Social and Behavioral Sciences Commons^™

Root Cause Analysis To Improve Incident Reporting In An Ambulatory Care Setting, Lisa Ann Duncan

Doctor of Nursing Practice (DNP) Projects

Problem: The subject organization (SO) is a Federally Qualified Health Center (FQHC) with an internally developed incident reporting system. The SO wanted to improve patient and employee safety using data from incident reports, but the incident reporting system did not give enough information to recognize patterns and develop countermeasures.

Context: Supervisors welcomed the opportunity to learn more about incident report follow-up and conducting root cause analysis (RCA). Members of the Safety Committee were eager for data to use to develop countermeasures to improve patient and employee safety. Decreases in employee injuries can save the SO from increases in the …

Searching For The Fulcrum: Can Accountable Care Organizations Lower Spending By Balancing Specialists-To-Primary Care Providers?, Vishal Shetty

Masters Theses

Background:

While value-based payment models emphasizing care coordination have been widely implemented to improve quality and lower expenditures, supporting empirical evidence is sparse. Our objective was to quantify the impact of specialist-to-primary care physician involvement within accountable care organization (ACO) and its association with lower spending.

Methods:

We conducted a retrospective cohort study of Medicare Shared Savings Program ACOs from 2012-2016 using publicly available data provided by the Centers for Medicare and Medicaid Services at the ACO level. We examined the association between the proportion of primary care services delivered by specialists versus other types of care providers and ACO …

Career Coaching: A Study Of Veterans Health Administration (Vha) Leaders', Jerelyn Dugas

Dissertations

Purpose: The purpose of this qualitative multiple case study was to explore and describe the impact of career coaching on the career performance growth and retention as perceived by healthcare’s emerging leaders who participated in selected coaching program institutes for a minimum of 1 year at VHA hospitals in Southern California.

Methodology: The researcher selected a qualitative multiple case study to explore and describe VHA leaders’ perceived impact of coaching on their career performance growth and retention. Further, the researcher conducted semi-structured, interviews with 15 participants to gain a better understanding of the lived experiences of the participants at the …

Exploring Direct And Indirect Effects Of English Proficiency On Access, Utilization, And Health Status Among Californian Adults With Limited English Proficiency (Lep), Renee E. Pierre-Louis

Seton Hall University Dissertations and Theses (ETDs)

Background and Study Purpose: Findings from previous studies suggest that, in a health care delivery context, individuals with limited English proficiency (LEP) are adversely impacted by lack of patient-provider language concordance. Yet, the concept of LEP has been mostly studied in the context of cultural competence and language has been generally considered a demographic or cultural characteristic. There is a growing body of research concerning LEP and health status; however, it is limited. This study sought to evaluate the effects of LEP on access, utilization, and self-rated health status (SRHS) among LEP respondents to a large health interview survey …

Policy Of Current Hospital Translation Services And Recommendations For Future Adjustments For Spanish-Speaking Patients, Isidora Rose Beach

Chancellor’s Honors Program Projects

No abstract provided.

Evaluation Of Disparities In Healthcare Experiences Between Racial Identities And Age Cohorts, Christopher Ruckman, Dnp, Mba, Msn, Rn, Cen

Doctor of Nursing Practice Projects

Background: Healthcare consumers have their own perspectives and expectations of what should occur during an encounter of care; these unmet expectations create healthcare disparities. However, there is limited data regarding healthcare experiences among racial and aging groups.

Objectives: To compare the physical and emotional responses of healthcare experiences among racial/ethnic and aged cohorts in the United States.

Methods: Applying a descriptive-correlational design, secondary data from the 2014 Behavioral Risk Factor Surveillance System related to healthcare experiences among racial groups (White, Black, Hispanic, and Asian) and aged cohorts (18-39, 40-54, and 55- 69 years) were assessed.

Results: In the sample, there …

Evaluation Of The Associations Between Unplanned Readmissions And The Lace Index And Other Variables, Cathy Stankiewicz, Dnp, Msn, Rn

Doctor of Nursing Practice Projects

Background: Unplanned readmissions, within 30 days following an inpatient hospital admission, are common and costly. Research has identified factors that predict readmissions, and predictive algorithms, such as the LACE index, have been studied and widely adopted by hospitals despite demonstrated variability in predictive ability.

Objectives: To examine the associations between unplanned readmissions and the LACE index, and other variables that reflect patient- and encounter-level factors not currently incorporated in the LACE index.

Methods: A retrospective analysis was conducted utilizing data from electronic health records of inpatients discharged from a large quaternary hospital located in the southeastern United States between January …

Coping With Sickle Cell Disease Using Cognitive Behavior Therapy, Helen Alexander

Walden Dissertations and Doctoral Studies

This project focused on identifying the best evidence available on the use of cognitive behavior therapy (CBT) for pediatric patients and families with sickle cell disease (SCD) to improve their coping skills with pain management. This resulted from an identified gap in nursing practice regarding psychosocial support for this subset of hospitalized pediatric patients. The practice-focused question was whether there was evidence in the literature on the use of CBT techniques to improve parental coping skills with children who have chronic and life-threatening illness that could be utilized with sickle cell disease. The theory of stress and coping guided the …

Family Relational Experiences During Major Transitions With A Chronic Illness, Juanita Sibayan

Walden Dissertations and Doctoral Studies

Although health care transitions have received some attention in the literature, few researchers have emphasized family relational experiences and communication during major changes while living with a chronic illness. The purpose of this phenomenological study was to understand the lived experience of parents and their adult children while transitioning from pediatric to adult care of a chronic illness. The bio-psychosocial theory, family systems theory, and attachment theory established the context for this study. A criterion-based sampling technique and snowball sampling were used to recruit 7 parents and 6 of their adult children aged 18 to 30 years who were diagnosed …

Advocating Ideal Type Policy For Police Officer Wellness Based On Body Mass Index As A Predictor Of Self-Reported Occupational Stress, Louis Chiappetta

Walden Dissertations and Doctoral Studies

Scholars have validated both the damaging presence of police officer stress and separately, their increasing obese condition in the United States. Previous studies of police officers focus on stress or body weight, but not these variables conjointly. The purpose of this study was to inform policy creation by examining the problem of officer stress in relation to the calculated body mass index (BMI) values and to gain insight into stress outcomes. Lazarus and Folkman's stress-coping theory served as the research lens to examine if BMI would significantly contribute to the percent change of R2 variance accounted for in the predictive …

Health Care Services For Child Survival And Performance-Based Management In Three Kosovo Municipalities, James Mugaju

Walden Dissertations and Doctoral Studies

After the Republic of Kosovo's declaration of independence in 2008, new municipal structures were created with the charge of monitoring the delivery of health care services; yet, no mechanism for monitoring performance was ever implemented. With the public value theory as the foundation, the purpose of this multiple case study of 3 Kosovo municipalities was to understand issues surrounding the capacity of local government health department to monitor their performance related to the delivery of services. Relevant data were collected through focus-group discussions with 10 nurses, 9 directors of family medicine centers, and 12 municipal program managers. Purposeful semistructured interviews …

Cost-Effectiveness Analysis Of Preimplantation Genetic Screening, William Andrew Moye

Walden Dissertations and Doctoral Studies

In vitro fertilization (IVF) is used to help infertile couples achieve a live birth. Clinical studies have suggested that multiple, consecutive cycles of IVF can increase live birth rate significantly. Others have documented improved live birth rates from the use of new laboratory techniques for preimplantation genetic screening (PGS). This genetic screening technique seeks to determine the ploidy of the embryo prior to implantation into the woman. To date, no study has examined the cost-effectiveness of using IVF in conjunction with PGS compared to that of IVF alone for 3 consecutive cycles in achieving a live birth. This study compared …