Organizational political affiliation and job seekers: If I don't identify with your party, am I still attracted?

Political divisions appear to be relatively frequent in today's world. Indeed, individuals on opposing sides of these divisions often view each other very negatively. The present multi-study investigation contributes to the nascent literature on organizational political affiliation by examining how job seekers view organizations with political affiliations, a practice that is becoming more prevalent. Studies 1 and 2 indicated that many job seekers are aware of organizations' political affiliations or stances, and that they often considered these affiliations and stances during recent job searches. For example, nearly one-third of participants said they did not apply to an organization because of its political affiliation or stances. Study 3 showed that the extent to which job seekers identified with the organization's party affiliation positively influenced their reactions toward the organization (e.g., perceived similarity and liking), as well as their intention to pursue employment with the organization. In contrast, job seekers' disidentification with the organization's affiliation decreased their feelings of perceived similarity and liking. Study 4 demonstrated that organizational affiliation with a political issue (i.e., gun control/second amendment) also influenced perceptions of similarity and liking. Taken together, results suggest that organizations' affiliations with political parties or their stances on political issues can influence the amount and types of potential employees that organizations attract. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Does Community- or University-Based Residency Sponsorship Affect Graduate Perceived Preparation or Performance?

BACKGROUND

Residency training occurs in varied settings. Whether there are differences in the training received by graduates of community- or medical school-based programs has been the subject of debate.

OBJECTIVE

This study examined the perceived preparation for practice, scope of practice, and American Board of Family Medicine (ABFM) board examination pass rates of family physicians in relation to the type of residency program (community, medical school, or partnership) in which they trained.

METHODS

Predetermined survey responses were abstracted from the 2016 and 2017 National Family Medicine Graduate Survey of ABFM and linked to data about residency programs obtained from the websites of national organizations. Descriptive statistics were used to summarize the data and logistic regression to examine differences between survey results based on type of residency training: community, medical school, or partnership.

RESULTS

Differences in the perception of preparation as well as current scope of practice were noted for the 3 residency types. The differences in perception were mainly noted in hospital-based skills, such as intubation and ventilator management, and in women's health and family planning services, with different program types increasing preparedness perception in different domains.

CONCLUSIONS

In general, graduates of family medicine community-based, non-affiliated, and partnership programs perceived they were prepared for and were providing more of the services queried in the survey than graduates of medical school-based programs.

Association of Clinician Health System Affiliation With Outpatient Performance Ratings in the Medicare Merit-based Incentive Payment System

IMPORTANCE

Integration of physician practices into health systems composed of hospitals and multispecialty practices is increasing in the era of value-based payment. It is unknown how clinicians who affiliate with such health systems perform under the new mandatory Centers for Medicare & Medicaid Services Merit-based Incentive Payment System (MIPS) relative to their peers.

OBJECTIVE

To assess the relationship between the health system affiliations of clinicians and their performance scores and value-based reimbursement under the 2019 MIPS.

DESIGN, SETTING, AND PARTICIPANTS

Publicly reported data on 636 552 clinicians working at outpatient clinics across the US were used to assess the association of the affiliation status of clinicians within the 609 health systems with their 2019 final MIPS performance score and value-based reimbursement (both based on clinician performance in 2017), adjusting for clinician, patient, and practice area characteristics.

EXPOSURES

Health system affiliation vs no affiliation.

MAIN OUTCOMES AND MEASURES

The primary outcome was final MIPS performance score (range, 0-100; higher scores intended to represent better performance). The secondary outcome was MIPS payment adjustment, including negative (penalty) payment adjustment, positive payment adjustment, and bonus payment adjustment.

RESULTS

The final sample included 636 552 clinicians (41% female, 83% physicians, 50% in primary care, 17% in rural areas), including 48.6% who were affiliated with a health system. Compared with unaffiliated clinicians, system-affiliated clinicians were significantly more likely to be female (46% vs 37%), primary care physicians (36% vs 30%), and classified as safety net clinicians (12% vs 10%) and significantly less likely to be specialists (44% vs 55%) (P < .001 for each). The mean final MIPS performance score for system-affiliated clinicians was 79.0 vs 60.3 for unaffiliated clinicians (absolute mean difference, 18.7 [95% CI, 18.5 to 18.8]). The percentage receiving a negative (penalty) payment adjustment was 2.8% for system-affiliated clinicians vs 13.7% for unaffiliated clinicians (absolute difference, -10.9% [95% CI, -11.0% to -10.7%]), 97.1% vs 82.6%, respectively, for those receiving a positive payment adjustment (absolute difference, 14.5% [95% CI, 14.3% to 14.6%]), and 73.9% vs 55.1% for those receiving a bonus payment adjustment (absolute difference, 18.9% [95% CI, 18.6% to 19.1%]).

CONCLUSIONS AND RELEVANCE

Clinician affiliation with a health system was associated with significantly better 2019 MIPS performance scores. Whether this represents differences in quality of care or other factors requires additional research.

Landscape of Health Systems in the United States

Despite the prevalence of vertical integration, data and research focused on identifying and describing health systems are sparse. Until recently, we lacked an enumeration of health systems and an understanding of how systems vary by key structural attributes. To fill this gap, the Agency for Healthcare Research and Quality developed the Compendium of U.S. Health Systems, a data resource to support research on comparative health system performance. In this article, we describe the methods used to create the Compendium and present a picture of vertical integration in the United States. We identified 626 health systems in 2016, which accounted for 70% of nonfederal general acute care hospitals. These systems varied by key structural attributes, including size, ownership, and geographic presence. The Compendium can be used to study the characteristics of the U.S. health care system and address policy issues related to provider organizations.

[Concerning the affiliations of authors who publish in the Revista Médica del IMSS]

In this editorial, it is exposed the importance of affiliations of authors who publish in journals, and especially in the Revista Médica del IMSS. Additionally, some examples of affiliations are exposed and the editorial handling that is given to them in several cases.

PBMs: Maligned as Middlemen, They're Hearing Wedding Bells

The PBM industry is under fire these days for what critics call its lack of transparency and its knotty contract language, secretive pricing schemes, and an inscrutable assortment of rebates, discounts, side deals, and administrative fees. Some see partnerships with insurers and retailers as a possible solution. Opponents see a risk of even higher drug prices.

Perceived organizational affiliation and its effects on patient trust: Role modeling with embodied conversational agents

OBJECTIVE

Verbal and non-verbal behaviors, which are known as "relational contextualization cues", relay information about relationships and how they are structured. We developed a computer-simulated provider conducting an informed consent process for clinical research to investigate the effects of a provider's alignment of interests with a patient, the research team, or a neutral party on patient trust in the provider.

METHODS

Participants (N=43) interacted with a simulated provider for a research informed consent process in a three-arm, counterbalanced, within-subjects experiment. Participants reported their trust in the simulated provider after each treatment.

RESULTS

Participants successfully recognized the alignment manipulation, and perceived the patient-aligned provider as more trustworthy than the other providers. Participants were also more satisfied with the patient-aligned provider, liked this provider more, expressed more desire to continue working with this provider, and stated that they were significantly more likely to sign the consent form after interacting with this provider compared to the other two.

CONCLUSION

Relational contextualization that aligns with the patient increases trust, satisfaction, and willingness to enroll in the context of research informed consent.

PRACTICE IMPLICATIONS

Health providers should align themselves with patients' interests.

The influence of the team in conducting a systematic review

There is an increasing body of research documenting flaws in many published systematic reviews' methodological and reporting conduct. When good systematic review practice is questioned, attention is rarely turned to the composition of the team that conducted the systematic review. This commentary highlights a number of relevant articles indicating how the composition of the review team could jeopardise the integrity of the systematic review study and its conclusions. Key biases require closer attention such as sponsorship bias and researcher allegiance, but there may also be less obvious affiliations in teams conducting secondary evidence-syntheses. The importance of transparency and disclosure are now firmly on the agenda for clinical trials and primary research, but the meta-biases that systematic reviews may be at risk from now require further scrutiny.

'The idea of the stand-alone hospital is gone'

Northwell Health, formerly known as North Shore-Long Island Jewish Health System, continues to pursue aggressive expansion moves throughout the New York City metropolitan area. CEO Michael Dowling is also stepping up the New Hyde Park, N.Y.-based system's investment in startup firms and innovative technologies that are launched in-house. Dave Barkholz, Modern Healthcare's Southern Bureau chief, caught up with Dowling at last month's J.P. Morgan Healthcare Conference in San Francisco. The following is an edited transcript.

Coordinated Management of Academic Health Centers

Academic health centers (AHCs) are the nation's primary resource for healthcare discovery, innovation, and training. US healthcare revenue growth has declined sharply since 2009, and is forecast to remain well below historic levels for the foreseeable future. As the cost of education and research at nearly all AHCs is heavily subsidized through large transfers from clinical care margins, our institutions face a mounting crisis. Choices centering on how to increase the cost-effectiveness of the AHC enterprise require unprecedented levels of alignment to preserve an environment that nurtures creativity. Management processes require governance models that clarify decision rights while harnessing the talents and the intellectual capital of a large, diverse enterprise to nimbly address unfamiliar organizational challenges. This paper describes key leadership tactics aimed at propelling AHCs along this journey - one that requires from all leaders a commitment to resilience, optimism, and willingness to embrace change.

Abbott-St. Jude merger gives providers what they want: fewer vendors

The Abbott-St. Jude merger will help hospitals consolidate vendor relationships, but it has the potential to lead to higher supply costs in the long term.

MACRA likely to accelerate consolidation; will the regulatory framework support it?

It took 17 years and more than a dozen acts of Congress before the Medicare sustainable growth-rate formula was replaced by the Medicare Access and CHIP Reauthorization Act in April 2015.

Developing Community Health Promotion Interventions: Selecting Partners and Fostering Collaboration

Although an often desired goal, true partnership between community members and university researchers can be difficult to achieve. Strategies implemented in a diabetes prevention and control program in a Latino community may be effective in overcoming hurdles to collaborative research. The development of selection criteria can be useful for objectively choosing a community organization as a partner agency. The implementation of formal partnership principles is proposed as a strategy for building a successful partnership. Partnership principles are a powerful mechanism to assure ethical relations between collaborators. As a strategy for process evaluation, they can help organize data on the extent to which intent has translated into action. They provide a structure for project stability that can outlast individual commitments and a mechanism to keep project commitment on course and maintain active engagement.

How is the sustainability of chronic disease health programmes empirically measured in hospital and related healthcare services?-a scoping review

OBJECTIVES

Programmes to address chronic disease are a focus of governments worldwide. Despite growth in 'implementation science', there is a paucity of knowledge regarding the best means to measure sustainability. The aim of this review was to summarise current practice for measuring sustainability outcomes of chronic disease health programmes, providing guidance for programme planners and future directions for the academic field.

SETTINGS

A scoping review of the literature spanning 1985-2015 was conducted using MEDLINE, CINAHL, PsychINFO and The Cochrane Library limited to English language and adults. Main search terms included chronic disease, acute care, sustainability, institutionalisation and health planning. A descriptive synthesis was required. Settings included primary care, hospitals, mental health centres and community health.

PARTICIPANTS

Programmes included preventing or managing chronic conditions including diabetes, heart disease, depression, respiratory disease, cancer, obesity, dental hygiene and multiple chronic diseases.

PRIMARY AND SECONDARY OUTCOME MEASURES

Outcome measures included clarifying a sustainability definition, types of methodologies used, timelines for assessment, criteria levels to determine outcomes and how methodology varies between intervention types.

RESULTS

Among 153 abstracts retrieved, 87 were retained for full article review and 42 included in the qualitative synthesis. Five definitions for sustainability outcome were identified with 'maintenance of programme activities' most frequent. Achieving sustainability was dependent on inter-relationships between various organisational and social contexts supporting a broad scale approach to evaluation. An increasing trend in use of mixed methods designs over multiple time points to determine sustainability outcomes was found.

CONCLUSIONS

Despite the importance and investment in chronic disease programmes, few studies are undertaken to measure sustainability. Methods to evaluate sustainability are diverse with some emerging patterns in measurement found. Use of mixed methods approaches over multiple time points may serve to better guide measurement of sustainability. Consensus on aspects of standardised measurement would promote the future possibility of meta-analytic syntheses.

Evaluating the Impact of Health Insurance Industry Consolidation: Learning from Experience

Research shows consolidation in the private health insurance industry leads to premium increases, even though insurers with larger local market shares generally obtain lower prices from health care providers. Additional research is needed to understand how to protect against harms and unlock benefits from scale. Data on enrollment, premiums, and costs of commercial health insurance--by insurer, plan, customer segment, and local market--would help us understand whether, when, and for whom consolidation is harmful or beneficial. Such transparency is common where there is a strong public interest and substantial public regulation, both of which characterize this vital sector.

Successful medical group integration: it's about more than the numbers

Key aspects of integrating a medical group into a health system include: Performing due diligence. Developing a culture of trust. Onboarding new physicians and groups. Dealing with underperforming physicians.

Health literature authored by nurses within the LAC region: a cross-sectional study

OBJECTIVE

To analyze current trends and directions in Latin America and Caribbean (LAC) nursing research and identify areas that need development.

METHODS

A search was conducted in PubMed and LILACS for studies published in English from 1 January 2008 to 26 June 2014 that met the inclusion criteria (health research conducted in the LAC region by authors with an explicit nursing affiliation working in a LAC country). Two reviewers assessed and extracted the data.

RESULTS

More than 4 000 references met the inclusion criteria and 1 343 of those were published in English during the search time period. Although the research originated from 17 different countries, most of it was produced by Brazil. The majority of the studies were from academic institutions (67%), 23.9% involved multi-institutional collaboration, and 5.4% involved multi-country collaboration. Almost all of the studies (98%) were applied research and had a descriptive (55%) or qualitative (30%) design. The most prevalent topic was nursing care (23.4%). Health systems and services were the least studied topics. /About 25% of the studies contained some reference to United Nations Millennium Development Goals.

CONCLUSIONS

The overwhelming majority of LAC countries rely on the scientific findings of a few leading countries in the region. Future directions should include the establishment of an agenda for the region and/or by country to define research priorities within the context of nursing practices. It is imperative for nurses to influence and conduct research in areas of policy and health systems and services given their important role in promoting, restoring, and maintaining health in individuals, and in helping to ensure universal access to health and universal health coverage.

Integrating team resource management program into staff training improves staff's perception and patient safety in organ procurement and transplantation: the experience in a university-affiliated medical center in Taiwan

BACKGROUND

The process involved in organ procurement and transplantation is very complex that requires multidisciplinary coordination and teamwork. To prevent error during the processes, teamwork education and training might play an important role. We wished to evaluate the efficacy of implementing a Team Resource Management (TRM) program on patient safety and the behaviors of the team members involving in the process.

METHODS

We implemented a TRM training program for the organ procurement and transplantation team members of the National Taiwan University Hospital (NTUH), a teaching medical center in Taiwan. This 15-month intervention included TRM education and training courses for the healthcare workers, focused group skill training for the procurement and transplantation team members, video demonstration and training, and case reviews with feedbacks. Teamwork culture was evaluated and all procurement and transplantation cases were reviewed to evaluate the application of TRM skills during the actual processes.

RESULTS

During the intervention period, a total of 34 staff members participated the program, and 67 cases of transplantations were performed. Teamwork framework concept was the most prominent dimension that showed improvement from the participants for training. The team members showed a variety of teamwork behaviors during the process of procurement and transplantation during the intervention period. Of note, there were two potential donors with a positive HIV result, for which the procurement processed was timely and successfully terminated by the team. None of the recipients was transplanted with an infected organ. No error in communication or patient identification was noted during review of the case records.

CONCLUSION

Implementation of a Team Resource Management program improves the teamwork culture as well as patient safety in organ procurement and transplantation.

Partners in clinical excellence. Community hospitals tap into top-quality expertise, while nationally renowned organizations expand their reach

Community hospitals form alliances with nationally renowned organizations to bring top-quality care home.

Physiology education in North American dental schools: the basic science survey series

As part of the Basic Science Survey Series for Dentistry, members of the American Dental Education Association (ADEA) Physiology, Pharmacology, and Therapeutics Section surveyed directors of physiology courses in North American dental schools. The survey was designed to assess, among other things, faculty affiliation and experience of course directors, teaching methods, general course content and emphasis, extent of interdisciplinary (shared) instruction, and impact of recent curricular changes. Responses were received from forty-four of sixty-seven (65.7 percent) U.S. and Canadian dental schools. The findings suggest the following: substantial variation exists in instructional hours, faculty affiliation, class size, and interdisciplinary nature of physiology courses; physiology course content emphasis is similar between schools; student contact hours in physiology, which have remained relatively stable in the past fifteen years, are starting to be reduced; recent curricular changes have often been directed towards enhancing the integrative and clinically relevant aspects of physiology instruction; and a trend toward innovative content delivery, such as use of computer-assisted instruction, is evident. Data from this study may be useful to physiology course directors, curriculum committees, and other dental educators with an interest in integrative and interprofessional education.

Trends in hospital network participation and system affiliation, 2007-2012

Key Findings. (1) Hospital network participation from 2007 to 2012 increased in larger hospitals (more than 150 beds), non-government not-for-profit hospitals, and metropolitan hospitals. Network participation changed inconsistently in other types of hospitals. (2) Hospital system affiliation has generally increased in hospitals of all sizes, non-government not-for-profit hospitals, hospitals in all census regions, CAHs, and both metropolitan and nonmetropolitan hospitals. There are notably higher percentages of system affiliation among midsized and large hospitals, investor-owned hospitals, and metropolitan hospitals compared to their counterparts.

In search of a perfect partner

When a financially stable sole community provider sought to affiliate with another hospital, its leaders encountered unexpected complications.

No longer the sole provider

A Texas system connects with local partners to expand services.