Business Commons^™

Correlations Between Management Behaviors And Financial Indicators With Fda Compliance Leading To Medicine Shortages, Francisco Gutierrez-Perez

2017 Program & Posters

A series of Food and Drug Administration (FDA) interventions and enforcement actions against pharmaceutical manufacturers in the past 5-6 years led to medicine shortages in the United States.

• The manufacturing shortfalls made essential medicines unavailable for the treatment of patients.

• Manufacturing shortfalls implied that quality management and manufacturing systems were not empowered or adequately staffed to support the critical functions of the pharmaceutical firms.

Strategies To Improve Job Satisfaction And Reduce Voluntary Employee Turnover Of Nurses, Stewart Proctor

Walden Dissertations and Doctoral Studies

Job satisfaction and employee turnover affect the health care industry in the form of overworked staff, inadequate health care, and loss of profits. In 2015, the United States health care industry had a shortage of over 923,000 registered nurses. Health care organizations lose an estimated $1.4 to $2.1 billion each year because of registered nurse (RN) turnover. These factors indicate that some managers lack the strategies to increase job satisfaction and reduce RN turnover. The purpose of this single case study was to use the Herzberg 2-factor theory to explore strategies 5 health care leaders use to improve nurses' job …

Healthcare Executive Leadership Development And Succession Planning, Robin Ford Dillard

Walden Dissertations and Doctoral Studies

Business leaders face leadership crises as executives from the baby boomer generation retire, creating a shortage of experienced and knowledgeable leaders. Some business leaders are unprepared for the replacement of retiring senior-level executives and lack strategies for succession planning. The findings of this study indicate succession planning and leadership development play a significant role in preparing future healthcare leaders in their ability to improve the quality of patient care and improve the strategic and financial health of the organization. Guided by the human capital theory the purpose of this multiple case study was to explore the strategies used by healthcare …

Leadership Practices That Improve The Workplace Safety Environment, Nathan Nomore Chikono

Walden Dissertations and Doctoral Studies

Inadequate leadership is the reason workplace accidents in the mining industry remain high, making the industry one of the most hazardous operational activities in the world. Unsafe leadership practices may result in death or injury to workers. A group of 30 mining company leaders from 3 gold mines in Zimbabwe revealed an exception to these hazardous practices, however, notable through their outstanding safety improvement records. To better understand what these practitioners were doing, this multicase study research design explored their strategies to improve the workplace safety environment in the mines. Data were collected using audio-recorded semistructured interviews and document analyses. …

Exploring The Strategies To Implement A Sustainable Energy Program In Hong Kong Public Hospitals, Terry Ting

Walden Dissertations and Doctoral Studies

Healthcare is one of the most energy-intensive industries because of its 24 hour-a-day and 7-days-a-week operation model. Climate change, due to environmental pollution, has increased the incidence of respiratory disease, cardiovascular disease, and cancer, which further overload the financial burden of our healthcare system. The National Health Service Sustainable Development Unit suggested that a sustainable healthcare sector also requires using their resources in an efficient and responsible way. Hong Kong public hospitals are facing this problem along with high energy expenditure. The purpose of this qualitative, multiple site case study was to explore strategies for Hong Kong's public hospital leaders …

Comparing The Effectiveness Of Masters-Prepared And Non-Masters-Prepared Nurse Leaders, Subha Narasimha Chari

Walden Dissertations and Doctoral Studies

The complex nature of healthcare requires nurse leaders to be skilled in professional practice, communication, teamwork, and problem solving to improve staff satisfaction and patient outcomes. The American Association of Colleges of Nursing and Institute of Medicine promotes graduate education for nurse leaders to enhance the delivery of quality care to the nation's diverse patient populations. Guided by the diffusion of innovation theory, this project explored the differences in nursing care hours, staff turnover, nurse quality indicators, as well as leadership characteristics on units lead by masters-prepared and non-masters-prepared nurses. Forty-eight nurse leaders completed the impact of graduate education among …

Engagement Strategies To Reduce Registered Nurse Turnover In Hospitals, Robert Neeley

Walden Dissertations and Doctoral Studies

Skilled and experienced registered nurse employees are critical to the organizational success and stability of hospitals, but an annual average registered nurse turnover rate of 14% can result in financial losses of millions of dollars annually for the typical hospital in the United States. The purpose of this multiple case study was to explore the engagement strategies hospital nurse managers use to retain registered nurses. The study population included 8 nurse managers employed by hospitals in West Central Florida who have successfully implemented engagement strategies to retain registered nurses. The conceptual framework for the study was based on systems theory …

How Does Organizational Culture Impact Rn Engagement, Veronica Anntionette Ruffin-Ellis

Walden Dissertations and Doctoral Studies

Lack of RN engagement in the acute care setting can result in poor staffing, nursing shortages, increased stress levels for nurses and decreased morale. When nurses are not engaged in their work setting, quality of care suffers. A wide range of literature focuses on the importance of RN engagement; however, few health care organizations have taken the initiative to implement programs that foster RN engagement, demonstrating a gap in practice. This study examined the relationship between the levels of RN engagement and their perceptions of their organizational culture. Kolcaba's humanistic approach to meeting the needs of RN staff was used …

Discovering Opportunities To Improve Profitability At A Federally Qualified Health Center, Robert Jackson Jackson

Walden Dissertations and Doctoral Studies

Federally Qualified Health Center (FQHC) organizations, which provide health care services to low-income, underserved patients, are underfunded. From 2000 to 2007, the cost of treating an FQHC patient increased by $146, while federal compensation to FQHCs increased by only $44 per patient. One FQHC organization in rural Alabama experienced financial losses from the fiscal year 2011 through 2014, jeopardizing services to approximately 6,000 low-income patients. The purpose of this qualitative case study was to analyze the subject organization and discover opportunities to improve financial performance. The research question pertained to the opportunities for improving profitability at the subject organization. The …

Human Resource Strategies For Improving Organizational Performance To Reduce Medical Errors, Dr. Mary Ellen Taylor-Hyde

Walden Dissertations and Doctoral Studies

Preventable medical errors are the third leading cause of death in the United States. Healthcare leaders must consistently promote the delivery of quality and safe care of patients to reduce unnecessary errors and prevent harm. The purpose of this case study was to explore human resource strategies for improving organizational performance to reduce medical errors. The study included face-to-face interviews with 5 healthcare clinical managers who work within a multifaceted health system in the Midwestern region of the United States. Complex adaptive systems theory was used to frame this study. Interview notes, publicly available documents, and audio recordings were transcribed …

Effective Strategies Employed By Retail Store Leaders To Reduce Employee Turnover, Alexandro Beato

Walden Dissertations and Doctoral Studies

Employee turnover affects retail organizations in the form of lower productivity, decreased profitability, and reduced sustainability. In 2014, organizations lost over $11 billion in tangible and intangible assets as the result of employee turnover. High employee turnover rates have an adverse effect on productivity, which lead to unsustainable business practices. The number of retail employees who quit their jobs each month increased from 432,000 in December 2016 to 464,000 in January 2017, which indicates that some managers lack strategies to reduce employee turnover. Using the transformational leadership theory, the purpose of this single case study was to explore effective strategies …

Work-Family Conflict: Does Romance Matter?, Christie Marie Charles

Walden Dissertations and Doctoral Studies

Research has shown that being in a romantic relationship has related negatively with work-family conflict. Using social exchange theory, the investment model, and role theory, this study examined the relationships among the dimensions of perceived partner support, romantic relationship interdependence, and work-family conflict. A sample of 192 adults in paid employment, currently involved in a romantic relationship, were recruited from SurveyMonkey Contribute. Study participants completed online a demographic survey, the revised Support in Intimate Relationships Rating Scale (SIRRS), the Investment Model Scale, and work-family conflict scales. Correlation analyses showed that work-to-family conflict and family-to-work conflict correlated negatively with commitment and …

Dentists As Clinician Managers: Leadership Influences On Dental Team Empowerment And Engagement, Scott Hinckley Craven

Walden Dissertations and Doctoral Studies

Leadership training is virtually nonexistent for dental students, and practicing dentists rarely engage in any form of leadership development, relying primarily on mentoring by senior colleagues and on-the-job experiences. Dentists serve in a hybrid role as clinicians and managers to provide quality dental care and establish a profitable business, respectively. This quantitative study investigated the ways in which the emotional intelligence (EI) and leadership styles of 16 dentist clinician managers (DCMs) affected their dental teams. Specifically, the effects of leadership style and EI of DCMs on individual psychological empowerment (PE), team PE, and employee engagement were explored. Team PE effects …

Strategies For Health Care Administration Leaders To Reduce Hospital Employee Turnover, Malee Kirk

Walden Dissertations and Doctoral Studies

Staff turnover is high in the hospital industry, influencing health care administration leaders to implement successful strategies to decrease staff turnover. The purpose of this case study was to explore successful strategies to reduce hospital employee turnover. Five health care leaders from Raleigh, North Carolina hospitals were in the sample drawn from the population of medical professionals with successful employee retention in their hospital settings. The conceptual framework for this study was the Herzberg dual-factor theory with the supporting theory, Maslow's hierarchy of needs theory, and the opposing theory, Vroom's expectancy theory. Semistructured interviews occurred with 5 leaders. The review …

Exploring Customer Service Through Hospital Management Strategies, Delores Leonard Leonard

Walden Dissertations and Doctoral Studies

Patient demand for a better quality of healthcare and services has increased as insurance companies have decreased payments to hospitals. The purpose of this qualitative single exploratory case study was to explore hospital managers' strategies to improve customer service. Data were gathered from semistructured interviews with 5 hospital managers who implemented customer service strategies in their hospital systems, hospital policy and procedure documents, and qualitative data from the Consumer Assessment of Healthcare Providers and Systems Hospital Compare website. Expectation-confirmation theory served as the conceptual framework that grounded the study. Data were analyzed using methodological triangulation, and 3 themes emerged: the …

Managerial Intervention Strategies To Reduce Patient No-Show Rates, Charl Mattheus

Walden Dissertations and Doctoral Studies

High patient no-show rates increase health care costs, decrease healthcare access, and reduce the clinical efficiency and productivity of health care facilities. The purpose of this exploratory qualitative single case study was to explore and analyze the managerial intervention strategies healthcare administrators use to reduce patient no-show rates. The targeted research population was active American College of Healthcare Executives (ACHE), Hawaii-Pacific Chapter healthcare administrative members with operational and supervisory experience addressing administrative patient no-show interventions. The conceptual framework was the theory of planned behavior. Semistructured interviews were conducted with 4 healthcare administrators, and appointment cancellation policy documents were reviewed. Interpretations …

Hospital Outcomes Based On Physician Versus Non-Physician Leadership, Collins Yazenga Mkandawire

Walden Dissertations and Doctoral Studies

Hospital performance metrics are an indicator of leadership performance. However, there is inadequate research on whether physician or nonphysician chief executive officers (CEOs) perform better in the U.S. hospitals. The purpose of this study was to examine which type of leaders is better. Leadership trait, situational leadership, and leadership behavior theories constituted the theoretical foundation. The key research question examined the relationship between a hospital's outcomes, which in this study, included hospital net income, patient experience ratings, and mortality rates, and the type of CEO in that hospital: physician or non-physician. A quantitative, causal comparative design was used to answer …

The Relationship Between Nurse Manager Leadership Style And The Enculturation Of Shared Governance, Anna Elizabeth Keane

Walden Dissertations and Doctoral Studies

Shared governance, a participative model of governance, implemented by healthcare organizations for more than 30 years has been associated with empowerment, job satisfaction, and retention of registered nurses. Recent studies document a lack of participation in shared governance by registered nurses; the reason for the change is unknown. The nurse managers' role in this change is unknown. The purpose of this non-experimental, cross-sectional survey design study was to test Bass' theory of transformational leadership that examines the relationship between the leadership style of the manager and the enculturation of shared governance in acute care hospitals in the United States. A …

Humanitarian Aid Workers' Perceptions Of Stress Management Services, Annette Hearns

Walden Dissertations and Doctoral Studies

Humanitarian aid workers live and work in harsh circumstances far from loved ones and support mechanisms. The problem is that international aid must continue to work effectively despite stress levels. The purpose of this phenomenological study was to understand how aid workers perceive their work-related stressors, examine their subsequent experiences of in-house stress management services, and describe the factors that influence aid workers' decisions to access in-house stress management services. The conservation of resources theory was used to understand aid workers experience of stress. A purposive sampling technique was used to identify 12 aid workers with a minimum of 5 …

Essential Executive Coaching Competencies For Enhancing Executive On-The-Job Performance: A Modified Delphi Study, Arturo Small Maxwell

Walden Dissertations and Doctoral Studies

Approximately 93% of Fortune 1000 companies in the United States rely upon executive coaching to accelerate executive performance. However, there is a lack of empirical research identifying effective executive coaching competencies. In this modified Delphi study, a panel of 17 executive coaching experts was purposefully selected from the International Coach Federation and the Society for Industrial and Organizational Psychology. Participant selection criteria included training in executive coaching, executive coaching credentialing, and -?¥3 years practicing executive coaching or purchasing executive coaching services. Participants used a 5 point Likert-type questionnaire to provide their expert opinion regarding essential executive coaching competencies for enhancing …

Sexual Harassment Experience, Psychological Climate, And Sex Effect On Perception Of Safety, Kenneth C. Barker

Walden Dissertations and Doctoral Studies

Sexual harassment has significant adverse psychological and physical effects on employees and can negatively impact the workplace, and overall business operations. A gap in current research was identified concerning whether the employee's sex affects employee's perceived workplace sexual harassment climate, sexual harassment experience, and perceived safety from sexual harassment. This study examined the effects of employee workplace sexual harassment experience and perception of workplace sexual harassment psychological climate on employee's perceived safety from sexual harassment moderated by sex. Results showed that perceived workplace sexual harassment climate and employee workplace sexual harassment experience were both significant predictors of perceived safety from …

A Phenomenological Study Of Correctional Officers' Perceived Emotions On The Job, Heather Susan Grammatico

Walden Dissertations and Doctoral Studies

Correctional officers work in a stressful environment and are regularly exposed to dangerous and emotionally charged situations. Researchers have detailed the potential negative outcomes of this occupation, yet little research has examined the extent to which correctional officers experience emotion while on their shifts, and how those emotions may translate into stress, divorce, substance abuse issues, domestic violence, and high mortality rates upon retirement. The purpose of this phenomenological study was to learn how correctional officers experience their felt and expressed emotions while at work. Data collection was done using a 15-item open ended questionnaire designed by the researcher and …

Voluntary Employee Turnover: Retaining High-Performing Healthcare Employees, Jesse J. Boyd

Walden Dissertations and Doctoral Studies

Voluntary employee turnover in the healthcare industry is one of the most expensive and disruptive business problems that healthcare organizations encounter. Healthcare organizations can expect employee replacement costs to represent up to 150% of a departing employee's annual salary in new employee acquisition and decreased productivity. Guided by the leader-member exchange theory, the purpose of this single case study was to explore the strategies healthcare managers used to retain high-performing healthcare employees. Using semistructured interviews, the targeted population encompassed 6 healthcare managers from a healthcare organization in Central Texas who have demonstrated successful strategies for retaining high-performing healthcare employees by …

Strategies For Managing The Shortages Of Registered Nurses, Jody-Kay Mcfarlane Peterson

Walden Dissertations and Doctoral Studies

The purpose of this multiple case study was to explore strategies that healthcare facility leaders in Central Minnesota use to recruit and retain qualified nurses. Participants were 6 healthcare facility leaders including 2 nursing directors, 2 human resource personnel, 1 nurse supervisor/administrator, and 1 nurse recruiter who had the knowledge and experience in recruitment and retention of Registered Nurses (RNs) in healthcare facilities in Central Minnesota. The Herzberg 2-factor theory was the conceptual framework. Semistructured interviews were used to collect data. Data were analyzed using Morse's 4 steps data analysis process. The major themes were recruitment strategies and retention incentives. …

Primary Care Nurse Practitioners And Organizational Culture, Leanne Christine Rowand

Walden Dissertations and Doctoral Studies

Nurse practitioners (NPs) were introduced to the British Columbia healthcare system 12 years ago. Integration challenges related to infrastructure and relationships between administrators and physicians continue. The purpose of this project was to understand how nurse practitioners, working in primary care roles, experience the organizational climate within their healthcare agency. Kanter's empowerment theory guided this project. Data were collected using the Nurse Practitioner Primary Care Organizational Climate Questionnaire. A total of 64 NPs relayed their degree of perceived organizational support. NPs scored highest on Autonomy and Independent Practice (Mean [M] = 3.54, Standard Deviation [SD] = 0.59). Organizational Support and …

Leadership Development For The Formal Nurse Leader, Lori Neu

Walden Dissertations and Doctoral Studies

Nurse leaders are essential to the advancement of healthcare because of their ability to bridge the gap of knowledge between clinical practice and the business of healthcare. Developing nurse managers is imperative to the future of nursing given their influential role in healthcare. The central topic of exploration in the project was how nurse managers use the American Organization of Nurse Executives (AONE) Nurse Manger Inventory Tool to assess their management skills after exposure to the leadership development program currently available to them. In this project, the novice to expert theory was used to evaluate the existing leadership development program …

Servant Leadership And Its Effect On Employee Job Satisfaction And Turnover Intent, Dennis M. Mitterer

Walden Dissertations and Doctoral Studies

Experts expect a shortage of more than 900,000 nurses by 2022, according to the United States Bureau of Labor Statistics Employment Projections. Turnover in nursing contributes significantly to the shortage and often results from poor leadership of nurse managers. The purpose of this quantitative study was to investigate how servant leadership behaviors affected the psychological state and behavioral response of staff nurses as reflected by job satisfaction and turnover intention. Specifically, the research question addressed whether servant leadership positively contributes to the psychological states and the behaviors of staff nurses leading to greater job satisfaction. The study design was correlational, …

Restaurant Management Strategies To Comply With Food Safety Regulations, Dr. Carlos Juan Calcador

Walden Dissertations and Doctoral Studies

The recent economic crisis in Puerto Rico has created decreased health department fiscal capabilities, adding more responsibilities to health department officials in charge of restaurant inspections without adding more operational funds, which in turn led to less regulatory capacity. This situation instigated increased food safety regulation violations, and food safety legislation changes, imposing more economic pressure to restaurant owners, which leads to a lack of restaurant sustainability. The purpose of this case study was to explore strategies six business visionaries, smart entrepreneurs, who have positioned themselves as successful restaurateurs, in the restaurant industry in Puerto Rico. They were key factors …

Collaborative Strategies Used To Reduce Billing Administrative Cost, Stella Fayomi-Olaleye

Walden Dissertations and Doctoral Studies

Billing inefficiencies represent 80% of wasteful healthcare administrative costs that are projected to reach $45 billion by 2018. Potentially, a reduced billing administrative cost is estimated to yield an annual savings of $60 billion that could fund other societal needs such as jobs, wage increases, and education. Through the conceptual framework of iceberg change management model, this single case study explored collaborative strategies 3 healthcare billing managers in Dallas, Texas successfully used to reduce billing administrative costs. Data were collected through semistructured interviews and the review of company documents. Using Yin's procedure of examining, comparing, categorizing, and coding data, the …

Impact Of Emergency Department Patient Flow Model And Triage Level On Patient Wait Times, Joann Lynn Featherstone

Walden Dissertations and Doctoral Studies

Some hospital emergency departments (EDs) are negatively affected by extended patient wait times, resulting in reduced hospital profitability. Therefore, it is critical hospital leaders understand factors impacting ED average patient wait times. Grounded in the business process improvement theoretical framework, the purpose of this causal comparative study was to examine the impact of an ED rapid evaluation unit (REU) patient flow model and emergency severity index (ESI) on average weekly patient wait times. Data collection comprised a census of 26 archival data records pre and postimplementation of an ED REU patient flow model from a hospital ED in Upstate New …