Phillip J. Decker

Organ Donation among African Americans: Opportunities for Increasing Donor Rates

n the United States the number of African American organ donors continI ues to be low relative to the demand for transplantable human organs. In 1999, for example, African Americans constituted 1 1.2 percent of all cadaveric donors (UNOS 2001a). Yet, in that same year African Americans comprised 25.5 percent of those on the National Transplant Waiting List (UNOS 2001b). Thus, there exists an acute shortage of organs suitable for matching to African Americans needing transplants. This shortage is particularly severe with regard to kidneys: African Americans constitute more than

The Hidden Competencies of Healthcare: Why Self-Esteem, Accountability, and Professionalism May Affect Hospital Customer Satisfaction Scores

Data from 103 for-profit, nonprofit, and government-owned hospitals, spread across about half of the United States clearly show that there are common elements and several core competencies in all hospitals, some probably driven by JCAHO accreditation standards, but others coming from universal experience stemming from the changes in healthcare. The common competencies that are not, in my opinion, driven directly by the JCAHO standards include professionalism, accountability, self-esteem, customer service/focus, communication, information management/using data in decision making, and teamwork. There are several possible connections among the core competencies that suggest that the effects of accountability and possibly self-esteem on such outcomes as patient satisfaction and quality of care should be the subject of more research in healthcare settings. There are, however, several possible interventions to increase the core competency base of any hospital, which can be applied without this research. Executives and managers who attempt to measure and change these common competencies through selection, assessment, organizational system change, or reward and compensation systems will change the competence base of their workforce in critical areas needed in the future healthcare economy. Using a competence model incorporating these competencies may change the culture of the organization toward that which will be needed for survival in the twenty-first century.

Leading the flock: organ donation feelings, beliefs, and intentions among African American clergy and community residents

CONTEXT Despite a considerable potential role in organ donation for African American clergy, there has been little investigation to date of the beliefs, attitudes, and personal intentions of such clergy regarding donation. OBJECTIVE To compare the beliefs, attitudes, and behavioral intentions regarding organ donation among African American clergy to those of African American residents of the same large US city. DESIGN Focus groups and 3 cross-sectional surveys. SETTING Greater Houston, Tex, metropolitan area. PARTICIPANTS A total of 761 randomly selected African American community residents and 311 African American clergy. MAIN OUTCOMES MEASURES Beliefs about the importance of organ donation; how comfortable one is in thinking about donation; whether one believes that organ donation is against ones religion; trust in healthcare professionals regarding death declaration; concerns that donation leads to body mutilation; and the likelihood that one will donate ones own organs upon death. RESULTS Compared to general African American residents, African American clergy in the Houston area were found more often to believe in the importance of donation; to be more comfortable with thinking about donation; to feel more certain that donation was not against their religion; to believe that they could trust healthcare professionals regarding death declaration; to feel less often that donation leads to mutilation of the body; and to indicate a greater likelihood of donating their own organs upon death. The same was found to be true among clergy and congregants of the largest religious denomination in Houston, the Baptists.

Beyond JCAHO: Using Competency Models to Improve Healthcare Organizations PART I

In 1996 the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) required hospitals to assess, prove, track, and improve the competence of all employees. Part 1 of this two-part series discusses competencies, their assessment, and the implications of meeting and going beyond JCAHOs requirements. Part 2, which will appear in the next issue of Hospital Topics, provides specific guidelines for the development of a competence assessment system and its practical application.

Evaluation Methodologies for Estimating the Likelihood of Program Implementation Failure.

Despite our best efforts as evaluators, program implementation failures abound. A wide variety of valuable methodologies have been adopted to explain and evaluate the why of these failures. Yet, typically these methodologies have been employed concurrently (e.g., project monitoring) or to the post-hoc assessment of program activities. What we believe to be missing are methods that will lead to the successful prediction of program implementation failures in advance, methods that will lead us directly to the “how” and, especially, the “how likely” of program implementation failure. To that end we propose, discuss, and illustrate three such methods that seemingly hold promise – marker analysis, the wisdom of crowds, and “Big Data.” Additionally, we call for an expanded role for evaluation – explanation, but also prediction without a total embrace of the need to understand why a prediction works.

Beyond JCAHO: Using Competency Models to Change Healthcare Organizations Part 2: Developing Competence Assessment Systems

In 1996, JCAHO required hospitals to assess, prove, track, and improve the competence of all employees. This article is the second part of a review of the concept of competency assessment and the implications of meeting and exceeding the JCAHO standards. Part 1 (in the previous issue of Hospital Topics) provided the theory of competence assessment, the current situation in JCAHO surveys, and an overview of the problems inherent in competency assessment. This part puts competence assessment in the context of quality improvement and provides the details of developing competence assessment systems.

Functional standards. The walls come tumbling down.

Hospital accreditation standards have changed from focusing on capability to actual performance and outcomes. This shift in emphasis requires organization leaders and staff members to make significant paradigm shifts. In this series of articles, the authors will discuss the functional standards for 1994-1995 and their implications.

A study of the psycho, social, & economic impact of a US Habitat for Humanity affiliate

Purpose – The purpose of this paper is to inform funders and potential funders alike of the likely outcomes of their financial contributions. Additionally, the authors reported on the assessment of the underlying logic model or theoretical underpinnings of what the authors will term the “Habitat Model.” Design/methodology/approach – This study utilized a one-shot case study design to obtain data. In a one-shot case study the experimental group is exposed to the independent variable (X), then observations of the dependent variable (O) were made. No observations were made before the independent variable was introduced. A one-shot case study design was necessary as this is the first impact study conducted by BAHFH because of the changes within BAHFH over the years as well as the lack of consistent archival data on families and operations. Findings – Most of the feedback obtained from stakeholders was positive. Many of the demographic variables showed significant improvement in partner family life style since...

What do adults with ASD desire in their residence

Purpose – Currently, approximately one in 100 Americans meet the criteria for an autism spectrum disorder (ASD) diagnosis. Males are four-to-five times more likely to be diagnosed than females. Because the demand for ADS community-based services outweigh available resources, applicants are placed on a waiting list until services are available. Some wait for years; many adults with an ASD continue to live with their parents who also often serve as de facto case managers. When the decision of which facility to place a resident comes, most families are unprepared to make the decision. The paper aims to discuss these issues. Design/methodology/approach – Community-based participatory research theory was used in designing interviews of family members facing residential facility placement decisions. Ten interviews were conducted with families. Findings – Participant answers were categorized within the topic areas of: physical site, staff, transportation, community, diet, behavior, medical, and faith. Research l...

Care of patients.

Hospital accreditation standards have changed from focusing on capability to actual performance and outcomes. This shift in emphasis requires organization leaders and staff members to make significant paradigm shifts. In this series of articles, the authors will discuss the functional standards for 1994-1995 and their implications.