Are Nursing Faculty Future-Ready? The Effects of Emerging Technologies on Nursing Education.

BACKGROUND: Preparing the next generation of nurses requires consideration for the integration of emerging technologies. This refers specifically to technologies that will shape and affect how care is delivered-not in today's health care facilities but in facilities 20 years from now and beyond. METHOD: A cross-sectional survey examining how seven emerging technologies were integrated into nursing curricula was developed and distributed to nursing faculty. A multiple linear regression model was used to analyze the data for the level of integration. The model was adjusted for all demographic measures, and the independent variables of interest were developed from unified theory of acceptance and use of technology (UTAUT) constructs. RESULTS: Performance, attitude, social influence, and effort were insignificant. Education and training, costs, and complexity were noted as top barriers to adoption. CONCLUSION: A literature gap regarding integrating emerging technologies in nursing curricula exists. Further research is warranted to understand factors influencing integration. [J Nurs Educ. 2023;62(12):689-700.].

The Efficiency of Ophthalmic Ambulatory Surgery Centers.

Ambulatory surgery centers (ASCs) are important providers of ambulatory surgeries. However, little research exists examining the efficiency of ASCs in providing ambulatory surgical services. This study examined the technical efficiency of ASCs that concentrated on performing cataract surgeries, which are among the surgeries most commonly performed in the outpatient setting. This study, based on data from all active ASCs that provided the two most common cataract surgeries in California, found that a large proportion of ophthalmic ASCs were operating at low technical efficiency levels. The amount of slacks in input and output variables was estimated for each ASC, and the mean slacks were reported. The numbers of cataract surgery patients and operating rooms were found to significantly affect the efficiency of ophthalmic ASCs.

The impact of demographic and perceptual variables on a young adult's decision to be covered by private health insurance.

BACKGROUND: The large number of uninsured individuals in the United States creates negative consequences for those who are uninsured and for those who are covered by health insurance plans. Young adults between the ages of 18 and 24 are the largest uninsured population subgroup. This subgroup warrants analysis. The major aim of this study is to determine why young adults between the ages of 18 and 24 are the largest uninsured population subgroup. METHODS: The present study seeks to determine why young adults between the ages of 18 and 24 are the largest population subgroup that is not covered by private health insurance. Data on perceived health status, perceived need, perceived value, socioeconomic status, gender, and race was obtained from a national sample of 1,340 young adults from the 2005 Medical Expenditure Panel Survey and examined for possible explanatory variables, as well as data on the same variables from a national sample of 1,463 from the 2008 Medical Expenditure Panel Survey. RESULTS: Results of the structural equation model analysis indicate that insurance coverage in the 2005 sample was largely a function of higher socioeconomic status and being a non-minority. Perceived health status, perceived need, perceived value, and gender were not significant predictors of private health insurance coverage in the 2005 sample. However, in the 2008 sample, these indicators changed. Socioeconomic status, minority status, perceived health, perceived need, and perceived value were significant predictors of private health insurance coverage. CONCLUSIONS: The results of this study show that coverage by a private health insurance plan in the 2005 sample was largely a matter of having a higher socioeconomic status and having a non-minority status. In 2008 each of the attitudinal variables (perceived health, perceived value, and perceived need) predicted whether subjects carried private insurance. Our findings suggest that among those sampled, the young adult subgroup between the ages of 18 and 24 does not necessarily represent a unique segment of the population, with behaviors differing from the rest of the sample.

Understanding the barriers to physician error reporting and disclosure: a systemic approach to a systemic problem.

INTRODUCTION: The issues of medical errors and medical malpractice have stimulated significant interest in establishing transparency in health care, in other words, ensuring that medical professionals formally report medical errors and disclose related outcomes to patients and families. However, research has amply shown that transparency is not a universal practice among physicians. METHODS: A review of the literature was carried out using the search terms "transparency," "patient safety," "disclosure," "medical error," "error reporting," "medical malpractice," "doctor-patient relationship," and "physician" to find articles describing physician barriers to transparency. RESULTS: The current literature underscores that a complex Web of factors influence physician reluctance to engage in transparency. Specifically, 4 domains of barriers emerged from this analysis: intrapersonal, interpersonal, institutional, and societal. CONCLUSION: Transparency initiatives will require vigorous, interdisciplinary efforts to address the systemic and pervasive nature of the problem. Several ethical and social-psychological barriers suggest that medical schools and hospitals should collaborate to establish continuity in education and ensure that knowledge acquired in early education is transferred into long-term learning. At the institutional level, practical and cultural barriers suggest the creation of supportive learning environments and private discussion forums where physicians can seek moral support in the aftermath of an error. To overcome resistance to culture transformation, incremental change should be considered, for example, replacing arcane transparency policies and complex reporting mechanisms with clear, user-friendly guidelines.

Emergency department utilization at a large regional hospital: a strategy for survivability.

This research effort provides a brief picture of the operational, patient, and financial patterns of the multiple emergency departments of a large hospital system located in the southeastern United States. The results are presented anonymously as a descriptive case study. A multifaceted strategy is presented to assist hospital leaders as they strive to ensure the survivability of their emergency departments in this era of high uncompensated care.

Internal marketing: creating quality employee experiences in health care organizations.

To cope with the recent challenges within the health care industry, health care managers need to engage in the internal marketing of their various services. Internal marketing has been used as an effective management tool to increase employees' motivation, satisfaction, and productivity (J Mark Commun. 2010;16(5):325-344). Health care managers should understand that an intense focus on internal marketing factors will lead to a quality experience for employees that will ultimately have a positive effect on the patient experiences.

Determinants of health insurance coverage rates for young adults: an analytical literature review.

This chapter summarizes the major determinants of health insurance coverage rates among young adults. Socioeconomic status, demographics, actual and perceived health status, perceived value, and perceived need are all examined in order to determine what the literature reveals regarding each variable and how each variable impacts a young adult's decision to purchase health insurance. Results indicate that socioeconomic status, demographics, perceived value, and perceived need were the most significant determinates of health insurance status of young adults. A conceptual framework is also examined and used to illustrate theoretical implications. Managerial implications for marketing health plans to young adults are also addressed. Finally, policy implications concerning the new Patient Protection and Affordable Care Act are addressed.

Retire already! Managing physicians who no longer want to work, but have to.

The economic downturn has wreaked havoc on our professional lives and has presented a whole host of challenges including managing physicians who can no longer retire due to the reduced value of their retirement savings. As a result, many medical practices are burdened with physicians who are disinterested in continuing to work in the practice, but who remain solely due to financial reasons. This article will provide practice managers with several means to encourage these "retired-on-the-job" physicians to improve their attitudes and productivity levels, or do what they have already informally done--retire. Specifically, this article reviews four options for dealing with such employees, including: (1) coaching; (2) offering flexible work options; (3) changing revenue-sharing agreement; and (4) dismissal.

Emergency department utilization by insured users: a study of motivating factors.

Emergency departments (EDs) represent a critical entryway into America's health care delivery system and are under significant pressure. This study seeks to understand why insured patients use EDs rather than more appropriate medical alternatives available to reduce the strain they are placing on this critical portal of entry. This exploratory research study surveyed insured patients presenting to 1 of 4 Central Florida EDs. Factor analysis and cluster analysis were used to identify groups of insured ED users defined by motivating factors. This study found that there exists a disconnect between insured individuals and the primary care system.

You've got them, now what? Successfully mentoring student interns.

This article, the third in the series, is designed to help medical group practices understand the mentoring process, which is critical to the success of the internship. This article provides medical group practices with tips to successfully mentor student interns in order to maximize the experience for both parties. This article provides characteristics of good mentors, a framework for the learning experience, tips on how to successfully mentor student and a discussion of the benefits to the mentor and student intern.

Internship logistics: successfully navigating the internship process.

This article, the second in the series, is designed to help medical practices understand how the internship process works. This article helps practice managers perform a needs analysis in order to determine if a student intern is appropriate, provides tools to help structure the internships and forms to evaluate the process, and identifies ways for the practice to avoid legal pitfalls when "employing" interns.

Free labor! How to successfully use student interns in your practice.

Medical practices have an untapped talent pool of free labor. students needing internships in health administration, health information management, and related programs. An internship, or pre-professional practice, refers to the experience whereby students are able to gain invaluable field experience that is beneficial to both medical practices and students. The first article of a three-part series on utilizing student interns in medical practice, this article provides an overview about this untapped resource and provides the reader with information about internships; the different types of internships available; the benefits to the practice, preceptor, and intern; and pitfalls to avoid.

Administrative decision making: a stepwise method.

Today's health care organizations face tremendous challenges and fierce competition. These pressures impact the decisions that managers must execute on any given day, not to mention the ever-present constraints of time, personnel, competencies, and finances. The importance of making quality and informed decisions cannot be underestimated. Traditional decision making methods are inadequate for today's larger, more complex health care organizations and the rapidly changing health care environment. As a result, today's health care managers and their teams need new approaches to making decisions for their organizations. This article examines the managerial decision making process and offers a model that can be used as a decision making template to help managers successfully navigate the choppy health care seas. The administrative decision making model will enable health care managers and other key decision makers to avoid the common pitfalls of poor decision making and guide their organizations to success.

The facility audit and review method: evaluating institutional ethics in health care organizations.

Auditing processes--such as financial, compliance, and investigative audits-are commonplace in the health care industry. However, an audit to assess institutional ethics in health care facilities is a fairly new concept. The Facility Audit and Review Method is an assessment tool that provides an evaluation scheme to review the organization's policies, procedures, and outcomes using an ethical perspective. This article discusses ethics in the context of health care, the various types of auditing mechanisms used in health care facilities, and how these two--ethics and audits--come together to form the 4-stage Facility Audit and Review Method.

The view from within: a comparison of traditional and non-traditional doctoral education from students' perspectives ... then and now.

This article compares and contrasts the differing doctoral experiences of the traditional and nontraditional doctoral programs. This paper examines the doctoral experiences at a traditional doctoral program, the University of Alabama at Birmingham's (UAB) Administration of Health program, and at a nontraditional program, the University of Central Florida's (UCF) Public Affairs doctoral program. Additionally, this paper explores the characteristics of each of these types of programs, including the benefits and drawbacks based upon research, as well as from firsthand experience. The authors share their personal experiences from the perspective of academics working in the field for several years. Lastly, the authors present several avenues for future research to further explore the differences between traditional and nontraditional doctoral educational programs.

Consumer determinants of the use of health plan information in plan selection.

One of the major issues in achieving optimum levels of performance in health-care markets is to enhance consumer understanding of their health plan choices in order to facilitate the expansion of 'high-value' health plans at the expense of 'low-value' health plans. The Federal government offers employees many choices of health plans and provides large amounts of information on all of these options through (1) comparative written health plan information, (2) information from the health plans themselves, and (3) comparative health plan information on the Internet. The present study examines the degree to which 1722 Federal employees in the Department of Health and Human Services utilized health plan information from the above three sources in making their annual health plan selection. Results indicate that most employees (64%) used at least one information source, with written information from health plans the most common (53%), followed by comparative written information in The Guide (32%) and the Internet (16%). Those employees who regularly search for information prior to making an important purchase, those with a short time in their current plan, those with family coverage, Whites, African-Americans, and men were all more likely to use health plan information to make their annual choice. The Internet was accessed more often by younger and higher paid employees. Implications for policy and future research are discussed.

Incorporating ethics into your comprehensive organizational plan.

Today's health care executives find their organizations facing internal and external environments that are behaving in chaotic and unpredictable ways. From inadequate staffing and an increase in clinical errors to outdated risk management procedures and increased competition for scare reimbursements, these health care managers find themselves making decisions without being fully informed of the ethical ramifications of these decisions. A 6-part Comprehensive Organizational Plan is presented that helps the health care decision maker better understand the key success factors for the organization. The Comprehensive Organizational Plan is an overall plan that is intended to protect and serve your organization. The 6 plans in the Comprehensive Organizational Plan cover the following areas: competition, facilities, finances, human resources, information management, and marketing. The comprehensive organizational plan includes an overlay of the ethical considerations for each part of the plan.

The comprehensive organizational plan: how a COP can protect and serve your health care organization.

In today's hyperturbulent and competitive health care environment, health care organizations must improve operating efficiency, reduce duplication, and compete effectively in the health care market to survive. The comprehensive organizational plan is a 5-stage development tool for health care organizations that is intended to protect and serve the health care organization in its survival efforts. Through its 5 planning stages-competitive, facilities, financial, human resources, and marketing-the comprehensive organizational plan assists the organization in optimizing the goals of cost containment, quality preservation, and universal access.

Determinants of the use of health plan information in formulating health plan selection decisions.

This study seeks to identify the impact of information on employees' health plan selection decision-making. Surveys were administered to 1,722 Federal employees working in the Department of Health and Human Services (DHHS) enrolled in the Federal Employees Health Benefits Program (FEHBP). This study focuses on the enrollees' access to and use of three types of health plan information: print information issued by the Federal government (in particular, The Guide to Federal Employees Health Benefit Plans), print information issued by the health plans, and web-based information. Literature from health plans was utilized to a greater degree than The Guide. Web-based information was the least accessed and used. Major positive predictors of the use of health plan information from any source were: race, time in Federal employment, whether the employee was considering a plan change, employees with less time in current plan, employees who search for information to make decisions, and spouses' health status. Younger and more-educated employees were more likely to access web-based information. Implications for management, policy, and future research are discussed.