Evidence‐based practice and health promotion

Introduction: In the past decade there have been many debates in the health sector about the nature of evidence and the use of evidence in determining policy and practice. The growing emphasis on evidence‐based decision making has led to a variety of responses among those working in health promotion. Some are ardent proponents of evidence‐based practice, while others are doubtful about its feasibility or value. This article is for those who are interested in evidence‐based practice but would like more information on how evidence can be appraised and used in health promotion settings.     

A red‐flag‐based approach to risk management of EHR‐related safety concerns

Although electronic health records (EHRs) have a significant potential to improve patient safety, EHR‐related safety concerns have begun to emerge. Based on 369 responses to a survey sent to the memberships of the American Society for Healthcare Risk Management and the American Health Lawyers Association and supplemented by our previous work in EHR‐related patient safety, we identified the following common EHR‐related safety concerns: (1) incorrect patient identification; (2) extended EHR unavailability (either planned or unplanned); (3) failure to heed a computer‐generated warning or alert; (4) system‐to‐system interface errors; (5) failure to identify, find, or use the most recent patient data; (6) misunderstandings about time; (7) incorrect item selected from a list of items; and (8) open or incomplete orders. In this article, we present a “red‐flag”‐based approach that can be used by risk managers to identify potential EHR safety concerns in their institutions. An organization that routinely conducts EHR‐related surveillance activities, such as the ones proposed here, can significantly reduce risks associated with EHR implementation and use.     

Business resilience: Reframing healthcare risk management

The responsibility of risk management in healthcare is fractured, with multiple stakeholders. Most hospitals and healthcare systems do not have a fully integrated risk management system that spans the entire organizational and operational structure for the delivery of key services. This article provides insight toward utilizing a comprehensive Business Resilience program and associated methodology to understand and manage organizational risk leading to organizational effectiveness and operational efficiencies, with the fringe benefit of realizing sustainable operational capability during adverse conditions.     

Getting back to healthcare: the new automation strategy

The health information professional's role as partner, consultant, and problem solver for clinicians is critical as the healthcare industry, the last major industry to automate itself, progresses toward true information management.     

Evidence‐based disparities: examining the gap between health expectations and experiences

Context  In a time of economic austerity, one of the most daunting questions is who decides on healthcare rationing? In the current study, we sought to examine if the public can in fact provide meaningful information regarding healthcare policy issues. Based on theories of public policy, this paper tries to find out if patients behave akin to ‘responsible citizens’ and can provide differentiated expectations between three healthcare dimensions. Methods  One thousand two‐hundred eleven individuals participated in a telephone interview. Participants were asked two series of questions, one regarding their views on the primary care, prevention and promotion practices they experience with their healthcare provider and one regarding the importance of these practices to them. We calculated a difference score representing the gap in each healthcare dimension. Findings  In all three healthcare dimensions, the mean gap is in the positive side of the axis indicating that the public does not receive what it expects to receive, or in policy terms there is ‘a responsiveness deficit’. The mean gap in relation to primary care is significantly lower than the mean gap in both preventive care and health promotion. Conclusions  The public can provide meaningful information even in areas of endless demand and can provide an addition point of view to be considered by policy makers in complicated healthcare rationing decisions.     

Enterprise risk management and the healthcare risk manager

The healthcare industry is dynamic and the industry changes require new tools to manage the risks generated by new core competencies. Silo‐centric practice is giving way to integration in the healthcare organization and in the discipline of risk management. Whether insurable or not, risk threatens the bottom line and business success. Enterprise Risk Management provides the tools for imbedding the discussion of Risk into the way an organization does business. Two tools described here are a Showstopper Risks List and a Risk and Response Map. The risk manager who adds value to the organization by aligning risk management strategies in support of business success will not only survive, but thrive in a constantly changing environment.