Emphasis on Financial vs Nonfinancial Criteria in Employer Benefits' Measurements.

Importance: Few studies have examined the extent to which employers emphasize financial over nonfinancial criteria in measurement, reporting, and decision-making about health care benefits.

Objective: To measure and identify factors associated with financial over nonfinancial emphasis in employer decision-making about health benefits.

Design, Setting, And Participants: A survey was administered to a nationally representative sample of US employers to assess the extent of employers' emphasis on benefits plans' costs over member experience, access to care, and equity, and on financial vs other considerations when choosing third-party benefits administrators.

Nurse Burnout and Patient Safety, Satisfaction, and Quality of Care: A Systematic Review and Meta-Analysis.

Importance: Occupational burnout syndrome is characterized by emotional exhaustion, depersonalization, and a diminished sense of personal accomplishment and is prevalent among nurses. Although previous meta-analyses have explored the correlates of nurse burnout, none have estimated their association with health care quality and safety and patient morbidity and mortality.

Objective: To evaluate the magnitude and moderators of the association between nurse burnout and patient safety, patient satisfaction, and quality of care.

A Coproduced Family Reporting Intervention to Improve Safety Surveillance and Reduce Disparities.

Objectives: Examine family safety-reporting after implementing a parent-nurse-physician-leader coproduced, health literacy-informed, family safety-reporting intervention for hospitalized families of children with medical complexity.

Methods: We implemented an English and Spanish mobile family-safety-reporting tool, staff and family education, and process for sharing comments with unit leaders on a dedicated inpatient complex care service at a pediatric hospital. Families shared safety concerns via predischarge surveys (baseline and intervention) and mobile tool (intervention).

Promoting equity, diversity, and inclusion in surveys: insights from a patient-engaged study to assess long COVID health-care needs in Brazil.

Background And Objective: Long COVID (LC) refers to persistent symptoms after acute COVID-19 infection, which may persist for months or years. LC affects millions of people globally, with substantial impacts on quality of life, employment, and social participation. Ensuring access to effective, patient-centered care for LC demands evidence, grounded in inclusive representation of those affected by the condition.

Engaging Interdisciplinary Innovation Teams in Federally Qualified Health Centers.

To foster bottom-up innovations, health care organizations are leveraging interdisciplinary frontline innovation teams. These teams include workers across hierarchical levels and professional backgrounds, pooling diverse knowledge sources to develop innovations that improve patient and worker experiences and care quality, equity, and costs. Yet, these frontline innovation teams experience barriers, such as time constraints, being new to innovation, and team-based role hierarchies.

Variation in Hospital Neuraxial Labor Analgesia Rates in California.

Background: Neuraxial analgesia provides effective pain relief during labor. However, it is unclear whether neuraxial analgesia prevalence differs across U.S.

More isn't always better: Technology in the intensive care unit.

Background: Clinical care in modern intensive care units (ICUs) combines multidisciplinary expertise and a complex array of technologies. These technologies have clearly advanced the ability of clinicians to do more for patients, yet so much equipment also presents the possibility for cognitive overload.

Purpose: The aim of this study was to investigate clinicians' experiences with and perceptions of technology in ICUs.

Safe Surgery Checklist Implementation: Associations of Management Practice and Safety Culture Change.

Designing and developing safe systems has been a persistent challenge in health care, and in surgical settings in particular. In efforts to promote safety, safety culture, i.e.

Innovation Diffusion Across 13 Specialties and Associated Clinician Characteristics.

Diffusion of innovations, defined as the adoption and implementation of new ideas, processes, products, or services in health care, is both particularly important and especially challenging. One known problem with adoption and implementation of new technologies is that, while organizations often make innovations immediately available, organizational actors are more wary about adopting new technologies because these may impact not only patients and practices but also reimbursement. As a result, innovations may remain underutilized, and organizations may miss opportunities to improve and advance.

Qualitative interview study of strategies to support healthcare personnel mental health through an occupational health lens.

Background: Employee Occupational Health ('occupational health') clinicians have expansive perspectives of the experience of healthcare personnel. Integrating mental health into the purview of occupational health is a newer approach that could combat historical limitations of healthcare personnel mental health programmes, which have been isolated and underused.

Objective: We aimed to document innovation and opportunities for supporting healthcare personnel mental health through occupational health clinicians.

Do patients who read visit notes on the patient portal have a higher rate of "loop closure" on diagnostic tests and referrals in primary care? A retrospective cohort study.

Objectives: The 2021 US Cures Act may engage patients to help reduce diagnostic errors/delays. We examined the relationship between patient portal registration with/without note reading and test/referral completion in primary care.

Materials And Methods: Retrospective cohort study of patients with visits from January 1, 2018 to December 31, 2021, and order for (1) colonoscopy, (2) dermatology referral for concerning lesions, or (3) cardiac stress test at 2 academic primary care clinics.

Assessing health care leadership and management for resilience and performance during crisis: The HERO-36.

Background: Whereas organizational literature has provided much insight into the conceptual and theoretical underpinnings of organizational leadership and management during emergencies, measures to operationalize related effective practices during crises remain sparse.

Purpose: To address this need, we developed the Healthcare Emergency Response Optimization survey, which set out to examine the leadership and management practices in health care organizations that support resilience and performance during crisis.

Methodology: We administered an online survey in April to May 2022 to health care administrators and frontline staff intimately involved in their hospital's emergency response during the COVID-19 pandemic, which included a sample of 379 respondents across nine rural and urban hospitals (response rate: 44.

Low Rate of Completion of Recommended Tests and Referrals in an Academic Primary Care Practice with Resident Trainees.

Background: A frequent, preventable cause of diagnostic errors involves failure to follow up on diagnostic tests, referrals, and symptoms-termed "failure to close the diagnostic loop." This is particularly challenging in a resident practice where one third of physicians graduate annually, and rates of patient loss due to these transitions may lead to more opportunities for failure to close diagnostic loops. The aim of this study was to determine the prevalence of failure of loop closure in a resident primary care clinic compared to rates in the faculty practice and identify factors contributing to failure.

Completion of Recommended Tests and Referrals in Telehealth vs In-Person Visits.

Importance: Use of telehealth has increased substantially in recent years. However, little is known about whether the likelihood of completing recommended tests and specialty referrals-termed diagnostic loop closure-is associated with visit modality.

Objectives: To examine the prevalence of diagnostic loop closure for tests and referrals ordered at telehealth visits vs in-person visits and identify associated factors.

A Multifaceted Intervention to Improve Teamwork on an Inpatient Pediatric Neurosurgery Service.

Background: Increased safety reports related to interprofessional teamwork on an acute care unit at a quaternary children's hospital prompted a teamwork-focused improvement effort on the pediatric neurosurgery service.

Methods: An interprofessional workgroup was formed and met twice monthly throughout the project. A survey using modified validated items was disseminated to pediatric neurosurgery nurses, advanced practice providers (APPs), and physicians in March 2021 to identify opportunities for improvement.

Rethinking Health and Health Care: How Clinicians and Practice Groups Can Better Promote Whole Health and Well-Being for People and Communities.

A new National Academies of Sciences, Engineering, and Medicine report, "Achieving Whole Health: A New Approach for Veterans and the Nation," redefines what it means to be healthy and creates a roadmap for health systems, including the Veterans Health Administration and the nation, to scale and spread a whole health approach to care. The report identifies 5 foundational elements for whole health care and sets 6 national, state, and local policy goals for change. This article summarizes the report, emphasizes the importance of preventive medicine, and identifies concrete actions clinicians and practices can take now to deliver whole health care.

Understanding care coordination for Veterans with complex care needs: protocol of a multiple-methods study to build evidence for an effectiveness and implementation study.

Background: For patients with complex health and social needs, care coordination is crucial for improving their access to care, clinical outcomes, care experiences, and controlling their healthcare costs. However, evidence is inconsistent regarding the core elements of care coordination interventions, and lack of standardized processes for assessing patients' needs has made it challenging for providers to optimize care coordination based on patient needs and preferences. Further, ensuring providers have reliable and timely means of communicating about care plans, patients' full spectrum of needs, and transitions in care is important for overcoming potential care fragmentation.

The association between care integration and care quality.

Objective: The study aims to analyze the relationship between care integration and care quality, and to examine if the relationship varies by patient risk.

Data Sources And Study Setting: The key independent variables used validated measures derived from a provider survey of functional (i.e.

The 'Product Environment' is an Important Driver of Health. It's Time to Measure It.

Through their products and services, businesses have a meaningful impact on their customers' health. When markets reward products that induce unhealthy behaviors, like poor diet and limited physical activity, they fuel the chronic disease epidemic. For market mechanisms to reward positive, and to punish negative, influences on healthy behaviors, companies' influences will need to be measured.

Enabling System Functionalities of Primary Care Practices for Team Dynamics in Transformation to Team-Based Care: A Qualitative Comparative Analysis (QCA).

Team-based primary care has been shown to be an important initiative for transforming primary care to achieve whole-person care, enhance health equity, and reduce provider burnout. Organizational approaches have been explored to better implement team-based care but a thorough understanding of the role of system functions is lacking. We aimed to identify the combinations of system functionalities in primary care practices that most enable effective teamwork.

High-performing primary care clinics across high-need, high-cost Medicare populations.

Background: To reduce spending and improve quality, some primary care clinics in the USA have focused on high-need, high-cost (HNHC) Medicare beneficiaries, which include clinically distinct subpopulations: older adults with frailty, adults under 65 years with disability and beneficiaries with major complex chronic conditions. Nationally, the extent to which primary care clinics are high-performing 'Bright Spots'-clinics that achieve favourable outcomes at lower costs across HNHC beneficiary subpopulations-is not known.

Objective: To determine the prevalence of primary care clinics that perform highly on commonly used cost or quality measures for HNHC subpopulations.