Organization of Healthcare Delivery

Streamlining how health care is delivered in the U.S.’s fragmented system.

Infants in Drug Withdrawal: A National Description of Nurse Workload, Infant Acuity, and Parental Needs

Feb. 1, 2018

Jessica G. Smith, Jeannette A. Rogowski, Kathryn M. Schoenauer, ...

In the Journal of Perinatal and Neonatal Nursing, Jessica Smith and colleagues, including Jeannette Rogowski and Eileen Lake, investigate how infants in drug withdrawal compare with nondrug withdrawal infants to inform proper nurse assignments based on infant acuity and parental needs. Though not commonly recognized, a troubling aspect of the opioid epidemic is increased drug use among pregnant women, which has led to an increase in infants who are...

New OECD Report Highlights Expanded Primary Care Role for Nurses

Jan. 9, 2018

To meet population health care needs in developed countries, health systems must shift their focus from treating acute episodes to managing chronic conditions. With the rise of chronic care comes a new set of tasks that are more time-consuming and team-oriented. Policymakers in many countries are seeking to align the size and composition of their primary care workforce to meet these new needs, by expanding the role of advanced nurses.

Physicians and Advanced Practitioners Specializing in Nursing Home Care, 2012-2015

Research Brief
Nov. 29, 2017

The number of clinicians specializing in nursing home care increased by 33.7% from 2012 to 2015, although nursing home specialists made up only 21% of nursing home clinicians in 2015. Most of these specialists were advanced practitioners (physician assistants and nurse practitioners) delivering post-acute care. The change in number of nursing home specialists varied significantly by geographic region.

System Redesign and the Health Care Workforce

Oct. 19, 2017

An interdisciplinary panel of experts from health care management, economics, and nursing came together at LDI’s 50th Anniversary Symposium to discuss their perspectives on how “organizational innovation” can be used to redesign health care systems and care delivery.

Moderator:
Linda Aiken, PhD, RN, University of Pennsylvania

Nursing Care Disparities in Neonatal Intensive Care Units

Oct. 11, 2017

Eileen T. Lake, Douglas Straiger, Erika Miles Edwards, Jessica G. Smith, Jeannette A. Rogowski

In Health Services Research, Eileen Lake and colleagues, including Jessica Smith and Jeannette Rogowski, compared missed nursing care for infants in neonatal intensive care units (NICUs) across hospitals with a predominantly-black versus non-black patient population. The authors sought to understand the factors that cause nurses to miss care. At sites across four states, NICU nurses completed a survey on the floor’s average patient load, nursing environment, and nursing professional characteristics, as well as their individual patient load and the care that they missed on their...

Addressing Gaps in Evidence-Based Opioid Policy and Practice

Aug. 29, 2017

Although evidence from health policy research should inform policymaking, researchers and policymakers don’t always communicate. A conference sponsored by the Center for Health Economics of Treatment Interventions for Substance Use Disorder, HCV, and HIV (CHERISH) – a NIDA-funded Center of Excellence – and hosted by the Leonard Davis Institute of Health Economics (LDI) sought to close this gap…if even for a day.

Post-operative mortality, missed care and nurse staffing in nine countries: A cross-sectional study

Aug. 28, 2017

Jane E. Ball, Luk Bruyneel, Linda H. Aiken, Walter Sermeus, Douglas M. Sloane, Anne Marie Rafferty, Rikard Lindqvist, Carol Tishelman, Peter Griffiths, RN4CAST Consortium

In International Journal of Nursing Studies, Jane Ball and colleagues, including Linda Aiken, examine if missed nursing care explains the observed association between nurse staffing levels and mortality. Previous research has shown that higher postoperative mortality rates are associated with lower nurse staffing levels. When nurse staffing levels are lower, there is a higher incidence of necessary but missed nursing care. The authors collected data from 422,730 patients from 300 general acute hospitals, and administered surveys to 26,516 registered nurses to understand staffing...

Structural, Nursing, and Physician Characteristics and 30-Day Mortality for Patients Undergoing Cardiac Surgery in Pennsylvania

Research Brief
Jul. 27, 2017

This study finds no relationship between mortality and cardiac ICU organizational factors, such as presence of daytime or nighttime intensivists, nurse ICU experience, or presence of interns or residents.

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