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Biomedical subjects

Kathryn H Dansky

Publications and source records attributed to Kathryn H Dansky.

12 recordsLinked to original sources
PubMed2005

Performance model for telehealth use in home health agencies.

Increasingly, home health agencies (HHAs) are considering the value of implementing telehealth technology. However, questions arise concerning how to manage and use this technology to benefit patients, nurses, and the agency. Performance models will be beneficial to managers and decision makers in the home health field by providing quantitative information for present and future planning of staff and technology usage in the HHA. This paper presents a model that predicts the average daily census of the HHA as a function of statistically identified parameters. Average daily census was chosen as the outcome variable because it is a proxy measure of an agency's capacity. The model suggests that including a telehealth system in the HHA increases average daily census by 40%-90% depending on the number of nurse full-time equivalent(s) (FTEs) and amount of travel hours per month. The use of a home telecare system enhances HHA performance.

Community Health Nursing↗
PubMed2005

Polypharmacy and possible drug-drug interactions among diabetic patients receiving home health care services.

OBJECTIVES: In this study, we examined the drug regimens of diabetic patients receiving home health care services to measure the prevalence of polypharmacy and to assess the likelihood of drug-drug interactions, a consequence of polypharmacy. DESIGN: The sample consisted of 139 diabetic patients who received home health care services from one home health agency in a large mid-Atlantic city. The data were collected from March 1, 1998 to September 30, 1999. Information regarding medications was collected by the home health nurse during the initial home visit and was recorded on the medication sheet in the patient's clinical record. Any changes in medications were noted on the medication sheets. METHODS: We identified all systemic medications prescribed for 139 home health patients. To assess drug-drug interactions, we used Micromedex formulary DRUG-REAX System. OUTCOMES: We calculated (1) the number of systemic medications taken, and (2) the number of possible severe, moderate, and mild drug-drug interactions. RESULTS: We found that the average number of medications taken was 8.9 (SD 3.4) prescribed medications per day. Our results show that 38.8% of the patients in the sample could potentially be subject to at least one severe drug-drug interaction. Nearly all of the patients (92.8%) were at risk for moderate drug-drug interactions, and 70.5% could have mild drug- drug interactions. CONCLUSION: We conclude that polypharmacy is a concern for home health care patients with diabetes and the potential for drug-drug interactions is substantial. Our results indicate that the drug regimens of diabetic patients should be monitored systematically to avoid adverse events such as hospitalization. Family practitioners and home health care takers are in a unique position to identify polypharmacy and to modify drug regimens.

Aged↗
PubMed2004

Racial and ethnic diversity and organizational behavior: a focused research agenda for health services management.

Initiatives to reduce racial and ethnic disparities are conceptualized as a three-legged stool. Public policy: to ensure a legal and regulatory environment designed to eliminate disparities in access and health status; clinical practice: to ensure patient satisfaction and loyalty and improve treatment outcomes through the cultural competence of clinicians; and organizational behavior: to ensure that leadership, staff, and the culture of the health services organization represents and values the communities they serve. Our review of the health services and general management literature published since 1990 reveals a paucity of research on organizational behavior. Based on our review of health services and general management organizational behavior and racial/ethnic diversity literature, we offer an agenda for future research in this area. Factors that will facilitate or inhibit the pursuit of the proposed research agenda are also identified and discussed. The literature reviewed is mainly from the United States and the proposed research agenda results from that review, which presents a potential limitation to its applicability internationally.

Breast Feeding↗
PubMed2004

Accountability framework for managing stakeholders of health programs.

Understanding the incentives of stakeholders and employing effective management practices with various stakeholder groups is essential for program sustainability. This paper offers a conceptual model that depicts four different types of stakeholder interests that are relevant to health service organizations. The study identified the major stakeholders of telehealth programs, compared the influence of stakeholders by organizational ownership and investigated the practices used to manage these stakeholders. Quantitative and qualitative analyses demonstrated empirical support for the stakeholder model. The paper suggests that the model can be used as a stakeholder management tool in healthcare organizations and offers an assessment of the utility of the stakeholder framework in organizational research

Health Services Administration↗
PubMed2002

Teaching self-management of diabetes via telehomecare.

This study demonstrates that telehomecare is an effective way to improve patient education and self-management outcomes. The cost effectiveness of this technology makes it an attractive medium for reaching patients who require close monitoring, reinforced teaching, and reassurance. telehomecare can also support caregivers and connect socially isolated individuals to their care providers. The possibilities for using telehomecare are just beginning to be realized. With the advent of PPS, telehomecare may be an effective substitute for visits that focus on teaching and monitoring. It is a new tool in the arsenal for the home care nurse to use for monitoring patients and promoting knowledge and behavior change. The video visits are short, focused opportunities for increased patient teaching; the one-on-one focus, audio-visual aids, and opportunities for patients to use the machines to self-monitor are all positive aspects.

Aged↗
PubMed2002

Lessons learned from a telehomecare project.

This article provides an update on the results of the Telehomecare Project, a demonstration funded by the US Department of Commerce through its Technology Opportunity Program. The goal of the project was to demonstrate and evaluate the use of telephone-based information technology (IT) in the provision of home health services. This effort was described in the August, 1999 (vol. 18, no. 8) issue of CARING.

Ambulatory Care Information Systems↗
PubMed2002

Quality management practices in telehealth programs: a stakeholder accountability framework.

Improved technologies, distances between providers and patients, and an emphasis on cost-containment have encouraged the use of telehealth as a method of service delivery. Despite the increased use of this technology, few studies have been conducted on management of telehealth programs. Research on quality management is essential for disseminating and generalizing information on best practices in telehealth programs. This study focused on quality management practices used in telehealth programs, using a Stakeholder Accountability Framework. We propose that different indicators of quality are employed to satisfy the expectations of different internal and external stakeholders. A national survey of telehealth programs (N=93) was conducted in January, 2001. Wide variations in practices were found, with the most notable differences between not-for-profit and proprietary programs. The dimensions illustrated in the Stakeholder Accountability Framework were supported empirically. Implications of differences are examined as they relate to advancing quality in telehealth.

Data Collection↗
PubMedDate not supplied

Organizational strategy and diversity management: diversity-sensitive orientation as a moderating influence.

Empirical studies on diversity suggest that health care organizations have been slow to embrace diversity management. We propose that sensitivity to diversity, at the corporate level, moderates strategic decision making, which influences human resource management practices such as diversity initiatives. This study of 203 hospitals explored the relationships among organizational strategy, organizational sensitivity to diversity, and diversity management practices.

Cultural Diversity↗
PubMedDate not supplied

Can organizational support for technology influence job satisfaction?

The relationship between organizational support for telemedicine and nurses' job satisfaction in home health agencies (HHAs) is investigated in this study. Drawing from the theory of perceived organizational support, we propose that HHAs that provide strong support for telemedicine will have higher nurse job satisfaction levels than those that do not. Primary data were collected from 29 HHAs and 917 nurses from 2004 to 2005. The results of the analysis indicate a strong, positive, significant association between organizational support for telemedicine and home health nurses' job satisfaction. We conclude that technological implementation, with sufficient organizational support, can be a strong competitive strategy to attract and retain high-quality nurses.

Female↗
PubMedDate not supplied

Racial/ethnic diversity management and cultural competency: the case of Pennsylvania hospitals.

Major demographic trends are changing the face of America's labor pool, and healthcare managers increasingly face a scarcer and more diverse workforce. As a result, healthcare organizations (HCOs) must develop policies and practices aimed at recruiting, retaining, and managing a diverse workforce and must meet the demands of a more diverse patient population by providing culturally appropriate care and improving access to care for racial/ethnic minorities. Ultimately, the goal of managing diversity is to enhance workforce and customer satisfaction, to improve communication among members of the workforce, and to further improve organizational performance. Research on diversity management practices in HCOs is scarce, providing few guidelines for practitioners. This study attempted to close that gap. Results show that hospitals in Pennsylvania have been relatively inactive with employing diversity management practices, and equal employment requirements are the main driver of diversity management policy. The number and scope of diversity management practices used were not influenced by organizational or market characteristics. The results suggest that hospitals need to adopt diversity management practices for their workforces and need to pay particular attention to marketing and service planning activities that meet the needs of a diverse patient population.

Cultural Diversity↗
PubMedDate not supplied

Marketing telehealth to align with strategy.

Telehealth is a twenty-first century solution to an old problem-how to deliver quality health services with shrinking resources. Telehealth enables healthcare providers to interact with and monitor patients remotely, thus adding value to service delivery models. On occasion, telehealth can substitute for live encounters, saving time and resources. Furthermore, as the geriatric population increases, telehealth will support independent living by supplementing the existing network of care. To be used most effectively, however, telehealth services must be carefully planned and executed. This study investigated management practices used to promote telehealth services, focusing on strategic goals for adopting telehealth. Interviews with senior managers from 19 home health agencies identified three strategic goals for adopting telehealth: (1) clinical excellence, (2) technological preeminence, and (3) cost containment. Organizational documents were analyzed to determine the extent to which the telehealth program was featured in marketing materials. Documents included the organization's brochure, newspaper ads and articles, and each home health agency's web site. Results showed that marketing practices vary widely but are correlated with motivations to adopt telehealth. The organizations with the highest marketing scores emphasize clinical excellence as a major reason for using telehealth, whereas those with the lowest marketing scores tend to focus on cost containment. Although this study focused on management practices in home health agencies, results are applicable to hospital and outpatient services as well as to other community-based programs. Using a strategic management framework, the authors offer recommendations to help organizations develop effective marketing approaches for telehealth programs.

Guidelines as Topic↗