Why Physician Leaders of Health Care Organizations Should Participate in Direct Patient Care

2017 ◽  
Vol 166 (5) ◽  
pp. 376
Author(s):  
Allan S. Detsky ◽  
Michael A. Gropper
Keyword(s):  
Health Care ◽  
Patient Care ◽  
Health Care Organizations ◽  
Direct Patient Care ◽  
Physician Leaders

scholarly journals Internal Medicine Residents' Time Study: Paperwork Versus Patient Care

2011 ◽  
Vol 3 (4) ◽  
pp. 550-553 ◽  
Author(s):  
Dalal Alromaihi ◽  
Amanda Godfrey ◽  
Tina Dimoski ◽  
Paul Gunnels ◽  
Eric Scher ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Health Care ◽  
General Practice ◽  
Patient Care ◽  
Health Care Workers ◽  
Direct Patient Care ◽  
Time Study ◽  
Structured Education ◽  
Internal Medicine Residents ◽  
Care Workers

Abstract Background Multiple factors affect residency education, including duty-hour restrictions and documentation requirements for regulatory compliance. We designed a work sampling study to determine the proportion of time residents spend in structured education, direct patient care, indirect patient care that must be completed by a physician, indirect patient care that may be delegated to other health care workers, and personal activities while on an inpatient general practice unit. Methods The 3-month study in 2009 involved 14 categorical internal medicine residents who volunteered to use personal digital assistants to self-report their location and primary tasks while on an inpatient general practice unit. Results Residents reported spending most of their time at workstations (43%) and less time in patient rooms (20%). By task, residents spent 39% of time on indirect patient care that must be completed by a physician, 31% on structured education, 17% on direct patient care, 9% on indirect patient care that may be delegated to other health care workers, and 4% on personal activities. From these data we estimated that residents spend 34 minutes per patient per day completing indirect patient care tasks compared with 15 minutes per patient per day in direct patient care. Conclusions This single-institution time study objectively quantified a current state of how and where internal medicine residents spend their time while on a general practice unit, showing that residents overall spend less time on direct patient care compared with other activities.

scholarly journals Limiting transmission of COVID-19 in an inpatient psychiatric hospital using a special care unit as a behavioral health model - Michigan, March 1-August 31, 2020

2021 ◽  
Vol 10 (3) ◽  
pp. 25
Author(s):  
William Sanders ◽  
Kimberley Greenwald ◽  
Joshua Foster ◽  
David Meisinger ◽  
Richelle Payea ◽  
...  
Keyword(s):  
Health Care ◽  
Patient Care ◽  
Behavioral Health ◽  
Clinical Care ◽  
Psychiatric Hospitals ◽  
Behavioral Health Care ◽  
Special Care ◽  
Direct Patient Care ◽  
Special Care Unit ◽  
Psychiatric Facilities

Approximately 53,000 patients/year are admitted to psychiatric hospitals in Michigan and treatment typically involves social gatherings and group therapies (SAMHSA 2017; Michigan DHS 2019). Often psychiatric inpatients are in close proximity placing them at high risk of infection and have comorbid medical conditions that predispose them to severe COVID-19 consequences. In March 2020, Pine Rest Christian Mental Health Services, Grand Rapids, MI initiated protocols and precautions to mitigate the spread of COVID-19 between patients and health care personnel (HCP) based on emerging CDC guidelines. Multiple strategies [COVID-19 testing, masking of patients and HCP, restricting visitors, and creation of Special Care Unit (SCU) with negative pressure] were effectively implemented and limited transmission of COVID-19 within Pine Rest. Admission to the SCU totaled 25 adults (three Pine Rest patients who tested positive during or after admission, and 22 COVID-19 positive patients who were transferred from other facilities). Average age of SCU inpatients was 38.5 ± 16.6 years with the majority being male. Average hospitalization was 9 ± 4 days. Among the 21 COVID-19 positive HCP, 15 [71%] provided direct clinical care on various units, zero provided care on the SCU, and six had roles with no direct patient care. Average age among COVID-19 positive HCP providing direct patient care[n = 15] was 29.5 ± 13.5 years, majority were female, and 3 [20%] were admitted to local medical hospital for treatment. This report demonstrates that quality behavioral health care can be safely provided at inpatient psychiatric facilities and serve as a guideline that other psychiatric facilities can follow to decrease transmission in future epidemics.

Can complexity science inform physician leadership development?

2016 ◽  
Vol 29 (3) ◽  
pp. 251-263 ◽  
Author(s):  
Colleen Marie Grady
Keyword(s):  
Complex System ◽  
Health Care ◽  
Leadership Development ◽  
Patient Outcomes ◽  
Health Care Organizations ◽  
Complexity Science ◽  
Primary Role ◽  
Physician Leadership ◽  
Content Type ◽  
Physician Leaders

Purpose The purpose of this paper is to describe research that examined physician leadership development using complexity science principles. Design/methodology/approach Intensive interviewing of 21 participants and document review provided data regarding physician leadership development in health-care organizations using five principles of complexity science (connectivity, interdependence, feedback, exploration-of-the-space-of-possibilities and co-evolution), which were grouped in three areas of inquiry (relationships between agents, patterns of behaviour and enabling functions). Findings Physician leaders are viewed as critical in the transformation of healthcare and in improving patient outcomes, and yet significant challenges exist that limit their development. Leadership in health care continues to be associated with traditional, linear models, which are incongruent with the behaviour of a complex system, such as health care. Physician leadership development remains a low priority for most health-care organizations, although physicians admit to being limited in their capacity to lead. This research was based on five principles of complexity science and used grounded theory methodology to understand how the behaviours of a complex system can provide data regarding leadership development for physicians. The study demonstrated that there is a strong association between physician leadership and patient outcomes and that organizations play a primary role in supporting the development of physician leaders. Findings indicate that a physician’s relationship with their patient and their capacity for innovation can be extended as catalytic behaviours in a complex system. The findings also identified limiting factors that impact physicians who choose to lead, such as reimbursement models that do not place value on leadership and medical education that provides minimal opportunity for leadership skill development. Practical Implications This research provides practical applications for physician leadership development and emphasizes that it is incumbent upon physicians and organizations to focus attention on this to achieve improved patient and organizational outcomes. Originality/value This study pairing complexity science and physician leadership represents a unique way to view the development of physician leaders within the context of the complex system that is health care.

scholarly journals Rapid Telehealth Implementation during the COVID-19 Global Pandemic: A Rapid Review

Healthcare ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. 517
Author(s):  
Cristian Lieneck ◽  
Joseph Garvey ◽  
Courtney Collins ◽  
Danielle Graham ◽  
Corein Loving ◽  
...  
Keyword(s):  
Health Care ◽  
Patient Care ◽  
Health Care Organizations ◽  
Standard Of Care ◽  
The United States ◽  
Rapid Review ◽  
Patient Privacy ◽  
Privacy And Security ◽  
Global Pandemic ◽  
Facilitators And Barriers

The implementation and continued expansion of telehealth services assists a variety of health care organizations in the delivery of care during the current COVID-19 global pandemic. However, limited research has been conducted on recent, rapid telehealth implementation and expansion initiatives regarding facilitators and barriers surrounding the provision of quality patient care. Our rapid review evaluated the literature specific to rapid telehealth implementation during the current COVID-19 pandemic from three research databases between January 2020 and May 2020 and reported using preferred reporting items for systematic reviews and meta-analyses (PRISMA). The results indicate the rapid implementation and enhanced use of telehealth during the COVID-19 pandemic in the United States surrounding the facilitators and barriers to the provision of patient care, which are categorized into three identified themes: (1) descriptive process-oriented implementations, (2) the interpretation and infusion of the CARES Act of 2020 telehealth exemptions related to the relaxation of patient privacy and security (HIPAA) protocols, and (3) the standard of care protocols and experiences addressing organizational liability and the standard of care. While the study limitation of sample size exists (n = 21), an identification of rapid telehealth implementation advancements and challenges during the current pandemic may assist health care organizations in the delivery of ongoing quality care during the COVID-19 pandemic.

A Retrospective Evaluation of the Perfecting Patient Care University Training Program for Health Care Organizations

2013 ◽  
Vol 29 (1) ◽  
pp. 30-38 ◽  
Author(s):  
Kristy Gonzalez Morganti ◽  
Susan Lovejoy ◽  
Ellen Burke Beckjord ◽  
Amelia M. Haviland ◽  
Ann C. Haas ◽  
...  
Keyword(s):  
Health Care ◽  
Patient Care ◽  
Training Program ◽  
Health Care Organizations ◽  
Retrospective Evaluation ◽  
University Training

scholarly journals 645 Acute Insomnia Disorder in Health Care Workers Before and During COVID-19: Rates and Predictive Factors

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A252-A253
Author(s):  
William McCall ◽  
Demetra Mensah-Bonsu ◽  
Allison Withers ◽  
Robert Gibson
Keyword(s):  
Risk Factors ◽  
Health Care ◽  
Patient Care ◽  
Health Care Providers ◽  
Health Care Workers ◽  
Tertiary Care ◽  
Direct Patient Care ◽  
Care Providers ◽  
Insomnia Disorder ◽  
Care Workers

Abstract Introduction Pandemics such as COVID-19 create population-wide stressors that create a natural laboratory for acute insomnia research. This study investigated risk factors and estimated rates of acute insomnia disorder in health care workers at the onset of the COVID-19 pandemic. Methods A Qualtrics survey of more than 2300 health care providers was conducted in a single academic health system on May 15th 2020, comprised of practicing attending physicians, residents and fellows in training, advanced practice providers, and nurses. Six hundred and sixty eight responded (29% response rate). The Research Diagnostic Criteria for Insomnia Disorder was used to diagnose Acute Insomnia Disorder. Results 573 respondent had no missing data pertaining to sleep, with a mean age of 43.4 + 12.5 years and 72% women. The rate of Insomnia Disorder before COVID-19 was 44.5%, while after COVID-19 it was 64.0% - a statistically significant increase. 10.2% of persons with Insomnia Disorder before COVID-19 stated it had resolved during COVID-19, while 43.4% of persons who did not have Insomnia Disorder before COVID-19 developed Acute Insomnia Disorder during COVID-19 (χ2=145.2; df=1; P<0.0001). New cases of Acute Insomnia Disorder increased with female gender, advancing age, and less time spent in direct patient care. Conclusion Insomnia Disorder showed high baseline prevalence before COVID-19, followed by a striking increase in incidence in this sample of tertiary care health care workers. The effects of gender and age were similar to what has been previously published as risk factors for insomnia. The surprising finding that less time spent in direct patient care was associated with more cases of Acute Insomnia Disorder might be related to the poorly understood stresses of working from home during COVID-19. Support (if any):

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