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Beverly EA, Koopman-Gonzalez S, Wright J, Dungan K, Pallerla H, Gubitosi-Klug R, Baughman K, Konstan MW, Bolen SD. Assessing Priorities in a Statewide Cardiovascular and Diabetes Health Collaborative Based on the Results of a Needs Assessment: Cross-Sectional Survey Study. JMIR Form Res 2024; 8:e55285. [PMID: 38607661 PMCID: PMC11053386 DOI: 10.2196/55285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 02/14/2024] [Accepted: 02/23/2024] [Indexed: 04/13/2024] Open
Abstract
BACKGROUND The Ohio Cardiovascular and Diabetes Health Collaborative (Cardi-OH) unites general and subspecialty medical staff at the 7 medical schools in Ohio with community and public health partnerships to improve cardiovascular and diabetes health outcomes and eliminate disparities in Ohio's Medicaid population. Although statewide collaboratives exist to address health improvements, few deploy needs assessments to inform their work. OBJECTIVE Cardi-OH conducts an annual needs assessment to identify high-priority clinical topics, screening practices, policy changes for home monitoring devices and referrals, and preferences for the dissemination and implementation of evidence-based best practices. The results of the statewide needs assessment could also be used by others interested in disseminating best practices to primary care teams. METHODS A cross-sectional survey was distributed electronically via REDCap (Research Electronic Data Capture; Vanderbilt University) to both Cardi-OH grant-funded and non-grant-funded members (ie, people who have engaged with Cardi-OH but are not funded by the grant). RESULTS In total, 88% (103/117) of Cardi-OH grant-funded members and 8.14% (98/1204) of non-grant-funded members completed the needs assessment survey. Of these, 51.5% (53/103) of Cardi-OH grant-funded members and 47% (46/98) of non-grant-funded members provided direct clinical care. The top cardiovascular medicine and diabetes clinical topics for Cardi-OH grant-funded members (clinical and nonclinical) were lifestyle prescriptions (50/103, 48.5%), atypical diabetes (38/103, 36.9%), COVID-19 and cardiovascular disease (CVD; 38/103, 36.9%), and mental health and CVD (38/103, 36.9%). For non-grant-funded members, the top topics were lifestyle prescriptions (53/98, 54%), mental health and CVD (39/98, 40%), alcohol and CVD (27/98, 28%), and cardiovascular complications (27/98, 28%). Regarding social determinants of health, Cardi-OH grant-funded members prioritized 3 topics: weight bias and stigma (44/103, 42.7%), family-focused interventions (40/103, 38.8%), and adverse childhood events (37/103, 35.9%). Non-grant-funded members' choices were family-focused interventions (51/98, 52%), implicit bias (43/98, 44%), and adverse childhood events (39/98, 40%). Assessment of other risk factors for CVD and diabetes across grant- and non-grant-funded members revealed screening for social determinants of health in approximately 50% of patients in each practice, whereas some frequency of depression and substance abuse screening occurred in 80% to 90% of the patients. Access to best practice home monitoring devices was challenging, with 30% (16/53) and 41% (19/46) of clinical grant-funded and non-grant-funded members reporting challenges in obtaining home blood pressure monitoring devices and 68% (36/53) and 43% (20/46) reporting challenges with continuous glucose monitors. CONCLUSIONS Cardi-OH grant- and non-grant-funded members shared the following high-priority topics: lifestyle prescriptions, CVD and mental health, family-focused interventions, alcohol and CVD, and adverse childhood experiences. Identifying high-priority educational topics and preferred delivery modalities for evidence-based materials is essential for ensuring that the dissemination of resources is practical and useful for providers.
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Affiliation(s)
- Elizabeth A Beverly
- Department of Primary Care, Ohio University Heritage College of Osteopathic Medicine, Athens, OH, United States
| | | | - Jackson Wright
- Department of Medicine, Case Western Reserve University, Cleveland, OH, United States
| | - Kathleen Dungan
- Department of Medicine, Ohio State University College of Medicine, Columbus, OH, United States
| | - Harini Pallerla
- Department of Family and Community Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, United States
| | - Rose Gubitosi-Klug
- Department of Medicine, Case Western Reserve University, Cleveland, OH, United States
| | - Kristin Baughman
- Department of Family and Community Medicine, Northeast Ohio Medical University, Rootstown, OH, United States
| | - Michael W Konstan
- Department of Medicine, Case Western Reserve University, Cleveland, OH, United States
| | - Shari D Bolen
- Department of Medicine, Case Western Reserve University, Cleveland, OH, United States
- Center for Health Care Research and Policy, MetroHealth Medical Center, Cleveland, OH, United States
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Zia Ud Din M, Yuan Yuan X, Ullah Khan N, Estay C. The impact of public leadership on collaborative administration and public health delivery. BMC Health Serv Res 2024; 24:129. [PMID: 38263150 PMCID: PMC10807078 DOI: 10.1186/s12913-023-10537-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 12/29/2023] [Indexed: 01/25/2024] Open
Abstract
BACKGROUND This research depicts the linkage of public leadership on public health delivery (PHD) and collaborative administration. The research is also focused to examine the effect of public leadership on public health delivery through the intervening variable of collaborative administration by using both social information processing theory and collaboration theory. METHODS This research is based on quantitative method. Data was collected from 464 public hospital administration in the context of Pakistan. This study evaluated data using SPSS, AMOS, and PROCESS Macro. RESULTS Public leadership has a positive profound effect on public health delivery and collaborative administration, and that collaborative administration significantly promotes public health delivery. The outcomes also exposed that public leadership has substantial influence on public health delivery through intervening collaborative administration. CONCLUSIONS Whilst public leadership demonstrated positive outcomes on public health delivery and collaborative administration, there is a need for more rigor studies on collaborative governance leadership, collaborative ethics and collaborative norms in the public health service.
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Affiliation(s)
- Muhammad Zia Ud Din
- School of Public Administration, Central South University, Yuelu District, Changsha, Hunan, 410017, China
| | - Xu Yuan Yuan
- School of Public Administration, Central South University, Yuelu District, Changsha, Hunan, 410017, China.
| | - Naqib Ullah Khan
- School of Public Administration, Central South University, Yuelu District, Changsha, Hunan, 410017, China.
| | - Christophe Estay
- FERRANDI Paris (France), Lirsa, Cnam, Hesam Université, Paris, France
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Walters JK, Sharma A, Boyce J, Harrison R. Analysis of Centralized Efficiency Improvement Practices in Australian Public Health Systems. J Healthc Leadersh 2023; 15:313-326. [PMID: 38020720 PMCID: PMC10657544 DOI: 10.2147/jhl.s435035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 11/10/2023] [Indexed: 12/01/2023] Open
Abstract
Aim Analysis of centralized efficiency improvement practices in Australian public health systems. Introduction Public health systems seek to maximize outcomes generated for resources used through efficiency improvement (EI) in response to funding and demand pressures. Despite this focus, evidence for EI approaches at the whole-of-system level is lacking in the literature. There is an urgent need for evidence-based approaches to centralized EI to address these pressures. This study aims to address this gap by answering the research question "How is EI conceptualized and managed by central public health system management entities in Australia?". Material and Methods Document analysis was selected due to its suitability for systematically searching and appraising health system documentation, with this study following Altheide's approach focusing on whole-of-system strategic plan and management framework documents originating from Australian public health organizations. Results Conceptualization of efficiency varied substantially with no consistent definition identified, however common attributes included resource use, management, service and delivery. Forty-two of 43 documents contained approaches associated with improving efficiency at the whole of system level. Discussion While no comprehensive framework for centralized EI was evident, we identified nine core approaches which together characterize centralized EI. Together these approaches represent a comprehensive evidence-based approach to EI at the whole of system level. Conclusion The approaches to whole-of-system EI identified in this study are likely to be highly transferable across health systems internationally with approaches including strategic priority setting, incentivization, performance support, use of EI evidence, digital enablement and workforce capability development.
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Affiliation(s)
| | - Anurag Sharma
- School of Population Health, UNSW, Sydney, NSW, Australia
| | - Jamie Boyce
- HealthShare NSW, NSW Health, St Leonards, NSW, Australia
| | - Reema Harrison
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, North Ryde, NSW, Australia
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Ye Y, Tao Q. Measurement and characteristics of the temporal-spatial evolution of China's healthcare services efficiency. Arch Public Health 2023; 81:197. [PMID: 37964289 PMCID: PMC10647113 DOI: 10.1186/s13690-023-01208-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 10/28/2023] [Indexed: 11/16/2023] Open
Abstract
BACKGROUND Healthcare services efficiency (HSE) is directly related to the healthcare demands of the general public and also plays an essential role in the country's coordinated economic and social development. METHODS In this study, the stochastic frontier approach (SFA)-Malmquist model was applied to measure the HSE of 31 Chinese provinces based on panel data from 2010-2020. Then, kernel density estimation, Markov chain, and exploratory spatial data analysis were adopted to study the temporal-spatial dynamic evolution characteristics of the HSE. RESULTS The study found that China's HSE showed an average value of approximately 0.841, indicating room for improvement. The HSE varied significantly across regions, presenting an "East > Central > West" distribution layout. The TFP of healthcare services in China grew by 1.6% per year, driven mainly by technological progress of 1.8% per year. The trend of the HSE shifting to a high level in China was significant, but its evolution exhibited stability of maintaining the original state, and it was harder to achieve leapfrog transfer. The temporal-spatial evolution of the HSE was also significantly affected by geospatial factors, with a clear spatial spillover effect and spatial agglomeration characteristics. Provinces with high-level HSE exhibited positive spatial spillover effects, while provinces with low-level HSE had negative spatial spillover effects. Thus, the "club convergence" phenomenon of "high efficiency concentration, low efficiency agglomeration, high levels of radiation, and low levels of suppression" was formed in the spatial distribution. CONCLUSIONS The results indicate that countermeasures should be taken to improve the HSE in China. Theoretical support for the improvement of HSE is provided in this paper.
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Affiliation(s)
- Yizhong Ye
- School of Hospital Economics and Management, Anhui University of Chinese Medicine, Hefei, 230000, China
- Key Laboratory of Data Science and Innovative Development of Chinese Medicine in Anhui Province Philosophy and Social, Hefei, 230000, China
| | - Qunshan Tao
- School of Hospital Economics and Management, Anhui University of Chinese Medicine, Hefei, 230000, China.
- Key Laboratory of Data Science and Innovative Development of Chinese Medicine in Anhui Province Philosophy and Social, Hefei, 230000, China.
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Bhati D, Deogade MS, Kanyal D. Improving Patient Outcomes Through Effective Hospital Administration: A Comprehensive Review. Cureus 2023; 15:e47731. [PMID: 38021686 PMCID: PMC10676194 DOI: 10.7759/cureus.47731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 10/26/2023] [Indexed: 12/01/2023] Open
Abstract
This comprehensive review delves into the critical role of effective hospital administration in shaping patient outcomes within the healthcare ecosystem. Exploration of key components, strategies, measurement methodologies, and future trends elucidates the multifaceted nature of hospital administration. Key findings underscore the profound impact of administrative decisions and practices on patient safety, satisfaction, and overall well-being. The review highlights the importance of patient-centred care and interdisciplinary collaboration for enhancing patient outcomes. It emphasises the significance of data-driven measurement and benchmarking, which are instrumental in assessing hospital performance and fostering continuous improvement. Looking ahead, emerging technologies, evolving healthcare policies, and persistent challenges are drivers of change in healthcare administration. However, amidst these transformations, the overarching message remains consistent: effective hospital administration is integral to improving patient outcomes. The conclusion calls for a collective commitment from healthcare leaders and policymakers to prioritise the development of capable administrators, invest in technology, promote value-based care, and address healthcare disparities. This collaborative effort ensures that the pursuit of better patient outcomes remains at the forefront of healthcare administration, ultimately shaping the future of healthcare for generations to come.
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Affiliation(s)
- Deepak Bhati
- Hospital Administration, School of Allied Health Sciences, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education & Research, Wardha, IND
| | - Meena S Deogade
- Ayurveda Pharmacology, All India Institute of Ayurveda, New Delhi, IND
| | - Deepika Kanyal
- Hospital Administration, School of Allied Health Sciences, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education & Research, Wardha, IND
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Silva JLD, Teston EF, Marcon SS, Vieira VCDL, Ferreira PC, Andrade GKSD, Arruda BCCG. Potencialidades e limites no cuidado domiciliar compartilhado entre equipes. REME: REVISTA MINEIRA DE ENFERMAGEM 2022. [DOI: 10.35699/2316-9389.2022.39204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2023] Open
Abstract
Objetivo: apreender como os profissionais atuantes na Atenção Primária à Saúde (APS) e no Serviço de Atenção Domiciliar (SAD) percebem as potencialidades e as limitações para o cuidado compartilhado. Método: estudo descritivo exploratório, de abordagem qualitativa, fundamentado nos pressupostos teóricos da Rede de Atenção à Saúde (RAS), realizado com 10 profissionais de saúde atuantes em uma capital brasileira. Os dados foram coletados em outubro de 2019 mediante a realização de uma única sessão de grupo focal, ocasião em que foram discutidas, a partir da construção da matriz SWOT (Strenghts, Weaknesses, Opportunities, e Threats), as forças, as fraquezas, as oportunidades e as ameaças que permeiam o cuidado compartilhado na atenção domiciliar. Os dados foram submetidos à análise de conteúdo, modalidade temática. Resultados: como potencialidades, foram destacadas: as ações de cuidado realizadas em conjunto pelos diferentes profissionais das equipes; a realização de reuniões objetivas e direcionadas; a divisão de responsabilidades e a definição de papéis; e os fluxos que podem melhorar a comunicação entre as equipes e potencializar a prática do cuidado compartilhado na atenção domiciliar. Como limitações, destacam-se: o conhecimento insuficiente dos critérios de elegibilidade para a atenção domiciliar; a deficiência de recursos materiais e de tecnologia da informação; e lacunas na formação profissional. Conclusão: os resultados podem contribuir para qualificação da assistência entre os diferentes serviços que compõem a Rede de Atenção à Saúde, especialmente pela identificação dos elementos relacionados ao próprio processo de trabalho que influenciam no cuidado compartilhado.
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Walters JK, Sharma A, Harrison R. Driving Efficiency Improvement (EI): Exploratory Analysis of a Centralised Model in New South Wales. Healthc Policy 2022; 15:1887-1894. [PMID: 36254223 PMCID: PMC9569157 DOI: 10.2147/rmhp.s383107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 09/30/2022] [Indexed: 11/06/2022] Open
Abstract
Introduction Public healthcare systems face rising demand coupled with reducing funding growth rates, necessitating ongoing approaches to efficiency improvement (EI). Centrally coordinated EI approaches l may support EI leaders, yet few such approaches exist internationally. This study provides evidence to inform system-wide EI by harnessing understanding of the perceptions, role demands and support requirements of key EI stakeholders in the centralised EI model implemented in New South Wales. Methods A purposive sample of key informants within NSW Health with responsibility for EI in their organisation were invited to participate. Semi-structured interviews were conducted, recorded and transcribed. A thematic analysis was undertaken using a theoretical deductive approach. Results Seventeen respondents participated who occupied EI leadership roles in metro (8) and rural (6) health services as well as non-clinical support (3) services. Four primary themes emerged on the perceptions and experiences of participants in 1. holding a unique skillset which enables them to undertake EI; 2. inheriting EI accountabilities as additional duties rather than holding dedicated EI roles; 3. the importance of senior support for EI success; and 4. feelings of isolation in undertaking EI. An additional underpinning theme that EI is not well conceptualized in public health systems also emerged, whereby EI planners felt that frontline staff generally do not consider efficiency as a component of their duties. Conclusion EI leaders provide points of authority, experience and influence across organisations within public health systems. This study finds that EI planners possess a unique skillset, can feel isolated both within their health organisation and within the broader public health system and believe that EI is poorly conceptualized amongst health staff. Centralised support for EI stakeholders across a public health system can promote knowledge sharing and capability development. Addressing the role and support requirements of key EI stakeholders is essential.
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Affiliation(s)
- James Kenneth Walters
- Patient Experience and System Performance Division, NSW Health, St Leonards, NSW, Australia,Correspondence: James Kenneth Walters, NSW Health, Level 9, 1 Reserve Road, St Leonards, NSW, Australia, Email
| | - Anurag Sharma
- School of Population Health, UNSW, Kensington, NSW, Australia
| | - Reema Harrison
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie Park, NSW, Australia
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