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Understanding Clinical Tool Adoption In Primary Care: A Case Study Of The Cmds Care Pathway, Khushbu Khatri Park
Understanding Clinical Tool Adoption In Primary Care: A Case Study Of The Cmds Care Pathway, Khushbu Khatri Park
All ETDs from UAB
The rising prevalence of obesity, diabetes, and cardiovascular disease (CVD) places increasing strain on healthcare systems and primary care providers (PCPs). In response, the University of Alabama at Birmingham (UAB) adapted the Cardiometabolic Disease Staging System (CMDS), a validated clinical decision support tool, designed to stratify patient risk and guide evidence-based treatment. Embedded within the electronic health record (EHR) as a Care Pathway, the CMDS was designed for real-time use during primary care visits. This dissertation examines utilization of the CMDS in a two-phase case study, guided by the Adult Learning Theory, Group Dynamics Theory, Force Field Theory and Change …
Organizational Factors That Impact Emergency Room Sepsis Bundle Compliance In U.S. Hospitals, Jason Lee Kimbrell
Organizational Factors That Impact Emergency Room Sepsis Bundle Compliance In U.S. Hospitals, Jason Lee Kimbrell
All ETDs from UAB
ORGANIZATIONAL FACTORS THAT IMPACT EMERGENCY ROOM SEPSIS BUNDLE COMPLIANCE IN U.S. HOSPITALS JASON L. KIMBRELL HEALTH SERVICES ADMINISTRATION ABSTRACT This in-depth study examines the organizational factors within U.S. hospital emergency rooms (ERs) that impact care teams’ adherence to established, time-sensitive sepsis protocols. The regression analysis revealed a concerning trend: for each 1% increase in annual patient walk-out rates, compliance with sepsis protocols declines by 2.10%. Additionally, the impact on poor ER throughput where the ESI level 3 length of stay increases by 1 minute, a hospital's compliance with the 3hr POA sepsis bundle decreases by .08%. These findings underscore the …
Mandatory Grade Retention: A Phenomenological Study Of The Lived Experiences Of Principals During The Implementation Of The Alabama Literacy Act, Kiana Billings Coleman
Mandatory Grade Retention: A Phenomenological Study Of The Lived Experiences Of Principals During The Implementation Of The Alabama Literacy Act, Kiana Billings Coleman
All ETDs from UAB
ABSTRACT For over 40 years, the standards-based reform movement has significantly influenced educational policy in the United States (Shanahan, 2014). Educators across the country are under increasing pressure to improve student achievement as states implement policies that link test scores to accountability measures. Recently, the adoption of mandatory grade retention policies has emerged as a popular intervention for addressing low academic performance. Effective leadership is vital to the success of policy initiatives. However, there is limited research on how school principals experience mandatory retention policies. Understanding how administrators navigate retention policies is essential for identifying effective leadership strategies that facilitate …
Erosion Of Trust In Healthcare Leadership: An Analysis Of Anomie And Social Exchange During The Covid-19 Pandemic, Ashleigh Allgood
Erosion Of Trust In Healthcare Leadership: An Analysis Of Anomie And Social Exchange During The Covid-19 Pandemic, Ashleigh Allgood
All ETDs from UAB
Background: The COVID-19 pandemic disrupted healthcare systems worldwide, posing profound challenges for healthcare professionals. This study examined how the pandemic affected healthcare workers' trust in their leaders, comparing the acute 2021 phase and more managed 2022 period. Objective: To investigate how healthcare workers' experiences of moral distress, organizational change, belongingness, and perceived organizational support influenced trust in supervisors and senior leaders across two pandemic phases. Methods: Anonymous survey data were analyzed from healthcare professionals at a Southeastern U.S. academic medical center in 2021 (n=2,991) and 2022 (n=2,581). Ordinal logistic regression examined relationships between trust and experiences of moral distress, discrimination, …
The Relative Impact Of Transformational Leadership On The Academic Optimism Of High Poverty Urban Elementary Schools In Alabama, Cheritta Latrice Hayes
The Relative Impact Of Transformational Leadership On The Academic Optimism Of High Poverty Urban Elementary Schools In Alabama, Cheritta Latrice Hayes
All ETDs from UAB
THE RELATIVE IMPACT OF TRANSFORMATIONAL LEADERSHIP ON THE ACADEMIC OPTIMISM OF URBAN ELEMENTARY SCHOOLS IN ALABAMA In an era of accountability, educational leaders seek and implement reform efforts to help promote school improvement and student achievement on a regular basis (Marzano et al., 2014). When considering school improvement, a possible strategy to increase student achievement could be the relationship between the school leadership style and the characteristics of the organization that are within the control of the school leader. The purpose of this study was to examine the relative impact of transformational leadership on the academic optimism of schools. Elementary …
Organizational Climate And Its Association With Eth Perceived Permanence Of An Evidence-Based Decision-Aid For Patients With Lupus, Aizhan Karabukayeva
Organizational Climate And Its Association With Eth Perceived Permanence Of An Evidence-Based Decision-Aid For Patients With Lupus, Aizhan Karabukayeva
All ETDs from UAB
It is increasingly evident that seemingly good ideas do not always result in changes in practice, and it is challenging to sustain evidence-based innovations, even if they are backed by substantial research. Long-term use of innovations seems more likely where favorable contextual conditions are in place, yet relatively little empirical research has taken up the question of how evidence-based practices are sustained and become established in day-to-day practice. This question of sustainability is crucial if the gains in patient care that derive from organizational innovations are to be maintained. The purpose of this dissertation was to examine the relationship between …
Advanced Applications Of Existing Technology And Their Influence On Quality Outcomes In Federally Qualified Health Centers, Ali Riza Demirbas
Advanced Applications Of Existing Technology And Their Influence On Quality Outcomes In Federally Qualified Health Centers, Ali Riza Demirbas
All ETDs from UAB
Increasing competition in the healthcare industry is compelling organizations to adopt new strategies to obtain and/or maintain a competitive advantage. To obtain a competitive advantage, healthcare organizations may need either more efficient processes or offer new or improved products and services through the utilization of these strategies. In competitive market environments, technological innovations can be a key competitive advantage to reduce expenses, improve quality, attract more customers, or a combination of all. All healthcare organizations can benefit from technological innovations, especially those with limited resources. One type of healthcare organization that highlights the disparity in resources is the Federally Qualified …
The Adoption Of New Cancer Drugs In Non-Academic Cancer Centers, Warren M. Smedley
The Adoption Of New Cancer Drugs In Non-Academic Cancer Centers, Warren M. Smedley
All ETDs from UAB
Advancements in medical knowledge are producing significant improvements in medical technology, developing breakthrough drug therapies, advancing the practice of medicine, and improving outcomes for cancer patients. However, there are delays in getting new and improved therapies incorporated into routine clinical use, depriving cancer patients of valuable and potentially lifesaving treatments. The purpose of this study was to examine the rate of adoption of new cancer drug discoveries into routine clinical practice in non-academic cancer centers. The process of adoption takes a period of time to embrace new therapies, due in part to a prescriber’s need to gain greater comfort with …
An Examination Of The Relationship Between The Role Of The Chief Diversity Officer And Hospital Financial Performance And Patient Experience Measures, Kemberly L. Blackledge
An Examination Of The Relationship Between The Role Of The Chief Diversity Officer And Hospital Financial Performance And Patient Experience Measures, Kemberly L. Blackledge
All ETDs from UAB
Healthcare organizations drive to achieve hospital measures has much to do with strategies put in place by the executive leadership team and resources of the firm. Forces such as regulatory changes reducing hospital payments and external forces such as social injustices leave executives turning to innovative ways to improve the bottomline. This study examined the Chief Diversity Officer (CDO) and the relationship with hospitals measures of financial performance and patient experience for hospitals with a CDO and without a CDO. Hospitals with a CDO can deploy organizational strategies such as diversity management and cultural competencies. These strategies are important because …
The Role Between Transactive Memory Systems In The Relationship Between Psychological Safety & Quality In Interprofessional Healthcare Teams, Tera L. Webb
All ETDs from UAB
During uncertainty, the optimum solution for work-related problems or patient care cases require the scopes of practice and competencies beyond a single profession. For this reason, the collaborative efforts of interprofessional teams are a widely used approach to patient care and medical decision making. The interdependency between healthcare professionals with varied expertise and input often lead to desired outcomes. Beyond the structure of the team, there are numerous cognitive processes at play that impact knowledge transfer in highly skilled teams that impact outcomes. Therefore, this dissertation will review relevant literature on two cognitive constructs – psychological safety and transactive memory …
Intra-University Collaboration Between And English Language Center And A Disability Resource Office To Support International Students With Disabilities: A Bridge Towards Inclusive Excellence, Matthias Maunsell
All ETDs from UAB
As universities endeavor to increase international student enrollment, they are also legally mandated to support international students with disabilities (ISWDs). For ISWDS engaged in English language study, both the English Language Center (ELC) and the Disability Resource Office (DRO) are directly implicated in their educational success. However, the connection between these two units and their efforts to leverage institutional resources have received limited attention. Guided by the Inclusive Excellence model that centers diversity, equity, and inclusion in all aspects of higher education and strongly emphasizes campus partnerships, this study explored the interrelationship between an ELC and a DRO in support …
Effectiveness Of A University Employee Assistance Program Using The Workplace Outcome Suite And Client Satisfaction Survey, Josephine Jackson Banks
Effectiveness Of A University Employee Assistance Program Using The Workplace Outcome Suite And Client Satisfaction Survey, Josephine Jackson Banks
All ETDs from UAB
Background: Gallup (2013) reported that 30% of the U.S. workforce was not engaged in their work which means they were not reaching their full potential or productivity level. For organizations, lost productivity due to absenteeism or less than ideal performance at work impacts company performance and bottom line. Employee assistance programs are a resource to help increase employee health, productivity, and satisfaction through counseling interventions. Methods: Data were collected by a large urban university EAP over a 20-month period. The analysis was limited to EAP clients over the age of 18. A total of 866 subjects participated in this study, …
A Grounded Theory Study: The Lived Experiences Of K-12 Administrators Regarding Leadership Effectiveness Over Time, Sandy Georgette Deades Ritchey
A Grounded Theory Study: The Lived Experiences Of K-12 Administrators Regarding Leadership Effectiveness Over Time, Sandy Georgette Deades Ritchey
All ETDs from UAB
The purpose of this study was to generate a theory in education comparable to studies in other disciplines by exploring how current leadership theories can be expanded to explain how leadership effectiveness changes over time. This study explored active and retired principals' experiences to see how their effectiveness may or may not have changed over time. I was particularly interested in learning if there was a point in their careers when they perceived that they were no longer as effective as they used to be or could have been, what this looked like, and how this guided their next steps. …
Examining Approaches For Peacebuilding In Post-Conflict, Post-Good Northern Ireland, Evan Wiley Smith
Examining Approaches For Peacebuilding In Post-Conflict, Post-Good Northern Ireland, Evan Wiley Smith
All ETDs from UAB
In this paper, I broadly describe the timeline of the conflict in Northern Ireland, examine negative and positive peace approaches to peacebuilding including political (or consociationalism-based), human rights-based, and reconciliation-based methods, and present my own conclusions based on the literature review I conducted as to the most efficacious strategy for ensuring long-lasting peace in Northern Ireland. To do this, I reviewed numerous articles, papers, and chapters on the conflict in Northern Ireland, approaches in post-conflict reconciliation, and conflict resolution theory. Because the conflict in Northern Ireland ended approximately twenty years ago, much of the research referenced in this paper is …
An Investigation Of Strain And Support Needs Of Caregivers Of Older Adults With Delirium And Allied Health Promotion Interventions, Jasmine Vickers
An Investigation Of Strain And Support Needs Of Caregivers Of Older Adults With Delirium And Allied Health Promotion Interventions, Jasmine Vickers
All ETDs from UAB
Delirium, or the sudden onset of confusion, is common, highly distressing, debilitating, and deadly among hospitalized older adults and is associated with adverse outcomes for their family caregivers. As people are living longer with more complex conditions, more people will face the task of caregiving for older adults with delirium. Family caregivers can make meaningful contributions to delirium care, but high distress, insufficient knowledge, and lack of skills often seen in caregivers can lead to maladaptation and negative health outcomes. A few studies have focused on distress in caregivers from witnessing delirium episodes; however more research is needed to understand …
Examining Teacher Perceptions Of Professional Learning Teams And Teacher Professionalism, Rebecca Thomas Stripling
Examining Teacher Perceptions Of Professional Learning Teams And Teacher Professionalism, Rebecca Thomas Stripling
All ETDs from UAB
EXAMINING TEACHER PERCEPTIONS OF PROFESSIONAL LEARNING TEAMS AND TEACHER PROFESSIONALISM This study explores the perceptions of teachers’ professionalism as they participate in professional learning teams. Through a qualitative lens, teacher perceptions of how their own professionalism (as indicated by the Professionalism Index by McMahon & Hoy, 2009) is influenced or affected as a result of their participation in a PLT were examined from the perspective of teachers that fell into three categories, those teachers that scored high on the Professionalism Index, those teachers that scored low on the Professionalism Index and those teachers that had a medium score on the …
An Exploratory Study Of The Influence Of Perceived Organizational Support, Coworker Social Support, The Nursing Practice Environment, And Nurse Demographics On Burnout In Palliative Care Nurses, Marcia Ann Lowe
All ETDs from UAB
AN EXPLORATORY STUDY OF THE INFLUENCE OF PERCEIVED ORGANIZATIONAL SUPPORT, COWORKER SOCIAL SUPPORT, THE NURSING PRACTICE ENVIRONMENT, AND NURSE DEMOGRAPHICS ON BURNOUT IN PALLIATIVE CARE NURSES MARCIA A. LOWE SCHOOL OF NURSING ABSTRACT Burnout, a condition characterized by emotional exhaustion, depersonalization, and decreased personal accomplishment, has been studied in many disciplines in healthcare, including nursing, medicine, and social work. Working with palliative care patients and their families is innately challenging and may predispose nurses to burnout. The purpose of this study is to examine the influence of perceived organizational support (POS), coworker social support, the nursing practice environment, and nurse …
Psychosocial Job Stress And Oxidative Stress In Emergency Department Nurses, Rupkatha Bardhan
Psychosocial Job Stress And Oxidative Stress In Emergency Department Nurses, Rupkatha Bardhan
All ETDs from UAB
Job stress often causes work-related physical injuries and chronic exposure to such environment may lead to poor health outcomes. Job stress in recent years has grown significantly within the workforce due to performance pressure, long work hours and poor pay structures. Nurses work in the forefront to save patients’ lives. High job demand in this noble profession often leads to progressive decline in physical and mental health. There are existing reports that nurses in the United States (US) suffer from “burnout” syndrome which may also negatively affect patient care. There are very few studies that measured work-related stress in nurses …
A Study To Examine The Relationship Between Hospital Mergers And Patient Experience, Timothy William Attebery
A Study To Examine The Relationship Between Hospital Mergers And Patient Experience, Timothy William Attebery
All ETDs from UAB
Since 2009, the United States has experienced another wave of hospital mergers. Consequently, health systems are getting larger and increasing their market concentration. How patients benefit from hospital consolidation remains an open issue for policy-makers, economists, health care executives, community leaders, politicians, government agencies, and others. One measure of healthcare consolidation’s impact, and its potential benefit/detriment, is how mergers affect patient experience, which, since 2007, has been measured by the standardized HCAHPS instrument. Hundreds of studies conducted over the past 50 years have found mergers trigger an internal, socially-disruptive effect in the first 12 to 24 months following the event …
Home Healthcare And Performance: Development And Application Of A Typology For Home Health Agencies, Ronique Nechelle Evans
Home Healthcare And Performance: Development And Application Of A Typology For Home Health Agencies, Ronique Nechelle Evans
All ETDs from UAB
This three-paper dissertation sought to examine the existence of strategic groups in the home health industry, the application of Porter’s generic strategies (cost leader, differentiator, “stuck-in-the-middle” and both cost leader/differentiator) in identifying these groups, and the association of group membership with agency performance. The findings of this study will provide researchers and managers with a highlight of the current strategic makeup of the home health industry and its relationship with quality and financial performance. The results of this dissertation provide some evidence that strategic groups do exist in the home health industry and can be described along the basis of …
Addressing School District Readiness For Elementary Health Education Using The Transtheoretical Model, Sarah Toth
Addressing School District Readiness For Elementary Health Education Using The Transtheoretical Model, Sarah Toth
All ETDs from UAB
The elementary classroom offers a potentially favorable setting to impact student health. However, research indicates that elementary health education (EHE) is frequently omitted or haphazardly delivered. Traditional efforts in educational change have had limited success and lack a theoretical foundation. The purpose of this study was to investigate the organizational readiness of a public school district in Alabama for the delivery of 60 minutes of weekly EHE using constructs of the Transtheoretical Model (TTM). This study was intended to identify the stage of readiness, decisional balance, self-efficacy, the extent to which the school district was engaging in behaviors that may …
Hospital Vertical Integration Into Sub-Acute Care Services, Carolyn Tory Harper Hogan
Hospital Vertical Integration Into Sub-Acute Care Services, Carolyn Tory Harper Hogan
All ETDs from UAB
The purpose of this dissertation was to examine the antecedents and outcomes of hospital vertical integration into Sub-Acute Care (SAC). Using a sequential quanqual mixed methods design, we examined why hospitals adopt a vertical integration strategy and the relationship this strategy has to performance. Findings from this dissertation are important to hospital administrators as they seek to find ways to respond to the changing payment structures established during the Affordable Care Act. The results of this dissertation suggest that not all market and organizational factors are associated with vertical integration strategies toward SAC. They also suggest that vertical integration into …
Liberty And Collaboration For All: A Case Study On Collective Impact, Social Capital, And Community Inclusion, Laura Peyton Vickery
Liberty And Collaboration For All: A Case Study On Collective Impact, Social Capital, And Community Inclusion, Laura Peyton Vickery
All ETDs from UAB
Disenfranchised communities often face exclusion at the hands of outside organizations trying to assist. Citizens within the community are excluded and left with few means of actively participating in the conversation and development surrounding these communities. This paper takes the position that the imbalance of power dynamics, where citizens become subjects, does not fully utilize the potential of those inside and those from outside the community. As discussed in Chapter 1, utilizing social capital to build networks and integrate insider and outsider organizations and resources will ultimately create optimization. Chapter 2 uncovers historical examples of civic life and a new …
Rural Hos[Ital Closure In Alabama - Post Aca, Dennis Otto Mccay
Rural Hos[Ital Closure In Alabama - Post Aca, Dennis Otto Mccay
All ETDs from UAB
RURAL HOSPITAL CLOSURES IN ALABAMA: POST ACA DENNIS O. MCCAY HEALTH SERVICES ADMINISTRATION ABSTRACT Rural hospitals differ from their urban counterparts with regard to two main areas. First, rural hospital patients are usually older, of lower income, and less healthy than those in urban areas. Second, their facilities tend to be smaller, older, and more prone to staff shortages than those in an urban environment. Rural hospitals have been closing at higher rates than their urban counterparts for a number of years, but more so since the implementation of the Affordable Care Act in 2010. The objective of this research …
The Effect Of Joining A Health System On Financial Performance, Kenneth Joseph Cochran
The Effect Of Joining A Health System On Financial Performance, Kenneth Joseph Cochran
All ETDs from UAB
The rate of hospitals merging has increased significantly over the last few years. The number of hospital mergers between 2003 and 2009 averaged 55 per year, while mergers for 2010 and 2011 were 72 and 90, respectfully. This research moved beyond anecdotal reports and by using publicly reported data to not only evaluate the financial success of mergers, but also to look at other factors such as size, ownership, geography, environment (urban vs. rural), and market competitiveness to assess impacts on financial outcomes of mergers. This study examined the effect of joining a hospital system based on financial performance. Further, …
Chief Executive Officer Characteristics In Relationship With Patient Experience Scores Of Hospital Value Based Purchasing, Christina Galstian
Chief Executive Officer Characteristics In Relationship With Patient Experience Scores Of Hospital Value Based Purchasing, Christina Galstian
All ETDs from UAB
ABSTRACT Patient experience scores have become important indicators of value in healthcare. This study was the first of its kind to examine CEO gender, tenure, and education in relationship with patient experience scores and all other value based purchasing scores, such as outcome, efficiency, clinical process of care, and total performance scores. This study suggested that hospitals with certain types of CEOs may perform better with respect to patient experiences and other value based purchasing scores. The primary analysis of this study was to examine the impact of hospital CEO characteristics (tenure, education, gender) on patient experience scores. A supplementary …
The Role Of The Teacher In Family Involvement: A Multiple Case Study, Terri Garrison
The Role Of The Teacher In Family Involvement: A Multiple Case Study, Terri Garrison
All ETDs from UAB
The purpose of this qualitative multiple case study was to explore the teacher's role in family involvement in preschool classrooms. Family involvement has been a relevant topic for early childhood educators for many years (Hoover-Dempsey & Sandler, 1995). When families are involved in their child's school experience, it has added a positive benefit to the child's development (Chavkin, 2005; Swick, 2004; Marcon, 1999). Regardless of this widely held belief, many families face barriers that prevent involvement from occurring (Gallimore & Goldenberg, 2001; Lamb-Parker, Piotrkowski, Baker, Kessler-Sklar, Clark, & Peay, 2001). This multiple case study was designed to answer the following …
Safety Culture And Patient Harm, Alfonso Gatmaitan
Safety Culture And Patient Harm, Alfonso Gatmaitan
All ETDs from UAB
SAFETY CULTURE AND PATIENT HARM EVENTS: A CONTINGENCY THEORY PERSPECTIVE IN THE CONTEXT OF COMPLEX ADAPTIVE SYSTEMS ALFONSO GATMAITAN ADMINISTRATION-HEALTH SERVICES ABSTRACT This study examines the correlation between a Culture of Patient Safety as measured by hospital staff surveys and actual patient harm attributed to hospital performance. It is generally accepted by health care management leaders that the presence of a strong culture of patient safety has become a critical component in reducing patient harm. However, little empirical evidence within multiple hospitals over time exists to support this belief. Healthcare managers can utilize this evidence in formulating patient safety improvement …
Internet Use And Depression: The Roles Of Emotional Support And Online Support Groups, Aowen Zhu
Internet Use And Depression: The Roles Of Emotional Support And Online Support Groups, Aowen Zhu
All ETDs from UAB
This paper explores the mediating mechanisms between internet use and depression among African Americans and Caribbean Blacks. The hypotheses are that emotional support and online support groups (OSGs) mediate the association between internet use and depression. Data come from the National Survey of American Life conducted between 2001 and 2003 that includes a nationally representative sample of African Americans and Black respondents of Caribbean descent (N=4771). Depression is measured by the Center for Epidemiological Studies-Depression scale with 12 questions. Internet use is measured as frequency of use. Emotional support is measured by a scale of 3 questions. OSGs are measured …
Hospital-Based Skilled Nursing Facilities: Predictors Of Survival And Performance, Shivani Gupta
Hospital-Based Skilled Nursing Facilities: Predictors Of Survival And Performance, Shivani Gupta
All ETDs from UAB
This three-paper dissertation examined the organizational and market factors predicting the response of hospital-based skilled nursing facilities (HBSNFs) to the changes in their environment such as the implementation of prospective payment system in 1998 and their role in coordination of care for patients in transition from acute care to home or a post-acute care facility. In the first study, population ecology of organizations framework was used to evaluate the organizational and market factors associated with HBSNFs’ closure after 1998. The event histories of all acute-care hospitals which had an open HBSNF in 1998 were examined across 15 years (1998-2012) to …