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EFFECTS OF HOSPITAL STRUCTURAL COMPLEXITY AND PROCESS ADEQUACY ON THE PREVALENCE OF SYSTEMIC ADVERSE EVENTS AND COMPLIANCE ISSUES: A BIOMEDICAL ENGINEERING TECHNICIAN PERSPECTIVE

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Date Issued:
2011
Abstract/Description:
Purpose: The purpose of this study is to understand the relationships among structural complexity, process adequacy, and level of quality in a hospital environment of care from the perspective of the biomedical engineering technician (BMET). The BMET health support occupation is under-represented in research. The BMET influences on patient outcomes were observed indirectly through the influence on nursing performance. The unit of analysis is biomedical engineering technician. The study examined the predictors of adverse events in hospital care and suggested how to promote reduction in adverse events (hospital acquired infections) associated with medical equipment. Methods: Primary data were gathered by the Biomedical Engineering Interdepartmental Survey of BMETs' professional perception of organizational factors (Structural Complexity), process factors (Process Adequacy), Level of Quality and control variables that characterizes the study population. A total of 317 BMETs in 46 states and the District of Columbia completed the survey. The survey instrument was developed using Dillman's Tailored Design Methods and validated for reliability. A majority of respondents reported 5+ years of experience working at large, non-profit, Joint Commission accredited, urban facilities across 5 regions. The effect of structural complexity and process adequacy was analyzed by structural equation modeling (SEM) under the theoretical framework of Donabedian's Structure-Process-Outcome model. Findings: The SEM data analysis indicates strong, positive relationships between constructs as statistically significant (2-tailed) with normal distribution: 1) Structural Complexity and Process Adequacy at Beta =.889, t=7.248, p<0.001; 2) Process Adequacy and Level of Quality at Beta =.563, t=3.136, p=0.002; and 3) Structural Complexity and Level of Quality at Beta =.430, t=2.469, and p=0.014. Translation of these findings into equation form as follows: Level of Quality = .889 Structural Complexity + .563 Process Adequacy The study finds several determinants of quality derived from structural complexity including 1) uniform standards, 2) inter-professional training, and 3) coordination evidence. In addition, the intervening effect of process adequacy comprising regular meetings, equipment purchasing involvement, formal equipment training across departments, and formal department information on the level of quality is supported. Conclusion: Predictors identified from interdepartmental and inter-professional partnerships and associated processes suggest that integration of the biomedical engineering technician into the hospital delivery system can improve the quality of care. Administrators can manage and improve quality through employing simple, effective and efficient solutions such as 1) updating internal hospital policy to require regularly scheduled meetings between nursing and biomedical staff regarding equipment issues, 2) linking the BMET department goals to organization objectives, 3) interdepartmental reporting of hospital acquired infections, and 4) standardizing clinical engineering practices to facilitate increased internal and external hospital quality.
Title: EFFECTS OF HOSPITAL STRUCTURAL COMPLEXITY AND PROCESS ADEQUACY ON THE PREVALENCE OF SYSTEMIC ADVERSE EVENTS AND COMPLIANCE ISSUES: A BIOMEDICAL ENGINEERING TECHNICIAN PERSPECTIVE.
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Name(s): Fiedler, Beth, Author
Wan, Thomas, Committee Chair
University of Central Florida, Degree Grantor
Type of Resource: text
Date Issued: 2011
Publisher: University of Central Florida
Language(s): English
Abstract/Description: Purpose: The purpose of this study is to understand the relationships among structural complexity, process adequacy, and level of quality in a hospital environment of care from the perspective of the biomedical engineering technician (BMET). The BMET health support occupation is under-represented in research. The BMET influences on patient outcomes were observed indirectly through the influence on nursing performance. The unit of analysis is biomedical engineering technician. The study examined the predictors of adverse events in hospital care and suggested how to promote reduction in adverse events (hospital acquired infections) associated with medical equipment. Methods: Primary data were gathered by the Biomedical Engineering Interdepartmental Survey of BMETs' professional perception of organizational factors (Structural Complexity), process factors (Process Adequacy), Level of Quality and control variables that characterizes the study population. A total of 317 BMETs in 46 states and the District of Columbia completed the survey. The survey instrument was developed using Dillman's Tailored Design Methods and validated for reliability. A majority of respondents reported 5+ years of experience working at large, non-profit, Joint Commission accredited, urban facilities across 5 regions. The effect of structural complexity and process adequacy was analyzed by structural equation modeling (SEM) under the theoretical framework of Donabedian's Structure-Process-Outcome model. Findings: The SEM data analysis indicates strong, positive relationships between constructs as statistically significant (2-tailed) with normal distribution: 1) Structural Complexity and Process Adequacy at Beta =.889, t=7.248, p<0.001; 2) Process Adequacy and Level of Quality at Beta =.563, t=3.136, p=0.002; and 3) Structural Complexity and Level of Quality at Beta =.430, t=2.469, and p=0.014. Translation of these findings into equation form as follows: Level of Quality = .889 Structural Complexity + .563 Process Adequacy The study finds several determinants of quality derived from structural complexity including 1) uniform standards, 2) inter-professional training, and 3) coordination evidence. In addition, the intervening effect of process adequacy comprising regular meetings, equipment purchasing involvement, formal equipment training across departments, and formal department information on the level of quality is supported. Conclusion: Predictors identified from interdepartmental and inter-professional partnerships and associated processes suggest that integration of the biomedical engineering technician into the hospital delivery system can improve the quality of care. Administrators can manage and improve quality through employing simple, effective and efficient solutions such as 1) updating internal hospital policy to require regularly scheduled meetings between nursing and biomedical staff regarding equipment issues, 2) linking the BMET department goals to organization objectives, 3) interdepartmental reporting of hospital acquired infections, and 4) standardizing clinical engineering practices to facilitate increased internal and external hospital quality.
Identifier: CFE0003980 (IID), ucf:48670 (fedora)
Note(s): 2011-08-01
Ph.D.
Health and Public Affairs, Department of Public Administration
Doctorate
This record was generated from author submitted information.
Subject(s): Public Policy
Interprofessional
Clinical Engineering
Hospital Administration
Persistent Link to This Record: http://purl.flvc.org/ucf/fd/CFE0003980
Restrictions on Access: campus 2012-07-01
Host Institution: UCF

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