Impact of Patient-Centered Care Innovations on Access to Providers, Ambulatory Care Utilization, and Patient Clinical Indicators in the Veterans Health Administration

Burkhart, Lisa; Sohn, Min-Woong; Jordan, Neil; Tarlov, Elizabeth; Gampetro, Pamela J.; LaVela, Sherri L.

doi:10.1097/qmh.0000000000000093

Cited by 4 publications

(6 citation statements)

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“…Secondary data provides researchers the ability to evaluate quality markers within institutions and the impact such initiatives may have that are independent of other variables within particular settings. 33…”

Section: Methodsmentioning

confidence: 99%

“…A cross-sectional study of secondary data is well suited for describing variables and their distribution patterns. Secondary data provides researchers the ability to evaluate quality markers within institutions and the impact such initiatives may have that are independent of other variables within particular settings 33 …”

Section: Methodsmentioning

confidence: 99%

“…Such variability in the perceptions of teamwork and communication has been shown in the literature to undermine collaboration efforts between these professional groups and contribute to inadequate collaboration practices, poor patient satisfaction, and preventable AEs. 17,26,33,38,43 Siedlecki and Hixson 38 found that patient care was impacted negatively when the nursing staff perceived healthcare teams that were not open to collaborative efforts. Poor teamwork impacts the effectiveness, safety, and outcome of children's care.…”

Section: Administrators/managers Misalignment With Providersmentioning

confidence: 99%

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Perceptions of Pediatric Hospital Safety Culture in the United States: An Analysis of the 2016 Hospital Survey on Patient Safety Culture

et al. 2019

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Introduction: Medical errors in the pediatric population can quickly cause harm. Research identified that hospitals with positive safety cultures work collaboratively to reduce errors. Strategies that identify gaps in hospital's safety culture within the pediatric milieu have not been initiated. This study addressed this gap from an interprofessional perspective.Methods: This cross-sectional descriptive study used data from the Agency for Healthcare Research and Quality's 2016 Hospital Patient Safety Culture survey measuring 12 safety culture dimensions for registered nurses (RNs), physician assistants/nurse practitioners (PAs/NPs), physicians (MDs), and administrators/managers (n = 6682) in the United States that were employed in 287 (42%) pediatric hospitals or specialty units.Results: Findings indicated that in the United States, the overall safety culture had low levels of agreement. Pairings between pediatric RNs, PAs/NPs, and MDs had similar levels of agreement for all dimensions but the perceptions of these three practitioners differed when compared with pediatric administrators/managers in nine of the 12 dimensions. The perceptions of pediatric RNs and MDs differed in six of the 12 dimensions, with MDs indicating higher levels of agreement. All four professional groups rated teamwork within hospital units with the highest level of agreement (mean, 4.14), with hospital handoffs and transitions rated the lowest (mean, 2.64). All four professional groups found punitive cultures (mean, 2.71) throughout the pediatric specialty.Conclusions: Variations regarding pediatric professional's perception of safety culture exist within U.S. hospitals. Effective and creative management will support cultures that prevents harm and improves the overall safety of children's care with initiatives that are dedicated to excellence.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Administrators/managers Misalignment With Providersmentioning

confidence: 99%

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Perceptions of Pediatric Hospital Safety Culture in the United States: An Analysis of the 2016 Hospital Survey on Patient Safety Culture

et al. 2019

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“…The innovation categories explored in each of the included articles are outlined in S3). Thirty-five per cent (13/37) [17][18][19][20][21][22][23][24][25][26][27][28][29] of the interventions/programmes impacted all of the 4Cs (Supplementary Table S2a). These programmes included, on average, 7.25 intervention categories each (median = 7), and the most recurrently explored outcome was healthcare costs and utilisation (which featured in 10 of the 13 articles), followed by population health outcomes (in five of the 13 articles).…”

Section: Descriptions Of Interventions Impact On the 4cs And Their Effects On Outcomesmentioning

confidence: 99%

Multicomponent interventions for enhancing primary care: a systematic review

et al. 2020

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BackgroundMany countries have implemented interventions to enhance primary care to strengthen their health systems. These programmes vary widely in features included and their impact on outcomes.AimTo identify multiple-feature interventions aimed at enhancing primary care and their effects on measures of system success — that is, population health, healthcare costs and utilisation, patient satisfaction, and provider satisfaction (quadruple-aim outcomes).Design and settingSystematic review and narrative synthesis.MethodElectronic, manual, and grey-literature searches were performed for articles describing multicomponent primary care interventions, providing details of their innovation features, relationship to the ‘4Cs’ (first contact, comprehensiveness, coordination, and continuity), and impact on quadruple-aim outcomes. After abstract and full-text screening, articles were selected and their quality appraised. Results were synthesised in a narrative form.ResultsFrom 37 included articles, most interventions aimed to improve access, enhance incentives for providers, provide team-based care, and introduce technologies. The most consistent improvements related to increased primary care visits and screening/preventive services, and improved patient and provider satisfaction; mixed results were found for hospital admissions, emergency department visits, and expenditures. The available data were not sufficient to link interventions, achievement of the 4Cs, and outcomes.ConclusionMost analysed interventions improved some aspects of primary care while, simultaneously, producing non-statistically significant impacts, depending on the features of the interventions, the measured outcome(s), and the populations being studied. A critical research gap was revealed, namely, in terms of which intervention features to enhance primary care (alone or in combination) produce the most consistent benefits.

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“…… aimed at improving patient care and included offerings aimed at improving the employee experience. (Burkhart et al , p103)56…”

Section: Resultsmentioning

confidence: 99%

Capturing what and why in healthcare innovation

Reid

Davis

Gordon

2023

leader

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Understandings of innovation usually encompass multiple overlapping aspects, putting innovation terminology at risk of vagueness and overuse. However, innovation concepts are expected to remain powerful and useful in healthcare beyond the pandemic and into the future, so clarity will be helpful for effective leadership. To disentangle and disambiguate meanings within innovation, we offer a framework that captures and simplifies foundational substance within innovation concepts. Our method is an overview review of innovation literature from the 5 years preceding COVID-19. 51 sources were sampled and analysed for explicit definitions of healthcare innovation. Drawing on broad themes suggested from previous reviews, and gathering specific themes emergent from this literary dataset, we focused on categorising the nature of innovations (the what) and reasons given for them (the why). We identified 4 categories of what (ideas, artefacts, practice/process and structure) and 10 categories of why (economic value, practical value, experience, resource use, equity/accessibility, sustainability, behaviour change, specific-problem solving, self-justifying renewal and improved health). These categories reflect contrasting priorities and values, but do not substantially interfere or occlude each other. They can freely be additively combined to create composite definitions. This conceptual scheme affords insight and clarity for creating precise meanings, and making critical sense of imprecision, around innovation. Improved communication and clear shared understandings around innovative intentions, policies and practices cannot but improve the chances of enhanced outcomes. The all-inclusive character of this scheme leaves space for considering the limits of innovation, and notwithstanding well-established critiques, provides a basis for clarity in ongoing usage.

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Impact of Patient-Centered Care Innovations on Access to Providers, Ambulatory Care Utilization, and Patient Clinical Indicators in the Veterans Health Administration

Abstract: Secondary data analysis can reveal longitudinal trends associated with system changes, thereby informing program evaluation and identifying opportunities for quality improvement.

Cited by 4 publications

References 5 publications

Perceptions of Pediatric Hospital Safety Culture in the United States: An Analysis of the 2016 Hospital Survey on Patient Safety Culture

Perceptions of Pediatric Hospital Safety Culture in the United States: An Analysis of the 2016 Hospital Survey on Patient Safety Culture

Multicomponent interventions for enhancing primary care: a systematic review

Capturing what and why in healthcare innovation

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