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Impact of health information technology on delivery and quality of patient care

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TitleInfo
Title
Impact of health information technology on delivery and quality of patient care
Name (type = personal)
NamePart (type = family)
Hessels
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Amanda Jane
NamePart (type = date)
1971-
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Amanda Hessels
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RoleTerm (authority = RULIB)
author
Name (type = personal)
NamePart (type = family)
Flynn
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Linda
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Linda Flynn
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Advisory Committee
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chair
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Cadmus
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Edna
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Edna Cadmus
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Advisory Committee
Role
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internal member
Name (type = personal)
NamePart (type = family)
Cimiotti
NamePart (type = given)
Jeannie P
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Jeannie P Cimiotti
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Advisory Committee
Role
RoleTerm (authority = RULIB)
internal member
Name (type = personal)
NamePart (type = family)
Gershon
NamePart (type = given)
Robyn R
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Robyn R Gershon
Affiliation
Advisory Committee
Role
RoleTerm (authority = RULIB)
outside member
Name (type = personal)
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Bakken
NamePart (type = given)
Suzanne R
DisplayForm
Suzanne R Bakken
Affiliation
Advisory Committee
Role
RoleTerm (authority = RULIB)
outside member
Name (type = corporate)
NamePart
Rutgers University
Role
RoleTerm (authority = RULIB)
degree grantor
Name (type = corporate)
NamePart
Graduate School - Newark
Role
RoleTerm (authority = RULIB)
school
TypeOfResource
Text
Genre (authority = marcgt)
theses
OriginInfo
DateCreated (qualifier = exact)
2014
DateOther (qualifier = exact); (type = degree)
2014-05
Place
PlaceTerm (type = code)
xx
Language
LanguageTerm (authority = ISO639-2b); (type = code)
eng
Abstract (type = abstract)
Adverse events in hospitalized patients are catastrophic and costly to individuals, hospitals and society. The use of electronic health records (EHR) is one promising system-level initiative that may improve provider performance, interdisciplinary communication, reduce adverse patient events, improve the overall quality of patient care, and ultimately improve patient satisfaction with hospital care. The study purpose was to examine the relationships among: (1) EHR adoption stage, (2) missed nursing care and (3) nursing practice environment, on hospitalized patient adverse outcomes and satisfaction. This secondary analysis of cross sectional data was compiled from four sources: (1) the State Inpatient Database, (2) Healthcare Information and Management Systems Society Dorenfest Institute database of EHR adoption, (3) Hospital Consumer Assessment of Healthcare Providers and Systems Survey, and (4) a survey of New Jersey hospital-based nurses. The analytic approach used ordinary least squares and multiple regression models to estimate the effects of EHR adoption on the delivery of nursing care and patient outcomes, controlling for characteristics of patients, nurses, and hospitals. Robust procedures with Huber-White sandwich variance estimators and clustered means were used to account for the clustering of patients within hospitals. The final analytic sample consisted of 854,258 patients and 7,679 nurses in 70 New Jersey hospitals. Significant findings from this study indicate positive relationships between nursing practice environment and patient satisfaction, and inverse relationships between: (a) advanced EHR adoption and adverse outcome of prolonged length of stay, (b) nursing practice environment and missed nursing care and (c) missed nursing care and patient satisfaction. Among the subscales of the nursing practice environment tested, staffing and resource adequacy was the strongest predictor of missed nursing care and patient satisfaction. Further, findings indicate strong, significant relationships among staffing and resource adequacy, missed nursing care and patient satisfaction, and that these strong relationships are not confounding the effects of EHR adoption stage on patient satisfaction. These important findings suggest that sufficient staffing and resources is essential for advanced EHR adoption and patient reported outcomes of satisfaction. These findings may also signify that the patient benefits of advanced technology will only be realized in context of sufficient human resources.
Subject (authority = RUETD)
Topic
Nursing
RelatedItem (type = host)
TitleInfo
Title
Rutgers University Electronic Theses and Dissertations
Identifier (type = RULIB)
ETD
Identifier
ETD_5350
PhysicalDescription
Form (authority = gmd)
electronic resource
InternetMediaType
application/pdf
InternetMediaType
text/xml
Extent
vi, 143 p. : ill.
Note (type = degree)
Ph.D.
Note (type = bibliography)
Includes bibliographical references
Note (type = vita)
Includes vita
Note (type = statement of responsibility)
by Amanda Jane Hessels
Subject (authority = ETD-LCSH)
Topic
Medical records--Data processing
Subject (authority = ETD-LCSH)
Topic
Patients--Care
RelatedItem (type = host)
TitleInfo
Title
Graduate School - Newark Electronic Theses and Dissertations
Identifier (type = local)
rucore10002600001
Location
PhysicalLocation (authority = marcorg); (displayLabel = Rutgers, The State University of New Jersey)
NjNbRU
Identifier (type = doi)
doi:10.7282/T3F769T9
Genre (authority = ExL-Esploro)
ETD doctoral
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Rights

RightsDeclaration (ID = rulibRdec0006)
The author owns the copyright to this work.
RightsHolder (type = personal)
Name
FamilyName
Hessels
GivenName
Amanda
Role
Copyright Holder
RightsEvent
Type
Permission or license
DateTime (encoding = w3cdtf); (qualifier = exact); (point = start)
2014-03-12 14:22:58
AssociatedEntity
Name
Amanda Hessels
Role
Copyright holder
Affiliation
Rutgers University. Graduate School - Newark
AssociatedObject
Type
License
Name
Author Agreement License
Detail
I hereby grant to the Rutgers University Libraries and to my school the non-exclusive right to archive, reproduce and distribute my thesis or dissertation, in whole or in part, and/or my abstract, in whole or in part, in and from an electronic format, subject to the release date subsequently stipulated in this submittal form and approved by my school. I represent and stipulate that the thesis or dissertation and its abstract are my original work, that they do not infringe or violate any rights of others, and that I make these grants as the sole owner of the rights to my thesis or dissertation and its abstract. I represent that I have obtained written permissions, when necessary, from the owner(s) of each third party copyrighted matter to be included in my thesis or dissertation and will supply copies of such upon request by my school. I acknowledge that RU ETD and my school will not distribute my thesis or dissertation or its abstract if, in their reasonable judgment, they believe all such rights have not been secured. I acknowledge that I retain ownership rights to the copyright of my work. I also retain the right to use all or part of this thesis or dissertation in future works, such as articles or books.
Copyright
Status
Copyright protected
Availability
Status
Open
Reason
Permission or license
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Technical

RULTechMD (ID = TECHNICAL1)
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ETD
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windows xp
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