Medicine and Health Sciences Commons^™

Effectiveness Of 7-Day And 30-Day Interval Aftercare To Reduce Psychiatric Readmissions, Aldrick Dwight Barr

Walden Dissertations and Doctoral Studies

The results for psychiatric readmissions and 7- and 30-day follow-up care post psychiatric discharge are mixed. Psychiatric readmissions of psychiatric patients are costly. The purpose of this quantitative study was to evaluate the association between 7- and 30-day follow-up care percentages and 30-day readmission rates for an inpatient psychiatric facility (IPF). The transtheoretical model was used to assess patient readiness for behavior change and a patient-centered guide that provides strategies for patient progression during hospital readmission and post psychiatric hospital discharge. In this study, a quantitative, correlational research design utilizing public secondary data retrieved from the Centers of Medicaid and …

Physician Retention Strategies In Small Military Treatment Facilities, Stacey Sherrice Amos

Walden Dissertations and Doctoral Studies

During a time of increasing physician shortages, health care leaders must identify successful physician retention strategies. Health care leaders are concerned with physician retention, as a lack of physicians minimizes patient access to care. Grounded in the stakeholder theory, the purpose of this qualitative multiple case study was to explore strategies health care leaders in small military treatment facilities in rural areas use to improve physician retention. The participants were five health care leaders from different Army military treatment facilities located in rural areas throughout the continental United States who had more than four months of experience in physician shortages …

Nurse Turnover A Crisis In Healthcare, Billie Robinson

Walden Dissertations and Doctoral Studies

Nurse turnover is a global, national, and local problem that impacts the ability of healthcare leaders to deliver high quality healthcare to the populations in need of healthcare services. The purpose of this study is to identify reasons nurses leave organizations. The Leader-Member Exchange Theory undergirds the quantitative research which was conducted using the Supervisor Leader Communication Inventory. Nurse leaders communicate with acute care nurses using principles of the Leader- Member Exchange Theory. The survey was distributed to members of the Georgia Nurse Association. Positive correlations were revealed between the independent and dependent variables. SPSS was used to establish the …

Preventable Error Reduction Leadership Strategies Of Nurse Managers In A Hospital Setting, Sedrick Diego Bedolla

Walden Dissertations and Doctoral Studies

AbstractPreventable medical errors in the healthcare industry account for hundreds of thousands of patient deaths annually. Nurse managers strive to develop strategies to reduce incidences of preventable medical error and increase patient safety in their organization to improve performance and reduce harm in the healthcare industry. Grounded in the complex adaptive systems theory, the purpose of this qualitative single case study was to explore strategies nurse managers use to reduce the rate of preventable medical errors among employees. The participants comprised 6 nurse managers who successfully used strategies to lower the rate of preventable errors in a healthcare facility in …

Lived Experiences Of Police Officers And Their Roles During Opioid Overdose, Sean Banks

Walden Dissertations and Doctoral Studies

Researchers have conducted multiple studies regarding opioid users, opioid addicts, relatives of addicts, and health professional responses. The opioid crisis has been a focus for scholars following the first wave of prescription in 1991 (CDC, 2016). However, there is limited research that examines the lived experiences of law enforcement officers and their roles during an opioid overdose. As the opioid crisis has continued to negatively affect individuals, families, communities, cities, and countries, federal, state, and local policymakers have searched for ways to combat the opioid crisis. For many law enforcement agencies, policymakers have enacted policy that mandates patrol officers carry …

Health Care Leaders Strategies And Patient Satisfaction, Aaronn Haerr

Walden Dissertations and Doctoral Studies

Ineffective patient satisfaction strategies can negatively impact patient satisfaction scores and overall organizational performance. Health care leaders who struggle to increase patient satisfaction are at high risk of diminished organizational performance and long-term sustainability. Grounded in the transformative learning theory, the purpose of this qualitative single case study was to explore strategies health care leaders implemented to improve patient satisfaction. The participants were five health care leaders in Ohio who effectively implemented strategies to increase overall patient satisfaction. Data were collected from semistructured interviews, organizational documents provided by the participants, and the company website. Yin’s five-step method was used to …

Strategies To Reduce Costs Caused By Medication Errors In Us Hospitals, Janice Leah Chobanuk

Walden Dissertations and Doctoral Studies

Medication errors result in patient harm, including deaths, costing American hospitals over $20 billion annually. The financial impact and reduced public confidence in safe patient care create a business problem for hospital leaders trying to contain costs, maintain a competitive edge, and sustain patient satisfaction. Grounded in the sociotechnical conceptual framework, the purpose of this generic qualitative study was to identify strategies hospital leaders use to reduce costs caused by medication errors in hospitals. Data collection involved semistructured interviews with 10 hospital leaders from various high-reliability hospitals across the United States and a review of documents related to medication management …

The Relationship Between Advanced Payment Model Providers And Patient Behavior, Harry Petaway

Walden Dissertations and Doctoral Studies

Public health initiatives include vaccination and screening efforts to reduce the burden of disease. This study addressed colorectal cancer (CRC) screening behaviors of accountable care organization (ACO) patients with different social determinants of health and providers’ ability to comply with the Medicare Shared Savings Plan (MSSP) quality measure ACO #19. This study followed the socioecological model and a cross-sectional quantitative design to assess data from the MSSP public use file 2019 across three manuscripts to expand on current literature. The purpose was to determine whether patient behavior was the primary driver to improve healthcare quality. Study results showed that performance …

Associations Between Provider Type And Medicaid Overpayments, Kezia Hercules

Walden Dissertations and Doctoral Studies

Healthcare costs have been rapidly increasing in the United States and consume a significant percentage of the Gross Domestic Product (GDP). A percentage of these costs are attributed to increased incidences of healthcare overpayments to providers. This study examined the impact of these overpayments by provider type, and the underlying reasons which resulted in overpayments from the Medicaid perspective. The theoretical framework used in this study was Ostrom’s institutional analysis and development (IAD) framework. The study used all available data (N = 682) from New York State Medicaid Inspector General final audits of providers for Medicaid overpayments. A chi-square test …

Relationship Between Social Support And Childhood Trauma On Resilience, Carol Krieger

Walden Dissertations and Doctoral Studies

People who have not overcome childhood trauma and who have developed mental illnesses have difficulties dealing with life challenges. The purpose of this quantitative study used a correlational design to test any relationship between childhood trauma experience levels and resilience against life challenges in adulthood. The theoretical framework used for this study was Barnes’ social support theory. Data were collected from 104 participants over a 7-week period. Participants voluntarily answered the ACE questionnaire, 2-way support scale, and resilience scale. Key results indicate that people with mental illness who receive social support are positive impacted by that support. Receiving adequate levels …

Retrospective And Forecasting Analysis Of Increased Long Term Care Demand In Niagara, Breanne Alissa Hines

Walden Dissertations and Doctoral Studies

A problem exists within the Canadian healthcare system as many patients experience longer lengths of stay (LOS) in acute care (AC) and complex care (CC) beds within hospitals because of a lack of long term care (LTC) facilities. The purpose of this study was to evaluate the extra days patients wait for placement and assess the benefits of increasing the number of LTC beds. The theoretical framework used was the four-level model of the health care system. Research questions involved 2017-2019 data for the number of LTC beds required to eliminate waits and evaluate beds needed in the future. This …

A Lebanese Health Care Organization’S Strategies To Secure Sustainable Funding, Dania Mahmoud Al Assadi

Walden Dissertations and Doctoral Studies

Fundraising and donations are the main sources of revenue for behavioral health care nonprofit organizations (NPOs) worldwide. Economic, political, social, or health crises impact fundraising and donation sources for behavioral health care NPOs. This qualitative case study addressed strategies that senior leaders of a Lebanese behavioral health care NPO could use in times of crisis. The study also addressed the behavioral health leaders’ experience managing a funding crisis. The Baldrige conceptual framework was used to assess the organization’s effectiveness in seven key areas. Interviews with the senior leaders and analysis of the organization’s archival data were used to inform the …

Unmet Needs Of Children With Special Health Care Needs When Transitioning To Adult Services, Kiara Monee Moseby

Walden Dissertations and Doctoral Studies

Health care transition planning could help decrease health care disparities among those who identify as an individual on the autism spectrum; however, less than a quarter of the adolescent population living with autism spectrum disorder receive transition planning. Decreasing health care disparities could lead to an increase in health care quality and longevity. The purpose of this study was to analyze if there was a relationship between (a) the number of physician visits, (b) if the physician treats only children, (c) if the physician talks about the child seeing physicians who treat adults, (d) if the physician worked with the …

Effective Physician Engagement Strategies For Improving Healthcare, Auriesheaua Bell

Walden Dissertations and Doctoral Studies

Middle and senior-level healthcare managers lack physician engagement strategies to help avoid physician burnout. Many physicians leave the healthcare profession due to disengagement, which could cause a significant healthcare crisis. Grounded in the transformational leadership theory, the purpose of this qualitative single case study was to explore the engagement strategies healthcare middle and senior-level managers used to help avoid physician burnout. Participants comprised seven middle and senior-level healthcare managers with a minimum of five years of employee management experience who effectively used physician engagement strategies to help avoid physician burnout at a Central Pacific United States healthcare organization. Data were …

Coping Strategies Of Dual-Role Informal Caregivers, Lorilee Maldonado

Walden Dissertations and Doctoral Studies

There are nearly 43.5 million informal caregivers (ICGs) in the United States, and this number will nearly double by 2030. Trying to fulfill the needs of an aging family member and commitments to work, home, and other relationships create a constant state of stress that may result in either leaving the workforce or placing the care recipient in a facility. Finding strategies that support both roles is economically and socially critical. This study explored the strategies that some ICGs have acquired that enable them to cope with these pressures. Work-family conflict theory, focusing on the conflict between work and family …

Relationship Between Nurse-To-Patient Ratios, Patient Satisfaction Scores, And Hospital Profitability, Patrick Ross Bumstead

Walden Dissertations and Doctoral Studies

In 2019, hospital profitability margins were at their lowest levels since the great recession due to a declining volume of patients. Hospital executives who fail to improve profitability are at risk of sustainability. Grounded in the service-profit chain theory, the purpose of this quantitative correlational study was to examine whether nurse-to-patient ratios and patient satisfaction scores significantly predict hospital profitability. Data were collected from 74 hospitals in Southern California from the Centers for Medicare & Medicaid Services government database and publicly available financial statements. Results from multiple regression analysis were not statistically significant. A key recommendation is for hospital executives …

Experiences Of Spanish-Speaking Patients Using Interpreter Services With Their Physicians, Rafael Raul Caycho

Walden Dissertations and Doctoral Studies

In the United States, many patients cannot speak English well enough to communicate with their medical providers. Many of these patients use professional interpreter services offered by their medical organizations to help with communication, which can lead to miscommunication due to the translation process between patients, interpreters, and physicians, and to incorrect diagnosis and poor health outcomes for the patient. The purpose of this study was to explore the experiences of Spanish-speaking patients who used interpreter services with their physicians. The transmission model was the theoretical framework used to explore the experiences and outcomes for the participants. In this study, …

Comparative Analysis Of Systemic Lupus Erythematosus Support Group Type On Quality Of Life, Mary Louise Giles

Walden Dissertations and Doctoral Studies

When individuals are diagnosed with systemic lupus erythematosus (SLE), they tend to go through emotional, psychological, and physical anguish that requires support. Studies have shown that a support group can provide SLE patients with an outlet in which they can share firsthand feelings and experiences and receive emotional support but it is not known if how the individual with SLE accesses online or face to face support makes a difference. The purpose of this study, guided by the Chronic Care Model, was to determine if there were differences in quality of life (QoL) for persons with SLE participating in an …

Developing Nurse Managers Through An Evidence-Based Education Program, Theresa Ann Hannu

Walden Dissertations and Doctoral Studies

AbstractThis study explored the lack of formalized managerial education and training for nurses new to leadership. This quantitative study specifically explored the knowledge gap of beginner nurse managers based on a lack of formalized education, a universal approach is supported by the research. Currently, there is no standard or formal nurse manager education program through the Department of Nursing or the Department of Learning and Development. The focus of the evidence-based project was to evaluate pre- and post-data assessing the impact of instituting a formal education program for beginner level nurse managers in collaboration with the human resources department of …

Association Of Surgical Site Infections With Hospital Size And Urban And Rural Locations In California, Jim Edjerore Omaraye

Walden Dissertations and Doctoral Studies

Approximately 20% of health care-associated infections (HAIs) result from surgical site infections (SSIs), increasing health costs, morbidity, and mortality. The mandates of public reporting of HAIs through the Centers of Medicare and Medicaid Services can have consequential effects on hospitals’ reimbursement, a significant concern to health care administrators. The primary purpose of this quantitative study was to determine if urban and rural locations and the size of hospitals affect the rate of SSIs in California. The two research questions addressed whether there is an association between the rate of SSIs in urban and rural locations and the size of hospitals …

Employee Retention Strategies In The Fast Food Industry, Patrick C. Umezurike

Walden Dissertations and Doctoral Studies

AbstractThe annual employee turnover rate in the fast-food industry is 73%, resulting in significant financial losses to the fast-food industry across the United States. The fast-food managers who lack strategies to improve employee retention; risk reduced organizational performance and effectiveness. Grounded in the eight motivational forces of voluntary employee turnover, the purpose of this qualitative multiple case study was to identify strategies managers in the fast-food industry used to improve employee retention. The participants were five senior fast-food managers in Baltimore, Maryland, who successfully improved restaurant employee retention. Data were collected through semistructured interviews; and documents (e.g., employee handbook, training …

The Combined Impact Of Race And Education On Obesity Among U.S. Adults By Fidelis Okoye, Fidelis Chidi Okoye

Walden Dissertations and Doctoral Studies

Walden University

College of Health Professions

This is to certify that the doctoral dissertation by

Fidelis Okoye

has been found to be complete and satisfactory in all respects, and that any and all revisions required by the review committee have been made.

Review Committee Dr. Vasileios Margaritis, Committee Chairperson, Public Health Faculty Dr. Srikanta Banerjee, Committee Member, Public Health Faculty Dr. James Rohrer, University Reviewer, Public Health Faculty

Chief Academic Officer and ProvostSue Subocz, Ph.D.

Walden University2021

AbstractThe Combined Impact of Race and Education on Obesity Among U.S. Adults by Fidelis Okoye

MA, Walden University, 2009BS, Marygrove College, 2001

Dissertation …

Relationship Between Faculty Age, Stress, And Intent To Leave Academic Medical Institutions, Susan Christian Atterton

Walden Dissertations and Doctoral Studies

Faculty intent to leave academic medicine affects clinical productivity, patient and teaching service quality, and institutions' profitability. Understanding factors associated with faculty intent to leave is critical for healthcare and human resources leadership within academic medical institutions in efforts to reduce faculty intent to leave. Grounded in Graves’ spiral dynamics theory, the purpose of this correlational study was to examine the relationship between faculty age, faculty stress, and faculty intent to leave academic medical institutions. The data were collected and analyzed for 125 faculty physicians with an M.D., Ph.D., D.O., or M.B.B.S. degree in an academic medical institution in the …

Strategies For Implementing Self-Service Technologies In Supermarket Retail Operations, Ryan Christopher Gurley

Walden Dissertations and Doctoral Studies

AbstractOrganization leaders who do not adopt self-service technology (SST) are at risk of failure. The adaptation of SST can aid leaders in the supermarket industry improve checkout operations, increase efficiency, and minimize customers’ waiting experiences, reducing the customers’ shopping satisfaction. Grounded in the disruptive innovation theory, the purpose of this multiple case study was to explore strategies supermarket managers use to adapt SST practices. The participants included six supermarket managers in Jackson County of Southern Illinois. Data were collected from face-to-face interviews with managers, company documentation, and observations. Thematic analysis was used to analyze the data. Four themes emerged: cultural …

Emergency Department Utilization And Length Of Stay Among Sickle Cell Patients, Rushali Naik

Walden Dissertations and Doctoral Studies

Patients with sickle cell disease (SCD) utilize the emergency department (ED) frequently due to limited access to adult health care providers. Few providers are knowledgeable about caring for patients with sickle cell disease. This quantitative study’s purpose and research questions addressed whether there was a correlation between ED utilization and ED length of stay (LOS) pre- and post-enrollment in an adult comprehensive sickle cell clinic between the years of 2012 and 2017. The Donabedian framework was used to examine the structure, process, and outcomes related to the benefits of care in a sickle cell center. The independent variables of pre- …

Role Of Case Management In Access To Mental Health Care Among African Americans With Medicaid, Kira-Jai Jayne Taylor

Walden Dissertations and Doctoral Studies

Disparity in access to appropriate mental health care among African Americans compared to non-Hispanic Whites is growing. The purpose of this quantitative retrospective study was to examine the relationship between access to an outpatient mental health facility with case management and access to outpatient mental health services among African Americans with Medicaid compared to non-Hispanic Whites with Medicaid. The theoretical framework was based on the conceptual framework for integration created by PATH. The study addressed whether there is a difference in the number of African Americans compared to non-Hispanic White patients with Medicaid in access to an outpatient mental health …

The Lived Experience Of African American Young Adult Men With Hiv And Self-Care Collaborative Management, Barbara A. Moore

Walden Dissertations and Doctoral Studies

AbstractAfrican American young adult (AAYA) men living with HIV often lack interventions that address the influence that HIV has on their quality of life, especially their relationships. Self-care collaborative management (SCCM) concerns related to disclosure and stigmatization complicate social, psychological, and SCCM behaviors. Intervention programs addressing these concerns should be based on relevant, accurate information, but this information is lacking for AAYAs. The purpose of this research was to explore and describe the lived experiences of male AAYAs with HIV and their use of SCCM. The study method was qualitative; Husserl’s transcendental phenomenology was the design. The individual family self-management …

Effects Of Cultural And Lived Experiences On Health Access Of Chamorro People On Saipan, Esther Lizama Muna

Walden Dissertations and Doctoral Studies

More than half of the population of the Commonwealth of the Northern Mariana Islands had not visited their primary care provider for a year in 2016. The Chamorro people are less willing to seek or access care than other ethnic groups. This qualitative study aimed to understand the Chamorro people's access and utilization of Saipan's health care services to improve their access and, ultimately, their health. The theoretical frameworks included Penchansky and Thomas's theory of access to explore the Chamorro people of Saipan's lived experiences with availability, accessibility, accommodation, affordability, and acceptability of health care services, as well as Spector's …

Nurse Turnover A Crisis In Healthcare, Billie Robinson

Walden Dissertations and Doctoral Studies

AbstractNurse turnover is a global, national, and local problem that impacts the ability of healthcare leaders to deliver high quality healthcare to the populations in need of healthcare services. The purpose of this study is to identify reasons nurses leave organizations. The Leader-Member Exchange Theory undergirds the quantitative research which was conducted using the Supervisor Leader Communication Inventory. Nurse leaders communicate with acute care nurses using principles of the Leader- Member Exchange Theory. The survey was distributed to members of the Georgia Nurse Association. Positive correlations were revealed between the independent and dependent variables. SPSS was used to establish the …

Strategies For Establishing A Diverse Workforce Within A University Health System’S Department, Shanee Chantel Morgan

Walden Dissertations and Doctoral Studies

Balanced diversity in health care promotes patient satisfaction and enhances innovation. Obtaining a culturally balanced workplace requires recruitment strategies that encourage inclusiveness among team members from various backgrounds. The purpose of this doctoral study was to explore the issue of lack of diversity in a behavioral health organization’s (BHO’s) student intern program and identify strategies for creating greater diversity in the workplace. The Baldrige excellence framework, the conceptual framework that guided the research, was designed to help BHOs to improve their overall business performance to accomplish goals and increase organizational sustainability. Three themes emerged from the data analysis: diversity training, …