Non-health Care Organizations Research Articles

Multi-Sector Assessment and Client-Perception of Social Need at Long-Term Follow-Up of a Group-Randomized Trial of Community-Engaged Collaborative Care for Adults with Depression.

Understanding client perceptions of need for underlying social determinant support may improve services for depression care. This secondary analysis examines perceptions of “social needs” related to housing and employment, financial, and legal (EFL) concerns among individuals with depression. Data were analyzed from Community Partners in Care, a randomized comparative effectiveness trial of multi-sector collaborative care for depression among a sample of people who were predominantly racial/ethnic minorities and low-income. Adults with depression (n = 980) in both interventions were surveyed at 36-month follow-up for (1) being asked about and (2) having social needs for housing or EFL concerns. In multivariate models, life difficulty and mental health visits in non-healthcare sectors predicted being asked about housing and EFL. Lower social determinants of health-related life satisfaction increased the odds of having unmet housing and EFL needs. These findings underscore the role of non-healthcare organizations as community resources for depression care and in screening and addressing social needs.

The impacts of collaboration between local health care and non-health care organizations and factors shaping how they work: a systematic review of reviews

BackgroundPolicymakers in many countries promote collaboration between health care organizations and other sectors as a route to improving population health. Local collaborations have been developed for decades. Yet little is known about the impact of cross-sector collaboration on health and health equity.MethodsWe carried out a systematic review of reviews to synthesize evidence on the health impacts of collaboration between local health care and non-health care organizations, and to understand the factors affecting how these partnerships functioned. We searched four databases and included 36 studies (reviews) in our review. We extracted data from these studies and used Nvivo 12 to help categorize the data. We assessed risk of bias in the studies using standardized tools. We used a narrative approach to synthesizing and reporting the data.ResultsThe 36 studies we reviewed included evidence on varying forms of collaboration in diverse contexts. Some studies included data on collaborations with broad population health goals, such as preventing disease and reducing health inequalities. Others focused on collaborations with a narrower focus, such as better integration between health care and social services. Overall, there is little convincing evidence to suggest that collaboration between local health care and non-health care organizations improves health outcomes. Evidence of impact on health services is mixed. And evidence of impact on resource use and spending are limited and mixed. Despite this, many studies report on factors associated with better or worse collaboration. We grouped these into five domains: motivation and purpose, relationships and cultures, resources and capabilities, governance and leadership, and external factors. But data linking factors in these domains to collaboration outcomes is sparse.ConclusionsIn theory, collaboration between local health care and non-health care organizations might contribute to better population health. But we know little about which kinds of collaborations work, for whom, and in what contexts. The benefits of collaboration may be hard to deliver, hard to measure, and overestimated by policymakers. Ultimately, local collaborations should be understood within their macro-level political and economic context, and as one component within a wider system of factors and interventions interacting to shape population health.

Quality of the discussion of asthma on twitter

Introduction Patients obtain a large amount of medical information online. Much of this information may not be reliable or of high quality. We investigated what influences the discussion of asthma on Twitter by evaluating the most popular tweets and the quality of the links shared. Methods We used Symplur Signals to extract data from Twitter examining characteristics of the top 100 most shared tweets and the 50 most shared links that included the hashtag #asthma. Information on each site was assessed using an Asthma Content score, and validated DISCERN scores and HONCode criteria. Results The top 100 asthma-related tweets were shared 10,169 times and had 16,044 likes. Healthcare organizations posted 49 of the top 100 tweets, non-healthcare individuals posted 20, non-healthcare organizations posted 16 and clinicians posted 14. Of the top 100 tweets, 62 were educational, 11 research-related, 10 political and 15 promotional. The top 50 links were shared 6009 times (median number of shares 92 per link (range 60-710)). Links most commonly (42%) led to educational content while 24% of links led to research articles, 22% to promotional websites, and 12% to political websites. Educational links had higher Asthma Content scores than other links (p < 0.005). Overall, all three scores were low for all types of links. Only 34% of sites met HONCode criteria, and 14% were assessed as high quality by DISCERN score. Conclusion The top tweets using the hashtag #asthma were commonly educational. The majority of top links on Twitter scored poorly on asthma content, quality, and reliability.

HOW RELIABLE ARE THE MOST COMMONLY SHARED ASTHMA LINKS ON TWITTER?

SESSION TITLE: Wednesday Abstract Posters SESSION TYPE: Original Investigation Posters PRESENTED ON: 10/23/2019 09:45 AM - 10:45 AM PURPOSE: Patients obtain a large amount of medical information online. However, much of this information may not be reliable or of high quality. Our goal was to assess the reliability and quality of links related to asthma. METHODS: The 50 most highly shared links on Twitter containing the hashtag #asthma in 2018 were examined for type of link, how often shared, and frequency of shares by stakeholder group (healthcare organizations, clinicians, non-healthcare individuals, and non-healthcare organizations). Quality and reliability of information on each site were assessed using DISCERN scores, HONCode criteria, and Asthma Content scores, collected independently by two investigators. RESULTS: In 2018, the top 50 links were shared 6009 times (median number of shares 92 per link, range 60-710 shares per link). Links most commonly (42%) led to general educational content while 24% of links led to research articles, 22% to promotional websites, and 12% to political websites. Most of the sites had low Asthma Content scores (median 3; 25-75% IQR 1-8; possible range 0-17). Only 34% of sites met HONCode criteria for high understandability, accessibility, and trustworthiness. Most of the websites (54%) had low quality information by DISCERN scores, while only 14% were assessed as high quality. General education links had higher Asthma Content scores than other links (P<0.005), although overall the scores were low for all types of links (median 7 (25-75% IQR 2-11) vs median 3 (25-75% IQR 0-4)). There were significant differences in which articles were more often shared by different stakeholder groups. Research article links were more likely to be shared by clinicians (OR 14.0; 95% CI 2.6-75.2), and had the highest HONCode scores (median 7 (25-75% IQR 5-7) vs median 5 (25-75% IQR 3-6); P=0.01). Promotional article links had the lowest HONCode scores (median 3 (25-75% IQR 2-4) vs median 6 (25-75% IQR 4-7); P=0.0004). HONCode, Asthma Content scores & overall DISCERN scores had high degrees of correlation. Links with high HONCode scores were more likely to be shared by clinicians, while links with high Asthma Content scores were more likely to be shared by healthcare organizations. Links with high overall DISCERN scores were more likely to contain general educational content. Links highly shared by individuals had lower DISCERN reliability scores, including several links with biased and potentially fraudulent content. CONCLUSIONS: The majority of the most commonly shared links on Twitter using the hashtag #asthma scored poorly in terms of asthma content, quality and reliability. Higher quality links more frequently contained general educational information and were mostly shared by healthcare organizations and clinicians. CLINICAL IMPLICATIONS: Highly shared links on social media are not the best source of information on medical topics. DISCLOSURES: No relevant relationships by Christopher Carroll, source=Web Response No relevant relationships by Neha Dangayach, source=Web Response No relevant relationships by Viren Kaul, source=Web Response No relevant relationships by Jay Peters, source=Web Response No relevant relationships by Kathleen Sala, source=Web Response shareholder relationship with HylaPharm Please note: $20001 - $100000 Added 06/14/2019 by Steven Simpson, source=Web Response, value=nothing, yet Consultant relationship with Aimmune Please note: $1001 - $5000 Added 03/01/2019 by David Stukus, source=Web Response, value=Consulting fee Consultant relationship with Before Brands Please note: $1001 - $5000 Added 03/01/2019 by David Stukus, source=Web Response, value=Consulting fee No relevant relationships by Tamas Szakmany, source=Web Response

Comparative Study of Employees´ Key Competencies in Selected Health Care and Non-Health Care Organizations

Abstract The key competences of the employees are currently discussed and the open labor market. Competencies can be divided into three basic categories: knowledge competencies, application competencies and social competencies. Each work environment brings its specifics and the aim of the article is to find similarities and differences in the key competencies of employees of healthcare organizations and non-healthcare organizations. In order to achieve the objective of the article, a questionnaire survey was used, involving 791 respondents from healthcare organizations and 647 nonhealthcare organizations. In total 1438 questionnaires were evaluated. The research was conducted from May 2017 to September 2018. The first phase of the research was conducted through semi-standardized interviews with 73 representatives of healthcare organizations and 69 representatives of non-healthcare organizations. Qualitative research was attended by representatives of the personnel department, respectively human resource management department. The second stage of the research was followed by quantitative research. Quantitative research was conducted from January 2018 to September 2018. Key competencies were selected on the basis of importance, and the author of the article deals with those that respondents have identified as most important for their work. Here we can find the first differences in the identification of key competencies in healthcare organizations and nonhealthcare organizations. Respondents of healthcare organizations have identified as the most important the ability to communicate, the ability to learn, teamwork, reliability, dedication to work, empathy, emotional maturity and work under stress, while non-healthcare organizations respond as key communication skills, IT skills, creativity, team work, reliability, emotional maturity, and work under stress. Three research hypotheses have been identified. The research hypotheses were verified using the Two-sample t-Test statistic for equal means.

The Capital Budgeting Process of Healthcare Organizations: A Review of Surveys

Several surveys have been administered over the last 40 plus years to learn about capital budgeting practices of healthcare organizations. In this report, we analyze and synthesize these surveys in a four-stage framework of the capital budgeting process: identification, development, selections, and post-audit. We examine three issues in particular: (1) efficiency of for-profit hospitals relative to not-for-profit hospitals, (2) capital budgeting practices of the healthcare industry vis-à-vis other industries, and (3) effects of healthcare mergers and acquisitions on capital budgeting decisions. We found indirect evidence that for-profit hospitals exhibited greater efficiency than not-for-profit hospitals in recent years. The acquisition of not-for-profits by for-profits is credited as the primary reason for growth of multihospital systems; these acquisitions may have contributed to the more efficient capital budgeting practices. One unique attribute of healthcare is the dominant role of physicians in almost all aspects of the capital budgeting process. In agreement with some researchers, we conclude that the disproportionate influence of physicians is likely to impede efficient decision making in capital budgeting, especially for nonprofit organizations.

Experienced Nurse Retention Strategies

Pursuit of high-quality care depends, in part, on hospital leaders' ability to retain an experienced RN workforce. Yet, 55% of nurses plan to retire between 2011 and 2020, heightening the need to identify proven retention strategies. Findings from 7 case studies conducted at hospitals and nonhealthcare organizations publicly recognized for success retaining experienced employees are summarized. The authors conclude that although the mix of retention strategies varies, all top-performing organizations share common success factors.

Job Embeddedness as a Nurse Retention Strategy for Rural Hospitals

RN turnover is expensive and disruptive for rural hospitals, constraining finances, impacting patient care, and stressing remaining nurses. Recent investigations have described a promising new construct related to employee retention: job embeddedness. Leaders in nonhealthcare organizations have adopted a job-embeddedness model to guide retention strategies and experienced a subsequent reduction in turnover. The author explores job embeddedness as an effective retention plan strategy for rural hospitals.

Improving the implementation of evidence‐based practice: a knowledge management perspective

Experience of knowledge management initiatives in non-health care organizations can offer useful insights, and strategies, to implement evidence-based practice in health care. Knowledge management offers a structured process for the generation, storage, distribution and application of knowledge in organizations. This includes both tacit knowledge (personal experience) and explicit knowledge (evidence). Communities of practice are a key component of knowledge management and have been recognized to be essential for the implementation of change in organizations. It is within communities of practice that tacit knowledge is actively integrated with explicit knowledge. Organizational factors that limit the development of knowledge management, including communities of practice, in non-health care organizations need to be overcome if the potential is to be achieved within health care.

Moving Toward Strategic Planning Unique To Healthcare

THE TWO FEATURE ARTICLES in this issue present the state of the art in and the application of strategic healthcare planning. THE TEN BEST PRACTICES AND FOUR STAGES OF SOPHISTICATION In examining the state of the art, Alan Zuckerman identifies ten best practices. Apparently, performing well on the first nine of the ten positions an organization at stage two in his four-stage model of strategic planning sophistication. Performing well on number ten-managing strategically-vaults an organization into stage three. To achieve the highest level of sophistication (stage four), Zuckerman proposes that the organization needs to employ an additional five practices drawn from companies outside of healthcare. Zuckerman asks, What should healthcare organizations do to increase the rigor and sophistication of their strategic planning practices? One might argue, Nothing! If planners and executives are in agreement and pleased with the results (as reported in his study), perhaps making strategic planning complicated and time consuming (rigorous and sophisticated) may not be such a great idea. His assumption seems to be that more advanced will mean effective in the long run, but at the margin, the time or cost required or the degree of effectiveness gained may not be worth the effort. Zuckermaris best practices are separated into five that are related to the product and five that address the process of strategic planning. Only the fifth practice, achieve real benefits, is actually a product; all the rest are processes-the means and not ends in themselves. Furthermore, all ten best practices are not created equal, but rather several serve as inputs to others. In addition, the five practices (planning characteristics) outlined by Zuckerman and drawn from pathbreaking companies outside of the healthcare sector are actually characteristics or qualities for performing the ten best practices. STAGE-FOUR STRATEGIC PLANNING FOR HEALTHCARE For years we have advocated that healthcare organizations should adopt strategic management practices developed in the business sector-especially considering the relatively long history of strategic planning in business and the relatively short history of its use in healthcare. Certainly, in the late 19805 and 19905 many healthcare organizations had much to learn from pathbreaking companies. It appears that this approach has, for the most part, worked pretty well. As a result, healthcare organizations have come a long way in installing strategic planning and management practices since their cost-plus protective covering was ripped away in the mid-1980s. Transferability Practices from pathbreaking companies outside of healthcare for strategic planning, however, may not transfer to healthcare. It is not that increased rigor and sophistication of strategic planning practices (stage-four strategic planning) is not an appropriate goal for healthcare organizations or that the pathbreaking company's planning models do not provide some useful insights, but rather that an entirely different type of stage-four planning may be required-one that acknowledges healthcare's unique organizational and market characteristics. Coarse grain (stage one) strategic planning practices may be applied to any industry. Fine grain (stage four) practices may or may not apply. Healthcare needs to define its own stage-four strategic planning qualities. Unique considerations might include the following. 1. Some strategic alternatives available to non-healthcare organizations may not be realistic for many healthcare organizations. For example, unrelated diversification or vertical integration may not be viable, as organizations with a single dominant core business that is both capital intensive and human intensive have considerable difficulty operating successfully outside of that core. Further, service area limitations restrict market expansion (market development) for many services. …

Ambiguity and Workarounds as Contributors to Medical Error

Why are some organizations error-prone-regularly subject to interruptions and inconveniences, some of which periodically coalesce catastrophically-whereas other organizations, although similar in the products and services they generate and the process technologies they use, are reliable, adaptable, and continuously self-improving, relentlessly learning from experience to get ever better? Analyzing medical error reports and studies of high-performing, non-health care organizations reveals 2 differences. High performers know how to prevent problems from producing further consequences once they occur and how to prevent their recurrence. They do this by specifying how work is expected to proceed-who will do what for whom, with what purpose, when, where, and how-before work is actually done. Then, when anything contrary to expectations occurs, it is immediately identified as a problem. Through this approach, the effects of problems are contained, the causes are quickly investigated, process knowledge is deepened, and recurrence is prevented. In contrast, error-prone organizations tolerate ambiguity, a prevailing lack of clarity over what is supposed to happen at any given time. Problems are thus hard to identify, and, even when recognized, they are worked around. People "get the job done," but don't initiate efforts to learn from the problem or improve the process. We believe that coupling high degrees of specification with rapid responses to individual problems can improve health care. Superlative manufacturing, service, and military organizations apply this approach to myriad processes and situations, and initial health care trials of this approach have been promising. We discuss how such an approach could be initiated in health care more broadly.

Relationships among quality management, IS use and organizational performance in the health care and non-health care setting

In this research, we investigate the relationships between organizational adoption and extent of use of Quality Management (QM) programmes and Information Systems (IS) in two somewhat different organizational settings--health care and non-health care. Specifically, we contend that organizations from the two settings may vary considerably in what we term QM Maturity. Some organizations appear to adopt QM only superficially, while others move far more fully into QM. We use the term QM Maturity to describe organizations that have adopted QM programmes more fully and in 'better' ways qualitatively. Are there differences in the paths which health care and non-health care organizations have used in approaching and implementing QM? In this research, we contend that QM Mature organizations will be characterized by perceptions that the culture is different in ways that are supportive of QM. Moreover, we argue that the higher QM Maturity organizations will approach IS implementation in more mature, qualitatively better ways. In turn, we expect QM Maturity and more mature IS adoption to lead to perceptions by those in the organization that both organizational performance and service quality are better. Where there are differences between health care and non-health care organizations, these areas could be impacted upon as well. Our exploratory research provides support for these ideas and suggests that there may, in fact, be differences in the two settings.

Looking beyond nursing for clues to effective leadership.

Effective leadership is one of the most elusive keys to organizational success yet it is a key ingredient to making any organization work. Leadership is also changing in nature. Our current faster, more flexible, flatter organizations face intense competition and require dynamic leadership. This article synthesizes research conducted during the past 5 years that quantifies what separates superior leaders from average leaders. Although this research originated from a study of top global nonhealthcare organizations, it relates to the nursing profession. The author discusses key elements of the research, including emotional intelligence and its link to performance.

Benchmarking the communication of continuous improvement activities.

Communication of a continuous improvement program in a large medical center was assessed using a formal benchmarking process with four non-health care organizations. Results indicated that continuous improvement must be integrated with the corporate strategic plan, must focus on customer satisfaction, and have active leadership support. A common framework should link different continuous improvement methodologies. Ongoing, open, multimedia two-way communication is required. Continuous improvement activities need to be integrated into all employees' daily work.

Policies and Procedures in the Workplace: How Health Care Organizations Compare

Many organizations are implementing programs and services to manage the human and economic costs of stress. A mail survey was conducted of 500 randomly selected Canadian organizations having at least 500 employees. The survey tapped four major areas: organizational policies and procedures for managing stress; programs and services offered; perceived benefits and constraints for the organization; and projected future directions in this area. Analyses of returns from 210 organizations-43 health and 167 non-health-revealed various findings. For example, over half of health care organizations have policies and procedures as opposed to less than half of non-health care organizations. Also, health care organizations place greater emphasis on smoking cessation, weight control programs and on stress management training. Although some Canadian organizations are addressing stress, much more could and should be done, especially by organizations that do not yet recognize the impact of stress on employees and their work performance.