Business Commons^™

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 …

A High-Level Overview Of How The New Accounting Standard Update On Revenue Recognition Impacts The United States Healthcare System, Leslie Johnson

Undergraduate Honors Theses

In May of 2014 the Financial Accounting Standards Board (FASB) and the International Accounting Standards Board (IASB) issued a long-awaited joint updated standard on revenue recognition, ASU 2014-09 – Revenue from Contracts with Customers. While almost all entities will be affected to some extent by the new standard, particularly the changes in required disclosures, this research seeks to examine the impact the new standard will specifically have on the healthcare industry. By highlighting areas of significant challenge a better understanding will be gained of the impact health care service entities will experience as they transition to a new standard.

Effects Of Incorporating Patient Acuity Into The Rn Assignment Process, Melissa L. Forton

Evidence-Based Practice Project Reports

As the largest sector of healthcare, nurses are the primary providers of patient care. By 2025, it is estimated that there will be a shortage of over 250,000 registered nurses (RNs) (American Association of Colleges of Nursing, 2011). Factors contributing to the nursing shortage include increased complexity of patients and decreased staffing that leads to decreased job satisfaction (Fox & Abrahamson, 2009). Over half of neonatal intensive care nurses reported missing at least one nursing task per shift when staffing was inadequate or patient acuity was high (TubbsCooley, Pickler, Younger, & Mark, 2015). The purpose of this evidence-based practice (EBP) …

Determining The Effects Of Hospital Consolidation: An Examination Of The Impact Of Hospital M&A On Financial And Quality Metrics, Hailey Perry

Honors Theses

The modern explosion of M&A activity in the United States has generated significant controversy and advocates both for and against hospital consolidation have been quite vocal in presenting their cases. Using mergers and acquisitions reports from Irving Levin Associates as well as financial and quality metrics from the Centers for Medicare and Medicaid Services and the American Hospital Directory, this study examines the differences between consolidated and unconsolidated hospitals in terms of overall revenue and quality, in addition to prices and costs for specified diagnoses.

Consolidated hospitals undergo significant changes during their transition and oftentimes operate in a manner different …

Prenatal Opioid Maintenance In The U.S. And Its Effect On Neonatal Abstinence Sysndrome: The Case Of West Virginia's Opioid Epidemic, Morgan Ruley

Theses, Dissertations and Capstones

Introduction: West Virginia’s opioid epidemic has been the cause of about 1,000 deaths each year. Opioid abuse has become an issue among pregnant mothers and has increased the effects of NAS in infants. The purpose of this research study was to evaluate the participation of prenatal opioid maintenance to determine if it has decreased the amount of treatment needed for NAS in infants in WV.

Methodology: The methodology for this study utilized a literature review and a semi-structured interview. It consisted of academic sources, five electronic databases, academic journals, and government websites. Thirty-seven sources were referenced for this literature …

Harm Reduction Programs: West Virginia Vs. United States, Morgan L. Belcher, Hannah Sayre

Theses, Dissertations and Capstones

Introduction: Harm reduction has been a movement for social justice built on a belief in, and respect for, the rights of people who use drugs. It has been defined as a set of practical strategies and ideas aimed at reducing negative consequences associated with drug use. The U.S. has been experiencing an opioid/heroin epidemic, with significant increases in overdose death among drug users with more than 72,000 Americans having died from drug overdoses in 2017.

Methodology: The methodology for this study was a literature review with a semi structured interview with Tina Rameriz of the Kanawha-Charleston Health Department …

The Process Of Adoption Of Disruptive Innovations In Local Health Care Agencies Delivering Primary Care, Aurora Aguirre Polanco

Open Access Theses & Dissertations

The current state of the U.S. health care system is complex and limit access to care to many consumers, thus compromising their health outcomes. The problems of limited access and questionable quality can be addressed by focusing on enhancing the primary health care field. Improvements in both the access and performance of primary health care agencies, derive in better health outcomes and cost savings to the system in the long-term. Disruptive innovations, that make products and services simpler and more affordable, are adopted in agencies and potentially improve access and performance measures. However, the adoption of disruptive innovations in local …

Accountable Care Organization Success Strategies: The Importance Of System Changes, Shelly Pierce

Walden Dissertations and Doctoral Studies

Accountable care organizations (ACOs) are a new health care reform initiative that has been highlighted as one of the most important organizational structures that could lead to quality improvements and cost savings in the United States through shared savings. The inability of health care managers to successfully implement ACOs could result in financial losses, reduced patient access to health care, and poor patient outcomes. Grounded by von Bertanlaffy's general systems theory, the purpose of this multiple case study was to explore the system change strategies health care managers used to implement an ACO to meet ACO quality and cost standards. …

Exploring Management Practices Of The Health Care System For Contractors, Gary L. Williams

Walden Dissertations and Doctoral Studies

Researchers have found that military members serving in war experienced changes in physical and mental health. Military members' healthcare is managed by the Department of Defense. The problem was that management practices of the system for providing long-term healthcare for employees of a contracting company working in foreign combat zones is either minimal or nonexistent. The purpose of this case study was to explore ways that contractor managers and government managers can work together to provide healthcare for those contract employees who will be deployed with the U.S. military. The primary research question was to determine what managers of contractors …

Strategies For Improving Healthcare Efficiency While Reducing Costs, Jean Calvin Tchatchoua

Walden Dissertations and Doctoral Studies

In comparison to the European healthcare system, the U.S. healthcare system has lower quality care, higher costs, and covers a smaller percentage of the population. Despite the high costs, the U.S. healthcare system remains dysfunctional. The purpose of this exploratory single case study was to identify the strategies that some healthcare managers in a hospital setting in the midwestern region of the United States use to improve efficiency while decreasing healthcare costs. Complex adaptive systems theory was used to frame this study that included face-to-face interviews with 6 highly experienced healthcare managers. Data were collected from audio recorded interviews and …

Strategies For Applying Electronic Health Records To Achieve Cost Saving Benefits, Daniel Kanyi Ngunyu

Walden Dissertations and Doctoral Studies

The American Recovery and Reinvestment Act (ARRA) of 2009 authorized the distribution of about $30 billion incentive funds to accelerate electronic health record (EHR) applications to improve the quality of care, safety, privacy, care coordination, and patients' involvement in healthcare. EHR use has the potential of saving $731 in costs for hospitals per patient admission; however, most hospitals are not applying EHR to reach the level at which cost savings are possible. The purpose of this single case study was to explore strategies that IT leaders in hospitals can use to apply EHR to achieve the cost saving benefits. The …

Strategies For Developing And Implementing Information Technology Systems For Ehrs, Priscilla Riddley

Walden Dissertations and Doctoral Studies

Some hospital leaders lack the technical expertise to implement electronic health records (EHRs) even though the healthcare industry has a government mandate. The purpose of this single case study was to explore strategies healthcare executives use to develop and implement information technology systems for processing EHRs. The target population consisted of healthcare leaders and managers successful in implementing EHR systems in a healthcare organization. Lewin's 3-step change theory was used as the conceptual framework for this study with data collected from observations (5), semistructured interviews (5), and organizational documents. Descriptive coding was used to identify 3 themes that emerged from …

Management Of Inappropriate Behaviors By Healthcare Risk Managers, Sahar Ebrahim Zadeh

Walden Dissertations and Doctoral Studies

Medical errors are the 3rd leading cause of death in the U.S.. The problem is timely recognition and management of inappropriate healthcare worker behaviors that lead to intimidation and loss of staff focus, eventually leading to errors. The purpose of this qualitative modified Delphi study was to seek consensus among a panel of experts in hospital risk management practices on the practical methods for early detection of inappropriate behaviors among hospital staff, which may be used by hospital managers to considerably mitigate the risk of medical mishaps. High reliability theory guided the research process, utilizing the conceptual framework of fair …

Strategies Department Store Managers Use To Increase Employee Engagement, Samara Desir

Walden Dissertations and Doctoral Studies

Business leaders are challenged with sustaining an engaged workforce to achieve economic prosperity in their organizations. The implementation of effective strategies to increase employee engagement can mitigate the challenges of employee disengagement. The purpose of this qualitative, single case study was to explore the strategies that department store managers used to increase employee engagement. The conceptual frameworks selected for the research were Vroom's expectancy theory of motivation and Kahn's engagement theory. The research participants consisted of 5 department store managers, from the northeastern United States, who successfully used strategies to increase employee engagement. Data were collected from the participants in …

Strategies To Mitigate Information Technology Discrepancies In Health Care Organizations, Oluwatosin Tolulope Oluokun

Walden Dissertations and Doctoral Studies

Medication errors increased 64.4% from 2015 to 2018 in the United States due to the use of computerized physician order entry (CPOE) systems and the inability to exchange information among health care facilities. Healthcare information exchange (HIE) and subsequent discrepancies resulted in significant medical errors due to the lack of exchangeable health care information using technology software. The purpose of this qualitative multiple case study was to explore the strategies health care business managers used to manage computerized physician order entry systems within health care facilities to reduce medication errors and increase profitability. The population of the study was 8 …

Strategies To Implement Innovations In Hospitals, Schola Mutumene Kabeya

Walden Dissertations and Doctoral Studies

The Patient Protection and Affordable Care Act, which promoted quality of care, started the transformation of healthcare systems in the United States. The purpose of this qualitative multiple case study was to explore clinical practice innovation strategies used by hospital middle managers to improve quality of care and profitability. Pettigrew's theory was the conceptual framework for this study. Participants were 8 middle managers from 2 high-performing hospitals in the southwestern region of the United States. Data were collected from semistructured interviews, personal notes, and review of the hospital's publicly reported documents and literature. Member checking and methodological triangulation increased the …

Examining The Relationship Between Organizational Climate And Organizational Citizenship Behaviors Within Hospitals, Michelle Christine Maus

Walden Dissertations and Doctoral Studies

Members of the healthcare industry have not fully understood organizational climate factors that enhance organizational citizenship behaviors (OCBs). This lack of understanding can result in negative patient outcomes. The purpose of this cross-sectional quantitative study was to examine the relationships between organizational climate factors and OCBs of employees at hospitals via person-organization fit theory. More, specifically, the purpose of this research was to explore (a) the relationships between organizational climate variables (i.e., welfare, autonomy, involvement, effort, training, integration, and supervisory support) and OCBs (n = 218), (b) differences in OCB scores between hospital leaders (n = 72) and followers (n …

Factors Influencing Emergency Registered Nurse Satisfaction And Engagement, Catherine Larock-Mcmahon

Walden Dissertations and Doctoral Studies

Employee satisfaction and engagement have a direct impact on customer satisfaction. Dissatisfaction and disengagement lead to an increased intent to leave a job, poor patient outcomes, and decreased productivity. The retention and recruitment of qualified staff becomes an urgent priority to ensure safe and prudent patient care. The purpose of the qualitative research study was to better understand the beliefs, attitudes, perceptions, and reasons for emergency department registered nurses (ED RN) satisfaction and engagement in the workplace focusing on Herzberg's, Vroom's, Yetton's, Maslow's, Benner's, and Kahn's motivation and engagement theoretical frameworks. The qualitative case research study focused on satisfaction and …

Strategies For Shipping Temperature-Sensitive Medical Devices Using Cognitive Mapping, Eric C. Guynes

Walden Dissertations and Doctoral Studies

Supply chain management (SCM) practitioners who ship temperature-sensitive diagnostic medical devices (DMDs) to clinicians must use effective cold chain management (CCM) strategies to avoid temperature excursions that contribute to medical device errors. Such errors have caused patient harm and death, which costs the U.S. health care system billions of dollars per year. The purpose of this qualitative multiple case study was to explore strategies for selecting and managing cold chain shipping solutions (CCSSs) requiring SCM executives to trade cost for regulatory compliance and predictability when mitigating temperature variations that occur during shipping. The conceptual framework for the study was the …

Strategies For Increasing Volunteer Engagement In Nonprofit Healthcare Organizations, Sanja Katina Hudson

Walden Dissertations and Doctoral Studies

Implementing effective strategies to address the challenges of volunteer engagement is critical for helping ensure the sustainability of nonprofit healthcare organizations. Nonprofit healthcare leaders seek strategies to increase the volunteer workforce and enhance volunteer engagement. Through the conceptual lens of Deci and Ryan's self-determination theory, the strategies nonprofit healthcare leaders used to reduce volunteer turnover were explored in this single-case study. Data were collected using semistructured interviews with 5 nonprofit healthcare leaders from a single organization in the southwestern United States. Analysis of internal and external organizational documents and publicly available data were manually coded and thematically organized. The use …

Impact Of Empowerment And Autonomy On The Nursing Director's Intent To Stay, Tiffany Bergquist

Walden Dissertations and Doctoral Studies

Retention of nursing directors is important to the viability and success of the healthcare industry because they have a large impact on nursing job satisfaction, overall retention of nurses in an institution, productivity, and patient outcomes. Factors that retain nurse directors, such as autonomy and empowerment, appear to be important to job satisfaction, but there is little in the current research to corroborate these findings. The purpose of this quantitative study was to determine what factors impact nursing directors' intent to stay in their current role and what effect role autonomy and empowerment have on their intent to stay as …

Successful Project Management, Tomomi M. Horning

Walden Dissertations and Doctoral Studies

High project failure rates result in billions of wasted dollars each year. Project failure does not discriminate by type of project or the industry from which they originate. The purpose of this qualitative single case study was to explore strategies that leaders at a health care organization located in Pennsylvania use to manage projects successfully. This population was selected due to the health care organization's reputation for successful project completion. The conceptual framework for this study was Fiedler's contingency theory. Data were collected by conducting semistructured interviews with 9 project leaders and reviewing project documents provided by study participants. Interviews …

The Impact Of Work Experience On Commitment To The Healthcare Administration Profession, Caroline Sweny

Honors Theses and Capstones

This research study analyses the relationships between career commitment and gender, career status, and career satisfaction. Results indicated three major findings. First, men are more likely to be committed to the healthcare administration profession. Second, commitment to the healthcare administration profession decreases as individuals advance further into their career. Third, commitment to the healthcare administration profession decreases the more satisfied an individual is with the progress they have made toward meeting their overall career goals. Further research is needed to understand the implications behind these findings.

Strategies For Healthcare Payer Information Technology Integration After Mergers And Acquisitions, Kishore Maranganti

Walden Dissertations and Doctoral Studies

Despite the high rate of failure in merger and acquisition (M&A) transactions, many organizations continue to rely on M&As as their primary growth strategy and to address market competition. The purpose of this qualitative single case study was to explore strategies managers from a large healthcare payer in the midwestern United States used to achieve operational and strategic synergies during the postacquisition information technology (IT) integration phase. Haspeslagh and Jemison's acquisition integration approaches model was the conceptual framework for the study. Methodological triangulation was established by analyzing the data from the semistructured interviews of 6 senior executives and 6 IT …

Chaplaincy Inclusion In Hospital Interdisciplinary Teams And Its Impact On Chaplains' Well-Being, Chike Nzegwu

Walden Dissertations and Doctoral Studies

Healthcare providers may impede the delivery of spiritual and emotional support to

patients and their families by healthcare professional chaplains if they misunderstand how to effectively use chaplains, who often prefer to be engaged sooner than they are. This issue prevents highly trained, board-certified professional chaplains from providing services, thereby impacting the quality of patient care. The purpose of this phenomenological study was to examine, through the lived experiences of professional chaplains, the extent to which chaplains feel that others perceive them as valued members of an interdisciplinary team (IDT), as well as to determine how team inclusion may impact …

The Survival Of Healthcare In Rural Texas, Destin Cook

Walden Dissertations and Doctoral Studies

Over 80 rural hospitals have closed in the United States since 2010, representing about half of all hospital closures during this period, and another 600-700 rural hospitals are at risk of closing shortly. The purpose of this qualitative exploratory multiple case study, which was based on transformational leadership and diffusion of innovation theories, was to gain a common understanding of financial problems and operational inefficiencies that may be impacting rural hospital leaders in the state of Texas. Data collection involved semi-structured interviews with 4 senior healthcare leaders from 3 separate regions in Texas. Data analysis included compiling, sorting, fragmenting, and …

The Balance Between Financial And Quality Performance In For-Profit Hospitals Versus Non-Profit Hospitals, Blake Seidner

CMC Senior Theses

Recent trends of financial distress for non-profit hospitals and the uptick in acquisition of these hospitals by for-profit entities indicate different focuses from the management of each type of hospital. Using data on hospital quality and basic financial measures, this study examines shift in the balance of financial and quality performance. The dataset focuses on private non-profit and for-profit hospitals with low bed counts, ranging from 50-200 total beds. Results indicate a positive relationship between for-profit status and basic financial performance measures, such as profitability, and a negative relationship with patient experience, cost reduction for the patient, and overall quality. …

Reducing Sepsis Mortality: A Cloud-Based Alert Approach, Janet A. Zink

Theses and Dissertations

The aim of this study is to examine the impact of a cloud-based CDS alerting system for SIRS, a precursor to sepsis, and sepsis itself, on adult patient and process outcomes at VCU Health System. The two main hypotheses are: 1) the implementation of cloud-based SIRS and sepsis alerts will lead to lower sepsis-related mortality and lower average length of stay, and 2) the implementation of cloud-based SIRS and sepsis alerts will lead to more frequent ordering of the Sepsis PowerPlan and more recording of sepsis diagnoses. To measure these outcomes, a pre-post study was conducted. A pre-implementation group diagnosed …

Examining Injury Data Reporting Practices Among Wildland Firefighters, Erin M. Boggs

Graduate Student Theses, Dissertations, & Professional Papers

Wildland Firefighter (WLFF) Crews lack an injury surveillance program to collect information on non-traumatic and traumatic injuries. Tactical athletes including: police, military and structural firefighters all have a variety of collection systems in place for injury data collection. The lack of injury data prevents WLFF crews from identifying high-risk environments, implementing injury prevention programs, and improving the overall quality of care on the job. Over the last several decades the recent rise in wildfire occurrences and wildfire suppression costs creates a need for healthy and strong individuals in the field. The cost of firefighter salaries and medical care can be …