Stop Making Sense? Seeking Clarity in a Chaotic or Complex World No abstract available

Alan B. Keesee, FACHE, President and CEO, Capital Regional Medical Center, Tallahassee, Florida No abstract available

The Butterfly Effect in Healthcare: What Happens When an Organization Tackles Unconscious Bias and Promotes Diversity of Thought? No abstract available

Designing the Future of Healthcare No abstract available

Professional Satisfaction of Advanced Practice Providers in Primary Care Specialties EXECUTIVE SUMMARY This prospective study focuses on professional satisfaction among advanced practice providers (APPs) in primary care. We aimed to determine whether incorporating specialty care clinics within primary care practices increases professional satisfaction. We administered the validated Misener Nurse Practitioner Job Satisfaction Scale and a self-developed demographic questionnaire to all primary care APPs before and one year after implementation of a gynecology practice within the primary care setting. APPs practicing in a dual-role specialty practice reported higher overall professional satisfaction; professional growth; intrapractice partnership/collegiality; professional, social, and community interaction; and benefits than their primary care–only counterparts. We concluded that professional satisfaction among APPs may contribute to staff retention.

PRACTITIONER APPLICATION: Professional Satisfaction of Advanced Practice Providers in Primary Care Specialties No abstract available

Measuring Nonprofit Hospitals’ Provision of Charity Care Using IRS and CMS Data Executive Summary We explore whether nonprofit hospitals report similar amounts of charity care to the Internal Revenue Service (IRS) and Centers for Medicare & Medicaid Services (CMS). We use nonprofit hospitals’ financial reports to the IRS and the CMS Medicare costs report for 2011 and 2012. In 2012, hospitals reported spending 7.6% more in charity care to the IRS than to CMS: 2.54% of revenues ($5.74 million per hospital) to the IRS versus 2.36% ($5.16 million) to CMS. While the averages are close, there are wide discrepancies for individual hospitals. For example, despite efforts for standardization, 80% of hospitals reported charity care to the CMS that was 40% greater in absolute value than what they reported to the IRS, and only 10% of hospitals reported charity care to CMS that was within 20% of what they reported to the IRS. Our findings suggest that individual hospitals routinely report different amounts of charity care to the IRS and CMS, yet we find relatively few hospital or market characteristics that may explain these differences.

PRACTITIONER APPLICATION: Measuring Nonprofit Hospitals’ Provision of Charity Care Using IRS and CMS Data No abstract available

Activities and Sensemaking Associated With Frontline Role Expansion in Primary Care Settings EXECUTIVE SUMMARY Many healthcare settings are embracing a dynamic of role expansion across occupational boundaries. This dynamic is particularly evident in organizations that are early adopters of innovations designed to improve care delivery. This study explores role expansion of frontline healthcare workers in primary care settings associated with early adoption of the patient-centered medical home. Qualitative data in the form of interviews were collected from 2012 to 2014 from six primary care practices functioning as early adopters of patient-centered medical homes. Fifty-one staff members were interviewed across the six practices. The author identified three forms of role expansion among frontline workers in these primary care practices. This role expansion was accompanied by key instances of work improvisation and enhanced social connections among staff and patients that fed into particular forms of sensemaking. Transformation of primary care delivery may be enhanced through expansion of frontline workers’ roles, particularly at the early adoption phase.

PRACTITIONER APPLICATION: Activities and Sensemaking Associated With Frontline Role Expansion in Primary Care Settings No abstract available