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Biomedical subjects

Kenn Finstuen

Publications and source records attributed to Kenn Finstuen.

12 recordsLinked to original sources

Executive competencies in healthcare administration: preceptors of the Army-Baylor University Graduate Program.

The purpose of this research was to identify the mentoring and executive competencies required among preceptors of the Army-Baylor University Graduate Program in Health and Business Administration, and to specify the requisite skills, knowledge, and abilities (SKAs) needed to achieve those competencies. In the first wave of inquiry, a list of 123 competencies and associated SKAs was elicited from a network of 80 current and past preceptor executives employing a Delphi methodology using e-mail. An expert panel, which consisted of seven past program directors, examined and sorted the list into four preceptor content domains, viz., Health Systems Management (HS Management), Leadership, Residency Administration, and Community Involvement. Frequency analyses showed that the HS Management domain constituted over half of the competencies, with particular emphasis on strategic thinking, planning, billing, finance, manpower, and contracting. In the second wave, the preceptor Delphi network reviewed the expertpanel list and made 7-pointSKA importance ratings on an 80-item structured questionnaire representative of the four domains. Findings indicated thataverage SKA ratings were reliable and agreed upon to a high degree among preceptors. Results, rank ordered by SKA item means within preceptor content domains and overall, suggested that the most important rated items centered on teamwork, negotiation, interpersonal skills, communication, leadership vision, and customer and healthcare business operations. Outcomes from the competency list are expected to be useful for preceptor mentoring, self-assessment, and for professional development. Additionally, specific SKAs can provide a means for developing job requirements and career performance criteria at a behavioral task level, and can contribute information for identifying continuing education and conference topical needs.

Competency-Based Education↗

Patient satisfaction in military medicine: model refinement and assessment of Department of Defense effects.

A sample of 154,893 patient responses from the Customer Satisfaction Survey database was drawn for 1999 to 2000. Average patient satisfaction levels consistently appeared to be high (between 6, very satisfied, and 7, completely satisfied, on the 7-point rating scale). Hierarchical regression results essentially replicated all three major constructs of an earlier theoretical attitude model. Refinements included adjustment and addition of categorical age and military beneficiary status for individual patient variables, addition of two beliefs about the care itself, substitution of waiting time variables, and addition of reason for visit situation variables. Hypothesis test results indicated that patient satisfaction constructs were homogeneous across the uniformed services for patients from all service branches, both enrolled and not enrolled within TRICARE regions, and among branch of service medical center, hospital, and clinic facilities. The final attitude model coefficient of multiple determinations obtained was R2 = 0.701 [F(25,154,867) = 14,539.33, p < 0.0001].

Adolescent↗

Staffing model for dental wellness and readiness.

Oral health is an integral part of general health. Previous research has shown that untreated oral conditions can result in increased rates of disease and nonbattle injury for deployed soldiers. The purpose of this study was to develop models for U.S. Army dental wellness and readiness using a multivariate regression analysis approach. Staffing levels and dental wellness and readiness rates were examined for the first three quarters of fiscal year 2002 at 40 Army installations. Full regression model equations were developed for percent dental wellness and readiness using location, time, dental provider types, and basic training installation as predictor variables. Both models were shown to be statistically significant, with wellness R2 = 0.37, F12,107 = 5.18, p < 0.001 and readiness R2 = 0.23, F12,107 = 2.65, p < 0.01. Further tests of specific predictor effects revealed that wellness was significantly associated with the specialties of general dentistry, hygienists, and oral surgery, and that readiness was significantly associated with region and the oral surgery specialty. Results may be useful for the U.S. Army to identify the best practices in an effort to optimize dental wellness and readiness.

Dental Clinics↗

U.S. Army-Baylor University Health Care Administration Program: evidenced-based outcomes in the military health system.

The purpose of this research is to assess the impact of an educational program on the Military Health System on some of the evidence-based educational outcomes for the Individual (student) and the Society (all Army Medical Treatment Facilities). The U.S. Army-Baylor University HCA program provides a unique opportunity to assess the impact of an educational program on the Military Health System (MHS). Since the majority of the graduate students are military officers who serve in military medical treatment facilities (MTFs), tracking their career progression allows assessing the value added of the U.S. Army-Baylor University HCA experience from 1951 to 2001 (n = 2234). The context of Society outcomes includes all the Army MTFs where U.S. Army-Baylor University HCA graduates execute their leadership skills. During the time from 1994 to 2001, all of the Army MTFs in the MHS (n = 38) were examined by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO). In a similar but shorter time frame (1997-2001), DoD patient satisfaction assessments were conducted. The Individual outcomes (career advancement, increase in status, higher professional association membership) demonstrate that the selection criteria used for program admission appear to be successful. The Society outcomes showed higher JCAHO scores and satisfied consumers in Army facilities with Baylor graduates as the Deputy Commander for Administration (DCA). Continued internal program assessments (curriculum reviews) and external reviews (Accrediting Commission on Education for Health Services Administration accreditations of 5 years in 1987, 8 years in 1993 and 7 years in 2001, and 7 ACHE student chapter awards) attest to the strengths of the U.S. Army-Baylor University HCA program. Educating the MHS shareholders (patients, beneficiaries, professional and support staff, senior leaders) and leveraging technology to. share best practices for all administrators (including non-Baylor graduates) will help improve the quality patient care of the Military Health System and other healthcare systems.

Career Mobility↗

Patient satisfaction in military medicine: status and an empirical test of a model.

The Department of Defense (DoD) is concerned about how well military medical treatment facilities in the military health system perform. Patient expectations, attitudes, and health care use have been examined in numerous studies; the results are fairly consistent. Eligible beneficiaries report moderate satisfaction with the health care received. In 1994-2001, annual DoD and monthly ambulatory patient surveys were conducted in military medical treatment facilities. The DoD surveys document how patients perceive the care provided. The obvious research concerns are: requirements for conducting surveys; who should be surveyed: eligible beneficiaries or actual users; when; where; representative sample; how often to conduct assessment; data collection methods; analytic schemes; overall trends; predictors of satisfaction; use of results; and timeliness of findings. This study examines these issues and analyzes raw data from selected annual DoD and monthly ambulatory surveys. The overall level of perceived satisfaction has been "good" over the years surveys were used. The model demonstrated the use of examining demographic and attitudinal components of patient satisfaction in military medical facilities.

Adult↗

Predictors of course completion for the U.S. Army pharmacy specialist course.

The purpose of this study was to determine predictors of successful completion of the U.S. Army Medical Department pharmacy specialist (91Q) training program. The sample consisted of 143 students from four course iterations, and only students enrolled in the course for the first time were included for analysis. The relationship between 16 predictor variables and successful completion was assessed. Five variables, the ranks of private (E1) and specialist (E4), cross-trainee status, gender, and Armed Services Vocational Aptitude Battery (ASVAB) general technical (GT) score, were found to be significant predictors using simple linear regression. Using hierarchical multiple linear regression analysis, three variables, service component, gender, and ASVAB GT score, were found to have a significant unique shared variance with success. The results of this study indicate that ASVAB GT scores are predictive of success (p < 0.01) in the 91Q training program. Using these predictors, the selection process may be modified to improve the likelihood of student success in the course.

Accreditation↗

Pharmacy executives: leadership issues and associated skills, knowledge, and abilities in the U.S. Department of Defense.

OBJECTIVES: To identify the issues or problems that current and aspiring U.S. Department of Defense (DoD) pharmacy executives will face in the future and to define the skills, knowledge, and abilities (SKAs) required to successfully address these issues. DESIGN: Delphi method for executive decision making. SETTING: DoD. PARTICIPANTS: Ninety-three pharmacists serving in the military grades of lieutenant colonel/commander and colonel/captain, as well as pharmacists selected for promotion to those grades. INTERVENTIONS: iterations of the Delphi method for executive decision making separated by an expert panel content analysis. MAIN OUTCOME MEASURES: Round 1--participants identified five major issues believed to be of greatest importance to pharmacy executives and reported specific SKAs that might be needed to successfully manage those issues. An expert panel sorted these issues into meaningful domains, then provided an appropriate title for each domain. Round 2--on a 7-point scale, respondents rated the SKA items according to their assessment of how much a future DoD pharmacy executive would need each SKA. RESULTS: Response rates were 44.1% and 46.2% for Delphi rounds 1 and 2, respectively. The first round generated 62 unique issues facing pharmacy executives. The expert panel reviewed and sorted the issues into eight domains and selected an appropriate title for each domain. The domains identified by the panel were human resources, pharmacy operations/business practices, information management and technology, financial resources, formulary management, drug therapy management, pharmacy benefit management, and leadership. During round 2, 73.3% of the top 15 rated SKAs came from the drug therapy management, leadership, and formulary management domains. The three highest-rated SKAs were "ability to see the big picture," "ability to build strong relations with medical staffs," and "skills in both writing and verbal communication." CONCLUSION: The issues facing future DoD pharmacy executives will require them to expand their clinical abilities as well as their ability to collaborate and communicate with other professionals.

Data Collection↗

Perception of managerial and administrative competencies of professional pharmacists in the U.S. Department of Defense.

OBJECTIVE: To determine whether executive and junior pharmacists perceive skills, knowledge, and abilities (SKA) items differently. DESIGN: Two-factor split-plot analysis of variance (ANOVA) mixed design with repeated measures. SETTING: U.S. Department of Defense (DoD). PARTICIPANTS: One hundred fifty-one active duty pharmacy officers in DoD, classified as either executive pharmacists (serving in the military grades of lieutenant colonel/commander [0-5] and colonel/captain [0-6], as well as pharmacists selected for promotion to those grades) or junior pharmacists (serving in the military grades of second lieutenant/ensign [0-1], first lieutenant/lieutenant junior grade [0-2], and captain/lieutenant [0-3], as well as pharmacists selected for promotion to those grades). INTERVENTION: Seven-point relative importance rating scales, with 1 = extremely unimportant to 7 = extremely important, were used to assess respondents' judgments of SKAs. MAIN OUTCOME MEASURES: Main effects of group membership (executive versus junior pharmacists), differences among items within eight specific domains, and assessment of potential interaction effects for the dependent variable of SKA item importance ratings. RESULTS: No main effects for overall rating differences between pharmacist groups were found for any of the eight domains; however, statistically significant and systematic within-main-effect differences were detected for SKA items in all domains. Additionally, statistically significant interaction effects emerged in five of the eight domains. CONCLUSION: The importance ratings given SKAs in the domains of human resources, pharmacy operations and business practices, drug therapy management, and leadership were highly similar between the two groups. However, executive pharmacists tended to place a much greater emphasis on the importance of SKAs within the financial resources and the pharmacy benefit management domains.

Adult↗

Pharmacy executive leadership issues and associated skills, knowledge, and abilities.

OBJECTIVES: To identify challenges that current and future pharmacy executives are facing or will face in the future and to define what skills, knowledge, and abilities (SKAs) are required to successfully negotiate these challenges. DESIGN: Delphi method for executive decision making. SETTING: Civilian pharmacy profession. PARTICIPANTS: 110 pharmacists who graduated from the GlaxoSmithKline Executive Management Program for Pharmacy Leaders. INTERVENTIONS: Two iterations of the Delphi method for executive decision making separated by an expert panel content analysis. MAIN OUTCOME MEASURES: Round 1--participants were asked to identify five major issues they believed to be of greatest importance to pharmacy leaders in the next 5-10 years and name specific SKAs that might be needed by future leaders to successfully deal with those issues. An expert panel reviewed the issues, classified issues into specific domains, and titled each domain. Round 2-participants rated the SKAs on a 7-point scale according to their individual assessment of importance in each domain. RESULTS: For Delphi rounds 1 and 2, response rates were 21.8% and 18.2%, respectively. More than 100 total issue statements were identified. The expert panel sorted the issues into five domains: management and development of the pharmacy workforce, pharmacy finance, total quality management of work-flow systems, influences on the practice of pharmacy, and professional pharmacy leadership. Five of the top 15 SKAs-and all four highest ranked items--came from the professional pharmacy leadership domain, including ability to see the big picture, ability to demonstrate the value of pharmacy services, ability to lead and manage in an ethical manner, and skills for influencing an organization's senior leadership. CONCLUSION: Through successful integration of communication skills, critical thinking, and problem solving techniques, future public-sector pharmacy executives will be better equipped to effectively position their organizations and the profession for the challenges that lie ahead.

Decision Making↗

Digital dental radiography needs assessment utilizing the Delphi process.

This article reports the results of a needs assessment using the Delphi process. The purpose of this study was to determine the architecture and equipment (radiographic and computer network) for establishing and supporting an enterprise's vast digital dental radiographic program. Two panels of subject matter experts identified the needs for a digital dental radiography system; one expert panel consisted of dentists while the other panel's members were information management/information technology (IM/IT) experts. Panelists rated digital dental radiography needs using descriptive statistics and a 7-point bipolar scale. Among dentists, the four most important needs were the capability to store images, image appearance, centralized image storage, and a dedicated back-up server; among IM/IT panelists, they were ensuring HIPAA compliance, use of a standard formatting procedure, excellent print quality, and use of encryption for data transmission. This study's findings are useful for any organization seeking to initiate or improve its own digital radiography program.

Computer Communication Networks↗