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Jean Ann Seago, PhD, RN

Associate Professor
Department of Community Health Systems

Research Scientist, Center for California Health Workforce Issues

2 Koret Way
San Francisco, CA  94143-0608

Office:  N-531E
Telephone: (415) 502-6340    Fax: 415-476-6042
Email:  jean.ann.seago@nursing.ucsf.edu

RESEARCH

My program of research focuses on understanding and testing how nursing systems and other organizational systems in acute care hospitals impact patient outcomes and patient safety and nurse workforce outcomes. Because of my operations work as an acute care hospital administrator and nurse executive, I am interested in factors that predict positive nurse workforce outcomes such as turnover, absenteeism, job satisfaction, and increased ethnic diversity.

Additionally I am also interested in organizational variables and the large databases that contain many of these variables. My program of research has begun to move in the direction of health services research with a focus on nursing systems and the nurse workforce. I investigate organizational variables as predictors (length of stay, hours per patient day, skill mix, RN union), and positive patient events (patient satisfaction) and adverse patient events (medication errors, patient falls, decubitus ulcers, mortality) as outcomes.

Our research team now works to incorporate secondary analyses of data from large databases to study patient and organizational outcomes (mortality, cost, staffing. shortage) as predicted by organizational (hospital ownership change, volume, case-mix) and environmental (county population of non white, urban/rural) factors.

SELECTED PUBLICATIONS

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PEER-REVIEWED PUBLICATIONS

(* data-based)

1. Seago, JA, McKenna Y. A three tier competency program. J Nurs Staff Dev. 9(6):283-286, 1993.[ case study]
2. *Seago, JA. Work group culture, stress, and hostility. Correlations with organizational outcomes. J Nurs Adm. 26(6):39-47, 1996.
3. *Seago, JA. Culture of troubled work groups. J Nurs Adm. 26(9):41-46, 1996.
4. *Seago, JA, Faucett J. Job strain among registered nurses and other hospital workers. J Nurs Adm. 27(5):19-25, 1997.
5. *Seago, JA. Organizational culture in hospitals: issues in measurement. Journal of Nursing Measurement. 5(2):165-178, 1997.
6. *Seago, JA, Weitz S, and Walczak S. Factors influencing stay in the postanesthesia care unit: a prospective analysis. Journal of Clinical Anesthesia.10(7):579-587, 1998. (Selected by the Dannemiller Memorial Educational Foundation for inclusion in AnesthesiaFile).
7. *Seago, JA. Evaluation of a hospital work redesign: patient-focused care. J Nurs Adm.29(11):31-38, 1999.
8. *Seago, JA. Registered nurses, unlicensed assistive personnel, and organizational culture in hospitals. J Nurs Adm.30(5):278-286, 2000.
9. *Spetz, J, Mitchell, S, and Seago, JA. The growth of multihospital firms in California. Health Affairs.19(6):224-230, 2000.
10. *Christensen, MA, Janson, S, and Seago, JA. Alcohol, head injury, and pulmonary complications. J Neurosci Nurs.33(4):184-189, 2001.
11. *Seago, JA, Ash, M, Spetz, J, Coffman, J, and Grumbach, K. Hospital registered nurse shortages: Environmental, patient, and institutional predictors. Health Serv Res.36(5):831-852, 2001. (included in the 2002 "The Nursing Workforce Digest", http://www.dartmouth.edu/~ahechome/workforce.html.)
12. *Grumbach, K, Ash, M, Seago, JA, Spetz, J, and Coffman, J. Measuring shortages of hospital nurses: how do you know a hospital with a nursing shortage when you see one? Med Care Res Rev.58(4):387-403, 2001.
13. *Mitchell, S, Spetz, J, and Seago, JA. Errors in data on hospital ownership. Inquiry.38(4):432-439, 2001. http://www.inquiryjournal.org/cont20.html#errors.
14. *Seago, JA. The California experiment: alternatives for minimum nurse-to-patient ratios. J Nurs Adm.32(1):48-58, 2002.
15. *Seago, JA and Ash, M. Registered nurse unions and patient outcomes. J Nurs Adm.32(3):143-51, 2002. Response to Letter to the Editor, J Nurs Adm 32(9), 439, 2002.
16. *Seago, JA. A comparison of two patient classification instruments in an acute care hospital. J Nurs Adm. 32(5):243-249, 2002.
17. *Seago, JA and Spetz, J. Registered nurse pre-licensure education in California. Nurs Econ.20(3):113-117, 125, 2002. Response to Letter to the Editor, Nurs Econ 20(5), 206-7, 2002.
18. *Coffman, JM, Seago, JA, and Spetz, J. Minimum nurse-to-patient ratios in acute care hospitals in California. Health Aff (Millwood). 21(5):53-64, 2002. Response to Letter to the Editor, Health Aff (Millwood) 22(1)281-2, 2002.
19. *Seago, JA, Spetz, J, Coffman, J, Rosenoff E, and O'Neil, E. Minimum nurse to patient ratios: The California Workforce Initiative Survey. Nursing Economics. 21(2):65-70, 2003.
20. Seago, JA and Barr SJ. New graduates in critical care: The success of one hospital. Journal for Nurses in Staff Development. 19(6): 297-304, 2003. [case study]
21. *Ash, M and Seago, JA. The effect of registered nurses' unions on heart-attack mortality. Industrial and Labor Relations Review. 57(3): 422-42, 2004.
22. *Seago, JA, Spetz, J, Mitchell, S. Nurse staffing ratios and hospital ownership in California. J Nurs Adm. 34(5): 228-37, 2004.
23. *Seago, JA and Spetz, J. California's minority majority and the white face of nursing J Nurs Educ (in press).
24. *Spetz, J, Dyer, WT, Chapman, S and Seago, JA. Hospital Demand for Licensed Practical Nurses. Western J of Nur (in press).

NON-PEER REVIEWED PUBLICATIONS AND OTHER CREATIVE ACTIVITIES

1. Seago, JA. A study of client perception of sensory alteration: A comparison of clients with and without fever. Oklahoma City, OK: School of Nursing, University of Oklahoma; 1979. [Master of Science thesis]
2. Seago, JA. A stranger's view of nursing in Micronesia. Rama Ubas: Newsletter for Guam Nurses' Association. Fall, 5-7, 1985.[opinion]
3. Seago, JA. Verbal abuse of nurses. Revolution: The Journal of Nurse Empowerment.3(3):62-63;106-107, 1993.[opinion]
4. Seago, JA. Traditions related to health. BISHINIK: The Official Publication of the Choctaw Nation of Oklahoma.6, December, 1994. [information]
5. Seago, JA. Work Group Culture, Workplace Stress and Hostility: Correlations with Absenteeism and Turnover in Hospital Nurses. San Francisco, CA: Community Health Systems, School of Nursing, University of California, San Francisco; 1995 [Doctoral dissertation].
6. Seago, JA. Five pitfalls of work redesign in acute care. Nursing Management. 28(10):49-50, 1997.[opinion]
7. Ash, M, Seago, JA. Do unionized Registered Nurses reduce AMI mortality? A working paper: Working Paper. No. 28, 2002. University of Massachusetts, Amerst Political Economy Research Institute: Working Paper Series, Amerst, MA. http://www.umass.edu/peri/pdfs/WP28.pdf.
8. Spetz, J, Seago, JA, Mitchell, S. The effect of hospital mergers and conversions on hospital employment. A working paper. No. 2003.20, 2003. Public Policy Institute of California: Working Paper Series, San Francisco, CA.

GOVERNMENT REPORTS

1. *Seago, JA, Coffman, J, Spetz, J, O'Neil, E. Nurse patient staffing ratios: A review of the literature. A preliminary report to the California Department of Health Services. San Francisco, CA: University of California, San Francisco, California Workforce Initiative and the Center for the Health Professions; December, 2000.
2. Seago, JA. Nurse Staffing, Models of Care, and Interventions. In: Shojania KG DB, McDonald KM, Wachter RM, ed. Making Health Care Safer: A Critical Analysis Patient Safety Practices. WAsh,ington, DC: Agency for Healthcare Research and Quality; Evidence/Technology Assessment No. 43, AHRQ Publication No. 01-E058.2001:427-451, July, 2001. [structured review] http://www.ahrq.gov/clinic/evrptfiles.htm.
3. *Seago, JA, Spetz, J. Admission Policies and Attrition Rates in California Community College Nursing Programs: A Report to Senator Charles Poochigian and the California Post Secondary Education Commission (CA SB 664). Sacramento, CA: California Post Secondary Commission and The University of California Policy Research Center; February 4, 2003.
   • http://www.cpec.ca.gov/completereports/2003reports/03-02.pdf;
   • http://www.cpec.ca.gov/Commission/Agenda0302/Tab_03.PDF;
   • http://www.ucop.edu/cprc/nursingprograms.pdf;
   • http://futurehealth.ucsf.edu/publications/index.html.
4. *Seago, JA, Spetz, J, Chapman, S, Dyer, W, & Grumbach, K. Supply, Demand, and Use of Licensed Practical Nurses. Report to the Department of Health and Human Resources, Health Resources Services Administration; Bureau of Health Professions. November, 2004.

OTHER REPORTS

1. *Spetz, J, Seago, JA, and Mitchell, S. Changes in hospital ownership in California. San Francisco, CA: Public Policy Institute of California; 1999. (Attached to California Assembly Bill 254 during the 99/00 session; listed in The California Institute For Federal Policy Research, Capitol Hill Bulletin 11/99; reviewed in the California Healthline 12/9/99).
2. *Spetz, J, Seago, JA, Coffman, J, Rosenoff E, and O'Neil, E. Minimum Nurse Staffing Ratios in California Acute Care Hospitals. San Francisco, CA: California Healthcare Foundation; December 4, 2000. http://futurehealth.ucsf.edu/publications/index.html.
3. *Coffman, J, Spetz, J, Seago, JA, Rosenoff E, and O'Neil, E. Nursing in California: A Workforce Crisis. San Francisco, CA: California Workforce Initiative and UCSF Center for the Health Professions; January, 2001. http://futurehealth.ucsf.edu/publications/index.html.
4. Seago, JA and Spetz, J. Job Satisfaction and Advancement of Minorities in Nursing. Berkeley, CA: Discrimination Research Center a project of the Impact Fund. March, 2005. http://drcenter.org/websys94.pl?wsi=0&websys_screen=public_reports#nurse.

EDITORIALS

1. O'Neil, E and Seago, JA. Meeting the challenge of nursing and the nation's health. Jama.288(16):2040-2041, Oct 23-30,2002. (invited)

PROCEEDINGS

1. *Seago, J A, Ash, M., Grumbach, K., Coffman, J., and Spetz, J. Predictors of nursing shortage: a retrospective analysis . Abstract Book / Association for Health Services Research, 16, 423-4. 1999.

1. *Spetz, J., Seago, J A, and Mitchell, S. The effect of hospital ownership on quality of health care. Abstract Book / Association for Health Services Research, 16, 313-4. 1999.
2. *Seago, JA and Ash, M., Registered nurse unions and patient outcomes . Abstract CD ROM/ Academy for Health Services Research and Health Policy, 17. 2000.
3. *Seago, JA,. Spetz, J., Coffman, J., Roseneff, E.. and O'Neil, E. Minimum nurse staffing ratios in California acute care hospitals [abstract]. Abstract CD ROM / Academy for Health Services Research and Health Policy, 18.2001.

MEDIA INTERVIEWS

1. American Broadcasting Company, San Francisco local television affiliate - Dr. Dean Edell, May 2, 1996.
2. "Beyond Nursing: A Talk with Jean Ann Seago, PhD", SYNAPSE UCSF student newspaper, September 25, 1997.
3. "Gray Matters", NurseWeek, newspaper, February 5, 2001.
4. "The Med Squad", NurseWeek, newspaper, August 14, 2001
5. UCSF In the News. "The Med Squad".August 21, 2001. http://pub.ucsf.edu/today/inthenews.php.
6. "Can We Mend the Worsening Ills of Health Care?, KMUD Radio, Redway/Garberville, CA FM 91.1 May 2, 2002
7. "Health Care Designs for the Future", WJFF Radio, Jeffersonville, NY, FM 90.5, May 7, 2002.
8. Case, J. & Welebob, E. The nursing shortage: Can technology help? Health Reports: First Consulting Group, The California Healthcare Foundation. 2002. http://www.chcf.org/documents/ihealth/NursingShortageTechnology.pdf.
9. Contra Costa Times and San Jose Mercury News newspapers in response to the JAMA editorial, "Meeting the challenge of nursing and the nation's health", 2002
10. Background for series of articles on hospital errors at King/Drew Medical Center. Los Angeles Times, newspaper, 2004
11. Background for article re tuberculosis in nurses. NurseZone, magazine, 2004

SELECTED RESEARCH AWARDS AND GRANTS

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