Current practice for screening and management of financial distress at NCCN member institutions.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 11615-11615
Author(s):  
Nandita Khera ◽  
Jessica Sugalski ◽  
Diana Krause ◽  
Richard Butterfield ◽  
Nan Zhang ◽  
...  
Keyword(s):  
Best Practices ◽  
Financial Distress ◽  
Online Survey ◽  
Management Practices ◽  
Median Number ◽  
Institutional Practice ◽  
Quality Metric ◽  
Number Of Patients ◽  
Oncology Practice ◽  
The Impact

11615 Background: Deficiencies and barriers exist to delivering comprehensive and affordable cancer care. Understanding the variation in organizational commitment, existing programs, and expected outcomes for screening and management of financial distress is needed. Methods: Representatives from 17 of 27 NCCN Member Institutions (63%) completed an online survey in November 2018 conducted by the NCCN Best Practices Committee. Centers were classified based on number of unique patients seen per year, as large ( > 10,000) (76%), or small ( < 10,000) (34%). The survey focused on institutions’ screening and management practices for patient financial distress, perceived barriers in implementation, and leadership attitudes. Results: Routine screening for financial distress was reported by 77% of centers, and most used social worker assessments (94%). 56% screened patients throughout the cancer journey. Help with drug costs, meal or gas vouchers and payment plans were offered by 100% of centers. Formal pre-authorization programs and assistance with claims and denials was offered by 81%. Charity care for medical costs was provided by 100% of the large centers compared to only 33% of small centers (p = 0.03). Median number of social workers (24 vs. 3; p = 0.01) and pharmacy representatives (6 vs. 2; p = 0.02) was also different between large and small centers. 76% evaluated the impact of financial advocacy services through number of patients assisted (85%), bad debt and charity write-offs (85%) or patient satisfaction surveys (54%). 6% and 12% reported overall effectiveness of institutional practice for screening and management of financial distress as poor/ very poor respectively. Inadequate staffing and real time resources (69%), limited institutional budget (50%), lack of reimbursement (50%), and clinical time constraints (50%) were reported as potential barriers in provision of these services. 94% agreed about stronger integration of financial advocacy services into oncology practice and 84% felt that success of these services should be a quality metric. 31% of large centers vs. 100% of small centers plan to increase staffing in this area in the next 5 years. Conclusions: Majority of NCCN Member Institutions report screening and management programs for financial distress, though the actual practices and range of services vary widely. Information from this study can help centers benchmark their performance relative to similar cancer programs and identify best practices in this area.

scholarly journals Current Practices for Screening and Management of Financial Distress at NCCN Member Institutions

2020 ◽  
Vol 18 (7) ◽  
pp. 825-831 ◽  
Author(s):  
Nandita Khera ◽  
Jessica Sugalski ◽  
Diana Krause ◽  
Richard Butterfield ◽  
Nan Zhang ◽  
...  
Keyword(s):  
Best Practices ◽  
Financial Distress ◽  
Online Survey ◽  
Management Practices ◽  
Healthcare Organizations ◽  
Validated Questionnaire ◽  
Number Of Patients ◽  
Study Team ◽  
Oncology Practice ◽  
The Impact

Background: Financial distress from medical treatment is an increasing concern. Healthcare organizations may have different levels of organizational commitment, existing programs, and expected outcomes of screening and management of patient financial distress. Patients and Methods: In November 2018, representatives from 17 (63%) of the 27 existing NCCN Member Institutions completed an online survey. The survey focused on screening and management practices for patient financial distress, perceived barriers in implementation, and leadership attitudes about such practices. Due to the lack of a validated questionnaire in this area, survey questions were generated after a comprehensive literature search and discussions among the study team, including NCCN Best Practices Committee representatives. Results: Responses showed that 76% of centers routinely screened for financial distress, mostly with social worker assessment (94%), and that 56% screened patients multiple times. All centers offered programs to help with drug costs, meal or gas vouchers, and payment plans. Charity care was provided by 100% of the large centers (≥10,000 unique annual patients) but none of the small centers that responded (<10,000 unique annual patients; P=.008). Metrics to evaluate the impact of financial advocacy services included number of patients assisted, bad debt/charity write-offs, or patient satisfaction surveys. The effectiveness of institutional practices for screening and management of financial distress was reported as poor/very poor by 6% of respondents. Inadequate staffing and resources, limited budget, and lack of reimbursement were potential barriers in the provision of these services. A total of 94% agreed with the need for better integration of financial advocacy into oncology practice. Conclusions: Three-fourths of NCCN Member Institutions reported screening and management programs for financial distress, although the actual practices and range of services vary. Information from this study can help centers benchmark their performance relative to similar programs and identify best practices in this area.

scholarly journals Medical oncology workload in Canada: infrastructure, supports, and delivery of clinical care

2018 ◽  
Vol 25 (3) ◽  
pp. 206 ◽  
Author(s):  
A. Fundytus ◽  
W.M. Hopman ◽  
N. Hammad ◽  
J.J. Biagi ◽  
R. Sullivan ◽  
...  
Keyword(s):  
Online Survey ◽  
Task Force ◽  
Clinical Care ◽  
Median Number ◽  
Models Of Care ◽  
Annual Number ◽  
Canadian Association ◽  
Level Of Activity ◽  
Medical Oncologists ◽  
Number Of Patients

Background In 2000, a Canadian task force recommended that medical oncologists (mos) meet a target of 160–175 new patient consultations per year. Here, we report the Canadian results of a global survey of mo workload compared with mo workload in other high-income countries (hics).Methods Using a snowball method, an online survey was distributed by national oncology societies to chemotherapy-prescribing physicians in 22 hics (World Bank criteria). The survey was distributed within Canada to all members of the Canadian Association of Medical Oncologists. Workload was measured as the annual number of new cancer patient consults per oncologist.Results The survey was completed by 782 oncologists from hics, including 58 from Canada. Median annual consults per mo were 175 in Canada compared with 125 in other hics. The proportions of mos having 100 or fewer consults or more than 300 consults per year were 3% (2/58) and 5% (3/58) in Canada compared with 31% (222/724) and 16% (116/724) in other hics (p < 0.001 and p = 0.023 respectively). The median number of patients seen in a full-day clinic was 15 in Canada and 25 in other hics (p = 0.220). Canadian mos reported spending a median of 55 minutes per new consultation; new consultations of 35 minutes were reported in other hics (p < 0.001). Median hours worked per week was 55 in Canada and 45 in other hics (p = 0.200).Conclusions Although the median annual clinical volume for Canadian mos aligns with recommended targets, half the respondents exceeded that level of activity. Health policymakers and educators have to consider mo workforce supply and alternative models of care in preparation for the anticipated surge in cancer incidence in the coming decade.

Planned retirement age: do attachment to work and expectations relating to workplace adjustments matter?

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Marie-Eve Dufour ◽  
Tania Saba ◽  
Felix Ballesteros Leiva
Keyword(s):  
Attachment Theory ◽  
Online Survey ◽  
Management Practices ◽  
Career Commitment ◽  
Work Role ◽  
Retirement Age ◽  
Content Type ◽  
Employment Conditions ◽  
Met Expectations ◽  
The Impact

PurposeIn the context of population aging, retirement has become a central issue in academic, professional and government discourse. A consensus can be seen to be emerging around the idea of postponing retirement in favor of promoting active aging. From this perspective, the purpose of this study, using work-role attachment theory and met expectations theory, is to focus on the pre-retirement period and aims to better understand how certain individual factors and expectations explain the planned age of retirement.Design/methodology/approachAn online survey was administered in 2015 to employees aged 45 and over working at a Canadian firm in the high-technology sector.FindingsThe results show that career commitment, attachment to work and expectations relating to workplace adjustments prior to retirement were positively associated with planned retirement age, whereas expectations relating to professional development showed a negative association with this variable.Practical implicationsThis study fits into a line of research focusing on the end-of-career period and sheds light on the decision to retire by looking closely at the impact of employment conditions and human resource management practices on this decision. In a labor market context marked by high numbers of workers aged 55 and older, combined with the increasingly critical need for skilled labor and considering the expectations of workers leading up to their retirement could help to better plan these workers' end-of-career period.Originality/valueMany studies have examined the characteristics of retirees after retirement. The authors’ study is one of the few that examines the aspirations of workers between the ages of 45 and 55 who are still employed but are beginning to consider their retirement plans, including the decision to continue working longer. Its originality also lies in combining work-role attachment theory and met expectations theory.

Understanding rider:horse bodyweight ratio trends, weight management practices and rider weight perceptions within leisure and amateur riders in the UK

2021 ◽  
pp. 1-16
Author(s):  
C.L. Challinor ◽  
H. Randle ◽  
J.M. Williams
Keyword(s):  
Weight Management ◽  
Online Survey ◽  
Management Practices ◽  
Management Strategies ◽  
Legal Responsibility ◽  
Estimation Methods ◽  
Social Licence To Operate ◽  
The Uk ◽  
Post Hoc ◽  
The Impact

Horse riders in the UK have a legal responsibility for the welfare of the horses in their care, outlined by the Animal Welfare Act (2006). Understanding weight management factors that influence rider: horse bodyweight (RHBW) ratio is key to safeguarding horse welfare as human obesity rates increase. Recent high-profile incidents have seen riders being asked to dismount for being too heavy, demonstrating an awareness of the possible impact of excessive rider weight, threatening the equestrian industry’s social licence to operate. This study investigated RHBW trends within the UK leisure and amateur rider population to understand rider perception of ‘ideal’ RHBW and factors influencing rider and horse weight management. An online survey (SurveyMonkey®) was distributed via UK equine-related Facebook™ groups and collected information on horse and rider demographics, rider weight management strategies and respondents’ views on the importance of rider weight on horse welfare. Kruskal-Wallis analyses with Mann Whitney U post-hoc tests identified whether differences in respondent views differed between RHBW groups. A total of 971 riders completed the survey; respondents were aged between 18-65+ years old and 88% (n=953) were experienced riders. RHBWs were calculated for 764 (79%) of respondents as 21.2% (n=206) did not know either their own and/or their horses’ weight. Weight tapes (44.5%; n=432) and weigh bridges (29.5%; n=286) were common horse weight estimation methods. RHBWs ranged from 4.9% to 21.88%, mean: 12.5%±2.7%. Riders with lower RHBW thought about their own weight less and measured their horses’ weight less often than those with higher ratios (P<0.005, P<0.0004, respectively). The majority of riders who participated were weight conscious and recognised potential detrimental impacts associated with increased rider weight. Development of RHBW guidelines supported by equestrian governing bodies would highlight the need for riders to consider the impact of weight and support them in choosing suitable horses.

Early versus late patient discussions in multidisciplinary tumor boards: Quality time for quality care.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e13539-e13539
Author(s):  
Sharif Ahmed ◽  
Greg Kubicek
Keyword(s):  
Patient Care ◽  
Median Time ◽  
Quality Care ◽  
Median Number ◽  
Quality Patient Care ◽  
Number Of Patients ◽  
Tumor Boards ◽  
Nurse Navigator ◽  
The Impact ◽  
Disease Specific

e13539 Background: Multi-disciplinary tumor boards (MTB) are a way to generate quality patient care by allowing different specialties to provide insight into patient care. While the vast majority of hospital systems have MTB there are several aspects of how to run the most efficient MTB. The aim of this study was to determine if there was a difference in patients presented early versus late in MTB. Methods: At our institution we have disease specific weekly MTB. Patients are added to MTB based on order they are received (physicians or APN will send patient name to the disease specific nurse navigator). We recorded the time devoted to each patient and the number of providers that gave a comment or suggestion per patient. The time and number of comments were compared for patients presented at the start of MTB versus towards the end of MTB. Unpaired T test was used to compare time and comments. Results: We analyzed a total of 25 MTBs which corresponded to 241 patients. The median number of patients discussed per MTB was 9 (range 5 to 16). The median time spent per patient was 5.21 minutes and the median number of providers providing comments was 3 (range 1 to 9) with an average of 3.2. When analyzed by the first 8 patients versus the remainder, the median time spent was 6.1 minutes on the first 1-8 patients and 3.4 for > 8 (P < 0.0001). The mean number of comments was 3.4 for the first 1-8 patients and 2.4 for > 8 (P < 0.0001). Conclusions: We found that patients discussed towards the end of weekly MTB had less amount of time per devoted per patient and less discussion (as measured by number of providers supplying comments and suggestions). While the impact on long-term patient care is unclear we feel that this data is important in helping to ensure productive MTB discussions and avoid any arbitrary factor for reduced multidisciplinary insight. MTB should be cognitive of this time and attention biases.

Telehealth acceptability and opioid prescribing patterns of providers of painful chronic diseases during the COVID-19 pandemic: A survey of sickle cell providers

2021 ◽  
Vol 17 (6) ◽  
pp. 489-497
Author(s):  
Martha O. Kenney, MD ◽  
Benjamin Becerra, DrPH; MBA, MPH, MS ◽  
Sean Alexander Beatty, BA ◽  
Wally R. Smith, MD
Keyword(s):  
Chronic Diseases ◽  
Sickle Cell ◽  
Online Survey ◽  
Management Practices ◽  
Risk Mitigation ◽  
The United States ◽  
Prescribing Patterns ◽  
Prescribing Practices ◽  
Opioid Prescribing ◽  
The Impact

Objective: The coronavirus disease 2019 (COVID-19) has led to a rapid transition to telehealth services. It is unclear how subspecialists managing painful chronic diseases—such as sickle cell disease (SCD), an inherited hemoglobinopathy with significant disparities in access and outcomes—have viewed the transition to telehealth or altered their pain management practices. This study elicits the views of sickle cell providers regarding their transition to telehealth and their opioid prescribing patterns during the COVID-19 pandemic.Design: An anonymous online survey was sent to eligible sickle cell providers.Setting: Comprehensive sickle cell centers and/or clinics across the United States. Participants: Physicians and advanced practice providers providing care to SCD patients.Main outcome measures: Respondents answered questions regarding their (1) views of telehealth compared to in-person encounters and (2) opioid prescribing practices during the early months of the pandemic.Results: Of the 130 eligible participants, 53 respondents from 35 different sickle cell centers completed at least 90 percent of the survey. Respondents reported a significant increase in telehealth encounters for routine and acute appointments (mean difference and standard deviation: 57.6 ± 31.9 percent, p 0.001 and 24.4 ± 34.1 percent, p 0.001, respectively) since COVID-19. The overwhelming majority of respondents reported no changes in their opioid prescribing patterns since COVID-19, despite increased telehealth use. Only a minority coprescribed naloxone as a risk mitigation strategy.Conclusion: The rapid uptake of telehealth has not suppressed ambulatory providers’ prescribing of opioids for SCD. Studies assessing the impact of the COVID-19 pandemic and telehealth on opioid prescribing practices in other painful chronic diseases are needed to ensure health equity for vulnerable pain patients.

scholarly journals The impact of leadership and organizational context on the acceptability of unethical HRM practices

Psicologia ◽  
2020 ◽  
Vol 34 (1) ◽  
pp. 56-66
Author(s):  
Eduardo Simões ◽  
Patrícia Duarte ◽  
Patrícia Nunes
Keyword(s):  
Ethical Leadership ◽  
Online Survey ◽  
Organizational Context ◽  
Management Practices ◽  
Codes Of Conduct ◽  
Socially Responsible ◽  
Hr Management ◽  
The Individual ◽  
Corporate Social ◽  
The Impact

Recent research has found that human resource (HR) practitioners judge the acceptability of ethically questionable practices based on the importance their organization attributes to ethical infrastructure (e.g., codes of conduct) and corporate social responsibility practices. This study sought to evaluate the effects of ethical leadership and the aforementioned factors on other non-HR organizational actors. More specifically, this research examined how these individuals judge the acceptability of three ethically dubious HR management practices: discrimination, disregard for the individual, and favoring those in power. Results obtained from data collected through an online survey indicate that ethical leadership is negatively associated with the acceptability of all three practices. Individuals in organizations with a stronger ethical infrastructurealso find discrimination and disregard for the individual less acceptable. The same is true of participants in organizations perceived as more socially responsible regarding employees and economic aspects.

scholarly journals The influence of human resource management practices on job satisfaction

2020 ◽  
pp. 217-222
Author(s):  
G. O. Mazhiyeva
Keyword(s):  
Resource Management ◽  
Human Resource Management ◽  
Human Resource ◽  
Employee Satisfaction ◽  
Online Survey ◽  
Management Practices ◽  
Statistical Significance ◽  
Factors Affecting ◽  
Human Resource Management Practices ◽  
The Impact

Organizations that want to improve their performance should focus on the satisfaction of their employees, because employees who are satisfied with their work are the largest asset in the organization, while unsatisfied employees are its biggest problems and obligations. Much attention should be paid to the problem of measuring employee satisfaction in an organization, since this circumstance clearly describes the current situation of the organization. Understanding how satisfied employees are with the job contains useful information to predict their future behavior and make the right managerial decisions. Human resource management can overcome many challenges by offering various methods that increase employee satisfaction. These methods will help the organization work better. It is imperative that organizations maximize the impact of supportive human resource management practices. The article presents the results of a study aimed at studying human resource management practices affecting employee satisfaction. The study was conducted by an online survey among employees of educational institutions of the city of Almaty. The results revealed practices that significantly affect employee satisfaction, in particular: training and development; awareness raising; democratic approach and fair distribution of power, the provision of authority; providing employment security; stimulation of self-realization and career advancement; initiative management. The socio-demographic factors affecting employee satisfaction were also identified. Indicators such as gender and income showed a high level of statistical significance.

scholarly journals Impact of COVID-19 Pandemic on Remote Monitoring of Cardiac Implantable Electronic Devices in Italy: Results of a Survey Promoted by AIAC (Italian Association of Arrhythmology and Cardiac Pacing)

2021 ◽  
Vol 10 (18) ◽  
pp. 4086
Author(s):  
Massimiliano Maines ◽  
Pietro Palmisano ◽  
Maurizio Del Greco ◽  
Donato Melissano ◽  
Silvana De Bonis ◽  
...  
Keyword(s):  
Remote Monitoring ◽  
Electronic Devices ◽  
Cardiac Pacing ◽  
Median Number ◽  
Temporal Perspective ◽  
Cardiac Implantable Electronic Devices ◽  
Outpatient Visits ◽  
Exponential Increase ◽  
Number Of Patients ◽  
The Impact

The COVID-19 pandemic has had a profound impact on the organisation of health care in Italy, with an acceleration in the development of telemedicine. To assess the impact of the COVID-19 pandemic on the spread of remote monitoring (RM) of cardiac implantable electronic devices (CIEDs) in Italy, a survey addressed to cardiologists operating in all Italian CIED-implanting centres was launched. A total of 127 cardiologists from 116 Italian arrhythmia centres took part in the survey, 41.0% of all 283 CIED-implanting centres operating in Italy in 2019. All participating centres declared to use RM of CIEDs. COVID-19 pandemic resulted in an increase in the use of RM in 83 (71.6%) participating centres. In a temporal perspective, an increase in the median number of patients per centre followed up by RM was found from 2012 to 2017, followed by an exponential increase from 2017 to 2020. In 36 participating centres (31.0%) a telehealth visits service was activated as a replacement for in-person outpatient visits (in patients with or without CIED) during the COVID-19 pandemic. COVID-19 pandemic has caused an acceleration in the use of RM of CIEDs and in the use of telemedicine in the clinical practice of cardiology.

scholarly journals How does COVID-19 Impact Oil Palm Management Practices in Indonesia?

2020 ◽  
Vol 3 (2) ◽  
pp. 56-67
Author(s):  
Ratnawati Nurkhoiry ◽  
Sachnaz Desta Oktarina
Keyword(s):  
Oil Palm ◽  
Online Survey ◽  
Management Practices ◽  
Selling Price ◽  
Fresh Fruit Bunch ◽  
Long Run ◽  
Harvesting Process ◽  
Turn Over ◽  
Business As Usual ◽  
The Impact

Disrupted economy due to COVID-19 pandemic has been spilled to multifaceted sectors. Agriculture, more specifically oil palm sector was also hit by the impact of the catastrophe. This study is aimed to decipher the effect of COVID-19 pandemic to the management of oil palm plantation. The pandemic has caused the mobility and morbidity of people in such a way that exacerbated distribution of input factor, harvesting process, and transporting activities. Through online survey to 59 farmers consist of smallholder, government, and private estates, the study indicated that there was salient change of limiting activities particularly during immature and mature stages. Hence, the production of fresh fruit bunch (FFB) also decreased by 15% compared to business as usual as measured on monthly bases. Although the magnitude of production change was not statistically significance, planters still suffered from declining FFB farm gate price. On average, they received 5% lower selling price of FFB as a consequence of contracted CPO demand from prominent importing countries such as China, India, and Italy. The lower selling farm gate price has caused the income shocks to the farmers. Thus, quite large number of them experienced either turn-over or cost efficiency at the expense of fertilizer input. It is perpetuating the vicious cycle of lower smallholder attainable FFB yield. For a group that is at the high risk of infections as well, this circumstances has bring about concerns to Indonesian palm oil development, especially in terms of replanting realization and biodiesel blending progress in the long run

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