Sabina Gesell | Wake Forest University School of Medicine (original) (raw)
Papers by Sabina Gesell
SAGE Open, Jul 1, 2021
This study tested the hypothesis that parents participating in a pediatric obesity intervention w... more This study tested the hypothesis that parents participating in a pediatric obesity intervention who formed social network ties with a parent in the intervention arm would engage in more daily physical activity and less sedentary behavior (after controlling for participant covariates). Data were collected at baseline, 12 months, and 36 months from 610 low-income parent–child pairs participating in an obesity prevention intervention for 3- to 5-year-old children. A network survey was used to identify social network ties among parents and accelerometers were used to measure parental physical activity and sedentary time. Longitudinal regression analyses tested effects of social network ties on parents’ physical activity and sedentary behavior. Compared with parents without a social network tie, having a tie with an intervention group participant was associated with a clinically meaningful 11.04 min/day decrease in parental sedentary behavior that approached statistical significance (95% confidence interval [CI] = [−22.71, 0.63], p = .06). Social network ties among parents in a pediatric obesity prevention intervention were not clearly associated with reduced sedentary behavior among those parents at the traditional level of p = .05. The large effect size (over 77 min per week improvement) suggests there might be potential importance of promoting new social networks in community-based health promotion interventions to elicit and support behavior change, but further examination is needed.
Childhood obesity, Apr 1, 2012
Background: Living near community recreation centers (CRC) is associated with increases in adoles... more Background: Living near community recreation centers (CRC) is associated with increases in adolescent and adult physical activity, but the efficacy of efforts to increase use among Latino parents and young children is unknown. We hypothesized that Latino parent-child dyads with exposure to a CRC through culturally tailored programming would be more likely to use the facility for physical activity a year after programming ended than dyads living in the same geographic area who were not exposed to the programming. Methods: self-identified Latino parent-child dyads who had participated in a randomized controlled trial (RCt) of a culturally tailored healthy lifestyle program and completed a 12-month follow-up assessment constituted the "exposed" group (n = 66). the "unexposed" group included 62 parent-child dyads living in the same zip codes as the exposed group, all within a 5-mile radius of the CRC. Participants completed in-person structured interviews. Results: Approximately two-thirds of exposed parents reported more than monthly use of the CRC for themselves a year after programming ended, compared to one-third of unexposed Latino families with the same geographic access (c2 = 11.26, p < 0.01). Parents in the exposed group were four times more likely than the unexposed group to use the CRC with their children on a monthly basis (odds ratio = 4.18, p < 0.01). Conclusions: CRCs that develop culturally tailored programs that invite Latino families inside can increase sustained CRC use for physical activity in this population at heightened risk for childhood obesity.
Connections (Toronto), 2020
The GROW Social Network datasets were compiled as part of a 3-year community-based family-based p... more The GROW Social Network datasets were compiled as part of a 3-year community-based family-based pediatric obesity prevention intervention (N = 610). The datasets include (i) multiplex edges between adult study participants at four timepoints (baseline, 3, 12, and 36 mon), and (ii) multiplex edges within small interventiononly subgroups (30 groups of approximately 10 adult intervention participants) and a previously validated self-report measure of perceived cohesion at three timepoints (3, 6, and 12 wk). Actor attributes are richly characterized in a linkable dataset.
The Gerontologist, 2020
Background and Objectives Stroke is a chronic, complex condition that disproportionally affects o... more Background and Objectives Stroke is a chronic, complex condition that disproportionally affects older adults. Health systems are evaluating innovative transitional care (TC) models to improve outcomes in these patients. The Comprehensive Post-Acute Stroke Services (COMPASS) Study, a large cluster-randomized pragmatic trial, tested a TC model for patients with stroke or transient ischemic attack discharged home from the hospital. The implementation of COMPASS-TC in complex real-world settings was evaluated to identify successes and challenges with integration into the clinical workflow. Research Design and Methods We conducted a concurrent process evaluation of COMPASS-TC implementation during the first year of the trial. Qualitative data were collected from 4 sources across 19 intervention hospitals. We analyzed transcripts from 43 conference calls with hospital clinicians, individual and group interviews with leaders and clinicians from 9 hospitals, and 2 interviews with the COMPAS...
J Healthc Qual, 2001
A self-administered satisfaction survey instrument for the assisted-living industry was developed... more A self-administered satisfaction survey instrument for the assisted-living industry was developed and validated. The survey contains 45 Likert-type items that measure residents' and family members' satisfaction with the most central aspects of housing and care. The scale covers six key service dimensions: activities, personnel, dining, apartment, facility, and management. Internal consistency tests indicate high reliability. Multiple tests of validity confirm the scale's effectiveness in measuring residents' and family members' satisfaction with the six dimensions. Overall, residents are less satisfied with assisted-living programs than their family members are, but they may feel inhibited about expressing criticism in the presence of family. A priority index highlights service areas in which performance improvement efforts should be made to obtain the greatest increases in satisfaction while making the most efficient use of limited resources. Managerial implications of the tool are discussed.
Additional file 2: Table S1. Implementation Strategies Used in the COMPASS Cluster-Randomized Pra... more Additional file 2: Table S1. Implementation Strategies Used in the COMPASS Cluster-Randomized Pragmatic Trial. Strategies used for the implementation of COMPASS.
Additional file 1: Figure S1. Days to Clinic Visit After Discharge. Histogram of percent of patie... more Additional file 1: Figure S1. Days to Clinic Visit After Discharge. Histogram of percent of patients seen for follow up clinic by days after discharge.
Stroke and TIA diagnostic algorithm. (PDF 358Â kb)
Journal of best practices in health professions diversity : research, education and policy, 2012
This study examined the influence of physicians' and nurses' patient-centeredness on the ... more This study examined the influence of physicians' and nurses' patient-centeredness on the satisfaction of African American female Medicaid patients. A multigroup structural equation modeling design was used to test the hypothesized model and its stability across national random test (Nt=98) and cross-validation (Ncv=296) samples. The model fit well. Physician and nurse patient-centeredness significantly and consistently influenced patient satisfaction, explaining 73% of its variance. One standardized deviation increase in physician patient-centeredness increased patient satisfaction, likelihood to recommend, and ratings of care by .698, .665, and .644 deviations. The corresponding effects for nursing were .643, .613, and .594. These effects were consistent across national random samples. The study offers an evidenced-based model that sheds light on provider patient-centered-ness' influence on African American female Medicaid patient satisfaction.
Healthcare benchmarks, 2001
The Joint Commission on Accreditation of Healthcare Organizations blitzed the health care market ... more The Joint Commission on Accreditation of Healthcare Organizations blitzed the health care market in December to announce new pain standards. They were developed over two years in conjunction with the University of Wisconsin, Madison School of Medicine, to ensure all patients the right to appropriate assessment and management of their pain. The standards underline that organizations have a responsibility to develop processes within their settings to help support improvements in pain management.
Quality Management in Health Care, 2004
Using the dimensions of patient-centered care defined by the Institute of Medicine, this study ex... more Using the dimensions of patient-centered care defined by the Institute of Medicine, this study examined patient satisfaction within 5 clinical conditions. Method: Items from the Press Ganey Inpatient Questionnaire were mapped onto the Institute of Medicine dimensions of patient-centered care. A standardized mail-out/mail-back methodology was used to collect data from random samples of patients within 5 days of discharge. Sample: Patients hospitalized for heart attack, heart failure, stroke, pneumonia, or childbirth were included in the study. The sample contained 10,000 patients at 210 hospitals. Results: Patients hospitalized for different clinical conditions expressed different levels of satisfaction. There may be different care needs, expectations, and evaluations of care based on these clinical conditions. However, it is probable that an all-encompassing patient-centered focus would improve care for all of these groups. Conclusions: Quality improvement professionals should attend to 2 Institute of Medicine dimensions: (1) respect for patient's values, preferences, and expressed needs and (2) emotional support, relieving fear and anxiety. It is in these areas that improved performance will be associated with the greatest increases in patient satisfaction. Four specific issues were identified as quality improvement priorities, regardless of condition: response to complaints; sensitivity to the inconvenience of hospitalization; including patients in decision making; addressing emotional and spiritual needs.
Quality Management in Health Care, 2006
Background: Observers predict that the influx of women into the medical profession will alter the... more Background: Observers predict that the influx of women into the medical profession will alter the way in which medicine is practiced, incorporating more "feminine" values of caring, listening to patients, and patient centeredness, in contrast to the "masculine" values of curing, dictating to patients, and care provider centeredness. Consequently, patient satisfaction with medical care will improve. Subjects and Methods: Retrospective database analysis of satisfaction survey data. A total of 3985 surveys from primary care patients were examined after having identified the gender of the patient's physician. Ten survey items that pertained to physician attributes were analyzed, individually and in the aggregate, in a series of 2 × 2 analyses of covariance, with physician gender and patient gender serving as independent variables, and patient age and the overall level of patient satisfaction from the physician's facility serving as covariates. An additional analysis of covariance, with the same independent variables and covariates, examined patients expressed likelihood of recommending their physician to others. Results and Conclusions: There were no main or interaction effects for physician gender or patient gender after adjusting for patient age and facility-level satisfaction. The implications of these results for the "feminization" hypothesis are discussed.
Quality Management in Health Care, 2004
The objective of this study was 2-fold: (1) to identify particular opportunities for improvement ... more The objective of this study was 2-fold: (1) to identify particular opportunities for improvement in patient-centered care of heart failure patients and (2) to suggest strategies for service quality improvement focusing on those areas. Sample: A national cross-sectional sample of survey data from diagnostic-related group 127 patients was collected between December 1, 2001, and November 30, 2003. Data were split into two 12-month samples to compare results over time. The 2002 sample included 5224 patients treated at 220 hospitals; the 2003 sample included 6531 patients treated at 269 hospitals. Method: A standardized mail-out/mail-back methodology was used to collect data from random samples of patients within 5 days of discharge. Results: For both samples, the ranking of service issues was highly similar, with the same 4 areas emerging as the foremost priorities: patient involvement in decision making, staff response to concerns voiced during the hospital stay, staff sensitivity to the inconvenience of heart failure and hospitalization, and emotional/spiritual support. Improvement in these 4 service areas should be associated with the greatest increases in patient satisfaction and quality of care for heart failure patients. Conclusions: Adequately addressing these patient needs should increase patient satisfaction and quality of care for heart failure patients.
Journal of Nursing Care Quality, 2004
In parallel to developing new cancer therapies, the healthcare community has the responsibility o... more In parallel to developing new cancer therapies, the healthcare community has the responsibility of creating positive treatment experiences for patients. Data from 5907 cancer outpatients treated at 23 hospitals across the United States were analyzed to identify the top priorities for service improvement in outpatient cancer treatment facilities. They included meeting patients' emotional needs, providing information to patients and family members, reducing waiting times, and providing convenience and coordinated care among physicians and other care providers.
Journal for Healthcare Quality, 2001
A self-administered satisfaction survey instrument for the assisted-living industry was developed... more A self-administered satisfaction survey instrument for the assisted-living industry was developed and validated. The survey contains 45 Likert-type items that measure residents' and family members' satisfaction with the most central aspects of housing and care. The scale covers six key service dimensions: activities, personnel, dining, apartment, facility, and management. Internal consistency tests indicate high reliability. Multiple tests of validity confirm the scale's effectiveness in measuring residents' and family members' satisfaction with the six dimensions. Overall, residents are less satisfied with assisted-living programs than their family members are, but they may feel inhibited about expressing criticism in the presence of family. A priority index highlights service areas in which performance improvement efforts should be made to obtain the greatest increases in satisfaction while making the most efficient use of limited resources. Managerial implications of the tool are discussed.
Journal for Healthcare Quality, 2006
Hospitals continuously look for ways to improve patient care and retain high-quality physicians. ... more Hospitals continuously look for ways to improve patient care and retain high-quality physicians. Previous research indicates that physicians&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; satisfaction with where they practice is a crucial part of addressing these issues. A reliable and valid method to assess physician satisfaction is needed in order to identify potential areas of discontent. The purpose of the present study was to develop and validate a self-administered medical staff satisfaction survey. The survey contains 13 Likert-type items divided into three reliable subscales: Quality of Patient Care (alpha = .84), Ease of Practice (alpha = .76), and Relationship with Leadership (alpha = .92). Results from both exploratory and confirmatory factor analyses supported the survey&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s structure and robustness across three independent samples.
American Journal of Medical Quality, 2003
This investigation tested the patient-centered Primary Provider Theory of Patient Satisfaction ac... more This investigation tested the patient-centered Primary Provider Theory of Patient Satisfaction across gender in national random samples of emergency patients. Using multigroup structural equation modeling, the results supported the model&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s robustness. Physician service, waiting time, and nursing satisfaction explained 48%, 41%, and 11% of overall satisfaction plus 92% and 93% of female and male satisfaction, respectively. Unit increases in physician service satisfaction increased waiting time, nursing, and overall satisfaction by 0.991, 0.844, and 1.031 units, respectively. Unit increases in waiting time satisfaction increased nursing and overall satisfaction by 0.417 and 0.685 units, respectively. A unit increase in nursing satisfaction increased overall service satisfaction by 0.221 units. The investigation offers an alternative paradigm for measuring and achieving emergency department satisfaction, hierarchically related to patient expectations, where the primary provider has the greatest clinical utility to patients, followed by waiting for the primary provider, and then by nursing service.
Journal of Nursing Care Quality, 2007
In the absence of a national measurement system, private vendors of satisfaction measurement and ... more In the absence of a national measurement system, private vendors of satisfaction measurement and improvement services have played a crucial role in the quality movement in the assisted living industry. Survey responses from 175 resident-family dyads at 20 facilities were analyzed to identify priorities for service improvement from the customers&amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; perspective. They include improving care provided by aides and management, meal service, and activities. Practical solutions for addressing these issues are presented.
Journal of Clinical and Translational Science
OBJECTIVES/GOALS: The LHS concept has been promoted as a means for health systems to improve qual... more OBJECTIVES/GOALS: The LHS concept has been promoted as a means for health systems to improve quality, safety, efficiency and equity. NAMs definition has been widely adopted, but is broad and has led to variation in how LHS is operationalized. Drawing on a taxonomy developed through a review of literature, we developed a tool that shows how LHSs are implemented in practice. METHODS/STUDY POPULATION: The LHS Implementation Assessment Tool (LHS-IAT) will indicate which forms of work are being carried out by a health system that purports to operate a LHS. LHS-IAT is based on the LHS Consolidated Framework (LHS-CF); which was developed through a qualitative analysis of LHS literature. LHS-CF contains 38 primary elements’ and 56 secondary elements’ that have been associated with the LHS construct. These elements are organized into 5 bodies of work• (e.g.; translating evidence into practice) and 4 enabling conditions• (e.g.; supportive culture). LHS-IAT assesses whether a health system ope...
SAGE Open, Jul 1, 2021
This study tested the hypothesis that parents participating in a pediatric obesity intervention w... more This study tested the hypothesis that parents participating in a pediatric obesity intervention who formed social network ties with a parent in the intervention arm would engage in more daily physical activity and less sedentary behavior (after controlling for participant covariates). Data were collected at baseline, 12 months, and 36 months from 610 low-income parent–child pairs participating in an obesity prevention intervention for 3- to 5-year-old children. A network survey was used to identify social network ties among parents and accelerometers were used to measure parental physical activity and sedentary time. Longitudinal regression analyses tested effects of social network ties on parents’ physical activity and sedentary behavior. Compared with parents without a social network tie, having a tie with an intervention group participant was associated with a clinically meaningful 11.04 min/day decrease in parental sedentary behavior that approached statistical significance (95% confidence interval [CI] = [−22.71, 0.63], p = .06). Social network ties among parents in a pediatric obesity prevention intervention were not clearly associated with reduced sedentary behavior among those parents at the traditional level of p = .05. The large effect size (over 77 min per week improvement) suggests there might be potential importance of promoting new social networks in community-based health promotion interventions to elicit and support behavior change, but further examination is needed.
Childhood obesity, Apr 1, 2012
Background: Living near community recreation centers (CRC) is associated with increases in adoles... more Background: Living near community recreation centers (CRC) is associated with increases in adolescent and adult physical activity, but the efficacy of efforts to increase use among Latino parents and young children is unknown. We hypothesized that Latino parent-child dyads with exposure to a CRC through culturally tailored programming would be more likely to use the facility for physical activity a year after programming ended than dyads living in the same geographic area who were not exposed to the programming. Methods: self-identified Latino parent-child dyads who had participated in a randomized controlled trial (RCt) of a culturally tailored healthy lifestyle program and completed a 12-month follow-up assessment constituted the "exposed" group (n = 66). the "unexposed" group included 62 parent-child dyads living in the same zip codes as the exposed group, all within a 5-mile radius of the CRC. Participants completed in-person structured interviews. Results: Approximately two-thirds of exposed parents reported more than monthly use of the CRC for themselves a year after programming ended, compared to one-third of unexposed Latino families with the same geographic access (c2 = 11.26, p < 0.01). Parents in the exposed group were four times more likely than the unexposed group to use the CRC with their children on a monthly basis (odds ratio = 4.18, p < 0.01). Conclusions: CRCs that develop culturally tailored programs that invite Latino families inside can increase sustained CRC use for physical activity in this population at heightened risk for childhood obesity.
Connections (Toronto), 2020
The GROW Social Network datasets were compiled as part of a 3-year community-based family-based p... more The GROW Social Network datasets were compiled as part of a 3-year community-based family-based pediatric obesity prevention intervention (N = 610). The datasets include (i) multiplex edges between adult study participants at four timepoints (baseline, 3, 12, and 36 mon), and (ii) multiplex edges within small interventiononly subgroups (30 groups of approximately 10 adult intervention participants) and a previously validated self-report measure of perceived cohesion at three timepoints (3, 6, and 12 wk). Actor attributes are richly characterized in a linkable dataset.
The Gerontologist, 2020
Background and Objectives Stroke is a chronic, complex condition that disproportionally affects o... more Background and Objectives Stroke is a chronic, complex condition that disproportionally affects older adults. Health systems are evaluating innovative transitional care (TC) models to improve outcomes in these patients. The Comprehensive Post-Acute Stroke Services (COMPASS) Study, a large cluster-randomized pragmatic trial, tested a TC model for patients with stroke or transient ischemic attack discharged home from the hospital. The implementation of COMPASS-TC in complex real-world settings was evaluated to identify successes and challenges with integration into the clinical workflow. Research Design and Methods We conducted a concurrent process evaluation of COMPASS-TC implementation during the first year of the trial. Qualitative data were collected from 4 sources across 19 intervention hospitals. We analyzed transcripts from 43 conference calls with hospital clinicians, individual and group interviews with leaders and clinicians from 9 hospitals, and 2 interviews with the COMPAS...
J Healthc Qual, 2001
A self-administered satisfaction survey instrument for the assisted-living industry was developed... more A self-administered satisfaction survey instrument for the assisted-living industry was developed and validated. The survey contains 45 Likert-type items that measure residents' and family members' satisfaction with the most central aspects of housing and care. The scale covers six key service dimensions: activities, personnel, dining, apartment, facility, and management. Internal consistency tests indicate high reliability. Multiple tests of validity confirm the scale's effectiveness in measuring residents' and family members' satisfaction with the six dimensions. Overall, residents are less satisfied with assisted-living programs than their family members are, but they may feel inhibited about expressing criticism in the presence of family. A priority index highlights service areas in which performance improvement efforts should be made to obtain the greatest increases in satisfaction while making the most efficient use of limited resources. Managerial implications of the tool are discussed.
Additional file 2: Table S1. Implementation Strategies Used in the COMPASS Cluster-Randomized Pra... more Additional file 2: Table S1. Implementation Strategies Used in the COMPASS Cluster-Randomized Pragmatic Trial. Strategies used for the implementation of COMPASS.
Additional file 1: Figure S1. Days to Clinic Visit After Discharge. Histogram of percent of patie... more Additional file 1: Figure S1. Days to Clinic Visit After Discharge. Histogram of percent of patients seen for follow up clinic by days after discharge.
Stroke and TIA diagnostic algorithm. (PDF 358Â kb)
Journal of best practices in health professions diversity : research, education and policy, 2012
This study examined the influence of physicians' and nurses' patient-centeredness on the ... more This study examined the influence of physicians' and nurses' patient-centeredness on the satisfaction of African American female Medicaid patients. A multigroup structural equation modeling design was used to test the hypothesized model and its stability across national random test (Nt=98) and cross-validation (Ncv=296) samples. The model fit well. Physician and nurse patient-centeredness significantly and consistently influenced patient satisfaction, explaining 73% of its variance. One standardized deviation increase in physician patient-centeredness increased patient satisfaction, likelihood to recommend, and ratings of care by .698, .665, and .644 deviations. The corresponding effects for nursing were .643, .613, and .594. These effects were consistent across national random samples. The study offers an evidenced-based model that sheds light on provider patient-centered-ness' influence on African American female Medicaid patient satisfaction.
Healthcare benchmarks, 2001
The Joint Commission on Accreditation of Healthcare Organizations blitzed the health care market ... more The Joint Commission on Accreditation of Healthcare Organizations blitzed the health care market in December to announce new pain standards. They were developed over two years in conjunction with the University of Wisconsin, Madison School of Medicine, to ensure all patients the right to appropriate assessment and management of their pain. The standards underline that organizations have a responsibility to develop processes within their settings to help support improvements in pain management.
Quality Management in Health Care, 2004
Using the dimensions of patient-centered care defined by the Institute of Medicine, this study ex... more Using the dimensions of patient-centered care defined by the Institute of Medicine, this study examined patient satisfaction within 5 clinical conditions. Method: Items from the Press Ganey Inpatient Questionnaire were mapped onto the Institute of Medicine dimensions of patient-centered care. A standardized mail-out/mail-back methodology was used to collect data from random samples of patients within 5 days of discharge. Sample: Patients hospitalized for heart attack, heart failure, stroke, pneumonia, or childbirth were included in the study. The sample contained 10,000 patients at 210 hospitals. Results: Patients hospitalized for different clinical conditions expressed different levels of satisfaction. There may be different care needs, expectations, and evaluations of care based on these clinical conditions. However, it is probable that an all-encompassing patient-centered focus would improve care for all of these groups. Conclusions: Quality improvement professionals should attend to 2 Institute of Medicine dimensions: (1) respect for patient's values, preferences, and expressed needs and (2) emotional support, relieving fear and anxiety. It is in these areas that improved performance will be associated with the greatest increases in patient satisfaction. Four specific issues were identified as quality improvement priorities, regardless of condition: response to complaints; sensitivity to the inconvenience of hospitalization; including patients in decision making; addressing emotional and spiritual needs.
Quality Management in Health Care, 2006
Background: Observers predict that the influx of women into the medical profession will alter the... more Background: Observers predict that the influx of women into the medical profession will alter the way in which medicine is practiced, incorporating more "feminine" values of caring, listening to patients, and patient centeredness, in contrast to the "masculine" values of curing, dictating to patients, and care provider centeredness. Consequently, patient satisfaction with medical care will improve. Subjects and Methods: Retrospective database analysis of satisfaction survey data. A total of 3985 surveys from primary care patients were examined after having identified the gender of the patient's physician. Ten survey items that pertained to physician attributes were analyzed, individually and in the aggregate, in a series of 2 × 2 analyses of covariance, with physician gender and patient gender serving as independent variables, and patient age and the overall level of patient satisfaction from the physician's facility serving as covariates. An additional analysis of covariance, with the same independent variables and covariates, examined patients expressed likelihood of recommending their physician to others. Results and Conclusions: There were no main or interaction effects for physician gender or patient gender after adjusting for patient age and facility-level satisfaction. The implications of these results for the "feminization" hypothesis are discussed.
Quality Management in Health Care, 2004
The objective of this study was 2-fold: (1) to identify particular opportunities for improvement ... more The objective of this study was 2-fold: (1) to identify particular opportunities for improvement in patient-centered care of heart failure patients and (2) to suggest strategies for service quality improvement focusing on those areas. Sample: A national cross-sectional sample of survey data from diagnostic-related group 127 patients was collected between December 1, 2001, and November 30, 2003. Data were split into two 12-month samples to compare results over time. The 2002 sample included 5224 patients treated at 220 hospitals; the 2003 sample included 6531 patients treated at 269 hospitals. Method: A standardized mail-out/mail-back methodology was used to collect data from random samples of patients within 5 days of discharge. Results: For both samples, the ranking of service issues was highly similar, with the same 4 areas emerging as the foremost priorities: patient involvement in decision making, staff response to concerns voiced during the hospital stay, staff sensitivity to the inconvenience of heart failure and hospitalization, and emotional/spiritual support. Improvement in these 4 service areas should be associated with the greatest increases in patient satisfaction and quality of care for heart failure patients. Conclusions: Adequately addressing these patient needs should increase patient satisfaction and quality of care for heart failure patients.
Journal of Nursing Care Quality, 2004
In parallel to developing new cancer therapies, the healthcare community has the responsibility o... more In parallel to developing new cancer therapies, the healthcare community has the responsibility of creating positive treatment experiences for patients. Data from 5907 cancer outpatients treated at 23 hospitals across the United States were analyzed to identify the top priorities for service improvement in outpatient cancer treatment facilities. They included meeting patients' emotional needs, providing information to patients and family members, reducing waiting times, and providing convenience and coordinated care among physicians and other care providers.
Journal for Healthcare Quality, 2001
A self-administered satisfaction survey instrument for the assisted-living industry was developed... more A self-administered satisfaction survey instrument for the assisted-living industry was developed and validated. The survey contains 45 Likert-type items that measure residents' and family members' satisfaction with the most central aspects of housing and care. The scale covers six key service dimensions: activities, personnel, dining, apartment, facility, and management. Internal consistency tests indicate high reliability. Multiple tests of validity confirm the scale's effectiveness in measuring residents' and family members' satisfaction with the six dimensions. Overall, residents are less satisfied with assisted-living programs than their family members are, but they may feel inhibited about expressing criticism in the presence of family. A priority index highlights service areas in which performance improvement efforts should be made to obtain the greatest increases in satisfaction while making the most efficient use of limited resources. Managerial implications of the tool are discussed.
Journal for Healthcare Quality, 2006
Hospitals continuously look for ways to improve patient care and retain high-quality physicians. ... more Hospitals continuously look for ways to improve patient care and retain high-quality physicians. Previous research indicates that physicians&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; satisfaction with where they practice is a crucial part of addressing these issues. A reliable and valid method to assess physician satisfaction is needed in order to identify potential areas of discontent. The purpose of the present study was to develop and validate a self-administered medical staff satisfaction survey. The survey contains 13 Likert-type items divided into three reliable subscales: Quality of Patient Care (alpha = .84), Ease of Practice (alpha = .76), and Relationship with Leadership (alpha = .92). Results from both exploratory and confirmatory factor analyses supported the survey&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s structure and robustness across three independent samples.
American Journal of Medical Quality, 2003
This investigation tested the patient-centered Primary Provider Theory of Patient Satisfaction ac... more This investigation tested the patient-centered Primary Provider Theory of Patient Satisfaction across gender in national random samples of emergency patients. Using multigroup structural equation modeling, the results supported the model&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s robustness. Physician service, waiting time, and nursing satisfaction explained 48%, 41%, and 11% of overall satisfaction plus 92% and 93% of female and male satisfaction, respectively. Unit increases in physician service satisfaction increased waiting time, nursing, and overall satisfaction by 0.991, 0.844, and 1.031 units, respectively. Unit increases in waiting time satisfaction increased nursing and overall satisfaction by 0.417 and 0.685 units, respectively. A unit increase in nursing satisfaction increased overall service satisfaction by 0.221 units. The investigation offers an alternative paradigm for measuring and achieving emergency department satisfaction, hierarchically related to patient expectations, where the primary provider has the greatest clinical utility to patients, followed by waiting for the primary provider, and then by nursing service.
Journal of Nursing Care Quality, 2007
In the absence of a national measurement system, private vendors of satisfaction measurement and ... more In the absence of a national measurement system, private vendors of satisfaction measurement and improvement services have played a crucial role in the quality movement in the assisted living industry. Survey responses from 175 resident-family dyads at 20 facilities were analyzed to identify priorities for service improvement from the customers&amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; perspective. They include improving care provided by aides and management, meal service, and activities. Practical solutions for addressing these issues are presented.
Journal of Clinical and Translational Science
OBJECTIVES/GOALS: The LHS concept has been promoted as a means for health systems to improve qual... more OBJECTIVES/GOALS: The LHS concept has been promoted as a means for health systems to improve quality, safety, efficiency and equity. NAMs definition has been widely adopted, but is broad and has led to variation in how LHS is operationalized. Drawing on a taxonomy developed through a review of literature, we developed a tool that shows how LHSs are implemented in practice. METHODS/STUDY POPULATION: The LHS Implementation Assessment Tool (LHS-IAT) will indicate which forms of work are being carried out by a health system that purports to operate a LHS. LHS-IAT is based on the LHS Consolidated Framework (LHS-CF); which was developed through a qualitative analysis of LHS literature. LHS-CF contains 38 primary elements’ and 56 secondary elements’ that have been associated with the LHS construct. These elements are organized into 5 bodies of work• (e.g.; translating evidence into practice) and 4 enabling conditions• (e.g.; supportive culture). LHS-IAT assesses whether a health system ope...