Conceptual Framework to Evaluate Health Care Professionals' Satisfaction in Utilizing Telemedicine.

CONTEXT: Several advantages of telemedicine have been reported, such as improved patient satisfaction, reduced costs, and broader access to specialists. However, most studies have focused on patient satisfaction with telemedicine services. A literature gap exists in evaluating health care professionals' (both referring and performing professionals) satisfaction in delivering telemedicine services. A clear picture of professionals' telemedicine satisfaction has the potential to improve care quality, care accessibility, and telemedicine adoption and to reduce overall health care costs. OBJECTIVES: To develop a framework to evaluate health care professionals' satisfaction in delivering telemedicine services and to articulate the factors that can contribute to their satisfaction. METHODS: We developed an initial conceptual framework based on existing literature and the research team's expertise. The initial framework was validated by a convenience group of 12 osteopathic and allopathic physicians, and the framework was further revised and refined according to their input. RESULTS: The refined framework includes 5 main components (professionals' demographics, care settings, motivations, experiences, and overall satisfaction) that can contribute to health care professionals' satisfaction or dissatisfaction in delivering telemedicine services. Detailed itemization is provided under each component, including hierarchical organizations of the items, definitions, and potential value sets. CONCLUSIONS: The refined conceptual framework may provide a comprehensive evaluation reference for measuring professionals' satisfaction in delivering telemedicine. Further customization according to the specific setting of telemedicine services is needed. This refined conceptual framework can also be used to identify areas that can be improved and to ultimately improve telemedicine services and care quality.

Comparing Hospital Mission Statement Content in a Changing Healthcare Field.

Mission statements are key elements of how an organization communicates its purpose and priorities to its community. This study considers how mission statements from Ohio, Florida, and Texas hospitals approach key concepts in healthcare - access, cost, and quality. It also considers the concept of community benefit, given its recent prevalence in policy changes. The analysis found quality represented within hospital mission statements at a rate of 65%, compared to 21% for access, 21% for cost, and 24% for community benefit. Investor-owned hospitals emphasize quality and cost at significantly higher rates while not-for-profit hospitals emphasize access and community benefit at significantly higher rates than other organization types.

Retaining experienced hospital administrators: a neglected topic in healthcare.

The sharp increase in the present need for healthcare services has been attributed to the expanding population of older adults (those above the age of 65 years) and the increasing number of aging healthcare professionals seeking retirement without enough qualified replacements. In this regard, retaining experienced healthcare professionals, especially hospital administrators, may be the key to managing this growing demand for healthcare services at present and for the future. Veteran hospital administrators have many years of experience and can offer a wide array of skills and competencies to their organization. As such, organizations should make every effort to retain these individuals and implement efforts for their continued contribution to the healthcare industry. Given the nature of their work and the various changes accompanying aging, experienced hospital administrators may have specific personal and professional challenges that may be compelling them to consider retirement options. The authors' primary focus was to identify the unique issues associated with retaining experienced hospital administrators and to propose certain accommodations and recommendations to promote their continued and valued contributions to the healthcare industry.

Recruitment and retention of rural hospital administrators: a multifaceted approach.

A major challenge confronting healthcare delivery in the United States is the shortage of clinical professionals in rural areas. Although most of the research surrounding this problem has focused on physicians and nurses, other healthcare professionals have received much less attention. Although not a clinician or hands-on care provider, the hospital administrator is an integral component of rural healthcare delivery systems and is instrumental in the organization and delivery of services. This article examines some of the factors that impact the recruitment and retention process for rural hospital administrators. The authors suggest that recruitment and retention success can be best achieved by adopting a multifaceted approach that includes aspects of and considerations from 3 separate areas: personal, organizational, and community attributes. The authors provide recommendations and insights for rural hospital governing boards responsible for this process.

Performance appraisal: helpful hints for the busy medical practice manager.

This article describes the performance appraisal process in terms of its three fundamental steps. defining job performance, measuring actual job performance, and providing job performance feedback. Given that most practice managers wear many hats and do not have extensive experience or staff support in human resources, the purpose of this article is to provide these busy individuals with useful, practical suggestions that should enhance the effectiveness of the performance appraisal process for nonphysician employees within the medical practice setting. Performance appraisal should be a priority for all practice managers, as the performance of individual employees represents the key to long-term success for any medical practice.

Recruiting and retaining mental health professionals to rural communities: an interdisciplinary course in Appalachia.

CONTEXT: Faculty from 5 disciplines (health administration, nursing, psychology, social work, and special education) collaborated to develop and teach a distance-learning course designed to encourage undergraduate and graduate students to seek mental health services employment in rural areas and to provide the skills, experience, and knowledge necessary for successful rural practice. METHODS: The primary objectives of the course, developed after thorough review of the rural retention and recruitment literature, were to (1) enhance interdisciplinary team skills, (2) employ technology as a tool for mental health practitioners, and (3) enhance student understanding of Appalachian culture and rural mental health. Didactic instruction emphasized Appalachian culture, rural mental health, teamwork and communication, professional ethics, and technology. Students were introduced to videoconferencing, asynchronous and synchronous communication, and Internet search tools. Working in teams of 3 or 4, students grappled with professional and cultural issues plus team process as they worked through a hypothetical case of a sexually abused youngster. The course required participants to engage in a nontraditional manner by immersing students in Web-based teams. FINDINGS: Student evaluations suggested that teaching facts or "content" about rural mental health and Appalachian culture was much easier than the "process" of using new technologies or working in teams. CONCLUSIONS: Given that the delivery of mental health care demands collaboration and teamwork and that rural practice relies increasingly more on the use of technology, our experience suggests that more team-based, technology-driven courses are needed to better prepare students for clinical practice.

Comparing mission statement content in for-profit and not-for-profit hospitals: does mission really matter?

In this article, the author examined the content of mission statements in both the for-profit and not-for-profit hospital sectors. He used content analysis to compare and contrast the existence and frequency of words or phrases found in the mission statements of each sector. In particular, he analyzed the following three concepts: cost, access, and quality. The author found no significant differences in mission statement content across these three concepts when he compared investor-owned (for-profit) and nongovernmental not-for-profit hospitals. The results of this study suggest that the hospital industry lags behind other sectors in the design and development of thorough and complete mission statements. Hospital executives are encouraged to devote more time to the construction of hospital-specific and comprehensive mission statements that will provide important information for stakeholders, while simultaneously capturing the organization's unique purpose and niche in the competitive healthcare environment.