Primary Care Quality Digest, Annotated Bibliography Example

Broom C, Tilbury MS. (2007). Magnet Status: A Journey, Not a Destination. J Nurs Care Qual, 22(2): 113 – 118.

This article discusses the history of the Magnet Recognition Program and the steps that a nurse must follow to achieve magnet status. The number of hospitals that have achieved magnet status have increased significantly since 1994. There are many factors nurses and hospitals should consider in their goal to achieve magnet status, including the organizational culture of their institution, institutional values and how these relate to performance, the structure of the organization and the ability to use this to advance professional practice, and professional development programs. Research has shown that hospitals that strive to achieve magnet status are more likely to perform well. Although nurses have many responsibilities to their patients, they should also be made responsible for the quality of their work environment. When nurses work together to develop strategy and organization techniques for their institution, they will become more effective healthcare practitioners. It is essential for nurses to understand and define their culture, and alter this culture to be a more productive one, if necessary. Ultimately, each member of an organization contributes to its success and every individual should therefore be held responsible for ensuring that this success is realized. Even when hospitals who strive to achieve magnet status fail, it is important to understand that they are continuously improving themselves simply by making this attempt. Eventually, this will contribute to better patient outcome, better overall productivity within the institution, and happier workers who feel that they are truly making a difference.

Key Words: Magnet Recognition Program, professional development, organizational culture, values, performance, professional practice.

This article helped increase my knowledge of healthcare finance because it relates organizational culture to the outcome and performance of the healthcare institution. It demonstrates that when each individual is motivated to contribute to the success of an institution, the overall atmosphere will be improved, which will increase overall productivity.

Hader R. (2007). Best-practice protocols: Get your board on board. Nursing Management. Retrieved from www.nursingmanagement.com

In this article, the author introduces the idea of the 5 Million Lives Campaign, which was created in response to the 100,000 lives movement. Both of these movements take advantage of the concept that nurses and physicians are scientists and as such, it would be useful to commit to a scientific approach in developing administrative framework and guidelines in healthcare facilities. The hospitals who participated in this administrative reorganization saw extremely positive results; many lives were saved as a result of improvement in care. In a sense, this framework requires many healthcare professionals to think and act as if they were a business trying to sell a product. Most board members don’t have a practice background in quality, but quality is essential to the well-being and care of patients. To resolve this problem, the article proposes that several performance standards are followed. These include paying special attention to patients who are given high-alert medications, reducing MRSA by reducing the prescription of antibiotics when a bacterial infection is not confirmed, preventing pressure ulcers, reducing surgical complications, and reducing readmissions by thoroughly examining cases as they are received. In order for this framework to succeed, hospitals need to commit to education programs that will train their healthcare staff to recognize these issues and what they can do to ensure they are avoided. A second thing that can be done is to ensure communication among the staff. It is essential that the healthcare team works together to solve these problems and prevent them from happening.

Key Words: Institute for Healthcare, 5 Million Lives Campaign, education, communication, accountability.

This article helped increase my knowledge of healthcare finance because it allowed me to why inefficiencies occur in the hospital setting. To ensure that patients aren’t paying for medications that hurt them and that nurses aren’t wasting their time helping to solve issues that could have already been taken care of, it is essential for nurses to communicate to one another in order to prevent the development of specific illnesses.

Hagland M. (2005). Six Sigma: It’s real, it’s data driven, and it’s here. Healthcare Strategic Management, 23(12): 1.

Although the six sigma method was designed for operation management, this article demonstrates that this concept is applicable to the healthcare field. The Mount Carmel Health System in Columbus, Ohio was the first to attempt use of this method, and in five years, it saved them $62.5 million dollars. As a consequence, the author believes that it is useful to spread the knowledge of this success, and recommends that other healthcare institutions follow these principles as well. Six sigma is a total quality management method that was originated in industry by Motorola. Mount Carmel initially used six sigma as a means to stay open. It had to lay off many of its employees due to financial issues, and decided that using this program would be a worthwhile attempt to stay in business. It would be useful for many other hospitals to use this program as well. Even if a hospital is not at risk for closure, this method can free up money that is needed elsewhere, such as for hiring additional staff and reducing hospital wait times. Other institutions that have implemented six sigma since the success at Mount Carmel state that their focus is on operational enhancements that will either lead to cost reduction or revenue gain. Like many other modern attempts to organize healthcare, this process focuses on education practices that will lead to increased organization of the institution. Six sigma is beneficial because it requires hospitals to thoroughly examine data and conduct research before making decisions.

Key Words: Six sigma, organization, education, profit, operations management, productivity.

This article helped increase my knowledge of healthcare finance because I hadn’t realized that six sigma was used to a significant extent in the healthcare field. I’m aware of how it helps businesses reduce waste and therefore increase productivity in the business world, but I hadn’t fully considered that hospitals could be treated as this sort of business until now.

Powell A, Rushmer R. (2009). Quality Improvement. British Journal of Healthcare Management, 15(1): 17-21.

This article explains that while many healthcare organizations are taking quality improvement measures, the meaning of quality improvement is difficult to define, which impairs progress in doing so. The authors recommend however, that the High Quality Care for All criteria be followed, which state that quality should be defined in terms of patient safety, patient experience, and effectiveness of care. Furthermore, there are six factors that determine the success of these three aspects of quality, including safety, effectiveness, patient-centeredness, timeliness, efficiency, and equity. While these principles appear straightforward, putting them into practice has raised some problems and debate. This article states that the proper way to do so is by putting the management in a leading role and by targeting the organization of individual departments. This concept was initially used in industry as a part of total quality management. Other industry practices that should be considered for use in the healthcare field include business process re-engineering, practitioner-led rapid change cycle, lean thinking, and six sigma. These methods have been used either alone or in combination in the healthcare field over the past few years. Although there are many methods that are useful for business purposes in industry, it’s important to consider that these concepts are new to the healthcare field. As a consequence, their use is in an experimental phase and it’s difficult to determine which techniques or combination of techniques will result in the best outcome. Therefore, it is necessary to keep track of the methods that hospitals have used in addition to their outcomes in order to gain a greater understanding of what is successful.

Key Words: Total quality management, quality care, management, quality improvement, industry.

This article helped increase my knowledge of healthcare finance because it allowed me to consider several of the methods used in industry to ensure quality control and understand how these factors can be used in healthcare quality management. It also informed me that while all of these are proposed as potentially good ideas, it’s important to conduct more research on this to determine which methods really work in the healthcare setting.

Ashurst A. (2008). Exceeding customer expectations in care homes. Nursing & Residential Care, 10(12): 616-619.

This article states that many care homes today are run by corporations, which ensures the quality of the care home. As a consequence, the expectations of customers who are searching for a care home has increased, which has driven the excellence of care homes in the industry. Even though care homes are a part of the healthcare field, they could also be viewed as businesses and businesses are constantly looking for new ways to stand out and attract new customers. This article summarizes how the extent and quality of customer care can impact business and that it is mostly the behavior of staff and management that affects the experience that an individual has in the care home and how the family feels about it as well. There are three principles that members of the care staff should follow in order to ensure quality: approach, attitude, and appearance. These principles apply even to auxiliary staff members, such as the reception, because even though they don’t contribute directly to the care of the patient, they are the face of the company. As a result, it is recommended that receptionists be warm, personable, and knowledgeable. The article notes that the care home should pay attention to detail in many aspects of its work. For example, while the meals may taste good, they are often not as presentable as one would expect. The chef and kitchen staff should work to ensure that the food looks as good as it tastes. A good way to achieve quality improvement in this situation is to ask for feedback from the residents and their relatives, and to act upon this advice.

Key Words: Approach, attitude, appearance, support staff, quality control, customer feedback.

This article helped increase my knowledge of healthcare finance because it demonstrated the importance of customer feedback in achieving quality control. Although not all customer complains can be addressed, it is important to make as many people happy as possible, so their opinions should be heard.

Elango B, Hunter GL, Winchell M. (2007). Barriers to nurse entrepreneurship: A study of the process model of entrepreneurship. Journal of the American Academy of Nurse Practitioners, 19: 198-204.

The authors believe that nurse entrepreneurship can be used to increase the effectiveness of healthcare delivery. Since costs associated with healthcare are on a continuous rise, it is important to find ways to ensure that healthcare is both affordable and effective for the many patients that rely on it. Professionals explain that the overhead cost of a nurse entrepreneur is low, so it is important for hospitals to take advantage of this resource. However, there are many barriers towards starting a business, and this is also the case for creating healthcare institutions that are structured like businesses. In order to fully understand the current mindset that nursing professionals have concerning the hospital as a business setting, the authors questioned the nurses about the barriers to starting a business while using the process model of entrepreneurship as criteria for analysis. It was found that unfortunately, many healthcare professionals regardless of their roles, administrative or otherwise, were unable to identify the potential of entrepreneurship within the healthcare setting. The authors state that this mindset needs to be overcome because of the potential benefits entrepreneurship could have in the industry. To do so, they believe that nursing professional associations should be informed of this issues and help spread this message to its members. In addition, the healthcare institution itself should implement educational programs to promote the knowledge necessary to undertake this movement. The major issue here is that a majority of nurses were simply not trained to be entrepreneurs, although due to their already present knowledge of the healthcare field, they could quickly be trained to supplement their current knowledge in ways that would support development of this program.

Key Words: Entrepreneurship, finance, training

This article helped increase my knowledge of healthcare finance because it showed that very few nurses are aware of the benefits that the nursing entrepreneurship could bring. It is important to demonstrate to them that this type of program could be effective because it helps maximize the resources that the hospital has available. When the hospital is able to save money, it is also able to ensure better patient care, which is an important concern for all employees in the healthcare field.

Price A. (2008). Primary care quality digest. Quality in Primary Care, 16: 217-219.

This document summarizes recent literature concerning guidelines in primary care. The first section of the report concerns the slow movement towards quality control in the healthcare setting due to the many barriers that exist. Ultimately, while many articles call for a need towards this trend, there are very few reports in the literature that indicate success in this attempt. The authors explain that a major reason for this is a consequence of healthcare disparity due to socioeconomic status. It is difficult to compare the hospitals that are implementing quality control in wealthy areas to the hospitals in poorer areas because it is likely that the wealthier hospital has more resources that will allow it to reorganize itself effectively. Furthermore, to ensure quality control, actual changes must be made in primary care. It is difficult to implement these changes, but electronic health record systems could be used to track these changes and determine success. This paper also examines whether the inverse care law in primary care is true. This concept was found to be valid in more economically deprived areas, indicating that healthcare organization needs to adjust to meet healthcare supply and demand. Another section of the review concluded that the culture within a healthcare team reflects certain beliefs and values, and this can influence the quality of care. However, rather than impacting the quality of care directly, nursing culture is shown to have a greater impact on teamwork. It is important to review articles that examine patient quality of care so that healthcare professionals are in a better position to ensure the services they deliver are effective.

Key Words: Electronic health record, quality control, inverse care law, teamwork, nursing culture, socioeconomic status.

This article helped increase my knowledge of healthcare finance because it demonstrated that there is a long way to go to enlist an industry style quality of control in the healthcare field. There are currently a lot of unknowns and more research needs to be done.

Stapleton P, Henderson A, Creedy DK, Cooke M, Patterson E, Alexander H, Haywood A, Dalton M. (2007). Boosting morale and improving performance in the nursing setting. Journal of Nursing Management, 15: 811-816.

Previous research shows that there is a clear connecting between nurse morale and culture in effective and efficacy and treatment. Despite this, it is not certain how hospitals can increase this morale in ways that confers benefit to the hospital. The authors argue that the ability to inspire morale is a key factor in improving performance in the hospital setting. Improved performance leads to many benefits. The authors propose that four concepts should be implemented in the clinical setting to ensure that employees are satisfied. These include role preparation for managers, understanding internal and external motivation, fostering internal motivation in nursing staff, and using the correct attitude when investing in relationships. Employee satisfaction is related to a number of factors, the most important of which is how they are treated by other members of staff and their managers. Ultimately, a positive experience in the workplace will lead to more productive organizational culture. When managers treat their employees with respect, the employees will be more motivated to perform well. As a consequence, it is essential to train managers in manners that defines this motivation. They must understand that they are not only leading a team to ensure they perform their tasks and well, but they are also responsible for finding new and useful ways in doing so. It is important for these managers to notice when their employees are doing a good job and to reward them for good practice. Likewise, it is necessary for managers to point out when their employees are not doing a good job. Instead of punishing them and reinforcing the negativity of the situation, a good managers informs an employee of improper behavior in a manner that will prevent them from repeating the behavior and allow them to want to contribute positively to the team.

Key Words: Leadership, morale, management, organizational culture.

This article helped increase my knowledge of healthcare finance because it demonstrated how managers can positively influence their workers. It also shows how managers can alter the behavior of employees based on their interactions and how they reward and punish individuals. This is important because it has an impact on productivity.

Casida J. (2008). Linking Nursing Unit’s Culture to Organizational Effectiveness: A Measurement Tool. Nursing Economics, (26)2: 106-110.

This study determines the relationship between nursing organization culture and their effectiveness in practice. The Denison organizational model is used to classify these organizational traits. “Adaptability” is a trait that is used to define the organizations ability to translate business demands into an action plan. It also includes the support that is necessary to ensure that these actions are carried out. The next trait “mission” defines the organizations ability to formulate a long-term goal. This can include a series of internal and external plans in order to meet a series of goals, with the ultimate achievement of one goal that ties all of the smaller goals together. The next trait is “involvement”, which includes traits of ownership and responsibility of staff members. Each nurse must recognize their specific contribution to the team, and coordinate these contributions in a way that is meaningful and helpful to the organization as a whole. The remaining trait is “consistency”, which defines the values and systems that are at the basis of the organizational culture. Once the organizational culture is defined, it should be carried out to ensure that all operations are performed equally, which will also ensure equal results. The Denison Organizational Culture Survey measures these traits and can allow healthcare institutions to determine where they stand in terms of organizational culture.

Key Words: Organizational culture, survey, measurement, mission, goals, involvement, consistency, adaptability

This article helped increase my knowledge of healthcare finance because it helped provide a clearer definition of organizational culture and gave me meaningful ways to measure it. This is useful when the performance of the healthcare facility needs to be made better.

Whitehead CH, Harding S, Giles LC, Crotty M. (2006). Establishment of and first 20 months of operating an outreach geriatric clinic in a regional centre. The International Electronic Journal of Rural and Remote Health Research, Education, Practice, and Policy. 6(444).

This article addresses the business issue of accessing individuals who live in remote suburban and rural environments. This is particularly problematic for geriatric patients who may have urgent needs and are unable to bring themselves into clinics and hospital. Furthermore, the amount of time needed to respond to them in cases of emergency is very high, and could potentially be the cause of death or severe impairment. The authors claim that it is therefore necessary to develop methods to bring healthcare to these patients and set up healthcare facilities more locally. As a result, patients were evaluated to determine their satisfaction and availability with the healthcare service they had available to them. To do so, the authors performed a data collection initiative to create a better understanding of services in the area. They then issued questionnaires to geriatric patients who have used these services in the past. They were then examined by a nurse. A majority of the questionnaire questions related to their accidents and falls. Upon evaluation, it was found that the patients would attend or fail to attend clinic at rates equal to those living in metropolitan settings, demonstrating that their distance from healthcare settings was not a factor in ability or likelihood to access care. Despite this, it may still be easier for many of these individuals to access healthcare if it were closer to them, but since there are many people living in rural settings, it would be nearly impossible to assist everyone.

Key Words: geriatric, distance, survey

This article helped increase my knowledge of healthcare finance because it called to my attention a problem in the geriatric population living in rural areas. Although this is an issue, it may not be worth the money to make new clinics in these areas because they are travelling to the healthcare facilities at the same rate as people living in urban environments. It helped me evaluate the supply and demand aspect of the healthcare industry and made me realize it would be more profitable to have larger well-cared for facilities where there are dense populations rather than many small ones that are evenly dispersed regardless of population.