The 130th Annual Meeting of APHA

Abstract #46578

Nicholas Warren, ScD, Ergonomic Technology Center, University of CT Health Center, 263 Farmington Avenue, MC 6210, Farmington, CT 01060-6210, 860-679-4023, warren@nso.uchc.edu

This presentation presents preliminary cross-sectional data and methodological issues emerging from an AHRQ-funded study of community-based health centers in Connecticut and Massachusetts. The longitudinal study a) examines a multifactoral web of factors that have an impact on health care quality and safety and b) focuses on a relatively under-examined causal route to quality: working conditions and resultant employee health, fatigue, and satisfaction. Data will be presented relating to: 1. Root organizational factors that affect the quality of patient care and safety, with primary emphasis on the determinants of employee working conditions relevant to these outcomes. 2. The pathways through which these working conditions affect the quality of patient care. 3. The role of employee health (mental and physical), fatigue, and job satisfaction in linking working conditions to quality of patient care. 4. Indicators of potential intervention points and strategies for improving the quality of care. Organizational data are collected through personnel records, public information, and interviews with key informants. Employee data are gathered primarily through survey instruments, focus groups, key informants, and observations of sample jobs. Quality/safety of care is primarily assessed primarily through measures of effectiveness of chronic disease management and preventive health, as well as patient satisfaction surveys. This combination of records, observation, survey and qualitative data provides multiple ways of assessing the associations of interest as well as multiple methodological challenges. The presentation will examine both.

Learning Objectives: Participants will be able to

• Describe the factors at the organizational and employee level relevant to quality/safety of patient care
• Identify causal pathways between these factors
• Understand methodological difficulties in this type of multilevel research.

Keywords: Health Care Quality, Stress

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.