Business Commons^™

Picc-Pal: A Support Band For Independent Picc Line Use, Kylie Luker

Honors Theses

This project presents the design and evaluation of PICC-PAL, a wearable assistive device intended to improve independence and usability for patients managing peripherally inserted central catheters (PICC lines) at home. Current at-home PICC line management often requires help due to the fine motor skills needed to connect and secure tubing. This increases reliance on caregivers and introduces potential risks such as infection and dislodgement. Through stakeholder analysis, prior art evaluation, and iterative prototyping, a device was developed to stabilize the PICC line lumen and enable one-handed connection of medical tubing. Throughout the project, multiple design concepts were explored, with the …

Sacred Steps: Walking, Religion, And The Path To Peace, Francesca Benna

International Journal of Religious Tourism and Pilgrimage

Walking is one of the simplest and most primordial human acts, yet it carries profound meanings that transcend cultures, religious traditions, and paths of individual and collective transformation. Walking is not merely a means of movement but a practice that fosters reconnection with oneself, the environment, and the community. Bruce Chatwin, in The Songlines (1987), highlights how nomadism is an inherent human condition, suggesting that movement is essential not only for physical survival but also for mental and spiritual well-being. In an era marked by environmental crises, conflicts, and increasing technological alienation, rediscovering the value of walking responds to a …

‘Clothesure’: The End Of The Narrative Of A Pilgrim’S Clothes; And How Pilgrim’S Clothes Contribute To Narrative Identity, Stephen F. Haller

International Journal of Religious Tourism and Pilgrimage

This paper provides the story, or narrative, which explains how pilgrim’s-identity is created and endures through the clothes they wear. The closure, or preferred ending, of this story of a pilgrim’s clothes, would be a ceremonious disposal, like burning them. Pilgrims are reluctant to simply throw their clothes, boots, and gear away. This paper is a philosophical reflection on how a pilgrim’s clothes construct the identity of a pilgrim; and how inanimate objects, like clothes, might become meaningful, or even ‘sacred’ in a non-religious way. This comes about because of a decision to treat them that way. We make sense …

Monastic Botanical Gardens: Medicinal Plants, Cultural Heritage, And Tourist Routes, Polyxeni G. Moira Dr, Dimitrios Mylonopoulos

International Journal of Religious Tourism and Pilgrimage

in the natural environment. The natural environment, of which humans are an integral part, served as the first laboratory for the production of medicines. Medicinal botany can be traced back to ancient Greece, continued through ancient Rome, was closely linked to Islamic tradition, and persisted through the rise of Christianity in monasteries, enduring to the present day. Monastic botanical gardens serve as living proof of the relationship between humans, nature, healing, and spirituality. These gardens, which for centuries cultivated plants for medicinal, nutritional, and functional uses, can now be leveraged to promote tourism, cultural heritage, and environmental awareness.

This study …

Killing Bali (Part I) A Journey From God’S Paradise To Human Inferno, Pierre Fournié, Dr Pierre Fournié

International Journal of Religious Tourism and Pilgrimage

Tourism is growing and growing fast. Before the pandemic, in 2018, the number of arrivals worldwide reached 1.4 billion arrivals from less than 600 million, twenty years earlier. In many countries, especially in developing ones, tourism is perceived as a unique opportunity, a model of territorial development, possibly a national strategy. In Indonesia, after being elected in 2014, former President Joko Widodo (Jokowi) emphasised the importance of tourism, considered as a strategic sector. It had to become the largest exchange currency contributor to Indonesia’s revenue thus bypassing rubber, coal, oil and gas (Fournié & Dou, 2018).

In the collective awareness …

Nonprofit Leaders’ Perceived Top Struggles: A Qualitative Study With Descriptive Quantification Of Capacity, Funding, And Operational Barriers, Angie Holzer

Journal of Nonprofit Innovation

Nonprofit organizations are widely understood to operate under conditions of persistent constraint, yet less is known about how nonprofit leaders themselves perceive and prioritize their struggles. This study presents findings from a qualitative analysis with descriptive quantification of open-ended responses from 77 nonprofit leaders who were asked to identify their biggest challenges. Using thematic coding, frequency counts, and order-based sequencing analysis, the study distinguishes between perceived struggles, immediate needs, and capacity-focused structural blockers. While funding and financial sustainability were the most frequently cited perceived struggles, capacity-related challenges—including board governance, staffing and volunteers, compliance burden, operational systems, and leadership bandwidth—emerged as …

Enhancing Assessment Tools For Foster Youth: A Phenomenological Approach To Preparing For Independent Living, Karen M. Armstead

Journal of Nonprofit Innovation

Abstract

Foster youth transitioning to independent living often face challenges that extend beyond technical life skills. This qualitative phenomenological study explored the lived experiences of 10 former foster youth (ages 18–21) regarding readiness for independent living and the adequacy of preparation they received. Semi-structured interviews were guided by an 18-question instrument reflecting real-world transition domains commonly addressed by nonprofit independent living programs. Thematic analysis yielded three primary themes: (1) lack of preparation, (2) emotional strain and abandonment, and (3) life skills training. Findings indicate that readiness is multidimensional and shaped by practical preparation, emotional readiness, and relational support. For nonprofit …

Esg Greenwashing And Ownership Structure Under Information Asymmetry, Luu Thu Quang, Nguyen Dang Hai Yen, Vo Thien Trang, Tran Hoang Vu

European Management Studies

Purpose: This is the first paper to investigate how ownership structure influences ESG greenwashing, with a focus on the moderating role of information asymmetry. The study is set in Vietnam’s stock market, where state ownership remains significant and disclosure standards are still developing.

Design/Methodology/Approach: We construct a unique hand-collected dataset of annual reports from listed firms between 2020 and 2024. Greenwashing is measured using both disclosure–performance gaps and narrative-based textual analysis. Ordinary least squares and two-stage least squares regressions are employed, with robustness checks using alternative proxies for information asymmetry.

Findings: Results show that in transparent environments, …

From People To Algorithms: Does Bpm Maturity Shape An Ai-Ready Workforce?, Piotr Sliż, Jędrzej Siciński, Beata Jackowska

European Management Studies

Purpose: Introducing AI into an organization should not be limited to technological implementation alone. It also requires a coherent management framework that supports this transformation – especially regarding the workforce. The research focuses on the question: What are the relationships between BPM maturity, AI implementation, and workforce maturity in the organizations studied? The main objective is to examine how these three elements interact and what this means for organizations aiming to build readiness for AI-driven change.

Design/methodology/approach: To explain the relationships between BPM maturity, AI implementation, and workforce maturity, a survey-based study was conducted among a convenience sample …

Factors Affecting Purchase Intention Toward Second Hand Clothes, Soumaya Mounir Kaakour, Fouad Saad

BAU Journal - Society, Culture and Human Behavior

Although the purchase of second-hand clothing remains a debated research topic, it is widely acknowledged that second-hand clothing (SHC) benefits society by reducing the waste of natural resources and promoting sustainability, however, it is yet to be determined whether the motivation behind buying second-hand clothing is driven by concerns for self, community, and nature.

This research aimed to investigate the impact of the five following factors frugality, perceived environmental knowledge, attitude, environmental concern, and mindful consumption on the purchase intention of second-hand clothing. A quantitative approach was used, and data was gathered online using Google Forms, where 308 responses were …

Enhancing Provider Engagement Through Peer-To-Peer Coaching: The Provider Ambassador Program, Jason Vallee, Jodi Stewart, Sam Verkhovsky, Steve Del Giudice, Janet Aug, Amanda Higgins, James Perry, Alice Kennedy, Brant Oliver

Patient Experience Journal

Provider burnout and disengagement are associated with diminished patient satisfaction, reduced clinical quality, and adverse organizational outcomes. Peer-to-peer coaching has emerged as a promising, scalable intervention to support provider engagement and improve the patient care experience. This study evaluates the effectiveness of the Provider Ambassador Program, a structured peer-to-peer coaching initiative designed to improve patient satisfaction by enhancing provider communication, professional behavior, and patient engagement skills. A pre-post quasi-experimental design was used to assess changes in provider CG-CAHPS ``Provider Overall'' top-box scores following coaching. Eligible providers (n = 83) across five BLANK Health locations were identified based on top-box scores …

A Hybrid Coaching Model In A Multi-Center Networked Care Experience Learning Collaborative, Elizabeth Rizzo, Victoria Adams, James Perry, Nicole Szalay, Samuel Verkhovsky, Megan Morse Holthoff, Alice Mae Kennedy, Brant Oliver

Patient Experience Journal

Coaching teams and leaders conducting quality improvement (QI) has shown to be an effective method for project success. Our coaches were well versed in Lean Six Sigma and IHI Model for Improvement methods. Certified Lean Six Sigma Blackbelts coaches were assigned to project teams. Routine participation in project team meetings and one-on-one coaching sessions reenforced tools necessary to complete improvement work. Additionally, coaches met with one another to discuss their methods, work through challenges, and celebrate successes. Fourteen improvement teams led work in Care Experience related projects. Eleven project leaders certified in Lean Six Sigma methodology through the Value Institute …

Documentation And Dashboard Driven Quality And Safety Improvement In Interpreter Services For Limited English Proficient Patients, Richard T. Dillehay, Samuel Verkhovsky, Andrew Bohm, Harley Friedman, Dawn Welshman, Ann Morong, Vidya Karthikeyan, Jessica Dampier, Amanda Racine, Brant Oliver

Patient Experience Journal

Limited English Proficiency is known as an independent driver of disparities in patient's access to healthcare and their healthcare outcomes. The Joint Commission standards require that health systems document language services delivery to patients with limited English proficiency in a systematic way. Our health system had not historically utilized a methodical system for documenting language services utilization prior to the launch of this initiative. By utilizing a Lean Six Sigma approach, a project team comprised of leaders from interpreter services, operations, data analytics, and data informatics codesigned an Epic SmartForm data collection instrument and series of Tableau dashboards to monitor …

``We'll Be Right With You'', Improving Patient Experience With Complaint Management Within A Learning Health System Collaborative, James J. Perry, Mackenzie Hahn, Angela Kmiec, Brant J. Oliver

Patient Experience Journal

An improvement team at Cheshire Medical-Dartmouth Health participated in the Care Experience Collaborative aimed at enhancing the patient and workforce experience. Utilizing a hybrid Lean Six Sigma DMAIC approach alongside modified Institute for Healthcare Improvement learning techniques, local teams were coached by quality improvement specialists. The project's focus was on improving the complaint management process to boost hospital ratings and recommendations. Initial assessments revealed significant inefficiencies, such as delays in response times and poor tracking of complaint resolutions. Implementing a new digital monitoring system in conjunction with standardized training resulted in substantial improvements: complaint resolution times decreased by 53%, while …

From Talking The Talk To Walking The Walk: Reflection On Dartmouth Health's Care Experience Week, Rosie Bartel, Corey Kimpson, Tanya Lord, Victoria Lyons, Tony Serge, Brant Oliver

Patient Experience Journal

This article explores the participation of expert members from the Beryl Institute's Global Patient and Family Advisory Board (GPFAB) during Dartmouth Health's Care Experience Week, under the theme ``From Talking the Talk to Walking the Walk.'' This week aligns with the national Patient Experience Week. The Patient Family Advisor (PFA) presenters and authors of this article have shared their lived experience locally, nationally, and internationally through conferences, webinars, podcasts, videos, blogs, white papers, journal articles, books, and in many other ways for and as PFA members of a multitude of healthcare organizations co-create change that improves outcomes for all human …

Improving Human Experience In Health Care: Leveraging ``Humanistic Learning Health Systems'' To Accelerate Change At Scale, Brant J. Oliver, Jason A. Wolf

Patient Experience Journal

Included in a special segment in this issue of the Patient Experience Journal, are a series of reports on improving HX in healthcare supported by a humanistic LHS– the Dartmouth Promise Partnership Coproduction Learning Health System in New Hampshire, USA. Promise is a strategic partnership between a medical school and a multi-center rural academic health system. It integrates translational science education and research, data informatics, and scaled and networked humanistic applied change initiatives. One of these initiatives is the Care Experience Collaborative, a multi-center improvement initiative across the health system focused on improving HX. This special segment includes five reports …

Patient Engagement In Developing Radiology Patient Education Materials, T Arleo, Harrisd Harrisd, J Hislop, J Moon, H Li, N Kadom

Patient Experience Journal

Purpose: This initiative aimed to engage patients in the process of developing patient education materials (PEM) on the major imaging modalities at our institution. Materials and Methods: PEM were created for computed tomography (CT), magnetic resonance imaging (MRI), ultrasound (US), fluoroscopy, and radiography. Content was sourced from various sources, consolidated into a draft, and iteratively updated: They were simplified using a ChatGPT-4.0 prompt designed to achieve a 7th grade reading level; they were reviewed for accuracy by subject matter experts (SME); they were assessed for readability and understandability using the Flesch-Kincaid Grade Level (FKGL) and the Patient Education Materials Assessment …

Utilization Of Visual Metaphors For Improving Health Literacy, Kadir Alp Özler, Morgan Dressel, Madeline Weiner, Robert D Lucito, Alice Fornari

Patient Experience Journal

Health education is practiced in patient encounters via verbal communication and educational pamphlets. However, these techniques are faulty and do not provide true patient comprehension of their conditions and treatments reform is necessary to prevent the mortality and hospitalization rates that are linked to poor health literacy. Visual aids and metaphors are individually known to be powerful educational tools. A student organization at Stony Brook University, Artists in Medicine, has sought to synergize these tools to create visual metaphors artwork that links everyday concepts to patient illnesses to facilitate comprehension of this information. For example, one project “Aortic Dissections” depicts …

Patient Experience (Px) In Low- And Middle-Income Countries (Lmics): A Scoping Review, Yara Abou Harb, Geoffrey A. Silvera

Patient Experience Journal

Patient Experience (PX) is a growing subject in the healthcare industry due to its association with improved clinical outcomes, patient safety, and business motives. While PX is well studied in high income countries, little is known about the state of PX in Low and Middle-income countries (LMICs). Objective: The study aims to examine literature on PX and related concepts in LMICs. Methods: This study executes a PRISMA literature review of academic databases (Ovid Medline, CINAHL, EMBASE and Google Scholar) as well as hand searching of PX related websites from 2005 to 2024. Results: 67 references met search criteria. Four themes …

Multilevel Factors Shaping The Patient Experience With Health Services In Torbat Heydarieh, Iran, Fatemeh Pourhaji, Mohammad Hossein Delshad

Patient Experience Journal

Background: One of the main aims of public health is to ensure that health services are used and available. However, access alone does not guarantee a positive patient experience, which is critical to achieving optimal health outcomes and ensuring health equity. Aims: The objective of this study is to analyse in a comprehensive way the multiple factors influencing the patient experience and subsequent use of healthcare services by households in Torbat Heydarieh, Iran, by examining the independent and interactive contributions of individual, household and environmental (community) determinants using THUMS data. Methods: This analytical study, which covered a 1-year period, looked …

Factors Influencing Patient Satisfaction In Health Services: A Cross-Sectional Study In The Holy City Of Najaf, Ahmed Abdul Hasan Mohsin, Lamees A. Abdul-Lateef, Noor Ismeal Nasser

Patient Experience Journal

The healthcare system in the city of Najaf works to improve the quality of services provided to patients. Since patient satisfaction serves as a key measure of service quality, this study was designed to identify the potential factors that influence satisfaction within these facilities. cross-sectional study was conducted for 300 patients using public healthcare services in Najaf. the selection of patients based on the stratified random sampling across hospitals and primary health centers. Data were collected using a 24-item structured questionnaire that measured four domains: accessibility, staff attitude, service quality, and physical environment, rated on a four-point Likert scale. The …

Nursing Staff Attitude Towards Nurse-Physician Collaboration In The Neonatal Intensive Care Unit In Al Ahsa City, Saudi Arabia, Makarim Taqi Al Helal, Yaqoub Yousef Al Mousa

Patient Experience Journal

Objective: Effective nurse-physician collaboration is fundamental to ensuring quality healthcare delivery, particularly in Neonatal Intensive Care Units (NICUs), where patient outcomes rely heavily on coordinated teamwork. This study aimed to assess nursing staff attitudes toward nurse-physician collaboration in NICUs, examine the influence of demographic and professional characteristics, and provide evidence-based recommendations to strengthen interprofessional collaboration. Methods: A quantitative, non-experimental, cross-sectional survey was conducted from April to June 2024 in the NICU of Maternity and Children's Hospital, Al Ahsa, Saudi Arabia. A total of 180 nurses with at least one year of NICU experience participated. Data were collected using the …

Do Allied Health Professionals' Workplace Experiences Affect Their Decisions To Stay? A Quantitative Investigation Into The Relationship Between Wellness And Employee Retention In United States Hospitals, Dina Jarjees, Lihua Dishman

Patient Experience Journal

Allied Health Professionals (AHPs) are university-trained practitioners with specialized skills essential for preventing, diagnosing, and treating health conditions. AHPs play a vital role in comprehensive healthcare, including hospitals, where they comprise a significant portion of the workforce and recurrent health expenditures. However, AHPs experience considerable burnout and emotional distress, negatively impacting retention. This issue worsens workforce shortages and limits access to care, which jeopardizes patient safety. This national, cross-sectional, quantitative study examined the relationship between AHPs' wellness dimensions (physical, emotional, mental, social, and spiritual) and AHPs' retention in United States hospitals. A self-developed survey instrument included 10 demographic and 25 …

Investigating The Effectiveness Of Different Modalities In Interprofessional Training, Rose Ann Mathai, Sean Lopez, Maureen Emlund, Jim Scherrer, Elisa Buzinski, Julia Sonnichsen, Myra Carew

Patient Experience Journal

Background: Interprofessional education (IPE) highlights the importance of values and ethics, teamwork, communication, and roles and responsibilities for healthcare professionals. Different modalities have been used to teach these skills. The most effective teaching modality must be determined to enhance the collaborative learning experience. Purpose: This study evaluated the changes in student perceptions on each interprofessional competency with respect to the teaching modality. Two groups were evaluated for this study. One was taught using a hybrid curriculum and the other in-person. Methods: This study utilized the Students' Perceptions of Interprofessional Clinical Education (SPICE-R2) survey to determine the changes in student …

Exploring Patient Satisfaction: Descriptive And Predictive Insights From Hcahps Surveys In U.S. Hospitals, Naveen Gudigantala, Tanush Sistla, Ramu Gudigantala, Naga Vemprala

Patient Experience Journal

This study analyzes patient experience data from the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) surveys across three time periods: 2020–21, 2021–22, and 2022–23. Utilizing both descriptive and predictive analytics, we examined ten key variables related to patient communication, hospital environment, discharge information, and overall hospital ratings. Descriptive analytics using longitudinal data analysis revealed that while patient experience metrics were strong in 2020–21, a significant downturn was observed in 2021–22, followed by a marked recovery in 2022–23. These results suggest that while COVID-19 pandemic negatively impacted patient satisfaction metrics in 2021–22, the emerging evidence suggests U.S. healthcare system …

Patient Satisfaction And Perceived Quality Of Care: A Population-Based Cross-Sectional Study Of United States Adults, Samuel Ofei-Dodoo, Carter Altenbernt, Yessin Wael, Hayrettin Okut, Alex Watkins, Nola Tran, Alishka Rojas-Addari

Patient Experience Journal

Patient satisfaction and perceived quality of care are key indicators of health care performance, yet the relative influence of demographic versus communication-related factors remains underexplored. Using data from 7,278 non-institutionalized United States adults in the nationally representative Health Information National Trends Survey, descriptive statistics summarized respondent characteristics and experiences with health care professionals, and survey-weighted multinomial logistic regression identified predictors of perceived health care quality. Respondents generally reported positive experiences, with communication-related factors emerging as the strongest predictors of excellent ratings. Patients who were always included in decisions (OR = 3.44; 95% CI, 1.11-10.69), received clear explanations (OR = 11.24; …

System-Level Barriers To Patient Engagement With Electronic Medical Records, Corey Adams, Reema Harrison, Guncag Ozavci, Kathleen Gray, Nilmini Wickramasinghe, Vicky Yuan, Tracey Bucknall, Elizabeth Manias

Patient Experience Journal

Objective: Electronic medical records (EMRs) can support patient-centered care, but system-level barriers often limit how patients engage with EMR systems. This study explored the system-level barriers and enablers to patient engagement with EMRs from the perspectives of healthcare leaders. Methods: Semi-structured interviews were conducted with 20 participants in senior EMR-related roles across healthcare organizations in two Australian states. Data were analyzed using reflexive thematic analysis to identify key system-level influences on patient engagement. Results: Seven themes were identified: 1) EMRs for digital storage, not connection, 2) Privacy rules create challenges to accessing information, 3) Communication barriers when using EMRs, 4) …

Virtual Caregiving And The Evolving Role Of Carers And Patients: Virtual Hospital Interview Analysis, Kanesha Ward, Tim Jackson, Jenna Bartyn, Shannon Saad, Sue Amanatidis, Owen Hutchings, Annie Y.S. Lau

Patient Experience Journal

Virtual hospitals are transforming healthcare by enabling remote monitoring and management of patients, improving accessibility and care continuity. As part of the transformation, there are changes to the roles and responsibilities of patients and their carers as they engage in virtual hospital care. The impact on family caregiving remains underexplored. Guided by Family Systems Theory, this qualitative study investigated how family caregiving roles adapt within a virtual hospital and identified opportunities to further support families. Semi-structured interviews were conducted with patients, carers, and healthcare workers from one model of care, at a metropolitan virtual hospital in New South Wales, Australia. …

Leveraging Digital Patient And Family Advisory Councils To Drive Patient Engagement, Priya Radhakrishnan, Shambhavi Mishra, Melissa Price, Cammy Sanders, Fiker Bekele, Kathi Zarubi, Craig Kartchner, Amrit Singh Johal, Carol Mayer, Craig Norquist

Patient Experience Journal

Patient and Family Advisory Councils (PFACs) have been integral in enhancing patient care, but their limited reach often excludes underrepresented populations. Digital PFACs present an opportunity to overcome these barriers and engage a broader spectrum of patients and families, fostering more inclusive healthcare decision-making. We implemented a Digital Patient and Family Advisory Council (DPFAC) at HonorHealth, as part of the Patient Centered Outcomes Research Institute (PCORI) capacity building grant. We used the RE-AIM and PRISM frameworks to engage participants through a digital platform. The process began with a needs assessment and was followed by the development of the platform, during …

Supporting Families Of Children With Craniosynostosis: A Qualitative Exploration Of Parental Usage Of Online Forums, Elisha L. Rea, Rachel M. Roberts, Amanda J. Osborn

Patient Experience Journal

Objective: Craniosynostosis is characterised by the early fusion of cranial sutures, resulting in an abnormal head shape. This study examines the psychosocial impact of a child's craniosynostosis diagnosis on families, by analysing online forum discussions. While surgery is often needed to address appearance-related and neuropsychological concerns, parents face challenges navigating their child's diagnosis. Many seek support through online forums, yet research on their experiences remains limited. This study aims to understand parental needs and experiences by analysing forum discussions. Method: Online forums were analysed using reflexive thematic analysis. Significant features of the data were systematically coded and themes reflecting …