Business Administration, Management, and Operations Commons^™

Impact Of State-Led Surveillance Programs On Neonatal Abstinence Syndrome, Patricia Lewis

Theses, Dissertations and Capstones

Introduction: Neonatal Abstinence Syndrome (NAS) has been costly for the healthcare system, for every 24 minutes a baby was diagnosed in 2020. Uniform programs to diagnosis, track and prevent NAS have not been implemented previously. The NCBDDD worked with 6 states to implement a uniform surveillance program. By tracking the NAS incidence rate, the Apgar scores of infants with NAS, the length of stay for those infants, the cost of care for those infants and the percentage of mothers of infants with NAS were participating in Medication Assisted Treatment the effectiveness of the surveillance programs may be assessed.

Methodology: This …

The Epidemic Of Opioid Usage In West Virginia, Kendra Lester, Carrington Hatfield

Theses, Dissertations and Capstones

The opioid epidemic in West Virginia is a complex interplay of factors, including poverty, low education, and high unemployment rates, which contribute to higher rates of substance use and opioid-related deaths. The number of people injecting drugs has risen from 36% in 2005 to 54% in 2015. WV recorded 871 overdose deaths from all drugs in 2019 with 76.8% involving at least one opioid. The purpose of this qualitative research study was to investigate and analyze the circumstances that contributed to West Virginia's opioid epidemic to determine if sociocultural factors, such as lifestyle, education, and demographics, influenced the epidemic as …

Understanding Hospital Chargemasters : Impact On Healthcare Finance, Alesia Moorman

Theses, Dissertations and Capstones

Introduction: This research delves into the critical examination of hospital chargemasters, exploring their intricate role in the complex landscape of healthcare finance. As the healthcare industry grapples with the challenges of balancing medical care and fiscal responsibility, the hospital chargemaster emerges as a dynamic entity, reflecting the interplay between healthcare providers, insurers, and patients. Beyond being a mere ledger of prices, the chargemaster influences the entire Revenue Cycle Management (RCM), impacting financial stability, patient satisfaction, and the effectiveness of healthcare delivery. Originating from the necessity to navigate reimbursement complexities, the chargemaster has become central to hospitals' financial strategies, shaping and …

Impact Of Medicaid Expansion On Substance Abuse Treatment, Kyle Chapman

Theses, Dissertations and Capstones

Introduction: The Medicaid expansion has insured millions of Americans since the passage of the Affordable Care Act in 2010. Among this newly insured population, many of the enrollees have been diagnosed with a substance abuse disorder. Patients who have a substance use disorder diagnosis typically have multiple conditions that are treated simultaneously. When these patients have to seek healthcare services they are often uninsured. Unfortunately, since the patients are uninsured, the most frequent healthcare access points have been through admissions to more expensive areas of healthcare delivery such as the emergency department and subsequent inpatient services. The goals of the …

The Impact Of Big Data Utilization On Quality Improvement In Inpatient Facilities, Lakyn Hare

Theses, Dissertations and Capstones

Introduction: Poor quality in healthcare has resulted in avoidable patient complications, including readmission rates. Big data in healthcare can be analyzed and built into a tools, with machine learning, to aid in reduced readmission rates and overall positive patient outcomes.

Purpose of the Study: The intention of this study was to evaluate the ways that big data can be analyzed to improve healthcare, specifically readmissions, patient outcomes, and show cost savings. This study examined different ways that big data could be used in concordance with machine learning, including predictive analysis, to make these improvements.

Methodology: The hypothesis was the …

Effects Of Burnout Amongst Primary Care Providers, Summer Payne

Theses, Dissertations and Capstones

INTRODUCTION: Physician burnout within the United States has been deemed an epidemic within the healthcare system with nearly 63% of physicians reporting burnout. The rate of burnout amongst Primary Care Providers (PCPs) is higher than other provider types at 70%. The presence of burnout affects the likelihood of medical errors, provider retention, and patient-provider communication. Fifty-six percent of PCPs that reported burnout also associated this burnout with their reason for leaving the practice. Physicians that are burnt out are less likely to find nonadherence in their patients, more likely to refer to specialists, and more likely to prescribe medications unnecessary. …

Radio Frequency Identification Enhances Patient Safety, Craig Kimble, Alberto Coustasse, Ken Maxik

Pharmacy Practice & Administration

Radio Frequency Identification (RFID) is a technology that uses tags and readers to identify and collect asset information. In pharmacies, this usually means RFID is used for high cost equipment or pharmaceuticals. RFID applications have been in use for many years but recently gained traction in health systems. RFID is becoming particularly effective in drug inventory and automation applications, such as medication carousels and pick-to-light systems.

Evaluate 503b Facilities For Outsourced Compounds, Sarah Clemente, Brittany Riley, Alberto Coustasse

Pharmacy Practice & Administration

The US health care system has encountered long-standing, complex challenges, including growing costs, overuse of care, staffing shortages and supply chain weaknesses. COVID-19 revived these pressures, transforming the health care landscape. Medication and staffing shortages plague hospital systems, and pharmacies are not exempt. Most health systems have experienced high levels of pharmacy technician turnover, with most reporting a minimum turnover rate of 21% last year. In addition, medication shortages of critical medications and infusions create significant workflow barriers that hospitals must address to ensure patient safety. In the face of these obstacles, health systems are turning to 503B compounding facilities …

Gabapentin Presents High Potential For Misuse, Alberto Coustasse, Stacie Deslich, Susan W. Lanham, Brittany Riley

Management Faculty Research

The FDA Approved Gabapentin in 1993 as a non-controlled substance and it has remained a non-controlled substance at the federal level. The drug was created as an anticonvulsant and used to treat seizure disorders. The medication has also been used to treat hot flashes, neuropathic pain, pain, postoperative nausea, substance abuse issues, and vomiting. It is estimated that approximately 1% of people in the United States misuse gabapentin. This fact has compelled certain states to generate legislative initiatives designed to monitor the use and/or reclassify gabapentin. In 2019, US pharmacies dispensed 69 million prescriptions for gabapentin.

Prescribing Controlled Substances Goes Electronic, Alberto Coustasse, Craig Kimble, Ken Maxik

Management Faculty Research

With the Affordable Care Act in 2010 came interoperability and meaningful use requirements. Part of these requirements included the implementation of electronic medical records (EMRs), which was a crucial part of achieving these standards. With EMRs, prescribers began sending electronic prescriptions. EMRs can provide advanced decision support when writing prescriptions, and they include features such as auto populating the quantity prescribed, formulary information, therapeutic duplications, warnings about interactions, or other potential clinical or regulatory issues. This system results in enhanced patient care and a more streamlined dispensing process. In addition, electronic prescriptions for controlled substances (EPCS) has become more widely …

Association Of Electronic Medical Records And Opioid Prescription, Archana Suwal, Jemimah Okonjo, Stacie Deslich, Alberto Coustasse

Management Faculty Research

A Prescription Drug Monitoring Program (PDMP) is an electronic database that tracks controlled substance prescriptions in a state. PDMPs can provide health authorities timely information about prescribing and patient behaviors that contribute to the epidemic and facilitate an agile and directed response. Electronic Prescribing for Controlled Substances (EPCS) aimed to eliminate paper prescriptions by allowing clinical prescribers to write prescriptions electronically, making them digital and trackable for both the prescriber and the pharmacist and has been an essential part of any health information technology system, as well as a requirement for 'meaningful use' (Blumenthal & Tavenner, 2010). However, one of …

Tele-Icu In The Unites States: Is A Cost-Effective Model?, Michael Robie, Stephanie Cole, Archana Suwal, Alberto Coustasse

Management Faculty Research

Introduction: The United States Society of Critical Care Medicine has announced a shortage of all critical care intensivists due to the increased need for critical care for the aging population with comorbidities and improved life expectancy. This shortage has led to tele-ICU programs that have allowed intensivists to care for patients simultaneously remotely.

Methods: This study aimed to assess the potential for the hospital implementation of tele-ICU to determine its overall healthcare cost-effectiveness. The methodology was a review that followed a systematic search approach utilizing 42 sources.

Results: The study findings showed that tele-ICU contributed to reduced hospital LOS by …

Chargemasters In The Age Of Hospital Price Transparency, Anthony Drumm

Theses, Dissertations and Capstones

Introduction: The cost of health care services in the United States (U.S.) varies from state to state and facility to facility. The compilation of such costs and their associated codes is referred to as a chargemaster, or charge description master (CDM), and each is unique to an individual facility. . The implementation of the 2019 Centers for Medicare and Medicaid (CMS) Hospital Price Transparency Rule was an initial step toward consumer empowerment by making services more shoppable but published CDM data failed to present the information most pertinent to patients: total out-of-pocket costs and the availability of lower-cost alternatives. Initiatives …

The Effect Of Magnet Hospitals On Nursing Burnout, Jonathan Settle, Michael Davis

Theses, Dissertations and Capstones

Introduction: Burnout has been a problem in health care for many years and it has particularly affected nurses. Nurse burnout was associated with worsened outcomes for nurses such as increased turnover or quitting and lower job satisfaction. There was a question as to how work environment and governance style influenced burnout.

Purpose of the study: The purpose of this research was to examine Magnet-designation status in U.S. hospitals, specifically shared governance and structural empowerment, and its effects on the rates of nurse burnout, nurse turnover, and job satisfaction of nurses.

Methodology: This study utilized a literature review. Four databases as …

Costs And Length Of Stay Associated With Treating Neonatal Abstinence Syndrome, Kimberly Stanfield, Kylie Day

Theses, Dissertations and Capstones

Introduction: Neonatal Abstinence Syndrome has been costly for the healthcare system, for every 19 minutes a baby was diagnosed in 2021. Costs and Length of Stay both had been increased for newborns diagnosed. Medically Assisted Treatment for expecting mothers has shown to decrease costs and length of stay for newborns with neonatal abstinence syndrome.

Methodology: This study utilized a literature review and a semi-structured interview. Three databases were used to collect 126 total sources. These sources were reviewed and reduced to 30 total sources that were used in the written research. Of these, 14 sources were used in the results …

Impact Of Cognitive Behavioral Therapy On Military Suicide Rates, Madison Lett, Jamia Bird

Theses, Dissertations and Capstones

Introduction: Suicide has been labeled a serious public health dilemma in the United States. Military personnel have suicide rates greater than non-military individuals. Cognitive Behavioral Therapy has been used as a means to help military personnel to overcome suicidal thoughts and feelings.

Purpose of the Study: The purpose of this study was to analyze the effect of Cognitive Behavioral Therapy on military patients’ mental health and how it affects the rate of suicidal ideation, suicide attempts, and deaths by suicide in military patients.

Methodology: This study utilized a literature review and a semi-structured interview with a Veteran Affairs social worker. …

Childhood Obesity And Adverse Childhood Experiences: The Role Of Medicaid Expansion, Sonya Dunlap

Theses, Dissertations and Capstones

Introduction: Obesity was defined as a Body Mass Index (BMI) over the 95th percentile as determined by the Centers for Disease Control and Prevention (CDC). Childhood obesity has been a worldwide concern, but has disproportionately affected the socioeconomically disadvantaged, racial/ethical minorities, and rural children. The presence of Adverse Childhood Experiences (ACEs) contributed to social and health problems. ACEs included the areas of domestic violence, mental illness, neighborhood violence, parent or guardian death, divorce or separation, parent or guardian incarceration, and substance misuse.

Purpose of Study: The purpose of this research was to compare the ACEs scores with childhood …

Covid-19 Financial Consequences In United States Hospitals, Hannah T. Osburn, Murat Mert Solakoglu, Gretel Toloza Alvarez

Theses, Dissertations and Capstones

Introduction: Since the wake of the coronavirus pandemic, United States (U.S.) hospitals have struggled to stay financially afloat amid the constant battle with unprecedented circumstances and financial consequences from the pandemic. The purpose of this research was to analyze the financial consequences of COVID-19 for U.S. hospitals to determine the impact on the number of inpatient cases, length of stay (LOS), surgeries performed, and operating expenses. The hypothesis was that U.S. hospitals were financially affected by the consequences of COVID-19, having more inpatient cases, increased LOS, fewer surgeries performed, and higher operating expenses.

Methodology: The methodology for this …

Sars-Cov-2 And Its Impact On Emergency Medicine, Abby Fowler

Theses, Dissertations and Capstones

The SARS-CoV-2 (COVID-19) pandemic impacted hospitals and healthcare workers throughout the world. This research sought to determine how the pandemic affected the mental health of healthcare workers in critical care, primarily because of hospitals’ focus on finances instead of healthcare workers’ mental well-being. This research included extensive literature review as well as a semi-structured interview with an emergency medicine physician in Ashland, KY, who worked before the COVID-19 pandemic and during the COVID-19 pandemic. It was hypothesized that as hospitals attempted to focus primarily on recovering financial losses incurred from the pandemic, the mental health of clinicians fell through the …

Store, Handle, And Administer Vaccines Safely To Prevent Errors, Craig Kimble, Kenneth Maxik, Alberto Coustasse

Management Faculty Research

Insufficient training, multiple manufacturers, and noninterchangeable products increase the risk of vaccine-related errors. Increasing the complexity are the addition of boosters with different doses, personnel new to the vaccine administration process, changes in dosing, easily misidentified labeling or products, vaccines given together, and the interchanging of booster products.2,3 As a result, there is an increased need to be alert in safety efforts with vaccine administration and storage. Pharmacy staff members must work together to improve safety and prevent vaccine-related errors.

The Financial Effect Of Covid-19 On Children's Hospitals Without Pediatric Psychiatric Units, Patricia Tran

Theses, Dissertations and Capstones

Introduction: Boarding of pediatric psychiatric patients in emergency departments and inpatient medical units while awaiting placement in psychiatric facilities was common before the COVID-19 pandemic and was associated with significant hospital cost. The COVID-19 pandemic triggered a mental health crisis in the pediatric population. This study looked at the how the COVID-19 pandemic affected pediatric psychiatric boarding and the effects of pediatric psychiatric boarding on hospital finances.

Methodology: The methodology of this study utilized a literature review with semi-structured interviews of local subject matter experts. The literature review analyzed the effects of the COVID-19 precipitated pediatric mental health …

Social Media By Providers And Patients In Healthcare, Madison K. Howell, Jirakamon Silapabanleng

Theses, Dissertations and Capstones

Introduction: Social media platforms such as Facebook, YouTube, and Twitter have been used in various industries to create direct-to-consumer interactive opportunities. 74% of the US population were social media active users. Around 40% of adults gather their health information from Facebook, a free social networking site, which has been available on various devices and can help many organizations advertise their services as well as communicate with their patients. Social networks had a powerful influence in making health decisions because it could be used as a means to spread either positive or negative health information.

Purpose of study: The …

Upcoding Medicare: Is Healthcare Fraud And Abuse Increasing?, Alberto Coustasse, Whitney Layton, Laikyn Nelson, Victoria Walker

Management Faculty Research

Medicare fraud has been the cause of up to $60 billion in overpaid claims in 2015 alone. Upcoding occurs when a healthcare provider has submitted codes for more severe conditions than diagnosed for the patient to receive higher reimbursement. The purpose of this study was to assess the impact of Medicare and Medicaid fraud to determine the magnitude of upcoding inpatient and outpatient claims throughout reimbursements.

The methodology for this study utilized a literature review. The literature review analyzed physician upcoding throughout present on admission infections, diagnostic related group upcoding, emergency department, and clinic upcoding. It was found that upcoding …

Potential Savings From Consumer-Driven Health Plans, William Ferguson, Brittany Smith, Jessica Mcnair, Sarah Miller, Bojing Wang, Alberto Coustasse

Management Faculty Research

Consumer Driven Health Plans (CDHPs) have been identified as a high-deductible insurance option that has increased consumer responsibility while healthcare expenditures have decreased. There has been an increasing need of these plans because they can help to control healthcare costs, and the increasing healthcare utilization. As the use of these plans have expanded, educated consumers have become more engaged in their healthcare services and have increased demands for transparency of healthcare costs. The methodology for this study was a literature review using 36 sources. The purpose of this study was to determine if CDHPs have created financial savings by increasing …

Managing The Unseen: Pandemic Prophylactics, Placebos & Panaciea, Nancy K. Lankton, Avinandan Mukherjee

Accounting Faculty Research

Introduction: The World Health Organization declared COVID-19 as a pandemic on March 11, 2020, when the disease had spread to 114 countries, infecting more than 118,000 people and killing almost 4,300.¹ As of mid-February 2021, over 109 million people worldwide had been infected with the virus and over 2.4 million people had died. COVID-19 is a pandemic of epic proportions that has changed the way we live, work, and do business.

This call for papers solicited manuscripts describing and analyzing the intersection of management, COVID-19, and the workplace. The goal was to create a special issue that would inform …

Black Swan To Phoenix: The Role Of Dynamic Capabilities, Ambidexterity And Corporate Insight, Marc D. Sollosy

Management Faculty Research

The paper presents the position that in times of Black Swan or other unforeseen or unprecedented events the path to survival is not the sole function of the company’s strategy. While much has been written about the need for companies to alter or adapt their strategies in face of such events, doing so is easier said than done. In fact, strategy is foundational and a function of and subject to the capabilities of the company. That there is no real strategy or strategy altering approach for preparing for a Black Swan like event.

The paper provides insights and alternative view …

Charge Masters And The Effects On Hospitals, Whitney Layton, Katie Lemmon, Alberto Coustasse

Management Faculty Research

The hospital chargemaster has been the heart of the healthcare revenue cycle, as it has served as the hospitals’ starting point for billing patients and payers. The CDM was made as an extensive breakdown of the cost of the care provided and in order for a hospital to correctly bill a patient for care received as every chargeable item in the hospital must be included in the master. The methodology for this study utilized a literature review. It consisted of academic sources, electronic databases, academic journals, and government websites. Thirty-eight sources were referenced for this literature review. The literature review …

Association Of Electronic Prescription In Controlled Substances Used, Archana Suwal, Jemima Akinyi Okonjo

Theses, Dissertations and Capstones

Introduction: Controlled substances have been described as pharmaceuticals or illegal medicines that act primarily on the central nervous system and could cause physical and mental dependence, eventually leading to addiction. Prescription opioids were a significant contributor to the opioid epidemic, accounting for more than 70,000 opioid-related overdose deaths, including illicit and prescription opioids, between 2018 and 2019. The Electronic Prescriptions for Controlled Substances (EPCS) initiative recently aimed to reduce rates of prescription opioid addiction, abuse, diversion, and death. The system for controlled substances had become more widely used as providers and governments trying to combat the opioid problem. Because …

Effects Of The Needle Exchange Program Implemented In West Virginia, Amber Graves, Anthony B. Uriarte, Katherine Duty

Theses, Dissertations and Capstones

Introduction: West Virginia has had a recent spike in infectious diseases such as HIV and hepatitis due to increased rates of injectable drug use. The rising costs associated with such diseases have been a cause for concern in the sector of healthcare and public health. In the state, the exchanging of dirty needles has resulted in the spread of bloodborne pathogens, however, the implementation of needle exchange programs has sought to decrease the rates of infection, improve health outcomes, and lower healthcare costs. However, there is a question as to the effectiveness of such programs.

Purpose of Study: …

The Effect Of The Affordable Care Act On Medicaid Payments In Long-Term Care Facilities, Victoria Walker, Morgan Ruley, Laikyn Nelson, Whitney Layton, Alberto Coustasse

Management Faculty Research

Long-term care has been defined as a continuation of medical services, social services, and housing for patients with chronic health conditions, limiting their abilities to partake in everyday activities. In the United States, the Affordable Care Act (ACA) was enacted to expand coverage for Medicaid and improve healthcare quality and cost. This qualitative research study aimed to evaluate the impact of the (ACA) on long-term care to determine if it has increased Medicaid payments. The methodology for this study utilized a systematic review complemented by a semi-structured interview. It was found that the ACA has increased Medicaid payments, and the …