Methods: PrivOBs, HospOBs, and CNMs completed a survey on attitudes about midwives, attitudes and practices regarding C-sections, and experiencing pressure to perform an elective C-section from different sources. Rates for nulliparous, term, singleton, vertex births were 30.4% for private pay, 15.6% for publicly or uninsured women. Nurse Midwife (CNM)-obstetrician hospitalist (HospOB) collaborative model. One community hospital had two separate systems of labor and delivery (L+D) care, with privately insured women delivering with an obstetrician in private practice (PrivOB), and publicly insured and uninsured women delivering within a Certified. All rights reserved.īackground: Rates of cesarean sections increased 50% between 19 with no evidence of improved health benefits for moms or babies in most cases. In doing so, this conceptual study brings to bear important contextual considerations, and motivates novel research areas where the SCM field can make substantial contributions. Grounded in Institutional Theory, this study conceptualizes the downstream healthcare delivery supply chain, highlights important regulatory pressures that influence this supply chain, and examines the effects of government regulation and the unique characteristics of this network on coordination. Unfortunately, our learnings from traditional manufacturing, and to some extent other service supply chains, do not always easily port to the downstream healthcare delivery supply chain due to regulatory issues and distinctive characteristics present in this network. As such, healthcare executives are increasingly turning to the operations and SCM field to provide thought leadership and establish best practices around coordinating information, material and financial flows in healthcare delivery. Hospital leaders face unprecedented pressure to improve traditional supply chain performance measures such as cost, quality, and customer experience. The crux of their disagreement centers on one question: how to make the organizational changes required to keep NWH effective and competitive in the face of a diminishing revenue growth rate, while honoring its tradition of physician independence. Diverging opinions over how to improve the hospital has exposed differences between some private practice physicians and the administration. In 2009, NWH is renowned for high-quality care and is financially strong yet, given external pressures, most at the hospital agree that reforms are needed to improve the hospital’s and physician’s profitability while maintaining highest-quality patient care. community hospitals, NWH has historically been staffed primarily with private practitioners however, in recent years Jellinek has taken several steps toward further integration, such as hiring primary care physicians and hospitalists, and even proposing formation of a physicians’ organization (PO) - a move its veteran private practitioners sharply oppose. This level of violence is just something we can’t tolerate, we have to address it,” she said.How will Newton-Wellesley Hospital (NWH) preserve its private practice tradition while remaining effective and competitive in a healthcare industry demanding increasing integration between physicians and hospitals? This is the decision facing Newton–Wellesley Hospital president Mike Jellinek in 2009, as several trends - higher costs and lower revenues, shifting workforce demographics, and changing reimbursement models - threaten to disrupt NWH’s organizational model. Over 70 percent of nurses in the emergency room report that they’ve been assaulted on the job. Ryan is supporting legislation at the State House aimed at curbing workplace violence. Middlesex District Attorney Marian Ryan told Boston 25 News she is concerned about rising cases of violence against nurses and other health care professionals. The facts of this case are revealed just a week a patient at Lowell General Hospital is accused of hitting a nurse in the back of her head with a fire extinguisher. Newton-Wellesley Hospital said in a statement that it has conducted its own thorough investigation of the incident and has reported it to the Massachusetts Department of Mental Health. No charges have yet been filed, but Boston 25 News learned that Newton Police are sending the case to a Newton District Court judge magistrate who will decide if charges should move forward. In its statement, Newton-Wellesley Hospital said the patient given appropriate supportive care and treatment. The nurse told Newton police she was one of the people injured in the incident. Instead, in just a matter of seconds, the nurse said, the patient became physical, with his arms and legs flailing. Other nurses, she said, tried to calm him down. The nurse told police she witnessed the patient was upset with a counselor and tried to swing his arm in an attempt to punch him in the face.
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