Congratulations to author, Dianne V. Jewell, on her candidacy for ‪APTA‬ President

Congratulations to Jones & Bartlett Learning author, Dianne V. Jewell, on her candidacy for APTA President.

We extend our best wishes to Dianne in the upcoming election!

Jewell’s bestselling Guide to Evidence-Based Physical Therapists Practice, Third Edition provides readers with the necessary tools needed to understand what constitutes evidence, how to search for applicable evidence, evaluate the findings, and integrate the evidence with clinical judgment and individual patient preferences and values.  This reader-friendly text facilitates learning and presents the knowledge and skills essential for physical therapist students to develop a foundation in research methods and methodologies related to evidence-based medicine.

 Key Features

  • Updated research examples
  • Presents statistics coverage with accessible content to review Description and Inference
  • Expanded content related to qualitative research designs

Instructor Resources

  • Sample Syllabus
  • Slides in PowerPoint format
  • Test Bank with 150 questions
  • Image Bank
  • Sample Evidence Appraisal Worksheets

 Student Resources

  • Crossword Puzzles
  • Flashcards
  • Interactive Glossary
  • Practice Quizzes
  • Web Links
  • Screenshots of electronic databases

To learn more about Guide to Evidence-Based Physical Therapist Practice, Third Edition, visit our website.

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Massachusetts Bill HB 2041 Would Recognize Pharmacists as Health Care Providers

According to the Massachusetts Pharmacists Association, bill HB 2041 would recognize pharmacists as health care providers. On April 9, pharmacists and pharmacy students gathered in Boston to advocate for HB 2041.

If the legislation passes this proposed bill it would allow pharmacists to bill MassHealth and the plans offered by the Group Insurance Commission for “drug therapy management services” to chronic disease patients when acting under the authority of a signed collaborative drug therapy management (CDTM) agreement with a physician. This bill would eliminate the list of disease states eligible for a CDTM agreement to allow pharmacists and physicians to team up on any disease that the physician requests.

To learn more about HB 2041 please visit Pharmacy Today.

Helpful titles for patient care, evaluation, assessment, diagnosis, and medication therapy:

 

 

 

 

 

Interested in learning more about our pharmacy titles? Visit our website.

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Endurance Events: What to Eat for the Long Haul

Lilah Al-Masri, MS, RD, CSSD, LD

Lilah Al-Masri, MS, RD, CSSD, LD

Simon Bartlett, PhD, CSCS, ATC

This week, our special guest bloggers, Lilah Al-Masri, MS, RD, CSSD, LD, and Simon Bartlett, PhD, CSCS, ATC, authors of 100 Questions and Answers about Sports Nutrition & Exercise, offer expert tips on endurance events.

Endurance events, such as marathons, ultra marathons, adventure races, and Ironmans, pose nutritional challenges for athletes. The mode of exercise, hours of competition, weather conditions, and racecourse all factor into creating a nutrition plan that maximizes energy consumption and hydration status.

During an endurance event, it is impossible to consume enough fuel or fluids to match what is being expended. Competitors must create an individual nutrition and hydration plan to ensure the body is receiving the maximal amount of fuel and fluids. The next four steps will help you formulate the proper plan for your event.

Step One: Know the Race Details

  1. Mode of Exercise: it is always possible to carry foods and fluids during exercise, but it is not always easy to consume the foods and fluids. For example, it is often easier for cyclist to eat and drink during exercise than a runner.
  2. Hours of Competition: longer events require higher carbohydrate and fluid needs. Endurance athletes are more susceptible to running out of fuel (“bonking”), dehydration or hyponatremia.
  3. Weather Conditions: sweat rates are influenced by cold, mild and hot weather.
  4. Racecourse: the variability of the racecourse may influence consumption. For example, it may be harder to eat/drink during more challenging areas of the course such as hills.

Step Two: Understand Basics Sports Nutrition Strategies

  1. Eat a balanced and easily digestible meal 1-4 hours prior to exercise.
  2. Consume a high carbohydrate snack and 8-16 ounces of fluid 30-60 minutes prior to exercise and/or competition.
  3. Eat and drink from the start of the event. Athletes that consume foods and fluids in the early minutes of the race perform stronger.
  4. Carbohydrate consumption: 30-60 grams per hour for 1 to 2.5 hours of activity and 80-90 grams per hour for 2.5 to 3 hrs and more of activity. Use carbohydrate sources that have multiple transportable carbohydrates (glucose and fructose) to increase absorption and reduce gastrointestinal distress. Consuming fructose only could cause symptoms such as bloating and diarrhea.
  5. Hydration: consume 5-12 ounces of fluid every 15-20 minutes during exercise. Amount varies due to sweat rate differences and individual gut tolerance. Sweat rate is influenced by weather, athlete’s size, conditioning, acclimatization, gender and age.
  6. Sweat losses during exercise should not exceed 2% of body weight. Greater than 2% loss can significantly decrease performance and increases the risk of medical complications such as heat stress and heat stroke.
  7. Sodium intake is essential to prevent hyponatremia, which is a dangerous condition that occurs when blood sodium levels are too low. Sodium can be consumed via sports drinks and foods.
  8. Flavor fatigue and taste changes are common during longer events. Notice changes in palatability during training in order to minimize fueling disruptions during competition.
  9. Consume foods that contain fat and protein (in addition to carbohydrates) during the event as they increase satiety and variety.
  10. Test foods and fluids throughout training to ensure gut tolerance during competition. Train your stomach like you train your muscles, start slowly and build up. For example, marathon training does not begin with a 26-mile run nor can your gut tolerate consuming 24 ounces of fluid during an hour of exercise if you are not used to consuming fluids. Progressively add fluids – 8 ounces then 16 then 24, etc. You must let your gut gradually accept the change.
  11. Set a watch/timer as a reminder to eat and drink at regular intervals.
  12. Use hydration and fueling devices, such as camelbacks and fuel belts.
  13. Carbohydrate loading prior to competition is beneficial.
  14. Know what foods and fluids will be offered during the competition. If these are not items you trained with, then you should not try them on race day.
  15. Examples of foods/fluids include: bananas, PB & J sandwich, peanut butter crackers, cheese sandwich, turkey and cheese sandwich, mini bagels, jerky, potato chips, crackers, fig newtons, soup/broth, cookies, candy, pretzels, sports drinks, liquid meals/shakes.

Step Three: Outline Your Nutrition and Hydration Plan

Hour 1: fig newtons+ 24 ounces of sports drink

Hour 2: banana + 24 ounces of sports drink

Hour 3: PB & J sandwich + 24 ounces of sports drink

Hour 4: pretzels + 24 ounces of sports drink

Hour 5: jerky + 24 ounces of sports drink

Hour 6: cookies + 24 ounces of sports drink

Step Four: Log and Revise

Log the successes and failures of your plan during training in order to revise it as needed before competition. Keep track of tolerated foods and fluids, ability to consume and ease of consumption of the foods and fluids, sweat losses (weight changes), gastrointestinal disturbances, performance, and recovery.

A “one-size fits all” plan does not exist thus devising a sports nutrition fueling and hydration plan will often include much trial and error. Sports Dietitians (credentials: RD, CSSD) are able to provide athletes with valuable guidance during this process. If you take the time to develop the right plan, you will be one step ahead of your competitors.

Thank you to our readers for submitting this question. We have had many wonderful questions/comments, which have resulted in several of the articles written thus far and questions that have been submitted in the last few months will be answered in the upcoming months.

http://www.jblearning.com/catalog/9780763778866/More information can be found in 100 Questions and Answers About Sports Nutrition and Exercise by Lilah Al-Masri, MS, RD, CSSD, LD and Simon Bartlett, PhD, CSCS, ATC.

Do you have a nutrition or exercise question? If so, submit them to adefronzo@jblearning.com . Questions will be answered on a monthly basis.

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NEW: Enhanced Edition of Fundamentals of the Physical Therapy Examination: Patient Interview and Tests & Measures

Enhanced Edition of Fundamentals of the Physical Therapy Examination: Patient Interview and Tests & Measures is available June 2015.

This bundle, including the text, Fundamentals of the Physical Therapy Examination: Patient Interview and Tests & Measures, packs not only the same price, but also-includes access, to the Navigate Companion Website and Navigate 2 Advantage Access that unlocks a comprehensive and interactive eBook, practice activities and assessments, instructor resources, and learning analytics reporting tools.

Navigate 2 Advantage Access materials include:

Student Resources:

  • A complete eBook with interactive tools, knowledge checks, and 71 videos
  • A virtual Study Center with robust practice activities and flashcards
  • Homework and testing Assessment Center with prepopulated quizzes and exams
  • Dashboards with learner and educator views that reports actionable data
  • Videos of Patient Interviews and Exams
  • Videos of Exam Procedures
  • Videos of Tests and Measures

Instructor Resources:

Sample Syllabus, Learning Objectives, Lecture Outlines, Slides in PowerPoint Format, Image Bank, and prepopulated Test Bank with automatic grading.

To learn more about the Enhanced Edition of Fundamentals of the Physical Therapy Examination: Patient Interview and Tests & Measures please visit our website.

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Mass Casualties and Health Care Managers

2014 Headshot_Short HairWhen we think about mass casualty events, we usually think about natural disasters, such as tornadoes, hurricanes, wildfires, and earthquakes. As noted in my blog on bioterrorism, we healthcare management educators tend not to dwell on or prepare for these and other disasters, such as chemical, biological, radiological, nuclear, and civil unrest. Living in Baltimore, Maryland, recent events have brought the matter home to our healthcare organizations in a way we have not seen since 1968. Peaceful marches and protests simmered in rage and boiled over into violence and fires. Currently, all the players—politicians, gang leaders, pastors, and community members are struggling to pull together to keep our beloved city calm and to support community members who are suffering from mental health issues associated with this tumult. As it became evident that mass casualties could occur, local hospitals were put on alert to receive injured protestors and police officers. But were they prepared?

Hsu, et al. (2004) reviewed articles on the effectiveness of hospital disaster drills, computer simulations, and table top exercises. They found:

• “Good internal and external communications were critical to success;
• A well-defined incident command center was a necessity;
• Accurate phone numbers for key players were required;
• Disaster drills improved clinicians’ knowledge of hospital disaster procedures;
• Computer simulations educated key hospital decision makers before implementation of a full-scale drill;
• Tabletop exercises motivated hospital staff to learn more about disaster preparedness; and,
• Regional exercises with top government officials helped to increase awareness of the need for better disaster response planning” (Hsu, 2004, p. 2).

It is clear from the literature that we educators must create more opportunities for our students to practice simulations of emergencies in interdisciplinary teams. A 2012 review of the interprofessional simulation-based education (IPSE) literature indicated:

“…IPSE scenarios and debriefing can be effective in facilitating appropriate individual professional responses within the scenarios and reflection on their own and others professional roles…” and “debriefing was vital to delivering the learning outcomes and emphasised the need to utilize faculty experienced in both simulation and debriefing activities.” (Gough, Hellaby, Jones, & MacKinnon 2012, p. 166).

Per the American College of Healthcare Executives, health care managers are expected to be prepared to take action in times of disaster. In an already crowded curriculum and with heavy teaching loads, it can be a challenge to find resources and add disaster preparedness to our to-do list. The Centers for Disease Control and Prevention Office of Public Health Preparedness and Response has online resources for health care managers across a wide array of settings (hospitals and healthcare systems, outpatient settings, long term care, etc.) to plan for and respond to all types of emergencies. These resources can be used to complement textbooks in planning coursework and interprofessional simulations for healthcare management students. Additional resources are available from:

• Office of the Assistant Secretary for Preparedness and Response (ASPR) which administers the Hospital Preparedness Program (HPP);
• The Emergency Management Institute;
Homeland Security; and
• The FEMA Center for Domestic Preparedness.

In the face of an upsurge of natural and manmade disasters, hospitals and emergency departments must be prepared. Mass casualties can occur at any given time, even on days when we are celebrating an athletic event. People who made it to the hospital after the bomb went off at the Boston Marathon survived because the hospitals and trauma centers in the city had practiced simulated mass casualty drills well ahead of the terrorist attack (Biddinger, Baggish, Harrington, d’Hemecourt, Hooley, Jones,… Dyer, 2013). As healthcare management educators, it is incumbent upon us to prepare our students to expect the unexpected.

Sharon B. Buchbinder, RN, PhD

Sharon Buchbinder is Professor and Program Coordinator for the MS in Healthcare Management at Stevenson University in the Graduate and Professional School and former chair of the Association of University Programs in Health Administration (AUPHA). She is also the author of three books from Jones & Bartlett: Introduction to Health Care Management, Cases in Health Care Management, and Career Opportunities in Health Care Management.
Here are some resources if you are interested in this topic:

Agiv-Berland, A., Ashkenazi, I., & Aharonson-Daniel, L. (2012). The Cross-National Adaptability of EMS Protocols for Mass Casualty Incidents. Journal of Homeland Security & Emergency Management, 9(2), -1. doi:10.1515/1547-7355.2036

American College of Healthcare Executives (ACHE). (2013, November 16) Healthcare executives’ role in emergency preparedness: Policy Statement. http://www.ache.org/policy/emergency_preparedness.cfm

Buchbinder, S. (2014, October 6). Bioterrorism and health care managers. Retrieved from http://blogs.jblearning.com/health/2014/10/06/bioterrorism-and-health-care-managers/

Biddinger, P. D., Baggish, A., Harrington, L., d’Hemecourt, P., Hooley, J., Jones, J., & … Dyer, K. S. (2013). Be prepared — The Boston Marathon and mass-casualty events. New England Journal Of Medicine, 368(21), 1958-1960. doi:10.1056/NEJMp1305480

Gough, S., Hellaby, M., Jones, N., & MacKinnon, R. (2012, September). A review of undergraduate interprofessional simulation-based education. Collegian: The Australian Journal of Nursing Practice, Scholarship and Research 19(3), 153-170.

James, J.J., Lyznicki, J.M., & Subbarao, I. (2012). Education and training of health professionals for mass fatality events. In Gursky, E.A. & Fierro, M.F. (2012). Death in large numbers: The science, policy, and management of mass fatality events (pp.427-458). Chicago, IL, American Medical Association..

Homeland Security. (2008). National incident management system. Homeland Security. Retrieved from http://www.fema.gov/pdf/emergency/nims/NIMS_core.pdf

Hsu, E.B., Jenckes, M.W., Catlett, C.L., Robinson, K.A., Feuerstein, C.J., Cosgrove, S.E,, Green, G., Guedelhoefer, O.C., Bass, E.B. (2004, April).Training of hospital staff to respond to a mass casualty incident. Summary, Evidence Report/Technology Assessment No. 95. (Prepared by The Johns Hopkins University Evidence based Practice Center.) AHRQ Publication No. 04-E015-1. Rockville, MD: Agency for Healthcare Research and Quality.

Kelly, M. & Jeffries, P. (2012, September). Clinical simulation in health care: Contemporary learning for safety and practice. Collegian: The Australian Journal of Nursing Practice, Scholarship and Research 19(3), 115-186.

Knudson, L. (2014). Hospital preparedness for a mass casualty event. AORN Journal, 100(3), C1. doi:10.1016/S0001-2092(14)00851-5

Nixon, R. & Shane, S. (2015, April 29). Taking to the Baltimore streets, but for peace and progress. The New York Times. http://www.nytimes.com/2015/04/30/us/taking-to-thebaltimore-streets-but-for-peace-and-progress.html?emc=edit_th_20150430&nl=todaysheadlines&nlid=36799837&_r=0

Reilly, M.J. & Markenson, D.S. (2011). Health care Emergency management: Principles and practice. Sudbury, MA: Jones & Bartlett Learning. http://www.jblearning.com/catalog/9780763755133/

Williams, J-J. (2015, April 30) Mental health help for residents affected by turmoil. The Baltimore Sun. Retrieved from http://www.baltimoresun.com/features/bs-hs-trauma-help-freddie-gray-riots-20150429-story.html

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New: Microsite for Respiratory Care: Principles and Practice, Third Edition

Great news—we’ve created a new microsite for Respiratory Care: Principles and Practice, Third Edition by Dean R. Hess. Written specifically for students in respiratory care, it is a complete exploration of the technical and professional aspects of respiratory care.

The microsite features:

  • Sample content: Front Matter, Chapters, Tables, Chapter Summary, Essay Questions, Table of Contents
  • Sample images from the text
  • Samples from the animation library
  • Features of the Third Edition
  • Student Resource: Navigate 2 Advantage Access jblnavigate.com/2
  • Instructor Resources
  • Recorded Webinar with co-author, William Galvin
  • View or download the Slide Presentation from the Webinar

Visit go.jblearning.com/Hess3e to learn more about Respiratory Care: Principles and Practice, Third Edition or contact your Account Specialist.

 

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Navigate 2 Advantage Access: Legal and Ethical Issues for Health Professionals, Fourth Edition

Navigate 2 Advantage Access for Legal and Ethical Issues for Health Professionals, Fourth Edition is available.

This bundle, including the text, Legal and Ethical Issues for Health Professionals, Fourth Edition includes access to Navigate 2 Advantage Access which unlocks a comprehensive and interactive eBook, practice activities and assessments, instructor resources, and learning analytics reporting tools.

Navigate 2 Advantage Access materials include:

Student Resources:

  • A complete eBook with interactive tools, knowledge checks, practice activities
  • A virtual Study Center with robust practice activities and flashcards
  • Homework and testing Assessment Center with prepopulated quizzes and exams
  • Dashboards with learner and educator views that reports actionable data

Instructor ResourcesSample Syllabus, Lecture Outlines in PowerPoint Format, and prepopulated Test Bank with automatic grading.

Please join our Webinar on Thursday, April 30th, 12:00 pm EST to learn more about Navigate 2 Advantage Access for Legal and Ethical Issues for Health Professionals, Fourth Edition.

Interested in learning more?  Visit our website or to learn more about Navigate 2, visit:http://www.jblnavigate.com/2

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Stretching: A Key Component of Physical Fitness

Lilah Al-Masri, MS, RD, CSSD, LD

Lilah Al-Masri, MS, RD, CSSD, LD

Simon Bartlett, PhD, CSCS, ATC

This week, our special guest bloggers, Lilah Al-Masri, MS, RD, CSSD, LD, and Simon Bartlett, PhD, CSCS, ATC, authors of 100 Questions and Answers about Sports Nutrition & Exercise, offer expert tips on stretching.

Regular stretching is an important part of physical fitness yet it is often omitted during workouts. Stretching is imperative to maintain flexibility (the range of motion one has in their joints) and is an essential component of all physical activities.

One’s flexibility is influenced by factors such as:

  • Age- The joints and surrounding connective tissues become more rigid and lose much of their elasticity as we age. This results in greater stiffness and decreased range of motion.
  • Gender- Women tend to have more flexibility than men most likely due to structural, anatomical and hormonal differences.
  • Activity level- Physical activity that stresses the joints with greater ranges of motion help maintain flexibility thus active individuals have greater flexibility than less active individuals.
  • Joint and tissue structure- there are inherent joint and tissue structure differences (joint capsules, tendons, ligaments and skin) between individuals that result in varying levels of flexibility. Certain individuals are endowed with higher elasticity and plasticity components to their connective tissue, making them inherently more flexible.

To improve flexibility, two stretching techniques are recommended: active stretching and passive stretching. An active stretch occurs when an individual applies the force for the stretch. For example, during the seated hamstring and lower back stretch, the individual would lean his or her upper torso down toward the lower torso, and upon meeting significant resistance would hold the stretch for a few seconds and then relax. On the other hand, the passive stretch requires the assistance of a person or device to apply the force for the stretch.   Using the same example of the seated hamstring stretch, a person would apply pressure on the back of the individual to help push the upper torso down.

Stretching can be further subdivided into static, dynamic and ballistic stretching.

  1. Static stretching is often referred to as the stretch-hold technique. The individual begins a stretch by moving the joint and muscle through the range of motion until the stretch sensation is felt in the belly of the muscle. The stretch is then held for 20 to 30 seconds followed by a relaxation period for a few seconds. The stretch is then repeated for an additional two repetitions with the goal of increasing the range of motion each time. The individual should always try to avoid stretching the muscle too intensely, as this could lead to injury. Static stretching is a very effective method for increasing flexibility, easy to learn and is generally considered to be safe.
  1. Dynamic stretching is a method of stretching using activity-specific movements to increase flexibility. This type of stretching helps prepare individuals for the movement patterns of their activity by stretching the involved muscles, tendons and joints. For example, a baseball pitcher could use stretch bands to simulate their throwing technique while increasing the intensity and range of motion during each successive throw. This stretching technique has an added advantage of developing both flexibility and strength concurrently.
  1. Ballistic stretching is often referred to as the bounce technique. The stretching movement is generally done rapidly without a hold (bouncing) at the end of each successive stretch. The muscle is stretched quickly and returned to its original position rapidly, and then stretched again. Ballistic stretching has the potential to cause harm and should be avoided. During ballistic stretching, the muscle is never allowed to relax causing a stretch reflex in the muscle (shortening), which leads to a tightening. An example of a typical ballistic stretch is the standing toe touch. During this technique, the individual stands with the legs slightly apart and tries to touch the toes by continuously bouncing up and down in rapid succession.

Flexibility is most effectively attained during the warm-up and cool-down periods of exercise. Prior to exercise, it is recommended that a general dynamic warm-up that involves the entire body (such as jumping jacks, fast walking with arm swings, light cycling) be completed for a few minutes to warm the muscles. When the muscles are warm, five to ten minutes of stretching can help reduce injury, increase joint range of motion and increase performance through increased elasticity of muscles and tendons. Post-exercise (cool-down), stretching the warm muscles allows the elastic components within the muscles and tendons to be more easily stretched. Warm muscles are able to stretch to greater lengths than cold muscles. To improve this capacity, stretching should be done when the muscles and tendons are warm and most receptive to being stretched.

Stretching is a simple way to maintain flexibility, increase physical fitness, reduce injuries and improve performance. Flexibility can be acquired quickly and can be maintained with incorporating just three stretching sessions per week. Persons of all ages and athletic abilities can improve their health by increasing their flexibility with stretching.

http://www.jblearning.com/catalog/9780763778866/More information can be found in 100 Questions and Answers About Sports Nutrition and Exercise by Lilah Al-Masri, MS, RD, CSSD, LD and Simon Bartlett, PhD, CSCS, ATC.

Do you have a nutrition or exercise question? If so, submit them to adefronzo@jblearning.com . Questions will be answered on a monthly basis.

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Support National Public Health Week!

Happy National Public Health Week!

Support National Health Week of their goal to make the U.S the Healthiest Nation in One Generation by 2030.

Please join us in celebrating National Public Health Week (NPHW) now through April 12th. NPHW has raised awareness of the role public health plays in our communities.

Get involved with the Daily Themes:

To learn more about public health, checkout Jones & Bartlett’s Public Health textbooks:

Want to learn more about National Public Health Week? Visit: http://www.nphw.org/.

Learn more about our Public Health textbooks on our website.

 

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Big Brother Is Watching

2014 Headshot_Short HairLast month, I talked about job searches from the other side of the desk, that of the candidate and how to help students avoid going into a house of horrors. In this post, I will be talking about something we don’t read a lot about in healthcare settings, but I anticipate we will be hearing more, that is employer surveillance and monitoring of employees.

Electronic Performance Monitoring and Control Systems (EMPCS)
We’ve all heard the announcement when we’ve called customer service lines: “This call may be monitored for quality and training purposes.” I suspect another purpose of the statement at the start of the call is to signal the customer to speak nicely to the agent. After all, isn’t the customer being monitored, too?

Increasingly, employers are going well beyond this type of surveillance. While on the employer’s clock, workers check and respond to personal emails, update their status in social media websites, participate in personal virtual messages and chats, check sports scores, and go shopping, to name but a few of the abuses that contribute to decreased worker productivity (Ciocchetti, 2011; Sanders, Ross, & Pattison, 2013). Ciocchetti’s 2011 review of employer electronic performance monitoring and control systems (EMPCS) included the following:

• Access panels;
• Attendance and time monitoring;
• Automatic screen warnings;
• Desktop monitoring programs;
• E-mail monitoring;
• Filters and firewalls restricting Internet access;
• Global Positioning Systems (GPS) and Radio Frequency Identification Devices (RFID);
• Internet use audits;
• Keystroke logging;
• Physical searches;
• Social-network and search engine monitoring;
• Telephone, text messages, and voicemail monitoring; and,
• Video surveillance. (Ciocchetti, 2011, pp. 302-321).

As faculty, I’m sure we’ve all given the same lecture to our students about not posting “bad” information about personal activities or over sharing on social networking sites. However, with newer technology in play, we need to be aware of what employers can do and provide advice about EMPCS to our students.

As we have warned our students time and again, employers often conduct Internet searches and examine social networking sites for inappropriate behaviors when considering a candidate for employment. In addition, depending on the level of the job and the security clearance required, they may also hire investigators to conduct extensive background checks. In my part of the country, many of the government agencies will send former or current FBI or ATF agents out to have face to face interviews with references. When I asked one such investigator why it couldn’t be conducted over the phone, he replied, “I need to see you and watch your body language.” Apparently the student and I passed his tests because the agency hired her.

EMPCS in Healthcare Settings
Once the candidate is employed in a healthcare organization, there is usually a lengthy orientation that includes a plethora of training modules for HIPAA and blood-borne illnesses, to name but a few. There is also a policy manual, either physical or electronic, that should specify any policies and procedures for employee surveillance. Even if the EMPCS are not specified, there are a number of laws that give the employer the right to use them. This doesn’t mean the employees like them or feel the use of certain invasive ones (physical search, for example) are justified.

Here are some examples of how EMPCS are being used and can be used in healthcare settings.

Access panels: Electronic pads or keypads allow employees with the correct code to access restricted areas, either by entering a code or by swiping with their employer identification badge (see also RFID). Ciocchetti (2011) writes that some extreme cases include access panels to rest rooms where the employee is allowed only a specific number of bathroom breaks per day.

Attendance and time monitoring: Most healthcare organizations have done away with the physical time clock where employees lined up to punch in. Replicon, one of many technology firms specializing in time tracking, offers various approaches to attendance monitoring, from waving a badge or swiping in at an access panel, to online computer clocking in, and now mobile device clocking in to a cloud for those employees who work away from home base.

Automatic screen warnings: These pop-ups act as warnings to the employee that their electronic journeys will be monitored. In some instances, it will appear on the screen if the employee spends too much time on the computer away from job related tasks. If the employee is supposed to be working on a financial spreadsheet and decides to go shopping online, the warning screen alerts the employee that this is not a good use of her time.

Desktop monitoring programs: Call it spyware, if you will, this is another way an employer can assess employee productivity. If the employee likes to play solitaire, this will track time spent on the card game and report it to the supervisor. These monitoring programs can also be inserted into emails and other “private” correspondence.

E-mail monitoring: Many companies already monitor emails for key words that can indicate a potential for violence, or other inappropriate behaviors, such as stalking or harassment. Others may be more interested in if you are sharing company secrets. In healthcare, we care most about patient privacy and securing medical information.

Filters and firewalls restricting Internet access: I know a few physicians who despise this feature on their hospital computer systems. Shopping websites have been barred from many, as well as websites that include the word “sex.” While it is likely the intention was to prevent employees from spending time on pornographic websites, the unintended consequence has been to deter physicians from providing information to patients who may have sexual issues.

Global Positioning Systems (GPS) and Radio Frequency Identification Devices (RFID): In response to loss and theft of durable medical equipment, some hospitals have implemented the use of GPS technology to reduce the loss of these assets. The days of wheel chairs rolling out the door without return may be over. In some instances, employees’ physical movements can be monitored, as well, to ensure they are where they are supposed to be.

Internet use audits: If a job does not require an employee to use the Internet, employees should not be surprised to find their access to the Internet is denied or restricted. Healthcare is no different from any other industry with respect to productivity expectations.

Keystroke logging: If your graduates work for an employer that expects them to be on the computer eight hours a day, their keystrokes may be monitored and converted to readable records of what was typed. According to Ciocchetti (2011, p. 315) “keystroke logging is generally done in secret to obtain more accurate results.” In a healthcare setting, I could imagine this being used as an investigative tool if someone is suspected of committing fraud or other illegal activities.

Physical searches: As noted before, the least justified in employee perception, as well in some courts of law, is the physical search. Employers have the right to search offices, files, lockers in some circumstances, such as suspicion of illegal activities. On two occasions, I witnessed pat downs of employees in a hospital by security personnel. Why? Because one was stealing drugs and needles and selling them on the street and the other was stealing drugs and using them.

Social-network and search engine monitoring: Once employed, our graduates should bear in mind the same warnings we gave them before graduation. Employees should never post inappropriate information on social networks or blogs. Nor should they complain about their employer or post potentially identifying information about patients. All of these can be considered grounds for termination.

Telephone, text messages, and voicemail monitoring: Much like email monitoring, some companies already monitor telephone, text, and voicemails for key words that can indicate a potential for violence, or other inappropriate behaviors, such as stalking or harassment. Others may be more interested in if you are sharing company secrets. As noted above, in healthcare, we care most about patient privacy and securing medical information.

Video surveillance: So called “granny cams” in long-term healthcare settings and other settings with vulnerable populations are no longer a possibility, but a reality. Cisco’s white paper on video surveillance in hospital settings provides ten compelling reasons for using their product.

1. Centralize patient observation;
2. Remotely monitor the emergency department;
3. Monitor for drug diversion;
4. Help prevent infant abduction;
5. Monitor patients with diminished faculties;
6. Help prevent theft;
7. Comply with operating room procedures;
8. Support triage in disaster scenarios;
9. Defend against false accidents claims; and
10. Increase safety in public areas. (Cisco, n.d., pp. 1-5)

With that list, why would anyone argue against video surveillance? Perhaps those who worry the video surveillance will extend to locker, changing, and rest rooms!

As healthcare management faculty, it is important for us to stay abreast of current employer expectations and inform and advise our students about these techniques. Employers are paying employees to work, not participate in leisure activities on company time. In a fluid and dynamic industry that is determined to control costs, increase quality, and increase access, we should expect to see increased use of employer electronic performance monitoring and control systems to decrease employee abuses and increase employee productivity.

Sharon B. Buchbinder, RN, PhD

Sharon Buchbinder is Professor and Program Coordinator for the MS in Healthcare Management at Stevenson University in the Graduate and Professional School and former chair of the Association of University Programs in Health Administration (AUPHA). She is also the author of three books from Jones & Bartlett: Introduction to Health Care Management, Cases in Health Care Management, and Career Opportunities in Health Care Management.

Here are some references if you are interested in this topic:
Ciocchetti, C. A. (2011). The eavesdropping employer: A twenty-first century framework for employee monitoring. American Business Law Journal, 48(2), 285-369.

Cisco. (n.d.) Cisco video surveillance in hospitals: Ten ways to save money and improve the patient experience: White paper. Retrieved from http://www.cisco.com/c/en/us/products/collateral/physical-security/video-surveillance-manager/white_paper_c11-716584.pdf

McNall, L. A., & Roch, S. G. (2007). Effects of electronic monitoring types on perceptions of procedural justice, interpersonal justice, and privacy. Journal of Applied Social Psychology, 37(3), 658-682.

Sanders, D. E., Ross, J. K., & Pattison, P. (2013). Electronic snoops, spies, and supervisory surveillance in the workplaces. Southern Law Journal, 23(1), 1-27.

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