implemented included providing information; the joint development of a team business plan and individual performance plans; a review of the team's structure, workload and business processes; engaging staff in quality improvements; and the development of relationships and leadership. As a result, the team reported being more comfortable and supported in their roles, had improved morale and worked better together with more consistent and improving business processes. They had clear purpose and expectations of their roles, displayed better customer service and had reduced sick leave. The study shows that in a high stress environment, such as a children's cancer centre, attention to the team's culture, vision and purpose, providing information and improving communication and relationships, when combined with a team's enthusiasm, will improve the team's growth, cooperation and work outcomes.

Work Mistreatment and Hospital Administrative Staff: Policy Implications for Healthier Workplaces

Research on work life quality in hospitals has focused on how nurses and physicians perceive or react to work conditions. We extend this focus to another major professional group - healthcare administrators - to learn more about how these employees experience the work environment. Administrators merit such attention given their key roles in sustaining the financial health of the hospital and in fulfilling management functions efficiently to support consistent, high-quality care. Specifically, we examined mistreatment in the workplace experienced by administrative staff from a hospital in a large Canadian city. Three dimensions of mistreatment - verbal abuse, work obstruction and emotional neglect - have been associated with diminished well-being, work satisfaction and organizational commitment, along with stronger intent to leave. In this paper, we provide additional support for interpreting these three dimensions as mistreatment and report on their frequencies in our sample. We then consider implications for policy development (e.g., communication and conflict resolution skills training, mentoring programs, respect-at-work policies) to make workplaces healthier for these neglected but important healthcare professionals.

Optimizing Venous Access Using the Web

Optimizing Venous Access Using the Web

Logistic Investigation of the Effects of Race and Insurance Coverage on Potentially Avoidable Hospitalization in Tennessee

Rationale: To examine: (1) the rates of potentially avoidable hospitalization (AH) of patients insured under Tennessee's Medicaid managed care program (TennCare) and compare them to those who have other types of insurance (e.g., Medicare or commercial insurance) and with those who are uninsured, and (2) the role of race in influcing the variations in hospitalization rate among the different insurance types. Objectives: The purpose of this paper is to test the hypothesis that significant variation exists in the probability of having an AH across different health insurance types and to evaluate indirectly the relative effectiveness of providing primary care across insurance types. Methodology: Logistic regression estimation of a multi-year, patient level UB-92 hospital discharge dataset for 2002-04 Anticipated Outcomes: The most direct outcome of the study will be baseline population-based relative prevalence rates of potentially avoidable hospitalization among different racial and insurance groups. These rates will reveal how severely the prevalence rate of avoidable hospitalizations of one population group (e.g., African Americans) differs from that of another group (e.g., white Americans) in Tennessee. Another important outcome will be a predictive model that can be used to estimate and predict the likelihood of being admitted to a hospital for an avoidable hospitalization and how that likelihood may be influenced by an individual's race, ethnicity, and insurance coverage. These probability estimates will be produced for each of the underlying medical conditions, called ambulatory-care sensitive or ACS conditions that can give rise to avoidable hospitalizations and for different racial/ethnic and insurance subgroups. Also available will be similar rates for individual hospitals and for different geographic areas across Tennessee based on, for example, the Health Planning Areas established by Tennessee Department of Health. When completed, the results will assist practitioners and hospital administrative staff in targeting groups at risk for unnecssary hospitalizations in an effort to improve quality of care and reduce costs.

The benefits of a qualitative approach to telemedicine research.

We used qualitative research to evaluate the experience of the participants in teleconsultations between primary and secondary care. Semistructured interviews were conducted with 15 hospital specialists, 24 general practitioners and 30 patients. Focus groups were also held with hospital specialists (two groups), general practitioners (six groups) and administrative staff (five groups). Sixty teleconsultations in six different specialties were video-recorded. Early findings show that the participants (hospital specialists, general practitioners and patients) had different perceptions of the same teleconsultations. Furthermore, the participants perceptions of consultations differed from those of the researchers.

Economic Issues in Observation Unit Medicine

Emergency department observation units are the rational choice for improving the utilization of health care resources and at the same time improving the quality of patient care. Potential pitfalls can be avoided by flexibility on both the part of the observation unit and the hospital administration staff. The continued growth of observation medicine throughout the country is evidence that most have been successful in designing creative solutions to accommodate this new health service.

Diagnostic and referral reliability in an alcoholism treatment network.

Diagnostic and referral reliability were studied throughout an integrated alcoholism referral and treatment network. Diagnosticians included volunteers from an inpatient alcohol program staff, an outpatient referral network, a hospital medical staff, and a hospital administrative staff. Participant category had no influence on diagnostic reliability and only minimal influence on referral reliability. Cases involving only physical addiction to alcohol, particularly withdrawal symptoms, were more reliably diagnosed and referred than were cases involving psychosocial problems alone. Diagnostic practices included consideration of multiple problem areas for each case. Results are related to prior research findings and current directions in the diagnosis and treatment of alcohol disorders.

Secure the Shadow: Death and Photography in America

No longer in the closet, death, like sex, is now a popular theme of another kind. Everyone's talking and lecturing about it, while photographs of the dead are everywhere. We discuss do-not-resuscitate and advanced-care directives with patients; the public debates whether death should be hastened; writers encourage everyone to prepare for dying and some tell how to do it; ethicists constantly remind us of patient autonomy in decisions at the end of life; hospital administrative staff ask patients if they have living wills or proxies; and the dying increasingly accept their terminality, seeking hospice care. Besides all this talk and writing about death are the daily camera shots of dead bodies from local gang wars and distant civil wars in news media everywhere. With so many views of the dead and so much discussion of death, can Jay Ruby's book, Secure the Shadow: Death and Photography in America , show or

Exempt Salary Administration

An exempt salary administration program can provide positive benefits for the professional nurses and the hospital, thus creating a "win-win" strategy for today's competitive environment. This compensation change requires careful planning and open discussion between hospital administration and professional nursing staff. In this era of diminishing human and economic resources, selection of nurse compensation programs that mirror the culture and strategic goals of an organization is key to the success of the institution.

The HIV Testing Policies of US Hospitals

To the Editor.— The recent article by Lewis and Montgomery1on human immunodeficiency virus (HIV) testing policies of US hospitals was a valuable contribution to information on that topic. Since policy decisions about hospital-based HIV testing will likely be influenced by their study, we raise several questions. First, who exactly is the chief hospital administrator (eg, the president, chief executive officer, chief of staff)? Second, does that person actually know what the hospital's HIV testing policy is? In our studies of knowledge and attitudes related to the acquired immunodeficiency syndrome (AIDS), hospital administrative staff were found to have higher levels of knowledge and positive attitudes than nurses but lower levels than physicians.2,3We believe that a survey of hospital-based infection-control practitioners would provide a more accurate assessment of a hospital's HIV testing policies. In addition, there is a significant gap between policy recommendations and actual practices that has

Reducing prophylactic antibiotic costs in cardiovascular surgery: the role of the clinical pharmacist.

A project was undertaken to demonstrate significant drug cost savings from clinical pharmacy services. The method of identifying and documenting the problem and the presentation and implementation of the project are discussed. The cost savings of the project are presented, including the economic impact on the patient and institution. The clinical pharmacist, the key figure in the success of the project, presented a complete pharmacological and financial analysis of the project to the medical staff. The project resulted in a financial savings of approximately $600 000/yr to patients in decreased drug charges, $200 000/yr in decreased drug purchases/inventory, and $105 000/yr to the hospital in an improved revenue/expense statement. This project represents an example of the important role of the clinical pharmacist in helping a hospital identify areas to reduce drug therapy costs. A future role for clinical pharmacists will be to work closely with the director of pharmacy, hospital administration, and medical staff in identifying and implementing cost-effective drug therapy.

Saving a dental residency: a joint commitment.

SummaryThe ability of the hospital to financially sustain a quality dental residency program depends on achieving the required increase in the volume of patients and the appropriate payer mix proportions. Although the importance of achieving financial viability places the program at a continuing risk, the dental department and the hospital's administrative staff members have taken a significant step forward to assure viability of the residency program in a financially uncertain health care environment.

Justifiable criticism from the Ombudsman

The problems facing the overseas visitor or resident seeking treatment under the National Health Service get talked about often enough in the abstract. In the third report from the Parliamentary Commissioner for Administration, by the Ombudsman, Sir Cecil Clothier, there is a case history that illustrates how easily the system can go wrong. In this instance it stemmed from an initial misunderstanding about the status of the patient?a young Italian who came here in July 1979 to find work and improve his English. In August of that year he fell in the restaurant in which he was working, cutting the tendons of his left wrist on some glass, and had to undergo an emergency operation. The problem arose, however, over his subsequent treatment?the accident required a second operation and physiotherapy. The hospital administrative staff decided he was not eligible, and their opinion was backed up by the Department of Health and Social Security. A great deal of argument took place?Mr B, the Italian, was lucky in that he had a friend, Mr A, who was able to fight his case?but with no result, and Mr B returned to Italy, where in January 1980 he had the second operation. By this time the DHSS had come to the conclusion that the work he had been doing had changed his status from visitor to worker and that, as he had paid National Insurance contributions and was receiving benefit in Italy based on his work here, he would, under Common Market regulations, be entitled to full NHS treatment if he returned to the UK.

Patient accountability–pharmacists' future

A philosophy of pharmacy practice is expressed, centering on service and accountability to the patient. To attain the goal of comprehensive pharmaceutical services, one must consider the factors of the environment and the characteristics of individual pharmacists. Aspects of the environment include support by the hospital administration and medical staff, and team cooperation among pharmacists and among all health professionals. Individual motivation to perform must be based on service to the patient. It is suggested that economic justification of pharmaceutical services should be a major goal of pharmacy organizations. The problem of employment opportunities for young pharmacists is discussed. The future of pharmacy practice is bright if pharmacists center their activity around the patient and become accountable for patient services.