Investigating hospital administrators' experience of workplace mistreatment.

Karen P. Harlos; Lawrence J. Axelrod

doi:10.1037/h0087261

Survey of Electronic Health Record (EHR) Systems in Kenyan Public Hospitals: A mixed-methods survey (Preprint)

10.2196/preprints.12995 ◽

2018 ◽

Cited By ~ 1

Author(s):

Naomi Muinga ◽

Steve Magare ◽

Jonathan Monda ◽

Mike English ◽

Hamish Fraser ◽

...

Keyword(s):

Management Information System ◽

Health Management ◽

Public Hospitals ◽

Health Management Information System ◽

Adoption Process ◽

Management Information ◽

Health Records ◽

Hospital Administrators ◽

Ehr Adoption ◽

Electronic Health

BACKGROUND As healthcare facilities in Low- and Middle-Income Countries (LMICs) such as Kenya adopt Electronic Health Record (EHR) systems to improve hospital administration and patient care, it is important to understand the adoption process, identify the key stakeholders, and assess the capabilities of the systems in use. OBJECTIVE To describe the level of adoption of Electronic Health Records systems in public hospitals and understand the process of adoption from Health Management Information System (HMIS) system vendors and system users. METHODS We conducted a survey of County Health Records Information Officers (CHRIOs) in Kenya to determine the level of adoption of Electronic Health Records systems in public hospitals. We conducted site visits to hospitals to view systems in use and to interview hospital administrators and end users. We also interviewed Health Management Information System (HMIS) system vendors to understand the adoption process from their perspective. RESULTS From the survey of CHRIOs, all facilities mentioned had adopted some form of EHR. Hospitals commonly purchased systems for patient administration and hospital billing functions. Radiology and laboratory management systems were commonly standalone systems. There were varying levels of interoperability within facilities that had more than one system in operation. We only saw one in-patient EHR system in use although many vendors and hospital administrators we interviewed were planning to adopt or support such systems. From the user perspective, issues such as system usability, adequate training, availability of adequate infrastructure and system support emerged. From the vendor perspective, a wide range of services was available to the hospital though constrained by funding and the need to computerise service areas that were deemed as priority. Additionally, vendors were unable to implement some data sharing modules linking to national HMIS due to lack of appropriate policies to facilitate this and users’ lack of confidence in new technologies such as cloud services. CONCLUSIONS EHR adoption in Kenya has been underway for some years, particularly in comprehensive care clinics, and hospitals are increasing purchasing systems to support administrative functions. Considerable support from government, donors and regional health informatics organisations will be required to enable hospitals to move to full EHR adoption for in-patient care.

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Management of a parenteral opioid shortage using ASHP guidelines

American Journal of Health-System Pharmacy ◽

10.1093/ajhp/zxaa425 ◽

2021 ◽

Vol 78 (5) ◽

pp. 426-435

Author(s):

Peter Vo ◽

Daniel A Sylvia ◽

Loay Milibari ◽

John Ryan Stackhouse ◽

Paul Szumita ◽

...

Keyword(s):

Electronic Health Record ◽

Drug Product ◽

Health Record ◽

Large Hospital ◽

Hospital Administrators ◽

Utilization Data ◽

Electronic Health ◽

Opioid Medications ◽

American Society ◽

The Impact

Abstract Purpose Management of an acute shortage of parenteral opioid products at a large hospital through prescribing interventions and other guideline-recommended actions is described. Summary In early 2018, many hospitals were faced with a shortage of parenteral opioids that was predicted to last an entire year. The American Society of Health-System Pharmacists (ASHP) has published guidelines on managing drug product shortages. This article describes the application of these guidelines to manage the parenteral opioid shortage and the impact on opioid dispensing that occurred in 2018. Our approach paralleled that recommended in the ASHP guidelines. Daily dispensing reports generated from automated dispensing cabinets and from the electronic health record were used to capture dispenses of opioid medications. Opioid prescribing and utilization data were converted to morphine milligram equivalents (MME) to allow clinical leaders and hospital administrators to quickly evaluate opioid inventories and consumption. Action steps included utilization of substitute opioid therapies and conversion of opioid patient-controlled analgesia (PCA) and opioid infusions to intravenous bolus dose administration. Parenteral opioid supplies were successfully rationed so that surgical and elective procedures were not canceled or delayed. During the shortage, opioid dispensing decreased in the inpatient care areas from approximately 2.0 million MME to 1.4 million MME and in the operating rooms from 0.56 MME to 0.29 million MME. The combination of electronic health record alerts, increased utilization of intravenous acetaminophen and liposomal bupivacaine, and pharmacist interventions resulted in a 67% decline in PCA use and a 65% decline in opioid infusions. Conclusion A multidisciplinary response is necessary for effective management of drug shortages through implementation of strategies and practices for notifying clinicians of shortages and identifying optimal alternative therapies.

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Advocacy Through Partnerships: Data, Demographics, and Decisions

Innovation in Aging ◽

10.1093/geroni/igaa057.1862 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 564-564

Author(s):

Briana Sisofo ◽

Anne Asman

Keyword(s):

Older Adults ◽

State Government ◽

City Government ◽

County Governments ◽

Non Profit ◽

Hospital Administrators ◽

Support Organizations ◽

Strategic Plans ◽

Private Citizens ◽

Home Health Agencies

Abstract The Summit County Aging Alliance (SCAA) in Park City, Utah is representative of state government, county and city government(s), private citizens, land developers, Senior Center attendees, national and local associations, non-profit support organizations, home health agencies, colleges and universities, recreation centers, hospital administrators and area associations on aging. The focus of the Alliance has been to provide a forum for critical listening and discussion. Data from a survey to determine the ‘real’ needs and vision of the older adult community provided perspective from more than 100 older adults representing diverse ethnic and socio-economic backgrounds. This work is now providing a benchmark from which both the city and county governments in Summit County are creating their strategic plans, and the Alliance has become the official voice of the community’s older adults.

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