Health care management review
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Health Care Manage Rev · Oct 2018
Insights into nurses' work: Exploring relationships among work attitudes and work-related behaviors.
Work attitudes have been associated with work productivity. In health care, poor work attitudes have been linked to poor performance, decreased patient safety, and quality care. Hence, the importance, ascribed in the literature, of work that clearly identifies the relationships between and among work attitudes and work behaviors linked to performance. ⋯ With limited resources, knowledge of nurse work attitudes can inform human resource practices and operational policies involving training programs in employee communication, transparency, interaction, support, and performance evaluation.
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Health Care Manage Rev · Jul 2018
Contextual factors that influence quality improvement implementation in primary care: The role of organizations, teams, and individuals.
Recent emphasis on value-based health care has highlighted the importance of quality improvement (QI) in primary care settings. QI efforts, which require providers and staff to work in cross-functional teams, may be implemented with varying levels of success, with implementation being affected by factors at the organizational, teamwork, and individual levels. ⋯ Health care managers in primary care settings should strive to create a strong teamwork climate, reinforced by opportunities for staff in various roles to discuss QI as a collective.
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Health Care Manage Rev · Apr 2018
Fostering evidence-based quality improvement for patient-centered medical homes: Initiating local quality councils to transform primary care.
Although the patient-centered medical home endorses quality improvement principles, methods for supporting ongoing, systematic primary care quality improvement have not been evaluated. We introduced primary care quality councils at six Veterans Health Administration sites as an organizational intervention with three key design elements: (a) fostering interdisciplinary quality improvement leadership, (b) establishing a structured quality improvement process, and (c) facilitating organizationally aligned frontline quality improvement innovation. ⋯ In order to successfully facilitate systematic, sustainable primary care quality improvement, regional and executive health care system leaders should engage interdisciplinary practice level leadership in a priority-setting process that encourages frontline innovation and establish local structures such as quality councils to coordinate quality improvement initiatives, ensure accountability, and promote spread of best practices.
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Health Care Manage Rev · Jul 2017
Integrating: A managerial practice that enables implementation in fragmented health care environments.
How some organizations improve while others remain stagnant is a key question in health care research. Studies identifying how organizations can implement improvement despite barriers are needed, particularly in primary care. ⋯ Our research explores an understudied element of how clinics can implement improvement despite barriers: integrating stakeholders within and outside the clinic into the process. It provides clinic managers with an actionable path for implementing improvement.
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Health Care Manage Rev · Jul 2017
Contextual factors associated with hospitals' decision to operate freestanding emergency departments.
Freestanding emergency departments (FSEDs) are fast growing entities in health care, delivering emergency care outside of hospitals. Hospitals may benefit in several ways by opening FSEDs. ⋯ The findings may be used by policy makers in developing regulations for hospitals opening FSEDs. Also, study findings of this study may be used by hospitals to make informed decisions when formulating strategies regarding FSEDs.