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1.
Hosp Top ; 101(2): 146-155, 2023.
Article in English | MEDLINE | ID: mdl-34738884

ABSTRACT

This study reviewed state and District of Columbia (DC) health department guidelines for the use of face masks by healthcare workers during the COVID-19 pandemic via an October 2020 internet search and compared these guidelines to those from the World Health Organization (WHO) and Centers for Disease Control and Prevention (CDC). Guidelines varied between states and DC with respect to N95 face mask and surgical mask use, as well as to extended use and re-use of N95 masks. Uniform guidance based on emerging evidence should be required for creating policy and procedures for healthcare workers during this and future pandemics.


Subject(s)
COVID-19 , Humans , COVID-19/prevention & control , Masks , Pandemics/prevention & control , District of Columbia , SARS-CoV-2 , Health Personnel
2.
J Public Health Policy ; 43(2): 234-250, 2022 Jun.
Article in English | MEDLINE | ID: mdl-35140363

ABSTRACT

The COVID-19 pandemic, caused by the SARS-CoV-2 virus, created the need for an effective vaccine. Questions arose about allocating the initial limited supplies in the United States. We present four allocation models and compare their characteristics for ethically meeting the health needs of the population. The literature shares broad agreement on guiding ethical principles with those of the four proposed models for vaccine allocation, featuring the concepts of utilitarianism, prioritarianism, equity, and reciprocity. We conclude that the "Interim Framework for COVID-19 Vaccine Allocation and Distribution in the United States" from the Johns Hopkins Bloomberg School of Public Health is the most comprehensive and ethically sound. We recommend government officials and policymakers at all levels consider the principles and objectives in this model as US COVID-19 vaccination distribution efforts continue. This model may serve as an effective framework for initial vaccine distribution efforts during future epidemic and pandemic events.


Subject(s)
COVID-19 , Pandemics , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19 Vaccines , Humans , Pandemics/prevention & control , Public Health , SARS-CoV-2 , United States/epidemiology
3.
Health Care Manag (Frederick) ; 37(1): 33-38, 2018.
Article in English | MEDLINE | ID: mdl-29266089

ABSTRACT

We explore the influence of the Thirteenth Amendment to the US Constitution on the enforceability of personal services contracts for physicians. This influence extends from the ambiguous definition to the legal interpretation of personal services contracts. The courts have struggled with determining contracts to be a personal service and whether to grant injunctions for continued performance. The award or denial of damages due to a breach of contract is vested in these enforceability complications. Because of the Thirteenth Amendment's influence, courts and contracting parties will continue to struggle with physician personal services contract enforceability; although other points of view may exist. Possible solutions are offered for health care contract managers dealing with challenges attributable to physician personal services contracts.


Subject(s)
Contract Services/legislation & jurisprudence , Employment/legislation & jurisprudence , Physicians/legislation & jurisprudence , Health Care Sector/legislation & jurisprudence , Humans
4.
Radiol Manage ; 38(4): 51-57, 2016 Jul.
Article in English | MEDLINE | ID: mdl-30508330

ABSTRACT

* Informal leaders are present in healthcare organizations. They exercise influence over their peers, which can impact the effectiveness and efficiency of the organization. The purpose of this study was to explore formal leaders' perceptions of informal leaders in their organizations in order to further the knowledge base and permit managers to better develop positive informal leader strategies. A total of 322 respondents (AHRA members) returned valid surveys in response to the study. Questions contained in the survey assessed the following factors: Professional Competency, Supporting the Mission, Influence of Informal Leaders, and Future of Informal Leaders. " The results of the survey suggest that personal demographics and facility characteristics do not account for significant variation in formal leaders' perception of informal leaders in their organizations.


Subject(s)
Attitude of Health Personnel , Diagnostic Imaging , Leadership , Professional Competence , Female , Humans , Male , Middle Aged , Surveys and Questionnaires
6.
J Healthc Manag ; 57(3): 200-12; discussion 212-3, 2012.
Article in English | MEDLINE | ID: mdl-22724377

ABSTRACT

From 1980 to 1999, rural designated hospitals closed at a disproportionally high rate. In response to this emergent threat to healthcare access in rural settings, the Balanced Budget Act of 1997 made provisions for the creation of a new rural hospital--the critical access hospital (CAH). The conversion to CAH and the associated cost-based reimbursement scheme significantly slowed the closure rate of rural hospitals. This work investigates which methods can ensure the long-term viability of small hospitals. This article uses a two-step design to focus on a hypothesized relationship between technical efficiency of CAHs and a recently developed set of financial monitors for these entities. The goal is to identify the financial performance measures associated with efficiency. The first step uses data envelopment analysis (DEA) to differentiate efficient from inefficient facilities within a data set of 183 CAHs. Determining DEA efficiency is an a priori categorization of hospitals in the data set as efficient or inefficient. In the second step, DEA efficiency is the categorical dependent variable (efficient = 0, inefficient = 1) in the subsequent binary logistic regression (LR) model. A set of six financial monitors selected from the array of 20 measures were the LR independent variables. We use a binary LR to test the null hypothesis that recently developed CAH financial indicators had no predictive value for categorizing a CAH as efficient or inefficient, (i.e., there is no relationship between DEA efficiency and fiscal performance).


Subject(s)
Efficiency, Organizational/economics , Emergency Service, Hospital/economics , Technology , Databases, Factual , Logistic Models
7.
J Nurs Adm ; 41(3): 138-43, 2011 Mar.
Article in English | MEDLINE | ID: mdl-21336042

ABSTRACT

Use of outsourced nurses is often a stop-gap measure for unplanned vacancies in smaller healthcare facilities such as long-term acute-care hospitals (LTACHs). However, the relationship of utilization levels (low, medium, or high percentages) of nonemployees covering staff schedules often is perceived to have negative relationships with quality outcomes. To assess this issue, the authors discuss the outcomes of their national study of LTACH hospitals that indicated no relationship existed between variations in percentage of staffing by contracted nurses and selected outcomes in this post-acute-care setting.


Subject(s)
Leadership , Nursing Staff, Hospital/statistics & numerical data , Outsourced Services/statistics & numerical data , Personnel Staffing and Scheduling/statistics & numerical data , Quality Indicators, Health Care/organization & administration , Skilled Nursing Facilities/statistics & numerical data , Acute Disease/therapy , Cross-Sectional Studies , Humans , Long-Term Care/organization & administration , Medication Errors/statistics & numerical data , Nursing Administration Research , Nursing Staff, Hospital/supply & distribution , Outcome Assessment, Health Care , Outsourced Services/organization & administration , Personnel Staffing and Scheduling/organization & administration , United States , Workforce
8.
J Nurs Adm ; 41(2): 90-6, 2011 Feb.
Article in English | MEDLINE | ID: mdl-21266888

ABSTRACT

When staffing effectiveness is not maintained over time, the likelihood of negative outcomes increases. This challenge is particularly problematic in long-term acute care hospitals (LTACHs) where use of outsourced temporary nurses is common when providing safe, sufficient care to medically complex patients who require longer hospital stays than normally would occur. To assess this issue, the authors discuss the outcomes of their survey of LTACH chief nursing officers that demonstrated LTACH quality indicators and overall patient satisfaction were within nationally accepted benchmarks even with higher levels of outsourced nurses used in this post-acute care setting.


Subject(s)
Attitude of Health Personnel , Nurse Administrators/psychology , Nursing Staff, Hospital/supply & distribution , Outsourced Services/organization & administration , Personnel Staffing and Scheduling/organization & administration , Skilled Nursing Facilities , Accidental Falls/statistics & numerical data , Analysis of Variance , Choice Behavior , Humans , Leadership , Linear Models , Medication Errors/statistics & numerical data , Michigan , Nursing Administration Research , Nursing Methodology Research , Outcome Assessment, Health Care , Patient Satisfaction , Quality Indicators, Health Care/organization & administration , Surveys and Questionnaires , Workforce
9.
Mil Med ; 172(1): 49-52, 2007 Jan.
Article in English | MEDLINE | ID: mdl-17274266

ABSTRACT

Confronted with a sudden and substantial change in the rules regarding who could command a military medical treatment facility (MTF), the Military Health System (MHS) responded to the challenge with an impressive human resource management solution-the Joint Medical Executive Skills Program. The history, emergence, and continuing role of this initiative exemplifies the MHS's capacity to fulfill the spirit and intent of an arduous Congressional mandate while enhancing professional development and sustaining the career opportunities of medical officers. The MHS response to the Congressional requirement that candidates for MTF command demonstrate professional administrative skills was decisive, creative, and consistent with the basic principles of human resource management. The Joint Medical Executive Skills Program is a management success story that demonstrates how strategic planning, well-defined skills requirements, and structured training can assure a ready supply of qualified commanders for the military's MTFs.


Subject(s)
Hospital Administrators/standards , Hospitals, Military/organization & administration , Leadership , Military Medicine/education , Military Personnel , Professional Competence , Program Development , Hospital Administrators/education , Humans , Personnel Management , United States
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