scholarly journals Audit feedback interventions to address high-risk prescriptions in long-term care homes: a costing study and return on investment analysis

2021 ◽  
Vol 2 (1) ◽  
Author(s):  
Kednapa Thavorn ◽  
Srishti Kumar ◽  
Catherine Reis ◽  
Jonathan Lam ◽  
Gail Dobell ◽  
...  
Keyword(s):  
Return On Investment ◽  
Cost Savings ◽  
Audit And Feedback ◽  
Health Staff ◽  
Financial Benefit ◽  
Term Care ◽  
Total Cost ◽  
Intervention Cost ◽  
Costing Study ◽  
Implementation Costs

Abstract Background Audit and feedback is a common implementation strategy, but few studies describe its costs. ‘MyPractice’ is a province-wide audit and feedback initiative to improve prescribing in nursing homes. This study sought to estimate the costs of ‘MyPractice’ and assess whether the financial benefit of ‘MyPractice’ offsets those costs. Methods We conducted a costing study from the perspective of the Ontario government. Total cost of ‘MyPractice’ was calculated as the sum of the costs of producing and disseminating the reports (covering three report releases) which were obtained from Ontario Health staff interviews and document reviews. Return on investment (ROI) was calculated as the ratio of net cost-savings and the intervention cost. Cost savings were based on the effectiveness of ‘MyPractice’ derived from a published cohort study. Cost-savings attributable to ‘MyPractice’ were estimated from the changes in the rates of antipsychotics over time between physicians who signed up and viewed the reports and those who did not sign up to the reports. Results Total intervention costs were C$223,691 (C$838 per physician and C$74,564 per release). Costs incurred during the development phase accounted for 74% of the total cost (C$166,117), while implementation costs for three report releases were responsible for 26% of the total costs (C$57,575). The ROI for every C$1 spent on the ‘MyPractice’ intervention was 1.02 (95% CI 0.51, 1.93) for three report releases. Conclusion ‘MyPractice’ report offers a good return on investment and the value for money could improve with greater number of report releases.

scholarly journals Audit Feedback Interventions to Address High-Risk Prescriptions in Long-Term Care Homes: A Costing Study and Return on Investment Analysis

2020 ◽  
Author(s):  
Kednapa Thavorn ◽  
Srishti Kumar ◽  
Catherine Reis ◽  
Jonathan Lam ◽  
Gail Dobell ◽  
...  
Keyword(s):  
Return On Investment ◽  
Long Term Care ◽  
Cost Savings ◽  
Audit And Feedback ◽  
Health Staff ◽  
Term Care ◽  
Total Cost ◽  
Intervention Cost ◽  
Costing Study

Abstract Background: Audit and feedback is a common implementation strategy, but little literature describes its costs. ‘MyPractice’ is an audit and feedback initiative produced by Ontario Health, the provincial agency tasked with supporting quality of care. This study sought to estimate the costs of ‘MyPractice’ and assess whether the financial benefit of ‘MyPractice’ offsets those costs. Methods: We conducted a costing study from the perspective of the government of Ontario, which funds both Ontario Health and necessary healthcare costs for people living in long-term care (LTC) homes in the province. Total cost of ‘MyPractice’ was calculated as the sum of the costs of producing and disseminating the reports (covering three report releases) which were obtained from Ontario Health staff interviews and document reviews. Return on investment (ROI) was calculated as the ratio of net cost-savings and the intervention cost. Net cost-savings were estimated as the reduction in the costs of antipsychotics incurred by LTC home residents attributable to ‘MyPractice’ reports. Results: Total intervention costs were C$223,691 (C$838 per physician and C$74,564 per release). Costs incurred during the development phase accounted for 74% of the total cost (C$166,117), while implementation costs for three report releases were responsible for 26% of the total costs (C$57,575). The ROI for every C$1 spent on the ‘MyPractice’ intervention was 1.22 (95% CI: 0.82, 1.61) for three report releases. Conclusion: ‘My Practice’ report offers a good return on investment and the value for money increases if physicians sign up and view the reports.

Return on Investment Analysis for the Integrated Parkinson’s Care Network: Lesson Learned from a Pilot Study

2021 ◽  
pp. 1-7
Author(s):  
Srishti Kumar ◽  
Julia Shen ◽  
David Grimes ◽  
Tiago Mestre ◽  
Kednapa Thavorn
Keyword(s):  
Return On Investment ◽  
Cost Savings ◽  
Self Management ◽  
Management Support ◽  
Societal Costs ◽  
Care Network ◽  
Single Center Experience ◽  
Intervention Cost ◽  
Implementation Costs ◽  
Set Up

Background: Parkinson’s disease (PD) is a complex and debilitating condition that requires care from a multispecialty team. The Integrated Parkinson Care Network (IPCN) is an innovative pragmatic care model that focuses on integrated care, self-management support and technology-enabled care. Objective: This study aims to estimate the costs of the IPCN and assess whether benefits gained from the intervention offset its costs based on a single center experience. Methods: We conducted a return on investment (ROI) analysis of the IPCN from a societal perspective. The ROI for the IPCN was estimated as a ratio of the net savings and the intervention cost. The intervention cost was calculated as a sum of set-up and implementation costs. Cost savings was measured as the absolute reduction in the societal costs realized by PD patients. A positive ROI indicated that savings generated from the intervention offset its cost. Results: The total cost of the IPCN for 100 PD patients was C$135,669, or C$226 per patient per month. IPCN was associated with the reduction in societal cost of C$915 per patient per month (95%CI: –2,782, 951). The ROI per PD patient per month for the IPCN was 3.08 (95%CI: –0.60, 22.93), suggesting that for every C$1 invested in the IPCN, C$4.08 is gained through reduction in societal costs. The returns were greater among advanced PD patients. Conclusion: The IPCN has the potential to offer a good return on investment for PD patients, and its value for money is higher among advanced PD patients.

scholarly journals Return on investment in blended advanced cardiac life support training compared to face-to-face training in Singapore

2018 ◽  
Vol 27 (4) ◽  
pp. 234-242 ◽  
Author(s):  
Pradeep Paul George ◽  
Chee Kheong Ooi ◽  
Edwin Leong ◽  
Krister Jarbrink ◽  
Josip Car ◽  
...  
Keyword(s):  
Return On Investment ◽  
Life Support ◽  
Health Care Systems ◽  
Productivity Loss ◽  
Cost Savings ◽  
Indirect Costs ◽  
Advanced Cardiac Life Support ◽  
Learning Technologies ◽  
Total Cost ◽  
Face To Face

Background Internet adoption during the past decade has provided opportunities for innovation in advanced cardiac life support (ACLS) training. With pressure on budgets across health care systems, there is a need for more cost-effective solutions. Recently, traditional ACLS training has evolved from passive to active learning technologies. The objective of this study is to compare the cost, cost-savings and return on investment (ROI) of blended ACLS (B-ACLS) and face-to-face ACLS (F-ACLS) in Singapore. Methods: B-ACLS and F-ACLS courses are offered in two training institutes in Singapore. Direct and indirect costs of training were obtained from one of the training providers. ROI was computed using cost-savings over total cost if B-ACLS was used instead of F-ACLS. Results: The estimated annual cost to conduct B-ACLS and F-ACLS were S$43,467 and S$72,793, respectively. Discounted total cost of training over the life of the course (five years) was S$107,960 for B-ACLS and S$280,162 for F-ACLS. Annual productivity loss cost account for 52% and 23% of the costs among the F-ACLS and B-ACLS, respectively. B-ACLS yielded a 160% return on the money invested. There would be 61% savings over the life of the course if B-ACLS were to be used instead of F-ACLS. Conclusion: The B-ACLS course provides significant cost-savings to the provider and a positive ROI. B-ACLS should be more widely adopted as the preferred mode of ACLS training. As a start, physicians looking for reaccreditation of the ACLS training should be encouraged to take B-ACLS instead of F-ACLS.

The Comparison between Cost and Benefit Business Model of Organic and Chemical Agricultural Vegetable Farming System

2020 ◽  
Vol 11 (1) ◽  
pp. 133-133
Author(s):  
Peerasak Puengpapat
Keyword(s):  
Production Process ◽  
Organic Farming ◽  
Business Model ◽  
Return On Investment ◽  
Agricultural Sector ◽  
Organic Production ◽  
Total Cost ◽  
Cost And Benefit ◽  
Net Profit ◽  
Organic Vegetables

This research is intended to compare and demonstrate the difference between the cost and benefit of organic farming and chemistry. Compare differences in the quality of yields and minerals in the soil both before and after cultivation and modeling of agribusiness. Using Business Model Canvas for the decision of agricultural entrepreneurs who want to modify the farming process.The research found that in the experiment comparing between the costs of Organic farming and Chemical farming to produce three types of vegetables that are cucumber ,red oak salad and radish, with the total cost of growing vegetables in Organic farming, higher than the total cost of growing vegetables in Chemical farming. There is a greater frequency of fertilizing and injecting Organic matter than chemical farming. The net profit from the sale of vegetables in the Organic agricultural sector is higher than the net profit from the sale of vegetables in the Chemical agricultural sector, as the production price of Organic agricultural sector is higher than the production price of Chemical agricultural sector because the production process of organic farming has a higher production process and requires higher production attention to produce quality, and another factor is that Organic vegetables have a higher production cost than vegetables from chemical farming, resulting in less volume of organic production in the market than vegetables from Chemical agricultural sector. Consumers are demanding more healthy Organic vegetables. As a result, the price of vegetables that produced by Organic agricultural sector is higher than the price of vegetables that produced by Chemical agricultural sector, and the Return on Investment in Organic vegetables is higher than the vegetables that produced by Chemical agricultural .The Return on Investment in production of Organic farming is 61.48% and The Return on Investment in production of Chemical farming is 33.87%. It is therefore possible to conclude that growing vegetables in Organic way is safe for vegetable farmers who do not have to be exposed to any harmful Chemicals, as well as the resulting produce that is safe from residues, allowing consumers to be safe from toxin residues and receive good quality vegetables. Type of Paper: Empirical/Experimental Keywords: Agricultural; Organics; Cost ;Business Model ;Comparison.

scholarly journals Calculating the True Costs of Food Service in Long-Term Care: Development of a Costing Methodology

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 88-88
Author(s):  
Mikaela Wheeler ◽  
Karen Abbey ◽  
Sandra Capra
Keyword(s):  
Long Term Care ◽  
Systems Approach ◽  
Food Service ◽  
Term Care ◽  
Oral Nutrition ◽  
Total Cost ◽  
Real Cost ◽  
Future System ◽  
Care Development

Abstract As population’s age and the need for long term care (LTC) increases, so too does the focus on the costs to provide that care. Providing food, oral nutrition supplements and meals, can be a considerable expense to a home. The objective of this research was to develop a valid foodservice costing tool (FCT), to calculate the real cost of providing foods and meals in LTC. Current costing methodologies are not specific to LTC and do not account for all costs of a foodservice, including staff, procurement and nutrition supplements. An initial tool was developed using the systems approach in conjunction with literature and professional knowledge. This was piloted in real world contexts, using volunteer LTC homes. Four iterations of the tool were completed to assess its feasibility in calculating costs and useability. Managers were interviewed after completing the tool to gather an understanding of how the tool was interpreted and to refine completion. Following feedback, the resulting tool consists of nine sections, measuring both costs incurred in meal production and service as well as analysis of staff workloads. Preliminary results show consistency between homes within Australia, indicating that the true cost is much higher than that reported in the literature to date. The development of a comprehensive, usable tool which captures the total cost of foodservice allows homes to accurately report and understand costs from a systems level. This information can be used to demonstrate cost effectiveness of a foodservice and the potential to justify and plan future system changes.

The Practice of Community Psychiatric Nursing and Mental Health Social Work in Salford Some Implications for Community Care

1988 ◽  
Vol 152 (6) ◽  
pp. 783-792 ◽  
Author(s):  
K. Wooff ◽  
D. P. Goldberg ◽  
T. Fryers
Keyword(s):  
Mental Health ◽  
Psychiatric Symptoms ◽  
Psychiatric Patients ◽  
Psychiatric Nurses ◽  
Health Staff ◽  
Mental Health Staff ◽  
Term Care ◽  
Community Psychiatric ◽  
Wide Range

The context and content of work undertaken with individual clients by community psychiatric nurses (CPNs) and mental health social workers (MHSWs) in Salford were found to be significantly different. Although there were some areas of overlap, the ways in which the two professions worked were quite distinct. MHSWs discussed a wide range of topics and were as concerned with clients' interactions with family and community networks as they were with symptoms. Their interviews with schizophrenic clients followed a similar pattern to those with other groups, and they worked closely with psychiatrists and other mental health staff. CPNs, on the other hand, focused mainly on psychiatric symptoms, treatment arrangements, and medications, and spent significantly less time with individual psychotic clients than they did with patients suffering from neuroses. They were as likely to be in contact with general practitioners as they were with psychiatrists, and had fewer contacts with other mental health staff than the MHSWs. There was evidence that the long-term care of chronic psychiatric patients living outside hospital required more co-ordinated long-term multidisciplinary input.

Enhancing Quality Care in Ontario Long-Term Care Homes Through Audit and Feedback for Physicians

2020 ◽  
Vol 21 (3) ◽  
pp. 420-425
Author(s):  
Cara L. Mulhall ◽  
Jonathan M.C. Lam ◽  
Patrick S. Rich ◽  
L. Gail Dobell ◽  
Anna Greenberg
Keyword(s):  
Long Term Care ◽  
Quality Care ◽  
Audit And Feedback ◽  
Care Homes ◽  
Term Care

scholarly journals 1236. Infection Control Risk Mitigation and Implementation of Best Practice Recommendations in Long-Term Care Facilities

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S375-S376
Author(s):  
Teresa Fitzgerald ◽  
Regina Nailon ◽  
Kate Tyner ◽  
Sue Beach ◽  
Margaret Drake ◽  
...  
Keyword(s):  
Infection Control ◽  
Best Practice ◽  
Long Term Care ◽  
Audit And Feedback ◽  
Risk Assessments ◽  
Term Care ◽  
Practice Recommendations ◽  
Care Facilities

Abstract Background Nebraska (NE) Infection Control Assessment and Promotion Program (ICAP) is a quality improvement initiative supported by the NE Department of Health and Human Services. This initiative utilizes subject matter experts (SMEs) including infectious diseases physicians and certified infection preventionists (IP) to assess and improve infection prevention and control programs (IPCP) in various healthcare settings. NE ICAP conducted on-site surveys and observations of IPCP in many volunteer facilities to include long-term care facilities (LTCF) between November 2015 and July 2017. SMEs provided on-site coaching and made best practice recommendations (BPR) for priority implementation. Impact of this intervention on LTCF IPCP was examined. Methods Using a standardized questionnaire, follow-up phone calls were made with LTCF to evaluate implementation of the BPR one-year post-assessment. Descriptive analyses were performed to examine BPR implementation in LTCF that had follow-up between 4/4/17 to 4/17/18 and to identify factors that promoted or impeded BPR implementation. Results Overall, 45 LTCF were assessed. The top 5 IC categories requiring improvement were audit and feedback practices (28 of 45, 62%), PPE supplies at point of use (62%), IC risk assessments (58%), TB risk assessments (56%), and supply and linen storage practices (56%). Follow-up assessments were completed for 270 recommendations in 25 LTCF. Recommendations reviewed ranged from three to 26 per LTCF (median = 15). The majority of the 270 recommendations (n = 162, 60%) had been either completely (35%) or partially (25%) implemented by the time of the follow-up calls. The ICAP visit itself was reported as the most helpful resource for BPR implementation (77 of 162). Lack of staffing was the most commonly mentioned barrier to implementation when LTCF implemented BPR partially or implementation was not planned (37 of 85). BPR Implementation most frequently involved additional staff training (64 of 162), review of policies and procedures (38 of 162), and implementing audit (34 of 162) and/or feedback (23 of 162) programs. Conclusion Numerous IC gaps exist in LTCF. Peer-to-peer feedback and coaching by SMEs facilitated implementation of many BPR directed toward mitigating identified IC gaps. Disclosures All authors: No reported disclosures.

scholarly journals Impact of an integrated mother-preterm infant intervention on birth hospitalization charges

2020 ◽  
Vol 40 (6) ◽  
pp. 858-866
Author(s):  
Susan C. Vonderheid ◽  
Chang G. Park ◽  
Kristin Rankin ◽  
Kathleen F. Norr ◽  
Rosemary White-Traut
Keyword(s):  
Preterm Infant ◽  
Neonatal Intensive Care ◽  
Cost Savings ◽  
Standard Of Care ◽  
Hospital Charges ◽  
Control Group ◽  
Intervention Cost ◽  
Hospital To Home ◽  
Intervention Costs ◽  
Birth Hospitalization

Abstract Objective To examine whether the H-HOPE (Hospital to Home: Optimizing the Preterm Infant’s Environment) intervention reduced birth hospitalization charges yielding net savings after adjusting for intervention costs. Study design One hundred and twenty-one mother-preterm infant dyads randomized to H-HOPE or a control group had birth hospitalization data. Neonatal intensive care unit costs were based on billing charges. Linear regression, propensity scoring and regression analyses were used to describe charge differences. Results Mean H-HOPE charges were $10,185 lower than controls (p = 0.012). Propensity score matching showed the largest savings of $14,656 (p = 0.003) for H-HOPE infants, and quantile regression showed a savings of $13,222 at the 75th percentile (p = 0.015) for H-HOPE infants. Cost savings increased as hospital charges increased. The mean intervention cost was $680 per infant. Conclusions Lower birth hospitalization charges and the net cost savings of H-HOPE infants support implementation of H-HOPE as the standard of care for preterm infants.

scholarly journals AI-Based Physical and Virtual Platform with 5-Layered Architecture for Sustainable Smart Energy City Development

2019 ◽  
Vol 11 (16) ◽  
pp. 4479 ◽  
Author(s):  
Sanguk Park ◽  
Sanghoon Lee ◽  
Sangmin Park ◽  
Sehyun Park
Keyword(s):  
Return On Investment ◽  
Cost Savings ◽  
Economic Benefits ◽  
Urban Environments ◽  
Sustainable Cities ◽  
City Development ◽  
Layered Architecture ◽  
Before And After ◽  
Virtual Platform ◽  
Energy Element

To build sustainable smart energy cities (SECs) around the world, many countries are now combining customized services and businesses within their energy infrastructure and urban environments. Such changes could then promote the development of platforms that ultimately provide benefits for citizens such as convenience, safety, and cost savings. Currently, the development of technologies for SECs focuses on independent products and unit technology. However, this is problematic, as it may not be possible to develop sustainable cities if there is a lack of connectivity between various elements within the SEC. To solve such problems, this paper presents an AI-based physical and virtual platform using a 5-layer architecture to develop a sustainable smart energy city (SSEC). The architecture employs both a top-down and bottom-up approach and the links between each energy element in the SSEC can readily be analyzed. The economic analysis based on return on investment (ROI) is carried out by comparing the economic benefits before and after the application of this system. Deploying the proposed platform will enable the speedy development and application of new services for SSECs and will provide SSECs with measures to ensure sustainable development, such as rapid urban development, and cost reductions.

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