Abstract:
BACKGROUND:The term "medical neighborhood" refers to relationships that patient-centered medical homes (PCMHs) seek to establish with other providers to facilitate coordinated patient care. Yet, how PCMHs can accomplish this coordination is not well understood. PURPOSE:Drawing upon organizational theory (; ; ), we explored how PCMHs use coordination mechanisms to build and optimize their medical neighborhoods. METHODOLOGY:We used mixed methods, blending data collected via interviews and surveys with practice leaders and care coordinators at 30 months after a PCMH collaborative intervention in Colorado as well as surveys from all providers from 13 PCMHs before and 30 months after the intervention. We used thematic analysis to understand the role and use of coordination mechanisms by PCMHs and changes in the ability to coordinate and deliver care continuity. FINDINGS:PCMHs drew on four coordination mechanisms to build relationships with their medical neighbors: interorganizational routines to improve reliability of information flow; information connectivity to facilitate continuity and safe care; boundary spanners to integrate care across silos; and communication, negotiation, and decision mechanisms to introduce shared accountability. When providers were fairly confident of the patient's diagnosis and management required sequential interactions (such as tests or procedures), PCMHs tended to coordinate care through interorganizational routines and information connectivity. When a diagnosis was less certain and required reciprocal interaction (i.e., consultation), PCMHs employed boundary spanners and communication, negotiation, and decision mechanisms. PRACTICE IMPLICATIONS:Use of coordination mechanisms by PCMHs can help to improve care coordination in medical neighborhoods. All four mechanisms appear to be useful. The optimal mix of coordination mechanisms requires attention to patient context. Successfully building medical neighborhoods also requires meta-leaders, collaboration competencies, and high-quality relationships between providers in primary care, specialty care, and hospitals.
journal_name
Health Care Manage Revjournal_title
Health care management reviewauthors
Alidina S,Rosenthal M,Schneider E,Singer Sdoi
10.1097/HMR.0000000000000063subject
Has Abstractpub_date
2016-04-01 00:00:00pages
101-12issue
2eissn
0361-6274issn
1550-5030journal_volume
41pub_type
杂志文章abstract::This article reports the findings of an analysis of the implementation of continuous quality improvement (CQI) or total quality management (TQM) programs in 10 hospitals. This analysis is the result of a 2-year study designed to identify and assess the ingredients that lead to the successful implementation of CQI prog...
journal_title:Health care management review
pub_type: 杂志文章,多中心研究
doi:
更新日期:1996-01-01 00:00:00
abstract::Evaluating health care advertising is a four-part process that enables health care managers to target particular markets and to determine the effects of advertising particular services and products. ...
journal_title:Health care management review
pub_type: 杂志文章
doi:
更新日期:1988-07-01 00:00:00
abstract::Using a combination of qualitative and quantitative research methodologies, this study identifies the dimensions of hospital service quality, operationalizes the dimensions, and develops an instrument to measure patient satisfaction. This instrument, the Key Quality Characteristics Assessment for Hospitals (KQCAH) sca...
journal_title:Health care management review
pub_type: 杂志文章
doi:10.1097/00004010-200104000-00005
更新日期:2001-04-01 00:00:00
abstract:BACKGROUND:Expanding the opportunities for for-profit nursing home care is a central theme in the debate on the sustainable organization of the growing nursing home sector in Western countries. PURPOSES:We conducted a systematic review of the literature over the last 10 years in order to determine the broad impact of ...
journal_title:Health care management review
pub_type: 杂志文章
doi:10.1097/HMR.0000000000000121
更新日期:2017-10-01 00:00:00
abstract:BACKGROUND:Health information technology (HIT) purports to increase quality and efficiency in health care organizations. However, health care organizations are situated in constantly changing environments. They need dynamic capabilities to implement HIT effectively. PURPOSES:This article builds on the dynamic capabili...
journal_title:Health care management review
pub_type: 杂志文章
doi:10.1097/HMR.0b013e31823c9b55
更新日期:2012-01-01 00:00:00
abstract:BACKGROUND:The presence of hospital-based palliative care programs has risen over time in the United States. Nevertheless, organizational and environmental factors that contribute to the presence of hospital-based palliative care programs are unclear. PURPOSE:The aim of this study was to examine the role of organizati...
journal_title:Health care management review
pub_type: 杂志文章
doi:10.1097/HMR.0000000000000031
更新日期:2015-10-01 00:00:00
abstract::Minnesota's 1994 health care reform legislation authorized the establishment of community integrated service networks (CISNs) and health care provider cooperatives, which were envisioned as new health care delivery models that could be successfully implemented in rural areas of the state. Four CISNs are licensed, and ...
journal_title:Health care management review
pub_type: 杂志文章
doi:
更新日期:1997-04-01 00:00:00
abstract::Congress has suggested that a prospective payment system for capital should permit the continuation of cost-based reimbursement for certain projects. A study was conducted to examine the components of the capital planning process used by eight hospitals and the effect of this process on completion of capital projects....
journal_title:Health care management review
pub_type: 杂志文章
doi:
更新日期:1988-04-01 00:00:00
abstract::American hospitals hoping to capitalize on the lucrative market for international patients may be in for some surprises. Not only is this market limited, but also the drawbacks may outweigh the potential benefits for hospitals seeking to enter this business. ...
journal_title:Health care management review
pub_type: 杂志文章
doi:
更新日期:1988-01-01 00:00:00
abstract::A decided advantage of investor-owned companies is their ability to preserve, accumulate and attract capital. This has become increasingly important as the capital requirements of hospitals for new construction, renovation or advances of technology have grown in the past decade. ...
journal_title:Health care management review
pub_type: 杂志文章
doi:
更新日期:1979-07-01 00:00:00
abstract:BACKGROUND:Numbering close to 300,000 nurse managers represent the largest segment of the health care management workforce. Their effectiveness is, in part, influenced by their job satisfaction. PURPOSE:We examined factors associated with job satisfaction of novice frontline nurse managers. METHODOLOGY/APPROACH:We us...
journal_title:Health care management review
pub_type: 杂志文章
doi:10.1097/HMR.0000000000000102
更新日期:2017-04-01 00:00:00
abstract::Although HMOs very often obtain discounts for hospital services, there is little evidence that they create price competition among hospitals. Location and the availability of services and specialists, rather than price, appear to be the most important factors in the selection of hospitals by HMOs. ...
journal_title:Health care management review
pub_type: 杂志文章
doi:
更新日期:1983-04-01 00:00:00
abstract::Team level tacit knowledge is related to the collective knowledge of the team members. It is the shared experience that results in the ability to successfully anticipate the reactions of teammates in typical and nontypical situations. This study evaluates how tacit knowledge and related team characteristics influence ...
journal_title:Health care management review
pub_type: 杂志文章
doi:10.1097/00004010-200607000-00008
更新日期:2006-07-01 00:00:00
abstract::Value-based leadership--linking "managership" and leadership approaches--is needed to meet today's ever-proliferating challenges to the fundamental philosophy and mission of health care organizations. To work, however, it requires important changes from everyone in the organization. ...
journal_title:Health care management review
pub_type: 杂志文章
doi:10.1097/00004010-198400940-00007
更新日期:1984-10-01 00:00:00
abstract:BACKGROUND:Benchmarking has become very popular among managers to improve quality in the private and public sector, but little is known about its applicability in international hospital settings. PURPOSE:The purpose of this study was to evaluate the applicability of an international benchmarking initiative in eye hosp...
journal_title:Health care management review
pub_type: 杂志文章
doi:10.1097/HMR.0b013e3181c22bdc
更新日期:2010-01-01 00:00:00
abstract::Managers may desire an approach to combining multiple productivity measurements into one score. This article demonstrates two approaches to aggregating multiple measurements, data envelope analysis (DEA) and the Multicriteria Performance/Productivity Measurement Technique (MCP/PMT). These methods are applied to actual...
journal_title:Health care management review
pub_type: 杂志文章
doi:10.1097/00004010-199201720-00006
更新日期:1992-04-01 00:00:00
abstract::This article describes the author's path from a Doctor of Science from Johns Hopkins to a career mostly involved with practice. This practice has focused on innovation and new business development requiring significant research and analytical application, as well as leadership of key people. ...
journal_title:Health care management review
pub_type: 杂志文章
doi:10.1097/00004010-200210000-00010
更新日期:2002-10-01 00:00:00
abstract::An important factor in pricing decisions is the concept of cost analysis. The objective of this article is to describe the relevant costs for pricing medical services in the managed care environment. It discusses how a proper understanding of costs enables one to make correct pricing decisions. ...
journal_title:Health care management review
pub_type: 杂志文章
doi:10.1097/00004010-199701000-00011
更新日期:1997-01-01 00:00:00
abstract::The relation between operating margin and quality of care is investigated by using survey and financial data for 82 small and medium-sized hospitals. A positive relation between the variables is found, and implications of that relationship are discussed. ...
journal_title:Health care management review
pub_type: 杂志文章
doi:
更新日期:1992-10-01 00:00:00
abstract::After this year, Medicare will no longer reimburse capital-related expenses. Instead, a new approach may be implemented. Should the new capital payment scheme be prospective? Should Medicare continue to recognize return on equity? What will be the relationship between Medicare payment and health care planning? These a...
journal_title:Health care management review
pub_type: 杂志文章
doi:10.1097/00004010-198601120-00004
更新日期:1986-04-01 00:00:00
abstract:BACKGROUND:Health care leaders have called for the development of communication and leadership skills to improve manager-employee relationships, employee job satisfaction, quality care, and work environments. PURPOSES:The aim of the study reported here was to pilot how a 2-day coaching workshop ("Coaching for Impressi...
journal_title:Health care management review
pub_type: 杂志文章
doi:10.1097/HMR.0b013e318294e586
更新日期:2014-07-01 00:00:00
abstract::The impact of public policy can be effectively and favorably managed at the local hospital level. But to do so requires using some old resources in some new ways and navigating in some areas that many administrators find uncomfortable, and in which there has traditionally been only marginal interest. ...
journal_title:Health care management review
pub_type: 杂志文章
doi:
更新日期:1980-10-01 00:00:00
abstract::Health care researchers and managers have viewed physicians traditionally through three major lenses, that is, as professionals, suppliers, and caregivers. This article makes a case for another lens, that of the physician as worker. The worker perspective complements these existing perspectives, serves as a generative...
journal_title:Health care management review
pub_type: 杂志文章,评审
doi:10.1097/00004010-200110000-00006
更新日期:2001-10-01 00:00:00
abstract:BACKGROUND:Public health institutions are making a great effort to develop patient-targeted online services in an attempt to enhance their effectiveness and reduce expenses. However, if patients do not use those services regularly, public health institutions will have wasted their limited resources. Hence, patients' el...
journal_title:Health care management review
pub_type: 杂志文章
doi:10.1097/HMR.0b013e31824b1c6b
更新日期:2013-01-01 00:00:00
abstract::Patient management teams are able to diagnose and begin to solve their own problems with the help of a self-instructional health team development (HTD) program. In this case, the focus is on those task-related issues which limit team effectiveness. ...
journal_title:Health care management review
pub_type: 杂志文章
doi:
更新日期:1976-07-01 00:00:00
abstract::The growth of for-profit managed care organizations raises serious ethical questions for managers in these settings, such as whether contemporary business ethics are most appropriate for health care organizations or how the principles of biomedical ethics can be integrated into profit-seeking firms. A model is propose...
journal_title:Health care management review
pub_type: 杂志文章,评审
doi:10.1097/00004010-199804000-00006
更新日期:1998-04-01 00:00:00
abstract::Of the many characteristics that classify the practice of medicine as a profession, autonomy plays the most important role. There are currently assaults on the profession's ability to select, train, and license its own practitioners and on the medical knowledge base itself, as well as the standards for applying it. Th...
journal_title:Health care management review
pub_type: 杂志文章
doi:10.1097/00004010-199201710-00008
更新日期:1992-01-01 00:00:00
abstract:AIM:The aim of this study was to examine the relationship between organizational, supervisor, and coworker support, as perceived by registered nurses and their boundary-spanning behaviors. Furthermore, this article examines the mediating role of the affective organizational commitment of nurses in these relationships. ...
journal_title:Health care management review
pub_type: 杂志文章
doi:10.1097/HMR.0000000000000210
更新日期:2020-04-01 00:00:00
abstract::A systematic, continuous approach to the problem of rising medical care costs and the need for improved resource management clearly require some level of input from physicians. ...
journal_title:Health care management review
pub_type: 杂志文章
doi:
更新日期:1980-01-01 00:00:00
abstract:BACKGROUND:The current literature on the enabling conditions of multidisciplinary teams focuses on the singular dimensions of the organizations (i.e., human resources, clinical pathways, objects) without shedding light on to the way in which these organizational factors interact and mutually influence one another. PUR...
journal_title:Health care management review
pub_type: 杂志文章
doi:10.1097/HMR.0000000000000115
更新日期:2017-10-01 00:00:00