Achieving Efficiency: Lessons From Four Top-Performing Hospitals

Synthesizes lessons from case studies of how four hospitals achieved greater efficiency, including pursuing quality and access, customizing technology, emphasizing communications, standardizing processes, and integrating care, systems, and providers

A survey of health care models that encompass multiple departments

In this survey we review quantitative health care models to illustrate the extent to which they encompass multiple hospital departments. The paper provides general overviews of the relationships that exists between major hospital departments and describes how these relationships are accounted for by researchers. We find the atomistic view of hospitals often taken by researchers is partially due to the ambiguity of patient care trajectories. To this end clinical pathways literature is reviewed to illustrate its potential for clarifying patient flows and for providing a holistic hospital perspective

Taxonomic classification of planning decisions in health care: a review of the state of the art in OR/MS

We provide a structured overview of the typical decisions to be made in resource capacity planning and control in health care, and a review of relevant OR/MS articles for each planning decision. The contribution of this paper is twofold. First, to position the planning decisions, a taxonomy is presented. This taxonomy provides health care managers and OR/MS researchers with a method to identify, break down and classify planning and control decisions. Second, following the taxonomy, for six health care services, we provide an exhaustive specification of planning and control decisions in resource capacity planning and control. For each planning and control decision, we structurally review the key OR/MS articles and the OR/MS methods and techniques that are applied in the literature to support decision making

Genesys HealthWorks: Pursuing the Triple Aim Through a Primary Care-Based Delivery System, Integrated Self-Management Support, and Community Partnerships

Details Triple Aim pilot programs to engage primary care doctors in care coordination, prevention, and efficient use of specialty care through a physician-hospital organization; promote healthy behaviors; and extend access for the poor and uninsured

Improving waiting times in the Emergency Department

Waiting times in the Emergency Department cause considerable delays in care and in patient satisfaction. There are many moving parts to the ED visit with multiple providers delivering care for a single patient. Factors that have been shown to delay care in the ED have been broken down into input factors such as triaging, throughput factors during the visit, and output factors, which include discharge planning and available inpatient beds for admitted patients. Research has shown that throughput factors are an area of interest to decrease time spent in the ED that will lead to decrease waiting room times. In this Quality Improvement project, we will develop a systematic check in system with ED providers that will allow providers to identify any outstanding issues that may be delaying care or discharge. We hypothesize that this system will increase throughput in the ED by resolving any lab, radiology, or treatments that were overlooked. Reviewing the results of this QI project will allow us to see if we were effective in our timing of scheduled check-ins. Ultimately, this will reduce time spent in the waiting room by allowing more patients to be seen. In the era of the Affordable Care Act, more patients have access to affordable healthcare and will increase volume in the ED. This check-in system will allow more patients to be seen smoothly and in a timely manner that will improve and increase patient care and satisfaction in the ED

Emergency Department Utilization and Capacity

Synthesizes research on who utilizes emergency departments, how often for non-urgent or preventable conditions and why, how cost-sharing affects utilization, and how utilization patterns affect hospital finances, overcrowding, and cost implications

Can This Marriage Be Saved?

Market forces in health care are paradoxically pulling physicians and hospitals apart and together at the same time. What are these forces and trends? Is the long-standing marriage of interdependence and productivity between them destined to fail, or can it be saved and even strengthened by emerging delivery and governance models in the so-called "market revolution" of consumer-driven health care? What are the implications for health care policy and practice? These are issues we explore in this Arizona Health Futures Policy Primer

Kent and Medway acute mental health services review

An independent analysis of the public response to a consultation on ‘achieving excellent care in a mental health crisis’ by the Centre for Nursing and Healthcare Research at the University of Greenwich. Background: This document presents the results of an analysis of the responses to the formal public consultation on Acute Mental Health Crisis Care services which took place over a 13 week period from 26 July 2012 to 26 October 2012. The consultation was conducted by NHS Kent and Medway working in partnership with Kent and Medway NHS and Social Care Partnership Trust, and the data gathered was analysed independently by the Centre for Nursing and Healthcare Research at the University of Greenwich

Access to Specialist Palliative Care Services and Place of Death in Ireland

The aim of this report is to provide data, analysis and commentary to stimulate discussion on emerging trends in relation to the provision of specialist palliative care in Ireland. The report mines existing data from four key sources -- the Health Service Executive's (HSE) Minimum Data Set for Palliative Care; the National Cancer Registry; the Hospital Inpatient Enquiry, and HSE population records (2011) -- to compare and contrast administrative regions of the health service against national averages on a number of key indicators (number of hospice beds, waiting times for first assessment of patient, place of death, etc), and to examine the impact of varying levels of investment in palliative care on access to services and service activity. In particular, the report seeks to explore possible relationships between access to specialist palliative care services and place of death. It is clear from the data emerging from all four sources that there is a marked correlation between the availability or otherwise of hospice/palliative care services and where people die

Financial Incentives in the Long-Term Care Context: A First Look at Relevant Information

Analyzes variations in Medicare payment and coverage among hospitals, nursing homes, assisted living facilities, and hospices; "bed-hold" and "reserved-bed" revenue streams; and other factors that may shape decisions to transfer residents to hospitals