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Issue 118 - 16 Nov 2009


by Grazier, Kyle L. Journal of Healthcare Management, Sep/Oct2008, Vol 53 Issue 5: p281
The article discusses various articles published within the issue, including one by Paula Lantz on gender equity in healthcare leadership, one by Patricia Adams-Graves and colleagues about an inpatient care model and one by Joseph Coyne and Sher Singh on early warning signs of financial trouble.

2. Interview with David A. Stark, FACHE, Executive Vice President/Chief Operating Officer, Iowa Health-- Des Moines.
Journal of Healthcare Management, Sep/Oct2008, Vol 53 Issue 5: p282-286
An interview with Iowa Health-Des Moines executive vice president and chief operating officer David A. Stark is presented. When asked about his essential achievements, he stresses his engagement in a year-long administrative fellowship which allowed him to get involved in projects. He cites the role of understanding the
theories he learned in graduate school and applying them in the real world. He also shares his insights on process differences in handling small and large hospital sites.

3. Choosing Your Charity
by Lutz, Sandy. Journal of Healthcare Management, Sep/Oct2008, Vol 53 Issue 5: p287-290
The article discusses the concept regarding hospital's provision of community benefits for consumers in the U.S. The author claims that the general idea on corporate responsibility has become the odd topic for hospitals, considering that many are safety-net facilities which caters charity care to the nation's uninsured. Some hospitals attempt to avoid their responsibilities to their communities, however most hospitals are mission driven and presume that the public is aware of the services they offer to this group of people. This public conceives the provision of charity care as the principal way hospitals offer community benefits. However, hospital executives must be more strategic on how to showcase this benefit and how to link it to the consumers' expectations and perceptions.

4. Gender and Leadership in Healthcare Administration: 21st Century Progress and Challenges
by Lantz, Paula M. Journal of Healthcare Management, Sep/Oct2008, Vol 53 Issue 5: p291-301
The need for strong leadership and increased diversity is a prominent issue in today's health services workforce. This article reviews the latest literature, including research and proposed agendas, regarding women in executive healthcare leadership. Data suggest that the number of women in leadership roles is increasing, but women remain underrepresented in the top echelons of healthcare leadership, and gender differences exist in the types of leadership roles women do attain. Salary disparity prevails, even when controlling for gender differences in educational attainment, age, and experience. Despite widespread awareness of these problems in the field, current action and policy recommendations are severely lacking. Along with the challenges of cost, quality, and an aging population, the time has come for a more thoughtful, policy-focused approach to amend the discrepancy between gender and leadership in healthcare administration. [ABSTRACT FROM AUTHOR]

5. Gender and Leadership in Healthcare Administration: Practitioner Application
Journal of Healthcare Management, Sep/Oct2008, Vol 53 Issue 5: p302-303
The article discusses another article in the issue, exploring the career development of females who work in the top echelons of healthcare leadership, and the need for hospital and health systems executives to encourage further gender and racial equity in leadership. The author shares that she had male mentors during her career, noting that females that might have been her mentor were balancing the demands of work and family. Topics include women in leadership roles that realize the value of mentoring, the transformational style of female leadership, and women executives who effectively manage their needs and goals.

6. Sickle Cell Hospital Unit: A Disease-Specific Model
by Adams-Graves, Patricia et al. Journal of Healthcare Management, Sep/Oct2008, Vol 53 Issue 5: p305-315
American urban hospitals often serve large populations of sickle cell disease (SCD) patients. Those hospitals that choose to implement an adult SCD-specific inpatient unit have the opportunity to acquire multiple operational benefits. Such units may ultimately reduce patient morbidity and mortality; improve timely access to quality medical care in a cost-effective manner; reduce overcrowding in the emergency department; and increase patient, family, physician, and payer satisfaction. SCD is a serious, painful, genetic blood disorder that affects a growing population of adults in the United States. A single mistake in the gene that codes for hemoglobin causes crescent-shaped red blood cells that are sticky, are stiff, and have a short life span. These cells cause blockages, tremendous pain brought on by lack of oxygen in the muscles, organ damage, stroke, and problems with infections. The cells' short life span often results in anemia. The unpredictable pain event-sickle cell disease with crisis-is the most common reason for presentation to the emergency department and for hospital admission. For many SCD patients, the emergency department process and the general, overly conservative approach to pain relief lead to a delay in treatment and prolong needless suffering. Regional Medical Center at Memphis (Tennessee) established an SCD unit and developed an inpatient care delivery model that decreases the burden of caring for SCD patients on its busy emergency department, improves SCD patients' satisfaction and access to timely quality care, and reduces the needless pain and suffering of SCD patients. This SCD model may be replicated in large urban hospitals with a daily SCD patient census of five or more. [ABSTRACT FROM AUTHOR]

7. Sickle Cell Hospital Unit: Practitioner Application
Journal of Healthcare Management, Sep/Oct2008, Vol. 53 Issue 5: p316-317
The article discusses another article in the issue, examining an inpatient model used to manage adult patients who have acute and chronic sickle cell disease (SCD) in urban hospitals. A direct call-in triage system allows the patients to bypass the emergency department, the author states. Topics include the cost of services for patients with sickle cell anemia, the development of an outpatient sickle cell day hospital in South Florida, and a decrease in emergency room visits. Also discussed are adolescents with SCD requiring adult care.

8. Using Leadership Development Programs to Improve Quality and Efficiency in Healthcare
by McAlearney, Ann Scheck. Journal of Healthcare Management, Sep/Oct2008, Vol. 53 Issue 5: p319-331
With heightened emphasis on the imperatives to improve the quality and efficiency of healthcare delivered in U.S. hospitals and health systems, healthcare managers are challenged to consider innovative approaches to address these issues. Leadership development programs are increasingly common offerings within healthcare organizations, but linking such initiatives to quality and efficiency improvement programs remains rare. This article uses data from three qualitative studies of leadership development in healthcare to answer the question, "What opportunities might exist to use leadership development programs to improve quality and efficiency?"
Interviews from 200 individuals were conducted between September 2003 and December 2007 with hospital and health system managers and executives, academic experts, consultants, individuals representing associations and vendors of leadership development programs, and program participants. Analyses of these data showed that leadership development programs provide four important opportunities to improve quality and efficiency in healthcare: (1) by increasing the caliber of the workforce, (2) by enhancing efficiency in the organization's education and development activities, (3) by reducing turnover and related expenses, and (4) by focusing organizational attention on specific strategic priorities. Several concrete examples of how to leverage leadership development in these ways are provided to help managers consider how to apply these research findings. Healthcare managers can use the results reported from these studies to extend the reach of current leadership development programs or to inform the design of new initiatives that focus specifically on quality and efficiency improvement. Although quantitative metrics are required to measure definitive improvements in quality and efficiency in healthcare, these qualitative data highlight opportunities through which leadership development initiatives can contribute to improvement efforts.[ABSTRACT FROM AUTHOR]

9. The Early Indicators of Financial Failure: A Study of Bankrupt and Solvent Health Systems
by Coyne, Joseph S.; Singh, Sher G. Journal of Healthcare Management, Sep/Oct2008, Vol 53 Issue 5: p333-345
This article presents a series of pertinent predictors of financial failure based on analysis of solvent and bankrupt health systems to identify which financial measures show the clearest distinction between success and failure. Early warning signals are evident from the longitudinal analysis as early as five years before bankruptcy. The data source includes seven years of annual statements filed with the Securities and Exchange Commission by 13 health systems before they filed bankruptcy. Comparative data were compiled from five solvent health systems for the same seven-year period. Seven financial solvency ratios are included in this study, including four cash liquidity measures, two leverage measures, and one efficiency measure. The results show distinct financial trends between solvent and bankrupt health systems, in particular for the operating-cash-flow-related measures, namely Ratio 1: Operating Cash Flow Percentage Change, from prior to current period; Ratio 2: Operating Cash Flow to Net Revenues; and Ratio 4: Cash Flow to Total Liabilities, indicating sensitivity in the hospital industry to cash flow management The high dependence on credit from third-party payers is cited as a reason for this; thus, there is a great need for cash to fund operations. Five managerial policy implications are provided to help health system managers avoid financial solvency problems in the future. [ABSTRACT FROM AUTHOR]

10. The Early Indicators of Financial Failure: Practitioner Application
Journal of Healthcare Management, Sep/Oct2008, Vol 53 Issue 5: p345-346
The article discusses another article in the issue, examining the understanding of predictors of financial failures of healthcare operations. Attention paid to cash liquidity measures appears to be a powerful tool in predicting hospital failures, the author suggests. Topics include is the lack of data concerning not-for-profit ventures, cash flow indicators which identify early signs of financial concern, and the relationship between hospital size and solvency. Also discussed are measures which speak to daily operational focus on activity.

Journals – Table of Contents

11. From Contemporary Nurse, Volume 33, Number 1 August 2009

11A. Team nursing in acute care settings: Nurses' experiences
11B. Does implementation of clinical practice guidelines change nurses' screening for alcohol and other substance use?
11C. Who’s talking? Communication and the casual/part-time nurse: A literature review
11D. Home alone: Patient and carer uncertainty surrounding discharge with continuing clinical care needs
11E. Complementary and alternative medicine and the search for knowledge by conventional health care practitioners
11F. Uncovering psychosocial needs: Perspectives of Australian child and family health nurses in a sustained home visiting trial
11G. Nursing student feedback on undergraduate research education: Implications for teaching and learning
11H. Culturally safe research with vulnerable populations
11I. An exploratory study of first year nursing students’ learning in the clinical workplace

12. From International Journal of Nursing Practice, Volume 15, Issue 5, October 2009
12A. Institutionalized children: The underprivileged
12B. Facilitating collaborative development in practice
12C. Registered nurse incentives to return to practice in the United States
12D. Change in knowledge and self-efficacy of patients with rheumatoid arthritis: A six-month follow-up study
12E. Nursing prioritization of the patient need for care: A tacit knowledge embedded in the clinical decision-making literature
12F. Nurse-led telephone triage in an Australian rural mental health service
12G. Initial evaluation of a new safety needle system at a clinical setting in Taiwan
12H. Work empowerment in multidisciplinary teams during organizational change
12I. Nursing the dying: A descriptive survey of Australian undergraduate nursing curricula
12J. Organizational factors influencing knowledge transfer into practice in Iranian nursing context: A grounded theory approach
12K. Nurses' attitude towards 'difficult' and 'good' patients in eight public hospitals
12L. Factors strengthening and weakening vaccination competence (p 444-454)
12M. Health-related quality of life among old residents of nursing homes in Norway
12N. The communication challenges faced in adopting a palliative care approach in advanced dementia
12O. Analysing oral history: A new approach when linking method to methodology

News – National

13. GP clinics stash reserves of $115m
Dominion Post - 16 November 2009
Locally-run GP health clinics have built up a $115 million treasure chest from money that is supposed to be spent on programmes to lift the nation's health.

14. STD passion killers
Sunday News - 15 November 2009
SEXUALLY transmitted infections are mainly passed on during sex but occasionally through casual contact, by sharing needles, or from mother to baby during pregnancy, birth or breastfeeding. There are now more than 30. Most are as old as sex itself, just ask any Roman emperor or medieval king. But the most dangerous, Aids, was recognised only in 1981.

15. Staff, courses hit by UCOL cuts
Manawtu Standard - 13 November 2009
More than 20 full-time UCOL staff will lose their jobs as courses are axed at the polytechnic's campuses in Palmerston North, Wanganui and the Wairarapa. In a bid to save $3 million a year, UCOL has reduced staff, trimmed class offerings and cut some courses entirely

16. Nurses in England Will Now Require Degree - Department of Health
TopNews - 13 November 2009
The Department of Health announced on Tuesday, that under a new regulation which aims at improving the quality of patient care in hospitals across UK, all new nurses now have to obtain a degree within 4 years, making nursing a degree only profession, as opposed to its earlier status of a diploma profession.

News - International

17. Nursing set to become all graduate entry by 2013
Department of Health website – 12 November 2009
Degree level education will raise quality of patient care. All new nurses will be educated to degree level from 2013 making them better equipped to improve the quality of patient care, Health Minister Ann Keen announced today. The minimum level for pre-registration courses for nurses will be raised from diploma to degree level and these courses will meet new standards developed by the Nursing and Midwifery Council (NMC), the professional regulator for nursing.

18. Fertility rate at postwar levels
The Australian - 12 November 2009
WOMEN in their late 30s are driving the nation's new baby boom, with fertility rates not seen since the end of World War II. And more women are having children in their 20s, paving the way for a return to larger families, the latest official data show.

19. Long-term care: life is still a postcode lottery
The Telegraph - 12 November 2009
Families with an older relative who needs long-term care are still being denied free NHS treatment because of where they live. The postcode lottery that is long-term care has worsened despite ombudsman intervention, widening the gap between the local primary care trusts providing eligible patients with NHS continuing care and those that are not.

20. Many breast cancers do not need treatment
The Australian - November 12, 2009
HUNDREDS of women every year are having treatments for breast cancer, including surgery and chemotherapy, that are unnecessary because nearly one-third of cancers detected by screening tests are not dangerous.

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