Medicine and Health Sciences Commons^™

Hospital Characteristics Impact On Left Without Being Seen, Anthony Roberts

MUSC Theses and Dissertations

Emergency Department (ED) care is provided to patients for urgent and life-threatening emergencies. Inefficiency and overcrowding of ED continues to be a problem for the U.S. Health systems threaten the ability to provide care for the most vulnerable patients. The inefficiency of ED and hospital throughput creates challenges in being able to provide timely and effective care for ED patients. Prolonged ED wait times can be related to the availability of ED and hospital beds, inefficiencies in the emergency department, staffing, and other factors. Timely and effective care is important to providing high-quality care and decreases the risk of serious …

Developing A Blueprint For Health Equity Programs And Investigating Interventions And Metrics, Belita Strudwick

MUSC Theses and Dissertations

Racial and ethnic minority groups and rural and low-income populations are examples of populations who continue to experience health disparities despite policy mandates to eliminate them. This doctoral project will provide a foundational blueprint to aid health plans in addressing and improving health equity internally and with external stakeholders. The blueprint will be based on research comparing the robust health equity initiatives of four states to the NCQA national guidelines. The barriers to achieving and recommendations for advancing the field of health equity by implementing and analyzing policies and data that target health disparities through improved access to quality care …

Healthcare Employees’ Perceptions On The Effects Of Internal Audits, Jeremy Mason

MUSC Theses and Dissertations

With limited research on the perceptions of internal audits, this study was

able to add more literature to the subject. The study’s aim was to survey

employee perceptions of the effects of internal audits. This study will provide organizations with results pertaining to how employees perceive the usefulness of internal audits. The study team conducted a single-site study and invited the healthcare organization's employee population to participate in the study. The survey captured 40 responses from 361 invitees (11%). The survey explored the perceptions on six categories of internal audits: Efficiency, Ethical Behavior, Effectiveness, Auidotr-Auditee Relationship Exchange, Learning from Audit, …

A Quality Improvement Initiative To Improve Follow-Up Time And Reduce Readmissions And Emergency Department Utilization For Oncology Patients, Delaney Serfling

MUSC Theses and Dissertations

Hospitals across the nation are facing extreme challenges with overcrowding. Unplanned readmissions and emergency department use are two significant contributors to this urgent issue. Historically, oncology patients are high utilizers of emergency department services, and have elevated numbers of unplanned readmissions. This is especially true of gastrointestinal medical oncology patients. In an effort to move the needle in the right direction, an operational quality improvement initiative to decrease emergency department utilization and unplanned readmissions was conducted. This pilot project took place over a three-month period, and consisted of protecting time for advanced practice providers (APPs) and updating inefficient workflows. The …

The Impact Of County Level Characteristics On Type 2 Diabetes Related Ed Utilization, Jessica Wilson

MUSC Theses and Dissertations

Approximately 90-95% of the more than 37 million American adults who are living with diabetes have type 2 diabetes. Additionally, those living in rural areas face poor health outcomes related to chronic diseases such as diabetes. The impact of factors related to social determinants of health such as the role of rurality and social vulnerability were described by examining county diabetes related Emergency Department (ED) visit rates for adults aged 18-25 living in North Carolina. No difference in county level diabetes related ED visits were observed between rural counties vs. nonrural counties in the state. However, patterns did emerge in …

Improving Scheduling For Diagnostic Imaging And The Effect On Hospital Revenue: An Ex Post Facto Study, Stephen Liebowitz

MUSC Theses and Dissertations

Background and Need: Outpatient diagnostic radiology can be a substantial driver for revenue growth in health systems but without proper processes in place, health systems may not be optimizing patient access within their radiology departments health systems who are having difficulty getting patients to obtain care at their departments/centers and retain loyalty (Lu et.al 2011). To evaluate radiology patient access, patient retention, and market analysis, in 2018, Berkeley Research Group, LLC (BRG) engaged with a six-hospital faith-based health system in New York State to evaluate, create, and implement a variety of different performance improvement (PI) initiatives with the goal of …

The Association Of Foreign Phi On Ame & Death, Larry Norman

MUSC Theses and Dissertations

Background: Recent data shows at least 1.5 million people are affected by adverse medication events (AME) every year. The purpose of this study is to see if increased use of FPHI is associated with lower instances of AME’s and lower mortality rates for hospitals.

Methods: Using a retrospective analysis and logistic regression, this study examines the relationship between IT use and quality. Specific metrics include AMEs and mortality rates in hospitals in the United States. Demographic data are used to control for confounders, CPT, DRG, and AHRQ questions are used as classifying variables for High IT utilization.

Results: Unadjusted rates …

Time Is Brain: How A Descriptive Analysis Of Telestroke Metrics Can Improve Program Performance, Christopher Cordero

MUSC Theses and Dissertations

In the event of an acute ischemic stroke, 1.9 million neurons are lost in the brain per minute. Since the inception of thrombolytic therapy and mechanical thrombectomy as effective tools in the treatment of acute ischemic stroke, the focal point of quality improvement in this field has become the time to treatment delivery. As rural and more interspersed environments exhibit high disability and mortality rates associated with these acute neurological conditions, inequities in timely care delivered to these patient populations persist. Limitations in access are now abated by the extension of neurologist expertise into these areas via Telestroke. This study …

Mapping The Opal Score For Clinical Trials To Coordinator Hours: A Single Site Study, Kesley Tyson

MUSC Theses and Dissertations

Workload assessments help provide validation to increase staff, evaluate and ensure equal distribution of work, and assist with budget justifications. The Ontario Protocol Assessment Level (OPAL) is one of the most widely used protocol assessment tools. This study mapped an adapted OPAL score for clinical trials to actual coordinator hours from a single site to determine if the adapted OPAL score could predict coordinator hours. The purpose was to project a more accurate capacity estimate when considering new studies. The Morehouse School of Medicine (MSM) clinical trials management system was queried for actively enrolling interventional studies with corresponding coordinator effort …