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Book part
Publication date: 24 October 2019

Jennifer L. Hefner, Ann Scheck McAlearney, Nicole Spatafora and Susan D. Moffatt-Bruce

High patient satisfaction is not simply a customer service goal; it is an important dimension of quality and part of financial incentives and public reporting requirements…

Abstract

High patient satisfaction is not simply a customer service goal; it is an important dimension of quality and part of financial incentives and public reporting requirements. However, patient experience is often siloed within health system organizational charts and considered separately from quality and safety initiatives, instead of being seen predominantly as a “customer service” initiative. Representatives from 52 health care systems across the United States completed an online survey to explore both the processes and infrastructure hospitals employ to improve patient experience, and the metrics hospitals use to assess the quality of patient experience beyond patient satisfaction survey data. When asked about performance metrics beyond satisfaction, most hospitals or systems noted other metrics of the entire patient experience such as the rate of complaints or grievances and direct feedback from patient and family advisors. Additionally, respondents suggested that a broader definition of “quality of the patient experience” may be appropriate to encompass measures of access, clinical processes, and quality of care and patient safety outcomes. Almost all respondents that we surveyed listed metrics from these less traditional categories, indicating that performance improvement within the patient experience domain in these organizations is linked with other areas of hospital performance that rely on the same metrics, such as clinical quality and patient safety.

Details

Structural Approaches to Address Issues in Patient Safety
Type: Book
ISBN: 978-1-83867-085-6

Keywords

Book part
Publication date: 31 July 2013

Marc Verschueren, Johan Kips and Martin Euwema

The purpose of the study was to explore in literature what different leadership styles and behaviors of head nurses have a positive influence on the outcomes of patient safety or…

Abstract

Purpose

The purpose of the study was to explore in literature what different leadership styles and behaviors of head nurses have a positive influence on the outcomes of patient safety or quality of care.

Design/methodology/approach

We reviewed the literature from January 2000 until September 2011. We searched Pubmed, Embase, Cinahl, Psychlit, and Econlit.

Findings

We found 10 studies addressing the relationship between head nurse leadership and safety and quality. A wide array of styles and practices were associated with different patient outcomes. Transformational leadership was the most used concept in the studies. A trend can be observed over these studies suggesting that a trustful relationship between the head nurse and subordinates is an important driving force for the achievement of positive patient outcomes. Furthermore, the effects of these trustful relationships seem to be amplified by supporting mechanisms, often objective conditions like clinical pathways and, especially, staffing level.

Value/originality

This study offers an up-to-date review of the limited number of studies on the relationship between nurse leadership and patient outcomes. Although mostly transformational leadership was found to be responsible for positive associations with outcomes, also contingent reward had positive influence on outcomes. We formulated some comments on the predominance of the transformational leadership concept and suggested the application of complexity theory and political leadership for the current context of care. We formulated some implications for practice and further research, mainly the need for more systematic empirical and cross cultural studies and the urgent need for the development of a validated set of nurse-sensitive patient outcome indicators.

Details

Leading in Health Care Organizations: Improving Safety, Satisfaction and Financial Performance
Type: Book
ISBN: 978-1-78190-633-0

Keywords

Book part
Publication date: 1 January 2008

Yee-Ching Lilian Chan and Alfred Seaman

This article looks at the alignment of performance management system with the strategy, structure, and organizational outcome in Canadian health care organizations. In this study…

Abstract

This article looks at the alignment of performance management system with the strategy, structure, and organizational outcome in Canadian health care organizations. In this study, balanced scorecard is the framework adopted for assessing the health care organization's performance management system (PMS) and outcome. CEO and clinical unit managers were surveyed for their perceptions on their organization's strategy, autonomy structure, PMS, and organizational performance. Path analysis was the methodology used in examining the relationship about the above organizational variables. The results indicate that patient satisfaction is the primary and most significant perspective of the depicted balanced scorecard in organizational performance. Patient satisfaction and research criteria, on the other hand, are the significant perspectives of a balanced scorecard in an organization's PMS, which are linked to strategy, autonomy structure, and organizational performance. Moreover, the results show that the strategy/structure links operated as suggested. Surprisingly, strategy on service innovation has a negative impact on the organizational outcome of patient satisfaction. Uncertainty from continuous development and organizational change in pursuing service innovation and cost-cutting measures in response to fiscal constraints are plausible explanations of the adverse impact reported.

Details

Advances in Management Accounting
Type: Book
ISBN: 978-1-84855-267-8

Book part
Publication date: 22 February 2010

Rebecca K. Givan, Ariel Avgar and Mingwei Liu

This paper examines the relationship between human resource practices in 173 hospitals in the United Kingdom and four organizational outcome categories – clinical, financial…

Abstract

This paper examines the relationship between human resource practices in 173 hospitals in the United Kingdom and four organizational outcome categories – clinical, financial, employee attitudes and perceptions, and patient attitudes and perceptions. The overarching proposition set forth and examined in this paper is that human resource management (HRM) practices and delivery of care practices have varied effects on each of these outcomes. More specifically, the authors set forth the proposition that specific practices will have positive effects on one outcome category while simultaneously having a negative effect on other performance outcomes, broadly defined.

The paper introduces a broader stakeholder framework for assessing the HR–performance relationship in the healthcare setting. This multi-dimensional framework incorporates the effects of human resource practices on customers (patients), management, and frontline staff and can also be applied to other sectors such as manufacturing. This approach acknowledges the potential for incompatibilities between stakeholder performance objectives. In the healthcare industry specifically, our framework broadens the notion of performance.

Overall, our results provide support for the proposition that different stakeholders will be affected differently by the use of managerial practices. We believe that the findings reported in this paper highlight the importance of examining multiple stakeholder outcomes associated with managerial practices and the need to identify the inherent trade-offs associated with their adoption.

Details

Advances in Industrial and Labor Relations
Type: Book
ISBN: 978-1-84950-932-9

Abstract

Details

The Online Healthcare Community
Type: Book
ISBN: 978-1-83549-141-6

Book part
Publication date: 22 July 2021

Michael Sauder, Hyunsik Chun and Wendy Espeland

Organizational metrics – including rankings, ratings, and other forms of public assessment – are inextricably tied to uncertainty. Metrics are not only responses to uncertainty in…

Abstract

Organizational metrics – including rankings, ratings, and other forms of public assessment – are inextricably tied to uncertainty. Metrics are not only responses to uncertainty in the organizational environment, but they also create new forms of uncertainty within the organizations they evaluate. Given this, it is productive to consider these metrics in relation to the garbage can model of organizational decision making, a framework that was designed to provide insight into uncertain and ambiguous contexts. In this paper, the authors use the case of patient experience surveys to argue for the value of this model for understanding responses to metrics in particular conditions. Specifically, the authors demonstrate how the different features of the garbage can model manifest themselves within organizations managing numbers, and the authors then use these findings to discuss the measurement conditions that promote garbage can responses, the distinctive types of unintended consequences these responses might produce, and the implications of the garbage can model for the understanding of metrics more generally.

Book part
Publication date: 31 October 2002

Laurette Dubé, Lefa Teng, Josiah Hawkins and Marilyn Kaplow

The thesis of this paper is that patient emotions have not been sufficiently integrated into patient-centeredness, a well-established organizing principle of health care…

Abstract

The thesis of this paper is that patient emotions have not been sufficiently integrated into patient-centeredness, a well-established organizing principle of health care management. We first review the scientific knowledge on emotions that is of relevance to support their being a core component of patient-centeredness. We then report a field study designed to investigate the mechanisms by which emotions influence care outcomes (specifically, patient satisfaction). Structural analyses performed on self-reports by 283 minor care patients in an Emergency Department revealed that both positive and negative emotions influence satisfaction indirectly by biasing patient perceptions of quality of care in a valence-congruent direction.Negative emotions have an additional direct effect on satisfaction. Patients who were made to wait longer to see the physician not only manifested a progressive deterioration of their emotional states (i.e. decrease in positive affects and increase in negative affects) but their satisfaction judgments became more importantly formed on the basis of emotions. Implications of the research for healthcare management are discussed.

Details

Advances in Health Care Management
Type: Book
ISBN: 978-1-84950-176-7

Book part
Publication date: 6 February 2007

Howard L. Smith, J. Deane Waldman, Jacqueline N. Hood and Myron D. Fottler

This paper analyzes health care as a context for building value through human capital and culture. We examine how health care managers can nurture a favorable culture for…

Abstract

This paper analyzes health care as a context for building value through human capital and culture. We examine how health care managers can nurture a favorable culture for providers enabling them to focus on customer service. A case study of a large medical center examines how organization culture affects clinicians versus support and managerial staff while adversely impacting patient satisfaction and organizational costs associated with turnover and the cost of replacing personnel. An agenda for managing internal customers and organization culture is presented.

Details

Strategic Thinking and Entrepreneurial Action in the Health Care Industry
Type: Book
ISBN: 978-1-84950-427-0

Book part
Publication date: 24 September 2018

Loren R. Dyck

This study examined the impact of resonance expressed by the positive emotional attractor (PEA) and dissonance represented by the negative emotional attractor (NEA) created by…

Abstract

This study examined the impact of resonance expressed by the positive emotional attractor (PEA) and dissonance represented by the negative emotional attractor (NEA) created by medical students during diagnostic encounters with standardized patients (SPs) (laypeople) from the clinical skills exam (CSE). Secondary data were collected from 116 videotaped CSE encounters between SPs and medical students. Associations among the PEA and NEA states, and medical student effectiveness measured by SP, faculty, and differential diagnosis scores using moderated multiple regression analysis were determined. Results suggest that the PEA and NEA are powerful conditions for determining medical student effectiveness in clinical encounters.

Book part
Publication date: 21 September 2015

Claudia Chaufan, Hegla Fielding, Catherine Chesla and Alicia Fernandez

Professional interpreter use improves care in patients with limited English proficiency (LEP) but inequalities in outcomes remain. We explore the experience of US Latinos with LEP…

Abstract

Purpose

Professional interpreter use improves care in patients with limited English proficiency (LEP) but inequalities in outcomes remain. We explore the experience of US Latinos with LEP and diabetes in language discordant care.

Methodology/approach

We conducted in-depth interviews of 20 low-income Latino patients with diabetes and LEP. We interviewed participants in Spanish, digitally recorded and transcribed interviews, and read transcripts to identify themes and interpret meanings using interpretive phenomenology as theoretical framework.

Findings

While patients preferred, and experienced greater trust in, language concordant clinical encounters, they did not believe that language discordance affected outcomes because they felt that these depended largely on their compliance with physicians’ recommendations. Patients also downplayed structural barriers to care and outcomes. Self-blame was paradoxically encouraged by physicians’ praise vis-à-vis favorable outcomes.

Research limitations/implications

Limitations include small and convenience sample and limited generalizability. However, findings illustrate communicational dynamics between patients and clinicians with important implications for health care practice and policy. They support the perception that trust develops best within language concordant care, which underscores the importance of recruiting clinicians with diverse language skills. They highlight the importance of sensitizing clinicians to the social determinants of health, which may be overlooked when treating patients with conditions requiring substantial self-management, like diabetes. Language barriers in health care must be understood in the broader context of structural inequalities in health care. The necessary emphasis on self-management may (inadvertently) strengthen the hegemonic view that places responsibility for diabetes outcomes on patients’ ability to self-manage their condition to the neglect of social/political determinants of diabetes.

Originality/value

Studies have quantitatively examined the effects of language discordant care on diabetes outcomes, yet few have done so qualitatively. To our knowledge, no study has attempted to understand the experience of language discordance from the perspective of LEP patients with diabetes and how this experience may explain observed differences in outcomes.

Details

Education, Social Factors, and Health Beliefs in Health and Health Care Services
Type: Book
ISBN: 978-1-78560-367-9

Keywords

1 – 10 of over 1000