Using Predictive Analytics to Improve Healthcare Outcomes

Cover
Title Page
Copyright Page
Contents
Contributors
Foreword
Preface: Bringing the Science of Winning to Healthcare
List of Acronyms
Acknowledgments
Section One Data, Theory, Operations, and Leadership
	Chapter 1 Using Predictive Analytics to Move from Reactive to Proactive Management of Outcomes
		The Art and Science of Making Data Accessible
		Summary 1: The “Why”
		Summary 2: The Even Bigger “Why”
		Implications for the Future
	Chapter 2 Advancing a New Paradigm of Caring Theory
		Maturation of a Discipline
		Theory
		Frameworks of Care
		RBC’s Four Decades of Wisdom
		Summary
	Chapter 3 Cultivating a Better Data Process for More Relevant Operational Insight
		Taking on the Challenge
		“PSI RNs”: A Significant Structural Change to Support Performance and Safety Improvement Initiatives and Gain More Operational Insight
		The Importance of Interdisciplinary Collaboration in Data Analysis
		Key Success Factors
		Summary
	Chapter 4 Leadership for Improved Healthcare Outcomes
		Data as a Tool to Make the Invisible Visible
		Leaders Using Data for Inspiration: Story 1
		Leaders Using Data for Inspiration: Story 2
		How Leaders Can Advance the Use of Predictive Analytics and Machine Learning
		Understanding an Organization’s “Personality” Through Data Analysis
Section Two Analytics in Action
	Chapter 5 Using Predictive Analytics toReduce Patient Falls
		Predictors of Falls, Specified in Model 1
		Lessons Learned from This Study
		Respecifying the Model
		Summary
	Chapter 6 Using the Profile of Caring® to Improve Safety Outcomes
		The Profile of Caring
		Machine Learning
		Exploration of Two Variables of Interest: Early Readmission for Heart Failure and Falls
		Proposal for a Machine Learning Problem
		Constructing the Study for Our Machine Learning Problem
	Chapter 7 Forecasting Patient Experience: Enhanced Insight Beyond HCAHPS Scores
		Methods to Measure the Patient Experience
		Results of the First Factor Analysis
		Implications of This Factor Analysis
		Predictors of Patient Experience
		Discussion
		Transforming Data into Action Plans
		Summary
	Chapter 8 Analyzing a Hospital-Based Palliative Care Program to Reduce Length of Stay
		Building a Program for Palliative Care
		The Context for Implementing a Program of Palliative Care
		Building a Model to Study Length of Stay in Palliative Care
		Demographics of the Patient Population for Model 1
		Results from Model 1
		Respecifying the Model
		Discussion
	Chapter 9 Determining Profiles of Risk to Reduce Early Readmissions Due to Heart Failure
		Step 1: Seek Established Guidelines in the Literature
		Step 2: Crosswalk Literature with Organization’s Tool
		Step 3: Develop a Structural Model of the 184 Identified Variables
		Step 4: Collect Data
		Details of the Study
		Limitations of the Study
		Results: Predictors of Readmission in Fewer Than 30 Days
		Next Steps
	Chapter 10 Measuring What Matters in a Multi-Institutional Healthcare System
		Testing a Model of Caring
		Further Discussion
		Summary
	Chapter 11 Pause and Flow: Using Physics to Improve the Efficiency of Workflow
		Types of Pause
		Types of Flow
		Methods
		Sample Size and Response Rates
		What We Learned About Pause
		What We Learned About Flow
		Application of Results to Operations
		Reflections from the Medical Unit—R6S
		Analyzing Pause and Flow of Work as a Method of Quality Improvement
		Summary and Next Steps
	Chapter 12 Lessons Learned While Pursuing CLABSI Reduction
		Development of a Specified Model of Measurement for Prevention of CLABSI
		First Lesson Learned: Quality Data Collection Requires Well-Trained Data Collectors
		Other Lessons Learned
		Summary and Next Steps
Section Three Refining Theories to Improve Measurement
	Chapter 13 Theory and Model Development to Address Pain Relief by Improving Comfor
t
		A New Theory
		Developing a New Model Based on a New Theory
		Clinicians’ Beliefs Drive Their Practice
		Dimensions of Comfort
		Predictors of Comfort
		The Model
		Summary
	Chapter 14 Theory and Model Development to Improve Recovery from Opioid Use Disorder
		The Current Costs of Opioid Use Disorder (OUD)
		Interventions for OUD
		Pain Management, OUD, and Therapeutic Relationships
		Interventions Which Include Potential Trusted Others
		Existing OUD Measurement Instruments
		Updating the Old OUD Measurement Instrument and Model to Include the Trusted Other
		Discussion
		Conclusion
Section Four International Models to Study Constructs Globally
	Chapter 15 Launching an International Trajectory of Research in Nurse Job Satisfaction, Starting in Jamaica
		Background
		The Hunch: Where Measurement Begins
		The Model
		Understanding the Context of Jamaica
		Methods to Study Job Satisfaction and Clarity in Jamaica
		Managing Disappointment with the Low Response Rate
		Results on the Social and Technical Dimensions of Nurse Job Satisfaction in Jamaica
		Results on the Relationship of Role Clarity and Demographics to Nurse Job Satisfaction in Jamaica
		Application of the Findings
	Chapter 16 Testing an International Model of Nurse Job Satisfaction to Support the Quadruple Aim
		The Four Goals of Our Study
		Methods
		Theoretical Framework
		Measurement Instruments and a Model of Measurement
		Order of Operations of the Study
		Simplifying the Model
		Respecifying the Model to Include Caring
		Results from Model 2
		How Job Satisfaction Relates to Turnover and Sick Time
		Recommendations Based on Findings
	Chapter 17 Developing a Customized Instrument to Measure Caring and Quality in Western Scotland
		Developing an Instrument to Measure Caring as Perceived by the Patient
		Results
		Discussion
	Chapter 18 Measuring the Effectiveness of a Care Delivery Model in Western Scotland
		The Caring Behaviors Assurance System (CBAS)
		Implementation of CBAS
		Measurement of CBAS
		Findings from the PCQI, the Operations of CBAS Assessment, and the HES
		Action Planning
		Discussion
Epilogue: Imagining What Is Possible
Appendix A Worksheets Showing the Progression from a Full List of Predictor Variables to a Measurement Model
Appendix B The Key to Making Your Relationship-Based Care® Implementation Sustainable Is “I2E2”
Appendix C Calculation for Cost of Falls
Appendix D Possible Clinical, Administrative, and Psychosocial Predictors of Readmission for Heart Failure in Fewer Than 30 Days After Discharge
Appendix E Process to Determine Variables for Lee, Jin, Piao, & Lee, 2016 Study
Appendix F Summary of National and International Heart Failure Guidelines
	National Institute for Health and Care Excellence (NICE) Guidelines
	European Society of Cardiology (ESC), Acute and Chronic Heart Failure Guidelines
	American College of Cardiology Foundation (ACCF)/American Heart Association (AHA), 2013 and 2017 Guidelines for Management of Heart Failure
Appendix GCrosswalk Hospital Tool and Guidelines
Appendix H Comprehensive Model of 184 Variables Found in Guidelines and Hospital Tool
Appendix I Summary of Variables That Proved Insignificant After Analysis
Appendix J Summary of Inconclusive Findings
Appendix K Nine Tools for Measuring the Provision of Quality Patient Care and Related Variables
	Three Tools for Assessing “Caring for the Patient” As Perceived By the Patient
	Three Tools for Assessing “Caring for the Patient” as Perceived By Staff Members
	Tools to Measure Self-Care; Nurse Job Satisfaction; and Clarity of Self, Role, and System
Appendix L Data From Pause and Flow Study Related to Participants’ Ability to Recall Moments of Pause and Flow Easily or with Reflection
Appendix M Identified Pauses and Proposed Interventions Resulting from a Pause and Flow Study
Appendix N Factors Related to a Focus on Pain Versus Factors Related to a Focus on Comfort
Appendix O Comfort/Pain Perception Survey(CPPS)—Patient Version
Appendix P Comfort/Pain Perception Survey (CPPS)—Care Provider Version
Appendix Q Predictors of OUD
Appendix R Personal Qualities of Clinicians and Others Suited to Become Trusted Others
	Modeling “Not Knowing”
	Cultivating Self-Awareness
	Commitment to Perspective-Seeking
Appendix S Qualities of Systems and Organizations Suited to Serve People Recovering from OUD
	Advancing a Culture in Which “Not Knowing” Is Accepted
	Advancing a Culture in Which Systemic Awareness Is Actively Sought
	Advancing a Culture in Which Perspective Seeking Is Prized
Appendix T Factor Loadings for Satisfaction with Staffing/Scheduling and Resources
Appendix U Detail Regarding Item Reduction of Instruments to Measure Caring
Appendix V Factor Loading for Items in the Healing Compassions Assessment (HCA) for Use in Western Scotland
Appendix W Factor Loadings of the Caring Professional Scale for Use in Western Scotland
Appendix X Factor Loadings for the Healing Compassion Survey—7Cs NHS Scotland (Staff Version)
Appendix Y Factor Analysis and Factor Ranking for Survey Items Related to Caring for Self and Caring of the Senior Charge Nurse
Appendix Z Demographics, Particularly Ward, as Predictors of Job Satisfaction
Appendix AA Demographic as Predictors of clarity
Appendix BB Correlates of Operations of CBAS with Items from the Healing Compassion Survey—7 Cs NHS Scotland (Staff Version)
References
Index
EULA