Abstract:
BACKGROUND:The healthcare industry is characterized by intensive, never-ending change occurring on a multitude of fronts. Success in such tumultuous environments requires healthcare providers to be proficient in myriad areas, including the manner in which they organize and deliver services. Less efficient designs drain precious resources and hamper efforts to deliver the best care possible to patients, making it imperative that optimal pathways are identified and pursued. One particular avenue that offers great potential for serving patients efficiently and effectively is known as the hub-and-spoke organization design. DISCUSSION:The hub-and-spoke organization design is a model which arranges service delivery assets into a network consisting of an anchor establishment (hub) which offers a full array of services, complemented by secondary establishments (spokes) which offer more limited service arrays, routing patients needing more intensive services to the hub for treatment. Hub-and-spoke networks afford many benefits for healthcare providers, but in order to capitalize fully, proper assembly is required. To advance awareness, knowledge, and use of the hub-and-spoke organization design, this article profiles Willis-Knighton Health System's service delivery network which has utilized the model for over three decades. Among other things, the hub-and-spoke organization design is defined, benefits are stipulated, and applications are discussed, permitting healthcare providers essential insights for the establishment and operation of these networks. CONCLUSIONS:The change-rich nature of the healthcare industry places a premium on incorporating advancements that permit health and medical providers to operate as optimally as possible. The hub-and-spoke organization design represents an option that, when deployed correctly, can greatly assist healthcare establishments in their quests to serve patients well.
journal_name
BMC Health Serv Resjournal_title
BMC health services researchauthors
Elrod JK,Fortenberry JL Jrdoi
10.1186/s12913-017-2341-xsubject
Has Abstractpub_date
2017-07-11 00:00:00pages
457issue
Suppl 1issn
1472-6963pii
10.1186/s12913-017-2341-xjournal_volume
17pub_type
杂志文章abstract:BACKGROUND:Colorectal cancer (CRC) is common and leads to significant morbidity and mortality. Although screening with fecal occult blood testing (FOBT) or endoscopy has been shown to decrease CRC mortality, screening rates remain suboptimal. Screening rates are particularly low for people with low incomes and members ...
journal_title:BMC health services research
pub_type: 杂志文章,随机对照试验
doi:10.1186/1472-6963-13-153
更新日期:2013-04-29 00:00:00
abstract:BACKGROUND:Deinstitutionalisation in Europe has led to the development of community-based accommodation for people with mental health problems. The type, setting, and intensity of support provided vary and the costs are substantial. Yet, despite the large investment in these services, there is little clarity on their a...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-017-2411-0
更新日期:2017-07-11 00:00:00
abstract:BACKGROUND:Although the value of telemonitoring in heart failure patients is increasingly studied, little is known about the value of the separate components of telehealth: ICT guided disease management and telemonitoring. The aim of this study is to investigate the value of telemonitoring added to ICT guided disease m...
journal_title:BMC health services research
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1186/1472-6963-11-167
更新日期:2011-07-13 00:00:00
abstract:BACKGROUND:China is reforming the way it finances health care as it moves towards Universal Health Coverage (UHC) after the failure of market-oriented mechanisms for health care. Improving financing equity is a major policy goal of health care system during the progression towards universal coverage. METHODS:We used p...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-017-2798-7
更新日期:2017-12-29 00:00:00
abstract:BACKGROUND:Recently, there has been growing interest in providing more tailored, patient-centered care for the treatment of type 2 diabetes mellitus (T2DM). Yet it remains unclear which patient characteristics should be determined to guide such an approach. Therefore, the opinions of healthcare providers (HCP) and peop...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-019-4371-z
更新日期:2019-08-16 00:00:00
abstract:BACKGROUND:Aging of the workforce is a growing problem. As workers age, their physical, physiological and psychosocial capabilities change. Keeping older workers healthy and productive is a key goal of European labor policy and health promotion is a key to achieve this result. Previous studies about workplace health pr...
journal_title:BMC health services research
pub_type: 杂志文章,评审
doi:10.1186/s12913-016-1518-z
更新日期:2016-09-05 00:00:00
abstract:BACKGROUND:In 2002, the World Health Organization published a health system performance ranking for 191 member countries. The ranking was based on five indicators, with fixed weights common to all countries. METHODS:We investigate the feasibility and desirability of using mathematical programming techniques that allow...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-4-19
更新日期:2004-07-22 00:00:00
abstract:BACKGROUND:Armenians very rarely seek healthcare services and, consequently experience more serious health conditions. With its ongoing reforms, Armenia is focusing on linking health system financing to the quality and volume of care provided. We examine the relationship between the perceived health status of the popul...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-016-1309-6
更新日期:2016-02-19 00:00:00
abstract:BACKGROUND:Coverage is an important indicator to assess both the performance and effectiveness of public health programs. Recommended methods for coverage estimation for the treatment of severe acute malnutrition (SAM) can involve active and adaptive case finding (AACF), an informant-driven sampling procedure, for the ...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-019-4791-9
更新日期:2019-12-16 00:00:00
abstract:BACKGROUND:Patients' expectations and perceptions of the medical encounter and interactions are important tools in diabetes management. Some problems regarding the interaction during encounters may be related to a lack of communication skills on the part of either the physician or the patient. This study aimed at explo...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-7-162
更新日期:2007-10-09 00:00:00
abstract:BACKGROUND:Several approaches to medication optimisation by identifying drug-related problems in older people have been described. Although some interventions have shown reductions in drug-related problems (DRPs), evidence supporting the effectiveness of medication reviews on clinical and economic outcomes is lacking. ...
journal_title:BMC health services research
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1186/s12913-020-5056-3
更新日期:2020-03-17 00:00:00
abstract::In the original publication of this article [1], there are two corrections. ...
journal_title:BMC health services research
pub_type: 杂志文章,已发布勘误
doi:10.1186/s12913-020-5052-7
更新日期:2020-03-19 00:00:00
abstract:BACKGROUND:Australians born in countries where hepatitis B infection is endemic are 6-12 times more likely to develop hepatocellular cancer (HCC) than Australian-born individuals. However, a program of screening, surveillance and treatment of chronic hepatitis B (CHB) in high risk populations could significantly reduce...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-10-215
更新日期:2010-07-21 00:00:00
abstract:BACKGROUND:Male involvement (MI) along the continuum of HIV healthcare services has been promoted as a critical intervention in low-income countries and represents one of the reasons for dropout and low retention of women along the cascade of care. The present review aims to identify interventions adopted to improve MI...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-019-4689-6
更新日期:2019-12-09 00:00:00
abstract:BACKGROUND:Pay-for-Performance programs have shown improvement in indicators monitoring adequacy and target achievement in diabetic care. However, less is known regarding the impact of this program on the occurrence and long-term effects of diabetic retinopathy. The objective of this study was to determine the effect o...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-018-3454-6
更新日期:2018-08-15 00:00:00
abstract:BACKGROUND:Publicly-funded drug plans often use prior authorization policies to limit drug prescribing. To guide physician prescribing of a class of antibiotics with broad antimicrobial activity (quinolone antibiotics) in accordance with new prescribing guidelines, Alberta's provincial health ministry implemented a new...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-12-290
更新日期:2012-08-30 00:00:00
abstract:BACKGROUND:To explore the perceptions of health workers on the risks of contracting tuberculosis at Namwala District Hospital. Tuberculosis literature indicates that health workers are at risk of contracting tuberculosis while conducting their daily duties in the workplace. This is mainly attributed to low tuberculosis...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-020-05877-0
更新日期:2020-11-12 00:00:00
abstract:BACKGROUND:Proposals to expand Medicare coverage tend to be expensive, but the value of services purchased is not known. This study evaluates the efficiency of the average private supplemental insurance plan for Medicare recipients. METHODS:Data from the National Health Interview Survey, the National Death Index, and ...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-5-23
更新日期:2005-03-14 00:00:00
abstract:BACKGROUND:The Plan-Do-Study-Act (PDSA) method is widely used in quality improvement (QI) strategies. However, previous studies have indicated that methodological problems are frequent in PDSA-based QI projects. Furthermore, it has been difficult to establish an association between the use of PDSA and improvements in c...
journal_title:BMC health services research
pub_type: 杂志文章,meta分析
doi:10.1186/s12913-019-4482-6
更新日期:2019-10-04 00:00:00
abstract:BACKGROUND:Most current knowledge of the incidence of medical adverse events (AEs) comes from studies carried out in hospital settings. Little is known about AEs occurring outside hospitals, in spite the fact that most of contacts between patients and health care take place in primary care. Small sample population stud...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-13-46
更新日期:2013-02-05 00:00:00
abstract:BACKGROUND:The value of the Internet to deliver preoperative education would increase if there was variability in questions patients want answered. This study's goal was to have patients consulting an orthopedic surgeon about undergoing either a total hip arthroplasty (THA) or a total knee arthroplasty (TKA) rate the i...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-3-11
更新日期:2003-06-24 00:00:00
abstract:BACKGROUND:Integrated care is the coordination of general and behavioral health and is a highly promising and practical approach to improving healthcare delivery and patient outcomes. While there is growing interest and investment in integrated care implementation internationally, there are no formal guidelines for int...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-019-4661-5
更新日期:2019-11-27 00:00:00
abstract:BACKGROUND:Regular health visits for parents with young children provide an opportunity for developmental surveillance and anticipatory guidance regarding common childhood problems and help to achieve optimal developmental progress prior to school entry. However, there are few published reports from Australian cultural...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-017-2143-1
更新日期:2017-03-22 00:00:00
abstract:BACKGROUND:There is consistent evidence highlighting the mal-distribution of the health workforce between urban and rural and remote regions. To date, addressing this mal-distribution has focused on medicine and nursing with limited initiatives targeted at allied health. Therefore, the aim of this research was to explo...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-020-4954-8
更新日期:2020-02-10 00:00:00
abstract:BACKGROUND:Medication errors have been reported to be a leading cause of death in hospitalized patients. In this study we focused on identifying and quantifying errors in the handwritten drug ordering and dispensing documentation processes which could possibly lead to adverse drug events. METHODS:We studied 1,934 orde...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-11-199
更新日期:2011-08-18 00:00:00
abstract:BACKGROUND:While local context costing evidence is relevant for healthcare planning, budgeting and cost-effectiveness analysis, it continues to be scarce in Ethiopia. This study assesses the cost of providing a prevention of mother-to-child transmission of HIV/AIDS (PMTCT) service across heterogeneous prevalence (high,...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-019-3978-4
更新日期:2019-03-06 00:00:00
abstract:BACKGROUND:Bronchiolitis is common in the first two years of life and is the most frequent cause of hospitalization in this age group. No previous studies have used an episode-of-care analysis to describe the frequency, duration, and predictors of bronchiolitis episodes of care during the first two years. METHODS:We c...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-12-144
更新日期:2012-06-08 00:00:00
abstract:BACKGROUND:In average-risk individuals aged 50 to 75 years, there is no difference in life-years gained when comparing colonoscopy every 10 years vs. annual fecal immunochemical testing (FIT) for colorectal cancer screening. Little is known about the preferences of patients when they have experienced both tests. METHO...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-015-0841-0
更新日期:2015-04-23 00:00:00
abstract:BACKGROUND:Lean thinking as a quality improvement approach is introduced in hospitals worldwide, although evidence for its impact is scarce. Lean initiatives are social, complex and context-dependent. This calls for a shift from cause-effect to conditional attributions to understand how lean works. In this study, we br...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-015-1081-z
更新日期:2015-09-21 00:00:00
abstract:BACKGROUND:Our previous work showed that providing additional rehabilitation on a Saturday was cost effective in the short term from the perspective of the health service provider. This study aimed to evaluate if providing additional rehabilitation on a Saturday was cost effective at 12 months, from a health system per...
journal_title:BMC health services research
pub_type: 杂志文章,随机对照试验
doi:10.1186/s12913-015-0822-3
更新日期:2015-04-18 00:00:00