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This paper investigates the relationship between organizational culture and financial performance in high-Medicaid Nursing Homes, nursing homes that serve a high proportion of Medicaid residents. As high-Medicaid Nursing Homes operate in resource-constrained environments, they usually have lower staffing and occupancy, higher minority resident mix, and worse quality of care. A specific organizational culture, assessed by the Organizational Culture Assessment Instrument, can be a strategy those nursing homes employ to secure resources necessary to survive. This instrument helps identify organizational culture types: adhocracy, clan, market, and hierarchically oriented. We tested whether a specific type of organizational culture was associated with higher financial performance, measured by an operating margin. Survey data of 348 nursing home administrators were collected in 2017-2018. We found that the market culture was positively associated with a higher operating margin. On the other hand, there was a negative relationship between a hierarchically oriented culture and financial performance. These findings can help nursing home administrators improve their financial performance through the adoption of certain organizational cultures. [ABSTRACT FROM AUTHOR]

Context: The COVID-19 pandemic has placed unprecedented stress on health care systems worldwide. The global scale of the outbreak and its unpredictable nature has put a significant leadership burden on health care leaders and decision-makers. Predefined emergency preparedness plans are no longer working. Evidence-based guidelines and crisis communication plans are insufficient. There is an increased amount of pandemic fatigue among the general population. Businesses are suffering. A financial crisis is looming. Health systems leaders need new leadership behaviors and mindsets to help them lead during the next phases of this dynamic crisis as well as in future pandemics. Despite a proliferation of perspectives on the topic, given the novelty of the situation there is no aggregated resource distilling the evidence about how to lead under crisis conditions. Objective: The aim of this paper is to systematically examine evidence from research on public health crisis leadership to determine what competencies are explicitly needed to better respond to pandemics like COVID-19. Specifically, we sought to map and assess published studies on pandemics (a) to characterize core competencies required to lead in the health sector during a pandemic, and (b) to identify contextual enablers and barriers to leading during a crisis. Methods: We conducted a rapid review using the methodological framework of Arksey and O'Malley (2005), the World Health Organization Rapid Review Guide, and the Joanna Briggs Institute 2020 guide to scoping reviews (Peters et al., 2020; Tricco et al., 2017). The Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-SR) guided our reporting of study findings. Data Sources: We performed a systematic and comprehensive search of MEDLINE (via Ovid), EMBASE, PsycINFO, Business Source Premier, and Canadian Business & Current Affairs for studies published between 2003 (since SARS) and July 28, 2020. Study Selection, Extraction, and Synthesis: We selected all empirical articles (quantitative, qualitative, and mixed methods) that discussed crisis leadership during a pandemic. Data Synthesis: The literature search identified 8,044 citations. A review of abstracts led to the retrieval of 749 full-text articles for assessment, of which 30 were selected for review. Conclusions: Our findings show that crisis leadership competencies commonly fall under three categories of leadership capacity: task, people, and adaptive. In pandemic-related leadership literature, task-related behaviors such as preparing and planning, establishing collaborations, and crisis communication often receive more attention. Our analysis revealed that during a crisis, people-oriented capacities and adaptive capacities are equally important for leaders to successfully lead in a dynamic situation shaped by structural, political, and cultural contextual factors. [ABSTRACT FROM AUTHOR]

U.S. Healthcare organizations are actively working to improve coordination of care between hospital and post-acute settings such as skilled nursing facilities (SNFs), in part through improved information sharing processes. The impact of electronic information sharing (EIS) on patient outcomes, in the context of post-acute care transitions, has yet to be explored. We first use a difference-in-differences analysis to analyze whether the selective implementation of an EIS system between one large academic hospital and three partnering SNFs resulted in an improvement in patient outcomes, relative to outcomes for patients discharged to SNFs without electronic information access. We then use a novel longitudinal dataset generated by these three SNFs' audited use of the EIS system to explore variation in when and how SNF providers accessed information to support post-acute patient care, and relationships between this variation and demonstrated improvement to patient outcomes. We find no overall net effect on patient readmissions over time due to the implementation of an EIS system connecting SNFs to the discharging hospital. However, significant variation in system use was observed within and across the electronically enabled SNF facilities. For facilities with organizationally consistent patterns of system use within the transition window of care, we observe significant improvements in the likelihood of patient rehospitalization. We therefore conclude that the availability of electronic information sharing between hospitals and SNFs may play a role in improving post-acute transitions of care, provided that it is consistently used in a timely and robust way relative to the timing of patient transition. [ABSTRACT FROM AUTHOR]

Sport has considerable power that, appropriately applied, can contribute to improving health and well-being in society. In this symposium, we adopt a broad perspective on "health and well-being in society", consistent with AOM's 2018 call and examine the ways in which sport can influence health and wellbeing in society (not always in a positive manner) Our three panel discussions will move from the influence of sport on individual participants, and in turn, on society; to the influence of college sport on participating athletes, the university, and society; and the phenomenon of sport team-healthcare system partnerships and their effects on individual and community health and wellbeing. Our two discussants will focus on how the topics addressed by each presenter might better contribute to the health and well-being of society. [ABSTRACT FROM AUTHOR]

In this study we have reported on factors impacting the physician's intention to follow imaging appropriateness criteria, an evidence-based practice to improve the use of imaging for prostate cancer patients, within the Michigan Urological Surgery Improvement Collaborative (MUSIC). We developed and deployed an instrument to assess and explain the specific factors affecting the behavioral intentions of the urologists in the collaborative. Results indicate that beliefs related to professional identity, along with patient or resource constraints, can negatively impact behavioral intention and be barriers to implementation. Additionally, knowing the criteria and its evidence, as well as having strong beliefs about the consequences, are the strongest predictors of an urologist's intention to follow the imaging appropriateness criteria. Furthermore, strong social influences from the practice and positive attitudes towards the collaborative will positively impact intentions, facilitating implementation efforts and possibly reduce barriers from the environment. [ABSTRACT FROM AUTHOR]