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A structured method for collaborative decision-making in in-hospital cardiac telemetry

Sharma, Varun (2015) A structured method for collaborative decision-making in in-hospital cardiac telemetry. Master Essay, University of Pittsburgh.

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Telemetry is a hospital service which is delivered by many different hospital professionals acting in concert. These inter-connections challenge telemetry work designs to account for each actor’s role and his effect on the system. Other difficulties in designing safe, efficient telemetry arise from the nature of telemetry. The ergonomics of device interfaces and operational idiosyncrasies can contribute to the instability of systems when employees react to stresses by departing from the ideal protocol. If that occurs too frequently, organized quality improvement becomes necessary to resolve the aggregate uncertainty surrounding the structure-process relationship. Thus, an equilibrium may be restored between caregivers and hospital structures. A structured method is proposed to facilitate front-line employee participation in collaborative decision-making throughout all stages of quality improvement. Employees are encouraged to conduct improvements within a decision space between the minimum regulatory requirement (resource minimum) and break-even budget constraint (resource maximum.) Decision-making occurs in two stages after employees are grouped by department. A nominal group technique is conducted within departments to generate ideas. These are sent to the hospital level. There, a modified Delphi technique includes a representative from each department. After consensus has been established, the group delineates an implementation path consistent with its other needs. Because a larger number of employees has participated in their creation, the structures resulting from this improvement initiative are likely to decay more slowly. But once they do, there will be a need for further modifications. Then, formal and informal infrastructure for quality improvement collaboration will still exist. Non-profit healthcare organizations create quality improvement infrastructure with partial subsidization by the community. Thus, the opportunity cost in the marketplace must be outweighed by decision-making infrastructure’s benefits to the total welfare. These benefits range across subjective and objective dimensions. More individuals’ preferences may be addressed, increasing aggregate utility. If the breadth of data collection contributes to a net allocative efficiency, objective outcomes may improve in the furtherance of public health.


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Item Type: Other Thesis, Dissertation, or Long Paper (Master Essay)
Status: Unpublished
CreatorsEmailPitt UsernameORCID
Sharma, Varun
ContributionContributors NameEmailPitt UsernameORCID
Committee ChairCastle, Nicholascastlen@pitt.eduCASTLENUNSPECIFIED
Committee MemberHoffmann, Rosemary L.rho100@pitt.eduRHO100UNSPECIFIED
Date: 29 June 2015
Date Type: Submission
Access Restriction: No restriction; Release the ETD for access worldwide immediately.
Publisher: University of Pittsburgh
Institution: University of Pittsburgh
Schools and Programs: School of Public Health > Health Policy & Management
Degree: MHA - Master of Health Administration
Thesis Type: Master Essay
Refereed: Yes
Uncontrolled Keywords: cardiac, telemetry, interdependence, quality, improvement, structured, decision, making, decision, space, ecology, of, games, cooperation
Date Deposited: 01 Mar 2016 18:35
Last Modified: 26 Oct 2021 10:55


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