Comparing costs of a senior wellness care redesign in group and independent physician practices of an accountable care organization.

Primary care redesign for older adult patients is currently ongoing in countries with aging populations. One of the main challenges of this type of transformations is how to estimate implementation costs in different types of health care delivery organizations. This study compares start-up and incremental expenses of implementing a primary care redesign across 2 organization types: integrated group (n = 31) practices and independent practice association (IPA) sites (n = 213). Administrators involved with implementing the redesign completed a cost capture template to quantifying expenses. The potential impact of measurement error, recollection bias, and implementation models across sites and geographic regions was examined in sensitivity analyses. Marginal start-up and incremental expenses were higher for Group sites ($122-$328) compared to IPA sites ($31-$227). Group and IPA sites, however, implemented the redesign with different intensities. According to our analyses, if IPA sites implemented the redesign with the same intensity as Group sites, marginal costs would have been $5 to $13 higher for IPA sites than for Group sites. This study shows how a flexible approach to estimate the cost of a wellness care redesign is needed when the intensity of the transformation differs across 2 different types of health care organizations.

Examination of the role of the rotating nursing department in the training of nursing staff based on SWOT analysis.

BACKGROUND: The implementation of the rotation system in the Chinese medical industry has achieved significant results. OBJECTIVES: The present study aims to 1) explore the strengths, weaknesses, opportunities and challenges of rotational nursing department implementation and 2) provide references for developing nursing staff's competencies in leadership, performance evaluation, quality of care, communication in relationships and human resources. METHODS: A total of 16 rotational nursing department staff members from a tertiary tuberculosis specialist hospital in Beijing were interviewed, and the interview data were analysed using a strengths, weaknesses, opportunities and threats analysis and class analysis. RESULTS: The advantages of the rotational nursing department included: (1) stimulating the nursing staff's enthusiasm and creativity; (2) strengthening the communication and collaboration between departments; (3) improving the detailed management of nursing quality; and (4) enhancing the nursing staff's comprehensive abilities. The disadvantages included: (1) the design of the rotation programme focusing on practice; (2) a lack of personalisation; and (3) imperfect performance assessment of the rotating staff. Opportunities included: (1) deepening the connotation of nursing job management and (2) developing the construction of nursing discipline and the need for personal career development and value realisation. Threats included the lack of a sound rotation management model to draw on. CONCLUSION: A rotational nursing department is conducive to enhancing the competence of nursing staff in management positions and providing new ideas for hospitals to select and train nursing management talents. By taking full advantage of the benefits of vertical nursing management, designing personalised rotation training programmes, building a diversified learning and training platform and developing a positive performance incentive mechanism is recommended to fully engage the role of rotation in nursing management talent training.

Effect of depressive symptoms on quality of work life in female nurses: a cross-sectional study using propensity score matching.

Background: Female nurses have been considered as a vulnerable population in the context of mental health, due to the nature of their work, which can be stressful and emotionally taxing. Understanding the relationship between depressive symptoms and quality of work life (QWL) can contribute to improving mental health and job performance. However, limited studies have focused on the effect of depressive symptoms on QWL in female nurses. Objectives: The present study aimed to assess the effect of depressive symptoms on female nurses' QWL using propensity score matching (PSM). Methods: A cross-sectional, online study using convenience sampling was conducted among 1,401 female nurses in China. PSM was used to minimize the impact of potential confounders between no depressive symptoms and depressive symptoms. Stepwise multiple linear regression analyses were performed on the PSM samples to explore the effects of depressive symptoms on the QWL. Results: The results revealed there were 33.5% of the female nurses reported depressive symptoms before PSM. And female nurses in this study had a moderate level of QWL before PSM (122.11 ± 18.15), which remained steady after PSM (118.33 ± 18.04). After PSM, the final sample contained 864 female nurses. Stepwise multiple linear regression results indicated that depressive symptoms were the most strongly associated with QWL (ß = -0.454, p < 0.001). Conclusion: This study highlights the importance of developing mental health plans and psychological interventions for female nurses to maintain mental health and QWL, which is critical to the nursing workforce's sustainability.

Potential effects of the nursing work environment on the work-family conflict in operating room nurses.

BACKGROUND: The nursing working environment is an important subsystem in the hospital environment. A good working environment could have a positive impact on nurses. However, the work-family conflict and unsatisfactory working environment could significantly reduce their working enthusiasm, efficacy as well as the overall quality of the nursing, increase their fatigue, and thereby compromise their career status. AIM: To explore the possible status quo and to analyze the correlation between work environment perception and the work-family conflict among nurses in the operating room. METHODS: A total of 312 operating room nurses from two first-class hospitals at Grade 2 and two first-class hospitals at Grade 3 in China from May to September 2017 were included in this research using the cluster sampling method. The data, including the general information questionnaire, the practice environment scale of the nursing work index (PES-NWI), and the work-family conflict scale, were systematically collected. Pearson correlation analysis was applied to analyze the correlation between the two scores, with influencing factors analyzed by hierarchical regression analysis. RESULTS: A total of 312 questionnaires were issued, and the response rate and effective questionnaire rate were both 96.15% (300/312). The total scores of the PES-NWI scale and the work-family conflict scale were 3.07 ± 0.43 (vs maximum up to 4 points) and 52.32 ± 8.79 (vs maximum up to 90 points), respectively. The scores of the PES-NWI scale were negatively correlated with that of work-family conflict scale (all P < 0.05). The perception of the nursing work environment and the number of night shifts per month were the major factors contributing to the work-family conflict (all P < 0.05). CONCLUSION: The nursing work environment and the work-family conflict among nurses in the operating room were both found at a medium level with a negative correlation between the two.

Correction: Effect of Physician-Pharmacist Participation in the Management of Ambulatory Cancer Pain Through a Digital Health Platform: Randomized Controlled Trial.

[This corrects the article DOI: 10.2196/24555.].