Subjects -> HEALTH AND SAFETY (Total: 1562 journals)
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HEALTH FACILITIES AND ADMINISTRATION (390 journals)                  1 2 | Last

Showing 1 - 200 of 397 Journals sorted alphabetically
ACI Open     Open Access  
Acta Bioquimica Clinica Latinoamericana     Open Access   (Followers: 1)
Administration and Policy in Mental Health and Mental Health Services Research     Partially Free   (Followers: 22)
Adnan Menderes Üniversitesi Sağlık Bilimleri Fakültesi Dergisi     Open Access   (Followers: 1)
Advanced Healthcare Materials     Hybrid Journal   (Followers: 17)
Advances in Dual Diagnosis     Hybrid Journal   (Followers: 48)
Advances in Human Factors/Ergonomics     Full-text available via subscription   (Followers: 26)
Advances in Medical Education and Practice     Open Access   (Followers: 34)
Advances in Mental Health and Intellectual Disabilities     Hybrid Journal   (Followers: 89)
Advances in Nursing Science     Hybrid Journal   (Followers: 43)
Advances in Simulation     Open Access   (Followers: 7)
African Journal of Primary Health Care & Family Medicine     Open Access   (Followers: 6)
AIDS and Behavior     Hybrid Journal   (Followers: 18)
American Journal of Hospice and Palliative Medicine     Hybrid Journal   (Followers: 48)
American Journal of Managed Care     Full-text available via subscription   (Followers: 13)
Analytical Methods     Full-text available via subscription   (Followers: 14)
Anthropologie et santé     Open Access   (Followers: 5)
Applied Clinical Informatics     Hybrid Journal   (Followers: 5)
Applied Health Economics and Health Policy     Full-text available via subscription   (Followers: 24)
Applied Research in Quality of Life     Hybrid Journal   (Followers: 13)
Archives of Public Health     Open Access   (Followers: 13)
Asian Journal of Health     Open Access   (Followers: 4)
Australasian Journal of Paramedicine     Open Access   (Followers: 7)
Australian and New Zealand Journal of Public Health     Hybrid Journal   (Followers: 17)
Australian Health Review     Hybrid Journal   (Followers: 7)
Australian Journal of Primary Health     Hybrid Journal  
Australian Journal of Rural Health     Hybrid Journal   (Followers: 18)
Autism     Hybrid Journal   (Followers: 350)
Avicenna     Open Access   (Followers: 3)
Balint Journal     Hybrid Journal   (Followers: 2)
Bereavement Care     Hybrid Journal   (Followers: 13)
BJR     Hybrid Journal   (Followers: 21)
BMC Medical Informatics and Decision Making     Open Access   (Followers: 25)
BMC Oral Health     Open Access   (Followers: 7)
BMJ Leader     Hybrid Journal  
BMJ Quality & Safety     Hybrid Journal   (Followers: 69)
BMJ Supportive & Palliative Care     Hybrid Journal   (Followers: 50)
British Journal of Healthcare Assistants     Full-text available via subscription   (Followers: 33)
British Journal of Healthcare Management     Full-text available via subscription   (Followers: 19)
British Journal of Hospital Medicine     Full-text available via subscription   (Followers: 18)
British Journal of Nursing     Full-text available via subscription   (Followers: 297)
British Journal of School Nursing     Full-text available via subscription   (Followers: 14)
Bruce R Hopkins' Nonprofit Counsel     Hybrid Journal   (Followers: 2)
Building Better Healthcare     Full-text available via subscription   (Followers: 1)
Canadian Nurse     Full-text available via subscription   (Followers: 8)
Cardiac Electrophysiology Clinics     Full-text available via subscription   (Followers: 1)
Children and Schools     Hybrid Journal   (Followers: 8)
Chinese Medical Record English Edition     Hybrid Journal  
CIN : Computers Informatics Nursing     Hybrid Journal   (Followers: 11)
Clinical Audit     Open Access   (Followers: 4)
Clinics and Practice     Open Access  
Cognition, Technology & Work     Hybrid Journal   (Followers: 14)
Communication & Medicine     Hybrid Journal   (Followers: 5)
Community Based Medical Journal     Open Access  
Conflict and Health     Open Access   (Followers: 8)
Contemporary Nurse : A Journal for the Australian Nursing Profession     Hybrid Journal   (Followers: 7)
Critical Public Health     Hybrid Journal   (Followers: 26)
Culture, Health & Sexuality: An International Journal for Research, Intervention and Care     Hybrid Journal   (Followers: 17)
Current Opinion in Supportive and Palliative Care     Hybrid Journal   (Followers: 28)
Das Gesundheitswesen     Hybrid Journal   (Followers: 10)
Death Studies     Hybrid Journal   (Followers: 22)
Dental Nursing     Full-text available via subscription   (Followers: 3)
Disaster Health     Hybrid Journal   (Followers: 1)
DoctorConsult - The Journal. Wissen für Klinik und Praxis     Full-text available via subscription  
Droit, Déontologie & Soin     Full-text available via subscription   (Followers: 3)
E-Health Telecommunication Systems and Networks     Open Access   (Followers: 2)
East and Central African Journal of Surgery     Open Access  
Éducation thérapeutique du patient     Full-text available via subscription   (Followers: 1)
eGEMs     Open Access  
Emergency Radiology     Hybrid Journal   (Followers: 10)
Enfermería Clínica     Full-text available via subscription   (Followers: 3)
Epidemiologic Methods     Hybrid Journal   (Followers: 4)
Ergonomics     Hybrid Journal   (Followers: 24)
Escola Anna Nery     Open Access   (Followers: 1)
Ethnicity & Health     Hybrid Journal   (Followers: 15)
European Journal of Public Health     Hybrid Journal   (Followers: 27)
European Journal of Work and Organizational Psychology     Hybrid Journal   (Followers: 35)
European Research in Telemedicine / La Recherche Européenne en Télémédecine     Full-text available via subscription   (Followers: 2)
Evaluation & the Health Professions     Hybrid Journal   (Followers: 11)
Evidence-Based Nursing     Hybrid Journal   (Followers: 74)
Evolution, Medicine, and Public Health     Open Access   (Followers: 12)
Expert Opinion on Therapeutic Patents     Hybrid Journal   (Followers: 12)
Families, Systems, & Health     Full-text available via subscription   (Followers: 9)
Family Practice Management     Full-text available via subscription   (Followers: 5)
Focus on Health Professional Education : A Multi-disciplinary Journal     Full-text available via subscription   (Followers: 7)
Frontiers in Public Health Services and Systems Research     Open Access   (Followers: 5)
Future Hospital Journal     Full-text available via subscription   (Followers: 2)
Gastrointestinal Nursing     Full-text available via subscription   (Followers: 5)
Geron     Full-text available via subscription  
Global & Regional Health Technology Assessment     Open Access   (Followers: 1)
Global Health Action     Open Access   (Followers: 12)
Global Health Management Journal (GHMJ)     Open Access   (Followers: 1)
Global Health Research and Policy     Open Access   (Followers: 4)
Global Journal of Hospital Administration     Open Access   (Followers: 1)
Global Public Health: An International Journal for Research, Policy and Practice     Hybrid Journal   (Followers: 21)
Globalization and Health     Open Access   (Followers: 9)
Handbook of Practice Management     Hybrid Journal   (Followers: 2)
Health     Open Access   (Followers: 5)
Health & Social Care In the Community     Hybrid Journal   (Followers: 54)
Health : An Interdisciplinary Journal for the Social Study of Health, Illness and Medicine     Hybrid Journal   (Followers: 16)
Health and Interprofessional Practice     Open Access   (Followers: 6)
Health and Technology     Hybrid Journal   (Followers: 4)
Health Care Analysis     Hybrid Journal   (Followers: 17)
Health Care Management Review     Hybrid Journal   (Followers: 16)
Health Economics     Hybrid Journal   (Followers: 59)
Health Expectations     Open Access   (Followers: 16)
Health Facilities Management     Free   (Followers: 10)
Health Informatics Journal     Hybrid Journal   (Followers: 28)
Health Information : Jurnal Penelitian     Open Access   (Followers: 5)
Health Information Science and Systems     Open Access   (Followers: 4)
Health Policy and Management     Open Access   (Followers: 7)
Health Policy and Planning     Hybrid Journal   (Followers: 27)
Health Professions Education     Open Access   (Followers: 3)
Health Promotion International     Hybrid Journal   (Followers: 28)
Health Promotion Practice     Hybrid Journal   (Followers: 18)
Health Psychology     Full-text available via subscription   (Followers: 62)
Health Psychology Review     Hybrid Journal   (Followers: 46)
Health Reform Observer : Observatoire des Réformes de Santé     Open Access   (Followers: 2)
Health Research Policy and Systems     Open Access   (Followers: 16)
Health Science Journal of Indonesia     Open Access   (Followers: 2)
Health Services Research and Managerial Epidemiology     Open Access   (Followers: 3)
Health, Risk & Society     Hybrid Journal   (Followers: 14)
Healthcare : The Journal of Delivery Science and Innovation     Full-text available via subscription   (Followers: 1)
Healthcare in Low-resource Settings     Open Access   (Followers: 1)
Healthcare Management Forum     Hybrid Journal   (Followers: 8)
Healthcare Policy / Politiques de Santé     Full-text available via subscription   (Followers: 5)
Healthcare Quarterly     Full-text available via subscription   (Followers: 10)
Healthcare Risk Management     Full-text available via subscription   (Followers: 5)
HealthcarePapers     Full-text available via subscription   (Followers: 2)
Hispanic Health Care International     Full-text available via subscription  
História, Ciências, Saúde - Manguinhos     Open Access   (Followers: 2)
Hong Kong Journal of Social Work, The     Hybrid Journal   (Followers: 3)
Hospital     Open Access   (Followers: 3)
Hospital a Domicilio     Open Access  
Hospital Medicine Clinics     Full-text available via subscription   (Followers: 2)
Hospital Peer Review     Full-text available via subscription   (Followers: 1)
Hospital Pharmacy     Partially Free   (Followers: 18)
Hospital Practice     Hybrid Journal   (Followers: 2)
Hospital Practices and Research     Open Access  
Housing, Care and Support     Hybrid Journal   (Followers: 9)
Human Factors : The Journal of the Human Factors and Ergonomics Society     Full-text available via subscription   (Followers: 39)
Human Resources for Health     Open Access   (Followers: 12)
ICU Director     Hybrid Journal  
Ids Practice Papers     Hybrid Journal  
IEEE Pulse     Hybrid Journal   (Followers: 5)
IISE Transactions on Healthcare Systems Engineering     Hybrid Journal   (Followers: 2)
Independent Nurse     Full-text available via subscription   (Followers: 3)
Index de Enfermeria     Open Access   (Followers: 7)
Indian Journal of Public Health     Open Access   (Followers: 1)
Informatics for Health and Social Care     Hybrid Journal   (Followers: 10)
Innovation and Entrepreneurship in Health     Open Access   (Followers: 1)
INQUIRY : The Journal of Health Care Organization, Provision, and Financing     Open Access   (Followers: 1)
Interface - Comunicação, Saúde, Educação     Open Access   (Followers: 1)
International Archives of Health Sciences     Open Access  
International Journal for Equity in Health     Open Access   (Followers: 9)
International Journal for Quality in Health Care     Hybrid Journal   (Followers: 41)
International Journal of Care Coordination     Hybrid Journal   (Followers: 7)
International Journal of Computers in Healthcare     Hybrid Journal   (Followers: 3)
International Journal of Electronic Healthcare     Hybrid Journal   (Followers: 2)
International Journal of Environmental Research and Public Health     Open Access   (Followers: 27)
International Journal of Health Administration and Education Congress (Sanitas Magisterium)     Open Access  
International Journal of Health Care Quality Assurance     Hybrid Journal   (Followers: 15)
International Journal of Health Economics and Management     Hybrid Journal   (Followers: 12)
International Journal of Health Governance     Hybrid Journal   (Followers: 27)
International Journal of Health Planning and Management     Hybrid Journal   (Followers: 6)
International Journal of Health Sciences Education     Open Access   (Followers: 2)
International Journal of Health Services Research and Policy     Open Access   (Followers: 1)
International Journal of Health System and Disaster Management     Open Access   (Followers: 3)
International Journal of Healthcare     Open Access   (Followers: 1)
International Journal of Healthcare Technology and Management     Hybrid Journal   (Followers: 7)
International Journal of Hospital Research     Open Access  
International Journal of Human Factors and Ergonomics     Hybrid Journal   (Followers: 20)
International Journal of Human Rights in Healthcare     Hybrid Journal   (Followers: 5)
International Journal of Medicine and Public Health     Open Access   (Followers: 6)
International Journal of Migration, Health and Social Care     Hybrid Journal   (Followers: 12)
International Journal of Occupational and Environmental Medicine, The     Open Access   (Followers: 16)
International Journal of Palliative Nursing     Full-text available via subscription   (Followers: 32)
International Journal of Positive Behavioural Support     Full-text available via subscription   (Followers: 38)
International Journal of Prisoner Health     Hybrid Journal   (Followers: 14)
International Journal of Privacy and Health Information Management     Full-text available via subscription   (Followers: 3)
International Journal of Public and Private Healthcare Management and Economics     Full-text available via subscription   (Followers: 4)
International Journal of Qualitative Studies on Health and Well-Being     Open Access   (Followers: 22)
International Journal of Reliable and Quality E-Healthcare     Full-text available via subscription   (Followers: 1)
International Journal of Research in Nursing     Open Access   (Followers: 12)
International Journal of Technology Assessment in Health Care     Hybrid Journal   (Followers: 16)
International Journal of Telemedicine and Clinical Practices     Hybrid Journal   (Followers: 5)
International Journal of Telework and Telecommuting Technologies     Full-text available via subscription  
International Journal of Therapy and Rehabilitation     Full-text available via subscription   (Followers: 42)
International Journal of User-Driven Healthcare     Full-text available via subscription   (Followers: 1)
International Journal on Disability and Human Development     Hybrid Journal   (Followers: 23)
Irish Journal of Paramedicine     Open Access   (Followers: 3)
JAAPA     Hybrid Journal   (Followers: 3)
Jaffna Medical Journal     Open Access  
Joint Commission Journal on Quality and Patient Safety     Hybrid Journal   (Followers: 41)
Journal for Healthcare Quality     Hybrid Journal   (Followers: 28)
Journal of Advanced Nursing     Hybrid Journal   (Followers: 251)
Journal of Advances in Medical Education & Professionalism     Open Access   (Followers: 10)
Journal of Aging and Health     Hybrid Journal   (Followers: 27)
Journal of Ambulatory Care Management, The     Hybrid Journal   (Followers: 4)
Journal of Applied Arts and Health     Hybrid Journal   (Followers: 1)

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Similar Journals
Journal Cover
Healthcare : The Journal of Delivery Science and Innovation
Number of Followers: 1  
  Full-text available via subscription Subscription journal
ISSN (Print) 2213-0764 - ISSN (Online) 2213-0772
Published by Elsevier Homepage  [3304 journals]
  • New Mother Number 14
    • Abstract: Publication date: Available online 6 March 2019Source: HealthcareAuthor(s): Aroonsiri Sangarlangkarn
  • Dopesick: Dealers, doctors, and the drug company that addicted America,
           Beth Macy (Ed.). Published by Little, Brown and Company, New York (2018),
           384 pp., 0316551244, ISBN- 978–0316551243
    • Abstract: Publication date: March 2019Source: Healthcare, Volume 7, Issue 1Author(s): Rick Mathis
  • Pragmatic clinical trials offer unique opportunities for disseminating,
           implementing, and sustaining evidence-based practices into clinical care:
           Proceedings of a workshop
    • Abstract: Publication date: March 2019Source: Healthcare, Volume 7, Issue 1Author(s): Leah Tuzzio, Eric B. Larson, David A. Chambers, Gloria D. Coronado, Lesley H. Curtis, Wendy J. Weber, Douglas F. Zatzick, Catherine M. Meyers The National Institutes of Health (NIH) Health Care Systems (HCS) Research Collaboratory hosted a workshop to explore challenges and strategies for the dissemination, implementation, and sustainability of findings from pragmatic clinical trials (PCTs) embedded in HCS. PCTs are designed to assess the impact of interventions delivered in usual or real-world conditions and leverage existing infrastructure to answer important clinical questions. The goal of the workshop was to discuss strategies for conducting impactful future PCTs that bridge the gap between evidence, practice, and policy. This paper summarizes presentations about how to design and conduct PCTs embedded in HCS and use dissemination and implementation strategies during the planning and conduct of projects, emphasizing the ever-changing world of care delivery and the need for pragmatic trial operations to adapt at various levels of operation.
  • Practice strategies to improve primary care for chronic disease patients
           under a pay-for-value program
    • Abstract: Publication date: March 2019Source: Healthcare, Volume 7, Issue 1Author(s): Dori A. Cross, Paige Nong, Christy Harris-Lemak, Genna R. Cohen, Ariel Linden, Julia Adler-Milstein BackgroundImproving primary care for patients with chronic illness is critical to advancing healthcare quality and value. Yet, little is known about what strategies are successful in helping primary care practices deliver high-quality care for this population under value-based payment models.MethodsDouble-blind interviews in 14 primary care practices in the state of Michigan, stratified based on whether they did (n = 7) or did not (n = 7) demonstrate improvement in primary care outcomes for patients with at least one reported chronic disease between 2010 and 2013. All practices participate in a statewide pay-for-performance program run by a large commercial payer. Using an implementation science framework to identify leverage points for effecting organizational change, we sought to identify, describe and compare strategies among improving and non-improving practices across three domains: (1) organizational learning opportunities, (2) approaches to motivating staff, and (3) acquisition and use of resources.ResultsWe identified 10 strategies; 6 were “differentiating” – that is, more prevalent among improving practices. These differentiating strategies included: (1) participation in learning collaboratives, (2) accessing payer tools to monitor quality performance, (3) framing pay-for-performance as a practice transformation opportunity, (4) reinvesting earned incentive money in equitable, practice-centric improvement, (5) employing a care manager, and (6) using available technical support from local hospitals and provider organizations to support performance improvement. Implementation of these strategies varied based on organizational context and relative strengths.ConclusionsPractices that succeeded in improving care for chronic disease patients pursued a mix of strategies that helped meet immediate care delivery needs while also creating new adaptive structures and processes to better respond to changing pressures and demands. These findings help inform payers and primary care practices seeking evidence-based strategies to foster a stronger delivery system for patients with significant healthcare needs.
  • Driving impact through investments in life science and healthcare: An
           interview with GV (formerly Google Ventures) partner Krishna Yeshwant
    • Abstract: Publication date: March 2019Source: Healthcare, Volume 7, Issue 1Author(s): Sanchay Gupta, Adam L. Beckman
  • How patient experience informed the SafeMed Program: Lessons learned
    • Abstract: Publication date: March 2019Source: Healthcare, Volume 7, Issue 1Author(s): Jill D. Nault Connors, Bonnie L. Binkley, J. Carolyn Graff, Satya Surbhi, James E. Bailey •Program theory of change must account for the lived experiences of medically and socially complex patients in order to affect dysfunctional patterns of acute care utilization.•Mental and emotional health, access to self-management resources, and patient-provider communication are key issues of importance to super-utilizing patients.•Transformation of didactic, patient education sessions to interactive, self-management support group sessions achieved success in improving patient engagement.•Lack of collaboration and compliance-oriented healthcare culture are primary threats to successful implementation of innovative healthcare delivery programs.•Linkage and navigation roles of healthcare staff are important in improving patient access to existing community resources, but further health system investments are required to effectively integrate community-based and social services into care delivery.•Peer support interventions are underutilized but hold great promise for addressing behavioral health needs of medically and socially complex patients.
  • Discharge to medical home: A new care delivery model to treat non-urgent
           cases in a rural emergency department
    • Abstract: Publication date: March 2019Source: Healthcare, Volume 7, Issue 1Author(s): Kathryn Zager, Yhenneko J. Taylor Emergency department visits for non-urgent reasons contribute to overcrowding and higher healthcare costs. Routing patients to lower cost care settings may improve outcomes. The Discharge to Medical Home model is a new care delivery model that routes low-acuity, ambulatory, emergency department (ED) patients to an adjacent primary care clinic, which provides the opportunity for patients to establish a medical home. During clinic hours, walk-in patients presenting to the ED are screened and, if appropriate, scheduled for a same-day appointment with a primary care provider. Over the first year of operation, the model reached 38% of all ED encounters and over 90% of daytime ED encounters. Over a third (36%) of daytime ED patients were discharged to primary care. Future steps include examining primary care follow up after initial discharge and examining models to best leverage the capacity of the primary care clinic to care for both walk-in and established patients.
  • Saving without compromising: Teaching trainees to safely provide high
           value care
    • Abstract: Publication date: March 2019Source: Healthcare, Volume 7, Issue 1Author(s): Timothy J. Judson, Matthew J. Press, Allan S. Detsky Hospitals are increasingly shifting toward value-based reimbursement and focusing on cost consciousness and patient experience. These concepts are crucial to high-quality, affordable healthcare. However, physicians are not well-trained in factoring cost and patient experience into clinical decisions. The addition of these ideas may create the opportunity for patient harm by depriving patients of necessary care. We discuss ways for physicians to mitigate this risk by engaging in online high value care curricula, using a “5-Question High Value Care Time Out,” getting mentorship from master clinicians and using clinical decision support tools.
  • (Expected) value-based payment: From total cost of care to net present
           value of care
    • Abstract: Publication date: March 2019Source: Healthcare, Volume 7, Issue 1Author(s): Nathaniel Z. Counts, Justin Dean Smith, Daniel Max Crowley
  • Building a model health insurer: An Interview with Blue Cross North
           Carolina CEO Patrick Conway
    • Abstract: Publication date: March 2019Source: Healthcare, Volume 7, Issue 1Author(s): Adam L. Beckman, Sanchay Gupta
  • Redesigning primary care in the safety net: A qualitative analysis of
           team-based care implementation
    • Abstract: Publication date: March 2019Source: Healthcare, Volume 7, Issue 1Author(s): Helena C. Lyson, Sara Ackerman, Courtney Lyles, Dean Schillinger, Pamela Williams, Gato Gourley, Reena Gupta, Margaret Handley, Urmimala Sarkar BackgroundTeam-based care is an innovative approach to primary care in which groups of health care professionals work collaboratively to manage care for groups of patients. Safety-net organizations face specific barriers to implementing health care innovations. More research is needed that documents the dynamics that inform implementation and sustainment of innovative practices in the safety net.MethodsWe conducted qualitative fieldwork, including purposeful observation and semi-structured and informal interviews, to explore the implementation of care teams in safety-net clinics in California. Field notes and transcripts were analyzed using an inductive approach to identify overarching themes across sites.ResultsSalient themes across clinics suggest that 1) well-designed physical layouts that promote sustained patterns of structured and spontaneous communication and collaboration are critical to creating high-functioning teams; 2) implementation of team-based care relies on a relaxing of the traditional clinic hierarchy into an agile organizational structure that empowers all clinic staff—most notably medical assistants—by facilitating an ethos of collaborative decision-making, interdependence, and shared responsibility; and 3) resource constraints related to recruitment and retention of qualified staff are key barriers to implementation.ConclusionsTeam-based care has the potential to improve patient outcomes, strengthen relationships and well-being among clinic staff, and expand staff roles to facilitate collective accomplishment of work goals. To successfully launch and sustain care teams in safety-net clinics, greater commitments to creating well-designed spaces and a re-envisioning of the training and compensation for medical assistants that reflects the valuable role these individuals can play appear to be necessary.
  • Time-driven activity-based costing to model the utility of parallel
           induction redesign in high-turnover operating lists
    • Abstract: Publication date: Available online 13 February 2019Source: HealthcareAuthor(s): Jarrod Basto, Rani Chahal, Bernhard Riedel BackgroundValue-based healthcare is strongly advocated to reduce the spiralling rise in healthcare expenditure. Operating room efficiency is an important focus of value-based healthcare delivery due to high costs and associated hospital revenue derived from procedural streams of care. A parallel induction design, utilising induction rooms for anesthetising patients, may improve operating room efficiency and optimise revenue. We used time-driven activity-based costing (TDABC) to model personnel costs for a high-turnover operating list to assess value of parallel induction redesign.MethodsWe prospectively captured activity data from high-turnover surgery allocated to induction of anesthesia within the operating room (serial design) or within induction rooms prior to completion of preceding surgery (parallel design). Personnel costs were constructed using TDABC following assignment of a case-mix that integrated our activity data. This was contrasted against procedural revenue to assess value of projected case throughput.ResultsUnder a parallel induction design, projected operating list duration was reduced by 55 min at marginal increase (1.6%) in personnel costs as assessed by TDABC. This could facilitate an additional short duration surgical case (e.g. Wide Local Excision, with potential additional revenue of $2818 per day and $0.73 M per annum per operating room.ConclusionsParallel induction design reduces non-operative time at minimal increase in personnel costs for all-day, high turnover surgery. An additional short duration surgical case is likely feasible under this model and represents a value investment with minimal requirement for additional personnel resources.ImplicationsA parallel induction design, within the constraints of finite healthcare funding, may help alleviate some of the global increase in demand for surgical capacity that accompanies an expanding and aging population.
  • Planning together: Patient-centered care planning to improve health
    • Abstract: Publication date: Available online 11 February 2019Source: HealthcareAuthor(s): Miriam C. Tepper, Ekta Taneja, Kristin M. King •Individuals with serious mental illness (SMI) experience significant health disparities and die much younger than the general population. Interventions to address this disparity have targeted nutrition, physical fitness, and smoking cessation, but have not yet resulted in significant improvements in health outcomes for this population.•The patient-centered care plan, used by providers and patients during outpatient visits, is a potential tool for engaging patients in their own care. We undertook a quality improvement initiative to boost the use of care plans.•Care plan completion increased substantially over the time period of the initiative. Interviews with patient-provider dyads indicated that patients found care plan conversations helpful for articulating and working toward their goals. Providers generally found them useful for refocusing the treatment, though some found the workflow cumbersome.•Improving health outcomes among those with SMI will likely require improving patient activation; the patient-centered care plan might be a useful tool for addressing patient activation.
  • How middle managers facilitate interdisciplinary primary care team
    • Abstract: Publication date: Available online 11 February 2019Source: HealthcareAuthor(s): Karleen F. Giannitrapani, Hector Rodriguez, Alexis K. Huynh, Alison B. Hamilton, Linda Kim, Susan E. Stockdale, Jack Needleman, Elizabeth M. Yano, Lisa V. Rubenstein BackgroundThe Veterans Health Administration (VA) primary care is organized as a Patient Centered Medical Home (PCMH) that is based on continuity management of patient panels by interdisciplinary “teamlets” consisting of primary care providers, nurses, and clerical associates. While the teamlets are envisioned as interdisciplinary in this model, teamlet members may continue to report separately to middle management supervisors within their respective disciplines. Little is known about the role of middle managers in medical home implementation; therefore, the study purpose is to examine and characterize teamlet members’ perceptions of middle managers’ role in primary care operations and teamlet functioning in an outpatient setting.MethodsThis study applied a formal qualitative data collection method and analysis based on semi-structured interviews of 79 frontline interdisciplinary staff (primary care providers, nurses, and clerical associates) in VA Patient Aligned Care Teams (PACT) teamlets. Interviews were analyzed using a method of constant comparison.ResultsTeamlet members recognize that their supervising middle managers are essential to daily functioning of PACT teamlets in terms of clarifying roles and responsibilities, setting expectations, providing coverage strategies, supporting conflict resolution, and facilitating teamlet-initiated innovation. Teamlet members identified challenges when middle manager involvement was lacking.ConclusionWithin a multilevel system, frontline interdisciplinary staff continue to perceive the need for leadership by middle managers from their own professional disciplines for solving interdisciplinary problems, setting role-specific schedules and expectations, and fostering innovation. As such, greater focus on the structure and training of middle managers for participation in PCMH models is needed.
  • Consensus statement on surgical system strengthening in rural india
    • Abstract: Publication date: Available online 30 January 2019Source: HealthcareAuthor(s): Association of Rural Surgeons of India - Lancet Commission on Global Surgery (ARSI-LCoGS) Consensus Committee In India, 90% of the rural population is estimated to lack access to safe, affordable, and timely surgical care. Surgical care in these settings is often characterized by limited resources. Provision of rural surgical care often requires novel approaches as compared to those in higher income urban sectors, specifically in areas of infrastructure, workforce, and blood. This consensus statement draws upon the wealth of experience held by India's rural surgeons to identify key problems and lay forth actionable solutions in the areas of surgical infrastructure, workforce, and blood supply.
  • A new model of online health care delivery science education for
           mid-career health care professionals
    • Abstract: Publication date: Available online 4 January 2019Source: HealthcareAuthor(s): Adrienne Faerber, Alice Andrews, Ano Lobb, Eric Wadsworth, Katherine Milligan, Robert Shumsky, Elliott Fisher, Tim Lahey Health care delivery science focuses on ways to improve health and health care services provided to individuals and populations. Health care professionals must be trained in health care delivery science in order to diagnose and treat the sources of health care system dysfunction and achieve better outcomes while controlling costs. The ideal model for health care delivery science training has not been fully defined, but doing so is critical especially for frontline mid-career health care professionals whose original clinical training omitted these concepts. To better prepare leaders to address the complex challenges of health care, we created a novel hybrid residential/online 18-month master's degree in health care delivery science. Key strengths of the program are the curriculum, pedagogy, teaching team and close-knit cohort. Here, we discuss the program design rationale and six years of evaluation data of a novel master of health care delivery science program. Novel online education in health care delivery science can empower inter-professional leaders in multiple leadership positions throughout health care to improve the United States health care system.
  • Patient-centered care innovations by accountable care organizations:
           Lessons from leaders
    • Abstract: Publication date: Available online 26 December 2018Source: HealthcareAuthor(s): Michael L. Millenson, David B. Muhlestein, Emily M. O’Donnell, Daniel A. Northam Jones, R. Sterling Haring, Thomas Merrill, Joel S. Weissman Although there is a widespread belief that ACOs must be patient-centered to be successful, evidence to guide them in achieving that goal has been lacking. This case report examines four ACO innovators in patient-centered care that together represent urban, suburban and rural populations with a broad range of economic, racial, ethnic and geographic diversity. Seven patient-centeredness strategies emerged: transform primary care practices into patient-centered medical homes; move upstream to address social and economic issues; use both high-tech and high-touch to identify and engage high-risk patients; practice a whole-person orientation; optimize patient-reported measures; treat patients like valued customers; and incorporate patient voices into governance and operations. Exemplars prioritized direct care interventions perceived as central to financial and clinical success, and organizational maturity played a role. Activities that decreased the traditional system's authority, such as incorporating patient voices, were less popular. Local practice factors were important, and a mixture of mission and margin energized front-line staff in implementing patient-centered care as “the right thing to do.” Unresolved questions remain that are related to the impact of individual and multiple interventions and how successful interventions can be disseminated widely. In order for patient-centeredness innovations to enable transformation, providers, payers and policymakers alike must consciously adopt strategies that nurture it.
  • Implementation of The Lancet Commission on Global Surgery in India
    • Abstract: Publication date: Available online 3 December 2018Source: HealthcareAuthor(s): Nakul Raykar, Swagoto Mukhopadhyay, Saurabh Saluja, Sheetal Amte, Siddharth David, Jesudian Gnanaraj, Raman Kataria, Balaram Jadhav, Walt Johnson, John Meara, Nandakumar Menon, Radhakrishna D. Prabhu, Devi Shetty, Ravikant Singh, Ravindranath Tongaonkar, Ravindra Vora, Nobhojit Roy
  • Strengthening primary care locally and globally: An interview with Asaf
           Bitton from Ariadne Labs
    • Abstract: Publication date: December 2018Source: Healthcare, Volume 6, Issue 4Author(s): Sanchay Gupta, Adam L. Beckman
  • Empowering people with their healthcare data: An Interview with Harlan
    • Abstract: Publication date: December 2018Source: Healthcare, Volume 6, Issue 4Author(s): Adam L. Beckman, Sanchay Gupta
  • Expanding access to primary healthcare for women through a microfinance
           institution: A case study from rural Guatemala
    • Abstract: Publication date: December 2018Source: Healthcare, Volume 6, Issue 4Author(s): Marcela Colom, Kirsten Austad, Neftali Sacuj, Karen Larson, Peter Rohloff The utilization of existing social networks is increasingly being recognized as a powerful strategy for delivering healthcare services to underserved populations in low- and middle-income countries. In Guatemala, multiple barriers prevent access to healthcare services for rural and indigenous populations, and strategies for delivering healthcare in more efficient ways are needed. The case study we describe here is a unique collaboration between a microfinance institution (Friendship Bridge) and a primary care organization (Wuqu' Kawoq Maya Health Alliance) to scale up healthcare through an existing lending-borrowing social network. The program provides primary care services to female clients of Friendship Bridge in rural areas of Guatemala, with nurses working as frontline primary care providers, providing door-to-door healthcare services. Over the first 22 months of the project, we have reached over 3500 of Friendship Bridge's clients, with overall high acceptance of services. All clinical documentation and program monitoring and evaluation are done through audit trails within an electronical medical record system, which improves efficiency and lowers the associated time and resources costs. We utilize quality improvement methodologies to aid in decision making and programmatic adjustments scale up. These strategies have allowed us to expand services rapidly under challenging geographic and logistical constraints, while concurrently iteratively improving staff training and supervision, clinical care, and client engagement processes.
  • The impact of tailored intervention services on charges and mortality for
           adult super-utilizers
    • Abstract: Publication date: December 2018Source: Healthcare, Volume 6, Issue 4Author(s): Josh Durfee, Tracy Johnson, Holly Batal, Jeremy Long, Deborah Rinehart, Rachel Everhart, Carlos Irwin Oronce, Ivor Douglas, Kimberly Moore, Adam Atherly BackgroundInterventions designed to improve care and reduce costs for patients with the highest rates of hospital utilization (super-utilizers) continue to proliferate, despite conflicting evidence of cost savings.MethodsWe evaluated a practice transformation intervention that implemented team-based care and risk-stratification to match specific primary care resources based on need. This included an intensive outpatient clinic for super-utilizers. We used multivariate regression and a difference-in-differences approach to compare changes in mortality, utilization, and charges between the intervention group and a historical control. Sensitivity analyses tested the robustness of findings and revealed the inherent challenges associated with quasi-experimental designs.ResultsObserved charges for the intervention group were significantly lower than expected charges as derived by the trend of the historical control (p
  • Achieving alignment in graduate medical education to train the next
           generation of healthcare professionals to improve healthcare delivery
    • Abstract: Publication date: December 2018Source: Healthcare, Volume 6, Issue 4Author(s): Christopher Moriates, Vineet M. Arora Medical training is increasingly focused on the need to improve healthcare delivery. To succeed in this endeavor, teaching hospitals should align their educational and clinical operations. This article discusses recent innovations and emerging strategies in medical training across three key components for achieving alignment: (1) bridging educational and clinical priorities; (2) developing curricula to support alignment; (3) and fostering resident-led programs that lead to systems change. Understanding the current landscape of educational and operational innovations across clinical learning environments can help health system leaders and medical educators work together to implement cohesive programs that achieve all of these key components.
  • Using Lean methodologies to streamline processing of requests for durable
           medical equipment and supplies for children with complex conditions
    • Abstract: Publication date: December 2018Source: Healthcare, Volume 6, Issue 4Author(s): Elise Fields, Smriti Neogi, Pamela J. Schoettker, Jennifer Lail BackgroundAn improvement team from the Complex Care Center at our large pediatric medical center participated in a 60-day initiative to use Lean methodologies to standardize their processes, eliminate waste and improve the timely and reliable provision of durable medical equipment and supplies.MethodsThe team used value stream mapping to identify processes needing improvement. Improvement activities addressed the initial processing of a request, provider signature on the form, returning the form to the sender, and uploading the completed documents to the electronic medical record. Data on lead time (time between receiving a request and sending the completed request to the Health Information Management department) and process time (amount of time the staff worked on the request) were collected via manual pre- and post-time studies.ResultsFollowing implementation of interventions, the median lead time for processing durable medical equipment and supply requests decreased from 50 days to 3 days (p < 0.0001). Median processing time decreased from 14 min to 9 min (p < 0.0001). The decrease in processing time realized annual cost savings of approximately $11,000.ConclusionsCollaborative leadership and multidisciplinary training in Lean methods allowed the CCC staff to incorporate common sense, standardize practices, and adapt their work environment to improve the timely and reliable provision of equipment and supplies that are essential for their patients.ImplicationsThe application of Lean methodologies to processing requests for DME and supplies could also result in a natural spread to other paperwork and requests, thus avoiding delays and potential risk for clinical instability or deterioration.
  • Moving forward the Lancet Commission on Global Surgery: The Karad
           Consensus Statement
    • Abstract: Publication date: Available online 26 November 2018Source: HealthcareAuthor(s): Nakul Raykar, John Meara, Atul Gawande, Paul Farmer, Nobhojit Roy
  • Enabling provider decision-making that improves quality and costs in
           oncology: An interview with Andrew Norden from Cota Healthcare
    • Abstract: Publication date: Available online 11 September 2018Source: HealthcareAuthor(s): Sanchay Gupta, Adam L. Beckman
  • Engage specialists to achieve value in healthcare: An interview with
           Brookings Institution Fellow Kavita Patel
    • Abstract: Publication date: Available online 7 September 2018Source: HealthcareAuthor(s): Suhas Gondi, Adam L. Beckman
  • Employing practitioner expertise in optimizing community healthcare
    • Abstract: Publication date: Available online 23 August 2018Source: HealthcareAuthor(s): Madeleine Ballard, Ryan Schwarz To harness the potential of community health workers (CHWs) to extend health services to poor and marginalized populations and avoid the pitfalls of the post-Alma-Ata period, there is an urgent need to better understand how CHW programs can be optimized. Understanding that several operational questions are unresolved by current academic evidence, this viewpoint considers the role of practitioner expertise in optimizing community health systems and highlights findings from a recently published report that captures implementation experience from 15 countries. The viewpoint considers applications of the report’s suggested community health design principles and implications for implementers, philanthropists, policymakers, and academic researchers.
  • Implementation of smart phones to facilitate in-hospital telephone
           communication: Challenges, successes and lessons from a neonatal intensive
           care unit
    • Abstract: Publication date: Available online 14 August 2018Source: HealthcareAuthor(s): Colleen A. Hughes Driscoll, Samuel Gurmu, Ahad Azeem, Dina El Metwally Implementation Lessons 1. Mobile telephony use in the hospital setting is complex and sub-optimal implementation of mobile communication technology can create inefficiencies in clinical workflow 2. Objective measurement of mobile technology’s impact on clinical communication workflow is necessary to identify and remediate associated inefficiencies in real-time 3. Functionality between mobile applications and devices should be evaluated when implementing technology, particularly when an application is non-native to a device 4. Continual collaboration between front-line clinicians and technical teams allows for early identification of adverse impacts from, and optimization of, mobile communication technology implementation.
  • The mayo clinic model of clinical integration
    • Abstract: Publication date: Available online 30 June 2018Source: HealthcareAuthor(s): Richard A. Helmers, C. Michel Harper The multi-campus Academic Health Center (AHC) of the future will need to be system-based and committed to clinical integration to continue to meet institutional goals and serve the needs of its patients. The key tactics we describe to accomplish this are:-the creation of a central governance body and a single strategic and operational plan-the subsequent development of specialty councils and independent multidisciplinary practices (IMP)-the creation of enterprise-wide specialty departments
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Heriot-Watt University
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