Article Type: Editorial
Author: O'Connor, Stephen J.
Pub Date: 09/01/2011
Publication: Name: Journal of Healthcare Management Publisher: American College of Healthcare Executives Audience: Trade Format: Magazine/Journal Subject: Business; Health care industry Copyright: COPYRIGHT 2011 American College of Healthcare Executives ISSN: 1096-9012
Issue: Date: Sept-Oct, 2011 Source Volume: 56 Source Issue: 5
Accession Number: 271594423
Full Text: The need for healthcare services will not slow down or end anytime soon. In fact, quite the opposite will occur as our population increases and baby boomers age. Along with this demand for services, health industry stakeholders will need to adjust to growing societal demands for cost effectiveness and quality. This issue of the Journal of Healthcare Management looks at the need for healthcare to become more accountable and to offer value for all. The issue also explores how to improve patient discharge, motivate employees to develop their leadership skills, refine estimates for optimal hospital bed capacity, and reduce healthcare-associated infections through leadership and culture. All of this issue's contents provide ideas and results that health administrators, researchers, and policymakers can use as they seek to improve quality and add value.

Our interview is with Brett D. Lee, PhD, FACHE, senior vice president of system clinical operations of Children's Healthcare in Atlanta and 2011 recipient of the Robert S. Hudgens Memorial Award for Young Healthcare Executive of the Year. Dr. Lee describes his career transition from physical therapist to healthcare leader, the mentors who actively helped him achieve success, his role as preceptor for numerous administrative residents, the rewards and challenges of working in pediatric healthcare, and how he cultivates leadership skills among employees.

Trends columnists Alan Goldberg, FACHE, and Shari Robbins examine the patient discharge process, an area that can seriously thwart best patient care when functioning ineffectively. They propose that efforts to improve large, difficult, and multidisciplinary processes such as patient discharge are best accomplished by breaking the overall change task into smaller, more manageable components called portion control activities (PCOs). The authors present five ways to improve the inpatient discharge process through the use of PCOs.

Reform columnist Nathan Kaufman describes a long-held and deeply seated culture of entitlement among US healthcare system stakeholders. As healthcare reform initiatives refocus incentives from utilization and entitlement to value and accountability, Kaufman offers nine practical steps for health systems seeking to reposition themselves in this new environment.

While increases in critical care utilization occur across the United States, so has the number of critical care beds in many hospitals. Data variables such as inpatient admissions, length of stay, and case mix index are commonly employed in models predicting hospital bed needs. Donna Jamieson and colleagues examine utilization review criteria to understand changes in level of patient care during a hospital stay and to inform critical care bed expansion needs at Children's Hospital of Wisconsin. Their findings suggest that considering the level of care that patients require can help refine estimates for bed capacity needs.

In 2008, the Centers for Medicare & Medicaid Services (CMS) implemented a policy whereby hospitals would no longer receive payment for services provided for patient infections that were not present on admission and were judged preventable. Given this backdrop, Tim Hoff, PhD, and colleagues explore how organizational elements, such as leadership and culture, leverage the CMS policy as a quality improvement facilitator in hospitals. This research is timely, as healthcare-associated infections occur regularly in hospitals and because a primary objective of the CMS policy is to facilitate enhanced infection-related scrutiny and prevention activity in hospitals.

Using a data set of 2,442 US acute care hospitals, Gregory Ginn, PhD, and colleagues study how hospital financial position relates to EHR adoption. As hospitals typically report financial requirements as being significant barriers to EHR adoption, this study provides a comprehensive investigation into the nature and impact of these financial barriers.

Stephen I. O'Connor, PhD, FACHE

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