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Results: 11 to 15 of 15

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Cleveland Clinic workshop on innovation in treatment of uremia: an introduction to the proceedings.
Fissell WH
(2009) Semin Dial 22: 597
MeSH Terms: Delivery of Health Care, Integrated, Diffusion of Innovation, Humans, Interdisciplinary Communication, Patient Care Team, United States, Uremia
Added August 21, 2013
0 Communities
1 Members
0 Resources
7 MeSH Terms
Peers, regulators, and professions: the influence of organizations in intensive insulin therapy adoption.
Campion TR, Gadd CS
(2009) Qual Manag Health Care 18: 115-9
MeSH Terms: Critical Care, Decision Making, Organizational, Diffusion of Innovation, Humans, Insulin, Joint Commission on Accreditation of Healthcare Organizations, Peer Group, United States
Show Abstract · Added January 20, 2015
INTRODUCTION - Following the landmark Leuven study in 2001, health care organizations implemented intensive insulin therapy (IIT) as the standard of care for critically ill patients. However, a recent meta-analysis showed no mortality benefit and an increased safety risk for patients treated with IIT. IIT affects labor and capital decisions related to nurses, physicians, pharmacists, managers, laboratory personnel, and informatics staff. The expenditure of labor and capital to provide IIT without corresponding outcome improvements suggests the adoption of IIT produces inefficiency in hospital.
THEORETICAL BACKGROUND - In sociology and organizational studies, the tendency for organizations to become more similar without necessarily becoming more efficient is called normalfont institutional isomorphism. Institutional isomorphism examines the pressure that organizations encounter from peers, regulators, and professions through mimetic, coercive, and normative mechanisms, respectively. To enhance their prospects of survival, organizations establish and maintain legitimacy by adopting socially acceptable approaches to work endorsed by successful peer organizations, regulatory agencies, and professional societies. ORGANIZATIONAL INFLUENCE IN THE ADOPTION OF IIT: This paper describes how organizational influence-through the Leuven study, the Joint Commission, and professional organizations-played a role in the widespread adoption of IIT. Divergence from institutionalized forms may explain variation in IIT studies following Leuven.
CONCLUSION - Health care researchers practitioners, and managers should consider organizational influence when implementing large-scale clinical activities.
0 Communities
1 Members
0 Resources
8 MeSH Terms
Courting change.
Siegel V
(2009) Dis Model Mech 2: 97-9
MeSH Terms: Animals, Biomedical Research, Communication, Diffusion of Innovation, Disease Models, Animal, Humans, Internet, Periodicals as Topic, Publishing
Show Abstract · Added December 1, 2015
In scientific communication, the long tail has not yet appeared. Why not?
0 Communities
1 Members
0 Resources
9 MeSH Terms
Crossing the implementation chasm: a proposal for bold action.
Lorenzi NM, Novak LL, Weiss JB, Gadd CS, Unertl KM
(2008) J Am Med Inform Assoc 15: 290-6
MeSH Terms: Attitude to Computers, Delivery of Health Care, Diffusion of Innovation, Health Facility Administration, Health Plan Implementation, Information Systems, Organizational Culture, Organizational Innovation, Systems Integration
Show Abstract · Added January 20, 2015
As health care organizations dramatically increase investment in information technology (IT) and the scope of their IT projects, implementation failures become critical events. Implementation failures cause stress on clinical units, increase risk to patients, and result in massive costs that are often not recoverable. At an estimated 28% success rate, the current level of investment defies management logic. This paper asserts that there are "chasms" in IT implementations that represent risky stages in the process. Contributors to the chasms are classified into four categories: design, management, organization, and assessment. The American College of Medical Informatics symposium participants recommend bold action to better understand problems and challenges in implementation and to improve the ability of organizations to bridge these implementation chasms. The bold action includes the creation of a Team Science for Implementation strategy that allows for participation from multiple institutions to address the long standing and costly implementation issues. The outcomes of this endeavor will include a new focus on interdisciplinary research and an inter-organizational knowledge base of strategies and methods to optimize implementations and subsequent achievement of organizational objectives.
0 Communities
1 Members
0 Resources
9 MeSH Terms
How wide is the gap in defining quality care? Comparison of patient and nurse perceptions of important aspects of patient care.
Young WB, Minnick AF, Marcantonio R
(1996) J Nurs Adm 26: 15-20
MeSH Terms: Attitude of Health Personnel, Diffusion of Innovation, Education, Nursing, Continuing, Humans, Midwestern United States, Nurse Administrators, Nursing Administration Research, Nursing Staff, Hospital, Patient Satisfaction, Quality of Health Care, Surveys and Questionnaires, Total Quality Management
Show Abstract · Added January 20, 2015
OBJECTIVES - The authors determine the importance that patients, nurses, and nurse managers place on aspects of care and measure nurses' care values based on their perceptions of their patients and nurse manager care values and their desire to meet these care expectations.
BACKGROUND - The literature has documented gaps in how nurses and patients define quality and value specific care aspects, but little is known about the situation in the current continuous quality improvement and patient-centered care environment, which emphasizes a customer focus. Misunderstanding patients' values and expectations may impede service improvement. Information about any existing gaps could help managers begin to devise patient satisfaction improvement strategies.
METHOD - Two thousand fifty-one medical-surgical patients, 1264 staff members, and 97 nurse managers from 17 randomly selected hospitals participated in study activities related to selected aspects of patient care. Trained interviewers surveyed patients by telephone within 26 days of discharge using a pretested instrument. Staff members and managers completed a coordinated written tool. Descriptive and correlational statistics were used in individual and unit-level analyses.
RESULTS - Staff members perceive correctly that patients value differently various aspects of care but do not agree with their managers on patients' value of aspects of care. Unit staff members' and managers' beliefs regarding patients' care values did not match those of their patients (-14 to 0.11 and -0.01 to 0.06 zero order correlations, respectively).
CONCLUSIONS - A unit's errors in defining patients' values may be self-reinforcing. Strategies to reorient personnel, including adoption of those suggested by the diffusion of innovation literature, may help bridge the gap and change practice.
0 Communities
1 Members
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12 MeSH Terms