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Effects Of An Integrated Electronic Health Record On An Academic Medical Center, Kenneth E. Koppenhaver Ii Jan 2016

Effects Of An Integrated Electronic Health Record On An Academic Medical Center, Kenneth E. Koppenhaver Ii

Walden Dissertations and Doctoral Studies

The debate about healthcare reform revolves around a triple aim of improving the health of populations, improving the patient experience, and reducing the cost of care. A major tool discussed in this debate has been the adoption of electronic health record (EHR) systems to record and guide care delivery. Due to low adoption rates and limited examples of success, the problem was a lack of understanding by healthcare organizations of how the EHR fundamentally changes an organization through the interactions of people, processes, and technology over time. The purpose of this case study was to explore the people, processes, and …


Evolution Of Physician-Centric Business Models Under The Patient Protection And Affordable Care Act, Tanya Nix, Lynn Szostek Jan 2016

Evolution Of Physician-Centric Business Models Under The Patient Protection And Affordable Care Act, Tanya Nix, Lynn Szostek

International Journal of Applied Management and Technology

For decades, the cost of medical care in the United States has increased exponentially. United States citizens spend twice as much as their European counterparts on medical care. Congress enacted the Patient Protection and Affordable Care Act (PPACA) to ensure affordable healthcare to the citizens of the United States. PPACA legislation is creating a new paradigm in healthcare delivery and provider business models. The purpose of this case study was to explore physicians’ perspectives regarding physician-centric business models evolving under the requirements of the PPACA legislation. Data were gathered through semistructured interviews and questionnaires with a purposive sample of 75 …


Job Satisfaction, Organizational Culture, And British Nurses' Intention To Leave Employment, Brendan Edward Williams Jan 2016

Job Satisfaction, Organizational Culture, And British Nurses' Intention To Leave Employment, Brendan Edward Williams

Walden Dissertations and Doctoral Studies

In spite of decades of research, concerning nurse's intention to leave their employer (ITL), in 2011, 31.2% of the British nurses surveyed indicated they had formed an ITL. Grounded in reasoned action theory as developed by Ajzen and Fishbein, the purpose of the correlational study was to provide hospital managers with information regarding the relationship among nurse's job satisfaction (JS), organizational culture (OC), and ITL. The archival data from the 2011 NHS Staff Survey included responses from nurses (n = 21,257) across the British National Health Service. The Spearman's rho correlates rs (21,257) indicated relationships among nurse's job satisfaction, organizational …


Meaningfulness Of Work As Perceived By Women From Diverse Social Classes: A Grounded Theory Exploration, Jennifer L. Hutmire Jan 2016

Meaningfulness Of Work As Perceived By Women From Diverse Social Classes: A Grounded Theory Exploration, Jennifer L. Hutmire

Walden Dissertations and Doctoral Studies

Despite research connecting the meaningfulness of work with positive organizational outcomes, such as increased employee well-being, job satisfaction, engagement, and retention, there remains a lack of adequate, inclusive research explaining differences in women's perceptions of the meaningfulness of work. The purpose of this qualitative grounded theory study was to address this gap in the literature by developing a theory about the formation of perceptions of the meaningfulness of work and about the impact of those perceptions. Research questions explored perceptions that women from diverse social classes have of the meaningfulness of work, what influenced those perceptions, the impact of those …


Total Quality System Breakdowns In Outsourced Clinical Trials, Hemali Barrios Jan 2016

Total Quality System Breakdowns In Outsourced Clinical Trials, Hemali Barrios

Walden Dissertations and Doctoral Studies

Numerous deaths, tragedies, and underreported drug side effects occur in outsourced clinical trials. Total quality system breakdowns occur even though quality agreement contracts and quality management systems are used by pharmaceutical organizations. The purpose of this single case study was to explore strategies clinical quality assurance managers use to avoid breakdowns in quality with outsourced clinical trials in Asia-Pacific countries. The study included a purposeful sample of 15 clinical quality assurance managers from 1 pharmaceutical organization located in the Northeast region of the United States. The conceptual framework was von Bertalanffy's general systems theory. Face-to-face semistructured interviews or e-mail questionnaires …


Predictive Ability Of Emotional Intelligence Scores On Employee Self-Reported Perception Of Comprehensive Organizational Credibility Inventory, Leif Allen Ford Jan 2016

Predictive Ability Of Emotional Intelligence Scores On Employee Self-Reported Perception Of Comprehensive Organizational Credibility Inventory, Leif Allen Ford

Walden Dissertations and Doctoral Studies

Research has shown that emotional intelligence (EQ) is positively related to beneficial outcomes in organizations. Research has also found that negative perceptions of organizational credibility (OC) can result in adverse economic and social costs for organizations and communities. To date, the existing research has failed to examine whether employee EQ might affect employee perceptions of OC. A quantitative, non-experimental study was conducted using a sample of employees in large health and medical organizations throughout the United States. The variables in the study were measured using the Assessing Emotions Scale and the Comprehensive Organizational Credibility Inventory. Multiple regression analyses and Pearson …


Strategies Technology Development Marketing Leaders Used To Commercialize A New Product Innovation, Roxie Mooney Jan 2016

Strategies Technology Development Marketing Leaders Used To Commercialize A New Product Innovation, Roxie Mooney

Walden Dissertations and Doctoral Studies

Strategies for commercialization of a new product innovation are critical for gaining a sustainable level of customer acceptance and financial performance. The purpose of this single case study was to explore the commercialization strategies used by 5 technology development marketing leaders from a healthcare company in Washington state. The conceptual framework for this study was commercialization of innovation theory (CoI). The data were collected through semistructured interviews and company documentation, and analyzed using Yin's 5-step data analysis process for case studies to identify and code themes. Analysis of data generated 3 major themes: strategies implemented during the prelaunch phase, strategies …


Strategies To Retain Employees In Clinical Laboratories, Amber Rose Phipps Jan 2016

Strategies To Retain Employees In Clinical Laboratories, Amber Rose Phipps

Walden Dissertations and Doctoral Studies

With 30 million citizens gaining access to U.S. healthcare through the Affordable Care Act by 2016, healthcare managers need preanalytic employees to ensure quality healthcare services can be provided. The purpose of this qualitative single case study explored strategies used to retain preanalytic employees. The target population consisted of 10 clinical laboratory managers in a single community-based clinical laboratory in the mid-southern United States, selected because of prior success in improved employee retention strategies. The conceptual framework grounding this study was the theory of work adjustment. Data triangulation occurred from using semistructured interviews and company documents. All interpretations from the …


Strategies For Successful Implementation Of Change Initiatives In Health Care, Kristy Trinidad Jan 2016

Strategies For Successful Implementation Of Change Initiatives In Health Care, Kristy Trinidad

Walden Dissertations and Doctoral Studies

Changing regulations, increased competition, and evolving customers' expectations have necessitated significant organizational changes in the health care industry. This multiple case study investigated the strategies of senior managers from 3 California health care organizations to implement significant change initiatives. The participating organizations had a positive reputation for successfully implementing change. Data from interviews and a review of organizational documents were analyzed through the conceptual lens of Lewin's phases of change model and Kotter's 8-step process for implementing change. The analysis revealed 3 general themes: communications, training, and employee involvement. The managers of each participating organization emphasized the importance of keeping …


Developing Strategies Of Organizational Sustainability For Solo And Small Business Medical Practices, Gerald Lloyd Anderson Jan 2016

Developing Strategies Of Organizational Sustainability For Solo And Small Business Medical Practices, Gerald Lloyd Anderson

Walden Dissertations and Doctoral Studies

Recent trends point toward a decline in solo and small business medical practices, yet, the need and demand still exists for this model of health care. The purpose of this case study was to explore effective approaches to help physicians in solo practice and small medical group primary care practitioners (PCPs) retain their small business medical practices. The study included purposive sampling and face-to-face interviews: 11 physicians, predominately primary care practitioners, in the Baltimore-Washington metropolitan region, were interviewed until data saturation was reached. A component of systems theory (strategic thinking) and the dynamic capabilities concept were used to frame the …


Strategies For Increasing Employee Engagement In The Service Industry, Tonia Ann Walker Jan 2016

Strategies For Increasing Employee Engagement In The Service Industry, Tonia Ann Walker

Walden Dissertations and Doctoral Studies

The annual loss to U.S. organizations consequential to a lack of employee engagement was approximately $300 billion in 2013. Employee engagement is vital to the business sustainability of an organization. The purpose of this qualitative single case study was to explore successful strategies that business leaders of a service organization used to increase employee engagement. The conceptual framework guiding this study was the behavior engineering model theory developed by Gilbert. A purposeful sample of 6 engineering managers was selected based on their success in creating strategies resulting in increased employee workplace engagement in a monopoly service organization in Connecticut. Semistructured …


An Exploration Of Bullied Nurses, Witnesses, And A Hospital's Bottom Lline, Brenda Kay Williams Jan 2016

An Exploration Of Bullied Nurses, Witnesses, And A Hospital's Bottom Lline, Brenda Kay Williams

Walden Dissertations and Doctoral Studies

Nurses experiencing bullying or witnessing other nurses bullied may choose to vacate their hospital positions. Nurse attrition negatively impacts a hospital's bottom line, which can lead to insolvency and a lack of access to healthcare by patients. The purpose of this phenomenological study was to understand the choices nurses made regarding their careers after experiencing or witnessing bullying and to calculate a hospital's cost of loss. Freire's oppressed group theory provided the conceptual framework for the study. The basis of the research questions was to understand how the nurse felt when bullied or observing a coworker bullied, the actions taken, …


The Relationship Between Hospital Leadership Activities And Clinical Quality Outcomes In Iowa, Sarah Pavelka Jan 2016

The Relationship Between Hospital Leadership Activities And Clinical Quality Outcomes In Iowa, Sarah Pavelka

Walden Dissertations and Doctoral Studies

The Centers for Medicare and Medicaid Services have been working with hospital networks across the United States to improve health care through education and training on clinical best practices and leadership frameworks. Some organizations have failed to reach the high-quality standards of care expected and have adverse patient care outcomes. The purpose of the study was to determine the relationship between leadership actions, funding type, and clinical care outcomes in participating Partners for Patients hospital programs in Iowa. The secondary variable data were provided from a Partnership for Patients contractor, through the Centers for Medicare and Medicaid Services Organizational Assessment …


Exploration Of Practice Managers' Decision-Making Strategies In A Managed-Care Paradigm, Lawrence Randolph Ford Jan 2016

Exploration Of Practice Managers' Decision-Making Strategies In A Managed-Care Paradigm, Lawrence Randolph Ford

Walden Dissertations and Doctoral Studies

Practice managers are facing challenging expectations when deploying a managed-care paradigm. The problem addressed in this study was a gap in knowledge regarding practice managers' decision-making strategies that affect, or could be perceived to affect, a climate of excellence with business and client relationships, primary health care, physicians, and patients in a managed-care paradigm. The purpose of the qualitative exploratory study was to explore practice managers' decision-making strategies affecting primary health care, physicians, and patients. Guided by Simon's ideology of decision-making strategies in a management environment, the overarching research question and 3 subquestions centered on how practice managers delineate their …


Strategies Ontario Hospital Administrators Apply To Generate Non-Government Revenue To Remain Sustainable, Frank Pieter Martien Naus Jan 2016

Strategies Ontario Hospital Administrators Apply To Generate Non-Government Revenue To Remain Sustainable, Frank Pieter Martien Naus

Walden Dissertations and Doctoral Studies

Health care administrators in Ontario want to transform health care with a focus on improving efficiency and quality of care, yet they pay little attention to increasing revenue. The purpose of this qualitative case study was to explore strategies Ontario hospital administrators apply to generate nongovernment revenue to remain sustainable. The target study population consisted of 2 chief executive officers and 2 chief financial officers at Ontario academic research hospitals. The conceptual framework for this study included radical organizational change theory supported by complexity leadership theory, and grounded in an evidence-based approach. The researcher conducted open-ended semi-structured interviews and made …


Exploring Leadership Strategy Influence On Nursing Personnel Retention Within Safety-Net Hospitals, Carl Brown Jan 2016

Exploring Leadership Strategy Influence On Nursing Personnel Retention Within Safety-Net Hospitals, Carl Brown

Walden Dissertations and Doctoral Studies

Frequent turnover among a hospital's nursing staff can profoundly impact organizational operating costs. With a national turnover rate of 17% in 2015, understanding the impact of management approaches on nurse attrition is vital to business success. Guided by Homan's social exchange theory, the purpose of this single case study was to explore leadership strategies used by safety-net hospital leaders to increase nursing personnel retention. Data collection consisted of semistructured interviews from a purposive snowball sampling of 8 senior directors working at a safety-net hospital in southern Maryland. Additional information collected involved documents and artifacts related to human resources management policies …


Pharmacy Stores Profitability And Sustainability In Bulawayo, Zimbabwe, Augustine Khoza Jan 2016

Pharmacy Stores Profitability And Sustainability In Bulawayo, Zimbabwe, Augustine Khoza

Walden Dissertations and Doctoral Studies

Zimbabwe's catastrophic economic decline resulted in a high unemployment rate (95%), declining socioeconomic indicators, pharmacy stores' unprofitability and lower sustainability. Profitable pharmacy stores play a fundamental role in ensuring public access to medication. Lack of pharmacy profitability leads to poor healthcare delivery, resulting in increased morbidity and mortality. A healthy population is panacea to economic growth and prosperity and enhances human dignity, social cohesion, and the quality of life. In this qualitative, descriptive multicase study design, using Porter's business strategies theory and the Deming process of quality assurance as conceptual frameworks, data from 11 pharmacy stores leaders in Bulawayo, Zimbabwe …


A Multisite Hospital's Transition To An Interoperable Electronic Health Records System, Valerie Gerene Drill Jan 2016

A Multisite Hospital's Transition To An Interoperable Electronic Health Records System, Valerie Gerene Drill

Walden Dissertations and Doctoral Studies

The health care industry is transforming into an industry that requires health information technology, yet many health care organizations are reluctant to implement new technology. The purpose of this case study was to explore strategies that led to a successful transition from an older electronic health record (EHR) system to a compliant EHR system at a multisite hospital system (MHS). The study included face-to-face and phone interviews with 12 managers who worked on the transition of an MHS's EHR system in the Pacific Northwest region of the United States. The technology acceptance model was used to frame the study. Audio …


Financial Distress In The Health Care Business, Firas Fathi Musmar Jan 2016

Financial Distress In The Health Care Business, Firas Fathi Musmar

Walden Dissertations and Doctoral Studies

Sixty-four United States hospitals closed for poor organizational performance during 2010 through 2016. Because of hospital closures, community members experienced delays in obtaining needed care, reduced access to specialty care, and increased travel distances. Based on the balanced scorecard model theory, the purpose of this qualitative single case study was to explore strategies that 10 health care leaders used at a healthcare organization in central Texas to prevent financial distress. Semistructured interviews were conducted and archival organizational accounting records were reviewed, including company surveys with employees and patients. Data were thematically analyzed and triangulated to ensure the trustworthiness of interpretations. …


Perceived Effects Of The Affordable Care Act On Emergency Preparedness, Tanya Marie Scherr Jan 2016

Perceived Effects Of The Affordable Care Act On Emergency Preparedness, Tanya Marie Scherr

Walden Dissertations and Doctoral Studies

National healthcare as executed through the Patient Protection and Affordable Care Act (ACA) was introduced in 2010, but was discussed for several decades prior to its enactment. Section 5210 of the ACA established funding for a Regular and Ready Reserve Corps (RRRC) to provide support to local healthcare entities with emergency preparedness. It is unknown what impact Section 5210 of the ACA has had on local emergency preparedness, as well as what obstacles are encountered with implementing this piece of legislation at the local level. The purpose of this case study was to understand the obstacles encountered at a local …


Strategies To Mitigate Nurse Turnover In Eastern And Northern Virginia, Fred E. Echoles Jan 2016

Strategies To Mitigate Nurse Turnover In Eastern And Northern Virginia, Fred E. Echoles

Walden Dissertations and Doctoral Studies

Registered nurses leaving the workplace are estimated to cost healthcare organizations and society between $1.4 and $2.1 billion annually. The purpose of this multiple case study was to explore what strategies leaders of healthcare organizations from the Eastern and Northern regions of Virginia can use to mitigate the effects of nurse turnover and its cost to the organization. The target population consisted of 8 RNs who experienced turnover during their nursing careers. The conceptual framework for this study was Herzberg's dual-factor theory. Face-to-face semistructured interviews were conducted and publically available documents were garnered. Thematic reduction of participants' interviews, coupled with …


Nurses' Experiences Transitioning From Staff Nurse To Management In A Community Hospital, Jennifer Sylvia Buffenbarger Jan 2016

Nurses' Experiences Transitioning From Staff Nurse To Management In A Community Hospital, Jennifer Sylvia Buffenbarger

Walden Dissertations and Doctoral Studies

This project study addressed the problem of frequent turnover of nurse managers at a Northeastern community hospital. The lack of retention of nurse managers has led to attenuated support for the nursing staff who continued to hold the front line in patient care. The purpose of this qualitative bounded case study was to explore nurse managers' experiences with turnover in order to identify strategies for enhancing retention. Work empowerment and servant leadership theories served as the frameworks for the study. Research questions focused on nurse managers' perceptions of empowerment and servant leadership characteristics that were important in decisions to assume …


The Indian Pharmaceutical Industry's Supply Chain Management Strategies, Prasad Bolineni Jan 2016

The Indian Pharmaceutical Industry's Supply Chain Management Strategies, Prasad Bolineni

Walden Dissertations and Doctoral Studies

Indian pharmaceutical companies spend one-third of their revenue from supply chain management (SCM) activities due to inherently poor transportation infrastructure. SCM is a vital function for many companies, as it is usually employed to lower expenses and increase sales for the company. SCM costs are higher in India than they are in other areas of the world, amounting to 13% of India's GDP. The purpose of this study was to explore SCM strategies Indian business leaders in the pharmaceutical industry have used to reduce the high costs associated with SCM. This study used a single case study research design and …


Assessing Nurse Manager Competencies In A Military Hospital, Ruby O. Anderson Jan 2016

Assessing Nurse Manager Competencies In A Military Hospital, Ruby O. Anderson

Walden Dissertations and Doctoral Studies

Military health care organizations need competent frontline managers with knowledge and skills to manage health care complexity and ensure evidence-based practice. With systematic, planned turn over of military managers, more civilian managers are needed to fill permanent positions in military hospitals. The purpose of this project was to provide a better understanding of the competencies perceived by nurse managers at a military medical center and whether they differed by military or civilian status. The American Organization of Nurse Executives competency model and framework provided the theoretical framework for the project. The design was nonexperimental, with an observational, descriptive, cross-sectional approach. …


The Connection Between Wellness Programs And Employee Job Satisfaction In Higher Education, Donel J. Richemond Jan 2016

The Connection Between Wellness Programs And Employee Job Satisfaction In Higher Education, Donel J. Richemond

Walden Dissertations and Doctoral Studies

Job dissatisfaction is becoming a fundamental concern for employers. Employee engagement makes an organization more productive and can reduce absenteeism. The purpose of this quantitative study was to examine the relationship between employer-sponsored wellness-program participation and job satisfaction among for-profit college and university leaders. Data collection involved an online survey of 400 faculty members' from for-profit universities in the United States contacted using the Job Satisfaction Survey; 103 participants completed the survey. The theoretical framework was the need-satisfaction theory, which includes the factors that promote job satisfaction and job dissatisfaction. The results came from a multiple regression analysis that indicated …


Frontline And Middle-Level Nursing Leader Transition Within The Military Health System, Rudolph George Newman Jan 2016

Frontline And Middle-Level Nursing Leader Transition Within The Military Health System, Rudolph George Newman

Walden Dissertations and Doctoral Studies

Healthcare delivery within the military requires a multifaceted approach to achieve the desired outcomes of safe, effective, patient-centered, timely, efficient, and equitable health care. The prospect of maintaining a cycle of continuous process improvements within military clinical settings hinge on frontline leaders and middle-level managers who must be prepared to execute the mission and motivate, supervise, coach and mentor the staff. This project showcases a review of current literature translated into the development of an evidence-based Transformational Leadership Induction Program (TLIP) module that consisted of 4 subsections: the environment of care, clinical decision support systems, human resources management, and change …


Evaluating Key Predictors Of Employee Response To Change In The Pharmaceutical Industry, Otis S. Johnson Jan 2016

Evaluating Key Predictors Of Employee Response To Change In The Pharmaceutical Industry, Otis S. Johnson

Walden Dissertations and Doctoral Studies

This study addressed the factors that predict employee response to large-scale change in the United States pharmaceutical industry. When poorly executed, major organizational changes such as mergers and acquisitions are often disruptive and costly to organizations and demoralizing to employees. Although employee responses to change have been studied in several industries, employee responses during change execution in the pharmaceutical industry have not been subject to study. The purpose of this correlational study was to reduce the knowledge gap related to organizational change in the pharmaceutical industry by evaluating key predictors of employee response to large-scale change. The theoretical framework consisted …


Influence Of The Patient Protection And Affordable Care Act On Small Businesses, Sean Gallman Jan 2016

Influence Of The Patient Protection And Affordable Care Act On Small Businesses, Sean Gallman

Walden Dissertations and Doctoral Studies

Business leaders lack strategies to implement the employer shared responsibility provision of the Patient Protection and Affordable Care Act (ACA). Small businesses pay approximately 18% more than larger companies for the same health coverage. Within a conceptual framework of management by objectives, the purpose of this qualitative multiple case study was to explore the strategies small business leaders use to implement the employer shared responsibility provision of the ACA. Data were gathered from the review of company documents, observations, and semistructured interviews with 5 senior business leaders from small business organizations in the Mid-Atlantic region of the United States. Data …


The Relationship Between Health Risk And Workplace Productivity In Saudi Arabia, Sarah Lorraine Hayman Jan 2016

The Relationship Between Health Risk And Workplace Productivity In Saudi Arabia, Sarah Lorraine Hayman

Walden Dissertations and Doctoral Studies

Rising worldwide rates of noncommunicable diseases (NCDs) in the Middle East, principally Saudi Arabia, have put an increasing load on the health system and employers. Middle Eastern organizations have been slow to develop targeted health programs, which include an emphasis on employee productivity. The purpose of this study was to determine the relationship, if any, between employee lifestyle and workplace productivity. Productivity is the amount of work produced based on the time and cost required to do so. The underlying theoretical foundations of this research were the socioecological health model and the human capital model. The quantitative, ex post facto …


Meeting Meaningful-Use Requirements With Electronic Medical Records In A Community Health Clinic, Tony Andrew Richardson Jan 2016

Meeting Meaningful-Use Requirements With Electronic Medical Records In A Community Health Clinic, Tony Andrew Richardson

Walden Dissertations and Doctoral Studies

Small nonprofit medical practices lack the technical expertise to implement electronic medical records (EMRs) that are consistent with federal meaningful-use requirements. Failure to comply with meaningful-use EMR requirements affects nonprofit community health care leaders' ability to receive reimbursement for care. Complexity theory was the conceptual framework used in this exploratory single case study. The purpose of the study was to explore the strategies nonprofit community health care leaders in Washington, DC used to implement EMRs in order to comply with the meaningful-use requirements. Data were collected via in-depth interviews with 7 purposively-selected health care leaders in a nonprofit clinic and …