Digital Commons Network^™

Care Of Adult Cancer Survivors, Kelsey Kloosterman

Doctoral Projects

As innovative cancer treatments emerge, more people are surviving cancer. Cancer survivors have multiple and unique healthcare needs due to their cancer and cancer treatments. Communication among those treating the cancer, primary care providers, and cancer survivors is necessary to coordinate care once treatment is finished. The development of a survivorship care plan that is reviewed with the cancer survivor is intended to facilitate communication among all stakeholders. This quality improvement project examined current practice in a survivorship clinic in a Midwestern health system cancer center that cares for a variety of types of cancer patients. By reviewing evidence in …

Implementation Of A Multimodal Hand Hygiene Intervention At A Rural Critical Access Hospital, Amy J. Hopp

Doctoral Projects

Healthcare acquired infections are the most common complication of hospital care in the United States, with subsequent negative implications on the healthcare system. While hand hygiene has long been considered the single most important and cost-effective way of reducing healthcareacquired infections, compliance among healthcare professionals is low, and most efforts to improve it fail. When compared to single-component hand hygiene interventions, research demonstrates that tailored multimodal interventions are an effective way to improve compliance with hand hygiene practices among healthcare professionals. This Doctor of Nursing Practice project focused on implementing a multimodal hand hygiene intervention, tailored to fit the specific …

Evaluation Of A Health System’S Community Targeted Program For Individual’S With Increased Risk For Cardiovascular Disease And Diabetes, Phallon Lovelady

Doctoral Projects

Introduction: Lack of a program evaluation plan for a community targeted primary prevention program poses a risk for undefined program effectiveness. Conducting a systemic program evaluation helps determine program effectiveness and value. The purpose of this paper is to discuss the process of implementing a program evaluation during a Doctorate of Nursing Practice (DNP) scholarly project.

Objectives: The objectives of this project were to apply a scholarly approach to program evaluation utilizing evidence-based practice tools, demonstrate DNP Essentials and health systems leader competencies, and describe the steps taken during the process.

Methods: The CDC Framework for Program Evaluation (2011) was …

Evaluation Of Processes And Procedures For Care Of The Opioid Recipient Patient In The Primary Care Setting, Anne Sproat

Doctoral Projects

Introduction: Chronic non-cancer pain is far reaching, affecting over 100 million Americans (Zgierska et al., 2018). Opioids are commonly prescribed for chronic pain, with approximately 20% of patients presenting to primary care offices with symptoms of pain or pain-related diagnoses (Dowell, Haegerich, & Chou, 2016). As a result, opioid prescribing rates are increasing at a faster rate for primary care practice compared with other specialties (Dowell et al., 2016). Within the United States population, it is estimated that three percent to four percent of the adult population are prescribed long-term opioids for the treatment of chronic non-cancer pain (Dowell et …

A Visionary Organization: From Donor Intent To New Horizons Of Race And Gender Equity, Carolyn Chernoff, V Varun Chaudhry

The Foundation Review

This article documents the unique trajectory of the Leeway Foundation and its transition from sole-director family foundation to an independent foundation. Over 25 years, Leeway shifted in structure and grantmaking, yet has remained in line with its founder’s original mission: to fund women artists in the Philadelphia region.

This article focuses on the shift from the founder’s initial intentions to what is now an organization informed by models of racial and gender equity, funding women, trans, and gender nonconforming artists working for social change. Leeway thus serves as a case study for examining transformational shifts in mission, vision, and constituency …

Leadership: Self-Awareness Of Leadership Styles In Occupational Therapy, Katrina Greathouse, Joseph Gritter, Alexandra Imhoff

Work

Successful organizations and professions depend on quality leadership. However, the literature on leadership in the field of occupational therapy, particularly understanding the effects of self-awareness, is limited. The qualitative, hermeneutic, phenomenological methodology combined with grounded theory analysis utilized in this study, examines the perceived effects of self-awareness of leadership styles on occupational therapy leaders’ decision making. Data was collected through semi-structured interviews, four weeks after the completion of two self-awareness assessments. There were a total of four participants. All participants were occupational therapists and currently held a formal leadership title in the Midwest United States. The data was transcribed verbatim …

Unpacking The Role Of Data In Philanthropy: Prospects For An Integrated Framework, R. Patrick Bixler, Marisa Zappone, Lin Rui Li, Samer Atshan

The Foundation Review

This article reports qualitative research that explores the role of data in philanthropy and proposes an integrated framework. Interviews with charitable foundations in central Texas, including members of a regional evaluation and learning collaborative, reveal an orientation toward data that is becoming increasingly institutionalized.

The research suggests that data are generated and used in a multiplicity of ways, including identifying populations and geographies in need of investment, informing funding decisions for service delivery as well as policy research and advocacy; evaluation and learning; and measuring community impact.

This article discusses these thematic findings, notes specific practices, and presents six principles …

A History Of The Missouri Conference On History, 1959-2016, James N. Giglio

Studies in Midwestern History

The Missouri Conference on History (MCOH) emerged in 1959 and has continued without missing a year, despite undergoing organizational changes over time. Many individuals have contributed to make it one of the most successful state conferences ever. This is a story worth telling, especially at time when many people are reconsidering the history of the Midwest and how to support the infrastructure necessary to promote the study of that history.

An Education Intervention To Increase Rounding And Toileting And Reduce Falls In A Hospital Acute Care Of The Elderly (Ace) Unit, Amelia Grayson

Doctoral Projects

Introduction: Falls are the most common accident reported in acute care hospitals and patients who are 65 and older are the most vulnerable. Falls can lead to physical and emotional injury, reduced mobility and functioning, increased length of hospital stay, increased healthcare costs, and admission to long-term care facilities. In 2008, the Center for Medicare & Medicaid Services (CMS) has eliminated reimbursement to hospitals for treatment of injuries resulting from a fall during hospitalization. Research on fall prevention in adult acute care found multifactorial interventions that address multiple risk factors for falls are the most successful at prevention. This …

Proposal Defense: Improving Patient Portal Adoption In Primary Care, Melissa Wagner

Doctoral Projects

Introduction: Stage three of Meaningful Use (MU) is currently underway and is focused on promoting patient portal use. If the electronic medical record patient portal use is less than 25%, primary care providers face reductions in value-based reimbursements. National adoption rates from portal use remain under 27% with some providers averaging well below the needed 25%. The following practice question is proposed, “In a low-income urban adult clinic, how does an interactive electronic education intervention compared to no education intervention affect patient portal adoption rates?”

Objectives: The purpose of this project is to identify whether an electronic patient educational video …

Structure, Process, And Outcomes: The Foundation For Continuous Quality Improvement In Primary Care, Mark A. Contreras

Doctoral Projects

Healthcare within the United States is notoriously fragmented and inefficient. Contemporary innovations for policy, reimbursement, and care delivery are consistently directed towards the promotion of value based care (Bates, 2010). These initiatives routinely coalesce around the promising potential of a robust primary care system. The Patient-Centered Medical Home (PCMH) model is increasingly becoming the standard of quality care and use of this model by healthcare providers is poised to bring about a paradigm shift towards value-based care (Henderson, Princell & Martin, 2012).

This scholarly project incorporated an evidence based approach to establishing continuous quality improvement in a primary care office …

Improving The Patient Handoff From Or To Picu In Children Who Have Undergone Cardiac Surgery Using A Standardized Handoff Tool, Amanda Taylor

Doctoral Projects

Inpatient hospitalizations for children are often costly. Children often transition from one setting to the next while hospitalized, therefore their provision of care is also transferred from one care team to the next. This transition presents a vital time for the child, that may be associated with adverse events and medical error. Adverse events can lead to poor outcomes for the child. Despite efforts to improve patient handoffs, communication failures are still abundant in healthcare. Research indicates that the use of a standardized handoff tool from one setting to the next is an effective method for improving the patient’s transition. …

Review -- Design Thinking For The Greater Good: Innovation In The Social Sector, Brenda Sipe

The Foundation Review

No abstract provided.

A Multidimensional Approach To Improve Cardiovascular Quality Measure Documentation In A Native American Population, Jessica A. Mastbergen

Doctoral Projects

Native Americans are more likely than white counterparts to be diagnosed with heart disease (Office of Minority Health [OMH], 2017). The scholarly project was conducted in response to the need for improvement in cardiovascular lifestyle interventions for Native Americans and their documentation to meet Government Performance Results Act quality measures. The clinical question addressed was: what is an evidence-based multidimensional approach to improve cardiovascular quality measure documentation in a Native American primary care clinic? The multidimensional interventions included educational sessions for Community Health Representatives (CHRs), a provider education session on appropriate documentation in order to satisfy quality measures, chart review …

Evidence Based Toolkit To Improve Oncology Referrals To Palliative Care, Katelyn M. Gettel

Doctoral Projects

As cancer related mortality decreases, the number of patients living with cancer symptoms and the side effects of cancer treatment will continue to grow. In 2016, over 1.5 million Americans were newly diagnosed with cancer (American Cancer Society, 2016). Several major medical organizations including the American Society of Clinical Oncology (ASCO), the National Comprehensive Cancer Network (NCCN), and the World Health Organization (WHO) endorse the integration of palliative care into cancer care (Ramchandran, 2015). Although many cancer centers report offering palliative care, this remains largely limited to inpatient services.

The stakeholders of the hospice and palliative care division of a …

Contextual Classification At Out On The Shelves Library, Amber Dierking

Conference Proceedings

Out On The Shelves is Vancouver’s only Lesbian, Gay, Bisexual, Transgender, Two-Spirit, Queer, Intersex, Aromantic/Asexual (LGBT2QIA+) library. Due to recent organizational changes, it has become apparent that its current classification system is no longer working effectively. Not only was the previous system unstructured and confusing, it failed to explicitly represent many aspects of the community it serves. This project was undertaken during the summer of 2018, researching alternative classification and queer issues in knowledge organization to determine how to improve it. This research, combined with careful consideration of the needs of the library itself and its users, suggested that building …

Thanks For The Feedback Taskforce Presentations, Emily Frigo, Susan Ponischil, Jacklyn Rander, Ashley Rosener

Presentations

The Thanks for the Feedback Task Force was empaneled to build a libraries-wide professional development experience including learning circles and workshops for formative colleague feedback and constructive handling of ‘conflict’ using the book Thanks for the Feedback by Douglas Stone and Sheila Heen as a guiding text for Summer 2018. Three goals were 1. Develop shared vocabulary on receiving (and giving) feedback. 2. Identify strategies and customize scripts for navigating conversations. 3. Create a tool kit on giving and receiving feedback.

An Evaluation Of A Care Conference Model And Improvement In The Transition Process For Medically Complex Pediatric Patients Between Inpatient And Outpatient Care, Tamara Van Kampen

Doctoral Projects

Medically complex and/or fragile pediatric patients are high utilizers of health care dollars. This population represents less than one percent of the general pediatric population, yet they account for more than 30% of pediatric healthcare costs. These patients tend to have longer lengths of stay in the hospital, high readmission rates, and lower healthcare satisfaction scores. They also have multiple transitions between inpatient and outpatient care which increases the opportunity for medical errors. Research has shown that care conferences attended by key stakeholders tend to reduce readmissions and healthcare utilization while improving satisfaction rates and patient outcomes. Research also shows …

We Are All Teachers: A Collaborative Approach To Digital Collection Development, Melanie Shell-Weiss, Annie Benefiel, Kimberly Mckee

Open Access Publishing Support Funded Articles

In libraries and archives, efforts to document underrepresented communities and diversify collections can be fraught with political tension. We explore an interdepartmental collaboration to create and preserve a digital collection documenting the Urban Native Relocation Program of the mid- to late-twentieth century in Grand Rapids, Michigan. Involving the Grand Valley State University Libraries, the Kutsche Office of Local History, and the university’s Native American Advisory Board, the project serves as a model not just for collaborative collection development but also for community engagement and outreach. We find that process is as important as product in developing collaborative digital collections.

Evaluation Of A Pilot Multidisciplinary Debriefing Program: Promoting Pediatric Provider Emotional, Social, And Spiritual Wellbeing, Allison E. Reynolds

Doctoral Projects

Regular exposure to trauma, such as the act of bearing witness to intense suffering and pain of pediatric patients and families, has a significant effect on healthcare professionals. Despite the fact that traumatic situations in pediatrics are a reality, there is little education and few interventions focused on how to prepare and support healthcare providers to care for dying children and families or for other clinically challenging situations. Pediatric residency program directors within a large, freestanding children’s hospital identified a subjective need for support for their pediatric residents in dealing with clinically challenging situations faced during residency, motivating residency program …

A Quality Improvement Initiative To Provide Comprehensive Diabetic Management In A Rural Midwestern Clinic, Jodi A. Drenth

Doctoral Projects

An estimated 25.8 million people in the United States (US) have diabetes (Center for Disease Control and Prevention [CDC], 2014). The 2010 Patient Protection and Affordable Care Act led to an increased focus on Quality Improvement (QI) programs to reduce healthcare associated expenditures (Patient Protection and Affordable Care Act, 2010). The purpose of this Doctor of Nursing Practice (DNP) project was to address the following clinical question: Can the comprehensive diabetic bundle of quality metrics for type 2 diabetes mellitus (T2DM) patients in a rural Midwestern clinic be improved through (1) the creation of a QI protocol, (2) increased provider …

Development Of A Patient-Centered Medical Home Toolkit At An Integrated Primary Care Clinic, Lyndsay A. Randall

Doctoral Projects

Health care spending in the United States far exceeds that of other high-income countries (Squires & Anderson, 2015). In 2013, the U.S. spent 17.1 percent of its gross domestic product (GDP) on healthcare, which was almost 50 percent more than the next highest spender noted as France (Squires & Anderson, 2015). While the U.S. spends more on healthcare than other countries, multiple other health outcome measures are worse including life expectancy, heart disease, diabetes, and chronic respiratory illnesses (Squires & Anderson, 2015). Today’s healthcare system is highly fragmented, lacking the necessary coordination within the primary care setting. Better care coordination …

A Neighborhood-Based Family Center Redesign Process: Taking A Systems Perspective, Patricia Bowie, Richard Sussman

The Foundation Review

This article describes how the Hartford Foundation for Public Giving, with a subset of its grantees and their program recipients, teamed with the UCLA Center for Healthier Children, Families & Communities to redesign its evaluation process.

The foundation’s shift from traditional program evaluation to a more participatory, learning-focused approach resulted in new tools to assess variables that had been previously unexamined but were critical to program success.

This article examines the redesign process and those new tools – the data from which are being used to improve employee engagement and front-line practice as part of a cross-agency learning network – …

Implementation Of The Reengineered Discharge Process And Transitional Care Management At A Rural Critical Access Hospital, Chad L. Wilfong

Doctoral Projects

Healthcare in the United States is changing from a fee-for-service to a value based healthcare delivery system. One area of national focus is reducing 30-day hospital readmissions by providing high-quality transitions-of-care. Patients leaving the hospital without proper assessment of home care needs, patient education, and coordination of care run into barriers managing health conditions, which contributes to hospital readmissions. Poor transitions-of-care contribute to deterioration of health leading to acute care utilization and hospital readmissions, which is costly for healthcare organizations, insurance payers, and individuals. In 2017, the value based healthcare structure will be decreasing reimbursement to hospitals that have 30-day …

Preparing For The Merit-Based Incentive Payment Structure: A Value-Based Business Plan, Ali R. Saheb

Doctoral Projects

The notion of delivering value-based care while maintaining corporate vitality in health care is a multifaceted process. Shaping a business model to reflect this process requires the alignment of quality implications, reimbursement initiatives, a framework that takes into account stipulations on reimbursement for different types of clinicians, and an understanding and preparedness for emerging guidelines and nationally recognized structures for quality indicators. When organizations recognize the need for change, but are not yet prepared to implement it, a comprehensive business plan can help the organization visualize a path to success. In this project, the foundation of requirements for a value-based …

Return On Investment Comparison Of Three Payment Models For Chronic Care Management Under Medicare In A Northwestern Physician Hospital Organization, Megan J. Madole

Doctoral Projects

Chronic disease is the most prevalent and costly health condition. The coordination of care provided to those with multiple chronic conditions (MCCs) is suboptimal and fragmented. This population is among the highest utilizers of healthcare, and accounts for the majority of Medicare expenditures annually. Chronic care management (CCM) programs represent evidence-based initiatives shown to improve outcomes, reduce hospital and emergency department utilization, and reduce healthcare costs. Centers for Medicare and Medicaid Services (CMS) have provided various payment models for reimbursement of CCM services. Primary care practices have stated that inadequate reimbursement and confusing payment models are barriers to CCM implementation. …

Acceptability Of The Md Anderson Symptom Inventory And Qualitative Analysis Of Barriers To Palliative Care Services For Rural And Non-Rural Populations, Daniel M. W. Johnson

Doctoral Projects

The United States health system strives to improve the care patients receive while reducing healthcare expenditures. A significant portion of the nation’s healthcare expenditure is spent on end of life care. Palliative care provides one solution to reducing healthcare expenditures while improving the patient experience. Reducing symptom intensity is one example of palliative care’s success. A midwest palliative care program was tasked to gather quality data on the service’s ability to manage patient symptoms.

The program selected the MD Anderson Symptom Inventory to improve symptom assessment and provide quality metrics for the organization. Additionally, research suggests rural populations have poorer …

Why Small Businesses And Nonprofits Need An It Strategy, Osita Mefor

Technical Library

Technology has a tremendous impact on the potential for growth and success of any business or organization. Whether an organization already acquires elements of success, such as having great products and or service offering, good customer focus, and employees who are passionate about its development, the organization must integrate to its norms, an understanding of the full value of IT, in order to maintain the same level of success in this day and age. Without the use of technology, a business cannot function, let alone grow, meaning that technology is the future of business. Although businesses have been using technology …

Through The Looking Glass: Foundation Evaluation And Learning And The Quest For Strategic Learning, Suzanne Kennedy Leahy, Sandra Wegmann, Lexi Nolen

The Foundation Review

Strategic learning, a critical if relatively new lens for philanthropy, is neither simple nor efficient to institutionalize or practice yet — foundations are still figuring out how to do it well. In 2015, the Episcopal Health Foundation launched a project to distill lessons about how leading foundations configure evaluation and learning, and how they allocate related responsibilities in support of strategic learning.

This article addresses different models that foundations use to establish and staff evaluation and learning functions, what other organizational considerations they should take into account in order to prioritize strategic-learning work, and what tools and approaches can be …

Mission Shift: Using And Evaluating Strategic Communications To Implement Organizational Change, Taryn Fort, Kelci Price

The Foundation Review

Strategic communications can play a role in implementing organizational change by reinforcing understanding of and advancing audiences to accept the changes that impact them. The Colorado Health Foundation uses strategic communications as an integral tool in achieving its organizational mission to improve the health of all Coloradans. Evidence reveals that it was critical to successfully announcing and implementing significant changes to how the foundation operates and invests.

This article profiles the strategic communications approach, from its inception through the application of learnings gathered from a subsequent evaluation. The success of the foundation’s “change” communications strategy was rooted in use of …