A Strategic Audit of Runza Restaurants

Runza is a well-known, Nebraskan restaurant. As Runza begins to expand, and a new generation of buyers approaches, it is important for Runza to examine the horizon and think critically about their future strategy. Runza will need to decide what their next steps will be to maintain a competitive advantage, and be successful for many more years to come. This strategic audit will look at the company’s background, business model, the internal and external environment, and company strengths and weaknesses. Then, several strategy alternatives are proposed, with the selection and implementation plan of the best strategic alternative

How do health systems approach patient experience? Development of an innovative elective curriculum for medical students

Medical students currently learn about patient-centered care and practice communication skills via a variety of curricula. However, there is little in the published literature describing a standardized approach for training future physicians how health systems approach and work to improve patient experience. The [Anonymous1 and Anonymous2] Schools of Medicine designed a plan to pilot a two-week elective for medical students in their clinical years. The curriculum is designed to help students understand and appreciate the key elements of the patient experience across the continuum of care and prepare students to impact the patient experience either as a practicing physician and/or as a future leader. Teaching methods include experiential activities as well as a variety of flipped-classroom sessions, dedicated time for independent reflection and study, interactive lectures, and a capstone project. This elective is slated for implementation at both medical centers over the next couple of years and the curriculum design stakeholders will continually review and refine the structure of the course based on feedback from participating students and core educators. The goal is to develop a novel and reproducible patient experience curriculum that can be taught to medical students around the country, ideally during both the clinical and pre-clinical years of their training. Experience Framework This article is associated with the Staff & Provider Engagement lens of The Beryl Institute Experience Framework. (http://bit.ly/ExperienceFramework) Access other PXJ articles related to this lens. Access other resources related to this lens

The triple helix of clinical, research, and education missions in academic health centers: A qualitative study of diverse stakeholder perspectives.

Introduction: Academic health centers are poised to improve health through their clinical, education, and research missions. However, these missions often operate in silos. The authors explored stakeholder perspectives at diverse institutions to understand challenges and identify alignment strategies. Methods: Authors used an exploratory qualitative design and thematic analysis approach with data obtained from electronic surveys sent to participants at five U.S. academic health centers (2017-18), with four different types of medical school/health system partnerships. Participants included educators, researchers, system leaders, administrators, clinical providers, resident/fellow physicians, and students. Investigators coded data using constant comparative analysis, met regularly to reconcile uncertainties, and collapsed/combined categories. Results: Of 175 participants invited, 113 completed the survey (65%). Three results categories were identified. First, five higher-order themes emerged related to aligning missions, including (a) shared vision and strategies, (b) alignment of strategy with community needs, (c) tension of economic drivers, (d) coproduction of knowledge, and (e) unifying set of concepts spanning all missions. Second, strategies for each mission were identified, including education (new competencies, instructional methods, recruitment), research (shifting agenda, developing partnerships, operations), and clinical operations (delivery models, focus on patient factors/needs, value-based care, well-being). Lastly, strategies for integrating each dyadic mission pair, including research-education, clinical operations education, and research-clinical operations, were identified. Conclusions: Academic health centers are at a crossroads in regard to identity and alignment across the tripartite missions. The study\u27s results provide pragmatic strategies to advance the tripartite missions and lead necessary change for improved patient health

Validity and usefulness of members reports of implementation progress in a quality improvement initiative: findings from the Team Check-up Tool (TCT)

<p>Abstract</p> <p>Background</p> <p>Team-based interventions are effective for improving safety and quality of healthcare. However, contextual factors, such as team functioning, leadership, and organizational support, can vary significantly across teams and affect the level of implementation success. Yet, the science for measuring context is immature. The goal of this study is to validate measures from a short instrument tailored to track dynamic context and progress for a team-based quality improvement (QI) intervention.</p> <p>Methods</p> <p>Design: Secondary cross-sectional and longitudinal analysis of data from a clustered randomized controlled trial (RCT) of a team-based quality improvement intervention to reduce central line-associated bloodstream infection (CLABSI) rates in intensive care units (ICUs).</p> <p>Setting: Forty-six ICUs located within 35 faith-based, not-for-profit community hospitals across 12 states in the U.S.</p> <p>Population: Team members participating in an ICU-based QI intervention.</p> <p>Measures: The primary measure is the Team Check-up Tool (TCT), an original instrument that assesses context and progress of a team-based QI intervention. The TCT is administered monthly. Validation measures include CLABSI rate, Team Functioning Survey (TFS) and Practice Environment Scale (PES) from the Nursing Work Index.</p> <p>Analysis: Temporal stability, responsiveness and validity of the TCT.</p> <p>Results</p> <p>We found evidence supporting the temporal stability, construct validity, and responsiveness of TCT measures of intervention activities, perceived group-level behaviors, and barriers to team progress.</p> <p>Conclusions</p> <p>The TCT demonstrates good measurement reliability, validity, and responsiveness. By having more validated measures on implementation context, researchers can more readily conduct rigorous studies to identify contextual variables linked to key intervention and patient outcomes and strengthen the evidence base on successful spread of efficacious team-based interventions. QI teams participating in an intervention should also find data from a validated tool useful for identifying opportunities to improve their own implementation.</p

Financing U.S. Graduate Medical Education: A Policy Position Paper of the Alliance for Academic Internal Medicine and the American College of Physicians

In this position paper, the Alliance for Academic Internal Medicine and the American College of Physicians examine the state of graduate medical education (GME) financing in the United States and recent proposals to reform GME funding. They make a series of recommendations to reform the current funding system to better align GME with the needs of the nation's health care workforce. These recommendations include using Medicare GME funds to meet policy goals and to ensure an adequate supply of physicians, a proper specialty mix, and appropriate training sites; spreading the costs of financing GME across the health care system; evaluating the true cost of training a resident and establishing a single per-resident amount; increasing transparency and innovation; and ensuring that primary care residents receive training in well-functioning ambulatory settings that are financially supported for their training roles

Arbor Day Foundation Tree Program Recommendation

We propose including an addition to the Tree City application for a grant awarded to Tree Cities that plant trees in underserved areas of the community. We also recommend inviting Tree Campus to join the Alliance for Community Trees (ACT). Through membership, they will attend and participate in the Partners in Community Forestry Conference

A Strategic Audit of Runza Restaurants

Runza is a well-known, Nebraskan restaurant. As Runza begins to expand, and a new generation of buyers approaches, it is important for Runza to examine the horizon and think critically about their future strategy. Runza will need to decide what their next steps will be to maintain a competitive advantage, and be successful for many more years to come. This strategic audit will look at the company’s background, business model, the internal and external environment, and company strengths and weaknesses. Then, several strategy alternatives are proposed, with the selection and implementation plan of the best strategic alternative