Health care management review
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Health Care Manage Rev · Oct 2007
A study of the effects of innovative and efficient practices on the performance of hospice care organizations.
Due to changes in social norms, funding initiatives, and other environmental factors, the business of hospice care has significantly evolved over the past 40 years. There has been an influx of for-profit firms, increased consolidation, and significant funding changes. We have witnessed a growth in utilization rates, an increase in insurance coverage, and improved governmental funding. Hospice care organizations have responded to these pressures by pursuing more efficient and innovative business practices. ⋯ It appears that incorporating innovative practices is positively related to quality of care. Although cost containment may be necessary for continued survival, efficiency improvement efforts do not seem to lead to improved quality of care.
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Despite the growing pervasiveness of team-based job designs in health care organizations, there is a degree of uncertainty and ambiguity about the process through which teams affect outcomes. ⋯ Although adopting team-based job designs is an important first step, attention must also be paid to the context and atmosphere of such teams. Better outcomes will be achieved when team members perceive a supportive team atmosphere and an empowering team context with clear and jointly developed goals, an appropriate mix of skills and expertise, and rewards linked to team performance.
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Health Care Manage Rev · Jul 2007
Impact of nurse staffing level on emergency department market share.
Emergency departments (EDs) function at the interface of complex systems of the hospital and play a critical role in safety net systems. Adequate level of nurse staffing is crucial in meeting patients' needs and assuring their safety in EDs. ⋯ Higher nurse staffing level is sensitively linked to the higher market share in emergency care services. These findings provide an initiative for hospital managers and nurse administrators to recruit and retain more nurses for pursuing higher nurse staffing. Furthermore, continuous effort should be made to develop a high standard of establishing and maintaining an adequate level of nurse staffing.
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Health Care Manage Rev · Apr 2007
Increasing the relevance of research to health care managers: hospital CEO imperatives for improving quality and lowering costs.
Evidence-based management assumes that available research evidence is consistent with the problems and decision-making conditions faced by those who will utilize this evidence in practice. ⋯ The results suggest a need to expand the methods utilized by health services researchers to make their research more relevant to health care managers. Expanding research methods to reflect the systemic way that managers view the challenges and solutions facing their organizations may enhance the application of research findings into management practice. Finally, better communication is needed between the research and practice communities. Researchers must learn to think more like managers if their research is to be relevant, and managers must learn to more effectively communicate their issues with the research community and frame their problems in researchable terms.
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Medical research continues to focus overwhelmingly on biomedical interventions, such as drugs, devices, and procedures. The dysfunctional health care cultures and systems need more attention for quality of care to improve further. ⋯ Health care organizations can improve the quality of care and reduce medical errors significantly by enhancing learning from mistakes and boosting camaraderie and morale of their employees. They can do so by breaking down silos in their structures, implementing just and fair management practices, and involving employees in decision making.