Health Services Administration Commons^™

Global Perspectives For Strengthening Health Education: A Mixed-Methods Study, Mohammad Torabi, Wasantha Jayawardene, Dennis Daniels, Tapati Dutta, Nicola Bragazzi, David K. Lohrmann

Health Behavior Research

This study aimed to identify the knowledge, experiences, and attitudes about current practices of health education (HE) among government-affiliated high-profile health administrators in developed and developing nations. Respondents (N = 21) were purposively selected based on their affiliation as a health administrator at the national level, with roles in high-profile decision-making for devising policies/programs and allocating funding or advocating strategies to advance HE. Information was gathered using a web-based cross-sectional survey in 5 languages, consisting of 14 closed-ended and 8 open-ended questions. A majority were males (70%) and spoke English (57%), 45% had postgraduate degrees, and 57% were from high-income ...

Provider Attitude Towards Postpartum Sexual Health, Katie Shearer, Pallavi Khanna

Longitudinal Scholar's Project

Background: The prevalence of female sexual dysfunction (FSD) worldwide is estimated to be 41%. FSD is even more prevalent in postpartum patients. There are significant barriers to addressing FSD in a busy clinic, and the use of a standardized screening questionnaire could be used to improve outcomes during postpartum appointments.

Methodology: Providers that care for postpartum patients at Regional One Health in Memphis, TN, were asked to complete an anonymous survey online. General knowledge and practices of providers were assessed.

Results: 79% of respondents answered that they felt very comfortable assessing for postpartum sexual health, and 88% of respondents expressed ...

Increasing Appointment Adherence In Patients With Diabetes Mellitus Via Appointment Reminders And Patient Education, Leslie Guy

Student Scholarly Projects

Practice Problem: Appointment no-shows and nonadherence have been an organization-wide concern within the project setting, resulting in increased healthcare costs and workload while disrupting the continuity of patient care.

PICOT: The PICOT question that guided this project was: In adult diabetic patients ages 19-99 (P), how do appointment reminders by nursing staff and patient education related to appointment adherence (I) compared to the current practice of appointment reminders by administrative assistants and no patient education related to appointment adherence (C) affect appointment adherence rates (O) within ten weeks (T)?

Evidence: Current evidence demonstrates that patient appointment reminders improve appointment adherence ...

Comparison Of Routine Health Screening Rates Between Two Emr Systems, Lauren M. Cancio, Caleb J. Berta

Longitudinal Scholar's Project

An EMR, electronic medical record, system refers to the software widely adopted by medical practitioners to reduce the use of hard-copy files, and improve the documentation, storage, and retrieval of patient information. Some EMR systems can generate automatic alerts reminding providers when patients are due for certain preventive services or meet the criteria for various screening measures. Epic, one of the leading EMR systems in use today, contains this additional feature. The screening recommendations built into Epic are derived from a committee of USPSTF, U.S. Preventive Services Task Force, medical experts whose focus is to improve patient health across ...

Ethical Implications Of Covid-19 Surveillance In Karnataka Using Nancy Kass Framework, Apurva Jain, Lakshya Arora

Journal of Health Ethics

Numerous public health hurdles, including pandemics such as COVID-19, have led to concerns about community health practices in relation, necessitating the application of an ethical perspective. International research ethics guidelines are only used in a restricted range of contexts of public health. As a result, a variety of frameworks have been established to assist ethical analysis of public health concerns. In this study, we have used the Nancy Kass framework for analyzing COVID-19 surveillance in Karnataka state of India, which is a six-step approach that can assist public health practitioners in evaluating the ethical consequences of interventions, policy initiatives, services ...

Overview Of Transition Care Clinics And Patient No-Shows, Manul Awasthi

Electronic Theses and Dissertations

Introduction

Transition care clinics (TCCs) have proven to be effective in meeting the time-sensitive needs of patients in the post-discharge period and ensuring smooth transitions of patients from hospital to home. These clinics have led to lower readmissions, lower emergency department visits, cost savings, and lower rates of other adverse events following discharge. However, TCCs, including the East Tennessee State University Family Medicine (ETSU-FM) TCC have been facing high rates of patient no-shows.

Aim

The aim of this dissertation is to identify the different components and outcomes of TCC based on the literature. We further aim to analyze the TCC ...

Analysis Of The Utilization Of Nebraska Medicine's Price Transparency Tool, Ingrid A. Olson

Capstone Experience

Healthcare costs have become a significant concern for patients, healthcare facilities, economists, and politicians within the United States. In an effort to understand and reduce health-related costs, price transparency laws were enacted at the beginning of 2021. Because of these new laws, hospitals must provide a price transparency tool for their patients. “Price transparency in healthcare makes pricing information more readily available, defines the value of services, and enables patients and other care purchasers to identify, compare, and choose providers that offer the desired level of value” (AAMC, 2022). However, research results on price transparency tools use and efficacy is ...

The Patient-Centered Medical Home And The Value Of Heightened Care Coordination: A Systematic Literature Review, Garrett L. Vetter

Capstone Experience

Health care spending in the United States continues to increase at a pace that far exceeds inflation. Representing a greater proportion of the nation’s gross domestic product (GDP) than any other country, costs associated with health care services in the U.S. lend support to growing concern regarding the sustainability of current systems. Furthermore, the fragmented nature of the current landscape often presents challenges to the provision of high-quality and efficient care. Satisfaction among both patients and health care providers, alike, suffers under the weight of increasing regulatory burden, the lack of integrated medical records systems, and growing complexity ...

Supporting Post-Secondary Implementation Of Recovery-Oriented Practice In A Stepped Care Model, Janis Campbell

The Organizational Improvement Plan at Western University

Student mental health has been a growing concern for higher education communities for many years. Campuses have been struggling to keep up with the increasing demand for services which has been complicated further by the COVID-19 pandemic. A Stepped Care model (SCM) developed at a Canadian university has been offering new ways of organizing mental health resources based on open access, student choice, and recovery principles. There are diverse definitions of recovery in the literature and are usually based on values such as empowerment, respect, and self-determination. SCMs have been shown to increase access to resources and reduce or eliminate ...

Sepsis: Do The Clinical Criteria Support The Medical Coding?, April M. Insco

Theses and Dissertations (ETD)

Background: Sepsis is a condition that can be very costly and very deadly. Diagnosing sepsis can be challenging as there is not one specific test that will identify whether a patient has sepsis and there are varying opinions as to the true definition of sepsis. The definition of sepsis used for this research is a combination of System Inflammatory Response Syndrome (SIRS) with an identified infection. Medical Coders must review the documentation provided in a medical record to accurately assign an ICD-10-CM code. Administrative data is then used to provide statistical information for research purposes. When coded data is not ...

Increased Rates Of Death From Unintentional Injury Among Non-Hispanic White, American Indian/Alaska Native, And Non-Metropolitan Communities, Lindsey R. Hammerslag, Jeffery Talbert, Tyrone F. Borders

Rural & Underserved Health Research Center Publications

Overview of Key Findings

• Living in a nonmetropolitan area is associated with an increase in the age-adjusted death rate from unintentional injuries, from 46.2 in metropolitan areas to 59.2 in nonmetropolitan areas in 2018, with all races/ethnicity groups affected except for non-Hispanic Black.
• The ratio of unintentional injury deaths in nonmetropolitan areas, compared to metropolitan areas, was 1.28 overall, ranging from 1.05 to 1.56 depending on race and ethnicity.
• American Indians and Alaska Natives have the highest rate of living in nonmetropolitan areas (39.5%), and this group has the greatest increase in death ...

Correlates Of Zero-Dose Vaccination Status Among Children Aged 12-59 Months In Sub-Saharan Africa: A Multilevel Analysis Of Individual And Contextual Factors, Chamberline Ozigbu, Bankole Olatosi, Zhenlong Li, James W. Hardin, Nicole L. Hair

Faculty Publications

Despite ongoing efforts to improve childhood vaccination coverage, including in hard-to-reach and hard-to-vaccinate communities, many children in sub-Saharan Africa (SSA) remain unvaccinated. Considering recent goals set by the Immunization Agenda 2030 (IA2030), including reducing the number of zero-dose children by half, research that goes beyond coverage to identify populations and groups at greater risk of being unvaccinated is urgently needed. This is a pooled cross-sectional study of individual- and country-level data obtained from Demographic and Health Surveys Program and two open data repositories. The sample includes 43,131 children aged 12–59 months sampled between 2010 and 2020 in 33 ...

Time-To-Event Modeling For Hospital Length Of Stay Prediction For Covid-19 Patients, Yuxin Wen, Md. Fashiar Rahman, Yan Zhuang, Michael Pokojovy, Honglun Xu, Peter Mccaffrey, Alexander Vo, Eric Walser, Scott Moen, Tzu-Liang Bill Tseng

Engineering Faculty Articles and Research

Providing timely patient care while maintaining optimal resource utilization is one of the central operational challenges hospitals have been facing throughout the pandemic. Hospital length of stay (LOS) is an important indicator of hospital efficiency, quality of patient care, and operational resilience. Numerous researchers have developed regression or classification models to predict LOS. However, conventional models suffer from the lack of capability to make use of typically censored clinical data. We propose to use time-to-event modeling techniques, also known as survival analysis, to predict the LOS for patients based on individualized information collected from multiple sources. The performance of six ...

Design And Preliminary Findings Of Adherence To The Self-Testing For Our Protection From Covid-19 (Stop Covid-19) Risk-Based Testing Protocol: Prospective Digital Study, Carly Herbert, John P. Broach, Ben S. Gerber, Nisha Fahey, Elizabeth Aaker Orvek, Peter Lazar, Julia M. Ferranto, Kamran Noorishirazi, Shivakumar Valpady, Qiming Shi, Honghuang Lin, Kathryn Marvel, Laura L. Gibson, Bruce A. Barton, Stephenie C. Lemon, Nathaniel S. Hafer, David D. Mcmanus, Apurv Soni

UMass Worcester PRC Publications

BACKGROUND: Serial testing for SARS-CoV-2 is recommended to reduce spread of the virus; however, little is known about adherence to recommended testing schedules and reporting practices to health departments.

OBJECTIVE: The Self-Testing for Our Protection from COVID-19 (STOP COVID-19) study aims to examine adherence to a risk-based COVID-19 testing strategy using rapid antigen tests and reporting of test results to health departments.

METHODS: STOP COVID-19 is a 12-week digital study, facilitated using a smartphone app for testing assistance and reporting. We are recruiting 20,000 participants throughout the United States. Participants are stratified into high- and low-risk groups based on ...

The Racial And Ethnic Diversity Of The Family Physician Workforce In Non-Metropolitan And Metropolitan Counties, Lars E. Peterson, Zachary J. Morgan

Rural & Underserved Health Research Center Publications

Overview of Key Findings

• The family physician workforce is becoming more racially diverse; however, non-metropolitan family physicians are not.
• Using data from over 24,000 family physicians who either registered to continue their American Board of Family Medicine (ABFM) certification or completed the graduate survey from 2017 to 2019, we found that early career family physicians are more diverse than later career physicians (66.9% vs. 72.8% White; 58.3% vs. 44.0% female) but, in both groups, the percentage of White non-metropolitan family physicians was even higher (82.7% to 90.5%).
• Minority non-metropolitan family physicians, particularly Black ...

Non-Metropolitan And Metropolitan Trends In Mental Health Treatment Availability In Community Health And Community Mental Health Centers, Tyrone F. Borders, Timothy Williams, Katherine Youngen, Julia Cecil

Rural & Underserved Health Research Center Publications

Key Findings

The supply of community mental health centers (CMHCs) decreased substantially from 2000 to 2019 and became nearly non-existent in non-metropolitan counties.

• The number of CMHCs in non-metropolitan counties declined from 182 to 15.
• The number of CMHCs in metropolitan counties declined from 582 to 104.

The supply of community health centers (CHCs) offering mental health services increased substantially over the same time period, or from 2000 to 2019.

• The number of CHCs in non-metropolitan counties increased from 184 to 573.
• The number of CHCs in metropolitan counties increased from 126 to 797.

Episode Based Payment Models And The Hospital Safety-Net: An Evaluation Of The Center For Medicare And Medicaid Services’ Comprehensive Joint Replacement Bundled Payment Program, John A. Gravina

Dissertations and Theses

Episode Based Payment Models and the Hospital Safety-net: An Evaluation of the Center for Medicare and Medicaid Services’ Comprehensive Joint Replacement Bundled Payment Program

By John Anthony Gravina

Advisor: Alexis Pozen, Ph.D.

Introduction: Payments for Healthcare services are increasingly being tied to clinical quality, patient experience, health outcomes, and efficiency through value-based payment arrangements (VBP). VBP presents a potential opportunity to reduce healthcare expenditures by requiring providers to take on financial risk associated with the cost and quality of care, therefore aligning payment incentives with the goals of providing higher quality and efficient care. As of 2020, 80 percent ...

Feasibility And Effectiveness Of A Prehabilitation Program Prior To Breast Cancer Surgery: A Critically Appraised Topic, Emma Choi, Alissa Lee, Kayla Woods, Morgan Mills, Carol Houston

Master of Occupational Therapy Student Critically Appraised Topics

The purpose of our project is to determine the feasibility and effectiveness of a prehabilitation (prehab) program for patients undergoing breast cancer surgery as compared to only receiving post-surgical rehabilitation. Our clinical mentor has recently obtained certification as a lymphedema specialist and is assisting with the opening of an outpatient mastectomy clinic through the Methodist University systems. Through our research process, we critically appraised two Level II articles, two Level III articles, and one Level IV article. Positive outcomes related to the feasibility were identified, however there is limited significant evidence supporting the effectiveness of the intervention. We recommend using ...

Lessons Learned From The World Health Organization’S Late Initial Response To The 2014-2016 Ebola Outbreak In West Africa, Chulwoo Park

Faculty Research, Scholarly, and Creative Activity

The purpose of this article is to 1) examine the role of the World Health Organization (WHO) in controlling infectious disease outbreaks, 2) evaluate if the WHO’s initial response to the 2014-2016 Ebola crisis was appropriate, 3) evaluate current WHO’s efforts to prevent future disease outbreaks after the Ebola elimination, and 4) suggest how WHO should be further reformed to provide prompt and accurate guidance to multi-sectoral health stakeholders at local, national, regional and global level for effective surveillance preparedness and response. This is a non-systematic narrative literature review. The articles from PubMed, Scopus, Medline, books, WHO documents ...

Effect Of Early Mobilization On Length Of Hospital Stay In Covid-19 Patients: A Critically Appraised Topic, Ashlee Hodges, Anna Claire Briscoe, Anna Beth Willoughby, Carlton Hubbard, Nathan Smith

Master of Occupational Therapy Student Critically Appraised Topics

For this project, we created a critically appraised topic to study the effects of early mobilization on length of hospital stay in COVID-19 patients in the ICU.