RBA News...Spring 2007
Come here to get a quick update on Richard Bogue and Affiliates. [Click here to ask questions or give feedback].
Since taking on a full-time position there in 2003, Richard Bogue has been working to redevelop and build the Center for Health Futures at Florida Hospital. Tidbits...
Improving physician satisfaction. The Center is leading the Physician to Physician (P2P) series of studies. In previous research, physician satisfaction has been found to be associated with medical errors, patient compliance, career exit, and patient care costs. Initiated in 2003, the P2P Satisfaction study (P2PS) collected 705 physician satisfaction surveys and conducted 26 one- to two-hour interviews with more highly satisfied physicians in various stages of career development. Survey results revealed strong associations between physicians' personal lives and stress, but physicians' work lives were not strongly associated with stress. Is a physicians' overall life circumstance the most important protective or destructive factor when it comes to their stressful careers? The goal of the interviews was to identify Life Practices of highly satisfied physicians, answering the question: "What do more highly satisfied physicians regularly DO that they think helps explain their higher satisfaction?' 10 Life Practices of highly satisfied physicians were identified in the 110 examples provided during the interviews.
Improving physician communication. The P2PC study resulted in a highly efficient instrument to allow physicians to provide each other anonymous--and straightforward--feedback on their communication strengths. Tapping four aspects of physician communication (face-to-face with families, face-to-face with other care givers, telephone, and written), the instrument exhibited a .95 Alpha for scale reliability in an assessment of 38 internal medicine doctors based on over 280 feedback surveys. More critically, the exercise produced increased attention to communication issues among the medical staff.
Examining nursing practice councils. Working with Florida Hospital's Center for Nursing Research and Innovation, the Center conducted a formative and summative evaluation of the implementation of nursing practice councils in seven hospitals. Nursing practice councils are hospital unit-level teams of nurses who identify opportunities for clinical process improvements and conduct research to produce recommendations for change. The study examined nurses' ratings of their unit practice councils in light of their self-rated sense of empowerment. One particularly interesting finding: nurse managers, perhaps pressured by being "in-between" their subordinates expectations of their ability to make change happen and their superiors' careful management of assets, rated themselves as having less empowerment than the nurses who report to them.
Improving hospital leadership in Latin America. Finally, the World Bank is reviewing a manuscript for monograph based on RBA's survey-based research on how hospital governance practices in Latin America link to hospital performance. This study is the first of its kind: multinational survey research examining whether and how different approaches to hospital governance are associated with hospital quality, financial performance, and excellence in accountabilities. The Bank is tentatively planning for worldwide distribution of the monograph.