Volatile business conditions have led to drastic corporate downsizing, meaning organizations are expected to do more with less. Managers must be more knowledgeable and possess a more eclectic myriad of business skills, many of which have not even been seen until recently. Many internal and external changes have occurred to organizations that have dictated the need to do business differently. Changes such as technological advances; globalization; catastrophic business crises; a more frantic competitive climate; and more demanding, sophisticated customers are examples of some of the shifts in the external business environment. Internal changes to organizations have been in the form of reengineering, accompanied by structural realignments and downsizing; greater emphasis on quality levels in product and service output; faster communication channels; and a more educated, skilled employee base with higher expectations from management.
Health care disparities in rural areas remain significant in the U.S. health care industry. Uncompensated care makes health care disparities in rural areas worse, and rural hospitals are unfavorably positioned to compete with urban hospitals in the economic-downturn marketplace. How uncompensated care affects quality care among rural hospitals has been lightly investigated. Given that many rural residents experience difficulty accessing high quality care and given the importance of establishing quality care practice standards in a rural setting, we conducted a systematic literature review to identify some quality-care barriers and opportunities and suggested strategies to strengthen the position of rural hospitals in response to uncompensated care.
Explaining the rationale as to why employees leave their jobs has led to many different strategies to retain employees. The model presented here seeks to explain why employees choose to stay or to leave their place of employment. The information from the analysis will provide managers with well-tested tools to reduce turnover and to ascertain what employees value from their work environment in order to help the organization to retain those employees. The model identifies key factors that management can utilize to provide barriers to exit and retain professional employees in their health care units. Recommendations are provided that reward loyalty and build barriers to exit.
Hospitals and other medical providers are intentional with respect to reinforcing desirable personal and emotional characteristics such as safety, security, relaxation, and comfort in the physical design and decoration of their facilities. For years, hospital aesthetics have been designed to reduce stress and provide the greatest amount of patient comfort and confidence. Given the explosion of Internet usage, consideration must be given to the virtual environment as well. Increasingly, patients use the Internet to gather medical information and to interact with healthcare providers; therefore, it is critical to reinforce desirable personal and emotional characteristics in the virtual environment.
Long-term care (LTC) facilities possess unique characteristics in terms of implementation and utilization of electronic medical records (EMRs). The focus of LTC is on a population requiring care encompassing all aspects associated with quality of life rather than simply acute treatment. Because this focus is of a larger scale than traditional medical facilities, the priorities in the implementation and utilization of EMRs are higher in accessing patient history information. The purpose of this study was to determine the EMR utilization in the chronic care settings. In conclusion, the literature review performed does not support the fact that EMRs are currently being effectively and widely used in the LTC facilities.
Both nationally and internationally, pharmaceutical counterfeiting has become a problem that is threatening economic stability and public health. The purpose of the present research study review was to analyze the scope and severity of pharmaceutical counterfeiting and to establish if the implantation of the Radio Frequency Identification Device (RFID) model can more efficiently be used within the pharmaceutical supply chain to reduce the problem counterfeit drugs impose on public health and international economic stability. Results indicated that implementing the RFID model for tracking drugs at the item level in the pharmaceutical supply chain has potential to alleviate the scope of the counterfeit drug problem. Recommendations for how the pharmaceutical industry may sooner adopt the RFID model are made.
Physician offices often lack the sense of incorporating appropriate strategies to make their facilities as marketer of their services. The patient experience at a physician's office not only incorporates the care they receive from the physician but also the other non-healthcare related aspects, such as the behavior of non-health professionals as well as the appearance of the facility itself. This paper is based on a primary research conducted to assess what patients assess from a physician office visit.
This study analyzed brand mark clusters (i.e., various types of brand marks displayed in combination) used by hospitals in the United States. The brand marks were assessed against several normative criteria for creating brand marks that are memorable and that elicit positive affect. Overall, results show a reasonably high level of adherence to many of these normative criteria. Many of the clusters exhibited pictorial elements that reflected benefits and that were conceptually consistent with the verbal content of the cluster. Also, many clusters featured icons that were balanced and moderately complex. However, only a few contained interactive imagery or taglines communicating benefits.
In this analysis, we study the relationship between hospital quality and hospital profits for a sample of 88 Alabama (USA) hospitals. Quality is measured by three groups of procedures performed on newly admitted patients as suggested by the Center for Medicare and Medicaid Services and the Health Quality Alliance (HQA) as well as a weighted quality measure. Profit is measured for eight hospital services. Profits from cardiac care were most responsive to the quality measures studied. Moreover, profits from six of the inpatient services increased as the weighted quality measure increased. Finally, in two cases quality increased with the relative number of employees a hospital utilized.
Objective: Our objective was to use Wisconsin's Medicaid Evaluation and Decision Support (MEDS) data warehouse to develop and validate a decision support tool (DST) that (1) identifies Wisconsin Medicaid fee-for-service recipients who are abusing controlled substances, (2) effectively replicates clinical pharmacist recommendations for interventions intended to curb abuse of physician and pharmacy services, and (3) automates data extraction, profile generation and tracking of recommendations and interventions. Methods: From pharmacist manual reviews of medication profiles, seven measures of overutilization of controlled substances were developed, including (1–2) 6-month and 2-month “shopping” scores, (3–4) 6-month and 2-month forgery scores, (5) duplicate/same day prescriptions, (6) count of controlled substance claims, and the (7) shopping 6-month score for the individual therapeutic class with the highest score. The pattern analysis logic for the measures was encoded into SQL and applied to the medication profiles of 190 recipients who had already undergone manual review. The scores for each measure and numbers of providers were analyzed by exhaustive chi-squared automatic interaction detection (CHAID) to determine significant thresholds and combinations of predictors of pharmacist recommendations, resulting in a decision tree to classify recipients by pharmacist recommendations. Results: The overall correct classification rate of the decision tree was 95.3%, with a 2.4% false positive rate and 4.0% false negative rate for lock-in versus prescriber-alert letter recommendations. Measures used by the decision tree include the 2-month and 6-month shopping scores, and the number of pharmacies and prescribers. The number of pharmacies was the best predictor of abuse of controlled substances. When a Medicaid recipient receives prescriptions for controlled substances at 8 or more pharmacies, the likelihood of a lock-in recommendation is 90%. Conclusion: The availability of the Wisconsin MEDS data warehouse has enabled development and application of a decision tree for detecting recipient fraud and abuse of controlled substance medications. Using standard pharmacy claims data, the decision tree effectively replicates pharmacist manual review recommendations. The DST has automated extraction and evaluation of pharmacy claims data for creating recommendations for guiding pharmacists in the selection of profiles for manual review. The DST is now the primary method used by the Wisconsin Medicaid program to detect fraud and abuse of physician and pharmacy services committed by recipients.
This study describes the use of analytic network process (ANP) in the Taiwanese hospital public relations personnel selection process. Starting with interviewing 48 practitioners and executives in north Taiwan, we collected selection criteria. Then, we retained the 12 critical criteria that were mentioned above 40 times by theses respondents, including: interpersonal skill, experience, negotiation, language, ability to follow orders, cognitive ability, adaptation to environment, adaptation to company, emotion, loyalty, attitude, and Response. Finally, we discussed with the 20 executives to take these important criteria into three perspectives to structure the hierarchy for hospital public relations personnel selection. After discussing with practitioners and executives, we find that selecting criteria are interrelated. The ANP, which incorporates interdependence relationships, is a new approach for multi-criteria decision-making. Thus, we apply ANP to select the most optimal public relations personnel of hospitals. An empirical study of public relations personnel selection problems in Taiwan hospitals is conducted to illustrate how the selection procedure works.
Of all the things managers perform to develop employees, many people believe the most important one is leadership. Leadership is defined as using skills, experience, and direction to help someone improve their performance. Leadership consists primarily of giving people feedback to reinforce what they do well while suggesting ways and means to improve. It implies that everybody can improve and it is hoped that everybody wants to get better at what they do.
Recent research discovered that economic processes influence national averages of customer satisfaction. Using time-series data from Japanese and South Korean hospitals, we conducted principal component regression analyses to examine whether these findings are transferable to patient satisfaction. Our results reveal that aggregate income has a positive impact and economic expectations have a negative impact on patient satisfaction. Further analyses demonstrate that these strong economic influences make it difficult for hospital managers to use patient satisfaction scores to assess the performance impact of their customer-oriented actions. In order to improve performance evaluations based on patient surveys, we thus recommend managers to remove economic influences from time-series of patient satisfaction.
Innovation drives productivity in the nonprofit sector as well as in the commercial sector. The greatest advances come not from incremental improvements in efficiency but from new and better approaches. The most powerful way to create social value, therefore, is by developing a new means to address social problems and putting it into widespread practice. The expertise, research capacity, and reach that companies bring to philanthropy can help nonprofits create new solutions that they could never afford to develop on their own. Corporate managers sometimes work directly with faculty and community residents to implement local business projects. These projects often have significant societal benefits, especially since student collaboration and involvement extend to communities in many different inner cities. These projects are incredibly diverse and through such initiatives, management education not only provides an educationally rewarding outlet for students but also endows and enriches inner city communities. Management students sometimes work directly with faculty and community residents to implement local business projects. These projects often have significant societal benefits, especially since student collaboration and involvement extend to communities in many different inner cities. These projects are incredibly diverse and through such initiatives, management education not only provides an educationally rewarding outlet for students but also endows and enriches inner city communities. This article looks at how to use corporate social responsibility and service learning to drive innovation for local inner-city economic development.
The aim of this literature review was to determine if there is adequate ethical justification for presymptomatic genetic testing on potential Huntington's disease patients. Huntington's disease is a neurological genetic disorder characterized by midlife onset which consists of cognitive, physical, and emotional deterioration. Although genetic testing has traditionally been guided by the principle of autonomy, severe psychological consequences such as depression, anxiety, survival guilt, and suicide have complicated the ethical issue of providing a presymptomatic yet definitive diagnosis for an incurable disease. An analysis of available articles yielded inconclusive findings, namely due to insufficient evidence, self-selection bias of test participants, or lack of a longitudinal design. Additional results indicated psychological distress is not solely associated with test result, but rather with individual characteristics including, but not limited to, psychological history, test motivation, level of preparation, social support, and age. In the interest of upholding the principles of autonomy, beneficence, nonmaleficence, and justice, it is recommended that medical professionals follow strict protocol, provide extensive counseling, and employ vigilance when assessing at-risk individuals for HD presymptomatic test eligibility to ensure psychological well-being.
A drastically increasing elderly population and disparity among disability poses a concern for the U.S. health care industry. This retrospective cross-sectional study analyzed whether ADL and IADL disabilities were different among non-Hispanic white (NHW) and non-Hispanic black (NHB) populations age 65 and over. Data was retrieved from the 2001-2003 National Health Interview Survey (NHIS) for comparing NHBs and NHWs using chi-square analysis for bivariate comparisons. For both elderly NHBs and elderly NHWs, increased rates of disability were reported for being over 75, female, single, and having lower education. NHBs reported statistically higher disability rates for ADL, IADL, and for any disability, with 10.0%, 18.0%, and 19.3%, respectively, compared to NHWs. There is a need to increase the access for NHBs to nursing home, hospice, and assisted-living facilities. Of further concern is the finding of lower institutionalization rates in the NHB population despite the significant presence of increased disability. The growing NHB elderly population needs an urgent societal intervention to address the persistent disparity, which has been neglected for so many years.
In today's highly competitive health care environment, many private health care settings are now looking into customer service indicators to learn customers’ perceptions and determine whether they are meeting customers’ expectations in order to ensure that their customers are satisfied with the services. This research paper aims to investigate whether the human elements were more important than the nonhuman elements in private health care settings. We used the internationally renowned SERVQUAL five-dimension model plus three additional dimensions—courtesy, communication, and understanding of customers of the human element—when evaluating health care services. A total of 191 respondents from three private health care settings in the Klang Valley region of Malaysia were investigated. Descriptive statistics were calculated by the Statistical Package for Social Sciences (SPSS) computer program, version 15. Interestingly, the results suggested that customers nowadays have very high expectations especially when it comes to the treatment they are receiving. Overall, the research indicated that the human elements were more important than the nonhuman element in private health care settings. Hospital management should look further to improve on areas that have been highlighted. Implications for management practice and directions for future research are discussed.
The analysis studies the relationship between hospital quality and hospital profits for a sample of 94 Alabama hospitals. Quality is measured by four groups of procedures performed on newly-admitted patients as suggested by the Center for Medicare and Medicaid Services. Profit is measured for five outpatient services. We find that the quality of inpatient care predicts profits in three of the five outpatient services. We also find that the association is due primarily to an increase in outpatient volume in response to quality rather than to higher profit margins. The notable exception is for profit margins for cardiac and surgical care.
