A State-Sponsored Approach to Quality Improvement in Nursing Homes: Insights From Providers

In 2006, the Minnesota Performance-based Incentive Payment Program (PIPP) was launched to fund provider-initiated quality improvement (QI) projects addressing a wide range of persistent quality issues in nursing homes (eg, falls, pain, mobility, psychotropic medication reduction, care transitions). In this article, the authors describe the perceptions of nursing home providers who participated in a PIPP-funded QI project and completed a survey addressing a variety of QI-related concerns. Respondents noted the importance of support from top leadership, reported being challenged by resource constraints, and generally thought that their project positively impacted quality within their facility. These findings highlight the importance of investing in QI initiatives at both the state and nursing home level to create sustainable QIs

The Effect of Telework

Priscilla Arling\u27s letter to the editor of Computerworld

THE HIDDEN VALUE OF IT: A Review of Information Technology and the Productivity Paradox

Book review of Lucas, H. C. (1999). Information technology and the productivity paradox: Assessing the value of the investment in IT. New York: Oxford University Press

State Uses Financial Incentives To Fund Nursing Home–Initiated Quality Improvement Projects Through Competitive Bidding Process, Leading to Better Care

Authorized in 2006 by the State legislature, Minnesota’s Performance-Based Incentive Program funds nursing home–initiated quality improvement projects for 1 to 3 years through increases of up to 5 percent in the operating per diem rate charged to Medicaid and private-pay residents. Funding decisions are made through a competitive bidding process administered annually by the Department of Human Services, with recommendations from a review committee. Program staff provide support to nursing homes during and after the application process. Nursing homes that do not achieve project-specific performance targets can lose up to 20 percent of the incentive payments. The program has engaged a high proportion of Minnesota nursing homes in quality improvement activities; meaningfully improved the quality of nursing home care; and had a positive impact on quality improvement processes, teamwork, and communication within nursing homes

Vodcast Impact on Students\u27 Attitudes and Behavioral Intentions

Purpose: This paper uses structural equation modeling to assess the effectiveness of Vodcasts (video podcasts) as part of a university’s communication strategy with prospective students. Design/methodology/approach: Three theoretical models were tested using a structural equation model. Findings: We find that perceived informativeness, credibility, and irritation of the advertising are directly related to the value of the Vodcast advertising. However of those three factors, only the informativeness is directly related to the intent to take further action toward enrollment. In addition, while prior work has suggested that perceived entertainment of advertising positively influences its perceived value, we find that for these university Vodcasts, perceived entertainment is not a statistically significant factor. Research limitations/implications: The results suggest that for Vodcasts used for these purposes, less attention should be given to entertainment value, and more attention should be focused on providing useful information in a manner that is credible and not irritating to students. Originality/value: Vodcasts have become part of the Internet multimedia experience and have been integrated into universities’ web-based promotion strategies. While prior work has examined general advertising on the web, few studies have considered the impact of the interactive medium of Vodcasts on attitudes and behavioral intentions

Do Green Lifestyle Consumers Appreciate Low Involvement Green Products?

Green products have become popular and have been targeted toward consumers who lead green lifestyles. Still, some green products are assumed to be more appealing to this group than others, sometimes based on level of involvement. This study tests a low involvement green product in terms of being appealing to consumers with green lifestyles. A theoretical model was developed and tested using a structural equation model. Results indicate that consumers with green lifestyles do value green attributes of low involvement products, in terms of consumer’s attitudes and behavioral intentions. These results imply that companies with green low involvement products should target high-income females and stress the green attribute to motivate purchase intention

The Impact of Team Member Familiarity on Communication Media Use and Subsequent Project Performance

This study explores how team member familiarity is related to the communication media used in the completion of projects and how that use impacts project performance. We surveyed 148 university undergraduate students who were enrolled in information systems courses. The students worked on projects in teams of 3 to 4 students. The results suggest that prior collaboration with current te am members, as well as a stude nt’s class year, are related to what communication media are used. The influen ce of team member familiarity and class year varies by the type of media used. We also find that higher levels of text messaging are related to lower project performance. The results have im plications for practitioners and educators looking to enhance project performance

Factores que complican la nutrición en pacientes embarazadas que asisten a la sede de sector Lidia Saavedra en el segundo semestre del año 2016 en la ciudad de Matagalpa

Según MINSA (Ministerio de Salud). La nutrición es un proceso biológico mediante el cual, el cuerpo recibe y utiliza de forma equilibrada energía y nutrientes de los alimentos que se consumen cada día, permite que nuestro organismo funcione adecuadamente para crecer, trabajar y desarrollarse plenamente. Durante la gestación se produce un gasto metabólico; por ello la dieta debe aportar proteínas, vitaminas y minerales, elementos esenciales para que él bebe crezca adecuadamente. La deficiencia de estos nutrientes puede llevar a la obesidad o desnutrición; siendo como tales un problema grave, que se puede complicar, y a consecuencia su hijo tiene riesgo de morir o de presentar alteraciones. El presente trabajo está basado en los factores que complican la nutrición en pacientes embarazadas que asisten al puesto de salud Lidia Saavedra Ortega. Evaluar la calidad de la medida de datos antropométricos según las normas del programa, para comprobar si se cumplen en los servicios de salud. Estandarizar planes de cuidados según las necesidades nutricionales de la paciente en estudio. El universo lo constituyeron 29 gestantes de las cuales tomamos un grupo conformado por 13 pacientes embarazadas, para esta selección se aplicó un muestreo no probabilístico a conveniencia. Se elaboró un instrumento (encuestas) que consto de 16 ítems dividido de acuerdo a los objetivos de investigación encontramos que, los factores percibidos y descritos que influyen en la nutrición de las paciente son: Factor Biológico; edad, Factor Cultural; estado civil, nivel académico, actividad física, actividad recreativa, Factor económico; situación de la vivienda, el ingreso económico familiar, ocupación u oficio de la mujer. No hay calidad en la toma de datos antropométricos. Con las necesidades encontradas en las pacientes se realizaron planes de cuidado según las 14 necesidades de Virginia Anderson para el mejoramiento de la nutrición y otras necesidade

Communication and effectiveness in a US nursing home quality-improvement collaborative

In this study, we explored the relationship between changes in resident health outcomes, practitioner communication patterns, and practitioner perceptions of group effectiveness within a quality-improvement collaborative of nursing home clinicians. Survey and interview data were collected from nursing home clinicians participating in a quality-improvement collaborative. Quality-improvement outcomes were evaluated using US Federal and State minimum dataset measures. Models were specified evaluating the relationships between resident outcomes, staff perceptions of communication patterns, and staff perceptions of collaborative effectiveness. Interview data provided deeper understanding of the quantitative findings. Reductions in fall rates were highest in facilities where respondents experienced the highest levels of communication with collaborative members outside of scheduled meetings, and where respondents perceived that the collaborative kept them informed and provided new ideas. Clinicians observed that participation in a quality-improvement collaborative positively influenced the ability to share innovative ideas and expand the quality-improvement program within their nursing home. For practitioners, a high level of communication, both inside and outside of meetings, was key to making measurable gains in resident health outcomes

Does Self-efficacy Influence the Application of Evidence-Based Practice?

Background: Implementation of Evidence-Based Practice (EBP) is complex and consequently, even within organizations that have made efforts to promote EBP use, EBP is often underutilized by individual clinicians. Purpose: The aim of our study was to better understand the relationship between self-efficacy and EBP implementation in clinical environments that have undergone efforts to increase EBP utilization. We suggest that EBP is a set of behaviors that result from individuals acquiring, applying, and sharing new knowledge with others in the organization. We hypothesize, based upon a social cognitive theoretical approach, that these behaviors are influenced by clinician perception of self-efficacy. Methods: We analyzed data provided by a 2011 survey of clinicians working within a national sample of hospitals that were actively participating in the Clinical Practice Model Resource Center (CPMRC), a collaborative consortium of health care organizations working to guide the implementation of EBP into the work worlds of clinicians. Structural equation modeling was used to examine the relationships between the acquisition, application, and sharing of evidence, and self-efficacy. Results: Self-efficacy increased the acquisition of evidence and application of evidence. Self-efficacy did not exert a significant influence on sharing evidence. Acquisition of evidence increased both application of evidence and sharing of evidence. Application of evidence then increased sharing of evidence among sampled clinicians. Conclusions: Efforts to promote self-efficacy in clinicians are powerful in that they directly promote the acquisition and application of evidence, and indirectly encourage communication between clinicians in an effort to justify and reinforce new knowledge. Efforts to boost self-efficacy would benefit from a focus on helping clinicians become more comfortable with actions related to acquiring evidence and generating new knowledge