102,269 research outputs found
Healthcare reform: Innovative and other proven strategies for successfully managing and implementing organizational change
No full textThe purpose of this study was to provide innovative and other proven change strategies that assist the healthcare industry and healthcare organizations with implementing organizational change. Evidence shows that healthcare spending in the United States grew ten times the base rate in 1980 from 2.6 trillion in 2010 (Centers for Medicare and Medicaid Services, 2012). Compounding this problem is the limited availability to patient care and the diminishing value of care. The U. S. healthcare industry cannot survive under these circumstances without changing the overall system. In order for healthcare organizations to survive, they must embrace innovative and other proven strategies to remain competitive.
Through examining healthcare trends, healthcare innovation, and organizational change theory, this dissertation found that various tools, best practices, and strategies exist that will aid U.S. healthcare organizations with the impending healthcare reform. By using an evRunning Head: HEALTHCARE REFORM: STRATEGIES FOR MANAGING CHANGE
Healthcare Reform: Innovative and Other Proven Strategies for Successfully Managing and Implementing Organizational Change
University of Maryland University College
Lisa M. Pinkney
A Thesis
Submitted to the
Graduate Faculty
of
University of Maryland University College
in Partial Fulfillment of
The Requirements for the Degree
of
Doctor of Management
G. David Andersen, Ed.D. Eric Dent, Ph.D.
Healthcare Reform: Strategies For Managing Change 2
Abstract
The purpose of this study was to provide innovative and other proven change strategies that assist the healthcare industry and healthcare organizations with implementing organizational change. Evidence shows that healthcare spending in the United States grew ten times the base rate in 1980 from 2.6 trillion in 2010 (Centers for Medicare and Medicaid Services, 2012). Compounding this problem is the limited availability to patient care and the diminishing value of care. The U. S. healthcare industry cannot survive under these circumstances without changing the overall system. In order for healthcare organizations to survive, they must embrace innovative and other proven strategies to remain competitive.
Through examining healthcare trends, healthcare innovation, and organizational change theory, this dissertation found that various tools, best practices, and strategies exist that will aid U.S. healthcare organizations with the impending healthcare reform. By using an evidence-based research methodology approach, this study identified change strategies for healthcare organizations and the healthcare industry to use to adequately manage organizational change. The dissertation concluded with strategies such as information technology, use of incentives, and best practices. These proven strategies will assist healthcare organizations when undergoing organizational change and that may serve to lessen the burden of healthcare cost, increase accessibility to care, and provide better quality healthcare.
Key Words: healthcare reform, organizational change, innovation, healthcare change, healthcare management, innovative strategies, innovation and healthcare, and change strategiesHealthcare Reform: Strategies For Managing Change 3
Acknowledgements
I would like to thank my mother, Dorothea “Dottie” Neal Pinkney. Dottie has been my biggest cheerleader providing support and encouragement throughout this journey. My mother has been patient and very understanding when I have been absent from family functions. Second, I would like to thank my family especially my sister Denise Pinkney Wright who constantly provided moral support to me and encouraged me through this process. The professional, academic, and personal discussions were invaluable and always helped me see the forest through the trees. I love you sis!
I would like to thank the University of Maryland University College for having a doctorate program that I was able to participate in while still working full time. It was truly a challenge, but at least I can sleep now. Thanks to my professors Dr. Michael Frank, Dr. Eric Dent, Dr. James Gelatt, Dr. Pearl Steinbuch, Dr. Laura Witz, Dr. Thomas Mierzwa, Dr. Subash Bijlani, and Dr. G. David Andersen for continuing to challenge me to strive for excellence. Special thanks to my former cohort peer Joanne Tritsch for your wittiness and humor throughout this journey. Thanks to my current cohort peer Denise Bailey Clark who is the ultimate professional who I truly admire, and Deborah Meadows who is the ultimate perfectionist. With cohort members like these, I could only soar! I would also like to thank Katherine “Kitty” Williams who always brought normality and humor to intense situations. Your help during this process was invaluable and I truly appreciate you.
Finally, I would like to thank GOD for providing me with the perseverance, fortitude, and strength to endure this rigorous program and for placing special people in my life that helped me thought this journey.Healthcare Reform: Strategies For Managing Change 4
Table of Contents
Abstract .....................................................................................................................................2
Acknowledgements....................................................................................................................3
Table of Contents.......................................................................................................................4
Chapter One: Introduction.....................................................................................................10
Background..............................................................................................................................11
Statement and Significance of the Problem................................................................................12
Purpose of the Study .................................................................................................................16
Research Questions ...................................................................................................................19
Research Assumptions ..............................................................................................................20
Research Proposition.................................................................................................................21
Definition of Terms...................................................................................................................21
Chapter Summary .....................................................................................................................22
Organization of Dissertation......................................................................................................23
Chapter Two: Literature Review ...........................................................................................25
Introduction to the Literature View ...........................................................................................25
The Healthcare Industry.........................................................................................................25
Literature Review Outline......................................................................................................26
Healthcare Industry Trends (Political, Cultural, and Economic) ................................................27
Political System.....................................................................................................................31
Enhancements in patient privacy.. ......................................................................................31
Advancement in achieving JCAHO compliance. ................................................................32
Culture .................................................................................................................................33
Improvement of workforce supply......................................................................................33
Improving staffing shortages..............................................................................................34
Economic System..................................................................................................................35
Electronic health records.. ..................................................................................................36
Telemedicine.....................................................................................................................36
Growth of healthcare sector................................................................................................36
Healthcare Innovation ...............................................................................................................38
Innovation Theory .................................................................................................................39Healthcare Reform: Strategies For Managing Change 5
Disruptive innovation.........................................................................................................39
Incremental innovation.......................................................................................................41
Architectural innovation.....................................................................................................42
Open innovation.................................................................................................................43
Compare-contrast innovations. ...........................................................................................44
Innovation as a Process..........................................................................................................45
Eight Promising Healthcare Innovations ................................................................................46
Checklists ..........................................................................................................................47
Payment innovations. .........................................................................................................47
Patient portals ....................................................................................................................47
Behavioral economics.. ......................................................................................................48
Surgical robots...................................................................................................................49
Genetic medicine. ..............................................................................................................49
Regenerative medicine. ......................................................................................................49
Accountable care organizations ..........................................................................................50
Information Technology in Healthcare...................................................................................50
Electronic Medical Records (EMR) .......................................................................................52
Automatic Tracking Software ................................................................................................52
Barriers.................................................................................................................................53
Costs.................................................................................................................................53
Culture change.. .................................................................................................................54
Patient privacy and trust.. ...................................................................................................55
Best Practices in Healthcare Innovation .................................................................................56
Healthcare innovation incentives........................................................................................56
National Best Practice Innovation..........................................................................................58
Organizational Change Theory..................................................................................................61
Planned Change Models ........................................................................................................64
Implementing Successful Change ..........................................................................................67
Propositions from the Literature Review ...................................................................................72
Summary of Literature Review..................................................................................................73
Chapter Three: Conceptual Framework................................................................................74Healthcare Reform: Strategies For Managing Change 6
Introduction to the Conceptual Framework................................................................................74
Message in the Literature Review..............................................................................................74
Literature review “lenses” – Integration of scholarship into the framework............................74
The System Lens ...................................................................................................................75
The Practical Lens .................................................................................................................76
The Theoretical Lens .............................................................................................................77
The Conceptual Framework ......................................................................................................78
Chapter Summary .....................................................................................................................80
Chapter Four: Methodology...................................................................................................81
Methodology Overview.............................................................................................................81
Evidence Based Research and Methodology..............................................................................81
Definition and Application to This Study...............................................................................81
Evidence Based Research in Theory and Practice ..................................................................82
Discussion of Relevant Scholarly Evidence...............................................................................85
Subject Matter Expert Panel......................................................................................................89
Subject Matter Expert’s Identification and Rationale for Selection.........................................90
The Feedback Process............................................................................................................91
Subject Matter Expert Feedback ............................................................................................92
Changes Resulting from the Feedback Results .......................................................................94
Chapter Summary .....................................................................................................................94
Chapter Five: Analysis and Discussion ..................................................................................96
Introduction ..............................................................................................................................96
Presentation and Summary of the Findings................................................................................96
Findings Research Question 1 ...................................................................................................97
Healthcare Innovation Findings .............................................................................................98
Innovation theory findings. ................................................................................................98
Promising healthcare innovation findings...........................................................................99
Information technology findings. .....................................................................................101
Organizational Change Findings ..........................................................................................105
Change theory findings ....................................................................................................105
Environmental change findings. .......................................................................................108Healthcare Reform: Strategies For Managing Change 7
Findings Research Question 2 .................................................................................................111
Healthcare Trends Findings .................................................................................................111
Enhancements in patient privacy ......................................................................................113
Advancement in achieving JCAHO compliance. ..............................................................113
Improvement of workforce supply....................................................................................113
Improving staffing shortages. ...........................................................................................114
Electronic health records. .................................................................................................114
Telemedicine. ..................................................................................................................115
Conclusions ............................................................................................................................115
Alternative Perspectives ..........................................................................................................116
Chapter Summary ...................................................................................................................117
Chapter Six: Conclusions, Implications, and Trends ..........................................................119
Introduction ............................................................................................................................119
Overall Conclusions ................................................................................................................119
Implication for Management ...................................................................................................121
Implications of Trends ............................................................................................................122
Global Trends in Healthcare....................................................................................................123
Limitations and Future Research .............................................................................................124
Summary................................................................................................................................125
References ..............................................................................................................................127
Appendix A Best Practices in Healthcare Innovation...............................................................148
Appendix B Public and Private Health Information Technology Initiatives .............................151
Appendix C Young’s Nine Change Literature Themes ............................................................152
Appendix D Kotter’s Eight Steps for Transforming an Organization .......................................154
Appendix E UMUC Executive Director’s Evaluation Form.....................................................155
Appendix F Dissertation Chapter Outline ................................................................................157
Appendix G Subject Matter Expert Evaluation & Feedback Form...........................................158
Appendix H Subject Matter Expert Evaluation & Feedback Form – Dr. Haley ........................159
Appendix I Subject Matter Expert Evaluation & Feedback Form – Dr. Young ........................162Healthcare Reform: Strategies For Managing Change 8
Figure 1 Social Process Framework...........................................................................................28
Figure 2 Diffusion of Health Information Technology...............................................................58
Figure 3 Literature Review Convergence ..................................................................................75
Figure 4 Conceptual Framework for Successfully Managing Healthcare Industry Change.........79
Figure 5 Hierarchy of Evidence.................................................................................................84
Figure 6 A Theoretical Model of the Dynamics of the Planned Change Model ........................109 Healthcare Reform: Strategies For Managing Change 9
Table 1 U.S. International Price Comparison of Specific Medical Products and Services...........16
Table 2 Social Process Framework- Trend Analysis Checklist...................................................29
Table 3 Database Search Combination – Word Search ..............................................................86
Table 4 Inclusion of Literature in this Study................
Statement by grand jurors that Thomas Pinkney and wife Harriet, free Negroes, guilty of assisting a slave to run away, October 1, 1960-October 31, 1860
No full textStatement by grand jurors that Thomas Pinkney and wife Harriet, free Negroes, guilty of assisting a slave to run away, [Frederick County], October 1, 1960-October 31, 1860
Bibliographie Hilarion G. Petzold 1958 – 2009 mit Anhang als Einführung
No full textDieses Archiv enthält die Gesamtbibliographie der Werke des Autors nebst einiger Texte „Über H. G. Petzold“ im Schlussteil der Bibliographie sowie einen Anhang mit einer Einführung in die Architektur des Werkes in seinem wissenslogischen Aufbau als Ausarbeitung seines „Tree of Science Modells“ (2007).This archive contains the complete bibliography of the author and some texts about H. G. Petzold, moreover an epilogue with an introduction to the architecture of the works in its epistemological structure and composition and as an elaborations of Petzold’s „Tree of Science Modell (2007).https://www.fpi-publikation.de/polyloge/01-2009-petzold-h-g-gesamtbibliographie-h-g-petzold-1958-2009-updating-november2009/peerReviewedpublishedVersio
Dispelling the Myths Behind First-author Citation Counts
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counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
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Personal Papers (MS 80-0002)
No full textLetter from Daniel W. Kempner to G. P. "Pink" Pearson confirming his attendance on November 29th and discussing their seats and parking for an upcoming Texas-A&M game in Austin
Recommended from our members
3346: Samuel G. Freedman, author, 2013
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The Right to Strike under the United States Constitution: Theory, Practice, and Possible Implications for Canada
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G-Rank: Unsupervised Continuous Learn-to-Rank for Edge Devices in a P2P Network
No full textRanking algorithms in traditional search engines are powered by enormous training data sets that are meticulously engineered and curated by a centralized entity. Decentralized peer-to-peer (p2p) networks such as torrenting applications and Web3 protocols deliberately eschew centralized databases and computational architectures when designing services and features. As such, robust search-and-rank algorithms designed for such domains must be engineered specifically for decentralized networks, and must be lightweight enough to operate on consumer-grade personal devices such as a smartphone or laptop computer. We introduce G-Rank, an unsupervised ranking algorithm designed exclusively for decentralized networks. We demonstrate that accurate, relevant ranking results can be achieved in fully decentralized networks without any centralized data aggregation, feature engineering, or model training. Furthermore, we show that such results are obtainable with minimal data preprocessing and computational overhead, and can still return highly relevant results even when a user’s device is disconnected from the network. G-Rank is highly modular in design, is not limited to categorical data, and can be implemented in a variety of domains with minimal modification. The results herein show that unsupervised ranking models designed for decentralized p2p networks are not only viable, but worthy of further research.https://github.com/awrgold/G-RankComputer Scienc
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