Patient Satisfaction in Quality of Managed Care
Aspect to be compared

Gender and Patient

Satisfaction in Managed Care, etc.

Stakeholder Perceptions of Quality in Managed Care Plans

Two Steps to Enhance Managed Care Quality

Author(s)/Date

Emily eisman, MS

Martha Romans

Jacobs Institute of omen's Health

ashington, DC

Carolyn M. Clancy, MD

Paul L. Grimaldi, Ph.D.

To determine what the differences are and what variables might affect women patients' perceptions of the quality of managed care

To find out what attributes three different health care stakeholders, physicians, employers and consumers, value most in determining their assessments of the quality of managed care health plans

To explain the ramifications of two developments in managed care: the new application form for MCOs to become Medicare risk contractors, and the National Committee for Quality Assurance plan to begin performance-based accreditation.

Hypotheses

Determining what the differences between men's and women's perceptions of the quality of health care may mean to the outcome of care; hypothesis was that the differences were minor despite…...

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Works Cited

Grimaldi, Paul L., Ph.D. "Two steps to enhance managed care quality." Nursing Management, August, 1998.

Thompson, Jon M. "Stakeholder perceptions of quality in managed care plans."?

Weisman, Carol S. et al. "Gender and patient satisfaction in managed care plans: Analysis of the 1999 HEDIS/CAHPS 2.0H Adult Survey."?

You have been appointed to chair a hospital-wide committee to develop and implement a plan to improve patient satisfaction in your facility. Your Chief Nursing Officer has provided you a summary report indicating a steady decline in patient satisfaction over the previous six months. You will need to identify the various resources available for tracking patient satisfaction, establish a clear bench mark and design a specific plan of action for reversing this trend. It is essential to note in your development that research has shown nurse communication and hourly rounding to be key drivers in patient satisfaction metric improvements. These points should be a focus of your change initiative.
Roger's Change Theory

The diffusion of innovation theory, or Roger's change theory, was first proposed by Everett Rogers more have a half a century ago. Despite the theories age, it remains relevant to any change process today. The premise of this theory is…...

The baseline data for the study was recorded during the first 2 weeks of the 6-week study period. The study design consisted of analyses of the data collected from the experimental (1-hour rounds and 2-hour rounds) versus the control nursing units with a nonrandom assignment of hospital units to these respective groups (the assignment was the responsibility of chief nursing officers and nurse managers). Although the determined to conduct 1-hour or 2-hour nursing rounding was left up to the nursing executives at the participating hospitals, the principal investigator ensured that the sample was stratified as to type of unit (i.e., medical, surgical, or combined medical -- surgical), unit size, and frequency of nursing rounds.
7.

Adequacy of the Sample

The researchers identified 26 different reasons for the use of call lights by patients in their review of the literature and coded data from the 14 hospitals whose data satisfied the study criteria…...

Nursing Unit Turnover on Patient Outcomes in Hospitals
While it might seem intuitive that higher rates of turnover within a unit are problematic, the study by Bae, Mark, & Fried (2010) attempts to show using a quantitative study the extent to which turnover has had a negative impact upon patient care. This study compared the levels of turnover at 268 units from 141 hospitals and assessed its relationship to both patient satisfaction and the nurse's own perceptions of cohesion, relational coordination, and learning. The study is quite distinct in design from qualitative studies which often have an anecdotal approach and emphasize experience vs. data in evaluating policies.

One problem, however, with the use of such a study which emphasizes numbers over narration is the difficulty of quantifying subjective variables like efficacy. In this instance, nurses' own perceptions of what policies were useful were assessed as well as patients' perceptions to contextualize…...

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References

Bae, S., Mark, Barbara, Fried, Bruce. (2010). Impact of nursing unit turnover on patient outcomes in hospitals. Journal of Nursing Scholarship, 42 (1): 40-49.

Hutcheson, G.D. (2011). Ordinary least-squares regression. In L. Moutinho and G.D.

Hutcheson. The SAGE Dictionary of Quantitative Management Research, 224-228.

hourly nurse rounds help to reduce falls, pressure ulcers, call light use and contribute to rise in patient satisfaction base on evidence base practice
The healthcare center is faced with numerous challenges affecting clinical results and client satisfaction (e.g., ulcers, use of call light and falls). The above challenges have brought on the need to develop and institute an appropriate framework to improve patient care delivery by means of better and increased interaction between patients and nurses. Chiefly, the creation of this sort of system necessitates striving for required authorization and assistance from leaders and staff members in the organization. This involves meeting with top management at organization appraisal board meetings, in addition to collaborating with peers concerning existing best practices for handling the issue. Taking into account organizational issues and nursing-related evidence-based practices (EBPs), the best answer to dealing with current issues is hourly nurse rounds. Implementing this recommended strategy…...

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References

AIPPG (2011). Comfort theory. Nursing Theories. Retrieved September 5, 2015 from  http://currentnursing.com/nursing_theory/comfort_theory_Kathy_Kolcaba.html 

Brosey, L., & March, K. (2015).Effectiveness of Structured Hourly Nurse Rounding on Patient Satisfaction and Clinical Outcomes. Journal of Nursing Care Quality, 30(2), 153-159. doi:10.1097/ncq.

Carroll, D., Dykes, P., & Hurley, A. (2010). Patients' perspectives of falling while in an acute care hospital and suggestions for prevention. Applied Nursing Research, 23(4), 238-241. doi:10.1016/j.apnr.2008.10.003

Deitrick, L., Baker, K., Paxton, H., Flores, M., & Swavely, D. (2012).Hourly Rounding. Journal of Nursing Care Quality, 27(1), 13-19. doi:10.1097/ncq.0b013e318227d7dd

Application: Systems Theory
Healthcare organizations provide nursing services centered on multiple theories. For instance, the Open Systems Theory established in 1978 by Katz and Kahn considers the healthcare organization as social systems divided into interconnected subsystems (Meyer & O’Brien-Pallas, 2010). Meyers and O’Brien-Pallas (2010) provide that these interrelated subsystems include outputs, throughputs, inputs, negative feedbacks and a cycle of events. The primary care hospital environment has various units that handle different cases including the intensive care, intermediate care, medical-surgery, emergency department (ED) etcetera. This paper delves into system theory in the emergency department, identify goals and challenges in this department and establishes an appropriate structural outcome.

Subsystems in Emergency Department

In the emergency department, the inputs include financial resources, supplies, and staffing needed for the unit to be functional. The emergency department is in operation all day and night and needs sufficient nurses and subordinate staff to give a throughput of services. More…...

Stagnant Health System Meets an Aging Population, Disaster Await
The Globe and Mail

Published Friday, Jan. 16, 2015

Most Canadians have expressed dissatisfaction with the manner that the health-care system looks after the elderly in society. A study carried out indicated that out of five individuals; four stated of their lack of confidence in accessing needed health care services. Lack of confidence reflects the depleting quality of care offered by nurses based on factors such as understaffing and the lack of resources to cater for the surging aging population. The study indicates that three-quarters expressed worries of inability to meet medical bills after they retire an indication of unsustainable policies that stretches hospital resources.

About 61% doubt the ability of the nation's long health-care facilities and hospitals in meeting the surging aging population in Canada. The challenge indicates a deteriorating state of quality of care offered by nurses due to stretching of the…...

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References

Roy, Avik (Jun 13, 2014). "If Universal Health Care Is The Goal, Don't Copy Canada" Forbes. Retrieved from  http://www.forbes.com/sites/theapothecary/2014/06/13/if-universal-health-care-is-the-goal-dont-copy-canada/ 

Flood, C. (July 22, 2014). Canada should look to Europe for health care, not the U.S. The Globe and Mail. Retrieved from  http://www.theglobeandmail.com/globe-debate/canada-should-look-to-europe-on-health-care-not-the-us/article19706492/ 

The Globe and Mail (Jan 16, 2015). When a stagnant health system meets an aging population, disaster awaits. The Globe and Mail. Retrieved from  http://www.theglobeandmail.com/globe-debate/editorials/when-a-stagnant-health-system-meets-an-aging-population-disaster-awaits/article22487481/ 

Sibbald, Barbara (Oct 15, 2015). Election 2015: party platforms on health issues. Canadian Medical Association Journal. Retrieved from  http://www.cmaj.ca/site/earlyreleases/15oct15_election-2015-party-platforms-on-health-issues-cmaj.109-5178.xhtml

patient satisfaction with the care provided by nursing staff and physicians, as well as how satisfaction can be improved through better communication among physicians and nurses, and with their patients. It will, in particular, deal with a nursing student's own clinical experience with patients and their perception of healthcare provider-patient communication. In addition, the paper will examine the student's project which considered the strategy of updating white boards in patient rooms regularly for better communication.
Ten medical surgical ward patients were interviewed during rounds by a student, who rated patient satisfaction and tried to discover some common theme. While patients expressed satisfaction with how nursing staff delivered care, they felt physicians didn't keep them informed. A number of patients were visited by two or more doctors. However, there was no communication between doctors, leading to issues such as a patient being marked "not ready for surgery" by the cardiologist, owing…...

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References

(2008). Home - Robert Wood Johnson Foundation. Improving Patient-Staff Communication Through White Boards - Robert Wood Johnson Foundation. Retrieved August 6, 2016, from  http://www.rwjf.org/en/library/articles-and-news/2008/06/improving-patient-staff-communication-through-white-boards.html 

(n.d.). Institute for Healthcare Communication. Impact of Communication in Healthcare - Institute for Healthcare Communication. Retrieved August 2, 2016, from  http://healthcarecomm.org/about-us/impact-of-communication-in-healthcare/ 

(2011). JBI COnNECT+. Effective communication between registered nurses and adult oncology patients in inpatient settings. Retrieved August 2, 2016, from  http://connect.jbiconnectplus.org/Viewsourcefile.aspx?0=7112 

(n.d.). Journal of Nursing - RN Journal. The Importance of Communication and Education toward Patient Literacy. Retrieved August 2, 2016, from http://rnjournal.com/journal-of-nursing/the-importance-of-communication-and-education-toward-patient-literacy

This is intended to be a working tool to assist you with organization of evidence for the Capstone Narrative Paper. Do not use Systematic Reviews or Meta-analysis studies for this assignment. Only primary research should be entered on this grid. Only a typed document will be accepted.Citation (APA)PurposeSampleDesignMeasurementResults/ConclusionsProposal ContributionRankingBoden-Albala, B., Goldmann, E., Parikh, N. S., Carman, H., Roberts, E. T., Lord, A. S., Torrico, V., Appleton, N., Birkemeir, J., Parides, M., & Quarles, M. (2018). Efficacy of a discharge educational strategy versus standard discharge care on reduction of vascular risk in patients with stroke and transient ischemic attacks: The DESERVE randomized controlled trial. JAMA Neurology, 76(1), 20-27.The study sought to assess the efficacy of a skill-based, culturally-tailored discharge education program with telephone follow-up vis--vis standard discharge care in reducing the risk of systolic blood pressure among patients with transient ischemic attack and stroke.The sample comprised of 1,083 patients selected randomly,…...

Patients in hospitals often complain of pain regardless of the diagnosis. Several activities in a patient's life contribute to pain. Some of the activities include amount of sleep, daily chores and quality of life (Alaloul, Williams, Myers, Jones, & Logdson, 2015). While health care expenses have increased significantly over the years, there have been great improvements in increasing both family and patient involvement in medical care. Hourly care is one of the strategies that have worked well in various healthcare settings. Hourly care has been a success in various areas but using it in urgent pediatric settings hasn't been well documented (Emerson, Chumra, & Walker, 2013). Opportunities still exist to look into pediatric family preferences and perspectives as pertains to the use of whiteboards (Cholli, et al., 2016). Several studies have been done in different setups and this paper references many of them. The research projects include in-patient surveys, quasi-experimental…...

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References

Alaloul, F., Williams, K., Myers, J., Jones, K. D., & Logdson, C. (2015). Impact of a Script-based Communication Intervention on Patient Satisfaction with Pain Management. Pain Management Nursing, 321 - 327.

Brosey, L., & March, K. (2015). Effectiveness of structured hourly nurse rounding on patient satisfaction and clinical outcomes. Journal of Nursing Care Quality, 153.

Cholli, P., Meyer, E., David, M., Moonam, M., Mahoney, J., Hession-Laband, E., . . . Bell, S. (2016). Family Perspectives on Whiteboard Use and Recommendations for Improved Practices. Hospital Pediatrics, 426 - 430.

Emerson, B., Chumra, K., & Walker, D. (2013). Hourly rounding in the pediatric emergency department: patient and family safety and satisfaction rounds. J Emerg Med, 99 - 104.

Inpatient Whiteboards
This study is a theoretical framework exploring whiteboard use preferences and recommendations for patient-centered care and communication through whiteboard use.

This study is a theoretical framework exploring whiteboard use, script-based communication, and hourly rounding to evaluate effectiveness of care associated with pain management and patient satisfaction.

The study utilizes a conceptual framework.

This article uses a conceptual framework that provides a literature review

Conceptual framework

Conceptual Framework

Conceptual Framework

A 3-week pilot involving multidisciplinary whiteboard use

The setting is Stanford University Medical Center

Sample characteristics (# of patients) Patients available for the pilot were 104 patients: 56 from inpatient units with use of whiteboards and 48 from inpatient units with no use of white boards.

internal medical residents were also surveyed.

Design: The study involved a semi-structured interview.

Setting: The interview took place in a pediatric urban academic hospital inpatient surgical service

Sample characteristics (# of patients) The number of people interviewed were 29 families.

Design: The researchers used a prospective, quasi-experimental…...

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References

Alaloul, F., Williams, K., Myers, J., Jones, K. D., & Logsdon, M. C. (2015). Impact of a Script-based Communication Intervention on Patient Satisfaction with Pain Management. Pain Management Nursing, 16(3), 321-327. doi:10.1016/j.pmn.2014.08.008

Brosey, L. A., & March, K. S. (2015). Effectiveness of Structured Hourly Nurse Rounding on Patient Satisfaction and Clinical Outcomes. Journal of Nursing Care Quality, 30(2), 153-159. doi:10.1097/ncq.086

Cholli, P., Meyer, E. C., David, M., Moonan, M., Mahoney, J., Hession-Laband, E., . . . Bell, S. K. (2016). Family Perspectives on Whiteboard Use and Recommendations for Improved Practices. Hospital Pediatrics, 6(7), 426-430. doi:10.1542/hpeds.2015-0182

Emerson, B. L., Chmura, K. B., & Walker, D. (2014). Hourly Rounding in the Pediatric Emergency Department: Patient and Family Safety and Satisfaction Rounds. The Journal of Emergency Medicine, 47(1), 99-104. doi:10.1016/j.jemermed.2013.11.098

setting, definition Sample/Setting
Conclusions (Appraisal)

Level of Evidence

(Flagg, 2015)

Implementing patient-focused healthcare within settings burdened by the combined challenges of scarce support systems, huge patient loads and constantly-growing patient care responsibilities, especially chronically ill patients

A healthcare organization with nursing staff on twelve-hour schedules

Characteristics: Number of patients individual nursing professionals have to cater to, which ranges between 3 and 5.

Catheter care, blood extractions, surgical schedules planned, antibiotic drugs' presence in the hospital inventory, patients' medicine/treatment plans

Necessity of bedside reporting, patient satisfaction and all-inclusive care framework

A case study technique implies researchers cannot undertake a broad-scale research using the sample. Outcomes might be case-specific and non-generalizable.

This article contributes to clarifying nursing role by employing numerous kinds of patient-focused care elements for improving care quality safely and manageably.

Level 4.d -- Descriptive Observational Studies -- Case Study

(Fawaz, Williams, Myers, Jones, & Logsdon, 2015)

Assessing the efficacy of a combined intervention entailing script-based interaction, hourly rounding and whiteboard use…...

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References

Ann Rodney, P. (2015). The Design and Implementation of a Relationship-Based Care Delivery Model on a Medical- Surgical Unit. WALDEN DISSERTATIONS AND DOCTORAL STUDIES.

Ciaramella, J., Longworth, N., Larraz, L., & Murphy, S. (2014). Improving Efficiency, Consistency and Satisfaction on a Mother-Baby Unit With the Discharge Nurse Position. Wiley Online Library.

Dempsey, C., Wojciechowski, S., McConville, E., & Drain, M. (2014). Reducing Patient Suffering Through Compassionate Connected Care. Journal of Nursing Administration, 517 - 524.

Elena, A. (2015). Understanding the Culture of the Single Room Maternity Care Unit: Ethnographic Study. University of Calgary - Electronic Thesis.

size is an important step in the sample selection process. In Negarandeh, Bahabadi & Mamaghani's (2014) study, the procedure used to determine the sample size is clearly described. Following a pilot study, using the sample size formula, and based on the population of the hospital in which the trial was carried out, the authors estimated the sample size at 100 participants (50 participants in each group). evealing how the sample size was determined enables readers to ascertain the extent to which the sample selected is representative of the larger population (Thomas, 2009). In quantitative research, a representative sample is important for improving the generalizability of findings (Bryman, 2008). In this case, the sample was quite representative of the study population. The study setting was a 530-bed hospital. The trial was specifically conducted in the medical surgical ward, which had 40 active beds, meaning the findings can readily be generalized…...

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References

Al-Abri, R., & Al-Balushi, A. (2014). Patient satisfaction survey as a tool towards quality improvement. Oman Medical Journal, 29(1), 3-7.

Broeck, J., Cunningham, S., Eeckels, R., & Herbest, K. (2005). Data cleaning: detecting, diagnosing, and editing data abnormalities. PLoS, 2(10), e267.

Bryman, A. (2008). Social research methods. 3rd ed. Buckingham: Open University Press.

Creswell, J. (2014). Research design: qualitative, quantitative, and mixed methods approaches. 4th ed. London: SAGE.

hospitals profits come from the cardiology department. One key strategy the hospital should adopt is specializing for growth. Not only has the rise in specialty hospitals increased in the last few years, but it has also enabled hospitals facing stiff competition to maintain or gain new patients. A specialized care strategy must be adopted for proper implementation of strategy. Hospital administrators in this role have to take the time to examine potential or existing specialty healthcare providers within the community. By identifying an area of opportunity, it becomes much easier put into effect a strategic plan that will gain the hospital national and even worldwide recognition.
Specialty hospitals satisfy the needs of a specific population. In the case of the hospital, those are elderly patients with cardiac problems. By examining if the local demographics match this population group, hospital administrators can then focus their attention on recruitment of specialized personnel…...

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References

Freeze, R., Vinze, A., Santanam, R., & Furukawa, M. (2012). IT Adoption: Healthcare Metrics Tracking. 2012 45th Hawaii International Conference On System Sciences.  http://dx.doi.org/10.1109/hicss.2012.392 

Girotra, S., Lu, X., Vaughan-Sarrazin, M., Popescu, J., Horwitz, P., & Cram, P. (2011). Abstract P314: The Impact of Hospital Cardiac Specialization on Outcomes After Coronary Artery Bypass Graft Surgery: Analysis of Medicare Claims Data. Circulation: Cardiovascular Quality And Outcomes,4(Suppl 1), AP314-AP314. Retrieved from  http://circoutcomes.ahajournals.org/content/4/Suppl_1/AP314.abstract

The ole of Empathy in Enhancing Trust and Efficiency in Healthcare: A Patient-Doctor PerspectiveIntroductionEmpathy, an integral part of human interaction, has been demonstrated to significantly impact various aspects of healthcare delivery (Decety & Fotopoulou, 2015). An empathetic approach is not only a crucial element in fostering trust between doctors and patients but it also results in substantial economic benefits and improved health outcomes (Halpern, 2003). This paper explores the idea that empathy in healthcare saves lives, time, and money, reinforcing the importance of a humanistic approach to medicine.Trust as the Foundation of the Doctor-Patient elationshipEmpathy in the context of healthcare involves understanding patients\\\' experiences, concerns, and perspectives, and communicating this understanding to them (Halpern, 2003). When doctors demonstrate empathy, it signals to patients that their feelings and experiences are acknowledged and validated. This fosters a sense of trust and connection between the patient and doctor. The psychological safety created through…...

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ReferencesBensing, J. (2000). Bridging the gap: The separate worlds of evidence-based medicine and patient-centered medicine. Patient Education and Counseling, 39(1), 17-25.Decety, J., & Fotopoulou, A. (2015). Why empathy has a beneficial impact on others in medicine: unifying theories. Frontiers in Behavioral Neuroscience, 8, 457.Flickinger, T. E., et al. (2016). Higher quality communication and relationships are associated with improved patient engagement in HIV care. Journal of Acquired Immune Deficiency Syndromes (JAIDS), 72(2), e23-e31.Halpern, J. (2003). What is clinical empathy? Journal of General Internal Medicine, 18(8), 670–674.Weng, H. C., Steed, J. F., Yu, S. W., Liu, Y. T., Hsu, C. C., Yu, T. J., & Chen, W. (2011). The effect of surgeon empathy and emotional intelligence on patient satisfaction. Advances in health sciences education, 16, 591-600.

Accountable Care Organizations (ACOs) like AdventHealth aim to improve healthcare quality by enhancing care coordination, reducing unnecessary spending, and focusing on preventative care. Metrics often used to evaluate their impact include patient satisfaction scores, hospital readmission rates, and the management of chronic conditions. ACOs are compared through benchmarks in these areas, cost savings, and quality of care improvements.

Determining the impact of AdventHealth ACO on healthcare quality and metrics requires a deep dive into several factors. Here's a breakdown of key aspects to consider:

Metrics used for evaluation:

• Healthcare Effectiveness Data and Information Set (HEDIS) scores: These standardized measures assess preventive....

Impact of Electronic Medical Records on Patient Care

The benefits and challenges of using electronic medical records (EMRs) in healthcare delivery
How EMRs have improved the accuracy, efficiency, and accessibility of patient information
The role of EMRs in reducing medical errors and improving patient safety
The potential risks to patient privacy and security associated with EMRs
The impact of EMRs on the patient-physician relationship and trust

Technological Considerations for EMR Implementation

The key technological requirements and challenges for successful EMR implementation
The different types of EMR systems available and their respective strengths and weaknesses
The importance of data interoperability and standards....

A thesis statement for a cause and effect essay on ways to improve patient satisfaction in nurse quality care could be: "Implementing effective communication strategies, increasing staffing levels, and providing continuous training and education for nurses are crucial steps towards improving patient satisfaction with the quality of care provided."

This thesis statement effectively lays out the main points that will be explored in the essay. It highlights the importance of communication, staffing, and training in improving the quality of care provided by nurses. By focusing on these key areas, healthcare organizations can work towards enhancing patient satisfaction and overall outcomes. Through research....

## Thesis Statement:

A comprehensive and multifaceted approach, including enhanced communication, patient-centered care, staff empowerment, and data-driven decision-making, is necessary to effectively improve patient satisfaction in nurse quality care.

### Introduction:

Patient satisfaction is a crucial indicator of the quality of healthcare services. Enhancing patient satisfaction leads to improved clinical outcomes, increased patient loyalty, and reduced healthcare costs. Nurses play a pivotal role in shaping patient experiences and influencing satisfaction levels. This thesis will explore the multifaceted strategies that can be implemented to improve patient satisfaction in nurse quality care.

### Body:

1. Enhanced Communication:

Establish clear channels of communication between nurses and patients, allowing....