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Dr. Beauvais is an educator and consultant in the field of health care management with a primary focus on quality improvement via innovative financing strategies and executive leadership development. He holds degrees from Colorado State (BS, MBA), the University of Oklahoma (MA in Economics), and Penn State University (PhD in Health Policy and Administration). He has also served as a Fellow for the Commission on Accreditation Healthcare Management Education (CAHME), was awarded a Joseph M. Juran Fellowship in Quality Leadership, and has earned his Fellowship in the American College of Healthcare Executives. Dr. Beauvais retired from the United States Army at the rank of Lieutenant Colonel in 2015, culminating a 20-year military career as the Associate Dean at the Army Medical Department Center & School Graduate School with concurrent appointment as an Associate Professor with the Army Baylor Masters of Healthcare and Business Administration Program. Dr. Beauvais specializes in graduate-level instructional design in the areas of applied finance, business valuation, and executive leadership focused on quality improvement. He is interested in research of health care organization quality, patient safety, and financial performance and has published in Health Services Research, the Journal of Health Care Finance, Health Care Management Review, Hospital Topics, the Journal of Healthcare Management and the Journal of Health Administration Education.
The relationship between healthcare organizational accreditation and their leaders’ professional certification in healthcare management is of specific interest to institutions of higher education and individuals in the healthcare management field. Since academic program accreditation is one piece of evidence of high-quality education, and since professional certification is an attestation to the knowledge, skills, and abilities of those who are certified, we expect alumni who graduated from accredited programs and obtained professional certification to have a positive impact on the organizations that they lead, compared with alumni who did not graduate from accredited programs and who did not obtain professional certification. The authors’ analysis examined the impact of hiring graduates from higher education programs that held external accreditation from the Commission on Accreditation of Healthcare Management Education (CAHME). Graduates’ affiliation with the American College of Healthcare Executives (ACHE) professional healthcare leadership organization was also assessed as an independent variable. Study outcomes focused on these graduates’ respective healthcare organization’s performance measures (cost, quality, and access) to assess the researchers’ inquiry into the perceived value of a CAHME-accredited graduate degree in healthcare administration and a professional ACHE affiliation. The results from this study found no effect of CAHME accreditation or ACHE affiliation on healthcare organization performance outcomes. The study findings support the need for future research surrounding healthcare administration professional graduate degree program characteristics and leader development affiliations, as perceived by various industry stakeholders.
Matthew Brooks; Brad Beauvais; Clemens Kruse; Lawrence Fulton; Michael Mileski; Zo Ramamonjiarivelo; Ramalingam Shanmugam; Cristian Lieneck. Accreditation and Certification: Do They Improve Hospital Financial and Quality Performance? Healthcare 2021, 9, 887 .
AMA StyleMatthew Brooks, Brad Beauvais, Clemens Kruse, Lawrence Fulton, Michael Mileski, Zo Ramamonjiarivelo, Ramalingam Shanmugam, Cristian Lieneck. Accreditation and Certification: Do They Improve Hospital Financial and Quality Performance? Healthcare. 2021; 9 (7):887.
Chicago/Turabian StyleMatthew Brooks; Brad Beauvais; Clemens Kruse; Lawrence Fulton; Michael Mileski; Zo Ramamonjiarivelo; Ramalingam Shanmugam; Cristian Lieneck. 2021. "Accreditation and Certification: Do They Improve Hospital Financial and Quality Performance?" Healthcare 9, no. 7: 887.
As many as 20-25% of the population experiences harm in outpatient settings, yet these locations are underrepresented in the literature compared to hospitals. We examined results from the Medical Office Survey on Patient Safety Culture designed by the Agency for Healthcare Research and Quality. The survey administered in 2012 gathered perceptions from 23,679 individuals in 934 unique medical offices. We examined associations of organizational patient safety climate composites on frequency of safety and quality issues, overall quality score, and safety rating. We found organizational patient safety composites are all positively and significantly associated with a higher overall quality score and patient safety rating, and fewer safety and quality issues. Office processes and standardization appeared to have the most consistent influence on perceived quality outcomes. Our results indicate it may be advantageous for medical offices to improve on the factors that contribute to positive safety climate.
Jason P. Richter; Brad M Beauvais; Lynn Downs; Matthew Calvert; Fernando Najera; Steven Wentz; Bob Wolfe; Forest Kim. Staff Perceptions of Organizational Patient Safety Climate and Quality Outcomes: An Examination of Outpatient Medical Offices. 2021, 1 .
AMA StyleJason P. Richter, Brad M Beauvais, Lynn Downs, Matthew Calvert, Fernando Najera, Steven Wentz, Bob Wolfe, Forest Kim. Staff Perceptions of Organizational Patient Safety Climate and Quality Outcomes: An Examination of Outpatient Medical Offices. . 2021; ():1.
Chicago/Turabian StyleJason P. Richter; Brad M Beauvais; Lynn Downs; Matthew Calvert; Fernando Najera; Steven Wentz; Bob Wolfe; Forest Kim. 2021. "Staff Perceptions of Organizational Patient Safety Climate and Quality Outcomes: An Examination of Outpatient Medical Offices." , no. : 1.
The impact of organizational accreditation and professional certification and the evidence-based measurable impact of those for both academic programs and affiliates is one of specific interest to universities and individuals in the healthcare management field [1]. The authors’ analysis examined the impact of hiring graduates from higher education programs that held external accreditation from the Commission on Accreditation of Healthcare Management Education (CAHME). Graduates’ affiliation with the American College of Healthcare Executives (ACHE) professional healthcare leadership organization was also assessed as an independent variable. Study outcomes focused on these graduates’ respective healthcare organization’s performance measures (cost, quality, and access) to assess the researchers’ inquiry into the perceived value of a CAHME-accredited graduate degree in healthcare administration and a professional ACHE affiliation [2]. The results from this study found no effect of CAHME accreditation or ACHE affiliation on healthcare organization performance outcomes. The study findings support the need for future research surrounding healthcare administration professional graduate degree program characteristics and leader development affiliations, as perceived by various industry stakeholders.
Matthew Brooks; Brad M Beauvais; Clemens Scott Kruse; Lawrence Fulton; Michael Mileski; Zo Ramamonjiarivelo; Ramalingam Shanmugam; Cristian Lieneck. Accreditation and Certification: Do they Improve Hospital Financial and Quality Performance? 2021, 1 .
AMA StyleMatthew Brooks, Brad M Beauvais, Clemens Scott Kruse, Lawrence Fulton, Michael Mileski, Zo Ramamonjiarivelo, Ramalingam Shanmugam, Cristian Lieneck. Accreditation and Certification: Do they Improve Hospital Financial and Quality Performance? . 2021; ():1.
Chicago/Turabian StyleMatthew Brooks; Brad M Beauvais; Clemens Scott Kruse; Lawrence Fulton; Michael Mileski; Zo Ramamonjiarivelo; Ramalingam Shanmugam; Cristian Lieneck. 2021. "Accreditation and Certification: Do they Improve Hospital Financial and Quality Performance?" , no. : 1.
The physical demands on U.S. service members have increased significantly over the past several decades as the number of military operations requiring overseas deployment have expanded in frequency, duration, and intensity. These elevated demands from military operations placed upon a small subset of the population may be resulting in a group of individuals more at-risk for a variety of debilitating health conditions. To better understand how the U.S Veterans health outcomes compared to non-Veterans, this study utilized the U.S. Centers for Disease Control and Prevention (CDC) Behavioral Risk Factor Surveillance System (BRFSS) dataset to examine 10 different self-reported morbidities. Yearly age-adjusted, population estimates from 2003 to 2019 were used for Veteran vs. non-Veteran. Complex weights were used to evaluate the panel series for each morbidity overweight/obesity, heart disease, stroke, skin cancer, cancer, COPD, arthritis, mental health, kidney disease, and diabetes. General linear models (GLM’s) were created using 2019 data only to investigate any possible explanatory variables associated with these morbidities. The time series analysis showed that Veterans have disproportionately higher self-reported rates of each morbidity with the exception of mental health issues and heart disease. The GLM showed that when taking into account all the variables, Veterans disproportionately self-reported a higher amount of every morbidity with the exception of mental health. These data present an overall poor state of the health of the average U.S. Veteran. Our study findings suggest that when taken as a whole, these morbidities among Veterans could prompt the U.S. Department of Veteran Affairs (VA) to help develop more effective health interventions aimed at improving the overall health of the Veterans.
Jose Betancourt; Paula Granados; Gerardo Pacheco; Julie Reagan; Ramalingam Shanmugam; Joseph Topinka; Bradley Beauvais; Zo Ramamonjiarivelo; Lawrence Fulton. Exploring Health Outcomes for U.S. Veterans Compared to Non-Veterans from 2003 to 2019. Healthcare 2021, 9, 604 .
AMA StyleJose Betancourt, Paula Granados, Gerardo Pacheco, Julie Reagan, Ramalingam Shanmugam, Joseph Topinka, Bradley Beauvais, Zo Ramamonjiarivelo, Lawrence Fulton. Exploring Health Outcomes for U.S. Veterans Compared to Non-Veterans from 2003 to 2019. Healthcare. 2021; 9 (5):604.
Chicago/Turabian StyleJose Betancourt; Paula Granados; Gerardo Pacheco; Julie Reagan; Ramalingam Shanmugam; Joseph Topinka; Bradley Beauvais; Zo Ramamonjiarivelo; Lawrence Fulton. 2021. "Exploring Health Outcomes for U.S. Veterans Compared to Non-Veterans from 2003 to 2019." Healthcare 9, no. 5: 604.
Background: Approximately 6.5 to 6.9 million individuals in the United States have heart failure, and the disease costs approximately $43.6 billion in 2020. This research provides geographical incidence and cost models of this disease in the U.S. and explanatory models to account for hospitals’ number of heart failure DRGs using technical, workload, financial, geographical, and time-related variables. Methods: The number of diagnoses is forecast using regression (constrained and unconstrained) and ensemble (random forests, extra trees regressor, gradient boosting, and bagging) techniques at the hospital unit of analysis. Descriptive maps of heart failure diagnostic-related groups (DRGs) depict areas of high incidence. State- and county-level spatial and non-spatial regression models of heart failure admission rates are performed. Expenditure forecasts are estimated. Results: The incidence of heart failure has increased over time with the highest intensities in the East and center of the country; however, several Northern states have seen large increases since 2016. The best predictive model for the number of diagnoses (hospital unit of analysis) was an extremely randomized tree ensemble (predictive R2 = 0.86). The important variables in this model included workload metrics and hospital type. State-level spatial lag models using first-order Queen criteria were best at estimating heart failure admission rates (R2 = 0.816). At the county level, OLS was preferred over any GIS model based on Moran’s I and resultant R2; however, none of the traditional models performed well (R2 = 0.169 for the OLS). Gradient-boosted tree models predicted 36% of the total sum of squares; the most important factors were facility workload, mean cash on hand of the hospitals in the county, and mean equity of those hospitals. Online interactive maps at the state and county levels are provided. Conclusions. Heart failure and associated expenditures are increasing. Costs of DRGs in the study increased $61 billion from 2016 through 2018. The increase in the more expensive DRG 291 outpaced others with an associated increase of $92 billion. With the increase in demand and steady-state supply of cardiologists, the costs are likely to balloon over the next decade. Models such as the ones presented here are needed to inform healthcare leaders.
Clemens Kruse; Bradley Beauvais; Matthew Brooks; Michael Mileski; Lawrence Fulton. Models for Heart Failure Admissions and Admission Rates, 2016 through 2018. Healthcare 2020, 9, 22 .
AMA StyleClemens Kruse, Bradley Beauvais, Matthew Brooks, Michael Mileski, Lawrence Fulton. Models for Heart Failure Admissions and Admission Rates, 2016 through 2018. Healthcare. 2020; 9 (1):22.
Chicago/Turabian StyleClemens Kruse; Bradley Beauvais; Matthew Brooks; Michael Mileski; Lawrence Fulton. 2020. "Models for Heart Failure Admissions and Admission Rates, 2016 through 2018." Healthcare 9, no. 1: 22.
Coronavirus (COVID-19) is a potentially fatal viral infection. This study investigates geography, demography, socioeconomics, health conditions, hospital characteristics, and politics as potential explanatory variables for death rates at the state and county levels. Data from the Centers for Disease Control and Prevention, the Census Bureau, Centers for Medicare and Medicaid, Definitive Healthcare, and USAfacts.org were used to evaluate regression models. Yearly pneumonia and flu death rates (state level, 2014–2018) were evaluated as a function of the governors’ political party using a repeated measures analysis. At the state and county level, spatial regression models were evaluated. At the county level, we discovered a statistically significant model that included geography, population density, racial and ethnic status, three health status variables along with a political factor. A state level analysis identified health status, minority status, and the interaction between governors’ parties and health status as important variables. The political factor, however, did not appear in a subsequent analysis of 2014–2018 pneumonia and flu death rates. The pathogenesis of COVID-19 has a greater and disproportionate effect within racial and ethnic minority groups, and the political influence on the reporting of COVID-19 mortality was statistically relevant at the county level and as an interaction term only at the state level.
Ian Feinhandler; Benjamin Cilento; Brad Beauvais; Jordan Harrop; Lawrence Fulton. Predictors of Death Rate during the COVID-19 Pandemic. Healthcare 2020, 8, 339 .
AMA StyleIan Feinhandler, Benjamin Cilento, Brad Beauvais, Jordan Harrop, Lawrence Fulton. Predictors of Death Rate during the COVID-19 Pandemic. Healthcare. 2020; 8 (3):339.
Chicago/Turabian StyleIan Feinhandler; Benjamin Cilento; Brad Beauvais; Jordan Harrop; Lawrence Fulton. 2020. "Predictors of Death Rate during the COVID-19 Pandemic." Healthcare 8, no. 3: 339.
COVID-19 is a potentially fatal viral infection. This study investigates geography, demography, socioeconomics, health conditions, hospital characteristics, and politics as potential explanatory variables for death rates at the state and county levels. Data from the Centers for Disease Control and Prevention, the Census Bureau, Centers for Medicare and Medicaid, Definitive Healthcare, and USAfacts.org were used to evaluate regression models. Yearly pneumonia and flu death rates (state level, 2014-2018) were evaluated as a function of the governors’ political party using repeated measures analysis. At the state and county level, spatial regression models were evaluated. At the county level, we discovered a statistically significant model that included geography, population density, racial and ethnic status, three health status variables along with a political factor. State level analysis identified health status, minority status, and the interaction between governors’ parties and health status as important variables. The political factor, however, did not appear in a subsequent analysis of 2014-2018 pneumonia and flu death rates. The pathogenesis of COVID-19 has greater and disproportionate effect within racial and ethnic minority groups, and the political influence on the reporting of COVID-19 mortality was statistically relevant at the county level and as an interaction term only at the state level.
Ian Feinhandler; Benjamin Cilento; Brad Beauvais; Jordan Harrop; Lawrence Fulton. Predictors of Death Rate During the COVID-19 Pandemic. 2020, 1 .
AMA StyleIan Feinhandler, Benjamin Cilento, Brad Beauvais, Jordan Harrop, Lawrence Fulton. Predictors of Death Rate During the COVID-19 Pandemic. . 2020; ():1.
Chicago/Turabian StyleIan Feinhandler; Benjamin Cilento; Brad Beauvais; Jordan Harrop; Lawrence Fulton. 2020. "Predictors of Death Rate During the COVID-19 Pandemic." , no. : 1.
BACKGROUND Electronic health records are a central feature of care delivery in the acute care hospital, but financial and quality outcomes associated with system performance remain unclear. OBJECTIVE This study evaluates the association between the top three electronic health record vendors and measures of hospital financial and quality performance. METHODS This study evaluates 2,667 hospitals with Cerner, Epic, or Meditech as their primary EHR and considers performance on net income, Hospital Value Based Purchasing (HVBP) Total Performance Score (TPS) and the unweighted sub-domains: Efficiency and Cost Reduction, Clinical Care, Patient and Caregiver-Centered Experience, and Patient Safety. We hypothesize there is a difference among the three vendors on each measure. RESULTS None of the EHR systems was associated with a statistically significant financial relationship in our study. Epic was positively associated with Total Performance Score outcomes (R2 = 23.6%; β:.0159, S.E.:.0079, P = .043) and higher patient perceptions of quality (R2 = 29.3%; β:.0292, S.E.:.0099, P =.003) but negatively associated with patient safety quality scores (R2 = 24.3%; β: -.0221, S.E.:.0102, P =.029). Cerner and Epic were positively associated with improved efficiency (R2 = 31.9%; Cerner: β:.0330, S.E.:.0135, P =.014; Epic: β:.0465, S.E.:.0133, P < .001). Lastly, all three vendors were associated with positive performance in the Clinical Care domain ( Epic: β:.0388, S.E.:.0122, P =.002; Cerner: β:.0283, S.E.:.0124, P =.022; Meditech: β:.0273, S.E.:.0123, P =.026) but with low explanatory power (R2 = 4.2%). CONCLUSIONS The results of this study provide evidence of a difference in clinical outcome performance among the top three EHR vendors and may serve as supportive evidence for healthcare leaders to target future capital investments to improve healthcare delivery.
Bradley Beauvais; Clemens Scott Kruse; Lawrence Fulton; Ramalingam Shanmugam; Zo Ramamonjiarivelo; Matthew Brooks. Electronic Health Record Vendors: An Evaluation of the Association with Hospital Financial and Quality Performance (Preprint). 2020, 1 .
AMA StyleBradley Beauvais, Clemens Scott Kruse, Lawrence Fulton, Ramalingam Shanmugam, Zo Ramamonjiarivelo, Matthew Brooks. Electronic Health Record Vendors: An Evaluation of the Association with Hospital Financial and Quality Performance (Preprint). . 2020; ():1.
Chicago/Turabian StyleBradley Beauvais; Clemens Scott Kruse; Lawrence Fulton; Ramalingam Shanmugam; Zo Ramamonjiarivelo; Matthew Brooks. 2020. "Electronic Health Record Vendors: An Evaluation of the Association with Hospital Financial and Quality Performance (Preprint)." , no. : 1.
Electronic health records (EHRs) are a central feature of care delivery in acute care hospitals; however, the financial and quality outcomes associated with system performance remain unclear. In this study, we aimed to evaluate the association between the top 3 EHR vendors and measures of hospital financial and quality performance. This study evaluated 2667 hospitals with Cerner, Epic, or Meditech as their primary EHR and considered their performance with regard to net income, Hospital Value–Based Purchasing Total Performance Score (TPS), and the unweighted subdomains of efficiency and cost reduction; clinical care; patient- and caregiver-centered experience; and patient safety. We hypothesized that there would be a difference among the 3 vendors for each measure. None of the EHR systems were associated with a statistically significant financial relationship in our study. Epic was positively associated with TPS outcomes (R2=23.6%; β=.0159, SE 0.0079; P=.04) and higher patient perceptions of quality (R2=29.3%; β=.0292, SE 0.0099; P=.003) but was negatively associated with patient safety quality scores (R2=24.3%; β=−.0221, SE 0.0102; P=.03). Cerner and Epic were positively associated with improved efficiency (R2=31.9%; Cerner: β=.0330, SE 0.0135, P=.01; Epic: β=.0465, SE 0.0133, P<.001). Finally, all 3 vendors were associated with positive performance in the clinical care domain (Epic: β=.0388, SE 0.0122, P=.002; Cerner: β=.0283, SE 0.0124, P=.02; Meditech: β=.0273, SE 0.0123, P=.03) but with low explanatory power (R2=4.2%). The results of this study provide evidence of a difference in clinical outcome performance among the top 3 EHR vendors and may serve as supportive evidence for health care leaders to target future capital investments to improve health care delivery.
Bradley Beauvais; Clemens Kruse; Lawrence Fulton; Ramalingam Shanmugam; Zo Ramamonjiarivelo; Matthew Brooks. Electronic Health Record Vendors: An Evaluation of the Association with Hospital Financial and Quality Performance (Preprint). Journal of Medical Internet Research 2020, 23, e23961 .
AMA StyleBradley Beauvais, Clemens Kruse, Lawrence Fulton, Ramalingam Shanmugam, Zo Ramamonjiarivelo, Matthew Brooks. Electronic Health Record Vendors: An Evaluation of the Association with Hospital Financial and Quality Performance (Preprint). Journal of Medical Internet Research. 2020; 23 (4):e23961.
Chicago/Turabian StyleBradley Beauvais; Clemens Kruse; Lawrence Fulton; Ramalingam Shanmugam; Zo Ramamonjiarivelo; Matthew Brooks. 2020. "Electronic Health Record Vendors: An Evaluation of the Association with Hospital Financial and Quality Performance (Preprint)." Journal of Medical Internet Research 23, no. 4: e23961.
In most consumer markets, higher prices generally imply increased quality. For example, in the automobile, restaurant, hospitality, and airline industries, higher pricing generally conveys a signal of complexity and superiority of a service or product. However, in the healthcare industry, there is room to challenge the price-quality connection as both health prices and health quality can be difficult to interpret. In the best of circumstances, health care costs, prices, and quality can often be difficult to isolate and measure. Recent efforts by the Trump Administration and the Center for Medicare and Medicaid Services (CMS) have required the pricing of hospital services to be more transparent. Specifically, hospital chargemaster (retail) prices must now be available to the public. However, many continue to question if the pricing of health care services reflects the quality of service delivery. This research focuses on investigating the prices hospitals charge for their services in relation to the costs incurred and the association with the quality of care provided. By analyzing data from a nationwide sample of U.S. hospitals, this study considers the relationship between hospital pricing (as measured by the charge-to-cost ratio) and hospital quality performance as measured by the Value Based Purchasing Total Performance Score (TPS) and its associated sub-domains. Results of the study indicate that hospital prices, as measured by our primary independent variable of interest, the charge-to-cost ratio, are significantly and negatively associated with Total Performance Score, Patient Experience, and the Efficiency and Cost Reduction domains. A marginal statistically significant positive association is shown in the Clinical Care domain. The findings indicate that unlike most other industries, in medicine, higher pricing compared to cost does not necessarily associate with higher quality and, in fact, might indicate the opposite. The results of this study suggest that purchasers of healthcare, at all levels, have justification in challenging the pricing of healthcare services considering the quality scores available in the public domain.
Brad Beauvais; Glen Gilson; Steve Schwab; Brittany Jaccaud; Taylor Pearce; Thomas Holmes. Overpriced? Are Hospital Prices Associated with the Quality of Care? Healthcare 2020, 8, 135 .
AMA StyleBrad Beauvais, Glen Gilson, Steve Schwab, Brittany Jaccaud, Taylor Pearce, Thomas Holmes. Overpriced? Are Hospital Prices Associated with the Quality of Care? Healthcare. 2020; 8 (2):135.
Chicago/Turabian StyleBrad Beauvais; Glen Gilson; Steve Schwab; Brittany Jaccaud; Taylor Pearce; Thomas Holmes. 2020. "Overpriced? Are Hospital Prices Associated with the Quality of Care?" Healthcare 8, no. 2: 135.
Intelligent use of rural residential land and sustainable construction is inexorably linked to cost; however, options exist that are eco-friendly and have a positive return on investment. In 2011, a research residence was built to evaluate various land-use and sustainable components. This Texas house has subsequently been used for both residential and research purposes. The purpose of this case study was to evaluate break-even construction considerations, to assess environmental impacts, and to evaluate qualitatively efficacy of sustainable options incorporated in the research residence. Some of the specific components discussed are home site placement (directional positioning); materiel acquisition (transportation); wood product minimization; rainwater harvesting; wastewater management; grid-tied solar array power; electric car charging via a solar array; geothermal heating and cooling; insulation selection; windows, fixtures, and appliance selection; and on-demand electric water heaters for guest areas. This study seeks to identify the impact of proper land use and sustainable techniques on the environment and return-on-investment in rural areas. Break-even and 15-year Net Present Value (NPV) analysis at 3% and 5% cost of capital were used to evaluate traditional construction, partially sustainable construction, and fully sustainable construction options for the case study house, which was built sustainably. The additional cost of sustainable construction is estimated at $54,329. At 3%, the analysis suggests a 15-year NPV of $334,355 (traditional) versus $250,339 million (sustainable) for a difference of $84K. At 5% cost of capital, that difference falls to $63K. The total estimated annual difference in carbon emissions is 4.326 million g/CO2e for this research residence. The results indicate that good choices for quick return-on-investment in rural construction would be the use of engineered lumber, Icynene foam, and Energy Star windows and doors. Medium-term options include photovoltaic systems (PVS) capable of powering the home and an electric car. Sustainable construction options should positively affect the environment and the pocketbook. Regulations and code should require adoption of short-range, break-even sustainable solutions in residential construction.
Lawrence Fulton; Bradley Beauvais; Matthew Brooks; Scott Kruse; Kimberly Lee. Sustainable Residential Building Considerations for Rural Areas: A Case Study. Land 2020, 9, 152 .
AMA StyleLawrence Fulton, Bradley Beauvais, Matthew Brooks, Scott Kruse, Kimberly Lee. Sustainable Residential Building Considerations for Rural Areas: A Case Study. Land. 2020; 9 (5):152.
Chicago/Turabian StyleLawrence Fulton; Bradley Beauvais; Matthew Brooks; Scott Kruse; Kimberly Lee. 2020. "Sustainable Residential Building Considerations for Rural Areas: A Case Study." Land 9, no. 5: 152.
A major consideration for consumers and the residential construction industry is the cost–benefit and break-even of various sustainable construction options. This research provides a publicly available simulation that allows users to compare baseline construction options versus sustainable options and evaluates both break-even costs as well as environmental effects. This R Shiny Monte Carlo simulation uses common pseudo-random number streams for replicability and includes options for solar, rainwater harvesting, wells, Icynene foam, engineered lumber, Energy Star windows and doors, low flow fixtures, aerobic/non-aerobic/city waste treatment, electric versus gasoline vehicles, and many other options. This is the first simulation to quantify multiple sustainable construction options, associated break-even points, and environmental considerations for public use. Using user default parameters, coupled with a 100% solar solution for a baseline 3000 square foot/279 square meter house with 2 occupants results in a break-even of 9 years. Results show that many of the sustainable options are both green for the environment and green for the pocketbook.
Lawrence Fulton; Bradley Beauvais; Matthew Brooks; Clemens Scott Kruse; Kimberly Lee. A Publicly Available Cost Simulation of Sustainable Construction Options for Residential Houses. Sustainability 2020, 12, 2873 .
AMA StyleLawrence Fulton, Bradley Beauvais, Matthew Brooks, Clemens Scott Kruse, Kimberly Lee. A Publicly Available Cost Simulation of Sustainable Construction Options for Residential Houses. Sustainability. 2020; 12 (7):2873.
Chicago/Turabian StyleLawrence Fulton; Bradley Beauvais; Matthew Brooks; Clemens Scott Kruse; Kimberly Lee. 2020. "A Publicly Available Cost Simulation of Sustainable Construction Options for Residential Houses." Sustainability 12, no. 7: 2873.
This publicly available simulation analysis compares baseline construction options versus sustainable options and evaluates both break-even costs as well as environmental effects. The simulation (https://rminator.shinyapps.io/sustain4/) provides users with comparative estimates based upon existing research on costs. This is the first simulation of its type that quantifies multiple sustainable construction options, associated break-even points, and environmental considerations for public use. Results estimate that a 100% solar solution for the baseline 3,000 square foot / 279 square meter house with 2 occupants results in a break-even of 9 years. The simulation includes options for rainwater harvesting or wells, Icynene foam, engineered lumber, Energy Star windows and doors, low flow water fixtures, aerobic / non-aerobic waste treatment or municipal services, and many other options. This is the first simulation of its type to provide publicly available sustainable construction analysis based on research, and it illustrates that sustainable construction might be both green for the environment and green for the pocketbook.
Lawrence Fulton; Bradley Beauvauis; Matthew Brooks; Scott Kruse; Kim Lee. A Publicly Available Cost Simulation of Sustainable Construction Options for Residential Houses. 2020, 1 .
AMA StyleLawrence Fulton, Bradley Beauvauis, Matthew Brooks, Scott Kruse, Kim Lee. A Publicly Available Cost Simulation of Sustainable Construction Options for Residential Houses. . 2020; ():1.
Chicago/Turabian StyleLawrence Fulton; Bradley Beauvauis; Matthew Brooks; Scott Kruse; Kim Lee. 2020. "A Publicly Available Cost Simulation of Sustainable Construction Options for Residential Houses." , no. : 1.
The question of building sustainable in a geographical locality is inexorably linked to cost. In 2011, one of the authors built a sustainable house that was (at the time) the highest certified sustainable home based on the National Association of Home Builder’s standards for sustainable construction. This Texas house has been used for residential and research purposes for the past decade. In this case study, the authors evaluate components of the construction and their effectiveness as well as unseen secondary and tertiary effects. Some of the specific components discussed are home site placement; rainwater harvesting (100% of residential requirements); aerobic septic system; grid-tied solar array power; electric car charging; geothermal heating and cooling; reclaimed wood framing; spray foam installation; selection of windows, fixtures, and appliances; on-demand electric water heaters for guest areas; generator backups; and use of local items. Electric bills and water system improvements are discussed in detail, as improvements were made as part of residential and research requirements. This case study suggests that the financial outlay is worth the extra up-front costs if residents in this geographical area and climate will occupy the residence 7 years.
Lawrence Fulton; Bradley Beauvais; Matthew Brooks; Clemens Scott Kruse; Kimberly Lee. Green for the Environment and Green for the Pocketbook: A Decade of Living Sustainably. 2020, 1 .
AMA StyleLawrence Fulton, Bradley Beauvais, Matthew Brooks, Clemens Scott Kruse, Kimberly Lee. Green for the Environment and Green for the Pocketbook: A Decade of Living Sustainably. . 2020; ():1.
Chicago/Turabian StyleLawrence Fulton; Bradley Beauvais; Matthew Brooks; Clemens Scott Kruse; Kimberly Lee. 2020. "Green for the Environment and Green for the Pocketbook: A Decade of Living Sustainably." , no. : 1.
Financial issues are top concerns for hospital executives. Evolving reimbursement structures focused on value provide an incentive to fully understand how patient safety performance and financial outcomes are connected. To that end, this study examines the relationships between Surgical Care Improvement Project (SCIP) measurements and hospital financial performance. Using multinomial logistic regression, we determined the association between hospital patient safety performances via analysis of eight prophylaxis data elements drawn from the archived Hospital Compare data. The measures are SCIP-Inf-1 (prophylactic antibiotic prophylaxis received within 1 hr prior to surgical incision), SCIP-Inf-2 (prophylactic antibiotic selection for surgical patients), SCIP-Inf-3 (prophylactic antibiotics discontinued within 24 hr after surgery end time), SCIP-Inf-4 (cardiac surgery patients with controlled 6 A.M. postoperative serum glucose management), SCIP-Inf-9 (urinary catheter removal postsurgery), SCIP-Inf-Card-2 (beta-blocker during the perioperative period), and SCIP-Inf-VTE-2 (venous thromboembolism prophylaxis). Data from the American Hospital Association provided two dimensions of organizational profitability: operating margin and net patient revenue. Our results indicate that improved hospital safety performance is associated with a relative risk of higher operating margin and net patient revenue, with some variation noted among the measures of patient safety. Our findings suggest that targeted improvement in patient safety performance, as evaluated in the Hospital Compare data, is associated with improved financial performance at the hospital level. Increased attention to safe care delivery may allow hospitals to generate additional patent care earnings, improve margins, and create capital to advance hospital financial position.
Brad Beauvais; Jason P. Richter; Forest S. Kim; Greg Sickels; Torry Hook; Sean Kiley; Thomas Horal. Does Patient Safety Pay? Evaluating the Association Between Surgical Care Improvement Project Performance and Hospital Profitability. Journal of Healthcare Management 2019, 64, 142 -154.
AMA StyleBrad Beauvais, Jason P. Richter, Forest S. Kim, Greg Sickels, Torry Hook, Sean Kiley, Thomas Horal. Does Patient Safety Pay? Evaluating the Association Between Surgical Care Improvement Project Performance and Hospital Profitability. Journal of Healthcare Management. 2019; 64 (3):142-154.
Chicago/Turabian StyleBrad Beauvais; Jason P. Richter; Forest S. Kim; Greg Sickels; Torry Hook; Sean Kiley; Thomas Horal. 2019. "Does Patient Safety Pay? Evaluating the Association Between Surgical Care Improvement Project Performance and Hospital Profitability." Journal of Healthcare Management 64, no. 3: 142-154.
As financial pressures on hospitals increase because of changing reimbursement structures and heightened focus on quality and value, the association between patient safety performance and financial outcomes remains unclear. The purpose of this study is to investigate if hospitals with higher patient safety performance are associated with higher levels of profitability than those with lower safety performance. Using multinomial logistic regression, we analyzed data from the spring 2014 Leapfrog Hospital Safety Score and the 2014 American Hospital Association to determine the association between Leapfrog Hospital Safety Score performance and three dimensions of organizational profitability: operating margin, net patient revenue, and operating income. Our findings suggest that improved hospital safety scores are associated with a relative risk of being in the top versus bottom quartile of financial performance: 5.41 times greater (p < .001) for operating margin, 10.98 times greater (p < .001) for net patient revenue, and 4.03 times greater (p < .001) for operating income. Our findings suggest that improved patient safety performance, as evaluated within the Leapfrog Hospital Safety Score, is associated with improved financial performance at the hospital level. Targeted focus on patient safety may allow hospitals to improve financial performance, maximize scarce resources, and generate additional capital to continue to positively evolve care.
Brad Beauvais; Jason P. Richter; Forest S. Kim. Doing well by doing good: Evaluating the influence of patient safety performance on hospital financial outcomes. Health Care Management Review 2019, 44, 2 -9.
AMA StyleBrad Beauvais, Jason P. Richter, Forest S. Kim. Doing well by doing good: Evaluating the influence of patient safety performance on hospital financial outcomes. Health Care Management Review. 2019; 44 (1):2-9.
Chicago/Turabian StyleBrad Beauvais; Jason P. Richter; Forest S. Kim. 2019. "Doing well by doing good: Evaluating the influence of patient safety performance on hospital financial outcomes." Health Care Management Review 44, no. 1: 2-9.
Background/Purpose Value-based purchasing (VBP) is increasing in influence in the health care industry; however, questions remain regarding the structural factors associated with improved performance. This study evaluates the association between age of hospital infrastructure and VBP outcomes. Methodology Data on 1,911 hospitals from three sources (the American Hospital Association Annual Survey Database, the American Hospital Association DataViewer Financial Module, and the Centers for Medicare & Medicaid Services Hospital VBP Total Performance Scores data set) were evaluated. Age of health care facilities was represented by the “average age of plant” financial ratio. VBP performance was measured by an aggregate Total Performance Score composed of four equally weighted domains, including Efficiency and Cost Reduction, Clinical Care, Patient- and Caregiver-Centered Experience, and Patient Safety. We hypothesize that average age of plant is negatively correlated with each of these measures. Results Hospitals within the lowest quartile of average age of plant (0–8.13 years) were found to have a total Performance Score of 2.35 points higher than hospitals with a an average age of plant in the fourth quartile (14.63 years and above; R2 = 21.5%; p < .001) while controlling for hospital ownership, size, teaching status, geographic location, service mix, case mix, length of stay, community served, and labor force relative cost. Comparable results were found within the VBP domains, specifically for Clinical Care (β = 4.09, p < .001) and Patient Experience (β = 3.41, p < .001). Findings for the Patient Safety and Efficiency domains were not significant. A secondary and more granular examination of capitalized assets indicates organizations with higher building asset accumulated depreciation per bed in service were associated with lower total performance (β = −.25, p < .001), Clinical Care (β = −.31, p < .05), and Patient Experience scores (β = −.45, p < .001). Conclusions The results of this study provide evidence of an inverse association between a hospital’s age of plant and specific elements of VBP performance. Practice Implications To date, no studies have investigated the relationship between hospital age of plant and value-based care. The results of our study may serve as supportive foundational evidence for health care leaders to target future capital investments to improve VBP outcomes.
Brad Beauvais; Jason P. Richter; Forest S. Kim; Erin L. Palmer; Bryan L. Spear; Robert C. Turner. A reason to renovate: The association between hospital age of plant and value-based purchasing performance. Health Care Management Review 2018, 46, 66 -74.
AMA StyleBrad Beauvais, Jason P. Richter, Forest S. Kim, Erin L. Palmer, Bryan L. Spear, Robert C. Turner. A reason to renovate: The association between hospital age of plant and value-based purchasing performance. Health Care Management Review. 2018; 46 (1):66-74.
Chicago/Turabian StyleBrad Beauvais; Jason P. Richter; Forest S. Kim; Erin L. Palmer; Bryan L. Spear; Robert C. Turner. 2018. "A reason to renovate: The association between hospital age of plant and value-based purchasing performance." Health Care Management Review 46, no. 1: 66-74.
Objective To explore antecedents and outcomes of nurse self‐reported job satisfaction and dissatisfaction‐based turnover cognitions, theorizing (using Self‐Determination Theory) that leaders can foster work conditions that help fulfill innate needs, thereby fostering satisfaction of nurses and patients, and reducing adverse events. Data Sources/Study Setting Primary and secondary data were collected within a 4‐month period in 2015, from 2,596 nurses in 110 Army treatment facilities (hospitals and clinics) across 35 health care systems. Data Collection/Extraction We collected individual nurse responses to the Practice Environment Scale‐Nursing Work Index, in addition to aggregated archival data from the same timeframe, including both facility‐level patient satisfaction records (the Army Provider Level Satisfaction Survey) and health care system‐level adverse events records (provided by the Army Programming, Analysis, and Evaluation office). Principal Findings Five predictors of nurse satisfaction and turnover cognitions emerged—supportive leadership, staffing levels, nurse–physician teamwork, adoption of nursing care practice, and advancement opportunities. Aggregated nurse satisfaction was the most consistent predictor of both patient satisfaction and adverse events. Conclusion These findings provide evidence of the importance of nurse attitudes in improving perceived and actual performance across facilities and health care systems; in addition to practical steps, managers can take to improve satisfaction and retention.
Sara Jansen Perry; Jason P. Richter; Brad Beauvais. The Effects of Nursing Satisfaction and Turnover Cognitions on Patient Attitudes and Outcomes: A Three‐Level Multisource Study. Health Services Research 2018, 53, 4943 -4969.
AMA StyleSara Jansen Perry, Jason P. Richter, Brad Beauvais. The Effects of Nursing Satisfaction and Turnover Cognitions on Patient Attitudes and Outcomes: A Three‐Level Multisource Study. Health Services Research. 2018; 53 (6):4943-4969.
Chicago/Turabian StyleSara Jansen Perry; Jason P. Richter; Brad Beauvais. 2018. "The Effects of Nursing Satisfaction and Turnover Cognitions on Patient Attitudes and Outcomes: A Three‐Level Multisource Study." Health Services Research 53, no. 6: 4943-4969.
The 2014 Military Health System Review calls for healthcare system leaders to implement effective strategies used by other high-performing organizations. The authors state, “ the [military health system] MHS can create an optimal healthcare environment that focuses on continuous quality improvement where every patient receives safe, high-quality care at all times” (Military Health System, 2014, p. 1). Although aspirational, the document does not specify how a highly reliable health system is developed or what systemic factors are necessary to sustain highly reliable performance. Our work seeks to address this gap and provide guidance to MHS leaders regarding how high-performing organizations develop exceptional levels of performance. The authors’ expectation is that military medicine will draw on these lessons to enhance leadership, develop exceptional organizational cultures, onboard and engage employees, build customer loyalty, and improve quality of care. Leaders from other segments of the healthcare field likely will find this study valuable given the size of the military healthcare system (9.6 million beneficiaries), the United States’ steady progression toward population-based health, and the increasing need for highly reliable systems and performance.
Brad Beauvais; Jason Richter; Paul Brezinski. Fix These First. Journal of Healthcare Management 2017, 62, 197 -208.
AMA StyleBrad Beauvais, Jason Richter, Paul Brezinski. Fix These First. Journal of Healthcare Management. 2017; 62 (3):197-208.
Chicago/Turabian StyleBrad Beauvais; Jason Richter; Paul Brezinski. 2017. "Fix These First." Journal of Healthcare Management 62, no. 3: 197-208.
The National Committee for Quality Assurance (NCQA) is the most widely used accrediting body of health plans, but no study has explored how differences in health quality affect the accreditation level. Consumers may benefit as they guide health insurance purchasing decisions toward a cost-quality evaluation. The authors conducted a multinomial logistic regression analysis using data from the 2015 NCQA Quality Compass of 351 health plans. This study’s outcome variable represented NCQA accreditation at 3 levels: accredited, commendable, and excellent. The authors examined the relationship of patient satisfaction, monitoring and prevention activities, appropriate care, and readmission rates on accreditation level. Satisfaction and monitoring and prevention activities were significantly associated with higher levels of accreditation in all analyses, but readmission was not. The expanded coverage of the Affordable Care Act provides an opportunity for health plans to market to consumers the benefits of accreditation to foster higher quality care.
Jason P. Richter; Brad Beauvais. Quality Indicators Associated With the Level of NCQA Accreditation. American Journal of Medical Quality 2017, 33, 43 -49.
AMA StyleJason P. Richter, Brad Beauvais. Quality Indicators Associated With the Level of NCQA Accreditation. American Journal of Medical Quality. 2017; 33 (1):43-49.
Chicago/Turabian StyleJason P. Richter; Brad Beauvais. 2017. "Quality Indicators Associated With the Level of NCQA Accreditation." American Journal of Medical Quality 33, no. 1: 43-49.