How employee engagement matters for hospital performance.

Managers increasingly understand that employee engagement is a prerequisite for high performance. This article examines how job, work environment, management and organizational factors influence levels of engagement among healthcare employees. Original data come from the Ontario Hospital Association-NRC Picker Employee Experience Survey, involving over 10,000 employees in 16 Ontario hospitals. The article provides a clear definition and measure of engagement relevant to healthcare. In addition to identifying the main drivers of engagement, findings shows that a high level of employee engagement is related to retention, patient-centred care, patient safety culture and employees' positive assessments of the quality of care or services provided by their team. Implications of these findings for healthcare leaders are briefly considered.

The safe tables collaborative: a statewide experience.

To achieve significant and sustainable statewide improvements in the safety of health care, the Washington State Hospital Association has launched a series of Safe Table Collaboratives. All 97 community hospitals in the state set ambitious goals, implement the latest medical evidence to improve care, and measure progress.

Measuring hospice care: the National Hospice and Palliative Care Organization National Hospice Data Set.

Hospice has seen rapid growth in recent years, but there is a lack of consistency among hospices when it comes to compliance with standards of care. Consequently, hospices vary in performance and in services they provide. With state hospice organizations, the NHPCO developed a National Data Set (NDS) intended to understand demographics, practices, and outcomes; illustrate industry effectiveness; facilitate communication of industry legislative needs; and to support agency performance and improvement. Our paper describes development of the NDS and data that are being collected, and summarizes key findings from the 2000, 2001, and 2002 NDS. The data collection process, which began in 1999, has evolved substantially over a 4-year period to the point that we believe the 2002 NDS represents a well-designed core that will receive only minor modifications annually. This database will be invaluable for comparative audit, clinical practice and managing services because only that which is measured can be improved.

[Introduction of the DRG system in Germany: problems and perspectives from the point of view of the German Hospital Federation]. / DRG-Einführung in Deutschland: Ziele, Problemfelder und Perspektiven auf der Grundlage des Fallpauschalengesetzes aus Sicht der Deutschen Krankenhausgesellschaft.

The medical self-governing bodies at state level have been legally commissioned to develop a DRG-based reimbursement system in Germany till January 1, 2003, the general political and economic conditions being outlined in a DRG law regulating the introduction of a DRG-based case payment system (Fallpauschalengesetz). From the point of view of the German Hospital Federation, though, caution is advised as many of these general conditions cannot easily be implemented into the reality of German hospital practice. For example, the time frame set for introducing DRGs in Germany seems to be near record levels and is bound to cause qualitative cutbacks on the introduction of the new DRG system meant to improve the quality of care. Current hospital planning will be turned inside out. Also, the interfaces between the hospital sector on the one hand and other areas of care on the other will be put to a real test of endurance.

Hospital CEOs' priorities and perceptions regarding industry issues and the Virginia Hospital Association's activities.

Based on a survey of Virginia hospital CEOs, it was revealed that four industry issues are causing a high degree of concern, namely Medicare/Medicaid reimbursement policies, personnel shortages, indigent care, and increased operating expenses. Each of these issues will be discussed regarding the VHA's activities to devise possible solutions. Regarding Medicare, the VHA has worked closely with the American Hospital Association in their federal advocacy efforts encouraging members to write, call, and visit their Congressional representatives to persuade them to pass legislation increasing the Medicare budget. Regarding Medicaid, which is administered by each state and in Virginia involves a 50/50 sharing of the funding between the federal and state governments, the VHA has challenged what it believes to be an illegal hospital reimbursement system through the federal judicial system. While the process is continuing, the VHA is encouraged by the U.S. Supreme Court's decision (July 1990) affirming hospitals' and all other health care providers' right, to pursue via the judicial process their allegation that a state is violating federal law by setting inadequate and inequitable Medicaid reimbursement rates to hospitals. In order to address the personnel shortages issue, the VHA has actively addressed recruitment and retention challenges by establishing a Health Manpower Resource Center and hiring a full-time director. This office targets high school students, second-career adults, and current health care professionals through communication and education programs. The area of indigent care represents one of the VHA's most notable achievements to date. This entails the recent Virginia legislation creating the Indigent Care Trust Fund. This fund's initial amount is some $15 million and represents an approximate 60/40 contribution ratio involving both the State of Virginia and hospitals in Virginia. A formula has been developed for each hospital in Virginia to assess how sensitive they are to indigent care patients, which includes patients who are either in households whose annual income is below the federal poverty level and/or patients who do not have health care insurance. Those Virginia hospitals who are less sensitive to indigent care will contribute to this fund, while those who have more exposure to indigent care patients will be reimbursed from it. Legislation will be proposed to the state legislature to broaden the contributory base to the Indigent Care Trust Fund by requiring employers who do not currently offer health care insurance to their employees to also contribute to the fund. Reimbursements from the fund to Virginia hospitals are scheduled to begin in FY 1991.(ABSTRACT TRUNCATED AT 400 WORDS)