Improving Capacity Management in the Emergency Department: A Review of the Literature, 2000-2012.

Capacity management (CM) is a critical component of maintaining and improving healthcare quality and patient safety. One particular area for concern has been the emergency department and the growing issues of patient overcrowding, boarding, and ambulance diversion, which can result in poor patient care and less efficient operations. This study provides a review of the current and most relevant academic literature on capacity management directly related to hospital emergency departments, identifies strengths and weaknesses of the approaches discussed in the literature, and provides practical recommendations for health services administrators implementing CM in their organizations.

Journal Rankings by Health Management Faculty Members: Are There Differences by Rank, Leadership Status, or Area of Expertise?

Health administration (HA) faculty members publish in a variety of journals, including journals focused on management, economics, policy, and information technology. HA faculty members are evaluated on the basis of the quality and quantity of their journal publications. However, it is unclear how perceptions of these journals vary by subdiscipline, department leadership role, or faculty rank.

Reassessing After-Hour Arrival Patterns and Outcomes in ST-Elevation Myocardial Infarction.

Introduction: Differences in after-hours capability or performance of ST-elevation myocardial infarction (STEMI) centers has the potential to impact outcomes of patients presenting outside of regular hours.

Methods: Using a prospective observational study, we analyzed all 1,247 non-transfer STEMI patients treated in 15 percutaneous coronary intervention (PCI) facilities in Dallas, Texas, during a 24-month period (2010-2012). Controlling for confounding factors through a variety of statistical techniques, we explored differences in door-to-balloon (D2B) and in-hospital mortality for those presenting on weekends vs.

The use of six sigma in health care management: are we using it to its full potential?

Popular quality improvement tools such as Six Sigma (SS) claim to provide health care managers the opportunity to improve health care quality on the basis of sound methodology and data. However, it is unclear whether this quality improvement tool is being used correctly and improves health care quality. The authors conducted a comprehensive literature review to assess the correct use and implementation of SS and the empirical evidence demonstrating the relationship between SS and improved quality of care in health care organizations.

Building the case for quality improvement in the health care industry: a focus on goals and training.

Health care organizations are under intense pressure to improve the efficiency and effectiveness of care delivery and, increasingly, they are using quality improvement teams to identify and target projects to improve performance outcomes. This raises the question of what factors actually drive the performance of these projects in a health care environment. Using data from a survey of health care professionals acting as informants for 244 patient care, clinical-administrative, and nonclinical administrative quality improvement project types in 93 health care organizations, we focus on 2 factors--goal setting and quality training--as potential drivers of quality improvement project performance.

Barriers and disparities in emergency medical services 911 calls for stroke symptoms in the United States adult population: 2009 BRFSS Survey.

Introduction: This study examines barriers and disparities in the intentions of American citizens, when dealing with stroke symptoms, to call 911. This study hypothesizes that low socioeconomic populations are less likely to call 911 in response to stroke recognition.

Methods: The study is a cross-sectional design analyzing data from the Centers for Disease Control's 2009 Behavioral Risk Factor Surveillance Survey, collected through a telephone-based survey from 18 states and the District of Columbia.

The use of six sigma in health care management: are we using it to its full potential?

Popular quality improvement tools such as Six Sigma (SS) claim to provide health care managers the opportunity to improve health care quality on the basis of sound methodology and data. However, it is unclear whether this quality improvement tool is being used correctly and improves health care quality. The authors conducted a comprehensive literature review to assess the correct use and implementation of SS and the empirical evidence demonstrating the relationship between SS and improved quality of care in health care organizations.

The joint relationship between organizational design factors and HR practice factors on direct care workers' job satisfaction and turnover intent.

Background: Human resource (HR) practices, such as training and communication, have been linked to positive employee job commitment and lower turnover intent for direct care workers (DCWs). Not many studies have looked at the combined interaction of HR practices and organizational structure.

Purpose: The aim of this study is to examine the relationship between organizational structure (centralization, formalization, and span of control) and HR practices (training, horizontal communication, and vertical communication) on DCW's job satisfaction and turnover intent.

Perception is reality: How patients contribute to poor workplace safety perceptions.

Background: Nurses and aides are among the occupational subgroups with the highest injury rates and workdays lost to illness and injury in North America. Many studies have shown that these incidents frequently happen during provision of patient care. Moreover, health care workplaces are a source of numerous safety risks that contribute to worker injuries.

Assessing the evidence of Six Sigma and Lean in the health care industry.

Background: Popular quality improvement tools such as Six Sigma and Lean Systems (SS/L) claim to provide health care managers the opportunity to improve health care quality on the basis of sound methodology and data. However, it is unclear whether these 2 quality improvement tools actually improve health care quality.

Methods: The authors conducted a comprehensive literature review to assess the empirical evidence relating SS/L to improved clinical outcomes, processes of care, and financial performance of health care organizations.

Need and feasibility of telemedicine in non-urban day care centres.

There appear to have been no studies of telemedicine in rural day care centres. We have assessed the feasibility of using telemedicine in eight rural day care centres in Pennsylvania, from the day care centres' perspective. The average number of children in these centres was 76 (range 20-150).

Investment, managerial capacity, and bias in public health preparedness.

Objective: Nearly $7 billion has been invested through national cooperative funding since 2002 to strengthen state and local response capacity. Yet, very little outcome evidence exists to analyze funding effectiveness. The objective of this research is to analyze the relationship between investment (funding) and capacity (readiness) for public health preparedness (PHP).

Finance at the front line. The effects of financial slack on community health center clinical process quality.

As the number of health centers increases through a federal initiative, questions remain about these primary care providers' capacity to provide sufficient care to the underserved. In the current study, the authors hypothesize that health centers with greater financial latitude or "slack" will provide medically appropriate primary care to greater proportions of their patients. Annual data from all US federally funded community health centers between 1998 and 2004 provide unusually rich data through which to test this hypothesis.

Home-based telehealth: a review and meta-analysis.

We conducted a systematic review to identify studies on the effect of home telehealth on clinical care outcomes. The search was restricted to peer-reviewed publications (published between 2001 and 2007) about studies conducted in home or residential settings. The search yielded 154 potential articles and dissertations.

Does money really matter? The effects of fiscal margin on quality of care in military treatment facilities.

This study was prompted by an escalating interest in the quality of healthcare provided within the United States. The authors hypothesized that one determinant of quality is the adequacy of financial resources available to the healthcare organization. The authors addressed their question by using data from two Defense Department sources: the 2003 Health Care Survey of Defense Department Beneficiaries (HCSDB) and 1999-2003 data from the Department of Defense Medical Expense Performance Reporting System (MEPRS).

Can organizational support for technology influence job satisfaction?

The relationship between organizational support for telemedicine and nurses' job satisfaction in home health agencies (HHAs) is investigated in this study. Drawing from the theory of perceived organizational support, we propose that HHAs that provide strong support for telemedicine will have higher nurse job satisfaction levels than those that do not. Primary data were collected from 29 HHAs and 917 nurses from 2004 to 2005.

Communities with and without children's hospitals: Where do the sickest children receive care?

The author's purpose in this study was to examine whether children's hospitals treat more resource-intense children within their communities than do general acute-care hospitals in the same communities, and then to examine which general acute-care hospitals in communities without children's hospitals fill the role of caring for very sick children. In large communities without children's hospitals, at least one general hospital is likely to treat resource-intense children. Healthcare managers in community hospitals need to be prepared to meet the healthcare needs of resource-intense children, which includes having the appropriate specialized staff and technology to care for the sickest children.

An examination of blood center structure and hospital customer satisfaction: what can centralized and decentralized blood centers learn from each other?

The cost of blood and blood products has increased rapidly over the last several years while the supply of available blood donors has simultaneously decreased. Higher blood costs and donor shortages have put a strain on the relationship between blood suppliers and their hospital customers. This study examines the association between blood center centralization or decentralization and several aspects of hospital satisfaction.

Computer skills for the next generation of healthcare executives.

Students beginning a career in healthcare administration must possess an array of professional and management skills in addition to a strong fundamental understanding of the field of healthcare administration. Proficient computer skills are a prime example of an essential management tool for healthcare administrators. However, it is unclear which computer skills are absolutely necessary for healthcare administrators and the extent of congruency between the computer skills possessed by new graduates and the needs of senior healthcare professionals.

An examination of hospital satisfaction with blood suppliers.

Background: The purpose of this study was to identify factors that predict overall hospital satisfaction with blood suppliers.

Study Design And Methods: The data for this study came from a 2001 satisfaction survey of hospital blood bank managers conducted by the National Blood Data Resource Center. A total of 1325 blood-utilizing hospitals were included in the final study database.