Timothy J Vogus

Vanderbilt University | Vander Bilt · Owen Graduate School of Management

Objective To examine the benefits of compassion practices on two indicators of patient perceptions of care quality—the Hospital Consumer Assessment of Healthcare Providers and systems (HCAHPS) overall hospital rating and likelihood of recommending.Study SettingTwo hundred sixty-nine nonfederal acute care U.S. hospitals.Study DesignCross-sectional s...

Context: Prior research has found that safety organizing behaviors of registered nurses (RNs) positively impact patient safety. However, little research exists on how engaging in safety organizing affects caregivers. Objectives: While we know that organizational processes can have divergent effects on organizational and employee outcomes, little...

We are what we repeatedly do. Excellence then, is not an act, but a habit.1 Healthcare leaders,2 ,3 academics4–7 and regulators,8 ,9 continue to push healthcare organisations to emulate high-reliability organisations (HROs) like aircraft carrier flight decks and nuclear power control rooms10 to solve long-standing quality and safety problems in he...

In recent years, research on mindfulness has grown rapidly in organizational psychology and organizational behavior. Specifically, two bodies of research have emerged: One focuses on the intrapsychic processes of individual mind-fulness and the other on the social processes of collective mindfulness. In this review we provide a pioneering, cross-le...

Hospitals are increasingly looking to new work practices and processes to reduce the epidemic of medical errors. The authors examine one such innovative approach emulating high-reliability organizations (e.g., nuclear power plants) that use a combination of specific work practices and behavioral processes to detect and adapt to unexpected events to...

Background Lung cancer screening is a complex clinical process that includes identification of eligible individuals, shared decision-making, tobacco cessation, and management of screening results. Adaptations to the delivery process for lung cancer screening in situ are understudied and underreported, with the potential loss of important considerat...

Background Research suggests that changes in nurse roles can compromise perceived organizational safety. However, over the past 15 years, many infusion tasks have been reallocated from specialty nurse infusion teams to individual generalist nurses—a process we call infusion task reallocation. These changes purportedly benefit employees by allowin...

Background: Lung cancer screening includes identification of eligible individuals, shared decision-making inclusive of tobacco cessation, and management of screening results. Adaptations to the implemented processes for lung cancer screening in situ are understudied and underreported, with potential loss of important considerations for improved imp...

Background Healthcare leaders look to high-reliability organisations (HROs) for strategies to improve safety, despite questions about how to translate these strategies into practice. Weick and Sutcliffe describe five principles exhibited by HROs. Interventions aiming to foster these principles are common in healthcare; however, there have been few...

Abstract Purpose Employment outcomes for individuals on the autism spectrum may be contingent upon employers’ knowledge of autism and provision of appropriate workplace supports. We aimed to understand the organizational factors that influenced the organizational socialization of autistic employees. Materials and methods We wrote nine case histori...

Employment outcomes for autistic1 individuals are often poorer relative to their neurotypical (NT) peers, resulting in a greater need for other forms of financial and social support. While a great deal of work has focused on developing interventions for autistic children, relatively less attention has been paid to directly addressing the employment...

Background Evidence for the central line-associated bloodstream infection (CLABSI) bundle effectiveness remains mixed, possibly reflecting implementation challenges and persistent ambiguities in how CLABSIs are counted and bundle adherence measured. In the context of a tertiary pediatric hospital that had reduced CLABSI by 30% as part of an interna...

Purpose Health care delivery is experiencing a multi-faceted epidemic of suffering among patients and care providers. Compassion is defined as noticing, feeling and responding to suffering. However, compassion is typically seen as an individual rather than a more systemic response to suffering and cannot match the scale of the problem as a result....

Background Medication reconciliation (MedRec) is an important patient safety initiative that aims to prevent patient harm from medication errors. Yet, the implementation and sustainability of MedRec interventions have been challenging due to contextual barriers like the lack of interprofessional communication (among pharmacists, nurses, and provide...

Due to the radical uncertainty associated with grand challenges, prior studies have emphasized the need for robust action, which preserves future options while taking existing means and institutional constraints seriously. In this conversation on entrepreneurial futures and possibilities, we suggest that for such approaches to avoid merely reproduc...

Introduction: Despite large-scale quality improvement initiatives, substantial proportions of patients with ST-elevation myocardial infarction (STEMI) transferred to percutaneous coronary intervention centers do not receive percutaneous coronary intervention within the recommended 120 minutes. We sought to examine the contributory role of emergenc...

Objective To quantify surgical trainees’ direct financial impact on an academic medical center (AMC) by modeling the cost of replacing them. Design The authors developed a model that estimates the financial costs to an AMC if surgical residents were replaced with surgical first assistants (SFAs) and physician assistants (PAs). Setting One AMC pro...

Objective From the perspective of percutaneous coronary intervention (PCI) centers, locations of ST‐segment elevation myocardial infarction (STEMI) diagnosis can include a referring facility, emergency medical services (EMS) transporting to a PCI center, or the PCI center's emergency department (ED). This challenges the use of door‐to‐balloon‐time...

Objectives Lung cancer has the highest cancer-related mortality in the United States and among Veterans. Screening of high-risk individuals with low-dose CT (LDCT) can improve survival through detection of early-stage lung cancer. Organizational factors that aid or impede implementation of this evidence-based practice in diverse populations are not...

Introduction The Veterans Affairs Partnership to increase Access to Lung Screening (VA-PALS) is an enterprise-wide initiative to implement lung cancer screening programs at VA medical centers (VAMCs). VA-PALS will be using implementation strategies that include program navigators to coordinate screening activities, trainings for navigators and radi...

Background The Veterans Affairs Partnership to increase Access to Lung Screening (VA-PALS) is an enterprise-wide initiative to implement high quality lung cancer screening programs at VA medical centers (VAMCs). VA-PALS will be using implementation strategies that include program navigators to coordinate screening activities, trainings for navigato...

Purpose – Healthcare delivery faces increasing pressure to move from a provider-centered approach to become more consumer-driven and patient-centered. However, many of the actions taken by clinicians, patients and organizations fail to achieve that aim. This paper aims to take a paradox-based perspective to explore five specific tensions that emerg...

Background: Despite regionalization efforts, delays at transferring hospitals for patients transferred with ST-elevation myocardial infarction (STEMI) for primary percutaneous coronary intervention (PCI) persist. These delays primarily occur in the emergency department (ED), and are associated with increased mortality. We sought to use qualitative...

Background: Prior research has found that adverse events have significant negative consequences for the patients (first victim) and caregivers (second victim) involved such as burnout. However, research has yet to examine the consequences of adverse events on members of caregiving units. We also lack research on the effects of the personal and job...

Mindfulness has become an increasingly popular practice and in parallel scholarly research has grown considerably. However, the study of mindfulness at work remains limited and motivates this special issue on “Mindfulness at Work: Pushing Theoretical and Empirical Boundaries.” In this introduction to the special issue we offer a brief initial groun...

Demands for more patient-centred care necessitate that leadership creates the conditions for more compassionate care that is sustainable even in periods of acute crisis. We draw on a growing body of empirical research in health services, management and medicine to highlight how the combination of interpersonal acts, leadership style and organisatio...

As the demands and nature of caregiving work in the health-care sector become more varied and challenging, our research and theories need to match this evolving reality. This editorial introduces theories of caregiving work and then uses each of the four papers featured in the special issue to advance a more nuanced and social approach to theorizin...

Objective: The aim of the study was to determine the incidence, type, severity, preventability, and contributing factors of nonroutine events (NREs)-events perceived by care providers or skilled observers as a deviations from optimal care based on the clinical situation-in the perioperative (i.e., preoperative, operative, and postoperative) care o...

The health care industry is complex, dynamic, and large. In such uncertain environments where a great deal of revenue is at stake, competition and comparative claims flourish. One such manifestation is hospital ratings systems. This research examines two influential hospital ratings to explore whether the hospital ratings of each system was straigh...

Objectives: We sought to evaluate whether the quality of coordination between physicians transferring comatose cardiac arrest survivors to a high-volume cardiac arrest center for targeted temperature management (TTM) was associated with timeliness of care. Methods: We conducted a retrospective analysis of inter-facility transfers to Vanderbilt Univ...

Background: Safety climate is an important marker of patient safety attitudes within health care units, but the significance of intra-unit variation of safety climate perceptions (safety climate strength) is poorly understood. This study sought to examine the standard safety climate measure (percent positive response (PPR)) and safety climate stre...

Background: Human suffering is prevalent and costly in health care organizations. Recent research links the use of compassion practices with improved patient experience and employee well-being, but little is known about how these practices create and sustain compassion to address workplace suffering and enhance care quality. Purpose: This study...

Background and objectives: Acute Ischemic stroke (AIS) is a time-sensitive emergency and patients frequently present to, and are transferred from emergency departments (EDs). We sought to evaluate potential factors, particularly organizational, that may influence the timeliness of interfacility transfer for ED patients with AIS. Methods: We cond...

While specialized infusion clinical services remain the standard of care, widespread curtailing and disbanding of infusion teams as a cost-cutting measure has been documented in health care organizations for nearly 2 decades. Owing to this trend, as well as recent government interventions in medical error control, the authors engaged in an explorat...

https://www.facs.org/education/division-of-education/publications/rise/articles/resident-training

Introduction Advances in ST-segment elevation myocardial infarction (STEMI) management have involved improving the clinical processes connecting patients with timely emergency cardiovascular care. Screening upon emergency department (ED) arrival for an early ECG to diagnose STEMI, however, is not optimal for all patients. In addition, the degree to...

Objective: The aim of this article is to describe the associations of nurses' hand hygiene (HH) attitudes, subjective norms, and perceived behavioral control with observed and self-reported HH behavior. Background: Hand hygiene is an essential strategy to prevent healthcare-associated infections. Despite tremendous efforts, nurses' HH adherence...

Background: AHA/ACC/ESC practice guidelines advise an ECG within 10 minutes for all patients with symptoms suggestive of ST-segment elevation myocardial infarction (STEMI). This facilitates early diagnosis and timely treatment. Earlier treatment, particularly percutaneous coronary intervention (PCI), has been associated with better clinical outcome...

Background: The emergency department (ED) plays a pivotal role in the care of patients with acute ischemic stroke, particularly when transferred to another facility for definitive treatment. Our objective was to identify potential factors that influence the timeliness of interfacility transfer for ED patients with an acute ischemic stroke. Methods:...

Achieving and sustaining superior relative performance is central to strategic organization research. Recently, strategic organization researchers have turned their attention to the broader set of people doing strategy work, how they do it, and what contributes to superior performance. We deepen this focus by arguing that operational activity on th...

Background: Emergency department (ED) acuity is the general level of patient illness, urgency for clinical intervention, and intensity of resource use in an ED environment. The relative strength of commonly used measures of ED acuity is not well understood. Methods: We performed a retrospective cross-sectional analysis of ED-level data to evalua...

Objective: Healthcare-associated infections (HAIs) pose a challenge to patient safety. Although studies have explored individual level, few have focused on organizational factors such as a hospital's safety infrastructure (indicated by Leapfrog Hospital Safety Score) or workplace quality (Magnet recognition). The aim of the study was to determine...

A growing body of research unveils the ubiquity of ambivalence—the simultaneous experience of positive and negative emotional or cognitive orientations toward a person , situation, object, task, or goal—in organizations, and argues that its experience may be the norm rather than the exception. Although traditionally viewed as something to be avoide...

and Keywords Patient-centered care (PCC) has been a focus of health care management for many years, with emphasis ranging from the policy and health system levels to individual care at the bedside. This chapter examines the state of PCC research and practice in the early 21st Century. We discuss how PCC has been defined by scholars, practitioners,...

Accountable Care Organizations' (ACOs) pursuit of the triple aim of higher quality, lower cost, and improved population health has met with mixed results. To improve the design and implementation of ACOs we look to organizations that manage similarly complex, dynamic, and tightly coupled conditions while sustaining exceptional performance known as...

As customer satisfaction and service quality have become increasingly important, management scholars have developed an impressive body of research regarding their antecedents. However, important gaps remain regarding satisfaction in diverse populations, better specifying practices and mechanisms, and the forms and effects of co-production practices...

Despite some notable advances in patient safety (eg, an average 17% reduction across a set of hospital-acquired conditions including adverse drug events and urinary tract infections in the USA between 2010 and 20151), substantially reducing or eliminating harm remains elusive for nearly every healthcare organisation. One consistent recommendation f...

In this paper, we propose that performance under uncertainty and ambiguity is enabled by a two-pronged set of practices enacted by leaders and frontline workers. These contextualized practices fuel performance by enabling teams and organizations to both discern, interpret and make sense of important discrepancies as situations unfold (what we refer...

Attempts to assess the quality and safety of hospitals have proliferated, including a growing number of consumer-directed hospital rating systems. However, relatively little is known about what these rating systems reveal. To better understand differences in hospital ratings, we compared four national rating systems. We designated "high" and "low"...

As reforms push for improved integration across the care continuum, managers and policy makers are increasingly concerned about care transitions, such as during shift changes or when moving patients between units or institutions. The authors examined transitions from an emergency department to inpatient units through a 2-year ethnographic study of...

Most US hospitals lack primary percutaneous coronary intervention (PCI) capabilities to treat patients with ST-elevation myocardial infarction (STEMI) necessitating transfer to PCI-capable centers. Transferred patients rarely meet the 120-minute benchmark for timely reperfusion, and referring emergency departments (EDs) are a major source of preven...

It is time to rethink and reframe crisis management. The literature in this crucial domain of organizational research and practice is missing the mark. Whereas much of the research is focused on the large-scale crises that blindside companies, the reality in today’s business environment is quite different. True, some organizations experience large-...

Human suffering is prevalent in healthcare organizations (HCOs). When caregivers struggle with personal and work- related losses and setbacks, these struggles can negatively impact both caregivers and their organizations in costly ways. Compassion is one way in which people attempt to relieve the suffering of others in the workplace. Many scholars...

Hospital-based emergency departments (EDs), given their high cost and major role in allocating care resources, are at the center of the debate about how to maximize value in delivering health care in the United States. To operate effectively and create value, EDs must be flexible, having the ability to rapidly adapt to the highly variable needs of...

The factors that compel individuals to exert the extraordinary effort needed to create high reliability—consistent error-free performance under trying conditions—remain unspecified. Here, we propose that when individuals experience emotional ambivalence and prosocial motivation, it induces the broad thinking and other-orientation that undergird min...

The increasingly complex and volatile nature of organizational environments and technologies exposes many organizations to unexpected, unpredictable, and uncertain vulnerabilities. A growing stream of organization theory proposes that the capability to adapt flexibly in real time results from organizing processes that foster collective mindfulness....

To develop a composite patient safety score that provides patients, health-care providers, and health-care purchasers with a standardized method to evaluate patient safety in general acute care hospitals in the United States. The Leapfrog Group sought guidance from a panel of national patient safety experts to develop the composite score. Candidate...

Emotion is a critical but relatively unexplored dimension of sensemaking in organizations. Existing models of sensemaking tend to ignore the role of emotion or portray it as an impediment. To address this problem, we explore the role that felt emotion plays in three stages of individual sensemaking in organizations. First, we examine emotion’s role...

Arend's response to our paper furthers the discussion on the origins of social entrepreneurship by suggesting that our focus on the motivational origins of social entrepreneurship is misplaced. We address his critiques by highlighting the fact that the social entrepreneur in our model is an embedded agent. While societal forces may shape the role o...