Hospital Topics (Hosp Top)

Publications in this journal

• Article: Hospital Compliance with a State Unfunded Mandate: The Case of California's Earthquake Safety Law.

  Michael J McCue, Jon M Thompson
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  ABSTRACT: Abstract In recent years, community hospitals have experienced heightened regulation with many unfunded mandates. The authors assessed the market, organizational, operational, and financial characteristics of general acute care hospitals in California that have a main acute care hospital building that is noncompliant with state requirements and at risk of major structural collapse from earthquakes. Using California hospital data from 2007 to 2009, and employing logistic regression analysis, the authors found that hospitals having buildings that are at the highest risk of collapse are located in larger population markets, possess smaller market share, have a higher percentage of Medicaid patients, and have less liquidity.
  Hospital Topics 10/2012; 90(4):91-97.
• Article: Cases of Mobbing Activities as Commonly Seen in the Healthcare Sector in the World and in Turkey.

  Gökhan Ofluoğlu, Sinem Somunoğlu
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  ABSTRACT: Abstract Service process on a site in the health sector does not only bring people and services into contact, but also all other people who share the fate of particular working medium. Although these people should cooperate and care about each other, contributing new merits to humanity with their synergy, meeting of people with the other people from time to time intertwine into a bitter, pain giving relation, like the way it happens with meeting of people with services. Owing to its controversy to humanitarian nature, religious and social values, the pain that human beings cause to one another is occasionally disguised behind a veil, thus turning into a life tragedy for individuals in the background. Mobbing which is commonly a confrontable problem in every workplace means psychological violence, enclosure, harassment, molestation or endurance. This study aims to draw attention to the precautions required to be taken against mobbing activities by analyzing situations of health employees who undergo mobbing actions in Turkey and in the World. To achieve this, the existing studies concerning mobbing in the healthcare sector have been examined. In conclusion; it is determined that mobbing activities towards healthcare workers have limited their communication possibilities, damaged social relations and social image, prevented vocational improvement and destroyed mental health of employees. With respect to mobbing behavior towards health employees, we should adopt a democratic, contributing, and guiding administration style, we should apply organizational justice, excessive work inspections must be reduced, work ethics and social responsibility awareness must be developed, we should clearly determine the duties and responsibilities, physical conditions must be improved and necessary legal arrangements concerning the subject must be made to be able to prevent mobbing.
  Hospital Topics 10/2012; 90(4):98-103.
• Article: Governance Issues in the Transition to Accountable Care: A Case Study of Silver Cross Hospital.

  Stephen G Morrissette
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  ABSTRACT: Abstract Recent developments in healthcare reform legislation and in the private-payer marketplace have increased impetus toward clinical integration. Industry changes require that healthcare delivery institutions confront fundamental scope and scale structural issues that may lead to increased vertical integration. To accomplish integration, firms must decide the organizational form of integration (alliance or merger/acquisition). One form of integration, accountable care organizations (ACOs), has featured prominently in recent legislation. Clinical integration and ACOs present significant shared-governance challenges that must be understood by hospital boards. The author outlines these governance issues using a case study of Silver Cross Hospital's governance structure for its ACO.
  Hospital Topics 10/2012; 90(4):104-112.
• Article: Hospitalists at an academic medical center, part 2: guidelines and suggestions for the successful expansion of a voluntary pilot hospitalist program.

  Elliot Frank, David P Paul, Roy Nersesian
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  ABSTRACT: Previously, the authors discussed the successful introduction of a pilot hospitalist program at an academic medical center. Here they examine best practices for the expansion of such a program. Many studies have shown hospitalists to be associated with improvements in hospital quality indicators such as decreased length of stay, but the conditions necessary for the expansion of a hospitalist program have received considerably less attention. The authors review guidelines and empirical evidence from the literature for the successful implementation of hospitalist programs generally and present specific recommendations for a previously described pilot hospitalist program at an academic medical center.
  Hospital Topics 10/2011; 89(4):82-91.
• Article: Accountable care organization musical chairs: will there be a seat remaining for the small group or solo practice? [corrected].

  Amy Vaughan, Alberto Coustasse
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  ABSTRACT: When it was introduced in the Affordable Care Act of 2010 as the new 2012 payment model for Medicare, an accountable care organization (ACO) was a new and untested concept in healthcare delivery and payment. The authors estimated the likelihood of engagement in ACOs by small group and solo healthcare practitioners. An evaluation of five case studies showed that significant organizational, financial, and technological challenges had to be met in order to launch an ACO. Sufficient resources to meet those challenges were best supplied by large organizations. Small or solo practices participated only through varying levels of integration as salaried physicians or in independent practice associations or physician hospital organizations.
  Hospital Topics 10/2011; 89(4):92-7.
• Article: Hospitalists at an academic medical center, part 1: impact of a voluntary pilot hospitalist program.

  Elliot Frank, David P Paul, Roy Nersesian
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  ABSTRACT: The use of hospitalists-physicians who limit their practice largely or exclusively to hospital inpatient care-has been a growing trend in the United States. The authors examine some pressures affecting an academic medical center and present the results of a hospitalist pilot project there. Based on the criteria of reduced patient length of hospital stay, hospital financial savings, physician satisfaction, and payer interest, the pilot hospitalist program was successful within 6 months.
  Hospital Topics 10/2011; 89(4):75-81.
• Article: Introducing the health coach at a primary care practice: impact on quality and cost (Part 1).

  Bethany Sneed Lanese, Asoke Dey, Prashant Srivastava, Robert Figler
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  ABSTRACT: The cost of healthcare in U.S. is a poor value proposition. One of the primary goals of the healthcare reform act is to reduce cost while improving healthcare quality. We believe that adding a health coach will help in achieving this goal. The health coach is a medical professional who supports both the physician and the patient by meeting previously established goals. This research presents and analyzes the key roles of a health coach in a primary care practice.
  Hospital Topics 01/2011; 89(1):16-22.
• Article: Capital expenditure trends in California hospitals: 2002-2007.

  Michael J McCue
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  ABSTRACT: From 1997 to 2001, hospitals expanded their capital expenditures by only 1% while future capital investment was expected to grow by 14% (Healthcare Financial Management Association 2004). Analyzing California hospital data from 2002 to 2004 to 2005 to 2007, the author identified and classified capital expenditures into 4 major types. Between the 2 study periods, growth in capital purchases exceeded 23% for medical equipment, expansion, and maintenance types of projects. Large nonprofit hospitals capturing a greater share of the market and serving fewer uninsured and government payers had a greater number of these types of capital purchases.
  Hospital Topics 01/2011; 89(1):9-15.
• Article: Derision is the sweet spot of adoption: unleashing disruptive growth.

  Wayne Poll
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  ABSTRACT: Energetic and ambitious clinicians frequently present new disruptive technologies and growth opportunities to hospital management. Far too often, established medical staff leadership respond to these replacement services with derision, as they sense that the value of their hard-fought experience is threatened. In this regard, derision is often disguised validation and may be the first indicator that the visionary physician is on to something. Truly disruptive service offerings cannot survive the scrutiny of layered medical staff structure or traditional fiscal review. Innovative hospital CEOs should take notice when a new idea is treated with derision and consider resourcing them through an alternative pathway.
  Hospital Topics 01/2011; 89(1):23-5.
• Article: Sticker shock: an exploration of supply charge capture outcomes.

  Gerald R Ledlow, James H Stephens, Heidi Hulsey Fowler
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  ABSTRACT: Do you find supply item charge stickers in shocking places in nursing units? Capturing supply item charges to increase net revenue or achieve break-even are based on efficiency. To determine practical efficiency for a hospital in supply charge capture, the authors examined the quantity of supply charge capture items, volume, and relative size of the hospital in 10 hospitals in the midwestern and southeastern United States. What differences in supply charge capture information can determine if a hospital can break even? Results show that hospital size and number of supply charge capture items to manage are important factors.
  Hospital Topics 01/2011; 89(1):1-8.
• Article: Evaluation methods for hospital projects.

  Janet R Buelow, Kathryn M Zuckweiler, Kirsten M Rosacker
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  ABSTRACT: The authors report the findings of a survey of hospital managers on the utilization of various project selection and evaluation methodologies. The focus of the analysis was the empirical relationship between a portfolio of project evaluation(1) methods actually utilized for a given project and several measures of perceived project success. The analysis revealed that cost-benefit analysis and top management support were the two project evaluation methods used most often by the hospital managers. The authors' empirical assessment provides evidence that top management support is associated with overall project success.
  Hospital Topics 01/2010; 88(1):10-7.
• Article: RFIDs can improve the patient care supply chain.

  Lee Revere, Ken Black, Faiza Zalila
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  ABSTRACT: Technologies that increase efficiency, enhance quality, and improve patient safety are essential for all healthcare organizations. Radio frequency identification devices (RFIDs) seem to be right for this challenge. RFIDs can be integrated into all areas of the internal patient supply chain, serving as clearinghouses of information. By providing timely information on patients, processes, and equipment, RFIDs can save time and reduce costs while simultaneously improving quality and patient safety. Healthcare leaders owe it to all constituencies to take a serious look at what RFIDs can offer.
  Hospital Topics 01/2010; 88(1):26-31.
• Article: Adverse medical events: do they influence discharge decisions?

  Robert W Broyles, Ann F Chou, Steve E Mattachione, A F Al-Assaf
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  ABSTRACT: The author examined relationships between adverse medical events (AMEs) on discharge decisions. Using secondary data capturing inpatient utilization from Oklahoma hospitals, the author employed logistic regression to estimate the probability of extended hospital stay and the need for postacute care as a function of AMEs, and multiple regression analysis to assess the effect of AMEs on the number of days of care. Findings showed that an AME increased the likelihood of extended hospital stay, number of extended days of care, and needed postacute care. Findings indicated that reducing AME incidence would likely improve quality while reducing healthcare utilization and spending.
  Hospital Topics 01/2010; 88(1):18-25.
• Article: Disparities in ADL and IADL disabilities among elders of Hispanic subgroups in the United States: results from the National Health Interview Survey 2001-2003.

  Alberto Coustasse, Sejong Bae, Cody Arvidson, Karan P Singh, Fernando Treviño
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  ABSTRACT: The authors compared disability and functional limitation among elder Hispanic subgroups by using data from the 2001-2003 National Health Interview Survey (National Center for Health Statistics 2008a). The authors applied chi-square analysis for bivariate comparisons and used multiple logistic regression analyses for making comparisons, estimating odds ratios, and predicting disabilities. Results revealed a 21.4% rate of disability of any type in Hispanics. Puerto Ricans reported the highest rates of Activity of Daily Living (ADL) and Instrumental Activity of Daily Living (IADL) disabilities compared with other Hispanic subgroups (Mexicans, Cubans, Central and South Americans) and reported a higher rate than did Blacks. Cubans showed the lowest rate of IADL and any disability among Hispanics and a lower rate than did Whites. These findings highlight the high rates of intragroup variability among the U. S. Hispanic population. Among seniors, ADLs and IADLs were significant predictors of admission to nursing homes and use of paid home care, physician services, and palliative care.
  Hospital Topics 02/2009; 87(1):15-23.
• Article: Kawasaki Syndrome in Texas.

  Alberto Coustasse, Julius J Larry, Witold Migala, Cody Arvidson, Karan P Singh
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  ABSTRACT: The authors examined hospitalization rates of Kawasaki Syndrome (KS) among Texas children to isolate clusters, identify demographic disparities, and suggest possible causative factors. Using a retrospective cross-sectional study design, they studied 330 KS cases from 2,818,460 hospital discharges. The majority of the cases (61.5%) occurred within the 1-4-years-old category, representing the highest hospitalization rate (14.3 per 100,000 children). Almost 75% of the KS population was less than 5 years old, with hospitalization rates approximately 8 times higher than that of all other children (p < .05). KS diagnosis occurred for only 49.4% of all KS cases upon admission. Along with high-density clusters identified in major metropolitan areas, the authors found the highest rates of KS among Asian and Pacific Islander and non-Hispanic black children. Genetic predispositions and access to healthcare issues may explain the results. The authors recommend improving educational initiatives with healthcare providers and establishing KS as a reportable condition.
  Hospital Topics 02/2009; 87(3):3-10.
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  Article: Health insurance sources for nonelderly patient visits to physician offices, hospital outpatient departments, and emergency departments in the United States.

  Manuel C F Pontes, Nancy M H Pontes, Phillip A Lewis
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  ABSTRACT: The authors used data from nationally representative surveys to estimate health insurance sources for non-elderly patient visits to U.S. physicians. Results show that hospital emergency departments attract a greater share of ambulatory care visits by uninsured patients than by patients with either Medicaid or private insurance. Results also show that hospital outpatient departments attract a greater share of visits by uninsured patients or patients with Medicaid than by patients with private insurance. The annual visit rate of uninsured individuals for nonemergency care is less than half of that for individuals with either private insurance or Medicaid. The proportion of uninsured emergency department visits by individuals between the ages of 0 and 64 years was significantly greater than the proportion of uninsured individuals between the ages of 0 and 64 years. In contrast, the proportion of uninsured physician office visits by individuals between the ages of 0 and 64 years was significantly less than the proportion of uninsured individuals between the ages of 0 and 64 years.
  Hospital Topics 02/2009; 87(3):19-27.
• Article: Geographic variation in minority participation in hospital management in the United States.

  Gary Gaumer, Robert F Coulam
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  ABSTRACT: Minority participation in hospital management is, by all estimates, lower than almost anyone is prepared to accept. However, to date, there has been no published study of hospital management diversity using comprehensive national data. In the present study, the authors used data from the U.S. Equal Employment Opportunity Commission to estimate more directly and comprehensively how management diversity in private U.S. hospitals varies by geographic area. Although minorities constitute over 33% of the U.S. population, they constitute only 14% of all top-level managers and officials in private U.S. hospitals. There is enormous geographic variation in this average across cities and regions. The authors found that minority management participation is systematically related to market factors, including demographic and education variables. These systematic patterns explain about 90% of the Metropolitan Statistical Area differences in minority manager percentage. However, even after adjusting observed variations for these differences, the authors found important unexplained geographic variations in minority managerial employment in hospitals across U.S. cities.
  Hospital Topics 02/2009; 87(2):13-22.
• Article: Perspectives from nurse leaders and chief information officers on health information technology implementation.

  Steven Szydlowski, Christina Smith
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  ABSTRACT: To enhance the limited empirical evidence in the literature, the authors developed new knowledge and information on the basis of implementation experiences (e.g., strategic planning, goals, outcomes, barriers, mistakes) of hospital executives with actual health information technology (HIT). The authors asked why hospital leaders implement HIT and how they do so, and then applied the answers to the theoretical framework of change management and leadership. The authors accomplished this through a qualitative research study design. Various employees from different levels of the organizational chart provide their perspectives, allowing the authors to examine internal trends related to HIT. The authors examined external trends through a comparative analysis of healthcare markets.
  Hospital Topics 02/2009; 87(1):3-9.
• Article: Recruitment and retention of rural hospital administrators: a multifaceted approach.

  David V Stretton, Douglas S Bolon
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  ABSTRACT: A major challenge confronting healthcare delivery in the United States is the shortage of clinical professionals in rural areas. Although most of the research surrounding this problem has focused on physicians and nurses, other healthcare professionals have received much less attention. Although not a clinician or hands-on care provider, the hospital administrator is an integral component of rural healthcare delivery systems and is instrumental in the organization and delivery of services. This article examines some of the factors that impact the recruitment and retention process for rural hospital administrators. The authors suggest that recruitment and retention success can be best achieved by adopting a multifaceted approach that includes aspects of and considerations from 3 separate areas: personal, organizational, and community attributes. The authors provide recommendations and insights for rural hospital governing boards responsible for this process.
  Hospital Topics 02/2009; 87(1):10-4.