Nonprofit Health Care Organizations Research Articles

Optimize and Thrive: An Electronic Health Record Optimization Program Case Study.

Although electronic health record optimization programs are common in healthcare organizations, a dearth of published evaluations of these programs exists. Little is known about the ability of optimization programs to handle flooding requests for change and achieve their objectives of cost savings, value, quality of care, and efficiency. This program evaluation reviewed one organization's electronic health record clinical optimization program. The evaluation examines the implementation of the insulin dosing calculator project at five hospitals within a large nonprofit healthcare organization using interviews, project documents, reported insulin dosing errors, and workflow observation to determine if the program provides sufficient structure and processes to successfully implement large optimization projects and achieve the project's desired outcomes. This evaluation finds that the optimization program processes support the implementation of large projects. The program can improve the planning of human resources to increase productivity and reduce waste. A clearer definition of meaningful project outcomes at the onset would allow the program to measure and communicate its accomplishments across the organization.

Improving the Recruitment and Retention of Unlicensed Assistive Personnel: A Quality Improvement Initiative.

With increasing demands for unlicensed assistive personnel, strategies for optimizing recruitment and retention are paramount. The purpose of this quality improvement project was to increase the recruitment and retention of unlicensed assistive personnel in a nonprofit healthcare organization. Initiatives included expanding academic affiliations enhancing pipeline, developing a tailored onboarding program, and introducing a clinical ladder. Results indicate increases in numbers of academic affiliations and hiring, with unlicensed assistive personnel turnover rates below national averages.

Drug development for major chronic health conditions—aligning with growing public health needs: Proceedings from a multistakeholder think tank

The global pharmaceutical industry portfolio is skewed towards cancer and rare diseases due to more predictable development pathways and financial incentives. In contrast, drug development for major chronic health conditions that are responsible for a large part of mortality and disability worldwide is stalled. To examine the processes of novel drug development for common chronic health conditions, a multistakeholder Think Tank meeting, including thought leaders from academia, clinical practice, non-profit healthcare organizations, the pharmaceutical industry, the Food and Drug Administration (FDA), payors as well as investors, was convened in July 2022. Herein, we summarize the proceedings of this meeting, including an overview of the current state of drug development for chronic health conditions and key barriers that were identified. Six major action items were formulated to accelerate drug development for chronic diseases, with a focus on improving the efficiency of clinical trials and rapid implementation of evidence into clinical practice.

Healthcare innovation and leadership in non-profit organisations: past, present and future trends

Non-profit healthcare organisations (NPHO's) serve a heterogeneous population, from the elderly in nursing homes to people with mental disorders or children and young people with chronic illnesses. Given the fast changing context in which they operate, their innovative capacity becomes a key element of their intervention. Thus, the way in which leadership is exercised has a major influence on the innovation results. Given the fragmentation on this topic, this study aimed at conducting a Systematic Literature Review (SLR). This SLR identified a total of 243 original articles published between 1985 and 2023, and, through a bibliometric analysis using the RStudio's Bibliometrix software, identified the different aspects between innovation and leadership in NPHO's present in the literature. Four main clusters were identified: innovation management in NPHO's – facilitators and obstacles; innovation and organisational performance – the centrality of the user and the quality of services; leadership as a vector of innovation; affective aspects and the performance of NPHO's. A conceptual model is proposed, the gaps are identified, such as future lines of research emerge from the results obtained. This SLR is intended to be a document that may support practical changes in the context that promote innovation in NPHO's.

Who Should Control Healthcare?

No abstract available. Article truncated after 150 words. The American Academy of Emergency Medicine (AAEM) is urging stiffer enforcement of decades-old statutes that prohibit the ownership of medical practices by corporations not owned by licensed doctors (1). These century-old laws and regulations were meant to fight the commercialization of medicine, maintain the independence of physicians, and prioritize the doctor-patient relationship over the interests of investors and shareholders (2). Thirty-three states (click to see list of states that prohibit corporate ownership) plus the District of Columbia have rules on their books against the so-called corporate practice of medicine. In Arizona ownership by nonprofit entities is permitted, however as most of us know, nonprofit healthcare organizations are nonprofit in name only. Furthermore, over the years, companies have successfully sidestepped bans on owning medical practices by buying or establishing local staffing groups that are nominally owned by doctors and restricting the physicians so they have no direct control. Those campaigning for …

Taking the time: remembering values-based legacy to serve organizational purposes

ABSTRACT How is a values-based legacy worked on in organizations to influence organizational members’ practices to bring forward the organizational purpose? Earlier studies have highlighted the process of remembering the organization’s motto as a way of recontextualizing the past, as well as the leaders’ role in recalling values. In analyzing both pioneers and contemporary leaders of a 150-year-old values-based nonprofit healthcare organization, this study find that the pioneers’ ideals, values, purposes, and intentions are remembered in contemporary leaders’ work of maintaining and bringing forward the values-based legacy. The work is based on the four micro-processes of openness, anchoring the practice in history, realization of values, and relational practices. The micro-processes are enhanced by mechanisms such as religious and historical inspiration, processes of expectation and interpretation, as well as enacting compassion and quality through relational work. The work of remembering institutional values has established a moral awareness and ethical sensitivity in the organization toward the maintenance of the mission of reaching out to marginalized groups of patients.

Opioid Overdose Risk Following Hospital Discharge Among Individuals Prescribed Long-Term Opioid Therapy: a Risk Interval Analysis.

Individuals prescribed long-term opioid therapy (LTOT) have increased risk of readmission and death after hospital discharge. The risk of opioid overdose during the immediate post-discharge time period is unknown. To examine the association between time since hospital discharge and opioid overdose among individuals prescribed LTOT. Self-controlled risk interval analysis. Adults prescribed LTOT with at least one hospital discharge at a safety-net health system and a non-profit healthcare organization in Colorado. We identified individuals prescribed LTOT who were discharged from January 2006 through June 2019. The outcome was a composite of fatal and non-fatal opioid overdoses during a 90-day post-discharge observation period, identified using electronic health record (EHR) and vital statistics data. Risk intervals included days 0-6 after index and subsequent hospital discharges. Control intervals ranged from days 7 to 89 after index discharge and included all other time during the observation period that did not fall within a risk interval or time readmitted during a subsequent hospitalization, which was excluded. Poisson regression was used to estimate incidence rate ratios (IRR) and 95% confidence intervals (CI) for overdose events during risk in comparison to control intervals. We identified 7695 adults (63.3% over 55 years, 59.4% female, 20.3% Hispanic) who experienced 9499 total discharges during the study period. Twenty-one overdoses occurred during their observation periods (1174 per 100,000 person-years [9 in risk, 12 in control]). Overdose risk was significantly higher during the risk interval in comparison to the control interval (IRR 6.92; 95% CI 2.92-16.43). During the first 7 days after hospital discharge, individuals prescribed LTOT appear to be at elevated risk for opioid overdose. Clarifying mechanisms of overdose risk may help inform in-hospital and post-discharge prevention strategies.

Applying the DEMATEL Method to Evaluate Social Media Criteria in Promoting Sustainable Health Behavior—A Case Study of Vegetarian Diet Promotion by a Non-Profit Organization

The purpose of this study was to identify and analyze the determinants of the success of social media health promotion by non-profit organizations. Based on a literature review, fourteen criteria were considered in the study. A questionnaire was administered to seventeen respondents working with a non-profit organization involved in healthcare services in Taiwan. The decision-making trial and evaluation laboratory (DEMATEL) method was used to evaluate the causal relationships among the proposed factors. The results indicated that user-friendliness, word of mouth, and security mechanisms are some of the key causal factors. In addition, cultural consideration, emotional connection, using the same language and tone, and mobilization are among the key effect factors. The findings provide non-profit healthcare organizations with insights about how they can better implement health promotion on social media. The study also provides an original contribution by examining the success criteria of social media health promotion using the DEMATEL method.

Impacts of Prosthetic Innovation in Ecuador Study Abroad Course.

Biomedical engineering (BME) students typically have a schedule filled with specific course requirements, leaving little room for spending a semester studying abroad. We established a new short-term BME study abroad course, partnering with a non-profit healthcare organization that provides high-quality prosthetic care to underserved populations. This innovative study abroad course was met with great student demand. The impact of this short-term study abroad course is increased by developing year-long BME senior capstone design projects based on the needs identified throughout the experience in Ecuador. Shortly after the conclusion of spring semester, students and two BME faculty/staff traveled to Ecuador. During the work week, the students participated in small teams in patient evaluations, castings, fabrication of prosthetics, device fittings, rapid prototyping-testing iterations, and post-prosthesis gait training with physical therapy. Weekends included guided cultural activities. Each student maintained a journal that reflected observations and insights from these experiences. Upon return to the US, students that registered for an additional course credit created video reflection presentations and wrote project proposal reports based on the needs identified in Ecuador. The project proposal reports were used to develop a BME senior capstone design project. Pre and post course self-assessment surveys showed significant increases in five ABET learning outcomes, three BME learning outcomes, and four course-specific learning outcomes. Students who took the two-credit course reported significant increases in four more learning outcomes than students who took the one-credit course. Many students described the experience as inspiring and life-changing, and the program continues to run each summer.

Addressing social determinants of health for colorectal cancer in the African American population: STAT (Screen, Trust, Access, Treat) phase I study.

143 Background: Colorectal cancer (CRC) is the third most common cancer and third leading cause of cancer deaths among African Americans, who have the highest CRC rates compared to other racial/ethnic groups, in the United States. STAT (Screen, Trust, Access, Treat) is a three-phase study assessing attitudes and perceptions related to disparities in CRC screening, treatment and clinical trial participation in the African American population. STAT Phase I surveyed attitudes/perceptions among health care providers (HCPs) and Phase II is ongoing to survey African American patients with CRC; in Phase III, data collected from Phases I/II will be used to design and test multiple interventions to reduce CRC disparities among African Americans. Here we present findings from STAT Phase I. Methods: Using non-probability and convenience sampling methodology, a survey link was exposed to over 3,000 HCPs through partnering non-profit health care organizations. The 20-item survey evaluated practitioner views on strategies for overcoming social determinants of health (SDOH), improving CRC outcomes among African Americans, and barriers/motivators for clinical trial enrolment. Results: Respondents (n = 109) comprised oncologists (53%), primary care providers (29%), gastroenterologists (2%), and representatives from other specialties (16%). They were predominantly White/Caucasian (65%); 22% were Asian/Asian American, 11% were African American/Black, and 6% were Hispanic/Latino. To overcome SDOH disparities, most HCPs used translation/interpreter services (83%), offered patients information in multiple languages (76%), and asked them to repeat back care instructions (73%); however, fewer offered provisions such as SDOH assessments (50%), access to financial assistance (66%), and transportation services (45%). Most HCPs agreed or strongly agreed they were prepared to care for patients from cultures differing from their own (91%), with health beliefs conflicting with Western medicine (71%), and with limited health literacy (83%). Increased community-based education (85%), community access to stool-based cancer screening tests (71%), and improved access to primary care physicians (69%) were viewed by HCPs as the favoured approaches to improve CRC outcomes among African Americans. Lack of awareness (43%) was reported as the predominant barrier to clinical trial enrolment, and HCPs agreed or strongly agreed that a patient eligibility screening system (86%) or clinical trial alert system (73%) would be a motivator to engage in clinical trials. Conclusions: Results from STAT Phase I reveal opportunities for HCPs to overcome inequities due to SDOH. Together with ongoing/planned research in STAT Phases II and III, these findings could inform strategies to reduce existing disparities in CRC care and improve outcomes for the African American population.

Transforming healthcare through a digital revolution: A review of digital healthcare technologies and solutions.

The COVID-19 pandemic has put a strain on the entire global healthcare infrastructure. The pandemic has necessitated the re-invention, re-organization, and transformation of the healthcare system. The resurgence of new COVID-19 virus variants in several countries and the infection of a larger group of communities necessitate a rapid strategic shift. Governments, non-profit, and other healthcare organizations have all proposed various digital solutions. It's not clear whether these digital solutions are adaptable, functional, effective, or reliable. With the disease becoming more and more prevalent, many countries are looking for assistance and implementation of digital technologies to combat COVID-19. Digital health technologies for COVID-19 pandemic management, surveillance, contact tracing, diagnosis, treatment, and prevention will be discussed in this paper to ensure that healthcare is delivered effectively. Artificial Intelligence (AI), big data, telemedicine, robotic solutions, Internet of Things (IoT), digital platforms for communication (DC), computer vision, computer audition (CA), digital data management solutions (blockchain), digital imaging are premiering to assist healthcare workers (HCW's) with solutions that include case base surveillance, information dissemination, disinfection, and remote consultations, along with many other such interventions.

Strategic Procurement of High-Cost Medical Devices

This manuscript addresses the problem of strategic procurement of high-cost medical devices at one of the largest nonprofit health-care organizations in the USA. A mixed-integer linear programming (MILP) model is used to reveal the effects of physicians’ allowing alternative devices to be used for their medical procedures, the impact of alternative incentive-pricing mechanisms negotiated with suppliers, and the potential impact of rigidly imposing supplier-scorecard standards on several dimensions – especially when such scorecards are commonly recognized as being subject to “common-variance” rater bias. Solutions are found to be more sensitive to general bias toward high or low ratings in producing scores for vendor performance than to correlations in scores due to common methods bias. Small changes in pricing parameters and scorecards can have outsized effects on “optimal” shares of business allocated to alternative suppliers. This may call for constraints to avoid disruptive shifts in business relationships when revising procurement strategies through time.

Improving quality in pastoral care using the Pastoral Care Activity Tracker (PCAT): A feasibility study of a digital tool within an Australian healthcare organization

Background Activity reporting of Pastoral Care Coordinators (PCCs) is often inadequate within care settings because of suboptimal analog data collection methods. This study aims to render pastoral care activity reporting more efficient through digitizing data collection in pastoral care settings. Methods A one-year feasibility (pilot) study of a digital tool, the “Pastoral Care Activity Tracker” (PCAT) was conducted between June 1, 2020 and May 31, 2021 at HammondCare, an Australian nonprofit healthcare organization. Feasibility was measured using electronic activity logs collected by the tool and user feedback surveys by PCCs. Results Of the 43 PCCs working in the organization, 42 (97.7%) used the PCAT tool to complete the logging of 66,298 pastoral care activities (M [SD] = 1,578.5 [827.8] activities per PCC). Most activities were logged successfully (98.3%) and took less than one minute (89.5%). Survey responses (n = 20, 46.6%) indicated many PCCs found the PCAT more convenient (n = 15, 75.0%) and easier to use (n = 10, 50.0%) than paper-based method. Conclusions PCCs found the PCAT to be feasible, favorable, and easier to use for report generation compared to paper-based methods. The feasibility of the PCAT improved pastoral care activity data capture, as perceived by PCCs.

Workgroup Inclusion Is Key for Improving Job Satisfaction and Commitment among Human Service Employees of Color

ABSTRACT Workplace inclusion is recommended for improving human service employee job satisfaction and commitment; however, limited research explores how perceptions of inclusion may differ by employee race and ethnicity. This study investigated the relationships between employee perceptions of department and workgroup inclusion with employee job satisfaction and commitment, and whether these perceptions differed by employee race and ethnicity. Data was collected at three time points from a U.S. nonprofit health care organization. Multiple group structural equation modeling results indicated that workgroup inclusion served as a critical focal point for cultivating department inclusion, employee job satisfaction, and workgroup commitment for employees of color.

Fitting in as an outsider: a resource dependence theory approach to outside boards

PurposeThis study draws on resource dependence theory (RDT) to explain a board's governance function in the United States (US) nonprofit healthcare industry. Specifically, while various nonprofit research studies have appealed to agency theory (AT) to explain the monitoring role of an outside board, RDT offers an alternative explanation that emphasizes an outside board's resource gathering role.Design/methodology/approachIn drawing on the nonprofit GuideStar database, a fixed effect (FE) panel estimation was conducted on a sample of 230 US Non Profit Healthcare Organizations (NPHCOs). This panel estimation examines the relationship between the composition of an outside board and an NPHCO’s revenue and public support performance.FindingsA key finding of this study is that the composition of an outside board involving its' number, compensation and gender impacts an NPHCO’s revenue and public support.Research limitations/implicationsThis study shows that the composition of an outside board impacts an NPHCO’s ability to gain access to external resources. As NPHCOs face increasing pressure to seek external forms of revenue support, this study suggests that boards should favor a larger number, compensation and female representation of outside members.Practical implicationsThe composition of an outsider board can offer external sources of revenue support that lower the poor's requirements for financial assistance and thus affirm an NPHCO’s identity as a charitable organization.Originality/valueAs an NPHCO’s identity as a charitable organization is dependent on serving the medical needs of the poor, an outside board not only introduces a resource gathering function that is absent in the monitoring explanations of AT, but that this resource gathering function is important to affirming this identity.

Compromiso laboral de los directivos intermedios en sanidad: factores organizativos gestionables

Middle-line managers are a key element in the management of health-care organizations. Reinforcing their commitment to their job could contribute to improving the health outcomes of the population they serve. ObjectiveAnalyzing the work commitment of middle-line managers to the health-care organizations they work for, as well as their profile and perception of the main manageable organizational factors involved. MethodologyDescriptive multicenter study based on a questionnaire about work commitment and 20 associated manageable factors, analyzing 60 variables (scale 1-10). The theoretical framework on which it was based was adapted from the model of demands and resources, along with 2organizational commitment questionnaires. It was distributed among the professionals of 23 non-profit health-care organizations belonging to the Health and Social Care Consortium of Catalonia, in the period 2015-2019. ResultsA number of 2,060 surveys were obtained; 60% were answered by women; 69% declared an antiquity of more than 10 years. Cronbach's alpha coefficient was 0.974. The overall indicator of work commitment received 7.94 points. Overall, job resources received higher scores than demands (7.39 versus 6.69 points). The 3highest-scoring manageable organizational factors were demand, equality policies with 8.27 points, and 2resources: professional autonomy (7.81 points) and job stability (7.79 points). The 3lowest scoring factors were 3demands: Remuneration (5.52 points), time and personnel resources (5.74 points) and social benefits (6.10 points). Seventy-one percent of middle-line managers’ work commitment to their institution was explained by 4manageable factors: Trust and coherence, professional autonomy, institutional image, and training and development. ConclusionsThe middle-line managers showed a high level of work commitment to their institutions. The main predictor of this commitment was the perception of trust in the institution and coherence in the management of the centers.

Improving Volunteer Engagement in Nonprofit Healthcare Organizations

Grounded in the conceptual lens of Deci and Ryan’s self-determination theory, the strategies nonprofit healthcare leaders use to reduce volunteer turnover were explored in this single-case study. The participations included 5 nonprofit healthcare leaders from a single organization in the Southwestern United States. Data were collected using semistructured interviews, internal and external organizational documents, and publicly available data. Analysis of internal and external organizational documents and publicly available data were manually coded and thematically organized. The use of a methodological triangulation process and member checking increased the reliability of data interpretation. Using the thematic approach, 3 themes emerged: volunteer recognition improved volunteer turnover, open communication improved volunteer turnover, and relationship building improved volunteer turnover. The findings from this study may contribute to positively social change by providing nonprofit leaders with strategies to reduce volunteer turnover, enhance operational processes, and improve organizational performance. The results of this study indicated that nonprofit healthcare leaders who develop volunteer engagement strategies could increase organizational success and develop successful work habits among volunteers to improve economic growth in the communities they serve.

Assessing Healthcare Leader Competency Proficiency Levels in Evaluating Graduate Healthcare Leadership Student Competency Proficiency Levels and Curriculum

Healthcare leaders must possess specific competencies to perform their job requirements by identifying what competencies may need development and take steps to further their education, knowledge, and proficiency. This exploratory research aims to utilize industry data when evaluating student competency proficiency and how that data might impact curriculum development. The research question that is addressed: At what competency proficiency level do working healthcare leaders rate themselves utilizing Benner’s Novice to Expert Theory (1982)? Graduate programs should evaluate current industry data to evaluate how students’ progress in their programs and determine if curriculum changes are needed. Graduate programs should also determine a competency proficiency level goal that students will achieve based off stakeholder input. Twenty-two healthcare leaders from a Midwest, non-profit healthcare organization were invited to participate in an online survey that utilized a 5-point Likert scale in which participants rated their level of proficiency across five domains: (a) leadership, (b) professionalism, (c) communication and relationship building, (d) knowledge of the healthcare environment, and (e) business skills. The corresponding competencies were adapted from the American College of Healthcare Executives (ACHE) Competencies Tool (2019) and the Healthcare Leadership Alliance (HLA) Competency Directory (2010). The majority of participants rated themselves between competent and intermediate/advanced on the competencies. Corresponding means and modes were rated highest with levels above three (intermediate) and four (between intermediate/advanced) related to the domains of leadership, professionalism, and communication and relationship building. The domains of knowledge of the healthcare environment and business skills had intermediate and intermediate/advanced ratings with lower means compared to the other three domains. The results of this study could help graduate programs define a program goal for student competency proficiency level and design a plan to utilize industry data to design, evaluate, and update graduate curriculum to help students meet the identified competency proficiency goal.

Accountability in non-profit health care organisations: towards building online practices

Online accountability (OA) is an essential aspect of overall organisational accountability efforts in non-profit organisations. The research project on which this article is based aimed to: (a) explore variations in OA practices in non-profit hospitals in the United States; and (b) determine the factors that are associated with higher levels of OA practices. The findings suggest that the majority of hospitals had resources for well-developed websites as overall accessibility scores were very high. However, they were not utilising this medium to the fullest extent for accountability purposes, especially in the areas of performance and governance information. In addition, the study demonstrated that hospital capacity (specifically, size and volume) and total private contributions were robust predictors of OA practices.

COVID-19 and cancer care: What have we learned?: Despite the enormous challenges, researchers are sharing valuable lessons regarding evaluating risks, setting priorities, and communicating with patients during the pandemic.

COVID-19 and cancer care: What have we learned?: Despite the enormous challenges, researchers are sharing valuable lessons regarding evaluating risks, setting priorities, and communicating with patients during the pandemic.