Business Commons^™

Preventable Error Reduction Leadership Strategies Of Nurse Managers In A Hospital Setting, Sedrick Diego Bedolla

Walden Dissertations and Doctoral Studies

AbstractPreventable medical errors in the healthcare industry account for hundreds of thousands of patient deaths annually. Nurse managers strive to develop strategies to reduce incidences of preventable medical error and increase patient safety in their organization to improve performance and reduce harm in the healthcare industry. Grounded in the complex adaptive systems theory, the purpose of this qualitative single case study was to explore strategies nurse managers use to reduce the rate of preventable medical errors among employees. The participants comprised 6 nurse managers who successfully used strategies to lower the rate of preventable errors in a healthcare facility in …

Strategies For Managing Work-Related Stress In The Petroleum Industry, Esang Lazarus Esitikot

Walden Dissertations and Doctoral Studies

High work-related stress negatively impacts workers’ health and productivity in the Nigerian petroleum industry. Supervisors in the Nigerian petroleum industry who lack strategies to reduce work-related stress significantly lose worker health and organizational productivity. Grounded in person-environment fit theory, the purpose of this qualitative multiple case study was to explore strategies Nigerian petroleum industry supervisors use to manage work-related stress. Participants were six supervisors who have successfully used strategies to reduce work-related stress in the Nigerian petroleum industry. Data were collected from semistructured interviews and internal company documents relevant to reducing work-related stress and analyzed using thematic analysis. Three major …

Caring For The Caregiver: Second Victim Recovery Following A Serious Medical Error, Beulah Patrice Vance

Walden Dissertations and Doctoral Studies

In 1999, it was estimated that 98,000 deaths were attributed to medical errors and were the fourth most common cause of death in the United States. In 2016, medical errors were estimated as the third leading cause of death, with a mean death rate of 251,454 each year. Nurse involved in errors are known as second victims. Almost one in seven staff members reported that they had experienced a patient safety event within the last year that caused personal problems such as anxiety, depression, or concerns about their ability to perform their job. This project explored whether nurses are able …

The Relationship Between Organizational Culture And Hospital Performance In The Veterans Health Administration, Darline Jasmin Nabbie

Walden Dissertations and Doctoral Studies

High quality care consists of a culture that involves staff who are engaged and keepthemselves accountable when providing care. In 2014, employees described their organizational culture at the Veteran Affairs (VA) as entrenched and intimidating. An audit also revealed that in 2014, patients were receiving substandard care. The present study was an analysis of the relationship between organizational culture and hospital performance in the Veterans Health Administration (VHA). This study provided key stakeholders such as the VA administration an understanding of work climate as an indicator of organizational culture and how it affected hospital performance with the VHA. The VHA …

Perceptions Of Nurse's Personal Smartphone Use At Work, Esperanza Criscuolo

Walden Dissertations and Doctoral Studies

Distracted nurses who use their personal smartphone at work has resulted in the diversion of attention from patient care. The specific problem is the personal smartphone use by nurses in the hospital settings has resulted in distracted patient care, leading to wrongful release of patient’s information, medical errors, injury or preventable patient death. The purpose of this qualitative study was to describe the perceptions of nurses regarding distracted patient care in their clinical workplace due to personal smartphone use by nurses. The study was grounded in the distraction-conflict theory conceptual framework. The key research question examined the perceptions of nurses …

Retrospective And Forecasting Analysis Of Increased Long Term Care Demand In Niagara, Breanne Alissa Hines

Walden Dissertations and Doctoral Studies

A problem exists within the Canadian healthcare system as many patients experience longer lengths of stay (LOS) in acute care (AC) and complex care (CC) beds within hospitals because of a lack of long term care (LTC) facilities. The purpose of this study was to evaluate the extra days patients wait for placement and assess the benefits of increasing the number of LTC beds. The theoretical framework used was the four-level model of the health care system. Research questions involved 2017-2019 data for the number of LTC beds required to eliminate waits and evaluate beds needed in the future. This …

Health Care Manager Electronic Medical Record Systems Implementation Strategies To Improve Patient Outcomes, Mcarthur Bruno Damis

Walden Dissertations and Doctoral Studies

Ineffective implementation of electronic medical record systems (EMRS) among health care outpatient clinics results in substantial financial loss. Health care managers (HCMs) in outpatient clinics who fail to implement EMRS adversely affect employee usage and performance. Grounded in fayolism theory, the purpose of this qualitative multiple case study was to explore the strategies health care managers used to implement EMRS in their organizations. The participants were six HCMs in a U.S East Coast city. Thematic analysis was used to analyze the data from semistructured interviews and internal company documents. Five themes emerged: internal communication, overcoming barriers, time management, compensation improving …

Relationship Between Nurse-To-Patient Ratios, Patient Satisfaction Scores, And Hospital Profitability, Patrick Ross Bumstead

Walden Dissertations and Doctoral Studies

In 2019, hospital profitability margins were at their lowest levels since the great recession due to a declining volume of patients. Hospital executives who fail to improve profitability are at risk of sustainability. Grounded in the service-profit chain theory, the purpose of this quantitative correlational study was to examine whether nurse-to-patient ratios and patient satisfaction scores significantly predict hospital profitability. Data were collected from 74 hospitals in Southern California from the Centers for Medicare & Medicaid Services government database and publicly available financial statements. Results from multiple regression analysis were not statistically significant. A key recommendation is for hospital executives …

Empowerment, Personality, And Leader-Member Exchange Quality In Physicians, Tony S. Reed

Walden Dissertations and Doctoral Studies

Nearly 100,000 people suffer injury or death each year due to errors in the United States healthcare system. Researchers have identified that empowerment by physicians can address this significant social issue. Despite this knowledge, qualifications to empowering behaviors in physicians have not been identified. A quantitative nonexperimental correlation approach was used to determine the role that personality type and high-quality leader-member exchange may play in the physician’s ability to create empowerment at academic medical centers in the United States. The theoretical framework of empowering leadership, Jung’s psychological types, and leader-member exchange quality informed the research design and contributed to the …

Fairness, Emotional Intelligence, And Ethical Decision-Making In Customer Evaluations Of Providers, Tameka Austin

Walden Dissertations and Doctoral Studies

Customer satisfaction is a topic that organizations must focus on for the success and continued sustainability of their organizations. Emotional intelligence, fairness, and ethical decision-making are areas that businesses must address to identify how their businesses are impacted by the choices that customers make when working with corporations. The gig economy (short- or long-term project in which a contract worker is hired to perform a specific task or long-term consultant assignment) is an area that has not been addressed to a great extent by psychology researchers. The purpose of this study was to examine the relationships between emotional intelligence, ethical …

Strategies For Catalyzing Clinicians’ Support Of Telemedicine Programs In Rural Communities, Jonathan Liwag

Walden Dissertations and Doctoral Studies

Clinicians’ failure to accept contemporary technology has been a critical barrier to telemedicine program adoption. Staff technical challenges and resistance to change can affect technology return on investment, which concerns telemedicine program leaders. Grounded in Davis’s technology acceptance model, the purpose of this qualitative, descriptive single case study was to explore strategies used by program leaders in the Marianas Islands who successfully gained clinicians’ acceptance of contemporary technology. The participants were 5 program leaders recommended by their institution because of their leadership role and telemedicine technologies experience. Data were collected from 4 face-to-face and 1 audio teleconference interview with the …

Strategies For Catalyzing Clinicians’ Support Of Telemedicine Programs In Rural Communities, Jonathan Liwag

Walden Dissertations and Doctoral Studies

Clinicians’ failure to accept contemporary technology has been a critical barrier to telemedicine program adoption. Staff technical challenges and resistance to change can affect technology return on investment, which concerns telemedicine program leaders. Grounded in Davis’s technology acceptance model, the purpose of this qualitative, descriptive single case study was to explore strategies used by program leaders in the Marianas Islands who successfully gained clinicians’ acceptance of contemporary technology. The participants were 5 program leaders recommended by their institution because of their leadership role and telemedicine technologies experience. Data were collected from 4 face-to-face and 1 audio teleconference interview with the …

Strategies For Implementing Self-Service Technologies In Supermarket Retail Operations, Ryan Christopher Gurley

Walden Dissertations and Doctoral Studies

AbstractOrganization leaders who do not adopt self-service technology (SST) are at risk of failure. The adaptation of SST can aid leaders in the supermarket industry improve checkout operations, increase efficiency, and minimize customers’ waiting experiences, reducing the customers’ shopping satisfaction. Grounded in the disruptive innovation theory, the purpose of this multiple case study was to explore strategies supermarket managers use to adapt SST practices. The participants included six supermarket managers in Jackson County of Southern Illinois. Data were collected from face-to-face interviews with managers, company documentation, and observations. Thematic analysis was used to analyze the data. Four themes emerged: cultural …

The Impact Of Assertiveness And Religiosity On The Expression Of Dissent Among U.S. Immigrant Nigerian Workers, Peter Osiabia Azorji

Walden Dissertations and Doctoral Studies

AbstractScholars have studied dissent in general, but few have focused on the impact of cultural contexts and characteristics on dissent. Literature on the influence of cultural factors on expression of disagreement in organizations, by immigrant Nigerian workers in the US has not received adequate attention. There is therefore a compelling need to bridge this gap. This quantitative nonexperimental correlation study examined the impact of assertiveness and religiosity (variables that may be influenced by culture), on expression of minority dissent among Nigerian immigrant workers in the United States. The inquiry was based on two theoretical models: Bourhis et al.’s interactive acculturation …

Effective Strategies To Reduce Employee Absenteeism Amongst Canadian Female Employees, Sue Haywood

Walden Dissertations and Doctoral Studies

High absenteeism in female employees costs Canadian hospitals millions of dollars annually. Leaders of Canadian hospitals who lack strategies to reduce absenteeism in female employees witness significant financial losses in their organizations. Grounded in Herzberg's two-factor theory, the purpose of this multiple case study was to explore strategies Canadian hospital leaders used to reduce absenteeism in female employees. Data were collected from semistructured interviews, annual reports, and publicly available datasets relating to hospital retention strategies and were analyzed using a thematic analysis. Four themes on strategies to reduce absenteeism emerged: creating a supportive stance towards absenteeism, investing in mental health …

Strategies Health Care Leaders Use To Implement Strategic Change Initiatives Successfully, Sophia F. Brown

Walden Dissertations and Doctoral Studies

Health care organizations lose a significant competitive edge when leaders fail to align strategic change initiatives with necessary operational activities. Health care leaders who struggle to maintain a competitive edge are at high risk for failure. Pettigrew and Whipp's content, process, and context strategic change management and Hoshin Kanri (HK) program deployment models constituted the composite conceptual framework for this study. The purpose of this qualitative multiple case study was to explore strategies health care leaders use to implement strategic change initiatives successfully. The participants comprised of 4 strategic change leaders from 2 health care organizations in Manhattan, New York, …

Physician Assistant Burnout And Fulfillment Related To Career Development And Physician Relationship, Kari Sue Bernard

Walden Dissertations and Doctoral Studies

Physician workforce shortages are driving increased clinical and administrative use of non-physician healthcare providers. As a result, physician assistants (PAs) may experience role expansion in a positive or negative manner. The purpose of this study was to determine if aspects of PA career development related to role expansion interacted with the quality of the collaborative physician (CP) relationship to predict PA well-being. The job demands-resources (JD-R) model was used as the theoretical foundation and the National Academy of Medicine’s conceptual model of clinician well-being was used as the conceptual framework. Research questions addressed whether PA experience level predicted well-being, and …

Healthcare Organizational Design Strategies To Improve Performance, Katherine Madonna Chubbs

Walden Dissertations and Doctoral Studies

Business leaders are exploring ways to improve organizational performance through organizational design, including reviewing the structures of their organization. Grounded in McKinsey’s 7S framework, the purpose of this qualitative single case study was to explore organizational design strategies healthcare leaders used to improve organization performance. Participants were 6 leaders within a healthcare organization in Alberta, Canada, who successfully developed and implemented organizational design strategies to improve organizational performance. The data collection techniques included a review of internal and external documents, a reflective journal, and semistructured interviews. I used methodological triangulation and thematic analysis to complete the data analysis. The data …

Leadership Strategies To Achieve Organizational Excellence, Cherron Lakisha Blakely

Walden Dissertations and Doctoral Studies

Inadequate quality management tools and processes can lead to inefficient hospital operations and poor organizational performance. Community hospital leaders who fail to improve operations and organizational performance risk negatively impacting patient care and profitability. Grounded in the theory of high-performance work systems (HPWS), the purpose of this qualitative single case study was to explore strategies community healthcare leaders use to effectively employ quality management approaches to improve operations and achieve organizational excellence. The participants comprised 5 community healthcare leaders in the northeast United States who effectively used quality management approaches to improve operations and achieve organizational excellence. Data were collected …

Urgent Care Centers And Workers’ Compensation Medical Cost Containment, Drema M. Thompson

Walden Dissertations and Doctoral Studies

In response to healthcare payment policy reforms, billions of dollars in healthcare provider charges are challenged annually. Following the implementation of the Virginia workers’ compensation medical fee legislation, healthcare organizations experienced declining worker compensation medical fee schedule reimbursements and lack of profitability. Grounded in the adaptive cycle model, the purpose of this qualitative single case study was to explore strategies 2 urgent care center (UCC) leaders in Virginia used to increase profits after implementing the Virginia workers’ compensation medical fee legislation. Data were collected via in-depth interviews and a review of company documents. Thematic analysis was used to analyze data. …

Strategies For Reducing Adverse Medical Events From Implanted Medical Devices, Gary John Zack

Walden Dissertations and Doctoral Studies

Managing medical device monitoring processes is challenging and lacks a realtime, life cycle tracking strategy to reduce adverse medical events and revision costs for hospital administrators, physicians, and patients. Understanding the malfunctions of medical devices for cardiac and orthopedic patients could save lives and reduce hospital liability. Grounded in the business process reengineering conceptual framework, the purpose of this single qualitative case study was to explore strategies hospital managers used to redesign the implant recall surveillance process at one hospital in Pennsylvania. The 5 participants selected successfully implemented a medical device surveillance process that reduced adverse medical events and revision …

A Health Care Management Organization's Internal Controls Strategy For Managed Care, Elizabeth E. David

Walden Dissertations and Doctoral Studies

A lack of effective operational internal controls among health management organization (HMO) leaders could lead to poor operational practices, mismanagement of the government's health care funds, increased health care spending, and a negative impact on patient health outcomes. Grounded in transformational leadership theory, the purpose of this qualitative, single case study was to explore successful internal control strategies used by leaders at a southeastern Pennsylvania HMO. Data were collected from semistructured interviews with 5 participants who held positions of director or above within the organization for at least 3 years, had institutional knowledge, and had responsibility for overseeing the organization's …

Understanding Behavioral Health Stigma Within The Healthcare Workforce, Jason Robert Martin

Walden Dissertations and Doctoral Studies

Individuals who seek mental health treatment in the United States face significant barriers. One such barrier is the belief that those seeking mental health treatment are subpar people with some moral failure. One area where this phenomenon exists is the behavioral healthcare workforce. This study was conducted to understand the phenomenon of stigma that behavioral healthcare leaders exhibit toward behavioral healthcare patients using the Baldrige framework as its conceptual framework. Using a qualitative approach and case study design, interviews were conducted with 6 leaders within a large healthcare system in the suburbs of a major metropolitan area to evaluate their …

Strategies To Retain Mental Health Workers In Community Mental Health Clinics, Debbie L. Young

Walden Dissertations and Doctoral Studies

In 2017, the United States employee turnover rate for mental health workers with 2 or more years of experience was more than 50%. High turnover rates among these mental health workers are associated with inadequate quality of care for patients with mental health issues in community mental health clinics. Grounded in Herzberg’s two-factor theory, the purpose of this qualitative multiple case study was to explore retention strategies used by health care administrators to retain their mental health workers with more than 2 years of experience. The participants consisted of 6 health care administrators who successfully implemented strategies to minimize high …

Therapeutic Communication Skills For Nurses Working With People Living With Hiv, Charaine Ferguson

Walden Dissertations and Doctoral Studies

Internalized stigma experienced by people living with HIV (PLWH) has been associated with numerous untoward health outcomes. Nurses' and healthcare professionals’ ability to effectively communicate can significantly affect the experience of stigma in PLWH. The practice-focused question was whether an interactive educational project could improve the knowledge and intent to use collective communication skills in nurses. This project uses concepts from Peplau's interpersonal relationship theory, principles of therapeutic communication, and unconscious bias. Online training content included patient testimonials related to stigma, discussions of unconscious bias by the Institute for Healthcare Improvement and Mayo Clinic professionals, review of Harvard University’s Implicit …

Successful Retention Strategies By Perfusion Managers To Reduce Perfusionist Attrition, Krysta Lynne Gleeson

Walden Dissertations and Doctoral Studies

Perfusion managers who lack strategies to mitigate perfusionist attrition place a strain on their remaining employees and incur replacement costs for their organization. Grounded in Vroom’s expectancy model, the purpose of this multiple case study was to explore strategies perfusion managers use to mitigate perfusionists attrition within open-heart centers in a northeast U.S. city. Data were collected through digital semistructured interviews with 5 licensed perfusionists who demonstrated successful staff retention. Perfusionist job listings were used as a secondary data source. Data were analyzed using Yin’s 5 step process. Four significant themes emerged: job satisfaction, work-life balance, surveys, and compensation. Perfusion …

Comparison Of Diagnosis And Hospital Referral Rates Between Physician And Non-Physician Practitioners, Joshua Alan Fisher

Walden Dissertations and Doctoral Studies

Physician extenders as support in healthcare facilities has been increasing in the United States and has the potential to help in currently under served communities. This study evaluated the quality of care provided by physician extenders through the examination of average diagnosis and referral rates that may inform healthcare leaders and policymakers in future decisions. The literature review pointed to a gap in the research related to the quality of care based on patient diagnosis and referral rates by physicians and physician extenders. The conclusions were based on a quantitative analysis of secondary data from the National Ambulatory Medical Care …

Motivating Factors For Nurses Aged 65 Years And Older To Extend Their Work Life, Dr. Cynthia M. Dobek

Walden Dissertations and Doctoral Studies

Nurses age 65 years and older who retire will leave a knowledge gap in the workforce unless motivated to continue working. A knowledge gap in the workforce is of concern to human resource professionals because healthcare professionals may not be able to keep pace with the increase in patients needing medical care. Grounded in Maslow’s hierarchy of needs theory, the purpose of this qualitative single case study was to explore what factors motivated nurses aged 65 years and older to extend their work life. The participants comprised 6 nurses aged 65 years and older who were still working or semiretired …

Small Business Leaders’ Strategies For Recruiting Veterans, Jamillah Deangela Stackhouse

Walden Dissertations and Doctoral Studies

Small business hiring managers who fail to implement recruitment strategies for

transitioning military veterans face hiring challenges with this population of workers.

Failed recruitment strategies are essential to small business leaders, as failure to attract

highly qualified military veterans places the organizations at a competitive disadvantage.

Grounded in recruitment theory, the purpose of this qualitative multiple case study was to

explore strategies used by leaders of small businesses to recruit, hire, and retain qualified

veterans. The participants included 3 purposefully selected hiring managers from 3 small

businesses in southeastern Virginia, who used successful strategies to recruit, hire, and

retain veterans. …

Effects Of Transformational Leadership On Direct Home Healthcare Employee Turnover, Lisa K. Johnson

Walden Dissertations and Doctoral Studies

Ineffective leadership and excessive direct home healthcare workers’ intent to resign may decrease home healthcare worker satisfaction, increase workplace accidents, and hinder the quality of patient home healthcare. Home healthcare leaders have a problem of retaining direct home healthcare workers and can benefit from comprehending the factors that enhance leadership and mitigate the turnover of home healthcare workers. Grounded in transformational leadership theory, the purpose of this quantitative correlational study was to examine the relationship between the perception of transformational leadership behaviors and direct care intent to resign. The population consisted of direct home healthcare workers who reported to frontline …