Business Administration, Management, and Operations Commons^™

Navigating The Path To Safe Compounding In Health Systems, Thomas Pile, Craig Kimble, Alberto Coustasse

Management Faculty Research

Across the country health systems are facing increasing drug shortages that are forcing pharmacists to rely far more heavily on compounding to meet the needs of patients. Additionally, several high-profile compounding incidents have helped highlight the importance of ensuring best practices are followed during sterile and nonsterile compounding to support patient safety and high-quality care. Specifically, in 2022, 160 drug shortages were reported in pharmacies. From January 1, 2023, to March 31, 2023, 47 drug shortages were reported, 55% of which were for injectables. In response, compounding has increasingly become a solution to bridge that gap.

The Effect Of Magnet Hospitals On Nursing Burnout, Jonathan Settle, Michael Davis, Eric Pulice, Alberto Coustasse

Management Faculty Research

Introduction:

The World Health Organization [2019] defined burnout as a syndrome caused by chronic job stressors that are not successfully managed, characterized by exhaustion, depersonalization, job detachment, and feelings of inadequacy (WHO, 2019). According to Murthy [2022], the nursing burnout crisis was underway before COVID-19. Nurse burnout recognized pre-COVID-19 was due to systemic organizational problems such as inadequate organizational support and underinvestment in public health (Murthy, 2022).

A 2022 survey of 2500 nurses exhibited increased rates of burnout during the pandemic, with 75% of respondents experiencing burnout, while 65% of those surveyed expressed their desire to leave the healthcare field …

Magnet Hospitals: An Update On The Impact On Nursing Burnout, Jonathan Settle, Michael Davis, Alberto Coustasse

Management Faculty Research

Nurse burnout has been associated with worsened outcomes for nurses, such as increased turnover or quitting and lower job satisfaction. The purpose of this research was to examine Magnet-designation status in U.S. hospitals, specifically shared governance and structural empowerment, and its effects on nurse burnout, nurse turnover, and job satisfaction of nurses. This study utilized a literature review complemented by two semi-structured interviews. The results showed that Magnet hospitals kept lower levels of burnout, better job satisfaction, and less turnover than non-Magnet hospitals, but this was only the case for some studies of Magnet hospitals. Some outcomes could be attributed …

Impact Of Emr/Ehr And Computer Decision Support Systems On Nursing Homes And Long-Term Care, Wendy Trzyna, Brian Cox, Alberto Coustasse

Management Faculty Research

Long-Term Care (LTCs) facilities and nursing homes have been an essential part of the healthcare industry to meet the needs of older adults. However, Electronic Medical Records (EMRs/ EHR within LTC facilities and nursing homes have lagged more than in other healthcare sectors. This research analyzed the impact of implementing EMR/EHR and Computerized Decision Support Systems within LTC facilities and nursing homes. In nursing homes and LTC facilities where EMR/EHR has been implemented, patient outcomes improved by reduced pressure ulcers and increased identification of patients at risk for malnutrition and falls. Integration of CDSSs with EMR/EHR improved documentation and prescribing …

Relationship Between The Hospital Readmission Reduction Program And Readmissions, Postoperative Complications, And Cost, Cary A. Blick, Blake P. Williams, Drake T. Myers, Joshua Pomranke, Sarah M. Clemente, Alberto Coustasse

Management Faculty Research

Hospital readmissions have contributed significantly to rising healthcare costs in the United States. To curb rising costs, the Centers for Medicare and Medicaid Services introduced the Hospital Readmissions Reduction Program (HRRP), a penalty-based program designed to decrease healthcare costs. This research aims to determine if the HRRP has successfully reduced healthcare costs and increased quality outcomes associated with total knee arthroplasty (TKA) or total hip arthroplasty (THA) as defined by a reduction in readmission rates, postoperative complications, and overall costs. Although a positive correlation has been shown between outcomes and costs post-HRRP, more research is needed to tease out the …

The Impact Of Big Data Utilization On Quality Improvement In Inpatient Facilities, Lakyn Hare

Theses, Dissertations and Capstones

Introduction: Poor quality in healthcare has resulted in avoidable patient complications, including readmission rates. Big data in healthcare can be analyzed and built into a tools, with machine learning, to aid in reduced readmission rates and overall positive patient outcomes.

Purpose of the Study: The intention of this study was to evaluate the ways that big data can be analyzed to improve healthcare, specifically readmissions, patient outcomes, and show cost savings. This study examined different ways that big data could be used in concordance with machine learning, including predictive analysis, to make these improvements.

Methodology: The hypothesis was the …

The Opioid Epidemic: Effects On Recidivism In West Virginia, Emilee Frye, Elizabeth Williams

Theses, Dissertations and Capstones

The opioid epidemic began in the 1990s with an increased prescribing of opioids across the nation. Between the years 2013 and 2014, opioid overdose death rates began to increase in West Virginia. By the year 2015, West Virginia held the highest number of opioid overdose death rates in the country. In 2021, fatal overdoses claimed more than 1,417 lives in West Virginia and of those 1,417, an estimated 1,201 of them were due to opioid use.

West Virginia had the highest opioid drug overdose rate in the nation and one of the highest incarceration rates for opioid-dependent individuals. West Virginia …

Benefits Of Medical Thc For Neurological Disorders In The U.S., Andrew Lester, Alexandria Gartin

Theses, Dissertations and Capstones

Introduction: The introduction of THC into the medical field has allowed medical professionals to offer a new treatment option to aid in their patients treatment plan by decreasing their symptoms of side effects of other medications used for their conditions.

Methodology: This study utilized a literature review. Five databases were used to collect 116 total sources. These sources were reviewed and reduced to 33 sources that were used in the written research. Of these, 16 sources were used in the results section.

Purpose of the Study: The purpose of this research was to analyze the prescription use of …

Long Term Substance Abuse Programs And Covid, Randall Craft

Theses, Dissertations and Capstones

Introduction: Access to behavioral health care has arisen as both a challenge and an opportunity as America deals with a health care landscape that has been significantly and probably permanently transformed by the COVID-19 pandemic. The pandemic increased the need for behavioral health services while creating new hurdles to care for those who already had disorders. The pandemic, however, also spurred innovation, leading to expanded tele-behavioral health treatments and other technological advancements. Also bringing Overdose death rates sky rocketing.

Methodology: This study utilized a literature review and a semi-structured interview. Four databases were used to collect 41 total …

Effects Of Burnout Amongst Primary Care Providers, Summer Payne

Theses, Dissertations and Capstones

INTRODUCTION: Physician burnout within the United States has been deemed an epidemic within the healthcare system with nearly 63% of physicians reporting burnout. The rate of burnout amongst Primary Care Providers (PCPs) is higher than other provider types at 70%. The presence of burnout affects the likelihood of medical errors, provider retention, and patient-provider communication. Fifty-six percent of PCPs that reported burnout also associated this burnout with their reason for leaving the practice. Physicians that are burnt out are less likely to find nonadherence in their patients, more likely to refer to specialists, and more likely to prescribe medications unnecessary. …

Implications Of Twitter During Its Use In Public Health Practice Involving The Distribution Of The Covid-19 Vaccine, Mia Casingal

Theses, Dissertations and Capstones

Introduction – There were 4.89 projected billion social media users in 2023. Social media platforms such as Twitter have allowed public health organizations to spread information regarding COVID-19 vaccines to the public. Twitter permits government organizations and public health agencies to release accurate information as a primary level of rapid communication.

Purpose – The purpose of this research was to explore the impact of the social media platform, Twitter, on public health information throughout the COVID-19 pandemic regarding the spread of information involving COVID-19 vaccine distribution to the public.

Methodology – This study utilized a literature review with a semi-structured …

Impact Of State-Led Surveillance Programs On Neonatal Abstinence Syndrome, Patricia Lewis

Theses, Dissertations and Capstones

Introduction: Neonatal Abstinence Syndrome (NAS) has been costly for the healthcare system, for every 24 minutes a baby was diagnosed in 2020. Uniform programs to diagnosis, track and prevent NAS have not been implemented previously. The NCBDDD worked with 6 states to implement a uniform surveillance program. By tracking the NAS incidence rate, the Apgar scores of infants with NAS, the length of stay for those infants, the cost of care for those infants and the percentage of mothers of infants with NAS were participating in Medication Assisted Treatment the effectiveness of the surveillance programs may be assessed.

Methodology: This …

The Epidemic Of Opioid Usage In West Virginia, Kendra Lester, Carrington Hatfield

Theses, Dissertations and Capstones

The opioid epidemic in West Virginia is a complex interplay of factors, including poverty, low education, and high unemployment rates, which contribute to higher rates of substance use and opioid-related deaths. The number of people injecting drugs has risen from 36% in 2005 to 54% in 2015. WV recorded 871 overdose deaths from all drugs in 2019 with 76.8% involving at least one opioid. The purpose of this qualitative research study was to investigate and analyze the circumstances that contributed to West Virginia's opioid epidemic to determine if sociocultural factors, such as lifestyle, education, and demographics, influenced the epidemic as …

Impact Of Medicaid Expansion On Substance Abuse Treatment, Kyle Chapman

Theses, Dissertations and Capstones

Introduction: The Medicaid expansion has insured millions of Americans since the passage of the Affordable Care Act in 2010. Among this newly insured population, many of the enrollees have been diagnosed with a substance abuse disorder. Patients who have a substance use disorder diagnosis typically have multiple conditions that are treated simultaneously. When these patients have to seek healthcare services they are often uninsured. Unfortunately, since the patients are uninsured, the most frequent healthcare access points have been through admissions to more expensive areas of healthcare delivery such as the emergency department and subsequent inpatient services. The goals of the …

Understanding Hospital Chargemasters : Impact On Healthcare Finance, Alesia Moorman

Theses, Dissertations and Capstones

Introduction: This research delves into the critical examination of hospital chargemasters, exploring their intricate role in the complex landscape of healthcare finance. As the healthcare industry grapples with the challenges of balancing medical care and fiscal responsibility, the hospital chargemaster emerges as a dynamic entity, reflecting the interplay between healthcare providers, insurers, and patients. Beyond being a mere ledger of prices, the chargemaster influences the entire Revenue Cycle Management (RCM), impacting financial stability, patient satisfaction, and the effectiveness of healthcare delivery. Originating from the necessity to navigate reimbursement complexities, the chargemaster has become central to hospitals' financial strategies, shaping and …

Gabapentin Presents High Potential For Misuse, Alberto Coustasse, Stacie Deslich, Susan W. Lanham, Brittany Riley

Management Faculty Research

The FDA Approved Gabapentin in 1993 as a non-controlled substance and it has remained a non-controlled substance at the federal level. The drug was created as an anticonvulsant and used to treat seizure disorders. The medication has also been used to treat hot flashes, neuropathic pain, pain, postoperative nausea, substance abuse issues, and vomiting. It is estimated that approximately 1% of people in the United States misuse gabapentin. This fact has compelled certain states to generate legislative initiatives designed to monitor the use and/or reclassify gabapentin. In 2019, US pharmacies dispensed 69 million prescriptions for gabapentin.

Evaluate 503b Facilities For Outsourced Compounds, Sarah Clemente, Brittany Riley, Alberto Coustasse

Pharmacy Practice & Administration

The US health care system has encountered long-standing, complex challenges, including growing costs, overuse of care, staffing shortages and supply chain weaknesses. COVID-19 revived these pressures, transforming the health care landscape. Medication and staffing shortages plague hospital systems, and pharmacies are not exempt. Most health systems have experienced high levels of pharmacy technician turnover, with most reporting a minimum turnover rate of 21% last year. In addition, medication shortages of critical medications and infusions create significant workflow barriers that hospitals must address to ensure patient safety. In the face of these obstacles, health systems are turning to 503B compounding facilities …

Radio Frequency Identification Enhances Patient Safety, Craig Kimble, Alberto Coustasse, Ken Maxik

Pharmacy Practice & Administration

Radio Frequency Identification (RFID) is a technology that uses tags and readers to identify and collect asset information. In pharmacies, this usually means RFID is used for high cost equipment or pharmaceuticals. RFID applications have been in use for many years but recently gained traction in health systems. RFID is becoming particularly effective in drug inventory and automation applications, such as medication carousels and pick-to-light systems.

Prescribing Controlled Substances Goes Electronic, Alberto Coustasse, Craig Kimble, Ken Maxik

Management Faculty Research

With the Affordable Care Act in 2010 came interoperability and meaningful use requirements. Part of these requirements included the implementation of electronic medical records (EMRs), which was a crucial part of achieving these standards. With EMRs, prescribers began sending electronic prescriptions. EMRs can provide advanced decision support when writing prescriptions, and they include features such as auto populating the quantity prescribed, formulary information, therapeutic duplications, warnings about interactions, or other potential clinical or regulatory issues. This system results in enhanced patient care and a more streamlined dispensing process. In addition, electronic prescriptions for controlled substances (EPCS) has become more widely …

Association Of Electronic Medical Records And Opioid Prescription, Archana Suwal, Jemimah Okonjo, Stacie Deslich, Alberto Coustasse

Management Faculty Research

A Prescription Drug Monitoring Program (PDMP) is an electronic database that tracks controlled substance prescriptions in a state. PDMPs can provide health authorities timely information about prescribing and patient behaviors that contribute to the epidemic and facilitate an agile and directed response. Electronic Prescribing for Controlled Substances (EPCS) aimed to eliminate paper prescriptions by allowing clinical prescribers to write prescriptions electronically, making them digital and trackable for both the prescriber and the pharmacist and has been an essential part of any health information technology system, as well as a requirement for 'meaningful use' (Blumenthal & Tavenner, 2010). However, one of …

Tele-Icu In The Unites States: Is A Cost-Effective Model?, Michael Robie, Stephanie Cole, Archana Suwal, Alberto Coustasse

Management Faculty Research

Introduction: The United States Society of Critical Care Medicine has announced a shortage of all critical care intensivists due to the increased need for critical care for the aging population with comorbidities and improved life expectancy. This shortage has led to tele-ICU programs that have allowed intensivists to care for patients simultaneously remotely.

Methods: This study aimed to assess the potential for the hospital implementation of tele-ICU to determine its overall healthcare cost-effectiveness. The methodology was a review that followed a systematic search approach utilizing 42 sources.

Results: The study findings showed that tele-ICU contributed to reduced hospital LOS by …

Store, Handle, And Administer Vaccines Safely To Prevent Errors, Craig Kimble, Kenneth Maxik, Alberto Coustasse

Management Faculty Research

Insufficient training, multiple manufacturers, and noninterchangeable products increase the risk of vaccine-related errors. Increasing the complexity are the addition of boosters with different doses, personnel new to the vaccine administration process, changes in dosing, easily misidentified labeling or products, vaccines given together, and the interchanging of booster products.2,3 As a result, there is an increased need to be alert in safety efforts with vaccine administration and storage. Pharmacy staff members must work together to improve safety and prevent vaccine-related errors.

Social Media By Providers And Patients In Healthcare, Madison K. Howell, Jirakamon Silapabanleng

Theses, Dissertations and Capstones

Introduction: Social media platforms such as Facebook, YouTube, and Twitter have been used in various industries to create direct-to-consumer interactive opportunities. 74% of the US population were social media active users. Around 40% of adults gather their health information from Facebook, a free social networking site, which has been available on various devices and can help many organizations advertise their services as well as communicate with their patients. Social networks had a powerful influence in making health decisions because it could be used as a means to spread either positive or negative health information.

Purpose of study: The …

Chargemasters In The Age Of Hospital Price Transparency, Anthony Drumm

Theses, Dissertations and Capstones

Introduction: The cost of health care services in the United States (U.S.) varies from state to state and facility to facility. The compilation of such costs and their associated codes is referred to as a chargemaster, or charge description master (CDM), and each is unique to an individual facility. . The implementation of the 2019 Centers for Medicare and Medicaid (CMS) Hospital Price Transparency Rule was an initial step toward consumer empowerment by making services more shoppable but published CDM data failed to present the information most pertinent to patients: total out-of-pocket costs and the availability of lower-cost alternatives. Initiatives …

The Effect Of Magnet Hospitals On Nursing Burnout, Jonathan Settle, Michael Davis

Theses, Dissertations and Capstones

Introduction: Burnout has been a problem in health care for many years and it has particularly affected nurses. Nurse burnout was associated with worsened outcomes for nurses such as increased turnover or quitting and lower job satisfaction. There was a question as to how work environment and governance style influenced burnout.

Purpose of the study: The purpose of this research was to examine Magnet-designation status in U.S. hospitals, specifically shared governance and structural empowerment, and its effects on the rates of nurse burnout, nurse turnover, and job satisfaction of nurses.

Methodology: This study utilized a literature review. Four databases as …

Costs And Length Of Stay Associated With Treating Neonatal Abstinence Syndrome, Kimberly Stanfield, Kylie Day

Theses, Dissertations and Capstones

Introduction: Neonatal Abstinence Syndrome has been costly for the healthcare system, for every 19 minutes a baby was diagnosed in 2021. Costs and Length of Stay both had been increased for newborns diagnosed. Medically Assisted Treatment for expecting mothers has shown to decrease costs and length of stay for newborns with neonatal abstinence syndrome.

Methodology: This study utilized a literature review and a semi-structured interview. Three databases were used to collect 126 total sources. These sources were reviewed and reduced to 30 total sources that were used in the written research. Of these, 14 sources were used in the results …

Impact Of Cognitive Behavioral Therapy On Military Suicide Rates, Madison Lett, Jamia Bird

Theses, Dissertations and Capstones

Introduction: Suicide has been labeled a serious public health dilemma in the United States. Military personnel have suicide rates greater than non-military individuals. Cognitive Behavioral Therapy has been used as a means to help military personnel to overcome suicidal thoughts and feelings.

Purpose of the Study: The purpose of this study was to analyze the effect of Cognitive Behavioral Therapy on military patients’ mental health and how it affects the rate of suicidal ideation, suicide attempts, and deaths by suicide in military patients.

Methodology: This study utilized a literature review and a semi-structured interview with a Veteran Affairs social worker. …

The Financial Effect Of Covid-19 On Children's Hospitals Without Pediatric Psychiatric Units, Patricia Tran

Theses, Dissertations and Capstones

Introduction: Boarding of pediatric psychiatric patients in emergency departments and inpatient medical units while awaiting placement in psychiatric facilities was common before the COVID-19 pandemic and was associated with significant hospital cost. The COVID-19 pandemic triggered a mental health crisis in the pediatric population. This study looked at the how the COVID-19 pandemic affected pediatric psychiatric boarding and the effects of pediatric psychiatric boarding on hospital finances.

Methodology: The methodology of this study utilized a literature review with semi-structured interviews of local subject matter experts. The literature review analyzed the effects of the COVID-19 precipitated pediatric mental health …

Childhood Obesity And Adverse Childhood Experiences: The Role Of Medicaid Expansion, Sonya Dunlap

Theses, Dissertations and Capstones

Introduction: Obesity was defined as a Body Mass Index (BMI) over the 95th percentile as determined by the Centers for Disease Control and Prevention (CDC). Childhood obesity has been a worldwide concern, but has disproportionately affected the socioeconomically disadvantaged, racial/ethical minorities, and rural children. The presence of Adverse Childhood Experiences (ACEs) contributed to social and health problems. ACEs included the areas of domestic violence, mental illness, neighborhood violence, parent or guardian death, divorce or separation, parent or guardian incarceration, and substance misuse.

Purpose of Study: The purpose of this research was to compare the ACEs scores with childhood …

Covid-19 Financial Consequences In United States Hospitals, Hannah T. Osburn, Murat Mert Solakoglu, Gretel Toloza Alvarez

Theses, Dissertations and Capstones

Introduction: Since the wake of the coronavirus pandemic, United States (U.S.) hospitals have struggled to stay financially afloat amid the constant battle with unprecedented circumstances and financial consequences from the pandemic. The purpose of this research was to analyze the financial consequences of COVID-19 for U.S. hospitals to determine the impact on the number of inpatient cases, length of stay (LOS), surgeries performed, and operating expenses. The hypothesis was that U.S. hospitals were financially affected by the consequences of COVID-19, having more inpatient cases, increased LOS, fewer surgeries performed, and higher operating expenses.

Methodology: The methodology for this …