Healthcare leaders who struggle to understand the importance of interactions between patients, staff, and physicians can result in poor patient experience. Healthcare care leaders who understand the importance of patient experience can develop customer service training modules and tutorials to improve organizational outcomes. The purpose of this correlational study was to examine the relationship between staff communication, physician communication, size of the hospital, and patient experience. House's path-goal theory was used to frame the study. Secondary data were collected from hospitals in Northeastern Ohio, that reported patient experience scores through the Centers for Medicare and Medicaid's Hospital Consumer Assessment of Healthcare Providers and Systems survey database for the years 2016 and 2017. The results of the multiple linear regression indicated the results were significant, F(5, 144) = 56.822, p <.001, R2 = .652. The findings may provide health care leaders with tools to communicate with staff on how to improve patient experience through improving employee and patient engagement, thereby improving patient experience scores.

Healthcare-associated infections (HAIs) are used as a measure for federal value-based payment programs. Using data for 2015, the Centers for Disease Control and Prevention (CDC) developed newer risk adjustment models to calculate the standardized infection ratio (SIR) for various infections occurring in hospitals. New national baselines were set to compare performance among medical facilities and states. Despite adjustments for various facility-level factors that contribute to HAI risk, there are ongoing concerns that SIR calculations do not adequately account for non-hospital risk factors that have been linked to clinical outcomes. This explanatory study evaluates state-level data using simple linear regression to determine relationships between the standardized infection ratio (SIR) for methicillin-resistant Staphylococcus aureus (MRSA) bacteremia and several socioeconomic and geographic factors. Bivariate analysis produced significant correlation between SIR and high school education, with states exhibiting lower SIR relative to the percent of adults who completed high school. Higher SIRs were found relative to the percent of state populations subjected to poverty, obesity, and diagnosis of diabetes. Percent of nonprofit hospitals, adults with bachelor’s degrees, and rural residents were not significantly correlated with state measures of MRSA bacteremia. These findings can help guide efforts to reduce HAIs, improve safety of care, and advance population health efforts. The results from this study reinforce the notion that non-hospital factors may have significant effects on the incidence of MRSA bacteremia events occurring in hospitalized patients. Current risk adjustment models that predict MRSA bacteremia events for quality reporting purposes may not adequately account for these risk factors. The present study highlights some ways that hospitals, patients, and policymakers can work together to address social risk factors as a strategy for promoting better and safer care, and healthier communities. This study investigates aspects of the bigger picture of health care quality, performance measurement, and population health. This “feel for the whole” underscores the implications on state performance in infection prevention in the context of socioeconomic and medical vulnerabilities. The study emphasizes the need for greater multidisciplinary collaboration to address community health needs and reduce social and medical disparities.

The role of purchasing has been evolving during the last years, increasing its strategic importance inside the organization. Traditionally viewed as a supportive function impacting only the bottom-line of the company, the main performance indicators for purchasing were cost-reduction and savings. Nowadays, organizations recognize the importance of the value added generated in the purchasing processes and they are broadening their vision of purchasing as a strategic contributor of value in both economical and intangible aspects.   One of the main intangible value contributions from the purchasing department (PD) of any company is the one provided to its internal customers; measured in the level of internal service quality and customer satisfaction. An adequate internal customer relationship management can translate into advantages for the PD, improving its strategic position in the organization, and in benefits for the company, increasing directly or indirectly its business performance.   The purpose of this research study was to understand how the purchasing department can create value inside an organization, how that value is measured and how it can be increased; being the central focus on the internal customers of the department. This research work was conducted as a single case study performed in a multinational company from the telecommunication industry. Qualitative data was gathered through structured interviews, formal and informal meetings with personnel from the company and a survey to triangulate the information. The objective was to determine the most important value adding factors for the internal customers of the purchasing department and evaluate their satisfaction level.   Two models for assessing the value contributed by the PD were the grounding for developing the tools used in the achievement of the objectives; one of them was based on the SERVQUAL model and the other one on the concept of meaningful involvement. Using inputs from both, a model for evaluating the value added to internal customer was proposed. In addition, the author identified improvement opportunities, related mainly with relationship management in the company and she suggested improvement measures accordingly. Finally, future courses of action were recommended, relating the value added concept with purchasing maturity models.

Skilled home health (HH) is the largest long-term care setting and the fastest-growing site of healthcare in the United States (U.S.). Home Health Value-Based Purchasing (HHVBP) is a structure of Medicare that penalizes U.S. HH agencies for high hospitalization rates. Prior studies have shown inconsistent evidence about associations of race with hospitalization rates in HH. Evidence supports that Black or African Americans are less likely to participate in advance care planning (ACP), or to complete written advance directives, which could affect their potential for hospitalization when nearing end of life. In this quasi-experimental study, we used Medicare administrative datasets, the Weighted Acute Care Services Use Rates (WACSUR) score, and the Advance Care Planning Protocol (ACPP) score to determine whether the proportion of Black HH patients in the U.S. was correlated with acute care use rates and the robustness of agency protocols on ACP. We used primary and secondary data from the U.S. from 2016-2020. We included Medicare-certified HH agencies. Spearman’s correlation coefficient was used. We found a statistical trend showing that the greater proportion of Black patients enrolled in a HH agency, the greater tendency to have a high hospitalization rate. Our findings suggest that HHVBP may encourage patient selection and exacerbate health disparities. Our findings support recommendations for alternative measures of quality in HH to include measures of goal-concordant care coordination when patients are denied admission to HH.

Patient satisfaction dimensions have a wide ranging and significant impact on organizational performance in the healthcare industry. In addition, the Centers for Medicare and Medicaid Services Hospital Value Based Purchasing (HVBP) Program links patient satisfaction to Medicare reimbursement, putting millions of dollars at risk for health systems. A gap in the literature exists in the exploration of how a patient's experience in the emergency department affects their satisfaction with inpatient services. In a multiple regression analysis, the relationship between HVBP Patient Experience of Care and hospital level factors including emergency department wait times are explored. Results indicate a statistically significant relationship between hospital level factors and standardized measure of patient satisfaction with a moderate adjusted effect size (p= <.0001, R2 adjusted= 0.184). Emergency department wait times post physician admit orders were most salient in predicting patient satisfaction scores (rs2= 0.434, β= -0.334, p= <.001). Recommendations to improve emergency department wait times include focusing on key decision points and implementation of electronic systems to support the movement of admitted patients out of the emergency department as quickly as possible.